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目的探讨饮砖茶水摄氟量与氟斑牙病情的剂量效应关系及其正常上限值,为制定砖茶含氟量卫生标准和儿童砖茶氟最大允许摄入量提供科学依据。方法在全国饮茶型氟中毒重病区四川省,选择有饮砖茶习惯的藏族牧区阿坝州阿坝县麦尔玛小学、格登寺附属小学,红原县阿木小学、江绒小学、龙让小学和希望小学,对其8～12岁儿童整群抽样,并采用Dean氏法诊断氟斑牙,采用氟离子电极法测定砖茶水氟和尿氟。再以定群调查的方法,确定每人每日从砖茶水中摄取的含氟量。结果8～12岁儿童氟斑牙检出率为52.15%,但主要为极轻病例,各年龄段检出率没有统计学差异;饮砖茶水量、和摄氟量随年龄增长呈梯度升高,但仍处在较低剂量范畴,对照组每日砖茶水摄氟量平均为(0.873±0.249)mg,病例组为(1.386±0.699)mg;儿童饮砖茶水摄氟量呈正偏态分布;各年龄段儿童饮砖茶水摄氟量的对数均值与氟斑牙指数呈直线正相关,r=0.919,P<0.05;计算出儿童每日总摄氟量正常上限值为2.243mg。结论①儿童饮茶型氟斑牙检出率虽然较高,但病情程度不重;②儿童每日砖茶氟摄入量处于较低水平,这完全符合饮茶型氟中毒儿童氟斑牙流行特点;③儿童每日砖茶氟摄入量正常上限值低于饮水型病区总摄氟量卫生标准。
Objective To investigate the relationship between dose-effect of fluoridation of drinking brick tea and dental fluorosis and its upper limit of normal, so as to provide a scientific basis for formulating the hygiene standards of fluorine content in brick tea and the maximum allowable intake of brick tea for children. Methods In the Sichuan Province, where tea-drinking-type fluorosis was endemic in China, we selected Ma’erma Primary School, Aberdeon Aba County Ma’erma Primary School, Gedeng Temple Affiliated Primary School, Hongyuan County Amu Primary School, Jiangrong Primary School, Longrang Primary School and Hope Primary schools were enrolled in a cluster sampling of 8-12-year-old children. The dental fluorosis was diagnosed by Dean’s method. Fluoride ion-electrode method was used to determine fluoride and urinary fluoride in brick tea. And then to determine the method of group investigation to determine per person per day from the brick tea water intake of fluorine content. Results The detection rate of dental fluorosis in children aged 8 ~ 12 years was 52.15%, but the incidence of dental fluorosis was very low. There was no significant difference in the detection rate of each age group. The amount of tea drinking water and fluoride intake increased with the increase of age, (0.873 ± 0.249 mg) in the control group, and (1.386 ± 0.699) mg in the case group. The fluorine content in drinking water of tea brick was positively skewed; Children aged drinking water brick tea fluoridation logarithmic mean fluoride index was positively correlated with fluorosis, r = 0.919, P <0.05; calculate the daily upper limit of fluoride in children with a normal upper limit of 2.243mg. Conclusions ① Although the detection rate of dental fluorosis in children is higher, the severity of dental fluorosis is not severe. ② The daily fluoride intake of brick tea in children is at a low level, which is completely in line with the epidemic characteristics of dental fluorosis in children with fluorosis ; ③ children’s daily upper limit of fluoride intake of brick tea is lower than the total fluoride intake of ward-type ward health standards.