Shandong Institute for Endemic Disease Prevention and Control

Jinan, China

Shandong Institute for Endemic Disease Prevention and Control

Jinan, China
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Zhai L.,Shandong Institute for Endemic Disease Prevention and Control | Wang X.,Shandong Institute for Endemic Disease Prevention and Control | Gao H.,Shandong Institute for Endemic Disease Prevention and Control | Li L.,Shandong Institute for Endemic Disease Prevention and Control | And 3 more authors.
Chinese Journal of Endemiology | Year: 2015

Objective To investigate the fluoride content in drinking water as well as the current status of endemic fluorosis in 5 counties of Shandong Province, in order to provide a scientific basis for making prevention and control strategies. Methods According to the survey data of fluoride content in drinking water in Shandong Province between 2005 to 2007, an epidemiological investigation was carried out in Mudan, Jiaxiang, Wucheng, Pingdu and Boxing Counties from September to November 2013. The fluoride content in drinking water and urine and dental fluorosis of children aged 8 to 12 were investigated in 3 - 4 major survey villages selected in the five counties. The fluoride content in drinking water was detected by fluoride ion selective electrode method, and dental fluorosis was diagnosed by Deans method. Results, Fifty-eight drinking water samples were investigated in 16 villages of the five counties. Water fluorine content in Wucheng, Mudan, Pingdu, Boxing and Jiaxiang counties was 4.14, 3.84, 1.83, 1.33 and 0.43 mg/L, respectively. There were 4 counties' fluorine content exceeding the national standard (1.20 mg/L) except Jiaxiang County. The exceeding rate was 100% in Wucheng and Mudan counties. Urine fluorine content of 320 children aged 8 to 12 in Wucheng, Mudan, Boxing, Pingdu and Jiaxiang counties was 4.51, 4.62, 1.82, 1.30, 1.01 mg/L respectively; the total detection rate of dental fluorosis of 574 children was 61.85% (355/574), the rate of dental damage was 12.89% (74/574), and dental fluorosis index was 1.27; the detection rate of dental fluorosis in Wucheng, Mudan, Boxing, Pingdu and Jiaxiang Counties was 90.18% (101/112), 97.73% (86/88), 62.22% (84/135), 54.90% (28/51) and 29.79% (56/188), respectively. Conclusions The exceeding rate of water fluorine content is very high in 5 counties of severe endemic fluorosis areas in Shandong Province. The urinary fluorine level of the population is still high and the prevalence of dental fluorosis of children is high. Endemic fluorosis in Shandong Province has not yet been effectively controlled, control situation is still grim.


Yun Z.,Shandong Institute for Endemic Disease Prevention and Control | Yin Y.,Shandong Institute for Endemic Disease Prevention and Control | Gao J.,Shandong Institute for Endemic Disease Prevention and Control | Zhang B.,Shandong Institute for Endemic Disease Prevention and Control | And 2 more authors.
Chinese Journal of Endemiology | Year: 2015

Objective To study the prevalence of drinking water type of endemic fluorosis in Shandong Province, and to provide a scientific basis in making strategies for prevention and control of the disease. Methods Ten counties (cities, districts) were selected by random number table method to carry out the epidemiological study, and to study the progress and effect of water-improving and defluoridation projects. Three villages in each county (city, district) were chosen to determine fluoride content of drinking water and to check the prevalence of dental fluorosis of children 8 to 12 years old. Water fluoride content was determined with fluoride ion-selective electrode, and dental fluorosis was diagnosed by the Deans method. Results In the 10 counties (cities, districts), a total of 515 water-improving and defluoridation projects were built covering 3 207 fluorosis villages, and the water-improving rate was 81.71% (3 207/3 925). A total of 85 water-improving and defluoridation projects were investigated in the 10 counties (cities, districts), and all of the projects were operating normally. The number of projects that water fluoride concentration ≤ 1.20 mg/L was 51; the qualified rate of water fluoride concentration was 60.00% (51/85), and the maximum value of water fluoride was 4.38 mg/L. A total of 29 villages that had water-improving and defluoridation projects were investigated in the 10 counties (cities, districts), and the number of villages that mean of water fluoride ≤ 1.20 mg/L was 21, accounting for 72.41% (21/29); > 1.20 mg/L was 8, accounting for 27.59% (8/29), and the maximum value of water fluoride was 4.02 mg/L. In the 21 qualified villages of water fluoride concentration, a total of 1 023 children aged 8 to 12 were examined; the positive rate of dental fluorosis was 38.12% (390/1 023); dental fluorosis index was 0.67, and the prevalence of dental fluorosis was extremely low. In the 8 exceeding-standard villages of water fluoride content, a total of 449 children aged 8 to 12 were examined; the positive rate of dental fluorosis was 54.79% (246/449); dental fluorosis index was 1.18, and the prevalence of dental fluorosis was mild. Conclusion In Shandong Province, the water fluoride content of water-improving and defluoridation projects exceeds the national standard seriously, and the condition of children's dental fluorosis is still serious, and the measures of water-defluoridation should be further strengthened.


