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目的了解四川省冕宁县饮水型型氟中毒病情现状及变化趋势,为制定地氟病防治防治策略提供科学依据。方法按照国家地病中心《饮水型地方性氟中毒监测方案(试行)》选择冕宁县,了解改水工程进度和运行效果,对监测病县8~12岁儿童氟斑牙、对25岁以上成人进行X线氟骨症检查。水氟测定采用《尿中氟化物的测定离子选择电极法》(WS/T 89-1996),儿童氟斑牙采用Dean氏诊断法(WS/T 208-2011),氟骨症诊断采用《地方性氟骨症诊断标准》(WS 192-2008)。结果冕宁县共有改水降氟工程10处,改水率为100%,覆盖10个村,覆盖人口1.44万人;2010调查10处工程中,正常运转10处,水氟合格7处,合格率70%,水氟最大值2.78 mg/L,2011年正常运转8处,间歇运转2处,水氟合格5处,合格率50%,水氟最大值为2.65 mg/L;2012年正常运转7处,间歇运转3处,水氟合格6处,合格率60%,水氟最大值为2.94 mg/L;8~12岁儿童氟斑牙平均检出率为76.49%,氟斑牙指数1.5,各年度氟斑牙检出率差异有统计学意义(χ2=119.03,P<0.05);X线氟骨症检查51人,检出率为60.78%。结论冕宁县饮水型氟中毒病区通过改水降氟病情得到一定控制,但局部病区病情仍严重,加强病情监测、健康教育和改水工程管理是防治饮水型氟中毒关键。
Objective To understand the current status and trend of drinking water fluorosis in Mianning County, Sichuan Province, and to provide a scientific basis for the prevention and control of endemic fluorosis. Methods According to the National Center for Disease Control and Prevention “drinking water endemic fluorosis monitoring program (for Trial Implementation)” Mianning County, to understand the progress and operation of the water diversion project, the monitoring of County children aged 8 to 12 dental fluorosis, 25 years of age adults X-ray skeletal examination. Determination of water fluoride using “Determination of fluoride in urine fluoride ion selective electrode method” (WS / T 89-1996), children’s dental fluorosis by Dean’s diagnostic method (WS / T 208-2011), fluorosis diagnosis using “place Sexual skeletal fluorosis diagnostic criteria ”(WS 192-2008). Results Mianning County, a total of 10 projects to improve water and fluoride, water change rate of 100%, covering 10 villages, covering a population of 14,400 people; 2010 survey of 10 projects, the normal operation of 10, qualified fluoride 7, qualified rate 70% water fluoride maximum 2.78 mg / L, 8 normal operation in 2011, intermittent operation 2, 5 qualified water fluoride, pass rate of 50%, maximum water fluoride 2.65 mg / L; normal operation in 2012 7 , The intermittent operation of 3, 6 qualified water fluoride, pass rate of 60%, maximum water fluoride 2.94 mg / L; 8 to 12-year-old child dental fluorosis average detection rate of 76.49%, dental fluorosis index of 1.5, The detection rates of dental fluorosis in each year were significantly different (χ2 = 119.03, P <0.05). The detection rate of fluorosis in X-ray was 51, the detection rate was 60.78%. Conclusion Mianning County drinking water fluoride poisoning by water and fluoride to reduce the disease has been some control, but the disease is still serious in the local ward, to strengthen disease surveillance, health education and water diversion project management is the key to prevention and treatment of drinking water fluorosis.