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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 張靜文(Ching-Wen Chang) | |
dc.contributor.author | Chu-Yun Lin | en |
dc.contributor.author | 林楚雲 | zh_TW |
dc.date.accessioned | 2021-06-16T03:41:21Z | - |
dc.date.available | 2020-03-13 | |
dc.date.copyright | 2015-03-13 | |
dc.date.issued | 2015 | |
dc.date.submitted | 2015-02-12 | |
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Sakamoto, R., Ohno, A., Nakahara, T., Satomura, K., Iwanaga, S., Kouyama, Y., Kura, F., Noami, M., Kusaka, K., Funato, T., Takeda, M., Matsubayashi, K., Okumiya, K., Nato, N., Yamaguchi, K., 2009. Is driving a car a risk for Legionnaires’ disease?. Epidemiol. Infect. 137, 1615-1622. Sakamoto, R., Ohno, A., Nakahara, T., Satomura, K., Iwanaga, S., Kouyama, Y., Kura, F., Kato, N., Matsubayashi, K., Okumiya, K., Yamaguchi, K., 2009. Legionella pneumophila in rainwater on roads. Emerging Infectious Diseases. 15 (8), 1295-1297. Simmons, R.B., Rose, L.J., Crow, S.A., Ahearn, D.G., 1999. The occurrence and persistence of mixed biofilms in automobile air conditioning systems. Current Microbiology. 39, 141-145. Thomas, V., Herrera-Rimann, K., Blanc, D.S., Greub, G., 2006. Biodiversity of amoebae and amoeba-resisting bacteria in a hospital water network. Applied and Environmental Microbiology. 72 (4), 2428-2438. Thomas, J.M., Thomas, T., Stuetz, R.M., Ashbolt, N.J., 2014. Your garden hose: a potential health risk due to Legionella spp. growth facilitated by free-living amoebae. Environ. Sci. Technol. 48, 10456-10464. Wallensten, A., Oliver, I., Ricketts, K., Kafatos, G., Stuart, J.M., Joseph, C., 2010. Windscreen wiper fluid without added screenwash in motor vehicles: a newly identified risk factor for Legionnaires’ disease. Eur. J. Epidemiol. 25, 661-665. Yli-Pirila, T., Kusnetsov, J., Haatainen, S., Hanninen, M., Jalava, P., Reiman, M., Seuri, M., Hirvonen, M.R., Nevalainen, A., 2004. Amoeba and other protozoa in material samples from moisture-damaged buildings. Environmental Research. 96, 250-256. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/54911 | - |
dc.description.abstract | 過去文獻證實棘阿米巴原蟲可存在於水體環境及車體空調系統中,流行病學研究則發現職業駕駛有較高的退伍軍人病感染風險,其暴露來源可能來自車體雨刷水或空調系統,然目前仍缺乏職業用大型車體暴露調查資訊。由於與棘阿米巴原蟲共生時,退伍軍人菌較能抵抗惡劣環境並增加致病性,本研究欲評估車輛雨刷水及空調系統棘阿米巴原蟲汙染情形以及其與環境物化因子及退伍軍人菌等生物因子之關聯性,並探討雨刷水空調及操作維護和車體資訊是否影響棘阿米巴原蟲檢出及孳生。據此,本研究於大台北都會地區進行採樣,自85輛客貨運車之大型車體採集其空調出風口抹拭樣本及雨刷水桶和其出水口之水樣,並以聚合酶連鎖反應搭配核酸染劑定量樣本中活性棘阿米巴原蟲濃度。此外,亦分析採集樣本中之退伍軍人菌及異營性細菌以及其他多項物化因子,同時設計問卷收集駕駛的用車與維護行為。 研究發現,在85輛大型車體空調系統中,活性棘阿米巴原蟲檢出率為40%,檢出濃度介於0.004–11.5 cells/cm^2。