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Objective:To evaluate the effect of prevention and control measures to drinking-water-borne endemic fluorosis in Qingdao, and to provide scientific basis for formulating prevention and control strategies.Methods:From 2019 to 2021, a full coverage surveillance was carried out in 1 146 villages in 7 drinking-water-borne endemic fluorosis areas in Qingdao, including the operation status of the water improvement and fluoride reduction project, the water fluoride content in the villages, and the prevalence of dental fluorosis among children aged 8-12 years.Results:From 2019 to 2021, all the 1 146 affected villages in Qingdao had improved their water supply, and the rates of water fluoride exceeding the standard were 7.16% (82/1 146), 1.40% (16/1 146) and 3.84% (44/1 146), respectively, and the differences between years were statistically significant (χ 2 = 48.36, P < 0.001). The detection rates of dental fluorosis in children aged 8-12 years were 3.11% (803/25 856), 2.68% (629/23 460) and 3.00% (655/21 846), respectively, and the differences between years were statistically significant (χ 2 = 8.26, P = 0.016). The detection rate of dental fluorosis among children in villages with qualified water fluoride (2.85%, 1 986/69 565) was lower than that in villages with excessive water fluoride (6.32%, 101/1 597), with a statistically significant difference (χ 2 = 67.74, P < 0.001). Conclusions:From 2019 to 2021, the effect of prevention and control measures to drinking-water-borne endemic fluorosis in Qingdao is significant and the detection rate of dental fluorosis in children is low, the detection rate of dental fluorosis in villages with qualified water fluoride is significantly lower than that in villages with excessive water fluoride. In the future, we should continue to strengthen water fluoride monitoring and engineering maintenance to ensure that the water fluoride content continues to be qualified and effectively reduce the harm of fluorosis.
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Objective:To learn about the distribution of fluoride content in drinking water of residents in Inner Mongolia Autonomous Region, so as to provide scientific basis for formulation of refined prevention and control measures for drinking-water-type endemic fluorosis.Methods:From January 2017 to December 2019, water fluoride surveys were carried out in all natural villages of 103 banners (counties) in 12 leagues (cities) of Inner Mongolia Autonomous Region, and drinking water samples of residents were collected according to different water supply methods (engineering water supply, physical and chemical water improvement, and decentralized water supply). The ion selective electrode method was used for water fluoride detection, and whether the water fluoride exceeded the standard was determined according to the "Standards for Drinking Water Quality" (GB 5749-2006).Results:The survey was carried out in 36 625 natural villages in 103 banners (counties) of 12 leagues (cities) in the region, among which 24 682 were engineering water supply villages, accounting for 67.39%; 2 610 were physical and chemical water improvement villages, accounting for 7.13%; and 9 333 were decentralized water supply villages, accounting for 25.48%. The median values of water fluoride in the engineering water supply villages, the physical and chemical water improvement villages and the decentralized water supply villages were 0.62, 0.23, and 0.52 mg/L, respectively, and the difference between different water supply methods was statistically significant ( H = 2 809.95, P < 0.001); the qualified rates of water fluoride were 96.47% (23 810/24 682), 99.73% (2 603/2 610) and 96.37% (8 994/9 333), respectively, and there was significant difference between different water supply methods (χ 2 = 132.74, P < 0.001). All the 12 leagues (cities) in the region had villages with water fluoride exceeding the standard, among which Chifeng City and Ordos City had more villages with water fluoride exceeding the standard (479, 282). Conclusions:All the 12 leagues (cities) in Inner Mongolia Autonomous Region have villages with water fluoride exceeding the standard. It is necessary to urge relevant departments to carry out planning and management of villages with water fluoride exceeding the standard.
