我國勞工健康檢查制度之現況與問題

Current Conditions and Problems Regarding the System of Occupational Health Examination in Taiwan

鍾佩樺(Pei-Hua Chung) ； 尤素芬(Su-Fen You) ； 鄭雅文(Ya-Wen Cheng)

《台灣公共衛生雜誌》 28卷2期 (2009/04) Pp. 155-166

https://doi.org/10.6288/TJPH2009-28-02-08

摘要

目標：勞工健康檢查是「職業健康服務」制度中相當重要的一環。對於工作者而言，是瞭解在職中的健康變化、早期偵測疾病的重要依據，更有助於釐清職業危害暴露對於健康的影響，甚至在離職退休後發現罹患職業病，亦是尋求補償認定的重要依據。本研究旨在探討我國勞工健康檢查制度現況與實務操作層面之問題。方法：研究材料主要來自15位相關人士之深度訪談（包括受僱者、工會代表、企業管理者，以及醫療健檢部門之執行者），並舉辦一次專家座談會，徵詢3位職業醫學與1位勞工安全衛生專家之意見。結果：我國勞工健檢雖有完整的制度設計，但實務運作上卻是問題重重，包括市場低價競爭、與全民健保成人健檢資源重疊、職業風險暴露記載不全、健檢資料缺乏有效的利用與管理、異常個案缺乏後續追蹤管理、職業醫學角色模糊、健檢資料保管與隱私權等問題。結論：本研究指出我國勞工健檢制度之問題，並提出改善建議。

關鍵字

職業健康檢查 ； 職業健康 ； 政策

並列摘要

Objectives: Occupational health examination plays an important role in occupational health services. Its functions are to trace changes in workers' health status, to detect work-related health problems at an early stage, and most importantly, to clarify the impacts of occupational hazards on workers' health. Documenting the occupational health status of workers may also provide valuable information when disputes occur in compensation claims. This study was designed to examine current conditions and problems with the system of occupational health examination in Taiwan. Methods: In-depth interviews with 15 stakeholders, including employees, union representatives, managers of enterprises, and executives of medical care facilities, were conducted. Experts' opinions were solicited through panel discussion with 3 occupational physicians and 1 professional specializing in occupational safety and health. Results: Many problems exist with the system of occupational health examination despite the fact that the system, enacted by the Labor Safety and Health Act, is well established in Taiwan. Problems include vicious market competition, poor coordination with the health examination services provided by National Health Insurance, a lack of occupational risk profiles, poor management of health data, a lack of follow-up programs, passive to no participation of occupational health professionals, and poor regulation with regard to the protection of workers' privacy. Conclusions: We identified several problems evident in the current system of the occupational health examination, and made recommendations for improvement.

並列關鍵字

occupational health examination ； occupational health ； policy

參考文獻

International Commission on Occupational Health(2005).Basic Occupational Health Services.Helsinki:International Commission on Occupational Health.

Carter T.,Baxter P (eds.),Adams P (eds.)(2000).Hunter's Diseases of Occupations.New York:Oxford University Press.

Levy B,Wegman D.(1995).Occupational Helath-Recognizing and Preventing Work-Related Disease.Boston:Little, Brown and Company.

LaDou J.(2002).The rise and fall of occupational medicine in the united states.Am J Prev Med.22,285-295.

Mizoue T,Higashi T,Muto T,Yoshimura T,Fukuwatari Y.(1996).Activities of an occupational health organization in Japan, in special reference to services for small-andmedium-scale enterprises.Occup Med.46,12-16.