(3.235.11.178) 您好!臺灣時間:2021/03/05 14:35
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

我願授權國圖
: 
twitterline
研究生:李俊賢
研究生(外文):LEE JYUHN-HSIARN
論文名稱:含氯碳氫化合物污染地下水之暴露社區居民死因勝算比研究
論文名稱(外文):Mortality Odds Ratio Study for Community People Exposed to Groundwater Contaminated with Chlorinated Hydrocarbons
指導教授:王榮德王榮德引用關係
指導教授(外文):WANG JUNG-DER
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:流行病學研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:1999
畢業學年度:87
語文別:中文
中文關鍵詞:死因勝算比研究含氯碳氫化合物地下水肝癌胃癌
外文關鍵詞:MOR (Mortality Odds Ratio)Chlorinated HydrocarbonsGroundwaterLiver cancerStomach cancer
相關次數:
  • 被引用被引用:6
  • 點閱點閱:169
  • 評分評分:系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:2
此研究的目的在計算死因勝算比,以釐清曾居住在地下水源已被含氯碳氫化合物污染地區之居民其癌症死亡率是否有增加的現象。在此收集西元1966年至1997年間桃園市與八德市兩個村里的死亡證明資料,以不同器官系統的癌症作為懷疑死因,心臟血管及腦血管疾病作為對照死因,並依照地下水文資料定義居住在RCA工廠地下水下游居民為暴露組,地下水上游區為非暴露組,計算性別、年齡、及潛伏期分層後之各種癌症的死因勝算比。
結果顯示在西元1966-1975年各種癌症的死因勝算比均無明顯增加,而在1976-1997年間50-69歲男性其胃癌、肝癌的危險性有顯著增加,其死因勝算比及95%信賴區間分別為4.28 (1.29, 16.40) 及2.89 (1.06, 8.19)。以對數複迴歸分析(Multiple Logistic Regression)模式,在調整年齡、死亡年代之作用後,估計暴露的相對危險性,男性之胃癌及肝癌的死因勝算比分別為2.02 (0.90, 4.52)及2.27 (1.09, 4.75)。根據氣相層析儀的分析資料,RCA工廠下游地區民宅水井中的污染物中,其可測得的最高濃度,四氯乙烯、三氯乙烯等十種含氯碳氫化合物超過飲用水水質標準(如四氯乙烯:<0.5-4800μg/L,三氯乙烯:<0.5-930μg/L,1,1-二氯乙烯:<0.5-1417.5μg/L),而分析考慮排除RCA員工、居住史至少大於五年以上,並且以暴露區再細分組之分析嘗試否證,在調整年齡、潛伏期,與死亡年代之作用後,死因勝算比研究顯示在男性的肝癌危險性有一致性增高的顯著趨勢,顯示含氯碳氫化合物的地下水污染與肝癌之間有因果關係存在的可能性。
基於死因勝算比研究的發現,必須針對其研究之限制,再進一步釐清暴露含氯碳氫化合物污染之地下水與各種癌症之因果關係。由於死因勝算比研究是無分母的病例對照研究,且在暴露評估方面以定性的兩分法區分,故進一步的研究需針對所有居住在地下水源遭污染的地區居民,使用地下水的暴露量作定量的估計,以計算總暴露人年,並且在控制個人其他變因下,求證劑量反應關係是否存在,以尋求因果推論上更明確的證據。
The objectives of this project are to conduct a MOR (mortality odds ratio) study and determine if there is increased cancer frequency among residents who have lived in a community where the groundwater was contaminated with wastes of chlorinated organic solvents disposed by an electronic manufacturing factory. Death certificate data of two villages at Taoyuan were collected for the period 1966-1997. Cancers at different organ systems were considered as the diseases of interest, while cardiovascular-cerebrovascular (CV-CB) diseases as the reference disease. After studying the groundwater hydrogeology, residents were classified as exposed and non-exposed groups according to villages where they once lived were either downstream or upstream of the contaminated factory. MORs were calculated for various kinds of cancers after stratified by sex, age, and latency period. Multiple logistic regression adjusting for age and period were performed to evaluate the exposure effect.
The results showed that there was no increase of MOR for all sites of cancers during the period 1966-1975. The MORs for stomach and liver cancers during 1976-1997 for men aged 50-69 were significantly increased with ORs (95% confidence interval) of 4.28 (1.29, 16.40) and 2.89 (1.06, 8.19). After adjustment for age and period, MORs for stomach and liver cancer in men were 2.02 (0.90, 4.52) and 2.27 (1.09, 4.75). Gas chromatography showed the contaminated compounds and their individual concentrations in wells of downstream village were tetrachloroethylene (<0.5~4800μg/L), trichloroethylene (<0.5~930μg/L), vinyl chloride (<0.5~25μg/L), 1,1-dichloroethylene (<0.5~1418μg/L), and 1,1,1-trichloroethane (<0.5~1121μg/L). Since there was a temporal trend i.e., the factory established in early 1970''s, and age, sex were under control in the analysis, we tentatively concluded that the causal association can not be ruled out.
