A Case-control Study of Sudden Unexplained Death Syndrome Among Southeast Asian Workers in Taiwan

台灣地區東南亞外籍勞工原因不明猝死症候群之病例對照研究

顏啟華(Chi-Hua Yen) ； 陳宣志(Shiuan-Chih Chen) ； 陳俊傑(Chun-Chieh Chen) ； 林鴻儒(Hung-Ju Lin) ； 杜宗禮(Chung-Li Du) ； 陳秋蓉(Chiou-Jong Chen) ； 李孟智(Meng-Chih Lee)

《中山醫學雜誌》 13卷2期 (2002/07) Pp. 157-165

摘要

前言：在台灣地區，許多來自東南亞外藉勞工所發生的原因不明猝死症候群已漸漸地引起學者及相關單位的注意，而猝死的病理機轉和危險因子目前仍無確切結論，值得進一步研究以為日後提出防治之道。
研究目的：本研究依據生活型態及法醫學檢驗的分析來探討台灣地區外勞原因不明猝死症候群的流行病學及可能的危險因子。
研究對象：自1996年7月起至1999年6月，自外勞死亡通報系統蒐集32位符合原因不明猝死症候群診斷條件之死者為病例，另以配對國籍及年齡下，自死者同工廠中隨機選取了57位外勞為對照組。
研究方法：接獲猝死通報後立即收集死者及對照組的個人、工作、在台居留時間、生活型態以及家族有無猝死病史等資料，此外，所有病例組皆須接受法醫解剖及毒理學檢查。
結果：死者特性的統計，以泰勞居多佔71.9%，其次為菲律賓佔25.01%。死者全為男性，平均年齡為33.3±6.7歲。大部分的猝死症發病於睡覺時(87.5%)，而有40.0%的人被發現時正在發病仍未死亡，但終均死亡。對死者的解剖及毒理學檢驗均未發現可致死的明確原因。將死者所得資料與對照組比較分析顯示，平日有飲酒習慣及猝死發作的睡前曾進食此二項與猝死症有關。若進一步經多重邏輯迴歸分析後，僅猝死發作的睡前進食為顯著的危險因子(調整勝算比=8.80；95%信賴區間=2.26－34.97 )
結論：死前進食是猝死症顯著危險因子，此初步結論可應用於未來猝死症的防治對策。然而，死前進食如何引起碎死，其機制為何，則有待將來進一步的研究。

關鍵字

原因不明猝死症候群 ； 流行病學 ； 睡前進食

並列摘要

Context: The medical community is beginning to pay serious attention to sudden unexplained death syndrome (SUDS), a mysterious illness that attacks young healthy males from Southeast Asian countries. The cause of SUDS remains unknown, It is evident, however, that dedicated research is urgently needed to determine the cause(s) which might lead to preventive strategies.
Objective: To determine the epidemiology of SUDS as it appears in Taiwan, using lifestyle analysis and forensic examination as a starting point.
Participants and Setting: A Case Group (totaling 32 individuals with confirmed SUDS symptoms) and a Control Group (totaling 57 individuals unaffected by SUDS but familiar with the deceased) were established in Taiwan for comparative purposes from July 1996 to June 1999 and in consultation with the Foreign Labor Death Promulgation System.
Main Outcome Measures: Demographic information (job status, period of residence in Taiwan, lifestyle, and family history of SUDS) was compiled for both groups. Forensic reports and toxicological examinations were included as research data.
Results: the majority of deceased individuals were Thai nationals (71.9%), followed by Filipinos (25%). All were males, with an average mean age of 33.3±6.7 years (87.5%) and were employed in Taiwan as foreign laborers. Highest rate of SUDS (87.5) occurred during sleep, significant rate (about 40.0%) were discovered during early morning hours, and a few succumbed during hospitalization. Postmortem forensic and toxicological examinations showed nothing remarkable. Comparative data from case and control groups indicated that alcohol and food consumption prior to sleep appeared a relatively important factor; risk associated with food intake was of particular significance when measured by multiple logistic regression analysis (adjusted odds ratio=8.80/95%; confidence interval=2.26-34.97)
Conclusion Food consumption prior to sleep may be a significant risk factor of SUDS. Such findings can be applied to prevention strategies; however, further investigation is required for complete verification.

並列關鍵字

sudden unexplained death syndrome ； epidemiology ； food consumption prior to sleep