- 學位論文
油煙暴露與婦女慢性支氣管炎之相關性探討-以社區為基礎之研究
Exposure to Cooking Oil Fumes and Female Chronic Bronchitis Risk-A Community-based Study
摘要
研究目的：本研究以社區病例對照研究方法探討油煙暴露與婦女慢性支氣管炎以及對其肺功能的影響之關係。 材料與方法：本研究的病例組與對照組均來自中央健保局高屏分局民國八十八年度一月至十二月的健保資料中40歲和以上的女性，且均居住在高雄市至少五年以上；病例組與對照組以區域、年齡(±3歲)作配對。病例組在研究期間被診斷為慢性支氣管炎(ICD-9 code: 491)至少兩次，且排除其它呼吸道疾病；而對照組在研究期間內，曾經因為交通意外或急性腸胃炎就醫的民眾，並且沒有慢性支氣管炎及其它與呼吸道疾病相關疾病的診斷。研究對象均經由統一訓練過的訪員以結構式問卷進行實際問卷訪視和肺功能檢查。 結果：訪視時間從民國九十一年七月至民國九十五年三月，總共完成300位病例組及300位對照組訪視。在這600位研究個案問卷結果，60位符合美國胸腔協會訂定的慢性支氣管炎之標準，而530位則無，另10位則無資料。以20-40歲時期及40歲以後兩個時期均有下廚習慣的514位婦女做分析，慢性支氣管炎者(n=55)有21位(38.2%)兩個時期均裝設排油煙機、有28位(50.9%)任一時期裝設排油煙機及6位(10.9%)兩個時期均無裝設排油煙機；相對於非支氣管炎者(n=459)，有228位(49.7%)兩個時期均裝設排油煙機、有215位(46.8%)任一時期裝設排油煙機及16位(3.5%)兩個時期均無裝設排油煙機，控制其他干擾因子，包括抽菸與二手菸暴露等，相較於兩個時期均無裝設排油煙機的婦女，兩個時期均裝設排油煙機與任一時期裝設排油煙機者，具慢性支氣管炎之危險比(OR值)分別是0.3 (95% CI = 0.1-0.9)與0.3 (95% CI = 0.1-0.9)；同時，相較於兩個時期均無使用排油煙機者，兩個時期均使用排油煙機者其肺功能FEV1，平均高於208 mL (p-value = 0.01)。 結論：本研究結果顯示，婦女烹飪是否使用排油煙機與慢性支氣管炎有關，亦與婦女肺功能的變化具有關聯。
並列摘要
Objective: We conducted a community-based case-control study to investigate that exposure to cooking oil fumes is associated with female chronic bronchitis and the effect of lung function. Materials and Methods: All study subjects were from the data bank of Taiwan National Health Insurance Bureau in Kao-Ping District in 1999 and had lived in Kaohsiung city for 5 years and over. The potential cases and controls were matched by age (±3 years) and district. The potential cases were diagnosed with chronic bronchitis (ICD-9 code: 491) at least twice by physicians in that year and excluded other respiratory diseases, whereas controls were diagnosed with traffic accident or acute gastroenterolitis and without any respiratory disease in the same year. Trained interviewers conducted personal structured questionnaires to collect epidemiology data and pulmonary function measurements form study subjects. Results: 300 potential cases and 300 potential controls were interviewed between July, 2002, and, March, 2006. The results of 600 questionnaires included 60 subjects who satisfied the criteria for chronic bronchitis by American Thoracic Society (ATS), 530 subjects were not, and 10 subjects had no data. We analyzed the 524 subjects who cooked in the home kitchen during both periods (20-40 years old and >40 years old). Among the subjects with chronic bronchitis (n=55), there were 21 (38.2%) subjects who had kitchen fume extractors at home during both periods of cooking, 28 (50.9%) subjects who had kitchen fume extractors at home during either period of cooking, and 6 (10.9%) subjects who did not have kitchen fume extractors at home during the same two periods. Among the subjects without chronic bronchitis (n=459), there were 228 (49.7%) subjects who had kitchen fume extractors at home during both periods of cooking, 215 (46.8%) subjects who had kitchen fume extractors at home during either period of cooking, and 16 (3.5%) subjects who did not have kitchen fume extractors at home during the same two periods. After adjusting other confounding factors, such as smoking habit and second-hand smoke exposure etc., the women who had kitchen fume extractors at home during both periods of cooking and those who had kitchen fume extractors at home during either period of cooking than those who did not have kitchen fume extractors at home during the same two periods, the odds ratio (OR) of developing chronic bronchitis was 0.3 (95% CI = 0.1-0.9) and 0.3 (95% CI = 0.1-0.9), respectively. Furthermore, the subjects who used fume extractors during both periods of cooking had FEV1 values higher than those who did not use fume extractors during the same two periods (208 ml; p-value = 0.01). Conclusions: Our study shows the women who cooked in the kitchen whether they could use fume extractors or not, which is associated with developing of chronic bronchitis and the change of pulmonary function.