Monitoring results of coal-burning-borne endemic fluorosis in Yunnan Province in 2020 / 中华地方病学杂志

Objective:To learn about the current situation of prevention and control of coal-burning-borne endemic fluorosis (coal burning fluorosis for short) in Yunnan Province, and comprehensively evaluate the implementation effect of prevention and control measures.Methods:From August to November 2020, according to the requirements of the Monitoring Program of Yunnan Province for Coal-burning-borne Endemic Fluorosis (2019 edition), monitoring was carried out in all natural villages in the disease areas of 13 counties (cities and districts, hereinafter referred to as counties) of the province, and 30 households were selected from each natural village to monitor the use of stoves and the formation of related healthy living behaviors. At the same time, children aged 8 - 12 years in the natural villages in the disease areas were examined for the prevalence of dental fluorosis. The evaluation for control and elimination of disease areas was carried out in accordance with the Evaluation Approach for Control and Elimination of Priority Endemic Diseases (2019 edition).Results:A total of 392 244 households were investigated, and the rates of qualified improved stoves, the correct utilization of qualified improved stoves and correct drying of corn and pepper were 99.42% (389 982/392 244), 99.70% (388 796/389 982) and 99.07% (388 579/392 244), respectively. A total of 227 057 children aged 8 - 12 years were examined, 9 413 children of dental fluorosis were detected, the detection rate of dental fluorosis was 4.15%, the dental fluorosis index was 0.10, and the prevalence intensity was negative. Taking the county as a unit, except Fuyuan and Zhenxiong, which reached the control standard of the disease area, the remaining 11 counties reached the elimination standard.Conclusion:The prevention and control measures on coal burning fluorosis are implemented well in Yunnan Province and healthy lifestyle has gradually taken shape, with the overall condition of the disease reduced.

Analysis of monitoring results of coal-burning-borne endemic fluorosis in Jiangxi Province from 2014 to 2018 / 中华地方病学杂志

Objective:To understand the status and tendency of coal-burning-borne endemic fluorosis after implementation of prevention and control measures in Jiangxi Province.Methods:According to the requirements of the national "Coal-burning-borne Endemic Fluorosis Monitoring Program", 3 fixed monitoring villages and 5 non-fixed monitoring villages in Luxi, Shangli were selected as monitoring sites every year from 2014 to 2018, respectively, 10 households were selected by simple random method in each village to survey the usage of stove and health behavior related to the consumption of pepper. At the same time, dental fluorosis and urinary fluoride were monitored in children aged 8 - 12 years in fixed monitoring villages.Results:There were significant differences in the utilization rate of improved stoves, the utilization rate of electric cookers and the qualified rate of improved stoves in fixed monitoring villages between each year (χ 2 = 111.70, 83.96, 36.64, P < 0.05), but there was no significant difference in the correct utilization rate of qualified improved stoves(χ 2 = 2.35, P > 0.05). There were significant differences in the utilization rate of improved stoves, the utilization rate of electric cookers, the qualified rate of improved stoves and the correct utilization rate of qualified improved stoves in non-fixed monitoring villages between each year (χ 2 = 132.32, 42.63, 50.03, 15.29, P < 0.05). There was no significant difference in pepper correct drying rates between fixed monitoring villages and non-fixed monitoring villages between each year (χ 2 = 4.068, 3.436, P > 0.05), the rate of pepper correct keeping and washing methods was 100% in monitored villages each year. From 2014 to 2018, the detection rate of dental fluorosis in children aged 8 - 12 years decreased from 17.04% (106/622) to 6.68% (90/1 347), and showed a downward trend year by year (χ 2trend = 72.60, P < 0.01). The annual geometric mean of urinary fluoride of children was 0.77, 0.74, 0.71, 0.74 and 0.72 mg/L, respectively. There was no significant difference among years ( H = 4.142, P > 0.05). Conclusion:Remarkable achievements have been made in the prevention and control of coal-burning-borne endemic fluorosis in Jiangxi Province.

