空氣污染物會引起不良的健康效應，已經被很多跨國的大型研究所證實。呼吸道、心血管、免疫系統、神經系統、黏膜表皮組織皆為其好侵犯之部位。其中黏膜以及表皮組織刺激性之研究，通常侷限在呼吸道的表皮，而鮮少專門提及眼黏膜的刺激。本研究目的即在探討空氣污染物與因結膜炎而看門診之間的關係。

　　本研究收集1997年台灣的五種法定空氣污染物（二氧化硫、一氧化碳、臭氧、氮氧化物、懸浮微粒）的濃度，以及全民健保中以非特異性結膜炎作為診斷的申報資料，加以標準化，來研究法定污染物與非特異性結膜炎之間的關係。並參考健保局的投保人數、疾病申報數、費用申報數等統計數字來相互比較。

　　本研究特地引進時序分析的方法，以時序的觀念分析其相關性。研究結果顯示：女性罹患非特異性結膜炎的比例高於男性。十歲以下的兒童罹患非特異性結膜炎比例高於其他年齡組，而其他年齡組的比例差不多。當週臭氧濃度與當週標準化病人就診數為正相關。而溫暖炎熱的天氣也是引起結膜炎的重要因素，需要被列入考慮。

　　臭氧引起黏膜不適已經有實驗性以及流病研究報告。本研究的結果符合前人文獻結果，並指出對於非特異性結膜炎的空氣污染物防治方向。

　　Air pollutants are known to cause adverse health effects as reported in many large-scale, multi-country studies. Respiratory system, cardiovascular system, immune system, nervous system and dermato-mucal tissues are the main susceptible targets to air pollutants. However, investigations on air pollutant effects on mucosa tissue are mainly focused on the respiratory mucus epithelia, and little was mentioned about the eye mucosa. This study is conducted to determine the relationship between criteria air pollutants and conjunctivitis clinic visit.

　　We collected the 5 criteria pollutant concentrations (SO2, CO, O3, PM10 and NOx) of 1997 in Taiwan from the included monitoring stations, and the patient visits of non-specific conjunctivitis from the database of National Health Insurance Bureau. The averaged weekly concentrations of air pollutants were compared with standardized weekly patient visits. The baseline data of total insured populations are also introduced for comparison.

　　The results showed that: (1) Females visited the clinic more often than males for non-specific conjunctivitis; (2) Children under 10 years old visited the clinic more often than other age group for non-specific conjunctivitis; (3) The weekly O3 concentration with no time lag is positively related to the standardized patient visits. (4) The hot weather also was a significant factor that correlated to high patient visits.

　　The results of our study about O3 and female susceptibility are compatible with previous studies. This result lead us a definite direction for air pollutant control for non-specific conjunctivitis.

Bell ML, Davis DL. Reassessment of the lethal London fog of 1952: novel indicators of acurte and chronic consequences of acute exposure to air pollution. Environ Health Perspect 2001; 109:389-394.

Schwela D. Public health implications of urban iar pollution in developing countries, Proc. 10th world clean air congress, Espoo, Finland, 1995.

Samet JM, Dominici F, Zeger SL, Schwartz J, Dockery DW. The National Morbidity, Mortality and Air Pollution Study. Part I: Method and methodologic issues. Research Report : Health Effect Institute 2000: 94 pt 1: 5-14.

Katsouyanni K, Schwartz J, Spix C, Touloumi G, Zmirou D, Zanobetti A, Wojtyniak B, Vonk JM, Tobias A, Ponka A, Medina S, Bacharova L, Anderson HR. Short-term effects of air pollution on health: a European approach using epidemiologic time series data : the APHEA protocol. J Epidemio & Commun Health 1996: 50 suppl 1: s12-18.

Schwartz J. Air pollution and hospital admissions for respiratory disease. Epidemio 1996 7: 20-28

Pope CA 3rd, Dockery DW, Kanner RE, Villegas GM, Schwartz J. Oxygen saturation, pulse rate, and particulate air pollution: A daily time-series panel study. Am J Respir Crit Care Med 1999; 159:365-272

Schwartz J. Air pollution and hospital admissions for heart disease in 8 US counties. Epidemiol 1999; 10:17-22

Zmirou D, Schwartz J, Saez M, Zanobetti A, Wojtyniak B, Touloumi G, Spix C, Ponce de Leon A, Le Moullec Y, Bacharova L, Schoute J, Ponka A, Katsouyanni K. Time-series analysis of air pollution and cause-specific mortality. Epidemiol 1998; 9:495-503

Katsouyanni K, Touloumi G, Spix C, Schwartz J, Balducci F, Medina S, Rossi G, Wojtyniak B, Sunyer J, Bacharova L, Schouten JP, Ponka A, Anderson HR. Short-term effects of ambient sulphur dioxide and particulate matter on mortality in 12 European cities: results from time series data from the APHEA. BMJ 1997; 314:1658-1663

Lee JT, Kim H, Yong YC, Kwon HJ, Schwartz J, Crhistiani DC. Air pollution and daily mortality in seven major cities of Korea, 1991-1997. Envrion Res 2000; 84: 247-254

Schwela D. Air pollution and health in urban area. Rev Environ Health. 2000; 15:13-42

Versura P, Profazio V, Cellini M, Torreggiani A, Caramazza R. Eye discomfort and air pollution. Ophthamologica. 1999; 213:103-109
Lee PP, Fellenbaum PS, Albrecht KG, Linton KL. The potential role of ophthalmology as an entry point to the healthcare system. Ophthalmol 1994; 101:397-400.

