<![CDATA[Precision Environmental Medicine @ National Taiwan University

<![CDATA[Precision Environmental Medicine @ National Taiwan University - Home]]>Tue, 07 Apr 2026 12:45:45 -0700Weebly<![CDATA[Conference 2026]]>Wed, 17 Dec 2025 08:43:37 GMThttps://www.precisionenvironmed.com/home/conference-2026Global Exposome Summit 2026 in Sitges (Barcelona), Spain
27 – 29 April 2026
https://www.globalexposomesummit.org/
Abstract submission deadline: 14 January 2026

EPICOH 2026 in Stockholm, Sweden
24 – 27 August 2026
https://www.epicoh2026.com/
Abstract submission deadline: 6 March 2026

ISEE 2026 in Munich, Germany
30 August – 2 September 2026
https://www.isee26.org/
Abstract submission deadline: 27 February 2026

ISES 2026 in Vancouver, Canada
4 – 8 October 2026
https://www.intlexposurescience.org/event/ises-2026-in-vancouver-canada/

APACPH 2026 in Tainan, Taiwan
20-23 October 2026
https://apacph2026.com/
Abstract submission deadline: 30 June 2026

ICOH 2027 in Mumbai, India
14 – 19 February 2027
https://www.icoh2027.in/
Abstract submission deadline: 10 April 2026]]><![CDATA[2025國家環境醫學研究所十週年專刊]]>Fri, 12 Dec 2025 07:56:59 GMThttps://www.precisionenvironmed.com/home/2025

環醫共進十載初心

2025 Taiwan NIEHS at 10: A Legacy of Dedication

]]><![CDATA[台灣禁用含馬兜鈴酸中藥的公共衛生行動與後續挑戰]]>Sat, 26 Jul 2025 03:58:18 GMThttps://www.precisionenvironmed.com/home/6851412最新且最具代表性的重要證據，來自美國國家癌症研究院於2025年7月發表於《Nature》期刊的一項研究，針對非吸菸者肺腺癌進行全基因體分析。研究發現，在169位台灣非吸菸肺腺癌患者中，有19%（32例）之腫瘤樣本呈現與馬兜鈴酸（aristolochic acid, AA）暴露高度相關的SBS22a突變特徵。尤為值得關注的是，在所有SBS22a陽性個案中，有88.9%（32例／36例）來自台灣，凸顯應深入探討含馬兜鈴酸中藥在台灣非吸菸肺癌發病中的潛在角色。此外，我們的初步分析追蹤至五種含馬兜鈴酸中藥禁用後10年，曾使用含馬兜鈴酸中藥的女性，其罹患肺癌風險略有上升，儘管未觀察到明確的劑量反應關係，此結果仍顯示即使為低劑量的含馬兜鈴酸中藥暴露，亦可能增加女性罹患肺癌的風險。針對過去暴露族群的健康風險監測與長期影響之追蹤，特別是尚未禁用的細辛中藥，仍為當前與未來不可忽視的重要任務。建議現行馬兜鈴酸相關法規與檢測標準，應採用更高靈敏度的LC-MS/MS分析方法，以強化監測與防制成效，確保公共衛生安全。

使用含馬兜鈴酸之中藥，早已被證實與慢性腎病、腎衰竭及泌尿道癌症等疾病高度相關。1992年比利時首先通報多位女性因服用含廣防己（Aristolochia fangchi）的減肥中藥而罹患馬兜鈴酸腎病變（aristolochic acid nephropathy, AAN），引發國際關注。我們研究團隊自1998年起即率先於台灣展開調查，發現中藥從業人員誤用或混用含馬兜鈴酸藥材，且其本身亦呈現腎衰竭與泌尿道癌的高風險，顯示職業性暴露為不可忽視的重要因素。

隨著研究證據日益增多，國際癌症研究機構（International Agency for Research on Cancer, IARC）於2002年將含馬兜鈴酸植物列為第一類人類致癌物，並於2012年進一步將馬兜鈴酸本身納入第一類致癌物名單。2000年起國內陸續有相關案例報告，2001年初國內學者即開始呼籲禁用含馬兜鈴酸中藥。2003年11月台北榮民總醫院舉辦的「中草藥中毒研討會」再度呼籲禁用，引起媒體高度關注，也引發中醫界反彈。但基於科學證據充分，時任衛生署陳建仁署長隨即正式宣布禁用關木通、廣防己、青木香、天仙藤、馬兜鈴等五種含馬兜鈴酸中藥，並註銷含有馬兜鈴酸中藥製劑的五十張藥證。政策實施後，全國癌症登記資料顯示，自2011年起上泌尿道上皮細胞癌與膀胱癌的發生率明顯下降。

