研究指出，一般人暴露汞之主要來源是食入受汞污染的魚所造成，而暴露汞所致危害與中樞神經系統損傷和腎臟功能傷害為主。近年來，研究發現暴露汞亦會誘導心血管系統的損傷。在東芬蘭所進行研究中，發現中年男性頭髮中高汞含量可能是急性冠狀動脈和心血管疾病、冠狀動脈心臟病及全死因死亡率的一個危險因子。調查指出，中石化舊台鹼安順廠過去以水銀電解法製造燒鹼及氯氣近40年，該廠將製程中產生之汞污泥掩埋與含汞廢水排放至廠區或鄰近之海水儲水池及鹿耳門溪，致海水儲水池底泥之總汞濃度高於全台灣12條主要河川之平均值將近600倍，多數魚體中甲基汞濃度均高於魚蝦衛生標準中甲基汞含量限值0.5 ppm。由於居住廢棄鹼氯工廠附近居民有長期捕捉該海水儲存池中之水生物加以食用或販售之習慣，因此當地居民受汞暴露的風險可能相當高，亟需進一步調查解析該地區居民在不同的汞暴露濃度對心血管疾病之影響。本研究的目的為解析汞及戴奧辛污染區域居民之血液中汞濃度分布及心血管疾病盛行率，進而探討該區居民之血中汞濃度與心血管疾病危險因子之相關性。本研究以居住於廢棄鹼氯工廠附近的居民為研究族群。研究對象選取係依戶政資料戶籍設在顯宮、鹿耳及四草里，年齡介於25 - 93歲之居民。本研究共完成1988位研究對象的調查，參與居民在填寫同意書後，接受理學檢查、問卷調查、血液採集及總汞及戴奧辛的分析。全部居民的血液總汞平均濃度 ± 標準差為11.4 ± 8.2 μg/L，而本研究居民之抽菸習慣（34.5 %）和高血壓盛行率（20.8 %）均顯著高於一般國人（33.9 %和13.2 %），在血液生化方面，本研究男女性居民之低密度脂蛋白膽固醇（男：119.1 ± 36.2 mg/dl，女：121.6 ± 36.7 mg/dl）、膽固醇（男：201.0 ± 42.8 mg/dl，女：204.7 ± 43.0 mg/dl）及三酸甘油脂（男：168.8 ± 218.1 mg/dl，女：120.7 ± 107.4 mg/dl）皆高於一般國人（男：116.1 ± 27.1 mg/dl，女：114.5 ± 27.3 mg/dl；男：181.2 ± 36.5 mg/dl，女：182.9 ± 36.8 mg/dl；男：138.9 ± 91.7 mg/dl，女：109.4 ± 66.4 mg/dl），且本研究男女性居民之高密度脂蛋白膽固醇（男：47.9 ± 14.5 mg/dl，女：57.9 ± 15.1 mg/dl）皆低於一般國人（男：51.3 ± 14.8 mg/dl，女：58.9 ± 14.3 mg/dl）。依本研究心血管疾病的定義疾病個案後，總計有466位罹患心血管疾病，盛行率為23.4 %（N= 1988）。經汞暴露濃度與心血管疾病相關性之回顧文獻後，發現血液總汞濃度若高於7.2 μg/L時，體內累積汞與發生粥狀動脈硬化發生具相關性。故本研究將居民血液總汞濃度分布大於第75 %分位（14.0 μg/L）作為高濃度組，與血液總汞濃度小於第25 %分位（6.5 μg/L）為對照組。結果顯示，高濃度組之506人的血液總汞平均濃度 ± 標準差為21.6 ± 9.7 μg/L，對照組494人之血液總汞平均濃度 ± 標準差為4.5 ± 1.5 μg/L，發現高濃度組的心血管疾病之罹患率達26.68 %，顯著高於對照組之19.43 %（p= 0.007）。而進一步校正年齡、性別、脂重及喝酒狀況等人口學和生活型態之影響因子後，結果顯示，研究族群分組的血液總汞濃度與膽固醇和高、低密度脂蛋白膽固醇等血脂肪生化指標以及腎功能指標之尿素氮間呈正相關，且均達統計上差異（p< 0.05）。最後，經校正年齡、脂重、抽菸與否、血中戴奧辛濃度、血糖、三酸甘油脂及膽固醇等七項的與汞暴露及心血管疾病有關之干擾因子之後，依舊顯示高濃度組之心血管疾病罹患率的勝算比明顯高於對照組達1.70倍（95 % CI= 1.20 - 2.42），且呈現統計上差異（p< 0.01）。因此，研究結論為血中汞濃度較高者，心血管疾病罹患率亦較高。由上述之解析可知，在校正相關之危險因子後，顯示血中汞濃度與心血管疾病具統計上顯著之相關性。

The main pathway of human exposure to mercury was fish consumption. Mercury’s toxic effects are well documented on the central nervous system, renal damage, and recent studies have shown that mercury can also induce cardiovascular lesions. The study reported that high content of mercury in hair may be a risk factor for acute coronary events and cardiovascular disease (CVD), coronary heart disease (CHD), and all-cause mortality in middle-aged eastern Finnish men. The An-Shun chlor-alkali plant, located in western Tainan, had produced sodium hydroxide and chlorine by electrolysis for decades. Lots of mercury contaminated sludge was dumped in/around the factory. Previous environmental survey showed that the sediments of rivers and seawater reservoir around the plant were highly contaminated with mercury. Therefore, the residents living in Hsien-Gong, Lu-Erh and Ssu-Tsao Lis near the An-Shun plant may have higher exposure risk of mercury due to consumption of contaminated fish and seafood from sea reservoir and rivers near plant. Those residents living in three Lis were recruited as study subjects. The aims of this study are 1) to investigate the blood mercury level and health index of residents living near