職業石綿暴露引起之惡性間皮瘤病例報告

Malignant Mesothelioma from Occupational Asbestos Exposure: A Case Report

惡性間皮瘤（malignant mesothelioma）和石綿暴露有高度相關，以男性為例，在職業及環境上可歸因於石綿約佔98％。數十年來惡性間皮瘤之發生率不斷上升，成為各國注目之公共衛生議題。不論何種石綿皆可能大幅增加罹患惡性間皮瘤的機率，全面禁用石綿已成為世界已開發國家的趨勢。台灣目前禁止青石綿及褐石綿之製造、販賣及進口，對於使用最為廣泛的白石綿則限制其用途，但仍沒有禁止石綿使用於惡性間皮瘤罹患率最高的隔熱相關產業。台灣本土之惡性間皮瘤案例報告有限，並且鮮少仔細探討石綿暴露之證據。本文報告一位男性罹患惡性間皮瘤，於造船廠從事配管工作有石綿暴露超過二十年，依據職業病診斷之準則分析此個案，並由文獻回顧簡介惡性間皮瘤及其與石綿暴露之關係。

Malignant mesothelioma (MM) is closely associated with asbestos exposure; 98% of MM in male can be attributable to occupational or environmental exposure to asbestos. Over the past several decades, the incidence of MM has consistently increased throughout the world, which has become a global health issue. All types of asbestos can act, as a carcinogen in the development of MM. Total ban on the manufacture, import and use of asbestos has become a consensus among the developed countries. Taiwan currently bans the manufacture, sale and import of crocidolite and amosite, but still permits the use of chrysotile on certain purposes, including insulation industry, where the workers have the highest risk of developing MM. In Taiwan, very few cases documented the association between MM and occupational asbestos exposure. Here we reported a male case of MM who had been working as a pipefitter in a shipyard with occupational asbestos exposure for more than 20 years. We analyzed the case by using the criteria for diagnosing occupational diseases, followed by a brief review of MM and its association with asbestos exposure.