臺灣博碩士論文加值系統

營建工程所使用的水泥中含有顯著量的六價鉻，以往流行病學研究發現水泥作業勞工有嚴重的皮膚疾病。六價鉻除了經由呼吸暴露的途徑進入人體內外，亦容易經由皮膚吸收。本研究針對泥水作業勞工，進行空氣及皮膚總鉻和六價鉻暴露測定，並收集尿液樣本以評估作業勞工總鉻和六價鉻暴露量。所收集樣本利用原子吸收光譜儀(Atomic Absorption Spectrometer, AA)及紫外光可見光分光光度儀（Ultra Violet-Visible Spectroscopy, UV/Vis），進行樣本三價及六價鉻的分析。此外，執行經皮水分散失(transepidermal water loss, TEWL)測定，以評估勞工皮膚的障壁功能。結合問卷所收集的暴露資料，包括：工作習慣、工作史，水泥成分、工作時間和頻率、手套使用等，綜合皮膚暴露指標（integrated dermal exposure index, IDEI）被計算，用以探討六價鉻皮膚暴露吸收情形與生物暴露指標的關係。結果顯示：空氣中六價鉻濃度為法定容許濃度(5 ?慊/m3)之千分之一，但勞工下班前尿中總鉻濃度約為生物暴露指標值（biological exposure index, BEI）25 ?慊/L 的2倍。單變量迴歸分析結果顯示TEWL與尿中鉻濃度未達統計上顯著相關，尿中鉻濃度隨IDEI上升而顯著上升（p<0.05），並與皮膚疾病嚴重呈顯著相關（r=0.4）。由現場空氣中極低鉻暴露，尿中鉻濃度與IDEI及皮膚疾病之顯著相關，推論泥水業作業勞工皮膚鉻暴露，可能是其體內鉻含量的主要來源。

Cement used in construction contains significant amount of hexavalent chromium (Cr6+). Historical epidemiological studies found that cement workers had severe dermatitis. Cr6+ can enter a human body not only by inhalation, but also through skin absorption. In this study, air and dermal exposure measurements of total chromium and Cr6+ were taken for cement workers. Urine samples of these workers were also collected to assess their total chromium and Cr6+ exposures. All samples collected were analyzed by using Atomic Absorption Spectrometer (AA) and Ultra Violet-Visible Spectroscopy (UV/Vis) to quantify the amounts of Cr3+ and Cr6+. In addition, measurements of transepidermal water loss (TEWL) were conducted to evaluate the skin barrier function of the workers. Combined the information collected by questionnaires, including work practices, work history, cement composition, work time and frequency, glove usage, etc., an integrated dermal exposure index (IDEI) was calculated to explore the relationship of Cr6+ skin absorption and biological exposure marker. The results showed that the concentrations of Cr6+ in the air samples were less than 1/1000 of the permissible exposure level (5 ?慊/m3), but the concentrations of total chromium in urine samples collected at end of shift on the workday were 2 times of the biological exposure index (BEI), 25 ?慊/L. The result of simple linear regression analysis showed the measurements of the TEWL were not significantly associated with the concentration of total chromium in the urine samples. The concentrations of total chromium in the urine samples increased as the IDEI values increased (p<0.05) and were significantly associated with the severity of skin diseases. Because of the low concentration of Cr6+ in the air of the work environment and significant associations between the urinary Cr6+ concentrations and the IDEI values and skin diseases, it is inferred that dermal chromium exposure probably was the main source of body chromium for cement workers.

中文摘要 I
Abstract……………………………...…………………………………………...….II
目錄……………………………...…………………………………………...……...IV
表目錄……………………………...……………………………………………..…VI
圖目錄……………………………...………………………………………….……VII
一、緒論 1
二、研究目的 5
三、研究架構 6
四、研究材料與方法 7
第一節 作業現場 7
4-1-1.研究對象 7
4-1-2.空氣採樣 8
4-1-3皮膚樣本的收集 8
4-1-4尿液樣本的收集 9
4-1-5 TEWL測定 9
4-1-6手部皮膚照相與診斷 9
4-1-7問卷收集與現場訪視紀錄 11
第二節 樣本儲存、運送、分析 12
4-2-1空氣樣本 12
4-2-2尿液樣本 12
4-2-3皮膚樣本 12
4-2-4儀器及設備 13
4-2-5樣本分析步驟 16
4-2-6品質的控制及資料處理 17
4-2-7資料處理 20
五、研究結果與討論 21
5-1.勞工基本資料 21
5-2.空氣濃度的採樣結果 22
5-3.皮膚樣本的採樣結果 23
5-4.尿液樣本的採樣結果 24
5-5.TEWL測定結果 25
5-6.皮膚診斷結果 25
5-7問卷調查 27
5-8尿液樣本與暴露之相關性探討 29
5-9 .TEWL與皮膚疾病與尿液樣本分析結果之相關探討…………………..30
5-10 IDEI和尿中鉻濃度之探討………………………………………………31
六、結論與建議……………………………………………………………………..32
七、研究限制………………………………………………………………………...33
八、參考文獻 34
附件一、泥水業作業勞工訪視問卷……………………………………………….39

Aalto-Korte K. Turpeinen M. Transepidermal water loss and absorption of approaches to enhance transdermal drug delivery. 1. Effect of lipid synthesis inhibitors. Pharmaceutical Sciences 1996; 85(6): 643-648.
