臺灣博碩士論文加值系統

國內研究結果顯示，飛機檢修業屬於職場高噪音作業環境場所，例如：航機起降及各種檢修工作等，在此高噪音環境工作下之勞工的確有顯著的聽力損失情況。近年來，有關聽力損失危害的研究已朝向噪音與有機溶劑暴露一併探討，過去已經有文獻指出，暴露於有機溶劑的作業環境中會與暴露噪音一樣引起聽力損失，而且許多的化學物質已經被證實為聽力毒性物質。根據行政院勞工委員會資料顯示，飛機檢修業普遍使用的有機溶劑，有大部分均為我國勞工安全衛生法規中指定之有害物。其中最常見的兩種有機溶劑分別為正己烷與丁酮。然而，至今尚未有單純暴露正己烷或丁酮對聽力系統所造成的影響研究或調查。因此，本研究的目的為：探討職業噪音、正己烷、丁酮暴露對飛機檢修員工聽力損失的影響。以國內一處機場男性檢修人員為研究對象，根據研究對象噪音、正己烷、丁酮暴露的情況分為單純噪音暴露組、單純正己烷暴露組、單純丁酮暴露組、噪音與正己烷共同暴露組、噪音與丁酮共同暴露組、噪音與正己烷及丁酮共同暴露組、對照組共7組。研究對象均接受問卷調查、身體健康檢查與聽力檢查測定。利用線性回歸進行多變項分析，以控制相關的影響因子。研究結果發現扣除年齡老化因素之後，單純噪音暴露組聽力損失介於3.1~9分貝，聽力損失盛行率33.3%；單純正己烷暴露組聽力損失介於3.8~11.8分貝，聽力損失盛行率35.1%；單純丁酮暴露組聽力損失介於2.8~8.8分貝，聽力損失盛行率21.7%；噪音與正己烷共同暴露組聽力損失介於2.7~8.4分貝，聽力損失盛行率32%；噪音與丁酮共同暴露組聽力損失介於3.6~14分貝，聽力損失盛行率33.3%；噪音與正己烷及丁酮共同暴露組聽力損失介於2.7~9.6分貝，聽力損失盛行率34.5%。控制其他影響因子後，隨著職業暴露情況的增加，聽力損失也顯著增加。由本研究發現，職業噪音及有機溶劑危害確實存在於飛機檢修人員中，在工作時減少噪音、有機溶劑接觸與佩帶相關防護裝備實為保護該工作之員工主要的建設；另外，建議暴露於有機溶劑環境中的員工也要納入聽力保護計畫內實施各項聽力保護措施。

Noise has been documented as the most important hazard about hearing loss, especially at occupational settings. Aircraft maintenance workers are at the high risk of hearing loss associated with a great amount of noise exposure at work such as regular check of airplane taking off and landing. Organic solvents exposure has been noted as an additional factor of hearing loss among aircraft maintenance workers. Previous studies have revealed that organic solvents related occupational hearing loss might be due to the ototoxicity after exposure in workers. N-hexane and MEK are the most frequently used solvents during the aircraft maintenance process. To the best of our knowledge, limited studies have been conducted on the hearing loss associated with n-hexane and/or MEK exposure and the interaction of with noise among aircraft maintenance workers. The purpose of this study is to investigate whether among aircraft maintenance workers exposed to noise, n-hexane, and MEK are at elevated risk of hearing loss. The aircraft maintenance workers in Taiwan were recruited as the subjects of this study. We classified these subjects into seven exposure groups based on their exposure profiles of noise, n-hexane, and MEK, including noise exposure only (group 1), n-hexane exposure group (group 2), MEK exposure only (group 3), noise and n-hexane co-exposure (group 4), noise and MEK co-exposure (group 5), noise, n-hexane, and MEK co-exposure (group 6), and non-exposure (group 7). Hearing loss examination was used to estimate the status of hearing impairment among workers. Information on demographics and potential confounders were collected using questionnaires. Linear regression models were used to estimate the risk of hearing loss among exposure groups controlling for potential confounders. The results showed that the ranges of hearing threshold loss of the all exposure groups on left and right ears were 3.1~9.0、3.8~11.8、2.8~8.8、2.7~8.4、3.6~14、2.7~9.6 dB, respectively; The prevalence of hearing loss among the corresponding exposure groups were 33.3%、35.1%、21.7%、32%、33.3%、34.5%, respectively. After adjustment of confounders, the threshold of hearing loss significantly increased as the exposure level increased. The results of this study indicate that exposure to occupational noise and organic solvents increased the risk of hearing loss for the aircraft maintenance workers. The aircraft maintenance workers are encouraged to use personal protective equipments at the work. We suggest that hearing conservation programs should be implemented for these aircraft maintenance workers.

圖表目錄 II
中文摘要 III
Abstract V
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 6
第二章 文獻回顧 7
第一節 噪音 7
第二節 有機溶劑 14
第三節 聽力損失 24
第四節 噪音與聽力損失的關係 27
第五節 有機溶劑與聽力損失的關係 29
第六節 噪音與有機溶劑混合暴露對聽力損失的影響 31
第三章 材料與方法 33
第一節 研究架構流程圖 33
第二節 研究對象 34
第三節 問卷調查 35
第四節 使用材料與評估方法 36
第五節 資料處理統計分析 40
第四章 結果 41
第一節 環境危害暴露評估 41
第二節 研究對象基本資料描述 45
第三節 飛機檢修工廠員工單純噪音及有機溶劑暴露，與非暴露員工 在聽力損失情況之比較 57
第四節 飛機檢修工廠員工單純噪音、噪音與有機溶劑共同暴露在聽 力損失情況之比較 75
第五章 討論與限制 80
第六章 結論與建議 85
參考文獻 87
附錄 96

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