Greater Taipei Area Research Articles

Effect of residential environment on children's allergic diseases in the Greater Taipei area

Effect of residential environment on children's allergic diseases in the Greater Taipei area

Exploring the Behavioral Intention of Vaccination against COVID-19 Using the Theory of Planned Behavior

People’s attitudes towards vaccines and beliefs about infectious disease prevention are closely related to the design and effectiveness of prevention strategies. This study explores Taiwanese people’s views on COVID-19 vaccines, beliefs about infectious disease prevention, and people's acceptance of vaccinations extent and influencing factors. This study is mainly aimed at the people in the Greater Taipei area as the research subject. The convenience sampling method is used to investigate the willingness of the people to receive the new coronary pneumonia vaccine. The relevant data is collected through the google online questionnaire. The study found that people’s attitudes, subjective norms, perceived behavioral control and behavioral intentions, social trust, health awareness, and expected emotions towards vaccination against COVID-19 were partially significant due to demographic variables. People’s attitudes, subjective norms, and perceived behavioral control have positive effects on behavioral intentions.

Effects of indoor air quality and home environmental characteristics on allergic diseases among preschool children in the Greater Taipei Area

Indoor air quality and home environmental characteristics are potential factors associated with the onset and exacerbation of allergic diseases. Our study examined the effects of these factors on allergic diseases (i.e., asthma, allergic rhinitis, allergic conjunctivitis, and atopic dermatitis) among preschool children. We recruited a total of 120 preschool children from an ongoing birth cohort study in the Greater Taipei Area. A comprehensive environmental evaluation was conducted at each participant's residence and included measurements of indoor and outdoor air pollutants, fungal spores, endotoxins, and house dust mite allergens. A structured questionnaire was used to collect information on the allergic diseases and home environments of participants. Land-use characteristics and points of interest in the surrounding area of each home were analyzed. Other covariates were obtained from the cohort data. Multiple logistic regressions were used to examine the relationships between allergic diseases and covariates. We observed that all mean indoor air pollutant levels were below Taiwan's indoor air quality standards. After adjustment for covariates, the total number of fungal spores and the ozone, Der f 1, and endotoxin levels were significantly associated with increased risks of allergic diseases. Biological contaminants more significantly affected allergic diseases than other pollutants. Moreover, home environmental characteristics (e.g., living near power facilities and gas stations) were associated with an increased risk of allergic diseases. Regular and proper home sanitation is recommended to prevent the accumulation of indoor pollutants, especially biological contaminants. Living away from potential sources of pollution is also crucial for protecting the health of children.

Investigation on Patient’s Self-medication, Medication Knowledge and Medication Behavior

Nowadays, with the development of information media, people can easily obtain information through the Internet, TV, and social media. However, the media are often full of exaggerated and false advertisements for medicines and healthy food, which induce people to spend money on products. It may have adverse effects on public health. The purpose of this study is to understand the current situation of general public's self-medication, medication knowledge and medication behavior, and to analyze the influence of public self-medication on medication behavior. The subjects of the survey were 300 people living in the Greater Taipei area, and convenience sampling was used. The study found that there are significant correlations between self-medication, medication knowledge and medication behavior. It is suggested that the government should continue to carry out various promotional activities on self-medication, medication knowledge and medication behavior, and integrate them into mass media.

Applying Problem Behavior Theory to Investigate the Factors Affecting Tobacco Products Use by Students at Eight Universities in the Greater Taipei Area

There is growing concern related to the recent rise in consumption of cigarettes, electronic cigarettes, and heated tobacco products. The government should pay more attention to the use of various tobacco products by university students. Problem behavior theory was used in this study to explore the factors influencing the use of various tobacco products by university students in the Greater Taipei area. In this cross-sectional study, convenience sampling was used to select eight institutions of higher education in the Greater Taipei area. Eight departments recognized by the Ministry of Education were then listed on a table for use in randomizing the selection of third- and fourth-year undergraduate students. A total of 115 participants filled out the questionnaires included in the self-administered online survey. Data analysis was conducted using logistic regression. The prevalence of tobacco-product use in the sample was 5.22%. Logistic regression analysis revealed having parents who smoked (adjusted odds ratio, AOR = 2.05), holding a positive attitude toward their parents' smoking (AOR = 4.23), having peers who smoked (AOR = 4.33), engaging in deviant behavior (AOR = 90.44), and having peers involved in deviant behavior (AOR = 103.99) to be associated with a higher likelihood of engaging in tobacco-product use. Family, peers and delinquency significantly influence the usage behavior of university students with regard to tobacco products. The government should allocate greater resources for tobacco harm prevention education aimed at the parents of university students. In addition, integrating tobacco harm education into campus curricula, utilizing social media for online digital education, and providing students with counseling and support measures are strategies that may help reduce the tobacco-product use among this vulnerable population.

