(34.228.41.66) 您好!臺灣時間:2018/12/12 20:40
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
本論文永久網址: 
line
研究生:胡佩莉
研究生(外文):Hu Pei - Li
論文名稱:氯乙烯聚合工人配偶生育能力之研究
論文名稱(外文):Time to Pregnancy Study among the Wives of Male Polyvinyl Chloride Workers
指導教授:陳保中陳保中引用關係
指導教授(外文):Chen Pau - Chung
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:2001
畢業學年度:89
語文別:中文
論文頁數:57
中文關鍵詞:氯乙烯聚合氯乙烯單體生育能力受孕所需時間
外文關鍵詞:polyvinyl chloridevinyl chloride monomerfecundibilitytime to pregnancy
相關次數:
  • 被引用被引用:3
  • 點閱點閱:497
  • 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:19
  • 收藏至我的研究室書目清單書目收藏:0
摘要
國際癌症研究機構將氯乙烯定為第一類致癌物,許多證據皆顯示職業暴露於氯乙烯單體會導致癌症,特別是肝血管肉瘤,國外研究指出會導致肝細胞癌、腦瘤及肺癌等,也曾報導男性氯乙烯單體暴露工人會導致性慾下降及影響精子生成。而國內氯乙烯聚合工人世代亦曾發表過肝癌、肝硬化、肝功能異常、及基因傷害等,但並未針對其潛在的生殖危害進行探討。氯乙烯單體是否會導致生殖系統的影響,並未有一致的定論,因此本研究乃探討氯乙烯聚合工人暴露於氯乙烯單體下,是否會降低其配偶的生育能力。
本研究以回溯性世代研究的方式,選擇國內五家氯乙烯聚合工廠潛在暴露於氯乙烯單體之男性員工,測量其配偶懷孕所需時間。男性員工潛在氯乙烯單體暴露評估,使用其配偶受孕前72天當時之工作暴露矩陣作為短期暴露指標,暴露濃度以中位數計算,分為低(1 ppm以下)、中(1-5 ppm)、及高暴露組(5 ppm以上);另外亦使用受孕前潛在暴露期間作為長期暴露指標,分為小於5年、6-15年、以及16年以上三組。使用結構性問卷以面訪之方式進行資料收集,包括詳細懷孕史及其他潛在干擾因子。問卷及說明書先行寄發給125位受訪配偶,其中問卷填寫完整者共93份提供310個孕次;剔除14年之前的孕次及受孕所需時間回憶困難者共59個孕次、母親本身可能有不孕問題而去求醫者37個孕次、以及受孕所需時間大於12個月4個孕次後,共有210個有效孕次。最後使用discrete Cox hazards model計算各暴露分層男性員工其配偶的生育能力密度比。
本研究低、中、高短期暴露指標分組各有144、50、及16個有效孕次,分析結果顯示在控制教育程度、抽煙、受孕年齡、以及孕次的潛在干擾因子之後,相對於低暴露組中暴露組的生育能力並未下降(生育能力密度比=1.30,95%信賴區間=0.90-1.86),而高暴露組生育能力則較為降低(生育能力密度比=0.61,95%信賴區間=0.33-1.12)。在長期暴露指標分組各有103、95、及12個有效孕次,結果顯示6-15年生育能力並未下降(生育能力密度比=1.15,95%信賴區間=0.81-1.62),16年以上生育能力則較為降低(生育能力密度比=0.73,95%信賴區間=0.33-1.61)。
氯乙烯聚合工人暴露氯乙烯單體,高暴露組暴露濃度中位數在5 ppm以上或暴露16年以上,可能會降低其配偶的生育能力,但並未達到統計顯著意義。
Abstract
Vinyl chloride has classified by the International Agency for Reseach on Cancer as a group one carcinogen. There is ample evidence about the relation between occupational expoure to vinyl chloride which will cause cancer especially angiosarcoma of the liver. Additionally, hepatocellular carcinoma, brain tumor, lung cancer were reported at foreign studies. Male vinyl chloride monomer (VCM) exposed worker have been also reported loss of libido and reduced spermatogenesis. Although there were several published works on abnormal liver function, liver cirrhosis or cancer, and genetic damages of the Taiwan polyvinyl chloride (PVC) cohort. The potential effect of VCM exposure on reproduction has not yet been studied. The prime purpose of the present investigation was to study the effect among the wives of male PVC workers exposure on fecundability measured by time to pregnancy (TTP).
