戶外空氣汙染與結核病之相關性：探討最佳的暴露評估方法

Correlation of outdoor air pollution and tuberculosis: Exploring the optimal exposure assessment

歐政寰(Jenq-Hwan Ou)

指導教授 ： 溫燕霞

高雄醫學大學/藥學院/藥學系碩士班/碩士(2017年)

摘要

背景：戶外空氣污染與結核病的相關性曾被數個流行病學研究探討，這些研究大多使用為缺乏證據支持的12或24個月的空氣汙染物平均濃度作為空氣汙染暴露評估。
目的：本研究欲針對常見戶外空氣汙染物，提供實證的暴露評估。
方法：研究收集2009至2016年台灣各直轄市每月結核病發生率、及2006至2016年每月空氣汙染物濃度，使用Pearson相關係數分析結核病通報前一至三十六個月平均空氣污染物濃度與結核病月發生率的相關性。
結果：隨著累積平均時間增加，各項空氣汙染物包含：懸浮微粒、細懸浮微粒、一氧化碳、氮氧化物、一氧化氮、以及二氧化氮，與結核病發生率呈現正相關以及周期性的波動，高峰依序出現在5-11、16-22、及29-34個累積平均月數，過往假設之12或24個累積平均月數可能不是最佳的暴露評估，二氧化硫相關性呈持續增長而波峰不明顯，臭氧則因相關程度弱不納入考量。此外，Pearson相關係數波動周期與空氣汙染濃度季節性循環時間相符，顯示空氣汙染濃度的季節性會對結核病發生率的預估產生影響。
結論：台灣六個直轄市中，戶外空氣汙染物平均濃度與結核病發生率相關程度的波峰依序出現在5-11、16-22、及29-34個累積平均月數，研究者可依照波峰出現之時間區段，選擇較適當的暴露評估時間，協助結核病發生率之預估。

關鍵字

戶外空氣汙染 ； 結核病 ； 暴露評估

並列摘要

Background: Several epidemiological studies have investigated the association between outdoor air pollution and tuberculosis (TB), in which the insufficiently supported 12- or 24-month average air pollutant concentration was used for exposure assessments.
Aim: The aim of this study is to provide evidence-based exposure assessment of criteria outdoor air pollutants.
Methods: Monthly TB incidence in six metropolitan cites in Taiwan was collected from 2009 to 2016 and air pollutant concentration was obtained from 2006 to 2016. Pearson correlation coefficient (Pearson’s r) was used to analyze the correlation between monthly TB incidence and cumulative average air pollutant concentration. Cumulative average of months was inspected in the range of 1- to 36-month.
Results: As the cumulative average of month increases, the correlation between TB incidence and air pollutant concentration [including particulate matter less than 10 μm in diameter (PM10), particulate matter less than 2.5 μm in diameter (PM2.5), carbon monoxide (CO), nitrogen oxides (NOx), nitrogen monoxide (NO), and nitrogen dioxide (NO2)] was consistently positive and fluctuated periodically. Peaks of Pearson’s r were achieved at 5-11, 16-22, and, 29-34 cumulative average of months, respectively, suggesting that 12- or 24-, month average air pollutant concentration would not be optimal for exposure assessment. The correlation with sulfur dioxide (SO2) increases without significant peak occurring and the correlation with ozone (O3) was unremarkable. In addition, it was revealed that the frequency of coefficient fluctuation was consistent with the seasonality of air pollution concentration, indicating the seasonality may affect the prediction of TB incidence.
Conclusions: In six metropolitan cites in Taiwan, the peak times of Pearson’s r between average outdoor air pollutant concentration and TB incidence was in 5-11, 16-22, and 29-34 cumulative average of months, respectively. Researchers may use the results in this study to select a more appropriate exposure assessment, improving the estimation of TB incidence.

並列關鍵字

outdoor air pollution ； tuberculosis ； exposure assessment

參考文獻

英文參考文獻

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