臺灣博碩士論文加值系統

空氣品質惡化可能會導致眼睛和呼吸系統的刺激、過敏、發炎反應、心血管疾病，和氧化壓力產生，此現象在易感受族群更為明顯。台北地區氣喘發生率顯示氣喘學童有逐年攀升的趨勢。本研究探討空氣汙染與氣喘學童的呼出氣體（Exhaled breath）中揮發性有機物質（VOCs）及肺功能（Lung function）相關性，以及空氣中微粒所產生的延遲效應（Lag effect）。
本研究將受試者分為有無罹患氣喘的學童，配合環保署超級測站的空氣品質監測資料，進行五個月的評估實驗，以比較兩組學童的生理指標變化情形。指標的檢測方法中，呼出氣體VOCs以熱脫附儀與氣相層析質譜儀進行分析，以呼出氣體中戊烷作為氧化性壓力的代表；肺功能以全自動肺功能檢測儀測量。由於實驗會重複量測受試者的各項生理指標，因此使用廣義線性估計方程式（Generalized Estimating Equations, GEEs）進行檢定，分析環境污染物質對呼出氣體及肺功能指標的影響。
結果指出，氣喘學童（Pentane=0.106, AG）氧化性壓力比非氣喘學童（Pentane=0.095, AG）高。而氣喘學童的肺功能指標平均值皆低於非氣喘學童。氧化壓力也會受性別、身體質量指數、感冒與否與空氣污染物，包括：SO2、CO、NO、NO2、PM2.5的影響。肺功能則會受到身高、體重、身體質量指數、住家是否鄰近大馬路、灰塵量多寡、有無服用維他命與SO2、CO、O3、NO、NO2、PM2.5等空氣污染物的影響。PM2.5的延遲效應可表現氧化性壓力的Lag10、Lag14、Lag30。PM10的延遲效應在氧化性壓力Lag5、Lag7、Lag10、Lag14、Lag30及肺功能指標的FVC、FEV1中有顯著關係。
在易感受族群的氣喘學童中氧化性壓力有高於非氣喘學童的趨勢。空氣污染物的急性與慢性傷害會表現在學童的氧化性壓力與肺功能指標上。懸浮微粒所產生的延遲效應，在氧化性壓力與肺功能指標中可以看到顯著關係存在。研究發現，氧化性壓力的敏感度高且可反映出長期暴露造成的傷害；另外，從肺功能指標可觀察到PM10的延遲效應。

Expose to air pollution has been associated with eye and respiratory system irritation, allergic and inflamed effects and cardiovascular disease. These symptoms were observable in susceptible groups. In Taipei metropolis, the asthma incidence rate rise yearly in schoolchildren. Therefore, the objective of this study was to investigate exhaled breath VOCs and lung function relevance of the air pollution in asthmatic children. Besides, the lag effect of exposure to particulate matter would also be studied.
The study divided participants into asthmatic and non-asthmatic schoolchildren. Take the exhaled breath and lung function cooperate with the air quality monitor data of EPA Supersite. The thermal desorption GC/MS was used to analyze the exhaled breath and conducted pentane as an indicator of oxidative stress; moreover, the lung function was measured by spirometer. Generalized Estimating Equations (GEEs) was used to examine the repeated measurement of the exhaled breath and lung function affected by air pollution.
As the result, the higher oxidative stress and the lower average lung function in asthmatic children (Pentane=0.106 and 0.095, AG) was observed gender, body mass index (BMI), flu, and air pollutant (SO2, CO, NO, NO2, PM2.5) had significant influence in oxidative stress. Lung function were affected by height, weight, BMI, road, dust, vitamins, and air pollutant (SO2, CO, O3, NO, NO2, PM2.5). Lag effect of PM2.5 exhibit the oxidative stress in Lag10, Lag14, Lag30. The lung function (FVC, FEV1) and Lag5, Lag7, Lag10, Lag14, Lag30 in oxidative stress showed the lag effect of PM10.
Asthmatic children which are susceptible had higher oxidative stress. The effects of air pollution display in oxidative stress and lung function of schoolchildren. The lag effects in oxidative stress and lung function of particulate matter were significant. This study indicated that oxidative stress is a sensitive factor and can reflect the long-term injury of exposure. In addition, the lag effect of PM10 was observed by lung function.

