農業從業者職業傷害保險相關之傷病分析

Analysis of Injuries and Illnesses Associated with Occupational Insurance among Agricultural Farmers

吳威德(Wei-Te Wu) ； 何雨芳(Yu-Fang Ho) ； 張靜文(Ching-Wen Chang)

《勞動及職業安全衛生研究季刊》 28卷3期 (2020/09) Pp. 63-70

摘要

農業從業者面臨許多職業暴露，衍生諸多職業傷害與職業病。然而，職場上的災害大都是可以防範的，針對職業災害優先順序加強預防宣導，不但可以避免農民發生職業災害，更可減少農業勞動力及罹災農民之補償損失。但目前農民職業災害保險剛試辦，即便內容對於因果關係明確的「職業傷害」進行保障，仍無法有效了解優先關注與預防之職業傷病類型。因此，本研究目的為探討農民在目前的職災給付規範下，農民職業災害保險保障之「職業傷害」與一般國人之差異情形，以及從主要農業縣市來探討該職災事故的一致性。本研究使用以國家基礎之大樣本族群，分析自1985年後農保開辦後所有農民被保險人，並與相同年齡、性別、鄉鎮別居住地區1：1配對的國人相比（皆為1,816,306人），具有全國農民代表性。結果發現現有的農民職業傷害範疇下，相較於國人配對組，疾病類殺蟲劑中毒為國人配對組的2.30倍風險（95%CI：2.16－2.45），其他特定氣體、燻煙和蒸氣之中毒意外為2.10倍風險（95%CI：1.99－2.22）。傷害類則以接觸農機具之意外傷害為2.42倍風險（95%CI：1.42－4.13），接觸含毒動物中毒意外為2.31倍（95%CI：2.17－2.47）。除了接觸含毒液動物中毒意外之外，各縣市在農藥中毒、特定氣體與蒸氣中毒和農機具受傷意外呈現一致性有風險較高的結果。最後，建議針對農藥中毒、特定氣體、燻煙和蒸氣之中毒、農機具之意外傷害與接觸含毒動物中毒意外，加強事前職業安全教育，讓農民先有職業安全保護意識，避免農民發生職業災害，如萬一發生職災時，農民也可以知道如何獲得相關權益的保障。

關鍵字

農民 ； 職業災害 ； 農藥中毒 ； 農機具安全 ； 含毒動物咬傷

並列摘要

Agricultural workers face many occupational exposures, resulting in many occupational injuries and diseases. However, most of the disasters in the workplace can be prevented. Strengthening prevention and advocacy for the priority of occupational disasters can not only avoid occupational disasters for farmers, but also reduce losing for agricultural labor compensate. However, the occupational injury insurance for farmers has just been piloted in Taiwan, and it is still not possible to completely understand the all types of occupational injuries and diseases that are needed to pay the priority attention. Therefore, the aim of this study is to explore the difference of the occupational injury between farmers and general population, and to discuss the consistency of occupational accidents among the main agricultural counties and cities. We used a large population-based study to analyze all the insured farmers since the start of the farmer insurance in 1985, and compared with the general population with the same age, sex, and the township (both n= 1,816,306). It was found that farmers have 2.30 times health risk (95%CI: 2.16-2.45) with pesticide poisoning compared to the general population. Other specific gas, smoke and vapor poisoning accidents are 2.10 times risk (95%CI: 1.99-2.22) relative to the general population. In the injury category, the accidents from agricultural machinery are 2.42 times risk (95%CI: 1.42-4.13) compared to the general population, and the relative risk of the accidents from poisonous animals' bites was 2.31 times (95%CI: 2.17-2.47). It is recommended to strengthen the pre-occupational safety education for pesticide poisoning, specific gas, smoke and steam poisoning, agricultural machinery safety and animal's bite poisoning. It will be helpful to avoid occupational disasters among farmers, and provide them with the information of obtain related rights and interests.

並列關鍵字

Farmers ； Occupational Disasters ； Pesticide Poisoning ； Agricultural Machinery Safety ； Poisonous Animal's Bite

參考文獻

Jawa RS, Young DH, Stothert JC, Yetter D, Dumond R, Shostrom VK, Cemaj S, Rautiainen RH, Mercer DW: Farm machinery injuries: the 15-year experience at an urban joint trauma center system in a rural state. Journal of agromedicine 2013, 18(2):98-106.

MacFarlane E, Carey R, Keegel T, El-Zaemay S, Fritschi L: Dermal exposure associated with occupational end use of pesticides and the role of protective measures. Safety and health at work 2013, 4(3):136-141.

Cliff K: Agriculture-the occupational hazards. Public health 1981, 95(1):15-27.

U.S. Bureau of Labor Statistics. Available online: http://www.bls.gov/news.release/pdf/osh.pdf. Accessed on January 15, 2013.; October 25, 2012.

Lower T, Rolfe M, Monaghan N: Trends and patterns in unintentional injury fatalities in Australian agriculture. J Agric Saf Health 2017, 23(2):139-151.