餐飲學校學生廚房實作課程與齲齒、聽力損失之相關性探討

Dental Caries and Hearing Loss in Association with Occupational Exposure among Hospitality College Students

張偉翔(Wei-Hsiang Chang)

指導教授 ： 吳聰能 ； 楊俊毓

高雄醫學大學/健康科學院/職業安全衛生研究所/碩士(2006年)

摘要

摘要
前言
近三十年台灣經濟發展快速，在社會結構的改變下，飲食習慣亦隨之變化，近來不斷有文獻探討餐飲相關行業因試吃的習慣造成較多的口腔齲齒及琺瑯質的破壞，而因品酒等職業需求造成牙齒腐蝕也時有所聞。再者職場上同儕們養成特殊的生活習慣，導致餐飲人員可能暴露於多種危害因子下，如噪音、喝酒、油煙霧滴與抽煙等都會直接或間接造成齲齒罹患率與聽力損失的增加。許多學者均指出抽煙與喝酒會影響血鉛值，而血鉛值的高低則間接造成齲齒與聽力損失這兩種職業傷病。
研究方法
本研究為Cross- sectional study，自民國93年9月至94年5月，收集南部某餐旅學校餐飲相關科系－西餐廚藝系、中餐廚藝系及烘焙管理系，非餐飲相關科系－休閒管理系、旅館管理系，及收集某醫學大學牙醫系為參考對象，進行左右耳0.5k、1k、2k、3k、4k、6k、8kHz純音聽力檢測並進行抽血及齲齒檢測。在進行檢測同時請學生自行填寫聽力及齲齒的相關問卷，包含基本資料、生活習慣、醫療紀錄三大部分。探討在學期間，餐飲相關科系學生由於廚房實作課程所需，將會暴露於排油煙機等的噪音、試吃與試飲等危險因子跟聽力損失及齲齒的相關性。
結果
餐飲相關科系、非餐飲相關科系及牙醫系三組在左右耳1k、2k及4k頻率的聽力閾值及齲齒有達統計上顯著意義（P<0.05）。利用線性複回歸分析探討廚房實作課程的噪音暴露對聽覺能力的影響，結果顯示在左右耳1k~4k頻率的模型裡，控制其他干擾因子後，餐飲相關科系的聽力閾值比牙醫系會顯著多2~5分貝；在右耳2k及左耳1k、2k、4k頻率的模型裡，控制其他干擾因子後，非餐飲相關科系則是比牙醫系會顯著多2~3分貝。在DMFT的模型裡，上過調酒課程者齲齒則是會增加1.06顆。在Blood lead level的模型裡，餐飲相關科系血中鉛值會比牙醫系增加0.75 μg/dl，而非餐飲相關科系則是會增加0.73 μg/dl；有上過調酒課程的學生血中鉛值會比沒上過調酒課程的學生增加0.55 μg/dl。
討論
廚房實作時的噪音對餐飲相關科系學生聽覺能力的影響是出現在左右耳1k~4k Hz，餐飲相關科系有80%的學生其高職時代也同樣是餐飲科，他們廚房實作課程的暴露在高職時代就已經開始，而大學則為延續其暴露的危害。調酒課程中的試酒行為會造成酒精的暴露，而對餐飲相關科系學生齲齒發生及血中鉛濃度都有顯著的影響。而本研究為三年cohort的第一年研究，之後將會繼續追蹤。
結論
本研究發現：顯示廚房實作課程時的環境噪音（77 dB(A)）雖然未超過法定標準(90dB(A))，但在長時間的暴露下對餐飲科系的學生的聽覺能力仍有顯著的影響。調酒課程對齲齒及血中鉛濃度有顯著影響，值得繼續追蹤。因此在學期間的暴露情形是我們職業衛生研究必須考量到的，更應該將職業安全衛生工作往前推至在學期間的學生。