目  錄
圖表目錄
中文摘要1
英文摘要2
第一章 導論 3
第一節 研究背景 3
第二節 研究目的5
第三節 研究流程 5
第二章 文獻回顧 6
第一節 含氯碳氫化合物之地下水污染6
第二節 含氯碳氫化合物之毒理資料與健康危害10
第三章 死因勝算比研究12
第一節 材料與方法 12
第二節 研究結果 17
第三節 討論 23
參考文獻28
附錄1:含氯碳氫化合物之健康危害(Health Hazards)
附錄2:含氯碳氫化合物之主要用途
參考文獻
【1】 行政院勞委會勞工安全衛生所。RCA桃園廠作業環境重建報告,1999。
【2】 行政院環保署。台灣美國無線電公司(RCA)場址,地下水污染調查專案小組。第一次至第十次會議記錄。台北:行政院環保署1994-7。
【3】 REVISED HEALTH ASSESSMENT. RCA/GE/Thomson, Taoyuan and Chupei Sites, Taiwan, Republic of China. Geomatrix Consultants Inc, San Francisco, CA, USA, 1995.
【4】 王榮德。對RCA/GE/Thomson "REVISED HEALTH ASSESSMENT" 報告之評論,1995。
【5】 金相燦。環境毒物有機物污染化學,淑馨出版社;台北,初版,1998。
【6】 陳鈞嗣,吳雪蘋,解富明,賈儀平。RCA桃園廠土壤及地下水污染整治之評估。國立台灣大學地質學系。經濟部中央地質調查所地質學會年會報告,1999。
【7】 Geomatrix Consultants Inc. Groundwater remediation technical practicability evaluation report, Taoyuan site, Taiwan: Report to General Electric Company and Thomson Consume Electronics, 1998.
【8】 郭育良等合著。職業病概論。第九章 職業性癌症。華杏出版股份有限公司,1998。
【9】 Toxicology, Occupational Medicine & Environmental Series (TOMES Plus System) CD-ROM database, Micromedex Inc., 1998.
【10】 Lynge E, Anttila A, Hemminki K. Organic solvents and cancer. Cancer Causes & Control 1997; 8(3): 406-19.
【11】 Aschengrau A, Paulu C, Ozonoff D. Tetrachloroethylene-Contaminated Drinking Water and the Risk of Breast Cancer. Environ Health Perspect 1998; 106(Suppl 4): 947-953.
【12】 Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological Profile for Trichloroethylene. U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, GA, 1992.
【13】 International Agency on Research of Cancer. Monographs on the evaluation of carcinogenic risks to humans. Dry cleaning. Volume 63, Lyon, France, 1995.
【14】 Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological Profile for Tetrachloroethylene. U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, GA, 1995.
【15】 Ruder AM, Ward EM & Brown DP. Cancer mortality in female and male dry-cleaning workers. J Occup Med 1994; 36:867-874.
【16】 Blair A, Stewart PA, Tolbert PE, Grauman D, et al. Cancer and other causes of death among a cohort of dry cleaners. British Journal of Industrial Medicine 1990: 47: 162-168.
【17】 Weiss NS. Cancer in relation to occupational exposure to perchloroethylene. Cancer Causes and Control 1995; 6: 257-266.
【18】 Miettinen OS, Wang JD. An alternative to the proportionate mortality ratio. Am J Epidemiol 1981; 114: 144-8.
【19】 Wang JD, Miettinen OS. The mortality odds ratio (MOR) in occupational mortality studies -- selection of reference occupation(s) and references causes of death. Ann Acad Med (Singapore) 1984; 13: 312-6
【20】 Sung JL, Chen DS,.Lai MY, et al. Epidemiological study on hepatitis B virus infection in Taiwan. Chinese J Gastroenterol 1984; 1:1-9.
【21】 Du CL, Wang JD. Increased morbidity odds ratio of primary liver cancer and cirrhosis of the liver among vinyl chloride monomer workers. Occup Environ Med 1998; 55: 528-532.
【22】 McLaughlin-JK, Blot-WJ. A critical review of epidemiology studies of trichloroethylene and perchloroethylene and risk of renal-cell cancer. International Archives of Occupational & Environmental Health 1997; 70(4): 222-31.
【23】 Lagakos SW, Wessen BJ, Zelen M. An analysis of contaminated well water and health effects in Woburn, Massachusetts. Journal of the American Statistical Association 1986; 81(395): 583-596.
【24】 Kristensen TS. Cardiovascular diseases and the work environment. A critical review of the epidemiologic literature on chemical factors. Scandinavian Journal of Work, Environment & Health. 1989; 15(4): 245-64.
【25】 Lewis RJ. Sax''s Dangerous Properties of Industrial Materials, 9th ed. Van Nostrand Reinhold Company, New York, 1996.
