臺灣博碩士論文加值系統

目的：國人飲食所攝食的食品防腐劑苯甲酸及己二烯酸，若食品防腐劑使用過量或違法使用，則可能威脅甚至影響到人體健康。本研究針對在食品中廣泛使用的苯甲酸及己二烯酸兩種食品防腐劑，調查經攝食後可能對人體健康產生的健康影響進行探討和調查。
方法：以1993-1996年及2005-2008年國民營養健康狀況變遷調查，分別依性別、五個地區分層，分別為客家地區、山地地區、東部地區、澎湖地區、及全臺地區，計算每人每日飲食攝入量，結合第二次台灣總膳食研究調查(Taiwan Total Diet Study, TTDS)分析防腐劑苯甲酸與己二烯酸之暴露濃度，進行五個地區分層居民之健康風險評估，以危害指數(%ADI)表示。另於全民健康保險資料庫研究過敏性疾病包括異位性皮膚炎、過敏性鼻炎、氣喘、蕁麻疹、及過敏性結膜炎進行盛行率分析。並進一步評估1993-1996年到2005-2008年國民營養健康狀況變遷調查防腐劑暴露的危害指數(%ADI)成長率，以邏輯斯迴歸方法進行過敏性疾病盛行情況分析。
結果：研究結果顯示，在1993-1996年國民營養健康狀況變遷調查中，19-64歲居民暴露苯甲酸之危害指數，男性最高為客家地區居民，女性則為東部地區居民，其第95百分位數分別為68%ADI及 73%ADI。己二烯酸對居民危害指數評估結果，男性最高為澎湖地區居民，女性則為山地地區居民，其第95百分位數分別為12%ADI及11%ADI。在2005-2008年國民營養健康狀況變遷調查中19-64歲居民暴露苯甲酸評估結果，男性及女性危害指數最高皆為客家地區，第95百分位數分別為70%ADI及 90%ADI。己二烯酸評估結果，以第95百分位數來看，男性危害指數最高為東部地區19%ADI，女性為客家地區27%ADI。在女性苯甲酸評估結果，只有第97.5百分位數，客家、東部、及澎湖地區皆高於危害指數%ADI標準值，分別為104.83%ADI、122.79%ADI、及 103.85%ADI。
過敏性疾病盛行率分析結果顯示，2005-2008年19-64歲男性患有過敏性疾病盛行率以澎湖地區為最高36.08%，東部地區過敏性疾病盛行率為最低27.71%。女性患有過敏性疾病盛行率以澎湖地區為最高55.89%，東部地區過敏性疾病盛行率為最低40.20%。本研究進一步分析苯甲酸及己二烯酸的健康風險危害指數%ADI，從1993-1996年到2005-2008年期間的%ADI成長率對過敏性疾病盛行情況進行探討，結果顯示攝食食品中苯甲酸及己二烯酸的健康風險在客家地區、山地地區、及澎湖地區與全臺地區比較會增加過敏性疾病盛行的情況，且有統計上顯著的意義。第97.5百分位數%ADI成長率，山地地區居民攝食食品防腐劑可能引起過敏性疾病是全臺地區的3.92倍(OR: 3.92，95% CI : 1.23-12.48)。
結論：經由蒙地卡羅模擬分析方法，以機率分布模式擬合計算之危害商數%ADI，無論男性或女性攝食食品中苯甲酸及己二烯酸之健康風險皆低於標準值。除了女性在2005-2008年期間，第97.5百分位數%ADI於客家、東部、澎湖地區高於標準值。然而1993-1996年到2005-2008年%ADI成長率(包括第50、95、及97.5百分位數%ADI)在客家地區、山地地區、及澎湖地區與全臺地區相比，發現對過敏性疾病盛行情況發現有增加的趨勢。山地地區民眾其攝食食品防腐劑可能引起過敏性疾病盛行情況為最高。

