臺灣博碩士論文加值系統

美容美髮從業人員常因工作接觸許多刺激性或有害化學物質，而引起皮膚、呼吸道及生殖系統等危害。此外長時間站立或維持相同姿勢，導致其下肢靜脈曲張或下背痛等肌肉骨骼症狀。本研究主要針對美容美髮從業人員為研究對象，經由方便採樣，並經店主及個人同意後，取得台灣中部64名，北部101名，共165名之美容美髮現行從業人員。進行該職業各項暴露危害因子的問卷調查、並採集唾液測定皮質醇（cortisol）及免疫球蛋白A (IgA)，進行統計分析，探討相互之間的關聯性。
問卷內容包含基本資料、工作概況、生活及飲食習慣、個人健康、疾病史、防護具使用、睡眠品質及工作壓力等部分。唾液樣本的採集時間，以早上9至11點之間的唾液作為樣本，進一步分析唾液中皮質醇(cortisol)及免疫球蛋白A(IgA)數據，與其職業危害暴露之相關性。唾液中皮質醇(cortisol)及免疫球蛋白A (IgA)則以酵素連結免疫分析法(enzyme-linked immunosorbent assay；ELISA)做測定。
結果顯示自覺暴露危害因子，主要為「皮膚接觸化學物質」佔76.4%、「因作業姿勢而導致肌肉骨骼酸痛或疼痛」佔72.1%、「暴露空氣粉塵」佔68.5%、「被器具或毛髮刺切割傷」佔65.5%、及「暴露有害氣體」佔64.2%。職業危害暴露相關症狀中，主要為「腸胃不適」佔53.9%、「胃痛」佔45.5%、「下肢靜脈曲張」佔42.4%、「眼睛乾澀發炎」佔40.6%及「皮膚乾裂」佔40.0%，另肌肉骨骼症狀以「肩膀」為主佔74.5%。有關唾液cortisol測定方面，有92.1%屬正常值(正常值為1.2-14.7ng/mL)，整體樣本平均值為6.64 ng/mL，標準差為4.17ng/mL；唾液IgA測定有85.5%屬正常值(正常值為40-170μg/mL)，整體樣本平均值為106.72μg/mL，標準差為50.59μg/mL。
問卷調查項目與唾液中cortisol之間有顯著性差異者(P<0.05)，為疾病史之「鼻炎」；「每天上班總時數」；飲食方面之「辣味食物」及「重鹹食物」；職業危害暴露相關症狀之「皮膚疹」、「腸胃不適」及「眼睛乾澀發炎」；主觀健康方面的「身體健康不佳」及「睡眠整體評價」。與唾液中IgA有顯著性差異者(P<0.05)之項目為育齡婦女生殖危害之「自然流產」；職業危害暴露相關症狀之「乾咳」及「下背痛」。另外，工作壓力調查中「工作控制決策自主性」與cortisol之間有顯著性差異；「心理負荷決策自主性」與IgA之間有顯著性差異。
本研究發現，美容美髮從業人員職業危害暴露，以化學危害為主，在生殖危害中，52.6%之育齡婦女「非正常生殖」。研究調查中，有多項職業危害暴露相關症狀，與唾液中的皮質醇（cortisol）及免疫球蛋白A (IgA)有統計學上的顯著性，故唾液中的皮質醇（cortisol）及免疫球蛋白A (IgA)，可作為美容美髮從業人員職業危害暴露的良好指標。

Cosmetology and hairdressing professionals often exposed many irritating or harmful chemicals, and cause skin, respiratory and reproductive and other hazards in their workplace, prolonged standing or maintain the same posture resulting in varicose veins or lower back pain. The 165 relevant employees, 64 from central Taiwan and 101 from northern Taiwan, were sampled randomly, and agreed with consent. A questionnaire survey of the occupational hazards of exposure factors, and collecting salivary for cortisol and immunoglobulin A (IgA) determination were conducted.

The contents of the questionnaire included basic information, job profile, living and eating habits, personal health, medical history, use of protective equipment, sleep quality and work pressure. The sample of saliva is collected during 9 a.m. to 11 a.m., it is used to analyze cortisol and IgA and compared with the exposure risk factor. The salivary cortisol and IgA were detected by the enzyme-linked immunosorbent assay (ELISA).

The results of this study showed that self-report risk factors were “skin exposure to the chemicals” (76.4%), “musculoskeletal pain caused by working positions” (72.1%), “exposure to the airborne dust” (68.5%), “hurt by tools or hair” (65.5%), and “exposure to harmful chemical vapor” (64.2%); and the related symptoms were mainly “gastrointestinal discomfort” (53.9%), “stomachache” (45.5%), “Varicose veins” (42.2%), “eye dryness and inflammation” (40.6%), and “chapped skin” (40.0%), musculoskeletal symptoms of shoulder mainly accounted for 74.5%. In regard to the salivary cortisol analysis, 92.1% of the all were normal, the average value of overall samples is 6.64 ± 4.17 ng/mL. For the IgA testing, 85.5% of the results are normal (40-170 µg/mL), the average is 106.72 ± 50.59 µg/mL.

