近三十年來，石化工業為一全球化程度相當高的產業，亦是推動台灣推動台灣經濟發展過程中扮演極為重要之角色。石化工業區所排放之污染物可能造成工業區及鄰近地區空氣污染，且由石化工業區與健康效應的研究調查發現，暴露於石化污染物與多種癌症發生率及死亡率有關，亦會影響呼吸道等相關疾病。然而目前石化工業暴露與勞工或居民之健康危害調查中，其暴露資訊來源有限，如以工廠之原物料推估、”石化區”及”非石化區”或是以居住於石化區距離遠近為石化污染暴露程度分類標準，故在探討石化工業污染與健康評估的相關性時有相當的限制。因此本研究欲整合工業區鄉鎮居民之暴露評估、風險評估及流行病學資料如死亡比、發生比分析，探討兩個不同開發時程的石化區對鄰近居民的健康效應影響及其差異，以建立在台灣本土特有環境下的健康流行病學調查。居民暴露資料為引用前期相關研究成果，以污染物空氣擴散模式模擬結果作為居民之暴露量，並依暴露量進行致癌風險推估，而健康影響評估主要利用死亡登記資料庫及癌登登記資料庫進行高雄工業區鄉鎮及雲林工業區鄉鎮居民之癌症、呼吸系統、神經系統及心血管疾病發生率及死亡率分析，並了解各疾病發生率及死亡率隨時間變化的趨勢。
　　由歷年各廠商之排放資料及氣象資料進行高雄工業區空氣擴散模式模擬結果發現居民之致癌性污染物暴露濃度所推算的致癌風險高於10-6，而且在A鄉的影響村落達70％，在B及C鄉的村落影響範圍最高至100％，顯示居民產生不良健康效應的危險性較高。另外，雲林工業區之污染物空氣擴散模擬是假設污染物排放量達現況環評承諾值及全量許可核定量，各污染物最大著地濃度大多位於廠區內，且由每一網格點濃度所推估之致癌風險發現除苯之致癌風險高於10-6的範圍較廣外，其餘均位於廠區內。
　　民國70-92年高雄三鄉鎮男、女性粗死亡率分別為6.22 ‰及4.06 ‰，全癌症粗死亡率分別為5.22 ‰及3.41 ‰；在麥寮鄉居民之民國85-92年男、女性粗死亡率分別為8.73 ‰及7.01 ‰，全癌症粗死亡率分別為1.28 ‰及1.10 ‰，兩地區皆以肝癌粗死亡率最高。不論以台灣地區人口數或高雄縣人口為參考族群，高雄工業區三鄉鎮之男性全死因、全癌症及女性其他消化器及腹膜之癌症、COPD with bronchiectasis、腦血管疾病標準化死亡比有顯著較高的現象，且男性居民的男性居民的全死因、全癌症、肺癌、呼吸系統及心血管疾病及女性神經系統疾病、肝疾病死亡率自70-92年有逐年上升的趨勢。另外，D鄉居民之疾病標準化死亡比分析發現D鄉及非工業區鄉鎮之肝癌、肺癌、心臟病及腦血管疾病死亡比皆有顯著較參考族群高的現象，尤其該鄉男性居民的腸胃癌及骨癌死亡比有明顯偏高的情形。
　　在標準化發生比分析部分，男性腎癌及女性白血病、腦癌、黑色素瘤發生率有逐年增加的趨勢。另外，雲林縣（包含工業區與非工業區）居民肝癌發生率明顯較台灣地區高，且D鄉男性肝癌發生率亦較非工業區居民高，但隨年代增加，其發生率卻有降低的趨勢。
　　結合空氣擴散模擬所得之暴露資料、致癌風險評估及流病調查結果發現，以高雄工業區為例，居住於工業區附近居民的健康表現與工業區存在時間有某一程度的相關性。而在探討雲林工業區對居民健康的影響時，因考慮慢性疾病潛伏期及病因複雜的因素下，目前尚無法完全釐清雲林工業區對居民健康效應的影響，然而本次健康資料調查可在未來雲林工業區長期開發後，作為評估居民健康的基線參考值。另外，由該鄉居民之疾病發生比及死亡比結果顯示當地居民之疾病死亡及發生情形可能在非工業區污染影響下，其基線背景值已有相對較高的現象，須進一步探討其他可能暴露來源。

　Over the decades, petrochemical industry plays an important role in the economic development and prosperity of Taiwan. Meanwhile, it is an important emission source for atmospheric VOCs as some specific VOCs are attributable to human carcinogenic effects and respiratory diseases. The conclusions, yet, have not been exactly consistent due partly to the different study groups, individual susceptibility, latency period of disease, research method and incomplete exposure data when the investigation took place. Therefore, this study aimed to examine the health effects of residences by exposure data, risk assessment and epidemiologic investigation near the two petrochemical industries of different developing time in Taiwan. The Kaohsiung and Yunlin petrochemical industry were selected as exposure areas and the cancers, respiratory system, nerve system and cardiovascular diseases were chosen to be index diseases. Exposure scenarios based on the emission data and risk assessment profiles were quoted from the related studies. SIR and SMR were calculated to examine the health implication for living around the neighborhood of industrial of petrochemical factories.
