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DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 陳佳堃(Jia-Kun Chen) | |
dc.contributor.advisor | 陳佳堃(Jia-Kun Chen | jkchen29@ntu.edu.tw | ), | |
dc.contributor.author | Ming-Hsien Chen | en |
dc.contributor.author | 陳明賢 | zh_TW |
dc.date.accessioned | 2023-03-19T22:11:32Z | - |
dc.date.copyright | 2022-10-17 | |
dc.date.issued | 2022 | |
dc.date.submitted | 2022-09-26 | |
dc.identifier.citation | 1. Hayes RB, Lim C, Zhang Y, et al. PM2.5 air pollution and cause-specific cardiovascular disease mortality. Int J Epidemiol 2020;49:25-35. doi: 10.1093/ije/dyz114. 2. International Agency for Research on Cancer. Air Pollution and Cancer. France: International Agency for Research on Cancer, 2013. 3. Lin HH, Suk CW, Lo HL, Huang RY, Enarson DA, Chiang CY. Indoor air pollution from solid fuel and tuberculosis: a systematic review and meta-analysis. Int J Tuberc Lung Dis 2014;18:613-21. doi: 10.5588/ijtld.13.0765. 4. 衛生福利部疾病管制署. 結核病診治指引第六版: 衛生福利部疾病管制署, 2017. 5. World Health Organization. Global tuberculosis report 2020. Geneva2020. 6. 衛生福利部疾病管制署. 2019年台灣結核病防治年報. 2020. 7. 衛生福利部疾病管制署. 108年度「結核病及漢生病直接觀察治療都治執行計畫」作業手冊. 2018. 8. 行政院環境保護署. 空氣污染排放清冊TEDS11.0排放量統計數據. 11.0 ed. 行政院環境保護署2022. 9. 行政院環境保護署. 空氣品質標準: 行政院環境保護署, 2010. 10. Lai TC, Chiang CY, Wu CF, et al. Ambient air pollution and risk of tuberculosis: a cohort study. Occup Environ Med 2016;73:56-61. doi: 10.1136/oemed-2015-102995. 11. Li YC, Chiou JY, Lin CL, Wei JC, Yeh MH. The association between air pollution level and breast cancer risk in Taiwan. Medicine (Baltimore) 2021;100:e25637. doi: 10.1097/md.0000000000025637. 12. Ku MS, Liu CY, Hsu CY, Chiu HM, Chen HH, Chan CC. Association of Ambient Fine Particulate Matter (PM(2.5)) with Elevated Fecal Hemoglobin Concentration and Colorectal Carcinogenesis: A Population-Based Retrospective Cohort Study. Cancer Control 2021;28:10732748211041232. doi: 10.1177/10732748211041232. 13. Pan W-C, Wu C-D, Chen M-J, et al. Fine Particle Pollution, Alanine Transaminase, and Liver Cancer: A Taiwanese Prospective Cohort Study (REVEAL-HBV). JNCI: Journal of the National Cancer Institute 2015;108. doi: 10.1093/jnci/djv341. 14. Patel V, Foster A, Salem A, et al. Long-term exposure to indoor air pollution and risk of tuberculosis. Indoor Air 2021;31:628-38. doi: 10.1111/ina.12756. 15. Jafta N, Jeena PM, Barregard L, Naidoo RN. Association of childhood pulmonary tuberculosis with exposure to indoor air pollution: a case control study. BMC Public Health 2019;19:275. doi: 10.1186/s12889-019-6604-9. 16. 彰化縣衛生局. 彰化縣衛生局公共衛生監測系統. Available at: https://chphs.tw/content/gis.html. 2022. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/84436 | - |
dc.description.abstract | 研究背景 在這個工業化的時代,因為大量使用石化燃料,而造成了嚴重的空氣汚染問題。這些空氣汚染物中,以細懸浮微粒(PM2.5)最為知名。細懸浮微粒指懸浮於空氣中,粒徑在2.5微米(μm)以下之粒子。長期暴露於細懸浮微粒,可引發心血管疾病、呼吸道疾病以及增加癌症的風險等。結核病是一個可空氣傳播感染的疾病,至今仍是國際重視的嚴重傳染病,也是全球公衛重大的負擔。大氣的空氣汚染,可能會傷害肺部的免疫機制,而增加了結核病的發生。 研究目的 由於細懸浮大氣細懸浮微粒和結核病都會對人體造成危害,且可能會有關連性,故本研究為探討大氣細懸浮微粒和結核病傳染可能的相關性。 研究方法 以2005-2012年彰化縣整合式健康篩檢參加者,追蹤結核病發生至2016年,得到整篩後結核病的發生率和時間。對照該地區的空氣品質監測站PM2.5年平均值,使用羅吉斯迴歸進行分析。並以貝氏層次變點模型來預測在實驗室診斷代檢網(NRLN)和都治計畫(DOTS)影響下,不同鄉鎮和年齡層至2035年結核病的發生率。 研究結果 高細懸浮微粒暴露組(PM2.5>35μg/m3)得到結核病的勝算比是低細懸浮微粒暴露組的1.69倍(95% CI 1.35 - 2.15)。每增加1μg/m3的年平均細懸浮微粒,結核病的勝算比增加為1.065倍(95% CI 1.035 - 1.097)。年齡每增加1歲,結核病的勝算比增加為1.084倍(95% CI 1.074 - 1.095)。男性結核病的勝算比是女性的3.093倍(95% CI 2.540 - 3.776)。而低教育程度發生結核病的勝算比是高教育程度的1.577倍(95% CI 1.176 – 2.151)。根據貝氏變點模型未來20年的結核病發生率為26.3每十萬人。 結論 大氣空氣汚染中的細懸浮微粒和結核病的發生有相關性。年齡、男性、低教育程度也和結核病有相關。為了達到2035年結核病發生率降到每10萬人口10例之全球目標,需要更多策略來幫忙。 | zh_TW |