摘要 I
Abstract III
目錄 V
圖目錄 IX
表目錄 XI
附錄 XIII
第一章、緒論 1
1.1 研究背景 1
1.2 研究目的 2
第二章、文獻探討 3
2.1 空氣污染造成的傷害 3
2.1.1 空氣污染的影響 3
2.1.2 氣狀污染物的影響 4
2.1.3 粒狀污染物的影響 5
2.2 空氣污染與氣喘的關係 6
2.3 氧化性壓力 7
2.4 呼出氣體中Pentane的應用 8
2.5呼出氣體之研究 10
2.5.1 呼出氣體之特性 10
2.5.2呼氣分析研究種類 11
2.6 肺功能測試 11
2.6.1 氣喘與肺功能的關係 12
2.6.2 肺功能的影響因子 12
2.7 微粒的延遲效應（Lag Effect） 13
第三章、材料與方法 15
3.1 實驗設計 15
3.2 實驗對象 15
3.3 採樣方法 16
3.4 實驗器材與設備 17
3.4.1 設備及材料 17
3.4.2 試劑 19
3.5 儀器操作條件 20
3.5.1 熱脫附裝置 20
3.5.2低溫濃縮捕集裝置 21
3.5.3氣相層析儀 21
3.5.4 質譜儀 21
3.5.5全自動肺功能檢測儀 22
3.6 呼出氣體樣本前處理 22
3.6.1 採樣管之填充 22
3.6.2 採樣管脫附（Conditioning） 22
3.6.3 樣本保存 23
3.6.4採樣管流量校正 24
3.6.5 採樣袋淨化 24
3.7 呼出氣體分析步驟 24
3.7.1 熱脫附裝置調整 24
3.7.2氣相層析儀 25
3.7.3 呼出氣體樣本分析 25
3.8 肺功能指標 26
3.9 QA/QC 26
3.9.1 儀器的空白分析 26
3.9.2 重複樣品分析 27
3.9.3 破出試驗 28
3.10 呼出氣體的定性、定量分析 28
3.10.1定性分析 28
3.10.2定量分析 28
3.11 空氣微粒的延遲效應 29
3.12 統計分析 30
第四章、結果 31
4.1 人口學基本資料 31
4.2 空氣污染背景調查 31
4.3 呼出氣體定性分析 32
4.4氣喘與非氣喘學童呼出氣體中VOCs比較 32
4.5學童肺功能之比較 33
4.5.1 氣喘與非氣喘族群間 33
4.5.2 男性與女性族群間 34
4.6 影響呼出氣體與肺功能的因子探討 34
4.6.1 人口學的資料探討 34
4.6.2 空氣污染資料的相關性 37
4.6.3 PM2.5的延遲效應 38
4.6.4 PM10的延遲效應 38
4.7 氧化性壓力與空氣污染的相關性 39
第五章、討論 41
5.1呼出氣體中VOCs的比較 41
5.2肺功能的比較 41
5.3 影響呼出氣體的變項 42
5.4 影響肺功能的變項 43
5.5 延遲效應 45
5.6 外生性氣體和氧化性壓力的相關性 46
5.7 研究限制 47
5.8 結論 48
參考文獻 49

Balmes, J. R., Chen L. L., Scannell C., Tager I., Christian D., Hearne P. Q., Kelly T. and Aris R. M. (1996). "Ozone-induced decrements in FEV1 and FVC do not correlate with measures of inflammation." American Journal of Respiratory and Critical Care Medicine 153(3): 904-909.
Bande, J., Clement J. and Van de Woestijne K. P. (1980). "The influence of smoking habits and body weight on vital capacity and FEV1 in male Air Force personnel: a longitudinal and cross-sectional analysis." American Review of Respiratory Disease 122 (5): 781-790.
Barck, C., Lundahl J., Hallden G. and Bylin G. (2005). "Brief exposures to NO2 augment the allergic inflammation in asthmatics." Environmental Research 97(1): 58-66.
Barnes, P. J. (1990). "Reactive oxygen species and airway inflammation." Free Radical Biology and Medicine 9(3): 235-243.
Barraza-Villarreal, A., Sunyer J., Hernandez-Cadena L., Escamilla-Nunez M. C., Sienra-Monge J. J., Ramirez-Aguilar M., Cortez-Lugo M., Holguin F., Diaz-Sanchez D., Olin A. C. and Romieu I. (2008). "Air pollution, airway inflammation, and lung function in a cohort study of Mexico City schoolchildren." Environmental Health Perspectives 116(6): 832-838.
