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研究生:陳麗惠
研究生(外文):Chen, Lii Hui
論文名稱:受孕前鉛暴露對女性生育能力之影響
論文名稱(外文):Preconceptional lead exposure and female fecundability
指導教授:陳保中陳保中引用關係
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:職業醫學與工業衛生研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文出版年:1999
畢業學年度:87
語文別:中文
論文頁數:69
中文關鍵詞:受孕所需時間生育力生殖危害
外文關鍵詞:leadtime to pregnancyfecundibilityreproductive hazards
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鉛對生殖的潛在危害在於它會干擾生殖過程的任何時期,因此,本研究乃探討有關鉛蓄電池工廠女性員工受孕前鉛暴露對生育能力的影響,利用受孕所需時間(time to pregnancy,TTP)作為生育能力評估工具,以早期篩除鉛對生殖危害。
選擇某鉛蓄電池工廠女性員工為研究對象,於進入工廠後曾經受孕有受孕所需時間之孕次且有血鉛值者為暴露組(n=64孕次);該鉛蓄電池工廠建廠後女性員工進入工廠前且過去工作史或生活環境無鉛暴露者為非暴露組(n=57孕次)。再與黃氏1999年台灣婦女生育力參考曲線做比較。此曲線研究對象為1990年四月登記結婚婦女(n=681孕次)。以回溯性研究利用非開放式問卷進行資料收集,問卷回收以訪員進行面訪,問卷填寫完整者,共回收251份問卷。排除有不孕方面醫療檢查或治療、懷孕史有婦科疾病、受孕所需時間大於24個月者。
研究結果發現暴露組受孕所需時間較非暴露組及台灣婦女曲線組為短,其非暴露組教育程度國中以下佔64.5%較暴露組40.9%為低、生活習慣中喝茶43.5%、喝咖啡45.2%與暴露組有差異。因此,非暴露組不適合當對照組。在台灣婦女曲線組發現教育程度、配偶喝咖啡習慣、孕次等兩組間有差異。其暴露組具健康工人效應,與台灣婦女曲線組比較缺乏族群一致性,故亦不適合當對照組。
因此,暴露組依各鉛暴露指標分層分析,除工作年資之外,其他鉛暴露指標的高暴露組受孕能力比皆小於1,未達到統計上顯著意義。所以,在目前暴露劑量及所使用的工具方法下,對女性受孕能力並無受孕力下降。
Objective: This study was designed to assess the fecundability among female lead battery workers using time to pregnancy (TTP).
Methods: We recurited he women who were pregnant after employment in a lead battery factory in southern Taiwan as the exposed group, and used those before employment in the same factory and the Taiwanese female fecundability reference curve as the non-exposed groups. This reference population was systemically sampled from the women who married in April 1990 and each sampled woman was interviewed between January and May 1999. Each female worker in the lead battery factory was also interviewed during the same period. We used a structured questionnaire to collect detailed pregnancy histores including TTP for each pregnancy. Regarding to pre-pregnancy lead exposure, we used the blood lead data from annually routine health examination to estimate individual short-term and cummulative lead exposure indices. Cox proportional hazard models were applied to calculate fecundability ratios and their confience intervals among the different exposed groups.
Results: Compared with the reference population, the mean of TTP in female lead battery workers was shorter. We found that the mean of TTP among the women who were pregnant after employment was also shorter than that in those before employment. According to various lead exposure indices except the duration of employment, we found that fecundability ratios were less than 1 among highest exposed groups although they were not statistically significant.
Conclusion: No significantly reduced fecundability was found in this study. This might be due to healthy worker effect.
摘要3
Abstract4
目錄5
表列7
圖列8
壹、緒論9
一、前言9
二、研究目的10
貳、文獻探討11
一、前言11
二、雌性生殖系統內分泌調控11
三、鉛對雌性生殖內分泌影響12
四、受孕力測量工具15
參、材料與方法17
一、研究設計17
二、研究對象17
三、問卷測量18
四、暴露分層19
六、統計分析21
肆、結果25
伍、討論48
一、樣本選取48
二、各鉛暴露指標評估48
三、生育能力測量之探討49
四、研究結果之探討51
五、研究限制52
陸、結論與建議54
參考文獻55
附錄60
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