以職業醫學觀論職業傷病之預防

The Obstacles of Occupational Medicine Practice for Prevention of Occupational hazards in Taiwan

劉紹興(Saou-Hsing Liou)

《中華職業醫學雜誌》 3卷2期 (1996/04) Pp. 89-96

https://doi.org/10.30027/CJOM.199604.0002

摘要

勞工安全衛生法實施以後，政府與民間無時不以降低職業災害為目標。職業災害之預防有賴於職業醫學和工業衛生人員的團隊合作與努力。但目前政府的種種措施使職業醫學面臨重重困難，使職業醫學醫師無法發揮其長才。這些困難包括政策之制定缺乏職業醫學醫師之參與，主管機關不重視職業醫學專科之設立，職業傷病之嚴重低估，職業傷病之制定權交給雇主，以及職業病種類表的缺失，加上主管勞工行政和勞工保險單位缺乏職業醫學專業人員，致使勞資爭議和職業傷病之認定糾紛不時出現。為提昇職業醫學在職業災害防治之貢獻，謹提出下列建議：(一) 職業災害就醫證明單應由診療醫師認定後填發；(二)提高職業傷病的醫療給付或以獎勵金方式獎勵職業傷病的診斷與治療；(三)設立職災基金培養職業醫學專科醫師；(四)修訂職業病種類表，並區分一般職業病與可補償的職業病；(五)制定因過去職業而罹患職業病如塵肺症，但已轉業勞工的醫療照顧。

關鍵字

職業傷病 ； 職業醫學專科醫師 ； 醫療給付 ； 職業病種類表

並列摘要

Since the enactment of the Occupational Health and Safety Act in Taiwan, the governmental and civil organizations have engaged in reducing occupational diseases and injuries. However, the rates of occupational disease and injury in Taiwan are still higher than in most of the developed countries. Prevention of occupational diseases and injuries relies on the cooperation of occupational medicine physicians and industrial hygieneists. The policies in practice of occupational health and safety neglected the roles of occupational medicine personnels in Taiwan. The obstacles included lacking of occupational medicine personnels in policy – making, lacking of persuasion to establish occupational medicine board in government, serious underestimation of occupational disease and injury rate, giving the right of certifying occupational disease and injury to the employer, and misuse of the listings of occupational diseases. The following recommendations are suggested to raise concerns about occupational medicine and to improve the efficacy of prevention of occupational hazards in Taiwan. First, to establish the board certification system to accredit occupational medicine specialist; Secondly, to tranfer the right of certifying occupational injuries and diseases from the employers to years to the occupational physicians; Thirdly, to revise of the listings of occupational diseases in labor insurance and to distinguish the compensable occupational diseases from noncompensable occupational diseases; Fourthly, to increase the medical payments to occupational specialists in out -patient clinic; Fifthly, to set up medical care policy of occupational disease patients who had tranferred to other industry. These recommendations would encourage physician to engage in occupational disease and injury prevention and have better care of patients with occupational diseases.

並列關鍵字

occupational disease and injury ； occupational medicine board ； medical payment ； the listing of occupational diseases