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Objective To observe the effect of health education and installation of improved stove in control of coal-burning-borne endemic fluorosis in Pingba County of Guizhou Province.Methods Two towns(Shizi and Qibo) of Pingba County that had implemented the health education and installed the improved stoves for control of coal-burning-borne endemic fluorosis were selected as the investigation sites.Two villages in each selected town and 30 householders as well as all students of grade 4-6 were investigated.Questionnaires were made by survey of the fluorosis control knowledge,household investigations were used to know the use of household stoves,corn and peppers drying method,and the dental fluorosis of children aged 8-12 were examined by Dean methods before the intervention(2006) and after implementation(2009) of health education and improvement of stoves.Results The awareness of fluorosis control among students and households after the intervention was 97.36％ (405/416) and 86.46％(415/480),respectively,and the difference was statistically significant(x2 =658.86,163.10,all P ＜ 0.01) compared with that before the intervention [32.19％(1083/3364),43.33％(130/300)].Correct using rate of the household stoves was 95.42％ (229/240) after the intervention and 45.85％ (3976/8672) before the intervention,the difference was statistically significant(x2 =230.25,P ＜ 0.01).The correct rates of drying corn and chili were 91.67％ (110/120) and 97.50％ (117/120) before the intervention,and 20.00％ (12/60),26.67％ (16/60) after the intervention,the difference was statistically significant(x2 =94.07,104.02,all P ＜ 0.01).The incidences of dental fluorosis of children aged 8-12 were 31.21％(1305/4182) after the intervention and 87.71％(2856/3256) before the intervention,the difference was statistically significant(x2 =2371.91,P ＜ 0.01).Conclusions The measures of health education and intervention of stove improvement in Pingba County of Guizhou Province for prevention and control of coal-burning-borne endemic fluorosis is effective.
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Objective To evaluate the effectiveness of health education on controlling of coal-burning-borne endemic fluorosis(referred to as endemic fluorosis) in Guizhou,and to provide a scientific basis for development of control strategies.Methods A total of 37 counties were selected in Guizhou province,and 3 townships were chosen in each project county.Heath educational activities were carried out in the classes of grade 5 in the Central Primary School of each selected township.In the meantime,3 villages were chosen in each selected township where the health education for women of child-bearing age in the community was carried out.Survey on knowledge questionnaire of endemic fluorosis control was conducted among 30 students of grade 5 in the Central Primary School and 15 women of childbearing age of each selected township before and after the health educational activities.Results The knowing rate of endemic fluorosis control of pupils in all the 37 counties increased from 45.03％(14637/32505) to 89.79％(52898/58910),of women of child-bearing age increased from 38.97％ (5729/14700) to 76.55％(19198/25080) after the health education.ConclusionsThe knowing rate of endemic fluorosis control among pupils and women of child-bearing age is remarkably increased after implementing the health education projects.They have better life and health habits,and the project has reached desired goal.
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Objective To investigate the usage of fluorine-proof iron stove in regions with coal-burning borne endemic fluorosis of Guizhou province and to provide scientific basis for the project management. Methods According to "the local prevention programs against coal-burning borne endemic fluorosis-Guizhou iron stove usage survey scheme", in the 18 counties implemented the project of improving the iron stove from 2005 to 2008, 2 townships were selected randomly in each county of each project annually, 2 villages were selected in each township randomly, and 10 households were checked in each village. The project households were investigated using questionnaire of the related health knowledge and awareness as well as the satisfaction of the households.Results ①The improvement rate of iron stove was 100.00%(1286/1286). ②The overall utilization rate of the improved stove was 94.09% (1210/1286), in which winter was 62.21% (800/1286) and annual was 31.88%(410/1286). ③Among the households that did not use the project stove, 46.05%(35/76) households was due to switch to other clean energy, in addition, 19.74%(15/76) was due to sell or send to other households, and 14.47%(11/76) was still used to use the open kitchen without the ventilating pipe, and still 13.16%(10/76) was due to high coal prices, and 6.58%(5/76) was due to that the improved stove can not meet the needs of life and no longer used. ④Amoag 1261 households investigated, households with damaged furnace was 24.58%(310/1261 ), and the parts damaged were mainly chimney (ventilating pipe) and the furnace core, accounting for 51.94%(161/310) and 29.03%(90/310), respectively. Repair rate of the damaged parts was 32.58%(101/310). ⑤The health knowledge rate was about 82.74% (1064/1286), and the satisfaction of the iron furnace was 88.65% (1140/1286).Conclusions The improved stoves for the prevention of endemic fluorosis in the diseased area meet the people's living habits, and meet their basic livelihood needs. Most project households are still using the improved furnace.But we still need to further strengthen the project management and the health education intervention, establish and improve stove maintenance network, and reach the goal of sustainable control of coal-burning borne endemic fluorosis.
