台灣餐飲業勞工肌肉骨骼疾病之流行病學研究

背景：近年來肌肉骨骼傷病已成為職業病關注焦點，其成因包含攜帶重物、長時間重複動作、不自然的姿勢等，肌肉骨骼傷病會影響工作效率甚至使勞工中止工作。這些危隩因子在餐飲業中也很常見，但但尚未有文獻針對餐飲業者研究肌肉骨骼傷病發生率。目的:本研究目的在於分析餐飲業勞工與全人口之勞保與健保資料等資料庫，以了解餐飲業工作者中肌肉骨骼傷病標準化發生率比起全人口是否偏高。方法：本研究將進行回溯性流行病學調查，分析從勞動部勞工保隩局獲得的餐飲業工作者之勞保單位被保隩人檔，合併從行政院衛福部衛生福利資料科學中心所申請之全民健保處方及治療明細檔(門急診、住院)作為研究組，並且以全人口(全民健保承保檔)作為對照組進行比較分析。分析2000~2014 年間餐飲業工作者帄均年齡、工作年資、肌肉骨骼傷病種類粗發生率等，並比較研究期間內研究組及全人口發生肌肉骨骼疾病之標準化發生率。另外，也進一步分析不同細行業別與不同證照別之餐飲業者比起全人口的肌肉骨骼傷病標準化發生率。結果：餐飲業女性工作者高年齡層的肌肉骨骼傷病粗發生率高於同高年齡層之男性工作者。男性罹患關節部位、肩部肌肉骨骼傷病以及筋膜炎之風隩比全國男性20 歲至64 歲人口為高且達統計上之顯著;女性罹患頸椎部位、腰背部位、關節部位之肌肉骨骼傷病其風隩高於全國女性20 歲至64 歲人口且達統計上之顯著。餐飲業細行業別男性在 II 餐館業、非酒精飲料店業、餐食攤販業中罹患肌肉骨骼傷病之標準發生率高於全人口且具統計上顯著。餐飲業證照別部分無論男女在全證照類別餐飲業工作者比起全人口肌肉骨骼傷病風隩皆有顯著高風隩，其中男性持有烘焙食品證照者發生率最高，女性持有中餐烹調證照者發生率最高。結論：從各方面來看可以發現肌肉骨骼傷病在餐飲業發生確實顯著高於一般人口，期許未來相關政府單位能制定更完善的制度以及企業能提供更完善的個人防護措施或者教育課程來降低餐飲業工作者罹患肌肉骨骼傷病的發生率，給餐飲業工作者一個保障。

關鍵字

餐飲業勞工；職業性肌肉骨骼傷病；標準化發生率

並列摘要

Background：Musculoskeletal disorders (MSDs) have been the focus of occupational diseases in recent years. The causes include carrying heavy objects, repetitive movements for a long time, and unnatural postures. Musculoskeletal disorders affect work efficiency and even stop laborers from working. These risk factors are also common in the restaurant and food services industry, but there is no literature focus on this industry. Objective：Therefore, the purpose of this study is to analyze the labor insurance and health insurance data in order to understand the types and standardization incidence of musculoskeletal disorders among restaurant and food services industry workers. Method：This study was designed for retrospective epidemiological analysis for the restaurant and food services industries, using data from the labor enrollment registry, company profile, death registry and the National Health Insurance Administrative Claim from the Ministry of Health and Welfare Information Science Center database. Analyze the average age of catering workers, the number of years of work, and the crude incidence of musculoskeletal injuries in the period from 2000 to 2014, and compare the standardized incidence of musculoskeletal disease in the study group and the entire population during the study period. In addition, we compared the outcomes of metrics among different types of subindustries as well as different types of occupational licenses in the restaurant and food services industries. Result：The higher incidence of musculoskeletal disorders among female workers was higher than that of male workers of the same age group. The standardized incidence rate of common occupational musculoskeletal injuries, back disorders in male workers is higher than the national population of male aged 20 to 64; As to female workers, the standardized IV incidence rate of common occupational musculoskeletal injuries, lower back disorders , cervical spine disorders also higher than the national population of female aged 20 to 64. The standardized incidence rate of musculoskeletal injuries in the male who works in the restaurant industry, non-alcoholic beverage stores, and food and beverage industry is higher than that of the national population and is statistically significant. Regardless of having licenses, the standardized incidence rate of musculoskeletal injuries in the restaurant and food services industry workers.is higher than national population. Among them, males have the baked food licenses and female have Chinese cooking licenses are highest. Conclusion：from all aspects, it can be found that musculoskeletal disorders in the restaurant and food services industry are indeed significantly higher than the general population. It is expected that government units can develop a more complete system to reduce the incidence of musculoskeletal disorders among restaurant and food services industry workers.