Analysis of surveillance results of drinking water type of endemic fluorosis in Qinghai province in 2009 / 中国地方病学杂志

ObjectiveTo investigate the development trend of drinking water type of endemic fluorosis in Qinghai province, and to provide the basis for the prevention and treatment of the disease. MethodsIn 2009, six monitoring counties were chosen by using simple random sampling methods, all diseased villages of the six monitoring counties were classified into light, moderate and severe disease types according to water fluorine content on the historical data, and 1 village was respectively chosen from each type. In monitoring villages with improved water, 3 tap water and one source water samples were collected, respectively. Five water samples were collected randomly in water unimproved monitoring villages according to water well locations of east, west, south, north and center. The fluorine content in water and urine was determined according to the Standard Testing Methods for Drinking Water (GB/T 5750-2006). Children aged 8 to 12 were examined for dental fluorosis by Dean method.Clinical osteofluorosis of all the resident over the age of 16 was examined, 2 village of these counties were randomly selected, and clinically diagnosed patients with skeletal fluorosis were examined again by X-ray using Diagnostic Criteria of Endemic Skeletal Fluorosis (WS 192-2008). Urine sample of 30 children aged 8 to 12 and of 20 adults over the age of 16 were randomly collected and urinary fluoride was determined by F-ion selective electrode method (WS/T 89-2006). ResultsImproving water projects had been implemented in 14 monitoring villages of the 18 villages in 6 counties, the rate of improved-water was 77.78％(14/18). Among the 14 projects, 5 improved-water projects ran normally, and 9 projects ran with intermittently water supply. Seventy-five water samples were tested, themean of water fluoride was 0.48 mg/L. The prevalence of dental fluorosis was 31.95％ (285/892), that of clinical skeletal fluorosis was 36.55％(1570/4295) and the X-ray detection rate of skeletal fluorosis was 25.64％ (20/78).Five hundred and seventy-one urine samples of children were determined, and geometric mean of urinary fluorine was 1.04 mg/L; 370 adult urine samples were determined, and geometric mean of urinary fluorine was 1.52 mg/L Conclusion Epidemic of drinking water type of endemic fluorosis is still serious in Qinghai province, and drinking water defluoride measures should be further strengthened and improved.

Endemic fluorosis in Huangyuan county Qinghai province in 2009: an analysis of surveillance results / 中国地方病学杂志

Objective To investigate the prevalence change of drinking water type of endemic fluorosis and the effect of control measures implemented in Huangyuan county of Qinghai province. Methods In 2009, all the endemic fluorosis villages in Huangyuan county were divided into two degrees, light and medium, according to the water fluorosis content before implementing the improving water project, 1 to 2 villages were selected from each degree village, respectively,as monitoring sites, and a total of 3 villages were selected. Source water and tap water samples were collected from each village and water fluoride concentration was determined. Dental fluorosis of all children aged 8 to 12 of monitoring villages was examined, and urine samples were collected by age group of children for determination of urinary fluoride. Clinical skeletal fluorosis of adults over 16 years of age was examined, and 20 copies of adults urine samples were collected to determine urinary fluoride. One village was selected in the 3 villages monitored to conduct X-rays examination of skeletal fluorosis. Water fluoride was tested in accordance with the "Non-metallic Targets Test Methods for Drinking Water" (GB/T 5750.6-2006); urinary fluoride was tested by fluoride ion-selective electrode method (WS/T 89-1996); dental fluorosis was diagnosed using Dean method;adult skeletal fluorosis was diagnosed by "Clinical Diagnostic Criteria for Endemic Skeletal Fluorosis"(WS 192-2008). Results Twelve water samples were assayed, water fluoride was (0.35 ± 0.43) mg/L. The detectable rate of dental fluorosis of 122 children aged 8-12 was 34.43%(42/122) and the geometric mean urinary fluoride was 0.89 mg/L of the 96 children. Of the 834 adults aged 16 and over, clinical detection of skeletal fluorosis was 47.72% (398/836) and geometric mean urinary fluoride was 1.10 mg/L of the 65 cases of adult urine samples assayed, detection rate of X-rays was 31.4% (11/35) in Gangou village of the 35 adults examined.Conclusions In Huangyuan county, water fluoride of the 3 surveyed villages are normal but the endemic fluorosis is still serious. It should strengthen monitoring and analyze the causes and improve prevention measures.

