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研究生:丁怡方
研究生(外文):Yi-Fang Ting
論文名稱:養豬場勞工個人生物氣膠暴露及健康影響
論文名稱(外文):Personal bioaerosol exposure and health effects of the workers in swine barns
指導教授:趙 馨
口試委員:龍世俊陳叡瑜
口試日期:2013-06-25
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:公共衛生學系暨研究所
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:2013
畢業學年度:101
語文別:中文
論文頁數:129
中文關鍵詞:生物氣膠、個人暴露評估、生物性職業危害
外文關鍵詞:BioaerosolsPersonal Exposure AssessmentOccupational Biohazards
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空氣中的生物氣膠無所不在,可能造成感染、過敏、毒性反應等健康危害,是相當重要的職業及環境衛生問題。許多職業環境中常有高濃度的生物氣膠暴露,但由於缺乏標準的生物氣膠採樣分析方法,鮮少有完整的個人暴露評估資料。本研究利用2011年現有個人生物氣膠採樣分析方法評估的研究結果,選出最適用於高生物氣膠暴露評估的採樣分析方法,於一高生物性危害職場(養豬場)進行個人暴露評估調查,以瞭解勞工的生物氣膠暴露特性及可能健康危害。本研究針對4家不同類型養豬場進行勞工生物氣膠個人暴露評估,並利用問卷調查及肺功能測量評估勞工的健康情形。根據本研究的結果發現,各家養豬場員工的個人生物氣膠暴露濃度都相當高,總細菌平均濃度為4.07×105 cells/m3,可培養細菌為12820 CFU/m3(美國的建議值為<10,000 CFU/m3),內毒素為286 EU/m3(荷蘭的標準為< 200 EU/m3),總真菌孢子為11850 spores/m3,可培養真菌為2446 CFU/m3;在進行會造成豬隻騷動(如人工餵食、疫苗注射及清洗豬舍)的工作項目時,最容易造成個人暴露濃度上升,例如在養豬場C進行人工餵食時,總細菌濃度為2.36?e106 cells/m3,可培養細菌為21743 CFU/m3,可培養真菌為4164 CFU/m3;在清洗豬舍時,總細菌濃度為1.65?e106 cells/m3,可培養真菌為3418 CFU/m3,皆高於該養豬場平均個人暴露濃度。在區域採樣部份,總細菌平均濃度為2.57×105 cells/m3,可培養細菌為5879 CFU/m3,內毒素為213 EU/m3,總真菌孢子為8859 spores/m3,可培養真菌為1666 CFU/m3;通風狀況為影響不同類型豬舍生物氣膠濃度的重要因素之一。在養豬場檢測到的細菌主要為豬隻及人類的皮膚及呼吸道正常菌叢,在真菌部份則為室外常見真菌。高濃度的總細菌、可培養細菌、可培養真菌及內毒素暴露,以及從事清掃豬舍工作,會造成養豬場員工肺功能下降。此外,受訪員工工作相關皮膚症狀與總細菌及可培養真菌間有顯著正相關;工作相關體癬與總細菌濃度有邊緣性顯著正相關,過敏性鼻炎與可培養真菌濃度有邊緣性顯著正相關。大部份的受訪員工工作時會穿著工作衣、雨鞋,工作完會洗手,但部份員工在從事高生物性暴露工作時並不會戴口罩或手套。在本研究養豬場中,可培養細菌有24%的個人採樣結果高於美國的建議值10000 CFU/m3,內毒素有41%的個人採樣結果高於荷蘭的標準200 EU/m3,因此仍有加強改善的空間。加強各類型豬舍的通風,建議員工依據工作特性使用個人防護,應可有效降低員工的生物性職業危害。本篇研究中四家不同規模養豬場的個人及區域生物氣膠濃度調查結果,可提供給其他相關類似的養殖業作為改善環境暴露及未來研究的參考。
Bioaerosols are ubiquitous in our daily environments and may cause infections, allergic diseases and toxic effects. Exposure to bioaerosols is an important occupational and environmental health issue that requires special concern. There are many occupational settings with high bioaerosol levels, but limited studies have been conducted to evaluate personal bioaerosol exposure comprehensively due to complex composition of bioaerosols and lack of standardized sampling/analysis methods. This study utilized the best personal sampling/analysis method for high bioaerosol exposure, according to our study results in 2011, to conduct personal exposure assessment in an occupational setting with high biohazards (i.e. swine barns). We conducted personal bioaerosol exposure assessment for the workers of 4 different types of swine farms, and evaluate their health conditions using a standardized questionnaire and spirometry. According to the results, the study workers had high personal exposure levels to bioaerosols. The average total bacterial level was 4.07×105 cells/m3; total culturable bacteria was 12820 CFU/m3 (the US guideline is <10000 CFU/m3); endotoxin level was 286 EU/m3 (the Dutch standard is <200 EU/m3); total fungal spore was 11850 spores/m3; and total culturable fungi was 2446 CFU/m3. Tasks resulting in pig disturbance, such as manual feeding and vaccination, were