HEALTH_Vol33No4_10

∫ ∑ «‘ ∑ ¬ “ ° “ √

∫ ∑ «‘ ∑ ¬ “ ° “ √ ª√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢π“¥ ª√‘¡“≥ΩÿÉπ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥ ª√‘¡“≥√«¡¢Õ߇™◊ÈÕ·∫§∑’‡√’¬ ª√‘¡“≥ √«¡¢Õ߇™◊ÈÕ√“„πÕ“°“»¿“¬„πÀâÕßªî¥ ·≈–§«“¡™ÿ°¢Õß°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¢Õßπ—°»÷°…“ Õ“®“√¬å·≈–‡®â“Àπâ“∑’Ë „π¡À“«‘∑¬“≈—¬·ÀàßÀπ÷Ëß

»‘√‘≈—°…≥å «ß…å«‘®‘µ ÿ¢ ™—≠≠“ ‡®’¬¡„® “¢“«‘™“Õ“™’«Õπ“¡—¬·≈–§«“¡ª≈Õ¥¿—§≥– “∏“√≥ ÿ¢»“ µ√å·≈– ‘Ëß·«¥≈âÕ¡ ¡À“«‘∑¬“≈—¬À—«‡©’¬«‡©≈‘¡æ√–‡°’¬√µ‘

∫∑§—¥¬àÕ °“√»÷°…“§√—Èßπ’È¡’«—µ∂ÿª√– ߧå‡æ◊ËÕ»÷°…“ª√‘¡“≥¡≈æ‘…„πÕ“°“»¿“¬„πÀâÕߪ≈–§«“¡™ÿ°¢Õß°“√‡°‘¥ Õ“°“√Õ“§“√ªÉ«¬ ∑”°“√‡°Á∫µ—«Õ¬à“ßÕ“°“»«‘‡§√“–ÀåÀ“ª√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢π“¥ (Total dust) ª√‘¡“≥ΩÿÉπ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡Õ¬Ÿà„π∂ÿß≈¡ªÕ¥‰¥â (Respirable dust) ª√‘¡“≥√«¡¢Õ߇™◊ÈÕ·∫§∑’‡√’¬ (Total bacteria) ·≈– ª√‘¡“≥√«¡¢Õ߇™◊ÈÕ√“ (Total fungi) ´÷Ëß∑”°“√‡°Á∫µ—«Õ¬à“ß„πÀâÕß∑’Ë¡’≈—°…≥–ªî¥∑—ÈßÀ¡¥®”π«π 77 ÀâÕß ·∫à߇ªìπ ÀâÕßæ—°Õ“®“√¬å 8 ÀâÕß ”π—°ß“π 17 ÀâÕß ÀâÕß∫√√¬“¬ 52 ÀâÕß ·≈–°≈ÿࡵ—«Õ¬à“ß∑’Ë∑”°“√ ”√«®Õ“°“√Õ“§“√ªÉ«®”π«π 638 §π ª√–°Õ∫¥â«¬Õ“®“√¬å∑—ÈßÀ¡¥ 92 §π ‡®â“Àπâ“∑’Ë∑—ÈßÀ¡¥ 135 §π·≈–π—°»÷°…“∑—ÈßÀ¡¥ 410 §π æ∫ «à“ΩÿÉπ√«¡∑ÿ°¢π“¥ (Total dust) ΩÿÉπ¢π“¥∑’ˇ¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥‰¥â (Respirable dust) „π ”π—°ß“π¡’ ª√‘¡“≥¡“°∑’Ë ÿ¥ ·≈–ª√‘¡“≥¢ÕßΩÿÉπ∑—Èß 2 ™π‘¥„πÀâÕß∑ÿ°ª√–‡¿∑¡’§à“‰¡à‡°‘π§à“¡“µ√∞“π ·≈–æ∫«à“„π ”π—°ß“π¡’ ª√‘¡“≥√«¡¢Õ߇™◊ÈÕ·∫§∑’‡√’¬·≈–‡™◊ÈÕ√“ Ÿß ÿ¥ ‚¥¬æ∫«à“„π√âÕ¬≈– 26.67 ¢Õß ”π—°ß“π·≈–√âÕ¬≈– 2.78 ¢ÕßÀâÕß ∫√√¬“¬¡’ª√‘¡“≥√«¡¢Õ߇™◊ÕÈ ·∫§∑’‡√’¬·≈–‡™◊ÕÈ √“‡°‘π§à“¡“µ√∞“π‡¡◊ÕË ‡ª√’¬∫‡∑’¬∫§«“¡·µ°µà“ߢÕß§à“§«“¡‡¢â¡¢âπ¢Õß ΩÿÉπ√«¡∑ÿ°¢π“¥ ΩÿÉπ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥ ª√‘¡“≥√«¡¢Õß·∫§∑’‡√’¬·≈–√“ ∑’˪π‡ªóôÕπ„πÕ“°“» ¿“¬„πÀâÕߢÕß∑—Èß 3 °≈ÿࡵ—«Õ¬à“ß §à“§«“¡‡¢â¡¢âπ¢ÕßΩÿÉπ√«¡∑ÿ°¢π“¥·≈–§à“§«“¡‡¢â¡¢âπ¢ÕßΩÿÉπ∑’Ë “¡“√∂‡¢â“·≈– – ¡„π∂ÿß≈¡ªÕ¥„π·µà≈–°≈ÿ¡à µ—«Õ¬à“ß¡’§“à ·µ°µà“ß°—πÕ¬à“ß¡’π¬— ”§—≠ ∑’Ë P < 0.05 °“√ ”√«®°“√‡°‘¥Õ“°“√Õ“§“√ªÉ«°≈ÿà¡Õ“°“√∑’ˇ°’ˬ«°—∫√–∫∫ª√– “∑‡ªìπ°≈ÿà¡Õ“°“√∑’Ëæ∫¡“°·≈–‡°‘¥¢÷Èπ‡∑à“°—∫√âÕ¬≈– 25.08 ¢Õß®”π«π°≈ÿࡵ—«Õ¬à“ß ‡¡◊ËÕæ‘®“√≥“·¬°„π·µà≈–°≈ÿࡵ—«Õ¬à“ßæ∫«à“°≈ÿࡇ®â“Àπâ“∑’Ë¡’°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬‡°‘¥¢÷Èπ¡“°°«à“ 1 °≈ÿà¡Õ“°“√‚¥à«π„À≠à¡’Õ“°“√„π°≈ÿà¡Õ“°“√∑“ßµ“ °≈ÿà¡Õ“°“√∑“ß®¡Ÿ°·≈–√–∫∫ª√– “∑ à«π°≈ÿࡵ—«Õ¬à“ß∑’ˇªìπÕ“®“√¬å·≈–

114 µÿ≈“§¡ - ∏—𫓧¡ 2553 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

ª√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢π“¥ ª√‘¡“≥ΩÿÉπ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥œ

π—°»÷°…“¡’Õ“°“√‡æ’¬ß°≈ÿà¡Õ“°“√‡¥’¬«§◊Õ √–∫∫ª√– “∑ º≈°“√»÷°…“§«“¡ —¡æ—π∏å√–À«à“ßªí®®—¬¥â“π§ÿ≥¿“æ Õ“°“»¿“¬„πÀâÕß æ∫«à“®”π«π‡™◊ÕÈ ·∫§∑’‡√’¬¡’§«“¡ —¡æ—π∏å°∫— °“√‡°‘¥°≈ÿ¡à Õ“°“√Õ“§“√ªÉ«¬Õ¬à“ß¡’π¬— ”§—≠∑’Ë p<0.05 √ÿªº≈°“√»÷°…“§√—ßÈ π’°È ≈ÿ¡à ‡®â“Àπâ“∑’‡Ë ªìπ°≈ÿ¡à ∑’æË ∫«à“¡’ª≠ í À“¢Õߧÿ≥¿“æÕ“°“»¿“¬„πÕ“§“√ ¡“°°«à“°≈ÿ¡à Õ◊πË Ê ·≈– ‡ªìπ°≈ÿࡵ—«Õ¬à“ß∑’ˇ°‘¥°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬ Ÿß ÿ¥ ¥—ßπ—ÈπºŸâ∑’Ë∑”ß“π„πÕ“§“√∑’Ë¡’ªí≠À“∑“ߥâ“π§ÿ≥¿“æÕ“°“»¡’ ‚Õ°“ ∑”„À⇰‘¥Õ“°“√°≈ÿà¡Õ“§“√ªÉ«¬‰¥â∂÷ß·¡â«à“ “‡Àµÿ∑’Ë∑”„À⇰‘¥®–‰¡à™—¥‡®ππ—° ·µàªí≠À“∑’ˇ°‘¥¢÷ÈπÕ“® àߺ≈µàÕ«‘∂’ °“√¥”‡π‘π™’«‘µ·≈–µàÕ¢«—≠·≈–°”≈—ß„®¢ÕߺŸâªØ‘∫—µ‘ß“π ®÷ߧ«√„À⧫“¡ π„®µàÕªí≠À“Õ“°“√Õ“§“√ªÉ«¬·≈–ªí®®—¬∑’Ë ∑”„À⇰‘¥Õ“°“√Õ“§“√ªÉ«§” ”§—≠ : Õ“°“»„πÕ“§“√ ¡≈æ‘…Õ“°“» Õ“°“√°≈ÿà¡Õ“§“√ªÉ«¬

Indoor air total dust, respirable dust, total bacteria, total fungi in close rooms and sick building syndrome levels of student lecturers and officer in university Sirilak Wongvijitsuk Chanya Cheamjai Occupational Health and Safety Faculty of Public Health and Environment, Huachiew Chalermprakiet University

Abstract This study aimed to evaluate the levels of air contaminants and sick building syndromes prevalence and determined the relationship between Sick building syndrome factors and sick building syndromes prevalence. Air contaminants including total dust, respirable dust, total bacteria and total fungi were studied. Air samples in 77 rooms, including 8 lecturer rooms, 17 office rooms and 52 lecture rooms were taken. 683 persons including 93 lecturers, 135 officers and 410 students were studied. It was founded that total dust and respirable dust in offices had the highest levels, but contaminants were not exceed the standard in all rooms. The levels of total bacteria and fungi in office were the highest levels. These microorganism contaminants in 26.67% of office and 2.78 % of lecture rooms exceeded the standard.

Comparison of air contaminants in each room types showed the levels of respirable dust and total bacteria levels were statistical significant different at p<0.05. Sick building syndrome were determined by frequency of symptoms expression (1-3 day/week), number of symptoms ( > 2 symptoms in 1 group) and these symptoms must expressed in workplace only. The results showed the highest symptoms of sick

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH October - December 2010

115

∫ ∑ «‘ ∑ ¬ “ ° “ √ building syndrome was neurological symptoms group (25.08%). Considering job characteristics of subjects, the officers had more than 1 symptom groups of sick building syndrome such as eye symptoms group, nose symptoms group and neurological symptoms group. The neurological symptoms group was found in lecturer and students. The results also showed total bacteria levels had significant relationship with sick building syndrome (p<0.05). Finally, this study showed that officers had the highest prevalence of sick building syndrome due to their exposure to the highest levels of indoor air pollution which was the main factor of sick building syndrome. Although, the relationship of some factors were not significant but they might effect the personsû a way of life and morale. Therefore, the management of sick building syndrome and its contributing factors should carefully considered.

Keywords: Indoor air, Air pollution, Sick building syndrome

∫∑π” ‡π◊ËÕߥ⫬„πªí®®ÿ∫—π§π‡√“®–„™â™’«‘µ à«π „À≠àª√–¡“≥√âÕ¬≈– 90 Õ¬Ÿà¿“¬„πÕ“§“√(1) ‰¡à «à“®–‡ªìπ∫â“π ∑’Ëæ—°Õ“»—¬ ‚√߇√’¬π À√◊Õ ∂“π∑’Ë ∑”ß“π ´÷Ëߧÿ≥¿“æÕ“°“»¿“¬„πÕ“§“√®÷ß¡’ à«π ∑’Ë®–‡ªìπªí®®—¬Àπ÷Ëß∑’Ë®– àߺ≈°√–∑∫µàÕ°“√‡°‘¥ ‚√§¢Õߧπ„πÕ“§“√π—Èπ ∑—Èßπ’ÈÕߧ尓√Õπ“¡—¬‚≈° (WHO) §“¥«à“ √âÕ¬≈– 30 ¢ÕßÕ“§“√∑—Ë«‚≈° Õ“®¡’ªí≠À“¥â“π§ÿ≥¿“æÕ“°“»¿“¬„πÕ“§“√ ∑’Ë ‡√’¬°«à“ çIndoor Air Qualityé ´÷Ëß®–𔉪 Ÿà ªí≠À“°≈ÿà¡Õ“°“√∑’ˇ°‘¥®“°°“√∑”ß“π„πÕ“§“√ ªî¥‰¥â(2) ·≈– WHO ‰¥â„Àâ§”π‘¬“¡¢Õߧ”«à“ °≈ÿ¡à Õ“°“√∑’ˇ°‘¥¢÷Èπ„π§π∑’Ë∑”ß“π„πÕ“§“√«à“ ç°≈ÿà¡ Õ“°“√Õ“§“√ªÉ«¬ (Sick building syndrome) é ‚¥¬¡’≈—°…≥–Õ“°“√√–§“¬‡§◊ÕߢÕߺ‘«Àπ—ß·≈– ‡¬◊ËÕ∫ÿ∑’ˇ°’ˬ«¢âÕß°—∫°“√∑”ß“π √«¡∂÷ß°“√√–§“‡§◊Õßµ“ À“¬„®µ‘¥¢—¥ ∫àπ‡°’¬Ë «°—∫‡√◊ÕË ß√–∫∫À“¬„® Õ“°“√ª«¥»’√…– ‰¥â°≈‘Ëπ∑’ˉ¡à –Õ“¥ º‘«·Àâß ÕàÕπ‡æ≈’¬ Õ“°“√‰´π— ‰Õ Õ“°“√·æâ∑“ߺ‘«Àπ—ß §≈◊Ëπ‰ â ·≈–‰¡à¡’ ¡“∏‘ ´÷Ëß®–µâÕß¡’√“¬ß“π®“°ºŸâ∑’Ë ∑”ß“π„πÕ“§“√ ”π—°ß“ππ—ÈπÕ¬à“ßπâÕ¬√âÕ¬≈– 20 ®÷ß®–π—∫«à“‡ªìπ°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬(3) ‰¥â¡’ 116 µÿ≈“§¡ - ∏—𫓧¡ 2553 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

