| 英文摘要 |
Objectives: Betel quid chewing is a major risk factor for oral cancer. Most studies on this topic have focused on the carcinogenicity of the areca nut, and limited attention has been given to exogenous contaminants that may be present in betel quid products. In consideration of this gap, the present study investigated pesticide residues and heavy metal content in commercial betel quid products in Taiwan, evaluated regulatory compliance, and established nationwide baseline data prior to the implementation of the Betel Quid Health Hazard Prevention Act. Methods: Betel quid samples, including areca nuts and both white-lime and red-lime betel quids, were collected from 19 counties and cities in Taiwan in 2023 and 2025. Pesticide residues were extracted and analyzed using liquid chromatography tandem mass spectrometry. In total, 200 pesticides were targeted. A subset of the 2025 betel quid samples was analyzed for heavy metals using Inductively Coupled Plasma Mass Spectrometry (ICP-MS), including arsenic, cadmium, lead, and mercury. Results: Among 211 samples analyzed for pesticides, the overall noncompliance rate was 84.8%. Multiple pesticides were detected in most samples, with the most severe contamination occurring in white-lime betel quids wrapped in betel leaves. The number of noncompliant pesticides in white-lime betel quid samples was 3.23 times that in areca nuts (p < .001). In 2025, 53.2% of white-lime betel quid samples contained more than 11 noncompliant pesticides. Several banned pesticides were also detected. In 2025, 19 samples were analyzed for heavy metals. Although mercury was not detected, arsenic, cadmium, and lead were detected in more than 80% of the samples, with red-lime betel quid exhibiting the highest level of contamination. Conclusions: Commercial betel quid products in Taiwan commonly contain multiple pesticide residues and heavy metals. These findings provide crucial nationwide baseline data and may serve as a reference for future monitoring and policy management. |