title: [Surveillance on drinking-water-born endemic fluorosis in China, 2013].
abstract: OBJECTIVE
  To investigate the prevalence of fluorosis and related control measures on drinking water type of endemic fluorosis in China.
  
  
  METHODS
  According to the national program- "Surveillance Scheme of Drinking-Water-Borne Endemic Fluorosis" , 136 counties were selected in 29 provinces, autonomous regions and municipalities. Three epidemic villages were randomly selected as fixed monitoring sites in each county. Dental fluorosis of all the children aged 8-12 living in the villages under the monitoring program, was identified under the ariteria from "Diagnosis of dental fluorosis" (WS/T 208-2011). Operating conditions and contents of fluoride in all the'water-improved projects' were investigated. Contents of fluoride in drinking water were tested in villages without the 'water-improved projects'. "Standard Test Method for Drinking Water" (GB/T 5750.5-2006) was used to detect the water fluoride.
  
  
  RESULTS
  The overall prevalence of dental fluorosis among children aged 8-12 in all the villages under monitor program, was 28.58% (7 950/27 817), with the dental fluorosis index (DFI) as 0.58. Among them, the prevalence was 22.28% (3 917/17 583) and DFI was 0.44 in the'water-improved projects' villages that under normal operation and with qualified fluoride contents. The prevalence appeared as 38.74% (1 926/4 971) with DFI as 0.84 in those villages with 'water-improved projects' but mal-operated or with excessive fluoride. The prevalence was 40.03% (2 107/5 263), and DFI was 0.81 in those villages without 'water-improved projects'. The prevalence rates of dental fluorosis in children from the three types of endemic areas were significantly different. For 'water-improved projects', the normal opration rate was 93.77% (286/305) and the qualification rate of fluoride content was 76.77% (228/297).
  
  
  CONCLUSIONS
  Dental fluorosis in children living in the drinking-water-born endemic fluorosis areas was on the edge of epidemics in China. Effective improvement on the quality of drinking water can significantly reduce the severity of dental fluorosis in children. The rate of proper operation on 'water-improved projects' was near to 95% in the endemic area. However, rate that met the criteria on qualified fluoride contents of these projects was still below 80%.
authors.affiliation: Institute for Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University. Key Lab of Etiologic Epidemiology of National Health and Family Planning Commission (23618504), Key Lab of Etiologic Epidemiology of Education Bureau of Heilongjiang Province, Harbin 150081, China.
authors.forename: L J
authors.initials: LJ
authors.lastname: Zhao
authors.forename: J R
authors.initials: JR
authors.lastname: Pei
authors.forename: W
authors.initials: W
authors.lastname: Zhang
authors.forename: W
authors.initials: W
authors.lastname: Wang
authors.forename: G Q
authors.initials: GQ
authors.lastname: Yu
authors.forename: D J
authors.initials: DJ
authors.lastname: Sun
authors.forename: Y H
authors.initials: YH
authors.lastname: Gao
mesh_terms: D002648:Child; D002681:China; D009050:Fluorosis, Dental; D006801:Humans; D015995:Prevalence; D014881:Water Supply