根據全民健康保險資料顯示，在禁用政策實施前的1997至2003年間，約三分之一台灣人口曾服用含馬兜鈴酸的中藥處方，儘管多數民眾累積劑量並不高，仍顯示中藥安全性亟需重視。我們進一步分析全民健康保險資料，證實使用含馬兜鈴酸中藥會顯著增加罹患慢性腎臟病、腎衰竭及泌尿道癌症的風險。此外，台大醫院泌尿科陳忠信醫師的研究顯示，在152位台灣上泌尿道癌患者中，有93位檢出馬兜鈴酸DNA鍵結物（aristolactam-DNA adducts）與腎皮質中的馬兜鈴酸特異性突變特徵。進一步研究也發現，在台灣透明細胞腎細胞癌（clear cell renal cell carcinoma, ccRCC）樣本中，有76%可偵測到馬兜鈴酸DNA鍵結物，且10個透明細胞腎細胞癌基因體中有6個呈現馬兜鈴酸突變特徵，進一步支持其致癌性。

我們亦將研究擴展至肝癌領域，發現B型肝炎患者若服用含馬兜鈴酸中藥，罹患肝細胞癌（hepatocellular carcinoma, HCC）之風險呈現明確的線性劑量反應關係；C型肝炎患者亦有類似結果。此發現與2017年新加坡研究一致，該研究指出，台灣多達78%的肝癌患者腫瘤中帶有馬兜鈴酸特異性突變，顯示馬兜鈴酸暴露可能為東亞地區肝癌的重要共同致癌因子。2022年我們進一步發表研究指出，第二型糖尿病患者若曾使用含馬兜鈴酸中藥，罹患多種癌症的風險顯著增加，包括腎臟、腎盂、輸尿管、膀胱、肝臟、結腸直腸癌，以及男性前列腺癌與女性肝外膽管癌，顯示其廣泛的致癌潛力。

總結而言，我們的系列研究已建立馬兜鈴酸與多種癌症間具因果關聯之科學證據，台灣推動並成功實施含馬兜鈴酸中藥禁令，為公共衛生防治立下典範。然而，針對過去暴露族群的健康風險監測，以及透過分子流行病學方法持續追蹤其長期影響，特別是尚未禁用的細辛中藥，建議現行馬兜鈴酸法規標準應採用較為靈敏的LC-MS/MS進行檢測，仍為當前與未來不可忽視的重要任務。

