11卷3期

• Link 原著 Original Article
• 肝細胞癌之流行病學特徵與危險因子Epidemiologic Characteristics and Risk Factors Hepatocellular Carcinoma
• 于明暉、陳建仁
  Ming-Whei Yu, Chien-Jen Chen
• 無
  Epidemiology ; Risk Factors ; Hepatocellular Carcinoma ; etiology
• 本文係探討近十年的文獻以瞭解肝細胞癌的流行病學特徵和危險因子。肝細胞癌的死亡率與發生率均隨年齡的增加而上升，但是不同地區的高峰年齡並不相同。男性的肝細胞癌在各國都是較女性偏高，性比例在2-4倍。肝細胞癌的發生率有明顯的地理差異，最高的發生率在東南亞和南部非洲。移民研究一致指出在新加坡、舊金山、洛杉機和夏威夷的中國人，其肝細胞癌發生率達高於其他種族。雖然近年來香港的肝癌死亡率維持不變而新加坡則呈下降；但在台灣和日本的肝癌死亡率，在男性有明顯增加，女性則未有明顯變化。B型肝炎病毒和C型肝炎病毒都和肝細胞癌的發生有密切相關。B型肝炎慢性帶原狀態是很多國家的主要肝細胞癌病因。C型肝炎病毒和肝細胞癌的困果相關，有待進一步研究的佐證，特別是世代追蹤研究的證據尤其重要。雖然黃麴毒素己證實是動物的肝臟致癌物，但它對人體的作用，因個人暴露量的測量方法有待改進，至今仍無定論。在中國和南部非洲的肝細胞癌組織，有p53基因249譯碼子的G→T突變，暗示黃麴毒素可能是該地區的肝細胞癌的致因，喝酒已被認定是人類肝細胞癌的重要危險因子，但是抽煙對肝細胞癌的作用，仍需繼續評估。肝硬化也在肝細胞癌的發生扮演重要角色。至於性荷爾蒙、微量營養素、遺傳疾病、糖尿病、人類白血球抗原等因素和肝細胞癌的相關性，有待進一步證實。最近的研究則指出B型肝炎病毒、C型肝炎病毒、喝酒、抽煙及家族肝癌史之間，有明顯的協同交互作用。
  Researsh on the epidemiologic characteristics and risk factors of hepatocellular carcinoma (HCC) in the recent decade were reviewed in detail. HCC mortality and incidence increase with age in most countries, but a striking discrepancy in peak age is observed in different areas. The HCC incidence is higher for men than for women with a male-to-female ratio of greater than 2.0 in almost all countries. There is significant geographical variation in HCC incidence with the highest occurring in southeastern Asia and southern Africa. Migrant studies show that the Chinese have a higher incidence than other ethnic groups in Singapore, San Francisco, Los Angeles and Hawaii. While HCC mortality remains constant in Hong Kong and slightly declines in Singapore, an increasing secular trend of HCC mortality is reported for males but not for females in Taiwan and Japan. Both hepatitis B virus (HBV) and hepatitis C virus (HCV) are associated with the development of HCC. Chronic HBV infection is a major cause of HCC in many countries. More epidemiological evidence especially those from cohort studies are needed to conclude whether HCV is a cause of HCC. Although aflatoxins are well documented animal hepatocarcinogens, their effects on humans are still inconclusive due to inadequacy in quantitation of individual aflatoxin exposure. A specific G ? T transversion on the third base of the p53 gene codon 249 recently found in HCC tissues from China and southern Africa suggests the importance of aflatoxin in the development of HCC. While alcohol drinking is an important risk factor in human HCC, the effect of cigarette smoking on HCC needs further assessment. Liver cirrhosis also plays a significant role in the development of HCC. The associations of HCC with sex hormones, micronutrients, genetic diseases, diabetes, and human leukocyte antigens have to be further validated. Synergistic interactions have recently been documented for HBV, HCV, alcohol drinking, cigarette smoking and a familial history of HCC.
