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標題: | 慢性疾病之職業駕駛人白天嗜睡程度之臨床探討 Clinical investigation of Daytime Sleepiness in Occupational Drivers with Chronic Illness |
作者: | Chung-Yin Wu 吳宗穎 |
指導教授: | 鄭雅文(Yawen Cheng) |
關鍵字: | 職業駕駛人,白天嗜睡,慢性疾病, occupational drivers,daytime sleepiness,chronic disease, |
出版年 : | 2012 |
學位: | 碩士 |
摘要: | 台灣地區人口稠密、車輛數目眾多,攸關民眾生命健康之交通安全尤其重要。因駕駛人的因素高度影響到交通事故之發生,進一步了解駕駛人之嗜睡行為及相關之健康因子,而進行本研究主題。
本研究的目的,在於探討職業駕駛人之白天嗜睡指數及其相關影響因子,同時並希望了解駕駛人有否罹患慢性病,是否會影響到他們之白天嗜睡程度。本研究之設計採cross sectional study,取樣對象為來醫院就診或體檢之occupational drivers及一般民眾。於2011年4月至2011年11月間收集來醫院體檢或門診之職業駕駛人共161人,有效樣本為141人。同一段期間亦收集age-matched control之來醫院體檢或門診之一般民眾 (非職業駕駛人)共158人,有效樣本為143人。兩組之有效樣本數共284人。測量工具採用廣為國際使用之Epworth Sleepiness Scale來測量嗜睡指數,除探討chronic disease對於嗜睡指數之影響外,並探討年齡、肥胖、抽菸、每天平均睡眠時數、駕駛年資、每天駕駛時數、已未婚、車輛種類等可能影響之相關變項。ESS score ≧11為國際研究普遍認定具有嗜睡意義之標準。 以univariate logistic regression對所有這些變項做分析後,呈現出有統計上的差異 (p value<0.05, OR≧2)之變項分別為代表肥胖之BMI≧ 27 (OR=4.21;95% CI為2.04-8.7;p值為0.0003)、smoking (OR= 4.97;95% CI為2.35-10.48;p值< 0.0001)、罹患chronic disease (OR= 2.89;95% CI為1.34-6.26;p值為0.006)及Driving years ≧ 15年 (OR =2.68倍;95% CI為1.31-5.51;p值<0.006)等變項。而將這些有significant之變項。再控制onfounding factors後,以multivariate logistic regression再分析的結果則有三項 (BMI、smoking、Driving years)具有統計上的差異,有一項 (Chronic disease)未達到統計上之差異。 研究結果發現,(1)肥胖的職業駕駛人其嗜睡指數較高;(2)抽菸之職業駕駛人的嗜睡指數較高;(3)駕駛年資愈久者嗜睡指數也較高。將職業駕駛人與對照之一般民眾組的ESS score相比,在ESS score≧11的變項方面,在141位職業駕駛人中ESS score≧11者有60位 (42.6%),而143位一般民眾組中ESS score≧11者有36位 (25.2%),chi-square=9.58、p=0.002。顯示出兩組有明顯的嗜睡程度之差異。 交通安全攸關民眾之生命與健康,本研究的結果不僅可以提供給職業駕駛人做為其工作與健康之參考與改進;對於一般民眾而言,選擇安全的職業駕駛人亦可保障其生命及安全。健康的駕駛人才可以保障乘客的安全,也是對於自己工作的一個長遠保障。有了解自己的身體狀況並持續促進本身的健康,才可以更能適應職業駕駛人這項工作。 Taiwan is a populous area and has large number of vehicles, so the traffic safety relevant to people’s life and health is especially important. The main accident cause of traffic accidents was highly related with driver’s factors. To understand the daytime sleepiness behavior and its associated factors is the main purpose of this study. Overseas studies have found that the traffic accidents were related to driver’s dozing or sleepiness. Japanese study has suggested that male drivers with obstructive sleep apnea syndrome are at an increased risk of motor vehicle accidents. Research in this area has yet been published in Taiwan. The purpose of this study is to explore the occupational drivers of daytime sleepiness and its associated factors. At the same time, we focus and want to know drivers who suffering from chronic diseases will affect the degree of daytime sleepiness. The research design adopted a cross sectional study, subjects were the drivers and outpatients who visited hospital for health examination or medical treatment from April 2011 to November 2011. They consisted of 161 occupational drivers with 141 effective number of samples, and a total of 158 age-matched control with an effective sample of 143 general people. In this study, we used the international use scale “Epworth Sleepiness Scale” to measure daytime sleepiness. In addition to investigate the effect chronic disease to the sleepiness scale, and to explore the associated variables such as age, obesity, smoking, average sleep length, driving years, driving hours, marital status, and vehicles type which may affect the sleepiness score. ESS score greater than 11 is generally recognized an international standard with the meaning of sleepiness. All variables were initially examined in univariate models, and the variables showed significant correlation (p value < 0.05 and OR≧ 2) were BMI≧ 27 (OR=4.21, 95%CI: 2.04-8.7, p=0.0003), smoking (OR=4.97, 95%CI: 2.35-10.48, p<0.0001), chronic disease (OR=2.89, 95%CI: 1.34-6.26, p=0.006), and driving years (OR=2.68, 95%CI: 1.31-5.51, p<0.006). To control confounding factors and to determine the main correlates, we then performed multivariate logistic regression analyses for all variables that showed a significant correlation in univariate models. Variables showed significant correlation were BMI, smoking and driving years, and variables showed no significant correlation was chronic disease (OR=2.00, 95%CI: 0.82-4.88, p=0.13). The results revealed that obese drivers, drivers with smoking habit, and drivers with longer driving years have higher sleepiness score. Compared with control group, the proportion of ESS score ≧11 of occupational drivers were higher and significant difference (42.6% vs. 25.2%), with chi-square=9.58, p=0.002. Traffic safety is relevant to people’s lives and health, the results of this study can not only provide information and improvement to occupational drivers for their work and health, but also for the general public in the choice of occupational drivers to protect their life and safety. Healthy drivers are not only the safety of passengers, but also a long-term protection for their work. Only in the understanding of self physical condition and continue to promote their own health, they can better adapt to the driving career. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/66561 |
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顯示於系所單位: | 公共衛生碩士學位學程 |
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