Dental fluorosis of children aged 8-12 in diseased areas in Xi 'an City from 2014 to 2018
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摘要:
目的 动态监测西安市饮水型氟中毒病区改水后水氟和儿童氟斑牙病情变化趋势,为改水降氟提供科学依据。 方法 2014—2018年在西安市选择10个区县的35个病区村作为固定监测点,调查改水方式、水氟含量和8~12岁儿童氟斑牙病情。 结果 2014—2018年病区村水氟含量超标率分别为22.86%,14.29%,11.43%,11.43%和8.57%,差异有统计学意义(χ2=16.44,P < 0.01)。各年度间8~12岁儿童氟斑牙总检出率依次为20.89%,18.22%,17.46%,18.13%,16.76%,且呈逐年下降趋势(χ趋势2=10.02,P < 0.01)。8,9岁组儿童氟斑牙检出率各年度间比较,呈逐年下降的趋势(χ趋势2值分别为6.53,4.54,P值均 < 0.05)。水氟含量超标村儿童氟斑牙总检出率、轻度及以下、中度及以上检出率与水氟含量合格村比较,差异有统计学意义(χ2值分别为179.22,167.93,10.35,P值均 < 0.01)。水氟含量超标病区村各年度间的氟斑牙检出率呈逐年下降趋势(χ趋势2=28.50,P < 0.01)。市政供水、低氟井与除氟处理3种改水方式儿童氟斑牙检出率差异有统计学意义(χ2=197.76,P < 0.01)。市政供水各年度间儿童氟斑牙检出率呈逐年下降趋势(χ趋势2=12.16,P < 0.01)。 结论 市政供水改水降氟效果显著,其他改水方式仍有部分病区村水氟及儿童氟斑牙检出率未达标,应继续加强改水后水氟含量和儿童氟斑牙病情监测。 Abstract:Objective To evaluate the dynamic prevalence of dental fluorosis of children and levels of fluoride in drinking water after improvement of water in Xi 'an City, to provide scientific basis for water fluoridation improvement. Methods A total of 35 fluorosis endemic villages were selected as fixed monitor sites in 2014-2018, the ways of water improvement were surveyed, water fluorine content were detected and the prevalence of dental fluorosis in children aged 8 to 12 years were examined. Results Rates of excess fluoride in drinking water from 2014 to 2018 were 22.86%, 14.29%, 11.43%, 11.43% and 8.57%, the difference were significant(χ2=16.44, P < 0.01).The dental fluorosis detection rates of children aged 8 to 12 years were 20.89%, 18.22%, 17.46%, 18.13% and 16.76% in 2014-2018 which showed a obvious descending trend by year(χ2=10.02, P < 0.01). The detection rate of dental fluorosis in children aged 8 and 9 years showed a decreasing trend by year(χ2=6.53, 4.54, P < 0.05).The difference of total rate of dental fluorisis, rate of mild cases rate of moderate-to-severe cases were statistically between the villages without qualified water and the villages with normal fluorine water(χ2=179.22, 167.93, 10.35, P < 0.01). The rate of detection in the villages with the water fluorine exceed standard in 2014-2018 showed a declining trend year by year(χ2=28.50, P < 0.01). The detection rate were significant different across water improvement methods (χ2=197.76, P < 0.01). Detection rate of dental fluorosis decreased from 2014 to 2018 in the areas with municipal water supply showed a decreasing after year(χ2=12.16, P < 0.01). Conclusion The improvement of municipal water supply shows significant effects on water fluorosis control, the detection rate of water fluoride and children's dental fluorosis in some villages with the other ways of water improvement are still higher than expected, the continuously monitor of fluoride content in water and dental fluorosis in children should be strengthened. -