• 165 - 187
• 10.6288/JNPHARC1992-11-03-01

• Link 原著 Original Article
• 某鉛蓄電池製造與回收工廠之鉛汙染差異觀察研究A Study of Lead Pollution in a Battery Manufacturing and a Lead Recycling Factory
• 陳美蓮、毛義方、藍忠孚、林宜長
  Mel-Lien Chen, I-Fang Mao, Chung-Fu Lan, Yi-Chang Lin
• 無
  ambient air ; soil lead pollution ; lead recycling ; lead-acid battery manufacture
• 本研究以台灣北部一鉛蓄電池製造工廠及另一廢鉛蓄電池回收工廠為研究對象，以高流量空氣採樣器在兩家工廠附近進行工廠工作日、休假日及日、夜之空氣採樣，並在蓄電池製造廠附近採土分析，目的在觀察不同鉛作業對附近環境污染程度和差異性，結果顯示，兩類工廠均造成附近環境空氣之鉛污染。各採樣點中，鉛濃度平均值最高和最低值，在製造廠是1. 09 μg/m^3及0.16 μg/m^3；在回收廠則是4.19 μg/m^3及0.48 μg/m^3；回收廠之空氣中鉛污染濃度約為製造廠之三倍。懸浮微粒濃度最高和最低值，在製造廠是97 μg/m^3及49 μg/m^3；回收廠是163 μg/m^3及123 μg/m^3而懸浮微粒含鉛量，回收廠與製造廠分別是11640 μg/g及5580 μg/g，均是回收廠污染量較大。研究結果亦顯示，蓄電池製造廠之土壤污染是另一重要環境污染問題，採樣點中鉛濃度平均值最高為2048 μg/go。本研究發現，鉛作業工廠必須確實作好污染防制及環境管理措施，以減低對附近環境之污染。
  This study was conducted to determine the severity of and differences in lead pollution in a battery manufacturing factory and a lead battery recycling factory. Air samples in the vicinity of these two factories and soil samples around the battery manufacturing factory were measured for lead concentrations during the day and at night on working days and on holidays. The results showed that the mean ambient air lead concentration in the battery manufacturing area was about three times higher than that in the battery recycling area. The highest concentrations were 1.09 µg/m3 around the battery manufacturing factory and 4.19 µg/m3 in the vicinity of the lead battery recycling factory; the amounts of lead in the suspended particulates in former area and the latter area were 5,580 µg/g and 11,640 µg/g, respectively. The top-soil around the battery manufacturing factory was also contaminated by lead dust; the highest concentration was 2,048 µg/g. The Results suggest that environmental management and pollution control facilities are needed to reduce the impact of air pollution derived from lead battery factories on neighboring areas.
• 188 - 195
• 10.6288/JNPHARC1992-11-03-02

• Link 原著 Original Article
• 影響群醫門診糖尿病病患疾病認知的因素An Assessment of Factors That Influence Disease Cognition of Diabetic Patients at GPCs
• 杜明勳
  Ming-Shium Tu
• 無
  Diabetes mellitus ; health belief model
• 群體醫療執業中心設置基層保健站推展居家護理工作，其目的在透過全貴公共衛生護士之努力，為婦幼衛生及中老年高危險群人口提供適當之服務，並增進服務對象健康認知及行為。本研究以三個月時間調查八里、三星、頭城三所群聲中心之糖尿病患者129人，分析其病患健康信念與疾病認知之關係，居家護理衛教對病人疾病認知之影響，居家護理對病人健康信念之影響及定期就醫之健康行為受健康信念因素影響情形。結果發現，居家照顧對糖尿病病人之疾病認知有助益，但對健康信念、及定期就醫之行為無顯著影響；而影響糖尿病病患疾病認知之獨立因素為病患年齡、教育年限、行為利益、行動線索及是否接受居家照顧；影響病患定期就醫之因素為行動利益及行動障礙。本調查顯示居家照護對於病患的疾病認知有幫忙，可以增加病人疾病相關問題之主動發問，但對其疾病可能導致併發症之嚴重性及定期就醫對其疾病之好處仍應加強宣導。另外，本研究亦將健康信念模式之理論架構做部份的調整。
  Group Practice Centers (GPCs) and Primary Health Care Units were set up by the government in 1983 to promote maternal and child health and care for older high-risk individuals in rural areas, with provision for full-duty home care nurses. It was supposed that these full-duty nurses would promote patient health cognition and behavior. This study was designed to detect its actual effectiveness for diabetic patients in increasing their disease cognition and to earn whether factors of personal demographic data and health belief models also play a role in disease cognition. We herein collected 129 cases from three GPCs during three consecutive months and analyzed the data using stepwise regression procedures. Results indicate that a patient's disease cognition is significantly related to their personal demographic data (age, educational level), action cues, benefits of action, and the receiving of home care services. Nevertheless, perceived barriers, perceived severity, disease duration, and a patient's presenting health behaviors were not significantly related to disease cognition. Regular clinical follow-up of patients was found to be influenced by benefits of action and perceived barriers of action. In the analysis of the contribution of home care service to a patint's health belief model, no relationship was found; however, it was noted that people cared for by home care services more actively asked questions about their diseases. We suggect some changes in the way home care and patient education are carried out, in order to promote their effectiveness. We also recommend from this study modifications in the theoretic structures of Rosenstock's health belief model.