Wang X.-H.,Shandong Institute for Endemic Disease Prevention and Control | Wang Y.-Y.,Shandong Institute for Endemic Disease Prevention and Control | Wang J.,Shandong Institute for Endemic Disease Prevention and Control | Qu F.-R.,Shandong Institute for Endemic Disease Prevention and Control | And 3 more authors.
Chinese Journal of Endemiology | Year: 2011

Objective: To investigate the incidence of Keshan disease(KSD) in Shandong province and to supply evidence for scientific control of the disease. Methods: According to the scheme of KSD monitoring in Shandong province, the KSD cases were searched in 7 counties, and representative 3 counties and 6 villages were selected as key monitoring sites. In each site, about 420 residents were checked by asking detailed disease history, physical examination, and electrocardiography(ECG) tracings. Suspected cardiac abnormalities were taken chest posteroanterior X-ray film. At the same time, residents hair and food samples were collected to detect selenium levels in internal and external environments, and residents' income and per capita share of grain and other basic information were collected. Results: Circled digit one Two hundred and fifty-nine medical units were searched, 1132 cases of myocardial disease were found out and 638 suspected cases were identified and 142 chronic KSD cases were diagnosed. Circled digit two In the 6 monitoring sites, 2538 residents were surveyed and 91 cases of KSD were detected (of which 77 cases of potential, 14 cases of chronic), the detection rate was 3.58%. A total of 2127 residents were traced ECG and the incidence of abnormal ECG was 24.5% (521/2127), of which ST-T changes, T-wave changes, sinus bradycardia, sinus arrhymia, sinus tachycardia, and atrial premature beats et al were more common. Of the 75 X-ray films, 39 cases had enlarged heart(in which 21 of mild, 13 of moderate, 5 of severe). Circled digit three A total of 406 hair and grain samples were collected, respectively, and the selenium content of hair was approaching the level of appropriate, and the selenium content of food was still low. The annual per capita incomes of each site were between 3000-5900 Yuan, and residents main staple food was flour. Conclusions: KSD in Shandong province is in a relatively stable situation. But latent and chronic KSD cases can still be detected. The internal environment selenium levels are elevated since the local living standards and dietary nutrition are improved.


Wang J.-B.,Shandong Institute for Endemic Disease Prevention and Control | Bian J.-C.,Shandong Institute for Endemic Disease Prevention and Control | Jiang W.,Shandong Institute for Endemic Disease Prevention and Control | Wang X.-M.,Shandong Institute for Endemic Disease Prevention and Control | And 6 more authors.
Chinese Journal of Endemiology | Year: 2010

Objective: To look into the current distribution of iodine deficiency area in Shandong province and to guide the re-defined iodine deficiency area and to supplement iodine scientifically. Methods: In 2008, 100 iodine deficiency counties (cities, districts), designated in Shandong province's "to supplement iodized salt to eliminate the hazard of iodine deficiency management regulations", were selected in the study. One to three samples were collected from water source which was used by the majority of local residents in the 100 iodine deficiency places and iodine concentration was tested by As 3+-Ce4+ catalyzing spectrophotometry. Results: A total of 65 716 water samples were collected. Sample recovery efficiency reached 99.8%(65 572/65 716). The median water iodine was 5.57 μg/L, with 82.05% (1097/1337) of the township(town) met criteria for the classification of iodine deficiency areas(water iodine < 10 μg/L), 17.43%(233/1337) of the township (town) water iodine moderate (water iodine 10-150 μg/L), and 0.52%(7/1337)of the township (town) should be defined high iodine areas(water iodine > 150-300 μg/L). Conclusions: The iodine deficiency areas should be redefined because water iodine concentrations of iodine deficiency areas have changed. We suggest that the smallest place to supply salt with different range of iodine content is set to the township (town).


