噪音與有機溶劑之共同暴露對合成皮業勞工的動態血壓及心跳速率影響之研究

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題名:	噪音與有機溶劑之共同暴露對合成皮業勞工的動態血壓及心跳速率影響之研究
作者:	林首宇;Shou-Yu Lin
貢獻者:	中國醫藥大學：環境醫學研究所碩士班
關鍵詞:	職業噪音;有機溶劑;動態血壓;心跳速率;共同暴露;occupational noise;organic solvents;ambulatory blood pressure;heart rate;co-exposure.
日期:	2006-06-05
上傳時間:	2009-08-11 16:56:48 (UTC+8)
摘要:	目的：探討職業噪音與化學有機溶劑的共同暴露對於合成皮業勞工動態血壓及心跳的影響。方法：本研究以國內某家合成皮製造廠30名自願參與的員工為研究對象，根據個人噪音及個人的化學暴露將研究對象分為高噪音(≧80 dBA)低化學暴露(C1/TLV1+C2/TLV2+…≧0.1)、高噪音極低化學暴露(C1/TLV1+C2/TLV2+…<0.1)、低噪音(<80 dBA)低化學暴露與低噪音極低化學暴露四組。我們利用噪音劑量計測量個人的噪音暴露，同時讓參與者配帶動態血壓心脈偵測儀以記錄其24小時之動態血壓及心跳；並且以問卷及勞工健檢資料收集相關的干擾因子。我們利用混合式線性迴歸進行多變項分析，以控制相關的干擾因子。結果：我們發現高噪音低化學暴露組及高噪音極低化學暴露組在上班時間比低噪音極低化學暴露組有顯著較高的收縮壓(G1N,ALL:138.62±16.75 mmHg；G2 N,ALL:138.50± 115.94 mmHg；G4 N,ALL:125.68±15.86 mmHg)及有顯著較高的舒張壓(G1 N,ALL:83.82± 16.80 mmHg；G2 N,ALL:83.90± 13.49 mmHg；G4 N,ALL:74.78±1288 mmHg)，而且收縮壓及舒張壓隨著暴露程度的增加有上昇的趨勢；在心跳速率方面，只有高噪音極低化學暴露組在上班時間有顯著高於低噪音極低化學暴露組(G2 N,ALL:82.45± 12.90 BPM；G4 N,ALL:75.99± 12.74 BPM)。結論：噪音與有機溶劑之共同暴露會影響合成皮業勞工之動態血壓和心跳速率，並且噪音暴露的影響明顯高於有機溶劑的暴露。同時噪音與有機溶劑之共同暴露可能會對於血壓及心跳速率產生加成的效應。 Objectives: The aim of this study was to investigate health effects of co-exposure to noise and organic solvents on ambulatory blood pressure and heart rate among synthetic leather workers. Methods: We recruited 30 volunteers of a synthetic leather manufacturing company with 75 employees as our studying subjects. We classified these 30 workers to four different-exposure groups based on their individual exposure of noise and organic solvent during their working periods. The four groups were high-noise(≧80 dBA) and low-chemical exposure group(C1/TLV1+C2/TLV2+…≧0.1), high-noise and extremely low-chemical exposure group(C1/TLV1+C2/TLV2+…<0.1), low-noise(<80 dBA) and low-chemical exposure group, and low-noise and extremely low-chemical exposure group. We used the Logging Noise Dose Meter (Type 4443) to determine each subject’s noise exposure and measured individual ambulatory blood pressure and heart rate by carrying the DynaPulse 5000A simultaneously for 24 hours. We collected some confounders by self-administered questionnaire and their health checkup results. Linear mixed-effecs regression models were used to analyze effects of co-exposure between different-exposure groups by controlling related confounders. Results: We found that high-noise and low-chemical exposure group and high-noise and extremely low-chemical exposure group had significantly higher systolic blood pressure than the low-noise and extremely low-chemical exposure group during the working period (G1 N,ALL:138.62±16.75 mmHg；G2 N,ALL:138.50± 115.94 mmHg；G4 N,ALL:125.68±15.86 mmHg). Similarly, the diastolic blood pressure was significantly higher in high-noise and low-chemical exposure group and high-noise and extremely low-chemical exposure group than in the low-noise and extremely low-chemical exposure group (G1 N,ALL:83.82± 16.80 mmHg；G2 N,ALL :83.90±13.49 mmHg；G4 N,ALL:74.78±1288 mmHg). Workers’ Systolic and diastolic blood pressures increased with the level of noise or chemical exposure. However, only the high-noise and extremely low-chemical exposure group had the significantly higher heart rate than the low-noise and extremely low-chemical exposure group during the working period (G2 N,ALL:82.45± 12.90 BPM；G4 N,ALL:75.99± 12.74 BPM). Conclusion: Co-exposure to noise and organic solvents can affect the ambulatory blood pressure and heart rate among synthetic leather workers. Noise exposure may have obviously higher effect than chemical exposure.There were synergistic effects on ambulatory blood pressure and heart rate when synthetic leather workers co-exposed to noise and organic solvents.
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