臺灣博碩士論文加值系統

本研究旨在了解底渣處理業勞工血液多氯戴奧辛/呋喃/擬似戴奧辛多氯聯苯 (Polychlorinated dibenzo-p-dioxins, dibenzofurans and dioxin-like Polychlorinated biphenyl, PCDD/F/dl-PCBs) 濃度與作業環境空氣暴露及勞工健康指標之相關性。本研究選取國內一座底渣處理廠之操作勞工為研究對象，進行勞工血液中PCDD/F/dl-PCBs濃度及生化荷爾蒙指標分析，同時輔以健康、飲食及時間-活動模式等相關暴露影響因子之問卷調查；亦選取廠內底渣儲存區與生產線區共2處為作業環境空氣採樣點，進行底渣處理廠作業環境空氣中氣固相PCDD/Fs濃度分析。結果顯示，底渣儲存區及生產線區作業環境空氣中17種氣固相PCDD/Fs毒性當量總濃度分別為0.252及0.350 pg I-TEQ/Nm3，其中固相PCDD/Fs毒性當量濃度均高於氣相，並均以OCDD、1,2,3,4,6,7,8-HpCDD、1,2,3,4,6,7,8-HpCDF及OCDF為主要貢獻同源物。血液部分，36位底渣處理勞工血液中17種PCDD/Fs之平均毒性當量總濃度為9.72 pg WHO-TEQ/g lipid，低於附近之樹林焚化爐周界居民血液中17種PCDD/Fs之平均毒性當量總濃度；另外，32位勞工血液中12種dl-PCBs佔總PCDD/F/dl-PCBs總毒性當量百分比平均值為29.2%，標準偏差為6.2，只有1位勞工在3倍標準偏差外，顯示廠內勞工之飲食習慣差異不大。若依底渣處理廠36位勞工血液中17種PCDD/Fs毒性當量濃度之中位數(8.83 pg WHO98-TEQDF/g lipid)區分為高、低濃度兩組勞工後，血液中17種PCDD/Fs毒性當量濃度分別為12.3 及7.20 pg WHO-TEQ/g lipid，其中兩組勞工在血液中17 種PCDD/Fs同源物之分布均以OCDD、1,2,3,4,6,7,8-HpCDD、1,2,3,4,6,7,8-HpCDF為主要貢獻，與作業環境空氣PCDD/Fs分布相似。再將該底渣處理廠與附近樹林焚化廠周邊居民比較，發現兩組勞工血液中PCDD/Fs之1,2,3,4,6,7,8-HpCDF之貢獻均高於背景居民，與空氣中PCDD/Fs同源物分布一致，顯示廠內勞工可能經由吸入途徑而有職業暴露PCDD/Fs之現象。底渣處理廠勞工之生化及荷爾蒙檢查在總蛋白質(16人)、膽固醇(15人)、尿酸(10人)、血糖(8人)、中性脂肪(8人)及雌二醇(6人)項目之異常人數較高，但兩組勞工之各項生化、荷爾蒙檢查異常率均無統計上之差異。底渣處理廠勞工之飲食習慣部分，低濃度組勞工在高脂肪含量食物，如雞鴨鵝肉、煙燻肉、花枝章魚類、內臟類及蛋類攝取量較高，且全脂牛奶攝取在10年內的有增加的趨勢(P<0.05)，顯示飲食攝入途徑在低濃度組勞工所佔之貢獻可能較高。關於勞工血液中17種PCDD/Fs毒性當量總濃度之影響因子解析，顯示年齡(P=0.002)與勞工總工作年資(P<0.001)為勞工血液中PCDD/Fs濃度之主要影響因子。比較底渣處理廠本土及外籍勞工血液中17種PCDD/Fs毒性當量總濃度，分別為10.5及8.21 pg WHO-TEQ/g lipid，以本土勞工較高並達統計上之顯著差異(P=0.033)，並解析可能影響勞工血液中17種PCDD/Fs毒性當量總濃度的影響因子，發現無論在年齡、工作年資、總工作年資、BMI值及體脂肪含量百分比皆無差異，又外籍勞工為底渣處理線上之主要操作勞工，顯示外籍勞工比例較高是A廠勞工血液中平均17種PCDD/Fs毒性當量總濃度偏低的主要原因之ㄧ。最後根據廠內空氣及勞工血液中17種PCDD/Fs毒性當量總濃度推估在底渣處理20、30及40年後之平均暴露劑量，介於世界衛生組織(World Health Organization)之建議範圍1-4 pg/kg/day內，顯示底渣處理廠勞工之PCDD/Fs 暴露可能和作業環境有關，但職業暴露情形尚不嚴重，但仍建議應強制廠內勞工佩戴適當之呼吸防護具，並定期追蹤勞工血中PCDD/Fs，確保勞工之健康。

The objective of this study was to investigate the health outcomes of polychlorinated dibenzo-p-dioxins, dibenzofurans and dioxin-like polychlorinated biphenyl (PCDD/F/dl-PCBs) exposure and to assess association between serum PCDD/Fs of workers and working environmental exposure in bottom ash treatment plant. A bottom ash treatment plant workers were selected as subjects, and the serum PCDD/F/dl-PCBs levels (including seventeen PCDD/Fs and twelve dl-PCBs), thirteen blood biochemistry and five hormones examination indices of workers were determined. At the same time, the personal exposure data and time activity pattern were collected with questionnaires. Seventeen