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研究生:林宜靜
研究生(外文):LIN,YI-JING
論文名稱:細懸浮微粒與急性支氣管炎之門診就醫:臺灣地區病例交叉設計研究
論文名稱(外文):Fine Particulate Air Pollution and Outpatient for Acute Bronchitis:A Case-Crossover Study in Taiwan
指導教授:林麗芬林麗芬引用關係
指導教授(外文):LIN,LIE-FEN
口試委員:陳甫州林敬恒
口試委員(外文):CHENG,FU-CHOULIN,CHING-HENG
口試日期:2017-06-06
學位類別:碩士
校院名稱:逢甲大學
系所名稱:統計學系
學門:數學及統計學門
學類:統計學類
論文種類:學術論文
論文出版年:2017
畢業學年度:105
語文別:中文
論文頁數:42
中文關鍵詞:PM2.5汙染物急性支氣管炎門診就醫病例交叉設計
外文關鍵詞:PM2.5pollutionacute bronchitisoutpatientcase-crossover design
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動機與目的:世界衛生組織(WHO)指出,PM2.5長時間暴露於空氣中,會對人們造成相當大的影響,甚至會提高罹癌的風險。近年來PM2.5的管制政策以及對健康經濟效益的影響是全球高度重視的議題。臺灣在2011年各空品區之年平均濃度都超出我國規定的標準,導致急性支氣管炎至門(急)診就醫次數大幅增加。故本研究目的是探討2011年全國空品區之急性支氣管炎與PM2.5濃度之間是否存在關聯。
方法:本研究使用2011年急性支氣管炎有關疾病之就醫資料,以及行政院環境保護署監測站資料,並針對2011年之每日就醫紀錄進一步研究。使用Person相關係數、病例交叉設計、條件邏輯斯迴歸等分析,探討急性支氣管炎受到PM2.5濃度之就醫關係。
結果:PM2.5濃度以就醫前7-9天之平均為風險期間,而就醫前14-16天之平均為對照期間之下,熱天(T≥23℃)不論在單一汙染物模型還是多汙染物模型中PM2.5皆為不顯著。對於單一汙染物模型(不受其他大氣汙染源控制),急性支氣管炎門診就醫在不分冷熱天和冷天(T<23℃)兩者之PM2.5是顯著且呈現正相關,PM2.5每增加21.06μg/m3之下,則分別增加7.9%(95%CI=1.1-15.1%)和25.5%(95%CI=12.0-40.6%)的風險。然而,進一步探討多汙染物模型中(每個模型最多兩個污染物),不分冷熱天和冷天兩者之下,控制所有汙染物,只有O3是顯著之下,PM2.5仍然顯著。
結論:急性支氣管炎之好發期於冷天,且PM2.5濃度越高時與急性支氣管炎門診就醫呈現顯著關係。
Motivation and purpose:World Health Organization (WHO) pointed out that exposure to the Particulate Matter 2.5(PM2.5) for a long time will cause serious impact on people, and even increase the risk of cancer. In recent years, the control policy of PM2.5 and the impact on health and economic efficiency are the issues which attaches great importance to the world. The average annual concentration of the region exceeded the prescribed standard in Taiwan during 2011, which leads to a substantial increase in the number of acute bronchitis of the outpatient or emergency treatment. Therefore this study will investigate if there’s a correlation between acute bronchitis and PM2.5 concentration of our national air quality region in the 2011. Method:This study is according to the information on the outpatient of acute bronchitis related diseases in 2011, as well as the information on monitoring stations of the Environmental Protection Administration (EY), and then we made a further study on the daily medical records in 2011. By using the Person correlation coefficient, case-crossover design, and conditional logistic regression analysis, we explored the relationship of outpatient between acute bronchitis and PM2.5 concentration.
Result:The average of 7-9 days before outpatient is the risk period of PM2.5 level, and the average of 14-16 days before outpatient is the Control period. PM2.5 level’s during warm days(≥23℃) is not significant no matter it is in single-pollutant model or two-pollutant models. For the single-pollutant model (it’s not controlled by other atmospheric pollutants), Acute bronchitis during outpatient no matter on warm and cool days or cold days(T<23℃) that PM2.5 shows the positive correlation, with an interquartile range (21.06μg/m3) increased outpatient risk by respectively 7.9% (95%CI=1.1-15.1%) and 25.5% (95%CI=12.0-40.6%). In two-pollutant models, PM2.5 remained significant even controlling for O3 no matter on warm and cool days or cold days.
Conclusion:Acute bronchitis morbidities more often during cool days, and the higher levels of PM2.5 with acute bronchitis outpatient was associated.

誌  謝 I
摘  要 II
ABSTRACT III
第一章 緒論 1
第一節 研究背景 1
第二節 研究動機 4
第三節 研究目的 5
第四節 研究流程 6
第二章 研究方法 7
第一節 資料分析工具 7
第二節 研究方法 7
第三章 資料處理 9
第一節 資料來源 9
第二節 居住地人口資料處理 12
第三節 急性支氣管炎資料處理 13
第四節 PM2.5與其他汙染源濃度及輔助性氣象資料處理 14
第五節 研究架構 14
第四章 研究結果 17
第一節 基本資料結果 17
第二節 PM2.5濃度不同暴露期間與急性支氣管炎門診就醫之比較 18
第三節 不同汙染物與PM2.5對急性支氣管炎門診就醫的顯著性 18
第四節 PM2.5短期暴露於不同區間內引起急性支氣管炎門診就醫的風險 18
第五章 結論與建議 26
第一節 結論 26
第二節 建議 27
參考文獻 28
附  錄 31
附表 31
程式碼 35
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