糜爛性食道炎之工作相關因素研究

Abstract

背景：胃食道逆流在近年來已經成為一個重要的健康課題。年紀大、肥胖、現代化的生活方式、及某些日常生活習慣已被知道與疾病的發生有關。然而，與工作相關的因素一直未被詳細探討。本研究的目的即在探討工作因素與經上消化道內視鏡診斷的糜爛性食道炎的相關性。 方法：研究對象為國內受僱工作者，在台灣北部的某健康體檢中心接受包括上消化道內視鏡的例行性常規健康檢查，進行持續性的收案。糜爛性食道炎的胃鏡檢查結果是以洛杉磯分類為診斷依據。一般常見的危險因子及工作相關的危險因子則以健康檢查及問卷取得資料。 結果：收案時間為2010年3月至2011年6月，總共有636人接受上消化道內視鏡檢查，並且完成了問卷調查；針對這些樣本進行統計分析：其中有144人（佔23％）被發現有糜爛性食道炎。經由校正性別、年齡、高身體質量指數、吸煙、飲酒和運動習慣等傳統的危險因子後，發現一邊吃飯一邊工作（AOR=2.27，CI=1.18-4.54），午休時有趴睡的習慣（AOR=4.07，CI=2.40-6.97），在工作時長時間坐著（AOR =2.67，CI=1.45-5.07），和主動型工作內涵者（AOR=2.49，CI=1.35-4.64）是與糜爛性食道炎有顯著相關的工作因素。 結論：除傳統的危險因子以外，工作時長時間坐著、工作時一邊吃飯、午休時有趴睡習慣、和主動型工作內涵可能為糜爛性食道炎之工作因素。對胃食道逆流之預防與治療，與工作有關的因素亦應列入考量。

Gastroesophageal reflux disorders have become an important problem in the recent years. Modern lifestyle, habits, old age and obesity are known contributors to this problem. However, the contribution of work-related factors has been unclear. This study aims to examine work-related factors of erosive esophagitis (EE) as diagnosed by endoscopy. The study subjects are people currently employed, and go through a regular physical examination including upper gastrointestinal panendoscopy in a health examination center of northern Taiwan. Consecutive recruitment is done. Erosive esophagitis was diagnosed based on the Los Angeles classification by endoscopy. A total of 636 currently employed participants undergo panendoscopy and complete the questionnaire satisfactorily and included for the final statistical analysis. Among the participants, 144 (23%) are found to have EE. Work-related factors significantly associated with EE are having meals while working (aOR=2.27, CI=1.18-4.54), taking afternoon nap at the desk (aOR=4.07, CI=2.40-6.97), long sitting time at work (aOR=2.67, CI=1.45-5.07), and active job content group by Job Content Questionnaire (aOR=2.49, CI=1.35-4.64) after adjusting for traditional risk factors of male gender, older age, high body mass index, ever smoking, and exercise habit. We conclude that work-related factors cannot be ignored when managing gastroesophageal reflux disorders in currently employed people.