職業性眼睛外傷調查及預防策略之研究-以某醫學中心為案例

Invertigation and Prevention of Occupational Ocular trauma in Kaohsiung City- a hospital based study

顏雅琳(Ya-Lin Yen)

指導教授 ： 何啟功

高雄醫學大學/健康科學院/職業安全衛生研究所/碩士(2005年)

摘要

研究目的：造成眼睛外傷成因之研究發現大多是因職業因素而造成，對於國家與雇主而言：會造成經濟競爭力的損失，對於勞工個人而言，更可能會導致家庭經濟陷入困境的問題，此已形成就業安全政策與國家勞動資本的一大隱憂。本研究目的在探討、評估眼睛外傷危害之現況及預防職業性眼睛外傷發生。
研究方法:I.描述型研究：為瞭解職業性眼睛外傷危害之現況，收集自90年1月至93年12月於高雄某醫學中心眼科住院治療病患，以病歷回顧探討職業性眼睛外傷與非職業性眼睛外傷之差異。並針對職業性眼睛外傷之個案以電話訪視進行問卷調查探討外傷發生之狀況。II.為探討作業勞工工作中相關安全衛生規範及安全衛生認知與行為對眼睛外傷發生之影響，本研究利用個案組及對照組進行相關安全衛生規範執行和勞工安全認知與行為之評估，個案組收集自職業性眼睛外傷之個案共計31位；對照組則選取與個案組之相同性別、年齡（±5歲）、及類似的行業別，個案組及對照組比例為1:2。
結果：I.描述型研究：189位（38.9%）職業性眼睛外傷之個案與297位（61.1%）非職業性眼睛外傷個案進行比較分析，結果發現職業性其年齡與受傷住院治療所花費的醫療費用，職業性眼睛外傷個案皆高於非職業性眼睛外傷個案。職業性眼睛外傷之調查部份發現，個案受傷類型以穿刺傷害的比例居多，大多都是以男性為主（91.5%），其教育程度是以高中職畢業居多（48.4%），工作內容則從事建築營造業為最高（33.9%），其工作年資大於十年為主（38.7%），職業性眼睛外傷病患以承攬作業勞工或是臨時工佔多數；在安全衛生防護的使用狀況，72.6%的傷者在工作中沒有配戴任何安全眼鏡，其大多數的勞工自覺工作不需要配戴任何安全防護具而暴露於發生眼睛外傷之危險性中。II.作業勞工工作中相關安全衛生規範及安全衛生認知與行為對眼睛外傷發生之影響研究結果發現，相關安全衛生規範執行對於眼睛外傷的發生具有顯著差異；安全衛生規範執行上也顯示沒有執行者以承攬商員工或臨時工居多。安全認知與行為調查的部份，個案組與對照組在工作安全、眼睛防護及一般公眾安全認知與行為方面，顯示兩者間分佈相同並無顯著差異。
結論與建議:建築營造業工作者所暴露之工作環境及工作條件是造成眼睛外傷主要原因之一，且大部分勞工對安全眼鏡的使用上不重視，公司與事業單位也並無強制使用安全眼鏡，因此增加眼睛外傷嚴重度。故我們根據此研究結果建議在工作中強制配戴安全眼鏡是預防眼外傷之有效方法，而對於小規模公司及契約工也應積極持續辦理安全衛生宣導與教育訓練，提升勞工安全衛生認知，以確實降低職業災害。

關鍵字

安全認知與行為 ； 職業性眼睛外傷

並列摘要

Objective: Epidemiologic studies reveal that the causes of most ocular traumas are occupation- related. Such occupation-related ocular trauma (OOT) is a potential threat to the policy of occupational safety and the national labor capital. It also results in injury of workers, loss of productive power and increase of social cost. The purposes of this study are to evaluate the situation of OOT and find out the methods to prevent OOT.
Methods: I. First, in order to understand the condition of OOT, we collected ocular trauma cases hospitalized in a medical center of Kaohsiung city from January 2001 to December 2004. After the cases were conferred the difference of OOT and non-OOT, they were interviewed (or telephoned) with questionnaires including epidemographic data, types of injury, places and times of injury, employee-/work-related awareness, risk factor and safety measurement, including the use of protection goggles. II. Second, with a case-control study, we evaluated workers’ acknowledgement of work safety, eyes protection, as well as the perception and behavior of safety and health of working environments. We collect 31 OOT patients in the case group, and the 62 controls with age and sex match.
Results: I. Totally, 486 patients were obtained for chart review. Within these cases, there were 189 patients who were OOT（38.9%） while 297（61.1%） patients who were non-OOT. The mean age of the patients in the OOT and non-OOT was 40.5 years old and 36.5 years old（p=<0.001）, respectively. The mean hospital stay was 8.3 days for the OOT and 8 days for the non-OOT（p<0.05）. The final visual outcome of the patients with OOT was poor（<0.1 was 24.3%,<0.8 was 21.6%）.The mean of hospitalization cost for OOT is relatively higher than non-OOT.
Among 189 OOT cases, 62 patients （62/189） were selected and interviewed. The main type of OOT cases was penetrating injuries. Of them are male（91.5%）, high school educated（48.4%），construction worker（33.9%）and working years over ten years（38.7%）. Of these OOT, 72.6% cases do not wear safety glasses. Most OOT cases are from small enterprise with workers number below 30 or contract employees. Hot weather, inconvenience and low perception of risk incur the attitude of not wearing glasses. II. The results show that case group is worse than control group in compliance of regulations of safety and health. Multivariate analysis indicated who worked received job safety and health training or other safety and health regularly by employers were at low risk of experiencing eye injuries. After re-grouping, it reveals most contractors and floaters are no compliance with related regulations. There are no significant difference between case and control group in work safety, eyes protection, as well as the perception and behavior for the general.
Conclusions and suggestions: Construction workers who are exposed to multiple hazards may get eye injuries at work. Enforcement of wearing protective glasses is the only way to avoid ocular trauma at workplace. It is necessary for those contract companies or contract workers to promote and continue education for increasing the perception of safety and health in order to reduce occupational disasters.

並列關鍵字

occupational ocular trauma ； safety perception and behavior

參考文獻

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