1-2 多氯聯苯/戴奧辛類環境毒性物質之人體健康影響：台灣油症

 郭育良 （成大醫學院教授）

ダイオキシン類環境毒性物質の人体への影響：WORD日文檔

在1979年台灣發生的米糠油中毒事件(稱為油症事件)，約有2000位民眾由於食用污染有多氯聯苯(polychlorinated biphenyls)與多氯夫喃(polychlorinated dibenzofurans)的米糠油而得病，是一個十分不幸的食物中毒事件，原由疾病管制單位負責照顧，而至2003年工作移交給國民健康局。中毒者發生多項健康問題，至今已發現中毒者在肝臟疾病尤其是肝硬化的死亡率是對照組的三倍左右(Guo et al., 1997)，且生存者肝病患的機會比未中毒高兩倍。經過個人訪視之研究，了解所有中毒者比對照之未中毒者，其罹病率提高，尤其甲狀腺腫大、皮膚病、女性貧血、及男性關節炎與椎間盤問題均比對照組為高(Guo et al., 1999)。另外在中毒女性中，死產與月經問題均比對照組高出許多(Yu et al., 2000)。由於多氯聯苯與多氯夫喃為環境中之內分泌干擾物質，中毒者與對照組之子代性別作一比較，發現在中毒男性中，中毒之後10年內所生的小孩，女性機率高出男性許多(del Rio-Gomez et al., 2002)。是否因為中毒男性精液品質不佳所造成？在男性精液檢查之中，發現中毒男性罹患精虫稀少者比對照組多約6倍；精虫型態異常多出18%；且與卵子結合能力大幅受損(Hsu et al., 2003)。我們認為油症中毒乃一生的中毒，因為油症女性中，即使在中毒事件十三年之後，其體內毒物濃度，仍比正常未受暴露者高出五十倍至一百八十倍之多（Guo et al., 1997）。其一生之健康均受到影響，故其長期之追蹤與持續的健康查，具有十分重要的意義。

油症中毒不只對中毒者本身是嚴重的傷害，對於中毒女性所產下的小孩，亦即在胎盤內暴露於多氯聯苯的油症兒，亦造成極大的影響。我們發現有智力發展的遲緩現象（Chen et al., 1992），此智力的發展遲緩問題，甚至在女性中毒後七至十二年所生的小孩仍會發生（Guo et al., 1994），而男孩受到的影響比女孩較為嚴重(Guo et al., 1995)。油症兒身高與身體肌肉發育有減慢的現象（Guo et al., 1994），牙齒發育之異常並比正常兒高出數倍（Wang et al., 2003）。對油症兒在中毒事件十二年之後的體內毒物濃度研究，發現其濃度仍比正常未受暴露者高出將近十倍（Ryan et al., 1994）。油症兒之罹患中耳炎的機會，比其對照組高上將近十倍左右，且其罹患的可能性，與油症兒血清中的多氯聯苯的相關性，反而不及與血清中的多氯夫喃的相關性為高（Chao et al., 1997）。若考量多氯聯苯與多氯夫喃可能為環境中之內分泌干擾物質，則其對生殖系統作用如何？我們發現，油症中毒之女性所生的男孩，在到達生殖系統成熟的年齡時(即他們母親中毒發生的16至20年之後)，其精子正常型態比例、活動力、與其穿透卵子的能力，均低於正常同年齡的男性（Guo et al., 2000）。由於這個論文是在人類流行病學研中，首次證實，經胎盤之毒性暴露會引起第二代之生殖細胞異常的重要發現，此一發現，被2000年 Science News所引用(158:303)。近來又發現，中毒第二代的小孩，其行為亦有異常的現象，尤其在身體不適、注意力不集中、不良行為、攻擊性行為等，中毒者小孩均比對照組為高（Lai et al., 2002）。此發現提供所有流行病學者與環境研究者一個警訊，環境毒性物質可能影響到人類的行為，且可以傳給第二代。


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