近年來受矚目的芳香療法是利用精油產品來進行身心靈方面之治療。精油的組成中多為揮發性有機物質 (VOCs)，過去研究顯示室內空氣中VOCs之暴露與病態建築症候群中神經性、刺激性以及呼吸道等相關症狀的表現有關；此外，精油主成分中的帖烯類物質 (Terpenes)，易與空氣中的強氧化物如臭氧等形成超細微粒 (Ultrafine particle)和甲醛等氧化產物，皆與眼睛黏膜之刺激、上/下呼吸道症狀之表現有關。然而，目前尚未有研究針對整體精油之暴露與可能導致的健康危害進行探討，且其暴露量與健康危害機制、危害程度之關係仍未明確。本研究之主要目的即為探討精油的暴露對健康之可能影響；首先選定精油暴露之高風險族群－芳療從業人員，進行各項健康指標的評估調查；進一步再模擬芳療師實際環境的暴露量及工作時數，以進行特定Terpene物質的人體暴露試驗，在控制條件的暴露系統下，深入探討精油暴露對於呼吸道指標之影響程度。
有關於芳療從業人員之健康評估部分，本研究挑選國內代表性芳療連鎖企業，於南部地區兩間不同類型及建築型態之分店內進行調查，針對其有意願參與的芳療從業人員（皆為女性）進行健康評估。所有受試者依據其工作內容、性質及工作療程時數分為行政人員（5位）、低暴露芳療師（6位）、高暴露芳療師（6位）三組，分別於其上班前及下班後進行各項健康指標之評估，包含血壓、淚膜破裂時間、吐氣和鼻腔一氧化氮濃度、肺功能量測等。調查結果顯示，在鼻腔一氧化氮濃度部分，三組人員之下班後濃度皆高於上班前，但未達統計上顯著意義。行政人員及低暴露組芳療師下班後的FEV1/FVC皆高於上班前，但高暴露組芳療師卻呈現相反的趨勢，而同時比較三組人員時則有顯著差異（行政人員：93.2±6.3 % vs. 97.0±4.4 %；低暴露組：85.0±9.3 % vs. 89.1±7.7 %；高暴露組：98.0±2.8 % vs. 94.6±6.7 %；p=0.06）。此外，不論是行政人員或是高暴露組芳療師，下班後之淚膜破裂時間，即反應眼睛乾燥程度之代表性指標，皆顯著低於上班前（行政人員：6.1±3.3秒 vs. 4.1±1.6秒；低暴露組：6.1±3.3秒vs. 5.2±2.5秒；高暴露組：9.3±5.2秒vs. 6.1±3.3秒）。
在人體暴露面罩系統試驗研究部分，主要是讓受試者在溫濕度調控的暴露艙室內帶上面罩，經由管線輸送穩定濃度之β-pinene（採用芳療職場中測得之濃度）至面罩系統內讓受試者暴露，總暴露時間亦為模擬職場芳療師之平均療程工作時數共6小時（中間休息1小時），並分別於暴露前、中、後進行呼吸道健康狀況調查，包含視覺化類比量尺問卷 (VAS)、鼻腔通暢程度、吐氣及鼻腔一氧化氮濃度、肺功能量測。7位女性自願受試者（4位健康者、3位鼻過敏患者，平均年齡23.1±2.0歲）之結果顯示，暴露六小時後，鼻腔體積及鼻腔截面積皆顯著降低（鼻腔體積：12.5±3.0 cc vs. 10.1±2.8 cc；鼻腔截面積：1.1±0.3 cm2 vs. 0.9±0.2 cm2），且在VAS自我症狀嚴重度評估部分，喉嚨乾、呼吸短促、感覺會喘和噁心等症狀嚴重度在暴露時皆明顯升高（喉嚨乾：1.8±3.0公分 vs. 2.3±2.2公分vs. 3.8±3.2公分vs. 4.0±3.3公分；呼吸短促：0.8±0.9公分vs. 2.6±1.8公分vs. 2.5±1.8公分vs. 1.3±1.1公分；感覺會喘：0.8±0.9公分vs. 2.6±1.8公分vs. 2.5±1.8公分vs. 1.3±1.1公分；噁心：0.6±0.6公分vs. 1.1±1.0公分vs. 1.0±1.1公分vs. 0.8±0.9公分）。
本研究發現，芳療職場環境內的確具有部分潛在的健康風險，尤其影響人員之眼睛黏膜組織，此外，精油成分β-pinene之暴露亦刺激鼻部黏膜組織，且會增加喉嚨乾、呼吸短促、感覺會喘和噁心等症狀之嚴重度表現。因此本研究透過實場調查及暴露艙室試驗證實，特定濃度的精油及其成分β-pinene之暴露與人員眼睛、鼻部黏膜及呼吸道等症狀的表現有關。

Aromatherapy, suggested to contribute to selected health benefits, has attracted increasing popularity over recent years. Meanwhile, researches have indicated that exposure to volatile organic compounds, main ingredients of essential oils used in the therapy, has been associated with reporting sick building syndromes such as neurological, irritation and respiratory symptoms . The composition of essential oils with one or more unsaturated carbon–carbon bonds may easily interact with oxidants easily available in indoor environment, such as ozone and generate secondary organic compounds, like formaldehyde and ultrafine particle presenting potential mucosal and eye irritation and upper/lower airway symptoms. To this date, no known study has investigated the exposure profile and useful biomarkers in relation to health concerns with exposure to essential oil.
This study first aimed to examine the health consequences of the highly exposed subjects-the aromatherapists with biologically plausible indicators. Second, to simulate the exposure level of the terpene of essential oil and the exposure time in working environment of aromatherapy and to measure the proposed indicators in well control system.
