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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 郭育良 | |
dc.contributor.author | Pei-Ying Huang | en |
dc.contributor.author | 黃沛盈 | zh_TW |
dc.date.accessioned | 2021-05-20T20:31:29Z | - |
dc.date.available | 2013-10-03 | |
dc.date.available | 2021-05-20T20:31:29Z | - |
dc.date.copyright | 2011-10-03 | |
dc.date.issued | 2011 | |
dc.date.submitted | 2011-08-10 | |
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Determinants of current hand eczema: results from case-control studies nested in the PACO follow-up study (PACO II). Contact Dermatitis 2010;62:363-70. 53.Uter W, Pfahlberg A, Gefeller O, Schwanitz HJ. Hand dermatitis in a prospectively-followed cohort of hairdressing apprentices: final results of the POSH study. Prevention of occupational skin disease in hairdressers. Contact Dermatitis 1999;41:280-6. 54.Watkins SA, Maibach HI. The hardening phenomenon in irritant contact dermatitis: an interpretative update. Contact Dermatitis 2009;60:123-30. 55.Susitaival P, Flyvholm MA, Meding B, et al. Nordic Occupational Skin Questionnaire (NOSQ-2002): a new tool for surveying occupational skin diseases and exposure. Contact Dermatitis 2003;49:70-6. 56.Meding B, Jarvholm B. Hand eczema in Swedish adults - changes in prevalence between 1983 and 1996. J Invest Dermatol 2002;118:719-23. 57.Meding B, Swanbeck G. Predictive factors for hand eczema. Contact Dermatitis 1990;23:154-61. 58.Loffler H, Aramaki JU, Effendy I. The influence of body mass index on skin susceptibility to sodium lauryl sulphate. Skin Res Technol 2002;8:19-22. 59.Yosipovitch G, DeVore A, Dawn A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol 2007;56:901-16; quiz 17-20. 60.Schols EH, van den Eijnde WA, Heus R. A method for assessing thermal comfort of shoes using a 'sweating' foot. Eur J Appl Physiol 2004;92:706-9. 61.Brasch J. Current knowledge of host response in human tinea. Mycoses 2009. 62.Woodfolk JA. Allergy and dermatophytes. Clin Microbiol Rev 2005;18:30-43. 63.Leung DYM, Eichenfield LF, Boguniewicz M. Atopic dermatitis. In: Freedbreg IM, Z. EA, Wolff K, Austen KF, Goldsmith LA, Katz SI, eds. Fitzpatrick's dermatology in general medicine. 6 ed: McGraw-Hill company; 2003:1180-94. 64.Fang KT, Shih SC, Chang CH, Ho JC. Study on cutaneous physio-immuno-pathological status in tinea pedis. Dermatol Sinica 1995;13:127-34. 65.Noguchi H, Hiruma M, Kawada A, Ishibashi A. Tinea pedis survey in members of the Japanese Self-Defense Forces undergoing ranger training. Mycoses 1994;37:461-7. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/9613 | - |
dc.description.abstract | 背景:在1994年臺灣職業性皮膚症狀研究發現從事環保清潔工作之勞工患有職業性上肢皮膚不適的比例最高;我們的清潔隊的先趨研究也發現環保清潔隊員似乎有較高比例罹患足部黴菌疾病。若能了解環保清潔隊員手部皮膚炎及足部黴菌疾病的盛行率與相關危險因子並加以預防,將有助於職場衛生。