Beasley, R., Keil U., von Mutius E., Pearce N., Ait-Khaled N., Anabwani G., Anderson H. R., Asher M. I., Bjorkstein B., Burr M. L., Clayton T. O., Crane J., Ellwood P., Lai C. K. W., Mallol J., Martinez F. D., Mitchell E. A., Montefort S., Robertson C. F., Shah J. R., Sibbald B., Stewart A. W., Strachan D. P., Weiland S. K., Williams H. C. and Int Study Asthma Allergies C. (1998). "Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC." Lancet 351(9111): 1225-1232.
Beeh, K. M., Ksoll M. and Buhl R. (2000). "Elevation of total serum immunoglobulin E is associated with asthma in nonallergic individuals." European Respiratory Journal 16(4): 609-614.
Bell, M. L., Dominici F. and Samet J. M. (2005). "A meta-analysis of time-series studies of ozone and mortality with comparison to the national morbidity, mortality, and air pollution study." Epidemiology 16(4): 436-445.
Blomberg, A., Krishna M. T., Bocchino V., Biscione G. L., Shute J. K., Kelly F. J., Frew A. J., Holgate S. T. and Sandstrom T. (1997). "The inflammatory effects of 2 ppm NO2 on the airways of healthy subjects." American Journal of Respiratory and Critical Care Medicine 156(2): 418-424.
Brauer, M., Hoek G., Van Vliet P., Meliefste K., Fischer P. H., Wijga A., Koopman L. P., Neijens H. J., Gerritsen J., Kerkhof M., Heinrich J., Bellander T. and Brunekreef B. (2002). "Air pollution from traffic and the development of respiratory infections and asthmatic and allergic symptoms in children." American Journal of Respiratory and Critical Care Medicine 166(8): 1092-1098.
Brook, R. D., Franklin B., Cascio W., Hong Y. L., Howard G., Lipsett M., Luepker R., Mittleman M., Samet J., Smith S. C. and Tager I. (2004). "Air pollution and cardiovascular disease - A statement for healthcare professionals from the expert panel on population and prevention science of the American Heart Association." Circulation 109(21): 2655-2671.
Carder, M., McNamee R., Beverland I., Elton R., Van Tongeren M., Cohen G. R., Boyd J., MacNee W. and Agius R. M. (2008). "Interacting effects of particulate pollution and cold temperature on cardiorespiratory mortality in Scotland." Occupational and Environmental Medicine 65(3): 197-204.
Cope, K. A., Solga S. F., Hummers L. K., Wigley F. M., Diehl A. M. and Risby T. H. (2006). "Abnormal exhaled ethane concentrations in scleroderma." Biomarkers 11(1): 70-84.
Cross, C. E., Louie S., Kwack S., Wong P., Reddy S. and Van Der V. A. (2001). "Atmospheric oxidants and respiratory tract surfaces." Environmental Stressors in Health and Disease: 225–236.
Delfi, n. R. (2002). "Epidemiologic evidence for asthma and exposure to air toxics: linkages between occupational, indoor, and community airpollution research." Environmental Health Perspectives 110 (suppl 4): 573-89.
Delfino, R. J., Gong H., Linn W. S., Pellizzari E. D. and Hu Y. (2003). "Asthma symptoms in Hispanic children and daily ambient exposures to toxic and criteria air pollutants." Environmental Health Perspectives 111(4): 647-656.
Delfino, R. J., Quintana P. J. E., Floro J., Gastanaga V. M., Samimi B. S., Kleinman M. T., Liu L. J. S., Bufalino C., Wu C. F. and McLaren C. E. (2004). "Association of FEV1 in asthmatic children with personal and microenvironmental exposure to airborne particulate matter." Environmental Health Perspectives 112(8): 932-941.
Delfino, R. J., Staimer N., Gillen D., Tjoa T., Sioutas C., Fung K., George S. C. and Kleinman M. T. (2006). "Personal and ambient air pollution is associated with increased exhaled nitric oxide in children with asthma." Environmental Health Perspectives 114(11): 1736-1743.
Delfino, R. J., Staimer N., Tjoa T., Gillen D., Kleinman M. T., Sioutas C. and Cooper D. (2008). "Personal and ambient air pollution exposures and lung function decrements in children with asthma." Environmental Health Perspectives 116(4): 550-558.
Drury, J. A., Nycyk J. A. and Cooke R. W. I. (1997). "Pentane measurement in ventilated infants using a commercially available system." Free Radical Biology and Medicine 22(5): 895-900.
