青海省部分地区饮茶型氟中毒流行现况调查

李强; 赵志军; 杨佩珍; 周昕; 陈萍; 李生梅; 喇翠玲; 王明君; 杨萍

doi:10.11847/zgggws1120683

青海省部分地区饮茶型氟中毒流行现况调查

Prevalence of tea-drinking type fluorosis in some regions of Qinghai province

摘要

摘要:
目的了解青海省海南州、海东地区饮茶型氟中毒的病情分布及流行现状，为今后饮茶型氟中毒防治提供依据。
方法 2016年按照“全国饮茶型地方性氟中毒流行现状调查方案”，选取海南州、海东地区所辖11县，每个县按东西南北中方位抽取5个乡（镇），每个乡（镇），随机抽取一个行政村作为调查点。水氟、尿氟测定采用氟离子选择电极法，8～12岁儿童氟斑牙检查采用Deans法，16岁以上成人临床氟骨症诊断参照《地方性氟骨症诊断标准》（WS192 – 2008）。
结果海南州5县饮用水氟均值为0.29 mg/L，成人尿氟几何均数为0.83 mg/L，儿童氟斑牙患病率为14.06 %，氟斑牙流行指数0.24，成人临床氟骨症检出率为8.01 %；海东地区6县饮用水氟均值为0.25 mg/L，成人尿氟几何均数为0.62 mg/L，儿童氟斑牙患病率为15.09 %，氟斑牙流行指数0.26，成人临床氟骨症检出率为2.44 %。
结论青海省海南州、海东地区11县饮茶型氟中毒病情总体较轻，但各县病情差异较大；海南州5县病情较海东地区6县病情为重，当地居民仍受高氟砖茶危害，应继续加强健康教育宣传。

Abstract:
Objective To examine the prevalence of tea-drinking related fluorosis in Hainan and Haidong prefecture of Qinghai province and to provide evidences for prevention and control of tea-drinking related fluorosis.
Methods We totally selected 55 administrative villages (one village in each town, 5 towns with different geographical location in each of all the 11 counties in the two prefectures) according to the regime of National Survey on Tea-Drinking Related Fluorosis. Then we recruited 60 adult residents (≥ 16 years) for urine fluoride detection and all children aged 8 – 12 years for dental fluorosis examination in each of the 55 villages during 2016; drinking water samples were also collected from the villages simultaneously. Fluoride concentration in water and urine samples were determined with ion selective electrode method; dental fluorosis was diagnosed using Dean′s index; and adults′ skeletal fluorosis was diagnosed based on Diagnosis Standard for Endemic Skeletal Fluorosis (WS192-2008).
Results The geometric means of fluoride in drinking water samples from Hainan and Haidong prefecture were all lower (0.29 mg/L and 0.25 mg/L) than the national standard (1.0 mg/l). The geometric means of fluoride in adult urine samples from Hainan (n = 800) and Haidong prefecture (n = 1 428) were 0.83 mg/l and 0.62 mg/L. The detection rate of dental fluorosis was 14.06% and 15.09% among the children in Hainan (n = 3 975) and Haidong prefecture (n = 2 677), with the prevalence indexes of 0.24 and 0.26. The prevalence rate of clinic skeletal fluorosis was 8.01% and 2.44% for the adults in Hainan (n = 1 484) and Haidong prefecture (n = 1 968), respectively.
Conclusion The prevalence of tea-drinking related fluorosis is generally at a low level and varies geographically in Hainan and Haidong prefecture of Qinghai province; the prevalence tea-drinking related fluorosis is relatively higher in Hainan prefecture than that in Haidong prefecture, indicating that health education on the risk of consumption of brick-tea with high fluoride should be promoted among the residents in the prefecture.

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