Key words:
- Fluorine /
- Wate pollution /
- Fluorosis, dental /
- Prevalence /
- Child
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表 1 西安市2014—2018年饮水型氟中毒监测村8~12岁儿童氟斑牙检出情况
Table 1. Detection rate of dental fluorosis of children aged 8 to 12 years in monitor villages of drinking water fluorosis in Xi'an City from 2014 to 2018
年份 8岁组 9岁组 10岁组 11岁组 12岁组 合计 氟斑牙指数 人数 氟斑牙人数 人数 氟斑牙人数 人数 氟斑牙人数 人数 氟斑牙人数 人数 氟斑牙人数 人数 氟斑牙人数 2014 418 57(13.64) 502 77(15.34) 461 93(20.17) 442 111(25.11) 413 129(31.23) 2 236 467(20.89) 0.44 2015 586 55(9.39) 488 62(12.70) 557 93(16.70) 493 105(21.30) 571 176(30.82) 2 695 491(18.22) 0.40 2016 471 41(8.70) 399 46(11.53) 460 74(16.09) 433 90(20.79) 477 140(29.35) 2 240 391(17.46) 0.35 2017 432 39(9.09) 455 53(11.65) 410 79(19.27) 465 99(21.99) 422 126(29.86) 2 184 396(18.13) 0.34 2018 422 33(7.82) 418 45(10.77) 457 75(16.41) 401 83(20.70) 438 122(27.85) 2 136 358(16.76) 0.32 合计 2 329 225(9.66) 2 262 283(12.51) 2 345 414(17.65) 2 234 488(21.84) 2 321 693(29.86) 11 491 2 103(18.30) 0.37 注: ()内数字为检出率/%。 表 2 西安市2014—2018年不同水氟含量监测村8~12岁儿童氟斑牙检出情况
Table 2. Detection rate of dental fluorosis in children aged 8 to 12 years in monitor villages with different water fluoride in Xi'an City from 2014 to 2018
水氟 年份 人数 氟斑牙人数 氟斑牙分度 氟斑牙指数 极轻 轻度 中度 重度 合格 2014 1 810 303(16.74) 108 162 18 15 0.38 2015 2 390 393(16.44) 186 115 62 30 0.37 2016 2 040 325(15.93) 175 79 64 7 0.32 2017 1 846 307(16.63) 177 93 31 6 0.31 2018 1 890 310(16.40) 157 119 23 11 0.31 超标 2014 426 164(38.50) 85 53 20 6 0.70 2015 305 98(32.13) 46 41 8 3 0.64 2016 200 66(33.00) 31 24 7 4 0.62 2017 338 89(26.33) 53 29 7 0 0.49 2018 246 48(19.51) 19 21 7 1 0.42 注: ()内数字为检出率/%。 表 3 西安市2014—2018年不同改水方式监测村8~12岁儿童氟斑牙检出情况
Table 3. Detection rate of dental fluorosis of children aged 8 to 12 years in monitor villages with different water improvement methods in Xi'an City from 2014 to 2018
改水方式 年份 人数 氟斑牙人数 氟斑牙分度 氟斑牙指数 极轻 轻度 中度 重度 市政供水 2014 131 32(24.43) 23 7 2 0 0.38 2015 235 48(20.43) 24 19 4 1 0.39 2016 264 46(17.42) 34 8 4 0 0.31 2017 284 48(16.90) 37 9 2 0 0.26 2018 280 32(11.43) 19 13 0 0 0.20 低氟井 2014 1 939 371(19.13) 131 186 33 21 0.43 2015 2 301 380(16.51) 169 115 64 32 0.38 2016 1 844 299(16.21) 149 79 60 11 0.33 2017 1 739 289(16.62) 161 95 27 6 0.32 2018 1 747 283(16.20) 139 110 22 12 0.32 除氟处理 2014 166 64(38.55) 39 22 3 0 0.61 2015 159 63(39.62) 39 22 2 0 0.66 2016 132 46(34.85) 23 16 7 0 0.63 2017 161 59(36.65) 32 18 9 0 0.67 2018 109 43(39.45) 18 17 8 0 0.79 注: ()内数字为检出率/%。 -
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