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研究生:謝明晏
研究生(外文):Shei Ming-Yen
論文名稱:機動車輛廢氣暴露與脂質氧化壓力之相關研究
論文名稱(外文):Exposure to traffic exhausts and lipid peroxidative stress
指導教授:賴錦皇賴錦皇引用關係
指導教授(外文):Lai Ching-Huang
學位類別:碩士
校院名稱:國防醫學院
系所名稱:公共衛生學研究所
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:2009
畢業學年度:97
語文別:中文
論文頁數:146
中文關鍵詞:高速公路收費員多環芳香烴氧化壓力
外文關鍵詞:highway toll station workerspolycyclic aromatic hydrocarbonsoxidative stress1-hydroxpyrene15-F2t-Isoprostanes
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機動車輛所產生的廢氣是都會區中最主要的移動式汙染源,這些汙染物中包含一氧化碳、氮氧化物、二氧化硫、苯與多環芳香烴(Polycyclic Aromatic Hydrocarbons, PAHs)等毒性物質。1989年,國際癌症研究組織(International Agency for Research on Cancer, IARC)將機動車輛廢氣列為2B(疑似人類致癌物質)。在台灣,高速公路收費站通行車輛次數由1998年的四億兩千萬輛上升至2007年的五億七千萬輛,因此收費員的工作環境屬於一個機動車輛廢氣高暴露的工作環境。本研究將以收費員為研究對象,探討暴露機動車輛廢氣與脂質氧化性傷害的相關性。
本研究為縱斷型研究設計,研究對象以泰山收費站收費員30名為暴露組,台北市內湖區某醫學中心行政人員15名為對照組。尿中1-hydroxypyrene(1-OHP)為PAHs暴露的內在劑量指標了解收費員機動車輛廢氣暴露的情形,並以尿中15-F2t-Isoprostanes評估收費員暴露機動車輛廢氣後體內脂質氧化性傷害。經連續四日上班前後之尿液收集以分析尿中1-OHP與15-F2t-Isoprostanes,並搭配每日暴露日記與結構式問卷之紀錄以獲得基本人口學、工作環境、飲食習慣等資料。
GEE分析結果顯示收費員下班後尿中1-OHP顯著較上班前增加0.207μg/g creatinine(95% CI: 0.004-0.409),但控制干擾因子後,
增加量與對照組間無顯著差異;收費員尿中15-F2t-Isoprostanes濃度下班後顯著較上班前增加1.97μg/g creatinine(95% CI: 0.89-3.06),且控制干擾因子後,收費員增加的幅度顯著高出對照組1.35μg/g creatinine(95% CI: 0.54-2.16)。多變項GEE分析結果顯示,在控制干擾因子後,收費員暴露小客車車流量每1000輛,下班後尿中1-OHP濃度即上升0.138μg/g creatinine(95% CI: 0.038-0.239)、15-F2t-Isoprostanes濃度上升0.78μg/g creatinine(95% CI: 0.19-1.37);多變項GEE分析尿中1-OHP與15-F2t-Isoprostanes濃度之相關性,在控制干擾因子後,尿中1-OHP濃度每上升1μg/g creatinine與15-F2t-Isoprostanes濃度顯著上升5.27μg/g creatinine(95% CI: 2.66-7.89)。
收費員暴露機動車輛廢氣導致其尿中1-OHP與15-F2t-Isoprostanes濃度的上升,顯示收費員暴露較高濃度的機動車輛廢氣暴露,並且其體內脂質氧化性傷害情形也較為嚴重。
Traffic exhaust is a major mobile source of air pollution in urban areas. These pollutants contain CO, NOx, SO2, benzene, polycyclic aromatic hydrocarbons (PAHs) and other toxic substances. In 1989, the International Agency for Research on Cancer (IARC) classified traffic exhaust as Group 2B pollutants, indicating its possible carcinogenic effects on humans. In Taiwan, the number of vehicles passing highway toll stations rose from 0.42 billion in 1998 to 0.57 billion in 2007. As a result, highway toll stations workers are exposed to increasingly heavy amounts of traffic exhaust in their workplace. The objective of this study was to assess the relation between exposure to traffic exhaust and the occurrence of lipid peroxidative damage.
