台灣：一個依然看不見職業病的國家－大數據的膚淺、謬誤、與傲慢－

Taiwan: A Country where Occupational Diseases Are Still Invisible ! -- The Skin-deepness, Error & Arrogance of Big Data --

黃百粲(Pai-Tsang Huang)

《中華職業醫學雜誌》 25卷4期 (2018/10) Pp. 241-263

摘要

我國的職業病通報補償體系未臻完善，正朝向職災保險單獨立法邁進。近年來因應此議題的呼聲不斷，主要論點為職業病通報數目低落，勞工保險局審查嚴格，勞保耗用健保資源，導致雇主責任無法落實。本文的目的在重新檢視相關文獻、研究報告、會議論文，深入解析國內外職業病數據。結果顯示我國在化學性疾病、人因工程性骨骼肌肉系統疾病、腦心血管疾病、以及精神疾病方面並無低報情形。物理性疾病與癌症並不明確。感染性疾病、肺病、與皮膚病應存在低報情形。由於各國國情大不相同，將眾多數據簡化成一個所謂職業病補償率並不妥適。此外勞工擁有多條申請、爭議管道；勞保局並未嚴審申請案，而勞保健保事實上彼此耗用，不易釐清。期待本文的結論有助於澄清現況，理清雜緒，為勞動保護體制的改革略効棉薄之力。

關鍵字

職業病 ； 職業病表 ； 通報 ； 補償

並列摘要

Labor insurance for occupational disease compensation remains much to be desired in Taiwan, though the country is heading towards an independent insurance system. On account of this issue, hot debate and argument has surfaced which focuses primarily on the lower number of compensated occupational diseases, strict reviewing of insurance claims, labor insurance depriving the resource of National Health Insurance, and employers' exemption of their responsibility. The aim of the article is to re-examine relevant publications, research reports, and conference presentation, in order to analyze those data on a deeper level. The results indicate that Taiwan does not lag in the reporting and compensation on chemical, musculoskeletal, cardiocerebrovascular, and mental occupational diseases. The data on physical diseases and cancers are uncertain, while there exist big shortages on infectious, respiratory, and dermal occupational diseases. It is deemed inappropriate to focus on a single rate of compensation for international comparison. Besides, a number of channels are available to works seeking compensation. The Bureau of Labor Insurance does not review cases unduly strictly, and both insurance systems encroach upon each other. It is expected the result of this article will help clarify our situation and contribute to the successful reformation of Labor Insurance System.

並列關鍵字

occupational diseases ； occupational disease list ； reporting ； compensation