肺功能與腎功能在臺灣北部某醫院特別危害健康作業員工中之相關性研究

The Association between Pulmonary Function and Renal Function among Special Health Hazardous Workers in a Northern Taiwan Hospital

楊庭安(Ting-An Yang) ； 張冠民(Guann-Ming Chang) ； 陳昭源(Jau-Yuan Chen)

《中華職業醫學雜誌》 30卷1期 (2023/01) Pp. 29-36

摘要

目的：長期的肺功能下降可能會導致腎功能缺損，然而一般族群少有常規進行肺功能檢測之機會，因此對於肺功能與腎功能之關聯性在各種次族群的資料分析尚未稱完整。本研究旨在評估臺灣北部某醫院特別危害健康作業員工族群中肺功能與腎功能之相關性。方法：本研究為回溯性橫斷性研究，納入2015至2019年北部某醫院從事特殊作業員工之健康檢查資料，分為男性及女性兩組，以及依FEV_1/FVC（用力呼氣1秒量[forced expiratory volume in 1second, FEV_1]/用力呼氣肺活量[forced vital capacity, FVC]）分為低、中、高三組。分析各項危險因子與FEV_1/FVC組間之關係，並分析FEV_1/FVC與腎功能降低風險之相關性。結果：共有792位醫療人員納入統計分析，平均年齡43.83歲。兩種性別族群在臨床數值上僅有FEV_1及總膽固醇無統計顯著差異；依FEV_1/FVC所分之男性族群三組間的腎功能無統計差異，而女性族群腎功能則有統計上之顯著差異。校正年齡及吸菸史、血壓、身體質量指數、低密度膽固醇、總膽固醇等多項變數後，男性肺功能與腎功能仍未呈現顯著相關。結論：本研究將常見勞工體檢項目多項變因納入控制後，顯示在醫療業從事特別危害健康作業的男女族群在肺功能及腎功能之相關性有性別差異。未來可納入非醫療相關之特別危害健康作業人員做後續研究，以期應用於廣泛員工的健康照護。

並列摘要

Background and Purpose: Long-term decline of pulmonary function could lead to renal function impairment, yet general population seldom has the chance to have pulmonary function test routinely. Previous analyses of association between pulmonary and renal function in different subgroups were not well-studied. Our study aimed to evaluate the association between pulmonary and renal function among special health hazardous workers in a Northern Taiwan hospital. Methods: This cross-sectional study recruited the health examination data from special health hazardous workers in a hospital from 2015 to 2019. The participants were divided into two groups for analysis according to sex, and further divided into low, middle and high FEV_1/FVC (forced expiratory volume in 1 second, FEV_1; forced vital capacity, FVC). We compared the demographic and clinical lab characteristics between subgroups and analyzed the association between FEV_1/FVC and decreased renal function. Result: A total of 792 hospital employees with average age of 43.83 years old were enrolled for analysis. There were significant differences in the demographic and clinical laboratory characteristics between male and female groups except for FEV_1 and total cholesterol. No significant difference of renal function was found in the male subgroups, while statistically significant difference of renal function was observed between female subgroups. After adjusted age, smoking history, blood pressure, body mass index, low-density lipoprotein cholesterol and total cholesterol, multiple linear regression revealed that no significant association between pulmonary and renal function in male group. Conclusion: Our study included demographic and clinical laboratory characteristics from general health examination for employees as controlled variables, and disclosed that there was sex difference of the association between pulmonary and renal function in special health hazardous workers in hospital. Future studies may enroll those special health hazardous workers from non-hospital workplace, in order to apply to health care for special employees.