Frampton, M. W., Balmes J. R., Cox C., Krein P. M., Speers D. M. and Tsai Y. (1997). "Effects of ozone on normal and potentially sensitive human subjects. Part III: Mediators of inflammation in bronchoalveolar lavage fluid from nonsmokers, smokers, and asthmatic subjects exposed to ozone: a collaborative study." Research Report Health Effects Institute 78: 73-79.
Gabriel Laszlo, M. A. (2000). "Pulmonary function tests in practice." Medicine 99(4): 20-26.
Gauderman, W. J., Avol E., Gilliland F., Vora H., Thomas D., Berhane K., McConnell R., Kuenzli N., Lurmann F., Rappaport E., Margolis H., Bates D. and Peters J. (2004). "The effect of air pollution on lung development from 10 to 18 years of age." New England Journal of Medicine 351(11): 1057-1067.
Gauderman, W. J., Gilliland G. F., Vora H., Avol E., Stram D., McConnell R., Thomas D., Lurmann F., Margolis H. G., Rappaport E. B., Berhane K. and Peters J. M. (2002). "Association between air pollution and lung function growth in southern california children -results from a second cohort." American Journal of Respiratory and Critical Care Medicine 166(1): 76-84.
Gauderman, W. J., Vora H., McConnell R., Berhane K., Gilliland F., Thomas D., Lurmann F., Avoli E., Kunzli N., Jerrett M. and Peters J. (2007). "Effect of exposure to traffic on lung development from 10 to 18 years of age: a cohort study." Lancet 369(9561): 571-577.
Goodman, P. G., Sinclair H., Clancy L. and Dockery D. W. (1999). "Evidence of a cumulative effect of particulate air pollution on mortality in Dublin." American Journal of Respiratory and Critical Care Medicine 159(3): A322-A322.
Gorham, K. A., Andersen M. P. S., Meinardi S., Delfino R. J., Staimer N., Tjoa T., Rowland F. S. and Blake D. R. (2009). "Ethane and n-pentane in exhaled breath are biomarkers of exposure not effect." Biomarkers 14(1): 17–25.
Greene, L. S. (1995). "Asthma and oxidant stress - nutritional, environmental, and genetic risk-factors." Journal of the American College of Nutrition 14(4): 317-324.
Grote, C. and Pawliszyn J. (1997). "Solid-phase microextraction for the analysis of humanbreath." Analytical Chemistry 69(4): 587-596.
Gryparis, A., Forsberg B., Katsouyanni K., Analitis A., Touloumi G., Schwartz J., Samoli E., Medina S., Anderson H. R., Niciu E. M., Wichmann H. E., Kriz B., Kosnik M., Skorkovsky J., Vonk J. M. and Dortbudak Z. (2004). "Acute effects of ozone on mortality from the "Air pollution and health: A European approach" project." American Journal of Respiratory and Critical Care Medicine 170(10): 1080-1087.
Guenegou, A., Leynaert B., Pin I., Le Moel G., Zureik M. and Neukirch F. (2006). "Serum carotenoids, vitamins A and E, and 8 year lung function decline in a general population." Thorax 61(4): 320-326.
Halliwell, B. and Gutteridge J. M. C. (1989). "Lipid peroxidation: a radical chain reaction. In: free radicals in biology and medicine." Clarendon Press 8: 188-249.
Hoek, G. and Brunekreff B. (1993). "Acute effects of a winter air pollution episode on pulmonary function and respiratory symptoms of children." Archives of Environmental Health 48(5): 327-335.
Holguin, F., Flores S., Ross Z., Cortez M., Molina M., Molina L., Rincon C., Jerrett M., Berhane K., Granados A. and Romieu I. (2007). "Traffic-related exposures, airway function, inflammation, and respiratory symptoms in children." American Journal of Respiratory and Critical Care Medicine 176(12): 1236-1242.
Hulsmann, A. R., Raatgeep H. R., Denhollander J. C., Stijnen T., Saxena P. R., Kerrebijn K. F. and Dejongste J. C. (1994). "Oxidative epithelial damage produces hyperresponsiveness of human peripheral airways." American Journal of Respiratory and Critical Care Medicine 149(2): 519-525.
Kan, H. D. and Chen B. C. (2003). "Air pollution and daily mortality in Shanghai: A time-series study." Archives of Environmental Health 58(6): 360-367.
