达能营养中心第十届学术研讨会论文集
向全永1 周明浩1 武鸣1 陶然1 陈连生1 张明访2 梁友信3
（1.江苏省疾病预防控制中心，南京，210009；2.江苏省泗洪县疾病预防控制中心，宿迁，223800；
3.复旦大学公共卫生学院，上海，200032）
摘要:目的探讨总摄氟量和氟骨症患病率间的确切剂量效应关系，为地方性氟中毒防治提供科学依据。方法根据家庭手压井饮水氟含量的不同，从地方性氟中毒重病区村瓦庙村抽取调查对象132名成人（平均年龄52.36岁；家庭手压井饮水含氟量为2.18±0.86mg/L,范围0.85－4.50mg/L），非病区村新淮村调查对象为35名（平均年龄48.11岁；家庭手压井饮水含氟量为0.37±0.09mg/L,范围0.21－0.55mg/L）。分别调查每位对象从不同途径的日平均总摄氟量和氟骨症患病情况。结果瓦庙村调查对象的氟骨症患病率为31.06%，新淮村未发现氟骨症患者。当把两村的调查对象作为一个整体，并根据每个调查对象的总摄氟量不同分为5个不同的剂量组时，可见随着总摄氟量的升高，氟骨症的患病率明显增加，并有显著的剂量效应关系（Quadriatic fit模型拟合曲线的回归方程为:y=2.624-6.855x+3.424x2）。根据这一剂量效应关系计算的总摄氟量的基准剂量的95%可信限的下限值为2.50mg/(人*日)，由此可得总摄氟量的参考计量为2.50mg/(人*日)。瓦庙村41氟骨症患者和91非氟骨症调查对象的总摄氟量也有显著的差异。结论在饮水型地方性氟中毒病区，总摄氟量和氟骨症患病率间有显著的正相关剂量效应关系。本研究所得的总摄氟量的参考剂量低于《中华人民共和国国家卫生标准—人群总摄氟量卫生标准》(WS/T 87-1996)的要求。
关健词:总摄氟量；氟骨症；剂量效应关系
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 highfluoride 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 lowfluoride 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 doseresponse relationship (regression equation: y=2.624-6.855x+3.424x2). The Benchmark Dose Lower Bound (BMDL) of daily total 的防治研究（Email: quanyongxiang@yahoo.com.cn）intake of fluoride was 2.50 mg F/person/day calculated according to this doseresponse 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 Xray detectable skeletal fluorosis and in 91 subjects without Xray detectable skeletal fluorosis. ConclusionsThese findings indicate that the daily total intake of fluoride have a significant positive doseresponse relationship with the prevalence of skeletal fluorosis in an endemic fluorosis area associated with highfluoride 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; Doseresponse relationship.