The items of the survey which have significant difference (P<0.05) with the cortisol in saliva are “rhinitis of disease history”, “daily working hours”, and “the diet habit of spicy and salty food”; the prevalence diseases related to occupational hazards are “skin rash”, “gastrointestinal discomfort” and “eye irritation”.

The items of the survey which have significant difference (P<0.05) with the IgA in saliva is “spontaneous abortion of reproductive harm to women in childbearing age”; the prevalance diseases of occupational hazards are “dry cough” and “lower back pain”. On the other hand, the survey for investigating the work pressure shows that “working control decisions autonomy” has significant difference with cortisol; “decision-making autonomy of the psychological load” has significant difference with IgA (P<0.05).

This study also finds that the exposure to the risk factor of cosmetology and hairdressing professionals is mainly “chemical hazards”;52.6% of women in childbearing age have the of “abnormal pregnancy”, that is very important issue for cosmetology and hairdressing professionals. The study suggested that salivary, cortisol and IgA can be useful indexes for evaluating such field and especially for cortisol.

目錄
摘要….……………………………………………………………………………………………………………………….I
Abstract IV
誌謝….……………………………………………………………………………………………………………………..VI
目錄….…………………………………………………………………………………………………………………….VII
圖目錄 XIII
表目錄 XIV
第一章 前言 1
1.1研究動機 1
1.2目的 3
第二章 文獻探討 4
2.1 美容美髮業 4
2.1.1美容美髮產業概況 4
2.1.2美容美髮業工作內容 5
2.2皮質類固醇（cortisol）之生理 7
2.3免疫球蛋白A(IgA)功能 9
2.4職業危害因子分析 10
2.4.1物理性危害 10
2.4.2化學性危害 10
2.4.2.1皮膚危害 10
2.4.2.2呼吸系統危害 12
2.4.2.3生殖系統危害 14
2.4.2.4心血管危害 15
2.4.3人因工程危害 16
2.4.4心理壓力危害 17
2.4.5電磁波非游離輻射危害 18
第三章 材料與方法 19
3.1材料 19
3.1.1化學試劑 19
3.1.1.1唾液中皮質醇(salivary cortisol)檢測之化學藥劑 19
3.1.1.2唾液中免疫球蛋白A (salivary IgA)檢測之化學藥劑 20
3.1.2器材 20
3.1.3分析儀器 20
3.2方法 21
3.2.1研究對象 21
3.2.2問卷設計與調查 21
3.2.2.1受訪者之基本人口資料表 21
3.2.2.2個人疾病史 21
3.2.2.3工作暴露危害因子調查表 22
3.2.2.4防護具使用情形 22
3.2.2.5工作壓力問卷 22
3.2.2.6身心健康調查表 23
3.2.2.7睡眠品質量表 23
3.2.2.8肌肉骨骼症狀表 24
3.2.3樣本之收集： 25
3.2.3.1唾液收集方法： 25
3.2.3.2唾液中皮質醇(cortisol)測定方法： 26
3.2.3.3唾液中免疫球蛋白A(IgA)測定方法： 27
3.3統計分析 29
第四章 結果 31
4.1問卷結果及分析 31
4.1.1研究對象的基本資料分析 31
4.1.1.1工作概況 32
4.1.1.2生活飲食習慣 32
4.1.1.3個人疾病史 33
4.1.1.4女性員工生殖危害 33
4.1.2美容美髮從業人員的職業危害暴露相關症狀 33
4.1.3美容美髮從業人員的自覺暴露危害因子 34
4.1.4美容美髮從業人員防護具使用情形 35
4.1.5美容美髮從業人員之工作壓力調查 35
4.1.6美容美髮從業人員之身心健康調查 36
4.1.7美容美髮從業人員之睡眠品質 36
4.1.8美容美髮從業人員之肌肉骨骼症狀 37
4.2唾液皮質醇及免疫球蛋白A測定 37
4.2.1皮質醇(cortisol) 標準品檢量線測定 37
4.2.2免疫球蛋白A（IgA）標準品檢量線測定 38
4.3唾液皮質醇及免疫球蛋白A與問卷變項分析 39
4.3.1美容美髮從業人員唾液中皮質醇及免疫球蛋白A分析 39
4.3.2美容美髮從業人員的基本資料與唾液中皮質醇及免疫球蛋白A分析 39
4.3.3美容美髮從業人員的疾病史與唾液中皮質醇（cortisol）及免疫球蛋白A（IgA）分析 39
4.3.4女性員工生殖危害與唾液中皮質醇及免疫球蛋白A分析 40
4.3.5美容美髮從業人員的工作概況與唾液中皮質醇及免疫球蛋白A分析 40
4.3.6美容美髮從業人員的生活飲食習慣與唾液中皮質醇及免疫球蛋白A分析 41
4.3.7美容美髮從業人員的職業危害暴露相關症狀與唾液中皮質醇及免疫球蛋白A分析 41
4.3.8美容美髮從業人員的防護具使用與唾液中皮質醇及免疫球蛋白A分析 42
4.3.9美容美髮從業人員的暴露危害因子與唾液中皮質醇及免疫球蛋白A分析 42
4.3.10美容美髮從業人員的工作壓力調查與唾液中皮質醇及免疫球蛋白A分析 43
4.3.11美容美髮從業人員的身心健康調查與唾液中皮質醇及免疫球蛋白A分析 43
4.3.12美容美髮從業人員的睡眠品質調查與唾液中皮質醇及免疫球蛋白A分析 44
4.3.13美容美髮從業人員的肌肉骨骼症狀與唾液中皮質醇及免疫球蛋白A分析 44
第五章 討論 45
5.1問卷項目與唾液中皮質醇（cortisol）、免疫球蛋白A（IgA）濃度討論 45
5.1.1美容美髮從業人員基本資料及工作概況 45
5.1.2 美容美髮從業人員生活與飲食習慣 46
5.1.3美容美髮從業人員個人疾病史 47
5.1.4 美容美髮從業人員職業暴露危害因子及相關症狀討論 48
5.1.5 美容美髮從業人員防護具使用情形 50
5.1.6 美容美髮從業人員工作壓力討論 51
5.1.7 美容美髮從業人員身心健康討論 52
5.1.8 美容美髮從業人員睡眠品質討論 52
5.1.9 美容美髮從業人員肌肉骨骼症狀討論 53
5.2研究限制 53
第六章 結論 54
參考文獻 57