Environmental determinants of household microbial and allergen levels in the Greater Taipei Area

People spend most of their time indoors, where they may be exposed to various microorganisms and allergens. In this cross-sectional study, we investigated the relationship between indoor microbial and allergen levels and indoor and outdoor household environmental characteristics. Participants were recruited from an ongoing cohort study in the Greater Taipei Area. Questionnaire administration and environmental sampling were conducted during home visits. Samples were collected from children's bedrooms, living rooms, kitchens, and outdoor areas (balconies) and analyzed for fungal spores, house dust mite allergens (Der p 1 and Der f 1), endotoxin, and cockroach allergens (Bla g 1). Indoor temperature and relative humidity were also measured, and the land-use characteristics and points of interest surrounding the residences were evaluated within specified radii. The mean levels of outdoor air pollutants were then estimated, and multiple regression analysis was performed to investigate the predictors of indoor microbial and allergen levels. In total, 136 homes were analyzed. The results indicated that dog ownership, air purifier use, and floor cleaning frequency were major predictors of indoor microbial and allergen levels. Moreover, proximity to parks, roads, and forests was associated with elevated levels of indoor microorganisms and allergens. Our results demonstrated that indoor concentrations of certain microorganisms and allergens tended to increase in households located within neighborhoods with particular characteristics. Overall, our research findings contribute to housing intervention protocols and policies aimed at reducing exposure to indoor microorganisms and allergens. Future studies should longitudinally investigate the health effects of indoor microorganisms and allergens.

Sex-differences in the effects of indoor air pollutants and household environment on preschool child cognitive development

Air pollution, outdoor residential environment, indoor household characteristics, and parental mental health are potential factors associated with child development. However, few studies have simultaneously analyzed the association between the aforementioned factors and preschool child (aged 2–5 years) development. This study investigated the effects of those factors on child development and their potential modifying effects. A total of 142 participants were recruited from a birth cohort study in the Greater Taipei Area, and the evaluation was conducted at each participant's home from 2017 to 2020. Child cognitive development was assessed by psychologists using the Bayley Scales of Infant and Toddler Development and the Wechsler Preschool & Primary Scale of Intelligence. Household air pollutants, outdoor residential environment, indoor household characteristics, parental mental health, and other covariates were evaluated. Multiple regressions were used to examine the relationships between child development and covariates. Stratified analysis by child sex and parental mental health was conducted. Average indoor air pollutant levels were below Taiwan's Indoor Air Quality Standards. After adjustment for covariates, the indoor total volatile organic compounds (TVOCs) level was significantly associated with poor child development (per interquartile range increase in the TVOC level was associated with a 5.1 percentile decrease in child cognitive development). Sex difference was observed for the association between TVOC exposure and child development. Living near schools, burning incense at home, purchasing new furniture, and parental anxiety were related to child development. Indoor TVOC level was associated with poor child cognitive development, specifically with the girls. Indoor and outdoor residential environment and parental anxiety interfered with child development. TVOCs should be used cautiously at home to minimize child exposure. A low-pollution living environment should be provided to ensure children's healthy development.

Incomplete off-duty work hours and sleep quality among firefighters: a cross-sectional study, Taiwan.

