目的依据国家标准对江苏省黄泛平原地区进行水源型高碘地区和地方性高碘甲状腺肿病区重新划定和确认。方法2005年在徐州市的丰县、沛县、铜山县、睢宁县、邳州市和淮安市的楚州区,以乡镇为单位,每个乡镇选择5个行政村,每个行政村按东、南、西、北、中各抽取1口井测定水碘,少于5口井的行政村全部测定,采用砷铈催化分光光度法检测水碘。在水碘中位数〉150—300μg/L的乡镇中,开展高碘甲状腺肿病情调查。依据GB/T19380—2003((水源性高碘地区和地方性高碘甲状腺肿病区的划定》标准.对上述地区进行重新划定和确认。结果共计调查158个乡镇,发现水碘中位数在150μg/L以上的乡镇79个。在水碘中位数〉150~300μg/L的32个乡镇中,有9个乡镇符合水源性高碘地区的标准,23个乡镇符合地方性高碘甲状腺肿病区标准,其中16个乡镇已先期停供碘盐,有16个新划定的水源性高碘地区(病区)乡镇未停供碘盐。在水碘中位数〉300μg/L的47个乡镇中,尚有4个乡镇未停供碘盐。结论应尽快落实在水源型高碘地区和地方性高碘甲状腺肿病区停供碘盐等补碘措施,防止双重补碘可能造成的危害。
Objective To affirm and classify the areas with high water iodine and the endemic areas of iodine excess goiter in Jiangsu Province according to national standard. Methods A cross section survey was conducted in 2005 at township level in Fenxian, Peixian, Tongshan, Suining, Pizhou counties in Xuzbou municipal and Chuzhou district in Huai 'an municipal in Jiangsu Province. One sample of drinking well water from five directions in the five villages located in the five directions of every township, namely east, west, south, north and central, was tested for its water iodine concentration. If the sample number was less than 5 in one village, then all the well water would be tested. Endemic status of iodine excess goiter was investigated in those townships whose median water iodine concentration was between 150 to 300 μg/L. Then status was affirmed and reclassified according to National Criteria GB/T 19380-2003. Results In all 158 townships from the 6 counties, the median of water iodine concentration in 79 townships were over 150μg/L, with 32 townships in the range of 150 to 300 μg/L. In those 32 townships, 9 met the criteria of area of high water iodine, 23 accorded with that of endemic areas of iodine excess goiter, 16 had stopped the supply of non-iodized salt in advance, but 16 newly detected areas were still served with iodized salt. Four were still served with iodized salt in 47 townships, there median of water iodine concentration were over 300 μg/L. Conclusions Iodized salt intervention should be stopped in all townships with the problems of high water iodine and the endemic areas of iodine excess goiter in order to prevent the possible hazards due to double iodine intake.