臺灣博碩士論文加值系統

過去一世紀來台灣溫度上升的趨勢是”政府間氣候變遷研究小組 (IPCC)”所測量的兩倍，而同時期降雨強度的上升趨勢亦同。但無論全球或台灣，對暖化環境下，降雨是如何影響傳染性疾病的分布與的流行之研究卻仍極有限。此研究之目的，即欲對氣候變遷下的極端降雨在台灣區域上之健康衝擊作詳細的探討。

我們先以1994年到2005年的日平均降雨量，依台灣中央氣象局的定義來決定雨量的分類與乾旱。當日平均降雨量大於130公釐、200公釐與350公釐時，定義為豪雨、豪大雨與超大豪雨。相反地，當日平均降雨量小於0.6公釐時則定義為乾旱日。以地理資訊系統檢定傳染性疾病顯著群聚之事件，再統整繪製地圖以了解極端降雨與相關傳染性疾病群聚之發生在地理分布上的相關。進一步以空間分析來檢定極端降雨事件時期，其相關變項對疾病群聚發生之影響。以回歸分析檢示平均雨量與特定疾病的相關性。再以空間分析去驗證雨量的分布與疾病群聚的關連性。

回歸分析發現日平均雨量與登革熱(p=0.003)、恙蟲病 (p<0.001)與日本腦炎(p<0.001)每日疾病數有顯著相關。且發現連續的乾旱日與登革熱 (p<0.001)、恙蟲病 (p<0.001)及桿菌性痢疾(p<0.001)的發生有顯著差異。研究發現在分布上，台灣極端降雨越劇時其相關疾病之群聚情形越明確。而空間統計結果顯示，降雨強度最強之極端降雨事件，其事件後一週的平均雨量對桿菌性痢疾之病例數有顯著影響(p=0.000)。乾旱期程最長之極端事件中，期程之平均雨量與登革熱之病例數有顯著相關(p=0.038)。而其他影響因子包括海拔高度、雨量、都市化與經濟主成分。

不同的降雨程度確實會影響台灣地區的傳染病分布。但是，各地區在資源及衛生醫療狀況等條件上的差異，對疾病在極端降雨事件下之群聚爆發亦有重要影響。因此在討論氣候對健康之影響時，亦須將區域特性及社經文化等因子納入考慮，方可有更完善之分析及討論。

The rate of increasing temperature is about twice of the average reported by IPCC over the past century in Taiwan. While the intensity of rainfall also showed an increasing trend during the same period, very few studied have directed at its potential impacts on distribution and epidemic of various infectious diseases.

Data of Central Weather Bureau during 1994 to 2005 in Taiwan were acquired. We defined the mean daily rainfall higher than 130mm, 200mm and 350mm would be categorized as heavy rain, torrential rain and extreme torrential rain, respectively. When the mean daily rainfall was less than 0.6mm, it would be defined as a drought day. Study tested significant clustering events for infectious diseases and mapped the distribution by Geographical information system (GIS). Regression analysis was to examine the correlation between mean rainfall and the cases of specific disease. Spatial regression model was applied to mapping and examining the relationship and distribution between rainfall and disease clustering.

Regression analysis found significant relationship between mean daily rainfall and the daily cases of Dengue fever (p=0.003), Scrub Typhus (p<0.001) and Japanese encephalitis (p<0.001). The continuing drought days significantly affected the occurrence of Dengue fever (p<0.001), Scrub Typhus (p<0.001) and Shigellosis (p<0.001). Spatial analysis showed that the rainfall density of a-week-lag torrential event has significant effect on reporting shigellosis cases (p=0.000). There was a statistical relationship between the average precipitation of a longest-duration drought and number of dengue cases (p=0.038). Other significant variables included elevation, rainfall, urbanization and economic component.

Difference level of rainfall appeared to affect geographical distribution of infectious diseases reported in Taiwan. However, difference in distributions of medical resources or sanitary condition would have to be taken into account in further analyses before the final conclusions between the climatic changes and infectious epidemics

論文合格證明 i
摘 要 ii
Abstract iii
誌 謝 iv
目 錄 vi
表 目 錄 viii
圖 目 錄 ix

第一章 緒 論 10
第一節 研究背景 10

第二章 文獻回顧 14
第一節 氣候變遷與降水 14
第二節 暖化、極端雨量與傳染性疾病在全球區域特性下之關係 17
第三節 暖化、極端雨量與傳染性疾病在台灣區域特性下之關係 19

第三章 材料與方法 21
第一節 研究資料 21
第二節 資料分析 24

第四章 研究結果 27
第一節 描述性統計與關聯性分析 27
第二節 颱風對疾病群聚之影響 31
第三節 極端降雨事件對疾病群聚之影響 35
第四節 乾旱對疾病群聚之影響 36

第五章 研究結論與討論 38
第一節 研究結論 38
第二節 疾病流行病學與氣候因子之探討 40
第二節 研究限制與建議 46

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