- 學位論文
美容美髮從業人員職業危害與唾液皮質醇及免疫球蛋白A研究
Study on occupational hazards exposure and salivary cortisol & IgA for cosmetology and hairdressing professionals
摘要
美容美髮從業人員常因工作接觸許多刺激性或有害化學物質，而引起皮膚、呼吸道及生殖系統等危害。此外長時間站立或維持相同姿勢，導致其下肢靜脈曲張或下背痛等肌肉骨骼症狀。本研究主要針對美容美髮從業人員為研究對象，經由方便採樣，並經店主及個人同意後，取得台灣中部64名，北部101名，共165名之美容美髮現行從業人員。進行該職業各項暴露危害因子的問卷調查、並採集唾液測定皮質醇（cortisol）及免疫球蛋白A (IgA)，進行統計分析，探討相互之間的關聯性。 問卷內容包含基本資料、工作概況、生活及飲食習慣、個人健康、疾病史、防護具使用、睡眠品質及工作壓力等部分。唾液樣本的採集時間，以早上9至11點之間的唾液作為樣本，進一步分析唾液中皮質醇(cortisol)及免疫球蛋白A(IgA)數據，與其職業危害暴露之相關性。唾液中皮質醇(cortisol)及免疫球蛋白A (IgA)則以酵素連結免疫分析法(enzyme-linked immunosorbent assay；ELISA)做測定。 結果顯示自覺暴露危害因子，主要為「皮膚接觸化學物質」佔76.4%、「因作業姿勢而導致肌肉骨骼酸痛或疼痛」佔72.1%、「暴露空氣粉塵」佔68.5%、「被器具或毛髮刺切割傷」佔65.5%、及「暴露有害氣體」佔64.2%。職業危害暴露相關症狀中，主要為「腸胃不適」佔53.9%、「胃痛」佔45.5%、「下肢靜脈曲張」佔42.4%、「眼睛乾澀發炎」佔40.6%及「皮膚乾裂」佔40.0%，另肌肉骨骼症狀以「肩膀」為主佔74.5%。有關唾液cortisol測定方面，有92.1%屬正常值(正常值為1.2-14.7ng/mL)，整體樣本平均值為6.64 ng/mL，標準差為4.17ng/mL；唾液IgA測定有85.5%屬正常值(正常值為40-170μg/mL)，整體樣本平均值為106.72μg/mL，標準差為50.59μg/mL。 問卷調查項目與唾液中cortisol之間有顯著性差異者(P<0.05)，為疾病史之「鼻炎」；「每天上班總時數」；飲食方面之「辣味食物」及「重鹹食物」；職業危害暴露相關症狀之「皮膚疹」、「腸胃不適」及「眼睛乾澀發炎」；主觀健康方面的「身體健康不佳」及「睡眠整體評價」。與唾液中IgA有顯著性差異者(P<0.05)之項目為育齡婦女生殖危害之「自然流產」；職業危害暴露相關症狀之「乾咳」及「下背痛」。另外，工作壓力調查中「工作控制決策自主性」與cortisol之間有顯著性差異；「心理負荷決策自主性」與IgA之間有顯著性差異。 本研究發現，美容美髮從業人員職業危害暴露，以化學危害為主，在生殖危害中，52.6%之育齡婦女「非正常生殖」。研究調查中，有多項職業危害暴露相關症狀，與唾液中的皮質醇（cortisol）及免疫球蛋白A (IgA)有統計學上的顯著性，故唾液中的皮質醇（cortisol）及免疫球蛋白A (IgA)，可作為美容美髮從業人員職業危害暴露的良好指標。
並列摘要
Cosmetology and hairdressing professionals often exposed many irritating or harmful chemicals, and cause skin, respiratory and reproductive and other hazards in their workplace, prolonged standing or maintain the same posture resulting in varicose veins or lower back pain. The 165 relevant employees, 64 from central Taiwan and 101 from northern Taiwan, were sampled randomly, and agreed with consent. A questionnaire survey of the occupational hazards of exposure factors, and collecting salivary for cortisol and immunoglobulin A (IgA) determination were conducted. The contents of the questionnaire included basic information, job profile, living and eating habits, personal health, medical history, use of protective equipment, sleep quality and work pressure. The sample of saliva is collected during 9 a.m. to 11 a.m., it is used to analyze cortisol and IgA and compared with the exposure risk factor. The salivary cortisol and IgA were detected by the enzyme-linked immunosorbent assay (ELISA). The results of this study showed that self-report risk factors were “skin exposure to the chemicals” (76.4%), “musculoskeletal pain caused by working positions” (72.1%), “exposure to the airborne dust” (68.5%), “hurt by tools or hair” (65.5%), and “exposure to harmful chemical vapor” (64.2%); and the related symptoms were mainly “gastrointestinal discomfort” (53.9%), “stomachache” (45.5%), “Varicose veins” (42.2%), “eye dryness and inflammation” (40.6%), and “chapped skin” (40.0%), musculoskeletal symptoms of shoulder mainly accounted for 74.5%. In regard to the salivary cortisol analysis, 92.1% of the all were normal, the average value of overall samples is 6.64 ± 4.17 ng/mL. For the IgA testing, 85.5% of the results are normal (40-170 µg/mL), the average is 106.72 ± 50.59 µg/mL. The items of the survey which have significant difference (P<0.05) with the cortisol in saliva are “rhinitis of disease history”, “daily working hours”, and “the diet habit of spicy and salty food”; the prevalence diseases related to occupational hazards are “skin rash”, “gastrointestinal discomfort” and “eye irritation”. The items of the survey which have significant difference (P<0.05) with the IgA in saliva is “spontaneous abortion of reproductive harm to women in childbearing age”; the prevalance diseases of occupational hazards are “dry cough” and “lower back pain”. On the other hand, the survey for investigating the work pressure shows that “working control decisions autonomy” has significant difference with cortisol; “decision-making autonomy of the psychological load” has significant difference with IgA (P<0.05). This study also finds that the exposure to the risk factor of cosmetology and hairdressing professionals is mainly “chemical hazards”;52.6% of women in childbearing age have the of “abnormal pregnancy”, that is very important issue for cosmetology and hairdressing professionals. The study suggested that salivary, cortisol and IgA can be useful indexes for evaluating such field and especially for cortisol.