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Objective To understand the current situation of endemic fluorosis in Shandong Province,and to provide a scientific basis for development of control strategies.Methods In accordance with the requirements of the national Surveillance Scheme of Drinking-Water-Borne Endemic Fluorosis (Trial) and Shandong Provincial Surveillance Scheme of Drinking-Water-Borne Endemic Fluorosis (Trial),and to understand the progress of the province's water-improvement projects,10 counties were chosen in the province,and 10 water-improvement projects were selected in each county.Running condition of the water-improvement projects was investigated,and water fluoride content was tested.Three epidemic villages were chosen as fixed monitoring villages in each county.In each village,fluoride content in drinking water was determined,and dental fluorosis of all children aged 8 to 12 was diagnosed.Water fluoride content was determined by fluoride ion selective electrode method,and dental fluorosis of children aged 8 to 12 was diagnosed by Dean method.Results ① There were 3570 water defluoridation projects in the province,and water-improvement rate was 87.49％ (10 122/11 569).Normal operating projects accounted for 89.10％ (3181/3570),and the passing rate of water fluoride content was 73.14％ (2611/3570),with the maximum water fluoride as 9.71 mg/L.② In the 10 counties,a total of 86 waterimprovement projects were monitored.Normal operation,intermittent operation and scrapped projects accounted for 95.35％ (82/86),3.49％ (3/86) and 1.16％ (1/86),respectively,and passing rate of fluoride content in water was 50.00％ (43/86),and the maximum water fluoride was 5.32 mg/L.③ In the 27 monitored villages with improved water quality,the passing rate of fluoride content in water was 74.07％ (20/27),and the maximum water fluoride was 4.50mg/L.In the 3 monitored villages without improved water quality,villages of mean water fluoride ≤ 1.20 mg/L and ＞ 1.20 mg/L accounted for 33.33％ (1/3) and 66.67％ (2/3),respectively,and the maximum water fluoride was 1.53 mg/L.④ In the 27 monitored villages with improved water quality,the detection rate of dental fluorosis among children aged 8 to 12 was 57.65％(791/1372),and the detection rate of defect type dental fluorosis was 7.80％(107/1372); the index of dental fluorosis was 1.15.In the 3 monitored villages without improved water quality,the detection rate of dental fluorosis among children aged 8 to 12 was 50.97％ (80/155),and the detection rate of defect type dental fluorosis was 7.10％(11/155); the index of dental fluorosis was 1.16.Conclusions In Shandong Province,the running condition of water improvement project to reduce fluoride still needs to be further improved,and the water fluoride is seriously overweight and endemic fluorosis has not been effectively controlled.Preventive measures should be strengthened.
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ObjectiveTo investigate the water fluoride level of the water improvement project and the prevalent condition of endemic fluorosis in 4 counties in Shandong province,and to provide a scientific basis for the development of control strategies to endemic fluorosis.MethodsAccording to “Shandong Province Survey Scheme of Endemic Fluorosis”,the service conditions of normal operated water improvement project and water fluoride content were investigated in Gaomi,Jiaxiang,Yuncheng and Boxing counties from May to November in 2010.The fluoride content in drinking water,the prevalence of dental fluorosis and urinary fluoride in children were investigated in nine major survey villages of the four counties.Water and urinary fluoride were determined by ion selective electrode and examination of dental fluorosis was done by using Dean method.ResultsA total of 288normal operated water improvement projects were examined in the 4 counties,the qualified rate of water fluoride (≤ 1.00 mg/L) of the projects was 51.39％(148/288),mean water fluoride was 1.35 mg/L and the maximum value was 6.27 mg/L.A total of 26 copies of drinking water samples were measured,the fluoride content ranged from 0.62mg/L to 4.36 mg/L,and mean water fluoride was 2.02 mg/L.A total of 685 children aged 8 to 12 were examined in the major investigated villages,the detection rate of dental fluorosis was 80.14％ (549/685),detectable rate of the defective dental fluorosis was 15.33％ (105/685),and dental fluorosis index was 1.56.Three hundred and seventynine copies of child urine samples were tested,the geometric mean of urinary fluoride were 0.66 - 13.28 mg/L,and the average was 3.04 mg/L.ConclusionsNearly 50％ of the water fluoride level of the water improvement project exceeds the standard ( ＞ 1.00 mg/L) in the 4 countries.The detection rate of dental fluorosis exceeds 80％ and urinary fluoride is significantly exceeds the standard in the major investigated villages.The endemic fluorosis is still serious and the situation of prevention and control of the disease is still grim.
