網版印刷工人暴露於乙二醇乙醚酯溶劑對血液系統危害之追縱研究

Follow-Up Study Of Hematological Effects Of Exposure To Ethylene Glycol Monoethyl Ether Acetate In A Silk-Screening Factory

謝明宏(Ming-Hung Hsieh)

指導教授 ： 吳聰能

高雄醫學大學/健康科學院/職業安全衛生研究所/碩士(2005年)

摘要

摘要
研究背景：乙二醇醚是一種對水及有機化合物均有良好溶解性之液體，由於乙二醇醚的良好溶解性與低蒸發率，最常用在油漆及瓷漆中當作溶劑；也常少量加在水性漆、黏膠及清潔劑中。過去幾十年中，乙二醇醚的毒性被廣泛的研究，特別是 ethylene glycol monomethyl ether (EGME,2-methoxyethanol (2-ME))、ethylene glycol monoethyl ether (EGEE,2-ethoxyethanol (2-EE)) 及其酯類 (如ethylene glycol monomethyl ether acetate (EGMEA,2-methoxyethanol acetate (2-MEA))、ethylene glycol monoethyl ether acetate (EGEEA,2-ethoxyethanol acetate (2-EEAc))確定會對人體及動物之血液系統，神經系統，生殖系統與致畸形作用會造成危害。乙二醇乙醚酯(EGEEA) 是一種廣泛使用於工業與商業界的溶劑，主要經由呼吸道，皮膚及腸胃道吸收至體內，乙二醇乙醚酯(EGEEA)主要代謝物 2-ethoxy acetic acid (2-EAAc) 被認為是造成人體及動物之血液系統，神經系統，生殖系統與致畸形作用之主要物質。目前除了對銅箔極版工人暴露於乙二醇甲醚(EGME)溶劑之血液毒性以及網版印刷工人暴露於乙二醇乙醚酯(EGEEA)溶劑之血液毒性外並沒有關於乙二醇醚溶劑長期危害之研究報告。

研究目的：本研究想對使用乙二醇乙醚酯(2-EEAc)溶劑之網版印刷工廠進行血液系統等健康調查，以及追縱先前研究之某一家網版印刷工廠是否經過介入改善後其血液系統的回復情形。
研究方法：以工廠為基礎的縱貫式研究（longitudinal study），利用民國87年至92年的勞工健康檢查資料探討該廠勞工暴露於2-EEAc對其血液系統長期危害的影響；選取的工廠則為台中工業區某家網版印刷工廠；研究對象選取使用2-EEAc作為洗版劑的某家網版印刷工廠高暴露組（暴露組）勞工40位、低暴露組（比較組）勞工47位，其工作類別分別為全自動與半自動印刷區、切割裁剪與配料感光區以及行政辦公區域，再用問卷以ㄧ對一會談方式收集研究對象之基本資料以及生活與工作習慣。
研究結果：第一部份橫斷面研究的民國87年血液常規檢查值在乙二醇乙醚酯高暴露組與乙二醇乙醚酯低暴露組在女性勞工中的血紅素與血比容之差異已達統計上的顯著差異，且血紅素、血比容、及紅血球數與空氣中2-EEAc有統計上的顯著負相關，且呈劑量-效應關係；之後民國89年以及民國92年的血液常規檢查值的女性勞工中高暴露組與低暴露組的血紅素、血比容與紅血球數皆已無差異。第二部份縱貫性研究結果女性高暴露組的血紅素、血比容與紅血球數皆有上升的趨勢，男性勞工的血液常規檢查值則無差異；且經過了三年度的變化後，控制了年齡、性別、BMI、與教育程度，暴露組的血紅素、血比容以及紅血球數皆與比較組的血紅素、血比容以及紅血球數各高了1.55 g/dl (p<0.001)、4.39 % (p<0.001)以及0.55 106/ul (p<0.05)。
研究討論：縱使空氣中2-EEAc濃度上升了，但是在印製區的女性勞工其血液系統確實有提高的情形發生，由此可知，即使經由呼吸系統暴露2-EEAc但是避免直接經由皮膚接觸2-EEAc而穿戴橡膠手套的女性勞工其血液系統的回復是可見的。但是須再釐清暴露2-EEAc代謝成urinary EAA之濃度的增加或減少對血液系統的進一步關係。

關鍵字

網版印刷 ； 乙二醇乙醚酯 ； 血液系統危害

並列摘要

Abstract
Background: Ethylene glycol ether (including ethylene glycol ether esters) are a group of solvents with medium-high boiling points and low evaporation rates. They have been widely used in coatings and in many other industries. Recently, the low molecular weight E-series glycol ethers (including ethylene glycol monomethyl ether (EGME, 2-ME), ethylene glycol monomethyl ether acetate (EGMEA, 2-MEA), ethylene glycol monoethyl ether (EGEE, 2-EE), ethylene glycol monoethyl ether acetate (EGEEA, 2-EEA), have been found to have haematological, neurological, reproductive and teratogenic toxicity. Ethylene glycol monoethyl ether acetate(EGEEA) is a solvent with broad industrial and commercial applications. It may be absorbed through gastrointestinal tract, respiratory tract and skin. Ethoxyacetic acid (EAA) the toxic metabolite of 2-EEAc, has been reported to cause encephalopathy, haematological toxicity, and infertility and teratogenesis. So far, there’s no related long-term study of exposed to ethylene glycol ethers except for haematological effect of exposed to 2-ME in copper-clad laminate manufacturer.
Objective: The objective of this study is to investigate the health effects, especially haematological effect, in the 2-EEAc exposed workers in studied silk-screening factory and to follow-up the haematological effects in a previously studied silk-screening factory workers after engineering control of 2-EEAc exposure.
Methods: The longitudinal study was based on the factory. To discuss workers’ haematological effects of exposed to 2-EEAc with health examination from 1998 to 2003. The silk-screening factory is in Taichung Industry Park. 40 high exposure workers (exposed group) and 47 low exposure workers (comparison group) was selected as the study population. Exposed group was from the silk-screening department, yet comparison group was from the photosensitising room, design room, product compiling room, cutting room, and administrative workers. Information of personal characteristics and working habits was obtained by using of the interview questionnaire.
Result: Of the cross-sectional survey, the haemoglobin and haematocrit in the female high 2-EEAc exposure workers were significantly lower than those of female workers in the comparison group in 1998. The haemoglobin, haematocrit, and RBC count in the study population had a significant dose-response relation with air 2-EEAc levels in 1998.There’s no difference between the female high 2-EEAc exposure workers and female comparison workers with the the haemoglobin and haematocrit in 2000 and 2003. Of the longitudinal study, the trend is on the rise with the haemoglobin, haematocrit, and RBC count of the female high 2-EEAc exposure workers, yet the trend is no difference in male workers. After adjusted for age, sex, BMI, and education level, the haemoglobin, haematocrit, and RBC count of the exposed workers were much higher 1.55 g/dl、4.39 % and 0.55 106/ul, respectively, through the 3 checkup years.
Discussion: Even though air-2EEAc was raised, the haematological effects of female high 2-EEAc exposure workers did improved. Thus it could be seen the recovery from haematological effect that the workers avoid directly dermal exposure of 2-EEAc but wearing rubber gloves. Still, it needs to find out the further relationship of concentration of urinary EAA, the metabolite of 2-EEAc, to affect the haematological effect.

並列關鍵字

haematological effect ； 2-EEAc ； silk-screening

參考文獻

參考文獻

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