2019年山东省饮水型地方性氟中毒病区监测结果分析

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目的:掌握山东省饮水型地方性氟中毒防治现状,为饮水型地方性氟中毒控制评价工作提供基本数据。方法:2019年6-12月,按照《全国饮水型氟中毒监测方案(2019版)》和《山东省饮水型氟中毒监测方案(2019版)》的要求,在山东省16个市的饮水型地方性氟中毒病区县(市、区)的全部病区村,采用横断面调查方法对病区村供水工程运转情况、生活饮用水氟含量及儿童氟斑牙病情进行监测。水氟检测采用《生活饮用水标准检验方法无机非金属指标》(GB/T 5750.5-2006),并按照《生活饮用水卫生标准》(GB 5749-2006)进行水氟含量合格与否判定。儿童氟斑牙检查和判定采用《氟斑牙诊断》(WS/T 208-2011),计算氟斑牙检出率,比较改水村与未改水村、水氟合格村与水氟超标村儿童氟斑牙检出率。结果:全省共有105个病区县(市、区)9 475个病区村,其中,改水村有9 370个,改水率为98.89%。全部改水村中,正常运转工程9 318个,间歇工程45个,报废工程7个。全部病区村中,水氟合格村有8 254个,水氟合格率为87.11%(8 254/9 475);改水村中,水氟合格村有8 210个,水氟合格率为87.62%(8 210/9 370);未改水村中,水氟合格村有44个,水氟合格率为41.90%(44/105),改水村水氟合格率显著高于未改水村(χn 2 = 193.31,n P < 0.05)。改水村儿童氟斑牙检出率为8.92%(25 624/287 405),未改水村儿童氟斑牙检出率为12.70%(271/2 134),未改水村儿童氟斑牙检出率高于改水村(χ n 2 = 37.23,n P < 0.05);水氟合格村儿童氟斑牙检出率为7.98%(20 200/253 082),水氟超标村儿童氟斑牙检出率为15.62%(5 695/36 457),水氟超标村儿童氟斑牙检出率高于水氟合格村(χ n 2 = 2 283.76,n P < 0.05)。n 结论:山东省大部分病区村已落实改水降氟措施,改水村儿童氟斑牙检出率低于未改水村。但部分改水工程存在水氟超标情况,后期管理维护应引起重视,防止病情反弹。“,”Objective:To master the current situation of prevention and control of drinking water-borne endemic fluorosis in Shandong Province, and to provide basic data for control and evaluation of drinking water-borne endemic fluorosis.Methods:From June to December 2019, in accordance with the requirements of the “National Drinking Water-Borne Fluorosis Monitoring Program (2019 Edition)” and “Shandong Province Drinking Water-Borne Fluorosis Monitoring Program (2019 Edition)”, cross-sectional survey method was used to monitor the operation of the water supply projects, the fluorine content in drinking water, and the condition of children with dental fluorosis in all the disease affected villages of the drinking water-borne endemic fluorosis counties (cities, districts) in 16 cities of Shandong Province. Water fluorine was detected by “Standard Examination Methods for Drinking Water-Nonmetal Parameters” (GB/T 5750.5-2006), and in accordance with the “Standards for Drinking Water Quality” (GB 5749-2006), the water fluorine content was judged to be qualified or not. The examination and determination of dental fluorosis in children adopted “Diagnosis of Dental Fluorosis” (WS/T 208-2011), and the detection rate of dental fluorosis was calculated, the detection rates of dental fluorosis were compared between water improvement villages and villages without water improvement, qualified water fluorine and unqualified water fluorine villages.Results:There were 9 475 drinking water-borne endemic fluorosis villages in 105 counties (cities, districts) in Shandong Province, of which 9 370 were water improvement villages, and the water improvement rate was 98.89%. Among all the water improvement villages, there were 9 318 projects in normal operation, 45 intermittent projects and 7 scrapped projects. Among all the drinking water-borne endemic fluorosis villages, 8 254 villages were qualified in water fluorine, and the qualified rate of water fluorine was 87.11% (8 254/9 475); among water improvement villages, 8 210 villages were qualified in water fluorine, and the qualified rate of water fluorine was 87.62% (8 210/9 370); among the villages without water improvement, 44 villages were qualified in water fluorine, and the qualified rate of water fluorine was 41.90% (44/105). The qualified rate of water fluorine in water improvement village was significantly higher than that in villages without water improvement (χn 2 = 193.31, n P < 0.05). The detection rates of dental fluorosis in children in water improvement villages and villages without water improvement were 8.92% (25 624/287 405) and 12.70% (271/2 134), respectively, and the detection rate of dental fluorosis in children in villages without water improvement was higher than that in water improvement villages (χ n 2 = 37.23, n P < 0.05). The detection rates of dental fluorosis in children in qualified water fluorine and unqualified water fluorine villages were 7.98% (20 200/253 082) and 15.62% (5 695/36 457), respectively, and the detection rate of dental fluorosis in children in unqualified water fluorine villages was higher than that in qualified water fluorine villages (χ n 2 = 2 283.76, n P < 0.05).n Conclusions:Water improvement and fluorine reduction measures have been implemented in most drinking water-borne endemic fluorosis villages in Shandong Province, the detection rate of dental fluorosis in children in water improvement villages is lower than that in villages without water improvement. However, attention should be paid to the situation of water fluorine exceeding the standard and later management and maintenance to prevent the rebound of the disease.
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