目的:了解環保清潔隊員手部皮膚炎、職業相關的手部症狀、以及足部黴菌疾病的盛行情況與相關危險因子。 方法:本研究為橫斷式研究。收案對象為現職男性清潔隊員,其工作包括掃街、清溝、洗垃圾箱、處理一般垃圾、資源回收、廚餘回收、以及清小廣告。本研究使用結構性問卷了解清潔隊員相關暴露、過敏情形以及過去一年的手部症狀,並由作者確定皮膚疾病診斷。本研究於2009年6月至11月間進行,由某環保單位的五區域隊員中隨機抽樣,共邀請346位參加者,最終共有274位有效樣本。並以邏輯斯迴歸(Logistic regression)分析各因子與疾病的關聯。 結果與討論:清潔隊員在過去一年中曾有工作相關的手部症狀與被診斷患有手部皮膚炎的盛行情況分別為19.0%與22.6%。工作中接觸清潔劑超過30分鐘會增加罹患皮膚炎的危險(aOR [95%CI] = 2.66 [1.11-6.20]),接觸水超過兩個小時也可能增加罹患皮膚炎的危險,但僅達到邊際顯著(aOR [95%CI] = 2.03 [0.98-4.22])。使用橡膠(aOR [95%CI] = 5.94 [1.04-33.90])及乳膠手套(aOR [95%CI] = 10.29 [1.35 -78.25])的隊員較容易發生手部皮膚炎。工作中經常發生手套滲漏也會增加患有手部不適(aOR [95%CI] = 2.32 [1.13-4.75])。而從事清溝工作為主的隊員亦會增加患有手部不適(aOR [95%CI] = 2.98 [1.03-8.62])。 在足部部分,清潔隊員足癬與甲癬的盛行率分別為47.8%與31.0%。年齡較長是罹患黴菌感染之重要危險因子,尤其年齡在50歲以上的清潔隊員,其罹患足癬(OR [95%CI] = 2.89 [1.05-8.74] )與甲癬(OR [95%CI] = 3.80 [1.18-16.96])的危險性皆較21至30歲的清潔隊員為高。身體質量指數(body mass index,BMI)超過25也會增加罹患足癬的機會(aOR [95%CI] = 2.34 [1.39-4.00]);穿運動鞋的時間越長,會增加罹患甲癬的危險(aOR [95%CI] = 3.59 [1.17-11.26])。 結論:清潔隊員的工作相關的手部不適以及皮膚炎盛行率各約二成。本研究發現工作中接觸清潔劑超過30分鐘、接觸水超過2小時、經常發生手套滲漏、使用乳膠或橡膠手套、以及清溝工作為主的隊員較容易患有手部皮膚問題。約五成清潔隊員患有足部黴菌疾病,罹病危險性隨年齡增加,BMI超過25kg/m2也會增加足癬的風險,減重可能有助於減少足癬的盛行率。 | zh_TW |
dc.description.abstract | Background: A nationwide survey in Taiwan in 1994 showed a high prevalence of work-related upper extremity symptoms in sanitary and pollution control personnel. In addition, a high prevalence of foot fungal infection was suggested in our pilot study for environmental sanitation workers. Identifying risk factors may provide us with prevention methods and improve workplace health.
Objectives: To determine the prevalence of hand dermatitis, work-related hand symptoms and foot fungal diseases and to identify risk factors. Methods: The cross-sectional study recruited current environmental sanitation workers engaged in a number of tasks, which were street-cleaning, gutter-cleaning, garbage can cleaning, disposal of general waste, resource recycling, food waste recycling, and removal of street ads. The study involved a structured questionnaire and a skin examination. The questionnaire consisted of personal exposures, allergic conditions, and hand skin symptoms in the past 12 months. The skin examination was conducted by the author. The study was conducted from June 2009 to November 2009. A total of 346 workers were randomly selected and the data of 274 eligible participants were analyzed. The association of risk factors and diseases were presented as an odds ratio utilizing logistic regression analysis. Results and Discussion: The prevalence of work-related hand symptoms in the past 12 months current hand dermatitis were 19.0% and 22.6%, respectively. Contact to detergent over 0.5 hour significantly increased the risk for hand dermatitis (aOR [95%CI] = 2.66 [1.11-6.20]). Contact with water for more than 2 hours at work showed a borderline increase of risk (aOR [95%CI] = 2.03 [0.98-4.22]). Using rubber (aOR [95%CI] = 5.94 [1.04-33.90]) or latex gloves (aOR [95%CI] = 10.29 [1.35 -78.25]) at work increased the risk of hand dermatitis. Frequent leakage of gloves at work predisposed to work-related hand symptoms (aOR [95%CI] = 2.32 [1.13-4.75]). Workers mainly involved in gutter cleaning also had a higher risk. (aOR [95%CI] = 2.98 [1.03-8.62]) The prevalence of tinea pedis and toenail onychomycosis were 47.8% and 31.0%, respectively. Age was the most significant risk factor, especially for workers over 50 years old, with odds ratios 2.89 (95%CI =1.05-8.74) for tinea pedis and 