Zhao L J, Pei J R, Zhang W, Wang W, Yu G Q, Sun D J, Gao Y H
Institute for Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University. Key Lab of Etiologic Epidemiology of National Health and Family Planning Commission (23618504), Key Lab of Etiologic Epidemiology of Education Bureau of Heilongjiang Province, Harbin 150081, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Jun;37(6):816-20. doi: 10.3760/cma.j.issn.0254-6450.2016.06.015.
To investigate the prevalence of fluorosis and related control measures on drinking water type of endemic fluorosis in China.
According to the national program- "Surveillance Scheme of Drinking-Water-Borne Endemic Fluorosis" , 136 counties were selected in 29 provinces, autonomous regions and municipalities. Three epidemic villages were randomly selected as fixed monitoring sites in each county. Dental fluorosis of all the children aged 8-12 living in the villages under the monitoring program, was identified under the ariteria from "Diagnosis of dental fluorosis" (WS/T 208-2011). Operating conditions and contents of fluoride in all the'water-improved projects' were investigated. Contents of fluoride in drinking water were tested in villages without the 'water-improved projects'. "Standard Test Method for Drinking Water" (GB/T 5750.5-2006) was used to detect the water fluoride.
The overall prevalence of dental fluorosis among children aged 8-12 in all the villages under monitor program, was 28.58% (7 950/27 817), with the dental fluorosis index (DFI) as 0.58. Among them, the prevalence was 22.28% (3 917/17 583) and DFI was 0.44 in the'water-improved projects' villages that under normal operation and with qualified fluoride contents. The prevalence appeared as 38.74% (1 926/4 971) with DFI as 0.84 in those villages with 'water-improved projects' but mal-operated or with excessive fluoride. The prevalence was 40.03% (2 107/5 263), and DFI was 0.81 in those villages without 'water-improved projects'. The prevalence rates of dental fluorosis in children from the three types of endemic areas were significantly different. For 'water-improved projects', the normal opration rate was 93.77% (286/305) and the qualification rate of fluoride content was 76.77% (228/297).
Dental fluorosis in children living in the drinking-water-born endemic fluorosis areas was on the edge of epidemics in China. Effective improvement on the quality of drinking water can significantly reduce the severity of dental fluorosis in children. The rate of proper operation on 'water-improved projects' was near to 95% in the endemic area. However, rate that met the criteria on qualified fluoride contents of these projects was still below 80%.
调查中国饮水型地方性氟中毒的患病情况及相关防控措施。
依据国家项目《饮水型地方性氟中毒监测方案》，在29个省、自治区、直辖市选取136个县。每个县随机选取3个流行村作为固定监测点。按照《氟斑牙诊断》（WS/T 208—2011）标准，对监测项目所在村8至12岁儿童的氟斑牙情况进行诊断。调查所有“改水工程”的运行状况及氟化物含量。对未实施“改水工程”的村进行饮用水氟化物含量检测。采用《生活饮用水标准检验方法》（GB/T 5750.5—2006）检测水氟含量。
监测项目所在村8至12岁儿童氟斑牙总体患病率为28.58%（7950/27817），氟斑牙指数（DFI）为0.58。其中，正常运行且氟化物含量合格的“改水工程”村患病率为22.28%（3917/17583），DFI为0.44；“改水工程”运行不良或氟化物超标的村患病率为38.74%（1926/4971），DFI为0.84；未实施“改水工程”的村患病率为40.03%（2107/5263），DFI为0.81。三类病区儿童氟斑牙患病率差异有统计学意义。“改水工程”正常运行率为93.77%（286/305），氟化物含量合格率为76.77%（228/297）。
中国饮水型地方性氟中毒病区儿童氟斑牙处于流行边缘。有效改善饮用水水质可显著降低儿童氟斑牙患病程度。病区“改水工程”正常运行率接近95%，但氟化物含量达标率仍低于80%。