A retrospective time to pregnancy study was conducted among the wives of male workers who were selected on five PVC factories in Taiwan exposure to VCM. The expousure assessment were used by those pregnancies which will be divided into those conceived before the start of employment and those conceived at lease 72 days after the start of employment. The latter will be grouped into pregnancies to low (<1 ppm), middle (1-5 ppm), high (>5 ppm) (median exposure concentration) exposure for short time exposure indicator. The exposure duration before those pregnancies will be grouped into three groups (<5 6-15, and >15 years) for long time exposure indicator. A structured questionnaire was used. The detailed pregnancy history including TTP for each conception and potential confounders was collected by face-to-face interview. Questionnaires were mailed to 125 womem who had preanancies less than 14 years before the study. A total of 93 wives of male PVC workers participated. The final study population consisted of 210 pregnancies after excluding those that may be related to subfecundability and whose TTP couldn’t be ascertained. The relative fecundability density ratios (FDRs) were calculated by using discrete Cox hazards models.
Compared with the low exposure group (N=144), fecundability in the middle exposure group (N=50) did not reduce (FDR=1.30, 95% CI=0.90-1.86) but that in high exposure group (N=16) decreased (FDR=0.61, 95% CI=0.33-1.12) after controlling education, smoking, age of conceived, and other potential confounders. In view of the cumulative exposure indicator, fecundability in the 6-15 years of exposure (N=95) did not reduce (FDR=1.15, 95% CI=0.81-1.62) but that in the more than 15 years of exposure (N=12) decreased (FDR=0.73, 95% CI=0.33-1.61) compared with the less than 5 years exposure (N=103).
Male PVC workers whom were exposed to VCM higher than 5 ppm or exposure duration longer than 15 years may reduce their fecundability although they are not statistically significant.
目錄
摘要1
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、氯乙烯單體與癌症之研究12
三、氯乙烯與基因毒性之研究13
四、氯乙烯與動物實驗之研究14
五、氯乙烯單體對生殖系統之影響15
六、受孕能力測量工具17
參、材料與方法19
一、研究設計19
二、研究對象20
三、問卷測量21
四、暴露分層23
五、統計分析26
肆、結果27
伍、討論42
一、樣本選取42
二、暴露指標評估42
三、生育能力測量之探討43
四、研究結果之探討43
陸、結論與建議47
參考文獻48
附錄…… 52
Binns CH. Vinyl chloride: a review. J Soc Occup Med 1979;29:134-41.
.Manson M. Epoxide is there a human health problem? Br J Ind Med 1980;37:317-36.
.Uzych L. Human male exposure to vinyl chloride and possible teratogenic and mutagenic risks: A review. Hum Toxicol 1988;7:517-27.
.台灣地區重要工業產品產銷月報表。工業簡訊,經濟部工業局,中華民國八十八年一月。
.Creech JL Jr, Johnson MN. Angiosarcoma of liver in the manufacture of polyvinyl chloride. J Occup Med 1974;16:150-51.
.Baxter PJ, Anthony PP, Macsween RN, et al. Angiosarcoma of the liver: annual occurrence and aetiology in Great Britain. Br J Ind Med 1980;37:213-21.
.Du CL, Wang JD. Increased morbidity odds ratio of primary liver cancer and cirrhosis of the liver among vinyl chloride nomomer workers. Occup Environ Med 1998;55:528-32.