An evaluation of stove and its usage in key coal-burning fluorosis areas in Guizhou / 中华地方病学杂志

Objective To investigate the usage of the stoves in the severe endemic areas of coal burning fluorosis, sum up experience timely, find problems and adjust strategy for making prevention and control measures. Methods In 23 counties of Guizhou Province in the severe endemic areas of coal burning fluorosis, a town was selected according to the east, west, south, north and center positions, three villages were selected from each town, and 20 families were selected from each village;household stoves and usage were investigated in 2013. And the data of 14 conties was compared with the survey results of 2007. Results A total of 6 916 families from 341 villages in 115 towns of the 23 counties were investigated. Average utilization rate of coal-fired furnace and electric cooker was relatively high, which was 91.34%(6 317/6 916) and 92.93%(6 427/6 916), respectively. Utilization rate of coal stove, firewood oven, gas stove and liquefied gas stove oven was 7.75% (536/6 916)-21.56%(1 491/6 916). The correct utilization rate of coal-fired furnace was 92.80%(5 862/6 317). The correct utilization rate of coal stove was 66.80%(839/1 256); 92.93%(6 427/6 916)of the families used electric cooker year around. Totally 89.82%(5 674/6 317) of the farmers used iron stove in winter. Compared with those of 2007, in 14 of the counties; the differences of coal-fired furnace, coal stove, firewood oven, electric cooker, gas stove, and liquefied gas stove utilization rate were statistically significant (χ2= 888.35, 6 210.71, 165.54, 9 194.29, 36.98, 729.76, all P<0.05). Conclusion After positive and effective comprehensive treatment for many years, great c hanges have taken place in energy structure, clean energy is widely used, the correct utilization rate of coal-fired stoves is increased, and indoor fluorine pollution caused by coal-burning is under control.

An evaluation of the effectiveness of prevention and control measures on coal-burning-borne endemic fluorosis in Guizhou Province / 中华地方病学杂志

Objective To evaluate the effects of health education and improved stoves on control of coalburning-borne endemic fluorosis in Guizhou Province.Methods In 2014,according to the detectable rate of dental fluorosis of children aged 8-12 before implementing control measures,11 counties were divided into three layers:low detection rate (detection rate was less than 60％),medium detection rate (detection rate from 60％ to 90％) and high detection rate (detection rate was greater than 90％).One county was selected from each layer and two towns were selected in each county.According to the Diagnosis of Dental Fluorosis (WS/T 208-2011),dental fluorosis of all children aged 8-12 was examined in all towns;At the same time,in the 2 villages in each town,20households and students of one class in grade 4 to 6 were selected to survey knowledge about prevention and control of coal-burning-borne endemic fluorosis;and to survey the situation of improved stoves,drying and elutriation of corn and chillies,and related life behavior.Results The detectable rate of dental fluorosis of children aged 8-12was 5.49％ (198/3 607),8.33％ (72/864),12.46％ (179/1 437),and it was significantly lower than before implementing control measures [41.88％ (931/2 223),61.91％ (4 863/7 855),91.25％(2 439/2 673),x2 =1 166.43,909.56,2 508.96,all P ＜ 0.01].Correct answer rates of students about knowledge on endemic fluorosis were 78.03％ (792/1 015),84.93％ (1 465/1 725) and 80.18％ (910/1 135),the correct answer rates of knowledge were significantly higher than those before implementing control measures [23.19％ (640/2 760),47.41％ (2 368/4 995) and 40.25％ (3 405/8 460),x2 =947.96,736.61,644.69,all P ＜ 0.01].Correct answer rates of family householders about knowledge on endemic fluorosis were 86.75％ 047/400),95.25％ (381/400) and 86.25％ (345/400),the correct answer rates of knowledge were higher than those before implementing control measures [17.78％ (80/450),37.20％ (279/750) and 25.27％ (139/550);x2 =402.97,359.49,344.55,all P ＜ 0.01].The percentages of households whose stoves were qualified and can be used correctly to the total households were 96.25％ (77/80),96.25％ (77/80) and 93.75％ (75/80),and before implementing control measures [4.92％ (348/7 078),21.51％ (7 461/34 693) and 6.73％ (475/7 062)],and the differences were statistically significant (x2 =1 181.55,262.63,842.82,all P ＜ 0.01).The percentages of households using clean energy in heating season to the total households increased from 0 (0/7 078),0 (0/34 693),0(0/7 062) to 98.75％ (79/80),98.75％ (79/80),96.25％ (77/80).The rates of the three counties whose inhabitants could bake the chillies correctly were 96.25％ (77/80),95.00％ (76/80) and 97.50％ (78/80),which were significantly higher than before implementing control measures [5.55％(5/90),26.00％ (39/150),52.73％ (58/110),x2=139.52,99.36,45.64,all P ＜ 0.01].Who cooked chillies after washing were 93.75％ (75/80),95.00％ (76/80),93.75％ (75/80),which were significantly higher than before implementing control measures [74.44％ (67/90),87.33％ (131/150),34.55％ (38/110),x2 =11.47,3.91,67.36,all P ＜ 0.05].Conclusion The effects of health education and improving stoves on coal-burning-borne endemic fluorosis in the three counties of Guizhou Province are remarkable.