附件一 JIRB申請通過證書 101
附件二 國家衛生研究院醫學研究倫理講習會上課證明 103
附件三 美容及美髮從業人員之職業危害暴露因子及健康影響問卷 104

 

圖目錄
圖一 壓力狀況下，皮質類固醇(cortisol)濃度之變化。 8
圖二 正常生理狀態下，皮質類固醇(cortisol)濃度之每日週期。 8
圖三 皮質醇(cortisol) 標準品之檢量線 37
圖四 免疫球蛋白A（IgA）標準品之檢量線 38

 

表目錄
表1 美容美髮國際技能認證等級 5
表2 化粧品含有醫療或毒劇藥品基準中染髮劑成分之使用限量管理規定 13
表3 美容美髮從業人員基本資料 65
表4 美容美髮從業人員工作概況 66
表5 美容美髮從業人員生活飲食習慣 68
表6 美容美髮從業人員生活與飲食習慣-依性別 70
表7 美容美髮從業人員個人疾病史 71
表8 美容美髮從業人員已婚(含離婚)女性員工生殖危害 71
表9 美容美髮從業人員職業危害暴露相關症狀 72
表10 美容美髮從業人員暴露危害因子 74
表11 美容美髮從業人員工作防護具使用情形 75
表12 美容美髮從業人員之工作壓力問卷調查 76
表13 美容美髮從業人員身心健康情形 78
表14 美容美髮從業人員整體身心健康分析 78
表15 美容美髮從業人員睡眠品質問卷調查 79
表16 美容美髮從業人員睡眠品質分析 79
表17 美容美髮從業人員肌肉骨骼症狀 80
表18 美容美髮從業人員唾液中皮質醇(cortisol)與免疫球蛋白A(IgA)測定分析 82
表19 美容美髮從業人員基本資料與唾液中皮質醇與免疫球蛋白A測定分析 83
表20 美容美髮從業人員個人疾病史與唾液中皮質醇與免疫球蛋白A測定分析 84
表21 美容美髮從業人員已婚(含離婚)女性員工生殖危害與唾液中皮質醇與免疫球蛋白A測定分析 84
表22 美容美髮從業人員工作概況與唾液中皮質醇與免疫球蛋白A測定分析 85
表23 中部美容美髮從業人員工作概況與皮質醇與免疫球蛋白A測定分析 87
表24 北部美容美髮從業人員工作概況與皮質醇與免疫球蛋白A測定分析 88
表25 美容美髮從業人員生活與飲食習慣與唾液中皮質醇與免疫球蛋白A測定分析 89
表26 美容美髮從業人員職業危害暴露相關症狀與唾液中皮質醇與免疫球蛋白A測定分析 91
表27 美容美髮從業人員防護具使用與唾液中皮質醇與免疫球蛋白A測定分析 93
表28 美容美髮從業人員暴露危害因子與唾液中皮質醇與免疫球蛋白A測定分析 94
表29 美容美髮從業人員工作壓力調查與唾液中皮質醇與免疫球蛋白A測定分析 95
表30 美容美髮從業人員身心健康調查與唾液中皮質醇與免疫球蛋白A測定分析 97
表31 美容美髮從業人員整體身心健康狀況與唾液中皮質醇與免疫球蛋白A測定分析 97
表32 美容美髮從業人員睡眠品質調查與唾液中皮質醇與免疫球蛋白A統計分析 98
表33 美容美髮從業人員整體睡眠品質與唾液中皮質醇與免疫球蛋白A統計分析 98
表34 美容美髮從業人員肌肉骨骼症狀與唾液中皮質醇與免疫球蛋白A測定分析 99

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