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作者:顏敏如
作者(外文):Min-Ju Yen
論文名稱:台北市計程車駕駛心血管疾病危險因子之橫斷性研究
論文名稱(外文):A Cross-Sectional Study on the Risk Factors of Cardiovascular Disorders in Taipei City Taxi Drivers
指導教授:張武修
指導教授(外文):Wushou P. Chang
學位類別:碩士
系所名稱:環境與職業衛生研究所
學號:880l08
出版年:90
畢業學年度:89
語文別:中文
中文關鍵詞:計程車駕駛員心臟血管相關疾病健康風險
外文關鍵詞:taxi driversoccupation-related cardiovascular disorders
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根據交通部於88年8月底的資料顯示,全台共有11萬1,051輛計程車,其中登記於台北市的計程車有37,325輛,約佔台灣地區的33.6 ﹪,截至目前為止針對此一大特殊職業族群的健康情形及可能的相關職業健康危害研究尚無系統全面的詳細研究;因此,本研究即針對計程車駕駛員可能與職業狀況有關之心臟血管相關疾病健康風險進行深入的探討。 此研究採用橫斷性研究,自89年1月至5月底截止採用台北市計程車駕駛員依自願於五家市區醫院進行職業健康檢查與自填職業衛生問卷資料,並依據世界衛生組織「多國合作監視心臟血管疾病走向及其決定因子計劃」研究結果判斷罹患心臟血管相關疾病之風險,進而分析職業工作狀況對其心臟血管系統可能造成之健康影響。
研究個案共1,720位,其中男性1,639位( 95.3 ﹪),女性81位( 4.7 ﹪),平均年齡37.6歲(標準差9.4歲),心電圖檢查異常共519人異常( 30.2 ﹪),心臟血管疾病危險因子中高血壓、空腹血糖檢查、血清總膽固醇、三酸甘油脂、尿酸異常率分別為 15.4、 8.8、 57.6、 27.0及 55.3 ﹪,經單變項邏輯迴歸分析發現心電圖檢查異常與身體質量指數、高血壓、飯前血糖、血清總膽固醇呈顯著相關(p<0.05),心臟血管疾病危險因子分別與職業型態分析後發現皆與工作年資呈現相關(p<0.01),並隨著工作年資愈久、每週工作時數愈長其心血管危險因子異常之相對危險性愈高,但與每天工作時數無關。進一步利用邏輯迴歸分析心臟血管疾病危險因子與其基本工作狀況發現,心臟血管疾病危險因子之相對危險性與工作年資、每週工作日數、每週工作時數呈現正相關。
本研究發現台北市計程車駕駛員之罹患心臟血管相關疾病之風險與其執業型態有關,從事計程車駕駛工作年資愈長、每週工作時數愈長,駕駛員其心臟血管危險因子有相對危險性之增加,換言之,其可能罹患心臟血管相關疾病之風險即較高;另因罹患心臟血管相關疾病之因素、相關及干擾之因子眾多,如何控制及排除非職業相關因素、僅有一次健康檢查資料數據及對照族群尋找之不易為此研究之限制,因此研究結果僅提供相關研究之初步參考及提供台北市計程車駕駛員職業衛生上之建議。
Based on the data from the Bureau of Transportation, there are 111,051 Taxi drivers in Taiwan in August 1999. In them, 37,325 are registered in Taipei City. However, no study has been aimed at the health condition and related occupational health on this particular working group in Taiwan. We in this cross-sectional study aim to evaluate the risks of occupation-related cardiovascular disorders in these taxi drivers. Since early 2000, the registered taxi drivers in Taipei City were provided with a comprehensive free occupational health surveillance by the Bureau of Transportation in 5 main hospitals in Taipei. They chose any one of the five hospitals and were requested to complete a self-filling occupational history questionnaire by themselves. Those individuals which were with cardiovascular health risk according to the criterion of the MONICA project of WHO were then evaluated for risks from their occupation or ob-job labor pattern. This study is a cross-sectional study. Taipei Taxi drivers chose any one of the five hospitals to have an occupational health examination and writing a questionnaire by themselves. And we chose the individual which may have the cardiovascular health risk according to the criterion from 「MONICA project」of WHO , then , analyses the relation between health examination results and questionnaires , and the health effect caused from occupational situation .