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Objective:To assess the operation and usage conditions of all water improvement projects in Qingdao, master the water fluoride content and the prevalence of dental fluorosis in children in drinking-water-borne endemic fluorosis villages, evaluate the prevention and control effect of water improvement project.Methods:From April to October in 2020, all drinking-water-borne endemic fluorosis villages in 7 cities (districts) of Qingdao were selected to investigate the operation and usage conditions of water improvement project, water fluoride and prevalence of dental fluorosis of 8 to 12 years old children. The prevention and control effect of water improvement project on drinking-water-borne endemic fluorosis in Qingdao was evaluated according to the control contents and criteria of drinking-water-borne endemic fluorosis.Results:There were 1 146 drinking-water-borne endemic fluorosis villages, the water improved rate of villages was 100.00% (1 146/1 146), the rate of normal operation of water improvement project was 99.91% (1 145/1 146). There were 1 130 villages with qualified water fluoride and the qualified rate was 98.60% (1 130/1 146). A total of 23 473 children aged 8 - 12 years old were examined, and 631 children were detected with dental fluorosis. The detection rate of dental fluorosis was 2.69% (631/23 473), the dental fluorosis index was 0.048, and the prevalence was negative. The detection rate of dental fluorosis of children in villages with excessive water fluoride (7.03%, 40/569) was higher than that in villages with qualified water fluoride (2.58%, 591/22 904, χ 2 = 41.235, P < 0.01). Conclusion:The operation and usage conditions of water improvement projects in 7 drinking- water-borne endemic fluorosis cities (districts) in Qingdao are good, and the detection rate of dental fluorosis in children is low, which has reached the national control standard.
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Objective:To understand the prevention and control progress of drinking water-borne endemic fluorosis in Henan Province, to evaluate the effects of prevention and control measures, and provide a basis for adjusting prevention and control strategies.Methods:In 2019, a general survey was conducted in all registered drinking water-borne endemic fluorosis villages in Henan Province to monitor the basic conditions of water improvement, the fluoride content of drinking water and the prevalence of dental fluorosis in children aged 8-12 years. The control compliance (water fluoride content qualified and the detection rate of dental fluorosis of children ≤30%) status of the villages was analyzed, and calculate the compliance rate.Results:A total of 17 504 drinking water-borne endemic fluorosis villages were monitored, among them, 17 352 villages with water improvement and 152 villages without water improvement, with a water improvement rate of 99.1%. Among the 3 685 water improvement projects constructed, 3 448 were in normal operation, and the normal operation rate was 93.6%. There were 13 526 villages with qualified drinking water fluoride content, and the qualified rate of water fluorine was 77.3%; the actual beneficiary population was 11 011 000, and the population benefit rate was 90.1%. The qualified rate of water fluoride in the villages with and without water improvement was 77.9% (13 512/17 352) and 9.2% (14/152), respectively; the qualified rate of water fluoride in the villages with water improvement was significantly higher than that in the villages without water improvement (χ 2=400.58, P < 0.05). A total of 498 527 children of 8 to 12 years old were examined, 68 972 cases of dental fluorosis were detected, the detection rate of dental fluorosis was 13.84%, and the dental fluorosis index was 0.3. The number of villages meeting the control standard was 12 488, and the compliance rate was 71.3%. Conclusions:In Henan Province, the water improvement projects in the drinking water-borne endemic fluorosis areas have been basically implemented, and the disease has been effectively controlled. However, there is still a certain gap with the target of the "13th Five-Year Plan on National Prevention and Control of Endemic Diseases", and timely rectification is needed to ensure the effectiveness of the water improvement projects.
