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| 題名: | 合成皮業勞工健康風險評估與管理計畫---子計畫合成皮業勞工噪音暴露及健康影響評估 |
| 作者: | 張大元(Ta-Yuan Chang);賴俊雄(Lai,Jim-Shoung) |
| 貢獻者: | 公共衛生學院職業安全與衛生學系 |
| 關鍵詞: | 合成皮業勞工;職業噪音;共同暴露;健康影響;Synthetic leather workers;Occupational noise;Co-exposure;Healthy effect |
| 日期: | 2006-07-31 |
| 上傳時間: | 2009-09-01 15:02:26 (UTC+8) |
| 摘要: | 目的：本研究為整合型研究計畫「合成皮業勞工健康風險評估與管理」之總計劃，主要是透過橫斷式研究設計來全面性地評估合成皮業勞工對於化學性因子及物理性因子之職業暴露，並進行健康風險評估，提供合成皮業者對於勞工暴露改善策略及主管機關制定勞工健康風險評估政策時之參考。方法：二甲基甲醯胺(DMF)及丁酮、甲苯等為合成皮業中經常使用的有機溶劑，這些有機溶劑進入勞工體內後，會造成不良健康影響；其中DMF 經文獻發現易由皮膚吸收，因此了解手套對混合溶劑之浸透性、破出時間及手套去污方法，對勞工之健康防護有很大幫助；又合成皮業勞工會暴露於噪音下，亦會影響勞工健康；若是同時暴露於溶劑及噪音下，其健康危害仍屬未知數。本研究以國內一家合成皮製造廠為研究對象，藉由生物偵測進行勞工尿中代謝物的暴露劑量分析，推估勞工體內暴露情形；並利用噪音劑量計(Logging Noise Dose MeterType 4443)來測量個人的噪音暴露，且透過問卷及勞工健檢資料收集可能的干擾因子，最後利用線性模式(Linear regression model)來分析不同暴露程度對合成皮業勞工之血壓、肝功能、腎功能之影響。結果：本研究開發頂空固相微萃取方法來分析尿液中DMF 等代謝物，其優點為可省下繁雜的前處理步驟及降低有機溶劑的使用，同時具有快速簡便、不易受到樣本基質干擾等優點。至於手套保養潔淨方法中，以40℃加熱之去污方法較其他方法適當，其中又以加熱10 小時為此部份研究之較適方法。而合成皮作業勞工健康評估方面，暴露於高噪音、低化學物質及高噪音、極低化學物質之勞工，比暴露於低噪音、極低化學物質者有較高的收縮壓；至於腎功能方面，高噪音低化學暴露組及高噪音極低化學暴露組相較於低噪音極低化學暴露組有顯著較高的肌酸酐濃度；而在尿酸方面則顯示出高噪音極低化學暴露組及低噪音低化學暴露組與低噪音極低化學暴露組有顯著的差異。然而在肝功能方面，血清麩草酸轉胺基?及血清麩丙酮酸轉胺基?都沒有統計上顯著差異。結論：噪音與有機溶劑之共同暴露會影響合成皮業勞工之血壓和腎功能，對於共同暴露於噪音及有機溶劑之勞工，其防護措施需要更嚴密周全，並使勞工重視防護手套之重要性，以確保勞工之身體健康。
This project is an integrated research project. The main title of "The Integrated Risk Assessment and Health Management inWorkers of Synthetic Leather Manufactories". The integrated occupational exposure factors both in chemical and physical agents are evaluated in labors of synthetic leather manufacturing through a cross-sectional study. The health outcome and risk assessment are performed. The results of this research will provide a health promotion strategy for exposure. And, if possible, the official authority can be employed for regulated policy in health risk assessment and management. Methods: N,N-dimethylformamide(DMF), methyl ethyl ketone(MEK) and toluene(TOL) are common solvents used in synthetic leather manufacturing. Health of workers can be affected by solvent and noise exposure. DMF can be exposed by skin. It's very helpful to protecting health of workers to realize the permeation rate, breakout time and washing decontamination methods. The health effect of co-exposure to noise and solvents is unknown.We recruited a synthetic leather manufacturing company as our studying subjects. The exposure of workers was assessed by analysis of biological sample of urine.We used the Logging noise dose meter (Type 4443) to measure individual exposure to noise during the study periods, respectively. We collected some confounders by self-administered questionnaire and their health checkup results. Linear regression models were used to analyze effects of blood pressure, liver function and kidney function between different-exposure groups. Results: The purpose of this research is to develop a solid-phase microextraction (SPME) method for analysis of biological monitoring of urinary metabolites, DMF. Advantages of SPME are simple steps and solvents free, fast, convenient and less matrix effect. In washing decontamination methods for protective equipment, 40 .degree.C@10H decontamination method is the more suitable method in the study. We found that high-noise, low-chemical exposure group and high-noise, extremely low-chemical exposure group had significantly higher systolic blood pressure than the low-noise, extremely low-chemical exposure group.We also found that high-noise, low-chemical exposure group and high-noise, extremely low-chemical exposure group had significantly higher concentration of creatinine than the low-noise, extremely low-chemical exposure group in the kidney function. And the high-noise, extremely low-chemical exposure group and low-noise, low-chemical exposure group had significant differences in the concentration of urine acid compared to low-noise, extremely low-chemical exposure group can be observed. However, there was no significant group-difference of the liver function index (i.e., serum glutamic oxaloacetic transaminase and glutamate pyruvate transminase) between the four groups. Conclusions: Co-exposure to noise and organic solvents can affect blood pressure and kidney function among synthetic leather workers. The more complete protection strategy for workers both exposure to noise and organic solvents and workers understanding the importance of protect gloves for health keeping are required.