3.80 (95%CI =1.18-16.96) for onychomycosis. Body mass index (BMI) over 25 kg/m2 increased the risk for tinea pedis (aOR [95%CI] = 2.34 [1.39-4.00]). Longer duration of wearing sneakers predisposed to onychomycosis (aOR [95%CI] = 3.59 [1.17-11.26]). Conclusion: Approximately 20% of environmental sanitation workers experienced work-related hand symptoms and hand dermatitis. The study showed the risk factors were contact to detergent and water, wearing rubber or latex gloves, and frequent experience of leakage while wearing gloves. Gutter cleaning may be a risk task. About 50% workers were diagnosed as having foot fungal infection. The risk increased with age. BMI over 25 kg/m2 predisposed to tinea pedis, suggesting weight reduction may lower prevalence. | en |
dc.description.provenance | Made available in DSpace on 2021-05-20T20:31:29Z (GMT). No. of bitstreams: 1 ntu-100-R97841022-1.pdf: 9546837 bytes, checksum: 2bbc0d577dc0310bf10979311a8d0423 (MD5) Previous issue date: 2011 | en |
dc.description.tableofcontents | 口試委員會審定書 i
致謝 ii 中文摘要 iii 英文摘要 v 第一章 背景及研究目的 1 1.1 背景 1 1.1.1 清潔人員皮膚炎盛行率的文獻回顧 1 1.1.2 手部皮膚炎簡介 1 1.1.3 手部暴露量的估計方法 2 1.1.4 足部黴菌感染簡介 3 1.1.5 足部黴菌感染的致病機轉 4 1.1.6 足部黴菌感染的危險因子 4 1.1.7 清潔隊員罹患足部黴菌感染情形 4 1.1.8 小結 4 1.2 研究目的 5 第二章 研究方法 6 2.1 研究設計 6 2.2 工作項目描述 6 2.3 收案條件 6 2.4 診斷標準 6 2.4.1 手部皮膚炎 6 2.4.2 自述過去一年曾有工作相關手部不適症狀 7 2.4.3 足癬定義 7 2.4.4 甲癬定義 7 2.5 進行流程 7 2.6 研究期間 7 2.7 統計方法 8 第三章 結果與討論─手部皮膚炎及工作相關手部不適症狀 9 3.1 抽樣架構 9 3.2 人口學資料 9 3.3 工作項目分布描述 9 3.4 手部皮膚狀況描述 9 3.5 手部皮膚炎的危險因子 10 3.6 自述過去一年曾患有工作相關手部不適的危險因子 10 3.7 工作項目與手部皮膚炎及手部不適的相關 11 3.8 討論 11 3.9 研究限制 13 3.10 結論與建議 14 第四章 結果與討論─足部黴菌感染 15 4.1 足部黴菌感染描述 15 4.2 人口學因子與足部黴菌感染之相關 15 4.3 各危險因子與足癬之相關 15 4.4 各危險因子與甲癬之相關 16 4.5 穿戴鞋子種類與黴菌感染之相關 16 4.6 工作項目與黴菌感染之相關 16 4.7 討論 16 4.8 研究限制 18 4.9 結論與建議 18 參考文獻 20 附錄一 環保清潔隊員皮膚健康檢查問卷 46 附錄二 皮膚健康檢查評估表 49 圖目錄 圖一、主要七項環保清潔工作的工作內容 25 圖二、手部皮膚炎及足部黴菌疾病之典型案例 27 圖三、清潔隊員皮膚健康檢查抽樣流程圖 28 表目錄 表一、清潔人員手部皮膚炎相關的國內外文獻 29 表二、足癬及甲癬盛行率的相關國內外文獻 30 表三、本研究族群的人口學資料 (n=274) 32 表四、清潔隊員工作時間分配的百分比及超過50%工時從事某項工作的人數 33 表五、清潔隊員自述皮膚症狀及皮膚檢查時醫師診斷的皮膚疾病分佈 (n=274) 34 表六、清潔隊員患有醫師診斷的手部皮膚炎與可能危險因子之相關性 35 表七、清潔隊員自述過去1年曾患有工作相關手部症狀的可能危險因子之相關性 37 表八、依從事工作項目時間分層顯現患有手部皮膚炎及工作相關手部症狀之關聯39 表九、清潔隊員罹患足癬與甲癬的人數及種類 (n=274) 40 表十、清潔隊員各內在相關危險因子與患有足癬的相關性 41 表十一、清潔隊員各內在危險因子與患有甲癬的相關性 42 表十二、清潔隊員各外在危險因子與患有足癬與甲癬的相關性 43 表十三、清潔隊員穿鞋時間與患有足癬和甲癬的相關性 44 表十四、清潔隊員的工作項目時間分層與罹患足癬與甲癬的相關性 45 | |
dc.language.iso | zh-TW | |
dc.title | 環保清潔隊員手部皮膚炎及足部黴菌疾病調查 | zh_TW |
dc.title | Hand Dermatitis and Foot Fungal Diseases in Environmental Sanitation Workers | en |
dc.type | Thesis | |
dc.date.schoolyear | 99-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 陳志傑 | |
dc.contributor.oralexamcommittee | 紀秀華,陳保中 | |
dc.subject.keyword | 環保清潔隊員,手部皮膚炎,手部濕疹,工作,職業,足癬,甲癬,危險因子, | zh_TW |
dc.subject.keyword | environmental sanitation workers,hand dermatitis,hand eczema,occupation,work,tinea pedis,onychomycosis,risk factors, | en |
dc.relation.page | 51 | |
dc.rights.note | 同意授權(全球公開) | |
dc.date.accepted | 2011-08-10 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 職業醫學與工業衛生研究所 | zh_TW |
顯示於系所單位: | 職業醫學與工業衛生研究所 |
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