疑似牆體拆除作業相關之矽肺症個案報告

矽肺症係由結晶型游離二氧化矽造成的結節狀肺部纖維化病變，以往的案例多半為從事採礦、鑿岩之作業人員，其他如挖掘隧道、研磨業、噴砂業、道路建築、爆破作業、石材切割、磚窯業、陶瓷業、鑄造業亦屬於高危險暴露群。然而國內目前對於游離二氧化矽之環測資料仍不是十分完整，因此上述作業尚無法概括所有高危險性作業類別。過去我們並未關注裝修或改建工程中拆除作業所產生的矽塵可能對人體造成的影響，國外文獻指出公路修整作業及大樓翻修作業亦為罹患矽肺症的高危險群，但並未報導過中小型拆除工作如牆體拆除作業所引起的矽肺症，由本文個案的報導可以發現實際的危險性不容忽視。本文報告一位68歲男性裝修工，過去二十餘年疑似長期接觸磚牆及混凝土牆拆除時的粉塵，而罹患矽肺症之病例，並探討中小型拆除工作導致矽肺症的可能原因。期望在拆修整建作業日漸頻繁的今日，相關作業人員暴露結晶型游離二氧化矽的風險能得到重視。

關鍵字

結晶型游離二氧化矽；矽肺症；磚牆拆除；混凝土牆拆除

並列摘要

Silicosis is caused by inhalation of unbound (free) crystalline silica dust and is characterized by nodular pulmonary fibrosis. In the past, most of the occupation of silicosis patients are mining and rock drilling. Besides, workers who are most at risk include those engaged in tunneling and excavation work, grinding, sandblasting, road building, explosive blasting work, as well as those in slate, granite cutting and brickmaking, ceramics, founding. However, industrial hygiene surveys at workplaces are insufficient in our country, the above-mentioned occupations are not enough to indicate the various high risk groups for airborne silica dust. Although we didn't pay attention to the health risks from airborne silica dust for demolition work and renovation before, some overseas literatures have been pointed that the workers in renovention of highway and buildings are among the high risk groups of silicosis. Wall demolition is not known to be related with silicosis in the past, but we could find the importance of its association with silicosis according to our case. We reported a 68-year-old male upfitter with a long-term exposure of a large number of suspected silica-containing materials from brick and concrete wall over the past 20 years, suffering from silicosis. We also discussed the possible causes of middle and small scale demolition work related silicosis. With the boom in demolition and renovention work going on around the world, we hope that the risk in silica-exposed workers could be highly respected.

並列關鍵字

unbound (free) crystalline silica ； silicosis ； brick wall demolition ； concrete wall demolition

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疑似牆體拆除作業相關之矽肺症個案報告

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