The study selected two branch stores, with different building characteristics, of representative chain aromatherapy salons in southern Taiwan. The staff, all females, based on the type and content of job, and aromatherapy time was categorized into administrative personnel (n=5), low exposure group of aromatherapists (n=6) and high exposure group of aromatherapists (n=6). The health performance indicators measured before and after work included blood pressure, lung function, tear film break up time, levels of exhaled nitric oxide, and nasal nitric oxide. The results indicate the nasal nitric oxide levels after work was higher than before work among the three groups, but there was not significant level. FEV1/FVC of administrative personnel and low exposure group after work higher than before work, but high exposure group was opposite trend, there was significant level among three groups (administrative personnel: 93.2±6.3 % vs. 97.0±4.4 %; low exposure group: 85.0±9.3 % vs. 89.1±7.7 %; high exposure group: 98.0±2.8 % vs. 94.6±6.7 %; p=0.04). For subjects with administrative personnel and high exposure group, the tear film break up time (BUT) was significantly lower after the work, BUT indicate the dryness level of eye (administrative personnel: 6.1±3.3 sec vs. 4.1±1.6 sec；low exposure group: 6.1±3.3 sec vs. 5.2±2.5 sec; high exposure group: 9.3±5.2 sec vs. 6.1±3.3 sec).
Part 2 was the exposure chamber study. The subjects in the full scale exposure chamber were exposed to β-pinene via face mask attached with Teflon tube to deliver the constant level of β-pinene. The concentration of β-pinene was based on the aromatherapy salons of concentration. The temperature and humidity can be regulated in the full scale exposure chamber. The exposure time of 6 hours was to stimulate the mean working hours of aromatherapist as surveyed in the previous study. There was usually an 1-hour break in between the exposure. Health indicators measured before, middle and after exposure included the fractional concentration of nitric oxide in exhaled breath and nasal, nasal patency, lung function test, visual analogue scale (VAS) of questionnaire. The recruited volunteers were seven female (health person: 4; allergic rhinitis: 3; mean age: 23.1±2.0 years). The results indicate nasal volume and minimum nasal cross-sectional (MCA) after exposure of 6 hours was significantly lower; nasal volume: 12.5±3.0 cc vs. 10.1±2.8 cc; MCA: 1.1±0.3 cm2 vs. 0.9±0.2 cm2. In VAS questionnaire, dry throat, shortness of breath, gasp and nausea during exposure, were significantly higher; dry throat: 1.8±3.0 cm vs. 2.3±2.2 cm vs. 3.8±3.2 cm vs. 4.0±3.3 cm; shortness of breath: 0.8±0.9 cm vs. 2.6±1.8 cm vs. 2.5±1.8 cm vs. 1.3±1.1 cm; gasp: 0.8±0.9 cm vs. 2.6±1.8 cm vs. 2.5±1.8 cm vs. 1.3±1.1 cm; nausea: 0.6±0.6 cm vs. 1.1±1.0cm vs. 1.0±1.1 cm vs. 0.8±0.9 cm.
