應用大氣能見度評估空氣污染對於 呼吸道疾病就診的影響

Applying the atmospheric visibility to assess the effects of air pollution on the hospital admissions for respiratory diseases

楊佳興(Chia-Hsin Yang)

指導教授 ： 張士昱 ； 陳詩潔

中山醫學大學/健康管理學院/公共衛生學系碩士班/碩士(2015年)

摘要

空氣污染影響人體健康的議題近年來受到極高的重視。以往的研究顯示大氣能見度可視為空氣污染與氣象條件的綜合指標，且為民眾對於空氣品質感同身受的直接判斷因子，但卻鮮少研究探討大氣能見度與人體健康的關係。本研究主要探討台中地區能見度與呼吸道疾病(ICD-9: 460-519)的相關性，從台中地區環保署空氣品質監測站取得2010年空氣污染物的每日濃度，並由全民健保資料庫取得2010年台中地區每日呼吸道疾病就診人數，利用統計方法進行分析，探討不同地理條件(海線、新都會地區)及天氣型態(傳輸型、非傳輸型)下，空氣污染情況是否有顯著差異，進而影響能見度與呼吸道疾病的關係。
本研究結果顯示，海線地區能見度為13.4km，新都會地區為9.5km，不同天氣型態以非傳輸型能見度較低。多元迴歸分析結果顯示，影響能見度的主要的空氣污染物為細懸浮微粒(PM2.5)。海線地區與新都會地區在能見度低於10公里時的相對風險(RR, Relative Risk)分別為1.088與1.042，且均達統計顯著(p-value＜0.0001)。以25百分位(Q1)、50百分位(Q2)及75百分位(Q3)區分，兩地區的能見度與所對應的呼吸道疾病就診人數健康風險，均可發現相對風險與大氣能見度間呈現達統計顯著的反比趨勢，同樣的結果也可以在不同天氣型態獲得驗證。本研究建立以大氣能見度衰減評估人體健康風險的方法，並評估台中地區大氣能見度衰減對於呼吸道疾病的健康風險影響，以新觀點提供民眾更簡單明瞭地辨別空氣污染與健康風險間的關係，經由現地目測觀察便可初步評估自身所處環境的健康風險。

關鍵字

PM2.5 ； 相對風險 ； 空氣品質 ； 就診人數 ； 呼吸道疾病 ； 能見度

並列摘要

Recently, air pollution has played an important role in causing a hazard to human health. The atmospheric visibility was the aggregative indicator of air pollution and meteorological condition. Although the visibility might be regarded as a direct indicator of determining the air quality, rare studies reported the relationship between the atmospheric visibility and health risk. This thesis tried to apply the atmospheric visibility to assess the effects of air pollution on the hospital admissions for respiratory diseases (ICD-9: 460-519).
Daily measurements of air pollutants, atmospheric visibility, and Taiwan's National Health Insurance Research Database were obtained for the period of one year in 2010 in Taichung. We compared the difference in different locations (coast and urban areas) and weather conditions (transported and non-transported types). Poisson regression analysis was also used to evaluate the relationship between the atmospheric visibility and the respiratory consultation rate, with adjustment for potential confounding including the meteorological factors and spatial variances and types of air pollution.

The primary results indicated that air pollution and visibility degradation were both more serious in the urban area than that in the coast area. There were significantly relative health risks of 1.088 in the coast area and 1.042 in the urban area under the hazard periods of atmospheric visibility ≤ 10 kilometers. The two areas which divided into Q1(The 25th percentile), Q2(The 50th percentile), Q3(The 75th percentile) distinction respectively, showing the inversely proportional trend between visibility range and health risks. Similar results can also be validated in different weather conditions. This study establishes the new point of view to assess the effects of air pollution on the hospital admissions for respiratory disease by applying the
atmospheric visibility. It also provides the convenient way for public to understand the relationship between the regional air pollution and the effect of human health.

並列關鍵字

PM2.5 ； Relative risk ； Air quality ； Consultation ； Respiratory diseases ； Visibility

參考文獻

陳瑀婕， 2012。 不同天氣型態下台中地區逐時氣膠酸度與大氣能見度的特性。中山醫學大學公共衛生研究所碩士論文。

黃超群，程萬里，郭冠廷， 2001。中部地區海陸風環流與高臭氧污染之相關分析，東海科學第三卷，57−80。

Barnett, A.G., Williams, G.M., Schwartz, J., Best, T.L., Neller, A.H., Petroeschevsky, A.L., Simpson, R.W., 2006. The effects of air pollution on hospitalizations for cardiovascular disease in elderly people in Australian and New Zealand cities. Environ Health Perspectives 114, 1018-1023.

Brook, R.D., Franklin, B., Cascio, W., Hong, Y., Howard, G., Lipsett, M., Luepker, R., Mittleman, M., Samet, J., Smith, Jr.S.C., 2004. Air pollution and cardiovascular disease A statement for healthcare professionals from the expert panel on population and prevention science of the American Heart Association. Circulation 109, 2655-2671.

Chan, C.C., Chuang, K.J., Chien, L.C., Chen, W.J., Chang, W.T., 2006. Urban air pollution and emergency admissions for cerebrovascular diseases in Taipei, Taiwan. European Heart Journal 27, 1238-1244.