related to higher personal exposure. For example, in the swine farm C, during manual feeding the concentrations of total bacteria, total culturable bacteria, and total culturable fungi were 2.36?e106 cells/m3, 21743 CFU/m3, and 21743 CFU/m3, respectively; and while cleaning barns the levels of total bacteria and total culturable fungi were 1.65?e106 cells/m3 and 3418 CFU/m3, respectively, all higher than the average personal exposure levels at the farm C. In area sampling, the average bioaerosol levels were 2.57×105 cells/m3 for total bacteria, 5879 CFU/m3 for total culturable bacteria, 213 EU/m3 for endotoxin, 8859 spores/m3 for total fungal spores, and 1666 CFU/m3 for total culturable fungi. Ventilation was one of the environmental factors closely related to the bioaerosol concentrations. Most detected airborne culturable bacteria were normal skin and respiratory tract flora of pigs and humans. The dominant airborne fungi in swine farms were common outdoor fungi. Expsore to high levels of total bacteria, culturable bacteria and fungi, and endotoxin, as well as involving in barn-cleaninrg task, were correlated to decreased lung fucitions. In addition, work-related skin symptoms were positively associated with total bacteria and total culturable fungi. Work-related tinea corporis had marginal significant relationships with total bacteria. Work-related allergic rhinitis had marginal significant relationships with total culturable fungi. Most study workers wore working clothes and rain boots at work, and washed hands after work. However, some workers did not use masks or gloves while performing tasks with high biological hazards. In this study, 24% of personal exposure to total culturable bacteria was higher than the US guideline 10000 CFU/m3, and 41% was higher than the Dutch standard 200 EU/m3. Thus improvement is needed. Increasing ventilation and using proper personal protection equipments according to work characteristics should be able to reduce occupational biohazards effectively. In this study, we investigated four pig farms with different charateritics and provided essential information about personal exposure and area concentrations of bioaerosols. Our fidinigns can be used as the basis for future studies, as well as for similar industries to improve their environmental exposure.
目錄
第一章、前言 1
1.1研究背景 1
1.2研究目的 4
第二章、文獻回顧 5
2.1生物氣膠的特性及健康危害 5
2.1.1真菌 6
2.1.2細菌 8
2.1.3內毒素 9
2.2養豬場其他環境因子 11
2.2.1二氧化碳 11
2.2.2一氧化碳 12
2.2.3揮發性有機化合物 12
2.2.4懸浮微粒 13
2.3各國相關建議值與標準 13
第三章、材料與方法 17
3.1研究地點與採樣策略 17
3.2個人暴露評估及環境監測 17
3.3生物氣膠樣本分析方法 18
3.3.1可培養細菌與真菌 20
3.3.2總細菌 21
3.3.3總真菌孢子 23
3.3.4內毒素分析 24
3.4實驗室品質保證與品質控制 26
3.5研究問卷設計與調查 26
3.6肺功能測量 27
3.7資料分析 28
第四章、結果 30
4.1養豬場特性與員工參與狀況 30
4.2養豬場生物氣膠濃度分佈 38
4.2.1細菌 47
4.2.2真菌 56
4.2.3內毒素 65
4.3養豬場環境因子分佈 66
4.4生物氣膠與其他環境因子之相關性 74
4.5問卷調查 77
4.5.1問卷回收率 77
4.5.2人口學資料 77
4.5.3員工個人健康況狀 80
4.5.4員工使用個人防護情形 85
4.6肺功能測量結果 87
4.7工作相關症狀與疾病之迴歸分析 94
第五章、討論 95
5.1養豬場生物氣膠濃度分佈 95
5.1.1真菌及細菌 95
5.1.2內毒素 98
5.1.3不同研究養豬場生物氣膠濃度比較 99
5.2環境因子 104
5.3肺功能測量 107
5.4研究限制 111
第六章、結論 112
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