RESUMO
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.
RESUMO
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.
RESUMO
Objective To investigate the distribution of endemic arsenism and to provide a scientific basis for control and prevention of the disease.Methods According to previous investigation,in the high-arsenic water areas,the arsenic diseased areas and the surrounding lands,35 counties were investigated.Water arsenic was screened in all the survey sites,villages with water arsenic exceeding the standard were quantitative surveyed of water arsenic and the disease conditions.Screening of arsenic content in drinking water was done by the method of half-quantitative fast reagent kit.Quantitative determination of arsenic in water was done by hydride generationatomic fluorescence spectrometry (HG-AFS).Patients of endemic arsenism were diagnosed by the Standard of Diagnosis for Endemic Arsenism (WS/T 211-2001).Identification of area was done by Definition and Division Standard for Endemic Arsenism (WS 277-2007).The data were analyzed using SPSS 13.0 for windows.Results Water arsenic of 151 villages in 15 counties among 1 771 villages were higher than the national drinking water quality level(0.05 mg/L).Exposure population of high arsenic was 177 018 people.The census results of high arsenic water sources indicated that the ratio of drinking water arsenic levels higher than the national standard was 35.10％ (2 355/6 709) and the highest contents of arsenic was 1.733 0 mg/L.The disease census indicated that there were 33 latency arsenism districts and 118 arsenism districts.There was totally 39 757 patients with latency arsenism.Totally 137 261 people lived in arsenism districts.Light,moderate and severe arsenism districts was 82,29 and 7,respectively.Totally 1 244 suspicious patients with endemic arsenism were discovered,and 3 473 light and more severe patients were discovered and the detected rate of light and more severe patients was 2.54％ (3 473/136 924).Most patient were not serious.Conclusions High arsenic areas and endemic arsenism areas are distributed in 15 counties of Shanxi Province.In the future primary task in prevention and control of endemic arsenism is comprehensive prevention and control measures.