臺灣博碩士論文加值系統

中文摘要
研究背景與目的
長期職業噪音暴露可能會對人體產生不良的健康效應。然而，能克服長期職業噪音隨時間而改變之世代研究十分有限，因此本研究將進行一個17年之世代研究，結合勞工調職紀錄及職業噪音暴露去有效評估長期職業噪音暴露對高血壓發展之相關性。
研究方法
本研究針對台灣某航空製造業2,459位健康勞工進行一項世代追蹤研究。將勞工之調職紀錄結合作業環境監測噪音值，運用累積噪音暴露公式估計勞工在職期間之累積噪音暴露值。最後利用Cox 比例風險回歸模式，探討長期職業噪音暴露對高血壓發展之關聯性。
研究結果
研究期間被診斷罹患高血壓之病人數共有875位勞工。與累積暴露小於80分貝之勞工相比，暴露於大於90分貝者有1.59倍罹患高血壓之風險(調整後之危險比adjusted HR: 1.59; 95% 信賴區間 95% CI: 1.04-2.44)。且生產線勞工暴露於90-94分貝-年與暴露小於80分貝者相比，其調整後之危險比為1.82(95% CI: 1.36-2.45)。
結論
本研究指出暴露大於90分貝之職業噪音勞工，相較於暴露小於80分貝者會增加罹患高血壓之風險。且生產線勞工暴露於90-94分貝-年之累積噪音會增加罹患高血壓的風險，但此現象並未於累積噪音暴露大於95分貝-年中所呈現。

關鍵字：長期職業噪音暴露、勞工調職紀錄、累積噪音、調職、高血壓

Abstract
Exposure to occupational noise might increase the risk of hypertension. However, there are limited cohort studies to address the occupational noise exposure may change over time. The present study conducted a 17-year cohort study and combined the working history as well as long-term occupational noise exposure to assess the relationship between occupational noise exposure and the development of hypertension. The study population including 2,459 workers in aircraft industry. The cumulated noise exposure levels were calculated by using time-weighted average exposure. The effect estimates were presented as hazard ratio and 95% confidence intervals of hypertension, adjusting for potential confounders. We further classified the cumulated noise exposure level into four categories, the reference level (<80dBA), low (80-84dBA), medium (85-89dBA) and high exposure (≥90dBA), and stratified sex and exposure time. In Cox proportional model adjusting for confounders, the hazard ratio (HR) of hypertension was related to high exposure (adjusted HR = 1.59, 95% confidence interval (95% CI): 1.04-2.44) as compared with the reference group (<80 dBA). Production-line workers who exposed to noise level 90-94 dBA-year had 1.82 (95% CI: 1.36-2.45) folds risk of hypertension. Our study refines the exposure assessment and suggests that workers exposed to noise above 90 dBA may associate with an increased risk of development of hypertension and production-line workers who exposed to the cumulative noise level 90-94 dBA-year may increase the risk of hypertension but the effect was not found in cumulative noise level above 95 dBA-year.
Keywords: Occupational noise exposure, Cumulative noise, Hypertension, Occupational health

Table of Contents
Chapter 1 Introduction.....................................1
1.1Background..............................................1
1.2Study objective.........................................2
Chapter 2 Literature review................................3
2.1 Cohort studies about noise exposure and hypertension...3
2.2 Other studies about noise exposure and hypertension....5
Chapter 3 Materials and methods............................7
3.1 Study Population.......................................7
3.2 Health Outcomes........................................8
3.3 Covariates.............................................9
3.4 Noise Exposure Assessment.............................10
3.5 Statistical Analyses..................................11
Chapter 4 Results.........................................12
4.1 Study Population......................................12
4.2 Noise exposure and Hypertension.......................13
4.3 Noise exposure and Hypertension among different working place.....................................................14
4.4 Association between noise exposure and hypertension among male and female.....................................15
4.5 Different exposure duration effects noise exposure on hypertension..............................................16
4.6 The association of cumulative noise exposure and hypertension..............................................17
Chapter 5 Discussion......................................18
5.1 Validity of results...................................18
5.2 Comparing with previous studies.......................19
5.3 Biological Mechanisms.................................22
5.4 Strengths of the present study........................23
5.5 Limitations of the present study......................24
Chapter 6 Conclusions.....................................25
Chapter 7 Reference.......................................26

Chapter 7 Reference
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