摘要
台灣在過去有超過五十萬人口曾經長期飲用含砷量超過安全標準（0.05ppm）的井水，由先前的研究發現在台灣西南沿海高砷暴露地區之皮膚癌、膀胱癌、肺癌以及心血管疾病的發生率高於其他地區，由此推論砷與癌化以及血管新生的過程有關。眼睛翼狀贅片（俗稱眼翳）為新生不良纖維血管組織，近期的實驗證據支持可能為良性腫瘤，因此本研究目的在於探討飲用水中砷暴露是否與眼睛翼狀贅片之盛行有相關。本研究在2005年於台灣西南沿海高砷暴露地區以及對照地區共收取381位40歲以上的居民進行健康檢查，對眼部拍照後由眼科醫師判讀眼睛翼狀贅片的有無，並以結構式問卷收取人口學以及砷暴露相關資料。研究結果顯示眼睛翼狀贅片的年齡標準化盛行率男性為26.5%；女性為24.6%。單變項分析中發現眼睛翼狀贅片盛行率與累積砷暴露有顯著相關，進一步使用多變項邏輯迴歸方式校正年齡、工作日曬及工作風沙暴露等干擾因子後，發現累積砷暴露量為0.1-14.9 mg/L 年以及大於15.0 mg/L 年的組別與累積砷暴露為<0.1 mg/L 年相比，分別有2.02 倍(95%信賴區間: 1.04 -3.95) 以及2.80倍(95%信賴區間: 1.38-5.67)的危險性得到眼睛翼狀贅片，眼睛翼狀贅片與砷暴露間也存在劑量效應關係(p for trend < 0.001)。本研究結果發現長期砷暴露與眼睛翼狀贅片有相關。

Abstract
More than half a million residents in Taiwan had drunk water with arsenic levels higher than the current safety standard (0.05 ppm). Previous studies have demonstrated an association between arsenic exposure and incidence of cancers of the skin, bladder, and lung in southwestern Taiwan, and therefore arsenic exposure may be related to the process of tumorgenesis and neovascularization. Pterygium is a growing abnormal fibrovascular tissue on the ocular surface that was found to have tumor-like characteristics by recent studies. The purpose of this study was to evaluate the association between inorganic arsenic exposure through drinking water and pterygium in southwestern Taiwan. In 2005, we recruited 381 residents of the arseniasis-endemic area and a neighboring nonendemic area in southwestern Taiwan who were over 40 year old. From each participant, photographs of both eyes were taken during a health examination, and pterygium was diagnosed by an ophthalmologist through reviewing the photographs. Demographic data and other related information were collected through a structured questionnaire. As a result, we found the age-adjusted prevalence rates of pterygium in men and women were 26.5% and 24.6%, respectively. There was a significant association between cumulative arsenic exposure [CAE] and the prevalence of pterygium, and This association remained significant after adjusting for age as well as sun and sandy wind exposure at work. The adjusted odds ratios were 2.02 (95% confidence interval [CI]: 1.04 to 3.95) for those who had CAE of 0.1-14.9 mg/L years and 2.80 (95% CI: 1.38 to 5.67) for those who had CAE ≥ 15.0 mg/L years in comparison with those who were not exposed. A dose-response relationship between CAE and prevalence of pterygium was also observed (p for trend < 0.001). The study results suggest chronic arsenic exposure may be related to the occurrence of pterygium.

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