Objective To study the epidemic status of drinking-tea-borne fluorosis in different occupational groups in Qinghai Province.Methods In Qinghai Province,28 counties were randomly selected.According to occupational groups,each county was divided into 4 groups:towns,agricultural areas,semi-agricultural and semi-pastoral areas and pastoral areas; a township was selected from each group (in case of agricultural county or pastoral county,one town and three townships were randomly selected),and two administrative villages (neighborhood committees) were selected in each township(town) as survey sites.Fifty adults over the age of 16 were selected in each survey site for examination of dental fluorosis and clinical skeletal fluorosis and their urine samples were collected ; the way of tea drinking,the amount of tea drank per capita daily and the household consumption of brick-tea were investigated; tea-water samples in each of the 5 different locations(the east,the west,the south,the north and the center) of the survey sites were collected.Detection of dental fluorosis was based on "Dental Fluorosis Diagnostic Criteria" (WS/T 208-2011),using Dean method; the clinical diagnosis of adult skeletal fluorosis was based on "Endemic Skeletal Fluorosis Diagnostic Criteria" (WS 192-1999); fluorine content was determined by fluoride ion selective electrode.Results Ten thousand and three hundred and thirty four adults over the age of 16 were detected,the detection rates of dental fluorosis and skeletal fluorosis were 24.1％(2 494/10 343) and 11.2％ (1 159/10 343),respectively.The detection rates of dental fluorosis in towns,agricultural areas,semi-agricultural and semi-pastoral areas and pastoral areas were 17.7％(366/2 069),26.6％(1 005/3 784),20.7％(330/1 594) and 27.4％(793/2 896),respectively; the detection rates of clinical skeletal fluorosis were 4.7％(98/2 069),7.3％ (299/1 159),9.2％(147/1 594) and 21.2％(615/2 896),respectively.Urinary fluoride levels were 0.9,1.3,1.7 and 1.9 mg/L,respectively.Drank brick-tea based people was 8 816,in which the highest proportion was agricultural population,accounted for 39.1％(3 443/8 816); drank milk-tea based people was 4 771,in which the highest proportion was pastoral population,accounted for 48.8％ (2 326/4 771); drank butter-tea based people was 1 624,in which the highest proportion was agricultural population,accounted for 50.3％(817/1 624).A total of 9 703 households were investigated,and the average household annual consumption of brick-tea was 10 kg.A total of 1 272 tea-water samples were tested,and fluoride content was 1.6 mg/L.Conclusions People from pastoral areas are seriously suffering from drinking-tea-borne fluorosis in Qinghai Province; people in pastoral,semi-agricultural and semi-pastoral areas are key point people concerning the prevention and control of the disease.