airborne PCDD/Fs levels in bottom ash storage area and treatment area were also determined. All the results were integrated to conduct the PCDD/F/dl-PCBs exposure assessment of workers in bottom ash treatment plant. The results show that airborne 17 PCDD/Fs levels in bottom ash storage area and treatment area are 0.252 and 0.350 pg I-TEQ/Nm3, respectively. Particle bound PCDD/Fs levels are higher than gaseous PCDD/Fs in the ambient air of bottom ash storage and treatment area. OCDD, 1,2,3,4,6,7,8-HpCDD, 1,2,3,4,6,7,8-HpCDF and OCDF are the main congeners. The average serum PCDD/Fs levels of 36 workers is 9.72 pg WHO-TEQ/g lipid, which is lower than the residents living near Shulin incineration plant. The average percentage of 12 dl-PCBs in total TEQ of PCDD/F/dl-PCBs of 32 workers is 29.2 %. 36 workers were grouped to high and low level groups by median serum PCDD/Fs. The serum PCDD/Fs levels are 12.3 and 7.20 pg WHO-TEQ/g lipid in high and low level groups, respectively. OCDD, 1,2,3,4,6,7,8-HpCDD, 1,2,3,4,6,7,8-HpCDF are the major congeners in high level group, and the congener pattern is the same as airborne PCDD/Fs. There are no significantly statistical differences in abnormal rate of blood biochemistry and hormone examinations between two groups. The food consumption of poultry products, smoked meat, octopus, eggs and viscera of pig, poultry and fish in low level group are significantly higher than high level group (P<0.05). Moreover, most dietary pattern were not changed during the previous 10 years, only the consumption of whole-fat milk in low level group is increased. The regression data showed that serum PCDD/Fs were highly correlated with total seniority and the age. The average serum PCDD/Fs levels in local worker (10.5 pg WHO-TEQ/g lipid) are significantly higher than foreign workers (8.21 pg WHO-TEQ/g lipid). And the age, seniority, total seniority, BMI, and lipid content between local and foreign workers shows no differences. So the more foreign workers who worked in treatment area are the main factor of low PCDD/Fs level in those subjects. The lifetime average daily dose (LADD) of workers were met the range of WHO daily tolerance dose (1-4 pg/kg/day). The senior workers were potentially exposed to higher level of 1,2,3,4,6,7,8-HpCDF emitted from bottom ash treatment process. The usage of personal protective measures was suggested to effectively reduce the exposure of PCDD/Fs.