A longitudinal study was performed on 30 Taishan toll station workers and 15 control subjects at a medical center in Neihu, Taipei. To evaluate traffic exhausts exposure, urinary 1-hydroxpyrene (1-OHP) was used as an internal dose biomarker. Urinary 15-F2t-Isoprostane was used as a lipid peroxidative damage biomarker. Spot urine samples were collected from each subject before and after his shift for 4 consecutive days. Demography, work environment, food intake, and other variables were taken into account by administering a questionnaire.
In a GEE analysis, toll station workers were determined to have significantly increased urinary 1-OHP levels after work (0.207μg/g creatinine; 95% CI: 0.004-0.409). This increase in urinary 1-OHP levels however was not significantly higher than that of the control group after confounding variables were taken into account. The urinary 15-F2t-Isoprostane concentrations of the toll station workers also significantly increased after work (1.97μg/g creatinine; 95% CI: 0.89-3.06). In this case, the urinary 15-F2t-Isoprostanes levels were significantly higher than the control group after possible confounding effects were adjusted(1.35μg/g creatinine; 95% CI: 0.54-2.16).
In this study, we also examined the relationship between cumulative traffic flow and 1-OHP and 15-F2t-Isoprostanes concentrations. A GEE analysis indicated that 1-OHP and 15-F2t-Isoprostanes concentrations were related to cumulative car flow. In terms of 1-OHP and 15-F2t-Isoprostane dosage, there were 0.138 (95% CI: 0.038-0.239) and 0.78 (95% CI: 0.19-1.37)μg/g creatinine increase per 1,000 cars respectively. In the GEE analysis, 15-F2t-Isoprostane concentration was found to be directly related to 1-OHP concentration (β=5.27, 95% CI: 2.66-7.89).
Toll station workers exposed to high levels of traffic exhaust exhibit increased urinary 1-OHP and 15-F2t-Isoprostane concentrations. This study indicates that toll station workers exposed to heavy amounts of traffic exhaust are highly susceptible to serious lipid peroxidative damage.
第一章 緒論……………………………………………………………………………………1
第一節 研究背景及重要性…………………………………………………………1
第二節 研究目的……………………………………………………………………4
第二章 文獻探討………………………………………………………………………………5
第一節 機動車輛廢氣之健康危害…………………………………………………5
第二節 多環芳香烴化合物…………………………………………………………8
第三節 機動車輛廢氣暴露與氧化壓力……………………………………………12
第四節 流行病學文獻整理…………………………………………………………19
第三章 材料與方法……………………………………………………………………………22
第一節 研究設計與研究架構………………………………………………………22
第二節 研究對象與地理位置………………………………………………………24
第三節 問卷資料收集與生物檢體收集……………………………………………26
第四節 職業暴露車流量估計………………………………………………………27
第五節 生物檢體分析………………………………………………………………28
第六節 實驗室品質管制……………………………………………………………33
第七節 資料處理與統計分析………………………………………………………35
第四章 研究結果………………………………………………………………………………38
第一節 研究對象描述性統計………………………………………………………38
第二節 研究對象尿中1-OHP濃度描述與檢定 ……………………………………43
第三節 研究對象尿中15-F2t-Isoprostanes濃度描述與檢定 …………………47
第四節 暴露評估指標與尿中15-F2t-Isoprostanes濃度間相關性描述與檢定.52
第五章 討論……………………………………………………………………………………56
第一節 實驗室品質管制與研究對象選取…………………………………………57
第二節 縱斷型研究尿中1-OHP濃度變化之探討 …………………………………59
第三節 縱斷型研究尿中15-F2t-Isoprostanes濃度變化之探討 ………………63
第四節 尿中1-OHP與15-F2t-Isoprostanes濃度之相關性探討…………………67
第六章 結論與建議……………………………………………………………………………68
參考文獻 ………………………………………………………………………………………70
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