空氣污染與學童呼出氣體及肺功能之相關性探討

Abstract

空氣品質惡化可能會導致眼睛和呼吸系統的刺激、過敏、發炎反應、心血管疾病，和氧化壓力產生，此現象在易感受族群更為明顯。台北地區氣喘發生率顯示氣喘學童有逐年攀升的趨勢。本研究探討空氣汙染與氣喘學童的呼出氣體（Exhaled breath）中揮發性有機物質（VOCs）及肺功能（Lung function）相關性，以及空氣中微粒所產生的延遲效應（Lag effect）。 本研究將受試者分為有無罹患氣喘的學童，配合環保署超級測站的空氣品質監測資料，進行五個月的評估實驗，以比較兩組學童的生理指標變化情形。指標的檢測方法中，呼出氣體VOCs以熱脫附儀與氣相層析質譜儀進行分析，以呼出氣體中戊烷作為氧化性壓力的代表；肺功能以全自動肺功能檢測儀測量。由於實驗會重複量測受試者的各項生理指標，因此使用廣義線性估計方程式（Generalized Estimating Equations, GEEs）進行檢定，分析環境污染物質對呼出氣體及肺功能指標的影響。 結果指出，氣喘學童（Pentane=0.106, AG）氧化性壓力比非氣喘學童（Pentane=0.095, AG）高。而氣喘學童的肺功能指標平均值皆低於非氣喘學童。氧化壓力也會受性別、身體質量指數、感冒與否與空氣污染物，包括：SO2、CO、NO、NO2、PM2.5的影響。肺功能則會受到身高、體重、身體質量指數、住家是否鄰近大馬路、灰塵量多寡、有無服用維他命與SO2、CO、O3、NO、NO2、PM2.5等空氣污染物的影響。PM2.5的延遲效應可表現氧化性壓力的Lag10、Lag14、Lag30。PM10的延遲效應在氧化性壓力Lag5、Lag7、Lag10、Lag14、Lag30及肺功能指標的FVC、FEV1中有顯著關係。 在易感受族群的氣喘學童中氧化性壓力有高於非氣喘學童的趨勢。空氣污染物的急性與慢性傷害會表現在學童的氧化性壓力與肺功能指標上。懸浮微粒所產生的延遲效應，在氧化性壓力與肺功能指標中可以看到顯著關係存在。研究發現，氧化性壓力的敏感度高且可反映出長期暴露造成的傷害；另外，從肺功能指標可觀察到PM10的延遲效應。

Expose to air pollution has been associated with eye and respiratory system irritation, allergic and inflamed effects and cardiovascular disease. These symptoms were observable in susceptible groups. In Taipei metropolis, the asthma incidence rate rise yearly in schoolchildren. Therefore, the objective of this study was to investigate exhaled breath VOCs and lung function relevance of the air pollution in asthmatic children. Besides, the lag effect of exposure to particulate matter would also be studied. The study divided participants into asthmatic and non-asthmatic schoolchildren. Take the exhaled breath and lung function cooperate with the air quality monitor data of EPA Supersite. The thermal desorption GC/MS was used to analyze the exhaled breath and conducted pentane as an indicator of oxidative stress; moreover, the lung function was measured by spirometer. Generalized Estimating Equations (GEEs) was used to examine the repeated measurement of the exhaled breath and lung function affected by air pollution. As the result, the higher oxidative stress and the lower average lung function in asthmatic children (Pentane=0.106 and 0.095, AG) was observed gender, body mass index (BMI), flu, and air pollutant (SO2, CO, NO, NO2, PM2.5) had significant influence in oxidative stress. Lung function were affected by height, weight, BMI, road, dust, vitamins, and air pollutant (SO2, CO, O3, NO, NO2, PM2.5). Lag effect of PM2.5 exhibit the oxidative stress in Lag10, Lag14, Lag30. The lung function (FVC, FEV1) and Lag5, Lag7, Lag10, Lag14, Lag30 in oxidative stress showed the lag effect of PM10. Asthmatic children which are susceptible had higher oxidative stress. The effects of air pollution display in oxidative stress and lung function of schoolchildren. The lag effects in oxidative stress and lung function of particulate matter were significant. This study indicated that oxidative stress is a sensitive factor and can reflect the long-term injury of exposure. In addition, the lag effect of PM10 was observed by lung function.