泡綿作業勞工健康狀況之調查研究

An Investigation of the Health Situation of Foam- Production Workers in Taiwan

列為特化物質的異氰酸鹽相關產品中，泡綿為最普遍的一種，也是該類產品在國內還保持固定生產線的異氰酸作業。泡綿製造也是異氰酸作業中，使用二異氰酸甲苯 （Toluene diisocyanate, TDl）比率最高的行業。本研究對登記在案的泡綿工廠，以問卷方式調查工廠管理狀況，並徵得相關作業勞工配合，進行肝功能檢查、肺部及皮膚理學檢查、填寫勞工健康問卷，並以血清中 TDI 專一性抗體探討其與過敏症狀的相關性。總共受訪視之 160 位勞工中，經專科醫師診斷呼吸道過敏 49 人（30.6%）、皮膚過敏 44 人（27.5%）、眼睛過敏 13 人（8.1%）。呼吸道過敏及皮膚過敏勞工群血清抗 TDI 抗體中，專一性 IgE 及 IgG 均高於無過敏勞工群；但僅 IgE 之測定值，在呼吸道過敏與非過敏的勞工群間有邊緣性顯著差異。本研究顯示該行業勞工，較其他異氰酸作業勞工呼吸道過敏症狀百分比較高；皮膚過敏症狀亦有不容忽視的發生比率；也不能排除其對肝腎功能影響。呼吸道及皮膚過敏現象，均可能與 TDI 專一性 IgE 及 IgG 抗體有關，顯示 TDI 確為誘發其過敏的最主要化學物質。

A large number of factories have been reported using isocyanates, and foam is widely used in their diversified products. Toluene diisocyanate（ TDI） is the most frequently used chemical in foam producing factories. It is reported to be first among all industrial chemicals causing occupational asthma. For this study, from workplaces using isocyanates, foam producing factories were selected and their workers investigated with health questionnaires as well as liver function, lung, and skin examination by doctors specialized in occupational disease. The conditions of hygiene management were investigated using questionnaires answered by management. The correlations between TDI specific antibodies and allergic symptoms were analyzed. Of the 160 TDI foam workers investigated, 49 workers (30.6%) were diagnosed with airway hyperresponsiveness and 44 (27.5%) with allergic dermatitis, and 13 (8.1%) showed allergic syndromes in their eyes. Groups with airway allergy or skin allergy showed higher titers in IgE and IgG antibodies specific to TDI than non-allergic groups. Marginal significant differences were observed in the mean values of specific IgE between allergic groups and non-allergic groups. The percentage of respiratory hypersensitivity is found to be higher in foam workers than in other isocyanate workers; skin hypersensitivity shows the same trend; and the effects of exposure on liver and kidney cannot be excluded either. Specific IgE and IgG against TDI are also found to be correlated with the allergic syndromes. These results indicate that the main cause of allergy in foam factories is TDI.