摘要目的 评价2014年江西省上栗县和袁州区燃煤污染型地方性氟中毒控制和消除情况.方法 在上栗县和袁州区所有病区村开展县级自评,其中上栗县145个村,袁州区32个村.省级复核是依据县级自评的结果,在每个县(区)抽取3个乡镇,每个乡镇抽取3个村,2个县(区)共复核18个村,并在每个病区村抽取10户居民进行复核.按照中国疾病预防控制中心地方病控制中心项目方案要求,在所有病区村对改良炉灶及使用情况和病区全部8～12岁儿童氟斑牙病情进行县级自评,省级复核依据方案进行,结果按《地方性氟中毒病区控制标准》(GB 17017-2010)和《燃煤污染型地方性氟中毒病区消除标准》进行判定.结果 县级自评结果:上栗县共调查110443户,合格改良炉灶率和合格改良炉灶正确使用率分别为92.45％(102 109/110443)和93.46％(95 427/102 109);袁州区共调查20 280户,合格改良炉灶率和合格改良炉灶正确使用率分别为98.28％(19 932/20 280)和98.47％(19 627/19 932);共对28 772名儿童进行了氟斑牙检测,检出氟斑牙儿童5 730例,氟斑牙检出率为19.92％(5 730/28 772);上栗县和袁州区均达到控制标准,控制率分别为95.17％(138/145)和100.00％(32/32).省级复核结果:共抽取180户进行复核,其中合格改良炉灶179户,合格改良炉灶正确使用177户,合格改良炉灶率和合格改良炉灶正确使用率分别为99.44％(179/180)和98.88％(177/179);共对805名儿童进行氟斑牙检测,检出氟斑牙139例,氟斑牙检出率为17.27％(139/805).县级自评和省级复核结果一致率为88.89％(16/18).结论 江西省上栗县和袁州区燃煤污染型氟中毒防治效果明显,病情得到有效控制.

abstractsObjective To evaluate the control effects on coal-burning-borne endemic fluorosis in Shangli County and Yuanzhou District of Jiangxi Province in 2014.Methods Self-evaluation at the county level was carried out in all diseased villages in Shangli County and Yuanzhou District,including 145 villages of Shangli County and 32 villages of Yuanzhou District.Review at the provincial level was based on the results of selfevaluation of the county,3 towns were chosen in each county (district),3 villages were chosen in each town,a total of 18 villages were re-checked in Shangli County and Yuanzhou District,and 10 households were chosen to recheck in each village.According to the project requirements for endemic disease control,in all diseased villages of Shangli County and Yuanzhou District,self-evaluation results of the county was used to evaluate the status of the improved and the used stoves,and dental fluorosis of children aged 8-12.Review at the provincial level was carried,and the results were evaluated based on "the Standards for Control Criteria for Endemic Fluorosis Areas" (GB 17017-2010) and "Elimination of Coal-burning-borne Endemic Fluorosis".Results Self-evaluation of the county:110 443 households in Shangli County and 20 280 households in Yuanzhou District were investigated,the qualified rates of improved stoves were 92.45％ (102 109/110 443) and 98.28％ (19 932/20 280),respectively;the correct-usage rates of qualified stoves were 93.46％ (95 427/102 109) and 98.47％ (19 627/19 932),respectively.Dental fluorosis of 28 772 children were examined,the number of dental fluorosis was 5 730,the prevalence rate of dental fluorosis was 19.92％ (5 730/28 772);Shangli County and Yuanzhou District were up to the standard of fluorosis control,the rates of control were 95.17％ (138/145) and 100.00％ (32/32),respectively.Review at the provincial level:180 households were selected,the qualified numbers of improved stoves and the correct-usage of qualified stoves were 179 and 177,respectively,the qualified rate of improved stoves was 99.44％ (179/180) and the correct-usage rates of qualified stoves was 98.88％ (177/179).Dental fluorosis of 805 children were examined,the number of dental fluorosis was 139,the prevalence rate of dental fluorosis was 17.27％ (139/805).The consistency rate of county-level and provincial-level was 88.89％ (16/18).Conclusion The control efficiency for coal-burningborne fluorides in Shangli County and Yuanzhou District of Jiangxi Province is obvious,the prevalence is under control.