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背景:三峡库区历史上曾为传染病、自然疫源性疾病和地方病的高发地区,其淹没面积大、人口密集,水库形成后的污染可能会造成对人群健康的危害。目的:通过分析开县地区人群的主要健康指标以及影响因素,对三峡水库形成后可能产生的对人群健康造成的影响因素进行预测性评估。设计:横断面调查。单位:重庆医科大学公共卫生学院及重庆市开县疾病控制中心。对象:调查于2004-02/05在重庆市开县完成,调查对象为该县所有人口的疾病监测资料,选择三峡库区重庆段其他库区县及非库区县人群的疾病监测资料作为对照。方法:收集有关社会发展、人群健康和与公共卫生体系的有关指标,深入有代表性的重点乡镇现场调查。对相关资料数据进行比较分析,并利用定量与定性相结合的方法对三峡工程对人群健康的潜在影响做出全面预测评估。主要观察指标:①开县、重庆市和全国1999～2001年一般人群的健康状况比较。②开县、重庆市和全国1999～2003年传染病发病率比较。③水库形成后对人群健康产生的潜在影响。结果:①开县、重庆市和全国1999～2001年一般人群的健康状况比较:开县孕产妇病死率、婴儿以及5岁以下儿童病死率高于全国和重庆市的平均水平,多项指标显示出开县的一般人群健康状况较差。②开县、重庆市和全国1999～2003年传染病发病率比较:重庆市的传染病发病率维持在250/10万左右,高于全国水平(190/10万左右)。开县的传染病发病率逐年升高,近两年的发病率达国内的1.5倍以上。③水库形成后可能发生的对人群健康产生的潜在影响:介水传染病尤其是病毒性肝炎的发病;自然疫源疾病及虫媒传染病性疾病的发生;肝癌等恶性肿瘤性疾病。结论:应加强对现有公共卫生体系相对薄弱环节和潜在各种疾病流行和突发公共卫生事件发生的认识。随着三峡工程的进度加快,必须加强防治对策,预防和减轻水库形成后可能对人群产生的健康危害。
Background: The Three Gorges reservoir area has historically been a high-risk area for infectious diseases, natural epidemics and endemic diseases. It has a large area of inundation and a dense population. Pollution after the formation of reservoirs may cause harm to the health of the population. OBJECTIVE: To analyze the main health indicators and influencing factors in the population of Kai County, and to make predictive assessment of the factors that may affect the health of the population that may occur after the formation of the Three Gorges Reservoir. Design: Cross-sectional survey. Unit: School of Public Health, Chongqing Medical University and Kaixian County Disease Control Center, Chongqing. Subject: The survey was completed in Kai County, Chongqing, from 2004 to 05/2004. The target of the survey was the disease surveillance data of all the population in the county, and the disease surveillance data of other reservoir districts and counties in the Three Gorges reservoir area in Chongqing and non-reservoir districts were selected as controls. Methods: Collect relevant indicators on social development, population health, and public health systems, and conduct in-depth surveys of key towns and villages on site. Comparing and analyzing relevant data and using quantitative and qualitative methods to comprehensively predict and evaluate the potential impact of the Three Gorges Project on population health. MAIN OUTCOME MEASURES: Comparison of the health status of the general population in Kaixian, Chongqing, and China from 1999 to 2001. 2 The incidence of infectious diseases in Kaixian County, Chongqing City, and the whole country from 1999 to 2003. 3 The potential impact on population health after the reservoir is formed. Results: 1 The health status of the general population in Kaixian County, Chongqing City, and the whole country from 1999 to 2001: The maternal mortality rate in the county of Kaixian, the mortality rate of infants and children under 5 years old was higher than the national average of Chongqing and Chongqing, and several indicators showed Kaixian County. The general population is in poor health. 2 The incidence of infectious diseases in Kaixian County, Chongqing City and the whole country from 1999 to 2003: The incidence of infectious diseases in Chongqing is maintained at around 250/100,000, which is higher than the national level (around 190/100,000). The incidence of infectious diseases in Kai County has increased year by year, and the incidence rate in the past two years has exceeded 1.5 times in China. 3 The potential impact on the health of the population that may occur after the formation of reservoirs: the incidence of waterborne infectious diseases, especially viral hepatitis; the occurrence of natural epidemic diseases and vector-borne diseases; and malignant tumors such as liver cancer. Conclusion: It is necessary to strengthen the understanding of the relative weaknesses of the existing public health system and the potential occurrence of various diseases and public health emergencies. With the accelerated progress of the Three Gorges Project, prevention and control measures must be strengthened to prevent and reduce the health hazards that may occur to the population after the formation of the reservoir.