台灣職業性與環境性鉛中毒之文獻回顧

A Review of Occupational and Environmental Lead Poisoning in Taiwan

鉛由於其優良特性，廣泛用於人類之環境中已有數千年的歷史，鉛中毒的案例也相繼被發現。本文回顧我國鉛中毒的文獻報告。中國史上最早文獻可查之鉛中毒案例是1892年病人因使用鉛導尿管而造成鉛中毒。台灣早期的鉛中毒案例均發生在幼兒，直到民國57年一位鉛蓄池工人因鉛腦症死亡，職業性鉛中毒才引起注意。民國61年起職業性鉛中毒的流行病學調查相繼展開，雖然被報導的鉛中毒案例不多，調查結果發現勞工血中鉛濃度已逐年下降，不過，仍有偏高的現象，鉛作業場所的危害控制仍須加強。另外，近來發現數件因服用中藥造成鉛中毒的案例，診斷鉛中毒來源時亦要列入鑑別診斷。

Lead has been used in industries for several thousand years due to its good properties of metal, meanwhiles, lead poisoning cases were documented for a long time. This article reviewed the documentations of lead poisoning in Taiwan. The earliest case of lead poisoning documented in China should be traced back to 1892, a patient who used leaded urinary catheter was reported to be lead poisoning. Most of the cases of lead poisoning documented in Taiwan occurred in infants or children due to environmental pollution. The first case of occupational lead poisoning in Taiwan was not documented until 1963, when a lead battery manufacturing worker was reported to be dead of lead encephalopathy. Since then on, a few epidemiological surveys of lead intoxication were performed among a variety of lead exposed factories and only few lead poisoning cases were found. These results showed that the mean blood lead levels in lead-exposed workers were decreasing, however, the mean blood lead level was still too high. These results imply that current control stragies are not enough to protect workers from lead overexposure. Recently, several cases of lead poisoning were documented due to consumption of herbal drugs. It is important to elicit the possibility of lead exposure other than industries in Taiwan.