Cohn MJ, Kurtz D. Frequency of certain urgent eye problems in an emergency room in Massachusetts. J Amer Optometric Assoc 1992; 63:628-633.

Lee CH, Chou YC. Statitical graphics of the Nation-wide health insurance in Taiwan and international comparisons. Report #DOH87-NH-047, 1999.

16 van Bijsterveld OP, Jager GV. Infectious diseases of the conjunctiva and cornea. Current Opinion Ophthalmol 1996; 7:65-70.

17 Cakmak S, Dales RE, Burnett RT, Judek S, Coates F, Brook JR. Effect of airborne allergens on emergency visits by children for conjunctivitis and rhinitis. Lancet 2002; 359:947-8.

18 Feretis E, Theodorakopoulos P, Varotsos C, Efstathiou M, Tzanis C, Xirou T, Alexandridou N, Aggelou M. On the plausible association between environmental conditions and human eye damage. Environ Sci Pollution Res 2002; 9:163-5.

Kulle TJ, Sauder LR, Hebel JR, Miller WR, Green DJ, Shanty F. Pulmonary effects of sulfur dioxide and respirable carbon aerosol. Environ Res 1986; 41:239-50.

20 Higgins BG, Francis HC, Yates CJ, Warburton CJ, Fletcher AM, Reid JA, Pickering CA, Woodcock AA. Effects of air pollution on symptoms and peak expiratory flow measurements in subjects with obstructive airways disease. Thorax 1995; 50:149-55.

21 Garcia-Marcos L, Guillen JJ, Dinwiddie R, Guillen A, Barbero P. The relative importance of socio-economic status, parental smoking and air pollution (SO2) on asthma symptoms, spirometry and bronchodilator response in 11-year-old children. Ped Allergy Immun 1999; 10:96-100.

Daniels MJ, Dominici F, Samet JM, Zeger SL. Estimating particulate matter mortality dose response curves and threshold levels: an analysis of daily time series for the 20 largest US cities. Am J Epidemiol 2000; 152:397-406.

Kelsall JE, Samet JM, Zeger SL, Xu J. Air pollution and mortality in Philidelphia: 1974-1988. Am J Epidemiol 1997; 146:750-762.

Schwartz J, Dockery DW. Increased mortality in Philadelphia associated with daily air pollution concentration. Am Rev Respir Dis 1992; 145: 600-604.

Schwart J. The distributed lag between air pollution and daily death. Epidemiol 2000; 11 : 320-326.

Drechsler-Parks DM. Effect of nitrogen dioxide, ozone, and peroxyacetyl nitrate on metabolic and pulmonary function. Research Report - Health Effects Institute. 1987; 6:1-37.

27 Yang CY, Wang JD, Chan CC, Chen PC, Huang JS, Cheng MF. Respiratory and irritant effects of population living in a petrochemical-polluted area in Taiwan. Envrion Research 1997; 74:145-149.

28 Kjaergaard S. Assessment of eye irritation in humans. Ann. NY Acad Sci 1992; 641:187-198.

29 Riediker M. Air pollutants enhance rhinoconjunctivitis symptoms in pollen-allergic individuals. Ann Allergy, Asthma Immunol 2001; 87:311-318.

30 Hashimoto K, Ishii Y, Uchida Y. Exposure to diesel exhaust exacerbates allergen-induced airway responses in guinea pigs. Am J Respir Crit Care Med. 2001; 164:1957-1963.

31 Fujieda S, Diaz-Sanchez D, Saxon A. Combined nasal challenge with diesel exhaust particles and allergen induces in vivo IgE isotype switching. Am J Respir Cell Mol Biol. 1998; 19:507-12.

33 Braga ALF, Zanobetti A, Schwartz J. The lag structure between particulate air pollution and respiratory and cardiovascular deaths in 10 US cities. J Occup Environ Med. 2001; 43:927-933.

34 Samoli E, Schwartz J, Wojtyniak B, et al. Investigating regional differences in short-term effects of air pollution on daily mortality in the APHEA project: a sensitivity analysis for controlling long-term trends and seasonality. Envrion Health Persp 2001; 109:349-353.

35 Zanobetti A, Schwartz J, Samoli E, et al. The temporal pattern of maorality responses to air pollution: a multicity assessment of mortality displacement. Epidemiol 2002; 13:87-93.

36 Bates DV. Epidemiologic basis for photochemical oxidant standard. Environ Health Persp 1983; 52:125-129 .

37 Hong YC, Lee JT, Kim H, Ha EH, Schwartz J, Christiani DC. Effects of air pollutants on acute stroke mortality. Environ Health Persp. 2002; 110:187-191.

38 Kyle AD, Woddruff TJ, Buffler PA, Davis DL. Assessing the public health benefits of reduced ozone concentrations. [Review]. Environ Health Persp 2001; 109:1215-1226.