ß“π«‘ ®— ¬ À≈“¬©∫— ∫ ∑’Ë ∑”°“√»÷ ° …“°“√‡°‘ ¥ °≈ÿà ¡ Õ“°“√Õ“§“√ªÉ«¬„π°≈ÿࡧπ∑’Ë∑”ß“π„πÕ“§“√ ´÷Ëß æ∫«à“°≈ÿࡧπ¥—ß°≈à“«¡’Õ“°“√∑’˧≈⓬°—π §◊Õ §—¥ ®¡Ÿ° ÕàÕπ‡æ≈’¬ ª«¥»’√…– §Õ·Àâß·≈–‡§◊Õßµ“(4 ,5) ¡≈æ‘…Õ“°“»¿“¬„πÕ“§“√‡°‘¥®“°ªí®®—¬À≈“Õ¬à“ߺ ¡°—𠇙àπ ªí®®—¬∑“ß°“¬¿“æ ∑“߇§¡’ ∑“ß ™’«¿“æ·≈–§«“¡æՇ撬߄π°“√√–∫“¬Õ“°“» ´÷ßË ‘ßË ªπ‡ªóÕô π„πÕ“°“»¿“¬„πÕ“§“√∑’‡Ë √’¬°«à“ ¡≈æ‘… Õ“°“» ®–¡“®“°Õ“°“»¿“¬πÕ°Õ“§“√·≈– °‘®°√√¡∑’ˇ°‘¥¢÷Èπ„π ∂“π∑’Ëπ—Èπ(6) „πª√–‡∑»‰∑π—∫µ—Èß·µàªï æ.».2536 ‰¥â‡√‘Ë¡„À⧫“¡ π„®‡°’ˬ« °—∫§ÿ≥¿“æÕ“°“»¿“¬„πÕ“§“√ ‚¥¬æ∫«à“°“√ ‡°‘¥°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬¢Õß°≈ÿࡧπ∑’Ë∑”ß“π„π Õ“§“√æ∫«à“§π∑”ß“π„πÕ“§“√ ”π—°ß“π„π‡¢µ °√ÿ߇∑æ¡À“π§√¡’§«“¡™ÿ°¢Õß°≈ÿà¡Õ“°“√Õ“§“√ ªÉ«¬√âÕ¬≈– 20.58 ·≈–‰¥â∑”°“√»÷°…“À“ ‘Ëßªπ ‡ªóôÕπ„π ∂“π∑’Ë∑’Ë·µ°µà“ß°—𠇙àπ „π‚√ß√∂ √â“π Õ“À“√ ‚√ß欓∫“≈·≈–√∂‚¥¬ “√ ´÷Ëߺ≈°“√ »÷°…“„πª√–‡∑»‰∑¬æ∫«à“ ‘Ëߪπ‡ªóôÕπ„πÕ“°“» ∑’ËÕ“®‡ªìπªí®®—¬ §◊Õ °ä“´§“√å∫Õπ‰¥ÕäÕ°‰´¥å ª√‘¡“≥ “√√–‡À¬ ª√‘¡“≥ΩÿÉπ¢π“¥‡≈Á° ‡™◊ÈÕ‚√§ ∫“ß™π‘¥ √«¡‰ª∂÷ßÕ—µ√“°“√√–∫“¬Õ“°“» ‡ªìπµâπ

ª√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢π“¥ ª√‘¡“≥ΩÿÉπ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥œ

·≈–·µà≈– ∂“π∑’Ë¡’ª√‘¡“≥¢Õß ‘Ëߪπ‡ªóôÕπ∑’Ë·µ° µà“ß°—π(7, 8, 9) ª√‘¡“≥¢Õß ‘Ëߪπ‡ªóôÕπ„πÕ“°“» ¿“¬„πµ—«Õ“§“√¡“®“°¡≈æ‘…Õ“°“»¿“¬πÕ° Õ“§“√√«¡∂÷ ß °‘ ® °√√¡µà “ ßÊ ∑’Ë ‡ °‘ ¥ ¢÷È π ¿“¬„π Õ“§“√¬—߇ªìπ·À≈àß°àÕ¡≈æ‘…‰¥â ®“°ß“π«‘®—¬æ∫ «à“‡™◊ÈÕ®ÿ≈‘π∑√’¬å„πÕ“°“»¡’§«“¡ —¡æ—π∏å°—∫°“√ ‡°‘¥°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬ ‚¥¬‡©æ“–‡¬◊ËÕ∫ÿµà“ßÊ ¢Õß√à“ß°“¬ ‡™à𠵓·≈–√–∫∫∑“߇¥‘πÀ“¬„®(10) ·≈–¬—ßæ∫«à“ΩÿÉπ∑’˪π‡ªóôÕπ„πÕ“°“» “¡“√∂°àÕ „À⇰‘¥ªí≠À“ ÿ¢¿“æµàÕ√à“ß°“¬¢Õߧπ‰¥â ‚¥‡©æ“–√–∫∫∑“߇¥‘πÀ“¬„®´÷ßË ΩÿπÉ ∑’¡Ë ¢’ 𓥇≈Á°°«à“ 10 ‰¡§√Õπ “¡“√∂≈ß≈÷°∂÷ߪե·≈–°àÕ„À⇰‘¥ Õ—πµ√“¬µàÕ‡π◊ÈÕªÕ¥‰¥â(11) ‰¥â¡’ß“π«‘®—¬√“¬ß“π «à “ ª√‘ ¡ “≥ΩÿÉ π ¿“¬„πÀâ Õ ß‡√’ ¬ π‚¥¬‡©æ“–ΩÿÉ π ∑’Ë “¡“√∂‡¢â“ Ÿ∂à ßÿ ≈¡‰¥â(PM10) ¡’ª√‘¡“≥ Ÿß(12) ΩÿπÉ ®÷߇ªìπ¡≈æ‘…™π‘¥Àπ÷Ëß∑’˧«√ π„®‡π◊ËÕß®“°µ“¡ ∏√√¡™“µ‘ΩπÿÉ ‡ªìπ¡≈æ‘…∑’¡Ë ’ ß‘Ë ªπ‡ªóÕô πÕ¬Ÿ„à πµ—«‡Õß ‡™àπ °“√‡°“–¢Õ߇™◊ÈÕ‚√§∫πΩÿÉπ °“√ª–µ‘¥¢Õß “√Õ◊ËπÊ °—∫ΩÿÉπ(11) ¥—ßπ—Èπ°“√µ√«®«—¥ª√‘¡“≥ΩÿÉπ ·≈–‡™◊È Õ ®ÿ ≈‘ π ∑√’ ¬å „ πÕ“°“»¿“¬„πÕ“§“√‚¥‡©æ“–Àâ Õ ß∑’Ë ¡’ ≈— ° …≥–ªî ¥ Àâ Õ ß∑’Ë ¡’ √ –∫∫ª√— ∫ Õ“°“»·µà¢“¥°“√√–∫“¬Õ“°“»∑’Ë¥’®–‡ªìπ·À≈àß – ¡¢Õ߇™◊ÈÕ·≈–ΩÿÉπ‰¥â ∂“π»÷°…“®—¥‡ªìπ ∂“π∑’Ë∑’Ë¡’≈—°…≥–ÀâÕß ∑’ˇªìπ·∫∫ªî¥·≈–¡’°‘®°√√¡„π°“√„™âÀâÕß ·≈– ≈—°…≥–ß“π∑’ËÀ≈“°À≈“¬ ‡™àπ ÀâÕ߇√’¬π ÀâÕßæ—° ·≈– ”π—°ß“π °“√»÷°…“„π§√—Èßπ’ȉ¥â∑”°“√»÷°…“ µ√«®À“ª√‘¡“≥¢ÕßΩÿπÉ √«¡ ΩÿπÉ ¢π“¥‡≈Á° ª√‘¡“≥ ‡™◊ÈÕ·∫§∑’‡√’¬·≈–‡™◊ÈÕ„πÕ“°“»¿“¬„πÀâÕߢÕß ∂“π»÷°…“ ´÷Ëß¡’≈—°…≥–ÀâÕ߇ªìπÀâÕßªî¥ ¡’°“√ „™â‡§√◊ËÕߪ√—∫Õ“°“» ·≈–»÷°…“§«“¡™ÿ°¢Õß°“√ ‡°‘¥Õ“°“√°≈ÿà¡Õ“§“√ªÉ«¬∑ÿ°°≈ÿà¡ß“π ‡π◊ËÕß®“° °“√»÷°…“∑’˺à“π¡“‡ªìπ°“√ ”√«®„π‡√◊ËÕߢÕß ‘Ëß ªπ‡ªóôÕπ ·≈–°“√𔇠πÕ§«“¡ —¡æ—π∏å„π‡√◊ËÕß

¢Õߺ≈°√–∑∫µàÕ ÿ¢¿“æ∑’Ë™’È„Àâ‡ÀÁπÕ—πµ√“¬‚¥°“√‡™◊ËÕ¡‚¬ß ªí®®—¬∑“ß ‘Ëß·«¥≈âÕ¡°—∫ ÿ¢¿“æ∑’Ë ‡°‘¥¢÷Èπ¬—ß¡’πâÕ¬ ·≈–„π¢≥–π’È„πª√–‡∑»‰∑¬π—Èπ ¬— ß ‰¡à ¡’ À πà « ¬ß“π„¥∑’Ë °”Àπ¥§à “ ¡“µ√∞“π §ÿ ≥ ¿“æÕ“°“»¿“¬„πÕ“§“√‚¥¬µ√ß ¡’ ‡ æ’ ¬ ß °ÆÀ¡“¬∫“ß©∫—∫∑’ˇ°’ˬ«¢âÕß ‡™àπ °Æ°√–∑√«ß ©∫—∫∑’Ë 33 (æ.».2535) À¡«¥ 2 √–∫∫√–∫“Õ“°“» √–∫∫‰øøÑ“ ·≈–√–∫∫ªÑÕß°—π‡æ≈‘߉À¡â ª√–°“»°√–∑√«ß “∏“√≥ ÿ¢∑’Ë 7/2538 ·≈– 8/ 2538 ‡√◊ËÕß°”Àπ¥®”π«π§πµàÕ®”π«πæ◊Èπ∑’Ë ¢Õß Õ“§“√§πß“π°àÕ √â“ß·≈–Õ“§“√‚√ßß“π¥â«¬ √«¡ ∂÷ßæ√–√“™∫—≠≠—µ§‘ ¡ÿâ §√Õß ÿ¢¿“æ¢ÕߺŸ‰â ¡à ∫Ÿ ∫ÿÀ√’Ë æ.».2534 ´÷ßË °”Àπ¥ ∂“π∑’Ë À√◊Õ¬“πæ“Àπ–„¥Ê ∑’‡Ë ªìπ ∂“π∑’ Ë “∏“√≥– ‡ªìπ‡¢µª≈Õ¥∫ÿÀ√’Ë ‡ªìπµâπ ¥— ß π—È π °“√»÷ ° …“«‘ ®— ¬ „π§√—È ß π’È ®÷ ß ‡≈Á ß ‡ÀÁ 𠧫“¡ ”§—≠„π°“√À“ª√‘¡“≥¡≈æ‘…„πÕ“°“»∑’Ë —¡º— ·≈–§«“¡™ÿ°¢Õß°“√‡°‘¥∑’ˇ°‘¥°≈ÿà¡Õ“°“√Õ“§“√ ªÉ«¬°—∫æπ—°ß“π∑’Ë∑”ß“π„πÕ“§“√ªî¥‡æ◊ËÕ„À⇰‘¥ ‡ªìπ¢âÕ¡Ÿ≈„π°“√¥”‡π‘π°“√§«∫§ÿ¡ ·≈–ªÑÕß°—π µàÕ‰ª

«‘∏’°“√»÷°…“ °“√«‘®—¬§√—Èßπ’ȇªìπ°“√»÷°…“·∫∫¿“§µ—¥ ¢«“ß(Cross sectional study) „ππ—°»÷°…“ Õ“®“√¬å · ≈–‡®â “ Àπâ “ ∑’Ë ∑’Ë ∑”ß“π„πÀâ Õ ßª√— ∫ Õ“°“»„πÕ“§“√¢Õß¡À“«‘ ∑ ¬“≈— ¬ ·Àà ß Àπ÷Ë ß ª√–™“°√„π°“√»÷°…“·∫à߇ªìπÀâÕß ·≈–§π„π Õ“§“√ °“√§”π«≥®”π«π(ÀâÕß)°≈ÿࡵ—«Õ¬à“ß ®“°ª√–™“°√ 102 ÀâÕß„™â Ÿµ√°“√À“¢π“¥¢Õß °≈ÿà ¡ µ— « Õ¬à “ ß·∫∫∑√“∫®”π«πª√–™“°√‚¥°”À𥧫“¡‡™◊ÕË ¡—πË ∑’Ë 95% §«“¡º‘¥æ≈“¥‰¡à‡°‘π 5% ¥—ß Ÿµ√¢Õß Taro Yamane ‰¥â‡∑à“°—∫ 81 ÀâÕß ·≈–‡æ◊Ë Õ ªÑ Õ ß°— 𠧫“¡º‘ ¥ æ≈“¥®“°°“√‡°Á ∫ µ—«Õ¬à“ßÕ“°“»‰¡à ¡∫Ÿ√≥å ®÷߉¥â∑”°“√ ”√Õß

