2009-2018年内蒙古自治区饮茶型地方性氟中毒监测结果分析

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目的:了解内蒙古自治区饮茶型地方性氟中毒(简称饮茶型氟中毒)病区人群病情变化趋势,为制定防治策略提供科学依据。方法:2009-2018年,采用横断面调查法连续10年在内蒙古自治区饮茶型氟中毒流行的6个旗县的30个病区村,调查居民饮茶习惯,在每个监测村抽取10户家庭,采集其砖茶样本,检测砖茶氟含量,并进行健康风险评估;在每个监测村,采集集中式供水水样1份,检测水氟含量;茶氟及水氟检测采用氟离子选择电极法。同时检查监测村所有8 ~ 12岁儿童氟斑牙患病情况,并对监测村所有36 ~ 45岁且在当地居住5年以上的常住人口进行X线检查及氟骨症诊断。结果:2009-2018年,共采集砖茶3 000份,茶氟几何均值为522.01 mg/kg,常住人口年人均砖茶消耗量为2.52 kg,人日均茶氟摄入量为4.11 mg。依据《人群总摄氟量》(WS/T 87-2016)标准,10年间有6年危险商> 1;依据世界卫生组织推荐标准,有5年危险商> 1,即存在健康风险。2012-2018年共检测水样210份,水氟几何均值为0.90 mg/L,合格率为84.76%(178/210)。共检查8 ~ 12岁儿童5 384人,检出氟斑牙患者1 562人,儿童氟斑牙检出率为29.01%(1 562/5 384),氟斑牙指数为0.62,流行强度为极轻度流行。共对1 890名36 ~ 45岁成人进行X线拍片,氟骨症检出率为18.10%(342/1 890),其中,中、重度氟骨症患者共77例。结论:内蒙古自治区居民饮用的砖茶氟含量较高,存在健康风险,而8 ~ 12岁儿童氟斑牙病情呈极轻度流行,成人检出中、重度氟骨症患者。应持续强化砖茶市场监管,加强居民健康教育。“,”Objective:To understand the change trend of people's condition in tea drinking endemic fluorosis area of Inner Mongolia Autonomous Region, and to provide scientific basis for formulating prevention and control strategies.Methods:From 2009 to 2018, a cross-sectional survey was conducted in 30 villages of 6 banners (counties) of drinking tea type of endemic fluorosis of Inner Mongolia Autonomous Region. The tea drinking habits of residents were investigated. Ten families were selected from each monitoring village to collect brick tea samples, and the fluorine content in brick tea was detected for health risk assessment. In each monitoring village, one water sample was collected from each drinking water source. Fluoride ion selective electrode method was used to detect fluorine in tea and water. The prevalence of dental fluorosis in children aged 8-12 years old was examined and the X-ray examination and analysis were carried out for all the permanent residents aged 36-45 years and living in the local area for more than 5 years.Results:From 2009 to 2018, a total of 3 000 brick tea samples were collected. The geometric mean value of tea fluorine was 522.01 mg/kg, and the annual per capita consumption of brick tea by permanent residents was 2.52 kg. The average daily intake of fluorine in brick tea was 4.11 mg. According to the standard of “Total Fluoride Intake of Population” (WS/T 87-2016), there were 6 years of risk quotient > 1 in 10 years, while according to the World Health Organization (WHO) recommend standard, there were 5 years of risk quotient > 1. From 2012 to 2018, 210 water samples were detected, and the geometric mean value of fluorine in water was 0.90 mg/L, and the qualified rate was 84.76% (178/210). A total of 5 384 children aged 8-12 years old were examined and 1 562 dental fluorosis patients were detected. The total detection rate of dental fluorosis in children was 29.01% (1 562/5 384), and the dental fluorosis index was 0.62 (very mild). A total of 1 890 adults aged 36 to 45 years old were examined by X-ray. The detection rate of skeletal fluorosis was 18.10% (342/1 890). There were 77 patients with moderate and severe skeletal fluorosis.Conclusions:The brick tea fluorine content of residents in Inner Mongolia Autonomous Region is high, and there are health risks. The dental fluorosis of children aged 8-12 years old is very mild, and there are still moderate and severe skeletal fluorosis patients in adults. Therefore, it is necessary to strengthen the supervision of brick tea market and strengthen health education for residents.
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