專題報導 台灣石化業的美麗與哀愁 從石化業的健康經驗談起 國家衛生研究院溫啟邦教授 3 101 9 5 一 前言 1
2
( ) 1875 700 120 3
二 研究方法的文獻 in vitro ( ) 4
三 石化業員工健康經驗的文獻 (cohort) SMR(Standardized Mortality Ratio) SMR PMR (Proportionate Mortality Ratio) SMR (Age adjusted mortality rates) SMR SMR SMR SMR (Healthy Worker Effect) SMR (relative risks) (absolute risks) SMR American Journal of Epidemiology SMR ( ) 5
1970 6
7
: 1. : 1996 Raabe Wong Meta-SMR (AML, Acute myeloid leukemia) 0.96 Chronic myeloid (0.89), acute lymphocytic (1.16), chronic lymphocytic (0.84) 35 PPM 1 PPM (1972-1987) (RR=1.2) AML(RR=3.1) 8
(90% ) (6%) 2. (Asbestos): (insulator) (bricklayer) (maintenance worker) 1972 3. (1,3 Butadiene): 4. (vinyl chloride): Angiosarcoma IARC (International Agency for the Research on Cancer IARC) (WHO) 1989 ( ) multiple myeloma, or non-hodgkin s lymphoma : 1937-1996 9
IARC IARC s evaluation. The conclusion reached by IARC (1989) was as follows: There is limited evidence that working in petroleum refineries entails a carcinogenic risk. This limited evidence applies to skin cancer and leukemia; for all other cancer sites on which information was available, the evidence is inadequate. Exposure to hydrocarbons in the petroleum industry includes inhalation of vapors and dermal contact of crude oil, feed stocks, intermediate products such as benzene during refining, and end products such as gasoline in marketing or distribution When several epidemiological studies show little or no indication of an association between an agent and cancer, the judgement may be made that, in the aggregate, they show evidence of lack of carcinogenicity. (International Agency for the Research on Cancer IARC) : 10
1930-1960 35 ppm 1 ppm 1000 ppm 1 ppm 21 IARC 1989 ( ) multiple myeloma, or non-hodgkin s lymphoma : 1937-1996 11
四 石化業工廠附近居民健康經驗的文獻 (Significant risk) ( ) ( ) 1 ppm 12