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Objective To understand the iodine nutritional status and thyroid function of different populations after 20 years of universal salt iodization in iodine deficiency area of Shanxi Province, and to provide data support for scientific iodine supplementation according to local conditions. Methods In 2014, six townships (Chengguan, Dadeng, Dengzhuang, Gucheng, Xiangling and Fencheng townships) in Xiangfen County, Linfen City, Shanxi Province, were selected as the place of investigation. Four hundred school-age children aged 6 - 12 years (school-age children), 400 child-bearing women aged 18 - 44 (child-bearing women), 400 pregnant women, 400 lactating women and their 0 - 6 months breast-feeding infants (breast-feeding infants), and 400 children aged 7 -24 months were selected by two-stage sampling method. Water samples of school-age children's domestic drinking water and salt samples for domestic consumption were collected, and the water iodine and salt iodine were detected by arsenic and cerium catalytic spectrophotometry ( recommended by the National Iodine Deficiency Disorders Reference Laboratory) and "General Test Method in Salt Industry-Determination of Iodine" (GB/T 13025.7-2012). Random urine samples of all subjects were collected, urine iodine was detected by "Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry" ( WS/T 107-2006 ) . Samples of filter paper dried blood spots (DBS) of school-age children, child-bearing women, pregnant women, lactating women and breast-feeding infants were collected, and serum total thyroxine (TT4) and thyroid stimulating hormone (TSH) levels were detected by time-resolved fluorescence immunoassay. Results A total of 290 water samples were collected, and the median of water iodine was 9.37μg/L. A total of 406 salt samples were collected, the median of salt iodine was 25.0 mg/kg, the coverage rate of iodized salt was 98.52％ (400/406), and the consumption rate of qualified iodized salt was 92.61％ (376/406). Urine samples of 389 school-age children, 379 child-bearing women, 363 pregnant women, 365 lactating women, 366 breast-feeding infants, and 366 children aged 7 - 24 months were collected, and the medians of urine iodine were 200.7, 175.0, 186.0, 113.2, 285.8 and 204.8 μg/L, respectively. Among them, school-age children, breast-feeding infants, and children aged 7-24 months were over the appropriate level, while the rest populations were at the iodine appropriate levels. Blood samples of 402 school-age children, 397 child-bearing women, 398 pregnant women, 390 lactating women, and 386 breast-feeding infants were collected, and the medians of TT4 were 127.2, 110.2, 141.7, 95.8 and 139.0 nmol/L, respectively; the medians of TSH were 1.2, 0.9, 0.8, 0.9 and 0.9 mU/L, respectively, and they were all within the reference ranges. The abnormal rates of TT4 (8.46％, 33/390) and TSH (7.95％, 31/390) in lactating women were higher than those in school-age children, child-bearing women, pregnant women and breast-feeding infants [TT4 abnormal rates were 0.25％(1/402), 1.26％ (5/397), 0.50％ (2/398), 1.04％ (4/386), respectively; TSH abnormal rates were 1.24％ (5/402), 1.51％ (6/397), 1.51％ (6/398) and 0.78％ (3/386), respectively, P < 0.05]. The rate of thyroid dysfunction in lactating women (7.95％, 31/390) was higher than those in the rest populations [1.24％ (5/402), 1.51％ (6/397), 1.51％ (6/398), 0.78％ (3/386), P < 0.05]. Conclusions The iodine intake of different populations in the survey area is generally sufficient, and the current salt iodine content standard can meet the iodine nutrition needs of different populations. Lactating women have a high rate of thyroid dysfunction. It is suggested to stick to the strategy of universal salt iodization to prevent iodine deficiency hazards in iodine deficiency areas, and further strengthen the monitoring of iodine nutrition and thyroid function of pregnant women and lactating women.
