中部地區鉻電鍍工人鼻中膈病變之研究

Study on the Nasal Septum Lesions among Chromium Electroplating Workers in Central Taiwan

為了瞭解中部地區電鍍工廠員工中膈異常盛行率及其影響因子，我們比較45位鍍硬鉻工人，136位鍍鉻鎳工人，及68位鋁件陽極氣化對照組工人的鼻腔黏膜變化。作業現場的空氣採樣及工人尿中鉻、鎳金屬濃度的測定當作暴露指標。結果顯示：在勞工鼻腔異常部分，硬鉻廠45人中有5人（佔11.1%）有鼻中膈穿孔，鎳鉻廠136人中有1人（佔0.7%），鼻中膈糜爛潰瘍比率分別為33.3%及4.4%，對照組均無，三組有統計上差異（p<0.01）。三組員工尿中鉻及鎳濃度有顯著性差異，硬鉻廠之尿中鉻濃度幾何平均值為2.29μg/g cre 最高，對照組為0.08μg/g cre最低。尿中鎳以鍍鉻鎳工廠勞工為4.03μg/gcre 最高，對照組為0.97μg/gcre 最低。在空氣採樣方面，鉻酸濃度在個人及區域採樣均以硬鉻廠最高，平均鉻酸濃度範圍0.2~92.5μg/m3，其次為鉻鎳廠，對照組最低。空氣中鉻酸暴露濃度與其尿中鉻之相關性有統計上之差異（r=0.54，p<0.01）。由對數迴分析顯示鼻中膈病變與鉻酸暴露有關。改善電鍍工廠環境衛生，加強局部排氣設備，注重個人防護具的使用，才能減少鉻酸暴露，減少鼻中膈病變的發生。

To investigate the prevalence of nasal septum lesions and its determinants, we conducted air sampling for chromium from electro-plating plants in central Taiwan. 249 workers were enrolled and divided into three groups including 45 hard chrom-plating workers, 136 nickel-chromium electroplating workers, and 46 aluminum anode-oxidation workers as reference group. Ambient monitoring and biological monitoring of chromium and nickel level in urine were performed as indices of exposure. The highest level of chromium in area sampling was found to be 0.2~92.5μg/m3 in hard chrome-plating factories. The level of chromium in the urine of hard chrome-plating workers appeared to be significantly higher than the nickel-chromium electroplating workers and reference group (geometric mean 2.29 vs. 0.31 and 0.08 μg/g cre). A positive correlation was found between ambient and urinary chromium concentrations (r=0.54, p<0.01). Among the 45 hard chrome-plating workers, there were 5 cases of nasal septum perforation and 15 cases with ulceration or erosion. Only one case of nasal septum perforation and 6 cases of ulceration or erosion were found in the nickel-chromium electro-ploating workers. None of the reference group showed any nasal septum abnormalities. Enforce the ventilation devices and personal protection equipments in chromium electroplating plants to improve occupational hygiene is mandatory.