Aalto-Korte K. Turpeinen M. Transepidermal water loss and absorption of hydrocortisone in widespread dermatitis. British Journal of Dermatology. 1993; 128(6): 633-635.
American Conference of Governmental Industrial Hygienists (ACGIH). Threshold Limit Values for Chemical Substances and Physical Agents & Biological Exposure Indices. Cincinnati, OH, American Conference of Governmental Industrial Hygienists, 2006.
Aitio A. Jarvisalo J. Kiilunen M. Tossavainen A. Vaittinen P. Urinary excretion of chromium as an indicator of exposure to trivalent chromium sulphate in leather tanning. Int Arch Occup Environ Health. 1984;54(3):241-9.
Anderson RA. Kozlovsky AS. Chromium intake, absorption and excretion of subjects consuming self-selected diets. Clinical Nutrition 1985; 41(6): 1177-1183.
Avnstorp C. Follow-up of workers from the prefabricated concrete industry after the addition of ferrous sulphate to Danish cement. Contact Dermatitis 1989; 20: 365-371.
Avnstorp C. Prevalence of cement eczema in Denmark before and since addition of ferrous sulfate to Danish cement. Acta Dermato-Venerologica 1989; 69: 151-155.
Baranowska-Dutkiewicz B. Absorption of hexavalent chromium by skin in man. Arch Toxicol 1981; 47: 47-50.
Barceloux DG. Chromium. Clinical Toxicology 1999; 37(2): 173-194.
Baruthio F. Toxic effects of chromium and its compounds. Biological Trace Element Research 1992; 32: 145-153.
Calnan CD. Cutaneous hazards for construction workers. Chem. and Ind.: 1973; 3-6.
Chang HY. Lin CC. Shih TS. Chou JS. Huang YS. Evaluation of the protective
effectiveness of gloves from occupational exposure to 2-methoxyethanol using the biomarkers of 2-methoxyacetic acid levels in the urine and plasma. OEM: 2003,011171.
Chen JL. Guo YL. Tsai PJ. Su LF. Use of inhalable Cr6+ exposures to characterize urinary chromium concentrations in plating industry workers. Occupational Health 2002; 44: 46-52.
Chou TC. Shih TS. Sheu HM. Chang SJ. Huang CC. Chang HY. The effect of personal factors on the relationship between carbon disulfide exposure and urinary 2-thiothiazolidine-4-carboxylic acid levels in rayon manufacturing workers. Science of the Total Environment 2004; 322(1-3): 51-62.
Corbett GE. Finley BL. Paustenbach DJ. Kerger BD. Systemic uptake of chromium in human volunteers following dermal contact with hexavalent chromium (22 mg/L). Exposure Analysis and Environmental Epidemiology 1997; 7(2): 179-89.
Cronin E. Contact dermatitis, Dermato-Venereologica, 1989; 69: 151-155.
Donald Barceloux, PO Box 1750, Topanga, CA 90290. Clinical Toxicology 1999; 37(2): 173–194
Drexler H. Goen T. Angerer J. Carbon disulphide. II. Investigations on the uptake of CS2 and the excretion of its metabolite 2-thiothiazolidine-4-carboxylic acid after occupational exposure. International Archives of Occupational & Environmental Health 1995; 67(1): 5-10.
Fendorf SE, Surface reactions of chromium in soils and waters. Geoderma 1995; 67: 55-71.
Fullerton A. Gammelgaard B., Chromium content in human skin after in vitro application of ordinary cement and ferrous-sulfate-reduced cement. Contact Dermatitis 1993; 29: 133-137.
Gammelgaard B. Fullerton A. Avnstorp C. Menne T. Permeation of chromium salts through human skin in vitro. Contact Dermatitis 1992 ; 27(5): 302-310.