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH October - December 2010

117

∫ ∑ «‘ ∑ ¬ “ ° “ √ ÀâÕ߇æ‘Ë¡√«¡∑—Èß ‘Èπ 92 ÀâÕß °√≥’°≈ÿࡵ—«Õ¬à“ß ¢ÕߺŸâ µ Õ∫·∫∫ Õ∫∂“¡ ‰¥â §”π«≥¢π“¥ µ—«Õ¬à“ß‚¥¬ R.V.Krejcie ·≈– D.W.Morgan ·≈– „™â«∏‘ °’ “√ ÿ¡à µ—«Õ¬à“ß·∫∫‚§«µ“ ª√–°Õ∫¥â«¬ °≈ÿ¡à µ—«Õ¬à“ß Õ“®“√¬å ‡®â“Àπâ“∑’Ë ·≈–π—°»÷°…“ ‰¥â °≈ÿ¡à µ—«Õ¬à“ߪ√–°Õ∫¥â«¬Õ“®“√¬å∑ß—È À¡¥ 196 §π ‡®â“Àπâ“∑’Ë∑—ÈßÀ¡¥ 186 §π ·≈–π—°»÷°…“∑—ÈßÀ¡¥ 367 §π „™â·∫∫ Õ∫∂“¡∑’Ëæ—≤π“¡“®“°π“¬·æ∑¬å ©—µ√™—¬ ‡Õ°ªí≠≠“ °ÿ≈ „π°“√‡°Á∫¢âÕ¡Ÿ≈Õ“°“√ °≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬·≈–¡’°“√µ√«® Õ∫§«“¡ ∂Ÿ°µâÕߢÕ߇π◊ÈÕÀ“‚¥¬ºŸâ‡™’ˬ«™“≠ ∑¥ Õ∫§«“¡ ‡™◊Ë Õ ∂◊ Õ ¢Õß·∫∫ Õ∫∂“¡¥â « ¬«‘ ∏’ Kuder Rihardson (KR- 20) ¡’À≈—°°“√æ‘®“√≥“°“√ ‡°‘¥Õ“°“√°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬ ¥—ßπ’È µâÕß¡’ Õ“°“√µ—ßÈ ·µà 1 - 3 «—π/ —ª¥“Àå„π·µà≈–Õ“°“√ ·≈– ¡’µ—Èß·µà 2 Õ“°“√„π·µà≈–√–∫∫®÷ß √ÿªº≈ «à“¡’ Õ“°“√„π√–∫∫π—È π ·≈–µâ Õ ß¡’ Õ “°“√‡©æ“–„π∑’Ë ∑”ß“π‡∑à“π—È𠇙àπ §π∑’Ë¡’°≈ÿà¡Õ“°“√∑“ßµ“ ‡™à𠵓·¥ßÕ¬à“߇¥’¬« ®÷ß∂◊Õ«à“‰¡à¡’Õ“°“√°≈ÿà¡Õ“°“√ Õ“§“√ªÉ«°“√‡°Á∫µ—«Õ¬à“ßÕ“°“» ·∫àßÕÕ°‡ªìπ °“√ ‡°Á∫ΩÿÉπ√«¡∑ÿ°¢π“¥ (Total dust) ·≈–ΩÿÉπ∑’Ë

“¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥ (Respirable dust), ‡™◊ÈÕ·∫§∑’‡√’¬ ·≈–‡™◊ÈÕ√“ 1) °“√‡°Á∫ΩÿÉπ√«¡∑ÿ°¢π“¥ (Total dust) ®–„™â«‘∏’°“√‡°Á∫µ“¡¡“µ√∞“π NIOSH 5000(13) 2) °“√‡°Á∫ΩÿÉπ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡ „π∂ÿß≈¡ªÕ¥ (Respirable dust) ®–„™â«‘∏’°“√ ‡°Á∫µ“¡¡“µ√∞“π NIOSH 6000 (13) 3) °“√‡°Á∫‡™◊ÕÈ ·∫§∑’‡√’¬ ·≈– ‡™◊ÕÈ √“ (Total bacteria count and fungal count) ®–„™â °“√‡°Á∫·∫∫ BioSampler one plate ´÷Ë߇ªì𠇧√◊Ë Õ ß¡◊ Õ ¡“µ√∞“π∑’Ë „ ™â ‡ °Á ∫ µ— « Õ¬à “ ß™’ « ¿“æ„π Õ“°“» ‚¥¬®–„ àÕ“À“√‡≈’Ȭ߇™◊ÈÕ ™π‘¥ SDA (Sabouraud Dextrose Agar) ”À√—∫‡™◊ÕÈ √“ ·≈– Blood agar ”À√—∫‡™◊ÕÈ ·∫§∑’‡√’¬ ≈ß„π Petri dish ·≈–µàÕ‡¢â“°—∫ªíö¡ ‡¡◊ËÕ‡ªî¥ªíö¡®ÿ≈‘π∑√’¬å∑’ˇ¢â“¡“ æ√âÕ¡°—∫Õ“°“»∑“ߥâ“π∫π®–µ°°√–∑∫≈ß∫π ¢Õ߇À≈« Õ—µ√“°“√¥Ÿ¥Õ“°“»¡’¢π“¥ 23.5 ≈‘µ√ µàÕπ“∑’ ´÷Ëß®–‡°Á∫π“π‡ªìπ‡«≈“ 25 π“∑’ À≈—ß ®“°‡°Á∫‡ √Á®‡™◊ÕÈ ®ÿ≈π‘ ∑√’¬®å –∂Ÿ°π”‰ª‡æ“–‡≈’¬È ߇™◊ÕÈ ∑’Ë 37 ÌC ‡ªìπ‡«≈“ 3 «—π ”À√—∫‡™◊ÈÕ·∫§∑’‡√’¬ ·≈– 37 ÌC ‡ªìπ‡«≈“ 5 «—π ”À√—∫‡™◊ÈÕ√“ ‡¡◊ËÕ§√∫ °”Àπ¥®–π”¡“∑”°“√π— ∫ ®”π«πµà Õ ‰ª ·≈– ∑”°“√§”π«≥ª√‘¡“≥¢Õ߇™◊ÈÕ¥—ß Ÿµ√µàÕ‰ªπ’È

®”π«π·∫§∑’‡√’¬„πÕ“°“»∑—ÈßÀ¡¥ = ®”π«π‚§‚≈π’∑—ÈßÀ¡¥ X 103 Colony Forming Unit (CFU/m3) ª√‘¡“µ√Õ“°“» (≈‘µ√) ° “ √ «‘ ‡ § √ “ – Àå ¢â Õ ¡Ÿ ≈ „ ™â ‚ ª √ · ° √ ¡ §Õ¡æ‘«‡µÕ√å ”‡√Á®√Ÿª·≈–𔇠πÕ¢âÕ¡Ÿ≈ª√‘¡“≥ ¡≈æ‘…·µà≈–™π‘¥·≈–§«“¡™ÿ°¢Õß°“√‡°‘¥°≈ÿà¡ Õ“°“√Õ“§“√ªÉ«¬·≈–·µà≈–°≈ÿà¡Õ“°“√ „π√Ÿª√âÕ≈–·≈–§«“¡‡™◊ËÕ¡—Ëπ∑’Ë√âÕ¬≈– 95 ∑”°“√‡ª√’¬∫ ‡∑’ ¬ ∫§«“¡·µ°µà “ ߢÕß§à “ ¡≈æ‘ … ·µà ≈ –™π‘ ¥ 118 µÿ≈“§¡ - ∏—𫓧¡ 2553 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

√–À«à“ß°≈ÿà¡∑’Ë¡’Õ“°“√Õ“§“√ªÉ«¬ °—∫°≈ÿà¡∑’ˉ¡à¡’ Õ“°“√Õ“§“√ªÉ«¬ ‚¥¬„™â ANOVA „π°“√∑¥ Õ∫ «‘ ‡ §√“–Àå À “§à “ §«“¡ — ¡ æ— π ∏å √ –À«à “ ß√–¥— ∫ ¢Õß °“√ —¡º— °—∫¢π“¥¢Õß°“√‡°‘¥°≈ÿà¡Õ“°“√Õ“§“√ ªÉ«¬ „™â Chi-square

ª√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢π“¥ ª√‘¡“≥ΩÿÉπ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥œ

º≈°“√»÷°…“ „π°“√«‘®—¬§√—Èßπ’È¡’°“√‡°Á∫µ—«Õ¬à“ß„πÀâÕß ª√—∫Õ“°“»∑’Ë¡’≈—°…≥–ªî¥≈âÕ¡ ®”π«πÀâÕß∑’Ë §”π«≥‰¥â‡∑à“°—∫ 81 ÀâÕ߇ªìπ°≈ÿࡵ—«Õ¬à“ß ·µà “¡“√∂‡°Á∫‰¥â®√‘ß®”π«π 77 ÀâÕß §‘¥‡ªìπ√âÕ¬≈– 95.06 ®”π«π¥—ß°≈à“«Õ¬Ÿà„π™à«ß§à“§«“¡§≈“¥ ‡§≈◊ËÕπ∑’ˬա√—∫‰¥â ± 5% µ“¡∑’ËÕÕ°·∫∫°“√ »÷°…“‰«â·≈–‰¥â·∫àßÀâÕß∑’¡Ë Õ’ ¬Ÿ„à πÕ“§“√ÕÕ°‡ªìπ 3 °≈ÿࡥ⫬°—𠵓¡≈—°…≥–°‘®°√√¡·≈–ºŸâ„™âß“π §◊Õ Àâ Õ ß∫√√¬“¬¡’ °‘ ® °√√¡∑’Ë ‡ °‘ ¥ ¢÷È π ¿“¬„πÀâ Õ ß ‡ªìπ°“√‡√’¬π°“√ Õπ ÀâÕßæ—°Õ“®“√¬å¡’°‘®°√√¡ ¿“¬„πÀâÕ߇ªìπ≈—°…≥–ß“π‡¢’¬π Õà“π·≈–°“√„™â §Õ¡æ‘ « ‡µÕ√å ·≈– ”π— ° ß“π≈— ° …≥–°‘ ® °√√¡ ‡ªì π °“√∑”ß“π‡°’Ë ¬ «¢â Õ ß°— ∫ ‡Õ° “√ °“√„™â Õÿª°√≥åº≈‘µ‡Õ° “√ ‰¥âº≈°“√»÷°…“¥—ßπ’È 1. §ÿ≥¿“æÕ“°“»¿“¬„πÀâÕßªî¥ º≈°“√°“√µ√«®«—¥·≈–‡ª√’¬∫‡∑’¬∫°—∫§à“ ¡“µ√∞“π¢Õߪ√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢π“¥ (Total Dust) ΩÿÉπ¢π“¥∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß ≈¡ªÕ¥‰¥â (Respirable Dust) ·∫§∑’‡√’¬„π Õ“°“»·≈–√“„πÕ“°“»¿“¬„πÀâÕßæ—°Õ“®“√¬å¡’ §à“§«“¡‡¢â¡¢âπ‡©≈’ˬ¢ÕßΩÿÉπ√«¡∑ÿ°¢π“¥ (Total Dust) (µ“√“ß∑’Ë 1) æ∫«à“ª√‘¡“≥ ‘Ëߪπ‡ªóôÕπ ¿“¬„πÕ“°“» §◊Õ ª√‘¡“≥ΩÿπÉ √«¡∑ÿ°¢π“¥ (Total dust) ª√‘¡“≥ΩÿÉπ¢π“¥∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡ „π∂ÿß≈¡‰¥â (Respiratory dust) ª√‘¡“≥‡™◊ÈÕ ·∫§∑’‡√’¬ ·≈–ª√‘¡“≥‡™◊ÈÕ√“„πÕ“°“» „πÀâÕß ∑”ß“π‡®â“Àπâ“∑’Ë ¡’®”π«πª√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢ π“¥·≈–ª√‘ ¡ “≥ΩÿÉ π ¢π“¥∑’Ë “¡“√∂‡¢â “ ∂÷ ß ·≈– – ¡„π∂ÿ ß ≈¡‰¥â ª√‘ ¡ “≥‡™◊È Õ ·∫§∑’ ‡ √’ ¬ ·≈– ª√‘ ¡ “≥‡™◊È Õ √“„πÕ“°“» Ÿ ß ∑’Ë ÿ ¥ √Õß≈ß¡“§◊ Õ ÀâÕ߇√’¬π ·≈–ÀâÕßæ—°Õ“®“√¬å‡ªìπÀâÕß∑’Ë¡’ª√‘¡“≥ ‘Ë ß ªπ‡ªóô Õ π‡À≈à “ π’È πâ Õ ¬∑’Ë ÿ ¥ ·≈–‡¡◊Ë Õ π”§à “ ª√‘¡“≥¢Õß ‘Ëߪπ‡ªóôÕπ‡À≈à“π’ȉª‡ª√’¬∫‡∑’¬∫°—∫

