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研究生:黃映嘉
研究生(外文):Ying-Chia Huang
論文名稱:影響台北地區家戶中過敏原之因素---初探性研究
論文名稱(外文):Factors associated with household allergens in the Taipei area-A preliminary study
指導教授:趙馨趙馨引用關係
指導教授(外文):Hsing Chao
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:公共衛生學系
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:2005
畢業學年度:93
語文別:中文
論文頁數:108
中文關鍵詞:塵蟎過敏原Der p 1Der f 1真菌寢具清洗狀況
外文關鍵詞:house dust mite allergenDer p 1Der f 1fungibedding
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相關文獻指出台灣地區因高溫、高濕度環境,十分適合塵蟎、真菌、細菌等微生物生長。而研究發現塵蟎過敏原(尤其是Der p 1和Der f 1)和兒童氣喘的發生有很高的相關性,家中主要的暴露來源是床鋪,如何減少床鋪中塵蟎過敏原(Der p 1和Der f 1)濃度是一項重要的環境衛生課題。
本研究針對大台北地區30個家戶在2004年12月及2005年4月進行調查,利用問卷蒐集居家環境、寢具、家具材質、清理方式及頻率、個人及家人健康狀況等相關資訊。此外蒐集客廳和臥房中的家塵樣本,分析塵蟎過敏原(Der p 1和Der f 1)及可培養真菌的濃度,並測量環境中溫度、濕度和二氧化碳濃度。利用統計模式評估影響塵蟎過敏原(Der p 1和Der f 1)與真菌濃度分佈的相關變項。研究結果顯示床鋪中Der f 1及Der p 1濃度的幾何平均值各為7.04及2.70μg/g,總真菌濃度為55247CFU/g,出現頻率最多的菌屬是Penicillium。有使用地毯、居住年數較短、屋齡較短、家中有過敏性疾病的人數較多、經常清理枕頭、近期清理的枕頭(≦1週)及經常清洗被套(≦1個月)與低塵蟎與真菌過敏原濃度相關。
本研究提供大台北地區過敏原的分佈情形,以及與過敏原相關的環境及居家狀況因子。未來應該進行長期追蹤性的調查,找出有效減少居家過敏原暴露的方法。
High temperature and relative humidity in Taiwan provides appropriate environmental conditions for microbial growth, including dust mites, fungi and bacteria. Studies have shown that dust mite allergens (especially Der p 1 and Der f 1) are highly correlated with childhood asthma, and bed is the major exposure source at home. Therefore, how to reduce dust mite allergen levels in bed becomes an important environmental issue.
We studied 30 households in the Greater Taipei area from December 2004 to April 2005. Questionnaires were used to collect information on home environments, types of beddings and furniture, cleaning methods/frequencies, and personal and family health. We collected dust samples from living rooms and bedrooms to analyze dust mite allergens (Der p 1 and Der f 1), and culturable fungi. Temperature, relative humidify, and carbon dioxide were measured concurrently. We used multiple regressions to evaluate the associations between allergens and environmental factors. According to our results, the geometric means of dustborne Der p 1 and Der f 1 in bed were 7.04 and 2.70 μg/g, respectively. The average total fungal concentration in bed was 55247 CFU/g. Penicillium was the fungal genus recovered most frequently in bed. Lower dust mite and fungal levels were associated with carpet presence, shorter house age and living period, more family members with allergic disease, frequently and recently cleaned pillows, and regularly cleaned quilt cover.
This study provides the distributions of allergens in the Greater Taipei area, and the environmental and household factors correlated with allergen levels. More follow-up studies should be conducted in the future in order to explore effective methods to reduce home allergen exposure.
第一章 前言 1
第一節 研究背景 1
第二節 研究目的 3
第二章 文獻探討 4
第一節 過敏性呼吸道疾病 4
第二節 塵蟎 6
一、塵蟎簡介: 6
二、健康效應: 6
三、塵蟎過敏原分佈及相關環境因子: 7
四、塵蟎過敏原在台灣的分佈: 8
五、防蟎措施 10
第三節 真菌 14
第四節 小結: 16
第三章 材料與方法 17
第一節 研究架構 17
第二節 研究對象 17
第三節 問卷調查資料 18
第四節 環境樣本 20
一、採樣時間及地點: 20
二、環境過敏原測量: 20
三、室內空氣品質因子測量: 25
第五節 資料分析: 27
一、資料建檔: 27
二、統計分析: 27
第六節 品質保證與品質控制: 28
一、採樣流程: 28
二、標準化流程: 28
三、灰塵樣本採樣工具: 28
四、直讀式儀器: 28
五、分析用工具: 28
六、真菌培養: 29
七、塵蟎過敏原分析: 29
八、資料建檔: 29
第四章 結果 30
第一節 研究對象 30
第二節 居家環境狀況 30
第三節 臥房與客廳環境狀況 31
第四節 過敏原分佈情形 32
一、灰塵重量 32
二、塵蟎過敏原 32
三、真菌 33
四、過敏原間的相關性 34
五、過敏原單變項迴歸模式分析 34
六、過敏原多變項迴歸模式分析 36
第五章 討論 39
第一節 重要研究結果 39
第二節 過敏原濃度分佈 39
一、塵蟎過敏原: 39
二、真菌濃度: 41
第三節 溫度、濕度、二氧化碳濃度 41
第四節 過敏原決定因子 42
一、塵蟎過敏原 42
二、真菌 43
第四節 研究限制 43
第五節 結論與建議 44
第六章 參考文獻 45
第七章 圖表 60
第一節 表格 60
第二節 圖 79
第八章 附錄 90
附錄一 同意書 90
附錄二 問卷 91
附錄三 塵蟎過敏原分析步驟 98
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