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  • 學位論文

兒童在胎兒及幼兒時期汞、甲基汞暴露對其三歲時認知、語言、動作發展之影響

The relationship between prenatal and postnatal mercury/methylmercury exposure and their cognitive, language and motor development at three years old

指導教授 : 簡伶朱

摘要


汞和甲基汞為神經毒性物質,會對中樞神經系統造成影響,若胎兒及幼兒暴露汞,對其生長發育情形可能有害,但過去研究較少同時針對兒童於胎兒及幼兒時期汞暴露進行探討,且兒童汞暴露與生長發育之關係未有一致結果。因此,本研究目的乃是利用不同的生物檢體(胎便、頭髮、手指甲、腳趾甲)來瞭解兒童總汞及甲基汞體內負荷情形,並探討兒童總汞及甲基汞體內負荷與其認知、語言、動作發展之關係。 本研究為一縱貫研究,以2008年8月至2009年12月出生之新生兒作為第一階段研究個案並於3年後進行追蹤。收集新生兒的胎便及兒童3歲時的頭髮、手指甲、腳趾甲作為評估兒童總汞與甲基汞暴露之生物檢體,另以貝萊嬰幼兒發展量表第三版對兒童之認知、語言、動作發展進行評估。以雙變項分析來探討不同人口學特徵中,兒童總汞與甲基汞體內負荷情形以及兒童3歲時生長發育是否有所差異;此外,亦會分析有參與第二階段研究個案和有進一步參與貝萊嬰幼兒發展量表第三版評估個案之代表性。利用斯皮曼相關來瞭解不同生物檢體間之總汞和甲基汞濃度及其與貝萊嬰幼兒發展量表第三版評估結果間之相關性。校正潛在干擾因子後,以多重線性迴歸來探討兒童總汞和甲基汞體內負荷情形對其3歲時生長發育所造成的影響,並考慮不同程度體內汞負荷、魚類攝取行為下所造成的影響。 本研究共納入83名個案。胎便中總汞濃度之幾何平均值為89.56 ng/g,頭髮、手指甲和腳趾甲中甲基汞濃度之幾何平均值則分別1.96、0.64、0.55 μg/g。頭髮、手指甲與腳趾甲之甲基汞濃度互達統計上顯著正相關,且三者亦與兒童魚類總攝取呈顯著正相關、與貝萊嬰幼兒發展量表第三版評估結果之表達性語言量表分數呈顯著負相關。線性迴歸分析發現,若校正干擾因子與胎便總汞濃度後,兒童幼兒時期甲基汞體內負荷情形並未與其發展有顯著關係,然而同時考慮不同程度甲基汞濃度和魚類攝取後,兒童魚類攝取量高且體內甲基汞濃度高則表達性語言發展顯著較差。 由本篇研究可發現,七成兒童髮汞濃度超出美國環保署的建議值,而影響兒童幼兒時期甲基汞體內負荷之重要因素為兒童魚類攝取行為。兒童幼兒時期甲基汞體內負荷情形會對其三歲時表達性語言發展造成不良影響,尤其是體內甲基汞濃度高且魚類攝取量高的兒童,影響更為顯著。

並列摘要


Mercury and methylmercury are neurotoxins, which can have serious effects on the central nervous system. Fetus or toddlers exposure to mercury may have adverse developmental outcome. However, there were few studies about children on both prenatal and postnatal mercury exposure, and there were no consistent evidences between mercury exposure and children developmental outcome. The aim of this study was to investigate the relationships between cognitive, language and motor development and mercury/methylmercury concentration in various biomarkers (including meconium, hair, fingernail, and toenail). This longitudinal study recruited mother-infant pairs between August 2008 and December 2009, and a second follow-up study of these children was completed after 3 years. We collected meconium after delivery, toenail, fingernail, and hair samples of children at 3 years old as biomarkers of mercury and methylmercury exposure. The Bayley Scales of Infant and Toddler Development (Bayley-III) for evaluating the cognitive, language, and motor development of 3 years old children are calculated and validated. Between-group differences (first and secondary study, cases completed Bayley-III and total cases) in demographic characteristics were evaluated by the bivariance analysis. Spearmans correlation was performed to indentify the correlation of mercury/merthylmercury concentration in different biomarkers, and of mercury/merthylmercury concentration and Bayley-III. We used multiple liner regression to examine the impact of mercury/methylmercury exposure to children development after adjusting potential confounders. There were total 83 mother-child pairs in this study. The geometric mean of total mercury concentration in meconium was 89.56 ng/g, and methylmercury concentration in hair, fingernail, and toenail were 1.96, 0.64 and 0.55 μg/g, respectively. There were significant positive correlation between methylmercury levels in hair, fingernail, and toenail, and they were significant positively correlated with children fish consumption and negatively correlated with expressive scale score of language of Bayley-III. In multiple liner regression, after adjusting confunder factors and total mercury concentration in meconium, higher child body burden of methylmercury was not significantly associated with worse child expressive scale score of language; however, if a child had high methylmercury body burden and high fish consumption then the score of expressive language was significantly worse. In conclution, 70% childern hair methylmercury concentrations were higher than the U.S. EPA reference (1 μg/g). Fish consumption was an important risk factor of child body burden of methylmercury. If children had higher body burden of methylmercury then they will had lower score of expressive of language, especially for children with high fish consumption.

參考文獻


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被引用紀錄


陳柏羲(2013)。甲基汞濃度對於婦女懷孕情形及相關影響因子之探討〔碩士論文,國立臺北科技大學〕。華藝線上圖書館。https://doi.org/10.6841%2fNTUT.2013.00351
許又文(2014)。育齡婦女髮甲基汞濃度與魚類攝取之關係及風險評估〔碩士論文,國立臺北科技大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0006-0108201422405600

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