| Objective A survey on the level of tea fluoride exposure,the prevalence of tea-type fluorosis and the knowledge of of tea-type fluorosis among adult residents in ethnic minority areas of Gansu were carried out,and related influencing factors of urine fluoride levels were analyzed in order to further confirm the tea-type fluorosis wards in Gansu and to provide a scientific basis for formulating intervention strategies and measuresMethods Taking ethnic minority counties in Gansu Province as investigation sites,719 adult residents and 1351 children aged 8-12 were selected through typical sampling methods.An epidemiological survey of face-to-face interviews was conducted through household and school survey,a series of data such as general demographic characteristics,dietary and tea drinking habits,prevalence of fluorosis,awareness of tea-type fluorosis were collected by using a self-designed questionnaire.In the household survey,samples of urine,tea and staple food were collected.In school investigations the prevalence of dental fluorosis was investigated and urine samples from children were collected.Fluoride ion selective electrode method was adopted for the detection of fluoride ion content,and it was operated in accordance with relevant national standards Descriptive health statistics were used for statistical analysis of data,and Spearman rank correlation analysis was used to explore the main influencing factors of urine fluoride levelsResults(1)A total of 719 adult residents were included in this survey,including 351 males(48.82%)and 368 females(51.18%),with an age range of 16 to 90 years and an average age of 51.94±14.22 years.86.37%of residents had the habit of drinking tea,mainly the brick tea(53.30%),and the main mothed of drinking tea was milk tea(56.84%).The median of urine fluoride content in residents was 2.928mg/L,and the fluctuation range was 0.191?25.512mg/L The total fluoride intake of the surveyed subjects was 5.270mg per day,of which tea-derived fluoride intake was 4.587mg.In 1352 children aged 8-12 years,the median urine fluoride content was 1.342mg/L,with a fluctuation range of 0.2111?5.703mg/L.(2)Results of dental fluorosis Detection:According to the diagnostic criteria of dental fluorosis(WS/T 208-2001),the detection rate of dental fluorosis in adults was 31.99%,and the rate in children aged 8-12 is 29.22%.(3)Results Single factor difference analysis on adult urine fluoride levels:there are significant differences in age,per capita annual income,ethnicity,occupation,BMI among different demographic characteristics(P<0.05).Eating habits:with different intakes of rice(r=-0.170,P<0.001),vegetables(r=-0.100,P=0.009),barley(r=0.201,P=0.001),beef(r=0.121,P=0.009),lamb(R=0.208,P<0.001),milk(r=0.156,P=0.002),dairy products(r=0.175,P=0.015)and others,urine fluoride content was significantly different.Tea drinking habits:whether drinking tea or not,tea drinking methods,tea types and tea consumption,as well as tea fluorine content could significantly affect urine fluoride levels(P<0.05).Those who knew about fluorine,tea-fluorosis,and those who knew toxicity of fluoride but still continue to drink tea had higher urine fluoride levels(P<0.05).(4)Results of single factor analysis of urine fluoride levels in children aged 8-12 years:there were relationship between urine fluoride level and age(r=0.349,P<0.001),ethnicity(rs=0.680,P<0.013),whether to drink tea(rs=0.404,P<0.001)and fluorosis(rs=0.290,P<0.001)(5)Results of multiple linear regression analysis:ethnicity,knowing the hazards of tea fluoride but still drinking tea,and daily barley consumption were influencing factors of urine fluoride level The results of multiple linear regression analysis of tea drinkers showed that influencing factors of urine fluoride level included tea consumption,ethnicity and tea types.The influencing factors of urine fluoride level of children aged 8-12 years were age,ethnicity,tea consumption and dental fluorosis.Conclusion(1)Minority residents(Kazakhs,Tibetans,Yugurs)in Gansu Province generally have the habit of drinking brick tea,and the way of drinking tea is mainly milk tea.(2)Adults and children aged 8-12 in some ethnic minority areas(Kazakhs,Tibetans,Yugurs)in Gansu Province have high levels of tea fluoride exposure and high detection rates of dental fluorosis,combined with the fluoride content of drinking water and tea fluoride as well as the average daily fluoride intake of the population and its source,it can be preliminarily judged that some minority areas are potential epidemic areas of tea-type fluorosis,and the further investigation should be further strengthened.(3)Nationalities,drinking tea,knowing harzard of high tea fluoride exposure but still drinking tea,brick tea consumption are risk factors for urine fluoride levels in adult;age,ethnicity(Kazakh,Tibetan,Yugurs,Mongolians)are risk factors for children's urine fluoride level The residents of Hui do not have the habit of drinking brick tea,so the urine fluoride level of Hui children is within the normal range. |
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