人因性肌肉骨骼傷害的防制流程落實於產業界之探討

A Study in the Implementation of Ergonomics-related Musculoskeletal Disorder Prevention in Industry

劉柏毅

指導教授 ： 游志雲

國立清華大學/工學院/工業工程與工程管理學系/碩士(2014年)

摘要

本研究目的在提議一個可以使事業單位落實人因性肌肉骨骼傷害防制計畫的方法，由於工作負荷所促發的肌肉骨骼傷害在工業化社會中是相當普遍且嚴重的，肌肉骨骼傷害所造成的損失工作天案件，占所有職業傷害案件數的比例都在30%以上。面對如此衝擊，是各先進國家急欲解決的職業安全衛生問題。我國在2013年時修訂職業安全衛生法，明訂雇主應妥善規劃以避免重複性作業促發肌肉骨骼傷病之發生。因此，為了協助全國事業單位都能順利配合法規與有效提升人因工程意識的普及，以落實肌肉骨骼傷害防制計畫，需要一套通用性高的防制流程。
為了發展一套簡易通用的肌肉骨骼傷害防制流程，將參考先進國家常見的防制作法並結合我國過去人因改善技術研究，一般常見的防制作法是經由一套完整的流程，使用人因工程檢核表或是簡易式表單。基本的流程有以下程序：分析工作現場、確認危害因子、人因工程工作危害分析、控制危害因子、實施控制計畫等，人因工程檢核表則有KIM, RULA , OCRA, HAL-TLV等。我國發展的人因改善技術，分為四步驟執行: 現況觀察、危害分析、改善方案與預估改善績效。
我們上述這些方法，整合設計了一套人因性肌肉骨骼傷害防制流程，包含下列四步驟：(一)調查肌肉骨骼傷害、(二)自主化改善、(三)進階改善、(四)管控與追蹤。第一步驟是肌肉骨骼傷害的調查，找出有高危害風險的員工來進行改善，第二步驟是自主化改善，一般可改善約七成簡單的案例，較複雜的案例，再由第三步驟，也就是安衛人員與安衛主管負責的進階改善來執行，最後經過改善後的案例需進行追蹤，沒有問題的員工仍需納入管控，以達持續改善。
而回顧過去自主化人因工程改善機制的相關研究時，發現其關鍵的改善方案一覽表應用在過去案例，通用比率不如預期的七成。因此，根據歷年訪視成果來擴充自主化檢核表，並加入人因改善原則。結果能到達自主化改善預期之七成以上，有助自主化改善技術在使用上的普及，以利推廣全員參與防制職場肌肉骨骼傷害。

關鍵字：人因性肌肉骨骼傷害、肌肉骨骼傷害防制流程、自主化改善

關鍵字

人因性肌肉骨骼傷害 ； 肌肉骨骼傷害防制流程 ； 自主化改善

並列摘要

The objective of this study is to propose an implementation guideline for industry in the prevention of ergonomic-related musculoskeletal disorders. In developed countries, ergonomic-related musculoskeletal disorders significantly impact the labor, the industry, as well as the society. To lower such an impact, most countries put much effort in implementing all sorts of measures for the prevention of ergonomic-related musculoskeletal disorders, and so does Taiwan. In 2013, the Occupational Safety and Health Act was revised by adding a clause ‘the employer is required to carefully plan and to take necessary safety and health measures to prevent musculoskeletal disorders due to repetitive strain injury’. To assist the employer to take practical measures in confirming the law, an easy-to-follow implementation guideline should be devised.
To devise such an easy-to-follow implementation guideline, the measures commonly used in developed countries and the intervention techniques developed in Taiwan are integrated. The common measures are process flow, ergonomic assessment checklists, and easy-to-follow checklist. The process flow basically consist of the following steps, such as: analyzing the workplace, identifying risk factors, ergonomics job hazard analysis, controlling risk factors, implementing controls, and etc... Ergonomic assessment checklists may be KIM, RULA, OCRA, HAL-TLV, and the like. The intervention techniques is characterized as 4 steps: “work observation,” “risk assessment,” “design improvement”; and “pre-evaluation”.
The aforementioned contents were integrated into a prevention guideline, which consists of 4 steps: (1) investigation of musculoskeletal disorders, (2) simple intervention, (3) advance intervention, and (4) control and follow-up. The first step is to identify the workers of high risk for ergonomic intervention. The second step is to intervene a large portion (e.g. 70 %) of common, simple and typical ergonomic hazards. Advance intervention is to be carried out by HSE personal with ergonomic training to perform complete intervention. Control and follow-up is to control the health of the workers and follow up those which have been intervened.
In addition, among this guideline, the most critical element is the ease-to-follow checklist used in simple intervention. The checklist is drawn with 40 simple, self-explanatory illustrations of works and workplaces, with a risky scenario on the left, and an improved scenario on the right. By checking into the checklist, the worker is able to identify risk factor, and adopt the improved suggestion. Nevertheless, it is found the checklist is only fit 52 % of workplace scenarios. Therefore in order to raise its coverage more than 70%, the checklist is extended to 60 scenarios using previous data. After extended, it is able to fit 84% of workplace scenarios. The checklist will be a power tool for the intervention of a large portion of workplaces with WMSD hazards.

Keywords： Ergonomics-related musculoskeletal disorder, Musculoskeletal disorder prevention technique, Musculoskeletal disorder prevention procedure

並列關鍵字

Ergonomics-related musculoskeletal disorder ； Musculoskeletal disorder prevention technique ； Musculoskeletal disorder prevention procedure

參考文獻

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