An evaluation of the prevention and control measures on coal-burning-borne endemic fluorosis in Shaanxi Province in 2014 / 中华地方病学杂志

Objective To investigate the usage of defluoridation stove and the formation of related behavior in the disease affected areas and the current situation of coal-burning-borne endemic fluorosis,to evaluate the control effect,so as to provide a theoretical basis for superior department to adjust the control strategy in time.Methods According to The Implementation Plan for Prevention and Treatment of Coal-burning-borne Endemic Fluorosis in Shaanxi Province,Ziyang and Langao in Ankang City were chosen for epidemiological survey.Using stratified sampling method,according to the degree of disease situation,each county was divided into 3 layers and then 5％ from each layer was extracted to carry out an investigation,respectively.The number of investigated village was at least 1,up to 30.The number in a non-endemic area was 1-3.Questionnaire survey of all residents was carried out to ask of the changes of cooking and heating fuel;the correct usage of the improved stove;the changes of life behavior related to the corn and pepper for human consumption and the development of prevention and treatment of post management.In endemic areas and in non-endemic areas,according to the Determination of Fluoride in Foods (GB/T 5009.18-2003),fluoride levels of corn (or rice) and chili which collected from 10 families were determined.Meanwhile,the criteria for Diagnosis of Dental Fluorosis (WS/T 208-2011) was used to diagnose dental fluorosis and the criteria of Urine-determination of Fluoride-ion Specific Electrode Method (WS/T 89-1996) was used to evaluate urine fluoride;dental fluorosis of every child aged 8-12 was examined and 10 copies of urine samples were randomly collected in each age group.Housewives and students over the age of 16 in endemic areas were quizzed of the knowledge of health and diagnosed serious skeletal fluorosis according to The Diagnostic Criteria of Endemic Fluorosis (WS 192-2008).Results The rates of correct usage of improved furnace and oven were 91.43％ (3 019/3 302) and 95.72％ (3 578/3 738).The autonomous maintenance rate of stoves was 0.61％ (49/7 998).In endemic areas,the correct drying rate and the correct storage rate of corn and pepper were all 100.0％ (300/300);the washing rate of corn and pepper before eating was 98.3％ (7 863/7 998).The fluoride median contents of corn and pepper was 0.800 and 2.863 mg/kg,respectively.In non-endemic areas,The fluoride median contents of corn and pepper was 0.443 and 4.065 mg/kg,respectively.The awareness rates of health knowledge were 81.27％ in housewives and 90.32％ in students.Dental fluorosis detection rate of 8-12 years old children was 12.52％ (87/695);the fluoride content was between 0.04-7.00 mg/L and the geometric mean value of fluoride content was 0.61 mg/L in endemic areas.There was no new case of serious skeletal fluorosis.Conclusions The prevention effect is obvious.Disease surveillance,health education and management of defluoridation stoves are keys to prevent coal-burning-borne endemic fluorosis.

Percepciones de mujeres rurales de una comunidad peruana acerca de su desempeño con cocinas mejoradas / Perceptions of rural females on their performance with upgraded stoves in a Peruvian community

Introducción: en la mayoría de los hogares rurales en Perú se usan cocinas tradicionales que emplean combustible productores de humo, contaminante del ambiente con afectaciones en la salud. El control de la contaminación del aire en viviendas rurales está siendo atendido con la implementación de proyectos de cocinas mejoradas. Objetivos: analizar las percepciones de las mujeres acerca del uso de la cocina mejorada y sus beneficios en salud. Métodos: investigación cualitativa realizada en cinco comunidades del municipio de San Jerónimo, Apurímac, Perú, 2009. Se seleccionaron 20 madres activas en eventos a favor de las cocinas mejoradas. Se utilizó una guía de observación, entrevistas en profundidad y grupos focales. Resultados: las condiciones físicas de la vivienda y las prácticas en el manejo de las cocinas mejoradas perpetuaron la contaminación del aire interior. Las motivaciones de las mujeres para usar estas cocinas se relacionaron con el ahorro de tiempo y de leña. Reconocieron la presencia de menos humo y mejoría en malestares oculares, tos y gripe, pero no los incluyeron entre las razones para continuar con el uso de estas cocinas. Conclusiones: la percepción de las mujeres es favorable en aspectos que concierne a la esfera económica. Perciben de forma limitada la vinculación entre el poco humo y la mejoría en problemas de salud con los beneficios que les brinda las cocinas mejoradas. La implementación de proyectos sobre estas cocinas debe contemplar la inclusión de temas sobre capacitación y buenas prácticas en salud para que sea un eficiente y participativo proyecto de salud(AU)