§à“¡“µ√∞“π§ÿ≥¿“æÕ“°“»¿“¬„πÕ“§“√ æ∫«à“ ª√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢π“¥·≈–ª√‘¡“≥ΩÿÉπ∑’Ë¡’¢π“¥ ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡‰¥â¡’ª√‘¡“≥‰¡à ‡°‘ π ‡°≥±å ¡ “µ√∞“π¢ÕßÀπà « ¬ß“π„πª√–‡∑» Õ‡¡√‘°“ Environmental Protection Agency (EPA)(14) ·≈– American Society Heating, Refrigerating and Air condition Engineer (ASHREA)(15) µ“¡≈”¥—∫ ª√‘¡“≥¢Õ߇™◊ÈÕ ·∫§∑’ ‡ √’ ¬ ·≈–‡™◊È Õ √“‰¥â „ ™â ‡ °≥±å ¡ “µ√∞“π¢Õß Àπ૬ߓπ American Conference of governmental Industrial Hygienist (ACGIH)(16) ª√–‡∑»Õ‡¡√‘ ° “‡ªì π ‡°≥±å ‡ ª√’ ¬ ∫‡∑’ ¬ ∫ ´÷Ë ß °”À𥉫â«à“ °“√∑”ß“π¿“¬„πÕ“§“√µ≈Õ¥ 8 ™—Ë « ‚¡ß°“√∑”ß“π ∂“π∑’Ë π—È π µâ Õ ß¡’ §à “ ¢Õ߇™◊È Õ ·∫§∑’‡√’¬·≈–‡™◊ÈÕ√“‰¡à‡°‘π 500 CFU/m3 æ∫«à“ ÀâÕßæ—°Õ“®“√¬å¡’ª√‘¡“≥¢Õ߇™◊ÈÕ‰¡à‡°‘π‡°≥±å ¡“µ√∞“π„π∑ÿ°ÀâÕßµ—«Õ¬à“ß ·µàÀâÕß∑”ß“π¢Õß ‡®â“Àπâ“∑’Ë√âÕ¬≈– 13.33 ·≈– 26.67 ¡’ª√‘¡“≥ ¢Õ߇™◊È Õ ·∫§∑’ ‡ √’ ¬ ·≈–‡™◊È Õ √“∑’Ë ª π‡ªóô Õ πÕ¬Ÿà „ π Õ“°“»¡“°°«à“§à“¡“µ√∞“πµ“¡≈”¥—∫ ÀâÕ߇√’¬π ¡’ª√‘¡“≥¢Õ߇™◊ÈÕ·∫§∑’‡√’¬·≈–‡™◊ÈÕ√“∑’˪π‡ªóôÕπ Õ¬Ÿà„πÕ“°“»¡“°°«à“§à“¡“µ√∞“π√âÕ¬≈– 16.67 ·≈– 2.78 µ“¡≈”¥—∫ ‡¡◊ËÕ∑”°“√‡ª√’¬∫‡∑’¬∫§«“¡·µ°µà“ß∑“ß ∂‘µ‘¢Õß§à“§«“¡‡¢â¡¢âπ¢ÕßΩÿÉπ√«¡∑ÿ°¢π“¥ ΩÿÉπ ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥ ·∫§∑’‡√’·≈–√“ ∑’˪π‡ªóôÕπ„πÕ“°“»¿“¬„πÀâÕߢÕß∑—Èß 3 °≈ÿࡵ—«Õ¬à“ß æ∫«à“§à“§«“¡‡¢â¡¢âπ¢ÕßΩÿÉπ√«¡ ∑ÿ°¢π“¥·≈–§à“§«“¡‡¢â¡¢âπ¢ÕßΩÿÉπ∑’Ë “¡“√∂‡¢â“ ·≈– – ¡„π∂ÿß≈¡ªÕ¥„π·µà≈–°≈ÿࡵ—«Õ¬à“ß¡’§à“ ·µ°µà“ß°—πÕ¬à“ß¡’π—¬ ”§—≠∑’Ë P < 0.05 à«π§à“ §«“¡‡¢â¡¢âπ¢Õ߇™◊ÈÕ·∫§∑’‡√’¬·≈–√“„πÕ“°“» ¢ÕßÀâÕß„π·µà≈–°≈ÿࡵ—«Õ¬à“߉¡à·µ°µà“ß°—π∑’Ë P< 0.05

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH October - December 2010

119

120 µÿ≈“§¡ - ∏—𫓧¡ 2553 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

100

100 100

0.1312±0.0694

0.2791±0.0699

0.2389±0.1207

14

30

97

0.1363±0.0622

0.1557±0.0940

0.0840±0.0670

100

100

100

212.70±156.36

222.36±113.40

110.04±27.91

83.33

86.67

100

74.06±49.07

85.67±23.15

56.14±10.91

Mold (CFU/m3)

97.22

73.33

100

ª√‘¡“≥ ¡“µ√∞“π√“ 500*** (CFU/m3)

* À¡“¬∂÷ß §à“¡“µ√∞“π¢ÕßΩÿÉπ∑—ÈßÀ¡¥∑’ËÕ¬Ÿà„πÕ“°“» ¿“¬„πÕ“§“√¢ÕßÀπ૬ߓπ Environmental Protection Agency (EPA) ª√–‡∑»Õ‡¡√‘°“ ** À¡“¬∂÷ß §à“¡“µ√∞“π¢ÕßΩÿπÉ ∑’¡Ë ¢’ 𓥇≈Á° “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥„πÕ“°“»¿“¬„πÕ“§“√¢ÕßÀπ૬ߓπ American Society Heating, Refrigerating and Air Condition Engineer (ASHRAE) ª√–‡∑»Õ‡¡√‘°“ *** À¡“¬∂÷ß §à“¡“µ√∞“π¢Õß·∫§∑’‡√’¬ À√◊Õ √“ „πÕ“°“»¿“¬„πÕ“§“√¢ÕßÀπ૬ߓπ American Conference of Governmental Industrial Hygienist (ACGIH) ª√–‡∑» Õ‡¡√‘°“

ÀâÕßæ—° Õ“®“√¬å (8 ) ”π—°ß“π (17) ÀâÕß ∫√√¬“(52)

°≈ÿ¡à ®”π«π §à“‡©≈’ˬ¢Õß “√¡≈æ‘…∑’ËÕ¬Ÿà¿“¬„πÕ“§“√ (Mean ± Sd) (®”π«π µ—«Õ¬à“ß ª√‘¡“≥ΩÿπÉ √«¡ √âÕ¬≈–¢ÕßÀâÕß∑’Ë ª√‘¡“≥ΩÿÉπ¢π“¥ √âÕ¬≈–¢ÕßÀâÕß∑’Ë ·∫§∑’‡√’¬ √âÕ¬≈–¢ÕßÀâÕß∑’Ë ÀâÕß) ∑ÿ°¢π“¥ ºà“π ¡“µ√∞“π ∑’Ë “¡“√∂‡¢â“∂÷ß ºà“π¡“µ√∞“π (CFU/m3) ºà“πª√‘¡“≥ 3 (µ ΩÿπÉ ∑ÿ°¢π“¥ ·≈– – ¡„π∂ÿß ΩÿπÉ ∑’ Ë “¡“√∂‡¢â“ ¡“µ√∞“π µg/m ) ·∫§∑’‡√’75* ∂÷ß·≈– – ¡„π ≈¡ªÕ¥ 3 # (µ 500*** ∂ÿß≈¡ªÕ¥ (µ µg/m ) µg/m ) (CFU/m3) 150** # µg/m ) (µ

µ“√“ß∑’Ë 1 · ¥ß®”π«π·≈–§à“√âÕ¬≈–¢Õß®”π«π®ÿ¥‡¡◊ËÕ‡ª√’¬∫‡∑’¬∫§à“¢Õß “√¡≈æ‘…∑’ËÕ¬Ÿà„πÕ“§“√°—∫§à“¡“µ√∞“π

∫ ∑ «‘ ∑ ¬ “ ° “ √

ª√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢π“¥ ª√‘¡“≥ΩÿÉπ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥œ

µ“√“ß∑’Ë 2 · ¥ßÕ—µ√“§«“¡™ÿ°¢Õß°“√‡°‘¥°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬„π·µà≈–°≈ÿࡵ—«Õ¬à“ß Õ—µ√“§«“¡™ÿ°¢Õß°≈ÿà¡Õ“°“√Õ“§“√ªÉ«°≈ÿà¡Õ“°“√ Õ“§“√ªÉ«¬

∑ÿ°°≈ÿࡵ—«Õ¬à“ß (N=638 §π)

Õ“®“√¬å (N=93 §π)

‡®â“Àπâ“∑’Ë (N=135 §π)

π—°»÷°…“ (N=410 §π)

¡’Õ“°“√ ‰¡à¡’Õ“°“√ ¡’Õ“°“√ ‰¡à¡’Õ“°“√ ¡’Õ“°“√ ‰¡à¡’Õ“°“√ ¡’Õ“°“√ ‰¡à¡’Õ“°“√ µ“ ®¡Ÿ° ≈”§Õ ∑“߇¥‘π À“¬„® √–∫∫ ª√– “∑ º‘«Àπ—ß

107 (16.77) 100 (15.67) 80 (12.54) 37 (5.80) 160 (25.08) 36 (5.64)

538 (83.23) 538 (84.33) 558 (87.46) 601 (94.2) 478 (74.92) 602 (94.36)

16 (17.20) 11 (11.83) 16 (17.20) 2 (2.15) 29 (31.18) 5 (5.38)

77 (82.80) 82 (88.17) 77 (82.80) 91 (97.58) 64 (68.82) 88 (94.62)

2. ¢âÕ¡Ÿ≈∑—Ë«‰ª¢Õß°≈ÿࡵ—«Õ¬à“ß °“√·®°·∫∫ Õ∫∂“¡„Àâ°≈ÿࡵ—«Õ¬à“ß¡’ºŸâ∑’Ë àß·∫∫ Õ∫∂“¡°≈—∫§◊π ª√–°Õ∫¥â«¬Õ“®“√¬å ∑—ÈßÀ¡¥ 92 §π §‘¥‡ªìπ√âÕ¬≈– 46.94 ‡®â“Àπâ“∑’Ë ∑—ÈßÀ¡¥ 135 §π §‘¥‡ªìπ√âÕ¬≈– 74.19 ·≈– π—°»÷°…“∑—ÈßÀ¡¥ 410 §π §‘¥‡ªìπ√âÕ¬≈– 111.72 ¢âÕ¡Ÿ≈∑—Ë«‰ª‰¥â Õ∫∂“¡‡°’ˬ«°—∫ Õ“¬ÿ ‡æ» ª√–«—µ‘°“√‡®Á∫ªÉ«¬ æ∫«à“°≈ÿà¡Õ“®“√¬å ¡’Õ“¬ÿÕ¬Ÿà „π™à«ß 31 - 40 ªï ‡ªìπ à«π„À≠à ®”π«π 35 §π §‘¥‡ªìπ√âÕ¬≈– 37.6 ª√–«—µ°‘ “√‡ªìπ‚√§æ∫«à“ à«π „À≠à‡ªìπ‚√§¿Ÿ¡‘·æâ √âÕ¬≈– 38.7 à«π¢âÕ¡Ÿ≈¥â“π ÿ¢¿“ææ∫«à“¡’ºŸâ∑’Ë¡’Õ“°“√∑“ß “¬µ“ ®”π«π 65 §π ‚¥¬¡’Õ“°“√ “¬µ“ —Èπ®”π«π 40 §π ‡ªìπ Õ“°“√∑’Ëæ∫¡“°∑’Ë ÿ¥ „π™à«ß 1 ‡¥◊Õπ∑’˺à“π¡“¡’ Õ“®“√¬å®”π«π 27 §π ‰¡à¡Õ’ “°“√∑“ßµ“ ∑“ß®¡Ÿ°

37 (27.41) 36 (26.67) 25 (18.52) 11 (8.15) 47 (34.81) 8 (5.93)

98 (72.59) 99 (73.33) 110 (81.48) 124 (91.85) 88 ( 65.19) 127 (94.07)

54 (13.17) 53 (12.93) 39 (9.51) 24 (5.85) 84 (20.49) 23 (5.61)

356(86.83) 357(87.07) 371(90.49) 386(94.15) 326(79.51) 387(94.39)

≈”§Õ √–∫∫∑“߇¥‘πÀ“¬„® √–∫∫ª√– “∑ º‘«Àπ—ß §‘¥‡ªìπ√âÕ¬≈– 29.0 ·µà„π°≈ÿà¡∑’Ë¡’Õ“°“√¡’®”π«π 66 §π ·≈–∑’Ë¡’Õ“°“√·µà‰¡à√∫°«π°“√∑”ß“π¬—ß §ß∑”ß“π‰¥âª°µ‘ ¡’®”π«π 41 §π §‘¥‡ªìπ√âÕ¬≈– 44.1 „π™à«ß 1 ‡¥◊Õπ∑’ºË “à π¡“¡’Õ“°“√‰¢âÀ«—¥ (‰¢â/ πÈ”¡Ÿ°/‡®Á∫§Õ/‰Õ/ª«¥‡¡◊ËÕ¬µ“¡µ—«) ®”π«π 56 §‘¥‡ªìπ√âÕ¬≈– 60.2 ‡ªìπÕ“°“√∑’Ëæ∫¡“°∑’Ë ÿ¥ ‡®â“Àπâ“∑’Ë ®”π«π 135 §π à«π„À≠à‡ªìπ ‡æ»À≠‘ߧ‘¥‡ªìπ√âÕ¬≈– 74.1 ·≈–¡’Õ“¬ÿÕ¬Ÿà„π™à«ß 31-40 ªï§‘¥‡ªìπ√âÕ¬≈– 49.6 ª√–«—µ‘°“√‡ªìπ‚√§ æ∫«à“ à«π„À≠à‡ªìπ‚√§¿Ÿ¡‘·æâ ®”π«π 49 §π §‘¥ ‡ªìπ√âÕ¬≈– 36.3 à«π¢âÕ¡Ÿ≈¥â“π ÿ¢¿“ææ∫«à“¡’ºŸâ ∑’Ë¡’Õ“°“√∑“ß “¬µ“ ®”π«π 97.0 ‚¥¬¡’Õ“°“√ “¬µ“ —πÈ ®”π«π 54 §π ‡ªìπÕ“°“√∑’æË ∫¡“°∑’ Ë ¥ÿ „π™à«ß 1 ‡¥◊Õπ∑’ºË “à π¡“¡’‡®â“Àπâ“∑’®Ë ”π«π 30 §π

