(3.215.77.193) 您好!臺灣時間:2021/04/17 01:17
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

我願授權國圖
: 
twitterline
研究生:馬翎瑜
研究生(外文):Ma, Ling-Yu
論文名稱:細懸浮微粒暴露與呼吸系統發炎生物標記之相關性研究
論文名稱(外文):Relation between Fine Particles Exposure and Respiratory Inflammation Biomarkers
指導教授:賴錦皇賴錦皇引用關係劉紹興劉紹興引用關係
指導教授(外文):Lai, Ching-HuangLiou, Saou-Hsing
口試委員:賴錦皇劉紹興郭憲文唐進勝黃翰斌
口試委員(外文):Lai, Ching-HuangLiou, Saou-HsingKuo, Hsien-WenTang, Chin-ShengHuang, Han-Bin
口試日期:2013-05-22
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:2014
畢業學年度:102
語文別:中文
論文頁數:98
中文關鍵詞:PM2.5個人空氣採樣肺功能FeNOCC16
外文關鍵詞:PM2.5Personal Environmental MonitorLung fuctionFeNOCC16
相關次數:
  • 被引用被引用:1
  • 點閱點閱:206
  • 評分評分:系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:2
流行病學研究指出空氣中的懸浮微粒與呼吸系統的健康效應有關,而細懸浮微粒(PM2.5) 粒徑小可吸入至肺泡與支氣管末端或穿透細胞膜,將汙染物帶入循環系統中,帶來的健康危害較PM10大,而台灣目前也較少探討空氣中的懸浮微粒與呼吸系統的健康效應之相關研究。故本研究目的為探討暴露於細懸浮微粒對肺功能、呼吸道發炎反應指標變化。

本研究採縱貫性研究設計,研究對象招募由工業區附近招募32位及住商混和區招募50位,共82位無慢性病、肺部疾病之健康者,並兩個月後進行第一次追蹤。本研究收集問卷、生物檢體、個人空氣採樣等資料,探討肺功能與肺部發炎生之變化,及基準點與第一次追蹤之縱貫分析,其統計分析使用 Generalized linear model和Generalized estimating equation。

研究發現控制可能的影響因素後,PM2.5濃度每增加10μg/m3,FEV1/FVC%顯著下降-0.73% (95% CI,-1.33~-0.12, p=0.02),CC16則增加1.04% (95% CI,0.00~0.03, p=0.05)。若將PM2.5濃度20 μg/m3作為切點,PM2.5濃度大於20μg/m3的人,其FEV1/FVC%、PEF%顯著低於PM2.5濃度小於20 μg/m3,而CC16則是顯著高於PM2.5濃度小於20 μg/m3,在縱貫分析上,控制其它影響因素後,第一次追蹤與基準值相比,PM2.5每增加10μg/m3,其FVC%百分比改變顯著下降10.33%、CC16百分比改變顯著增加24.04%。

本研究發現年輕族群暴露到PM2.5會導致肺功能下降及肺部發炎指標上升,PM2.5濃度大於20μg/m3,肺功能顯著低於、CC16顯著高於PM2.5濃度小於20μg/m3的人。

Numerous studies have shown that particulate matter is associated with respiratory system health effect. The different aerodynamic diameters of the particles and the different deposition locations in the respiratory system cause different harmful effects on human beings. Like PM2.5 is aerodynamic diameter≦2.5μg/m3 and the pollution can reach a large surface area. It is more prone to carrying a variety of toxic heavy metals and other chemicals in alveolar and bronchial ends. It can enhance antigen-presenting by Endocytosis of macrophages, or enter the blood circulation system by lung air exchange to reach the other organs and causing the damage of structure and function in the respiratory.

This study aimed to assess the relationship between PM2.5 exposure and lung inflammation and lung function in healthy adults.

For this longitudinal study, we recruited 82 subjects from 2 different areas (Area A [residential and commercial area] and Area B [industrial area]) in Taipei Metropolitan at baseline. We investigated pulmonary and inflammation markers and lung function. We used personal samplers to collect 24 hours PM2.5 exposure samples. Venous blood and urine samples were collected on the next day morning. And serum clara cell protein (CC16), nitric oxide inexhaled breath (FeNO) were measured as inflammation markers and lung function was measured as health effects. All of subjects were repeated measured after two months. Statistical Methods used Generalized linear model and Generalized estimating equation.

