臺灣地區氯乙烯暴露工人世代追蹤研究

A Cohort Study of Vinyl Chloride Factory Workers in Taiwan

本研究利用回溯性世代研究法進行台灣地區氯乙婦工人死因分析，根據十二家工 廠之勞保資料，共蒐集 4317 名員工資料，其中 3472 名男性員工於 1950 年 1 月 1 日 至 1991 年 12 月 31 日間進入工廠工作，且年資在一年以上者列入分析。利用衛生署 死亡登記檔及健保資料檔，追蹤世代成員自 1985 年至 1996 年間之存活狀況，死亡者 共有 127 名，整體追蹤率為 98.3%，總追蹤人年為 40，371.0 人年。結果顯示氯乙婦工 人全死因標準化死亡比為 68.8 （95% C.I. = 57.3-81.8），可能具有健康工人效應存在； 而隨著工人的第一次進廠時之年齡的增加，肝癌之標準化死亡比亦隨之減小。而消化 系統癌症以及肝癌仍以在 1970 年以前進廠者有較高的標準化死亡比，更進一步分析 在 1970 年以前即進廠的氯乙婦緊合工人，結果顯示其消化系統癌症有顯著較高的標 準化死亡比 （SMR = 242.8，95% C.I. = 135.8 - 400.6），肝癌的標準化死亡比也到達統 計顯著性 （SMR = 549.7，95% C.I. = 274.0 - 983.7），因此本國氯乙婦工人可能有較高 的消化系統癌症，特別是肝癌。

A retrospective cohort was conducted and standardized mortality ratios (SMRs) for different causes of death were determined for workers of twelve vinyl chloride factories in Taiwan. 3472 male workers who had been employed for at least one year from January 1, 1950 to December 31, 1991 were included in the analysis. A total of 127 cohort members were identified as having died during period 1985-1996 using Taiwan s National Mortality Registry. The completeness of follow-up was 98.3%, and the total number of person-years at risk was 40371.0. The results showed that the SMR for causes of death was 68.8 (95% C.I. = 57.3 - 81.8), indicating a possible “health - workers' effect. The SMR due to liver cancer decreased with increasing age of first exposure to vinyl chloride monomer. Cancer of digestive system and liver for those who were first exposed before 1970 also had a higher SMR. The association was prominent for PVC workers first employed before 1970 with SMRs of 242.8 in cancer of digestive system (95% C.I. = 135.8 - 400.6) and 549.7 in liver cancer (95% C.I. = 274.0 - 983.7). It is concluded that the vinyl chloride workers may experience higher risk of developing cancer of digestive system, especially liver cancer.