A total of 1,720 taxi drivers were included in this analysis, with 1,639 (95.3%) male subjects and 81 (4.7%) female subjects and the mean age of 37.6 years old (1 standard deviation as 9.41). In them, 519 taxi drivers were diagnosed preliminarily with abnormal EKG finding. Abnormal cardiovascular risks identified in them included increased blood pressure (15.4%), post-prandial hyperglycemic (8.8%), elevated total cholesterol (57.6%), elevated high triglycerides (27.0%), and hyper-uricemia (55.3%). By multi-logistic regression analysis, the body mass index (BMI), elevated blood pressure (HBP), abnormal post-prandial glucose, and elevated cholesterol levels are significantly associated with risk of abnormal EKG finding (p<0.05), and years of work as taxi driver (p<0.00).
The taxi drivers in Taipei may carry higher risks of cardiovascular diseases and these risks might be related to some occupational patterns in their daily driving practices just like working years, driving hours per day, working days per week, and working hours per week. The study finds the driver who has worked as Taxi driver many years may have higher risk of cardiovascular diseases.
Therefore, the study suggests that 5 days and 40 hours per week is the best way for these Taxi drivers to avoid having risk of cardiovascular diseases.
一、前言...............................................1 1.1台灣地區計程車概況介紹..............................2
1.2研究背景............................................3
1.3研究目的............................................4
二、文獻探討...........................................5
2.1癌症研究............................................5
2.2健康狀況調查........................................7
2.3環境與職業暴露研究..................................9
2.4心臟血管疾病研究...................................10
2.5心臟血管相關疾病簡介與危險指標探討.................12
三、材料與方法........................................16
3.1研究族群...........................................16
3.2資料收集方法.......................................17
3.3心臟血管疾病相關危險因子定義.......................19
3.4統計分析方法.......................................20
四、研究結果..........................................23
4.1基本人口學特性.....................................23
4.2基本職業健康檢查分析...............................25
4.3執業型態與心血管疾病相關指標關係分析...............27
4.4執業型態對心臟血管疾病相關指標關係之相對風險分析...28
五、討論與結論........................................31
5.1研究族群選擇討論...................................31
5.2心血管風險預測限制之討論...........................32
5.3計程車駕駛心血管相關疾病危險因子與職業型態之探討...33
5.4職業健康之相關討論.................................38
5.5結論...............................................39
參考文獻..............................................41
1. 陳俊良. 1995. 台北市公車司機職業健康調查研究.國立陽明大學公共衛生研究所碩士論文.
2. 杜宗禮、許嘉和 .1996.台灣地區勞動工作者營養狀況和慢性疾病研究.行政院勞委會勞工安全衛生研究所.
3. 張武修. 2000.台北市計程車駕駛員健康檢查研究.台北市政府交通局委託計劃.
4. 張武修、陳秋蓉. 2000.台北市計程車司機職業安全調查.行政院勞委會勞工安全衛生研究所委託計劃.
5. Balarajan R , McDowall ME, Professional drivers in London: a mortality study. British Journal of Industrial Medicine, 1988. 45(7):483-6.
6. Borgia P, Forastiere F, Rapiti E, Rizzelli R, Magliola M E, Perucci C A, Axelson O, Mortality among taxi drivers in Rome: a cohort study. American Journal of Industrial Medicine, 1994. 25(4):507-17.
7. Rafnsson V ,Gunnarsdottir H, Mortality among professional drivers. Scandinavian Journal of Work, Environment & Health, 1991. 17(5):312-7.
8. Jakobsson R, Gustavsson P, Lundberg I, Increased risk of lung cancer among male professional drivers in urban but not rural areas of Sweden. Occupational & Environmental Medicine, 1997. 54(3):189-93.
9. Hansen J, Raaschou-Nielsen O, Olsen J H, Increased risk of lung cancer among different types of professional drivers in Denmark. Occupational & Environmental Medicine, 1998. 55(2):115-8.
10. Ueda T, Hashimoto M, Yasui I, Sunaga M, Higashida T, Hara I, A questionnaire study on health of taxi drivers--relations to work conditions and daily life. Sangyo Igaku - Japanese Journal of Industrial Health, 1989. 31(3):162-75.
11. Ueda T, Hashimoto M, Kosaka M, Higashida T, Hara I, Kurimoto T, A study on work and daily life factors affecting the health of taxi drivers. Nippon Koshu Eisei Zasshi - Japanese Journal of Public Health, 1992. 39(1):11-21.
12. Nakano Y, Nakamura S, Hirata M, Harada K, Ando K, Tabuchi T, Matunaga I, Oda H, Immune function and lifestyle of taxi drivers in Japan. Industrial Health, 1998. 36(1):32-9.
13. Dalziel J R ,Job R F, Motor vehicle accidents, fatigue and optimism bias in taxi drivers. Accident Analysis & Prevention, 1997. 29(4):489-94.