We found FEV1/FVC% decreasing -0.73% as PM2.5 increasing 10μg/m3 , while CC16 increasing 1.04% as PM2.5 increasing 10μg/m3. And people who exposed PM2.5 levels above 20 μg/m3 the lung function parameters (FVC%, PEF%) were lower than that of exposed PM2.5 under 20 μg/m3, CC16 would be higher compared to that of PM2.5 exposure under 20 μg/m3 . In addition, after controlling for confounding factors , the first repeated follow-up , as PM2.5 increasing 10 μg/m3,CC16 increasing 24.04% and FVCdecreasing 10.33% compared with that of baseline .

We conclude young healthy subjects exposed to PM2.5 can lead to lung function decreasing or lung inflammation.

表目錄 III
圖目錄 IV
附錄目錄 V
中文摘要 VI
Abstract VII
第一章 緒論 1
第一節 研究背景 1
第二節 研究重要性 2
第三節 研究目的 4
第二章 文獻探討 5
第一節 細懸浮微粒來源 5
第二節 各國PM2.5濃度法規標準 8
第三節 細懸浮微粒的暴露評估 11
第四節 細懸浮微粒的毒性 13
第五節 肺功能及肺部發炎指標 15
第六節 細懸浮微粒與呼吸系統相關之流行病學研究 21
第三章 研究方法與步驟 25
第一節 研究設計與架構 25
第二節 研究對象 27
第三節 研究工具 28
第四節 資料收集方法與步驟 35
第五節 實驗品質管制與保證 37
第六節 資料處理與統計分析 40
第四章 研究結果 41
第一節 研究對象描述性統計與檢定 41
第二節 個人採樣與環境測站之PM2.5濃度 43
第三節 研究對象肺功能指標之描述與檢定 44
第四節 研究對象發炎反應標記之描述與檢定 47
第五章 討論 50
第一節 研究對象選取與兩地區濃度差異比較 51
第二節 PM2.5濃度探討 53
第三節 PM2.5對於肺部的影響 54
第四節 研究限制 58
第六章 結論與建議 59
第一節 結論 59
第二節 建議 60
參考文獻 61

