台灣風險分析學會
Taiwan Society for Risk Analysis
2021年第23期
地區碼與基因碼哪一個重要？ 給我們的風險啟示
臺灣大學公共衛生學院環境與職業健康科學研究所 邱嘉斌
Release: Dec. 27, 2021
地區碼(如郵政編碼)代表居家環境位置，也是代表環境暴露資訊，而基因碼則是代表家族與個人的遺傳訊息，地區碼與基因碼的比較所代表的是後天環境與先天基因的影響。美國有一份研究透過大型的健保數據系統性地調查表基因型和環境貢獻在560種疾病表基因型的變異，其中包括特定的環境風險因素，例如社會經濟狀況、污染暴露和氣候。研究中也量化了個人的基因碼和地區碼的貢獻，研究針對居住在美國的44,859,462個人中，有介於0至24歲之間的56,396對雙胞胎和724,513對兄弟姐妹的表基因型。研究顯示40% (225/560)的基因型變異來自基因型因子所貢獻，24.6% (138/560)的基因變異則來自環境變數因子所貢獻。然而，研究同時也顯示在量化了個人基因碼和地區碼(社會經濟狀況、氣候和空氣污染)相同的尺度下，有551 種疾病相關的表基因型變異可連結到外部地理資料庫[1-7]。相信地區碼可能比基因碼更重要以決定健康正在取得進展，然而如果要消弭這樣的影響，政府需要透過精準醫學以改善個人健康，同時需要針對特定的族群，同步努力改善族群健康[8]。
在台灣，不論環境暴露監測[9]、污染排放清冊[10]、空氣品質模擬[11]、環境流行病學[12]或健康風險評估[13]各方面，均反映出環境暴露或健康風險具有高度的空間變異性，顯然健康與地區碼有著密不可分地關聯。國人總是自許台灣的健保系統是領先全球，然而除了健保費用的問題外，個人的精準醫學與環境污染致病因素仍是值得研究的課題，基因碼與地區碼都需要同等被關注，如此才能保護全民健康。
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