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目的 全面了解饮茶型氟中毒在青海省僧侣中的分布与危害.方法 全省抽选28个县,每个县选1个寺院,作为调查点.登记每个僧侣日饮茶水量和寺院年人均砖茶消耗量,采集僧侣饮水、砖茶和尿样,检测氟含量;对8～ 12岁儿童和16岁以上成人僧侣进行氟斑牙检查;同时对16岁以上僧侣进行临床氟骨症检查,并抽取其中1个寺院,进行氟骨症X线检查.水氟、茶氟和尿氟测定采用离子选择电极法,氟斑牙检查采用《氟斑牙诊断标准》(WS/T 208-2001),氟骨症诊断依据《地方性氟骨症诊断标准》(WS 192-1999).结果 共检测生活饮用水28份,水氟均值为(0.26±0.13) mg/L;砖茶69份,茶氟均值为667.12 mg/kg.共调查成人僧侣777人,日饮茶水量为(1 943.93±1 078.93)ml;共调查儿童僧侣224人,日饮茶水量为(795.09±389.81)ml;年均砖茶消耗量为5.30 kg;成人日均摄氟量为4.47 mg,儿童为1.83 mg;对1 001名僧侣进行氟斑牙检查,氟斑牙检出率为29.07％(291/1 001),其中8～ 12岁儿童氟斑牙检出率为39.74％(93/234);16岁以上成人氟斑牙检出率为26.00％(202/777).临床氟骨症检出率为4.76％(37/777),X线氟骨症检出率为4.88％(2/41).检测成人尿样777份,尿氟几何均数为1.11 mg/L,范围为0.15 ～ 10.00mg/L;儿童尿样224份,尿氟几何均数为1.23 mg/L,范围为0.08 ～ 6.62 mg/L.结论 青海省僧侣砖茶消耗量大、砖茶氟含量高,由饮砖茶引起的氟中毒分布广、病情重,亟待制定有效措施控制流行.“,”Objective To know the distribution and harm of brick-tea type fluorosis in monks in Qinghai Province.Methods Twenty-eight temples were selected as survey sites from 28 counties of Qinghai Province.The amounts of drinking tea-water of each monk and the brick tea capita consumption per temple each year were recorded.Drinking water,tea water and urine samples of monks were collected and fluorine content was tested; dental fluorosis of children aged 8-12 years and of adult monks over the age of 16 were examined; clinical skeletal fluorosis of monks 16 years of age and older and X-ray skeletal fluorosis of all adult monks in the temple were examined.Fluorine content in drinking water,brick tea and urine was tested using F-ion selective electrode.Dental fluorosis was checked using the dental fluorine diagnostic criteria (WS/T 208-2001),and skeletal fluorosis was diagnosed based on the endemic skeletal fluorosis diagnosis standard (WS 192-1999).Results A total of 28 copies of drinking water samples were tested,and mean water fluoride was (0.26 ± 0.13) mg/L; in the 69 copies of brick tea,the mean fluoride value was 667.12 mg/kg; a total of 777 adult monks,the average daily drinking water of brick tea was (1 943.93 ± 1 078.93)ml; a total of 224 children monks,the average daily drinking water of brick tea was (795.09 ± 389.81)ml; annual per capita consumption of brick was 5.30 kg; adult daily fluoride intake was 4.47 mg,child was 1.83 mg; the prevalence rate of dental fluorosis was 29.07％(291/1 001),the prevalence rate of dental fluorosis of 8-12 years old children was 39.74％(93/234),the adult was 26.00％(202/777); the prevalence rate of clinical skeletal fluorosis was 4.76％(37/775); and the prevalence rate of X-ray skeletal fluorosis was 4.88％(2/41).The geometric mean of adult urinary fluoride was 1.11 mg/L(0.15-10.00 mg/L) of the 777 copies of urine samples tested,and that value of children was 1.23 mg/L(0.08-6.62 mg/L) of the 224 copies of samples.Conclusions The amount of annual brick tea consumption and daily intake of fluoride are big; brick-tea type fluorosis is serious and widely distributed in monks,so effective measures to control the epidemic are in urgent need.