Analysis of surveillance results of drinking-water-borne endemic fluorosis in Jiangsu Province in 2009 / 中国地方病学杂志

ABSTRACT

Objective To investigate the development trend of drinking-water-borne endemic fluorosis in Jiangsu Province,and to provide the basis for further prevention and treatment of the disease.Methods In 2009,eight major counties were chosen,and in each county all diseased villages were classified into light,moderate and severe disease types according to water fluorine content based on historical data,and one village was chosen from each type.In monitoring villages with improved water,one source water and three tap water samples were collected,respectively.Five water samples were collected in water unimproved monitoring villages according to water well locations of the east,the west,the south,the north and the center.The fluorine content in water 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.Residents over the age of 16 were examined for clinical osteofluorosis,and two monitoring counties were chosen,then one village was respectively chosen in each county,and clinically diagnosed patients with skeletal fluorosis were examined again by X-ray.Both clinical and X-ray diagnosis were on the basis of Diagnostic Criteria of Endemic Skeletal Fluorosis (WS 192-2008).Urine samples 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 89-1996).Results Of all the 24 villages of 8 counties,20 villages were water improved,and water-improvedprojects ran normally in 18 villages,while scrapped in the rest 2 villages.One hundred and two samples were tested,and the mean of water fluoride in water-improved villages was 1.10 mg/L,while in water unimproved villages and villages with water improved projects scrapped was 1.90 mg/L.The prevalence of dental fluorosis was 42.51％(854/2009).The prevalence of clinical skeletal fluorosis was 23.23％ (2024/8713) and the X-ray detection rate was 32.00％ (24/75).Six hundred and sixty-four urine samples of children were determined,and geometric mean of urinary fluorine was 1.59 mg/L,while 370 adult urine samples were determined,and geometric mean of urinary fluorine was 2.20 mg/L.Conclusions Endemic fluorosis in Jiangsu Province has not been fully controlled and there are signs of recovery.We must pay attention to water improvement measures to reduce fluoride and the management and maintenance of water improvement projects,and further strengthen the prevention and control of endemic fluorosis.