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DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 詹長權(Chang-Chuan Chan) | |
dc.contributor.author | Yi-Ching Hsieh | en |
dc.contributor.author | 謝宜靜 | zh_TW |
dc.date.accessioned | 2023-03-19T22:17:54Z | - |
dc.date.copyright | 2022-10-21 | |
dc.date.issued | 2022 | |
dc.date.submitted | 2022-09-29 | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/84620 | - |
dc.description.abstract | 背景 自COVID-19大流行已對全球造成各種嚴重的影響,無法進行日常活動改變了人類的生活模式,研究發現在工作場所會暴露到病毒,在大流行期間工廠感染控制措施對於降低職場COVID-19傳播的效果則少有研究。本研究將使用越南某工廠針對員工以職業衛生手段進行主動篩檢的防疫資料建立傳染病傳播模型,探討在工作場所使用篩檢措施介入對於工廠內疫情控制的效果,並以成本效益分析篩檢措施的價值。 材料與方法 本研究透過越南A廠於2021年10月25日至12月22日於Delta變異株流行的背景實施篩檢介入措施結果取得之次級資料,根據資料中的疫苗及曾經確診康復具短暫抗體的條件,以擴展SIQR、SEIQR、SEIQRV隔室模型等傳染病傳播模型進行模擬,挑選最適合A廠之疫情發展之模型,進一步了解在同樣條件下,不實施篩檢措施會造成的影響,並觀察在不同篩檢頻率的情境下的疫情發展狀況。為了更真實呈現工廠非封閉狀態,加入非工作時間與社區接觸為另一感染源,使用混合SEIQRV隔室與代理人基模型,並以規則基礎模型以更簡單地表達複雜的交互作用,假設篩檢可用性有限的條件模擬研究期間的發展動態。成本效益分析對篩檢措施的成本與效益進行評估,探討不同情境的效果並建議選擇適合的篩檢措施以供決策。 結果 在本研究期間工廠七天移動平均的篩檢陽性率與越南篩檢陽性率軌跡趨勢相似。以Delta變異株的傳染力並與每日一次、每週五次、每三日一次及每七日一次的篩檢頻率組合中,使用SIQR模型模擬的結果,每日一次及每週五次的頻率不會在工廠內造成傳播,每三日一次的頻率會造成0.1%的人被感染,每七日一次的頻率則會造成1%的人被感染。而在SEIQR模型中,同樣在每日一次及每週五次的篩檢頻率下不會造成疫情的傳播,每三日一次的頻率會在前期造成COVID-19的傳播,並在第二天達到高峰值,每七日一次的頻率會使具有傳染力的人在工廠內造成小規模的傳播並在第四天達到高峰直到模型結束。SEIQRV模型中即便實施每日的篩檢措施也無法阻止傳染,在模擬的第三天會達到最大的感染數,而篩檢頻率越低會將高峰時間往後,且感染人數更多。 觀察三個擴展隔室模型在Delta變異株的傳染力與不同頻率組合進行模擬的結果顯示工廠實際的軌跡發展動態與趨勢隨時間增加且斜率大小與SIQR模型及每週一次篩檢的組合模擬結果最接近,選定SIQR模型為最佳模型後,以此模擬不實施篩檢措施會在研究期間造成44.5%的員工遭受感染。 混合SEIQRV隔室與代理人基的模型中,是篩檢量能足以提供所有人篩檢的情況下,不會造成病毒的傳播,而在量能10%的情境下,可能最多有10%的人會遭到感染,而在5%量能的情形中可能會有15%的人被感染,在僅有1%量能的情境中,可能會有30%的人被感染。 SIQR模型用於評估成本效益,本研究以產能做為效益的目標,隨著篩檢頻率增加成本亦會更高,ACER的結果表示每週一次篩檢的每單位成本最低廉;在本研究中以產能最大化為目的,ICER的結果中表示選擇每週五次的篩檢頻率可以使損失產能最少且較每日篩檢的實施成本更便宜。 結論 根據本研究的模擬結果發現在盛行率低的工廠中,高頻率的實施篩檢可以有效地控制疫情,調整或是降低篩檢頻率以節省成本,當篩檢量能有限時,暴露風險最高及具有脆弱性的工人應優先進行測試。以本研究發現為基礎,建議透過對COVID-19更廣泛的監測以獲取更可靠的真實數據來建立預測性更好的模型,並針對盛行率高的環境中評估僅實施高頻率的篩措施能否降低疫情的傳播風險。在職業衛生方面,有效地控制COVID-19需要在工作場所進行全面的評估以選擇適當的控制措施及組合包含篩檢與戴口罩,COVID-19對於工人來說是重要的生物性危害,未來應正視在工作場所中的預防策略,以防止傳播、個人危害和經濟損失,本研究中工作場所中傳染預測模型顯示了其在預防新發傳染病傳播方面的潛力,應在未來的研究中進一步探索。 | zh_TW |
dc.description.abstract | Background Globally, the COVID-19 pandemic has a severe impact on all facets of society. Previous studies have shown that occupational exposure was an important transmission route for COVID-19, the effectiveness of infection control measures within companies for contacting COVID-19 is not well studied. This study has built infection transmission models for a factory in Vietnam to investigate the effectiveness of screening tests performed among their workers as a workplace infection control intervention. By evaluating whether frequent screening tests can be a successful occupational hygiene measure that maintains maximum productivity and infection control for occupational settings during the pandemic of the Delta variant. Material and Methods This study has used secondary data obtained from antigen test interventions implemented in Factory A from October 25 to December 22, 2021 in the background of Delta variant prevalence. Vaccination records and diagnosis and recovered data of workers has been used into extended