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH October - December 2010

121

∫ ∑ «‘ ∑ ¬ “ ° “ √ ‰¡à¡’Õ“°“√∑“ßµ“ ∑“ß®¡Ÿ° ≈”§Õ √–∫∫∑“߇¥‘π À“¬„® √–∫∫ª√– “∑ º‘«Àπ—ß §‘¥‡ªìπ√âÕ¬≈– 22.2 ·µà„π°≈ÿà¡∑’Ë¡’Õ“°“√¡’®”π«π 104 §π ·≈–∑’Ë¡’ Õ“°“√·µà‰¡à√∫°«π°“√∑”ß“π¬—ߧß∑”ß“π‰¥âª°µ‘ ¡’®”π«π 67 §π §‘¥‡ªìπ√âÕ¬≈– 49.6 „π™à«ß 1 ‡¥◊Õπ∑’ºË “à π¡“¡’Õ“°“√‰¢âÀ«—¥(‰¢â/πÈ”¡Ÿ°/‡®Á∫§Õ/ ‰Õ/ª«¥‡¡◊ËÕ¬µ“¡µ—«)®”π«π 87 §‘¥‡ªìπ√âÕ¬≈– 64.4 ‡ªìπÕ“°“√∑’Ëæ∫¡“°∑’Ë ÿ¥ °≈ÿà¡π—°»÷°…“®”π«π 410 §π à«π„À≠à ‡ªìπ‡æ»À≠‘ߧ‘¥‡ªìπ√âÕ¬≈– 81.9 ¡’Õ“¬ÿÕ¬Ÿà„π™à«ß 21-30 ªï §‘¥‡ªìπ√âÕ¬≈– 62.7 ª√–«—µ‘°“√‡ªìπ ‚√§æ∫«à“ à«π„À≠à‡ªìπº◊Ëπ∑’˺‘«Àπ—ß®”π«π 177 §π §‘¥‡ªìπ√âÕ¬≈– 43.2 à«π¢âÕ¡Ÿ≈¥â“π ÿ¢¿“æ æ∫«à“¡’ºŸâ∑’Ë¡’Õ“°“√∑“ß “¬µ“ ®”π«π 183 §π ‚¥¬¡’ Õ “°“√ “¬µ“ —È π ®”π«π 155 §π ‡ªì π Õ“°“√∑’Ëæ∫¡“°∑’Ë ÿ¥ „π™à«ß 1 ‡¥◊Õπ∑’˺à“π¡“¡’ ‡®â“Àπâ“∑’®Ë ”π«π 107 §π ‰¡à¡Õ’ “°“√∑“ßµ“ ∑“ß ®¡Ÿ° ≈”§Õ √–∫∫∑“߇¥‘πÀ“¬„® √–∫∫ª√– “∑ º‘«Àπ—ß §‘¥‡ªìπ√âÕ¬≈– 26.1 ·µà„π°≈ÿà¡∑’Ë¡’Õ“°“√ ¡’®”π«π 303 §π ·≈–∑’Ë¡’Õ“°“√·µà‰¡à√∫°«π °“√∑”ß“π¬—ߧß∑”ß“π‰¥âª°µ‘ ¡’®”π«π 157 §π §‘¥‡ªìπ√âÕ¬≈– 38.3 „π™à«ß 1 ‡¥◊Õπ∑’˺à“π¡“¡’ Õ“°“√‰¢âÀ«—¥(‰¢â/πÈ”¡Ÿ°/‡®Á∫§Õ/‰Õ/ª«¥‡¡◊ËÕµ“¡µ—«)®”π«π 298 §‘¥‡ªìπ√âÕ¬≈– 72.7 ‡ªìπ Õ“°“√∑’Ëæ∫¡“°∑’Ë ÿ¥ 3. ¢âÕ¡Ÿ≈≈—°…≥–°“√‡°‘¥Õ“°“√°≈ÿà¡ Õ“°“√Õ“§“√ªÉ«¬„π°≈ÿࡵ—«Õ¬à“ß·µà≈–°≈ÿà¡ °“√»÷°…“§√—Èßπ’ȉ¥â Õ∫∂“¡∂÷ß≈—°…≥–¢Õß °“√‡°‘¥Õ“°“√Õ“§“√ªÉ«¬ ·≈– ∂“π∑’Ë∑’ˇ√‘Ë¡¡’ Õ“°“√‡°’ˬ«°—∫°≈ÿà¡Õ“°“√∑“ß µ“, ®¡Ÿ°, ≈”§Õ, ∑“߇¥‘πÀ“¬„®, √–∫∫ª√– “∑·≈–º‘«Àπ—ß ‰¥âº≈ √ÿª‡°’ˬ«°—∫≈—°…≥–·≈–¢π“¥¢Õß°≈ÿà¡Õ“°“√ Õ“§“√ªÉ«¬∑’‡Ë °‘¥¢÷πÈ „π·µà≈–√–∫∫¢Õß°≈ÿ¡à Õ“®“√¬å ‡®â“Àπâ“∑’Ë ·≈–π—°»÷°…“ 122 µÿ≈“§¡ - ∏—𫓧¡ 2553 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

°“√‡°‘¥Õ“°“√¢Õß°≈ÿà¡Õ“°“√Õ“§“√ªÉ«∑’‡Ë °‘¥¢÷πÈ µ“¡Õ«—¬«–µà“ßÊ „π°≈ÿ¡à µ—«Õ¬à“ß Õ“®“√¬å ‡®â“Àπâ“∑’Ë ·≈–π—°»÷°…“ ‚¥¬æ‘®“√≥“®“°ºŸâ∑’Ë¡’ Õ“°“√°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬ §◊Õ ¡’§«“¡∂’Ë¢Õß °“√‡°‘¥Õ“°“√µ—Èß·µà 1-3 «—πµàÕ —ª¥“Àå ·≈–¡’µ—Èß ·µà 2 Õ“°“√„π 1 °≈ÿà¡Õ“°“√ ‚¥¬Õ“°“√π—Èπ®– ‡°‘¥¢÷Èπ‡©æ“–„π∑’Ë∑”ß“π‡∑à“π—Èπ „π¿“æ√«¡æ∫ «à“°≈ÿà¡Õ“°“√√–∫∫ª√– “∑‡ªìπ°≈ÿà¡Õ“°“√∑’Ëæ∫ ¡“°·≈–¡’Õ—µ√“§«“¡™ÿ°‡∑à“°—∫√âÕ¬≈– 25.08 ¢Õß ®”π«π°≈ÿà ¡ µ— « Õ¬à “ ß·≈–‡¡◊Ë Õ æ‘ ® “√≥“·¬°„π ·µà ≈ –°≈ÿà ¡ µ— « Õ¬à “ ßæ∫«à “ °≈ÿà ¡ ‡®â “ Àπâ “ ∑’Ë ¡’ ° ≈ÿà ¡ Õ“°“√Õ“§“√ªÉ«¬‡°‘¥¢÷Èπ¡“°°«à“ 1 °≈ÿà¡Õ“°“√ ‚¥¬®–æ∫°≈ÿà¡Õ“°“√∑“ßµ“ °≈ÿà¡Õ“°“√∑“ß®¡Ÿ° ·≈–√–∫∫ª√– “∑ à « π°≈ÿà ¡ µ— « Õ¬à “ ß∑’Ë ‡ ªì π Õ“®“√¬å · ≈–π— ° »÷ ° …“æ∫«à “ ¡’ Õ “°“√‡æ’ ¬ ß°≈ÿà ¡ Õ“°“√‡¥’ ¬ «§◊ Õ √–∫∫ª√– “∑ ¡’ √ “¬≈–‡Õ’ ¬ ¥ · ¥ß„πµ“√“ß∑’Ë 2 4. ¢âÕ¡Ÿ≈· ¥ß§«“¡ —¡æ—π∏å√–À«à“ß ªí®®—¬¥â“π§ÿ≥¿“æÕ“°“»¿“¬„πÀâÕß ªí®®—¥â“π∫ÿ§§≈°—∫°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬∑’ˇ°‘¥¢÷Èπ °“√»÷°…“§«“¡ —¡æ—π∏å√–À«à“ßªí®®—¬¥â“π §ÿ ≥ ¿“æÕ“°“»°— ∫ ®”π«π§π∑’Ë ‡ °‘ ¥ Õ“°“√°≈ÿà ¡ Õ“°“√Õ“§“√ªÉ«¬ æ∫«à“ª√‘¡“≥¢ÕßΩÿÉπ√«¡∑ÿ° ¢π“¥·≈–ΩÿÉπ¢π“¥‡≈Á°∑’Ë “¡“√∂‡¢â“ Ÿà∂ÿß≈¡ªÕ¥ ‰¥â¡§’ “à ‰¡à‡°‘π¡“µ√∞“π®÷߉¡à “¡“√∂§”π«≥º≈‰¥â ¥—ßπ—πÈ ®÷ß· ¥ßº≈‡©æ“–®”π«π·∫§∑’‡√’¬·≈–‡™◊ÕÈ √“ „πÀâÕß∑”ß“π/‡√’¬π ‚¥¬æ∫«à“®”π«π·∫§∑’‡√’∑’ºË “à π‡°≥±å¡“µ√∞“πÀ√◊Õ‰¡àº“à π‡°≥±å¡“µ√∞“π ¡’§«“¡ —¡æ—π∏å°∫— ®”π«π§π∑’¡Ë Õ’ “°“√Õ“§“√ªÉ«Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘∑’Ë P< 0.05 à«π§«“¡ —¡æ—π∏å√–À«à“ß®”π«π‡™◊ÈÕ√“°—∫®”π«π§π∑’ˇ°‘¥ Õ“°“√°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬ æ∫«à“®”π«π‡™◊ÈÕ√“ „πÀâÕß∑”ß“π/‡√’¬π ∑’˺à“π‡°≥±å¡“µ√∞“πÀ√◊Õ ‰¡àºà“π‡°≥±å¡“µ√∞“π ‰¡à¡’§«“¡ —¡æ—π∏å°—∫

ª√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢π“¥ ª√‘¡“≥ΩÿÉπ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥œ

®”π«π‡™◊ÕÈ √“„πÀâÕß∑”ß“π/‡√’¬π ∑’Ë P< 0.05 ·≈– º≈°“√»÷°…“§«“¡ —¡æ—π∏å√–À«à“ßªí®®—¬¥â“π∫ÿ§§≈ §◊Õ ‡æ» Õ“¬ÿ ·≈–°“√¡’‚√§ª√–®”µ—«°—∫®”π«π §π∑’ˇ°‘¥Õ“°“√°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬ æ∫«à“‰¡à¡’ ªí ® ®— ¬ ¥â “ π∫ÿ § §≈™π‘ ¥ „¥∑’Ë ¡’ § «“¡ — ¡ æ— π ∏å °— ∫

®”π«π§π∑’Ë¡’Õ“°“√Õ“§“√ªÉ«¬ Õ¬à“ß¡’π—¬ ”§—≠ ∑“ß ∂‘µ‘∑’Ë P< 0.05 ¡’√“¬≈–‡Õ’¬¥¥—ßµ“√“ß∑’Ë 3 ·≈– 4

Õ¿‘ª√“¬º≈°“√»÷°…“ º≈°“√»÷°…“§√—Èßπ’È°≈ÿà¡∑’Ëæ∫«à“¡’°“√‡°‘¥

µ“√“ß∑’Ë 3 · ¥ß§«“¡ —¡æ—π∏å√–À«à“ßªí®®—¬¥â“π§ÿ≥¿“æÕ“°“»¿“¬„πÀâÕß°—∫®”π«π§π∑’ˇ°‘¥ Õ“°“√°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬∑’ËÕ«—¬«–·≈–√–∫∫µà“ß Ê ªí®®—¬¥â“π§ÿ≥¿“æÕ“°“»

®”π«π‡™◊ÈÕ ·∫§∑’‡√’®”π«π‡™◊ÈÕ√“

≤ 500 (ºà“π) > 500 (‰¡àºà“π) ≤ 500 (ºà“π) > 500 (‰¡àºà“π)

Õ“°“√Õ“§“√ªÉ«¬(√âÕ¬≈–) ¡’Õ“°“√

‰¡à¡’Õ“°“√

257 (54.8%) 79 (16.8%) 277 (59.1%) 77 (16.4%)

90 (19.2%) 43 (9.2%) 99 (21.1%) 24 (5.1%)

χ2

p- value

3.85

0.05

0.75

0.38

µ“√“ß∑’Ë 4 · ¥ß§«“¡ —¡æ—π∏å√–À«à“ßªí®®—¬¥â“π∫ÿ§§≈·≈–®”π«π§π∑’ˇ°‘¥Õ“°“√°≈ÿà¡Õ“°“√ Õ“§“√ªÉ«¬∑’ËÕ«—¬«–·≈–√–∫∫µà“ß Ê ªí®®—¬¥â“π∫ÿ§§≈

‡æ» Õ“¬ÿ

‚√§ª√–®”µ—«

™“À≠‘ß πâÕ¬°«à“ 20 ªï 20-30 ªï 31-40 ªï 41-50 ªï ¡“°°«à“ 50 ªï ¡’

