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  • 學位論文

汞齊合金之使用對牙科醫護人員的相關性探討

The effect of mercury alloy on dental professionals

指導教授 : 黃純德
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摘要


背景: 汞在環境中無所不在,人類知道且使用這種液體金屬元素已有幾千年的歷史了。汞齊合金(Amalgam)又稱為『銀粉』,是以一種或多種金屬與汞混合而成的合金,在牙科主要是後牙窩洞之填補,然而最大的問題是汞齊裡含有汞金屬及其潛在的毒素。汞是屬於毒性極強的重金屬物質,依其存在的型態而異,其毒性之高低則不同,汞齊的使用對於牙科醫謢人員否是會造成危害,這都是值得關切的問題。研究結果將有助於瞭解牙科醫護人員,在使用接觸汞齊之下,體內所累積的汞含量,並可做為汞暴露早期的健康指標。 研究目的: 擬瞭解牙科醫護人員年資、汞齊接觸狀況及使用與尿液、頭髮中總汞濃度之相關因素。 研究方法: 採橫斷研究並且配合問卷調查及尿液、頭髮生化檢驗之方式進行,樣本為台南縣(市)、高雄縣(市)牙醫師公會會員名冊之牙醫師及助理為研究對象,以隨機取樣的方式選出樣本,並以電話詢問參與者之意願,同意受訪才列為研究對象。問卷及實驗所得資料先鍵入Microsoft Excel資料庫,並以JMP5.1.2統計軟體進行統計分析。 結果: 本次研究共收集到126位牙科醫護人員之問卷、生化檢體,男生有55人;女生有71人。牙醫師共有75人;牙科助理51人。經由冷蒸氣原子吸收光譜儀的偵測所得到總汞濃度,尿液部份:牙醫師平均濃度為4.03μg/l,助理平均濃度為0.43μg/l,牙醫師尿液中汞濃度確實比助理高;頭髮部份;牙醫師平均濃度為0.15μg/g,助理平均濃度0.00μg/g。而汞齊每週填補(接觸)平均顆數、口罩使用狀況、牙齒是否有填補汞齊、遠洋魚類食用及性別、年齡、年資等變項與尿液及頭髮中總汞濃度均有相關性影響(p-value<0.05)。 結論: 本次研究結果牙醫師尿液及頭髮中汞濃度確實比助理來的高,但其濃度均屬安全範圍值之內。汞齊所釋放出微量的汞而被身體所吸收,但現有的相關數據尚未明確證實是否對人體的健康造成危害。潛在的健康影響在於吸收的源頭,進而需要更多相關的研究。牙材汞齊之使用導致汞蒸氣對於牙科團隊的汞暴露,因此謹慎使用將是有效的防止汞暴露,如加強個人職業衛生習慣的重要性、診間通風狀況等,汞齊接觸時應配戴能有效的防護措施如以有效的隔絕汞蒸氣。

並列摘要


Background: Mercury is everywhere in our environment. Mercury, a liquid metal element, has been known and used by mankind for several thousand years. Amalgam is a kind of alloy using one or more metals mixed with mercury. It is mainly used for filling teeth. However, it is a major problem because the mercury contained in amalgam may cause potential toxicity. The toxicity level of mercury is related to its oxidation state. Whether the use of amalgam will present a hazard to dental professionals has become a great concern. Our findings are helpful to understand the effect of mercury levels in dental personnel when amalgam is used and become an early health indicator for mercury exposure. Objectives: To understand the related factors, seniority of dental personnel, contact status wirh amalgam and the urine and hair mercury levels of dental personnel were employed in this study. Methods: A cross-sectional survey was used and conducted with biochemical tests of urine and hair in this study. The subjects are dentists and assistants who are registered in the Dental Association of Tainan County (City) and Kaohsiung County (City). After randomly selecting the samples, we asked for the participants’consent. Data collected from questionnaires and tests were coded with Microsoft Access and analyzed by the software package JMP version 5.12. Results: We collected a total of 126 questionnaires and urine specimens including 55 males and 71 females. There were 75 dentists (59.52%) and 51 assistants (40.48%). We employed cold vapor atomic absorption spectrometer (CV-AAS) to mecsaue the mercury levels in the participants hair and urine specimens. In urine, the concentration of mercury for dentists (4.03μg/l) was higher than in assistants (0.43μg/l). In terms of hair, the concentration in dentists was 0.15μg/g and 0.00μg/g in assistants. As a result, the number of amalgam fillings each week, whether wearing masks or not, whether the teeth have amalgam fillings or not, eating pelagic fish or not and sex and age and working period had a significant correlation with total concentration of mercury in urine and hair (p<0.05). Conclusion: The mercury concentration in the urine and hair of the dentists is higher than it is in the assistants; however, it is in the secure range. The mercury that amalgam releases will be absorbed by the body; however, there is no relative data to confirm whether it will harm the human body or not. Due to the potential influence on health being in the source of absorption, further related research should be carried out. Using amalgam will cause dental personnel exposure to mercury vapor; therefore, better protection will be able to reduce mercury exposure more effectively. For example, emphasize the importance of personal professional health habits and ventilation status of the room. Moreover, when contacting amalgam, dental personnel should wear protective equipment to isolate mercury vapor effectively.

並列關鍵字

Amalgam Cavity Repair Material Health Indicators

參考文獻


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被引用紀錄


謝彥中(2008)。牙醫工作人員頭髮和尿液中汞濃度及其相關因子之探討〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-2307200813173700

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