目標：檳榔嚼食為台灣口腔癌重要危險因子，但相關研究多聚焦於檳榔子本身致癌性，較少探討檳榔嚼塊中可能存在的外源性污染物。本研究檢測台灣市售檳榔嚼塊之農藥殘留與重金屬含量，評估其合規性，作為《檳榔健康危害防制法》施行前之全國基線資料。方法：於2023與2025年自台灣19縣市抽樣市售檳榔嚼塊樣本，包含檳榔子、白灰檳榔與紅灰檳榔。以FaPEx前處理結合LC–MS/MS質譜快速篩檢技術對200種農藥殘留進行定性定量分析，以判定農藥殘留的合規性。2025年的部分檳榔嚼塊樣本以ICP-MS分析砷、鎘、鉛與汞的重金屬檢出情形。結果：農藥殘留檢測樣本共211件，整體農藥殘留不合格率為84.8%，多數樣本檢出多重農藥殘留，又以含荖葉之白灰檳榔最為嚴重，其不合格農藥數為檳榔子的3.23倍（p<0.001），以2025年為例，檢出11種以上不合格農藥的比例為53.2%。除了多重農藥，亦檢出多種禁用農藥。2025年另送驗重金屬共19件，雖未檢出汞，但砷、鎘與鉛之檢出率皆逾八成，又以紅灰檳榔全部檢出最為嚴重。結論：台灣市售檳榔嚼塊普遍存在多重農藥殘留與重金屬暴露風險。本研究提供專法施行前之全國基線資料，可作為未來監測與政策管理之參考。

Objectives: Betel quid chewing is a major risk factor for oral cancer. Most studies on this topic have focused on the carcinogenicity of the areca nut, and limited attention has been given to exogenous contaminants that may be present in betel quid products. In consideration of this gap, the present study investigated pesticide residues and heavy metal content in commercial betel quid products in Taiwan, evaluated regulatory compliance, and established nationwide baseline data prior to the implementation of the Betel Quid Health Hazard Prevention Act. Methods: Betel quid samples, including areca nuts and both white-lime and red-lime betel quids, were collected from 19 counties and cities in Taiwan in 2023 and 2025. Pesticide residues were extracted and analyzed using liquid chromatography tandem mass spectrometry. In total, 200 pesticides were targeted. A subset of the 2025 betel quid samples was analyzed for heavy metals using Inductively Coupled Plasma Mass Spectrometry (ICP-MS), including arsenic, cadmium, lead, and mercury. Results: Among 211 samples analyzed for pesticides, the overall noncompliance rate was 84.8%. Multiple pesticides were detected in most samples, with the most severe contamination occurring in white-lime betel quids wrapped in betel leaves. The number of noncompliant pesticides in white-lime betel quid samples was 3.23 times that in areca nuts (p < .001). In 2025, 53.2% of white-lime betel quid samples contained more than 11 noncompliant pesticides. Several banned pesticides were also detected. In 2025, 19 samples were analyzed for heavy metals. Although mercury was not detected, arsenic, cadmium, and lead were detected in more than 80% of the samples, with red-lime betel quid exhibiting the highest level of contamination. Conclusions: Commercial betel quid products in Taiwan commonly contain multiple pesticide residues and heavy metals. These findings provide crucial nationwide baseline data and may serve as a reference for future monitoring and policy management.

檳榔嚼塊；農藥殘留；重金屬；口腔癌；檳榔健康危害防制法

betel quid; pesticide residues; heavy metals; oral cancer; Betel Quid Health Hazard Prevention Act