職場低頻噪音暴露評估與健康影響研究

Taipei Medical University Institutional Repository > 公共衛生暨營養學院 > 公共衛生學系暨研究所 > 碩博論文 > Item 987654321/50359

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題名:	職場低頻噪音暴露評估與健康影響研究 Assessment on the effect of low-frequency noise on health
作者:	趙寶強 Chao, Pao-Chiang
貢獻者:	胡景堯陳秋蓉
關鍵詞:	低頻噪音,序列篩檢,振動聲學症,心臟超音波,E/A Ratio,複合效應 Low Frequency Noise,Serial Screening Method,Vibroacoustic Disease
日期:	2012-12-27
上傳時間:	2018-09-27 14:15:53 (UTC+8)
摘要:	目前世界各國對低頻噪音定義不盡相同，國內勞工主管機關對職場低頻噪音尚無政策規範與準則，本研究目的在開發職場低頻噪音檢測技術，進而探討國內職場低頻噪音暴露員工之健康效應，並了解噪音與其他暴露因子的複合效應。研究對象是飛機修護員工213人與半導體電子業員工125人，其中部份員工大量長期暴露於低頻噪音的工作環境中，所造成生理心理之健康效應值得關切，而噪音、低溫與振動的複合效應則由23名自願者於暴露艙中進行實驗。本研究除進行作業環境測定以分析工作現場之低頻噪音頻譜外，並執行員工健康檢查如：心臟超音波、純音聽力檢查、唾液中可體松、免疫球蛋白A 、及α-澱粉酶等項目，以剖析低頻噪音對人體之身心影響。研究結果發現，在職場低頻噪音檢測技術上，開發提出三個條件序列篩檢法(LF≧65dB；LF ≥MF+5dB ≥HF+10dB ；且＞10dB)，可對職場環境中之低頻噪音做快速簡便的篩檢，此法應用在職業場所中因低頻噪音暴露引起的厭煩度評估上，值得推薦。另外在工作環境中噪音、振動、低溫等危害因子對人體之複合效應研究上，發現手指皮膚溫度、手指靈活度及平均動脈壓等生理參數，其最大影響因素為工作環境的氣溫，其次為暴露時間；在暫時性聽力損失上之主要影響因子為噪音，而振動與溫度對實驗者並無影響。此外在低頻噪音對人體健康效應上發現，其聽力損失在高頻4kHz、6kHz較為嚴重並高達40分貝以上；而暴露於低頻噪音勞工之心臟超音波檢測參數中，E/A Ratio值異常比例高達31%，遠高於一般噪音組（8%）及對照組（13%），且達統計上顯著差異，本論文驗證了國外文獻報導，長期大量暴露於低頻噪音對人體所產生的振動聲學症之心臟健康效應；此外暴露於低頻噪音職場員工唾液中可體松濃度，在上班前濃度為0.21 μg/dL達到最高峰，隨著工作30分鐘後開始下降至0.12 μg/dL，下班時降至最低0.03 μg/dL；在免疫球蛋白A的濃度，上班前為129.84 μg/ml，上班後105.13 μg/ml，下班後降至81.63μg/ml，免疫球蛋白A的濃度變化情形與可體松一致；而α-澱粉酶濃度則呈現相反趨勢，隨勞工工作時間增加而增加，α-澱粉酶於上班前為20.84 U/ml，上班中45.83 U/ml，下班後上升至59.88 U/ml。本論文證實低頻噪音對人體生理與心理的效應確有影響，其致病機轉以及與其它暴露因子之複合效應，實有必要做更深入的探討。 The definition on the low frequency noise varies in each nation around the world. The policy and the regulation standard of the low frequency noise have yet to be established in Taiwan. The purpose of this research was to develop a technology for examining occupational low frequency noise and to evaluate the health effect oriented from long time exposure on the low frequency noise experienced by working personnel and to understand the combined effect between noise and other exposing factors. 213 aircraft maintenance personnel and 125 semiconductor working personnel were recruited for this study. The combined effect of noise, low temperature, and vibration experienced by 23 volunteers were carried out in the exposing cabin. In this research, we not only analyzed low frequency noise spectrum in work field, but also conducted labor health inspections including echocardiography, pure tone hearing inspection, and cortisol, immunoglobulin A, and α-amylase contents in saliva. Results showed that as far as developing technology for examining occupational low frequency noise were concerned, we proposed a three- conditions- series- screening method (LF≧65dB;LF≧MF+5 dB≧HF+10 dB; and ΔLC-A＞10 dB) which allowed for fast screening and was easy to use. This method possessed advantages like high differentiate sensitivity and low false-negativity that made it a very recommendable method to evaluate the degree of tiredness induced by low frequency noise. As for the combined effect of noise, low temperature, and vibration in the working environment, it was found that the most influential factor for finger temperature, finger dexterity, and average vein pressure was the temperature in the working environment, and exposure time came second. The major influential factor for temporary hearing loss was found to be noise, but vibration and temperature did not. When evaluated the effect of low frequency noise on human health, it was found that the workers’ hearing loss was more serious at high frequency 4kHz and 6kHz and could be more than 40 dB. The abnormality of echocardiographic E/A ratio (31%) was also higher than that of the general noise group（8%）and control group（13%）with statistically significant difference. This finding agreed with the reported research conclusions drew by foreign scholars in that vibroacoustic disease(VAD) induced by long term exposure on the low frequency noise did have effect on heart health. The cortisol content in the saliva of the employers exposed on the low frequency noise reached the highest level (l0.21 μg/dL ) before they went to work, and gradually decreased to 0.12 μg/dL after working for 30 minutes and to 0.03 μg/dL off duty. The variation of the SIgA concentration in the saliva was in agreement with the cortisol concentration in that SIgA concentration before work, during working and after work was found to be 129.84 μg/ml, 105.13 μg/ml and 81.63μg/ml, respectively. The α-amylase concentration increased as the work hours increased in that the α-amylase concentration before work, during working and after work was found to be 20.84 U/ml， 45.83 U/ml，and 59.88 U/ml, respectively. This research verified that low frequency noise does impose influence on human physical and psychological aspect, especially on heart health. However, its mechanism and the combined effect with other damaging factors need to be further studied.
描述:	博士論文指導教授-胡景堯共同指導教授-葉錦瑩共同指導教授-陳秋蓉委員-韓柏檉委員-蘇德勝委員-郭宏亮委員-毛義方
資料類型:	thesis
顯示於類別:	[公共衛生學系暨研究所] 碩博論文

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