以Multiple logistic regression with stepwise procedure分析空調出風口抹拭樣本活性棘阿米巴原蟲檢出與否之影響因子,顯示原蟲之檢出顯著受總退伍軍人菌及異營性細菌之正向影響(OR= 5.71, 95% CI= 1.74–18.76及OR= 14.29, 95% CI= 4.11–49.73),且停靠於有遮蔽室內或室外之車輛有較高之原蟲檢出(OR= 0.32, 95% CI= 0.13–0.81)。另以Multiple linear regression with stepwise procedure分析與空調活性棘阿米巴原蟲濃度相關之影響因子,發現清潔或更換空調過濾網之間隔日數越長,活性棘阿米巴原蟲檢出濃度亦越高(β=0.02, P=0.0002)。 至於在大型車體雨刷水系統中,85輛車之雨刷水桶及出水口活性棘阿米巴原蟲檢出率分別為37.7%及36.5%,陽性檢出濃度介於2.91–5.15 log cells/L及2.76–5.07 log cells/L。雖然雨刷水桶及出水口處原蟲檢出率及檢出濃度無顯著差異,然雨刷水出水口/雨刷水桶濃度比值大於1,顯示管線很可能有生物膜引致原蟲繁殖現象。當以Multiple logistic regression with stepwise procedure分析大型車體雨刷水桶內影響活性棘阿米巴原蟲檢出與否之水質因子,發現雨刷水桶內活性棘阿米巴原蟲檢出受導電度及水溫之正向影響(OR= 3.66, 95% CI= 1.10–12.15及OR= 12.24, 95% CI= 1.27–118.24),且受到pH值之負向影響(OR= 0.33, 95% CI= 0.12–0.93)。而 Multiple logistic regression with stepwise procedure分別分析影響雨刷水桶及出水口活性棘阿米巴原蟲檢出之車體使用維護因子時則發現,行經工業區或廢水處理地區有顯著較高之機率自雨刷水桶及出水口內檢出活性棘阿米巴原蟲(OR= 7.35, 95% CI= 2.12–25.53及OR= 9.60, 95% CI= 1.95–47.25),每月平均噴灑雨刷水之次數越多,較不易檢出雨刷水出水口活性棘阿米巴原蟲(OR= 0.08, 95%CI = 0.01–0.60),固定行車路線為台中以南之車輛,其活性棘阿米巴原蟲濃度較行駛於苗栗以北之車輛高(β=25.6,P=0.03)。 本研究為首次針對車體空調與雨刷水系統進行活性棘阿米巴原蟲的定量,亦是首次發現影響空調與雨刷水內活性棘阿米巴原蟲存在之顯著因子。若能從上述高風險之因子進行環境清潔或控制,將可控制活性棘阿米巴原蟲滋生,以降低民眾暴露甚至感染之此原蟲或是其相關寄生性病原細菌的風險,保護職業駕駛人以及民眾的健康。 | zh_TW |
dc.description.abstract | Previous studies have shown the presence of Acanthamoeba in aquatic environments and automobile air conditioning system. Epidemiology studies have also shown that occupational drivers are in higher risk of Legionnaires' disease. Contaminated sources, such as automobile windscreen wipers or air conditioning systems, could be potential transmission routes of Acanthamoeba and Legionella spp. However, environmental surveillance of Acanthamoeba in occupational large vehicles is unavailable. Since Acanthamoeba have been known to protect Legionella spp. by enhancing virulence against harsh conditions, this study assesses the relationship between viable Acanthamoeba contamination in windscreen wipers and air conditioning systems and physicochemical and biological parameters. Information about windscreen wipers, air conditioning system maintenance, and vehicle characteristics were collected to determine factors influencing viable Acanthamoeba presence and abundance. Thus, water samples from tanks and outlets of windscreen wiper systems and swab samples from air conditioning vents were collected in long-distance buses and garbage trucks in the Taipei metropolitan area. Furthermore, quantitative real time polymerase chain reaction (qPCR) coupled with ethidium monoazide was performed to quantify the concentration of viable Acanthamoeba, and drivers were surveyed on their maintenance behaviors. This study