• 196 - 203
• 10.6288/JNPHARC1992-11-03-03

• Link 原著 Original Article
• 醫院氣體消毒工作人員環氧乙烷曝露與基因傷害的監視Monitoring of the Exposure Level and Sister Chromatid Exchange Frequency in Ethylene Oxide Exposed Gas Sterilization Workers
• 陳明宏、劉紹興、徐尚為、林春蓮
  Ming-Hon Chen, Saou-Hsing Liou, Shang-Wei Hsu, Chuan-Lian Lin
• 環氧乙烷 ； 曝露濃度 ； 姊妹染色體交換
  ethylene oxide ; EtO concentration ; sister chromatid exchange
• 環氧乙烷是一普通被各醫院所採用的消毒氣體，具有很強的烷基化能力且被認為是人體可能的致癌物。為暸解氣體消毒工作人員環氧乙烷曝露情形，本研究採立意取樣，選取北部4所醫院，以檢知管法檢測工作環境中環氧乙烷的瞬問曝露濃度，另外，長時間平均曝露濃度之監測則以美國職業安全衛生署OSHA-50之採樣方法採樣，以HP-5890氣相層析議分析。對曝露於此可能致癌物的氣體消毒工作人員，姊妹染色體交換（SCE）頻率是一極敏感的生物監測方法。醫院氣消工作場所的工作人員均納入為曝露組（41人）；另外，從各醫院選出49位在性別、年齡及抽煙習慣均與曝露組分佈相似的行政或資訊單位人員為比較組，比較兩組人員周邊淋巴球之SCE頻率。研究結果發現：氣消過程中，在移鍋時的環氧乙烷曝露濃度最高，有兩種消毒鍋機型其瞬間曝露濃度高達到50~60 ppm及大於100 ppm，而其他機型或工作項目之瞬間曝露濃度均小1 ppm。以個人採樣方法監測發現負責操作移鍋工作者，其15分鐘短時間暴露濃度（STEL），或4小時時平均暴露量（TWA）均高於其他工作人員，且隨醫院使用消毒鍋機型而有所差異。以環境採樣方法監測發現環氧乙烷因消毒鍋種類，有無獨立消毒房及通風設備是否良好尚有所差異。曝露組的SCE頻率與比較組（7.5 v.s. 7.7 SCEs/cell）並無差異。但抽煙者顯著高於不抽煙者（8.8 v.s. 7.6 SCEs/cell）。以迴歸模式，校正可能干擾因素亦得到相同結果。而以個人之工作月數及負責移鍋次數等曝露資料來探討曝露對SCE的效應，亦無發現劑量一效應關係。以高姊妹染色體交換頻率細胞方法對曝露但與比較組進行比較，兩組仍無差異。但以此方法比較抽煙者與非抽煙者，則發現兩者有顯著統計上的差異。
  Ethylene Oxide (EtO) is widely used in hospitals for sterilization of heat-sensitive devices. EtO is an alkylating agent and binds irreversibly to DNA as an adduct. Sister chromatid exchange (SCE) has been found to be a very sensitive bio-monitoring method for alkylating agent exposure. Four hospitals in northern Taiwan were selected for study. The instantaneous EtO concentration, IS-minute sterilization, short-term and 4-hour time-weighted average (TWA) exposure levels were measured. The EtO concentration varied with the type of sterilizers and work practice. During sterilizers are opened for unloading, the instantaneous EtO concentration is as high as greater than is as high as 100 ppm and greater than 50-60 ppm. The instantaneous EtO concentrations were less than 1 ppm for all other work practices. The IS-minute short-term exposure levels (STEL) in two hospitals which used Castle 3240 sterilizers were high (24.7 ppm and 29.6 ppm) for unloading workers. The 4hr TWA was also higher than 1 ppm. However, the exposure levels in one hospital which used a Castle 3371 sterilizer manufactured after 1984 were much lower (15 minute STEL 0.5-1.0 ppm, 4-hr TWA < 0.5 ppm). Excluding two with a history of cancer, 41 sanitary workers working in the sterilizing units of these four hospitals had blood samples taken for SCE analysis and were compared with a sex and smoking-statusmatched reference group comprised of 49 volunteers from administrative or computer units in the same hospital. The SCE frequency in the exposed group (7.5 SCEs/cell) was not different from that in the reference group (7.7 SCEs/cell). However, smokers had a higher SCE frequency than non-smokers (8.5 v.s. 7.6 SCEs/cell). The frequency of SCE was not different between hospitals and was not correlated with the duration of employment and the frequency of unloading. The percentage of high SCE frequency cells (HFC) was also not different between the exposed and reference groups, but HFCs were higher in smokers than in non-smokers.
