探討細懸浮微粒(PM2.5)之暴露與失智症發生相關性-以高雄與宜蘭地區為例

背景與目的有許多研究指出空氣污染物會造成人體健康危害，多注重於空氣污染物與呼吸道疾病、心血管疾病之相關性探討，近年來，越來越多流行病學研究發現空氣污染物質會造成較差的認知功能或認知功能的退化，且在動物實驗中，已發現空氣污染物質會造成失智症之產生。本研究使用衛生福利部統計處公開資料及環境保護署空氣品質資料來做為資料，探討細懸浮微粒暴露在暴露濃度高與較低的地區之失智症就診人數之相關性。方法本研究以回溯性追蹤方式進行研究，資料來源為2007-2015年衛生福利部統計處全民健康保險醫療統計公開資料，選取ICD- 9-CM診斷碼290.2931.294.297.330.331等與失智症相關代碼者，選取居住在暴露濃度較高的高雄地區及暴露較低的宜蘭地區者。空氣污染物質濃度資料則使用我國環境保護署空氣品質監測站之資料，研究地區為高雄與宜蘭地區2007-2015年間之細懸浮微粒暴露濃度進行推估比較，利用推估比較方式來推論PM2.5在暴露濃度不同之地區失智症發生影響。研究結果本研究結果在高濃度曝露的高雄地區，其PM2.5自2007-2015年大幅下降57.19%，在失智症就診人數方面，在門住診失智症就醫人數及急診就醫人數以ICD-9-CM2931.亞急性膽妄就診人數為最多數，住院費用以ICD-9-CM294.其他器質性精神病態為多。在低濃度曝露的宜蘭地區，其PM2.5大幅下降88.37%，可是臭氧卻增加1.11%，原因可能與氣候及季風有關，在宜蘭地區門住診失智症就醫人數以ICD-9-CM2931.亞急性膽妄就診人數為最多數，急診就醫失智症人數，以ICD-9-CM294. 其他器質性精神病態為多，在住院費用以ICD-9-CM297.妄想狀態為多，推論可能與政府積極介入空氣污染防制成效良好，但失智症就診人數仍增加可能與少子女化及老年人口增加之人口型態改變並推動失智症早期發現及早期就醫政策有關。

關鍵字

失智症；細懸浮微粒（PM2.5）；空氣污染

並列摘要

Background and purpose Many studies have pointed out that air pollutants can cause harm to human health, and more attention is paid to air pollution. Discussion on the correlation between air pollutants and respiratory diseases and cardiovascular diseases. In recent years, more and more epidemiological studies have found that air pollutants can cause poor cognitive function or cognition functional degradation, and in animal experiments, air pollutants have been found to cause dementia production. This research uses public data from the Statistics Department of the Ministry of Health and Welfare and the air Quality data as data to discuss the exposure of fine aerosols to high and low exposure concentrations. The correlation of the number of patients with dementia in the region. method This research is conducted in a retrospective way, the data source is 2007-2015 Public Health Insurance Medical Statistics from the Statistics Department of the Ministry of Health and Welfare, select ICD-9-CM 290.2931.294.297.330.331 and other codes related to dementia, selection. Those who live in Kaohsiung area with higher exposure concentration and Yilan area with lower exposure. Uses the Air pollution Contaminant concentration data that from the air quality monitoring station of the Environmental Protection Agency of our country. The study area is the increase in the concentration of fine suspended particulates in Kaohsiung and Yilan between 2007 and 2015. Perform and use estimation comparison method to infer PM2.5 where the exposure concentration in different district dementia occurs. Research result The results of this study are in the Kaohsiung area with high levels of exposure, and its PM2.5 from 2007-2015. A sharp decrease of 57.19% in these years, in terms of the number of patients with dementia, in the outpatient clinic. ICD-9-CM2931 is the number of Subacute biliary delirium people is the largest emergency medical visits. The number of hospitalization expenses is ICD-9-CM294.that Other organic mental illnesses are more. At low concentration in the exposed Yilan area, PM2.5 dropped by 88.37%, but ozone increased 1.11%, the reason may be related to climate and monsoon. Dementia in outpatient clinics in Yilan area the number of dementia is ICD-9-CM2931. The number of patients subacute biliary delirium is the largest.The number of people with dementia is ICD-9-CM294. Other organic mental illnesses are the most. The cost in hospital is ICD-9-CM297. The state of delusion is more, because of the inference may be related to the government’s active intervention in the air pollution prevention is effective, but the number of patients with dementia is still increasing. The demographic change of the annual population increase and promote the early detection of dementia and early medical treatment policies related.