相關著作

羅財樟：中藥製造從業人員罹患腎臟疾病死因研究。台北，台灣：行政院衛生署疾病管制局疫情組流行病學訓練科論文，2000。
羅財樟：台灣地區中藥製造從業人員罹患慢性腎臟疾病個案對照研究【碩士論文】。台北，台灣：國立臺灣大學職業醫學與工業衛生研究所，2003。
曾韋綸：1997-2001年全民健保馬兜鈴酸相關方劑處方概況【碩士論文】。台北，台灣：國立臺灣大學職業醫學與工業衛生研究所，2005。
楊孝友：台灣中醫藥從業人員腎臟危害流行病學研究【博士論文】。台北，台灣：國立臺灣大學職業醫學與工業衛生研究所，2010。
賴銘南：混誤用馬兜鈴酸中藥處方與慢性腎病或泌尿道癌之發生【博士論文】。台北，台灣：國立臺灣大學職業醫學與工業衛生研究所，2010。
林杏樺：一、分析馬兜鈴酸藥材禁用後中藥從業人員及家屬血清中馬兜鈴酸之濃度，二、評估馬兜鈴酸藥材禁用後中藥師血中鉛、汞及馬兜鈴酸與腎功能之相關性【碩士論文】。台北，台灣：國立臺灣大學職業醫學與工業衛生研究所，2011。
王碩盟：馬兜鈴酸、Statin類藥物與阿斯匹靈在末期腎病患者泌尿上皮癌的角色【博士論文】。台北，台灣：國立臺灣大學職業醫學與工業衛生研究所，2014。
楊曜旭、吳清源、陳保中：馬兜鈴酸與肝腎疾病風險、及馬兜鈴酸禁用法規公告後之成效評估(MOST 107-2314-B-182-060)。台北，台灣：科技部補助專題研究計畫成果報告，2019。
Yang HY, Chen PC, Wang JD. Chinese herbs containing aristolochic acid associated with renal failure and urothelial carcinoma: a review from epidemiologic observations to causal inference. BioMed Research International 2014 Aug; 2014: 569325. https://doi.org/10.1155/2014/569325
Lai MN, Lai JN, Chen PC, Tseng WL, Chen YY, Hwang JS, Wang JD. Increased risks of chronic kidney disease associated with prescribed Chinese herbal products suspected to contain aristolochic acid. Nephrology (Carlton) 2009 Apr; 14(2): 227-234. https://doi.org/10.1111/j.1440-1797.2008.01061.x
Lai MN, Lai JN, Chen PC, Hsieh SC, Hu FC, Wang JD. Risks of kidney failure associated with consumption of herbal supplements containing Mu Tong or Fangchi: A population based case-control study. American Journal of Kidney Diseases 2010 Mar; 55(3): 507-518. https://doi.org/10.1053/j.ajkd.2009.10.055
Lai MN, Wang SM, Chen PC, Chen YY, Wang JD. Population-based case-control study of Chinese herbal products containing aristolochic acid and urinary tract cancer risk. Journal of the National Cancer Institute 2010 Feb; 102(3): 179-186. https://doi.org/10.1093/jnci/djp467
Wang SM, Lai MN, Wei A, Chen YY, Pu YS, Chen PC, Wang JD. Increased risk of urinary tract cancer in ESRD patients associated with usage of Chinese herbal products suspected of containing aristolochic acid. PLoS ONE 2014 Aug; 9(8): e105218. https://doi.org/10.1371/journal.pone.0105218
Chen CJ, Yang YH, Lin MH, Lee CP, Tsan YT, Lai MN, Yang HY, Ho WC, Chen PC. Herbal medicine containing aristolochic acid and the risk of hepatocellular carcinoma in patients with hepatitis B virus infection. International Journal of Cancer 2018 Oct; 143(7): 1578-1587. https://doi.org/10.1002/ijc.31544
Chen CJ, Yang YH, Lin MH, Lee CP, Tsan YT, Lai MN, Yang HY, Doyle P, Ho WC, Chen PC. Herbal medicine containing aristolochic acid and the risk of primary liver cancer in patients with hepatitis C virus infection. Cancer Epidemiology, Biomarkers and Prevention 2019 Nov; 28(11): 1876-1883. https://doi.org/10.1158/1055-9965.EPI-19-0023
Chen CJ, Chiu WC, Tseng YH, Lin CM, Yang HY, Yang YH, Chen PC. Aristolochic acid and the risk of cancers in patients with diabetes: Nationwide population-based cohort study. Phytomedicine 2022 May; 99: 154023. https://doi.org/10.1016/j.phymed.2022.154023
Yang HY, Wang JD, Lo TC, Chen PC. Increased mortality risk of kidney and other urinary organs cancers in Chinese herbalists. Journal of Epidemiology 2009 Feb; 19(1): 17-23. https://doi.org/10.2188/jea.JE20080035
Yang HY, Wang JD, Lo TC, Chen PC. Increased risks of upper tract urothelial carcinoma in male and female Chinese herbalists. Journal of the Formosan Medical Association 2011 Mar; 110(3): 161-168. https://doi.org/10.1016/S0929-6646(11)60026-0
Yang HY, Wang JD, Lo TC, Chen PC. Occupational kidney disease among Chinese herbalists exposed to herbs containing aristolochic acids. Occupational and Environmental Medicine 2011 Apr; 68(4): 286-290. https://doi.org/10.1136/oem.2010.058594
Yang HY, Wang JD, Lo TC, Chen PC. Occupational exposure to herbs containing aristolochic acids increases the risk of urothelial carcinoma in Chinese herbalists. Journal of Urology 2013 Jan; 189(1): 48-52. https://doi.org/10.1016/j.juro.2012.08.090
Lin HH, Chou SA, Yang HY, Hwang YH, Kuo CH, Kao TW, Lo TC, Chen PC. Association of blood lead and mercury with estimated GFR in herbalists after the ban of herbs containing aristolochic acids in Taiwan. Occupational and Environmental Medicine 2013 Aug; 70(8): 545-551. https://doi.org/10.1136/oemed-2012-101066
Hoang ML, Chen CH, Chen PC, Roberts NJ, Dickman KG, Yun BH, Turesky RJ, Pu YS, Vogelstein B, Papadopoulos N, Grollman AP, Kinzler KW, Rosenquist TA. Aristolochic acid in the etiology of renal cell carcinoma. Cancer Epidemiology, Biomarkers and Prevention 2016 Dec; 25(12): 1600-1608. https://doi.org/10.1158/1055-9965.EPI-16-0219
Chen CJ, Yang YH, Lin CC, Lu TP, Chen JS, Chen PC. Aristolochic acid and the risk of female lung cancer: population-based case-control study. Environmental Health Perspectives ISEE Conference Abstracts 2023; 2023(1): https://doi.org/10.1289/isee.2023.FP-011. 35th Annual Conference of the International Society for Environmental Epidemiology (ISEE 2023), Kaohsiung, Taiwan, September 17-21, 2023.

