- 期刊
臨床寄生蟲糞便檢驗如何符合認證之要求
How to Meet Accreditation Requirements for Stool Parasite Examination
摘要
寄生蟲病在熱帶及亞熱帶地區(泰國、越南、印尼、緬甸)普遍流行的疾病。腸道寄生蟲的病原體常見：(1)原蟲感染，如：阿米巴痢疾、梨形鞭毛蟲及隱胞子蟲等。(2)蠕蟲感染如蛔蟲、鉤蟲、鞭蟲、蟯蟲、中華肝吸蟲及絛蟲等。外籍勞工原蟲感染又以人芽曩原蟲檢出率占最高，部分勞工甚至帶有兩種以上的感染源。勞動部職業安全衛生署明文規定為落實勞工健康保護，即早偵測勞工健康異常情形，並作為雇主選配勞工及採行健康管理與職業病預防措施之參考依據。國內大部分事業單位的寄生蟲體檢，除衛福部指定的外勞特約醫院外，大都委託一般醫療機構負責，政府主管機關未制訂國內勞工健康檢查機構的檢驗品質保證之要求，導致檢驗品質良莠不齊將造成防疫之漏洞。因此醫院檢驗室應建立腸道內寄生蟲糞便檢驗品質系統標準作業規範，可提昇檢驗室檢驗品質及符合認證之要求。腸道內寄生蟲糞便檢驗品質系統包括管理要求與技術要求及病人安全維護之要求，來確保檢驗室的能力與檢驗報告之正確性。目前台灣區勞工醫院除接受衛福部醫院評鑑外，也自我要求第三方認證機構來評核檢驗室是否符合國際醫學檢驗之標準規範。CAP-LAP為國際認證機構，ISO 15189為國際間醫學檢驗室認證之共同標準規範，通過認證是台灣地區勞工醫院檢驗室全面品質之保證，也是檢驗室所追求的目標與未來之趨勢。
並列摘要
Parasitosis is prevalent among tropical and subtropical countries, including Thailand, Vietnam, Indonesia, and Myanmar. Common pathogens of intestinal parasitosis include: protozoans (such as Amoeba, Giardia and Cryptosporidium) and helminthes (such as Ascaris, hookworm, whipworm, pinworm, Clonorchis and tapeworm) with Blastocystis hominis being the most prevalent among foreign laborers. Some laborers are even infected with protozoans of over 2 types. To ensure the health and protection of labors, Occupational Safety and Health Administration, Ministry of Labor has stipulated that abnormal physical conditions of labors should be detected timely, which should act as reference for employment of labors, health management and for preventive actions against occupational diseases. Though there are hospitals for foreign labors designated by Ministry of Health and Welfare, most domestic enterprises have entrusted the parasite examinations to ordinary medical facilities. Since the regulatory authorities have not stipulated any requirements regarding quality assurance of health examination for domestic labors, the quality of such examinations are not guaranteed and thus disease control could suffer. Hence, hospital laboratories should establish a standard operation procedure for stool examination of intestinal parasites to enhance the laboratory quality and fulfill the requirements of accreditation. Standard operation procedure for stool examination of intestinal parasites should include management requirements and technical requirements, as well as requirements for patient safety to ensure the capability of laboratory and the accuracy of test reports. In addition to hospital accreditation conducted by Ministry of Health and Welfare, many medical laboratories in Taiwan are also accredited by a third party using the international accreditation standards. CAP-LAP is an international accreditation organization, while ISO 15189 is a common standard requirement for international accreditation for medical laboratories. An accreditation is an overall quality assurance for labor health checkup and also the objective and future trends of medical laboratories.