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目的:掌握安康市燃煤污染型氟中毒病区病情变化、防氟炉灶使用和相关行为形成情况,评价防治效果,为燃煤型氟中毒防治工作提供理论依据。方法:2010年对安康市岚皋、平利县6个自然村进行监测。采用单纯随机抽样方法,在2个监测县实施改炉改灶的病区村中各随机抽5个病区村,在抽中的每个病区村和6个监测村各抽取10户家庭,调查炉灶使用及相关行为转变情况;调查监测村所有8~12岁学生氟斑牙患病情况,氟斑牙诊断采用Dean氏法。同时对8~12岁学生每年龄段采集10份尿样,检测尿氟,尿氟测定采用尿中氟的离子选择电极法(WS/T 30-1996),依据《人群尿氟正常值》WS/T256-2005进行评价。对监测村25周岁以上人群,按每个年龄段随机抽取20人进行氟骨症X线检查。诊断采用《地方性氟骨症诊断标准》(WS192-2007)。结果:病区普遍使用铁炉和改良灶,铁炉、改良灶的合格率及正确使用率均较低;玉米、辣椒正确干燥率和保管率均不高;玉米、辣椒加工前淘洗率均在95.00%以上;6个检测村8~12岁儿童氟斑牙检出率为59.00%(118/200);共采集儿童尿样200份,尿氟在0.55~2.02 mg/L,几何均数1.09 mg/L;X线共拍片576人,氟骨症检出率为16.23%(93/576)。结论:安康市燃煤污染型氟中毒呈流行态势,防氟炉灶损坏较为严重,健康行为形成率较低,加强病情监测、防氟炉具后期管理和健康教育干预工作是防治燃煤污染型氟中毒的关键。
OBJECTIVE: To grasp the changes of the disease conditions, the use of antifouling stoves and the related behaviors in the coal-burning fluorosis area of Ankang City, evaluate the prevention and treatment results, and provide a theoretical basis for the prevention and control of coal-fired fluorosis. Methods: In 2010, six natural villages in Langao, Pingli County of Ankang City were monitored. A simple random sampling method was used to randomly select 5 ward villages in the ward villages where the furnaces were switched to stoves in 2 monitoring counties and 10 families were sampled from each ward village and 6 monitoring villages in the sampling area. Investigate the use of stoves and related behavioral changes; Surveillance monitoring of all children aged 8 to 12 dental fluorosis dental prevalence, dental fluoroscopy using Dean’s method. At the same time, urine samples were collected from 8 to 12-year-old students in each age group. Urine and urinary fluoride were measured by fluoride ion selective electrode (WS / T 30-1996) in urine. / T256-2005 for evaluation. To monitor the village over the age of 25 people, randomly selected for each age group of 20 X-ray examination of skeletal fluorosis. Diagnostic use of “local diagnostic criteria for skeletal fluorosis” (WS192-2007). Results: Iron stoves and improved stoves were commonly used in the wards. The passing rate and correct use rate of iron stoves and improved stoves were low. The correct drying rate and storage rate of corn and pepper were not high. (95.00%). The detection rate of dental fluorosis was 59.00% (118/200) in 6 children aged 8 ~ 12 years. A total of 200 urine samples were collected from children with urine fluoride ranging from 0.55 to 2.02 mg / L. The geometric mean 1.09 mg / L; 576 were X-ray films, the detection rate of skeletal fluorosis was 16.23% (93/576). CONCLUSION: Coal-fired pollution fluorosis in Ankang City is in a epidemic situation with serious damage to fluorinated stoves and low rate of health behaviors formation. Strengthening disease surveillance, late management of anti-fluoride stoves and intervention in health education are the key measures to prevent and control coal- The key to poisoning.