Wang X.-H.,Shandong Institute for Endemic Disease Prevention and Control
Chinese Journal of Endemiology | Year: 2010

Objective: To measure the serum selenium levels in patient with Keshan disease(KSD) and in healthy controls in Shandong, Sichuan and Inner Mongolia KSD areas, to monitor the long-term dynamic changes of hair and serum selenium levels in Shandong KSD areas, and to provide scientific basis for preventing KSD. Methods: A cross-sectional survey was carried out in KSD areas of Shandong, Sichuan and Inner Mongolia in 2009. The research subjects which come from KSD areas were 77 cases and 63 healthy controls from Shandong ; 35 patients and 36 healthy controls from Sichuan; and 17 patients and 18 healthy controls from Inner Mongolia. Additional 33 healthy people from Jinan city were selected as controls of non-KSD areas. Blood and hair samples were collected and selenium levels were measured by 2,3-diaminonaphthalene fluorescence spectrometry. Retrospective method was used to analyze the hair and serum selenium data collected between 1976 and 2004 in Shandong KSD areas, and these data were compard with the data of 2009 to observe the long-term dynamic changes. Results: Circled digit one The serum selenium levels of KSD patients in Shandong and Inner Mongolia were significantly lower than that of healthy subjects of KSD areas[(0.0773±0.0113) vs (0.0895±0.0256),(0.0347±0.0107) vs (0.0469±0.0161), t = 3.52, 3.87, all P < 0.01]. No significant difference was found between KSD patients and healthy people in Sichuan[(0.0792±0.0162) vs (0.0774±0.0103), t = 0.55, P > 0.05]. Circled digit twoThe serum selenium levels of KSD patients in Shandong, Sichuan and Inner Mongolia KSD areas were lower than that of non-KSD area[(0.0988±0.0231) mg/L, q = 6.74, 5.83, 19.47, all P < 0.01]. The serum selenium levels of healthy people in Sichuan and Inner Mongolia KSD areas were significantly lower than that of non-KSD area(q = 6.68, 16.36, all P < 0.01). The serum selenium levels of healthy controls in Inner Mongolia were lower than that of in Shandong and Sichuan(q = 13.63, 14.74, 13.62, 1.46, all P< 0.01). Circled digit threeFrom 1976 to 2009, the hair and serum selenium levels of Shandong resident were increased 1.68 times(0.343/0.128-1) for hair and 0.98 times(0.091/0.046-1) for serum, respectively. But there was no significant difference between the average growth rate of hair and serum selenium levels (χ2= 1.38, P > 0.05). Conclusions: Circled digit oneThe hair and serum selenium levels of KSD patients are lower than that of healthy controls in non-KSD area. Circled digit twoThe serum selenium levels of Shandong, Sichuan and Inner Mongolia are different between KSD patients and healthy controls in the diseased areas. Circled digit threeThe hair and serum selenium data of Shandong resident show an upward trend over the past 30 years. We suggest to continue the comprehensive measures of adding selenium in KSD areas.


Yun Z.-J.,Shandong Institute for Endemic Disease Prevention and Control | Chen P.-Z.,Shandong Institute for Endemic Disease Prevention and Control | Bian J.-C.,Shandong Institute for Endemic Disease Prevention and Control | Wang Y.-T.,Shandong Institute for Endemic Disease Prevention and Control | Ma A.-H.,Shandong Institute for Endemic Disease Prevention and Control
Chinese Journal of Endemiology | Year: 2010

