Article(id=1325535304534478992, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325535161890398372, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025348, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1753200000000, receivedDateStr=2025-07-23, revisedDate=1757952000000, revisedDateStr=2025-09-16, acceptedDate=null, acceptedDateStr=null, onlineDate=1793961843856, onlineDateStr=2026-11-06, pubDate=1766592000000, pubDateStr=2025-12-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793961843856, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793961843856, creator=13701087609, updateTime=1793961843856, updator=13701087609, issue=Issue{id=1325535161890398372, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='12', pageStart='1673', pageEnd='1824', issueExtLink='null', onlineDate='null', pubDate='1766592000000', pubDateStr='2025-12-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793961809846, creator='13701087609', updateTime=1793961809846, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1800, endPage=1804, ext={EN=ArticleExt(id=1325535310381338770, articleId=1325535304534478992, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Urinary fluoride benchmark dose and its association with dental fluorosis among children from drinking water-borne endemic fluorosis areas in Tianjin, columnId=1325500884406379444, journalTitle=Chinese Journal of School Health, columnName=Disease Control, runingTitle=null, highlight=null, articleAbstract=
Objective To understand the dose-response relationship between urinary fluoride and dental fluorosis among children from drinking water-borne endemic fluorosis areas in Tianjin, so as to provide a scientific basis for assessing fluoride exposure risk among children from endemic areas and establishing reference values for urinary fluoride.
Methods From January to December 2024, 83 endemic villages were selected in Tianjin. A total of 2 382 children aged 8-12 years from these villages underwent dental fluorosis examination, along with water fluoride and urinary fluoride testing. Additionally, data from areas where the drinking water fluorosis control target was achieved for more than 12 years (10 villages, 50 people per village) were included as controls. A restricted cubic spline model was used to analyze the relationship between urinary fluoride levels and dental fluorosis prevalence, and benchmark dose (BMD) and benchmark dose lower bound (BMDL), as well as reference dose (RfD), were calculated using the benchmark dose method.
Results The prevalence rates of dental fluorosis among children in drinking water-borne endemic fluorosis areas and areas of normal fluoride content in water in Tianjin were 10.58%, 7.60%, with a geometric mean urinary fluoride level of 0.72 and 0.60 mg/L, respectively. There were statistically significant differences in both dental fluorosis prevalence and geometric mean urinary fluoride levels between the drinking water-borne endemic fluorosis areas group and the areas of normal fluoride content in water (χ2/Z=4.05, -7.31, both P < 0.05). Across different periods of water source improvement, there were statistically significant differences in overall population, male, and female dental fluorosis prevalence rates and geometric mean urinary fluoride levels (χ2/H=44.95, 23.96, 21.05; 168.39, 63.93, 107.50, all P < 0.01). Significant differences were also observed across age groups among children from drinking water-borne endemic fluorosis areas in terms of dental fluorosis prevalence and geometric mean urinary fluoride levels (χ2/H=32.14, 79.73, both P < 0.01). The results of the restricted cubic spline model showed that the risk of dental fluorosis in different sex, age and overall children in the drinking water-borne endemic fluorosis areas increased significantly with rising urinary fluoride concentration(all Pgeneral trend < 0.05). The BMD value for the drinking water-borne endemic fluorosis areas was 1.72 mg/L, the BMDL was 1.31 mg/L, and the RfD was 1.31 mg/L.
Conclusions The prevalence of dental fluorosis among children in the drinking water-borne endemic fluorosis areas in Tianjin has been effectively controlled, but it is still higher than that in the areas of normal fluoride content in water. Moreover, urinary fluoride levels and dental fluorosis prevalence among children from drinking water-borne endemic fluorosis areas show a clear dose-response relationship.