mercury and dioxins co-contaminated area, 2) to investigate the prevalence and risk factors of cardiovascular disease of residents, 3) to assess the association between blood mercury and risk factors of cardiovascular disease. The inclusion criteria were living in three Lis and aged from 25 to 93 years. After signing consent form and completing overnight fast, 1988 participant provided blood for mercury, PCDD/Fs analysis and blood biochemistry test. Mean of blood mercury level for all residents was 11.4 ± 8.2 μg/L. Smoking habitant (34.5 %) and hypertension prevalence (20.8 %) of the sampling population are higher than general Taiwanese (33.9 % and 13.2 %). According to biochemical test, low density lipoproteins-cholesterol (male: 119.1 ± 36.2 mg/dl, female: 121.6 ± 36.7 mg/dl), total cholesterol (male: 201.0 ± 42.8 mg/dl, female: 204.7 ± 43.0 mg/dl) and triglyceride (male: 168.8 ± 218.1 mg/dl, female: 120.7 ± 107.4 mg/dl) of males and females in this study are higher than general Taiwanese (male: 116.1 ± 27.1 mg/dl, female: 114.5 ± 27.3 mg/dl; male: 181.2 ± 36.5 mg/dl, female: 182.9 ± 36.8 mg/dl; male: 138.9 ± 91.7 mg/dl, female: 109.4 ± 66.4 mg/dl). However, high density lipoproteins-cholesterol (male: 47.9 ± 14.5 mg/dl, female: 57.9 ± 15.1 mg/dl) is lower than general Taiwanese (male: 51.3 ± 14.8 mg/dl, female: 58.9 ± 14.3 mg/dl). According to the definition of cardiovascular disease in the present study, there were 466 cases have cardiovascular disease. The prevalence rate of CVD was 23.4 %. Previous studies reported that blood mercury level (> 7.2 μg/L) was associated with accelerated progression of atherosclerosis. Thus, the population was divided into high- and low-Hg groups using 14.0 μg/L (the 75th percentile of blood Hg level) and 6.5 μg/L (the 25th percentile of blood Hg level) as the dividing point (H-Hg: 21.6 ± 9.7 μg/L; N = 506; L-Hg: 4.5 ± 1.5 μg/L; N = 494). The prevalence of cardiovascular disease in high blood mercury group (CVD: 26.68 %) was significantly higher than low blood mercury group (CVD: 19.43 %) (p= 0.007). After adjusting factors like demographic characteristics and lifestyle (e.g. age, sex, body fat and alcohol intake), there were significant positive correlations between blood mercury and lipid indicator (e.g. cholesterol, high and low density lipoproteins- cholesterol) and kidney indicator (e.g. blood urea nitrogen) (p< 0.05) in study subjects. After adjusting seven confounding factors that such as age, body fat, smoking, serum PCDD/Fs, glucose, triglyceride, and cholesterol, significant association between blood mercury level and cardiovascular disease (OR=1.70, 95 % CI= 1.20 - 2.42) was found. High morbidity of cardiovascular disease in high blood mercury group was found in this study. The results seem to support the hypothesis that blood mercury level is involved in the pathogenesis of cardiovascular disease.

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