工作場所的生殖危害：職業化學性暴露對生殖健康的影響

Abstract

於2006年，在《職業醫學》雜誌上有一系列的深度文獻回顧被發表，以全面呈現工作場所中的危害暴露對生殖健康的影響。經過16年的時間，有許多關於生殖健康和職業危害之間關係的研究背發表了。 本次研究回顧了自2006年至2021年間國際科學文獻中相關的文章，這些文章是透過搜尋MEDLINE資料庫。本次文獻回顧僅收錄人類流行病學的研究，包括病例對照研究、病例世代研究與世代研究，且僅收錄討論化學性危害暴露與生殖健康的文獻。 在關鍵字搜尋後共有5,441篇文章，再經過篩選後，本次文獻分析共105篇人類的流行病學研究。除了過去大量討論過的化學物質，例如重金屬、有機溶劑或農藥外，過去15年中還新興了許多的化學物質，包含非金屬元素、雙酚類、環氧乙烷、多環芳香烃、揮發性有機化合物和粒子粉塵等。 接續2006年的深度文獻回顧報告，本次文獻回顧將過去十六年的研究收錄後並整理，顯示出有許多新興的化學物質與生殖健康有關，且呈現的負面影響不僅僅是早產、流產等傳統的生殖危害，而是包含從親代生育力、胚胎生長、子代發育等生殖健康的影響。雖然目前仍然只有有限的流行病學證據且結果不一定一致，但基於預防原則，我們仍建議積極採取預防措施，以保護職場中的父母與其子代的健康。同時我們也建議仍需要更多的相關研究，以提供不論是學術上的知識發展或實務上的改進措施。

In 2006, a series of in-depth reviews was published in the Occupational Medicine to present a comprehensive picture of the role of occupational risk factors in reproductive health. After 16 years, there are lots of updating studies about the relationship between reproductive health and occupational hazards. The studies examined relevant articles published in the international scientific literature during 2006 to 2021, which were identified through the search of MEDLINE database. Among these articles, we only include human epidemiologic studies, including case-control, case-cohort, and cohort studies, which address occupational chemical exposures Among 5,441 searched articles, 105 articles were included. In addition to previously discussed chemical agents, including metals, solvents, and pesticides and other chemicals used in the workplace, there are emerging chemical agents discussed in the past 15 years, all of the were about non-metal element, bisphenols, ethylene oxide, PAH, VOC, and particles. Based on the prior review in 2006, we conducted an updated review showing that there are new emerging chemical agents linking to reproductive health more than pregnancy outcomes. Although there are only limited epidemiological evidence with mixed results, preventive interventions are suggested for precautious protection of reproductive health of both women and men, and more evidence is needed to be concluded.