SIQR, SEIQR, and SEIQRV compartment models. This data is used to simulate, and selected the most suitable model for the development of COVID-19 transmission in Factory A. Additionally, to better understand transmission dynamics among factory employees, different scenarios such as increasing or decreasing screening frequency, and not implementing screening at all, were simulated. In order to more realistically present the non-closed state of the factory, we add non-working time and community contact as another potential source of infection for the SEIQRV compartment with agent-based model, to simulate transmission developments during the study period under the assumption that testing capacity is limited. The cost-effective analysis conducted, evaluates the costs and effectiveness of screening test strategies in the factory, by discussing the potential effect of different scenarios, and finally recommends appropriate screening test strategies for decision making. Results The transmission rate of the Delta variant was paired with different test frequencies and using SIQR model simulation, the results of the test frequencies of once a day and five times a week would not cause infection in the factory. The frequency of once every three days results in 0.1% of people being infected. The frequency of once-a-week results in 1% of the population being infected. In SEIQR model, the frequency of test once a day and five times a week will not cause the spread of the disease. The frequency of once every three days causes the spread of COVID-19 in the early stage, with a peak on the second day. The frequency of once a week would allow contagious people to cause a small spread within the factory until the end of the model. In the SEIQRV model, even a daily screening test strategy cannot stop the infection. Examining the simulation results of the three extended compartment models in different transmission rate of the Delta variant and different test frequencies show that the development dynamics and trend of the factory increase with time, and the magnitude of the slope is similar to the results of SIQR model with weekly test therefore SIQR model was chosen as the best model and use it to simulate. 44.5% Of the workers would be infected during the study period if no screening test strategy was implemented. In the hybrid SEIQRV compartment and agent-based model, no increased infection rates were observed, assuming that test capacity is sufficient for all workers. In the scenario of 10% test capacity, up to 10% of people may be infected. In 5% test capacity scenarios, 15% of people may be infected. In 1% test capacity scenarios, 30% of people may be infected. SIQR model was also used to assess cost-effectiveness, with production capacity as the effectiveness parameter in this study and more testing is more expensive. ACER results show that the lowest cost is weekly test. In this study, our objective is to maximize production capacity, ICER results show that the frequency of five times per week lost the least production capacity and is less expensive than the daily screening test. Conclusion According to the