　The risk assessment was estimated by the exposure scenarios based on the emission data collected for selected carcinogenic VOCs emitted in Kaohsiung petrochemical industries. The results showed that the personal lifetime cancer risks of residences near the Kaohsiung petrochemical industries were higher than 10-6, and most of the villages were at high risk of hazardous health effects. However, the lifetime cancer risk values higher than 10-6 that evaluated based on environment impact assessment and permitted emission value by EPA were located in the exposure zones, except for the lifetime cancer risk of benzene.
　In 1981-2003, the crude mortality of male and female were 6.22% and 4.06 ‰, respectively, in Kaohsiung studying area. The crude mortality of male and female were 8.73 ‰ and 7.01 ‰, respectively, in Yunlin studying area in 1996-2003. The crude mortality of liver cancer was highest in both areas. For the investigation of SMR for index diseases in these study areas, when using either the entire population of Taiwan or only those residents of Kaohsiung/Yunlin County as the reference group, the SMR of total death, total cancer for males and the cancer of other ingestive organs and peritoneum, COPD with bronchiectasis, Brain blood vessel diseases for females appeared to be higher. Moreover, the SMR of some diseases increased as the time passed by. In the other studying area, the SMR of liver cancer, lung cancer, heart diseases and Brain blood vessel diseases appeared to be higher.
　The SIR of kidney cancer for male and leukemia, brain cancer, melanoma for female were a steadily increasing trend in Kaohsiung study areas. In general, the SIR of liver cancer was significantly higher in the industry and non-industry areas in Yunlin County, but the morbidity decreased.
　The results from the exposure assessment, risk assessment and epidemiologic study were consistent in suggesting the exposure time to emissions on the health effects of residences near the petrochemical industry. However, the causal relationship should be affirmed by adjusting the confounding factors. Though no absolute conclusions can be properly drawn at this point, the results are apt to serve as reference to form a future management plan for factories in these complexes.

Aksoy M. Erdem S. DinCol G. Leukemia in shoe-workers exposed chronically to benzene. Blood. 1974; 44(6):837-41.
Afolabi BM. Akintonwa A. and Ekanem EE. Evidence for obstructive and restrictive lung pathology among tetra-ethyl lead handlers and petrol tanker fillers at a petrochemical industry in Nigeria. West African Journal of Medicine 1999; 18: 265-9.
Axelsson G. and Molin I. Outcome of pregnancy among women living near petrochemical industries in Sweden. International Journal of Epidemiology 1988; 17: 363-9.
Belpoggi F. Soffritti M. Filippini F. Maltoni C. Results of long-term experimental studies on the carcinogenicity of methyl tert-butyl ether. Annals of the New York Academy of Sciences. 1997; 837:77-95.
Bird MG. Burleigh-Flayer HD. Chun JS. Douglas JF. Kneiss JJ. Andrews LS. Oncogenicity studies of inhaled methyl tertiary-butyl ether (MTBE) in CD-1 mice and F-344 rats. Journal of Applied Toxicology. 1997; 17 Suppl 1:S45-55.
