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研究生:趙婉愉
研究生(外文):Wan-Yu Chao
論文名稱:鉛蓄電池廠員工子女齒鉛與神經行為發展研究
論文名稱(外文):Lead in Deciduous Teeth and Neurobehavioral Development in the Offspring of Workers in Lead Battery Factories
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:2004
畢業學年度:92
語文別:英文
論文頁數:60
中文關鍵詞:兒童乳齒神經行為測驗
外文關鍵詞:deciduous toothbehaviorchildleadneurobehav
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已知鉛可能會對兒童的神經發展造成危害,本研究以乳齒作為出生前後鉛暴露的指標,以區分出生前後的鉛暴露量對兒童神經行為發展相關性的影響。
本研究為回溯性世代研究,以鉛蓄電池廠員工在工作期間受孕,目前已7-10歲的兒童為暴露組﹔另外以相似城鄉發展為條件,選擇某國小同齡的兒童為參考族群。對研究對象施行電腦中文化神經行為測驗並收集基本問卷資料及乳齒,載暴露組共收集50顆牙齒,非暴露組96顆。齒鉛量測部份,以乳齒中不同部位鉛含量來劃分出生前後的鉛暴露,並使用感應耦合電漿質譜儀做齒鉛分析。神經行為測量方面,施行中文化神經行為測驗,量測的項目包括手指敲擊、連續性操作、視覺數字反應測驗、圖像比對、圖像記憶。本研究的干擾因子包括家長教育程度、家庭環境、教養方式等,我們則另外以面訪的方式用家庭環境量表取得相關資料。

以Student’s t test 分析暴露雨非暴露組出生前後齒鉛含量與神經行為測試的結果﹔且以Multiple linear regression控制兒童性別、年齡、家庭教養狀況、母親教育程度及玩電玩的經驗後做鉛暴露量與神經行為間相關性的分析。結果顯示出生後的鉛暴露量顯著比出生前高且暴露組的齒鉛值顯著高於非暴露組;在慣用手的手指敲擊和連續性測驗的遺漏次數上都與出生前後鉛暴露有顯著的相關。

依據本研究的結果和之前的文獻相比較,我們可以得知兒童受鉛暴露會影響神經行為測驗中的手指敲擊和連續性測驗。這顯示出小孩的視覺和動作反應會受到鉛暴露的影響,和先前的研究結果相符合。依據結果我們建議鉛蓄電池廠的員工應該多注意自身的衛生習慣以免提高其下一代的鉛暴露量。
As we know lead might affect the neurophysiological development of children. The purpose of this study was to identify the association between children’s neurobehavioral performance and the teeth level of prenatal and postnatal lead exposed. We used deciduous primary teeth to be prenatal and postnatal lead exposed biomarker.

Our study was a retrospective cohort study. We included the seven to ten years old children whose father or mother worked in battery factories during pregnancy period. Moreover we enrolled the children of an elementary school as the reference group, who lived in the similar development of the city as the exposure group. We tested the computerized Neurobehavioral Evaluation System 2 in Chinese version (CNES-2) and collected basic questionnaires and deciduous teeth. We collected 50 deciduous teeth of exposed group , and 96 deciduous teeth of reference group. The lead analyses of primary teeth used different part of the teeth to identify prenatal and postnatal lead exposed. The deciduous teeth used Inductively Coupled Plasma Mass Spectrometry (ICP-MS) to detect lead. In children neurobehavioral test, we used CNES2 and the items of testing included finger tapping, continuous performance test, visual digit span, pattern comparison, and pattern memory. The confounders of this study included maternal educational level, home environment, and parents rear. We used Home Observation for Measurement of the Environment scale (HOME scale) to interview and collect the information.

We used independent Student’s t test to compare the CNES2 results between exposure and non-exposure groups. After adjusted children sex, age, HOME scale, maternal educational level, and computer game experience, we used multiple linear regressions to analyze the relation between prenatal or postnatal teeth lead and CNES2. The results showed the postnatal teeth lead was significant higher than prenatal one. No matter pre or postnatal, there was significant higher level of lead in exposed and non-exposed group. The prenatal and postnatal teeth lead level showed reverse relationship to preferred hand of finger tapping and omission of continuous performance test.

According to our results, we found that lead exposure might influence children neurobehavioral performance expressed in finger tapping and continuous performance test. It might represent lead exposure will effect motor function and visual function. Base on the result we proposed the battery workers should attach important to their sanitary habits to avoid the increase of lead exposure to their children.
摘要 1
Abstract 2
Contents 4
List of Tables 5
List of Figures 6
Introduction 7
Material and Methods 9
Study Design and Study Population 9
Neuropsychological Testing 9
Lead Analysis in Teeth 10
Questionnaire 11
Home Observation for Measurement of the Environment Scale 12
Statistical Analysis 12
Results 14
Discussion 32
Conclusions 36
References 37
Appendix 1. Reference figure 42
Appendix 2. Reference tables 43
Appendix 3. 孩童健康調查問卷 50
Appendix 4. MC-HOME 55
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