finds that, in the air conditioning system of eighty-five large vehicles, prevalence of viable Acanthamoeba is 40%; concentration range of viable Acanthamoeba is 0.004-11.5 cells/cm^2. In multiple logistic regression with stepwise procedure for factors influencing viable Acanthamoeba presence in swab samples, total L. pneumophila and heterotrophic bacteria show significant positive association with viable Acanthamoeba (OR= 5.71, 95% CI= 1.74–18.76 and OR= 14.29, 95% CI= 4.11–49.73); Vehicle parks at sheltered outdoor or indoor have greater risk of viable Acanthamoeba presence than those who parks at unsheltered places(OR 0.32, 95%CI 0.13–0.81). Further, in multiple linear regression with stepwise procedure, regular interval of cleaning or replacement air conditioning filters is positively associated with viable Acanthamoeba concentration (β=0.02,P=0.0002). In the windscreen wiper system of eighty-five large vehicles, prevalence of viable Acanthamoeba in tanks and outlets is 37.7% and 36.5%; the positive concentration range of viable Acanthamoeba is 2.91–5.15 log cells/L and 2.76–5.07 log cells/L. Although no significant differences were found between tanks and outlets, viable Acanthamoeba concentration in outlet samples was greater than that in tank samples, a fact indicating the possibility of biofilm in wiper pipeline influencing Acanthamoeba proliferation. Multiple logistic regression with stepwise procedure of large vehicle tanks finds that water temperature and conductivity are positively associated with viable Acanthamoeba presence (OR= 3.66, 95%CI= 1.10–12.15 and OR= 12.24, 95%CI= 1.27–118.24), while pH is negatively associated with viable Acanthamoeba presence (OR= 0.33, 95%CI= 0.12–0.93). In multiple logistic regression with stepwise procedure of vehicle maintenance factors influencing viable Acanthamoeba presence in tanks and outlets finds that vehicles that drive through industrial or sewage treatment areas have higher prevalence of viable Acanthamoeba than those that do not(OR= 7.35, 95% CI= 2.12–25.53 and OR= 9.60, 95% CI= 1.95–47.25), vehicles that have higher frequency of wiper spraying is more unlikely to detect viable Acanthamoeba in wiper outlet (OR= 0.08, 95%CI = 0.01–0.60), and vehicles that drives to the south regular have higher concentration of viable Acanthamoeba in tank(β=25.6,P=0.03). This study is the first to quantify viable Acanthamoeba presence in automobile air conditioning and windscreen wiper systems, and is also the first to indicate the key influencing factors of viable Acanthamoeba presence and abundance in large vehicles. Environmental disinfection and control of risk factors are crucial for reducing exposure to potential viable Acanthamoeba or amoeba-resistant pathogens, and in protecting the health of occupational drivers and the public. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T03:41:21Z (GMT). No. of bitstreams: 1 ntu-104-R00844015-1.pdf: 4602918 bytes, checksum: f9f66727de82da0d33232e24f97d4a5e (MD5) Previous issue date: 2015 | en |
dc.description.tableofcontents | 中文摘要 1 Abstract 3 圖目錄 8 表目錄 8 第一章 文獻回顧 13 1.1 環境中棘阿米巴原蟲及其影響因子 13 1.2 棘阿米巴原蟲 18 1.3 阿米巴原蟲與退伍軍人菌關係 18 1.4 空調系統中棘阿米巴之存在 20 1.5車體空調及雨刷水系統中退伍軍人菌汙染 20 1.6車輛空調與雨刷系統之原理與結構 23 1.7 研究背景及其重要性 24 第二章 研究目的 25 第三章 研究架構 26 第四章 材料與方法 27 4.1環境採樣策略 27 4.1.1 採樣對象 27 4.1.2 採樣位置 27 4.1.3 採樣方式 28 4.1.4採樣時間及採樣數量 31 4.1.5空白樣本 31 4.1.6運送條件 32 4.2 培養基及緩衝液 32 4.2.1 R2A培養基 32 4.2.2 BCYEα培養基 32 4.2.3 DGVP 培養基 33 4.2.4 PBS磷酸鹽緩衝液 34 4.2.5 PAS 原蟲食鹽緩衝液(Page's Amoeba Saline Solution) 34 4.2.6 TE緩衝液 35 4.2.7 酸性緩衝液 (KCl-HCl buffer) 35 4.3 樣本分析 35 4.3.1 樣本前處理 38 4.3.2 EMA treatment 39 4.3.3 Acanthamoeba DNA萃取 40 4.3.4 L. pneumophila DNA萃取 41 4.3.5 Acanthamoeba DNA稀釋 41 4.3.6 Real-time 分析 41 4.3.6.1 製備棘阿米巴原蟲 DNA 標準品及檢量線 41 4.3.6.2 Acanthamoeba real-time PCR分析 42 4.3.6.3 L. pneumophila real-time PCR分析 43 4.3.7 培養法分析 45 4.4評估指標 49 4.5統計分析 51 4.5.1數據處理 51 4.5.2 統計方法 51 第五章 結果 54 5.1採樣對象 54 5.1.1採樣對象之車體基本資訊及駕駛習慣 54 5.2空調出風口抹拭樣本 58 5.2.1活性棘阿米巴原蟲檢出率和陽性檢出濃度 59 5.2.2空調系統生物性因子陽性樣本之數值分布 61 5.2.3空調系統操作維護描述性統計 63 5.2.4空調系統活性棘阿米巴原蟲相關性分析 70 5.3雨刷水系統之活性棘阿米巴原蟲分析 106 5.3.1雨刷水中活性棘阿米巴原蟲陽性檢出率 107 5.3.2雨刷水中活性棘阿米巴原蟲陽性樣本之檢出濃度 108 5.3.3雨刷水桶及其出水口活性棘阿米巴原蟲及嗜肺性退伍軍人菌之OT比 110 5.3.4雨刷水桶水體中物化與生物因子 116 5.3.5雨刷水系統操作維護描述性統計 120 5.3.6雨刷水桶水體中活性棘阿米巴原蟲相關性分析 127 第六章 討論 187 6.1 空調系統之棘阿米巴原蟲存在 187 6.2空調系統中微生物與棘阿米巴原蟲之互動 187 6.3職業駕駛用車習慣及空調系統清潔維護 191 6.4職業駕駛用車習慣及雨刷水系統清潔維護 191 6.5雨刷水中之棘阿米巴原蟲存在 193 6.6雨刷水水質因子與棘阿米巴原蟲存在之關係 193 第七章 結論 200 文獻引用 205 附錄 209 | |
dc.language.iso | zh-TW | |
dc.title | 大型車體雨刷及空調系統棘阿米巴原蟲研究 | zh_TW |
dc.title | Acanthamoeba in windscreen wiper and air-conditioning systems in large vehicles | en |
dc.type | Thesis | |
dc.date.schoolyear | 103-1 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 洪弘(Hung Hung),林嘉明(Jia-Ming Lin) | |
dc.subject.keyword | 棘阿米巴原蟲,空調系統,雨刷水,空調過濾網,職業駕駛,嗜肺性退伍軍人菌,退伍軍人菌, | zh_TW |
dc.subject.keyword | Acanthamoeba,air conditioning system,windscreen wiper fluid,air conditioning filter,occupational drivers,Legionella, | en |
dc.relation.page | 231 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2015-02-12 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 環境衛生研究所 | zh_TW |
顯示於系所單位: | 環境衛生研究所 |
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