]]><![CDATA[Impact of rapid temperature fluctuations on acute stroke risk: a nationwide case-crossover study from 2001 to 2020]]>Sun, 06 Apr 2025 08:04:19 GMThttps://www.precisionenvironmed.com/home/impact-of-rapid-temperature-fluctuations-on-acute-stroke-risk-a-nationwide-case-crossover-study-from-2001-to-2020https://www.sciencedirect.com/science/article/pii/S2666606525000835

]]><![CDATA["COMBAT: A COMmunity-based Behavioral and Attitudinal survey in Tuvalu—Longitudinal follow-up and health interventions" Principal Investigator: Dr. Chih-Fu Wei (魏志阜醫師)]]>Sat, 05 Apr 2025 03:07:15 GMThttps://www.precisionenvironmed.com/home/combat-a-community-based-behavioral-and-attitudinal-survey-in-tuvalu-longitudinal-follow-up-and-health-interventions-principal-investigator-dr-chih-fu-wei

]]><![CDATA[Conference 2025]]>Tue, 31 Dec 2024 02:08:40 GMThttps://www.precisionenvironmed.com/home/conference-20252025 International Conference on Occupational Hygiene and Occupational Medicine
Place: Tainan, Taiwan
Date: April 25-27, 2025
Website: https://oheomc2025.toha.org.tw/

Joint Annual Meeting of the International Society of Exposure Science and the International Society for Environmental Epidemiology 2025 (ISES-ISEE 2025)
Place: Atlanta, Georgia, USA
Date: August 17-20, 2025
Website: https://www.isesisee2025.org/

8th International Conference on Work Environment and Cardiovascular Diseases
Date: 20-22 August 2025
Place: Bangkok, Thailand
Website: https://www.ph.mahidol.ac.th/ICOH2025/

13th World Congress of the International Society for Developmental Origins of Health and Disease (DOHaD 2025)
Date: September 7-10, 2025
Place: Buenos Aires, Argentina
Website: https://www.dohad2025.com.ar/

International Symposium on Biological Monitoring (ISBM13)
Date: 9-12 September 2025
Place: Milan, Italy
Website: https://isbm13.studioprogress.it/

30th Annual Conference on Epidemiology in Occupational Health (EPICOH 2025)
Date: 6-9 October 2025
Place: Utrecht, the Netherlands
Website: https://epicoh2025.com/

2nd International SC Occupational Medicine Conference
Date: 27-29 November 2025
Place: Lima, Perù
Website:

]]><![CDATA[Bridging Environmental Science and Precision Medicine: Insights from PEMlab@NTU's Key Research Initiatives]]>Sat, 13 Jul 2024 01:53:12 GMThttps://www.precisionenvironmed.com/home/precision-environmental-medicine-national-taiwan-university

Precision Environmental Health Sciences is an innovative approach that integrates the study of environmental exposures with genomics, biomonitoring, and advanced epidemiologic study designs to address complex health issues. At PEMlab@NTU (National Taiwan University), our research focuses on cutting-edge measurements to inform personalized interventions and population-level health strategies aimed at addressing emerging environmental risks.

