牙體技術師作業場所生物氣膠特性採樣評估

牙體技術師的工作涉及在石膏模型上建造和固定假牙，以及製作活動牙齒矯正器，在這些過程中常常使用和釋放大量有害物質，其中可能包含生物氣膠。生物氣膠通常與人類活動相關，這些氣膠中包含著細菌，而吸入鮑曼不動桿菌、銅綠假單胞菌和碳青黴烯類腸桿菌科細菌具有抗生素抗藥性的生物氣膠，可能造成難以治療的肺炎，但這些生物性的危害卻往往易被忽略。使用Andersen Six Stage Viable Particle Sampler，於三處作業場所進行三次採樣，並使用BD Phoenix進行細菌菌種鑑定和藥敏性測試。然後選擇一組抗藥性菌株，使用鋅、鉻、鋯三種金屬，進行金屬水溶液的暴露。本研究之優勢菌屬為Staphylococcus spp.，雖然在牙體技術師的作業過程中能採集到具多重抗藥性的細菌，但在工作一段時間後發現濃度均有所下降，這代表空氣清淨機能有效過濾這些細菌。根據SASS統計軟體的Spearman相關性分析，細菌濃度會與人數、人積比、Occupant Emission Rate (OER)呈顯著相關。本研究使用Yersinia pseudotuberculosis暴露於不同濃度之金屬水溶液，相比於對照組，除了TZP外，其餘測試抗生素之最小抑菌濃度(MIC)皆有明顯微變化，像是FEP、CMZ、CIP、GM、LVX、MI、TGC、SXT等等抗生素之MIC數值皆幾乎有所上升，這表明金屬暴露會增加細菌對某些抗生素的抗藥性，影響其療效。本研究中揭示了牙體技術所作業環境中的細菌分布和抗藥性情況，強調了空氣清淨措施在控制生物氣膠濃度中的重要性。這些發現有助於了解有關牙體技術師工作環境中生物氣膠危害，以保障牙體技術師的工作安全和健康。

The work of a dental technician involves building and fixing dentures on plaster models, as well as creating removable dental braces. These processes often use and release large amounts of harmful substances, which may include bioaerosol. Bioaerosol, typically associated with human activities, contain bacteria. Inhaling bioaerosols that have antibiotic-resistant bacteria such as Acinetobacter baumannii, Pseudomonas aeruginosa, and carbapenem-resistant Enterobacteriaceae may cause hard-to-treat pneumonia, yet these biological hazards are often overlooked.The Andersen Six Stage Viable Particle Sampler was used to conduct three replicate samplings at three different workplaces, and the BD Phoenix was used for bacterial strain identification and antibiotic susceptibility testing. A group of resistant bacteria strains were then selected and exposed to heavy metal aqueous solutions using three metals, such as zinc, chromium, and zirconium with different concentrations. The results of the study showed that the dominant bacterial genus in this study was Staphylococcus spp.. Although multi-drug-resistant bacteria were collected during the dental technician's work process, a decrease in bacterial concentration was observed after a period of work. This indicates that air cleaners can effectively filter these bacteria. According to Spearman correlation analysis using SASS statistical software, bacterial concentration was significantly related to the number of people, the ratio of people to area, and the Occupant Emission Rate (OER).In this study, Yersinia pseudotuberculosis was exposed to different concentrations of metal solutions. Compared to the control group, all tested antibiotics, except for TZP, showed Minimal Inhibitory Concentration (MIC) changes. MIC values for antibiotics such as FEP, CMZ, CIP, GM, LVX, MI, TGC, and SXT almost increased, indicating that metal exposure increases bacterial resistance to certain antibiotics, affecting their efficacy.This study reveals the distribution and antibiotic resistance of bacteria in the dental technician's work environment, emphasizing the importance of air purification measures in controlling bioaerosol concentrations. These findings help to know the bioaerosol hazards in the dental technician's work environment, ensuring the safety and health of dental technicians.