不同職業場所中真菌暴露評估

Fungal Exposures in Four Different Occupational Settings

蔡榮賢(Jung-Hsien Tsai)

指導教授 ： 陳叡瑜博士 ； 趙馨博士

臺北醫學大學/公共衛生暨營養學院/公共衛生學研究所/碩士(2003年)

摘要

真菌暴露是環境及職業衛生研究的重點之一，因為真菌可能引起傳染性疾病、中毒、過敏性疾病及反應等等。一些特別的職業環境，因為其工作性質，可能造成工作環境中的真菌濃度較高。因此本研究在四個不同的職業環境進行暴露評估，測量可培養真菌的濃度變化和分佈，以及其他空氣品質因子，並評估這些環境因子對職場員工健康的影響。 本研究從醫院、動物收容所、花店、餐廳等四種職場中，各選取二家進行暴露評估。每家依據其大小和工作性質選取1-4個地點及室外1點進行兩天（每天上下午各一次）的環境採樣。採樣項目包括室內空氣中可培養真菌(culturable fungi)、室內空氣品質因子（溫度、濕度、臭氧、二氧化氮、二氧化碳及懸浮微粒），而室外的可培養真菌提供室作為內真菌來源鑑定。在採樣的第一天，並發給採樣地點每位全職員工一份問卷，調查員工的基本資料、自覺健康狀態及工作環境狀況等等。 本研究的結果發現，從事花店工作者的真菌暴露，顯著高於其他三種職業的員工。特別在花店早上進貨時，空氣中的真菌濃度有明顯的增加。此外，若研究場所中室內真菌濃度低於室外，增加通風量可能導致室內真菌濃度增加。反之，若室內真菌濃度高於室外（例如花店、動物收容所1），則增加通風量可使室內真菌濃度降低。在多變項迴歸分析中顯示，總真菌濃度會受到相對濕度、温度與CO2等空氣品質因子影響。員工的自覺健康狀況與總真菌濃度及其他環境因子間並無顯著的相關性，但眼睛的不適症狀與自覺之工作環境狀況有正相關。 本研究顯示，不同的職業場所，真菌暴露隨工作的性質有顯著不同。因此，適當的改善工作環境，維護員工的健康，是建立良好職業及環境衛生的重要議題。

關鍵字

醫院 ； 餐廳 ； 花店 ； 動物收容所 ； 可培養真菌 ； 職業暴露評估

並列摘要

Fungal exposures have been the focus of many environmental and occupational health researchers because of the potential infectious, toxic and allergenic effects. Specific occupational environments with higher fungal levels are of special concerns. Therefore, we conducted an exposure assessment study to evaluate fungal distributions and variations at four different occupational environments and their effects on workers’ health. We conducted two-day environmental samplings at two of each selected occupational environments, including hospitals, animal shelters, florists and restaurants. At each sampling location, we selected one to four sites to characterize the overall environmental exposures. We measured indoor and outdoor culturable fungi, and other environment factors (e.g., temperature, relative humidity, O3, NO2, CO2, particulates) in the mornings and afternoons at each sampling day. At the beginning of the sampling, a detailed questionnaire was administered to each full-time worker at the sampling site to obtain their personal information, perceptions of health and working environment. Our findings demonstrated that fugal concentrations in florists were significantly higher than those in other occupational environments, especially during the morning loading hours. In addition, if the indoor fungal levels were lower than outdoors, higher ventilation rate might result in higher fungal concentrations. On the contrary, if the indoor fungal levels were higher than outdoors (i,e., in florists and animal shelter 1), fungal levels could be diluted by higher ventilation. In the multivariate data analysis, we found total fungal levels were associated with relative humidity, temperature and CO2 concentration. Workers’ perceptions of health were not significantly correlated with total fungal concentrations and other environmental factors. However, eye irritation was positively associated with perceived working environments. Our study elucidates that fungal exposures are different in various occupational environments. Thus, it is of special importance to improve working environments with precautions in order to keep good occupational and environmental health.

並列關鍵字

animal shelters ； culturable fungi ； florists ； hospitals ； indoor air quality ； occupational exposure assessment ； restaurants

參考文獻

4. Gravesen S. Fungi as a cause of allergic disease. Allergy 34:135-54(1979).

5. Schlueter DP, Fink JN, Hensley GT. Wood-pulp workers'' disease: a Hypersensitivity Pneumonitis caused by Alternaria. Annals of Internal Medicine 77:907-14(1972).

7. Harrison J, Pickering CA, Faragher EB, Austwick PK, Little SA, Lawton L. An investigation of the relationship between microbial and particulate indoor air pollution and the sick building syndrome. Respiratory Medicine 86:225-35(1992).

8. Li C-S, Hsu C-W, Tai M-L. Indoor Pollution and Sick Building Syndrome Symptoms among Workers in Day-Care Centers. Archives of Environmental Health May/June 52:200-207(1997).

9. Fisk WJ, Rosenfeld AH. Estimates of improved productivity and health from better indoor environments. Indoor Air 7:158-172(1997).