.翁瑞宏。台灣地區氯乙烯暴露工人世代追蹤研究。勞工安全衛生研究季刊,2001;9:1-12。
.Barlow SM, Sullivan FM. Reproductive hazards of industrial chemicals. New York, NY: Academic Press, 1982. (Abstract in Micromedex Health series Reprotext: Vinyl chloride, 7.0 Reproductive effects.)
.Registry of toxic effects of chemical substances (RTECS). Cincinnati, OH: National institute for occupational safety and health, Englewood, CO: Micromedex, Inc., 1996. (Micromedex Health series Reprotext Vinyl chloride 7.0 Reproductive effects.)
.勞工作業環境空氣中有害物質容許濃度標準。行政院勞工委員會,中華民國八十四年九月。
.翁瑞宏。氯乙烯暴露世代研究(博士論文)。台北:國立台灣大學公共衛生學院職業醫學與工業衛生研究所,2001。
.Watanabe PG, Zempel JA, Gehring PJ. Comparison of the fate of vinyl chloride following single and repeated exposure in rats. Toxicol Appl Pharmacol 1978;44:391-99.
.Whysner J, Conaway CC, Verna L, et al. Vinyl chloride mechanistic data and risk assessment: DNA reactivity and cross-species quantitative risk extrapolation. Pharmacol Ther 1996;71:7-28.
.Heldaas SS, Langard SL, Andersen A. Incidence of cancer among vinyl chloride and polyvinyl chloride workers. Br J Ind Med 1984;41:25-30.
.OSHA. OSHA safety and health standards. U.S. Department of Labor, Occupational Safety and Health Adminitration. Code of Federal Regulations. 29 CFR 1910.1010,1983.
.勞工作業環境空氣中有害物質容許濃度標準。行政院勞工委員會,中華民國八十四年九月。
.Elloitt P, Kleinschmidt I. Angiosarcoma of the liver in Great Britain in proximity to vinyl chloride sites. Occup Environ Med 1997;54:14-18.
.Theriault G, Allard P. Cancer mortality of a group of Canadian workers exposed to vinyl chloride monomer. J Occup Med 1981;23:671-76.
.Smulevich VB, Fedotova IV, Filatova VS. Increasing evidence of the rise of cancer in workers exposed to vinylchloride. Br J Ind Med 1988;45:93-97.
.Heldaas SS, Langard SL, Andersen A. Incidence of cancer among vinyl chloride and polyvinyl chloride workers. Br J Ind Med 1984;41:25-30.
.Picciano DJ, Flake RE, Gay PC, et al. Vinyl chloride Cytogenetics. J Occup Med 1977;19:527-30.
.Fucic A, Vrhovac VG, Dimitrovic B, et al. The persistence of sister-chromatid exchange frequencies in men occupationally exposed to vinyl chloride monomer. Mutat Res 1992;281:129-32.
.Hrivnak L, Rozinova Z, Korony S, et al. cytogenetic analysis of peripheral blood lymphocytes in workers exposed to vinyl chloride. Mutat Res 1990;240:83-85.
.Awara WM, Ei-Nabi SH, Ei-Gohary M. Assessment of vinyl chloride-induced DNA damage in lymphocytes of plastic industry workers using a single-cell gel eletrophoresis technique. Toxicology 1998;128:9-16.
.Du CL, Kuo ML, Chang HL, et al. Changes in lymphocyte single strand breakage and liver function of workers exposed to vinyl chloride monomer. Toxicol Lett 1995;77:379-85.
.Wong RH, Wang JD, Hsieh LL, et al. Effects on sister chromatid exchange frequency of aldehyde dehydrogenase 2 genotype and smoking in vinyl chloride workers. Mutat Res 1998;420:99-107.
.Du CL, Chan CC, Wang JD. Comparison of personal and area sampling strategies in assessing workers’ exposure to vinyl chloride monomer. Bull Environ Contam Toxicology 1996;56:534-42.