Adamkiewicz, G., Ebelt, S., Syring, M., Slater, J., Speizer, F. E., Schwartz, J., Suh, H. & Gold, D. R. 2004. Association between air pollution exposure and exhaled nitric oxide in an elderly population. Thorax, 59, 204-9.
American Thoracic, S. & European Respiratory, S. 2005. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med, 171, 912-30.
Andrew, P. J. & Mayer, B. 1999. Enzymatic function of nitric oxide synthases. Elsevier Science.
Berkman, N., Avital, A., Breuer, R., Bardach, E., Springer, C. & Godfrey, S. 2005. Exhaled nitric oxide in the diagnosis of asthma: comparison with bronchial provocation tests. Thorax, 60, 383-8.
Bernard, A., Hermans, C. & Van Houte, G. 1997. Transient increase of serum Clara cell protein (CC16) after exposure to smoke. Occup Environ Med, 54, 63-5.
Bigert, C., Alderling, M., Svartengren, M., Plato, N. & Gustavsson, P. 2011. No short-term respiratory effects among particle-exposed employees in the Stockholm subway. Scand J Work Environ Health, 37, 129-35.
Brauer, M., Ebelt, S. T., Fisher, T. V., Brumm, J., Petkau, A. J. & Vedal, S. 2001. Exposure of chronic obstructive pulmonary disease patients to particles: respiratory and cardiovascular health effects. J Expo Anal Environ Epidemiol, 11, 490-500.
Broeckaert, F. & Bernard, A. 2000. Clara cell secretory protein (CC16): characteristics and perspectives as lung peripheral biomarker. Clinical and Experimental Allergy. 469-475.
Brunekreef, B. & Holgate, S. 2002. Air pollution and health. The Lancet, 360, 1233-1242.
Chen, J., Lam, S., Pilon, A., Mcwilliams, A., Melby, J. & Szabo, E. 2007. The association between the anti-inflammatory protein CC10 and smoking status among participants in a chemoprevention trial. Cancer Epidemiol Biomarkers Prev, 16, 577-83.
Chen, S. Y., Su, T. C., Lin, Y. L. & Chan, C. C. 2012. Short-term effects of air pollution on pulse pressure among nonsmoking adults. Epidemiology, 23, 341-8.
Coleman, J. W. 2001. Nitric oxide in immunity and inflammation. Int Immunopharmacol, 1, 1397-406.
Cummings, K. J., Nakano, M., Omae, K., Takeuchi, K., Chonan, T., Xiao, Y. L., Harley, R. A., Roggli, V. L., Hebisawa, A., Tallaksen, R. J., Trapnell, B. C., Day, G. A., Saito, R., Stanton, M. L., Suarthana, E. & Kreiss, K. 2012. Indium lung disease. Chest, 141, 1512-21.
Deng, X., Zhang, F., Rui, W., Long, F., Wang, L., Feng, Z., Chen, D. & Ding, W. 2013. PM2.5-induced oxidative stress triggers autophagy in human lung epithelial A549 cells. Toxicol In Vitro, 27, 1762-70.
Doyle, I. R., Hermans, C., Bernard, A., Nicholas, T. E. & Bersten, A. D. 1998. Clearance of Clara Cell Secretory Protein 16 (CC16) and Surfactant Proteins A and B from Blood in Acute Respiratory Failure. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 158.
Elango, N., Kasi, V., Vembhu, B. & Poornima, J. G. 2013. Chronic exposure to emissions from photocopiers in copy shops causes oxidative stress and systematic inflammation among photocopier operators in India. Environ Health, 12, 78.
Epa. 2006. Area designations for 2006 24-hour fine particle (PM2.5) standards: basic information [Online]. U.S. Environmental Protection Agency. [Accessed 12 Oct 2013].
Gauderman, W. J., Avol, E., Gilliland, F., Vora, H., Thomas, D., Berhane, K., Mcconnell, R., Kuenzli, N., Lurmann, F., Rappaport, E., Margolis, H., Bates, D. & Peters, J. 2004. The effect of air pollution on lung development from 10 to 18 years of age. N Engl J Med, 351, 1057-67.
Gehring, U., Gruzieva, O., Agius, R. M., Beelen, R., Custovic, A., Cyrys, J., Eeftens, M., Flexeder, C., Fuertes, E., Heinrich, J., Hoffmann, B., De Jongste, J. C., Kerkhof, M., Klumper, C., Korek, M., Molter, A., Schultz, E. S., Simpson, A., Sugiri, D., Svartengren, M., Von Berg, A., Wijga, A. H., Pershagen, G. & Brunekreef, B. 2013. Air Pollution Exposure and Lung Function in Children: The ESCAPE Project. Environ Health Perspect.
