背景與目的：在工業化發展後，各國在經濟發展歷程中總會面臨到經濟發展與環境問題的角力，台灣也是其中之一，火力發電廠提供能源，石油化學工業帶來經濟產值，卻也排放大量細懸浮微粒。隨著過去空氣汙染歷史事件與科學研究之進展，已有諸多文獻證實細懸浮微粒對健康所造成的負面影響，但過往研究常受限於區域層級資料或研究對象之年齡層，導致無法推論個人或其他群體，也無法針對個人健康狀況與行為進行完整的控制。此外，結合死亡與失能的健康餘命為現今重要評估群體健康的指標之一，但卻鮮少有文獻探討PM2.5對健康餘命的影響。故本研究目的欲以台灣具全國代表性個人追蹤資料探討在控制與平均餘命/健康餘命相關變項後，估算PM2.5對台灣人民之平均餘命與健康餘命造成的衝擊。

方法：本研究自行政院環境保護署取得2005年至2014年PM2.5各監測站數據，並以克利金法推估各鄉鎮市區PM2.5年平均濃度，研究對象取自2005年及2009年國民健康訪問調查中資料完整之收案者。透過串連衛生福利部死因統計檔追蹤至2014年之存活狀況，以Gompertz PH model分析控制教育程度、健康行為與社經地位變項後，估算男、女性各年齡層之死亡風險，並以歐盟所開發之可歸因工具推估男、女性各年齡層各危險因子之不健康比例，最後再以生命表與Sullivan的方法計算高、中、低濃度地區之平均餘命及健康餘命，以及台灣處於高、中、低濃度地區之平均餘命與健康餘命，並估計PM2.5對平均餘命與健康餘命的效應。

結果：（一） PM2.5皆會增加男女性死亡與不健康的危害效應，且對男性的健康效應略大於女性。（二） 當各濃度地區保持一樣的其他危險因子比例時，中、高濃度地區的PM2.5濃度若下降至與低濃度地區相同，中、高濃度地區男性平均餘命可分別因此增加0.751年與0.76年，健康餘命可因此增加0.936年與0.943年；中、高濃度地區女性平均餘命可分別因此增加0.665年與0.638年，健康餘命可因此增加0.565年與0.545年。 （三） 當全台灣從低濃度轉為中、高濃度時，男性將分別因PM2.5損失0.373歲與0.757歲的平均餘命，以及損失0.638年與0.942年的健康餘命；女性則分別因PM2.5提高0.309歲與0.627歲的平均餘命，以及因PM2.5損失0.287年與0.536年的健康餘命。

結論：在各濃度地區不改變其他個人危險因子的狀態下，男性與女性會因PM2.5會降低的平均餘命與健康餘命；且當全台灣從低濃度轉變為中、高濃度時，PM2.5對男性與女性的死亡與健康危害也因此上升，經比較後發現本研究所估算之PM2.5所造成之平均餘命效應較他人研究小，且PM2.5對女性的健康影響較男性小，與過去文獻不符，可能是因未控制種族、個人收入或其他干擾因子所造成，未來仍待更多研究釐清。本篇研究突破過去僅使用區位資料之限制，並提供了PM2.5對台灣人民平均餘命與健康餘命之實證數據，將可作為未來政策擬定與空氣汙染防治之參考。

In the past, many studies found ambient fine particulate matter (PM2.5) increase the risk of disease and mortality. The aim of this study was to examin the adverse health effect of PM2.5 on life expectancy and healthy expectancy in Taiwan.
The PM2.5 concentrations of every township were calculated by Kringing method from 76 monitoring station in Taiwan Air Quality Monitoring Network. Based on the PM2.5 concentrations, townships were divided to high, middle, and low concentration area. The study population from 2005, 2009 National Health Interview Survey (NHIS) for whom 20-year-old to 90-year-old and complete risk factor data.Follow-up duration from interview data to death or alive to 2014. Sex- and age-specific life expectancy (LE) was estimated by multivariable Gompertz PH model and life-table method, sex- and age-specific healthy expectancy (HE) based on self-rated health was estimated by Sullivan’s method.
If other risk factors of high, middle, and low concentration area remain the same proportion, In middle concentration area, PM2.5 reduced LE by 0.751 years and HE by 0.936 years for male, also reduced LE by 0.665 years and HE by 0.565 years for female. In high concentration area, PM2.5 reduced LE by 0.760 years and HE by 0.943 years for male, also reduced LE by 0.638 years and HE by 0.545 years for female. Otherwise, if PM2.5 concentrations in Taiwan rise from low to middle, male would decrease 0.373 years LE and 0.638 years HE, female would decrease 0.309 years LE and 0.287 years HE; if PM2.5 concentrations in Taiwan rise from low to high, male would decrease 0.757 years LE and 0.942 years HE, female would decrease 0.627 years LE and 0.536 years HE.
There may exit potential important confounding factors we didn’t control, including race, income, etc. We provide the evidence of the health impact of PM2.5 on LE and HE in Taiwan, and it would be taken environmental policy as a reference in the future.

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