Blair, A. P.A. Stewart. R.N. Hoover. et al. Mortality among industrial workers exposed to formaldehyde exposure. J. Natl. Cancer Lnst. 1986. 76(6):1071-1084.
Byren, D. Eeenggholm, G. Englund, A. et al.(1976) Mortality and cancer morbidity in a group of Swedish VCM and PVC production workers. Environmental Health Perspective 1976, 17: 167-170.
Chen PC. Lai YM. Wang JD. Yang CY. Hwang JS. Kuo HW. Huang SL. and Chan CC. Adverse effect of air pollution on respiratory health of primary school children in Taiwan. Environmental Health Perspectives 1998; 106: 331-5.
Cooper SP. Labarthe D. Downs T. Burau K. Whitehead L. Vernon S. Spitz M. New B. and Sigurdson A. Cancer mortality among petroleum refinery and chemical manufacturing workers in Texas. Journal of Environmental Pathology, Toxicology & Oncology 1997; 16: 1-14.
Diodovich C. Bianchi MG. Bowe G. Acquati F. Taramelli R. Parent-Massin D. Gribaldo L. Response of human cord blood cells to styrene exposure: evaluation of its effects on apoptosis and gene expression by genomic technology. Toxicology. 2004; 200(2-3):145-57.
Divine BJ. Hartman CM. Wendt JK. Update of the Texaco mortality study 1947-93: Part II. Analyses of specific causes of death for white men employed in refining, research, and petrochemicals. Occupational & Environmental Medicine. 1999; 56(3):174-80.
de Peyster A. MacLean KJ. Stephens BA. Ahern LD. Westover CM. Rozenshteyn D. Subchronic studies in Sprague-Dawley rats to investigate mechanisms of MTBE-induced Leydig cell cancer. Toxicological Sciences. 2003; 72(1):31-42.
Delzell Elizabeth. Sathiakumar N. Hovinga M. A follow-up study of synthetic rubber workers. Toxicology. 1996; 113: 182-189.
Du CL. Wang JD. Increased mortality odds ratio of primary liver cancer and cirrhosis among VC monomer workers. Occup Environ Med 1998; 55: 528-532.
Gamble JF. Pearlman ED. and Nicolich MJ. A nested case-control study of kidney cancer among refinery/petrochemical workers. Environmental Health Perspectives. 1996; 104: 642-50.
Glass DC. Gray CN. Jolley DJ. Gibbons C. Sim MR. Fritschi L. Adams GG. Bisby JA. Manuell R. Leukemia risk associated with low-level benzene exposure. Epidemiology 2003; 14(5):569-77.
Gun RT. Pratt NL. Griffith EC. Adams GG. Bisby JA. Robinson KL. Update of a prospective study of mortality and cancer incidence in the Australian petroleum industry. Occupational & Environmental Medicine. 2004; 61(2):150-6.
Hajat S. Haines A. Atkinson RW. Bremner SA. Anderson HR. Emberlin J. Association between air pollution and daily consultations with general practitioners for allergic rhinitis in London, United Kingdom. American Journal of Epidemiology. 2001; 153(7):704-14.
Hong YC. Lee JT. Kim H. Ha EH. Schwartz J. Christiani DC. Effects of air pollutants on acute stroke mortality. Environmental Health Perspectives. 2002; 110(2):187-91.
Jo WK. Kim KY. Park KH. Kim YK. Lee HW. Park JK. Comparison of outdoor and indoor mobile source-related volatile organic compounds between low- and high-floor apartments. Environmental Research.2003; 92(2):166-7.
Jo WK. Lee JW. Shin DC. Exposure to volatile organic compounds in residences adjacent to dyeing industrial complex. International Archives of Occupational & Environmental Health.2004; 77(2):113-20.
Kalabokas PD. Hatzianestis J. Bartizis JG. and Papagiannakopoulos P. Atmospheric concentrations of saturated and aromatic hydrocarbons around a Greek oil refinery. Atmospheric Environment. 2001; 35:2545-55.
