台灣空氣污染與社區居民健康效應

Air Pollution and Its Health Effects on Residents in Taiwanese Communities

葛應欽(Ying-Chin Ko)

《The Kaohsiung Journal of Medical Sciences》 12卷12期 (1996/12) Pp. 657-699

https://doi.org/10.6452/KJMS.199612.0657

摘要

台灣的空氣污染，有許多特點：(1)台灣地區環境空氣負荷比一般報告更嚴重。平均一平方公里有800輛機動車輛，6家以上工廠。(2)空氣污染嚴重是全面性。以最近的83年監測報告來看，整個台灣地區都不合格，小於10微米懸浮微粒（PM10）年平均值70.5μg/Nm^3。(3)污染來源大多數和工廠有關。和教科書上所寫不一樣的是，在台灣空氣污染源多數和工廠有關，尤其總懸浮微粒，懸浮微粒（PM10），二氧化硫等三種空氣污染物，總懸浮微粒佔68%，懸浮微粒佔51%，二氧化硫更高達94%。(4)工廠與住宅區無區隔。行政院環境保護署，對於大社、林園及頭份三個石化工業區的調查，13%與民宅距離五百公尺。(5)戶內／戶外污染濃度都高。懸浮微粒（PM10）戶內／戶外流通率大約在60－70%，如加上55%－60%的人吸菸及室內其他空氣污染，戶內的空氣污染往往比戶外嚴重。
空氣污染對健康的影響，在台灣有關的研究報告不多：(1)以醫院的肺癌病例對照研究，吸菸因素外，居住在工業區3公里內也是發生肺癌有意義的危險因素，歸因解釋有9%。(2)以石油及石化工業區附近居民癌症死亡比研究，與台灣地區相比，在全癌症、肺癌、腎臟及泌尿器官癌、淋巴造血組織、白血病等標準化死亡比較高，20歲以下青少年兒童的腦癌，標準化死亡比在2－4倍，和醫學文獻記載暴露石化工業致癌危險性及部位似相符合。(3)火力發電廠及儲煤廠附近居民呼吸疾病研究，經隨機抽樣的民眾，排除年齡、性別、身高、吸菸率等干擾因素，也顯示肺功能較差。(4)電池回收廠附近兒童比對照組兒童，有較高的血中鉛濃度。(5)工業區附近學童氣喘盛行率污染物濃度有相關。
針對以上有限的流行病學證據，提出一些建議：(1)應迅速進行空氣污染物對台灣居民之疾病罹病率及死亡率相關調查。(2)建立可適切保護台灣居民健康之空氣品質標準。(3)分析過去的各項空氣污染物濃度，以資判斷其改善程度。(4)空氣污染防制費的徵收。(5)速成立公害健康受害補償法及其相關的制度。(6)發展環境健康工業。(7)各方便的參與。

並列摘要

The are a number of particular features of air pollution in Taiwan, as described below:
(1) In Taiwan area, the air load of pollutants is more serious than previously reported.
(2) There exists severe air pollution throughout the island.
(3) Industry is the major source of pollution.
(4) No demarcation exists between plants and residential quarters.
(5) There is a high concentration of pollutants indoors/outdoors.
The influence of air pollution spreads over all aspects of physical health, primarily on the respiratory tract, causing lung cancer and exaggerating cardiovascular diseases. A few Taiwanese studies are reviewed below which deserve more elaboration.
(1) Use PM for indexing health effect. The annual average value of PM10 in Taiwan has been around 70μg/m3 in 1994. Dr. Schwarz indicated that no safety margin could be derived; for each additional 10μg/ m3 of PM10, the death number could be increased by 1% on the basis of Western studies.
(2) Research with reference to lung cancer cases in the Kaohsiung Medical College Hospital. Living within 3 km of industrial district counted for 9% of cases and caused a 6-fold increase in the risk of disease for people living more than 20 years in the case control study for lung cancer.
(3) Death due to cancer of inhabitants close to petroleum and petrochemical industries. For youths and children below 20 years, cancers related to brain tumors were 2-4 fold of what was expected deaths. Analysis of another petrochemical complex in Chienchen, Kaohsiung, revealed the inhabitants within 1 km showed a higher standardized mortality ratio for cancers of the lung, kidney, urinary bladder, and leukemia than was to
be expected.
(4) Lower lung function and higher incidence of respiratory diseases among residents near a coal-fired power plant (within 3 Km) compared to residents who lived further away from the plant (3-11 Km).
(5) Lead contamination around a kindergarten near a battery recycling plant. There was increased lead absorption among children of the exposed kindergarten and its this was associated with the extent of air and soil pollution in the surrounding area.
In considering above limited epidemiologic evidence, the following recommendations are presented:
(1) to conduct investigation promptly for the correlation of air pollution to disease morbidity and death of inhabitants of Taiwan.
(2) to reevaluate ambient air quality standards on the basis of Taiwanese health studies.
(3) to assess the analytical data of past records on the concentrations of air pollutants.
(4) collection of surcharge fee for air pollution.
(5) Regulation for compensation of pollution victims among industry.
(6) development of environmental health related industries.
(7) Participation of various parties who are concerned the environmental health.
One thing is certain, everyong would be able to breath air which, as far as possible, is clean.

並列關鍵字

air pollution ； community ； health