8卷3期

• Link 綜論 Review Article
• “愛滋病的危機？難題？？何去何從？？？”：民國七十八年度中華民國公共衛生學會座談記錄“愛滋病的危機？難題？？何去何從？？？”：民國七十八年度中華民國公共衛生學會座談記錄
• 許國雄、顔春輝、黃明和、 祁家威、柯賢忠、晏涵文、莊哲彥、張珏、李伸一
  許國雄、顔春輝、黃明和、 祁家威、柯賢忠、晏涵文、莊哲彥、張珏、李伸一
• 無
  none
• 無
  none
• 141 - 149
• 10.6288/JNPHARC1988-08-03-01

• Link 原著 Original Article
• 台北縣貢寮鄕糖尿病人疾病壓力與家庭支持之研究－初步報告Illness-Related Stress and Family Support of Diabetic Patients in Kung-Liao Community a Preliminary Report
• 田玫、季瑋珠、張智仁、張珏
  Mei Tyan, Wei-Chu Chie, Chih-Jen Chang, Chueh Chang
• 無
  diabetes mellitus ; illness-related stress ; family support
• 本研究以半結構式問卷，訪問了台北縣貢寮鄉收案管理的42位糖床病患者，探討了由於罹患糖尿病所造成的各項壓力、家庭關懷、及家庭對醫療照顧的參與。並以相關矩陣探討疾病壓力總分與各項可能相關因素的關係。結果發現最大的壓力依次?「害怕併發症」、「要控制飲食」、「自己打針」、「不會斷根」、「症狀本身」、「定期就醫」，及「每天要吃藥（打針）」等“病人的家庭關懷指數都相當高，平均16.87±3.75。家庭參與以「定期就醫」?最多，占75.0%，但與居家照顧比較密切相關的「服藥」只占35.0%，「飲食控制」只占42.5%。而疾病壓力總分與「飯前血糖」、「飯後血糖」，和「血紅素AIC(HbA1C)」均有顯著正相關。其中又以「血紅素A1C」?最高。此外，「家庭參與」也與疾病壓力總分呈較弱（未達顯著意義）的正相關。
  In this study, a semi-structured questionnaire interview with observation was performed on 42 diabetic patients in Kung-liao Community to detect their illness-related stress and family support in medical care. The most severe stress was ”fear of complications”, followed by ”diet control”, ”self-injection”, ”chronicity”, ”symptoms”, ”regular visits”, ”regular medication”, etc. The family APGAR Score was high. Family participation of medical care was limited on ”regular visits”, 75.0%, while in ”diet control” only 42.5%, ”medication” only 35.0%. The total score of illness-related stress was positively related to the disease control variables, especially HbA1C, and only weakly (non-significant) related to family participation.
• 150 - 160
• 10.6288/JNPHARC1988-08-03-02