, authors=Yani DUAN, Yang WANG
*, Fang LI, Yushan CUI, Wenfeng LI, Dandan ZHANG, authorsList=Yani DUAN, Yang WANG, Fang LI, Yushan CUI, Wenfeng LI, Dandan ZHANG, authorCompany=null, correspAuthors=Yang WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325535328462983321, articleId=1325535304534478992, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=天津市饮水型地方性氟中毒病区儿童尿氟基准剂量及与氟斑牙的相关性, columnId=1325500884628677558, journalTitle=中国学校卫生, columnName=疾病控制, runingTitle=null, highlight=null, articleAbstract=
目的 了解天津市饮水型地方性氟中毒(简称“饮水型氟中毒”)病区儿童尿氟水平与氟斑牙之间的剂量-反应关系，为地方性氟中毒病区儿童氟暴露风险的评估和尿氟参考限值标准的制定提供科学依据。
方法 2024年1—12月，在天津市选取83个病区村，对其中2 382名8~12岁儿童开展氟斑牙检查、水氟及尿氟检测，并纳入实现饮水型氟中毒控制目标12年以上地区数据(10个村，每村50人)作为对照，采用限制性立方样条模型分析儿童尿氟水平与氟斑牙检出率的剂量-反应关系，使用基准剂量法计算儿童尿氟的基准剂量(BMD)及其95%可信限的下限(BMDL)和参考剂量(RfD)。
结果 天津市饮水型氟中毒病区儿童氟斑牙检出率为10.58%，尿氟几何均值为0.72 mg/L；水氟正常地区儿童氟斑牙检出率为7.60%，尿氟几何均值为0.60 mg/L；饮水型氟中毒病区与水氟正常地区儿童氟斑牙检出率和尿氟几何均值差异均有统计学意义(χ2/Z值分别为4.05，-7.31，P值均 < 0.05)。不同改水年限间的总人群、男童和女童氟斑牙检出率和尿氟几何均值差异均有统计学意义(χ2/H值分别为44.95，23.96，21.05；168.39，63.93，107.50，P值均 < 0.01)。不同年龄组间病区儿童氟斑牙检出率、尿氟几何均值差异均有统计学意义(χ2/H值分别为32.14，79.73，P值均 < 0.01)。限制性立方样条模型结果显示，病区不同性别、年龄及总体儿童氟斑牙的患病风险均随着尿氟水平的增加而上升(P总趋势值均 < 0.05)。病区儿童尿氟的BMD为1.72 mg/L，BMDL为1.31 mg/L，RfD为1.31 mg/L。
结论 天津市饮水型氟中毒病区儿童的氟斑牙患病情况已得到有效控制，但仍高于对照组儿童；病区儿童尿氟水平与氟斑牙检出率呈现剂量-反应关系。
, authors=段雅妮, 王洋
*, 李芳, 崔玉山, 李文凤, 张丹丹, authorsList=段雅妮, 王洋, 李芳, 崔玉山, 李文凤, 张丹丹, authorCompany=null, correspAuthors=王洋, authorNote=
段雅妮(1992-)，女，内蒙古集宁人，硕士，主管医师，主要从事地方病预防控制和健康教育工作
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, copyrightStatement=版权所有©《中国学校卫生》编辑部2025, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=l45HEyqNjssZ013GPiEiyg==, magXml=tSHa4H2tuM4MSCzmxayxPQ==, pdfUrl=null, pdf=fASfxheRsh8mxEh7Wb7iKA==, pdfFileSize=532406, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=eglb7FdDxASoSSvKxHg+1A==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=v9vDuLEFMbrU0tlCmg7pTQ==, mapNumber=null, fund=null)}, authors=[Author(id=1325535335257755807, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1325535336453132449, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, authorId=1325535335257755807, language=EN, stringName=Yani DUAN, firstName=Yani, middleName=null, lastName=DUAN, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Institute of Environment and Public Health, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1325535340559356066, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, authorId=1325535335257755807, language=CN, stringName=段雅妮, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=天津市疾病预防控制中心环境健康与公共卫生所，300011, bio={"content":"
段雅妮(1992-)，女，内蒙古集宁人，硕士，主管医师，主要从事地方病预防控制和健康教育工作
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段雅妮(1992-)，女，内蒙古集宁人，硕士，主管医师，主要从事地方病预防控制和健康教育工作
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Toxics, 2020, 8(4): 110., articleTitle=null, refAbstract=null), Reference(id=1325535442883596541, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=23, rfOrder=38, authorNames=null, journalName=null, refType=null, unstructuredReference=孙殿军, 刘辉, 于钧, 等. 我国地方病防控当前面临的主要问题与对策建议[J]. 中华地方病学杂志, 2023, 42(1): 1-3., articleTitle=null, refAbstract=null), Reference(id=1325535443483382014, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=23, rfOrder=39, authorNames=null, journalName=null, refType=null, unstructuredReference=SUN D J, LIU H, YU J, et al. Current main problems and countermeasures for prevention and control of endemic diseases in China[J]. 