背景：根據內政部的統計資料中顯示，國人每年檳榔的總消費額僅次於茶葉、香菸和酒。檳榔內有多種成分已被證實為致癌物質，許多研究指出嚼食檳榔會增加罹患口腔癌、口咽癌和肝癌等風險，也會導致精神方面的障礙，國內有研究報告指出檳榔中的荖葉會導致皮膚病變，另外從事檳榔包裝者常有手部病變發生，但對於檳榔導致皮膚病變的相關研究甚少。因此本研究希望藉由研究檳榔中的成分那些會導致檳榔工作者手部病變，並且提供合適的保護措施以減少這些工作者手部病變的發生；研究分析台灣南部地區檳榔包裝者其手部病變的盛行率。
材料方法：本研究為橫斷式研究設計，以問卷收集基本人口學與生活習慣，工作中相關危險因子暴露及皮膚健康情形；用檳榔中的成分如荖葉、紅灰、白灰和檳榔子作為過敏原，以貼膚測試釐清這些成分是否會導致檳榔包裝者其手部病變。並提出合適的保護措施減少檳榔工作者暴露於危險因子之下，以期對檳榔工作者有所裨益。
結果：在問卷調查中，我們收集到的有效問卷數共110份，這些工作者常見的皮膚傷害包含紅斑(23.6%)、皮膚增厚或苔蘚化(16.3%)、搔癢(13.6%)、色素沈澱(12.7%)和濕疹(11.8%)，大部份的檳榔包裝者手部病變輕微。在貼膚試驗中我們共招募了33位受試者，貼膚測試未未發現檳榔包裝者的致敏原，然而在問卷調查及皮膚檢查中發現工作中有使用防護具(如手套)其有顯著較低的風險發生手部病變。
結論：大多數檳榔檳榔包裝工作者手部的病變為輕微。在貼膚測試中，我們並未找到明確的過敏原，但經由問卷調查及手部皮膚檢查，我們發現有使用手套的工作者比未使用手套者有顯著較低的風險發生手部皮膚病變，證實戴手套可減少手部病變。

Background:According to the data of Ministry of Interior, the consumption of betel quid was preceded only by tea, cigarettes, and alcohol. Some ingredients of the betel quid have been identified as carcinogens, and many studies have shown that betel quid chewing can not only increase the risk of oral cancer, oropharyngeal cancer and liver cancer but also lead to mental disorders. Studies in Taiwan have also shown that the betel leaf can cause skin dermatitis and that those who engaged in packing betel quid reported more skin dermatitis. Associations between the ingredients of the betel quid and skin disorders are unclear, and there are few related studies. Therefore, we conduct a study to investigate which ingredients of betel quid may lead to skin disorders of betel quid assemblers and thus recommend appropriate protective measures to reduce the risk of skin damage. In addition, we assessed the prevalence of skin disorders in betel quid assemblers in southern Taiwan.
Methods:This is a cross-sectional study. We collected data on demographics, lifestyle, work-related risk factors and skin health status by using a questionnaire. In addition, we used betel leaves, white lime, red lime and areca catechu as allergens to perform skin patch test. Furthermore, we proposed appropriate protective measures to reduce betel quid assemblers’ exposure to the risk factors. Result:We obtained questionnaires from 110 assemblers and performed skin patch tests on 33. The common skin injuries include erythema (23.6%), thickened or lichenified (16.3%), itching (13.6%), pigmentation (12.7%), and eczematous (11.8%). In most cases, the skin disorders were mild. In skin patch tests, we did not identify the allergens among these workers.
Conclusions:The prevalence of skin disorders was high in betel quid assemblers, but most of them had mild hand skin damages. We results did not identify allergens in skin patch tests but found the prevalence of hand skin disorders was lower in betel quid assemblers who wore gloves.

中文摘要 I
Abstract II
致謝 IV
Table of contents V
List of tables VI
List of figures VII
Chapter 1 Introduction 1
Chapter 2 References review 3
1. The Ingredients of Betel Quids 3
2. The Distribution of Betel Quids 5
3. The Health Effects Related to the Betel Quids 5
4. Discussion on the Betel Quids Assembler's Hand Damage 8
5. Contact Dermatitis 9
6. Mechanism of Allergic Contact Dermatitis 10
Chapter 3 The Purposes and Importance of the Research 12
1. The Purposes of the Research 12
2. Importance of the Research 12
Chapter 4 Research Materials and Methods 14
1. Research Design and Framework 14
2. The Subjects and the Selection Criteria 14
3. Data Collection 14
4. Study Protocol 15
5. Statistic Analysis 16
Chapter 5 Research Results 17
1. Results of the Questionnaire Survey 17
2. Skin Patch Test Results 18
3. Skin Diseases Diagnosed among Betel Quids Assemblers 19
Chapter 6 Discussion 20
1. The Results of Questionnaire Survey on the Betel Quid assemblers' Hand Skin manifestations 20
2. The Results of Skin Patch Test 21
3. Research limitations 22
Chapter 7 Conclusions 23
References 24

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