某醫學中心職業病環境病門診1987至1995年間之個案分析

Analysis of Outpatient Visits at a University Hospital Occupational and Environmental Clinic between 1987 and 1995

鄭尊仁(Tsun-Jen Cheng) ； 王文正(Wen-Cheng Wang) ； 王榮德(Jung-Der Wang)

《中華公共衛生雜誌》 18卷3期 (1999/06) Pp. 222-227

https://doi.org/10.6288/CJPH1999-18-03-06

摘要

目標：本研究利用某醫學中心環境與職業病門診個案的資料，進行疾病及行業別等特性分析，並對有助於診斷職業病的因素加以探討。方法：研究對象是1987至1995年間到台灣大學醫學院附設醫院環境及職業病門診就醫的病人，利用修正過的Newman問卷表詳細調查每一位病人的病史，包括個人基本資料、過去醫療史和詳細工作史等。職業病的診斷則依據疾病証據、暴露証據、時序性、一致性及排除其它因素等五原則；符合五原則者為職業或環境相關之疾病，符合前四條件者則很可能是環境病或職業病。結果：分析顯示1987至1995年間共673位新病人，其中192人確定是或很可能是職業或環境相關疾病，以呼吸性疾病最多，其次是外傷、鉛中毒及皮膚疾病，而主要危害物為有機化學物。以邏輯式迴歸分析發現診斷為職業病具顯著性的相關因子為工作環境中有其它同事志有相同症狀（勝算比＝313）、醫師轉介（勝算比＝176），工作中使用口罩（勝算比＝1.34），抽菸（勝算比＝1.20）和年齡（勝算比＝1.02）結論：本研究有助於了解臺灣職業病概況及提供職業病診斷之參考。由於研究對象限於一醫學中心門診病人，應進一步分析其他醫學中心職業病門診資料或全國性通報系統，使臺灣職業病現狀更清楚。

關鍵字

環境病 ； 職業病 ； 診斷

並列摘要

Objectives: This study was designed to investigate the characteristics of environment and occupational seas (EODs) in Taiwan. The factors associated with the characteristics of a diagnosis for EOD were so determined. Methods: A modified Newman questionnaire was administered to outpatients seen in the environmental and occupation medicine clinic at a medical center in northern Taiwan between 1987 and 1995 to obtain personal data and a detailed occupation and medic history. Evidence of disease, evidence of exposure, temporality, consistency, and the exclusion of other common disease causes were used as criteria for making an EOD diagnosis Patients with the first four criteria were classified as probably having an EOD. Those with as five criteria were classified as having an EOD. Results: Among 673 patients registered and reviewed between 1987 and 1995, 192 individuals were diagnosed as having or probably having an EOD. Respiratory tract diseases accounted for most EOD, followed by injuries, lead poisoning and skin diseases. Chemicals were the agents most commonly causing EOD. Logistic regression analysis also showed that significant factors leading to EOD diagnoses were coworkers having similar symptoms (odds ratio [OR] =3.13), referrals by other physicians (OR=1.76), using a mask (OR=1.34), smoking (OR=1.20) and age (OR=1.02). Conclusions: The results provide some insight in understanding the current characteristics of EOD in Taiwan and some clues in reaching a diagnosis of EOD. Because data were collected from only one medic center, further study to include more data from other medical centers and a national surveillance system may show the whole picture of EOD in Taiwan.

並列關鍵字

Environmental and occupational diseases ； diagnosis criteria