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[目的]了解重庆市燃煤型氟中毒病区各种流行因素如经济收入、文化程度、卫生行为生活习惯等对燃煤型氟中毒的影响,为燃煤型氟中毒防治决策提供科学依据。[方法]采用问卷调查的方式对12个病区村进行入户调查,调查居民的经济收入、文化程度、主食结构、卫生行为、生活习惯、燃料结构、炉灶使用情况等信息,并对这些因素进行单因素R×C关联性分析和多因素Logistic回归分析。[结果]本次共调查8个病区县9个乡镇12个村4512户。4512个户主检出氟斑牙2831人,检出率为62.74%;检出氟骨症257人,检出率为5.70%。单因素统计分析结果显示:户主的年龄(X1)、文化程度(X2)、水缸使用情况(X3)、残留食物存放情况(X4)、厨房卫生情况(X5)、厨房通风情况(X6)、住房结构(X7)、经济收入(X8)、烟道是否出屋(X9)、室内煤烟情况(X10)、燃料种类(X11)、是否食用大米(X12)、是否食用玉米(X13)、是否食用土豆(X14)、是否食用禽肉(X15)、是否食用辣椒(X16)与地氟病流行的关联性都具有统计学意义(r值分别为0.197、0.046、0.094、0.115、0.094、0.047、0.042、0.097、0.110、0.109、0.085、0.052、0.145、0.142、0.030、0.044)。Logistic多因素回归分析结果显示:燃煤型氟中毒流行的主要因素:烟道是否出屋(X9)(OR=2.513,95%CI:1.865～3.387)、燃料种类(X11)(OR=0.561,95%CI:0.413～0.764)、是否食用玉米(X13)(OR=3.500,95%CI:2.585～4.789)。[结论]重庆市燃煤污染型地方性氟中毒的防治应当采取以改炉改灶为主、调整燃料结构、改善饮食结构的综合性防治措施。
[Objective] To understand the influence of various epidemic factors such as economic income, educational level and health habits and habits on the coal-based fluorosis in Chongqing coal-fired fluorosis area and provide a scientific basis for the prevention and control of coal-fired fluorosis. [Methods] The questionnaires were used to conduct household surveys in 12 ward villages to investigate the residents’ economic income, educational level, staple food structure, health behaviors, living habits, fuel structure, stove use and other information, and these factors Univariate R × C correlation analysis and multivariate Logistic regression analysis. [Results] A total of 4512 households in 12 villages and 9 towns in 8 ward counties were investigated. 4512 households detected 2831 dental fluorosis, the detection rate was 62.74%; detected 257 skeletal fluorosis, the detection rate was 5.70%. The results of the single factor statistical analysis showed that the age (X1), education level (X2), water tank usage (X3), residual food storage (X4), kitchen hygiene (X5), kitchen ventilation (X6) Whether the housing structure (X7), economic income (X8), the flue out of the house (X9), indoor soot (X10), the type of fuel (X11), whether to eat rice (X12), whether to eat corn Potato consumption (X14), consumption of poultry meat (X15), consumption of hot pepper (X16) and the prevalence of endemic fluorosis were statistically significant (r values were 0.197,0.046,0.094,0.115,0.094,0.047, 0.042, 0.097, 0.110, 0.109, 0.085, 0.052, 0.145, 0.142, 0.030, 0.044). Logistic multivariate regression analysis showed that the main factors affecting the prevalence of coal-based fluorosis were: whether the flue gas was out of the house (OR = 2.513, 95% CI: 1.865-3.387), type of fuel (X11) 95% CI: 0.413 ~ 0.764) and corn (X13) (OR = 3.500, 95% CI: 2.585 ~ 4.789). [Conclusion] Prevention and treatment of endemic fluorosis in coal-fired pollution in Chongqing City should be taken as a comprehensive prevention and control measures based on the principle of reformer with a focus on the stove, adjusting the fuel structure and improving the diet structure.