職業健康服務制度的發展與台灣制度現況

Development of Occupational Health Services and the Current System in Taiwan

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

《台灣公共衛生雜誌》 28卷4期 (2009/08) Pp. 255-267

https://doi.org/10.6288/TJPH2009-28-04-01

摘要

職業健康服務制度乃是國家勞動保護制度中重要的一環；其中，健康檢查與偵測不僅可積極地預防職業疾病的發生，也是促進雇主改善工作環境的重要依據；勞工健康檢查的資料，也是流行病學探究因果關係以及政府發展職業傷病防治策略的基礎。我國職業健康服務制度自1974年「勞工安全衛生法」頒布以來已有30多年歷史，但此制度問題重重，未能充分發揮上述功能。我國制度沿襲自日本，而日本制度又深受西方工業國家影響，因此，考察先進國家制度發展過程與精神有其必要。本文回顧歐美與日本職業健康服務制度之歷史緣起與內容，並回顧國際勞動組織有關職業健康服務之相關報告書所彰顯的制度精神，接著我們回顧台灣職業健康服務制度的發展沿革，並分析檢討目前制度現況，最後對現行制度提出改善建議。從國際制度的發展歷程與制度內容可發現，雇主責任乃是職業健康服務制度的核心原則，而政府政策是否積極介入，以及勞工是否積極參與，乃是該制度能否發揮保護勞工功能之關鍵。

關鍵字

職業健康服務 ； 職場健康檢查 ； 歷史沿革 ； 國際比較

並列摘要

A system of occupational health services is required by the nation's labor protection provisions. Use of data from routine health examinations and surveillance is meant to provide empirical evidence for proactively preventing work-related illness and improving working conditions. Occupational health data also serve as the basis for epidemiologic research that evaluates the link between work hazards and health outcomes, as well as for the development of adequate occupational health policies. The system, in Taiwan, which has been operational since the implementation of the Occupational Safety and Health Act in 1974, has been criticized as problematic and poorly functioning. In this paper, we first reviewed the historical development and principles of occupational health services in Western countries as well as in Japan (as the current system in Taiwan used the Japanese system as a model, which in turn was greatly influenced by Western experiences). We also reviewed related documents published by the International Labor Organization. Finally, we reviewed the development of Taiwan’s system, examined its current condition, and proposed some recommendations for its improvement. On the basis of this review, we conclude that the occupational health service system imposes on employers the responsibility to protect the health of their employees. Nevertheless, enforcement of this obligation is greatly determined by the extent of government’s involvement and workers' participation.

並列關鍵字

occupational health services ； workplace health examination ； historical development ； international comparison

參考文獻

鍾佩樺、尤素芬、鄭雅文(2009)。我國勞工健康檢查制度之現況與問題。台灣衛誌。28，155-166。

范國棟、李蘭(2008)。職場健康促進：國際與台灣經驗之比較。台灣衛誌。27，271-281。

尤素芬、陳美霞(2007)。企業內安全衛生保護之勞工參與機制探析。台灣衛誌。26，419-432。

Aoyama H.(1982).Workers' participation in occupational safety and heal thin Japan.Int Labour Rev.121,207-216.

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