台灣地區女性肺癌死亡率別空氣浮游塵致變力流布研究

1. 台灣地區女性肺癌死亡率別空氣浮游塵致變力流布研究台灣地區女性肺癌死亡率別空氣浮游塵致變力流布研究 最近數十年來世界各地的肺癌病患率都在增加，臺灣地區肺癌死亡率 亦有逐年增加之趨勢。空氣污染危害人體健康，會導致呼吸系統疾病，流 行病學初步證明空氣污染是造成肺癌主要原因，但空氣浮游塵中具有致癌 性、致突變性的物質可能是重要因子。目前有愈來愈多的研究顯示，高空 氣污染區與肺癌之生成有關。臺灣地區之年齡標準化肺癌死亡率隨日本之 後自1954年起即呈明顯增加之趨勢。在近40幾年來已增加達八倍之多，男 女性比例均維持在2.0左右且具有城市與鄉村，工業區與住宅、商業 區之 差異現象。這種地域差異現象所造成的不同死亡率可能與都市化、工商業 化的結果有關。 由於肺癌是一種具有多重致病因的疾病，本研究藉由 病因實驗流行病學之模式，以臺灣全地域單時程面地就1972?1983年間臺 灣地區女性年齡標準化氣管暨肺癌死亡率程度別，儘量除去吸菸的因素， 依高、中、低死亡率三級做全省鄉鎮區的選樣。 考量致癌性空氣污染 物之季節變動性大，其致變力在冬春季呈最高的現象，遂於1990年一月至 四月以高速裸體攜動式空吸吸塵機 ( Model GMWL-2000) 作集中式各區一 次採樣時程作業。依 Hoffman 氏法作玻璃纖維濾紙試樣成份抽離後，以 Ames Salmonella/mammalian microsome mutagenicity test法測試致突 變力，測試菌株為對空氣污染物較敏感的 Salmo-nella typhimurium TA98，並分析各地的降雨量及風向干擾因素，逕行評估各區域大氣污染物 質之變異原性，及與1995年女性肺癌死亡率之關係。 浮游塵量在北、 南及東部地域大致與罹癌程度成正順位相關關係，以全省綜合平均數來看 ，則明顯地呈現出正相關。若以城市與鄉村，工業區與住宅區、商業區別 ，與總致變力作分析，亦呈明顯相關，即致變力為工業區大於商業區、住 宅區，都市大於鄉村。再以女性肺癌死亡率，分高、中、低死亡率三級與 總致變力加以分析，復呈現相關性，p<0.05 。同時，我們亦發現，總致 變力與浮游塵重的相乘效果(致變力積)也有明顯意義相關(p<0.05)。 本論文僅就空氣浮游塵致變力之流布分析，探討其與臺灣地區女性肺癌死 亡率之關係，結果顯示空氣污染的程度可能與近數十年來台灣女性肺癌死 亡率的節節上升有明顯關係。雖然如此，導致肺癌的因素很多，詳盡的流 行病學研究應廣泛評估，若能多方驗證，必能臻於完美，確立空氣污染程 度與罹患肺癌之關係。

2. Cross-sectional Assay on the Mutagenicities of Air-suspended Particulate Distributed Geographically in Taiwan by the Levels of Female Lung Cancer Mortality • Lung cancer has become prevalent since early 1950s. The • standardized mortalities of lung cancer have been obviously • increased in Taiwan year by year, came up to 8 times level from • 1954 to 1990 in Taiwan with sex ratio of male to female around • 2.0 and with a rather obvious area -specific distribu-tion. • Some carcinogenic and mutagenic substances of air-suspended • particulates were probably the important pathogenic risk • factor of lung cancer,this may also be considered to being • related with urbanization and industrialization. However the • health hazard effects of air pollution are principally • detected out from respiratory diseases. There are more and • more evidences showed the close relationship between high air • pollution and lung cancer incidence. Owing to the • multiple causations of lung cancer, we first try to assess • rather directly the genotoxic responses of air suspended • particulate samples.The sampling areas of urban and rural • townships around the Formosa island were selected according to • the high,middle and low levels of standardized mortality rates • of female lung cancer in Taiwan from 1972 to 1983 for mostly • preclude the confounding effect of personally smoking. • A routine air sampling procedure by 24 hrs suction with the high • volume airsampler(Model GMWL-2000) was carried out once a time • at each selected township from Jan. to April, 1990. The glass • fiber filters were extracted by Hoffman&apos;s method. Then the • mutageni-cities of extracted tars were assayed by the Ames • Salmonella/Mammalian Microsome Mutagenicity Test using • Samonella typhimurium TA98 with S9 mix addition. We also

3. checked and correlated the corresponding pollution data with • the meteorological conditions on precipitation and win speed. • Meanwhile, those female lung cancer mortality rates of 1994-1995 • were used as the probable outcome indices. • The average weights of particulate matters were increased with • the ascend-ing order of mortality levels of lung cancer, and the • mutagenicities come out rather proportional to the levels of • pollution when we calcu-lated the total mutagenicity by • mutation responses timing together with the sample particu-late • weight. There were found a good correlation between the total • mutageni-city and the levels of female lung cancer mortality ( • p<0.025). We also found that these total mutagenicities were • rather area-specifically distributed ( p = 0.033). • Our cross-sectional analysis on the total mutagenicity indicates • that there is a significant relationship between the incidence • of lung cancer and thelevel of air pollution.We need a more • long-term follow-up study to confirm the exact causal • relationship between air pollution and lung cancer.