• Link 原著 Original Article
• 臺灣地區石綿工廠工業衛生普查Industrial Hygiene Survey for Asbestos-Related Factories in Taiwan
• 張火炎、王榮德、張錦輝、陳誠仁、索任、吳敏鑑
  H-Y Chang, J-D Wang, J-W Chang, C-R Chen, R Suoo, M-C Wu
• 無
  asbestos ; industrial hygiene ; survey
• 本研究以問卷調查配合現場訪視，對全省石綿工廠工業安全衛生，情形作調查研究。計有石綿水泥業21廠，石綿耐磨材料業10廠，石錦紡織與石綿絕緣常業1廠共33廠。結果發現石綿使用量以石綿水泥業日平均6，300公斤為最大；其中30家工廠原料來自國外。成品銷售水泥及紡織業以內銷為主，耐磨材料業及絕緣業以外銷為主。員工缺席資料有28家(85%)記錄不全，有5家無任何衛生表報記錄。有12廠未設安全衛生人員；曾委託安全衛生公司作進環境測定者僅7家，且僅測量粉塵總濃度；有22家廠未提供合格之呼吸防護具；有8家完全未實施任何體檢；有11家工廠未加裝任何空氣濾淨裝置。生產進程所產生廢棄物之處理，回收使用與供給下游工業佔18廠。我們的建議：本省石綿工廠應儘量改用非石綿原料，生產製程予以隔絕密閉；且作好局部排氣；教導工人使用合格防護具並定期施以安全衛生教育及健檢；建立員工長期資料並聘用合格的工業安全衛生人員；妥善處理廢棄物，避免造成二次污染。
  The purpose of this study was to determine the current occupational health conditions in asbestos-related factories in Taiwan. We visited 33 factories including 21 asbestos cement, 10 friction material, 1 textile and 1 insulating material. The average consumption of asbestos in cement manufactories is 6300 kg/day, more than the others. The records of absenteeism in 28 factories were incomplete. 5 factories had none of the records related to occupational health and safety, while the other 28-were also incomplete. 12 factories employed no safety personnel. Only 7 out of 33 factories had envirornental monitorings, which were all performed by outside companies of occupational health service and only total suspending particulates were measured. 22 factories did not provide any qualified respiratory protective device. 8 factories did not perform any regular health examination on their employees. 11 factories did not install any air cleaning device. Waste generated from production of 18 factories were recycled and/or transfered to downstream factories for reuse. We concluded that current occupational health condition in asbestos factories of Taiwan was relatively poor and made following suggestions: 1.Substitute materials for asbestos should be seriously considered. 2. Enclosure, isolation and effective ventilation control should be implemented immediately at workplaces wherever asbestos is used. 3. Worker's education and training should be done, especially for good workpractice, housekeeping, and the appropriate use of respiratory protective device. 4. Regular health examination should be done. 5. Records regarding medical and occupational histories should be kept for a longer period of time. 6. Asbestos waste should be deposited or recycled properly to avoid secondary pollution.
• 161 - 171
• 10.6288/JNPHARC1988-08-03-03

• Link 原著 Original Article
• 公共衛生教學人力的特性Characteristics of Public Health Teacidng Manpower
• 江東亮、 蕭正光、劉慧俐
  Tung-Liang Chiang, Cheng-Kwang Shaw, Hui-Li Liu
• 無
  Public Health Teaching ; Manpower
• 1987年初，台灣地區共有80名講師級以上的公共衛生教師。經由郵寄問卷，本研究調查所有公共衛生教師的特性，包括他們的人口學資料、學位、主修，以及1986年的研究活動。結果發現：公共衛生的師資相當年輕，素質佳，並且充滿活力。
  In early 1987 there were 80 public health teachers in Taiwan. Through a questionnaire survey, this study examined the characteristics of all public health teachers, including their demogaphic variables, academic degrees obtained, majors, and research activities during 1986. The results indicated that public health teaching manpower was rather young, of high quality, and spirited.
• 172 - 175
• 10.6288/JNPHARC1988-08-03-04

• Link 其他 Others
• 台灣地區惡性贅瘤之流行病學特徵：Ⅲ.胃癌Epidemiologic Characteristics of Malignant Neoplasms in Taiwan: ?. Stomach Cancer
• 黃裕權、蔡淑芳、李心馨、許光宏、游山林、林東明、 陳建仁
  Yu-Chuang Huang, Shu-Fang Tsai, Shin-Shin Lee, Kuang-Hung Hsu, San-Un You, Tong-Ming Lin, Chien-Jen Chen
• 無
  Stomach cancer ; eptaemiotogy ; Taiwan
• 本研究以台灣地區1954~1983年胃癌死亡率及1983~1985年胃癌發生率資料，描述胃癌在台灣地區之長期趨勢，年齡，性比例及地理分佈特徵，並進行國際及移民比較。 台灣地區胃癌死亡率及發生率皆有隨年齡增加而呈現對數增加之趨勢，高年齡層之胃癌死亡率也最高。男性各年齡層之死亡率及發生率皆約?女性的2倍。自1970年代開始，男、女性年齡標準化死亡率皆有逐漸下降之趨勢。 在17個國家及地區中，台灣男、女性胃癌，累積死亡率分別佔第11位及第13位。高死亡率地區大多集中在台灣東北部及東部及山地鄉鎮。移民比較發現，美國華人的胃癌發生率遠比上海、新加坡、台北及香港的華人?低。
  Mortality rates from 1954 to 1983 and incidence rates from 1983 to 1985 of stomach cancer in Taiwan were analyzed to examine its secular trend, age curve, sex ratio, geographical clustering, international variation and migrant difference. Both mortality and incidence rates of stomach cancer increased with age in a log-linear relationship and peaked at the highest age group. The sex (male-to-female) ratio remained consistently around two-fold for age-specific mortality and incidence rates. The age-adjusted mortality has been decreasing since early 1970s for both males and females. Among 17 countries and areas compared, cumulative stomach cancer mortality in Taiwan ranked as the 11th and 13th, respectively, for males and females. High stomach cancer mortality rates were found to cluster in northeastern area and eastern aboriginal townships in Taiwan. Migrant study showed that Chinese in United States had much lower stomach cancer incidence than those in Shanghai, Singapore, Taipei and Hong Kong.
• 176 - 188
• 10.6288/JNPHARC1988-08-03-05