Our results imply that aromatherapy salons appear to present potential health impacts, especially in the eye mucosal irritation. In addition, exposure to β-pinene, which is a main ingredient of essential oil, seems to contribute most significantly to nasal mucosal irritation, and to increase the symptoms of dry throat, shortness of breath, gasp and nausea. Both the field and human chamber study suggest that exposure to the level of essential oil in the aromatherapy salons and β-pinene may be a risk factor to reporting symptoms of eye and nasal irritation and respiratory systems.

Aoki T, Tanabe S. 2007. Generation of sub-micron particles and secondary pollutants from building materials by ozone reaction. Atmospheric Environment 41(15): 3139-3150.
Bakke JV, Norback D, Wieslander G, Hollund BE, Moen BE. 2007. Pet keeping and dampness in the dwelling: associations with airway infections, symptoms, and physiological signs from the ocular and nasal mucosa. Indoor Air 17(1): 60-69.
Bernstein JA, Alexis N, Bacchus H, Bernstein IL, Fritz P, Horner E, et al. 2008. The health effects of nonindustrial indoor air pollution. Journal of Allergy and Clinical Immunology 121(3): 585-591.
Bleasel N, Tate B, Rademaker M. 2002. Allergic contact dermatitis following exposure to essential oils. Australasian Journal of Dermatology 43(3): 211-213.
Bonn B, Schuster G, Moortgat GK. 2002. Influence of water vapor on the process of new particle formation during monoterpene ozonolysis. Journal of Physical Chemistry A 106(12): 2869-2881.
Boonchai W, Iamtharachai P, Sunthonpalin P. 2007. Occupational allergic contact dermatitis from essential oils in aromatherapists. Contact Dermatitis 56(3): 181-182.
Carraro S, Gottardi G, Bonetto G, Baraldi E. 2007. Exhaled nitric oxide in children with asthma and sinusitis. Pediatric Allergy and Immunology 18: 28-30.
Cermelli C, Fabio A, Fabio G, Quaglio P. 2008. Effect of eucalyptus essential oil on respiratory bacteria and viruses. Current Microbiology 56(1): 89-92.
Cometto-Muniz JE, Cain WS, Abraham MH. 2004. Detection of single and mixed VOCs by smell and by sensory irritation. Indoor Air 14: 108-117.
Englert N. 2004. Fine particles and human health - a review of epidemiological studies. Toxicology Letters 149(1-3): 235-242.
Ernstgard L, Lof A, Wieslander G, Norback D, Johanson G. 2007. Acute effects of some volatile organic compounds emitted from water-based paints. Journal of Occupational and Environmental Medicine 49(8): 880-889.
Fan ZH, Lioy P, Weschler C, Fiedler N, Kipen H, Zhang JF. 2003. Ozone-initiated reactions with mixtures of volatile organic compounds under simulated indoor conditions. Environmental Science & Technology 37(9): 1811-1821.
Franklin P, Dingle P, Stick S. 2000. Raised exhaled nitric oxide in healthy children is associated with domestic formaldehyde levels. American Journal of Respiratory and Critical Care Medicine 161(5): 1757-1759.