Katrine A. Gorham1, M. P. S. A., Simone Meinardi1, Ralph J. Delfino2, Norbert Staimer2, Thomas Tjoa2, F. Sherwood Rowland1, and Donald R. Blake1 (2009). "Ethane and n-pentane in exhaled breath are biomarkers of exposure not effect." Biomarkers 14(1): 17–25.
Kauffmann, F., Dizier M. H., Annesi-Maesano I., Bousquet J., Charpin D., Demenais F., Ecochard D., Feingold J., Gormand F., Grimfeld A., Lathrop M., Matran R., Neukirch F., Paty E., Pin I., Pison C., Scheinmann P., Vervloet D. and Lockhart A. (1999). "EGEA (epidemiological study on the genetics and environment of asthma, bronchial hyperresponsiveness and atopy) - descriptive characteristics." Clinical and Experimental Allergy 29: 17-21.
Keaney, J. F., Larson M. G., Vasan R. S., Wilson P. W. F., Lipinska I., Corey D., Massaro J. M., Sutherland P., Vita J. A. and Benjamin E. J. (2003). "Obesity and systemic oxidative stress - Clinical correlates of oxidative stress in the Framingham Study." Arteriosclerosis Thrombosis and Vascular Biology 23(3): 434-439.
Kelly, F. J. (2003). "Oxidative stress: Its role in air pollution and adverse health effects." Occupational and Environmental Medicine 60(8): 612-616.
Kelly, F. J., Blomberg A., Frew A., Holgate S. T. and Sandstrom T. (1996). "Antioxidant kinetics in lung lavage fluid following exposure of humans to nitrogen dioxide." American Journal of Respiratory and Critical Care Medicine 154(6): 1700-1705.
Koren, H. S. (1995). "Associations between criteria air-pollutants and asthma." Environmental Health Perspectives 103: 235-242.
Kulkarni, N., Pierse N., Rushton L. and Grigg J. (2006). "Carbon in airway macrophages and lung function in children." New England Journal of Medicine 355(1): 21-30.
Larstad MAE, Toren K, Bake B and AC. O. (2007). "Determination of ethane , pentane and isoprene in exhaled air –effects of breathholding,flow rate and purified air." Acta Physiol 189: 87–98.
Lagorio, S., Forastiere F., Pistelli R., Iavaronem I., Ostro B. D., Michelozzi P. and Fano V. (2004). "Air pollution and lung function among susceptible adult subjects: A panel study." Epidemiology 15(4): S45-S46.
Lebecque P, Kiakulanda P and AL. C. (1993). "Spirometry in the asthmatic child: is FEF25–75 a more sensitive test than FEV1/FVC?" Pediatr Pulmonol 16: 19–22.
Lebecque, P., Kiakulanda P. and Coates A. L. (1993). "Spirometry in the asthmatic child: is FEF25–75 a more sensitive test than FEV1/FVC." Pediatric Pulmonology 16: 19–22.
Lee, Y. L., Hsiue T. R., Lee Y. C., Lin Y. C. and Guo Y. L. L. (2005). "The association between glutathione S-transferase P1, M1 polymorphisms and asthma in Taiwanese schoolchildren." Chest 128(3): 1156-1162.
Leonard, A. G. G., McVerry B. P. and Crowley D. (1941). "Air pollution in Dublin during 1940." Scientific Proceedings of the Royal Dublin Society 22: 399-404.
Lewis, T. C., Robins T. G., Dvonch J. T., Keeler G. J., Yip F. Y., Mentz G. B., Lin X. H., Parker E. A., Israel B. A., Gonzalez L. and Hill Y. (2005). "Air pollution-associated changes in lung function among asthmatic children in Detroit." Environmental Health Perspectives 113(8): 1068-1075.
Li, N., Hao M. Q., Phalen R. F., Hinds W. C. and Nel A. E. (2003). "Particulate air pollutants and asthma - A paradigm for the role of oxidative stress in PM-induced adverse health effects." Clinical Immunology 109(3): 250-265.
Li, N., Xia T. and Nel A. E. (2008). "The role of oxidative stress in ambient particulate matter-induced lung diseases and its implications in the toxicity of engineered nanoparticles." Free Radical Biology and Medicine 44(9): 1689-1699.
