摘要目的 调查江西省萍乡市地方性氟中毒病区儿童饮水、膳食及空气摄氟量,探索摄氟的主要来源,为当地选择防治措施提供理论依据.方法 2011年,在萍乡市湘东区湘东镇甘泉村和美建树,选择41名当地出生居住的8～12岁儿童作为调查对象,根据Dean法检查儿童氟斑牙结果进行分组:牙齿正常者为对照组；可疑氟斑牙者为可疑组；极轻度、轻度、中度和重度氟斑牙者为氟斑牙组,分别为10、14、17人.采用三日称量法进行儿童膳食调查,并采集饮水、尿液、食物、空气等样品,用氟离子选择电极法检测含氟量.结果 对照组、可疑组和氟斑牙组儿童饮水含氟量均数分别为0.17、0.69、0.80 mg/L,其中可疑组和氟斑牙组明显高于对照组(H值分别为10.644、12.384,P均＜0.01)；日均饮水氟摄入量均数分别为0.23、0.61、0.99 mg/d,其中可疑组和氟斑牙组明显高于对照组(Z值分别为-2.615、-3.075,P均＜0.01)；日均食物氟摄入量和日均空气氟摄入量分别为(0.93±0.46)、(1.04±0.49)、(1.05±0.52)mg/d和(0.10±0.07)、(0.14±0.13)、(0.11±0.09)mg/d,3组间比较,差异无统计学意义(F值分别为0.195、0.420,P均＞0.05).上述3组儿童日均总氟摄入量分别为(1.26±0.52)、(1.79±1.04)、(2.15±1.42)mg/d,组间比较差异无统计学意义(F=1.952,P＞ 0.05).通过岭回归分析,日均饮水氟摄入量与总氟摄入量之间的相关系数为0.530,二者呈正相关关系(t=2.42,P＜0.05).结论 饮水氟含量高是造成该地区地方性氟中毒的主要原因,应该从改换水源角度落实相应的防治措施.

abstractsObjective To explore the major source of fluoride intake by investigating the total fluoride intake through dietary,drinking water and air to provide a theoretical basis for local selection of control measures.Methods Forty one native-born children aged 8 to 12 were randomly recruited from two villages,Ganquan and Meijian,in Pingxiang city in 2011.According to Deans classification,we defined the groups as normal group(NG,score 0),questionable group(QG,score 1) and very mild,mild,moderate and severe dental fluorosis as fluorosis group (FG,score 2,3,4 and 5),and there were 10,14 and 17 persons in each group,respectively.We sampled and weighted the three days foods.We also sampled the drinking water,instant urine,indoor air,soil and coal,and measured fluoride concentration in all the samples using fluoride-ion selective electrode.Results The fluoride levels of drinking water were 0.17,0.69,0.80 mg/L,and the amounts of fluoride intake were 0.23,0.61,0.99mg/d,respectively,in NG,QG,FG groups.Compared with the NG,the fluoride levels of drinking water were higher in QG(H =10.644,P ＜ 0.01) and FG(H =12.384,P ＜ 0.01); and the amounts of fluoride intake in drinking water were also higher in QG (Z =-2.615,P ＜ 0.01) and FG (Z =-3.075,P ＜ 0.01).The amounts of fluoride intake from dietary and indoor air were (0.93± 0.46),(1.04± 0.49),(1.05± 0.52)mg/d and (0.10± 0.07),(0.14±0.13),(0.11± 0.09)mg/d,respectively,in NG,QG,FG groups.However,the difference was not statistically significant between the three groups(F =0.195,0.420,all P＞ 0.05).The mean of the total fluoride intake was (1.26±0.52),(1.79± 1.04),(2.15± 1.42)mg/d,respectively,in NG,QG,FG groups,and the difference was not significant statistically in the three groups (F =1.952,P＞ 0.05); the correlation coefficient was 0.530 between water fluoride intake and total fluoride intake by Ridge regression analysis,the beth changes had positive correlation (t =2.42,P ＜ 0.05).Conclusions The fluoride concentration of drinking water is high,which is the main reason for dental fluorosis.We should change the water source or decrease the fluoride level of drinking water to protect the people.