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研究生:陳芷凌
研究生(外文):TZU-NING CHEN
論文名稱:鉛暴露工人下一代神經行為發展評估之研究
論文名稱(外文):Neurobehavioral Deficits Among the Offspring of Lead Exposed Workers. A Feasibility Study.
指導教授:陳保中陳保中引用關係
指導教授(外文):Pau-Chung Chen
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:2003
畢業學年度:91
語文別:中文
論文頁數:64
中文關鍵詞:兒童神經行為測驗出生前暴露後來效應
外文關鍵詞:ChildrenLeadNeurobehavioral testPrenatal Exposure Delayed Effects
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環境與職業中的鉛暴露造成的健康效應在過去幾十年中已廣泛地被探討,鉛可能會對神經系統產生有害效應,並對認知、記憶力、智力等方面產生影響;但對於鉛暴露工人的下一代的健康效應則鮮少研究。本研究是回溯性世代研究,選定34位其父親在受孕期間或是母親在懷孕期間受到鉛暴露且年齡為六至八歲的小孩,個別進行問卷訪視以及神經行為的測量;此外,依照暴露來源分類:父親受暴露、母親受暴露以及雙親皆受到暴露,其血鉛平均值分別是23.3、14.0及25.5 g/dl。依據研究結果,連續性操作當中的按錯次數在不同暴露來源分組中會呈現出生前鉛暴露劑量越高,錯誤次數也有顯著地增加。第二部份為選一非工業區鄉鎮,並選定一間國民小學之一至三年級小朋友視為參考族群,進行相同的問卷以及神經行為測量。再依性別、年齡以1比4配對出136位小朋友作為本研究之非暴露組,比較兩組在控制其它變項後出生前鉛暴露與神經行為表現之相關性。有許多測驗項目包括手指敲擊、連續性操作、視覺數字反應以及圖像記憶等,在比較有無暴露兩組神經行為結果上有達到統計上顯著差異。本研究的結果指出出生前的鉛暴露對於後來的神經行為發展的影響在處理干擾因子後可能因為樣本數不足而無法看出效應。此外,本研究首次以電腦化「神經行為表現測驗」測量出生前鉛暴露對學齡時期孩童的神經行為發展情形,可能因為該工具對此劑量造成之效應敏感度不足所致。本研究限制主要是樣本數不足以及未取得出生後環境鉛暴露之直接生物指標。
Environmental and occupational lead exposure induced health effect has been widely explored in several decades. Lead might produce adverse effect to nervous system and influence cognition, memory and intelligence. However, few studies have yet investigated its effect on reproduction and potential effect on offspring. The present study was a retrospective cohort study. We selected 34 valid children whose ages were between six and eight years and one or both of their parents worked at lead battery factories before their deliveries. We individually interviewed their parents to complete questionnaire and conducted a neurobehavioral test using Chinese version neurobehavioral performance system (NES2). We used annual examination of blood lead and divided into three groups, namely, paternal, maternal and parental exposure whose mean blood lead were 23.3, 14.0 and 25.5μg/dl, respectively. The results showed error counts of continuous performance test would significantly increase with an elevation of prenatal lead exposure dose. Moreover, we selected the children of an elementary school in non-industrial area as a reference population. We used a 1:4 ratio of exposure to non-exposure subjects with same gender and age. These 136 children subgroup were considered as a non-exposure group. After controlling potential confounders there were significantly differences between exposure and non-exposure group in several test items such as finger tapping and continuous performance test. The study was the first time to measure neurobehavioral effect of prenatal lead exposure in school age. The results demonstrated prenatal lead exposure might induce minimal effect of lately neurobehavioral development. Our limited evidence may come from small sample size, lack of lead exposure data after delivery, and insensitive neurobehavioral measure for the lead effects.
Chinese Abstract i
English Abstract ii
Contents iii
Table Lists iv
Figure Lists v
1. Introduction 1
2. Material and Methods 4
2.1 The pilot study 4
2.2 Study Population 4
2.3 Lead Exposure Measures 5
2.4 Neurobehavioral Test 5
2.5 Potential Confounders 7
2.6 Statistical Analysis 7
3. Results 9
3.1 Neurobehavioral performances test 9
3.2 NES between exposure and non-exposure groups 9
4. Discussion 11
References 14
Appendix A 40
Appendix B. 46
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