Galdi E, Perfetti L, Calcagno G, Marcotulli MC, Moscato G. 2003. Exacerbation of asthma related to Eucalyptus pollens and to herb infusion containing Eucalyptus. Monaldi Archives for Chest Disease 59(3): 220-221.
Grosjean D, Williams EL, Seinfeld JH. 1992. ATMOSPHERIC OXIDATION OF SELECTED TERPENES AND RELATED CARBONYLS - GAS-PHASE CARBONYL PRODUCTS. Environmental Science & Technology 26(8): 1526-1533.
Hagvall L, Skold M, Brared-Christensson J, Borje A, Karlberg AT. 2008. Lavender oil lacks natural protection against autoxidation, forming strong contact allergens on air exposure. Contact Dermatitis 59(3): 143-150.
Henley DV, Lipson N, Korach KS, Bloch CA. 2007. Brief report - Prepubertal gynecomastia linked to lavender and tea tree oils. New England Journal of Medicine 356(5): 479-485.
Janes SEJ, Price CSG, Thomas D. 2005. Essential oil poisoning: N-acetylcysteine for eugenol-induced hepatic failure and analysis of a national database. European Journal of Pediatrics 164(8): 520-522.
Kharitonov SA, Barnes PJ. 2001. Exhaled markers of pulmonary disease. American Journal of Respiratory and Critical Care Medicine 163(7): 1693-1722.
Kleno J, Wolkoff P. 2004. Changes in eye blink frequency as a measure of trigeminal stimulation by exposure to limonene oxidation products, isoprene oxidation products and nitrate radicals. International Archives of Occupational and Environmental Health 77(4): 235-243.
Leikauf GD. 2002. Hazardous air pollutants and asthma. Environmental Health Perspectives 110: 505-526.
Librando V, Tringali G. 2005. Atmospheric fate of OH initiated oxidation of terpenes. Reaction mechanism of alpha-pinene degradation and secondary organic aerosol formation. Journal of Environmental Management 75(3): 275-282.
Madureira J, Alvim-Ferraz MCM, Rodrigues S, Goncalves C, Azevedo MC, Pinto E, et al. 2009. Indoor Air Quality in Schools and Health Symptoms among Portuguese Teachers. Human and Ecological Risk Assessment 15(1): 159-169.
Moss M, Hewitt S, Moss L, Wesnes K. 2008. Modulation of cognitive performance and mood by aromas of peppermint and ylang-ylang. International Journal of Neuroscience 118(1): 59-77.
Nielsen GD, Larsen ST, Hougaard KS, Hammer M, Wolkoff P, Clausen PA, et al. 2005. Mechanisms of acute inhalation effects of (+) and (-)-alpha-pinene in BALB/c mice. Basic & Clinical Pharmacology & Toxicology 96(6): 420-428.
Pan Z, Molhave L, Kjaergaard SK. 2000. Effects on eyes and nose in humans after experimental exposure to airborne office dust. Indoor Air 10(4): 237-245.
Payne DNR, Adcock IM, Wilson NM, Oates T, Scallan M, Bush A. 2001. Relationship between exhaled nitric oxide and mucosal eosinophilic inflammation in children with difficult asthma, after treatment with oral prednisolone. American Journal of Respiratory and Critical Care Medicine 164(8): 1376-1381.
Piacentini GL, Bodini A, Costella S, Vicentini L, Mazzi P, Sperandio S, et al. 1999. Exhaled nitric oxide and sputum eosinophil markers of inflammation in asthmatic children. European Respiratory Journal 13(6): 1386-1390.
Prashar A, Locke IC, Evans CS. 2004. Cytotoxicity of lavender oil and its major components to human skin cells. Cell Proliferation 37(3): 221-229.
Rohr AC, Wilkins CK, Clausen PA, Hammer M, Nielsen GD, Wolkoff P, et al. 2002. Upper airway and pulmonary effects of oxidation products of (+)-alpha-pinene, d-limonene, and isoprene in BALB/c mice. Inhalation Toxicology 14(7): 663-684.
