舊船解體業勞工世代之罹病住院率分析

Morbidity Analysis of Ship Breaking Workers-A Cohort Study

楊冠洋(G.Y. Yang) ； 吳聰能(T.N. Wu) ； 林浩稜(Y.S. Chen) ； 陳以新(H.L. Lin) ； 柯桂女(K.N. Ko) ； 劉紹興(S.H. Liou) ； 賴俊雄(J.S. Lai)

《中華公共衛生雜誌》 15卷2期 (1996/04) Pp. 116-123

https://doi.org/10.6288/CJPH1996-15-02-02

摘要

舊船解體作業的主要過程可分成清艙、以乙炔氧氣燄切割船板、與分離船體等作業。勞工長期暴露於切割鋼板所產生的燻煙微粒中，可能會發生呼吸器官的慢性疾病。為瞭解過去拆船業工作環境對勞工健康的影響，本研究以民國七十四年高雄市舊船解體職業工會的4,189名男性會員年籍資料為基礎，建立舊船解體業勞工的族群世代。其中以從事船艙鋼板切割工作的瓦斯工人數最多（2,834人），吊工（875人）、與雜工（248人）等次之。經由比對民國七十四年起的國人死亡登記與勞工保險住院給付中請資料，本研究追蹤世代的罹病住院情形至民國八十年底止。與民國七十七年全國勞工罹病住院率相比較，舊船解體業勞工全世代於同年的上呼吸道（罹病住院率比：2.50）、呼吸系統（罹病住院率比：1.89）等項疾病之直接年齡標準化罹病住院率顯著地偏高；瓦斯工在上呼吸道疾病（罹病住院率比：2.02）的罹病住院率也顯著地偏高。在次世代間之比較則要現：瓦斯工在急性支氣管炎之間接年齡標準化發病住院率顯著的高鈴非瓦斯工（吊、雜工等）次世代。本研究的結果雖與文獻上所報告的發現類似，但是因為受資料本身的限制，所以仍需要進一步的研究加以驗證。本研究的經驗顯示：以職業工會會員資料合併健康登錄資料進行世代健康危害追蹤的方式，所需人力、經費與時間較少，應是可行且經濟之前驅研究的糢式。

關鍵字

舊船解體業 ； 標準化罹病住院率 ； 勞工健康保險 ； 焊工 ； 肺部疾病

並列摘要

Using ethylene-oxygen torch to cut shipboard was the major operation in the ship breaking industry in Taiwan. Metal fume exposure, which might result in pulmonary disorders, was one of the major hazardous occupational exposures for the workers. To study the adverse health effects of metal fume exposure, this historical cohort study enrolled 4, 189 ship breaking labors who were active members of Kaoshung Ship Breaking Workers Union in 1985. Health status (causes and dates of hospitalizations) of the cohort workers were followed up till December, 1991, by linkage of the personal identifier of worker to the death registry and the database of hospitalization claims to the Labor Insurance. In comparison to the disease prevalence (by selecting the first hospitalization in the particular year) of all labors covered by the Labor Insurance in 1988, the whole ship-breaking cohort had more hospitalizations for upper respiratory diseases (prevalence ratio: 2.5), and also in pulmonary diseases (prevalence ratio: 1.89). Subcohort analysis, using ”non-exposed” workers (875 lifters and 248 manual workers) as a control, showed that the flame cutter (n=2,834) had more attacks (by selecting the first hospitalization in the whole follow up period) of acute bronchitis, with an indirect age-adjusted disease specific hospitalization ratio at 5.06. The finding of an elevated risk of flame cutters in pulmonary diseases was compatible with other published studies. And, the experience of this study also demonstrates the feasibility of conducting a pilot cohort study through database linkage, which is probable easy and cost-effective in Taiwan.

並列關鍵字

ship breaking ； morbidity ； Labor Insurance ； flame cutter ； pulmonary disease