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研究生:楊世寬
研究生(外文):Shih-Kuan Yang
論文名稱:空氣污染物與幼兒神經行為發展之相關性
論文名稱(外文):The Relationship between Ambient Air Pollutants and Early Childhood Neurobehavioral Development
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:2008
畢業學年度:96
語文別:英文
論文頁數:70
中文關鍵詞:空氣污染神經行為發展孕程階層式分析
外文關鍵詞:air pollutionneurobehavioral developmenttrimestemultilevel analysis
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背景:目前已知暴露於空氣污染物將對於人體健康造成不良影響,但是空氣污染物對新生兒的神經行為發展的影響,目前仍有許多未知。
目標:探討母親於懷孕期間各孕程以及胎兒出生後主動暴露於空氣污染,對於幼兒早期神經行為發展之影響。
方法:本研究於2003年11至12月於台灣11鄉鎮收集的533對的母親以及其新生兒。並分別於其6個月以及18個月大時進行家訪,蒐集問卷及神經行為發展量表等資料。連結空氣污染監測站資料後,計算每位研究對象懷孕期間各孕程及嬰幼兒出生至6個月、7至12個月以及13至18個月大時之一氧化碳、臭氧、粒狀污染物 (氣動直徑 ≤ 10μm)、二氧化硫、二氧化氮以及碳氫化合物暴露之平均濃度。最後,利用階層分析模式控制可能干擾因子後,評估空氣污染暴露對嬰幼兒早期神經行為發展之影響。
結果:母親懷孕期間各孕程及嬰幼兒出生後12個月大前暴露於二氧化硫對於兒童18個月時之細動作分數有顯著不良的影響 (第一孕程β=-0.083 se = 0.030; 第二及三孕程β=-0.114 se = 0.045; 出生後至十二個月β=-0.091 se = 0.034)。此外,母親懷孕第二與第三孕程暴露非甲烷類碳氫化合物則對兒童六個月之粗動作發展分數有顯著之不良影響 (β=-8.742 se=3.512)。其餘污染物對於嬰幼兒之神經行為發展則沒有發現顯著不良之影響。
結論:母親懷孕期間各孕程及新生兒12個月前暴露於低濃度之二氧化硫對於幼童18個月之細動作表現可能有不良之影響。母親懷孕第二及第三孕程暴露於非甲烷類碳氫化合物,對與幼兒六個月時之粗動作表現亦有可能產生不良影響。
BACKGROUND: It is widely acclaimed that air pollution can cause adverse health effects. However, the impact of air pollution exposure on neurobehavioral development in children still remains unclear.
OBJECTIVE: To investigate the relationship between the ambient levels of air pollutants exposure during prenatal and postnatal stages and early childhood neurobehavioral development.
METHODS: We recruited 533 mother-infant pairs from 11 towns in Taiwan from November to December, 2003. All study subjects were requested to complete the childhood neurobehavioral development scales and questionnaires when their children were at the ages of 6 months and 18 months, respectively. Air pollutants, including particulate matter ≤10 μm (PM10), carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and hydrocarbons, were measured at air quality monitoring stations within the same towns where the subjects inhabit. We used multilevel analysis to assess the association between average exposure levels of air pollutants and early childhood neurobehavioral development at different trimesters during pregnancy and children at the ages of 0 to 6, 7 to 12, and 13 to 18 months, respectively.
RESULTS: We found that at the age of 18 months, adverse fine motor score was associated with the average levels of exposure to SO2 during pregnancy of all trimesters and postnatal age before 12 months ( first trimesterβ=-0.083 se = 0.030; second and third trimesterβ=-0.114 se = 0.045; from birth to children twelve months of age β=-0.091 se = 0.034 ). Furthermore, the adverse gross motor score at the age of six months was associated with the increased average level of NMHC at the 2nd and 3rd trimesters (β=-8.742 se=3.512 ).
CONCLUSIONS: Low level SO2 exposure during prenatal and postnatal age before twelve months can cause adverse neurobehavioral development at 18 months of age. Maternal NMHC exposure during 2nd and 3rd trimesters of pregnancy was also associated with poor gross motor development at 6 months of age of early childhood.
摘要 2
Abstract 4
List of Tables and Figures 8
Introduction 9
Material and methods 12
Study population 12
Exposure assessment 12
Data collection 14
Neurobehavioral development 15
Statistical analysis 16
Results 18
Study subjects 18
Exposure to pollution 18
Multilevel analysis 18
Discussions 21
Main finding 21
Strength 21
Exposure 22
Outcome 22
Mechanism 23
Limitation 26
Comparison with other studies 27
References 36


Appendix 1 43
Appendix 2 44
Appendix 3 47
Appendix 4 50
Appendix 5 53
Appendix 6 60
Appendix 7 61


List of Tables and Figures

Table 1 Characteristic of study subjects 29
Table 2 Mean and standard deviation of air pollutant concentrations at different periods 30
Table 3 Multilevel analysis of single air pollutant and neurodevelopment scores at six months of age 31
Table 4 Multilevel analysis of single air pollutant and neurodevelopment scores at eighteen months of age 33

Figure 1 SO2 exposure versus fine motor scores at 18 months of age. 35
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