• 204 - 213
• 10.6288/JNPHARC1992-11-03-04

• Link 原著 Original Article
• 台灣地區C型肝炎病毒感染之血清盛行狀況初探A Preliminary Study on Seroprevalence of Hepatitis C Virus Infection in Taiwan
• 陳慧祺、游山林、 陳建仁、王秋華、楊照雄
  Hui-Chi CHEN, San-Lin You, Chien-Jen Chen, Chu-Hwa Wang, Czau-Siung Yang
• 無
  Hepatitis C virus ; seroprevalence ; Taiwan
• 本研究係自台灣地區20個鄉鎮區7282名居民研究世代中，隨機選取100名B型肝炎表面抗原帶原者，100名非帶原者為研究對象。利用酵素免疫法之商用試劑測定血清樣本中的C型肝炎病毒抗體（anti-HCV）。結果顯示anti-HCV陽性率為2.5%，在帶原者中為2.0%，非帶原者中為5.0%，但其差異未達統計上顯著意義。山地鄉、平地鄉鎮及都市的陽性率分別為10.0%、0.9%、2.5%，在都市化程度上有顯著差異，經過人口比例加權後的台灣地區一般人口之anti-HCV陽性率約為1.8%。男性和女性之抗體陽性率則頗相近，分別為3.3%和3.7%；高中以上教育程度者（0.0%）低於國中以下程度者（4.7%）：已婚者（5.1%）則高於未婚者（0.0%），但是年齡、性別、教育程度及婚姻狀況別的陽性率，由於樣本數太小和陽率偏低，所以未建統計顯著意義。
  A total of 200 study subjects including 100 hepatitis B surface antigen (HBsAg) carriers and 100 non-carriers were randomly selected from a cohort of 7282 residents in 20 townships in Taiwan. Antibodies against the hepatitis C virus (anti-HCV) in serum samples were examined by an enzyme immunoassay using commercial kits. The overall anti-HCV positive rate was 3.5%. HBsAg carriers had a lower rate (2%) than non-carriers (5%), but the difference was not statistically significant. The anti-HCV positive rate in aboriginal, rural and urban townships were 10%, 0.9% and 2.5%, respectively. The geographical variation in anti-HCV prevalence was statistically significant. Weighted by the proportion of population in various townships, the anti-HCV prevalence was estimated as 1.8% for the general population in Taiwan. Males and females had a similar positive rate of 3.3% and 3.7%, respectively. The positive rate was 1.9%.3.9% and 4.3%, respectively, for age groups of less than 26, 26-45 and 46 or more years old. Subjects with a higher educational level had a lower positive rate than those with a lower educational level (0% vs. 4.7%), and married individuals had a higher rate than unmarried individaels (5.1% vs. 0%). Due to the small sample size and low prevalence, differences by age, sex, educational level and marital status were not statistically significant.