Ko YC. Air pollution and its health effects on residents in Taiwanese communities. Kaohsiung Journal of Medical Science 1996; 12(12):657-69.
Koken PJ. Piver WT. Ye F. Elixhauser A. Olsen LM. Portier CJ. Temperature, air pollution, and hospitalization for cardiovascular diseases among elderly people in Denver. Environmental Health Perspectives. 2003; 111(10):1312-7.
Lee BE. Ha EH. Park HS. Kim YJ. Hong YC. Kim H. Lee JT. Exposure to air pollution during different gestational phases contributes to risks of low birth weight. Human Reproduction. 2003; 18(3):638-43.
Lewis RJ. Schnatter AR. Drummond I. Murray N. Thompson FS. Katz AM. Jorgensen G. Nicolich MJ. Dahlman D. Theriault G. Mortality and cancer morbidity in a cohort of Canadian petroleum workers. Occupational & Environmental Medicine. 2003; 60(12):918-28.
Li CY. Chen KR. Wu CH. and Sung FC. Job stress and dissatisfaction in association with non-fatal injuries on the job in a cross-sectional sample of petrochemical workers. Occupational Medicine (Oxford) 2001; 51: 50-5.
Lin MC. Yu HS. Tsai SS. Cheng BH. Hsu TY. Wu TN. Yang CY. Adverse pregnancy outcome in a petrochemical polluted area in Taiwan. Journal of Toxicology & Environmental Health Part A 2001; 63(8):565-74.
Luc D. Leclerc A. Begin D. Demers PA. Gerin M. Orlowski E. Kogevinas M. Belli S. Bugel I. Bolm-Audorff U. Brinton LA. Comba P. Hardell L. Hayes RB. Magnani C. Merler E. Preston-Martin S. Vaughan TL. Zheng W. Boffetta P. Sinonasal cancer and occupational exposures: a pooled analysis of 12 case-control studies. Causes & Control. 2002; 13(2): 147-57.
Martins MC. Fatigati FL. Vespoli TC. Martins LC. Pereira LA. Martins MA. Saldiva PH. Braga AL. Influence of socioeconomic conditions on air pollution adverse health effects in elderly people: an analysis of six regions in Sao Paulo, Brazil. Journal of Epidemiology & Community Health. 2004; 58(1):41-6.
Matos EL. Vilensky M. Mirabelli D. Boffetta P. Occupational exposures and lung cancer in Buenos Aires, Argentina. Journal of Occupational & Environmental Medicine. 2000; 42(6):653-9.
Mehlman MA. Carcinogenicity of methyl-tertiary butyl ether in gasoline. Annals of the New York Academy of Sciences. 2002; 982:149-59.
Morgenstern P. Versteegh AF. de Korte GA. Hoogerbrugge R. Mooibroek D. Bannink A. Hogendoorn EA. Survey of the occurrence of residues of methyl tertiary butyl ether (MTBE) in Dutch drinking water sources and drinking water. Journal of Environmental Monitoring. 2003; 5(6):885-90.
NTP. Toxicology and Carcinogenesis Studies of Ethylbenzene (CAS No. 100–41–4) in F344/N Rats and B6C3F1 Mice (Inhalation Studies). National Toxicology Program. 1999; NTP TR 466, NIH Publications No. 96–3956.
Nyberg F. Gustavsson P. Jarup L. Bellander T. Berglind N. Jakobsson R. Pershagen G. Urban air pollution and lung cancer in Stockholm. Epidemiology. 2000; 11(5): 487-95.
Ohlson C. Hardell L. Testicular cancer and occupational exposures with a focus on xenoestrogens in polyvinyl chloride plastics. Chemosphere. 2000; 40(9-11):1277-82.
Pan BJ. Hong YJ. Chang GC. Wang MT. Cinkotai FF. and Ko YC. Excess cancer mortality among children and adolescents in residential districts polluted by petrochemical manufacturing plants in Taiwan. Journal of Toxicology & Environmental Health 1994; 43: 117-29.
Puntoni R. Ceppi M. Gennaro V. Ugolini D. Puntoni M. La Manna G. Casella C. Merlo DF. occupational exposure to carbon black and risk of cancer. Cancer Causes & Control. 2004; 15(5):511-6.
