||Self-reported health of tour managers in Taiwan
||Institute of Environmental and Occupational Health
本研究共收案390名，其中包括內勤行政人員238名、兼職領隊95名、專任領隊57名。行政人員以女性為多(73.1%，領隊組為52.0%，p值< 0.001)。領隊組年紀較長(平均46.8歲，相較行政人員平均34.2歲，p值< 0.001)、教育程度較高(p值=0.011)、有較高的飲酒比率(p值=0.004)、且上班日較少的睡眠時間(平均5.8±1.3小時，相較行政人員平均6.9±1.2小時)；身體質量指數(BMI)及抽菸比例則在二組無明顯差異。
Although travel is associated with obvious health hazards such as infection, circadian rhythm disruption, and vehicle sickness, there are few studies on the health conditions of tour managers, who are frequently exposed to these hazards. Therefore, we conducted a survey on health conditions of tour agency employees in Taiwan.
We adopted a cross-sectional study design and recruited tour managers and office staff in tour agencies. With assistance of the Association of Tour Managers, Taiwan, a local trade association of travel agents, and a tour company, we sent anonymous questionnaires to the participants, which collected data on demographic characteristics, medical history, symptoms, and concepts of occupational health. The study period was from Oct. 2014 to Feb. 2015. We used logistic regression models to evaluate relationship between work exposure and health outcomes. The data were analyzed using software SPSS V17.0.
#Results and Discussion
There were a total of 390 respondents, including 238 office staff, 95 part-time tour managers, and 57 full-time tour managers. We found a female predominance in the office staff (73.1% versus 52.0%, p < 0.001). Tour managers were older (average 46.8 versus 34.2 years old, p < 0.001) and had higher education levels (p = 0.011). Tour managers had higher prevalence of alcohol consumption (p = 0.004) and slept less during a typical work day (average 5.8±1.3 versus 6.9±1.2 hours). There was no significant difference in the body mass index (BMI) and smoking history between the two groups. As to health outcomes, tour managers were more likely to have gastroesophageal reflux disease (GERD) (odds ratio [OR]: 3.8, 95% confidence interval [CI]: 1.2-11.7) and lower back pain (OR: 6.1, 95% CI : 1.6-23.9), after adjusting forsex, age, education level, and alcohol consumption. Furthermore, the prevalence of peptic ulcer/gastritis, GERD, and lower back pain increased as the weighted job tenure increased (all with p <0.05 for test for trend). In further analyses of data on tour managers, we found those who managed tours to North-East Asia reported more recent coughs (OR: 14.8, 95%CI: 3.1-70.7), after adjusting for effect of multiple tour-leading areas, sex, age, BMI, educational level, smoking, and alcohol consumption. As for concepts of occupational health, tour managers did better than office staff, regarding regular health check-up, seeking for health information before traveling, and seeking for advice from travel medicine specialists (all p<0.05), while only 19.9% tour managers sought for advice from travel medicine specialists.
The study found higher prevalence of self-reported GERD and lower back pain among tour managers compared to office staff. We also found that as the duration of being a tour manager increased, peptic ulcer/gastritis, GERD, and lower back pain were more likely to be reported. In addition, tour managers managing tours to North-East Asia reported more coughs in the past three months.
摘 要 i
誌 謝 iii
目 錄 iV
表 目 錄 Vi
本 文 1
I. Introduction 1
A. Background and motivation 1
B. Research questions 2
II. Literature review 2
A. Health problems among travelers 2
B. Health problems among flight attendants 4
1. Respiratory system 4
2. Malignancy 5
3. Mental conditions 5
4. Cardiovascular system 6
III. Significance 6
A. Objectives 6
B. Significance 6
IV. Materials and methods 7
A. Study structure and study design 7
1. Tour manager 7
2. Office staff in tour agencies 7
3. Questionnaire survey 7
4. Health outcome comparison 7
5. Other comparison 8
B. Statistical analysis 8
C. Ethical statement 8
V. Results 9
A. Respondent 9
B. Demographic data and personal factors 9
C. Health outcomes 10
1. Self-reported diseases 10
2. Self-reported symptoms in recent three months 10
D. Test for trend 11
1. Categorized by the proportion of working as a tour manager in the whole career 11
2. Categorized by adjusted job tenure of working as a tour manager 11
E. Comparison between main tour-leading areas 12
1. Demographic data and personal factors of tour managers with different tour-leading areas 12
2. Comparisons of self-reported health outcomes of tour managers with different tour-leading areas 12
F. Concepts of occupational health 13
1. Regular health check-up 14
2. Insights of health conditions 14
3. Health behaviors of traveling 14
VI. Discussion 14
A. Health problems amongst tour managers 15
B. Comparison between different tour-leading areas 19
C. Concept of occupational health amongst tour managers 20
D. Limitations of the study 22
E. Further efforts warranted 23
附 錄 - 旅遊從業人員健康狀況調查問卷 46
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