• Link 其他 Others
• 台灣地區惡性贅瘤之流行病學特微：Ⅳ.肺癌Epidemiologic Characferistics of Malignant Neoplasms in Taiwan: ?. Lung Cancer
• 鄭淑姿、蔡淑芳、李心馨、許光宏、林東明、陳建仁
  Sock-Chee Tay, Shu-Fang Tsai, Shin-Shin Lee, Kuang-Hung Hsu, Tong-Ming Lin, Chien-Jen Chen
• 肺癌 ； 流行病學 ； 台灣地區
  lung cancer ; epidemiology ; Taiwan
• 本研究分析台灣地區1954至1983的肺癌死亡率和1983至1985的肺癌發生率，以期瞭解台灣地區肺癌的長期趨勢、年齡曲線、性比例、地理聚集、國際比較和移民差異等流行病學特徵。台灣地區的年齡標準化肺癌死亡率，自1954年起即呈明顯的增加趨勢；在近三十年來，增加達八倍之多。但男女性比例均維持在2.0左右。男女性之年齡別肺癌死亡率，均隨年齡的增加而呈倍數增加；而且越年輕的出生世代，年齡別死亡率越高。在18個國家或地區當中，台灣地區的肺癌累積死亡率在男性佔第17位，僅高於中國大陸，在女性則居第9位，男女性比例為各國最低者。就華人地區而言，肺癌死亡率以香港最高，新加坡、台灣次之，而以中國大陸最低，且各年齡層均如此。台灣地區男女性之年齡標準化肺癌死亡率偏高的鄉鎮區，都明顯聚集在大都市和烏腳病盛行地區。肺癌之年齡別發生率同樣的隨著年齡增加而增加，而且各年齡之男女性比例均在2.0倍左右。就華人之年齡標準化肺癌發生率的移民比較而言，男性以新加坡、舊金山較高，香港、上海居中，而洛杉磯、夏威夷台北較低；女性則以舊金山、夏威夷和香港較高，新加坡、上海居次，而洛杉磯與台北較低，至於相同地區不同種族間的肺癌發生率也有很大的差異。
  In order to examine the epidemiologic characteristics of lung cancer in Taiwan, its mortality rates from 1954 to 1983 and incidence rates from 1983 to 1985 were analyzed. The age-adjusted mortality rate of lung cancer has been increasing since early 1950s. During recent three decades, there was an eightfold increase in lung cancer mortality but the sex (male to female) ratio remained consistently around two-folds. In both males and females, the higher the age, the greater the lung cancer mortality. The age-specific mortality rates of lung cancer significantly higher in recent cohorts than old cohorts. Among the 18 countries and areas compared, the cumulative mortality of lung cancer ranked in Taiwan as the 17th and the 9th, respectively, for males and females, and the sex ratio was the lowest. Chinese in Hong Kong and Singapore had a much higher mortality rates of lung cancer than those in Taiwan and mainland China for all age groups. Areas of high mortality rates of lung cancer in Taiwan were found to cluster in metropolitan precincts and the blackfoot diseass endemic area. Incidence rates of lung cancer increased with age and peaked at age of 75. Migrant study showed a significant difference in the incidence rate of lung cancer among Chinese men in Singapore, San Francisco, Hong Kong, Shanghai, Los Angeles, Hawaii and Taipei; while the difference was much less striking among Chinese women in these areas. Ethnic difference in the age-adjusted incidence rate of lung cancer was also observed in these cities.
• 189 - 201
• 10.6288/JNPHARC1988-08-03-06