.John JA, Smith FA, Leong BKJ, et al. The effects of maternally inhaled vinyl chloride on embryonal and fetal development in mice, rats, and rabbits. Toxicol Appl Pharmacol 1977;39:497-513.
.Ungvary G, Hudak A, Tatrai E, et al. Effects of vinyl chloride exposure alone and in combination with trypan blue-applied systematically during all thirds of pregnancy on the fetuses of CFY rats. Toxicology 1978;11:45-54.
.Edmonds LD, Anderson CE, Flynt JW Jr, et al. Congenital central nervous system malformations and vinyl chloride monomer exposure: a community study. Teratology 1978;17:137-42.
.Infante PF, Wagoner JK, McMichael AJ, et al: Genetic risks of vinyl chloride. Lancet 1976;1:734-35.
.Paddle GM: Genetic risks of vinyl chloride. Lancet 1976;1:1079.
.Lindbohm ML, Hemminki K, Kyyronen P. Spontaneous abortions among women employed in the plastics industry. Am J Ind Med 1985;8:579-86.
.Ahlborg G Jr, Bjerkedal T, Egenaes J. Delivery outcome among women employed in the plastics industry in Sweden and Norway. Am J Ind Med 1987;12:507-17.
.Hardell L, Ohlson CG, Fredrikson M. Occupational exposure to polyvinyl chloride as a risk factor for testicular cancer evaluated in a case-control study. Int J Cancer 1997;73:828-30.
.Ohlson CG, Hardell L. Testicular cancer and occupational exposures with a focus on xenoestrogens in polyvinyl chloride plastics. Chemosphere 2000;40:1277-82.
.Weinberg CR, Baird DD, Wilcox AJ. Sources of bias in studies of time to pregnancy. Stat Med 1994;13:671-81.
.Baird DD, Wilcox AJ, Weinberg CR. Use of time to pregnancy to study environmental exposures. Am J Epidemiol 1986;124:470-80.
.Joffe M. Time to pregnancy: a measure of reproductive function in either sex. Asclepios Project. Occup Environ Med 1997;54:289-95.
.Joffe M, Villard L, Li Z, et al. A time to pregnancy questionnaire designed for long term recall: validity in Oxford, England. J Epidemiol Community Health 1995;49:314-19.
.Guyton AC, Hall JE. Textbook of Medical Physiology 9th edition. Philadelphia: W.B. Saunders, 1996;1003:4.
.Norusis MJ/SPSS Inc. SPSS for Windows: Base System User’s Guide, Release 6.0. Chicago, IL: SPSS, Inc., 1992.
.Norusis MJ/SPSS Inc. SPSS for Windows: Advanced Statistics, Release 5. Chicago, IL: SPSS, Inc., 1992.
.黃郁芳。氯乙烯聚合工人尿中Thiodiglycolic acid之研究(碩士論文)。台北:國立台灣大學公共衛生學院職業醫學與工業衛生研究所,2000。
.黃文郁。臺灣地區婦女生育力參考曲線之建立(碩士論文)。台北:國立台灣大學公共衛生學院職業醫學與工業衛生研究所,1999。
.謝功毅。晶圓製造廠女性員工生殖健康之研究(碩士論文)。台北:國立台灣大學公共衛生學院職業醫學與工業衛生研究所,1998。
.Bracken MB, Hellenbrand KG, Holford TR. Conception delay after oral contraceptive use: the effect of estrogen dose. Fertil Steril 1990;53:21-27.
.Weinberg CR, Wilcox AJ, Baird DD. Reduce fecundabililty in women with prenatal exposure to cigarette smoking. Am J Epidemiol 1989;129:1072-78.
.Olsen J. Cigarette smoking, tea and coffee drinking, and subfecundity. Am J Epidemiol 1991;133:734-39.
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