作業環境之生物性氣膠危害：文獻探討及台灣地區高暴露行業之初步調查

Occupational Hazards of Bioaerosols: Literature Review and A Preliminary Survey on Occupations of Potential High Bioaerosol Exposures in Taiwan

生物性氣膠（Bioaerosols）一般泛指存在於空氣中，經由活的生物體所衍生而來的粒子，而高溫、高濕度環境是生物性氣膠生長、繁生的基本條件。臺灣終年濕熱的海島型氣候和人口密度特高的生活型態，尤其有助於生物性氣膠的存活和傳播。依此衍論，國內的從業勞工除了暴露於傳統上已較被熟悉、研究的各種化學性、物理性危害之外，也可能受到並存在作業環境中，來自室外環境，或室內污染源，甚至作業過程中所衍生的生物性因子之危害。本研究首先收集並分析國外現存之相關文獻資料以瞭解有關勞工受生物性氣膠危害之最新案例、研究方向及需求。同時整理國內有關之散存資料，調查可能暴露於此項危害之勞工人品，及所相關之健康影響，並評估可能所缺乏之背景數值資料。同時依抽樣標準，以問卷方式向第一階段所評估而得之若干重點行業施行其所屬勞工健康資料基本調查，以瞭解國內實際現況。本研究結果發現，在校正過年齡、性別、教育程度、抽煙與否、受二手煙暴露、及居家環境因子後，從事醫療服務業的人員相對於其他行業而言，增加了43%的機會容易在工作場所覺得胸悶，而此現象在回家後即消失。而就所調查之呼吸道疾患而言，許多與職業較無相關之因子，尤其是抽煙、受二手煙暴露及家中是否可見霉斑生長等，顯然可能在所有勞工人口中，都表現了重要的影響。

Bioaerosols usually include airborne particles that are derived from living organisms such as viruses, bacteria, and fungi (mold) as well as toxic and allergenic compounds produced by their growth in the environment. Situated at the subtropical climate where high temperature and humidity are present year-round, Taiwan offers an optimal environment for the microbial growth and survival. Therefore, the issues of occupational exposure to bioaerosols from the general environments or the working processes in Taiwan deserve special concerns in addition to the traditionally better-recognized types of occupational hazards such as chemical and physical stresses. This study first conducts a thorough literature review on the current understanding of the associations among bioaerosol exposure, occupations of interest, and their corresponding health evidences worldwide. Previous studies conducted in Taiwan are among the special focuses to estimate the size of working population that are potentially at such a risk. A questionnaire asking basic respiratory health conditions, home and occupational characteristics was randomly sent to selected unions with potential high level exposure to bioaerosol exposure, including rice husking, cotton textile mills, animal feeds preparation, tea producing, pulp and paper producing, catering and dining service, animal raising, medical and health service. The members of advertising service unions were chosen as the 'control' group for comparison of bioaerosol exposure with respect to respiratory health outcomes. The analysis results show that after controlling the factors for age, sex, education, smoking, environmental tobacco smoking, and home characteristics, the chance for those people at the medical and health service profession to report 'chest-tightness at the workplace while the symptom disappears after they arrive home' is 43% greater than people from other professions of comparison.