Use of Epidemiologic Methods in Studying Diseases Caused by Toxic Chemicals

用流行病學方法研究毒性化學物質所引起之疾病

王榮德(Jung-Der Wang)

《中華民國公共衛生學會雜誌》 12卷4期 (1993/12) Pp. 326-334

https://doi.org/10.6288/JNPHARC1993-12-04-02

摘要

流行病學方法原用於研究人類疾病及其決定因子，特別是病因。由於臺灣未有一個類似「物質安全資料表」的危害通識系統，臨床醫師甚難診斷毒化物所引起之病。我們使用流行病學方法基本原則－猜測與否證，運用推翻假說的方式在過去10年間診出10種職業病。本文中以找出某種職業性皮膚癌之病因雙啶及異構物做例子來說明此方法，此外，流行病學方法也可以幫助我們找出早期診斷之標準與預估可能的健康危害。最近我們發現某鉛回收廠有31位（約50%）工人鉛中毒，且其旁之幼稚園小孩鉛吸收增加而智商下降，搬離工廠二年後才恢復。以上敘述二例子作為流行病學方法研究環境毒物之示範。

關鍵字

流行病學 ； 雙吡啶 ； 鉛中毒 ； 皮膚癌

並列摘要

Epidemiologic methods are primarily used for the study of the determinants and occurrence of human illnesses. They have also been applied widely for the discovery of etiologic agents. Because we did not implemented a system of hazard communication e.q. material safety data sheet (MSDS) in Taiwan before 1991, it has been relatively difficult for clinicians to recognize diseases caused by toxic chemicals. By carefully falsifying alternative hypotheses, we have documented 10 kinds of diseases caused by industrial toxic chemicals during 1 983-1992 through the application of epidemiologic methods, which can be considered as a game of conjectures and refutations. We shall share this experience on the documentation of bipyridyl and its isomers as the cause of occupational skin cancer. Epidemiologic methods can also be used to set up early diagnostic criteria and to quantitatively assess the health risk of potential hazards. We have recently found 31 cases (48% of all examined workers) of lead poisoning in a lead recycling factory, and found both an increased lead absorption and a decreased intelligence quotient (IQ) of kindergarten children nearby the factory. Their blood leads decreased and IQ improved significantly after being moved 2 kilometers away from the factory for 2.5 years. These two examples illustrate how the epidemiologic methods can be used on the study and prevention of diseases caused by toxic chemicals.

並列關鍵字

epidemiologic method ； bipyridyl ； lead poisoning ； skin cancer