摘要
目的了解拉萨市近年来饮茶型氟中毒流行现状,为疾病防控提供线索和基础资料。方法按照分层整群抽样的方法,2016年在拉萨市墨竹工卡县和尼木县,2017年在达孜区,2018在拉萨市城关区、堆龙德庆区和曲水县,每个县(区)按照东、南、西、北、中5个方位各抽取1个乡(镇),每个乡(镇)抽取1~2个行政村作为调查点,每个调查点招募年龄≥18岁的村民志愿者作为调查对象,进行氟斑牙检查(Dean法)和氟骨症检查(X线),并采集生活饮用水、家庭饮用砖茶以及居民尿液样本,离子选择电极法进行水氟、茶氟、尿氟检测。结果共采集水样30份,水氟含量均<1.0 mg/L。共采集砖茶314份,茶氟含量平均值为1167.5 mg/kg,明显超过了国家标准(≤300 mg/kg)。各调查县(区)砖茶合格率在0~16.7%,日人均砖茶氟摄入量为6.4 mg。共调查18岁以上村民1929人,氟斑牙检出率为18.1%(350/1929),6个调查县(区)中有4个县(区)边缘或极轻度氟斑牙流行。共检测成人尿样1637份,尿氟值范围在0.01~11.01 mg/L,几何均值为1.07 mg/L,各调查县(区)人群尿氟值均未超标(≤1.6 mg/L)。X线检出8例Ⅰ度氟骨症患者,检出率为0.4%(8/1929),有20.2%(390/1929)的人报告患有2种及以上骨关节疾病,6个调查县(区)均为饮茶型氟中毒轻病区。结论2016-2018年拉萨市砖茶氟含量严重超标,部分县(区)存在氟斑牙轻度流行,6个县(区)均属于饮茶型氟中毒轻病区。
Objective To investigate the prevalence of drinking-tea fluorosis from 2016 to 2018 in Lhasa City,Tibet,and to provide clues and basic data for preventing this disease.Methods According to the stratified cluster sampling method,Mozhugongka County and Nimu County in 2016,Dazi District in 2017,Chengguan District,Duilongdeqing District and Qushui County of Lhasa City in 2018 were selected as survey counties(districts),each county(district)selected 1 township(town)according to the 5 directions of east,south,west,north,and middle,and each township(town)selected 1 to 2 administrative villages as survey points,and each survey point recruited villager volunteers aged≥18 years for survey subject.All volunteers were tested for dental fluorosis(Dean method)and skeletal fluorosis(X-ray),and samples of drinking water,brick tea consumed at home and residents'urine were collected for water fluoride,tea fluoride,and urine fluoride testing.Results A total of 30 water samples were collected,and the water fluoride content was all<1.0 mg/L.The average fluorine content was 1167.5 mg/kg among 314 samples of brick tea investigated in this study.The qualification rate of brick tea in each survey county was 0-16.7%.The daily intake of fluoride in brick tea per person was 6.4 mg.The prevalence of dental fluorosis was 18.1%(350/1929)among all enrolled participants,4 of the 6 survey counties(districts)had varying degrees of dental fluorosis.A total of 1637 urine samples were collected and detected,and the urine fluorine level ranged from 0.01 to 11.01 mg/L,with a geometric mean of 1.07 mg/L.The urine fluorine levels in all investigated counties(districts)were under the standard limits(≤1.6 mg/L).Eight adults were diagnosed with skeletal fluorosis of degreeⅠvia X-ray detection,with a detection rate of 0.4%(8/1929).Totally 20.2%(390/1929)of people reported suffered from two or more joint disease.Furthermore,6 counties(districts)in Lhasa City were identified as mild drinking-tea type endemic fluorosis disease areas.Conclusion From 2016 to 2018,the fluorine content of brick tea in Lhasa has exceeded the standard seriously,dental fluorosis is mildly prevalent in some counties(districts),and 6 counties(districts)are all mild tea-drinking fluorosis areas.
作者
格桑卓嘎
汤晓佳
西洛
Gesangzhuoga null;Tang Xiaojia;Xi luo(Department of Endemic Disease,Lasha Center for Disease Control and Prevention,Lhasa 850000,China;Mozhugongka Center for Disease Control and Prevention,Mozhugongka 850200,China)
出处
《中华地方病学杂志》
CAS
CSCD
北大核心
2020年第9期658-662,共5页
Chinese Journal of Endemiology
关键词
砖茶
氟斑牙
氟骨症
尿
氟
Brick tea
Dental fluorosis
Skeletal fluorosis
Urine
Fluorine
