| Abstract: | 台灣地區由於人口綢密及社會經濟迅速成長，造成垃圾量急速增加，前衛生署環保局規劃設置 23 座焚化廠來解決垃圾問題。垃圾焚化所排放的物質中含有多種有害空氣污染物，而垃圾焚化廠員工可能有多重的職業暴露，其對健康的影響需要更多的研究來釐清。本研究的主要目的是調查台中市都市垃圾焚化廠員工的健康情形、偵測工作場所的懸浮微粒濃度、探討員工的血液生化指數與其職業暴露之間的關係。研究方法分三部份，首先是面訪問卷調查，收集的資料有健康狀況、職業史、時間活動模式、與重要的干擾因子。第二部份是偵測工作場所懸浮微粒之濃度，將依據員工時間活動模式選擇 3~5 個地點，在不同季節偵測一週五天、共兩週。第三部份是員工健康檢查、血液生化和重金屬檢驗。本研究運用 SAS 軟體作資料分析，方法包括敘述性統計、雙因子分析、Multiple linear regression。共有 122 員工參與本研究的問卷調查與健康檢查，參加率是 89.7%，依照其工作職稱與內容分為暴露組與對照組。懸浮微粒(PM10)濃度以飛灰處理場最高。以迴歸分析，同時控制年齡、性別、在廠工作年數、抽煙後，暴露組血液中的砷和 cadmium 濃度比對照組高，達統計上顯著的差異。血液生化的迴歸分析結果發現：暴露組比對照組有較低的收縮壓、尿酸、球蛋白等。其他的肝臟的消化脢、血脂肪、免疫球蛋白(E, G, M)等在暴露組與對照組並無顯著的差異。本研究使人們更了解垃圾焚化廠員工的健康狀況、職業暴露情形，及 二者之間的相關性。
Disposal of large quantities of municipal wastes has become a serious problem in many cities in Taiwan. There is an increasing trend in using incineration as an alternative way to solve the problem of waste management. Fourteen large-scale municipal waste incineration plants are currently operating in Taiwan, with nine more under construction or planned for the near future. Waste incineration emits many air pollutants, and incinerator workers may have multiple occupational exposures. The potential adverse effects of the exposures on incinerator workers' health are not well understood. The purpose of this epidemiological study was to investigate the occupational exposures and health status in workers of the Taichung city municipal waste incineration plant. The specific aims were to: (1) assess hepatic function, blood lipids, immune parameters, and blood levels of certain heavy metals in incinerator workers; (2) monitor ambient concentrations of particulates in the waste incineration plant; and (3) examine the association between the occupational exposures and various health outcomes in incinerator workers, controlling for confounding factors. This study had three main parts. The first part was an interview survey of health problems, occupational history, time-activity profiles, and potential confounders of all workers in the incineration plant. The second part comprised workplace air monitoring of particulates in three to five selected locations based on the time-activity profiles, five days a week for two weeks in different seasons. The third part consisted of physical examination by an occupational medicine physician and blood chemistry and heavy metal analysis. Workers were classified into two groups, exposure and control, based on their job titles. Data analysis consisted of descriptive statistics, bivariate analysis, and multiple linear regression analysis, using SAS software. In total, 122 workers participated in both questionnaire interview and physical examination, with a response rate of 89.7%. Means of several parameters were significantly different between groups, including hemoglobin, glucose, globulin, arsenic, and lead. Sixty air samples were collected 10 locations during the weeks before physical examination. Workplace ambient air concentrations of PM10 were higher in the fly ash handling area and the areas near the offices for maintenance departments, followed by the incinerator area. Finally, blood levels of arsenic and cadmium, respectively, were significantly higher in exposure group than in controls, adjusting for duration of employment, age, sex, and cigarette smoking. Exposure group had significantly lower systolic blood pressure, uric acid, globulin, total bilirubin in the multiple regression analysis. Hepatic enzymes, blood lipid parameters, IgE, IgG, and IgM were not significantly different between groups. Moreover, blood cadmium level was significantly associated higher levels of triglyceride, r-GT and IgE. Further studies are needed to clarify the associations between cadmium and triglyceride, r-GT and IgE, respectively, before conclusions can be made. |
