鉛蓄電池回收場熔煉工人之鉛中毒

Lead Poisoning In A Battery Recycling Smelter

本研究之目的在了解臺灣北部某鉛蓄電池回收廠員工鉛中毒的盛行率、危險因子、和症狀。在110位員工之中，有64位（58.2%）接受我們的體檢。每一位員工都接受細的檢查，包括問卷、神經學檢查、血中鉛、全血球計數、嗜鹼性顆粒紅血球計數、血清肌氨酸酐、血液尿素氮、天門冬酸轉氨基酶（Aspartate aminotransferase）、丙胺酸轉氨基酶（Alanine aminotransferase）、和常規尿液檢查。血中鉛以原子吸收光譜測定法（Aiomic absorption spectrophotometry）測量。結果顯示有55位員工的血中鉛超過40μg/dl，並且31位員工被診斷為鉛中毒。在熔爐、維修、和工地清潔（只有男性）的工人，其血中鉛平均值超過80μg/dl。在切割、精煉、或堆高機的工人其血中鉛平均值則在60到70μg/dl之間。即使辦公室職員和警衛的血中鉛值也有38.5±4.9μg/dl。抽煙、喝酒、和戴口罩與血中鉛值高低無統計相關。血中嗜鹼性顆粒紅血球隨著中鉛之增加而增加。和其它症狀的組合比較，以嗜鹼性顆粒紅血球數≧8/1000或神經學徵象陽性，兩者存在至少一項為依據，其診斷準確率為最高。我們的結論為：鉛中毒在臺灣是一種嚴重的職業病，需要儘速控制。

This study was undertaken to determine the prevalence risk factors and symptomatology for lead poisoning among workers in a lead – battery recycling plant located in northern Taiwan. Sixty-four (58.2%) out of 110 workers were enrolled in our study. A comprehensive medical examination including a questionnaire, neurological examination, blood lead, complete blood count (CBC), count of erythrocyte with basophilic stippling (B.S.RBC), serum creatinine, blood urea nitrogen (BUN), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and routine urine examination was performed on each worker. Blood lead levels were measured by atomic absorption spectrophotometry. The results revealed that 55 workers' blood lead levels were above 40 μg/dl, and 31 workers were diagnosed with lead poisoning. The average blood lead level of workers whose jobs involved furnace, maintenance, and workplace cleaning (male only) were all over 80μg/dl, while those whose jobs involved dissecting, refining, or crane operations were between 60 and 70μg/dl. Even office workers and guards had blood lead levels averaging 38.5±4.9μg/dl. Smoking, drinking, and wearing a cotton mask were not associated with blood lead level. B.S.RBC increased with blood lead level. Either B.S.RBC≧8/1000 or positive neurological signs has the highest diagnostic accuracy when compared with other combinations of symptoms and/or signs. We conclude that lead poisoning is a serious occupational problem in Taiwan which needs to be controlled immediately.