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目的探索贵州省地氟病特重病区村形成的原因,了解流行因素的变化情况,为地氟病防治提供依据。方法采取回顾性调查和现况调查的方法,对调查村的一般情况、村民生活习惯、炉灶使用情况、氟中毒病情、燃料及燃料氟含量进行调查。结果3个调查村均是地氟病流行村,儿童氟斑牙检出率分别为94.3%、82.7%和99.55%,上世纪80年代时荷花和联合村人群X线氟骨症检出率高达98%和73%,吉坪村则为25.5%。调查村均以煤为主要生活能源,特重病区村燃煤使用量和燃料总氟释放量不同年代均高于对照村(P<0.05)。上世纪80年代,调查村均是采取敞煤火烘烤的方式干燥玉米,但特重病区村采取集体烘烤的方式,对照村则由农户自行分散敞烘烤。调查村习惯使用敞炉灶炊事取暖,敞灶率从上世纪80年代的100%降至30%以下,但联合村的敞灶率仍达100%。特重病区的荷花村农户家庭主食构成中玉米的比重已降低至20%,但联合村农户家庭的主食构成中玉米的比重仍高达80%,对照村农户家庭已不食用玉米。总体来看,特重病区村农户家庭各年代玉米的食用量高于对照村,对照村村民不同年代的玉米食用量低于特重病区村(P<0.05)。结论燃煤总量和燃料氟释放量、玉米干燥方式、玉米占主食的比例、辣椒干燥和及食前淘洗习惯及文化水平的差异是特重病区村形成的主要因素。
Objective To explore the reasons for the formation of endemic ward in endemic areas of endemic fluorosis in Guizhou Province, understand the changes of epidemic factors, and provide the basis for the prevention and treatment of earth-borne fluoro-disease. Methods The methods of retrospective survey and current situation survey were used to investigate the general situation of the village, the living habits of the villagers, the use of the stove, the fluorosis, the fluorine content of fuel and fuel. Results All the three surveyed villages were endemic to endemic fluorosis. The detection rates of dental fluorosis in children were 94.3%, 82.7% and 99.55%, respectively. In the 1980s, the detection rate of skeletal fluorosis was higher in lotus and Union village 98% and 73%, Ji Ping Village is 25.5%. The villages surveyed all took coal as the main living energy. The coal consumption and the total fluorine emission of the villages in the special serious ward area were all higher than those in the control villages at different ages (P <0.05). 80s of last century, the survey village are taken to open the way of drying the coal to dry the corn, but the special ward village to take a collective way of baking, the control village by the farmer scattered their own open roasting. The village surveyed habitually use the stove cooking warmth, open stove rate from 100% of the last century 80% down to 30%, but the Union Village stove rate is still up to 100%. The proportion of corn in the staple food composition of the Lotus Village household in the special-weight ward has been reduced to 20%. However, the proportion of maize in the staple food composition of the Lianhe Village is still as high as 80%. The reference farm households have no longer consumed corn. In general, the consumption of maize in each age group of households in the special ward was higher than that of the control village. The corn consumption of different age groups in the control villagers was lower than that in the wihtsia village (P <0.05). Conclusion The main factors contributing to the formation of the village are the total amount of coal combustion, the amount of fluorine released from the fuel, the drying method of corn, the proportion of maize to staple food, the drying habits of peppers and the pre-harvest washing habits and cultural level.