國內某人造纖維製造工廠疑似二硫化碳中毒職業病案例調查研究

An Occupational Disease Survey for Suspected Carbon Disulfide Intoxication in a Viscose Rayon Factory

國內某人造纖維製造工廠於民國八十一年發生疑似二硫化碳中毒職業病案例，勞工安全衛生研究所進行此調查研究，全面之作業環境測定、暴露勞工之生物偵測以及健康危害評估。於八十一年至八十三年間進行三次環境測定。定點採樣之二硫化碳濃度測定，切棉機濃度最高，約為100 ppm至200 ppm左右；個人採樣之幾何平均值為12.19 ppm、幾何標準偏差為3.99。由於工廠陸續地進行危害控制工程，比較前二次之定點採樣，二硫化碳濃度稍有降低，新生產線切棉機濃度最佳可控制到10 ppm至20 ppm。但第三次採樣二硫化碳濃度又稍上升。以勞工下班時尿液中二硫化碳代謝物2-thiothiazolidine-4-carboxylic acid （TTCA）作為生物偵測之指標，其幾何平均值為1.48 mg/g creatinine，幾何標準偏差為4.74。76％的勞工下班時尿液中TTCA濃度低於美國政府工業衛生師協會（ACGIH）所建議之生物偵測暴露指標值（BEI）：5 mg/g creatinine。對於該工廠可能暴露二硫化碳之163位員工，進行特殊健康檢查，包括感覺神經閾值檢查、傳統神經傳導速度檢查以及核磁共振掃描檢查。十位員工確認為末梢神經病變，其中九位在切棉組，一位在紡棉組。最後建議工廠加強工程危害控制及行政管理措施，以保護勞工之健康。

Because of an outbreak of neuropathy in a viscose rayon factory in 1992, the Institute of Occupational Safety and Health took an exposure survey from 1992 to 1994 in this factory. Environmental monitoring, biological monitoring and physical examinations were applied to evaluate workers' carbon disulfide exposure. The environmental monitoring was conducted from 1992 to 1994. The cutting machine in old production lines had the highest concentration of carbon disulfide, about 100 ppm to 200 ppm. The geometric mean of personal samples (n=76) was 12.19 ppm, and the geometric standard deviation was 3.99. Since the engineering control was improved, the concentrations of carbon disulfide reduced slightly in the new manufacturing lines. The concentration of cutting machine on the new line was as low as 10 to 20 ppm in its best condition. However, in the third environmental monitoring the concentration of carbon disulfide increased a little. The geometric mean of urinary 2-thiothiazolidine-4-carboxylic acid (TTCA) at the end of shift was 1.48 mg/g creatinine, and the geometric standard deviation was 4.74 (n=57). Clinical examinations for 163 workers who were potentially exposed to carbon disulfide including sensory nerve action potentials, motor nerve conduction velocity and nuclear magnetic resonance examinations were performed. Ten workers were diagnosed as neuropathy, nine of them were involved in cutting operation, and the other was in spinning operation. Engineering control and management control should be implemented to protect workers' health.