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研究生:任鈺鈴
研究生(外文):Jen,Yu-ling
論文名稱:潛在暴露於含氯碳氫化合物污染地下水與居民下一代早產之研究
論文名稱(外文):The Study of Preterm Delivery among the Offspring of Residents Potentially Exposed to Groundwater Contaminated with Chlorinated Hydrocarbons
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:76
中文關鍵詞:含氯碳氫化合物地下水居民早產
外文關鍵詞:Chlorinated HydrocarbonsGroundwaterResidentsPreterm delivery
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目的:探討受含氯碳氫化合物污染地下水暴露之社區居民其新生兒出生異常結果與嬰兒死亡率是否較高。
材料與方法:本研究使用內政部1978至1997年的「出生發生登記檔」,選取戶籍登記村里為RCA桃園廠所在地村里及其週邊村里的新生兒為研究對象,並將年份劃分為1978至1982年、1983至1987年、1988至1992年、以及1993至1997年等四個年代。依照地下水流動方向進行暴露分層:居住在RCA桃園廠所在地村里為高暴露區,其地下水下游村里為低暴露區,地下水上游村里為對照區。為釐清職業上潛在的含氯碳氫化合物暴露對新生兒出生異常結果的影響,研究的族群中排除了父母親任何一方曾為該工廠員工之新生兒。分析四個年代中各暴露區域低出生體重及早產之盛行率,並以多變項邏吉斯迴歸(multiple logistic regression)調整新生兒性別、胎次、母親婚姻狀況、母親生育年齡、母親教育程度、及母親職業等出生異常危險因子,以探討地下水污染與低出生體重及早產之關係。
結果:在新生兒出生的基本資料中,嬰兒性別、接生者身分、母親生育年齡等在各年代中各區域並無差異;父母親教育程度在高暴露區較高,父母親職業在高暴露區中屬於白領階級的比例較高。在新生兒出生異常結果分析中低出生體重、嬰兒死亡的相對危險性在高低暴露區中皆沒有統計上顯著差異;控制早產相關危險因子之後,在1988至1992年間,高暴露區早產之勝算比為1.67(1.03-2.71);低暴露區與對照區相較,其早產之勝算比為1.57(95﹪信賴區間為1.07-2.30)。在1993至1997年間,高暴露區早產之勝算比為1.60(1.14-2.24);低暴露區與對照區相較,其早產之勝算比為1.23(0.91-1.65)。
結論:潛在暴露於含氯碳氫化合物污染地下水之社區居民其下一代早產的相對危險性較高,但仍需進一步調查以釐清早產相關危險因子的影響。
This study was to determine whether there was an increased risk of having an adverse birth outcome and infant mortality among the residents who lived in a community where the groundwater was contaminated with chlorinated organic solvents by a manufacturing factory.
We used the birth registration data, between 1978 and 1997, to identify singletons born to parents living in villages around the factory. Based on the groundwater hydrogeology, we classified study villages into three areas, factory located as a high-exposure area, those in the downstream as low-exposure areas, and those in the upstream as reference areas. The factory workers were excluded to control the exposure source from the groundwater. Associations between the exposure area and adverse birth outcomes were determined by four periods 1978-82,1983-87,1988-92, and 1993-97.
Parents in high-exposure areas received more education and were more likely with white collar occupation than parents in low-exposure areas and reference areas. The relative risks for low birth weight, and infant mortality in high-exposure area were not statistically significant different from other two areas. After controlling for infant sex, parity, maternal marital status, maternal age at birth, maternal education, and maternal occupation, the adjusted odds ratio for preterm delivery among the high-exposure and low-exposure areas during 1988-92 were 1.67 (95% CI=1.03-2.71) and.1.57 (95% CI=1.07 — 2.30). During 1993-97, the adjusted odds ratio for preterm delivery among the high-exposure and low-exposure areas during 1988-92 were 1.60 (95% CI=1.14 - 2.24). and 1.23 (95% CI=0.91 — 1.65).
It was concluded that there might be an increased risk of having a preterm birth to residents who lived in a community with chlorinated organic solvents contaminated groundwater.
中文摘要I
英文摘要II
目錄III
表列V
圖列VI
壹、前言1
貳、研究目的3
參、文獻探討4
一、水污染相關的流行病學4
二、含氯碳氫化合物的生殖危害探討8
肆、材料與方法10
一、暴露評估10
二、研究族群12
三、資料庫的使用14
四、統計分析17
肆、結果21
一、暴露區的定義21
二、含氯碳氫化合物暴露世代之描述26
三、社區居民下一代之出生異常結果26
伍、討論26
陸、結論26
參考文獻26
附錄26
附錄一 目前地下水污染案件之摘要表及個案26
附錄二 工研院調查採樣之範圍26
附錄三 自來水優先接管範圍26
附錄四 台北盆地、桃園台地地下水位站井況26
附錄五 台灣地區早產及低出生體重盛行率、嬰兒年齡別死亡率26
附錄六 各地下水位站年平均水位(公尺, M)26
附錄七 RCA廠附近水樣三氯乙烯、四氯乙烯分析結果26
附錄八 RCA附近水井分析濃度26
附錄九 現行嬰兒出生申請登記流程圖26
附錄十 早產的危險因子─流行病學研究26
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