We examined whether firefighters in Taiwan have a sleep problem and investigated the related factors of poor sleep quality. In this cross-sectional study, 2123 male shift firefighters in the Greater Taipei area were invited, and 37.7% of them satisfactorily completed the questionnaire online. The Chinese version of Pittsburgh sleep quality index (PSQI) was used to evaluate sleep quality. Multiple logistic and linear regression analyses were used to determine the associations among demographic characteristics, work-related characteristics, and poor sleep quality. As revealed by 801 valid questionnaires, 77.2% were poor sleepers (PSQI cutoff score > 6), and 61.2% reported incomplete off-duty in the past month. Moreover, 42.6% of incomplete off-duty workers reported extended overtime of more than 5h on off-duty days in the past month. Poor sleep quality was associated with the following factors: (1) demographic characteristics: age, working tenure, having children, and chronotype and (2) work-related characteristics: shift schedule and incomplete off-duty. The final model for poor sleep quality as per PSQI included age, chronotype, shift schedule, and incomplete off-duty hours in the past month. Longer hours of incomplete off-duty work were associated with increased risks of overall poor sleep quality and of poor subjective sleep quality, long sleep latency, sleep disturbances, and daytime dysfunction. Firefighters are advised to have a complete off-duty day to avoid poor sleep quality, long sleep latency, short sleep duration, sleep disturbances, and daytime dysfunction. Our results confirm the need for implementing appropriate shift schedules to ensure adequate rest time for firefighters.

Enhancing value‐in‐use in the FinTech innovation context

AbstractThe contribution of this study is its investigation of the engine driving consumer value‐in‐use through a resource—integration capability—value framework from the perspective of a resource‐based view and a capability‐based view. We analyze how business resources and consumer resources influence individual and collective value‐in‐use via the causal mechanisms of resource integration capability and relationship integration capability. The study surveys 511 respondents in the greater Taipei area and employs a structural equation model to examine eight hypotheses. The results show that the main causal path was that consumer resources had a positive impact on relationship integration capability. Relationship integration capability showed a primarily positive impact on collective value‐in‐use.

Frequent occurrence of respiratory symptoms in children is associated with exposure to air pollution, land use types, and parental mental health in the Greater Taipei area

Although studies have investigated the individual effects of air pollution, land use types, and parental mental health on children's respiratory health, few studies have examined the effects of these risk factors simultaneously in children aged <2 years. We investigated the effects of exposure to air pollution, land use types surrounding residences, and parental mental health on the frequent occurrence of respiratory symptoms in children aged <2 years in the Greater Taipei area. Participants were recruited from an ongoing Taiwanese birth cohort study. We analyzed the data of the participants who had been recruited from January 2011 to April 2014 and had responded to the follow-up questionnaires at 6, 12, and 24 months. Self-administered questionnaires were used to collect participants' sociodemographic background and health, such as respiratory symptoms, and parental mental health. Pre- and postnatal pollution levels were estimated using the spatial interpolation technique (ordinary kriging) at children's residential addresses. Land use types surrounding participants' homes were evaluated by performing buffer analysis. Multiple logistic regression analyses were conducted to examine the effects of risk factors on the frequent occurrence of child respiratory symptoms in children aged 6, 12, and 24 months. We included 228, 360, and 441 children aged 6, 12, and 24 months, respectively. Our results indicated that postnatal exposure to PM2.5 and O3 was positively associated with children's respiratory symptoms. Traffic-related land-use types, sports facilities, and commercial land surrounding homes exerted adverse effects on children's respiratory symptoms, whereas the presence of schools in the neighborhood was beneficial. Parental mental health was also associated with children's respiratory symptoms. Postnatal exposure to air pollution and land use types surrounding residences were associated with respiratory health in children aged <2 years. The residential environment is a critical factor affecting children's respiratory health of children aged <2 years.

Effects of air pollution, land-use type, and maternal mental health on child development in the first two years of life in the Greater Taipei area

IntroductionFew studies have investigated the associations of child development with air pollution, land-use type, and maternal mental health simultaneously. Therefore, we evaluated the effect of exposure to air pollutants during several critical periods of life, with adjustment for land-use type and maternal mental status, on child development at 6, 12, and 24 months of age in the Greater Taipei area. MethodsParticipants were selected from an ongoing Taiwanese birth cohort study. We analyzed the data of the participants who had been recruited from January 2011 to April 2014. Self-administered standardized questionnaires were used to collect information on sociodemographic factors, infant development and health, maternal mental status, etc. Air pollution levels in pre- and postnatal periods were estimated using a spatial interpolation technique (ordinary kriging) at children's residential addresses. Land-use types around participants' homes were evaluated using buffer analysis. We used multiple logistic regression analysis to examine the relationships between child development delay and environmental factors. ResultsIn total, 228, 361, and 441 families completed child development forms at 6, 12, and 24 months of age, respectively. Our results indicated that prenatal exposure to particulate matter with aerodynamic diameter ≤10 μm and O3 and postnatal exposure to NO2 were negatively associated with child development. Traffic-related land-use types, gas stations, and power generation areas around participants’ homes were also adversely correlated with child development. Moreover, poor maternal mental health was associated with child development delay. ConclusionPrenatal exposure and postnatal exposure to air pollution were associated with development delay in children under 2 years of age, specifically those under 1 year of age, even after adjustment for land-use type and maternal mental status. Living environment is critical for the development of children under 2 years of age.