ABSTRACT
Objective To investigate the current status of endemic fluorosis in Shandong province,and to provide a scientific basis for the development of preventive strategies.Methods In accordance with the requirements of the national Technical Implementation Plan for Endcmic Disease Control Project in 2009 and Drinking-Water-Borne Endemic Fluorosis Monitoring Program (trial),ten counties were selected to carry out the epidemiological investigation,to understand the progress and the effect of the water improvement projects; three villages were selected in each county,to determine fluoride content of drinking water,to check dental fluorosis of children aged 8 to 12 and skeletal fluorosis of adults over the age of 25.Water fluoride content was determined by fluoride ion selective electrode method,children dental fluorosis was diagnosed with Dean method and adults skeletal fluorosis by the National Standard for Diagnosis of Endemic Skeletal Fluorosis (WS 192-2008).Results There were a total of 687 improved-water defluoridation projects of the 10 counties,the improved-water rate was 83.34％ (3247/3896).The investigation was taken place in 84 improved-water projects of the 10 counties,the projects running normally accounted for 98.81％ (83/84); 41 projects had water fluoride concentration ≤1.20 mg/L,and the pass rate was 48.81％(41/84),with the maximum water fluoride as 5.76 mg/L.In the 26 villages with improved-water projects of the 10 counties,villages with a mean water fluoride ≤ 1.20 mg/L were 15,which accounted for 57.69％ (15/26),＞ 1.20 mg/L were 11,which accounted for 42.31％ (11/26),with the maximum water fluoride as 5.58 mg/L.In the 4 yet to improve water quality villages of the 10 counties,1 village had mean water fluoride ≤ 1.20 mg/L,3 villages had mean water fluoride ＞ 1.20 mg/L,with the maximum water fluoride as 2.92 mg/L.A total of 1331 children aged 8 to 12 were checked in the 26 improved water villages,the detection rate of dental fluorosis was 59.73％ (795/1331),the index of dental fluorosis was 1.17 and the defect rate was 10.14％ (123/1331).A total of 138 children aged 8 to 12 were checked in the 4 yet to improve water quality villages,the detection rate of dental fluorosis was 51.45％(71/138),the index of dental fluorosis was 0.95 and the defect rate was 0.72％ (1/138).In water quality improved villages and yet to improve water quality villages,X-ray detection rates of skeletal fluorosis were 8.80％ (113/1284) and 3.05％ (6/197),respectively,in adults over the age of 25.Conclusions The water fluoride content of improved-water defluoridation projects exceeds the national standard seriously and fluorosis has not been effectively controlled in Shandong province.
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Objective To investigate the prevailing status of endemic fluorosis in the south area of Shandong province and to provide a scientific basis for formulating control measures against the disease.Methods According to the present distribution of fluorosis areas in the south area of Shandong province and the Shandong Province Technical Scheme for Endemic Disease Control,13 counties(districts) in the south area of Shandong province were selected as the survey counties in 2009.Based on the state of endemic fluorosis,the disease was classified into light,moderate and severe types in the 13 monitoring counties (districts),and one diseased village was selected from each type as the survey spots.The drinking water fluoride level,the prevalence of dental fluorosis of children aged 8-12,adult clinical skeletal fluorosis and urinary fluoride level of the children and adults were surveyed in the 39 villages selected.The content of fluoride in drinking water and urine was dctermined by F-ion selective electrode while dental fluorosis of the children aged 8-12 was diagnosed by Dean method and adults skeletal fluorosis by the national standard for Diagnosis of Endemic Skeletal Fluorosis (WS 192-2008).Results A total of 172 water samples were tested in the 39 villages(26 villages with improved water and 13 villages with unimproved water) of the 13 counties(districts),the fluoride content of the 74 water samples(51 from 13 villages with unimproved water and 23 from 6 villages with improved water) exceeded the national standard(＞ 1.0 mg/L),and the rate of exceeded the standard was 43.02％(74/172) with 24 of ＞ 2.0-4.0 mg/L and 3 of ＞ 4.0 mg/L,and the maximum value of the water fluoride was 7.76 mg/L.A total of 1118 copies of children urine samples were tested,geometric mean of urinary fluoride was 1.82 mg/L; 764 copies of adults' urine samples were tested,geometric mean of urinary fluoride was 1.98 mg/L.A total of 1908 children aged 8-12 were examined of dental fluorosis,the detection rate was 45.18％ (862/1908),tooth defection rate was 9.12％ (174/1908),and dental fluorosis index was 1.07.A total of 25 295 adults were checked of clinical skeletal fluorosis,the detection rate was 5.96％(1509/25 296) with 670 moderate or scrious cases.Conclusions In the south area of Shandong province,excessive water fluoride is still serious,mainly in the diseased villages with unimproved water(including water improvement villages discarded water improvement thereafter).Urine fluoride remains at a relatively high level,and the dental and skeletal fluorosis are still comparatively serious.High tluoride hazard still exists to a certain degree.Therefore,the scientific control measures need to be strengthened to control the prevalent of endemic fluorosis.
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To isolate and identify the influenza virus in Shandong Province in 2009-2010 and analyze the genetic characteristics of hemagglutinin and neuraminidase gene, further study the variation of gene. A total of 17 126 nasopharyngeal swabs from fever patients were collected and detected by real time quantitative RT-PCR method. The results showed 4004 samples were pandemic influenza A (H1N1) virus positive, with an overall positive rate as 23.38%. The positive samples were incubated and cultured in MDCK cells. The HA and NA genes of isolated pandemic influenza A(H1N1) virus were sequenced, the homology analysis of the HA and NA genes showed an average of 96.9%-99.3% and 99.1%-99.6% sequence identity, respectively, compared with WHO-recommended vaccine strain. The genetic evolution and amino acid substitutions were performed with Mega 4.0 Software. Twenty one amino acids were changed in HA protein, of which 11 were located in the antigenic site; Sixteen amino acids were changed in NA protein, which didn't lead to the changes of enzyme sites. Furthermore, one glycosylation site of HA protein and NA protein were changed respectively. No H275Y mutation in NA protein was found. The results showed that the HA and NA genes of the epidemic strains were highly homologous, some mutations in the HA and NA proteins were found, the antigenic site and glycosylation site of some strains were changed during the epidemic process. All the strains were sensitive to oseltamivir.