Õ“°“√Õ“§“√ªÉ«¬(√âÕ¬≈–) ¡’Õ“°“√

‰¡à¡’Õ“°“√

93 (14.6%) 361 (56.6%) 55 (8.6%) 268 68 46 15 439

40 (6.3%) 144 (22.6%) 18 (2.8%) 117 29 15 5 181

χ2

p- value

0.12

0.72

1.80

0.77

1.34

0.25

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH October - December 2010

123

∫ ∑ «‘ ∑ ¬ “ ° “ √ Õ“°“√Õ“§“√ªÉ«¬ Ÿß§◊Õ °≈ÿࡇ®â“Àπâ“∑’Ë ´÷Ëß¡’ ªí®®—¬À≈—°§◊Õ §ÿ≥¿“æÕ“°“»¿“¬„πÕ“§“√ ∑’ˉ¡à ‡À¡“– ¡¡“°°«à“°≈ÿà¡Õ◊ËπÊ ‡π◊ËÕß®“°ª√‘¡“≥ΩÿÉπ ∑’Ë·µ°µà“ß°—π¡“®“°°‘®°√√¡∑’ˇ°‘¥¢÷Èπ¿“¬„πÀâÕß ∑”ß“π·≈–ÀâÕ߇√’¬π¡’°‘®°√√¡∑’Ë·µ°µà“ß°—π „π ÀâÕß∑”ß“π¢Õ߇®â“Àπâ“∑’Ë®–¡’°“√„™âÕÿª°√≥åµà“ßÊ ∑’Ë°àÕ„À⇰‘¥ΩÿÉπ‰¥â ‡™à𠇧√◊ËÕß∂à“¬‡Õ° “√ ‡§√◊ËÕß à߇հ “√(17,18) à«π„π°√≥’¢ÕßÀâÕß∫√√¬“¬∂÷ß ·¡â «à “ ®–‰¡à ¡’ ° “√„™â Õÿ ª °√≥å ‡ À≈à “ π’È · µà æ ∫«à “ ®”π«π§π∑’Ë„™âÀâÕß¡’®”π«π¡“° ‚¥¬¡’®”π«π§π ∑’Ë„™âÀâÕß¡“°°«à“ 71 §π Õ¬Ÿà√âÕ¬≈– 30 ´÷Ë߇ªì𠓇ÀµÿÀπ÷ßË ∑’∑Ë ”„À⇰‘¥°“√ªπ‡ªóÕô π¢ÕßΩÿπÉ ‰¥â (19,20) à«πª√‘¡“≥¢Õ߇™◊ÈÕ·∫§∑’‡√’¬·≈–‡™◊ÈÕ√“ æ∫«à “ Àâ Õ ßæ— ° Õ“®“√¬å ¡’ ª √‘ ¡ “≥¢Õ߇™◊È Õ ‰¡à ‡ °‘ π ‡°≥±å ¡ “µ√∞“π„π∑ÿ ° Àâ Õ ßµ— « Õ¬à “ ß ·µà Àâ Õ ß ∑”ß“π¢Õ߇®â“Àπâ“∑’Ë·≈–ÀâÕ߇√’¬π¡’ª√‘¡“≥¢Õß ‡™◊ÈÕ·∫§∑’‡√’¬·≈–‡™◊ÈÕ√“∑’˪π‡ªóôÕπÕ¬Ÿà„πÕ“°“» ¡“°°«à “ §à “ ¡“µ√∞“π„π∫“ßÀâ Õ ß ‡π◊Ë Õ ß®“° ≈—°…≥–ÀâÕß∑”ß“π¢Õ߇®â“Àπâ“∑’Ë‚¥¬ à«π„À≠à®– ¡’ ≈— ° …≥–Àâ Õ ß∑’Ë ¡’ æ◊È π ∑’Ë ¢ 𓥇≈Á ° ‡¡◊Ë Õ ‡∑’ ¬ ∫°— ∫ ®”π«π§π ´÷Ëßæ∫«à“ªí®®—¬¢Õߪ√‘¡“≥§π∑’Ë„™â ÀâÕß(19,20) ∑”„Àâª√‘¡“≥¢Õ߇™◊ÈÕ®ÿ≈‘π∑√’¬å¡’§«“¡ ·µ°µà“ß°—π ·≈–®“°°“√»÷°…“§√—Èßπ’ȉ¥â∑”°“√ ‡°Á ∫ µ— « Õ¬à “ ßÕ“°“»„π™à « ß∑’Ë ¡’ ° “√„™â Àâ Õ ßµ“¡ ≈—°…≥–ª°µ‘ ´÷Ëß°“√ªπ‡ªóôÕπ¢Õ߇™◊ÈÕ®ÿ≈‘π∑√’¬å„π Õ“°“» “¡“√∂‡°‘¥¢÷Èπ‰¥â®“°µ—«∫ÿ§§≈∑’ˇ¢â“‰ª„™â ÀâÕß‚¥¬æ∫«à“À“°¡’ºŸâ¡’‡™◊ÈÕ®ÿ≈‘π∑√’¬å·≈–¡’Õ“°“√ ∑“ß√–∫∫À“¬„® ‡¡◊ËÕ®“¡ÕÕ°¡“‡™◊ÈÕ®ÿ≈‘π∑√’¬å∑’Ë ‡°‘¥®“°°“√®“¡ “¡“√∂·æ√à°√–®“¬„πÕ“°“»‰¥â ·≈– “¡“√∂Õ¬Ÿà‰¥âπ“πÀ“° ¿“«–„π∫√‘‡«≥π—Èπ ‡À¡“– ‡™àπ ¡’§«“¡™◊Èπ∑’ËæÕ‡À¡“– 70% À√◊Õ ‰¡à¡’ · ß·¥¥‡¢â “ ∂÷ ß °“√ªπ‡ªóô Õ π¢Õß “√Õ‘ π ∑√’ ¬å „ π Õ“°“»´÷Ë߇ªìπ·À≈àßÕ“À“√∑’ˇ™◊ÈÕ “¡“√∂‡°“–·≈– ‡¢â“ Ÿà√à“ß°“¬‚¥¬°“√À“¬„®‰¥âßà“¬¢÷Èπ(11) À√◊Õ¡’ 124 µÿ≈“§¡ - ∏—𫓧¡ 2553 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

·À≈à ß °”‡π‘ ¥ ‡™◊È Õ ®ÿ ≈‘ π ∑√’ ¬å „ π∫√‘ ‡ «≥π—È π ‡™à π °√–¥“…∑’¡Ë §’ «“¡™◊πÈ ´÷ßË ‡ªìπ·À≈àß∑’¥Ë ’ ”À√—∫‡™◊ÕÈ √“ ≈—°…≥–·≈–¢π“¥¢Õß°≈ÿà¡Õ“°“√Õ“§“√ ªÉ«¬∑’ˇ°‘¥¢÷Èπ„π°≈ÿà¡Õ“®“√¬å ‡®â“Àπâ“∑’Ë ·≈–π—° »÷°…“ ‚¥¬°“√»÷°…“«‘®—¬§√—Èßπ’È ‰¥â»÷°…“≈—°…≥– ·¬°°≈ÿ¡à Õ“°“√ÕÕ°µ“¡Õ«—¬«–∑’‡Ë °‘¥Õ“°“√ §◊Õ µ“ ®¡Ÿ° ≈”§Õ °“√À“¬„® √–∫∫ª√– “∑·≈–√–∫∫ º‘«Àπ—ß ‰¥âº≈ √ÿª‡°’ˬ«°—∫≈—°…≥–·≈–¢π“¥¢Õß °≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬∑’ˇ°‘¥¢÷Èπ„π·µà≈–√–∫∫¢Õß °≈ÿà¡Õ“®“√¬å ‡®â“Àπâ“∑’Ë ·≈–π—°»÷°…“ ¥—ß· ¥ß„π √Ÿª∑’Ë 1 √ÿª‰¥â«à“°≈ÿࡇ®â“ÀπⓇªìπ°≈ÿà¡∑’Ë¡’√âÕ¬≈– ¢Õߧπ∑’Ë¡’Õ“°“√°≈ÿà¡Õ“§“√„π·µà≈–√–∫∫ Ÿß∑’Ë ÿ¥ ‚¥¬¡’°≈ÿ¡à Õ“°“√Õ“§“√ªÉ«¬∑’‡Ë °’¬Ë «‡π◊ÕË ß°—∫¥«ßµ“ §◊Õ ¡’Õ“°“√√–§“¬‡§◊Õßµ“ µ“·Àâß πÈ”µ“‰À≈ §—𠵓 µ“·¥ß ·≈–· ∫µ“ §‘¥‡ªìπ√âÕ¬≈– 27.41 ¡’ °≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬∑’ˇ°’ˬ«‡π◊ËÕß°—∫®¡Ÿ° §◊Õ ¡’ Õ“°“√√–§“¬‡§◊Õß®¡Ÿ° §—¥®¡Ÿ° πÈ”¡Ÿ°‰À≈ §—π®¡Ÿ° · ∫®¡Ÿ° ‡≈◊Õ¥°”‡¥“‰À≈ §‘¥‡ªìπ√âÕ¬≈– 26.67 °≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬∑’ˇ°’ˬ«‡π◊ËÕß°—∫≈”§Õ §◊Õ ¡’ Õ“°“√§Õ·ÀâßÀ√◊ÕÀ‘«πÈ”∫àÕ¬ · ∫§Õ √–§“¬§Õ ‡®Á∫§Õ °≈◊π≈”∫“° ·≈–‡ ’¬ß·À∫ §‘¥‡ªìπ√âÕ¬≈– 18.52 °≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬∑’ˇ°’ˬ«‡π◊ËÕß°—∫°“√ À“¬„® §◊Õ ¡’Õ“°“√·πàπÀπâ“Õ° À“¬„®≈”∫“° À“¬„®¢—¥ Õ÷¥Õ—¥∫√‘‡«≥Àπâ“Õ° ‰Õ ·≈–Õ“°“√ §≈â “ ¬ÀÕ∫ §‘ ¥ ‡ªì π √â Õ ¬≈– 8.15 °≈ÿà ¡ Õ“°“√ Õ“§“√ªÉ«¬∑’ˇ°’ˬ«‡π◊ËÕß°—∫√–∫∫ª√– “∑ §◊Õ ¡’ Õ“°“√ª«¥»’√…– ¡÷π»’√…– ßà«ß‡Àß“À“«πÕπ ÕàÕπ ≈â“ÕàÕπ‡æ≈’¬ ¢“¥ ¡“∏‘„π°“√∑”ß“π·≈–¡’Õ“°“√ §≈◊Ëπ‰ â §‘¥‡ªìπ√âÕ¬≈– 34.81 ·≈–°≈ÿà¡Õ“°“√ Õ“§“√ªÉ«¬∑’ˇ°’ˬ«‡π◊ËÕß°—∫º‘«Àπ—ß §◊Õ ¡’Õ“°“√ º‘«·Àâß √–§“¬‡§◊Õß º◊Ëπ·¥ß∑’ËÀπâ“ º◊ËππŸπ·¥ß µ“¡º‘«Àπ—ß §—π∫√‘‡«≥πÕ°√ࡺⓠ·≈–º◊πË º‘«Õ—°‡ ∫ §‘¥‡ªìπ√âÕ¬≈– 5.93 “‡Àµÿ∑’Ë∑”„À⇮â“Àπâ“∑’Ë

ª√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢π“¥ ª√‘¡“≥ΩÿÉπ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥œ

√Ÿª∑’Ë 1 · ¥ß√âÕ¬≈–¢Õß°“√‡°‘¥°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬∑’ËÕ«—¬«–·≈–√–∫∫µà“ßÊ„π·µà≈–°≈ÿà¡ Õ“®“√¬å ‡®â“Àπâ“∑’Ë·≈–π—°»÷°…“

π—°»÷°…“

Õ“®“√¬å

‡ªìπ°≈ÿà¡∑’Ëæ∫Õ“°“√Õ“§“√ªÉ«¬„π∑ÿ°°≈ÿà¡√–∫∫ Ÿß°«à“°≈ÿà¡Õ◊ËπÊ ‡π◊ËÕß®“°°≈ÿࡵ—«Õ¬à“ß∑’ˇªìπ‡®â“ Àπâ“∑’Ë¡’ªí®®—¬∑’Ë∑”„À⇰‘¥Õ“°“√Õ“§“√ªÉ«¬ ‡™àπ ®“° ∂“π∑’Ë∑”ß“π¢Õß°≈ÿࡇ®â“Àπâ“∑’Ë¡’≈—°…≥– ‡ªìπÀâÕߪ“°°«à“°≈ÿà¡Õ◊ËπÊ ·≈–¡’≈—°…≥–°“√ ∑”ß“π √–¬–‡«≈“°“√∑”ß“π„π ∂“π∑’Ë∑’Ë∑”ß“π π“π°«à“°≈ÿࡵ—«Õ¬à“ßÕ◊Ëπ®÷ß∑”„Àâæ∫Õ“°“√¡“° °«à“°≈ÿà¡Õ◊ËπÊ ´÷Ëß Õ¥§≈âÕß°—∫°“√»÷°…“„πÕ¥’µ ∑’Ë æ ∫«à “ æπ— ° ß“π∑’Ë ∑”ß“π„π ”π— ° ß“π¡’ Õ “°“√ °≈ÿ¡à Õ“§“√ªÉ«¬ Ÿß ´÷ßË ¡’≈°— …≥–ß“π∑’„Ë ™â “¬µ“¡“° ‡™àπ ß“π‡Õ° “√(21,22) °“√„™â§Õ¡æ‘«‡µÕ√å (23,24) ®“°°“√»÷ ° …“§«“¡ — ¡ æ— π ∏å √ –À«à “ ß®”π«π ·∫§∑’ ‡ √’ ¬ °— ∫ °“√‡°‘ ¥ Õ“°“√°≈ÿà ¡ Õ“°“√Õ“§“√ ªÉ«¬∑’ËÕ«—¬«–·≈–√–∫∫µà“ßÊ ¢Õß°≈ÿࡵ—«Õ¬à“ß ∑—ÈßÀ¡¥ æ∫«à“®”π«π¢Õ߇™◊ÈÕ·∫§∑’‡√’¬∑’Ë —¡º— ·≈–¡’§à“‡°‘π‡°≥±å¡“µ√∞“π¡’§«“¡ —¡æ—π∏åÕ¬à“ß ¡’π—¬ ”§—≠∑“ß ∂‘µ‘°—∫°“√‡°‘¥Õ“°“√°≈ÿà¡Õ“°“√ Õ“§“√ªÉ«¬∑’ˇ°‘¥¢÷Èπ°—∫°≈ÿà¡√–∫∫µ“ ®¡Ÿ° ·≈– √–∫∫ª√– “∑ ∑’Ë p<0.05 ·µà ®”π«π¢Õß ·∫§∑’‡√’¬∑’Ë —¡º— ‡∑’¬∫∑’˺à“π·≈–‰¡àºà“π‡°≥±å ¡“µ√∞“πæ∫«à “ ‰¡à ¡’ § «“¡ — ¡ æ— π ∏å °— ∫ °“√‡°‘ ¥