Ling Liu, Raymond Poon, Li Chen, Anna-Maria Frescura, Paolo Montuschi, Giovanni Ciabattoni, Amanda Wheeler and Dales1 R. (2009). "Acute Effects of Air Pollution on Pulmonary Function, Airway Inflammation, and Oxidative Stress in Asthmatic Children." Environmental Health Perspectives 117 number 4
Mar, T. F., Jansen K., Shepherd K., Lumley T., Larson T. V. and Koenig J. Q. (2005). "Exhaled nitric oxide in children with asthma and short-term PM2.5 exposure in Seattle." Environmental Health Perspectives 113(12): 1791-1794.
McConnell, R., Berhane K., Yao L., Jerrett M., Lurmann F., Gilliland F., Kunzli N., Gauderman J., Avol E., Thomas D. and Peters J. (2006). "Traffic, susceptibility, and childhood asthma." Environmental Health Perspectives 114(5): 766-772.
Meagher, E. A. and Fitzgerald G. A. (2000). "Indices of lipid peroxidation in vivo: Strengths and limitations." Free Radical Biology and Medicine 28(12): 1745-1750.
Miekisch, W., Schubert J. K. and Noeldge-Schomburg G. F. E. (2004). "Diagnostic potential of breath analysis - focus on volatile organic compounds." Clinica Chimica Acta 347(1-2): 25-39.
Miller, R. D., Cucchiara R. F. and Miller E. D. J. (2000). "Anesthesia. fifth edition." Churchill Livingstone: 886-888.
Min, J. Y., Min K. B., Cho S. and Paek D. (2008). "Lag effect of particulate air pollution on lung function in children." Pediatric Pulmonology 43(5): 476-480.
Montuschi, P., Nightingale J. A., Kharitonov S. A. and Barnes P. J. (2002). "Ozone-induced increase in exhaled 8-isoprostane in healthy subjects is resistant to inhaled budesonide." Free Radical Biology and Medicine 33(10): 1403-1408.
Moretti, M., Phillips M., Abouzeid A., Cataneo R. N. and Greenberg J. (2004). "Increased breath markers of oxidative stress in normal pregnancy and in preeclampsia." American Journal of Obstetrics and Gynecology 190(5): 1184-1190.
Nel, A. E., Diaz-Sanchez D., Ng D., Hiura T. and Saxon A. (1998). "Enhancement of allergic inflammation by the interaction between diesel exhaust particles and the immune system." Journal of Allergy and Clinical Immunology 102(4): 539-554.
Nemmar, A., Nemery B., Hoet P. H. M., Vermylen J. and Hoylaerts M. F. (2003). "Pulmonary inflammation and thrombogenicity caused by diesel particles in hamsters - Role of histamine." American Journal of Respiratory and Critical Care Medicine 168(11): 1366-1372.
Phillips, M. (1997). "Method for the collection and assay of volatile organic compounds in breath." Analytical Biochemistry 247(2): 272-278.
Phillips M, Cataneo RN, Greenberg J, Grodman R and M. S. (2003). "Breath markers of oxidative stress in patients with unstable angina." Heart Disease 5(2): 95-9.
Phillips, M., Cataneo R. N., Cummin A. R. C., Gagliardi A. J., Gleeson K., Greenberg J., Maxfield R. A. and Rom W. N. (2003). "Detection of lung cancer with volatile markers in the breath." Chest 123(6): 2115-2123.
Phillips, M., Cataneo R. N., Greenberg J., Grodman R., Gunawardena R. and Naidu A. (2003). "Effect of oxygen on breath markers of oxidative stress." European Respiratory Journal 21(1): 48-51.
Phillips, M., Cataneo R. N., Greenberg J., Grodman R. and Salazar M. (2003). "Breath markers of oxidative stress in patients with unstable angina." Heart Disease 5(2): 95-9.
Phillips, M., Gleeson K., Hughes J. M. B., Greenberg J., Cataneo R. N., Baker L. and McVay W. P. (1999). "Volatile organic compounds in breath as markers of lung cancer: a cross-sectional study." Lancet 353(9168): 1930-1933.
Phillips, M., Greenberg J. and Cataneo R. N. (2000). "Effect of age on the profile of alkanes in normal human breath." Free Radical Research 33(1): 57-63.
Pleil, J. D. and Lindstrom A. B. (1997). "Exhaled human breath measurement method for assessing exposure to halogenated volatile organic compounds." Clinical Chemistry 43(5): 723-730.
Pope, C. A., Dockery D. W., Spengler J. D. and Raizenne M. E. (1991). "Respiratory health and pm10 pollution - a daily time-series analysis." American Review of Respiratory Disease 144(3): 668-674.
