- 學位論文
職場男性員工吸菸和飲用咖啡與心血管疾病危險性之相關性研究
Cardiovascular risk of male workers:relationship with smoking and coffee comsumption.
摘要
菸品與咖啡同樣都是具有刺激性、成癮性的物質，目前國人的吸菸率仍高，而咖啡飲用量也與日遽增，職場員工由於工作提神需求或個人嗜好而同時長期暴露此兩種物質的情形十分普遍，流行病學研究已經證實吸菸會導致心血管疾病，而飲用咖啡對心血管的影響則仍無一致的結論，同時暴露於吸菸與咖啡是否會產生交互作用而增加心血管疾病的危險性，乃成為一值得探討的議題。 本研究樣本為某職場之自願受試男性員工，經同意收集其尿液進行尿中可丁尼(菸品中尼古丁的代謝產物) 與咖啡因濃度測定，並以問卷收集研究對象之人口學基本資料、吸菸與飲用咖啡情形及壓力量表，同時提供健康檢查之心血管疾病危險指標資料（含血壓、身體質量指數、腰臀比、膽固醇、三酸甘油脂及血管硬化指數等）。利用統計方法控制其他干擾因子，分析菸品、咖啡對心血管疾病危險指標之單獨或交互影響。 結果共收集181位研究樣本，樣本平均年齡32.5±5.4歲，曾經吸菸者有97位(52.0%)，其中13位已戒菸；有飲用咖啡習慣者有76位(42.0%)，既吸菸又有飲用咖啡習慣者共45位(24.3%)。尿中可丁尼濃度與其他菸品暴露指標均有統計上之顯著相關性(p<0.01)，其中與呼出氣體CO濃度相關最強，相關係數為0.83；與尼古丁依賴性分數之相關係數為0.51；與問卷獲得之菸品累積暴露劑量的相關系數為0.34。 研究結果顯示，菸與咖啡在總膽固醇、三酸甘油酯、動脈硬化指標、血管收縮與舒張間隔時間等都有不良影響趨勢，雖未皆達統計顯著性，但鑒於國人男性員工吸菸率仍高，而咖啡飲用量奕逐漸增加，未來值得進行更大樣本數或以更高年齡層為對象之研究；並建議未來職場仍應在菸害防制與節制咖啡飲用量之衛生教育方面多所努力。
並列摘要
Cigarettes and coffee are both irritant and addictive substances. The prevalence of adult smoking in Taiwan is historically high to date. Especially for male workers, they use a large amount of coffee and cigarettes in work places for keeping better working conditions. Therefore, exposure to these two substances simultaneously is very common. According to prior studies, smoking can lead to cardiovascular diseases, but the healthy effect of coffee on cardiovascular diseases is uncertain. Hence, it is important to understand the interactive effects of smoking and drinking coffee on the risk on cardiovascular disease. We collected data from volunteer Taiwanese male workers in May in 2006. Each subject was given a self-administered questionnaire, which includes questions regarding smoking behaviors, coffee consumption, and stress. Then each subject had a medical examination including blood pressure, BMI, waist-hip ratio, total cholesterol, triglyceride, and stiffness index etc. Urinary cotinine, caffeine concentrations, expired CO concentration, and arterial stiffness measurements were then processed and calculated for every subject. The results showed that the average age of 181 male workers was 32.54 (SD=5.37；range=19~49years). About half of the sample smoked and 7% had quit smoking. Forty two percent drink coffee. About 45% are both smokers and coffee drinkers. Urinary cotinine concentration is positively correlated with cigarette exposed dose(r=0.34), expired CO(r=0.83), and the Fagerstr?m Test for Nicotine dependence(r=0.51) respectively。 Although we have assessed the relationships between cigarette and coffee consumption and total cholesterol, triglyceride, stiffness index, peak to peak time, the relationships are found to be not significant. However, more studies are needed to clarify these relationships in other populations.