dc.description.abstract | Objectives Air pollution due to petrochemical fuel is a critical problem in industrial era. The most famous pollutant is fine particulate matter (PM2.5). PM2.5 are particles less than 2.5 micrometers. Long term exposure to PM2.5 may induce cardiovascular disease, respiratory disease, and cancers on vulnerable populations. Tuberculosis is an airborne disease. Ambient air pollution may harm immune system and increase incidents of tuberculosis. Methods Attendees to Changhua Community integrated screening (ChCis) from 2005 to 2012 had been followed until 2016. Incidence and time of active tuberculosis in this population was recorded. Ambient PM2.5 values collected by Air Quality Monitoring Stations was downloaded from Environmental Protection Administration (EPA) website. Logistic regression model was used for analysis. We develop a Bayesian change-point model to assess the effectiveness of National Reference Laboratory Network (NRLN) and Directly Observed Treatment Short-Course (DOTS) and elucidate the causal inference of both strategies in reducing TB incidence. Result Higher PM2.5 exposure group (PM2.5 >35 μg/m3) has higher risk of active tuberculosis than lower PM2.5 exposure group (adjusted OR: 1.69/μg/m3 (95% CI 1.35 - 2.15)). Exposure to fine particulate matter (PM2.5) was associated with increased risk of active tuberculosis (adjusted OR: 1.065/μg/m3 (95% CI 1.035 - 1.097)). Age was associated with increasing risk of active tuberculosis (adjusted OR: 1.084/years old (95% CI 1.074 - 1.095)). Male had higher risk of active tuberculosis then females (adjusted OR: 3.093 (95% CI 2.540 - 3.776)). Less-educated people had more tuberculosis (adjusted OR: 1.577 (95% CI 1.176 – 2.151)). Based on Bayesian change point model to predict the incidence trend in the next two decades, the predicted incidence of TB will be 26.3 per 100,000 person-year. Conclusions Ambient PM2.5 may associate with the incident of tuberculosis. To reach the goal of WHO, we need more strategy to control tuberculosis. | en |
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dc.description.tableofcontents | 論文口試委員會審定書 i 誌謝/ Acknowledgement ii 中文摘要 iii Abstract v 目錄/ Contents vii 圖目錄/ List of figures viii 表目錄/ List of tables ix 第一章 導論 1 第一節 實習單位特色與簡介 1 第二節 研究目的與研究問題 1 第三節 研究目的與研究問題 2 第二章 文獻回顧 5 第一節 大氣空氣品質與結核病關聯性 5 第二節 大氣空氣品質與癌症風險關聯性 6 第三節 室內空氣品質與結核病關聯性 7 第三章 研究方法 9 第一節 研究架構 9 第二節 研究資料變項 14 第三節 統計分析 15 第四章 研究結果 17 第一節 研究對象基本資料 17 第二節 彰化細懸浮微粒監測值 23 第三節 細懸浮微粒與結核病相關性 25 第四節 以PM2.5數值預測彰化結核病發生率變化趨勢 29 第五章 討論 31 第六章 結論 36 參考文獻 37 | |
dc.language.iso | zh-TW | |
dc.title | 大氣細懸浮微粒與結核病之關係 | zh_TW |
dc.title | Ambient Fine Particulate Matter and Risk of tuberculosis | en |
dc.type | Thesis | |
dc.date.schoolyear | 110-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 陳秀熙(Hsiu-Hsi Chen) | |
dc.contributor.oralexamcommittee | 葉彥伯(Yen-Po Yeh) | |
dc.subject.keyword | 細懸浮微粒,結核病,空氣汚染,實驗室診斷代檢網,都治計畫, | zh_TW |
dc.subject.keyword | fine particulate matter,tuberculosis,air pollution,National Reference Laboratory Network,Directly Observed Treatment Short-Course, | en |
dc.relation.page | 38 | |
dc.identifier.doi | 10.6342/NTU202203147 | |
dc.rights.note | 同意授權(限校園內公開) | |
dc.date.accepted | 2022-09-26 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 公共衛生碩士學位學程 | zh_TW |
dc.date.embargo-lift | 2022-10-17 | - |
顯示於系所單位: | 公共衛生碩士學位學程 |
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