Objectives: Daily consumed food could contain food preservatives, benzoic acid and sorbic acid. If food preservatives were used excessively or illegally, it might have adverse effect on human health. This study explored the intake of food preservatives (benzoic acid and sorbic acid) in daily consumed food and further assessing the health risk in Taiwan.
Methods: This study used three major national representative databases including: 1) Nutrition and Health Survey in Taiwan (NAHSIT), 2) Taiwan Total Diet Study (TTDS) and 3) National Health Insurance Research Database (NHIRD) to assess exposure and its related health risk. Exposure assessments during 1993-1996 and 2005-2008 and their change in five diet strata (Hakka area; Mountainous area; Peng-Hu islands; East coast; and Taiwan) were assessed. The prevalence of allergic diseases including atopic dermatitis, allergic rhinitis, asthma, urticaria, and allergic conjunctivitis was assessed by using NHIRD. The odds ratio was estimated based on logistic regression model to explore the increase of allergic diseases prevalence associated with increment of hazard index %ADI from 1993-1996 to 2005-2008 based on NAHSIT. The data management and statistical analyses was conducted by using Microsoft Office Excel 2003, Crystal Ball® (Version 7.3, Decisioneering, Inc., Denver, Co., USA) software, and SAS statistical software package version 9.2 (SAS the System for windows, Version 9.2). P <0.05 was set as statistical significance level.
Results: This study results showed that the highest 95th %ADI of benzoic acid for males and females was 68%ADI in Hakka area and 73%ADI in East coast respectively for age 19-64 years old during 1993-1996 based on NAHSIT. The highest 95th %ADI of sorbic acid for males and females was 12%ADI in Peng-Hu islands and 11%ADI in Mountainous area respectively for age 19-64 years old during 1993-1996. Furthermore, the highest 95th %ADI of benzoic acid for males and females was 70%ADI and 90%ADI respectively in Hakka area for age 19-64 years old during 2005-2008 based on NAHSIT. The highest 95th %ADI of sorbic acid for males and females was 19% in East coast and 27% in Hakka area respectively for age 19-64 years old during 2005-2008. The highest 97.5th %ADI of benzoic acid for females was 103.85%ADI, 104.83%ADI, and 122.79%ADI (higher than the standard) in Peng-Hu islands, Hakka area, and East coast respectively for age 19-64 years old during 2005-2008.
The highest allergic diseases prevalence for males and females was 36.08% and 55.89% respectively in Peng-Hu islands among age 19-64 years old during 2005-2008. In this study, allergic diseases prevalence associated with %ADI increment rate from 1993-1996 to 2005-2008 was further explored. The results showed that larger daily food preservatives increment rate (benzoic acid and sorbic acid) was significantly related to higher allergic diseases prevalence. Compared with Taiwan, as a reference group, the 97.5th %ADI increment rate of food preservatives intake in the Mountain area potentially had the highest odds ratio associated with allergic diseases (OR: 3.92, 95% CI: 1.23-12.48).
Conclusion: Based on the Monte Carlo Simulation estimated distribution of %ADI, the benzoic acid and sorbic acid seems to be lower than standard except for females in Hakka area, Ease coast and Peng-Hu islands for the highest exposure category, 97.5th %ADI. However, the increment of food preservatives intake, for all three 50th %, 95th % and 97.5th %ADIs, in Hakka area, Mountainous area and Peng-Hu islands from 1993-1996 to 2005-2008 could be significantly related to allergic diseases prevalence. Further study is suggested.

中文摘要...................................................i
英文摘要.................................................iii
目錄.......................................................v
表目錄...................................................vii
圖目錄....................................................ix
附錄目錄...................................................x
第一章 緒論................................................1
1.1 研究背景與研究動機.....................................1
1.2 研究目的...............................................3
1.3 研究假設...............................................4
1.4 名詞界定...............................................5
第二章 文獻探討............................................7
2.1 苯甲酸及己二烯酸之特性.................................7
2.1.1苯甲酸................................................7
2.1.2己二烯酸.............................................10
2.2 苯甲酸及己二烯酸與健康風險評估........................13
2.2.1國內苯甲酸及己二烯酸使用情形.........................13
2.2.2國內食品防腐劑健康風險評估...........................16
2.2.3國外食品防腐劑健康風險評估...........................16
2.3 苯甲酸及己二烯酸與健康危害探討........................20
第三章 材料方法...........................................22
3.1 研究架構流程..........................................22
3.2 資料來源..............................................25
3.2.1臺灣國民營養健康狀況變遷調查.........................25
3.2.2總膳食調查研究.......................................25
3.2.3全民健康保險研究資料庫...............................26
3.3 研究設計..............................................27
3.3.1食品安全健康風險評估.................................27
3.3.2過敏性疾病分析.......................................29
3.4 研究對象..............................................31
3.4.1臺灣國民營養健康狀況變遷調查.........................31
3.4.2全民健康保險研究資料庫...............................31
3.5 資料統計與分析........................................32
第四章 研究結果...........................................36
4.1 苯甲酸及己二烯酸食品安全風險評估結果..................36
4.2 苯甲酸及己二烯酸與過敏性疾病分析結果..................67
第五章 討論...............................................91
第六章 結論與建議.........................................96
6.1 研究限制..............................................96
6.2 研究結論..............................................97
6.3 建議..................................................98
參考文獻..................................................99
附錄.....................................................107

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