Introduction: most of the rural households in Peru have traditional stoves using smoke-producing fuels that cause air pollution with the resulting health effects. The indoor air pollution in rural households is being managed with the implementation of the upgraded stove program. Objectives: to analyze women's perceptions about the use of upgraded stoves and their health benefits. Methods: qualitative research study conducted in five communities of San Jeronimo municipality in Apurimac, Peru in 2009. Twenty active mothers in favor of upgraded stoves were selected. An observational guide, in-depth interviews and focal groups were all used. Results: the physical conditions of dwellings and the practice in handling the upgraded stoves perpetuated the indoor air pollution. The incentives to use this type of stoves were linked to time and firewood saving. They admitted that there was less smoke around and their eye problems, cough and cold had reduced, but they did not include these benefits in the reasons offered to continue using these stoves. Conclusions: the female perceptions are favorable as to the economic advantages, but they perceive in a restricted way the relationship between reduced volumes of smoke and health improvement due to the benefits of the upgraded stoves. Therefore, the implementation of stove upgrading programs should take into account topics on training and good practice in health so that they can turn into efficient participatory health projects(AU)

Evaluation of the prevention and control measures on coal-burning endemic fluorosis in Guizhou 2013 / 中华地方病学杂志

Objective Through investigation of children fluorosis illness,family households improved stoves and related life styles,to provide a scientific basis for sustainable control of endemic fluorosis.Methods In 2013,in Huishui County and Baiyun District,3 towns were selected in each county(district),and 3 villages were selected in each town.All 8-12 years old children in the school of these villages were checked dental fluorosis,which was diagnosed according to Dental Fluorosis Diagnosis (WS/T 208-2011); at the same time,10 families were selected to survey the situation of improved stoves and related life styles.Results Dental fluorosis detection rate of 8-12 years old children in Huishui and Baiyun were 2.75％ (23/836) and 2.26％ (11/487),which were all lower than 30％.Qualified rate of improved stoves and qualified stoves correct utilization rate were all 100.0％ (90/90).For human consumption,the correct rate of corn drying was 100.0％ (90/90) ; the correct rates of chili drying were 98.9％ (89/90) and 100.0％ (90/90).Conclusions The prevention effect is obvious,which has reached the control standards.We should continue to improve the long-term mechanism of comprehensive control measures,and to achieve substantial elimination of coal-burning endemic fluorosis.

Effects of health education and stove improvement in preventing coal-burning-borne endemic fluorosis in Pingba County of Guizhou Province / 中国地方病学杂志

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.

Effect of Cooking Stoves Improved in Controlling Fluorosis Caused by Burning Coal / 环境与健康杂志

Objective To know the implementary circs and short-dated effects of cooking stoves improvement in reducing fluoride level in the endemic fluorosis areas and to offer the background information and scientific basis for continuing the development of cooking stoves improvement in reducing fluoride level. Methods To do the surveys in the households, 769 families were selected and investigated from 38 000 peasant families in the program, by cluster sampling with 2% sample rate and 70 families were randomly selected from them, the fluoride levels in the air, foodstuff, non-staple food was determined. Results 98.7% of the families in the cooking stoves improvement areas could rightly use the improved stove. The fluoride levels in corn and hot peppers were greatly improved in county A compared with that in 2000, but the fluoride levels in the air, foodstuff, non-staple food still exceeded the standard limit, not all reached the national standard. Conclusion The headstream interventions measure in coal-burning type endemic fluorosis areas is effective. Controlling the fluoride pollution of capsicum and tea is necessary, the production methods must be improved. The health education and management should be strengthened for reducing fluoride level in the investigated areas.