Analysis on the prevention and treatment of drinking water fluorosis Guide county, in Qinghai province / 中国地方病学杂志

Objective To observe the state of endemic flurosis, construction and running status of water improvement projects in order to provide a scientific basis for prevention and treatment fluorosis. Methods Water samples of the diseased and nondiseased villeges were collected from east, west, south, north and centre of each villege in 2005, and fluoride concentration was determined for each surveyed village with unimproved-water. At the same time, all the tap water and source water samples were collected to determine fluoride concentration in each water-improved village surveyed. In 2008, all the endemic fluorosis villages in Guied county were divided into slight, medium and heavy types according to the water fluoride content before water improved, and 1,1,3 survey villages were chosen from each type. In all of the village children aged 8 to 12 years were tested for dental fluorosis by Dean method. Six copies of the urinary fluoride were sampled in different age groups. The fluorine content in water and urine was determined by F-ion selective electrode. The situation of clinical skeletal fluorosis of adults over 16 years of age was investigated, 20 adults (evenly divided between men and women) in the villages of medium and heavy types were examined by X-ray for skeletal fluorosis. Results In 3 village fluoride content of drinking water exceeded the national drinking water standards ( <1.0 mg/L) of 85 surveyed villages with improved-water. Among the 16 projects, 8 were intermittently running and 3 were retired, leaving only 31.25% of the projects active. Theprevalence of enamel fluorosis was 41.13%( 116/282), that of skeletal flurosis was 47.95%(969/2021) and that of X-ray checked was 20.73% (17/82). The median of urine fluoride was 1.06 mg/L and the scope was 0.20 - 9.44 mg/L.Conclusions Most of the improved-water projects do not normally supply water in the disease ward of Guide county. Therefore, there is an increasing trend of the disease, so further control measures are needed.

Investigation on prevalence and dietary structure of drinking-tea fluorosis in Qinghai province in 2007 / 中国地方病学杂志

Objective To investigate epidemical situation of drinking-tea fluomsis in Qinghai province, in order to understand diet structure to provide the scientific basis for the prevention and control and the scientific research. Methods In 2007, according to "Scheme for Survey on Epidemical Drinking-tea Fluorosis", we carried out an customized investigation in 28 counties, 3 townships sampled in each county, 2 villages in each township, 50 adults and 50 school-age children in each village; at same time, 1 monk temple was sampled in each county, 50 clergy adults and 50 children in each temple. Then we investigated the resident income, the diet structure, the brick tea consumption and so on, and applied Dean method to diagnose dental fluorosis. The patient number estimated based on the survey result. Results ①Yeady per capita income of people was mostly 500 - < 1000yuan, next 1000 - < 3000 yuan; economic income in pasturing area was higher than that of agriculture, half area and half agriculture and half pastoral region and township. ②Staple food was bread flour primarily in the animal husbandry agricultural half pastoral area,next were the roasted barley and the rice;the bread flour was the principle food in the agricultural region and the cities,next were the rice and the roasted barley;among non-staple food,meat came fimt and milk foHowed,egg the last.③The frequently edible vegetables Was potato.cabbage and greenpepper,eaten by a majority of people[62.82%(6497/10 343)];as for fruits,apple,pear and orange was primarily consumed,75.95%(7856/10 343)of people ate less than 10 times every month.④Sixty-one thousand nine hundred and ninety-nine residents were registered,153 335 kg ofbrick tea was consumed in villages and towns,2.47 kg per person;in 1001 monks investigated,4120 kg of brick tea was consumed every year,4.12 kg per person.⑤Detection rate of adult dental fluorosis in the villages and towns was 24.11%(2494/10 343),that of the children was 24.38% (3012/12 355);detection rate of dental fluorosis in monks was 26.13%(203/777),that of the children was 39.73% (89/224).⑥Detection rate of adult skeletal fluorosis in villages and towns was 15.60%(17/109);that of monks was 4.88%(2/41).⑦The 95%confidence limit estimated a total number of dental fluorosis patients were 1 084 306- 1 134 170 persons.the median Was 1 109 238 persons;the 95% confidence limit estimated a total number of skeletal fluorosis patients were 309 177-758 199 persons,the median was 533 688 persons.Conclusions Qinghai province has a great quantity of brick tea consumption,having lots of people with drinking-tea fluorosis which is in severe degree.The resident food structure was monotonous and mostly transpolted from other region.

