摘要目的 掌握江苏省苏北地区饮水型地方性氟中毒(简称地氟病)病情及降氟改水工程使用情况.为进一步开展地氟病的防治工作提供科学依据.方法 2008年,在徐州、连云港、宿迁市的10个饮水型地氟病重点县(区),按照以往水氟调查资料,采用分层抽样的方法,抽取40个病区村,对所有8～12岁儿童进行氟斑牙检查;对所有16岁以上成人进行临床氟骨症检查.在40个病区村中,抽取30%的病区村,每个病区村选择20名16岁以上成人进行X线氟骨症检查,抽取50%病区村,每个村采集30名8～12岁儿童的任意一次尿样 检测尿氟.在每个市,选择1个县,对分层抽样方法抽取剑的病区村的改水工程现状、供水能力及覆盖范围等进行调查.结果 共计对3560名8～12岁儿童进行氟斑牙检查,检出率为38.51%(1371/3560).缺损率为5.34%(190/3560),氟斑牙指数为0.8;共抽取708份尿样,尿氟中位数为1.47 mg/L,范围为0.08～10.08 mg/L;16岁以上成人临床氟骨症检出率为21.3%(1294/6083),X线氟骨症检出率为39.2%(123/314).共调查了248个集中式改水设施,无经费运行或损坏的有49个,水氟>1.0 mg/L的有18个.结论 江苏省苏北地区饮水型地氟病病情尚未完全控制,并有回升趋势,须进一步加强降氟改水监管力度.

abstractsObjective To investigate the state of endemic fluorosis, running status of water improvement project to reduce fluoride in Jiangsu province, and to provide a scientific basis for prevention and control of endemic fluorosis. Methods In 2008, in the ten key counties of endemic fluorosis (zone), in Xuzhou,Lianyungang and Suqian, a stratified sampling method was employed to select 40 diseased villages according to their past water fluoride survey data. All children aged 8 to 12 were examined dental fluorosis, and all adults over 16 years were examined clinical skeletal fluorosis. Thirty per cent of the 40 diseased villages were selected, and 20 adults over the age of 16 in each selected village were examined by X-ray, respectively;50% of the 40 diseased villages were selected, and 30 any time urine samples of children aged 8 to 12 in each diseased village were tested urine fluoride. In each city, select a county, the status of water improvement project to reduce fluoride, water supply capacity and coverage in the county were investigated. Results A total of 3560 children aged 8 to 12 were examined, the detection rate of dental fluorosis was 38.51% (1371/3560), tooth defect rate was 5.34% (190/3560), and dental fluorosis index was 0.8. Seven hundred and eight urine samples were tested, the median urinary fluoride was 1.47 mg/L and the range was 0.08 ~ 10.08 mg/L. Clinical detection of skeletal fluorosis was 21.3% among adults over the age of 16, and X-ray detection rate of skeletal fluorosis was 39.2% (123/314).Investigated a total of 248 facilities of centralized water improvement projects, no funds to run or damaged 49, the water fluoride > 1.0 mg/L was 18. Conclusions Endemic fluorosis in Northern Jiangsu province has not been controlled completely, but has a rising trend, we should further strengthen the supervision of water fluoride reduction.