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目的探讨贵州燃煤型地方性氟中毒(地氟病)重病区总摄氟量变化。方法采用随机分层抽样方法,对地氟病重病区村作了流行病学现况和回顾性调查。结果 4个历史重病区村儿童氟斑牙总体检出率达90%以上,缺损型达40%以上,临床氟骨症检出率达40%以上,其中重度检出率达5%以上,但8、9岁组儿童氟斑牙检出率、16岁组临床氟骨症检出率已经显著下降,未见儿童长骨畸形患者。20世纪90年代前历史重病区村日人均总摄氟量30 mg以上,近年仍达18 mg。氟来源的摄入构成顺序依次为辣椒>玉米>大米>蔬菜>饮水>空气,这与10年前构成截然不同。2个对照村地氟病病情显著低于历史重病区村,但其患病时间等分布情况与历史重病区村类似。结论近10年贵州省地氟病重病区总摄氟水平显著降低,病情得到显著控制。但是,历史重病区氟污染仍然十分严重,摄氟量仍然较高。病区摄氟途径构成明显改变,通过烘炕干辣椒摄氟途径需要高度重视。
Objective To investigate the change of total fluoride exposure in Guizhou endemic fluorosis (Fluorosis). Methods A randomized stratified sampling method was used to investigate the epidemiology and retrospective investigation of endemic fluorosis in villages. Results The overall detection rate of dental fluorosis was over 90% in children with severe history in four districts, the defect type was over 40%, the detection rate of clinical skeletal fluorosis was more than 40%, and the detection rate of severe dental fluorosis was over 5%. The detection rate of dental fluorosis in children aged 8 and 9 and the detection rate of clinical skeletal fluorosis in 16-year-old group have been significantly decreased. Children with long-bone deformities were not seen. Before the 1990s, the average per capita intake of fluoride in the villages with the highest incidence of serious illness in the 1990s was more than 30 mg, still reaching 18 mg in recent years. The order of intake of fluoride sources was pepper> corn> rice> vegetables> water> air, which is quite different from that of 10 years ago. The prevalence of endemic fluorosis in the two control villages was significantly lower than that in the seriously ill-ward villages, but the distribution of the prevalence was similar to that in the seriously ill-ward villages. Conclusion In recent 10 years, the total fluorosis level of endemic fluorosis in Guizhou Province was significantly reduced and the disease was significantly controlled. However, fluorine pollution in seriously ill history is still very serious, and fluorine intake is still high. Fluorosis pathways constitute a significant change in Fuping, dried kang dry pepper fluoride pathway needs attention.