摘要目的 探讨燃煤污染型氟、砷中毒对儿童智力和生长发育的影响.方法 2011和2012年,从陕南燃煤污染型氟、砷中毒病区中选择重病区和轻病区作为调查点,非病区作为对照点,对8～ 12岁在校学生进行智力测试、氟斑牙和生长发育水平调查.分析比较各组间儿童智力和生长发育水平的差异.采集8～ 12岁儿童尿样,测定尿氟、尿砷含量.结果 重病区、轻病区、非病区8～12儿童尿氟中位数分别为1.96、0.81、0.54mg/L;尿砷中位数分别为0.023、0.019、0.018 mg/L.儿童智力分别为101.22±15.97、104.83±12.78、107.92±13.62.重病区、轻病区、非病区之间身高、体质量、胸围、肺活量组间比较,差异均有统计学意义(x2=36.549、25.859、28.021、45.627,P均＜0.01).重病区、轻病区儿童身高、体质量、胸围、肺活量(136 cm、31 kg、64 cm、1 432ml,137 cm、30 kg、65 cm、1 433 ml)均低于非病区(141 cm、34 kg、67 cm、1 660ml,Z值分别-5.858、-4.151,-4.196、-4.500,-5.189、-3.240,-6.698、-4.008,P均＜0.01),重病区肺活量低于轻病区(Z=-2.395,P＜0.05).儿童尿氟、尿砷与智力均呈负相关关系(r=-0.560,-0.353,P均＜0.05).结论 氟、砷暴露不利于儿童的智力发育和生长发育.建议加强改炉改灶工作,促进儿童健康成长.

abstractsObjective To investigate the influence of fluoride and arsenic exposure on children's intelligence and growth development.Methods The illness seriously and lightly affected areas in the coal-burning-borne arsenism and fluorosis areas in the south part of Shaanxi were selected as survey sites from 2011 to 2012,while the illness non-affected areas as controls.Children's IQ was tested,dental fluorosis and growth level of 8-12-year-old students in the school were investigated by random sampling,and the differences of children's IQ and the level of their growth among different groups were analyzed.Urine samples of the children were collected to determine the fluoride and the arsenic content.Results In the illness seriously affected,lightly affected and nonaffected areas,the medians of urinary fluoride of children were 1.96,0.81 and 0.54 mg/L,respectively; and the medians of their urinary arsenic were 0.023,0.019 and 0.018 mg/L,respectively.The average IQ levels were 101.22 + 15.97,104.83 ± 12.78 and 107,92 + 13.62,respectively.In illness seriously affected,lightly affected and non-affected areas,the differences of their height,weight,chest circumference and lung capacity between groups(x2 =36.549,25.859,28.021 and 45.627,all P ＜ 0.01) were significantly different.The height,weight,chest circumference and lung capacity of the children in illness seriously affected(136 cm,31 kg,64 cm,1 432 ml) and lightly affected areas (137 cm,30 kg,65 cm,1 433 ml) were all less than those of the illness non-affected areas (141 cm,34 kg,67 cm,1 660 ml,Z =-5.858,-4.151,-4.196,-4.500,-5.189,-3.240,-6.698 and -4.008,all P ＜ 0.01) ; lung capacity of children in illness seriously affected areas was less than that of the illness lightly affected areas (Z =-2.395,P ＜ 0.05).Their urinary fluoride and arsenic levels were negatively correlated with their IQ(r =-0.560,-0.353,all P ＜ 0.05).Conclusions Fluorine and arsenic exposure is not conducive to children's intellectual development and growth.We propose to strengthen the measure of changing stove furnace in order to provide a healthy growth environment for children.