墓碑刻字工人罹患矽肺症之病例報告

Silicosis in a Tombstone Sculptor: A Case Report

黃百粲(Pai-Tsang Huang) ； 謝玲俐(Lin-Li Hsieh) ； 溫仁和(Jen-Ho Wen) ； 林同森(Tong-Sun Lin) ； 葉坤土(Qun-Tu Yieh) ； 張靜文(Ching-Wen Chang) ； 湯大同(Ta-Tong Tang)

《中華職業醫學雜誌》 3卷2期 (1996/04) Pp. 57-62

摘要

本文報告一位石刻店老闆，因為咳嗽和勞動時呼吸困難到本院就診。胸部X 光發現右側氣胸，兩側中上肺野多發結節狀浸潤，以及蛋殼狀肺門淋巴節腫大。在懷疑矽肺症的診斷下進行工廠調查，發現患者從事墓碑和金斗刻字工作約37 年，工作的方式很可能使息者暴露於細微的石屑粉塵中。所用的六種石材經過傅立葉轉換紅外線光譜分析，發現其中三種含有超過百分之十的游離結晶二氧化矽。患者由於胸管持續氣漏因而接受迷你胸廓切開術，病理切片呈現矽結節，因此本病例屬於塵肺症中的矽肺症。墓碑刻字在彰化地區多為小型家庭企業，不一定加入工會和勞保，也鮮少接受勞工檢查輔導或參與勞工健康檢查“這個病例可以作為預警事件，藉以提高對石作業者職業安全衛生的重視。

關鍵字

墓碑刻字 ； 矽肺症

並列摘要

An owner of a stone shop presented symptoms of cough and exertional dyspnea in recent one month . Chest X-ray on admission revealed pneumothorax on the right lung , multiple fibronodular lesions over bilateral lung fields , and egg-shell type lymphadenopathy at hili. With strong suspicion of silicosis , a field survey was conducted. It disclosed that the victim had sculptured words and patters on tombstones without appropriate ventilation and protective equipment for nearly 37 years . He was potentially exposed to fine dusts generated during the sculptural processes . Three out of six kinds of stones used in this stone shop contained more than 10 % of free silica analysed by Fourier transformation infrared spectrometry. The patient received thoracoplasty operation due to persistent air leakage . The biopsy specimens revealed existence of multiple silicotic nodules . A case of silicosis was diagnosed under pathological confirmation . This case can serve as a sentinel event to strengthen the practice of occupational health in such small and neglected sector in Taiwan .

並列關鍵字

tombstone sculpture ； silicosis