Characterization of the vehicle emissions in the Greater Taipei Area through vision-based traffic analysis system and its impacts on urban air quality

In recent years, many surveillance cameras have been installed in the Greater Taipei Area, Taiwan; traffic data obtained from these surveillance cameras could be useful for the development of roadway-based emissions inventories. In this study, web-based traffic information covering the Greater Taipei Area was obtained using a vision-based traffic analysis system. Web-based traffic data were normalized and applied to the Community Multiscale Air Quality (CMAQ) model to study the impact of vehicle emissions on air quality in the Greater Taipei Area.According to an analysis of the obtained traffic data, sedans were the most common vehicles in the Greater Taipei Area, followed by motorcycles. Moderate traffic conditions with an average speed of 30–50 km/h were most prominent during weekdays, whereas traffic flow with an average speed of 50–70 km/h was most common during weekends. The proportion of traffic flows in free-flow conditions (>70 km/h) was higher on weekends than on weekdays. Two peaks of traffic flow were observed during the morning and afternoon peak hours on weekdays. On the weekends, this morning peak was not observed, and the variation in vehicle numbers was lower than on weekdays.The simulation results suggested that the addition of real-time traffic data improved the CMAQ model's performance, especially for the carbon monoxide (CO) and fine particulate matter (PM2.5) concentrations. According to sensitivity tests for total and vehicle emissions in the Greater Taipei Area, vehicle emissions contributed to >90% of CO, 80% of nitrogen oxides (NOx), and approximately 50% of PM2.5 in the downtown areas of Taipei. The vehicle emissions contribution was affected by both vehicle emissions and meteorological conditions. The connection between the surveillance camera data, vehicle emissions, and regional air quality models in this study can also be used to explore the impact of special events (e.g., long weekends and COVID-19 lockdowns) on air quality.

Associations of birth outcomes with air pollution and land use characteristics in the Greater Taipei Area

BackgroundUnderstanding the effects of environmental factors on birth outcomes is crucial for public health because newborns' birth size affects their likelihood of childhood survival, risk of perinatal morbidity, and subsequent health and growth. Therefore, we investigated the associations of birth outcomes with prenatal air pollutant exposure and residential land use characteristics in the Greater Taipei Area. MethodsParticipants were selected from the Longitudinal Examination across Prenatal and Postpartum Health in Taiwan study, which is an ongoing prospective study launched in July 2011. Parental sociodemographic data and medical histories were collected using standardized questionnaires. Mean air pollutant levels during each trimester were estimated using the spatial interpolation technique (Ordinary Kriging). Land use types surrounding participants' homes were evaluated within a designated radius of their residential addresses. We used multiple regressions to examine relationships between birth outcomes (i.e., birth weight, height, and head circumference) and environmental factors after adjustment for parental characteristics. ResultsA total of 436 pregnant women–infant pairs were included. Birth weight was negatively associated with commercial land and greenhouse areas near the residence. Living near greenhouse areas negatively affected birth height, but higher greenness level within 100 m of the residence had a positive effect. Birth head circumference was only associated with sociodemographic factors in the multivariate model. ConclusionLand use types near the homes of pregnant women, but not exposure to air pollutants, were significantly associated with birth weight and height in the Greater Taipei Area. Increased greenness level was positively associated with birth height, and living near commercial or greenhouse areas had adverse effects on birth outcomes. Living in a healthy neighborhood is critical for the birth outcomes of infants and presumably their health in early childhood.

