本研究旨在探討性早熟女童與對照組(一般女童)尿液中鄰苯二甲酸酯類(Phthalate esters，簡稱PAEs)代謝物與家戶灰塵PAEs含量之相關性，並利用標準化問卷來調查PAEs相關暴露來源及因子。本研究自南部某醫學中心小兒科門診中招募性早熟女童（排除由腫瘤或創傷所引起之性早熟女童），再以自願參與的方式招募一般女童為對照組。利用HPLC-MS/MS分析尿液中五種PAEs之代謝物，同時以GC/MS分析其家戶灰塵中五種PAEs濃度。
結果顯示，32位性早熟女童與20位一般女童家戶中四個區域(客廳地板及沙發、房間地板、小孩床舖及地板之上區域) 之灰塵PAEs濃度均以DEHP(834.7~1643.6 mg/kg)、DBP(21.5~34.4 mg/kg)及BBP(3.03~4.16 mg/kg) 為主，其中DEHP佔PAEs總濃度96%以上。在小孩床鋪之灰塵DBP含量方面，性早熟女童組明顯高於一般女童組(23.17 vs. 15.1 mg/kg)，且達統計上顯著之差異(P=0.02)。整體而言，本研究之家戶中各區域之灰塵中DMP、DEP、DBP及BBP濃度均低於世界各國檢測之結果，但DEHP濃度高於德國、美國及挪威約2.3-4.8倍。所有女童尿液代謝物濃度以MBP (78.1 µg/g creatinine)濃度為最高，依序為MEP (18.7 µg/g creatinine)、MEHP (12.9 µg/g creatinine)、MMP (9.09 µg/g creatinine)及MBzP (5.25 µg/g creatinine)。性早熟女童尿液中MEP濃度明顯高於一般女童(25.5 vs.10.9 µg/g creatinine，P=0.013)，但一般女童MBP濃度則明顯高於性早熟女童(118 vs.76.4 µg/g creatinine，P=0.043)。整體而言，我國女童之MBP濃度高於美國孩童2倍，MEHP濃度皆高於德國與美國境內孩童約2.5倍。飲食習慣方面，性早熟女童每月攝取之牛羊肉、低/脫脂牛奶及熱狗的總攝取量明顯高於一般女童。而以塑膠袋包裝之外食，性早熟女童每月攝取總量顯著高於一般女童。以女童家戶灰塵中DBP、BBP及DEHP之中位數濃度進行分組，結果發現高濃度組之家戶中客廳地板及房間地板有較多使用塑膠材質之趨勢；以女童尿液中五種PAEs代謝物中位數濃度進行分組後，發現高濃度組之女童於每月外食、外飲總量及總個人衛生用品使用量上有較高之現象。利用女童由灰塵暴露鄰苯二甲酸酯之每日平均暴露劑量與尿液中鄰苯二甲酸酯代謝物進行單變項回歸分析，發現二者並無相關性。
進一步以藥物動力學模式推估女童體內五種PAEs之日暴露劑量中位數濃度順序如下，DEHP 5.21(0.38-74.36) µg/kg/day、DBP 2.69(0.77-15.54) µg/kg/day、DEP 0.64(0.04-13.05) µg/kg/day、DMP 0.31(0.03-4.42) µg/kg/day及BBP 0.17(0.03-2.75) µg/kg/day 。

This research is aimed to investigate the relationships between urinary monoester metabolites and the PAE levels in house dust for precocious puberty girls and normal girls. The demographic characteristics and exposure scenario including dietary ingestion, personal care products and cosmetic usage for subjects were obtained from an interviewed questionnaire. The precocious puberty girls were recruited from the policlinic of Pediatric Endocrinology in National Cheng Kung University Hospital and normal girls were recruited as control group. The urinary monoester metabolites of subjects and the phthalate ester levels in house dust were measured by HPLC-MS/MS and GC/MS, respectively. The analytic results from all house dust samples in four different areas shows that DEHP (834.7~1643.6 mg/kg) is the dominant compound in all samples, followed by DBP (21.5~34.4 mg/kg) and BBP(3.03~4.16 mg/kg). DEHP contributes over 96% of total PAE concentration in house dust samples. The levels of DBP in the dust from bed of precocious puberty girls were significantly higher than those from normal girls (P=0.02). In total, the levels of DEHP in house dust in Taiwan were 2.3-4.8 folds higher than those in German, US and Norway. The highest PAE metabolites in urine samples from all subjects were MBP (78.1 µg/g creatinine), followed by MEP (18.7 µg/g creatinine), MEHP (12.9 µg/g creatinine), MMP (9.09 µg/g creatinine) and MBzP (5.25 µg/g creatinine). The levels of MEP in precocious puberty girls were significantly higher than those in normal girls(25.5 vs.10.9 µg/g creatinine，P=0.013), while the MBP was on the contrary. In general, the internal dose of MBP in this study groups were 2 times higher than American children and the internal dose of MEHP were 2.5 times higher than American children and German childen, respectively. In the dietary comsumption survey, the consumption quantities of beef, mutton, milk products, and hot dog in precocious puberty girls were higher than normal girls. The plastic packaged convenient foods were consumed more frequently in precocious puberty girls than normal girls. All subjects were divided into high and low PAE level groups by median level of house dust and adjusted-urinary samples. The data shows that the high PAEs in house dust group used more plastics materials as flooring material than low level group. The consumption quantities of off-premises eating, off-premises drinking and the usage of personal care products in high urinary PAE group were higher than low PAE group. Futhermore, there was no relationships between urinary monoester metabolite concentrations and dust PAE levels in precocious puberty girls. The daily intake dose (DIest) of five PAEs in all subjects were estimated from the level of urinary PAE metabolites based on the pharmacokinetics model. The calculated median DIest (µg/kg/day) of five PAEs in all girls were as followed: DEHP was 5.21(0.38-74.36) µg/kg/day, DBP was 2.69(0.77-15.54) µg/kg/day, DEP was 0.64(0.04-13.05) µg/kg/day, DMP was 0.31(0.03-4.42) µg/kg/day and BBP was 0.17(0.03-2.75) µg/kg/day, respectively.

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