加油工人油氣與噪音暴露危害研究

Abstract

噪音與汽油油氣暴露在石油化學產業是常見的危害，加油工人在石油產品製造或是分配的過程中都會接觸到此類的危害，本論文將包含兩個研究，第一部份探討加油站員工下班時候交通事故是否與工作中加油槍洩露汽油油氣有關，研究方法以汽油油氣暴露組(油品銷售部門)對照非汽油油氣暴露組(總公司，探採，煉製，及研究發展部門)，利用加油站安裝不同油氣回收裝置的三個時期(1991-92,1993-96,1997-2000)作分層分析，利用累積發生率(Cumulative Injury Rate, CIR)來推估不同時期員工交通事故的終生風險外，也使用潛在工日損失(Potential Workday Loss, PWDL)及潛在薪資損失(Potential Salary Loss, PSL)來表示公司人力和薪資成本。計算rate ratio(RR)來表示不同時期及交通事故類別員工交通事故的風險比。研究結果對照非汽油油氣暴露組，分析結果顯示油氣暴露組男性員工下班時交通事故率比(Rate Ratio, RR)由2.15(1991-1992年)降至0.73(1993-1996年)，至0.53(1997-2000年)，表示上班時汽油油氣暴露與員工下班時交通事故的發生有顯著關係。 第二部分探討噪音引起聽力損失與員工高血壓的關係，利用2001年某公司員工健康檢查結果及2003年純音聽力檢查結果為分析資料，利用噪音引起聽力損失（NIHL）作為勞工總噪音暴露量之指標，了解聽力損失與勞工高血壓之關係，排除已有糖尿病，其它心血管疾病者及純音聽力檢查結果無法判別是否為噪音引起的個案後，共有662位男性員工為研究對象，收集年齡，年資(至少10年)，工作型態，高血壓家族史，身體質量指數(BMI)，抽菸習慣，喝酒習慣，三酸甘油酯值，總膽固醇值，純音聽力檢查結果，高血壓診斷，利用多元邏輯式回歸分析探討噪音引起聽力損失與高血壓之關係。分析結果顯示除了年齡(Adjusted OR=1.1, CI=1.0-1.1)，身體質量指數(BMI) (Adjusted OR=1.2, CI=1.1-1.3)，高血壓家族史(Adjusted OR=3.4, CI=2.2-5.3)，輪班工作(Adjusted OR=2.9, CI=1.2-7.5)外，噪音引起聽力損失(Adjusted OR=1.7, CI=1.1-2.8)與原員工高血壓也有顯著關係。

Noise and gasoline vapor exposures are common hazard in the petrochemical company. In the process of manufacturing products and distribution, gasoline distribution workers exposed easily to such kinds of hazard. This thesis embraced two parts of studies, the first part is “Reduction of post-shift traffic injuries among gasoline station workers: Are they related to the reduction of occupational gasoline vapor exposure? ”, and the second part is “Association between noise-induced hearing loss and prevalence of hypertension in male petrochemical workers ”. In the first part, the occupational injury registry data of 1991-2000 in a petrochemical company containing 20,000 workers analyzed. Cumulative injury rate (CIR) calculated to estimate lifetime risk. The potential workday loss (PWDL) and the potential salary loss (PSL) calculated for traffic injuries. Workers of gasoline sales compared with those without gasoline exposure for commuting traffic injuries. The rate ratio (RR) calculated based on a person-time data. The CIR dropped 3.14 times during 1997-2000 for commuting accidents on the way back home compared with that during 1991-92, and the PWDL and PSL dropped 25.2 and 21.5 times, respectively. The RRs of commuting accidents on the way back home in the exposed group significantly decreased from 2.15 to 0.53. The decreases of commuting injuries on journey back home for gasoline workers was probably related to the effective reduction of solvent exposure. In the second part, we determined the association between the noise-induced hearing loss and hypertension in a group of male petrochemical workers. A cross-sectional study was conducted between September 2001 and June 2003 in a population of workers who participated in two annual health examinations, including audiometry, in a petrochemical company of Taiwan. 662 male workers were recruited. Multiple logistic regression analyses was performed to explore if presence of hypertension was associated with existed NIHL after controlling other risk factors, including family history, age, body mass index (BMI), and shift work. The multiple logistic regressions showed that age (Adjusted OR=1.1), BMI (Adjusted OR=1.2), family history of hypertension (Adjusted OR=3.4), shift work (Adjusted OR=2.9), and NIHL (Adjusted OR=1.7) associated with hypertension. This outcome suggests that there may be a population of worker with noise-induced hearing loss (at least one ear with hearing threshold more than 25 dB) was at high risk of hypertension. Although the multiple associations between NIHL and hypertension needed further assessed, the audiometry could used as one auxiliary method to elicit more accurate history of noise exposure.