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Objective To study the follow-up management strategies after improving stoves for controlling coal-burning type endemic fluorosis in Guizhou and to provide a scientific basis for exploring the follow-up management measures.Methods In 2006 - 2009,three counties of Puding,Bijie and Liuzhi with improved stoves in 2005 and implemented follow-up management measures for subsequent three years were chosen,3 towns were chosen randomly in each chosen county,2 villages were selected randomly in each chosen town,10 households were investigated randomly in each chosen village,and 20 students were investigated of the knowledge of fluorosis control.The investigation included also the usage of the stoves,dehydration methods of grain and related conditions.Results ①The head of the family and student awareness of fluorosis control were 82.6％(743/900)and 91.7％ (1650/1800),respectively,and 35.0％ ( 385/1100 ) and 61.0％ (6605/10 835 ),respectively,before the test,and the difference was statistically significant( x2 =33.04,1189.12,all P ＜ 0.01 ).②The rates of chimney out of the house were 88.5％(69/78) and 100.0％(102/102),respectively,compared with those before the trial[74.4％(2125/2856) and 2.1％(104/4984),respectively],the difference was statistically significant(x2 =720.56,4295.38,all P ＜ 0.01).The iron stove and the table stove's airtight utilization rates were 85.9％(67/78) and 100.0％(102/102),respectively.③The corn and the hot pepper's correct drying rates were 100.0％(180/180).Compared with those[27.2％(49/180) and 32.2％(58/180),respectively]before the trial,the difference was statistically significant(x2 =26.68,37.38,all P ＜ 0.01 ).The corn and the hot pepper's washing rates before eating were 95.0％(57/60) and 98.3％(177/180),respectively.Compared with those[85.0％(153/180) and 77.8％(140/180)]before the trial,the difference was statistically significant(x2 =135.00,490.82,all P ＜ 0.01 ).Conclusions The target population's awareness and knowledge of fluorosis prevention and related behavior are significantly elevated and enhanced after implementation of the three years post-management,which has reached the desired goal.The strategies of the follow-up management suits Guizhou province and widespread application is suggested.
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Objective To explore the mechanism of skeletal fluorosis via observation on the expression of bone γ-carboxyglutamic acid-containing protein (BGP) and osteoprotegerin (OPG) in the residents of coal-burning fluorosis regions, and to provide a basical data for further monitoring and evaluating the effects of fluoride-reducing projects. Methods Stratified sampling was applied, the 6 villages of fluorosis were chosen as focusing areas for investigation. The residents of villages underwent clinical examination of the skeletal fluorosis. And according to the degree of skeletal fluorosis, villages were divided into three groups, namely light, moderate and severe villages. Radio-Immunoassay and Enzyme-linked immunosorbent assay were used to check the expression of BGP and OPG in the serum. Results The levels of serum BGP in the severe skeletal fluorosis cases[(6.78±4.43)μg/L] were significantly higher(P<0.05) than those in the normal, moderate and the severe groups [ (3.58±1.53), (3.44±2.66), (3.41±2.20)μg/L], respectively. The expression of OPG in the light, moderate and the severe groups [(1251.55±998.31), (1265.94±931.77), (1560.55±858.07)ng/L] were significantly higher (P<0.05) than those in the normal[(520.81±385.05)ng/L], respectively. The levels of BGP in mixed type[(6.09±2.62)μg/L] were much higher(P<0.05) than no mixed type[(3.97±1.53), (3.20±2.12)μg/L]. The levels of OPG in the osteosclerosis, osteoporesis and mixed type[(1321.63±1017.00), (1205.42±852.22), (1529.01±402.83)ng/L] were significantly higher(P<0.05) than those of the normal, respectively. The levels of OPG in the light villages [(452.06±338.10)ng/L] were significantly lower(P<0.05) than moderate and severe villages[(1266.30±899.14), (1851.80±956.08 )ng/L], respectively. The levels of OPG in the severe villages were significantly higher(P<0.05) than moderate villages. Conclusions It indicates that OPG can be used as an early indicator in coal-burning pollution endemic fluorosis results in biochemical changes in the composition of bone.