【26】 White RF, Proctor SP. Solvents and neurotoxicity. Lancet. 1997; 349: 1239-43.
【27】 StatXact-4 for Windows. Version 4.0. Cytel Software Corporation, 1998.
【28】 Gart J. Point and interval estimation of the common odds ratio in the combination of 2×2 tables with fixed marginals. Biometrika 1970; 57:471-475.
【29】 Breslow NE, Day NE. The analysis of case-control studies. IARC Scientific Publications No. 32, Lyon, France, 1980.
【30】 SPSS for Windows. Release 8.0. SPSS Inc., 1997.
【31】 Lodon WL, McGlynn KA. Chapter 36 Liver cancer. Cancer Epidemiology and Prevention. Schottenfield D, Fraumeni JF. (editor) Second edition Oxford Univ Press, 1996.
【32】 行政院環保署專案計劃「含氯揮發性有機物污染事件居民流行病學調查與風險評估」居民健康檢查及問卷資料,1999。
【33】 蔡淑芳,陳建仁。台灣地區惡性腫瘤重要危險因子的生態相關研究;台大醫學院公共衛生學研究所碩士論文,1987。
【34】 Beasley RP, Hwang LY, Lin CC, Chien CS. Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22 707 men in Taiwan. Lancet 1981;2: 1129-33.
【35】 Beasley RP. Hepatitis B Virus: The major etiology of hepatocellular carcinoma. Cancer 1988; 61: 1941-1956.
【36】 International Agency on Research of Cancer. Monographs on the evaluation of carcinogenic risks to humans. Hepatitis viruses, Volume59, Lyon, France, 1994.
【37】 Sharara AI, Hunt CM, Hamilton JD. Hepatitis C. Annals of Internal Medicine 1996;125 (8):658-668.
【38】 Chen DS, Kuo GC, Sung JL, et al. Hepatitis C virus infection in an area hyperendemic for hepatitis B and chronic liver disease: the Taiwan experience. Journal of Infectious Diseases. 1990; 162(4): 817-22.
【39】 Wang JT. Hepatitis C infection in Taiwan. Gastroenterol F Taiwan 1995; 12:66.
【40】 Wang LY, Hatch M, Chen CJ, et al. Aflatoxin exposure and risk of hepatocellular carcinoma in Taiwan. Int. J. Cancer 1996; 67:620-625.
【41】 Nomura A. Chapter 34 Stomach cancer. Cancer Epidemiology and Prevention. Schottenfield D, Fraumeni JF. (editor) Second edition Oxford Univ Press, 1996.
【42】 Lee HH, Wu HY, Chunag YC, et al. Epidemiologic characteristics and multiple risk factors of stomach cancer in Taiwan. Anticancer Res. 1990; 10: 875-882.
【43】 吳明賢,林肇堂,陳建仁。胃癌之臨床病理特徵,基因變化與流行病學研究。國立台灣大學醫學院臨床醫學研究所博士論文,1998。
【44】 陳淑媛,林肇堂,陳建仁。台灣地區胃癌及馬祖地區腸性化生之流行病學研究。國立台灣大學公共衛生學院公共衛生學研究所博士論文,1998。
【45】 行政院主計處。戶口普查資料檔,民國六十九年、七十九年,桃園縣桃園市龍岡里,八德鄉茄冬村及高明村。
【46】 Ko YC, Lee CH, Chen MJ, et al. Risk factors for primary lung cancer among non-smoking women in Taiwan. International Journal of Epidemiology 1997; 26(1): 24-31.
【47】 呂宗學,林金坤,李孟智,周明智。臨床醫師對死因診斷所因有的觀念及態度。台灣醫界 37卷第6期: 89-92。
【48】 呂宗學,石台平,賴華山等。台灣地區死因統計準確度評估(I):可能錯誤來源與評估方法。中華衛誌 1995: 14(2): 179-190。
【49】 Kaplan GA, Keil JE. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation 1993; 88(4): 1973-98.
【50】 台灣省自來水公司第二區管理處桃園服務所自來水遷管名單。
【51】 Weisel CP, Jo WK. Ingestion, inhalation and dermal exposure to chloroform and trichloroethene from tap water. Environmental Health Perspective 1996; 104 (1): 48-51.
【52】 Kuo HW, Chiang TF, Lo II, Lai JS, Chan CC, Wang JD. VOC concentration in Taiwan''s household drinking water. The Science of the Total Environment 1997; 208:41-47.
【53】 陳成裕。國內乾洗業作業勞工四氯乙烯暴露現況。勞工安全衛生簡訊 第三十四期 民國八十八年四月。
【54】 International Labour Organization. ILO Encyclopaedia of Occupational Health and Safety, CD-ROM version, 1998.
【55】 NIOSH Pocket Guide to Chemical Hazards. NIOSH Publication No. 94-116, 1994.
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
系統版面圖檔 系統版面圖檔