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研究生:林純吉
研究生(外文):Chun-Chi Lin
論文名稱:台北市國小學童上呼吸道症狀與其學校附近交通流量之關係研究
論文名稱(外文):The association between upper airway symptoms in elementary students in Taipei and traffic density near school
指導教授:陳美蓮陳美蓮引用關係
指導教授(外文):Mei-Lien Chen
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:環境與職業衛生研究所
學門:工程學門
學類:環境工程學類
論文種類:學術論文
畢業學年度:97
語文別:中文
論文頁數:99
中文關鍵詞:交通流量上呼吸道症狀氣喘國小學童
外文關鍵詞:traffic densityupper airway respiratory symptomsasthmaschool children
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流行病學的研究和動物及人體實驗的資料證實,空氣污染物不只可以直接傷害呼吸道組織,更可能間接加重過敏反應的產生,而增加過敏病的發生率。對兒童而言,更容易受到空氣污染的影響。
本研究的目的在探討台北市學校附近交通流量對學童呼吸道健康的影響,學校附近車流量分為高、中、低交通流量三組,而呼吸道健康研究共分為兩個部份。第一部分屬於橫斷式研究,討論學童過敏性疾病,包括氣喘、過敏性鼻炎、異位性皮膚炎與學校附近不同交通流量的相關性。第二部份為病例-對照研究,探討學校附近不同交通流量對於患有氣喘學童及沒有氣喘的學童在上呼吸道症狀的差異。
在第一部份的橫斷式研究中,共包含台北市10所國民小學,4,952位學童。研究發現過敏性疾病的盛行率仍有逐漸上升的趨勢。經醫師診斷患有氣喘之比率由父母世代的6.9%,至學童世代為14.9%。患有過敏性鼻炎之比率為55.2%,患有溼疹的比率為21.3%。經校正其他因素後,學童產生氣喘與學校附近的交通流量並無相關,而與性別(勝算比為1.7)、自覺空氣污染程度(勝算比為1.4倍)、及父母親氣喘史(勝算比分別為4.8及2.6)呈明顯相關。氣喘發作呈現季節的變化,以冬季症狀的發生率最高,且有高交通流量組較為嚴重的傾向。病例-對照研究結果發現氣喘學童在上呼吸道症狀的發生次數及嚴重度,明顯高於沒有氣喘學童。在病例組(氣喘學童),上呼吸道症狀的發生率及嚴重度,以低交通流量地區為最高;而在對照組(沒有氣喘學童),以高交通流量地區為最高。
綜上所述,學校附近交通流量並未顯著影響台北市國小學童過敏性疾病之盛行率,且上呼吸道症狀的發生率及嚴重度與學校附近交通流量高低並未一致,這項結果仍需要進一步研究,以釐清其他因素的影響。
There is strong evidence from epidemiological, animal and human studies that air pollution not only contributes to direct injury of respiratory tract but also aggravates allergic disease indirectly. Children are a vulnerable group suffering from air pollution.
The purpose of this study was to examine the association between respiratory health in elementary students in Taipei and traffic density near school. Traffic density of elementary school was categorized into high, medium and low and the study of heath effect had two parts. Part one was a cross-sectional study which investigates the difference of allergic disease (asthma, allergic rhinitis, atopic dermatitis) among different traffic density. Part two was a case-control study to explore the difference of upper airway symptoms in asthma and non-asthma children among different traffic density.
It included ten elementary schools in Taipei, involving 4,952 students, in the cross-sectional studies. The result showed childhood allergic disease has been in increasing trend in Taipei. Compared to parents’ generation, proportion of physician -diagnosed asthma increased from 6.9% to 14.9%. Proportion of physician-diagnosed allergic rhinitis and atopic dermatitis was 55.2% and 21.3% respectively. After adjusting for confounding factors, traffic density near school was not a risk factor of physician-diagnosed asthma. Gender (aOR 1.7), self-reported air pollution severity (aOR 1.4), father asthma history (aOR 4.8) and mother asthma history (aOR 2.6) were significantly associated with physician-diagnosed asthma. The proportion of asthma attack had seasonal change, highest in winter, and had increasing tendency in high traffic density group. Results of case-control study showed children with asthma had higher incidence and severity of upper airway symptoms than those without asthma. In case group (children with asthma), the area with low traffic density had the highest incidence and severity of upper airway symptoms. On the contrary, the highest incidence and severity occurred in area with high density in control group (children without asthma)
In conclusion, these results disclosed there was no significant association between traffic density near school and prevalence of allergic diseases of elementary students in Taipei, and traffic density near school was inconsistent with the incidence and severity of upper airway symptoms. It needs further investigations to elucidate the effects of other confounding factors.
中文摘要-----------------------------------------------------------------------------i
英文摘要---------------------------------------------------------------------------iii
目錄---------------------------------------------------------------------------------vii
圖表目錄----------------------------------------------------------------------------ix
第一章、緒論-----------------------------------------------------------------------1
第一節 研究動機------------------------------------------------------------------1
第二節 研究目的------------------------------------------------------------------2
第二章、文獻回顧-----------------------------------------------------------------3
第一節 國小學童呼吸道疾病-氣喘----------------------------------------3
第二節 交通相關的空氣污染物--------------------------------------------7
第三節 呼吸道症狀與交通污染的流行病學研究----------------------10
第三章、材料與方法-------------------------------------------------------------16
第一節 研究對象的選取--------------------------------------------------16
第二節 問卷調查-----------------------------------------------------------16
第三節 統計分析方法-----------------------------------------------------18
第四章、結果----------------------------------------------------------------------19
第一節 研究對象資料分析-以性別區分-------------------------------19
第二節 研究對象資料分析-以交通流量區分-------------------------21
第三節 氣喘學童的資料分析--------------------------------------------23
第四節 其他過敏性疾病個案分析--------------------------------------26
第五節 學童上呼吸道症狀之病例對照研究--------------------------28
第五章、討論----------------------------------------------------------------------31
第六章、結論----------------------------------------------------------------------36
參考文獻---------------------------------------------------------------------------37
附件、本研究問卷---------------------------------------------------------------85
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