Objective: To investigate the distribution of water-borne fluoride and the current status of water defluoridation project by improving drinking water quality in endemic fluorosis areas in Shandong province, and to provide scientific basis for making strategies in prevention and control of the disease. Methods: According to "the National Technical Scheme for Endemic Disease Control in 2004, 2005 and 2006", 113 endemic fluorosis diseased counties (cities, and districts) of the province's 17 cities were screened in order to investigate the fluoride level in drinking water in fluorosis villages, recheck the fluoride level after implementing the water defluoridation project, and investigate the current status of the water defluoridation project. The fluoride level in drinking water was determined by F-ion selective electrode. Results: There were a total of 5816 water defluoridation projects in the province. Most of them were carried out by drilling a deep well to get under-ground water. The wells still in good condition were accounted for 72.80% (4234/5816). Intermittent operated wells were accounted for 3.11% (181/5816). Abandoned wells were accounted for 24.09% (1401/5816). Level of water fluoride was determined in 6940 samples from fluorosis villages (villages that not carry out the water defluoridation project as well as villages carried out the water defluoridation project with abandoned wells were included) and the value that lower or equal to 1.00 mg/L was determined in 2987 villages which accounted for 43.04% (2987/6940). Level of water fluoride that over 1.00 mg/L was found in 3953 villages which accounted for 56.96% (3593/6940), and the highest level of water fluoride was 11.33 mg/L. Level of water fluoride were determined in 4415 samples from water defluoridation project and the value lower or equal to 1.00 mg/L was in 2983 wells which accounted for 65.53%(2983/4415). The value over 1.00 mg/L was in 1522 wells which accounted for 34.47% (1522/4415), the highest value of water fluoride was 9.71 mg/L Conclusions: Level of water fluoride in up to 1/2 of the villages and 1/3 of the projects, is still higher than the standard in Shandong province. Nearly 1/4 of the project has been abandoned. The current situation for endemic fluorosis control is still not good in the province, countertneasures for endemic fluorosis must be carried out as soon as possible and surveillance of water defluoridation project must be strengthened.


Chen P.-Z.,Shandong Institute for Endemic Disease Prevention and Control | Yun Z.-J.,Shandong Institute for Endemic Disease Prevention and Control | Gao H.-X.,Shandong Institute for Endemic Disease Prevention and Control | Li H.-X.,Shandong Institute for Endemic Disease Prevention and Control | And 3 more authors.
Chinese Journal of Endemiology | Year: 2012

Objective: To investigate the prevailing status of endemic fluorosis in the south area of Shandong province and to provide a scientific basis for formulating control measures against the disease. Methods: According to the present distribution of fluorosis areas in the south area of Shandong province and "the Shandong Province Technical Scheme for Endemic Disease Control", 13 counties (districts) in the south area of Shandong province were selected as the survey counties in 2009. Based on the state of endemic fluorosis, the disease was classified into light, moderate and severe types in the 13 monitoring counties (districts), and one diseased village was selected from each type as the survey spots. The drinking water fluoride level, the prevalence of dental fluorosis of children aged 8-12, adult clinical skeletal fluorosis and urinary fluoride level of the children and adults were surveyed in the 39 villages selected. The content of fluoride in drinking water and urine was determined by F-ion selective electrode while dental fluorosis of the children aged 8-12 was diagnosed by Dean method and adults skeletal fluorosis by the national standard for "Diagnosis of Endemic Skeletal Fluorosis" (WS 192-2008). Results: A total of 172 water samples were tested in the 39 villages (26 villages with improved water and 13 villages with unimproved water) of the 13 counties(districts), the fluoride content of the 74 water samples(51 from 13 villages with unimproved water and 23 from 6 villages with improved water) exceeded the national standard(> 1.0 mg/L), and the rate of exceeded the standard was 43.02%(74/172) with 24 of > 2.0-4.0 mg/L and 3 of > 4.0 mg/L, and the maximum value of the water fluoride was 7.76 mg/L. A total of 1118 copies of children urine samples were tested, geometric mean of urinary fluoride was 1.82 mg/L; 764 copies of adults' urine samples were tested, geometric mean of urinary fluoride was 1.98 mg/L. A total of 1908 children aged 8-12 were examined of dental fluorosis, the detection rate was 45.18% (862/1908), tooth defection rate was 9.12% (174/1908), and dental fluorosis index was 1.07. A total of 25 295 adults were checked of clinical skeletal fluorosis, the detection rate was 5.96%(1509/25 296) with 670 moderate or serious cases. Conclusions: In the south area of Shandong province, excessive water fluoride is still serious, mainly in the diseased villages with unimproved water (including water improvement villages discarded water improvement thereafter). Urine fluoride remains at a relatively high level, and the dental and skeletal fluorosis are still comparatively serious. High fluoride hazard still exists to a certain degree. Therefore, the scientific control measures need to be strengthened to control the prevalent of endemic fluorosis.