Pope, C. A., Hansen M. L., Long R. W., Nielsen K. R., Eatough N. L., Wilson W. E. and Eatough D. J. (2004). "Ambient particulate air pollution, heart rate variability, and blood markers of inflammation in a panel of elderly subjects." Environmental Health Perspectives 112(3): 339-345.
Pope, C. A., Schwartz J. and Ransom M. R. (1992). "Daily mortality and pm10 pollution in utah valley." Archives of Environmental Health 47(3): 211-217.
Quanjer, P. H. (1992). "A 10 year follow-up of 180 adults with bronchial-asthma - factors important for the decline in lung-function." Thorax 47(6): 484-484.
Rajagopalan, S., Sun Q. H. and Chen L. C. (2005). "Particulate pollution and endothelial function - Deja Vu all over again in the air." Circulation 111(22): 2869-2871.
Risby, T. H. and Sehnert S. S. (1999). "Clinical application of breath biomarkers of oxidative stress status." Free Radical Biology and Medicine 27(11-12): 1182-1192.
Risom, L., Moller P. and Loft S. (2005). "Oxidative stress-induced DNA damage by particulate air pollution." Mutation Research-Fundamental and Molecular Mechanisms of Mutagenesis 592(1-2): 119-137.
Rueckerl, R., Ibald-Mulli A., Koenig W., Schneider A., Woelke G., Cyrys J., Heinrich J., Marder V., Frampton M., Wichmann H. E. and Peters A. (2006). "Air pollution and markers of inflammation and coagulation in patients with coronary heart disease." American Journal of Respiratory and Critical Care Medicine 173(4): 432-441.
Samet, J. M., Dominici F., Curriero F. C., Coursac I. and Zeger S. L. (2000). "Fine particulate air pollution and mortality in 20 US Cities, 1987-1994." New England Journal of Medicine 343(24): 1742-1749.
Samoli, E., Aga E., Touloumi G., Nislotis K., Forsberg B., Lefranc A., Pekkanen J., Wojtyniak B., Schindler C., Niciu E., Brunstein R., Fikfak M. D., Schwartz J. and Katsouyanni K. (2006). "Short-term effects of nitrogen dioxide on mortality: an analysis within the APHEA project." European Respiratory Journal 27(6): 1129-1137.
Sarnat, J. A. and Holguin F. (2007). "Asthma and air quality." Current Opinion in Pulmonary Medicine 13(1): 63-66.
Scholpp, J., Schubert J. K., Miekisch W. and Geiger K. (2002). "Breath markers and soluble lipid peroxidation markers in critically ill patients." Clinical Chemistry and Laboratory Medicine 40(6): 587-594.
Schubert, J. K., Miekisch W., Geiger K. and Noldge-Schomburg G. F. (2004). "Breath analysis in 74 critically ill patients: potential and limitations." Expert Review of Molecular Diagnostics 4(5): 619-29.
Schubert, J. K., Spittler K. H., Braun G., Geiger K. and Guttmann J. (2001). "CO2-controlled sampling of alveolar gas in mechanically ventilated patients." Journal of Applied Physiology 90(2): 486-492.
Schwartz, J. (2001). "Air pollution and blood markers of cardiovascular risk." Environmental Health Perspectives 109: 405-409.
Schwarz, K. B. (1996). "Oxidative stress during viral infection: A review." Free Radical Biology and Medicine 21(5): 641-649.
Shih-Da, S. (2007). "The word of the president of a council." Taiwan Association of Asthma Education, from http://www.asthma-edu.org.tw/asthma/aboutus.aspx.
Shrestha, S. L. (2007). "Time series modelling of respiratory hospital admissions and geometrically weighted distributed lag effects from ambient particulate air pollution within Kathmandu Valley, Nepal." Environmental Modeling & Assessment 12(3): 239-251.
Sies, H. (1985). "Oxidative stress: introductory remarks." Academic Press In: Sies H, editor.Oxidative Stress.(1-8).
Sies, H. (1986). "Biochemistry of oxidative stress." Angewandte Chemie International Edition 25: 1058-1071.
Smith, A. D., Cowan J. O., Filsell S., McLachlan C., Monti-Sheehan G., Jackson P. and Taylor D. R. (2004). "Diagnosing asthma - Comparisons between exhaled nitric oxide measurements and conventional tests." American Journal of Respiratory and Critical Care Medicine 169(4): 473-478.