Raaschou-Nielsen O. Hertel O. Thomsen BL. Olsen JH. Air pollution from traffic at the residence of children with cancer. American Journal of Epidemiology. 2001; 153(5):433-43.
Ruder AM. Ward EM. Dong M. Okun AH. Davis-King K. Mortality patterns among workers exposed to styrene in the reinforced plastic boatbuilding industry: an update. American Journal of Industrial Medicine. 2004; 45(2):165-76.
Simonato L. L'Abbe KA. Andersen A. et al. A collaborative study of cancer incidence and mortality among VC workers. Scand J Work Eeenviron Health 1991; 17: 159-169.
Shvedova AA. Kisin ER. Murray A. Kommineni C. Vallyathan V. Castranova V. Pro/antioxidant status in murine skin following topical exposure to cumene hydroperoxide throughout the ontogeny of skin cancer. Biochemistry-Russia. 2004; 69(1):23-31.
Scelo G. Constantinescu V. Csiki I. Zaridze D. Szeszenia-Dabrowska N. Rudnai P. Lissowska J. Fabianova E. Cassidy A. Slamova A. Foretova L. Janout V. Fevotte J. Fletcher T. Mannetje A. Brennan P. Boffetta P. Occupational exposure to vinyl chloride, acrylonitrile and styrene and lung cancer risk (europe). Cancer Causes & Control. 2004; 15(5):445-52.
Sielken RL Jr. Valdez-Flores C. Dose-response implications of University of Alabama study of lymphohematopoietic cancer among workers expose to 1,3-butadiene and styrene in the synthetic rubber industry. 2001; Chemico-Biological Interactions. 135-136:637-51.
Speer SA. Semenza JC. Kurosaki T. Anton-Culver H. Risk factors for acute myeloid leukemia and multiple myeloma: a combination of GIS and case-control studies. Journal of Environmental Health. 2002; 64(7):9-16; quiz 35-6.
Stayner L.T. L. Elliott L. Blade R. Keenlyside and W. Halperin. A restrospective cohort mortality study of workers exposed to formaldehyde in the garmet industry. Am. J. Ind. Med. 1988; 13(6):667-682.
Stephen GA. McRill C. Mack MD. O'Rourke MK. Flood TJ. Lebowitz MD. Assessment of respiratory symptoms and asthma prevalence in a U.S.-Mexico border region. Archives of Environmental Health. 2003; 58(3):156-62.
Tarkiainen TH. Timonen KL. Vanninen EJ. Alm S. Hartikainen JE. Pekkanen J. Effect of acute carbon monoxide exposure on heart rate variability in patients with coronary artery disease. Clinical physiology & Functional Imaging. 2003; 23(2):98-102.
Tsai SP. Wendt JK. Ransdell JD. A mortality, morbidity, and hematology study of petrochemical employees potentially exposed to 1,3-butadiene monomer. Chemico-Biological Interactions. 2001; 135-136, 555-567.
Tsai SS. Huang CH. Goggins WB. Wu TN. Yang CY. Relationship between air pollution and daily mortality in a tropical city: Kaohsiung, Taiwan. Journal of Toxicology & Environmental Health Part A. 2003; 66(14):1341-9.
van der Zee SC. Hoek G. Boezen MH. Schouten JP. van Wijnen JH. Brunekreef B. Acute effects of air pollution on respiratory health of 50-70 yr old adults. European Respiratory Journal. 2000; 15(4):700-9.
Vaughn TL. C. Strader S. Davis and J.R. Daling. Formaldehyde and cancers of the pharynx, sinus and nasal cavity: I. Occupational exposure. Int. J. Cancer. 1986a; 38: 677-683
Venners SA. Wang B. Xu Z. Schlatter Y. Wang L. Xu X. Particulate matter, sulfur dioxide, and daily mortality in Chongqing, China. Environmental Health Perspectives. 2003; 111(4):562-7.
Wong O. Raabe GK. Cell-Type-Specific Leukemia Analyses in a Combined Cohort of More Than 208,000 Petroleum Workers in the United States and the United Kingdom, 1937-1989.Regulatory Toxicology and Pharmacology 1995; 21(2), 307-321.