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Objective To understand the defluoridation effect in the historical severe endemic fluorosis areas of Shandong Province,and to analyze characteristics of children's dental fluorosis and related factors.Methods In 2015,using cross-sectional survey,11 villages in historical severe endemic fluorosis counties were selected for water fluoride test according to previous investigation of endemic diseases in Shandong Province.In which,4 normal water fluoride villages,4 excessive water fluoride villages and 3 villages without water improvement were included.Dental fluorosis in children aged 7 to 12 was examined and urine fluoride was measured.Logistic regression was used to analyze the related factors affecting the detection rate of dental fluorosis.Results A total of 732 children aged 7 to 12 were examined,with total detection rate of dental fluorosis 73.2％ (536/732).The detection rate of dental fluorosis was 31.0％ (65/210),86.7％ (176/203) and 92.5％ (295/319) in the villages with normal,excessive and without water improvement villages,respectively.And the differences were statistically significant (x2 =270.498,P ＜ 0.01).The prevalence of dental fluorosis in girls (77.4％,264/341) was significantly higher than that in boys (69.6％,272/391,x2 =5.337,P ＜ 0.05),and the dental fluorosis prevalence in elderly group (10-12 years old,76.9％,382/497) was higher than that of younger group (7-9 years old,65.5％,154/235),the difference was statistically significant (x2 =10.445,P ＜ 0.05).In water fluoride normal villages,the detection rate of dental fluorosis in girls (40.0％,36/90) was higher than that in boys (24.2％,29/120,x2 =6.033,P ＜ 0.05).In water fluoride unqualified villages,the dental fluorosis prevalence rates in boys and girls were 89.7％ (243/271) and 90.8％ (228/251),and the difference was not statistically significant (x2 =0.202,P ＞ 0.05).The urinary fluoride content of children with dental fluorosis was higher than that of non-fluorosis children [(4.5 ± 2.7) vs (1.9 ± 1.5) mg/L,t =-8.125,P ＜ 0.01].Logistic analysis showed that the risk of children's dental fluorosis in unqualified water fluoride village was 14.362 times high than that of normal water fluoride villages.The risk of dental fluorosis in children with high urinary fluoride was 2.497 times higher than that in normal urinary fluoride group.The risk of detecting moderate and severe fluorosis in children in the elderly group was 2.270 times higher than that in the younger group.The risk of detecting moderate and severe dental fluorosis in girls was 1.988 times higher than that in boys.The risk of detecting moderate and severe dental fluorosis in children in unqualified water fluoride villages was 49.190 times higher than that in normal water fluoride villages.Conclusions Water-quality-improvement project is an effective means to control the epidemic of dental fluorosis in children in severe fluorosis areas.Age,gender and water fluoride are influencing factors associated with dental fluorosis.
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Objective To investigate the influence of different water-improving defluoridation projects and different water-improving years on children's dental fluorosis,and to provide a scientific basis for further defluoridation of drinking water.Methods Totally 1/4 endemic fluorosis villages in all agricultural-related areas of Tianjin were selected by random sampling method from 2016 to 2017.The situation of water-improving defluoridation project was investigated in these villages.The ways of water improvement included municipal water supply,double pipe network,barreled water,low fluorine well and centralized water supply.The years of water improvement were ＞ 15,＞ 10-15,5-10,and ＜ 5 years,respectively.Totally 821 water samples (surface water,barreled water and groundwater) were collected.Fluoride ion selective electrode method was used for determination of water fluorine content.According to the "Diagnosis of Dental Fluorosis" (WS/T 208-2011),the prevalence of dental fluorosis in children aged 8 to 12 was examined.Results A total of 524 villages with drinking water endemic fluorosis and 35 870 children aged 8 to 12 were investigated in Tianjin.The water improvement rate was 73.28％ (384/524).Water fluoride qualified village accounted for 53.24％ (279/524).The detection rate of dental fluorosis was 47.98％ (17 209/35 870),the detection rate of dental fluorosis was different with different water improvement methods (x2 =1 955.742,P ＜ 0.05).Children's dental fluorosis detection rate in the area of municipal water supply was lower (33.19％,4 121/12 416),while that in double pipe network reconstruction area was 43.37％ (995/2 294).Children's dental fluorosis detection rates in the areas of barreled water supply,low fluoride well and centralized water supply were higher (58.47％,6 268/10 720;66.84％,1 719/2 572;53.75％,623/1 159).The median of water fluoride in the renovated area of municipal water supply was 0.24 mg/L,and the proportion of villages with water fluoride ≤ 1.2 mg/L was 100.00％ (133/133).With the increase in water-improving years (more than 10 years),children's dental fluorosis prevalence [＞ 15,＞ 10 ～ 15 years were 17.41％ (428/2 459),14.19％ (266/1 875)] in the areas of municipal water supply reached the control standards (≤30％).Conclusions The improvement of the municipal water supply network is thorough,which can meet the requirement of continuously ensuring the safety of drinking water for residents,especially those over 10 years.Other forms of water-improving need to be further optimized.