Yun Z.-J.,Shandong Institute for Endemic Disease Prevention and Control | Chen P.-Z.,Shandong Institute for Endemic Disease Prevention and Control | Bian J.-C.,Shandong Institute for Endemic Disease Prevention and Control | Wang Y.-T.,Shandong Institute for Endemic Disease Prevention and Control | And 4 more authors.
Chinese Journal of Endemiology | Year: 2012

Objective: To investigate the current status of endemic fluorosis in Shandong province, and to provide a scientific basis for the development of preventive strategies. Methods: In accordance with the requirements of the national "Technical Implementation Plan for Endemic Disease Control Project in 2009" and "Drinking-Water-Bome Endemic Fluorosis Monitoring Program(trial)", ten counties were selected to carry out the epidemiological investigation, to understand the progress and the effect of the water improvement projects; three villages were selected in each county, to determine fluoride content of drinking water, to check dental fluorosis of children aged 8 to 12 and skeletal fluorosis of adults over the age of 25. Water fluoride content was determined by fluoride ion selective electrode method, children dental fluorosis was diagnosed with Dean method and adults skeletal fluorosis by the National Standard for "Diagnosis of Endemic Skeletal Fluorosis"(WS 192-2008). Results: There were a total of 687 improved-water defluoridation projects of the 10 counties, the improved-water rate was 83.34% (3247/3896). The investigation was taken place in 84 improved-water projects of the 10 counties, the projects running normally accounted for 98.81% (83/84); 41 projects had water fluoride concentration ≤1.20 mg/L, and the pass rate was 48.81%(41/84), with the maximum water fluoride as 5.76 mg/L. In the 26 villages with improved-water projects of the 10 counties, villages with a mean water fluoride ≤1.20 mg/L were 15, which accounted for 57.69% (15/26), > 1.20 mg/L were 11, which accounted for 42.31%(11/26), with the maximum water fluoride as 5.58 mg/L. In the 4 yet to improve water quality villages of the 10 counties, 1 village had mean water fluoride ≤1.20 mg/L, 3 villages had mean water fluoride > 1.20 mg/L, with the maximum water fluoride as 2.92 mg/L. A total of 1331 children aged 8 to 12 were checked in the 26 improved water villages, the detection rate of dental fluorosis was 59.73% (795/1331 ), the index of dental fluorosis was 1.17 and the defect rate was 10.14% (123/1331). A total of 138 children aged 8 to 12 were checked in the 4 yet to improve water quality villages, the detection rate of dental fluorosis was 51.45%(71/138), the index of dental fluorosis was 0.95 and the defect rate was 0.72%( 1/138). In water quality improved villages and yet to improve water quality villages, X-ray detection rates of skeletal fluorosis were 8.80%( 113/1284) and 3.05%(6/197), respectively, in adults over the age of 25. Conclusions: The water fluoride content of improved-water defluoridation projects exceeds the national standard seriously and fluorosis has not been effectively controlled in Shandong province.


Yun Z.-J.,Shandong Institute for Endemic Disease Prevention and Control | Chen P.-Z.,Shandong Institute for Endemic Disease Prevention and Control | Bian J.-C.,Shandong Institute for Endemic Disease Prevention and Control | Wang Y.-T.,Shandong Institute for Endemic Disease Prevention and Control | And 4 more authors.
Chinese Journal of Endemiology | Year: 2011

