向全永¹ 周明浩¹ 武鳴¹ 陶然¹ 陳連生¹ 張明訪(fǎng)² 梁友信³

 

（1.江蘇省疾病預防控制中心，南京，210009；2.江蘇省泗洪縣疾病預防控制中心，宿遷，223800；

3.復旦大學(xué)公共衛生學(xué)院，上海，200032）

 

 

 

 

 

摘要:目的探討總攝氟量和氟骨癥患病率間的確切劑量效應關(guān)系，為地方性氟中毒防治提供科學(xué)依據。方法根據家庭手壓井飲水氟含量的不同，從地方性氟中毒重病區村瓦廟村抽取調查對象132名成人（平均年齡52.36歲；家庭手壓井飲水含氟量為2.18±0.86mg/L,范圍0.85－4.50mg/L），非病區村新淮村調查對象為35名（平均年齡48.11歲；家庭手壓井飲水含氟量為0.37±0.09mg/L,范圍0.21－0.55mg/L）。分別調查每位對象從不同途徑的日平均總攝氟量和氟骨癥患病情況。結果瓦廟村調查對象的氟骨癥患病率為31.06%，新淮村未發(fā)現氟骨癥患者。當把兩村的調查對象作為一個(gè)整體，并根據每個(gè)調查對象的總攝氟量不同分為5個(gè)不同的劑量組時(shí)，可見(jiàn)隨著(zhù)總攝氟量的升高，氟骨癥的患病率明顯增加，并有顯著(zhù)的劑量效應關(guān)系（Quadriatic fit模型擬合曲線(xiàn)的回歸方程為:y=2.624-6.855x+3.424x2）。根據這一劑量效應關(guān)系計算的總攝氟量的基準劑量的95%可信限的下限值為2.50mg/(人*日)，由此可得總攝氟量的參考計量為2.50mg/(人*日)。瓦廟村41氟骨癥患者和91非氟骨癥調查對象的總攝氟量也有顯著(zhù)的差異。結論在飲水型地方性氟中毒病區，總攝氟量和氟骨癥患病率間有顯著(zhù)的正相關(guān)劑量效應關(guān)系。本研究所得的總攝氟量的參考劑量低于《中華人民共和國國家衛生標準—人群總攝氟量衛生標準》(WS/T 87-1996)的要求。

關(guān)健詞:總攝氟量；氟骨癥；劑量效應關(guān)系

 

 

 

 

 

Study on the Relationship of Daily Total Intake of Fluoride and the

Prevalence of Skeletal Fluorosis

Xiang QuanyongZhou MinghaoWu MingTao RanChen Liansheng

 

Zhang MingfangLiang Youxin

 

（Jiangsu Center for Disease Control and Prevention, Nanjing, 210009, China）

 

 

Abstract：ObjectiveDaily total intake of fluoride in relation to the prevalence of skeletal fluorosis was investigated in two villages in Jiangsu Province to provide the scientific data for the control and prevention of endemic fluorosis. MethodsIn the highfluoride village of Wamiao, 132 adults (average age 52.36 years; water fluoride 2.18±0.86mg/L, range 0.85－4.50mg/L), and in the lowfluoride village of Xinhuai, 35 adults (average age 48.11 years; water fluoride 0.37±0.09mg/L, range 0.21－0.55mg/L) were surveyed in this study according to the fluoride concentration in their household shallow well. The average daily total intake of fluoride from different source and the skeletal fluorosis were investigated for each subject.  ResultsThe prevalence of skeletal fluorosis in Wamiao village was 31.06%, in Xinhuai village there were not skeletal cases. When the subjects from two villages were divided into five subgroups according to the daily total intake of fluoride, higher daily total intake of fluoride was strongly associated with a higher prevalence of skeletal fluorosis in the form of a significant positive doseresponse relationship (regression equation: y=2.624-6.855x+3.424x2). The Benchmark Dose Lower Bound (BMDL) of daily total 的防治研究（Email: quanyongxiang@yahoo.com.cn）intake of fluoride was 2.50 mg F/person/day calculated according to this doseresponse relationship, the Reference Dose (RfD) was 2.50mg F/person/day. In Wamiao village a significant difference was also found between daily total intake of fluoride in 41 subjects with Xray detectable skeletal fluorosis and in 91 subjects without Xray detectable skeletal fluorosis. ConclusionsThese findings indicate that the daily total intake of fluoride have a significant positive doseresponse relationship with the prevalence of skeletal fluorosis in an endemic fluorosis area associated with highfluoride drinking water; and the RfD in this study was lower than that in the national standard of "Hygienic standard for daily total intake fluoride” (WS/T 87-1996) of China.

Keywords:Daily total intake of fluoride; Skeletal fluorosis; Doseresponse relationship.