海軍造船廠鉛作業員工血中鉛濃度與健康危害長期趨勢研究

Assessment the Relationship between Blood Lead Levels and Health Effects in Shipbuilding Employees

楊燦(Tsan Yang) ； 賴錦皇(Ching-Huang Lai) ； 石建晟(Jiann-Chian Shyr) ； 吳德敏(Der-Min Wu) ； 申慕韓(Mu-Han Shen) ； 林釗正(Chao-Cheng Lin) ； 劉紹興(Saou-Hsing Liou)

《中華職業醫學雜誌》 10卷3期 (2003/07) Pp. 117-130

https://doi.org/10.30027/CJOM.200307.0001

摘要

鉛中毒是一古老的疾病，因職業或環境所造成的鉛中毒案例亦早有所間，而個體血中鉛濃度之變化會隨著不同的職業有著不同的環境暴露與個人特質而有所不同。依過去研究資料顯示，在軍方所屬各鉛作業工廠中鉛暴露危害最大者為造船廠鉛作業員工，其工作項目包括：電氣焊之焊接焊切、噴砂、噴漆、電瓶之充放電等。本研究即是以第一及第四造船廠鉛作業員工為研究對象，分前後兩次以原子吸收光譜儀進行血鉛濃度檢測，第一次納入本研究對象計有第一造船廠90人，第四造船廠85人。第一造船廠於第二次採血前，進行鉛作業危害教育介入，第四造船廠為對照組，並未進行衛教介入。結果顯示：第一次血鉛分析第一造船廠血鉛平均濃度6.7±3.8μg/dl (血鉛範園2.8-22.7μg/dl) ，第四造船廠血鉛平均值烏9.6±4.7μg/dl (血鉛範圍2.9-31.0μg/dl )。第四造船廠血鉛平均值顯著高於第一造船廠血鉛平均濃度。第二次血鉛分析第一造船廠血鉛平均濃度8.0±4.2μg/dl (血鉛範圍2.9-31.0μg/dl)，第四造船廠血鉛平均值為10.2 ±5.9μg/dl (血鉛範圍3.2-31.6μg/dl)。第四造船廠血鉛平均值亦顯著高於第一造船廠血鉛平均濃度。由此結果似乎發現第二次採血血鉛濃度均較第一次採血時為高。特別是第一造船廠有實施員工職業衛生教育介入，由結果來看似乎看不出其成效，反而血鉛平均值有略為上升之現象，可能原因為研究對象血鉛濃度較低，未出現高於40μg/dl之高鉛族群，故衛教介入其成效不顯著，未達統計上顯著差異。因此，血鉛濃度改善計畫中個人衛生教育介入成效較不易在低鉛含量的勞工中顯現出來。整體而言本次結果與81年第一造船廠鉛作業人員血鉛平均值為18.7± 10.5μg/dl (血鉛範園4.3-57.2μg/dl)；第四造船廠血鉛平均值為25.2± 11.9μg/dl (血鉛範園4.2-57.2μg/dl )比較來看，整體的作業環境改善以及職業衛生觀念的提升，都對血鉛濃度的降低有很大的幫助。

關鍵字

造船廠 ； 血鉛濃度 ； 衛教介入

並列摘要

Lead poisoning is an ancient disease. Lead poisoning cases resulting from occupational or environmental causes have been noted since early times. Individual blood lead levels vary with different occupations and with differing environmental lead exposure. Subjective personal traits are equally important. As reported in the past survey data, the shipyard workers suffered from the most serious of lead exposure hazards amongst all the workers in other lead factories belonging to the armed forces. Their work includes electric welding and cutting, sand blasting, spray painting, battery charging and discharging, etc. The subjects of this survey were the employees of Shipyard I and Shipyard IV. We commenced with two blood lead level tests using an Atomic Absorption Spectrophotometer﹒The first was with 90 employees from Shipyard I, and 85 from Shipyard IV included in this study. Before the second blood sampling, an educational intervention of lead-related work hazards had been implemented in Shipyard' I while Shipyard IV serving as a contrast group, without any health related education programs. The results demonstrated that the average blood lead level of Shipyard I was 6.7±3.8μg/dl (ranged from 2.8μg/dl to 22.7μg/dl), and the average level of Shipyard IV was 9.6±4.7μg/dl (ranged from 2.9μg/dlto 31.0μg/dl). This was much higher than that of Shipyard I. The second blood lead analysis showed the average blood lead level for Shipyard I was 8.0±4.2μg/dl (ranged from 2.9μg/dl to 31.0μg/dl), and the average for Shipyard IV was 10.2±5.9μg/dl (ranged from 3.2μg/dl to 31.6μg/dl), this again was significantly higher than that of Shipyard I. From these facts we discovered, that all the blood levels for the first time period were significantly higher that those of the second test. In particularly, there seemed to be no positive impact upon Shipyard I, even though an occupational health education had been implemented. The average blood lead level actually rose a little higher. This may be because no blood lead levels over 40μg/dl were found in this group. Thus the impact of the health education intervention was not remarkable and did not reach to a statistically significant level. Therefore, we can conclude the individual blood lead level health education program has had a minor impact for laborers of low lead levels. Overall, the average blood lead level of this survey together with those for Shipyard I in 1992 was 18.7±10.5μg/dl (ranged from 4.3μg/dl to 57 .2μg/dl); the average of Shipyard IV was 25.2±11.9μg/dl (ranged from 4.21μg/dl to 57.2μg/dl). In comparison, the improvement of the entire local environment, along with the enhancement of occupational health concepts were key reasons driving the blood lead level low.

並列關鍵字

Shipyard ； Blood lead level ； Health education intervention