炉灶使用及燃煤方式在贵州省地方性氟中毒病区形成中的作用

目的 探讨炉灶使用及其燃煤方式对贵州省燃煤型地方性氟中毒(简称地氟病)流行的影响.方法 采用分层抽样方法,对3个历史重病区村、2个病区对照村进行炉灶使用、燃煤方式、病情等状况的现况和回顾性流行病学调查.结果 20世纪90年代以前,历史重病区村所有住户使用没有烟囱的烧煤台灶或简易炉灶,采取村民组集中方式烘炕干燥玉米,玉米和室内空气氟污染严重.90年代后各户自行用敞煤火烘炕干燥玉米,但逐渐使用台灶和铁炉,燃煤氟释放量显著减少,粮食和室内空气污染减轻,病情得以控制.但是.在重病区联合与吉丰村,住户基本上还是使用简易敞煤火炉灶,冬季取暖铁炉烟囱出屋率较低,分别为51.3%(41/80)、41.7%(35/84),室内空气和粮食氟污染较重,与病情结果一致.2006年荷花村8岁以上人群氟斑牙总检出率96.08%(392/408)]较1979年90.51%(248/274)]明显增高(χ2=7.85,P＜0.01).结论 炉灶燃煤方式对贵州省燃煤型地氟病病区形成有显著影响,炉灶类型与使用不当是贵州省地氟病重病区形成的主要因素之一.

Influence of stove an d coal-burning mode on formation of severe endemic fluorosis regions in Guizhou Province

Objective To explore the influence of stoves and mode of coal-burning on the prevalence of endemic fluorosis in Guizhou Province.Methods Three previous severe endemic villages and two mild villages(as control)were investigated by ways of random sampling in the present and retrospect epidemiological study on stove usage,coal burning mode and the severity of disease.Results Before the 1990's Of 20th century all the households in the previous severe endemic villages used the open stove without ventilated pipe(chimney)and dehydrated the corn over the coal-fire of the open stoves in house,which resulted in severe pollution of the corn and indoor air by fluoride.After the 1990's,each household,although still dried the corn with the coal fire,used the table stoves and iron stoves increasingly year by year,which resulted in the decrease of the emitted fluoride from the coal fire significantly,reduced the fluoride pollution of the indoor air and the main food,thus the incidence of endemic fluorosis consequently decreased. On the other hand, most of the households in the previous severe endemic villages such as Lianhe and Yuanzi still used the open, unventilated stove without chimney, very few installed chimney leading to outside of the room,the rates being 51.3%(41/80)and 41.7%(35/84),respectively.It was concordant to the high incidence of endemic fluorosis.Compared with 1979,the detective rates of dental fluorosis in the crowd aged above 8 years old were increased significantly in Hehua Village in 2006,90.51%(248/274)and 96.08%(392/408),respectively(χ2=7.85,P＜0.01).Conclusions The usage of stoves and mode of coal-burning significantly influence the incidence of the endemic fluorosis caused by domestic coal-burningin Guizhou Province,and inappropriated use of stove and the mode of coal burning are the key factors in cause the prevalence of the severe fluorosis in endemic regions in Guizhou.