Investigation And Analysis On Control Status Of Endemic Fluorosis Area In Jilin Province

Objective:To understandthe situation of water-improving and defluorination project in Jilin endemic fluorosis areas and grasp the present control situation as well as timely problem detection existing in implementation process;to provide a scientific basis for prevention and control strategies.Methods:The identified endemic fluorosis areas in Jilin province were stratified by using stratified cluster sampling in 2015,one county(district)were randomly selected from each city(state)in the areas(Taonan,Qianan,Lishu,Nongan,Antu,Huinan),a total of 977 villages were selected as survey spots where endemic fluorosis control status investigationwas conducted includingwater-improving and defluorination project,children dental fluorosis detection aging from 8 to 12.Water fluoride determination by ion selective electrode method(GB/T 5750.5 2006);children dental fluorosis detection aging from 8 to 12 using Dental Fluorosis Diagnosis(WS/T208-2011),Fluorosis index was used to determine the prevalence of fluorosis;fluorosis area control determination on the basis of endemic fluorosis area control standard(GB 17017-2010);data collection and sorting by Microsoft EXCEL 2007;data analysis using SPSS17.0 software and ratio comparison by Chi-squared test.Results:1.Basic situation of survey spotsA total of 997 natural villages in the 6 counties(cities)with the population of 527550.There were 153 natural villages without children aged 8 to 12 years old,13225 children from 8 to 12 years old were surveyed inthe rest 844 villages.2.Water-improving and defluorination project implementation in survey spotsA total of 933 villages out of 997 had been implemented the project with water-improving rate of 93.58%;64 villages did not implement the project,accounting for 6.42%.693projects under normal service conditions with normal utilization rate of 74.28%;240projects could not normallybe used,accounting for 25.72%.584 villages out of 693 had qualified water fluorine content(?1.2mg/L),accounting for 84.27%,there were 109 villages exceeded standard(>1.2mg/L),accounting for 15.73%.3.Water-improving and defluorination project implementation in the villages where children dental fluorosis detection aging from 8 to 12 was conductedA total of 780 villages out of 844 had been implemented the project with water-improving rate of 92.42%;there are 64 did not implement the project,accounting for 7.58%.568 project under normal service conditions with normal utilization rate of 72.82%;212 projectscould not normally be used,accounting for 27.18%.485 villages out of 568 had qualified water fluorine content,accounting for 85.39%,there were 83 villages exceeded standard,accounting for 14.61%.4.Children dental fluorosis detection aging from 8 to 12A total of 3193 cases out of 13225 had been detected with detection rate of 24.14%,dental fluorosis index was 0.42.In the water-improving villages with detection rate of 23.55%,dental fluorosis index was 0.41;in the no water-improving villages with detection rate of 32.13%,dental fluorosis index was 0.46;the comparison of children dental fluorosis detection between water-improving villages and non-water-improving villages had significant difference(?2=32.244,P<0.001).In the villages where project under normal service conditionswith detection rate of 17.40%,dental fluorosis index was 0.28;in the villages where project could not under normal service conditions with detection rate of 42.83%,dental fluorosis index was 0.84;The comparison of children dental fluorosis detection between villages under normal use seditions and the abnormal(?2= 8.106,P<0.001).In the villages where project under normal service conditions and water fluorine contents were qualified with detection rate of 15.67%,dental fluorosis index was 0.22;in the villages wherewater fluorine contentsexceeded standard with detection rate of 34.54%,dental fluorosis index was 0.80;The comparison of children dental fluorosis detection between villages with qualifiedwater fluorine contents and standard exceeding villages(?2=1.922,P<0.001).Children dental fluorosis detection rate of each age groupwas compared,there was no significant difference among non-water-improving villages(?2=3.981,P>0.05);there was significant difference among villages where project could not be normally used(?2= 28.336,P<0.001);there was significant difference among villages where project could be normally used(?2= 29.121,P<0.001).5.Control status of endemic fluorosis area where children dental fluorosis detection aging from 8 to 12 was conductedA total of 388 villages out of 844 had qualified drinking water fluorine contentswith dental fluorosis detection rate of 30% or less,the 45.97% could meet the control standard;there were 456 villages did not reach thecontrol standard,the 54.03% could meet the control standard.there were 359 villages where drinking water fluorine content was unqualified and not meet control standard;there were 97 villages where dental fluorosis detection ratewas more than 30%,did not reach thecontrol standard.Conclusion:Survey spots has not yet been fully implemented water improvement;has been implementedwater improvement,but some project cannot be normal used;in the area where project can be normally used,there is a phenomenon that water fluorine content exceeded the standard.Children dental fluorosis detection rate aging from 8 to 12 in survey spots has reduced to non-endemic area(?30%),dental fluorosis was on the verge of epidemic process,dental fluorosis detection rate is over 30% in Taonan,the epidemic process is in mild level,other counties has reduced to non-endemic area.Children dental fluorosis detection rate in non-water-improving areas is over 30%,dental fluorosis was on the verge of epidemic process.Children dental fluorosis detection rate inthe areas where the project could not be normally used and water fluorine contents exceeded the standard was over 30%,the epidemic process is in very light level.Children dental fluorosis detection rate in the areas where the project could be normally used and water fluorine contents meet the standardhas reduced to non-endemic area,No dental fluorosis is found,the condition has been effectively controlled.Less than 50% of endemic fluorosis areas can meet the control standard in Jilin province.