• 214 - 219
• 10.6288/JNPHARC1992-11-03-05

• Link 原著 Original Article
• 醫師對全民健康保險的意見調查An Opinion Survey of Physicians on National Health Insurance
• 林芸芸、江東亮
  Yun-Yun Lin, Tung-Liang Chiang
• 無
  National Health Insurance ; reimbursement ; practice patterns ; practice location ; choice of specialty
• 我國已經決定在1994年完成實施全民健康保險，以保障人人有公平就醫的機會。為探討醫師對實施全民健康保險的意見，本研究以中華民國醫師公會全國聯合會醫師會員為研究對象，於1989年11月進行郵寄問卷調查，共收集1619名醫師資料，回收率為21.6%。結果顯示：（1）四分之三的醫師贊成實施全民健康保險；（2）三分之二的醫師贊成院所的保險特約以自由申請為主；（3）四分之三的醫師贊成以論量計酬支付醫療費用；（4）六成的醫師贊成同病同酬的醫療支付標準；（5）約六分之一的醫師預期全民健康保險實施後會改行；（6）大多數的醫師認為實施全民健康保險後理想的執業地點為都市，並且贊成限制醫師前往醫師過剩的地區執業；（7）大多數的醫師認為實施全民健康保險後理想的執業科別為一般科與家庭醫學科。根據上述發現，本研究對全民健康保險規劃提出有關的政策與研究建議。
  In order to further protect the right of access to health care by citizens, the government of the Republic of China has decided to fully implement the National Health Insurances (NHI) program by 1994. This study examines opinions of physicians in Taiwan on NHI. The data for the analysis came from a mail survey of 7500 physicians in November 1989, among them 1619 or 21.6% responded. The results of this study showed that: (1) three-quarters of the physicians are in favour of NHI; (2) two-thirds of the physicians are in favour of freely making a contract with NHI to provide health care services; (3) three-quarters of the physicians prefer a fee-for-services system to a capitation payment system; (4) fifty-eight percent of the physicians agree with the ”equal service, equal pay” criterion of payment; (5) approximately one-sixth of the physicians might stop practicing after NHI starts; (6) most physicians are in favour of practicing in urban areas in the NHI era, and agree to restrict entry of physicians into oversuppied areas; and (7) most physicians are in favour of being a general practitioner or family physician in the NHI era. Based on the above findings, this study further discusses the policy and research implications for NHI planning.
• 220 - 227
• 10.6288/JNPHARC1992-11-03-06

• Link 原著 Original Article
• 消防員急慢性健康危害之探討Acute and Chronic Health Effects of Fire Fighters-A Review
• 劉紹興、 許清漢、徐尚為、林春蓮
  Saou-Hsing Liou, Chin-Han Sheu, Shang-Wei Hsu, Chuan-Lian Lin
• 消防員 ； 健康危害 ； 施行病學研究
  Fire fighters ; health hazards ; epidemiologic studies
• 由於工業新產品投入建築、裝潢和傢俱材料，一旦發生火災，這些材料形成非常複雜的燃燒產物。一般不被認為有毒物質燃燒後，可產生多種有害氣體或致癌物。燃燒之有害產物包括有毒氣體如一氧化碳、氮氧化物，二氧化硫或鹵化物；和致癌物如石棉，重金屬，多環類芳香烴，苯或氯乙烯單體等。有毒氣體造成呼吸道的刺激作用，長期暴露則可能造成非特異性呼現道症狀的增加或肺功能的降低，甚至引起心臟血管疾病或死亡率的昇高。致癌物的暴露則可能造成消防員癌症的增加。消防員可能曝露於多種且複雜的化合物下，但是其真正暴露物質或量隨火災種類和燃燒情形之不同而有所改變，很難測定火場中的真正暴露。因此，定期偵測消防員的健康狀況變成預防危害的重要方法。本文的目的即回顧過去文獻以探討消防員潛在的急性或慢性危害。消防員的急性危害包括溫度、噪音、心理壓力、意外傷害和有害氣體造成的肺部傷害。長期暴露造成的慢性危害包括肺功能受損，非癌症性呼吸道疾病，心臟血管疾病和癌症。由流行病學調查方法的限制，慢性危害的證據目前不是很充足，救火與慢性危害之因果關係尚待更多的研究來確定。
  A great variety of plastics, additives and synthetic materials are now widely used in furnishings, appliances, building materials and coatings, this has made the composition of combustion products more complex in recent decades. Although the majority of these substances are not normally considered hazardous, some can be converted into toxic gases and chemical carcinogens by heat and combustion. Fire fighters are potentially exposed to toxic substances during fire fighting. The toxic gases generated in the process of combustion include carbon monoxide, nitrogen oxide, sulfur dioxide and halogen acids. Carcinogens which may be encountered during fire fighting are asbestos, heavy metals, polycyclic aromatic hydrocarbons (PAHs), benzene or vinyl chloride monomer. The inhalation of toxic gases results in irritation of the respiratory tract, an increase in respiratory symptoms and even cardiovascular diseases. Exposure to carcinogens may increase the risk of cancer. Although the potential for exposure to toxic substances is great, it is nearly impossible in a real fire situation to ascertain what specific combustion products and what amounts of such products are generated during the fire and which agents might be responsible for hazards. Therefore, periodical monitoring of health effects is an alternative for control of occupational hazards. The purpose of this review was to elucidate the acute and chronic health effects of fire fighters potentially exposed to a mixture of toxic substances. The acute health hazards of fire fighters include temperature, noise, stress, accidents and pulmonary lesions caused by inhalation of toxic gases. The chronic exposure to combustion products may lead to pulmonary function defects, respiratory disorders, cardiovascular diseases and cancer. Conflicts existing in the limited epidemiological studies of the chronic health effects, indicate that more studies are warranted to determine the long-term effects of fire fighting.