A COMPARISON OF THE PREDICTIVE POWERS OF TENURE CHOICES BETWEEN PROPERTY OWNERSHIP AND RENTING

This paper compares the predictive powers of hierarchical generalized linear modeling (HGLM), logistic regression, and discriminant analysis with regard to tenure choices between buying property and renting property by sampling the residents of the Greater Taipei area. The results imply that the hit rate and other indicators included in HGLM have better predictive power with regard to tenure choices than the binary logistic regression model and the discriminant analysis model. That is, using HGLM to process nested data can increase prediction accuracy regarding household tenure choices. Furthermore, cross-validation is performed to analyze hit rate stability. The hit rate sequencing from this cross-validation is found to be consistent with the HGLM results, implying that the comparison of the three models in terms of hit rate performance prediction in this study is stable and reliable.

Effects of Air Pollution and Land Use Characteristics on Development and Respiratory Health among Children in the Greater Taipei Area

Indoor and outdoor air pollution poses an important health threat to children. Exposure to air pollution may cause various acute and chronic respiratory diseases, and affect neurodevelopment and cognitive functions in children. To evaluate the impact of air pollution on children's health, we conduct a study to examine the effect of prenatal and early childhood exposure to air pollution on development and respiratory health in the first 3 years of life among a birth cohort in the Greater Taipei area. We will recruit 500 cohort children, and evaluate their development and respiratory diseases using standardized questionnaires and Bayley Scales of Infant and Toddler Development. One hundred children will be selected to conduct indoor and outdoor environmental samplings of their residences. Four hundred and fifty-six cohort children have been recruited so far, and environmental measurements have been implemented in 40 homes. According to our analyses, most ambient pollutant concentrations near participants' homes were lower than Taiwan National Ambient Air Quality Standard, expect PM2.5, which exceeded the annual average level (15µg/m3). A few households had elevated indoor pollution levels due to a low ventilation rate or recent remodeling. Several children's bed dust samples contained dust mite allergen levels &amp;gt; 2 µg/g, which may increase the risk of child sensitization to dust mites. According to multiple regression analyses, a high level of nitrogen oxides during first trimester near residence as well as living near gas stations, social welfare facilities, or high ways had adverse effects on children's health; living near green parks was beneficial to children's neurodevelopment. Overall, residential environments, such as air quality and land use type nearby, may significantly influence children's health and neurodevelopment.

Outpatient Visits for Allergic Diseases are Associated with Exposure to Ambient Fungal Spores in the Greater Taipei Area

Allergic diseases are prevalent worldwide and may result from exposure to various substances. Exposure to ambient bioaerosols is a potential risk factor for allergic diseases; however, accurate exposure assessment is challenging due to the limited number of outdoor monitoring stations. In this study, the relationships between ambient bioaerosol exposure and allergic diseases (viz., acute conjunctivitis, allergic rhinitis, and asthma) were evaluated using validated land-use regression (LUR) models to estimate the exposure levels. Data on the daily outpatient visits were retrieved from the Taiwan National Health Insurance Research Database. The total fungal spore count was associated with acute conjunctivitis in males at the second and third quartiles with relative risks (RRs) of 1.75 (95% confidence interval [CI] = 1.24, 2.48) and 1.32 (95% CI = 1.03, 1.70), respectively. It was also associated with asthma in both sexes when the concentration ≥ 95^(th) percentile with RRs = 3.06 (95% CI = 1.89, 4.95) in males and 1.73 (95% CI = 1.08, 2.76) in females. Cladosporium was correlated with acute conjunctivitis in females at a concentration ≥ 95^(th) percentile with RR = 2.90 (95% CI = 1.40, 6.04). Basidiospores were associated with allergic rhinitis in males at the third and fourth quartiles with RRs = 1.88 (95% CI = 1.44, 2.45) and 1.49 (95% CI = 1.20, 1.84), respectively. Meteorological parameters, including relative humidity and rainfall, were also crucial factors associated with the number of outpatient visits. Our results revealed that ambient fungal spores are critical determinants of allergic diseases. In addition, using LUR models to assess exposure to ambient bioaerosols is feasible.

Bubbles Are Departures from Equilibrium Housing Markets: Evidence from Singapore and Taiwan.

