由于饮水氟化预防龋齿而导致的按年龄性别和后遗症特异性划分的伤残调整生命年（DALYs）：伊朗 2016 年国家和国家级以下地区的评估。
Age-sex specific and sequela-specific disability-adjusted life years (DALYs) due to dental caries preventable through water fluoridation: An assessment at the national and subnational levels in Iran, 2016.
机构信息
Department of Environmental Health Engineering, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
The Persian Gulf Marine Biotechnology Research Center, Bushehr University of Medical Sciences, Bushehr, Iran; Department of Environmental Health Engineering, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran; Systems Environmental Health, Oil, Gas and Energy Research Center, Bushehr University of Medical Sciences, Bushehr, Iran.
出版信息
Environ Res. 2018 Nov;167:372-385. doi: 10.1016/j.envres.2018.08.005. Epub 2018 Aug 4.
We assessed disability-adjusted life years (DALYs) due to dental caries preventable through water fluoridation apportioned by sex, age group, sequela, province, and community type in Iran, 2016. The burden of disease due to dental caries was extracted from the Global Burden of Disease Study 2016 (GBD 2016) and the caries preventive effect of water fluoridation was calculated using a database of fluoride levels in drinking water. All the preventable DALYs were caused by years lived with disability (YLDs) because of the non-fatal character of dental caries. DALYs and DALY rate (per 100,000 people) preventable through water fluoridation at the national level in 2016 were 14,971 (95% uncertainty interval 7348- 24,725) and 18.73 (9.19-30.93), respectively. The national population preventable fraction (PPF) of dental caries by water fluoridation was determined to be as high as 0.176 (0.141-0.189). The share of sequelae in the preventable DALYs at the national level were estimated to be 76.8% for edentulism and severe tooth loss, 21.4% for caries of permanent teeth, and 1.8% for caries of deciduous teeth. The national DALYs and DALY rate preventable through water fluoridation exhibited no difference by sex, but considerably increased by age from 110 (37-223) and 1.5 (0.5-3.1) for the age group 0-4 y to 4331 (2334-6579) and 88.9 (47.9-135.1) for the age group 65 y and older, respectively. Over 80% of the national preventable DALYs occurred in urban areas due to higher population and lower coverage of fluoridated drinking water. The highest provincial DALYs and DALY rate preventable by water fluoridation were observed in Tehran and Gilan to be 3776 (1866-6206) and 37.2 (18.6-60.8), respectively. The results indicated that water fluoridation can play a profound role in the promotion of dental public health and compensate the spatial inequality and increasing temporal trend of health losses from dental caries at the national level.
我们评估了 2016 年伊朗通过饮水氟化预防的龋齿可调整伤残生命年（DALYs），按性别、年龄组、后遗症、省份和社区类型进行了细分。龋齿疾病负担数据来源于 2016 年全球疾病负担研究（GBD 2016），饮水氟化的龋齿预防效果则是通过饮用水中氟化物水平数据库计算得出。所有可通过饮水氟化预防的伤残生命年（YLDs）都归因于龋齿的非致命性。2016 年，全国范围内因饮水氟化可预防的 DALYs 为 14971（95%不确定区间为 7348-24725），DALY 率（每 10 万人）为 18.73（9.19-30.93）。全国范围内，饮水氟化预防龋齿的人群预防分数（PPF）被确定为 0.176（0.141-0.189）。在全国范围内，后遗症导致的可预防 DALYs 占比估计为：无牙和严重失牙 76.8%，恒牙龋齿 21.4%，乳牙龋齿 1.8%。饮水氟化预防的全国 DALYs 和 DALY 率在性别上没有差异，但随着年龄的增长而显著增加，从 0-4 岁年龄组的 110（37-223）和 1.5（0.5-3.1），分别增加到 65 岁及以上年龄组的 4331（2334-6579）和 88.9（47.9-135.1）。由于人口较多且氟化物饮用水覆盖率较低，超过 80%的全国可预防 DALYs 发生在城市地区。通过饮水氟化预防可导致的 DALYs 最多的省份是德黑兰省和吉兰省，分别为 3776（1866-6206）和 37.2（18.6-60.8）。研究结果表明，饮水氟化在促进口腔公共卫生方面可以发挥重要作用，并可以弥补全国范围内因龋齿造成的健康损失的空间不平等和时间趋势增加。
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