Society, A. T. (1991). "Lung-function testing - selection of reference values and interpretative strategies." American Review of Respiratory Disease 144(5): 1202-1218.
Sun, Q. H., Wang A. X., Jin X. M., Natanzon A., Duquaine D., Brook R. D., Aguinaldo J. G. S., Fayad Z. A., Fuster V., Lippmann M., Chen L. C. and Rajagopalan S. (2005). "Long-term air pollution exposure and acceleration of atherosclerosis and vascular inflammation in an animal model." Jama-Journal of the American Medical Association 294(23): 3003-3010.
Tager, I. B., Balmes J., Lurmann F., Ngo L., Alcorn S. and Kunzli N. (2005). "Chronic exposure to ambient ozone and lung function in young adults." Epidemiology 16(6): 751-759.
Tiidus, P. M. (2000). "Estrogen and gender effects on muscle damage, inflammation, and oxidative stress." Canadian Journal of Applied Physiology-Revue Canadienne De Physiologie Appliquee 25(4): 274-287.
Trenga, C. A., Sullivan J. H., Schildcrout J. S., Shepherd K. P., Shapiro G. G., Liu L. J. S., Kaufman J. D. and Koenig J. Q. (2006). "Effect of particulate air, pollution on lung function in adult and pediatric subjects in a Seattle panel study." Chest 129(6): 1614-1622.
Vedal, S., Petkau J., White R. and Blair J. (1998). "Acute effects of ambient inhalable particles in asthmatic and nonasthmatic children." American Journal of Respiratory and Critical Care Medicine 157(4): 1034-1043.
Vichit-Vadakan, N., Ostro B. D., Chestnut L. G., Mills D. M., Aekplakorn W., Wangwongwatana S. and Panich N. (2001). "Air pollution and respiratory symptoms: Results from three panel studies in Bangkok, Thailand." Environmental Health Perspectives 109: 381-387.
Villeneuve, P. J., Chen L., Rowe B. H. and Coates F. (2007). "Outdoor air pollution and emergency department visits for asthma among children and adults: A case-crossover study in northern Alberta, Canada." Environmental Health Perspectives 6.
Wong C-M, Atkinson RW, Anderson HR, Hedley AJ, Ma S and Chau PYK (2001). "A tale of two cities: effects of air pollution on hospital admissions in Hong Kong and London compared." Environ Health Perspect 110: 67-77.
Wong, T. W., Lau T. S., Yu T. S., Neller A., Wong S. L., Tam W. and Pang S. W. (1999). "Air pollution and hospital admissions for respiratory and cardiovascular diseases in Hong Kong." Occupational and Environmental Medicine 56(10): 679-683.
Wood, L. G., Gibson P. G. and Garg M. L. (2003). "Biomarkers of lipid peroxidation, airway inflammation and asthma." European Respiratory Journal 21(1): 177-186.
Wyse, C. A., Preston T., Yam P. S., Sutton D. G. M., Christley R. M., Hotchkiss J. W., Mills C. A., Glidle A., Cumming D. R. S., Cooper J. M. and Love S. (2004). "Current and future uses of breath analysis as a diagnostic tool." Veterinary Record 154(12): 353-+.
Yang, Q. Y., Chen Y., Shi Y. L., Burnett R. T., McGrail K. M. and Krewski D. (2003). "Association between ozone and respiratory admissions among children and the elderly in Vancouver, Canada." Inhalation Toxicology 15(13): 1297-1308.
Zanobetti, A., Schwartz J., Samoli E., Gryparis A., Touloumi G., Atkinson R., Le Tertre A., Bobros J., Celko M., Goren A., Forsberg B., Michelozzi P., Rabczenko D., Ruiz E. A. and Katsouyanni K. (2002). "The temporal pattern of mortality responses to air pollution: A multicity assessment of mortality displacement." Epidemiology 13(1): 87-93.
Zhang, J. F., Hu W., Wei F. S., Wu G. P., Korn L. R. and Chapman R. S. (2002). "Children''s respiratory morbidity prevalence in relation to air pollution in four Chinese cities." Environmental Health Perspectives 110(9): 961-967.
林冠宇 (2004). 偵測呼出氣體中所含揮發性有機物作為指標在環境衛生上的應用──可行性探討. 國立台灣大學公共衛生學院環境衛生研究所碩士論文.
高佩鈴 (2007). 抽菸對人體呼出氣體中揮發性有機物質的影響. 國立台灣大學公共衛生學院環境衛生研究所碩士論文.