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Objective To evaluate the effect of water improvement projects on drinking-water-borne endemic arsenism in Shanxi Province,to work out and refine sustainable prevention and control strategies.Methods The operating situation of water-improvement projects was investigated and monitored,and the arsenic content in drinking water was determined in drinking-water-borne arseniasis areas,which including 14 monitored sites in 5 countries from 2012 to 2017.The condition of arsenic poisoning in the resident population of the monitored sites was investigated and the arsenic content in the urine of patients was determined.Results Totally 14 monitored sites were already finished water improvement,the rate of water-improvement was 100％.Totally 11 water-improvement projects were monitored,including 7 small-scale water-improvement projects and 4 large-scale water-improvement projects,which all qualified and operated normally from 2012 to 2015.In 2016,one water-improvement project was found with excessive level (＞ 0.01 mg/L) of arsenic in drinking water in Shanyin County,and the other 10 water-improvement projects' arsenic contents were qualified.In 2017,two unqualified large-scale water-improvement projects had water arsenic content over (＞ 0.01 mg/L) in Shanyin County and Ying County,respectively.And the other 9 water-improvement projects were qualified.The detection rates of arsenic poisoning from 2012 to 2017 were 1.36％ (104/7 641),1.57％ (123/7 832),1.61％ (123/7 621),1.53％ (120/7 857),1.28％ (102/7 963) and 1.56％ (124/7 958),respectively,and the differences were not statistically significant (x2 =4.979 9,P ＞0.05).Most patients with arsenic poisoning were mild to moderate patients,accounted for 82.61％ (575/696) and no new case was detected.Conclusions Arsenic poisoning in drinking-water-borne arseniasis areas in Shanxi Province has been controlled.Natural operation of water-improvement projects has kept water arsenic levels normal.Water arsenic content has exceeded the standard in some of the water-improvement projects.The key point of next stage is strengthen the management of water improvement projects in prevention and treatment of drinking-water type endemic arsenism.
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Objective To evaluate the effects of prevention and control measures on coal-burning-borne endemic fluorosis in Shanxi Province, and to provide a scientific basis for further prevention and treatment of the disease. Methods In 2016, 7 diseased counties (cities) were selected in the whole province, three diseased townships were selected in each county(city), and five diseased villages were selected in each diseased township as the investigation sites. The investigation was carried out on the changes of improved stove and correct usage of the improved stove, and the correct drying behavior related to the corn and pepper for human consumption. Children aged 8 to 12 were examined dental fluorosis. In each village, 20 urine samples of 8 to 12 years old children were collected for fluorine determination. Urine fluoride was determined via the fluoride ion selective electrode method, and children dental fluorosis was diagnosed by "Diagnosis of Dental Fluorosis" method (WS/T 208-2011). Results Altogether 105 villages were investigated, including 31 696 households. The rates of the improved stove and the correct usage of the improved stove were 98.46%(31 209/31 696)and 98.80%(30 834/31 209);the correct drying rate related to the corn and pepper for human consumption was 99.97%(31 685/31 696);the dental fluorosis rate of 8 to 12 years old children,and the dental fluorosis index were 5.56%(264/4 751) and 0.13. The urine fluoride content was between 0.15 - 4.33 mg/L and the geometric mean value of fluoride content was 0.72 mg/L. Conclusions The prevention and control effect is obvious on coal-burning-borne endemic fluorosis in Shanxi Province. Disease surveillance,health education,the management and maintenance work of defluoridation stoves are keys in prevention of coal-burning-borne endemic fluorosis.
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Objective To master the results of examination and evaluation of coal-burning-borne endemic fluorosis in Shanxi Province,and to provide a scientific basis for further prevention and treatment of the disease.Methods In 2012-2015,the prevention and control situation and condition survey were carried out in all coalburning-borne endemic fluorosis villages of 20 counties in Shanxi Province.A county-level self-inspection and a provincial-level spot-check were conducted to investigate the changes of improved stove and correct usage of the improved stove,and the correct drying of corn and pepper for human consumption.Children aged 8 to 12 were examined for dental fluorosis.The endemic areas were selected according to the Control Standards of Endemic Fluorosis in Endemic Areas (GB 17017-2010) and Eliminating Standards of Coal-burning Type Endemic Fluorosis,and dental fluorosis children was diagnosed based on the Diagnosis of Dental Fluorosis method (WS/T 208-2011).Results Totally 3 371 villages and 716 683 households were investigated,the rates of the improved stove and the correct usage of the improved stove were 98.72％ (707 502/716 683) and 98.74％ (698 608/707 502);the correct drying rate of corn and pepper for human consumption was 99.85％ (715 605/716 683);the dental fluorosis rate of 8 to 12 years old children and the dental fluorosis index were 6.41％ (6 762/105 453) and 0.14.A total of 20 counties in the province,9 counties had reached the control standards,11 counties had reached the elimination standards.Provincial and municipal level checked a total of 57 towns,157 villages,and the results of the overall compliance rate was 87.26％ (137/157).Conclusions The prevention and control effect is obvious on coalburning-borne endemic fluorosis in Shanxi Province.Disease surveillance,health education,the management and maintenance work on defluoridation stoves are keys in control of coal-burning-borne endemic fluorosis.
