台灣細懸浮微粒對 急性呼吸道疾病之風險評估

Abstract

近年來工業發展越來越興盛，因此人們開始關切工業發展對環境的破壞以及環境中汙染物對人體造成的傷害。由於細懸浮微粒（Fine Particulate Matter，簡稱PM_2.5）對人體健康造成的傷害非常嚴重，短期暴露於PM_2.5的環境中會造成各種呼吸道疾病、心肺疾病，長期暴露甚至可能導致死亡，因此，PM_2.5逐漸受到各國的重視。根據台灣健保署資料顯示，台灣每人平均每年會因為急性上呼吸道感染就醫2.29次，就醫次數還在逐年成長當中。因此，本研究之主要目的即是針對台灣不同地區、性別、年齡層的族群，評估其罹患急性呼吸道疾病的風險程度。研究資料來源包括2011年全民健康保險資料庫及2011年取自行政院環境保護署的細懸浮微粒每日濃度。本研究先將台灣十九個城市分群，並針對各群組中的不同性別與年齡層分別建立卜瓦松迴歸模型，利用PM_2.5值來預測國人急性呼吸道感染就診次數並考慮到PM_2.5對急性呼吸道感染之遞延效應，最後參考流行病學評估疾病風險之方法，使用每增加四分位距單位PM_2.5濃度值之風險值來表示急性呼吸道疾病之風險。分析結果顯示，PM_2.5濃度會影響急性上呼吸道感染的就診次數。罹患急性呼吸道之風險偏高的皆為位於嘉義市、高雄市、屏東縣等0-64歲族群。在不同之地區、年齡層中改變PM_2.5濃度對該疾病就診次數的風險程度的影響很明顯，但性別因素則不明顯。遞延效應的分析顯示，年齡層以青、壯年族群的遞延效應天數最短，而老年族群天數則最長，大多為四天。

With the growth of the industry development, people start to concern the environment destruction and pollutants effect. Due to the fatal effect of Fine Particulate Matter (also called PM_2.5), that being exposed to environment with PM_2.5 may cause respiratory diseases, cardiopulmonary diseases or even death. Thus, PM_2.5 is an important part of environment protection in many countries. According to the data from National Health Insurance Administration, Taiwanese has approximately 2.29 hospital admissions on average because of acute respiratory diseases and the number of hospital admissions is still increasing every year. Therefore, the objective of this study is to investigate the relationship between PM_2.5 and acute respiratory diseases in different cities, sex group and age group in Taiwan. The data includes everyday hospital admissions retrieved from the National Health Insurance Research Database and everyday PM_2.5 concentration from the Environment Protection Administration. First, to cluster 19 cities in Taiwan into several area. Secondly, for each area, construct a Poisson Regression to predict the hospital admissions of acute respiratory disease considering the lag time using concentration of PM_2.5 for each sex, age group and city. Finally, investigating the risk of disease in epidemiology, the result reveals that the concentration of PM_2.5 affect significantly the hospital admissions of acute respiratory diseases. The people with the highest risk to get acute respiratory diseases when the concentration of PM_2.5 increases is the 0 to 64 year-old group in Chia-Yi City and Kaohsiung City at Taiwan. In addition, the impact of increase in concentration of PM_2.5 with different living area and ages groups differs significantly. However, the impact of increase in concentration of PM_2.5 with different gender is not clear. The result of lag-time analysis reveals that 0 to 64 year-old Taiwanese have the shortest lag time, but more than 65 year-old Taiwanese have approximately 4-days lag time.