Sarac N, Ugur A. 2008. Antimicrobial activities of the essential oils of Origanum onites L., Origanum vulgare L. subspecies hirtum (Link) Ietswaart, Satureja thymbra L., and Thymus cilicicus Boiss. & Bal. growing wild in Turkey. Journal of Medicinal Food 11(3): 568-573.
Shimizu K, Gyokusen M, Kitamura S, Kawabe T, Kozaki T, Ishibashi K, et al. 2008. Essential oil of lavender inhibited the decreased attention during a long-term task in humans. Bioscience Biotechnology and Biochemistry 72(7): 1944-1947.
Silva WJ, Doria GAA, Maia RT, Nunes RS, Carvalho GA, Blank AF, et al. 2008. Effects of essential oils on Aedes aegypti larvae: Alternatives to environmentally safe insecticides. Bioresource Technology 99(8): 3251-3255.
Su HJ, Chao CJ, Chang HY, Wu PC. 2007. The effects of evaporating essential oils on indoor air quality. Atmospheric Environment 41(6): 1230-1236.
Tamas G, Weschler CJ, Toftum J, Fanger PO. 2006. Influence of ozone-limonene reactions on perceived air quality. Indoor Air 16(3): 168-178.
Walinder R, Ernstgard L, Johanson G, Norback D, Venge P, Wieslander G. 2005. Acute effects of a fungal volatile compound. Environmental Health Perspectives 113(12): 1775-1778.
Walinder R, Ernstgard L, Norback D, Wieslander G, Johanson G. 2008. Acute effects of 1-octen-3-ol, a microbial volatile organic compound (MVOC)-An experimental study. Toxicology Letters 181(3): 141-147.
Wang SB, Ang HM, Tade MO. 2007. Volatile organic compounds in indoor environment and photocatalytic oxidation: State of the art. Environment International 33(5): 694-705.
Warke TJ, Fitch PS, Brown V, Taylor R, Lyons JDM, Ennis M, et al. 2002. Exhaled nitric oxide correlates with airway eosinophils in childhood asthma. Thorax 57(5): 383-387.
Wilkins CK, Clausen PA, Wolkoff P, Larsen ST, Hammer M, Larsen K, et al. 2001. Formation of strong airway irritants in mixtures of isoprene/ozone and isoprene/ozone/nitrogen dioxide. Environmental Health Perspectives 109(9): 937-941.
Williams JD, Tate BJ. 2006. Occupational allergic contact dermatitis from olive oil. Contact Dermatitis 55(4): 251-252.
Wolkoff P, Clausen PA, Larsen K, Hammer M, Larsen ST, Nielsen GD. 2008. Acute airway effects of ozone-initiated d-limonene chemistry: Importance of gaseous products. Toxicology Letters 181(3): 171-176.
Wolkoff P, Clausen PA, Wilkins CK, Nielsen GD. 2000. Formation of strong airway irritants in terpene/ozone mixtures. Indoor Air 10(2): 82-91.
Wolkoff P, Wilkins CK, Clausen PA, Nielsen GD. 2006. Organic compounds in office environments - sensory irritation, odor, measurements and the role of reactive chemistry. Indoor Air 16(1): 7-19.
Zhang JW, Li SK, Wu WJ. 2009. The Main Chemical Composition and in vitro Antifungal Activity of the Essential Oils of Ocimum basilicum Linn. var. pilosum (Willd.) Benth. Molecules 14(1): 273-278.
卓芷聿，精油全書，商周出版社，2002，第一版。
徐國興，眼科學基礎 (Fundamentals of ophalmology)，新文京開發，初版。
麥麗敏，新編生理學，永大書局，1996，第二版。
龔大瑋，精油薰香溢散物及其潛在的氣狀及粒狀二次污染物之定性及定量分析研究，國立成功大學環境醫學研究所碩士論文，2007。