‡®â“Àπâ“∑’Ë

√–∫∫µ“ √–∫∫®¡Ÿ° √–∫∫§Õ √–∫∫À“¬„® √–∫∫ª√– “∑ √–∫∫º‘«Àπ—ß

Õ“°“√°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬∑’Ë√–∫∫≈”§Õ √–∫∫ ∑“߇¥‘ π À“¬„®·≈–º‘ « Àπ— ß Õ¬à “ ß¡’ π— ¬ ”§— ≠ ∑’Ë p<0.05 ‡¡◊ËÕ§”π«≥§«“¡ —¡æ—π∏å√–À«à“ß®”π«π ‡™◊ÈÕ√“∑’Ë —¡º— ‡∑’¬∫°—∫∑—Èß°“√ºà“π‡°≥±å·≈–‰¡à ºà“π‡°≥±å¡“µ√∞“π°—∫°“√‡°‘¥Õ“°“√°≈ÿà¡Õ“°“√ Õ“§“√ªÉ«¬æ∫«à“‰¡à¡’§«“¡ —¡æ—π∏å°—π ∑—Èßπ’ÈÕ“® ‡π◊ËÕß¡“®“°ª√‘¡“≥¢Õß ‘Ëߪπ‡ªóôÕπ„πÕ“°“»„π ÀâÕß∑’ËÕ¬Ÿà¿“¬„πÕ“§“√¡’ª√‘¡“≥‰¡à¡“°®π∂÷ߢ—Èπ ∑’Ë®–∑”„À⇰‘¥°“√· ¥ßÕ“°“√Õ¬à“߇¥àπ™—¥·≈– ºπ«°°— ∫ °“√‡°‘ ¥ Õ“°“√¢Õß°≈ÿà ¡ Õ“°“√Õ“§“√ ªÉ«¬¡’ªí®®—¬ à«π∫ÿ§§≈∑’ˇ¢â“¡“‡°’ˬ«¢âÕß ‡™àπ ¿Ÿ ¡‘ §ÿâ ¡ °— π à « π∫ÿ § §≈∑’Ë · µ°µà “ ß°— π ∑”„Àâ ‡ °‘ ¥ Õ“°“√‰¥â·µ°µà“ß°—𠇪ìπµâ𠧫“¡ —¡æ—π∏å√–À«à“ßªí®®—¬¥â“π∫ÿ§§≈°—∫ °“√‡°‘¥Õ“°“√°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬∑’ËÕ«—¬«–·≈– √–∫∫µà“ßÊ ¢Õß°≈ÿࡵ—«Õ¬à“ß∑—ÈßÀ¡¥ „π°“√ »÷°…“§√—Èßπ’ȉ¥âæ‘®“√≥“ªí®®—¬¥â“π∫ÿ§§≈ §◊Õ ‡æ» Õ“¬ÿ ·≈–°“√¡’ ‚ √§ª√–®”µ— « ‡¡◊Ë Õ §”π«≥ À“§«“¡ —¡æ—π∏åæ∫«à“ªí®®—¬∑—Èß 3 ‰¡à¡’§«“¡ —¡æ—π∏å°—∫°“√‡°‘¥Õ“°“√°≈ÿà¡Õ“§“√ªÉ«¬Õ¬à“ß¡’ π—¬ ”§—≠∑’Ë p<0.05 ´÷Ëߺ≈°“√»÷°…“„π§√—Èßπ’È·µ°

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH October - December 2010

125

∫ ∑ «‘ ∑ ¬ “ ° “ √ µà“ß°—∫ß“π«‘®—¬∑’˺à“π¡“ (25) ∑’Ëæ∫«à“„πªí®®—¬∑“ß ¥â“π∫ÿ§§≈®—¥‡ªìπªí®®—¬‡ √‘¡À√◊Õ∑’ˇ√’¬°«à“ªí®®—‡°’ˬ«‡π◊ËÕß∑’Ë∑”„À⇰‘¥Õ“°“√Õ“§“√ªÉ«¬ ∑—Èßπ’ÈÕ“® ‡π◊ËÕß¡“®“°°≈ÿࡵ—«Õ¬à“ß∑’Ë„™â„π°“√»÷°…“·µ° µà“ß°—π ‚¥¬°≈ÿࡵ—«Õ¬à“ß„π°“√»÷°…“§√—Èßπ’È¡’ §«“¡À≈“°À≈“¬„π≈—°…≥–ß“π §◊Õ ß“π Õπ ß“π ”π—°ß“π·≈–°“√‡√’¬π ·µà„π°“√»÷°…“Õ◊ËπÊ ®– „™â°≈ÿࡵ—«Õ¬à“ß∑’Ë¡’≈—°…≥–ß“π„°≈⇧’¬ß°—π ·≈– °≈ÿࡵ—«Õ¬à“ß¡’ ∂“π∑’Ë∑”ß“π∑’Ë¡’≈—°…≥–·µ°µà“ß °—π §◊Õ ÀâÕßæ—°Õ“®“√¬å ”π—°ß“π ·≈–ÀâÕ߇√’¬π ´÷Ëß¡’≈—°…≥–·≈–§ÿ≥¿“æ¢ÕßÕ“°“»¿“¬„πÀâÕß∑’Ë ·µ°µà“ß°—π ´÷Ëß Õ¥§≈âÕß°—∫ß“π«‘®—¬(22,6) ∑’Ë°≈à“« «à “ §ÿ ≥ ¿“æÕ“°“»¿“¬„πÀâ Õ ß¡’ º ≈µà Õ °“√‡°‘ ¥ Õ“°“√Õ“§“√ªÉ«º≈°“√»÷°…“§«“¡ —¡æ—π∏å√–À«à“ßªí®®—¥â“π∫ÿ§§≈ „π§√—Èßπ’È¡’·µ°µà“ß°—∫ß“π«‘®—¬∑’˺à“π ¡“(25) ∑—Èßπ’ÈÕ“®‡π◊ËÕß¡“®“°°≈ÿࡵ—«Õ¬à“ß∑’Ë„™â„π °“√»÷°…“·µ°µà“ß°—π ‚¥¬°≈ÿࡵ—«Õ¬à“ß„π°“√ »÷°…“§√—ßÈ π’¡È §’ «“¡À≈“°À≈“¬„π≈—°…≥–ß“π §◊Õ ß“π Õπ ß“π ”π—°ß“π·≈–°“√‡√’¬π ·µà„π°“√ »÷°…“Õ◊ËπÊ ®–„™â°≈ÿࡵ—«Õ¬à“ß∑’Ë¡’≈—°…≥–ß“π„°≈â ‡§’¬ß°—π ·≈–≈—°…≥– ∂“π∑’Ë∑”ß“π°“√»÷°…“ §√—Èßπ’È·µà≈–°≈ÿࡵ—«Õ¬à“ß®–·µ°µà“ß°—π ·µà‡¡◊ËÕ æ‘®“√≥“∂÷ß√âÕ¬≈–¢Õß°“√‡°‘¥Õ“°“√°≈ÿà¡Õ“°“√ Õ“§“√ªÉ « ¬„π·µà ≈ –√–∫∫æ∫«à “ °≈ÿà ¡ µ— « Õ¬à “ ß∑’Ë ‡ªì π ‡®â “ Àπâ “ ∑’Ë ¡’ Õ “°“√¢ÕßÕ“°“√°≈ÿà ¡ Õ“°“√ Õ“§“√ªÉ«¬¡“°°«à“°≈ÿà¡Õ◊ËπÊ ´÷Ëß Õ¥§≈âÕß°—∫ ß“π«‘®—¬¢Õß Burge PS. (2004) ∑—Èßπ’ÈÕ“®¡’ “‡Àµÿ À ≈— ° ∑’Ë ∑”„Àâ ° ≈ÿà ¡ ∑’Ë ∑”ß“π„π ”π— ° ß“π ‡ªìπ°≈ÿ¡à ∑’æË ∫Õ“°“√°≈ÿ¡à Õ“§“√ªÉ«¬ Ÿß°«à“°≈ÿ¡à Õ◊πË §◊ Õ °“√‡°‘ ¥ Õ“°“√°≈ÿà ¡ Õ“§“√ªÉ « ¬¡’ º ≈¡“®“° ªí®®—¬®“°°“√ —¡º— °—∫ “√¡≈æ‘…∑’˪π‡ªóôÕπÕ¬Ÿà „πÕ“°“» ´÷ËßÕ“®®–ª≈àÕ¬ÕÕ°¡“®“°‡§√◊ËÕß„™â À√◊ÕÕÿª°√≥å ”π—°ß“π ·≈– “‡Àµÿ‡°’ˬ«‡π◊ËÕß §◊Õ 126 µÿ≈“§¡ - ∏—𫓧¡ 2553 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

≈—°…≥–ß“π´÷Ëß √â“ߧ«“¡‡§√’¬¥®“°°“√∑”ß“π ‰¥â¡“°°«à“°≈ÿà¡Õ“®“√¬å·≈–π—°»÷°…“ √–¬–‡«≈“ „π°“√∑”ß“π¿“¬„πÕ“§“√µàÕ«—π´÷Ëß Õ¥§≈âÕß°—∫ ß“π«‘®—¬¢Õß ©—µ√™—¬ ·≈–§≥– (2548) ∑’ˉ¥â »÷°…“‚√§®“°°“√∑”ß“π„πµ÷° æ∫«à“ Õ“°“√¡’ §«“¡ —¡æ—π∏å°—∫™à«ß‡«≈“∑’ËÕ¬Ÿà„πÕ“§“√∑’Ë∑”ß“π ™—Ë«‚¡ß°“√∑”ß“ππ“π ¡’§«“¡ —¡æ—π∏å°—∫°≈ÿà¡ Õ“°“√Õ“§“√ªÉ«¬ ·≈– ‡√“µâÕßÕ¬Ÿà°—∫∑’Ë∑”ß“π ‡ªìπ‡«≈“π“π ®– àߺ≈‡ ’¬µàÕ ÿ¢¿“æ¡“°¡“¥—ßπ—Èπ°≈ÿࡵ—«Õ¬à“ß∑’ˇªìπ‡®â“Àπâ“∑’Ë®÷ß¡’‚Õ°“ „π °“√‡°‘¥Õ“°“√°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬‰¥âßà“¬°«à“ °≈ÿà¡Õ◊Ëπ °“√»÷°…“§√—Èßπ’È¡’¢âÕ®”°—¥ 1. ªí≠À“¢Õß ∂“π∑’Ë„π°“√‡°Á∫µ—«Õ¬à“ß ‡π◊ËÕß®“°°“√‡°Á∫µ—«Õ¬à“ßÕ“°“»®–µâÕß∑”°“√ ‡°Á ∫ „π¢≥–∑’Ë ¡’ ° “√∑”°‘ ® °√√¡Õ¬Ÿà „ πÀâ Õ ßπ—È π Ê ∑”„À⇰‘¥ªí≠À“„π°“√‡°Á∫ ‡™àπ °√≥’∑’ˇªìπÀâÕß ∫√√¬“¬‡π◊ËÕß®“°√–À«à“߇√’¬π®–‡°‘¥°“√√∫°«π ¡“∏‘¢Õßπ—°»÷°…“ ª√–°Õ∫°—∫°“√‡°Á∫µ—«Õ¬à“ß µâÕ߇°Á∫„π™à«ß‡«≈“„°≈⇧’¬ß°—π ®÷ß∑”„Àâ®”π«π Àâ Õ ß ∑’Ë ∑” ° “ √ ‡ °Á ∫ ‰ ¡à ‡ ªì π ‰ ª µ “ ¡ ®” π « π µ—«Õ¬à“ß(ÀâÕß)¢Õß°“√‡°Á∫Õ“°“»∑’˧”π«≥‰«â ·µà‡π◊ËÕß®“°„π°“√ÕÕ°·∫∫°“√»÷°…“§√—Èßπ’ȉ¥â ∑”°“√§”π«≥¢π“¥µ—«Õ¬à“߉«â∑’Ë §à“§«“¡‡™◊ËÕ¡—Ëπ 95 % ·≈–¡’§à“§«“¡§≈“¥‡§≈◊ËÕπ‰¡à‡°‘π ±5% ‡∑à“°—∫ 77-85 ÀâÕß ¥—ßπ—Èπ®”π«πÀâÕßµ—«Õ¬à“ß∑’Ë ‡°Á∫‰¥â®√‘ß 77 ÀâÕß ®÷߬—߇ªìπµ—«·∑π∑’Ë¥’¢Õß ª√–™“°√ 2. ¢“¥°“√‡°Á∫µ—«Õ¬à“ߧÿ≥¿“æÕ“°“» ∑“ߥâ“π “√‡§¡’ ´÷Ë߇ªìπ ‘Ëߪπ‡ªóôÕπ∑’ˇªìπªí®®—À≈—°¢Õß°“√‡°‘¥ªí≠À“§ÿ≥¿“æÕ“°“»„π ∂“π∑’Ë ∑”ß“π ∑”„Àâ‰¡à “¡“√∂∫Õ°∂÷ß “‡Àµÿ·≈–§«“¡ — ¡ æ— π ∏å √ –À«à “ ß°≈ÿà ¡ Õ“°“√Õ“§“√ªÉ « ¬°— ∫ §ÿ≥¿“æÕ“°“»‰¥â™—¥‡®π ∂÷ß·¡â°“√»÷°…“§√—Èßπ’È