Goh C L. Gan S L. Change in cement manufacturing process, a cause for decline in chromate allergy? Contact Dermatitis 1996; 34: 51-54.
Guo Y L. Wang BJ. Yeh KC. Wang JC. Kao HH. Wang MT. Shih HC. and Chen CJ. Dermatoses in cement workers in southern Taiwan. Contact Dermatitis. 1999; 40: 1-7.
Halbert AR. Gebauer KA. Wall LM. Prognosis of occupational chromate dermatitis. Contact Dermatitis 1992; 27: 214-219
Hayes R. Carcinogenic effects of chromium. Biological and environmental spects of chromium. Elsevier Amsterdam, Biomedical Press 1992; 221-247.
Hersting K. Adelmann M. Determination of the chromium-VI content of cement. Implementation of TRGS613: First experiments”, Staub Reinhaltungder Luft 1994; 54: 409-413.
International Agency for Research on Cancer (IARC). IARC monographs of the evaluation of the carcinogenic risk of chemicals to humans: Chromium, Nickel and Welding, IARC, Lyon, 1990; p49.
Irvine C. Pugh C.E. Hansen E.J. Rycroft R.J.G. Cement dermatitis in underground workers during construction of the Channel Tunnel. Occupational Medicine 1994; 44: 17-23.
Jeejeebhoy KN. The role of chromium in nutrition and therapeutics and as
a potential toxin. Nutr rev 1999; 57(11): 329-335.
Johnston A J M, Calnan C D. Cement dermatitis（I）. Chemical aspect. Trans St John’s Hosp Derm Soc 1958; 41: 11-16.
Kanikkannan N. Singh M. Skin permeation enhancement effect and skin Irritation of saturated fatty alcohols. International Journal of Pharmaceutics. 2002; 248(1-2): 219-228
Karita K. Shinozaki T. Tomita K. Yano E. Possible oral lead intake via contaminated facial skin. Science of the Total Environment. 1997; 199(1-2): 125-131,.
Kiilunen M. Kivisto H. Ala-Laurila P. Tossavainen A. Aitio A. Exceptional pharmacokinetics of trivalent chromium during occupational exposure to chromium lignosulfonate dust. Scand Work Environ Health 1983; 9: 265-271.
Langard S. Chromium. In： metals in the environment. Waldron, H.A., Eds, Academic Press, London, 1980, 111.
Lin SC. Tai CC. Chan CC. Wang JD. Nasal septum lesions caused by chromium exposure among chromium electroplating workers. American Journal of Industrial Medicine 1994; 26(2): 221-228.
Lumens ME. Ulenbelt P. Geron HM. Herber RF. Hygienic behaviour in chromium plating industries. International Archives of Occupational and Environmental Health 1993; 64(7): 509-514.
NIOSH：Criteria for a recommended standard-occupational exposure of chromium(VI). DHEW(NIOSH) 1975: 76-129.
Occupational Safety and Health Administration, 29 CFR Parts 1910, 1915 et al., Occupational Exposure to Hexavalent Chromium; final rule Federal Register 2006; 71(39).
Pellerin C., Booker SM. Reflections on hexavalent chromium: health hazards of an industrial heavyweight. Environ. Health Perspect. 2000; 108(9): 402-407.
Pinnagoda J. Measurement of the Trasepidermal Water Loss. In: Serup J, Jemec GBE. Handbook of Non-invasive Methods and the Skin, CRC Press, Inc., Boca Raton, Florida 1995; 173-178.
Tandon R. Aarts B. Chromium, nickel and cobalt contents of some Australian cements. Contact Dermatitis 1993; 28: 201-205.
The National Academy of Sciences : National research council recommended dietary allowances. National Academy of Sciences, Washington, DC, 1980.
Tossavainen A. Nurminen M. Mutanen P. Tola S. Application of mathematical modelling for assessing the biological half-times of chromium and nickel in field studies. British Journal of Industrial Medicine 1980; 37(3): 285-291.
Tsai JC. Guy RH. Thornfeldt CR., Gao WN. Feingold KR. Elias PM.
Metabolic Worksafe Australia, Cement dermatitis. Australian Government Publishing Service, GPO Box 84, Canberra ACT 2601, Australia, 16p. 1993.
行政院勞工委員會勞工安全衛生研究所，作業環境空氣中六價鉻與三價鉻定量分析技術之研究, 1996. 計劃編號：IOSH 83-A302.
行政院勞工委員會勞工安全衛生研究所，勞工鉻暴露生物偵測標準參考方法之建立,1997. 計劃編號：IOSH 85-A308.
行政院勞工委員會，勞工作業環境空氣中有害物容許濃度標準，2003。