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Objective To understand the changes of arsenic poisoning in drinking water arsenic poisoning areas in Inner Mongolia Autonomous Region,to provide a scientific basis for timely adjustment of local arsenic poisoning prevention and control measures.Methods In accordance with the requirements of the national "Surveillance Scheme of Drinking-Water-Borne Endemic Arsenism",38 villages were selected from 8 cities as monitoring sites in Inner Mongolia Autonomous Region in 2015.The situation of the villages in improving water quality and operation of the arsenic reducing projects was investigated,water samples were collected to detect water arsenic content of all the monitoring villages exposed or previously exposed to high arsenic water in the resident population,and 30 adult patients with arsenic poisoning were tested urine arsenic level.Results Thirty-eight monitored villages had changed the water sources;the change rate was 100.00％ (38/38).Water arsenic content qualified projects were 17,covering 36 villages.The project with water arsenic content exceeded the national standard was 1,the rate of exceeded standard was 5.56％ (1/18),covering 2 monitored villages.In the 36 water arsenic content qualified natural villages,4 163 people were examined,and arsenic poisoning patients detection rate was 10.21％ (425/4 163).The incidence of mild,moderate,severe and skin cancer cases was 7.59％ (316/4 163),1.68％ (70/4 163),0.86％ (36/4 163) and 0.07％ (3/4 163),respectively,no new cases and new skin cancer cases.In the natural villages where the content of arsenic in water exceeded the standard,461 resident people who were drinking high arsenic water were examined.The detection rate of arsenic poisoning patients was 3.69％ (17/461),no moderate,severe,new and skin cancer cases.A total of 1 107 patients with arsenic poisoning were tested for urinary arsenic levels in the 36 villages with normal water available and water arsenic levels in the range of 0.000-0.441 mg/L with a median of 0.011 mg/L.The content of urinary arsenic in 60 patients with arsenic poisoning was detected in the 2 natural villages with the arsenic content exceeded the standard.The range was 0.030-0.268 mg/L and the median was 0.155 mg/L.Conclusions The projects of anti-arsenic water have effects in Inner Mongolia Autonomous Region.But there are still water projects with water arsenic content exceeded the standard,which seriously affects the health of residents,and the water management and maintenance of water projects needs to be strengthened.
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BACKGROUND: In 2004, the Korean government and blood transfusion community deliberated on the issue of a national blood system reform and agreed to implement a 5-year project (2004-2009) to further improve safety measures. Our study delineates the basis of the current national blood program and analyzes the performance of this 5-year project initiated by the Korean government. METHODS: A performance review of the 5-year project was conducted from May 2009 to February 2010 using various approaches. Numerous data and documentation were collected from the Korean Red Cross and the Korean Centers for Disease Control and Prevention and reviewed by experts. Approximately 20 interviews with representatives of stakeholder groups were conducted to gather information, opinions, and perceptions. We conducted a nationwide field survey on a total of 144 blood donor centers. RESULTS: Among the 5 major categories of the 5-year project, blood donor recruitment, laboratory testing, and product manufacturing were improved in terms of quality performance. Specifically, government's financial support ensured that the infrastructure of blood donor centers and blood laboratory centers improved. The pivotal role of the government contributed to improvements in the national blood program and enhanced national surveillance for blood safety. CONCLUSION: Korea has made a tremendous effort with positive outcomes to provide safety measures for blood products for transfusion in its citizens. In all areas of blood management, from blood donations to transfusions, continuous developments in monitoring safety standards and practices are paramount.