目的：本研究主要是透過橫斷式研究設計來評估合成皮業勞工之噪音、二甲基甲醯胺(N,N-dimethylformamide, DMF)、甲苯(toluene, TOL)的共同暴露對於勞工血壓、肝功能、腎功能之健康影響。方法：本研究以國內一家合成皮製造廠75 名的員工作為研究對象，扣除外勞之後，有59 名自願者參與本研究。我們利用噪音劑量計(Logging Noise Dose Meter Type 4443)、活性碳管（SKC 226-01）及火焰離子偵測氣相層析儀來測量個人在工作日的噪音及化學暴露，並且依據測量結果將研究對象分為高噪音(≧80 dBA)低化學暴露(C1/TLV1+C2/TLV2≧0.1)、高噪音極低化學暴露(C1/TLV1+C2/TLV2＜0.1)、低噪音(＜80 dBA)低化學暴露與低噪音極低化學暴露四組。我們透過問卷及勞工健檢資料收集可能的干擾因子，並且利用線性模式(Linearregression model)來分析不同暴露程度對合成皮業勞工之血壓、肝功能、腎功能之影響。結果：我們發現高噪音低化學暴露組（n = 17）及高噪音極低化學暴露組（n = 10）相較於低噪音極低化學暴露組（n = 18）有較高的收縮壓，但在舒張壓方面，四組則無統計上顯著的差異。在腎功能方面，我們發現在高噪音低化學暴露組及高噪音極低化學暴露組相較於低噪音極低化學暴露組有顯著較高的肌酸酐濃度；而在尿酸方面則顯示出高噪音極低化學暴露組及低噪音低化學暴露組與低噪音極低化學暴露組有顯著的差異。然而在肝功能方面，不論是血清麩草酸轉胺基?或血清麩丙酮酸轉胺基?，四組都沒有顯著性的差異。結論：噪音與有機溶劑之共同暴露會影響合成皮業勞工之血壓和腎功能，而且 toluene 的暴露可能會對收縮壓及creatinine 有加成作用，未來應針對共同暴露於噪音及有機溶劑所產生的健康影響做更深入的了解與探討。
Objectives: The aim of this study was to investigate health effects of co-exposure to noise, n, n-dimethylformamide, and toluene on blood pressure, liver function, and kidney function among synthetic leather workers. Methods:We recruited 59 volunteers of the synthetic leather manufacturing company with 75 employees excluding 16 foreign workers as our studying subjects.We used the Logging noise dose meter (Type 4443) and a charcoal tube (SKC, No. 226-01) analyzed with the GC-FID system to measure individual exposure to noise and organic solvents during the study periods, respectively. We classified workers to four different-exposure groups based on their individual exposure to noise and organic solvent during their working days. The four groups were high-noise(≧80 dBA) and low-chemical exposure group(C1/TLV1 or C1/TLV1+C2/TLV2≧0.1), high-noise and extremely low-chemical exposure group(C1/TLV1 or C1/TLV1+C2/TLV2＜0.1), low-noise(＜80 dBA) and low-chemical exposure group, and low-noise and extremely low-chemical exposure group. We collected some confounders by self-administered questionnaire and their health checkup results. Linear regression models were used to analyze effects of blood pressure, liver function and kidney II function between different-exposure groups. Results:We found that high-noise and low-chemical exposure group (n=17) and high-noise and extremely low-chemical exposure group (n=10) had significantly higher systolic blood pressure than the low-noise and extremely low-chemical exposure group (n=18) but not observed the significant group-difference of diastolic blood pressure between the four groups.We found that high-noise and low-chemical exposure group and high-noise and extremely low-chemical exposure group had significantly higher concentration of creatinine than the low-noise and extremely low-chemical exposure group in the kidney function.We also observed that high-noise and extremely low-chemical exposure group and low-noise and low-chemical exposure group had significant differences in the concentration of urine acid compared to low-noise and extremely low-chemical exposure group. However, there was no significant group-difference of the liver function index (i.e., serum glutamic oxaloacetic transaminase and glutamate pyruvate transminase) between the four groups. Conclusions: Co-exposure to noise and organic solvents can affect blood pressure and kidney function among synthetic leather workers. There were synergistic effects on systolic blood pressure and creatinine when workers co-exposed to toluene.We suggest further studies to explore and investigate deeply for the healthy affects of co-exposure to noise and organic solvents among synthetic leather workers. |
| 顯示於類別: | [職業安全與衛生學系暨碩士班] 研究計畫
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