Objective: To investigate the current status of endemic fluorosis in Shandong province, and to provide the scientific evidence for making strategies for prevention and control of the disease. Methods: According to "The National Technical Scheme for Endemic Disease Control in 2008", thirty-four counties were divided into mild, moderate and severe endemic fluorosis areas and a village was randomly selected from each category of the area to carry out the monitoring of endemic fluorosis. The content of fluoride in drinking water and urine was determined by F-ion selective electrode, dental fluorosis of children aged 8 to 12 was diagnosed by Dean method and skeletal fluorosis diagnosed by clinic and X-rays. Results: The monitoring was done in 70 water-improving villages in 34 counties, among which 54 villages had water fluoride content ≤ 1.00 mg/L and accounted for 77.14% (54/70), 16 villages had water fluoride content > 1.00 mg/L and accounted for 22.86% (16/70), the highest water fluoride content was 4.46 mg/L The monitoring was also carried out in 32 non-water-improving villages in 34 counties, among which 9 villages had water fluoride content ≤ 1.00 mg/L and accounted for 28.12% (9/32), 23 villages had water fluoride content > 1.00 mg/L and accounted for 71.88% (23/32), the highest water fluoride content was 4.09 mg/L. The total rate of dental fluorosis of children aged 8 to 12 was 45.81% (1988/4340), the index of dental fluorosis was 0.97 and the rate of dental damage was 6.91% (300/4340). The urinary fluoride values above 1.40 mg/L were found in 55.33% (1417/2657) of children aged 8 to 12, with the highest urinary fluoride concentrations was 18.53 mg/L. The rate of skeletal fluorosis by clinic and X-rays in adults older than 16 years were 4.25% (2462/57 968) and 28.40% (23/81), respectively. The urinary fluoride values above 1.60 mg/L were found in 55.86% (1130/2023) of adults older than 16 years, with the highest urinary fluoride concentrations was 25.44 mg/L. Conclusions: Endemic fluorosis in Shandong province has not yet been effectively controlled, control situation is still grim. Prevention efforts need to be further strengthened.


Chen P.,Shandong Institute for Endemic Disease Prevention and Control | Yun Z.,Shandong Institute for Endemic Disease Prevention and Control | Li H.,Shandong Institute for Endemic Disease Prevention and Control | Zhai L.,Shandong Institute for Endemic Disease Prevention and Control | And 4 more authors.
Chinese Journal of Endemiology | Year: 2014

Objective To investigate the present situation of water-improving projects and water iluonde level as well as the prevalence of endemic fluorosis in five monitored counties of Shandong Province from 2007 to 2011, and to observe the effectiveness of prevention and control measures. Methods In 2007 - 2011, according to "Shandong Province Key-point Survey Scheme of Endemic Fluorosis", water fluoride content of 100 water-improving projects (all were selected if less than 100 projects) was determined in Gaomi City and Boxing, Jiaxiang, Yuncheng and Liangshan Counties of Shandong Province; 3-5 key-point monitoring villages were selected in the endemic fluorosis villages of the five monitoring counties ( cities ), fluoride concentration of household water samples was determined; prevalence of dental fluorosis and urinary fluoride concentration of children aged 8 - 12 of all keypoint monitoring villages were investigated. The water and urinary fluoride contents were determined using fluoride ion-selective electrode. Dental fluorosis of children was diagnosed by Deans method. Results In 2007 - 2011, the water fluoride level of 1 833 water-improving projects was investigated in five monitoring counties (cities ), and the total exceeded rate over the national standard ( > 1.0 mg/L) was 42.50% (779/1 833) and the highest value of water fluoride was 6.27 mg/L. Mean values of household water fluoride in the key-point monitoring villages in 2007 -2011 were (2.57 ± 1.78), (2.53 ± 1.64), (2.11 ± 1.29), (2.03 ± 1.33) and (1.96 ± 1.66) mg/L,respectively. The exceeded rate was not significantly different between each year(χ2 = 3.09, P > 0.05), In 2007 - 2011, the detection rates of dental fluorosis of children aged 8-12 were 86.17% (760/882), 84.31% (473/561 ), 79.70% (534/670), 80.14% (549/685) and 72.48% (432/596), respectively; the detection rate of dental fluorosis was significantly different between each year(χ2 = 48.39, P < 0.01), and dental fluorosis indexes were 1.94, 1.88, 1.66, 1.56 and 1.48, respectively; geometric means of urinary fluoride concentration of children were 3.14, 3.67, 2.18, 3.04 and 2.45 mg/L, respectively, and the mean value of the geometric means was 2.85 mg/L, which was higher than the normal upper limit (1.40 mg/L). Conclusions In each monitored county (city), excessive water fluoride is still a serious problem in the water-improving projects ; although the prevalence of child dental fluorosis has declined, urinary fluoride levels of children are higher than the normal upper limit. Endemic fluorosis has not yet been fully controlled. We should continue to strengthen the prevention and control measures to reduce fluoride in drinking water.

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