鄰苯二甲酸酯類(phthalic acid esters, PAEs)為塑膠工業中最常使用的塑化劑，廣泛用於PVC(polyvinylchloride)產品如塑料玩具、裝潢建材、醫療器具，以及食物保鮮膜，以增加塑膠製品之韌性和延展性。過去文獻指出，PAEs暴露可能干擾或修飾體內荷爾蒙正常運作之能力，而目前台灣地區以鄰苯二甲酸二(2-乙基己基)酯(Di-(2-ethylhexyl) phthalate, DEHP)使用量最高，年平均使用量約20萬公噸左右，研究顯示PVC塑膠及橡膠相關製造業勞工均為DEHP之高暴露族群，故本研究以PVC塑膠粒製造及加工作業共62位勞工為研究對象，評估勞工於此環境下工作DEHP暴露程度。評估項目包括勞工個人工作前後尿液、血液荷爾蒙、個人空氣、手腕紗布之採樣及分析與基本問卷調查。經由分析所得數據則用以評估PVC塑膠粒製造及加工作業勞工DEHP可能之暴露途徑，以及DEHP暴露對血液荷爾蒙可能之影響。
本研究依照勞工職務及暴露潛勢將研究對象分成高、低暴露組，結果顯示高暴露組(n=47)勞工個人空氣、紗布中DEHP濃度，以及工作前後尿液中DEHP三種代謝物濃度均顯著高於低暴露組(n=15)勞工(P<0.05)，表示高暴露組確實有較高的職業暴露。此外勞工個人空氣、紗布中DEHP濃度則分別與工作後尿液中MEOHP濃度呈現顯著相關 R2=0.319(P<0.0001)及R2=0.222(P=0.0003)，不僅顯示廠內空氣中DEHP吸入為勞工之暴露途徑外，亦可經由含DEHP粉塵沈降於皮膚表面，進而吸收或間接食入。因此進一步比較吸入、皮膚吸收之DEHP暴露劑量與尿液代謝物所回推之總暴露劑量三者之相對比例，結果顯示吸入及皮膚吸收之暴露劑量皆小於總暴露劑量之25 %，高暴露組勞工相對於低暴露組勞工經由空氣吸入及皮膚吸收之DEHP劑量佔總暴露之貢獻比例均較高，而低暴露勞工之暴露劑量小於總暴露劑量之10 %。低暴露組勞工經由食入途徑暴露到之DEHP大部分是經由日常生活的飲食所貢獻，來自職業上之暴露極微，而高暴露組勞工除了日常飲食之食入暴露外，尚有職業上之暴露，但其實際暴露比例較難定量之。此外本研究亦分析勞工工作後尿液中DEHP代謝物濃度與血液荷爾蒙之相關性，結果顯示血液中E2濃度與尿液中MEHP、MEHHP、MEOHP濃度及DEHP代謝物總和呈現顯著的正相關，顯示DEHP之暴露可能會誘導體內E2分泌增加，另外研究亦顯示勞工FAI值則與MEHP %呈現顯著的正相關(P<0.01)，表示當勞工體內MEHP濃度較高時會影響男性雄性激素之分泌。以尿液中DEHP代謝物含量回推每日暴露劑量，且以USEPA之RfD計算危害指標(HI)，有14.75 %之勞工其HI值是大於1，顯示DEHP之暴露可能會對部分高暴露勞工造成健康上之危害，另以CSTEE之TDI計算危害指標(HI)，則顯示幾乎整體勞工之HI值是小於1，僅有一名勞工HI值大於1，表示當以CSTEE之TDI為參考劑量時，應不至於對勞工之健康產生影響。
綜合以上資料，部分PVC塑膠粒製造及加工作業勞工確實有DEHP職業暴露，於職場中對高暴露組勞工而言，除空氣吸入及皮膚吸收之暴露途徑外，尚有食入之暴露，此外DEHP之暴露確實會影響勞工體內荷爾蒙之分泌，由於DEHP為已知的內分泌干擾物質，因此未來應收集更多暴露及危害的相關數據來支持這些發現。

Phthalate esters (PAEs) are esterified derivatives from phthalic acid. PAEs are commonly used as plasticizers in the plastic industry to make plastics ductile and flexible, especially in polyvinylchloride (PVC) products such as plastic toys, building material, medical devices and food contact films. Di (2-ethylhexyl) phthalate (DEHP) is the most abundant product of all the phthalates in Taiwan. In animal studies, PAEs showed the toxic effects on female and male reproductive system, interfered with the development of the offspring and acted as an endocrine disruptor. Literature review showed, polyvinylchloride (PVC) processing and rubber industries worker frequently exposed to phthalates via inhaled ambient air and dust in the workplace. PVC pellets manufacturing industry is the upstream manufacturing industry for PVC products. DEHP may be emitted into ambient air during manufacturing process. Until now, little is known about the occupational PAEs exposure levels in PVC pellets manufacturing industry. The aims of this study were first to investigate the exposure scenario of workers in PVC pellets manufacturing industry, and then to evaluate the probable exposure routes of workers in PVC pellets manufacturing process. Finally to assess the health outcomes on the reproductive and thyroid hormones for workers who exposured to high level of PAEs.
We recruited 62 male workers who may expose to DEHP in PVC pellets manufacturing industries as subjects. We conduct the present study to implement the blood hormones examination, personal air DEHP sampling and analysis, pre- and post-shift urine sampling and urinary metabolites of DEHP analysis, wrist gauze sampling and analysis for all selected workers. According to the job category and DEHP exposure possibility, the workers are classified to high exposure group (operator on-the-spot, n=47) and low exposure group (packing and patrolling workers, officer, n=15). The DEHP concentration of air and gauze samples for high exposure group were significant higher than low exposure group (P<0.05). The pre- and post-shift urinary MEHP, MEHHP, MEOHP concentrations of high exposure group were significant higher than low exposure group (P<0.05). Moreover, in present study, the positive correlation between DEHP concentration of air and gauze samples with post-shift urinary MEOHP concentration were found (R2=0.319, P<0.0001 and R2=0.222, P=0.0003). The result shows that the ambient exposure and skin deposition are the potential DEHP exposure routes in this working environment. We compared the back-calculated DEHP exposure doses with urinary DEHP metabolites, inhalation and transdermal absorption DEHP doses, and found inhalation and dermal exposures doses contributed part of total exposure doses. The relative contribution of transdermal and inhalation exposure doses to total DEHP exposure doses for high exposure group are higher than low exposure group, but the relative contribution of transdermal and inhalation exposure doses to total DEHP exposure dose is less than 50%. After adjusting for age, BMI, seniority, smoking and drinking, MEOHP, MEHHP and sum of urinary DEHP metabolites were positively associated with estradiol (E2) respectively and MEHP % was negatively associated with free androgen index (FAI) (P<0.01). When RfD conducted by USEPA was regarded as reference dose, the calculated hazard index (HI) of DEHP for 14.75 % of workers were higher than one. It indicated that some high exposure workers may have high health risk. DEHP daily intakes of most workers were lower the tolerable daily intake (TDI) set by Scientific Committee for Toxicity, Ecotoxicity and the Environment (CSTEE).
In conclusion, the workers in PVC pellets manufacturing industries really exposed to DEHP. The potential exposure routes of DEHP in the working environment were inhalation, dermal absorption and indirect ingestion. In present study, the reproductive hormones of workers may be disrupted by the DEHP expsoure. Further study is needed to collect more data to confirm this finding.

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