摘要目的 掌握陕西省燃煤污染型氟中毒病区病情变化,防氟炉灶的使用情况以及相关行为形成情况,评价防治效果,为上级决策提供理论依据.方法 2010年,选择陕西省安康、汉中市的3个县9个自然村作为监测村.在3个监测县实施改炉改灶的病区村中各抽取5个病区村,在抽中的每个病区村和9个监测点各抽取10户家庭,调查炉灶使用及相关行为转变情况.调查监测村所有8 ～ 12岁学生氟斑牙患病情况,氟斑牙诊断采用Dean法,同时对8～ 12岁学生每年龄段采集10份尿样,检测尿氟,尿氟测定采用氟的离子选择电极法(WS/T 30-1996),依据《人群尿氟正常值》(WS/T 256-2005)进行评价.对监测村25周岁以上人群,按每个年龄段抽取20人,进行氟骨症X线检查,诊断采用《地方性氟骨症诊断标准》 (WS 192-2007).结果 铁炉、改良炉的合格户数和正确使用率、玉米辣椒的正确干燥率和保管率均较低,玉米、辣椒食用前的淘洗率均在95％以上;9个监测村检查儿童350人,氟斑牙检出率为59.71％(209/350);Ⅹ线共拍片871人,氟骨症检出率为17.22％(150/871);共采集儿童尿样350份,尿氟在0.07～ 2.02 mg/L,几何均数为0.66 mg/L.结论 陕西省燃煤型氟中毒呈流行态势,防氟炉具灶炉损坏现象较多,健康行为形成率较低.加强病情监测、健康教育和防氟炉具的后期管理工作是今后防治燃煤型氟中毒的关键.

abstractsObjective To investigate the current situation of coal-burning borne endemic fluorosis in the infected area,the usage of defluoridation stove and the formation of related behavior; to evaluate the control effect,so as to provide a theoretical basis for superiors' policy-making.Methods Nine villages in three counties of Ankang city and Hanzhong city Shanxi province were monitored in 2010.Choose five disease infected villages with oven changed in the three monitoring counties,and 10 families were randomly selected in each of the nine monitoring points and every chosen village,and a survey on the stove using and related behavior changes was carried out.By using Dean method,the dental fluorosis of every child aged 8 - 12 in the monitoring villages was examined.Meanwhile 10 copies of urine samples were randomly collected in each age group in the above-mentioned villages.The content of fluoride in urine was determined by F-ion selective electrode(WS/T 30-1996) and evaluated according to “The Normal Concentration of Urinary Fluoride of Population” (WS/T 256-2005).Twenty men over 25years old in the monitoring counties were randomly selected in each age group to be examined skeletal fluorosis by X-rays,and diagnosis was based on “The Endemic Skeletal Fluorosis Standard”(WS 192-2007).Results The proper utilization rate and the qualified households of iron stoves and improved stoves,the correct drying rate and the correct storage rate of peppers and coms were all low.The washing rate of corns and peppers before eating was higher than 95％.Of the 350 children being examined of dental fluorosis in the 9 monitoring villages,the detection rate of dental fluorosis was 59.71％ (209/350).A total of 871 adults over the age of 25 were examined,and the detection rate of skeletal fluorosis was 17.22％ (150/871).A total of 350 copies of children urine samples were tested and the fluoride content were between 0.07 - 2.02 mg/L,the geometric mean value of fluoride content was 0.66 mg/L.Conclusions The coal-burning borne endemic fluorosis in Shanxi is in a growth phase,many defluoridation stoves are out of order,and the formation of healthy behaviors is low.To strengthen the disease surveillance,health education and management of defluoridation stoves are keys to prevent coal-burning borne endemic fluorosis in the future.