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(in Chinese), articleTitle=null, refAbstract=null), Reference(id=1325535447316975874, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=26, rfOrder=43, authorNames=null, journalName=null, refType=null, unstructuredReference=国家疾病预防控制局. 人群尿氟安全指导值: WS/T 10023—2024[S]. 2025-03-01., articleTitle=null, refAbstract=null), Reference(id=1325535448411689219, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=26, rfOrder=44, authorNames=null, journalName=null, refType=null, unstructuredReference=National Disease Control and Prevention Administration. Safety guidance value of urinary fluoride in population: WS/T 10023-2024[S]. 2025-03-01. (in Chinese), articleTitle=null, refAbstract=null)], funds=[Fund(id=1325535390656123093, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, awardId=null, language=CN, fundingSource=国家自然科学基金项目(82173641)；天津市医学重点建设学科(TJYXZDXK-3-020B)；天津市卫生健康科技项目(TJWJ2024QN091), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325535334263705755, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, xref=null, ext=[AuthorCompanyExt(id=1325535334343397532, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, companyId=1325535334263705755, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Institute of Environment and Public Health, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China), AuthorCompanyExt(id=1325535334397923485, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, companyId=1325535334263705755, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=天津市疾病预防控制中心环境健康与公共卫生所，300011)])], figs=[ArticleFig(id=1325535376026390731, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, language=EN, label=Fig.1, caption=
Dose-response relationship between urinary fluoride levels and dental fluorosis prevalence in children from endemic areas, figureFileSmall=LutX8tLugr41sCFxXq4zHQ==, figureFileBig=eglb7FdDxASoSSvKxHg+1A==, tableContent=null), ArticleFig(id=1325535376701673676, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, language=CN, label=图1, caption=
病区儿童尿氟水平与氟斑牙检出情况的剂量-反应关系, figureFileSmall=LutX8tLugr41sCFxXq4zHQ==, figureFileBig=eglb7FdDxASoSSvKxHg+1A==, tableContent=null), ArticleFig(id=1325535379994202317, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, language=EN, label=Fig.2, caption=
Benchmark dose (BMD) analysis of urinary fluoride levels in relation to dental fluorosis prevalence in children from endemic areas, figureFileSmall=coIXA52MmjAbM9pfhyRZUQ==, figureFileBig=ft4lTz/Hezlr6WynQLwnDA==, tableContent=null), ArticleFig(id=1325535380828868814, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, language=CN, label=图2, caption=
病区儿童尿氟水平与氟斑牙检出率之间的BMD测算分析注：BMD为基准剂量；BMDL为BMD 95%可信限的下限；图中竖线表示儿童尿氟水平所对应的氟斑牙检出率的范围。
, figureFileSmall=coIXA52MmjAbM9pfhyRZUQ==, figureFileBig=ft4lTz/Hezlr6WynQLwnDA==, tableContent=null), ArticleFig(id=1325535381806141647, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, language=EN, label=Tab.1, caption=
Comparison of the detection rates of dental fluorosis among children with different water treatment years in different endemic areas