Outcome analysis on drinking-water type endemic fluorosis in Qinghai in 2008 / 中国地方病学杂志

Objective To observe the state of endemic flurosis in Qinghai province in 2008 and to provide scientific basis for endemic flurosis control and prevention. Methods All the endemic fluorosis villages in Qinghai province was divided into slight,medium and heavy degree according to the water fluoride content before improving water,and 2,4,4 villages were collected from each degree,respectively. Water samples were collected from each direction of east,west,south,north and centre,and fluoride concentration were determined from each surveyed villages with unimproved-water. At the same time,3 copies of the peripheral water samples and a sample of source water were collected to determine fluoride concentration. In all the village children aged 8 to 12 were tested for dental fluorosis by Dean method. Six copies of the urinary fluoride were randomly sampled in different age groups. The fluorine content in urine was determined with F-ion selective electrode. The situation of clinical skeletal fluorosis of adults over 16 years of age was examined,and 20 adults in the villages of medium and heavy levels were filmed for skeletal fluorosis. Results The detectable rate of dental fluorosis of children aged 8-12 years old was 43.59% (245/562),that of skeletal flurosis of adults aged above 16 years was 50.32% (1582/3144) and detectable rate of X-ray was 29.45% (48/163). Fluoride content in urine was 1.52 mg/L. Conclusions Endemic fluorosis is still very serious in Qiaghai province in a rising trend,so the control measures need to be strengthen.

Report on the surveillance results of endemic fluorosis in Qinghai Province in 2007 / 中国地方病学杂志

Objective To investigate the fulfillment of improved water measures for endemic fluomsis and to find out the trend of prevalence in Qinghai Province in order to provide scientific basis and technical support for the government to formulate control strategies for endemic fluorosis.Methods Usage and management of reforming water facilities in Huzhu County were generally surveyed.Yanya Village,Caijiabu Town,Huzhu County was chosen as the surveillance spot.The household drinking water was surveyed.The dental fluorosis and urine fluoride content of children aged 8-12 years and adult above 16 years were examined.Skeletal fluorosis of adult was checked.The fluomsis content in drinking water and urine was determined with F-ion selective electrode method.The dental fluowsis was examined with Dean index.Skeletal fluorosis was diagnosed according to eountry standard(GB 16396-1996.WS 192-1999).Results The rate of water-improving was 60%(36/60)in Huzhu County.The mean of fluoride content in drinking water Was 1.25 mg/L The prevalence rate of dental fluorosis of children aged 8-12 years was 90.20%(46/51);that of adult was 88.89%(48/54).The dental fluorosis index of children was 1.77,that of adult was 2.95.The prevalence rate of skeletal fluorosis was 98.15% indicated by clinical data,18.87% by X-ray.The ufine fluorosis content of children was 2.27 mg/L,that of adult was 2.00 mg/L.Conclusion The disease condition of endemic fluorosis in Qinshai is serious,defluofidation is slow in effect.