目的了解贵州省燃煤污染型地方性氟中毒重点病区病情变化情况,为进一步开展防治需求调查提供科学依据。方法以2000年全省流行病学调查结果为依据,采用分层随机抽样方法,分别在氟斑牙流行强度为较显著(A)和中等(B)的病区抽取调查村,对村小学8～12岁学生进行氟斑牙检查,并与2000年调查结果进行比较,同时抽样采集调查村室内存放3月以上的大米、玉米、辣椒,以及主要生活饮用水、煤、拌煤粘土进行氟含量测定并估算人群总氟摄入量。结果病区县调查点生活饮用水氟浓度远低于国家标准;煤及拌煤粘土氟含量较高,粘土氟平均含量是煤的3.5倍;室内干燥储存的玉米、辣椒氟含量超标,但与2000年调查结果比较,污染程度均有所降低;除长顺、龙里外,其余病区县人群摄氟量均超标,辣椒已成为病区的主要携氟介质;在A类病区,与2000年调查结果比较,8～12岁学生氟斑牙检出率无显著变化或这种变化并无实际意义,氟斑牙病例主要表现为轻度和中度,氟斑牙流行强度除黔西降为中等外,其余县仍为较显著;在B类病区,与2000年调查结果比较,8～12岁学生氟斑牙检出率平均下降29.71个百分点,其中龙里降幅达64.27个百分点,氟斑牙病例主要表现为极轻度和轻度,其中极轻度病例占50%以上,除六枝外,其余县氟斑牙流行强度均下降,龙里已降至阴性。结论通过多年的综合治理,中等病区病情大幅下降,防治效果十分显著,但历史重病区病情仍然较重,防治任务十分艰巨;在改良炉灶的同时,采取避免辣椒遭受氟污染的技术措施是现阶段我省预防控制燃煤型地氟病流行的关键所在。 Objective To understand the situation of the endemic fluorosis in key coal-consuming areas in Guizhou Province and to provide a scientific basis for further investigation on the demand for prevention and control. Methods Based on the epidemiological survey of the province in 2000, stratified random sampling method was used to survey villages in endemic areas where the intensity of dental fluorosis was significant (A) and moderate (B), respectively. At the age of 12 years, students were examined for dental fluorosis and compared with the survey results in 2000. At the same time, samples of rice, corn, peppers, and main drinking water, coal, Measure and estimate total population fluoride intake. Results The fluoride concentration in drinking water was significantly lower than the national standard at the investigation points in ward and county. The content of fluoride in coal and mixed clay was higher than that in coal, and the average content of fluorine in clay was 3.5 times that of coal. The content of fluorine in corn and chili In addition to Changshun and Longli, fluoride levels in other districts, counties and prefectures exceeded the standard. Chili has become the main fluorosis medium in the ward. In type A wards, 2000 survey results, 8 to 12-year-old students no significant change in the detection rate of dental fluorosis or change of no significance, dental fluorosis cases were mainly mild and moderate, dental fluorosis intensity except Qianxi In Class B wards, compared with the survey results in 2000, the average detection rate of dental fluorosis among students aged 8 to 12 years dropped by an average of 29.71 percentage points, of which Longli fell by 64.27 percentage points The cases of dental fluorosis mainly showed mild and mild cases, of which extremely mild cases accounted for over 50%. Except for six branches, the prevalence of dental fluorosis in other counties decreased, and Longli had dropped to negative. Conclusions After many years of comprehensive treatment, the condition of the moderate ward has dropped significantly and the prevention and treatment effect has been very remarkable. However, the condition of the seriously wounded area is still heavy and the prevention and control tasks are arduous. In the process of improving the stove, the technical measures to prevent the pepper from being contaminated by fluorine are Stage in our province prevention and control of coal-based fluorosis endemic key.