第一章 研究背景與目的 1
1-1 研究背景 1
1-2 研究目的 3
第二章 文獻回顧 4
2-1 PCDD/F/dl-PCBs之特性 4
2-1-1 PCDD/F/dl-PCBs之基本特性 4
2-1-2 PCDD/F/dl-PCBs之物理、化學特性 4
2-2 PCDD/F/dl-PCBs之毒性 5
2-2-1 生殖毒性 5
2-2-2 肝毒性 6
2-2-3 皮膚毒性 6
2-2-4 神經系統毒性 6
2-2-5 致癌毒性 7
2-2-6 其他毒性作用 7
2-3 PCDD/F/dl-PCBs之毒性當量因子 8
2-4 PCDD/F/dl-PCBs之暴露途徑 9
2-4-1 PCDD/Fs之暴露途徑 9
2-4-2 dl-PCBs之暴露途徑 10
2-5 PCDD/F/dl-PCBs之代謝 10
2-6 PCDD/F/dl-PCBs來源及環境流布 10
2-6-1 PCDD/Fs來源及環境流布 10
2-6-2 dl-PCBs來源及環境流布 11
2-7 PCDD/Fs職業暴露 11
第三章 材料與方法 13
3-1 研究對象選取 13
3-1-1 基本資料收集與分析 13
3-1-2 研究對象篩選與現勘結果 13
3-1-3 勞工對象選取及說明 14
3-2 操作勞工血液一般臨床生化檢查及健康問卷調查 15
3-2-1 健康門診與血液採集 15
3-2-2 血液中一般臨床生化檢查 15
3-2-3 血液中荷爾蒙檢查 16
3-2-4 健康、飲食及時間-活動模式問卷內容設計與調查方法 16
3-3 空氣中氣固相PCDD/Fs的採樣及分析 18
3-3-1 空氣採樣地點選擇 18
3-3-2 空氣中氣固相PCDD/Fs採樣方法及規範 19
3-3-3 PCDD/Fs空氣樣本前處理方法 20
3-3-4 PCDD/Fs空氣樣本之分析方法及分析條件 23
3-4 勞工血液中PCDD/F/dl-PCBs分析 28
3-4-1 前處理方法 28
3-4-2 PCDD/F/dl-PCBs 血液樣本之分析及操作條件 31
3-4-3 所使用的標準品 32
3-4-4 所使用的各種管柱內含物及作用 33
3-4-5 血液樣品分析之品保品管 33
3-6 統計方法 40
3-7 底渣處理業勞工健康風險評估 41
第四章 結果與討論 43
4-1 品質保證/品質管制資料 43
4-1-1 空氣樣本 43
4-1-2 勞工血液樣本 43
4-2 作業環境空氣中氣固相PCDD/Fs之濃度分布 44
4-2-1 A廠作業環境空氣中氣固相PCDD/Fs濃度及分布 44
4-2-2 A廠作業環境空氣中PCDD/Fs同源物分布情形 46
4-2-3 A廠作業環境空氣與底渣中PCDD/Fs同源物分布比較 48
4-3 底渣處理業勞工問卷資料整理分析48
4-3-1 勞工基本資料整理 48
4-3-2 勞工生活習慣分布 49
4-3-3 勞工職業史及相關暴露資料分布 49
4-3-4 勞工健康情形資料分布 50
4-3-5 勞工飲食習慣情形資料分布 50
4-4 勞工血液生化、荷爾蒙指標檢查結果 52
4-4-1 勞工血液生化檢查結果 52
4-4-2 勞工血液荷爾蒙檢查結果 52
4-5 勞工血液中 PCDD/F/dl-PCBs分析結果 53
4-5-1 勞工血液中PCDD/F/dl-PCBs濃度分布情形 53
4-5-2 高、低濃度組勞工血液中PCDD/Fs濃度差異原因探討 56
4-5-3 健康指標與勞工血液中PCDD/F/dl-PCBs濃度之相關性探討 57
4-5-4 勞工血液中PCDD/F/dl-PCBs影響因子解析 57
4-5-5 A廠中本土及外籍勞工血液中PCDD/Fs及dl-PCBs毒性當量濃度比較 58
4-6勞工血液與作業環境空氣中PCDD/Fs同源物分布比較 58
4-7 底渣處理業勞工與一般居民血液中PCDD/Fs同源物分布比較 59
4-8 底渣處理業勞工致癌風險評估 60
第五章 結論與建議 61
5-1 結論 61
5-2 建議 62
參考文獻 63

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