Gioldassi, X. M., Papadimitriou, H., Mikraki, V. & Karamanos, N. K. 2004. Clara cell secretory protein: determination of serum levels by an enzyme immunoassay and its importance as an indicator of bronchial asthma in children. Journal of Pharmaceutical and Biomedical Analysis, 34, 823-826.
Gonzalez-Flecha, B. 2004. Oxidant mechanisms in response to ambient air particles. Mol Aspects Med, 25, 169-82.
Goss, C. H., Newsom, S. A., Schildcrout, J. S., Sheppard, L. & Kaufman, J. D. 2004. Effect of ambient air pollution on pulmonary exacerbations and lung function in cystic fibrosis. Am J Respir Crit Care Med, 169, 816-21.
Gotschi, T., Heinrich, J., Sunyer, J. & Kunzli, N. 2008. Long-term effects of ambient air pollution on lung function: a review. Epidemiology, 19, 690-701.
Halatek, T., Opalska, B., Lao, I., Stetkiewicz, J. & Rydzynski, K. 2005. Pneumotoxicity of dust from aluminum foundry and pure alumina: a comparative study of morphology and biomarkers in rats. Int J Occup Med Environ Health, 18, 59-70.
Jaakkola, M. S. & Jaakkola, J. J. K. 1997. Assessment of exposure to environmental tobacco smoke. European Respiratory Journal, 10, 2384-2397.
Jacobs, L., Nawrot, T. S., De Geus, B., Meeusen, R., Degraeuwe, B., Bernard, A., Sughis, M., Nemery, B. & Panis, L. I. 2010. Subclinical responses in healthy cyclists briefly exposed to traffic-related air pollution: an intervention study. Environ Health, 9, 64.
Jansen, K. L., Larson, T. V., Koenig, J. Q., Mar, T. F., Fields, C., Stewart, J. & Lippmann, M. 2005. Associations between health effects and particulate matter and black carbon in subjects with respiratory disease. Environ Health Perspect, 113, 1741-6.
Janssen, N. A., De Hartog, J. J., Hoek, G., Brunekreef, B., Lanki, T., Timonen, K. L. & Pekkanen, J. 2000a. Personal exposure to fine particulate matter in elderly subjects: relation between personal, indoor, and outdoor concentrations. J Air Waste Manag Assoc, 50, 1133-43.
Janssen, N. a. H., De Hartog, J. J., Hoek, G., Brunekreef, B., Lanki, T., Timonen, K. L. & Pekkanen, J. 2000b. Personal Exposure to Fine Particulate Matter in Elderly Subjects: Relation between Personal, Indoor, and Outdoor Concentrations. Journal of the Air & Waste Management Association, 50, 1133-1143.
Jerrett, M., Burnett, R. T., Ma, R., Pope, C. A., Krewski, D., Newbold, K. B., Thurston, G., Shi, Y., Finkelstein, N., Calle, E. E. & Thun, M. J. 2005. Spatial Analysis of Air Pollution and Mortality in Los Angeles. Epidemiology, 16, 727-736.
Jorens, P. G., Sibille, Y., Goulding, N. J., Van Overveld, F. J., Herman, A. G., Bossaert, L., De Backer, W. A., Lauwerys, R., Flower, R. J. & Bernard, A. 1995. Potential role of Clara cell protein, an endogenous phospholipase A2 inhibitor, in acute lung injury. European Respiratory Journal, 8, 1647-1653.
Kan, H., London, S. J., Chen, G., Zhang, Y., Song, G., Zhao, N., Jiang, L. & Chen, B. 2007. Differentiating the effects of fine and coarse particles on daily mortality in Shanghai, China. Environ Int, 33, 376-84.
Karottki, D. G., Spilak, M., Frederiksen, M., Gunnarsen, L., Brauner, E. V., Kolarik, B., Andersen, Z. J., Sigsgaard, T., Barregard, L., Strandberg, B., Sallsten, G., Moller, P. & Loft, S. 2013. An indoor air filtration study in homes of elderly: cardiovascular and respiratory effects of exposure to particulate matter. Environ Health, 12, 116.
Kharitonov, S. A. & Barnes, P. J. 2001. Exhaled markers of inflammation. Curr Opin Allergy Clin Immunol, 1, 217-24.
Knaapen, A. M., Borm, P. J., Albrecht, C. & Schins, R. P. 2004. Inhaled particles and lung cancer. Part A: Mechanisms. Int J Cancer, 109, 799-809.
Koenig, J. Q., Jansen, K., Mar, T. F., Lumley, T., Kaufman, J., Trenga, C. A., Sullivan, J., Liu, L. J., Shapiro, G. G. & Larson, T. V. 2003. Measurement of offline exhaled nitric oxide in a study of community exposure to air pollution. Environ Health Perspect, 111, 1625-9.
