砷是一種廣泛存在於生活環境中的元素。有機砷富含於海產食物中，是低毒性或接近無毒的；無機砷的毒性較有機砷大很多，職業性或非職業性的過量暴露會導致多種急慢性健康效應。我國依法規要求砷作業勞工必須接受包含尿中砷檢驗的特殊健康檢查：包括尿液三價砷、五價砷、單甲基砷、雙甲基砷及尿液肌酸酐，並據以進行健康管理。然而海產食物中的有機砷，會嚴重影響尿中雙甲基砷酸的數值，且此一影響會因受檢者的種族、個體基因多型性及攝食水產食物種類之不同而有不同影響型態，有些干擾因子些無法以現行要求檢驗前三天禁食海產食物的方式予以消除。而受檢者的尿液濃縮程度亦會影響檢驗值，必須使用尿肌酸酐濃度加以校正。本文回顧相關文獻，分析台灣目前尿中砷檢驗項目及判讀分級標準的可能問題，提出改善建議。

Arsenic is a ubiquitous element in the environment. Organic arsenic is rich in seafood and is less toxic or relatively nontoxic. Toxicity of inorganic arsenic is much higher. Occupationally or non-occupational overexposure to inorganic arsenic will generate many acute and chronic adverse health effects. Employees occupationally exposed to arsenic need to receive an annular special health examination containing urinary concentration of inorganic arsenic metabolites, including arsenate, arsenite, monomethylarsonic acid (MMA), dimethylarsinic acid (DMA). And accepting health management according to the health examination result. However, the dietary organic arsenic in seafood will seriously interfere the level of dimethylarsinic acid in urine. The range of this interference is different because of different ethnic group, individual variability of genetic polymorphism, and seafood type. Some of these confounding cannot be eliminated by avoiding seafood for 3 days before urine sampling. Besides, concentration of the urine sample also interfere the test result and need to be adjusted by the urinary creatinine level. I reviewed articles for possible problems of the current urine arsenic test items and interpretation standards in Taiwan and make recommendations for improvement.