電子業從業人員職業性手部皮膚疾病之盛行率與相關因子調查

Prevalence and Related Factors of Occupational Hand Dermatoses among Electronics Workers

接觸性手部皮膚炎是電子從業人員較常見的健康問題之一。截至今日，我們對於此類問題的發生與職業暴露間之關係的認知仍相當有限。本研究的主要目的為瞭解造成這些問題的因素與表現型態，並進一步地探討其預防之道。我們共完成3070位電子從業人員的問卷調查。結果顯示受測者皮膚不適的盛行率相當高；26.3％（807人／3070人）的受訪者表示曾經歷過皮膚不適的問題，且479人（15.6％）的受訪員工認為皮膚問題與工作相關的。皮膚不適主要的發生部位，依次為手掌、臉部、手臂、手背、手指縫及手腕等；其主要症狀則包括紅、癢、乾燥、脫皮、龜裂等。造成職業性皮膚紅癢之相關因子則包括軟化／去膠、沾錫／鍍錫、包裝／出貨、印刷／打印、晶元製造、手銲零件、銲晶及切割等八項工作；個人因素則有蕁麻疹、金屬過敏、異位性皮膚炎、氣喘症及過敏性鼻炎。我們從807位自述有皮膚不適的從業人員中挑選出230位手部皮膚曾出現紅或癢的從業人員作健康檢查與貼膚試驗，最後總共完成183位。在183位受檢者中，對鎳過敏者為16.4％（30人）；而對鉻（14.2％，26人）與鈷（9.8％，30人）及4-Phenylenediamine（6.0％，ll人）等呈陽性反應的比率亦高。在檢查當日經診斷為患有職業性皮膚病者共70位。其中6位是過敏性接觸皮膚炎患者，64位為刺激性接觸皮膚炎患者；前者的主要致病物質為鎳、鈷、鉻、Benzocaine及4-Phenylenediamine，後者則為接觸粉塵／粉屑（如玻璃纖維）、燒／燙傷、暴露於有機溶劑、電鍍液及強酸或其它的物理因素等。對於上述的結果，我們認為有必要作更進一步地追蹤與探討。至於那些工作上須經常使用或暴露於上述所列物質者，我們建議加強宣導物質正確使用及操作的知識，並鼓勵提高防護措施的使用率，如手套、口罩及工作服等，以期降低或預防職業性皮膚疾病或傷害的發生。

Occupational hand dermatoses are often seen in electronics workers. However, investigation regarding the prevalence and risk factors among these workers in the Taiwan Area has been limited. This study surveyed electronics workers to determine the prevalence, types and risk factors of occupational hand dermatoses in them. We completed 3070 questionnaire interviews on workers from 5 large electronic factories. The results of questionnaire survey showed high prevalence of skin problems of hands in 807 (26.3%) subjects. Among them, 479 (15.6%) workers believed that the skin problem is work-related. The chief complaints included redness, itching, dryness, desquamation and fissure on palms, face, forearms, dorsums, finger webs and wrists. Eight job categories were associated with work-related skin redness and itching on the hands, including softening/degluing, tin plating, packing, printing, chip production, parts-soldering, chip-soldering, and board cutting; and the five personal factors associated were urticaria, metal allergy, atopic dermatitis, asthma, and allergic rhinitis. We further invited 230 subjects, who had chief complaints of skin redness or itching on hands, for skin examination and patch testing. A total of 183 out of the 230 subjects completed the examination. The results of patch test showed that the major allergens to our subjects were nickel sulfate (16.4%), cobalt chloride (14.2%), potassium dichromate (9.8%), and phenylenediamine (6.0%). Of the 183 subjects, 6 were diagnosed as having allergic contact dermatitis, and 64 as having irritant contact dermatitis at the time of skin examination. The causal factors for irritant contact dermatitis were exposure to fiberglass, solvents, acids, and chemical burns, or work-related physical factors. With the findings, we recommend that all workers from the electronics industry should be better educated on knowledge of occupational health and safer handling procedures at worksites. We also suggest the electronics workers, especially those whose work involves exposure to the irritant or allergenic substances, to use protective equipment; such as gloves, caps, and masks, in order to reduce work-related skin diseases.