• 228 - 248
• 10.6288/JNPHARC1992-11-03-07

• Link 原著 Original Article
• 排列致癌物可能危險性以擬管理優先順序之模式A Scheme for Listing Carcinogens for Control
• 郭育良、 胡淑貞、 李惠玲
  L. Yue-Liang Guo, Shu-Chen Hu, Huei-Ling Lee
• 無
  carcinogens ; toxic substances
• 由於工業上使用致癌物陸續增多，我們在工業及環境中無時無刻可能接觸到致癌物。致癌物管理是保護環境衛生及全民使康的重要步驟之一。然因致癌物數目之多，勢必無法涵蓋每一個可能的致癌物，而需根據其毒性大小，暴露方式與暴露量等因素而有所取捨。本文以危害物評估的四個步驟，討論排序致癌物危險性的一般原則如下：（一）成立毒性化學物質管理諮詢委員會，由委員會批選出具權威性的參考機構。（二）由參考機構所報告的資料列舉可能的致癌物，以為排序的對象。其判定原則，以流行病學證據有致癌性為優先，而以動物實驗證據為輔。（三）將排序對象致癌物根據毒性大小作優先組別的分組。（四）以總體暴露量作為暴露認定的評估值，以加權的方式增加其列管的優先性。加權時考慮以下因素：1.可能的暴露方式，2.環境的流佈與蓄積，包括化學物質之辛醇對水相對溶解度及其土壤、水、及空氣中的半生期，3.國內的總輸入量或用量。（五）綜合以上所提各化學物質的致癌性質，致癌毒性強度，及可能的暴露量，排列選取出較重要的致癌物。（六）每年或每兩年根據新發表的資料，修訂列管致癌物之優先順序。根據上述之排序方法，工業上之化學物品可以依致癌的危險度分成不同組別。政府機構可針對致癌危險度最高者逐次進行管理。
  The risk of encountering carcinogenic hazards is increasing due to increasing use of these chemicals in industries. Controlling carcinogenic chemicals at production, importation, use, and disposal is important for the public health, but is difficult because of the large number of possible carcinogens used. We propose a scheme for prioritizing carcinogenic chemicals for control by the government. This scheme uses the available data internationally, and takes into consideration the principles of risk assessment, i.e., risk identification, dose-response relationship, exposure assessment, and risk charcterization. The scheme is as follows: 1. ”Toxic Substances Control Scientific Advisory Panel” will be formed consisting experts in Toxicology, Environmental Sciences, Public Health, Biology, Medicine, etc. This ”Scientific Advisory Panel” will select the ”authoritative organizations” from which scientific data on carcinogenicity will be considered authoritative, e.g., International Agency for Research on Cancer (IARC) or United States Environmental Protection Agency (USEPA). 2. Chemicals reported by the ”authoritative organizations” as carcinogenic will be listed as candidates for control, e.g., IARC group 1 and 2, and USEPA Class A, B, and C chemicals. 3. The candidate chemicals will be categorized according to the carcinogenic potency form the available data, e.g., the 50% Tumorogenic Dose (TD50) of Carcinogenic Potency Data Base (CPDB). 4. Consideration will be given to the probability of exposure. The chemicals used extensively in the environment, with long half life and accumulation, or of large amount of import or domestic production will be moved up to categories of higher priority. 5. Categorization of chemicals to different priority levels will be done according to the strength of evidence of carcinogenicity, the potency, and the probability of exposure. 6. The ”Toxic Substances Control Scientific Advisory Panel” will meet yearly to update the categories of toxic chemicals by reviewing the newest available scientific data. According to this prioritizing scheme, industrial chemicals can be categorized into different levels of risk of carcinogenicity. The government agencies can control the most important carcinogens by the categories of carcinogenicity in this scheme. A list of carcinogens in different categories of priority for control is presented.
• 249 - 266
• 10.6288/JNPHARC1992-11-03-08