The housing prices in many Asian cities have grown rapidly since mid-2000s, leading to many reports of bubbles. However, such reports remain controversial as there is no widely accepted definition for a housing bubble. Previous studies have focused on indices, or assumed that home prices are lognomally distributed. Recently, Ohnishi et al. showed that the tail-end of the distribution of (Japan/Tokyo) becomes fatter during years where bubbles are suspected, but stop short of using this feature as a rigorous definition of a housing bubble. In this study, we look at housing transactions for Singapore (1995 to 2014) and Taiwan (2012 to 2014), and found strong evidence that the equilibrium home price distribution is a decaying exponential crossing over to a power law, after accounting for different housing types. We found positive deviations from the equilibrium distributions in Singapore condominiums and Zhu Zhai Da Lou in the Greater Taipei Area. These positive deviations are dragon kings, which thus provide us with an unambiguous and quantitative definition of housing bubbles. Also, the spatial-temporal dynamics show that bubble in Singapore is driven by price pulses in two investment districts. This finding provides a valuable insight for policymakers on implementation and evaluation of cooling measures.

Half-Managed Care: A Preliminary Assessment of a Capitation Program in a Health Care System Without Gatekeepers.

In 2011, a novel capitation program was launched in Taiwan under its universal health insurance plan. This study aimed to assess the short-term impact of the program. Two hospitals in the greater Taipei area, one participating in the "loyal patient" model (13,319 enrollees) and one in the "regional resident" model (13,768 enrollees), were analyzed. Two comparison groups were selected by propensity score matching. Generalized estimating equation models with differences-in-differences analysis were used to examine the net effects of the capitation program on health care utilization, expenses, and outcomes. Enrollees in the loyal patient model had fewer physician visits in the host hospital, but more physician visits outside that hospital during the program year than they had the year before. Compared with non-enrollees, the loyal patient model enrollees incurred fewer physician visits (β = -0.042, p < .001), fewer emergency department visits, (β = -0.140, p < .001), and similar total expenses and outcome. For the regional resident model, no differences were found in the number of physician visits, expenses, or outcomes between enrollees and non-enrollees. The novel capitation models in Taiwan had minimal impact on health care utilization after 1 year of implementation and the health care outcome was not compromised.

The spatiotemporal distributions and determinants of ambient fungal spores in the Greater Taipei area

Airborne fungal spores, a type of bioaerosols, are significant air pollutants. We conducted a study to determine the spatiotemporal distributions of ambient fungi in the Greater Taipei area and develop land use regression (LUR) models for total and major fungal taxa. Four seasonal sampling campaigns were conducted over a year at 44 representative sites. Multiple regressions were performed to construct the LUR models. Ascospores were the most prevalent category, followed by Aspergillus/Penicillium, basidiospores, and Cladosporium. The highest fungal concentrations were found in spring. According to the LUR models, higher concentrations of Aspergillus/Penicillium and basidiospores were respectively present in residential/commercial areas and in areas with shorter road lengths. Various meteorological factors, particulates with aerodynamic diameters of ≤10 μm, and elevation also had significant relationships with fungal concentrations. The LUR models developed in this study can be used to assess spatiotemporal fungal distribution in the Greater Taipei area.

Spatiotemporal Distributions and Land-Use Regression Models of Ambient Bacteria and Endotoxins in the Greater Taipei Area

Ambient bacteria and endotoxins are components of bioaerosols, which are abundant in ambient air. Exposure to ambient bacteria and endotoxins has been associated with respiratory symptoms. We monitored the spatiotemporal distributions of ambient bioaerosols in the Greater Taipei area by using multisite sampling and developed regression models for ambient bacterial and endotoxin concentrations. Forty-four representative sampling sites were selected from the Greater Taipei area. Samples were collected in 4 seasons throughout a 1-y study period. Ambient bacteria were quantified using acridine orange staining, and endotoxins were analyzed using Limulus amebocyte lysate assays. Land-use types and major determinants of the bioaerosols were used to develop regression models. Ambient bacteria ranged from < limit of detection (LOD) to 1.68 × 105 cells/m3, whereas endotoxins ranged from < LOD to 20.62 EU/m3. Significant seasonal variations were observed for both bioaerosols, with the highest concentrations observed in spring. Regression analyses revealed temperature, relative humidity, and particulate matter as the major predictors of ambient bacteria and endotoxins. No land-use type was correlated with any of the bioaerosols. The number of schools and gas stations was positively associated with both bioaerosols. The leave-one-out cross-validation R2 of the final models for ambient bacteria and endotoxins were 0.11 and 0.31, respectively. The results of this study revealed high spatiotemporal variations in the distributions of ambient bacteria and endotoxins in the Greater Taipei area. Additional potential predictors should be included in future studies to develop better predictive models for ambient bacteria and endotoxins.