Introduction:Coal-burning pollution type of endemic fluorosis remains a significant public health threat in certain rural areas of China.This study aimed to analyze the long-term trends in dental fluorosis prevalence ...Introduction:Coal-burning pollution type of endemic fluorosis remains a significant public health threat in certain rural areas of China.This study aimed to analyze the long-term trends in dental fluorosis prevalence in coal-burning fluorosis areas in China from 2009 to 2023.Methods:We collected and analyzed dental fluorosis detection rates among children aged 8–12 in 12 coalburning fluorosis provincial-level administrative divisions(PLADs)of China(2009–2023).The optimal Autoregressive Integrated Moving Average with Exogenous Inputs(ARIMAX)time series model was used to predict dental fluorosis detection rates in children from 2019 to 2023.The GeoDa(version 1.20.0;GeoDa Institute)software was employed for spatial analysis,while the SaTScan(version 10.1;GeoDa Institute)was used to analyze spatial-temporal aggregation patterns.Results:From 2009 to 2023,the dental fluorosis detection rates in children aged 8–12 years showed a decreasing trend,declining from 49.51%to 1.56%.After 2016,achieving the elimination standard(<15%).There was a goodagreement between the observed detection rates andexpected values,with a relative risk(RR)of 0.98.Global analysis shows that the detection rate of dental fluorosis is randomly dispersed.The Moran’s I index for dental fluorosis detection rates was positive in 2009,2011,and 2013,and negative in other years,with Z-values ranging from−1.53 to 0.99.Local analysis indicates that Yunnan Province has continuously presented a low-high aggregation pattern from 2011 to 2013.Space-time analysis identified that Yunnan was classified as a highprevalence cluster in 2022–2023[odds ratio(OR)=1.07,Log likelihood ratio(LLR)=30.45,P<0.05].Conclusions:China has achieved remarkable success in the prevention and control of coal-burning fluorosis.These spatial findings provide critical reference values to support targeted prevention strategies for coalburning fluorosis.展开更多
基金Supported by the National Key Research and Development Program of China(2022YFC2503101)the National Natural Science Foundation of China(82273749 and 82473747).
文摘Introduction:Coal-burning pollution type of endemic fluorosis remains a significant public health threat in certain rural areas of China.This study aimed to analyze the long-term trends in dental fluorosis prevalence in coal-burning fluorosis areas in China from 2009 to 2023.Methods:We collected and analyzed dental fluorosis detection rates among children aged 8–12 in 12 coalburning fluorosis provincial-level administrative divisions(PLADs)of China(2009–2023).The optimal Autoregressive Integrated Moving Average with Exogenous Inputs(ARIMAX)time series model was used to predict dental fluorosis detection rates in children from 2019 to 2023.The GeoDa(version 1.20.0;GeoDa Institute)software was employed for spatial analysis,while the SaTScan(version 10.1;GeoDa Institute)was used to analyze spatial-temporal aggregation patterns.Results:From 2009 to 2023,the dental fluorosis detection rates in children aged 8–12 years showed a decreasing trend,declining from 49.51%to 1.56%.After 2016,achieving the elimination standard(<15%).There was a goodagreement between the observed detection rates andexpected values,with a relative risk(RR)of 0.98.Global analysis shows that the detection rate of dental fluorosis is randomly dispersed.The Moran’s I index for dental fluorosis detection rates was positive in 2009,2011,and 2013,and negative in other years,with Z-values ranging from−1.53 to 0.99.Local analysis indicates that Yunnan Province has continuously presented a low-high aggregation pattern from 2011 to 2013.Space-time analysis identified that Yunnan was classified as a highprevalence cluster in 2022–2023[odds ratio(OR)=1.07,Log likelihood ratio(LLR)=30.45,P<0.05].Conclusions:China has achieved remarkable success in the prevention and control of coal-burning fluorosis.These spatial findings provide critical reference values to support targeted prevention strategies for coalburning fluorosis.
