摘要目的 了解饮水型地方性氟中毒的病情动态,评价防治措施的落实效果,为及时调整防治策略提供科学依据.方法 在河北省的10个饮水型氟中毒病区市各抽取1个县(市、区),每个县(市、区)调查10个改水工程运行情况及采集水样,了解改水工程水氟含量.在每个县(市、区)抽取3个村进行病情监测,监测包括改水工程运行情况、水氟含量、8～ 12岁学生氟斑牙检查和成人氟骨症X线检查.结果 共调查93个改水工程,工程正常运转率为94.6％(88/93),水氟含量(国家标准≤1.2 mg/L)合格率为54.8％(51/93),其中9个大型改水工程中,有7个工程水氟含量＞ 1.2 mg/L.在23个改水村中,水氟合格工程10个,合格率为43.4％(10/23),有3个大型改水工程水氟含量＞1.2 mg/L;8～12岁儿童氟斑牙检出率为33.2％(532/1601),氟斑牙指数为0.74;成人氟骨症X线检出率为5.7％(66/1155).在7个未改水村中,水氟＞2.0 mg/L且≤4.0 mg/L的村有2个,其余5个村水氟含量在正常范围(≤1.2 mg/L);8～12岁儿童氟斑牙检出率为33.4％(111/332),氟斑牙指数为0.72;成人氟骨症X线检出率为2.9％ (10/350).结论 河北省饮水型氟中毒流行仍然较为严重,防治措施落实不到位,改水工程水氟(≤1.2 mg/L)合格率较低,应加快改水降氟进度并提高改水工程质量.

abstractsObjective To find out the status of drinking-water-borne endemic fluorosis and the effect of preventive measures in Hebei Province,so as to provide a basis to prevent and cure fluorosis.Methods One affected county (city,district) with drinking-water-borne endemic fluorosis was sampled in every city and 10 water improvement projects were investigated in that county.Three villages were taken out in every county.The operating state of the projects,the water fluoride content,and the dental fluorosis of children aged 8-12 and skeletal fluorosis of adults were investigated in these villages.Results A total of 93 projects were investigated,among which 94.6％(88/93) were operating properly and the qualified rate(fluoride content ≤ 1.2 mg/L) of the projects was 54.84％(51/93).Among the 9 large projects,the water fluoride content of 7 projects exceeded 1.2 mg/L.A total of 23 villages with water improvement projects were investigated and only 43.4％ (10/23) of them water fluoride content were lower than 1.2 mg/L.The dental fluorosis rate,the dental fluorosis index and the rate of skeletal fluorosis were 33.2％ (532/1601),0.74 and 5.7％ (66/1155),respectively.In the 7 villages without water improvement projects,2 of them exceeded 2.0 mg/L,but lower than and equal to 4.0 mg/L of water fluorosis and 5 of them were normal(＜ 1.2 mg/L).The dental fluorosis rate,the dental fluorosis index and the rate of skeletal fluorosis were 33.4％ (111/332),0.72 and 2.9％ (10/350),respectively.Conclutions The qualified rate of water improvement projects of fluoride content ≤ 1.2 mg/L is low and the endemic fluorosis is still comparatively serious in Hebei Province.The progress of water improvement projects in the areas with endemic fluorosis should be accelerated and the quality of water improvement projects should be increased.