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研究生:蔡嘉修
研究生(外文):Chia-Hsiu Tsai
論文名稱:空軍基地地勤人員之職業噪音暴露引起聽力損失與代謝症候群盛行率之關係研究
論文名稱(外文):空軍基地地勤人員之職業噪音暴露引起聽力損失與代謝症候群盛行率之關係研究
指導教授:張大元
學位類別:碩士
校院名稱:中國醫藥大學
系所名稱:職業安全與衛生學系碩士在職專班
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:2016
畢業學年度:104
語文別:中文
論文頁數:91
中文關鍵詞:地勤人員聽力損失代謝症候群職業噪音
外文關鍵詞:ground staffhearing lossmetabolic syndromeoccupational noise
相關次數:
  • 被引用被引用:1
  • 點閱點閱:338
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
背景:許多流行病學證據發現,環境噪音除了和心血管疾病有關,也會造成人體產生壓力荷爾蒙,使得腰圍變粗、血壓、血脂及血糖異常,但少有研究直接評估職業噪音暴露與代謝症候群的關係。噪音暴露評估的精確度會受勞工使用聽力防護具而造成暴露偏差,因而影響到研究結果,而本研究以高頻聽力損失作為噪音暴露之生物標記來探討職業噪音與代謝症候群的關係。
目的:本研究調查國軍某空軍基地地勤人員之代謝症候群盛行率和聽力損失的情形及職業噪音聽力損失與代謝症候群的關係。
方法:本研究採橫斷性研究方法,徵求159名自願者進行健康行為問卷調查,並收集2014年~2015年人員之年度健康檢查資料及2015年純音聽力計檢測結果。我們以高頻聽力損失在4kHz之雙耳聽力損失之平均數作為噪音暴露之生物標記調查噪音暴露與代謝症候群之關係,將工作人員分為高度聽力損失組(個案數:58位,平均高頻聽力損失大於等於15B;≧75%)、中度聽力損失組(個案數:52位,平均高頻聽力損失大於等於10dB及小於15dB;25-75%) 、低度聽力損失組(個案數:49位,平均高頻聽力損失小於10dB;<25%)。我們採邏輯斯迴歸評估三組之間罹患代謝症候群風險之差異。
結果:我們發現地勤人員代謝症候群盛行率為14.83%,其中高度聽力損失組、中度聽力損失組及低度聽力損失組代謝症候群盛行率分別為25%、10%及8.2%。調整相關因子之後,高度聽力損失組相較於低度聽力損失組有顯著較高的代謝症候群盛行率風險(OR=4.80 ;95%CI=1.20-19.20 ;p=0.026)。此外,我們發現每增加一分貝4kHz平均的聽力損失,其新陳代謝症候群的風險增高0.13倍(OR=1.13;95%CI:1.06-1.20,p<0.001)。
結論:以4kHz之雙耳聽力損失平均數作為職業噪音暴露的生物標記顯示高噪音暴露與代謝症候群之盛行率有關。


Background:
Many epidemiological studies have demonstrated that environmental noise not only contributes to the development of cardiovascular diseases, but also to cause larger waist circumference, hypertension, dyslipidemia and hyperglycemia by releasing stress hormone. However, few studies have directly assessed the association between occupational noise exposure and metabolic syndrome . The accuracy of noise exposure assessment is affected by the use of personal protective equipment among workers to produce the exposure bias in research results .The high-frequency hearing loss has been used as a biomarker of noise exposure to investigate the association between occupational noise and metabolic syndrome.
Objectives:
The study investigated the prevalence of metabolic syndrome and noise-induced hearing loss amongground staffsin an air-force base.
Methods:
In this cross-sectional study,we recruited 159 volunteers to complete health-behavior questionnaires and collected their health checkups during 2014-2015 to analyze the prevalence of metabolic syndrome .The mean of high-frequency hearing loss(HL) bilaterally at 4 kHz was used as a biomarker of noise exposure. The workers were divided into a high HL group (n =58; average HLVs ≥ 15 dB at 4 kHz bilaterally; ≧third quantile),a median HL group (n = 52; 10 ≤ average HLVs< 15dB at 4 kHz bilaterally; second quantile-third quantile) and a low HL group (n = 49; average HLVs < 10 dB at 4 kHz bilaterally; <first quantile). We used multivariate logistic regressions to compare the risk of metabolic syndrome between three groups.
Result:
We found that the prevalence of metabolic syndrome among total subjects was 14.83% .The prevalence of the metabolic syndrome in the high HL, median HL and low HL groups were 25% , 10% and 8.2%, respectively . The HL group compared with the low HL group had the higher risk of prevalent metabolic syndromeafter adjusting for confounding factors (OR=4.80; 95%CI=1.20-19.20; p=0.026). In addition, one- dB increase in hearing loss was associated with the increased 13 % risk of prevalent metabolic syndrome(OR=1.13 ;95%CI:1.06-1.20 ;p<0.001).
Conclusion:
The use of hearing loss bilaterally at 4 kHz as a biomarker for occupational noise exposure may be associated with the prevalence of metabolic syndrome.


致謝 1
中文摘要 3
ABSTRACT 5
目錄 Ⅰ
表目錄 Ⅳ
圖目錄 Ⅵ
第一章 緒論 1
第一節 研究背景 1
第二節 研究重要性 4
第三節 研究目的 4
第四節 研究假設 4
第五節 名詞界定 5
第二章文獻回顧 8
第一節 機場噪音概述 8
第二節 噪音的特性 8
第三節 聽力損失 12
第四節 代謝症候群的危害與現況 14
第五節 噪音對健康的危害 17
第六節 代謝症候群的危險因子 22
第七節 噪音暴露與代謝症候群發生的可能機轉 23
第三章 研究方法 24
第一節 研究設計 24
第二節 資料收集 26
第三節 資料統計與分析 32
第四章 結果 35
第一節 研究對象之健康檢查資料與生活習慣 35
第二節 高頻聽力損失分組與代謝症候群的關係 36
第三節 每一分貝聽力損失與代謝症候群的關係 37
第四節 工作時間和高頻聽力損失的關係 37
第五節 代謝症候群各因子與聽力損失的關係 39
第五章 討論 44
第一節 代謝症候群盛行率 45
第二節 高頻聽力損失與代謝症候群盛行率之關係 45
第三節 每一分貝高頻聽力損失與代謝症候群盛行率之關係 46
第四節 代謝症候群各因子與聽力損失之關係 46
第五節 本研究聽力損失之特性 47
第六章 結論與建議 47
第一節 結論 47
第二節 本研究優勢 48
第三節 研究限制 48
第四節 應用與建議 49
參考文獻 50
附錄 55

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