染料業暴露員工世代之建立

Establishment of a Cohort of Dyestuff Workers in Taiwan

染料製造在台灣地區已有40 年的歷史，而聯苯胺類染料已被證實會導致膀胱癌，其潛伏期最短有6 個㈪，但也有長達48 年，有些國家在禁止製造該類染料後，膀胱癌患者還是會持續出現。在台灣地區聯苯胺類雖已歸為列管的毒性物質，但根據台灣地區染料業的發展過程來算，相信膀胱癌患者的陸續出現應可預期，最好能早期加以診治。本研究為探討台灣染料業者在長期暴露下之健康狀況，採回溯性世代研究法，以台灣地區染料顏料同業公會之會員名冊為依據，蒐集染料業者員工之基本資料，再根據其身份證字號由死亡登記檔及癌症登記檔做比對以建立世代資料檔，作為分析其死因或病因與職業暴露關係之基礎。研究結果共收集以聯苯胺為主的酸性及直接染料等類之製造業㈨家，以及螢光染料為主的染料業者三家等之員工勞保資料，共約一萬四千名，其中男性8,085 名，女性5,869 名，入廠年齡平均約二十六歲，工作年資平均約三年，製造現場人員佔百分之㈤十㈦以上；在1992 年聯苯胺類染料停止製造以前，進入該類工廠服務達一年以上者有4,078 名，其中現場工作者2,588 人應為最高暴露者，以及每週須至現場之中暴露群503 人，均須加強追蹤其健康狀況。又由員工身份證統一編號與全國死亡檔及癌症登記檔作十碼比對，共發現45 名死亡或癌症患者；其中骨折或受傷者14 名，約佔死亡人數的三分之一，均為中高暴露者；癌症則有20 名，其中膀胱癌2 名均為高暴露者，肝癌及子宮頸癌各3 名，其他尚有口腔癌、食道癌、胃癌、鼻咽癌及結腸癌者，亦以中高暴露者為多，而膀胱癌患者卻出現在一家兼營染料製造與染整業者之染整及布廠等下游部門中，故建議應進一步訪察染料相關的下游工業現場作業狀況，以深入瞭解其業者膀胱癌發生之可能性。

Bladder cancer was reported to be caused by benzidine, 4-aminobiphenyl, 2- naphthylamine, and benzidine-based dyes. As benzidine-based dyes have been produced and used in Taiwan for more than forty years, new patients with occupational urothelial cancer can be expected in the near future. A cohort of workers from twelve dyestuff factories consisted of nine benzidine-based dye related factories and three non-benzidine-based dye factories was established. A total of 13,954 workers who had been employed by 1998 was included in this cohort. There were 4,078 workers who once worked in benzidine-based dye factories for at least one year until the production of such dyestuff was prohibited in 1992. There were 2,588 workers with previous high exposure and follow-up health surveillance should be conducted. Forty-five dead cohort members were identified as having died during 1987-1996 by linking with Taiwan’s National Mortality Registry or reported with incident cancer during 1983-1996 in Taiwan’s National Cancer Registry. Among them, there were 20 cancer patients with jobs of middle or high exposure. Two cases of bladder cancer were identified to have worked mainly in the cloth-printing department of a dye factory. It is recommended that a whole cohort of the dyestuff workers should be completed and a health surveillance program be conducted as well to be performed for dyestuff workers.