, figureFileSmall=null, figureFileBig=null, tableContent=
| 性别 | 改水年限/年 | 人数 | 氟斑牙检出人数 | χ2值 | P值 |
|---|
| 男 | < 5 | 336 | 36(10.71) | 23.96 | < 0.01 |
| 5~< 8 | 323 | 55(17.03) | | |
| ≥8 | 529 | 34(6.43) | | |
| 女 | < 5 | 368 | 40(10.87) | 21.05 | < 0.01 |
| 5~< 8 | 333 | 55(16.52) | | |
| ≥8 | 493 | 32(6.49) | | |
| 总体 | < 5 | 704 | 76(10.80) | 44.95 | < 0.01 |
| 5~< 8 | 656 | 110(16.77) | | |
| ≥8 | 1 022 | 66(6.46) | | |
), ArticleFig(id=1325535382544339152, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, language=CN, label=表1, caption=
不同改水年限病区儿童氟斑牙检出率比较
, figureFileSmall=null, figureFileBig=null, tableContent=
| 性别 | 改水年限/年 | 人数 | 氟斑牙检出人数 | χ2值 | P值 |
|---|
| 男 | < 5 | 336 | 36(10.71) | 23.96 | < 0.01 |
| 5~< 8 | 323 | 55(17.03) | | |
| ≥8 | 529 | 34(6.43) | | |
| 女 | < 5 | 368 | 40(10.87) | 21.05 | < 0.01 |
| 5~< 8 | 333 | 55(16.52) | | |
| ≥8 | 493 | 32(6.49) | | |
| 总体 | < 5 | 704 | 76(10.80) | 44.95 | < 0.01 |
| 5~< 8 | 656 | 110(16.77) | | |
| ≥8 | 1 022 | 66(6.46) | | |
), ArticleFig(id=1325535384389832913, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, language=EN, label=Tab.2, caption=
Comparison of geometric mean of urinary fluoride among children with different water treatment years in different endemic areas
, figureFileSmall=null, figureFileBig=null, tableContent=
| 性别 | 改水年限/年 | 人数 | 尿氟几何均值/(mg·L-1) | H值 | P值 |
|---|
| 男 | < 5 | 336 | 0.97 | 63.93 | < 0.01 |
| 5~< 8 | 323 | 0.65 | | |
| ≥8 | 529 | 0.64 | | |
| 女 | < 5 | 368 | 1.00 | 107.50 | < 0.01 |
| 5~< 8 | 333 | 0.60 | | |
| ≥8 | 493 | 0.62 | | |
| 总体 | < 5 | 704 | 0.98 | 168.39 | < 0.01 |
| 5~< 8 | 656 | 0.62 | | |
| ≥8 | 1 022 | 0.63 | | |
), ArticleFig(id=1325535385606181074, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, language=CN, label=表2, caption=
不同改水年限病区儿童尿氟几何均值比较
, figureFileSmall=null, figureFileBig=null, tableContent=
| 性别 | 改水年限/年 | 人数 | 尿氟几何均值/(mg·L-1) | H值 | P值 |
|---|
| 男 | < 5 | 336 | 0.97 | 63.93 | < 0.01 |
| 5~< 8 | 323 | 0.65 | | |
| ≥8 | 529 | 0.64 | | |
| 女 | < 5 | 368 | 1.00 | 107.50 | < 0.01 |
| 5~< 8 | 333 | 0.60 | | |
| ≥8 | 493 | 0.62 | | |
| 总体 | < 5 | 704 | 0.98 | 168.39 | < 0.01 |
| 5~< 8 | 656 | 0.62 | | |
| ≥8 | 1 022 | 0.63 | | |
), ArticleFig(id=1325535386763808979, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, language=EN, label=Tab.3, caption=
Comparison of urinary fluoride levels of children of different ages and genders in endemic areas/(mg·L-1)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 组别 | 选项 | 人数 | 尿氟范围 | 尿氟几何均值 |
|---|
| 年龄/岁 | 8 | 261 | 0.08~6.08 | 0.64 |
| 9 | 669 | 0.05~12.00 | 0.71 |
| 10 | 640 | 0.04~4.22 | 0.62 |
| 11 | 562 | 0.10~7.01 | 0.79 |
| 12 | 250 | 0.05~9.34 | 0.96 |
| 性别 | 男 | 1 188 | 0.04~12.00 | 0.72 |
| 女 | 1 194 | 0.05~9.34 | 0.71 |
), ArticleFig(id=1325535388949041364, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325535304534478992, language=CN, label=表3, caption=
病区不同年龄和性别儿童尿氟水平比较/(mg·L-1)
, figureFileSmall=null, figureFileBig=null, tableContent=
| 组别 | 选项 | 人数 | 尿氟范围 | 尿氟几何均值 |
|---|
| 年龄/岁 | 8 | 261 | 0.08~6.08 | 0.64 |
| 9 | 669 | 0.05~12.00 | 0.71 |
| 10 | 640 | 0.04~4.22 | 0.62 |
| 11 | 562 | 0.10~7.01 | 0.79 |
| 12 | 250 | 0.05~9.34 | 0.96 |
| 性别 | 男 | 1 188 | 0.04~12.00 | 0.72 |
| 女 | 1 194 | 0.05~9.34 | 0.71 |
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