ª√‘¡“≥ΩÿÉπ√«¡∑ÿ°¢π“¥ ª√‘¡“≥ΩÿÉπ∑’Ë “¡“√∂‡¢â“∂÷ß·≈– – ¡„π∂ÿß≈¡ªÕ¥œ

®–æ∫«à“‰¡à¡’§«“¡ —¡æ—π∏å°—∫°“√‡°‘¥°≈ÿà¡Õ“°“√ Õ“§“√ªÉ«¬Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ ∑—Èßπ’ȇπ◊ËÕß¡“ ®“°¢âÕ§”∂“¡„π·∫∫ Õ∫∂“¡´÷Ëß„™â∂“¡°—∫°≈ÿà¡ µ—«Õ¬à“ß∑’Ë·µ°µà“ß°—π„π¥â“𧫓¡√Ÿâ Õ“¬ÿ ∑’˧àÕπ ¢â“ß¡“°·≈–¡’®”π«π§”∂“¡∑’Ë¡“°·≈–∂“¡Õ“°“√ ¬âÕπÀ≈—ßÕ“®∑”„À≥⧔µÕ∫∑’§Ë ≈“¥‡§≈◊ÕË π‰ª∫â“ß ·µà°“√»÷°…“§√—Èßπ’ȉ¥â™’È„Àâ‡ÀÁπ«à“ªí®®—¬∑“ߥâ“π §ÿ≥¿“æÕ“°“»‡ªìπªí®®—¬À≈—°∑’Ë¡’§«“¡ ”§—≠µàÕ °“√‡°‘¥°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬¡“°°«à“ªí®®—¬¥â“π Õ◊πË Ê ∑’‡Ë ªìπªí®®—¬‡°’¬Ë «‡π◊ÕË ß ·≈–°‘®°√√¡∑’∑Ë ” √«¡ ∂÷ßÕÿª°√≥å∑’Ë„™â∑’˪≈àÕ¬ “√‡§¡’¡’º≈µàÕ°“√∑”„Àâ ‡°‘¥°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬∑’Ë·µ°µà“ß°—π

√ÿª·≈–¢âÕ‡ πÕ·π–„π°“√»÷°…“ °“√»÷°…“À“§«“¡ —¡æ—π∏å√–À«à“ßªí®®—¥â“π§ÿ≥¿“æÕ“°“» ªí®®—¬ à«π∫ÿ§§≈°—∫°“√‡°‘¥ °≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬ §√—Èßπ’ȇªìπ§√—Èß·√°∑’Ë¡’°“√ »÷°…“„π ∂“π∑’Ë∑’Ë¡’≈—°…≥–°“√∑”ß“π∑’Ë·µ°µà“ß °—π ·≈–„™â°≈ÿࡵ—«Õ¬à“ß·µ°µà“ß°—π ´÷Ëß∑”„À≥⠢âÕ¡Ÿ≈ª√‘¡“≥¡≈æ‘…„πÕ“°“»∑’Ë —¡º— ·≈–§«“¡ ™ÿ°¢Õß°“√‡°‘¥∑’ˇ°‘¥°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬°—∫ æπ— ° ß“π∑’Ë ∑”ß“π„πÕ“§“√ªî ¥ ∑’Ë ¡’ ≈— ° …≥– °‘®°√√¡µà“ß°—π Õ—π “¡“√∂𔉪„™â‡æ◊ËÕ„À⇰‘¥ ª√–‚¬™πåµàÕ°“√¥”‡π‘π°“√§«∫§ÿ¡ ªÑÕß°—π·≈– à߇ √‘¡ ÿ¢¿“æ¢Õß°≈ÿࡧπ„π ∂“π»÷°…“µàÕ‰ª

¢âÕ‡ πÕ·π–„π°“√»÷°…“§√—ÈßµàÕ‰ª 1. „ π à « π ¢ Õ ß Àâ Õ ß ∑’Ë ‰ ¡à ºà “ π ‡ ° ≥ ±å ¡“µ√∞“π§«√¡’°“√»÷°…“∑¥≈Õß·°â‰¢ªí®®—¬µà“ßÊ ∑’ËÕ“®∑”„Àâª√‘¡“≥¢Õß “√ªπ‡ªóôÕπ¡’¡“° À√◊Õ ªí ® ®— ¬ ∑’Ë ∑”„Àâ ‡ °‘ ¥ °≈ÿà ¡ Õ“°“√Õ“§“√ªÉ « ¬·≈– ∑”°“√‡°Á∫¢âÕ¡Ÿ≈„À¡à ‡æ◊ËÕ„Àâªí®®—¬∑’Ë·∑â®√‘ß·≈– “¡“√∂∑”°“√ªÑÕß°—π·≈–·°â‰¢ªí≠À“ ÿ¢¿“扥â Õ¬à“ß¡’ª√– ‘∑∏‘¿“æ 2. §«√∑”°“√»÷°…“°“√ªπ‡ªóôÕπ¢Õß “√ ‡§¡’ °ä“´ ™π‘¥Õ◊ËπÊ ∑’Ë¡’º≈µàÕ ÿ¢¿“æ ‡™àπ “√ øÕ√å ¡ Õπ¥’ ‰ Œ¥å (Formaldehyde) °ä “ ´ §“√å∫Õπ‰¥ÕÕ°‰´¥å (CO2) ·≈– “√‰Õ√–‡À(volatile organic compounds) ‡ªìπµâπ 3. §«√∑”°“√«‘®—¬·π«≈÷°„π°“√»÷°…“À“ °“√‡°‘¥¿Ÿ¡‘·æâ „π°≈ÿà¡∑’Ë∑”ß“π„π ∂“π∑’Ëæ∫«à“¡’ °“√ªπ‡ªóôÕπ¢Õ߇™◊ÈÕ„πÕ“°“» Ÿß ‡™àπ °“√µ√«® «—¥‡™◊ÈÕ∑’ˇ©æ“–‡®“–®ß„π°“√∑”„À⇰‘¥Õ“°“√¢Õß ¿Ÿ¡‘·æâ 4. ∑”°“√»÷°…“«‘®—¬„π≈—°…≥–‡¥’¬«°—∫ ∂“π∑’Ë∑”ß“πÕ◊ËπÊ ‡™àπ ‚√߇√’¬π ∂“π∑’Ë∑”ß“π Õ“§“√‡ªî¥ ‚√ßß“π ‡æ◊ËÕ‡°Á∫¢âÕ¡Ÿ≈§«“¡·µ°µà“ß ¢Õß ‘Ëߪπ‡ªóôÕπ„πÕ“°“»„π ∂“π∑’Ë·µ°µà“ß°—π °—∫º≈°“√‡°‘¥°≈ÿà¡Õ“°“√Õ“§“√ªÉ«¬·≈–„™â‡ªìπ ¢âÕ¡Ÿ≈æ◊Èπ∞“π‡ πÕ·π«∑“ß°“√·°â‰¢¡“µ√∞“π °“√ —¡º—

‡Õ° “√Õâ“ßÕ‘ß 1.«—π∑π’ æ—π∏ÿåª√– ‘∑∏‘Ï , «‘∑¬“ Õ¬Ÿà ÿ¢. §ÿ≥¿“æÕ“°“»¿“¬„πÕ“§“√ ”π—°ß“π„π°√ÿ߇∑æ¡À“π§√ «“√ “√§«“¡ª≈Õ¥¿—¬·≈– ‘Ëß ·«¥≈âÕ¡ 2544; 11(4): 50-57.

2. Daisey, J.M., Angell W.J. A Survey and Critical Review of the Literature on Indoor Air Quality Ventilation and Health Symptoms in Schools. Lawrence Berkeley National Laboratory Report 1998; No.LBNL-41517 3. Kreiss Kathleen. The Sick Building Syndrome: Where Is the Epidemiologic Basis. American Journal of Public Health 1990; 80:1172-73.

4. National Institute for Occupational Safety and Health. NIOSH Facts: Indoor environmental Quality (IEQ) 1997-[cited 2007 November 3]. Available from: http// www.cdc.gov/niosh/ieqfs.html.

5. Harrison J, Pickering CAC, Faragher EB, Austwick PKC, Little SA, Lawton L. An investigation of the relationship between microbial and particulate air pollution and sick building syndrome. Respir Med 1992; 86: 225-235

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH October - December 2010

127

∫ ∑ «‘ ∑ ¬ “ ° “ √ 6. Martin brains, Parla Rezacova and Marketa Domasova. The effect of outdoor air and indoor human activity on mass concentrations of PM10, PM2.5 and PM1 in classroom. Environmental Research 2005; 99: 143-149.

7. °ƒ…≥’ —ߢ®—π∑√“ππ∑å ·≈–§≥–. ™π‘¥·≈–ª√‘¡“≥¢Õ߇™◊ÈÕ·∫§∑’‡√’¬·≈–‡™◊ÈÕ√“∑’Ë°àÕ‚√§„π‚√ß欓∫“≈·≈–°“√‡ª√’¬∫‡∑’¬∫ °“√∑”ß“π¢Õ߇§√◊ËÕß¡◊Õ‡°Á∫µ—«Õ¬à“ß®ÿ≈‘π∑√’¬å„πÕ“°“».«“√ “√°“√Õπ“¡—¬·≈– ‘Ëß·«¥≈âÕ¡ 2006; 113-124.

8. ¡≥±“∑‘æ¬å ‚√®π“®‘≥, ≥—∞ Õ“® ¡‘µ‘. °“√»÷°…“‡∫◊ÈÕßµâπ‡°’Ë¬«°—∫ª√‘¡“≥·≈–™π‘¥®ÿ≈‘π∑√’¬å„π‚√ßß“π∑Õºâ“. «“√ “√°“√ Õπ“¡—¬·≈– ‘Ëß·«¥≈âÕ¡ 2535; 15(2): 65-71.

9. Pipat Luksamijarulkul et al. Microbial Air Quality in Mass Transport Buses and Work-Related Illness among Bus Drivers of Bangkok Mass Transit Authority. J Med Assoc Thai 2004; 87(6): 697-703.

10. Burge PS. Sick building syndrome. Occup Environ Med 2004; 61(2):185 - 90 11. Deacon. Jim. The Microbial World: Airborne Microorganism. 2002 [cited 2007 December 20]. Available from: http://www.biology.ed.ac.uk/research/groups/jdeacon/microbes/airborne.htm.2002 12. Lee S.C and Chang M. Indoor and outdoor air quality investigation at schools in Hong Kong. Chemoshere 2000; 40: 109-113.

13. Occupational Safety and Health Administration [homepage on the internet].U.S.Department of Labor. Indoor Air Quality: Evaluation and Control. [Cite 2007 November 3] Available from: http:// www.osha.gov. 1999 14. US.EPA. [homepage on the internet]. New York: Indoor Air Quality Basic for Schools in indoor Air quality.

[Cite 2007 September 1] Available from: http:// www.epa.gov/iaq/pubs/sbs.html.1996 15. US.EPA. [homepage on the internet]. New York: Indoor Air Facts No.4 (revised) Sick Building Syndrome in indoor Air quality. [Cite 2007 September 1] Available from: http:// www.epa.gov/iaq/pubs/sbs.html.

2000 16. American Conference of Governmental Industrial Hygienists. Guidelines for the Assessment of Bioaerosols in the Indoor Environmen.Cincinnati, OH: American Conference of Governmental Industrial Hygienists.1989.

17. Chia-Weilee and Der-jen Hsu. Measurements of fine and ultrafine particles formation in photocopy center in Taiwan. Atmospheric Enviroment 2007; 41: 598-6609.

18. Gallardo M et al. Siderosilicosis due to photocopies toner dust. Lancet 1994; 344: 412-413.

19. Zweers T et al. Health and indoor climate complains of 7043 office workers in 61 building in the Netherlands.

Indoor air 1992; 2(3):127-136.

20. Chao HJ et al. The work environment and workersû health in four large office building. Environ Health Persp 2003; 111(9): 1242-1248.

21. Bholah R, Fagoonee I and Subratty AH. Sick building syndrome in Mauritius: Are symptoms associated with the office environment. Indoor Built Environ 2000; 9(1):44-51.

22. Bourbeau J, Brisson C and Allaire S. Prevalence of the sick building syndrome symptoms in Office workers before and after being exposed to a building with an improved ventilation system. Occup Environ Med 1996; 53 (3): 204-214.

23. Jaakkola MS and Jaakkola JJ. Office equipment and supplies: A modern occupational health Concern.Am J Epidemiol 1999; 150(11): 1223-123.

24. Destaillats Hugo et al. Indoor pollutants emitted by office equipment: A review of reported data and information needs. Atmospheric Environment 2008; 42: 1371-1388.

25. ©—µ√™—¬ ‡Õ°ªí≠≠“ °ÿ≈, «‘‚√®πå ‡®’¬¡®√— √—ß ’ ·≈– √âÕ¬ ÿ¥“ ‡° √∑Õß. §«“¡™ÿ° ªí®®—¬∑’ˇ°’ˬ«¢âÕß·≈–º≈°√–∑∫¢Õß°≈ÿà¡ Õ“°“√ªÉ«¬‡ÀµÿÕ“§“√¢ÕߺŸ∑⠔ߓπ„πÕ“§“√ ”π—°ß“π„π‡¢µ°√ÿ߇∑æ¡À“π§√. «“√ “√«‘™“°“√ “∏“√≥ ÿ¢. 2548; 14: 453-463.

26. Burge PS, Hedge A, Wilson S et al. Sick building syndrome; a study of 4373 office workers Ann Occup Hyg 1987; 31:493-504.

HEALTH

128 µÿ≈“§¡ - ∏—𫓧¡ 2553 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