Department of Preventive Medicine, Guiyang Medical College, School of Public Health, Guiyang, Guizhou 550004, China.
J Environ Public Health. 2009;2009:969764. doi: 10.1155/2009/969764. Epub 2009 Oct 19.
We assess the prevalence and pathogenic stage of skeletal fluorosis among children and adolescents residing in a severe coal-burning endemic fluorosis area of southwest China.
We used a cross-sectional design. A total of 1,616 students aged between 7 and 16 years in Zhijin County, Guizhou, China in late 2004 were selected via a cluster sampling of all 9-year compulsory education schools to complete the study questionnaire. Any student lived in a household that burned coal, used an open-burning stove, or baked foodstuffs over a coal stove was deemed high-risk for skeletal fluorosis. About 23% (370) of students (188 boys, 182 girls) were identified as high-risk and further examined by X-ray.
One-third of the 370 high-risk participants were diagnosed with skeletal fluorosis. Overall prevalence of child skeletal fluorosis due to indoor burning of coal was 7.5%. Children aged 12-16 years were significantly more likely to be diagnosed with skeletal fluorosis than children aged 7-11 years (OR = 1.84, 95% CI: 1.17-2.90; P = .0082). Four types of skeletal fluorosis were identified: constrictive (60.7%), raritas (15.6%), mixed (16.4%), and soft (7.4%). Most diagnosed cases (91%) were mild or moderate in severity. In addition, about 97% of 370 high-risk children were identified with dental fluorosis. Dental fluorosis was highly correlated with skeletal fluorosis in this study.
Skeletal fluorosis among children may contribute to poor health and reduced productivity when they reach adulthood. Further efforts to reduce fluoride exposure among children in southwestern of China where coal is burned indoors are desperately needed.
我们评估了中国西南地区一个严重燃煤地方性氟中毒地区儿童和青少年的氟骨症患病率和发病阶段。
我们采用了横断面设计。2004 年末，在中国贵州省织金县，通过对所有 9 年义务教育学校进行整群抽样，共选择了 1616 名 7 至 16 岁的学生完成研究问卷。任何居住在燃煤、使用敞开式炉灶或在煤炉上烘烤食物的家庭的学生都被认为有氟骨症高风险。约 23%（370 名）的学生（188 名男生，182 名女生）被确定为高危人群，并进一步接受 X 射线检查。
370 名高危参与者中有 1/3 被诊断为氟骨症。由于室内燃煤导致的儿童氟骨症总患病率为 7.5%。12-16 岁儿童被诊断为氟骨症的可能性显著高于 7-11 岁儿童（OR=1.84，95%CI：1.17-2.90；P=0.0082）。共发现 4 种氟骨症类型：缩窄型（60.7%）、稀少型（15.6%）、混合型（16.4%）和疏松型（7.4%）。大多数诊断病例（91%）为轻度或中度。此外，370 名高危儿童中约有 97%患有氟斑牙。在这项研究中，氟斑牙与氟骨症高度相关。
儿童氟骨症可能会导致他们成年后健康状况不佳和生产力下降。在中国西南地区，需要进一步努力减少室内燃煤地区儿童的氟暴露。
