工作過勞致死之定義及診斷基準

Definition and Diagnostic Criteria of Death from Overwork

羅士翔(Shih-Hsiang Lo) ； 陳文慶(Wen-Ching Chen) ； 柯景塘(Jiing-Tang Ko) ； 王榮德(Jung-Der Wang)

《北市醫學雜誌》 4卷2期 (2007/02) Pp. 95-102

https://doi.org/10.6200/TCMJ.2007.4.2.01

摘要

1969年日本報導第一個過勞死案例，因此引起大眾的關心。過勞死，顧名思義，即是「因工作過度勞累而致死」之意。其致死的主要原因，為心臟病發或腦中風。日本於1970年代開始實施生產管理計畫(JPM)，因此員工覺得容易疲累、壓力、緊張，而且罹患骨骼肌肉疾病的個案增加，這些都與過勞死可能有關。勞工與雇主均常要求工作過度的證據，但因診斷工具的限制，在判定上很難令人滿意；災難後症候群因為有清楚的定義和臨床症狀表現，這種診斷較容易被接受。美國國家職業安全和衛生研究所(NIOSH)已發展出一套模式以描述這兩者之間的關係。日本勞動省也強調不只是過度工作的標準和急性循環系統疾病的診斷必須被考慮，其他工作變異的相關因素，也必須加以考量。我們須要更多流行病學的研究來制定適合臺灣勞工族群之職業醫學診斷依據，以釐清因工作過度勞累而致死之相關性。

關鍵字

過勞死 ； 工作壓力 ； 急性循環系統疾病

並列摘要

The first case of Karoshi was reported in 1969 and gave rise to public concern. Karoshi can be translated quite literally as ”death from overwork”. The major medical causes of karoshi-deaths are heart attack and stroke. Japanese production management (JPM) has been conducted in since 1970s, which increased fatigue, stress, tension, and usculoskeletal disorders and may be associated with these causes of deaths. More and more employees suffering from sudden death have tried to claim for the cause of overwork, but imperfect diagnostic criteria make such claims difficult to be acceptable in most jurisdictions. A diagnosis of post-traumatic stress disorder was more acceptable because of the clear identification of etiological incident and symptoms. NIOSH model of job stress was developed to describe such a potential causal relationship. The Japan Ministry of Labor revised not only the criteria of ”overwork” and diagnosis of acute circulatory diseases but also other work-related factors, which need to be taken into consideration. We need more epidemiological investigations of death from overwork covering the Taiwan occupational population to establish the criteria and relationship of death related to overwork.

並列關鍵字

karoshi ； job stress ； acute circulatory system diseases