14. Maag U, Vanasse C, Dionne G, Laberge-Nadeau C, Taxi drivers' accidents: how binocular vision problems are related to their rate and severity in terms of the number of victims. Accident Analysis & Prevention, 1997. 29(2):217-24.
15. Backman A L ,Jarvinen E, Turnover of professional drivers. Scandinavian Journal of Work, Environment & Health, 1983. 9(1):36-41.
16. Figa-Talamanca I, Cini C, Varricchio G C, Dondero F, Gandini L, Lenzi A, Lombardo F, Angelucci L, Di Grezia R, Patacchioli F R, Effects of prolonged autovehicle driving on male reproduction function: a study among taxi drivers. American Journal of Industrial Medicine, 1996. 30(6):750-8.
17. Zayed J, Gerin M, Loranger S, Sierra P, Begin D, Kennedy G, Occupational and environmental exposure of garage workers and taxi drivers to airborne manganese arising from the use of methylcyclopentadienyl manganese tricarbonyl in unleaded gasoline. American Industrial Hygiene Association Journal, 1994. 55(1):53-8.
18. Zayed J, Mikhail M, Loranger S, Kennedy G, G L E, Exposure of taxi drivers and office workers to total and respirable manganese in an urban environment. American Industrial Hygiene Association Journal, 1996. 57(4):376-80.
19. Kapaki E N, Varelas P N, Syrigou A I, Spanaki M V, Andreadou E, Kakami A E, Papageorgiou C T, Blood lead levels of traffic- and gasoline-exposed professionals in the city of Athens. Archives of Environmental Health, 1998. 53(4):287-91.
20. Rosengren A, Anderson K, Wilhelmsen L, Risk of coronary heart disease in middle-aged male bus and tram drivers compared to men in other occupations: a prospective study. International Journal of Epidemiology, 1991. 20(1):82-7.
21. Gustavsson P, Alfredsson L, Brunnberg H, Hammar N, Jakobsson R, Reuterwall C, Ostlin P, Myocardial infarction among male bus, taxi, and lorry drivers in middle Sweden. Occupational & Environmental Medicine, 1996. 53(4):235-40.
22. Paradis G, Theriault G, Tremblay C, Mortality in a historical cohort of bus drivers. International Journal of Epidemiology, 1989. 18(2):397-402.
23. Tuchsen F, Bach E, Marmot M, Occupation and hospitalization with ischaemic heart diseases: a new nationwide surveillance system based on hospital admissions. International Journal of Epidemiology, 1992. 21(3):450-9.
24. Hedberg G E, Jacobsson K A, Janlert U, Langendoen S, Risk indicators of ischemic heart disease among male professional drivers in Sweden. Scandinavian Journal of Work, Environment & Health, 1993. 19(5):326-33.
25. 王宗道.1990.簡明病理學. 合計書局.
26. 林依萍. 1994. 社區個案心電圖ST段下降及T波倒置之心肌缺血特徵及臨床診斷之缺血性心臟病之多重危險因子病例對照研究.國立台灣大學公共衛生研究所碩士論文.
27. 吳德朗.冠狀動脈疾病的診斷及治療.長庚護理. 1995. 6 (2).
28. Andersen, P., et al., Hyperlipoproteinaemia and reduced fibrinolytic activity in healthy coronary high-risk men Plasma triglycerides: a cardiovascular risk factor?Twenty-five-year mortality follow-up in the Belgian Bank Study Long-term epidemiologic prediction of coronary disease. The Framingham experience. Acta Medica Scandinavica, 1981. 209(3): 199-202.
29. Kannel, W.B. and M. Larson, Long-term epidemiologic prediction of coronary disease. The Framingham experience. Cardiology, 1993. 82(2-3): 137-52.
30. Ding, Y.A., Plasma triglycerides: a cardiovascular risk factor? Chung Huai Hsueh Tsa Chih - Chinese Medical Journal, 1992. 49(5): 297-302.
31. Kornitzer, M., et al., Twenty-five-year mortality follow-up in the Belgian Bank Study. Cardiology, 1993. 82(2-3): 153-71.
32. 戴基福. 2000.職業流行病學標準對照人口資料之建立.行政院勞委會勞工安全衛生研究所.
33. WHO, MONICA Manual. 1998: WHO.
34. 莊人祥. 1994.金門冠狀動脈心臟疾病危險因子之盛行率及影響調查.國立陽明大學公共衛生研究所碩士論文.
 
 
 
 
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