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系統識別號 U0026-1302201416051800
論文名稱(中文) 電子設備的使用與孩童弭患氣喘及過敏性疾病和哮喘之相關性研究
論文名稱(英文) Association Between Usage of Electrical Equipment and Childhood Allergies and Asthma
校院名稱 成功大學
系所名稱(中) 環境醫學研究所
系所名稱(英) Institute of Environmental and Occupational Health
學年度 102
學期 1
出版年 103
研究生(中文) 貝琳答
研究生(英文) Belinda N. Makadia
電子信箱 belindamakadia2011@gmail.com
學號 S76017021
學位類別 碩士
語文別 英文
論文頁數 61頁
口試委員 指導教授-蘇慧貞
口試委員-張志欽
口試委員-郭炤裕
中文關鍵字 室內空氣  氣喘  過敏性鼻炎  濕疹  電子設備  揮發性有機化合物 
英文關鍵字 Indoor air  asthma  rhinitis  eczema  electrical equipment  VOC 
學科別分類
中文摘要 世界各地孩童氣喘及過敏性疾病之發病率出現令人擔憂的增長趨勢,探究可能因素,顯示環境暴露是考量遺傳因素後的一項重要影響因子。隨著科技的蓬勃發展,室內空間所使用的電器種類日漸繁多,然而由其衍生的汙染物是否貢獻於孩童過敏氣喘之發生仍是不清楚。因此本研究擬嘗試釐清2-6歲學齡前孩童罹患氣喘或其他過敏性疾病與其居家電器設備使用之關係。
本研究將透過2005年台南地區2-6歲學齡前孩童之健康及其居家生活環境品質之大規模問卷調查所累積收集的數據資料,進一步分析瞭解電器設備之使用與孩童罹患氣喘或過敏性疾病之間的關係。本研究有效問卷數為14862份,並使用卡方檢定找出與氣喘、過敏性鼻炎及濕疹有關的居家環境因子,再透過邏輯斯回歸模式校正相關影響因子,評估家中電器的使用對於過敏性疾病發生之風險。
在描述性統計部分,本研究有6482位男孩(51.5%)、6101位女孩(48.5%)其平均年齡為5歲,標準差為0.99。另外由醫師診斷確認的過敏性疾病-氣喘、過敏性鼻炎及濕疹這些其盛行率依序為9.3%、19.3%、17.6%。
本研究在單變量分析中發現使用真空吸塵器、空氣蒸汽增濕機、空氣清淨機、除濕機、負離子空氣清淨機和個人電腦會和至少兩種以上的過敏性疾病呈現顯著的正相關係(p-value < 0.005)。
在邏輯斯回歸模式校正性別、年齡、家族過敏性疾病史、抽菸等相關變數後,發現電子設備的使用與過敏性疾病的發生呈現統計上的正相關。空氣清淨機的使用與發生氣喘、過敏性鼻炎及濕疹其勝算比依序為1.46、1.347、1.192,所對應的p-value依序為小於 0.001、小於0.001、0.005。在空氣蒸汽增濕機的使用與發生過敏性鼻炎及濕疹其勝算比的部分依序為1.241、1.146、1.194,所對應的p-value依序為0.007、小於0.001、0.003。在使用負離子空氣清淨機與發生過敏性鼻炎及濕疹其勝算比的部分依序為1.314、1.335、1.310,所對應的p-value依序為0.008、小於0.001、小於0.001。另外在使用電視與發生濕疹的勝算比部分為1.230,所對應的p-value為0.002。
根據上述的統計結果發現,空氣清淨機、空氣蒸汽增濕機、負離子空氣清淨機與過敏性疾病呈現顯著的正相關。另外,有趣的是,在使用電視與個人電腦的部分也發現與過敏性疾病呈現正向的關係。本研究發現使用五到十年和使用十年以上的電視會增加學齡前孩童過敏性鼻炎的風險,其勝算比依序為1.286、1.255,所對應的p-value依序為0.024、0.047。在電腦部分,發現學齡前孩童一個禮拜平均使用電腦1.18個小時會增加發生氣喘的風險,其勝算比為1.021,相對的p-value為0.006。此外本研究也發現不同地點和氣喘與濕疹的發生也有關係。在敏感度分析中發現與先前研究的結論呈現一致性。另外發現在使用電視與過敏性鼻炎發生的交互作用分析中,發現男孩發生的風險大於女孩,其勝算比為1.347,對應的p-value為0.011。
總結來說,居家中電子設備的使用,可能會增加學齡前孩童發生過敏性疾病的風險,像是除濕機、空氣清淨機、負離子空氣清淨機和電視機的使用。
英文摘要 There is an alarming global increase in asthma and allergic disease incidences especially in children, an indication that the cause may be due to changes in environmental exposure rather than genetics. With modernization and improved technology, the indoor environment has had an influx of electrical equipment and appliances. However, there is little known about the effect on children’s health caused by electrical equipment and appliances. Therefore, this study aims to investigate the association between electrical equipment usage and childhood allergy and asthma.