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Objective To master the iodine nutritional status of residents and to evaluate the effect of iodine nutrition improvement on residents health after the adjustment of salt iodine concentration. Methods According to the method of population proportion sampling, 30 county-level monitoring sites were selected in 2014, a primary school was selected from each county (city, district) by the method of simple random sampling and 50 students aged 8 - 10 (half males and half females) were selected in each school, B ultrasound was used to detect thyroid volume, arsenic cerium catalytic spectrophotometry (WS/T 107-2006) was used to detect urinary iodine, direct titration was used to detect salt iodine; At the same time, 20 pregnant women were selected from each town and urinary iodine was determined. All results were compared with the results of 2011 to evaluate the effect of iodine nutrition improvement on resident's health after the adjustment of salt iodine concentration. Results A total of 1 437 edible salt samples were tested, the median of salt iodine concentration was 24.1 mg/kg. Based on the new standard (18 - 33 mg/kg), the coverage rate of iodized salt was 95.4%(1 371/1 437), the qualified rate of iodized salt was 80.3%(1 101/1 371), the consumption rate of qualified iodized salt was 76.6% (1 101/1 437). A total of 1 496 urine samples of children and 630 urine samples of pregnant women were tested, the median of urinary iodine of children and pregnant women was 224.6 and 177.1 μg/L, respectively, which were significantly lower than those of 2011 (274.6, 279.6μg/L), the differences were statistically significant (H=70.10, 153.50, all P<0.05). The proportion of counties which iodine nutrition of children and pregnant women in suitable range was 36.7% (11/30) and 56.7% (17/30), which were higher than those of 2011 [6.5%(2/31), 25.8%(8/31)], the differences were statistically significant (χ2 = 7.88, 5.00, all P < 0.05). Totally 1 552 children were examined thyroid in Shanxi Province, the rate of goiter was 4.4% (69/1 552). Conclusion The new standard of iodine concentration makes it possible to maintain a sustainable elimination of iodine deficiency disorders, and it can improve the iodine nutrition of children aged 8-10 years and pregnant women to more reasonable level.
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Objective To observe the implementation of prevention and control measures for water quality improvement in drinking water type of fluorosis and arsenic poisoning areas,to investigate the operating condition of fluoride-safe water supply projects,and to comprehensively evaluate the project's quality and its effectiveness on water quality improvement.Methods According to the Shanxi Province Drinking Water-Borne Fluorosis and Arsenic Poisoning Fluoride-Safe Water Supply Projects Monitoring Programme,in October 2012-June 2013,45 counties in the province were selected to monitor fluorosis and arsenic poisoning.The running condition of fluoridesafe water supply projects was investigated.One factory water sample was collected to determine the water fluoride (arsenic) concentration.Meanwhile,3 tap water samples were collected to determine the water fluoride (arsenic)concentration in each village,using the Standards for Drinking Water Quality (GB/T 5750.5-2006).Results Totally 1 804 fluoride-safe water supply projects had been surveyed,and 1 673 were in normal condition,accounting for 92.7％.The number of projects supplying fluoride-safe water was 1 328,accounting for 73.6％,benefiting a population of 2.636 779 million people.A total of 2 277 villages were investigated,and 1 826 villages had fluoride-safe water,accounting for 80.2％ of the investigated villagcs.One hundred and forty-five arsenic-safe water supply projects in drinking water type of arsenic poisoning areas were investigated,and 138 were in normal condition,accounting for 95.2％.One hundred and forty-three arsenic-safe water supply projects were qualified,accounting for 98.6％,benefiting a population of 295 240 people.One hundred and fifty-nine villages in drinking water-borne arsenic poisoning areas were investigated,and 156 villages were qualified in water arsenic,accounting for 98.1％ of the investigated villages.Conclusions The qualified rate of fluoride-safe water supply projects is relatively low in drinking water type of fluorosis areas.It has not yet reached the national standard and the management of fluoride-safe water supply projects should be strengthened.The effect of arsenic-safe water supply projects on prevention of drinking water type of arsenic poisoning is significant.