氯乙烯單體 (Vinyl chloride monomer, VCM) 被國際癌症研究署 (International Agency for Research on Cancer, IARC) 列為第一級人類致癌物，因此聚氯乙烯 (Polyvinyl chloride, PVC) 工業的勞工長期暴露VCM，很有可能會發展成肝癌並造成其導致健康與經濟衝擊。為評估健康風險及其造成的經濟和健康損失，需要為廠內之相似暴露族群建立VCM的長期暴露資料庫。因此，如何發展合適的技術以達到前述目的，已經成為職業衛生領域中一個迫切而重要的議題。
本研究以1970至2010期間，以每十年為分界，共五個起始聘雇年份進入PVC工廠工作之勞工，評估其受聘後假設勞工持續工作至退休共30年之長期暴露濃度、健康風險、預期壽命損失及終生醫療花費。VCM暴露濃度以臺灣勞動部職業安全衛生署之勞工作業環境監測資訊系統 (WEMIS)及其他來自PVC工廠之文獻資料，以預測PVC廠中10個相似暴露族群 (Similar exposure groups, SEG) 的VCM暴露濃度，並建立勞工長期VCM暴露資料庫。在計算不同相似暴露族群之增量致肝癌風險時，以臺灣最新之研究結果來計算相對應之預期壽命損失及終生醫療花費。上述研究結果並與台灣相關產業之失能傷害嚴重率 (Disabling Severity Rate, SR) 及我國勞保傷病給付進行比較，最後透過法定容許暴露濃度、健康風險評估、失能傷害嚴重率及勞保傷病給付四個標準，判定各SEG於不同時期入廠的長期暴露是否可被接受。
本研究發現以不同判定標準，不同SEG在不同時期入廠結果有所不同。結果顯示在1970年代入廠工作的勞工之VCM長期暴露濃度最高，隨後便大幅下降。全部的SEG在2000年後入廠，其長期暴露濃度第95百分位值已低於容許暴露濃度3ppm。然而前述所有的SEG之增量致癌風險仍皆超過可接受之風險值10-4，且若以失能傷害嚴重率為標準則發現，重合作業也都超過可接受之暴露。在量化勞工暴露VCM之健康衝擊方面，本研究發現在1970年入廠的重合作業男及女性勞工每人具有最高的預期壽命損失及終生醫療花費 (分別約841與678天；3311與3089美元)，但至2010年入廠時則全部10個SEG男性及女性勞工每人均已低於10天及10美元。
本研究發現即使各SEG之暴露小於法定容許濃度時，如以其它判定暴露評估之則仍不一定可被接受，且健康風險評估之敏感度最高。故僅用法定容許濃度值評估勞工作業場所暴露評估仍有其不足之處，因此本研究開發之技術能更全面性的幫助職業衛生管理策略擬定，以減少VCM為臺灣社會帶來的衝擊。

The purpose of this study is to develop a method to establish a long-term exposure databank for Taiwan PVC workers, and assess if their VCM exposure concentrations during 30 employed years were acceptable using multiple evaluation criteria for 10 similar exposure groups (SEGs) in PVC manufacturing industries. The criteria adopted in this study include the VCM exposure concentrations, the resultant health risks, the expected year of life losses, and the lifetime costs. VCM workers started to be employed from1970 to 2010 (per 10-year basis, assuming workers continuously worked for 30 years before retirement) were included in the present study. Results show that, among all studied SEGs, only those with first employed year later than 2000 were found with 95th%-tile of the long-term exposure concentrations less than permissible exposure limit (PEL-TWA) of 3 ppm. Nevertheless, their excessive liver cancer risks still exceed the designated acceptable risk of 10-4. In addition, among those SEGs with the year 2000 as their first employed year, polymerization operators were found to be unacceptable when severity rate was used as the evaluation criteria. Therefore, our results suggest even though the VCM exposure concentration for an SEG was lower than PEL, it may still be unacceptable if different determining criteria were used. Our study also found that health risk assessment has the highest sensitivity. The technology developed in this research would provide VCM industries in Taiwan more comprehensive decision-making strategy for assessing the acceptability of workers' exposures, and eventually initiate more effective control measures for reducing their health impact.

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