We take advantage of data collected by structured questionnaire survey conducted in 2005 with the aim of identifying the relationship between indoor environmental quality in the home and preschool children’s health. A total of 14862 questionnaires were collected in preschool children aged 2-6 years in the greater Tainan metropolitan area of southern Taiwan. Chi-square tests were applied to assess the association between home characteristics and presence of asthma, allergic rhinitis, and eczema among participants. Besides, logistic regression models have been used to evaluate the risk of home electrical appliances with adjustments for gender, age, family history of allergic disease and smoking behavior.
The baseline descriptive statistics showed that there were 6482, boys (51.5%) and 6101 girls (48.5%) with a mean age of 5.0 years old (standard deviation= 0.99). The prevalence for doctor diagnosed asthma, doctor diagnosed allergic rhinitis and eczema in the last 6 months was 9.3%, 19.3% and 17.6% respectively.
Univariate analysis indicated that vacuum cleaner, humidifier, air cleaner, air humidifier, ionizer, television and Personal computer have positive associations with increased prevalence of at least two of the three diseases (p<0.005 for all variables). In adjusted logistic regression models, all electronics increase the odds of having all diseases outcome. Air cleaner is significant for asthma (OR: 1.46; p< 0.001), rhinitis OR: 1.347; p<0.001), eczema (OR: 1.192; p= 0.005), air humidifier is significant for asthma (OR: 1.241; p=0.007), rhinitis (OR: 1.416; p<0.001), eczema (OR: 1.194; p=0.003), Ionizer is significant for asthma (OR: 1.314; p=0.008), rhinitis (OR: 1.335; p<0.001), eczema (OR: 1.310; p<0.001).TV is significant for eczema (OR: 1.230; p=0.002).
Air cleaner, air humidifier, and ionizer showed statistical significant results. Interestingly, televisions and Personal computers showed positive associations with children’s allergic diseases. TV that is older than 5 years of age increases the risk of rhinitis significantly (6-10yrs, OR: 1.286; p=0.024, <10yrs, OR: 1.255; p=0.047). A child spending mean time of 1.18hours on a weekday with PC had an increased risk of asthma (OR: 1.021; p=0.006). The location and age of TV may also influence the occurrence of asthma and eczema. Sensitivity analysis made no significant change to previous results. Interaction analysis shows that TV affects more boys than girls in rhinitis occurrence (OR: 1.347; p=0.011).
In conclusion, electronic devices at home may be risk factors for allergic diseases, specifically air humidifier, air cleaner, ionizer and TV.
論文目次 TABLE OF CONTENTS
中文摘要 II
ABSTRACT IV
ACKNOWLEDGEMENTS VI
TABLE OF CONTENTS VII
LIST OF TABLES IX
LIST OF FIGURES X
CHAPTER ONE INTRODUCTION 1
1.1 Research Background 1
1.2 Prevalence of Allergic Diseases 1
1.3 Burden and Impact of Diseases 2
CHAPTER TWO LITERATURE REVIEW 4
2.1 Asthma. 4
2.1.1 Mechanism of asthma 4
2.1.2 Asthma Triggers: 6
2.2 Atopic Dermatitis/ Eczema 6
2.2.1 Description 6
2.2.2 Mechanism for Atopic Dermatitis 7
2.2.3 Triggers for AD 8
2.3 Allergic Rhinitis 8
2.3.1 Description 8
2.4 Allergies (Asthma, Rhinitis, Eczema) and Indoor Air 8
2.5 Problem Statement 9
2.5.1 Electronic Equipment at Home 9
2.5.2 Why Electronics?? 10
2.6 Objective 14
CHAPTER THREE RESEARCH DESIGN AND METHODOLOGY 15
3.1 Subject Selection 15
3.1.1 Who is at risk? 15
3.2 Study Design 16
3.2.1 Questionnaires 17
3.3 Statistical Analysis 19
CHAPTER FOUR RESEARCH RESULTS 22
CHAPTER FIVE DISCUSSION 27
5.2 Study subjects’ baseline characteristics effects on outcome. 27
5.2.1 Chi-Square tests for Electronic Effects 29
5.3 Television and Personal Computers 30
5.4 Sensitivity Analysis 31
5.5 Interactions 31
CHAPTER SIX CONCLUSION 33
6.1 LIMITATIONS 34
REFERENCES 35
TABLES OF STATISTICAL RESULTS 42
FIGURES 56
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