合成橡膠燻煙與上呼吸道危害病例報告

合成橡膠工廠的材料、合成物及製造過程的中間產物常戚對上呼吸道產生刺激或過敏反應的危害。一個案病例為鋼鐵公司控管製流程之作業員，作業中不時會吸入機器上橡膠過熱所造成的大量燻煙，常有刺激、黏膜酸感、咳嗽及黃痰等情形；持續兩年的作業，斷斷續續有喉嚨紅腫、慢性扁桃腺炎及聲音沙啞，並主訴有視力變差(VA：6/30，OU)，步行後易呼吸急促滿頭痛現象；病例後來接受扁桃腺切除術，且經檢查有聲帶閉鎖不全及纖維化，肺潮氣容積減少(FEV1，FVC及FEF25-75%減少，FEV1/FVC=0.85)。一般合成橡膠的成份為苯乙烯(Styrene)及丁二烯(Butadiene)，都有黏膜及呼吸道刺激作用，另外常見的合成橡膠有尼奧普林(Neoprene)、氯丁二烯(Chloroprene)、而基合成橡膠(Butyl rubber)、靛類(Nitriles)及聚脲乙烯(Polyurethane)合成橡膠等，而橡膠加熱所產生的燻煙形同合成橡膠所產生的Curing fume易引起咳嗽、多痰、感冒症狀、支氣管炎，且肺活量計顯示呼吸流速減低。此個案的症狀考量為橡膠過熱產生的燻煙引起，但造成聲帶閉鎖不全及纖維化卻少有文獻探討，應對橡膠工廠的可能危害作業詳細評估，並且預防作業員過度的暴露於危害的環境。

關鍵字

合成橡膠燻煙；上呼吸道刺激；聲帶閉鎖不全

並列摘要

Some raw rubber materials, polymerization products, and unreacted chemical intermediates in synthetic rubber industry may damage mucous membran and irritate respiratory tract. Here, we reported one case of victim from steel product company. The job title of this patient is control and maintenance of the production flow. When he worked at this department, he inhaled a large amount of over-heat rubber fume from the rubber pad of machines. He felt irritation of upper respiratory tract, acidic sensation of oral mucous membrane, cough, and phlegm production. He worked at this department for over two years. Throat congestion, chronic pharyngitis and hoarseness on and off was noted at that period of time. His chief complain was that impairment of visual acurity(VA: 6/30, OU), shorthess of breath after waling, and headache. He received tonsilectomy of bilateral tonsils later. After series of examinations, vocal cord incompetence and fibrosis was found. Spirometry showed that vital capacity was reduced (FEV1, FVC, and FEF25-75% was reduced, FEV1/FVC=0.8).The most widely used synthetic synthetic rubber is a copolymer of styrene and butadiene. Fume of 1,3-butadinede may irritate mucous membrane and respiratory tract and so do as other synthetics include Neoprene (polychloroprene), Chloroprene (2-chloro-1,3-butadiene), butyl rubber, nitriles and polyurethane elastomers. Rubber fume produced from heating was the same as curing fume of rubber. Symptoms reported by exposed workers have included cough and phlegm production, chest colds, and episodes of bronchitis. Spirometry has shown decrements in flow preservation of lung volumes. The symptoms of this case may contribute to rubber fume produced by heating. Since few reference mentioned about vocal cord incompetence and fibrosis caused by rubber fume, the possible exposure in rubber industry should be elaborated and prevent from overexposure of rubber workers.

並列關鍵字

Synthetic rubber fume ； irritation of upper respiratory ytract ； vocal cord lncompetence

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合成橡膠燻煙與上呼吸道危害病例報告

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