摘要 目的：本研究的目的主要是探討中台灣某廢紙回收紙廠中，不同作業類別勞工其呼吸系統症狀及肺功能異常的比例及其影響因素。 方法：總共有321位勞工進入到此一橫斷式研究。呼吸系統症狀評估使用改編自美國胸腔學會的問卷。肺功能則以肺量計遵照美國胸腔學會的標準作業程序進行。懸浮微粒之粒徑分布及質量濃度以即時的10階多粒徑粉塵分析衝擊器收集採樣。採樣時間為10分鐘，流速240ml/min，在不同的時間點測量2次。最後我們以聖喬治呼吸問卷來評估呼吸系統症狀及肺功能異常對勞工健康生活品質的影響。 結果：紙廠員工的平均年齡為38歲，其平均服務年資為12年。環境採樣的可呼吸性粉塵濃度以烘缸作業區最高（0.078mg/m3），而且濃度遠低於台灣的粉塵危害標準。四組不同作業員工間的呼吸系統症狀盛行率並無顯著差異。在多變項邏輯式迴歸分析模式中，我們發現行政人員和其他各組比較有最高的危險性發生呼吸系統症狀。抽菸量（包-年）和年資是發生呼吸系統症狀的危險因子，而且有劑量-反應之關係存在，不過年資在統計上未達顯著相關。肺功能異常的盛行率在男性行政人員最高，佔了36.8%。雖然年資和肺功能異常間看起來有劑量-反應之關係存在，不過沒有顯著相關。男性員工用力性肺活量的平均測量值和國內外作者推估的預期值相比約少20%。聖喬治呼吸問卷中各項構面的分數和呼吸症狀數目間有高度的相關性，但是肺功能異常則沒有看到此現象。 結論：我們的研究顯示，在廢紙回收紙廠的員工雖然紙塵暴露濃度不高，但是卻有相當比例的呼吸系統症狀和肺功能異常，這些情形和生活習慣如抽菸具有高度相關。所以我們建議應該及早推行「無菸職場」的成立。; Abstract Objective: The objectives of this study were to assess the respiratory symptoms and pulmonary function of four types of workers in a paper recycling plant in central Taiwan. Methods: 321 employees were recruited in this cross-sectional study. All workers’ respiratory symptoms were evaluated using the American Thoracic Society (ATS) questionnaire, and pulmonary function was also assessed using a dry spirometer under the standardized procedure, based on the ATS criteria. Particle size distributions in different working areas were measured using a real time 10-stage particle size analyzer. Particle samples were collected at a flow rate of 240ml/min, for 10 minutes in each work area on two different days. St. George’s Respiratory Questionnaire (SGRQ) was carried out to measure the impact of respiratory symptoms and pulmonary function impairment on workers’ daily life. Results: The mean age of the studied workers was 38 years, and the mean duration of their exposure was 12 years. The measured concentrations of respirable dust in this plant were far lower than those recommended by Taiwan standards. Level of respirable dust concentrations were the highest at the dry machine area (0.078mg/m3). No significant difference in the prevalence of respiratory symptoms of four types of workers. Using multiple logistic regression analysis, we found that administrative workers had the highest risk of developing respiratory symptoms, compared to the other job types. Smoking level (packs-year) and work duration were dose-dependently related to risk of respiratory symptoms. However, the latter association was non-significant. The prevalence rates of pulmonary abnormalities were highest among male administrative workers (36.8%) compared to the other job types, and were related to work duration dose-dependently, although these associations were not significant. For male paper recycling workers, the measured FVC were generally 20% lower than predicted values in a review of literature. All different scores of SGRQ were highly correlated with numbers of respiratory symptoms but not pulmonary function impairment. Conclusion: Our study suggests that work in the paper-recycling plant is associated with respiratory impairment despite the relatively low paper dust levels. This may be attributed to lifestyle habits in the workplace, such as smoking. The authors recommend, therefore, that paper recycling plants be made smoke-free workplaces.
