嫘縈絲廠男性勞工二硫化碳暴露與其配偶懷孕所需時間研究;嫘縈絲廠男性勞工二硫化碳暴露與生殖內分泌研究

Time to Pregnancy Study in Male Workers Exposed to Carbon Disulfide in the Rayon Industry;Reproductive Endocrine Study in Male Workers Exposed to Carbon Disulfide in the Rayon Industry

張光億(Kuang-Yi Chang)

指導教授 ： 陳保中

國立臺灣大學/公共衛生學院/職業醫學與工業衛生研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.00852

摘要

第一部分
此研究目的為評估暴露於二硫化碳(carbon disulfide)下是否對男性受孕力有所影響。受孕力研究以回溯性研究設計，評估男性暴露於二硫化碳下是否會延長其配偶受孕所需時間（time to pregnancy），共有五十六位男性 員工加入此研究，並直接暴露於二硫化碳，因此將五十六對夫婦共有150孕次作為研究族群並將其暴露分組及計算暴露年資，而等待受孕的時間定義為在懷孕前，也就是開始於最後一次月經週期來潮前及之前持續停止避孕的一段時間，利用家訪方式訪問每一位參與研究的男性員工及其配偶，以清楚測量每次懷孕受孕所需時間；藉以探討其配偶受孕所需時間是否延長，二硫化碳暴露評估使用先前空氣採樣資料進行暴露分組，最後分別使用discrete Cox迴歸統計模式進行分析。
分析結果顯示相對於不曾暴露於二硫化碳的孕次，暴露10年以上者有較低的生育能力密度比 (FDR＝0.47; 95% CI: 0.23 to 0.93)，且暴露濃度大於30 ppm也有較低的生育能力密度比 (FDR＝0.58; 95% CI: 0.26 to 1.29) 但是並無達到統計顯著意義。若同時暴露30 ppm且時間持續暴露10年以上生育能力密度比則有顯著的下降 (FDR＝0.42; 95% CI: 0.19 to 0.93). 結果顯示出暴露於二硫化碳對男性生育能力有顯著影響，而長期且高濃度暴露其生育力下降的趨勢較為明顯。

第二部分
此研究目的為評估縲縈絲製造廠男性員工暴露於二硫化碳下是否對其生殖荷爾蒙造成影響。此研究為一橫斷性研究，研究對象為五十三位在台灣某縲縈絲製造廠中不同工作環境工作至少超過三個月之男性。在這五十三位男性員工中，皆直接暴露於二硫化碳，二硫化碳之暴露評估是使用先前空氣以及個人採樣資料進行暴露分組，並計算暴露年資以及累積暴露值 (暴露濃度×年資)；對照組部份來自另兩間無暴露於二硫化碳的工廠，共一百零六位男性員工。男性生殖荷爾蒙是由免疫螢光分析方式來測定血清中的濾泡刺激素 (follicle stimulating hormone)、黃體生成素 (luetinizing hormone) 及睪固酮 (testosterone)、抑制素B (inhibin B)。藉以探討暴露二硫化碳是否改變男性生殖荷爾蒙， 進一步了解其對生殖系統的影響。統計分析方式以General linear model分析。
分析結果顯示在年齡分層後比較未曾暴露以及其他暴露分組，在濾泡刺激素、黃體生成素及睪固酮三種荷爾蒙方面並無顯著差異；而在高暴露組部分相對於低暴露以及對照組部分，抑制素B則是有顯著的昇高。研究結果表示縲縈絲男性勞工暴露於二硫化碳下，對於生殖荷爾蒙有非臨床症狀的影響，但是對於真正的危害機制仍須更進一步的研究探討。

關鍵字

黃體生成素 ； 受孕所需時間 ； 二硫化碳 ； 男性 ； 睪固酮 ； 生育能力 ； 濾泡刺激素 ； 抑制素B

並列摘要

part I
The aim of study was to estimate whether exposed to carbon disulfide (CS2) has an impact on couple fecundability. For couple fecundability used a retrospective cohort in design. A total of 56 male workers in the rayon industry were recruited. We used time to pregnancy (TTP) as a measure of couple fecundability, which was defined as the duration between the dates of discontinuing contraceptive procedures and beginning of last menstrual period before pregnancy, and used a structured questionnaire to interview each male worker and his spouse. We conducted the exposure assessment of CS2 using previously air-sampling data. Finally, we analyzed the data of TTP using the discrete Cox’s proportional hazards model. The pregnancies with the employment of 10 years or more had a lower fecundability density ratio (FDR＝0.47; 95% CI: 0.23 to 0.93) and those exposed more than 30 ppm had a lower ratio (FDR＝0.58; 95% CI: 0.26 to 1.29) compared to those before the employment. Furthermore, workers exposed more than 30 ppm and their employment of 10 years or more were associated with a decreased fecundability density ratio (FDR＝0.42; 95% CI: 0.19 to 0.93). The results showed that the exposure to CS2 had a significant effect on male fecundability, especially for those with the CS2 exposure of long duration and high concentration.

part II
The objective of the study was to estimate whether exposed to carbon disulfide (CS2) has an impact on male reproductive endocrine. The study was a cross-sectional study in design. The study population consisted of 53 male workers with the continuous work in the rayon manufacturing factory at least three months. All 53 workers from the department of a viscose rayon factory with potentially direct exposure to CS2, and 106 male workers in other factories were recruited as the exposed groups and non-exposed group. We conducted the exposure assessment of CS2 using previously air-sampling data, including area and personal sampling. We calculated not only cumulative potential exposure dose from information on the total number of years working with CS2 but also cumulative index (ppm×years). The level of serum follicle stimulating hormone (FSH), luetinizing hormone (LH), total testosterone, and inhibin B were used to determine by enzyme-linked immunosorbent assay (ELISA). Finally, we analyzed the data of reproductive endocrine using the General linear models.
The exposure group of serum FSH, LH, and testosterone were no significant association with exposure after age stratified. However, the serum inhibin B was significantly increased with high exposure. We found the potential effects of exposure CS2 induced subclinical alterations in male reproductive endocrine. Furthermore, the CS2 damage on reproductive endocrine mechanism is still a question that we need to clarify.

並列關鍵字

testosterone ； time to pregnancy ； inhibin B ； follicle stimulating hormone ； luetinizing hormone ； fecundability ； male ； carbon disulfide

參考文獻

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