In collaboration with the National Institute of Environmental Health Sciences in Taiwan, our key projects include the Taiwan Longitudinal Cohort Study of Children and Families (TCAF), which investigates how early environmental exposures, such as microplastics, impact children's neurodevelopment using advanced exposomics tools. Another major initiative is the Taiwan Alliance for Precision Environmental Medicine (TPEM), which examines specific environmental exposures. For instance, the ExWAS-LANS project explores environmental and occupational risk factors for lung adenocarcinoma in never-smokers. Additionally, we conduct cross-generational cohort studies on aerotropolis development and the health of shipbuilders. The Taiwan Human BioMonitoring Program (THBM) collects biomonitoring data across the country to assess environmental health trends. Finally, the Taiwan Net Zero and Sustainable Health (TNSH) program evaluates the health effects of climate change, with a focus on neurological and mental health impacts, as part of a broader effort to understand the consequences of environmental changes on human health.

Our mission is to bridge environmental science and precision medicine, ultimately developing proactive and adaptive solutions for future environmental health challenges. By addressing both immediate and long-term health outcomes, PEMlab@NTU is uniquely positioned to provide insights and strategies that will safeguard future generations from the evolving and often unpredictable environmental health challenges of the modern world.

]]><![CDATA[Conference 2024]]>Thu, 21 Dec 2023 03:52:46 GMThttps://www.precisionenvironmed.com/home/conferences-20242024 International Conference on Occupational Health and Occupational Medicine
https://oheomc2024.toha.org.tw/
April 19 - 21, 2024, Taichung, Taiwan

ICOH 2024
https://www.icoh2024.ma/
April 28 – May 3, 2024, Marrakesh, Morocco
Abstract submission deadline: July 31, 2023

ISEE-AWPC & ISES-AC 2024
https://iseeawpc-isesac2024.com/
June 23 - 26, 2024, Kota Kinabalu, Sabah, Malaysia
Abstract submission deadline: January 15, 2024

ISEE 2024
https://iseeconference.org/
August 25-28, 2024, Santiago, Chile
Abstract submission deadline: February 7, 2024

2024 Annual Conference of Taiwan Public Health Associations
October 5-6, 2024, Hualien, Taiwan
https://www.publichealth.org.tw/

ISES 2024
https://www.intlexposurescience.org/ises-2024-annual-meeting/
October 20-24, 2024, Montreal, Canada
Abstract submission deadline: April 2024

]]><![CDATA[Conference 2023]]>Sat, 10 Jun 2023 04:20:39 GMThttps://www.precisionenvironmed.com/home/conference-2023EPICOH 2023, Mumbai, India
29th International Symposium on Epidemiology in Occupational Health
March 14 - 17, 2023
https://www.epicoh2023.in/

2023 International Conference on Occupational Health and Occupational Medicine, Taipei, Taiwan
April 21 - 23, 2023
https://oheomc2023.toha.org.tw/

ISPEM 2023, Kaohsiung, Taiwan
International Symposium of Precision Environmental Medicine (Spring)
April 29, 2023
https://www.precisionenvironmed.org/

ISBM-12, Porto, Portugal
12th International Symposium on Biological Monitoring in Occupational and Environmental Health
June 21 - 23, 2023
https://www.isbm12.com/

ISES 2023, Chicago, United States
Annual Meeting of International Society of Exposure Science
August 27 - 31, 2023
https://www.intlexposurescience.org/ises-2023-annual-meeting/

2023 Annual Conference of Taiwan Public Health Associations, Kaohsiung, Taiwan
September 16 - 17, 2023
https://www.publichealth.org.tw/

ISEE 2023, Kaohsiung, Taiwan
35th Annual Conference of the International Society for Environmental Epidemiology
September 17 - 21, 2023
https://www.iseeconference.org/

APHA Annual Meeting, Atlanta, United States
Annual Meeting of American Association of Public Health
November 12 - 15, 2023
https://www.apha.org/

ACOH 2023, Daegu, Korea
23rd Asian Congress on Occupational Health
November 22 -25, 2023
https://www.acoh2023.org/

]]><![CDATA[ISEE 2023 - Kaohsiung, Taiwan]]>Sat, 18 Jun 2022 04:24:33 GMThttps://www.precisionenvironmed.com/home/isee-2023-kaohsiung-taiwanInternational Society for Environmental Epidemiology
https://www.iseepi.org/
ISEE 2022 - Athens, Greece (Europe)
https://isee2022.org/
ISEE 2023 - Kaohsiung, Taiwan (Asia)
https://www.iseeconference.org/
ISEE 2024 - Santiago, Chile (South America)
ISEE 2025 - Atlanta, Georgia (United States)

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