摘要目的 评估贵州省习水县燃煤污染型地方性氟中毒(简称燃煤型氟中毒)综合防治措施落实后病区居民相关健康行为形成情况及病情控制效果.方法 2013年,在习水县实施燃煤型氟中毒综合防治措施的15个病区乡镇中,按东、南、西、北、中5个方位,各抽取1个乡镇,每个乡镇抽取3个村和1所小学作为调查点.每个村抽取20户居民进行相关健康行为及氟中毒防治知识问卷调查;在被抽取小学3～6年级中,每个年级抽取1个班,对全体学生进行Dean法氟斑牙检查及氟中毒防治知识问卷调查,在抽中班级各抽取20名8 ～12岁学生(男、女各半),采集即时尿样,检测尿氟含量.同时,收集2007年病区8～ 12岁儿童氟斑牙患病情况、目标人群氟中毒防治知识知晓情况、相关健康行为形成情况资料,以及2000年8～12岁儿童尿氟含量数据.分析比较2000、2007年(干预前)和2013年(干预后)的调查结果.结果 干预后3～6年级学生和家庭户主氟中毒防治知识知晓率分别为90.95％(11 773/12 945)、84.27％(3 792/4 500),均较干预前[19.29％(1 039/5385)、26.27％(394/1 500)]明显提高(x2=9 279.14、l 794.22,P均＜0.01);干预后台灶正确使用率为100.00％(37/37)、铁炉正确使用率为99.64％ (279/280)、辣椒正确干燥率为100.00％(299/299),与干预前[3.20％(43/1 345)、90.28％(1 207/1 337)、62.14％(855/1 376)]比较,差异均有统计学意义(校正x2=601.12、27.28、164.32,P均＜ 0.01);干预后8～ 12岁儿童氟斑牙检出率为24.21％(206/851),与干预前(61.62％,2 150/3 489)比较,差异有统计学意义(x2=385.93,P＜0.01);干预后儿童尿氟含量为(0.51±0.29)mg/L,与干预前[(1.55±1.59)mg/L]比较,差异有统计学意义(t'=10.25,P＜ 0.01).结论 贵州省习水县燃煤型氟中毒综合防治措施实施后病区居民相关健康行为形成及病情控制效果显著.

abstractsObjective To evaluate the effectiveness of comprehensive prevention and control measures on coal-burning-borne endemic tluorosis in Xishui,on residents healthy behavior and situation of the disease.Methods In 2013,five towns were selected according to their location of east,south,west,north and centre.Three villages and one elementary school in each town were chosen,and 20 families' related behavior and fluorine prevention knowledge questionnaire in each village were surveyed.All the students from one class aged 8-12 of grade 3-6 in each school were selected,according to the "Diagnosis of Dental Fluorosis",dental fluorosis was examined and fluorine knowledge questionnaire was surveyed.At the same time,the detection rate of dental fluorosis of children aged 8-12,information of the knowledge about prevention and cure of fluorosis and related behavior of target groups in 2007,and the urinary fluoride contents of children aged 8-12 in 2000 were collected.Analysis and comparison of the data in 2000,2007 and 2013 were done.Results After the intervention,the witting rates of students and family householders 90.95％ (11 773/12 945),84.27％ (3 792/4 500),were significantly higher than those of before the intervention [19.29％ (1 039/5 385),26.27％ (394/1 500),x2 =9 279.14,1 794.22,all P ＜ 0.01].Proper utilization rate of cooking stove was 100.00％ (37/37),iron stove utilization rate was 99.64％ (279/280),dry chili correct rate was 100.00％ (299/299) and before the intervention,these values were 3.20％ (43/1 345),90.28％ (1 207/1 337)and 62.14％ (855/1 376),respectively,and the differences were statistically significant (x2 =601.12,27.28,27.28,all P ＜ 0.01).Children's dental fluorosis detection rate was 24.21％ (206/851),compared with that of before the intervention,61.62％ (2 150/3 489),the difference was statistically significant (x2 =385.93,P ＜ 0.01).Children's urine fluoride was (0.51 ± 0.29) mg/L,and before the intervention [(1.55± 1.59) mg/L],the difference was statistically significant (t'=10.25,P ＜ 0.01).Conclusions The effect of comprehensive prevention and control measures against coal-burning-borne endemic fluorosis in Xishui are remarkable.The residents health related behavior has been formed and the condition is reduced markedly.