Lakind, J. S., Holgate, S. T., Ownby, D. R., Mansur, A. H., Helms, P. J., Pyatt, D. & Hays, S. M. 2007. A critical review of the use of Clara cell secretory protein (CC16) as a biomarker of acute or chronic pulmonary effects. Biomarkers, 12, 445-67.
Langrish, J. P., Li, X., Wang, S., Lee, M. M., Barnes, G. D., Miller, M. R., Cassee, F. R., Boon, N. A., Donaldson, K., Li, J., Li, L., Mills, N. L., Newby, D. E. & Jiang, L. 2012. Reducing personal exposure to particulate air pollution improves cardiovascular health in patients with coronary heart disease. Environ Health Perspect, 120, 367-72.
Larsson, B. M., Sehlstedt, M., Grunewald, J., Skold, C. M., Lundin, A., Blomberg, A., Sandstrom, T., Eklund, A. & Svartengren, M. 2007. Road tunnel air pollution induces bronchoalveolar inflammation in healthy subjects. Eur Respir J, 29, 699-705.
Lee, Y. L., Lin, Y. C., Hsiue, T. R., Hwang, B. F. & Guo, Y. L. 2003. Indoor and Outdoor Environmental Exposures, Parental Atopy, and Physician-Diagnosed Asthma in Taiwanese Schoolchildren. Pediatrics, 112, e389-e389.
Liou, S.-H., Tsou, T.-C., Wang, S.-L., Li, L.-A., Chiang, H.-C., Li, W.-F., Lin, P.-P., Lai, C.-H., Lee, H.-L., Lin, M.-H., Hsu, J.-H., Chen, C.-R., Shih, T.-S., Liao, H.-Y. & Chung, Y.-T. 2012. Epidemiological study of health hazards among workers handling engineered nanomaterials. Journal of Nanoparticle Research, 14.
Lund, M. B., ksne, P. I., Hamre, R. & Kongerud, J. 2000. Increased Nitric Oxide in Exhaled Air: An Early Marker of Asthma in non-Smoking Aluminium Potroom Workers. Occup Environ Med.
Maier, K. L., Alessandrini, F., Beck-Speier, I., Hofer, T. P., Diabate, S., Bitterle, E., Stoger, T., Jakob, T., Behrendt, H., Horsch, M., Beckers, J., Ziesenis, A., Hultner, L., Frankenberger, M., Krauss-Etschmann, S. & Schulz, H. 2008. Health effects of ambient particulate matter--biological mechanisms and inflammatory responses to in vitro and in vivo particle exposures. Inhal Toxicol, 20, 319-37.
Mcdonnell, W. F., Nishino-Ishikawa, N., Petersen, F. F., Chen, L. H. & Abbey, D. E. 2000. Relationships of mortality with the fine and coarse fractions of long-term ambient PM10 concentrations in nonsmokers. J Expo Anal Environ Epidemiol, 10, 427-36.
Oftedal, B., Brunekreef, B., Nystad, W., Madsen, C., Walker, S. E. & Nafstad, P. 2008. Residential outdoor air pollution and lung function in schoolchildren. Epidemiology, 19, 129-37.
Ostro, B., Broadwin, R., Green, S., Feng, W.-Y. & Lipsett, M. 2006. Fine Particulate Air Pollution and Mortality in Nine California Counties: Results from CALFINE. Environmental Health Perspectives, 114, 29-33.
Pearson, J. F., Bachireddy, C., Shyamprasad, S., Goldfine, A. B. & Brownstein, J. S. 2010. Association between fine particulate matter and diabetes prevalence in the U.S. Diabetes Care, 33, 2196-201.
Pope, C. A., 3rd & Dockery, D. W. 2006. Health effects of fine particulate air pollution: lines that connect. J Air Waste Manag Assoc, 56, 709-42.
Provost, E. B., Chaumont, A., Kicinski, M., Cox, B., Fierens, F., Bernard, A. & Nawrot, T. S. 2014. Serum levels of club cell secretory protein (Clara) and short- and long-term exposure to particulate air pollution in adolescents. Environ Int, 68C, 66-70.
Rice, M. B., Ljungman, P. L., Wilker, E. H., Gold, D. R., Schwartz, J. D., Koutrakis, P., Washko, G. R., O'connor, G. T. & Mittleman, M. A. 2013. Short-term exposure to air pollution and lung function in the Framingham Heart Study. Am J Respir Crit Care Med, 188, 1351-7.
Ross, M. H. & Pawlina, W. 2011. Histology: A Text and Atlas, with Correlated Cell and Molecular Biology Lippincott Williams & Wilkins.
Sørensen, M., Daneshvar, B., Hansen, M., Dragsted, L. O., Hertel, O., Knudsen, L. & Loft, S. 2002. Personal PM2.5 Exposure and Markers of Oxidative Stress in Blood. Environmental Health Perspectives, 111, 161-165.
