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目的 林州市食管癌发病率、死亡率南北相差(1-3)倍、历史变化较为明显,既往没有文献进行解释,本文对这两种现象与浊漳河水的关系进行了研究。方法对林州市居民食管癌发病率、死亡率南北差异及历史性变化与浊漳河水(红旗渠水)的关系进行相关分析。结果(1)浊漳河水是林州市北部居民饮用水和工农业用水的重要水源,与林州市北部食管癌发病率、死亡率高于南部(1.3-3)倍的地理分布一致;(2)1959年-2003年45年间,林州市食管癌发病率和死亡率曲线呈现多峰型显著的上升和下降变动状态。1959年-1961年相对偏低(89.80/10万、84.69/10万)红旗渠通水,6年后1969年-1970年食管癌发病率、死亡率达到高峰(183.87/10万、171.35/10万),然后显著下降,又显著上升和显著下降,1995年后稳定在较低水平。(3)林州市食管癌随着浊漳河(渠水)水量的时多时少、时断时流,食管癌南、北两地发病率、死亡率随之波动,渠水供水后期食管癌发病率、死亡率显著高于供水前期,居民改饮用地下水5年后,食管癌发病率、死亡率大幅度下降。结论浊漳河水的供水范围决定着食管癌的地理分布特征,林州市居民食管癌发病率、死亡率南北差异及历史性变化与居民饮用浊漳河水的人数多少变化有关,即人群有效污染比率越大,或者说有效暴露率越大,死亡率越高。预防措施应在原来五项防癌措施基础上,加强“氮循环”病因假说的宣传教育,要特别预防浊漳河水源的工农业污染,净化红旗渠水后再灌溉土地,同时加强饮用水管理和检测,改水、改厕、改善环境卫生、保护水源是预防食管癌的关键措施。
Objectives The incidence and mortality rate of esophageal cancer in Linzhou city are between 1 and 3 times of that in the south and north, and the historical changes are obvious. There is no previous literature to explain. The relationship between these two phenomena and the muddy river water was studied in this paper. Methods The relationship between the incidence and mortality of esophageal cancer and the difference between historical and historical changes of esophageal cancer in Linzhou City was analyzed. Results (1) The Dangzhuo River water is an important source of water for drinking water and industrial and agricultural water in northern Linzhou City. The incidence and mortality of esophageal cancer in the northern part of Linzhou City are higher than that in the south (1.3-3) times; ( 2) During the 45 years from 1959 to 2003, the morbidity and mortality curves of esophageal cancer in Linzhou City showed a multi-peak pattern of significant increases and decreases. From 1959 to 1961, relatively low (89.80/100,000, 84.69/100,000) Red Flag Drainage, 6 years after 1969 to 1970, the incidence and mortality of esophageal cancer peaked (183.87/100,000, 171.35/10) Millions), then dropped significantly, again rose significantly and dropped significantly, and stabilized at a low level after 1995. (3) Esophageal cancer in Linzhou City The water volume of the Zhuozhang River (drainage) varies from time to time, intermittently, and the morbidity and mortality of esophageal cancer fluctuate in the south and north of the esophageal cancer. Canal water supplies water to the esophageal cancer at the latter stage. The morbidity and mortality were significantly higher than the previous period of water supply. After residents changed drinking groundwater for 5 years, the incidence and mortality of esophageal cancer dropped drastically. Conclusion The water supply range of the Zhuozhang River determines the geographical distribution of esophageal cancer. The incidence and mortality of esophageal cancer in Linzhou city are different from the changes in the historical and historical changes of the population. The effective population pollution rate The greater, or the greater, the effective exposure rate, the higher the mortality rate. Preventive measures should be based on the original five anti-cancer measures to strengthen the propaganda and education of the “nitrogen cycle” cause hypothesis, in particular to prevent industrial and agricultural pollution of the Zhuoyu River water source, purify the red flag canal water and then irrigate the land, and strengthen the management of drinking water. And testing, changing water, changing toilets, improving environmental hygiene, and protecting water are key measures to prevent esophageal cancer.