博士 / 國立臺灣大學 / 環境衛生研究所 / 90 / (1)The Relationship between Meteorological Factors and Circulatory Mortality in The Elderly, Taiwan
Studies on cardiovascular events in association with seasonal variations have rarely simultaneously considered the effects of temperature, barometric pressure changes and air pollution. Using government assembled data, the authors observed the independent effects on mortality from circulatory causes by age (65-74, 75-84, and 85 and above years) in association with temperature (＜13, 13-16, 17-20, 21-24, 25-28 and ≧29℃), barometric pressure change (0-2, 3, 4 and ≧5 hPa) in 1994 to 1998. The age-specific risk for 18,649 deaths to observe the impact of temperature and barometric pressure changes on circulatory causes were measured first in Taipei area. The multivariate Poisson regression adjusted for air pollution showed that there were 55% excess deaths for the 65-74 years group, 46% for the 75-84year group and 24% for the 85 years and above group when the temperature was less than 13℃, compared with 25-28℃ (all p=0.0001). The corresponding age-specific excess risks were 3% (p=0.54), 5% (p=0.22) and 26% (p=0.0008), respectively, when the barometric pressure change was 5 hPa or greater, compared with a change of 0-2 hPa. At this barometric pressure change, the significant excess risks in deaths for the most senior group exhibited from heart failure (51%, p=0.016), coronary heart diseases (35%, p=0.0007) and ischaemic heart disease (42%, p=0.0051) but not cerebrovascular disease (11%, p=0.34).
The author furtherly compared the association between the circulatory deaths and meteorological conditions among Taipei, Taichng and Kaohsiung areas in 1989-1998. Compared with the optimal temperature, the overall risk were 1.62 (95% confidence interval (CI) 1.45-1.80) in Taipei area when the temperature decreased to 11℃, 1.57 (95% CI 1.38-1.80) in Taichung area when the temperature decrease to 13℃, and 1.50 (95% CI 1.28-1.77) in Kaohsiung area when the temperature decreased to 15℃. Temperature changes exhibited greater influence than barometric pressure change for the younger elderly. The effect of barometric pressure changes is strengthened for the most senior age group due to cardiac conduction and modulating system disorders.
(2)Mortality among Shipbreaking Workers－A 13-year Follow-up Study.
This study examined the mortality among shipbreaking workers from 1985 to 1997, after the shipbreaking industry was banned in 1985-1986. The study cohort consisted of men including 2,850 flame cutters, 871 lifters, 240 odd-jobbers and 225 other workers registered in 1985 at Kaohsiung Shipbreaking Workers Union. Mortality (n=336) data examined were obtained from the Vital Statistics Registry from January 1985 to December 1997. Standardized mortality ratio (SMR) and proportional hazard regression were used to estimate the risk of mortality from neoplasms, injuries and other causes. Compared to the local reference population, the deaths that were significantly higher than the expected numbers among all workers included deaths from cumulative all-causes (SMR=1.11, 95% confidence interval (CI) =1.00-1.23), and deaths from external causes of injury and poisoning (SMR=1.75, 95% CI =1.47-2.09). Based on hazard ratio, both lifters and odd-jobbers were about six times more likely than flame cutters to die from accidental falls. Flame cutters in the youngest group, on the other hand, had very significant excess deaths from nasopharynx neoplasm (SMR=5.2, 95% CI=1.7-16.2) and pleural neoplasm (SMR=104.1, 95% CI=14.0-739.0). Former shipbreaking workers are more likely to be at higher risk of injuries and the young flame cutters are at higher risk of neoplasms.
| Identifer | oai:union.ndltd.org:TW/090NTU01519002 |
| Date | January 2002 |
| Creators | Yi-Kuen Liu, 劉怡焜 |
| Contributors | John F C Sung, 宋鴻樟 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 143 |
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