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目的：动态观测青海省饮水型地方性砷中毒(简称地砷病)病情变化趋势，综合评价防治措施落实效果，为及时调整防治措施提供科学依据。方法2010-2013年，按照《饮水型地方性砷中毒监测方案》要求，以青海省2个县的3个村作为监测点，测定居民家中饮用水砷含量；调查全部监测村改水工程运行情况，同时对常住人口进行地砷病病情调查，并检测尿砷含量。水砷、尿砷含量检测采用氢化物原子荧光光度法，砷中毒诊断依照《地方性砷中毒诊断标准》(WS/T 211-2001)。结果共监测3个改水工程，其中2个水砷超标，1个间歇运转。2010-2013年，保宁村地砷病检出率分别为27.30%(193/707)、31.90%(245/768)、29.35%(221/753)、28.22%(219/776)；克才村分别为32.62%(107/328)、34.83%(124/356)、31.26%(131/419)、29.35%(118/402)；麻尼磨台村分别为56.58%(43/76)、52.81%(47/89)、45.10%(46/102)、34.69%(34/98)；3个监测村4年中地砷病检出率比较差异无统计学意义(χ2=3.09、0.04、0.92，P均>0.05)。2010-2013年，女性地砷病检出率分别为36.45%(203/557)、40.59%(246/606)、36.12%(225/623)、34.77%(218/627)；男性分别为25.27%(140/554)、28.01%(170/607)、26.57%(173/651)、23.57%(153/649)；女性地砷病检出率高于男性(χ2=16.25、21.32、13.49、19.38，P均<0.05)。0.05). From 2010 to 2013, women arsenic poisoning detection rate was 36.45%(203/557), 40.59%(246/606), 36.12%(225/623) and 34.77%(218/627), respectively;men was 25.27%(140/554), 28.01%(170/607), 26.57%(173/651) and 23.57%(153/649), respectively;women arsenic poisoning detection rates were higher than those of men (χ2 = 16.25, 21.32, 13.49, 19.38, all P < 0.05). Arsenic poisoning detection rate of people younger than 60 years old had a tendency to increase with age. In 2012 and 2013, 105 and 93 urine samples were tested, respectively; urinary arsenic geometric mean was 0.113 and 0.149 mg/L. Conclusions Water improvement projects and water quality are not optimistic, and prevalence of arsenic poisoning is still at a higher level. A sound long-term monitoring program should be established as soon as possible, the management and maintenance of water improvement projects should be strengthened, and the monitoring and prevention work should not be neglected.