S.Salvi & S.T.Holgate 1999. Mechanisms of particulate matter toxicity. Clinical and Experimental Allergy, 29.
Schikowski, T., Sugiri, D., Ranft, U., Gehring, U., Heinrich, J., Wichmann, H. E. & Kramer, U. 2005. Long-term air pollution exposure and living close to busy roads are associated with COPD in women. Respir Res, 6, 152.
Shijubo, N., Itoh, Y., Yamaguchi, T. & Abe, S. 2000. Development of an enzyme-linked immunosorbent assay for Clara cell 10-kDa protein: in pursuit of clinical significance of sera in patients with asthma and sarcoidosis. ANNALS NEW YORK ACADEMY OF SCIENCES.
Shijubo, N., Itoh, Y., Yamaguchi, T., Shibuya, Y., Morita, Y., Hirasawa, M., Okutani, R., Kawai, T. & Abe, S. 1997. Serum and BAL Clara cell 10 kDa protein (CC10) levels and CC10-positive bronchiolar cells are decreased in smokers. European Respiratory Journal, 10, 1108-1114.
Smargiassi, A., Goldberg, M. S., Wheeler, A. J., Plante, C., Valois, M. F., Mallach, G., Kauri, L. M., Shutt, R., Bartlett, S., Raphoz, M. & Liu, L. 2014. Associations between personal exposure to air pollutants and lung function tests and cardiovascular indices among children with asthma living near an industrial complex and petroleum refineries. Environ Res, 132C, 38-45.
Strak, M., Janssen, N. A., Godri, K. J., Gosens, I., Mudway, I. S., Cassee, F. R., Lebret, E., Kelly, F. J., Harrison, R. M., Brunekreef, B., Steenhof, M. & Hoek, G. 2012. Respiratory health effects of airborne particulate matter: the role of particle size, composition, and oxidative potential-the RAPTES project. Environ Health Perspect, 120, 1183-9.
Timonen, K. L., Hoek, G., Heinrich, J., Bernard, A., Brunekreef, B., De Hartog, J., Hameri, K., Ibald-Mulli, A., Mirme, A., Peters, A., Tiittanen, P., Kreyling, W. G. & Pekkanen, J. 2004. Daily variation in fine and ultrafine particulate air pollution and urinary concentrations of lung Clara cell protein CC16. Occup Environ Med, 61, 908-14.
Wang, G., Jiang, R., Zhao, Z. & Song, W. 2013. Effects of ozone and fine particulate matter (PM(2.5)) on rat system inflammation and cardiac function. Toxicol Lett, 217, 23-33.
Who 2006. Air Quality Guidelines Global Update 2005.
Yamazaki, S., Shima, M., Yoda, Y., Oka, K., Kurosaka, F., Shimizu, S., Takahashi, H., Nakatani, Y., Nishikawa, J., Fujiwara, K., Mizumori, Y., Mogami, A., Yamada, T. & Yamamoto, N. 2014. Association between PM2.5 and primary care visits due to asthma attack in Japan: relation to Beijing's air pollution episode in January 2013. Environ Health Prev Med, 19, 172-6.
Yang, J. Y., Kim, J. Y., Jang, J. Y., Lee, G. W., Kim, S. H., Shin, D. C. & Lim, Y. W. 2013. Exposure and toxicity assessment of ultrafine particles from nearby traffic in urban air in seoul, Korea. Environ Health Toxicol, 28, e2013007.
Ye, Q., Fujita, M., Ouchi, H., Inoshima, I., Maeyama, T., Kuwano, K., Horiuchi, Y., Hara, N. & Nakanishi, Y. 2004. Serum CC-10 in inflammatory lung diseases. Respiration, 71, 505-10.
Zanobetti, A., Canner, M. J., Stone, P. H., Schwartz, J., Sher, D., Eagan-Bengston, E., Gates, K. A., Hartley, L. H., Suh, H. & Gold, D. R. 2004. Ambient pollution and blood pressure in cardiac rehabilitation patients. Circulation, 110, 2184-9.
Zuurbier, M., Hoek, G., Oldenwening, M., Meliefste, K., Krop, E., Van Den Hazel, P. & Brunekreef, B. 2011. In-traffic air pollution exposure and CC16, blood coagulation, and inflammation markers in healthy adults. Environ Health Perspect, 119, 1384-9.
林洺秀 2001. 陶瓷業勞工肺部健康危害探討. 勞工安全研究所90年度計畫.
洪粕宸 2001. 呼氣中的一氧化氮濃度增加-非抽煙的鋁電解槽室工人氣喘的早期性指標?. 勞工安全衛生簡訊.
陳玫茵, 唐憶淨, 楊宗穎 & 劉丕華 2006. 肺功能量計的判讀. 基層醫學 第二十一卷第十期.
程潔菡 & 徐世達 2009. 關於呼氣一氧化氮(exhaled NO)測量的臨床應用. 台灣氣喘衛教學會.
臺北市政府主計處 2003. 99 年大臺北地區(雙北市)15 歲以上居民通勤通學型態分析.
論壇健康促進與疾病預防委員會 2001. 吸菸對幼兒及青少年功能發育與呼吸道疾病之影響, 財團法人國家衛生研究院.

QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
系統版面圖檔 系統版面圖檔