關鍵字

餐飲 ； 噪音 ； 齲齒

並列摘要

Abstract
Introduction
The students of hospitality college are likely to have experienced long-term exposures during practicum, including the noise of range hoods or refrigerator, tasting foods or drinking. These potential hazards may lead to hearing loss and dental caries. In 2005, approximately 12,000 hospitality graduates in Taiwan, including 9270 vocational students and 2702 college students, were potentially exposed to the hazard of noise and tasting. Therefore, the prevalences of hearing loss and caries in students of hospitality college need investigation.
Method
This cross-sectional study was conducted at a hospitality college and a medical university between September 2004 and May 2005. Students’ participation in this survey was voluntary, and this study was approved by the Human Subjects Committee of Kaohsiung Medical University. The students of hospitality college were divided into a hospitality department, including department of western culinary art (47 students), Chinese culinary art (51 students), and baking technology and management (36 students), and a non-hospitality department, including department of leisure recreation tourism (47 students) and hotel management (45 students). We also recruited a reference group – department of dentistry (64 students). Hearing loss was quantified using Pure Tone Audiometry in a soundproof booth and caries was diagnosed by a specialized dentist. Socio-demographic profile, life style, occupational and health-related data were obtained using a self- administered questionnaire. Data analysis was performed on Statistical Package for Social Science (SPSS).
Results
A comparison of the pre- and practicum showed that the averagea of A-scale-decibel (dBA) sound-pressure levels had increased 10~15 dB(A) sound-pressure levels .The hearing threshold of students in hospitality department was significantly higher than that of the other two groups at 500, 1k, 2k and 4k Hz of both ears (p<0.05). The prevalence of caries in the students of non- hospitality department was significantly higher than the other two groups (p<0.05). The blood lead level of the students in the hospitality department was significantly higher than that of the other two groups (p<0.05).All students were divided into two groups - mixology course and non-mixology course. The hearing threshold of students of mixology course was significantly higher than that of non-mixology course at 500 and 2k Hz of right ear and 500, 1k and 2k of left ear (p<0.05). The prevalence of caries and blood lead level in the students of non- mixology course was significantly higher than that of non-mixology course (p<0.05).We compared the prevalence of hearing ability, caries, and blood lead level within and among schools. Firstly, comparison was made within schools, and the hearing threshold of the students of hospitality department was significant higher than that of students of non-hospitality department at 1k, 2k, 3k and 4k Hz of right ear and 1k, 2k, and 4k Hz of left ear (p<0.05). Secondly, comparison was made among schools, and the hearing threshold of students of hospitality college was significant higher than that of dentistry department at 2k and 4k Hz of right ear and 1k, 2k, and 4k Hz of left ear (p<0.05). The prevalences of caries and blood lead level in the students of hospitality college were significantly higher than those of dentistry department (p<0.05).
Then, the effect of culinary practicum (regression coefficient=2.42, 4.43, 2.23, 3.76, 5.11, 4.50, 2.42, 4.17) remains to be a statistically significant determinant of hearing ability (1k~4k Hz of both ear) (p<0.05). Furthermore, the effect of gender (regression coefficient=1.82, 2.48, 1.82, 2.46, 1.96, 2.68) remains to be a statistically significant determinant of hearing ability (1k, 3k, and 4k Hz of both ear) (p<0.05). The effects of age (regression coefficient=0.55), gender (regression coefficient=-2.02), mixology course (regression coefficient=1.06), and milk drinking habits (regression coefficient=1.31) remain statistically significant in determining dental caries (p<0.05). The effects of culinary practicum (regression coefficient=0.79), mixology course (regression coefficient=0.5), and gender (regression coefficient=0.54) remain statistically significant in determining dental caries (p<0.05).
Discussion
In this study, noise exposure during kitchen practicum had affected the auditory ability in the students of hospitality department, especially at 1k~4k of both ears. There were 80% students of hospitality department of this study that graduated from hospitality high school. They might expose to kitchen practicum from high school and now continued in college. Both dental caries and blood lead level were positive associated with mixology course. The habitual behavior of tasting food or drinking led to higher prevalence of dental caries and increased blood lead level among the students of hospitality department.
Conclusion
The results of this study suggested that long-term exposed to cooking- induced noise might have an effect on auditory ability in the students of hospitality department. The correlation between dental caries, blood lead level and mixology course seems need to further investigation. Therefore, possible scholastic exposure was not neglected.

並列關鍵字

Hospitality ； Food - beverage ； noise ； dental caries

參考文獻

參考文獻

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