results of this study, implementing a high-frequency screening test strategy in a factory with initially low COVID-19 prevalence, can effectively control COVID-19 infections, and adjusting or reducing the test frequency can save costs. Further studies are recommended to obtain more real-world data and more extensive surveillance of COVID-19 to build reliable predictive models in the work environmnet. This is especially needed to assess the effectiveness of screening test strategy in reducing COVID-19 spreading in the workplace during episodes of high COVID-19 prevalence. The role of occupational hygiene in controlling COVID-19 effectively requires a comprehensive hazards assessment in the workplace to select appropriate control measures including the combination of testing and wearing masks. COVID-19 is an important biological hazard for workers and more attention is needed for prevention strategies in the workplace to prevent transmission, personal harm and economic loss. Transmission modeling in occupational settings, such as factory environments, that include testing strategies as conducted in this study, show its potential for preventing transmission of newly emerging infectious disease and should be explored further in future research. | en |
dc.description.provenance | Made available in DSpace on 2023-03-19T22:17:54Z (GMT). No. of bitstreams: 1 U0001-2709202213425800.pdf: 10780758 bytes, checksum: 040b80abcf90675b15e6e619baa8ebd6 (MD5) Previous issue date: 2022 | en |
dc.description.tableofcontents | 致謝 I 中文摘要 I ABSTRACT IV 目錄 VII 圖目錄 IX 表目錄 XIII 第一章 研究背景 1 第二章 文獻探討 3 2.1新冠肺炎 (CORONA VIRUS DISEASE-2019, COVID-19) 3 2.2 職業衛生與職業暴露 8 2.3越南COVID-19疫情概述 18 2.4研究目的 24 第三章 研究方法 25 3.1研究架構 25 3.2研究地區和對象 26 3.3入廠篩檢措施 27 3.4篩檢工具介紹 30 3.5資料來源 31 3.6 模型建立 32 3.6.1 隔室模型(Compartment Model, CM) 32 3.6.2 代理人基模型(Agent-based model, ABM) 48 3.6.3敏感性分析 54 3.7 成本效益分析(COST-EFFECTIVENESS ANALYSIS, CEA) 54 第四章 研究結果 57 4.1研究對象基本統計資料 57 4.2篩檢措施介入結果 59 4.3隔室模型模擬結果 62 4.3.1 SIQR模型模擬結果 62 4.3.2 SEIQR模型模擬結果 64 4.3.3 SEIQRV模型模擬結果 67 4.3.4 重現工廠COVID-19發展動態 69 4.4代理人基模型模擬結果 74 4.5成本效益分析結果 77 第五章 討論 80 5.1隔室模型模擬結果討論 80 5.2代理人基模型模擬結果討論 88 5.3評估成本效益 91 5.4COVID-19與職業衛生 95 5.5研究限制 110 第六章 結論 111 第七章 建議 112 參考文獻 113 附錄 135 附錄一 SIQR模型模擬結果 135 附錄二 SEIQR模型模擬結果 139 附錄三 SEIQRV模型模擬結果 147 附錄四 ABM模型模擬結果 155 附錄五 CODE 163 | |
dc.language.iso | zh-TW | |
dc.title | 新冠肺炎大流行中某職場疫情控制成效研究 | zh_TW |
dc.title | The effectiveness of infection control strategies in a workplace during COVID-19 pandemic | en |
dc.type | Thesis | |
dc.date.schoolyear | 110-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 蘇大成(Ta-Chen Su),袁子軒(Tzu-Hsuen Yuan) | |
dc.subject.keyword | 新冠肺炎,職業衛生,篩檢,隔室模型,代理人基模型, | zh_TW |
dc.subject.keyword | COVID-19,occupational hygiene,screening test,compartmental models,agent-based models, | en |
dc.relation.page | 169 | |
dc.identifier.doi | 10.6342/NTU202204157 | |
dc.rights.note | 同意授權(限校園內公開) | |
dc.date.accepted | 2022-09-29 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 環境與職業健康科學研究所 | zh_TW |
dc.date.embargo-lift | 2027-09-29 | - |
顯示於系所單位: | 環境與職業健康科學研究所 |
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