Yang CY. Wang JD. Chan CC. Chen PC. Huang JS. and Cheng MF. Respiratory and irritant health effects of a population living in a petrochemical-polluted area in Taiwan. Environmental Research 1997; 74: 145-9.
Yang CY. Chang CC. Chuang HY. Ho CK. Wu TN. Chang PY. Increased risk of preterm delivery among people living near the three oil refineries in Taiwan. Environment International. 2004; 30(3):337-42.
Zanobetti A. Schwartz J. Samoli E. Gryparis A. Touloumi G. Peacock J. Anderson RH. Le Tertre A. Bobros J. Celko M. Goren A. Forsberg B. Michelozzi P. Rabczenko D. Hoyos SP. Wichmann HE. Katsouyanni K. The temporal pattern of respiratory and heart disease mortality in response to air pollution. Environmental Health Perspectives. 2003; 111(9):1188-93.
Zhou W. Huang G. Zhang H. Ye S. Effects of methyl tertiary butyl ether on cell cycle and cell apoptosis. Chung-Hua Yu Fang i Hsueh Tsa Chih [Chinese Journal of Preventive Medicine]. 2000; 34(4):221-3.
Zhou W. Ye S. Zhu Y. Effects of methyl tertiary butyl ether on liver tissue gene expression in rats. Chung-Hua Yu Fang i Hsueh Tsa Chih [Chinese Journal of Preventive Medicine]. 1999; 33(2):85-7.
余榮彬（1997），「工業區VOC各成分監測及管制規劃研究」，行政院環保署專題研究計畫成果報告，EPA-86-FA15-09-E5。
田浚致（2003），「利用空氣擴散模式模擬石化工業區致癌性污染物之濃度及推估居民之致癌風險」，碩士論文，國立成功大學環境醫學研究所。
許惠悰、林清和、陳明仁、梁菁萍、蘇智憲、謝裕平（2003），「石化工業區有害空氣污染物之健康風險評估」，第十六屆環境與規劃管理研討會。
張寶額（1998），「運用傅立葉紅外光遙測技術執行石化工業區空氣污染物成份監測及危害評估」，行政院環保署專題研究計畫成果報告，EPA-87-FA14-03-43。
張寶額（1999），「運用紅外光遙測技術執行石化工業區污染監測計畫」，行政院環保署專題研究計畫成果報告，EPA-88-FA32-03-1001。
蔡俊鴻（1997），「石化業上、中游工廠附近大氣環境中之VOC特徵成份及濃度分佈調查（Ⅲ）」，行政院環保署專題研究計畫成果報告，EPA-86-FA44-09-38。
台灣區石油化學同業公會（1999），「1999中華民國的石油化學工業」。
行政院環境保護署（2004），「高屏地區空氣品質測站資料」。
王鵬仁（1999）「南高屏地區空氣污染總量管制規劃-A3子計畫南高屏地區石化工業及化學工業排放量整合與推估」，環保署專題研究計畫成果報告，EPA-88-FA21-03-0012
謝祝欽（1997）「雲林沿海工業區施工中VOCs成分與濃度背景調查分析」，第十四屆空氣污染控制技術研討會論文專輯; Proceedings of the Fourteenth Air Pollution Control Technology Conference, p178-185。
李俊璋（1996）「石化工業區附近大氣中揮發性有機物質特徵成分與致突變關係之研究」，第十三屆空氣污染控制技術研討會論文專輯; Proceedings of the Fourteenth Air Pollution Control Technology Conference, p1021-1031。
朱信（1996~1999）「六輕案施工期間空氣品質調查監測（D國中）」，台塑石化股份有限公司委託計畫。
張艮輝（2003）「六輕廠區反應性空氣品質管理規劃及空氣污染物健康風險評估計畫(一)」，南亞環工暨工安管理中心委託案。
美兆自動化健檢「健康檢查」2004年年度報告。
高雄市立小港醫院2005，「高雄縣工業區附近民眾血液檢測分析研究計劃」，高雄縣政府衛生局研究計畫。