台灣與先進工業化國家的事業單位肌肉骨骼傷害防制流程比較

A Comparison in the Procedure of Musculoskeletal Disorder Prevention in Industry between Taiwan and Industrialized Countries

彭文政

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在職專班/碩士(2014年)

摘要

勞工的肌肉骨骼傷害情形相當普遍與嚴重，因此先進工業國家均發展與推廣很完善的防制流程。肌肉骨骼傷害不僅危害勞工的健康，同時也會降低公司生產力，增加社會成本。為了消除以及降低並且預防肌肉骨骼傷害，各國的安全衛生組織極力推廣各種以人因工程技術改善工作場所的肌肉骨骼傷害的防制流程。
本研究透過比較美國、英國、澳洲以及我國的肌肉骨骼傷害防制流程的優缺點，從而改進我國的流程。各國所提出的流程大體上可以歸納為：觀察工作現場發現有肌肉骨骼傷害的工作站，分析作業動作判斷危害因子的，針對危害因子提出人因工程改善方案，以及改善後的績效評估。結果顯示，美國的優點在於人因工程警覺檢核表可快速判定優先改善順序；英國的優點是對於抬舉的荷重、力量與頻率有明確的快速篩選機制；澳洲的優點則是利用二階段的勾選式圖形化檢核表粗篩與確認危害因子，以及邏輯化的改善流程。這三個國家共同缺點：在作業現況說明中並未詳細列舉相關的作業描述、設施佈置、工作站配置圖…等相關作業空間資訊，要找出危害因子必須具備相當程度的人因工程專業知識，比較不適合一般事業單位的安全衛生人員；在改善方案方面，美國的缺點在於改善方案的構想是還必須依靠有改善經驗的人員，英國則是稍有針對問題點提出改善方案的雛形，但是還欠缺完整的改善思考邏輯，澳洲則是有整個改善架構但還欠缺較有具象化的改善設計模型。我國的優點在於現況說明除了可以能夠充分的描述作業，並將這些資訊與數據結合成一個有關聯、有組織的作業描述，讓人明瞭這個作業的情形，在改善方案的構想自訂出一個循序漸進的改善方案發展的流程圖，並且搭配圖形化的表單，以供改善者按圖索驥。
台灣的改善流程圖比較完整，也比較邏輯，使用門檻較低，只要簡短的訓練，一般工安人員可以輕易上手。然而可以再加強的地方是融入英國的抬舉荷重與頻率的篩選圖、澳洲的問題檢核表。

關鍵字

肌肉骨骼傷害 ； 肌肉骨骼傷害防制技術 ； 肌肉骨骼傷害改善流程

並列摘要

Work-related musculoskeletal disorder (WMSD) is a common occupational disease in industrialized countries, it affects the worker’s health, decreases productivity, and increases significant social cost. In order to prevent WMSDs, almost all countries have established many WMSD prevention procedures are established by health and ergonomics bodies aiming at worksite improvement based on ergonomics principle to be used on WMSDs prevention practice in the field. This thesis compared the pros and cons of the prevention procedures in literatures, like governmental publication, and internet web pages of the US, UK, Australia, and Taiwan, and in a hope to come up with good recommendation for Taiwan. The prevention procedures from these countries basically consists of 4 steps: from worksite observation in assessing WMSD incidence, diagnosing risk factors based on information gathered in observation, proposing improvement design against identified risk factors, and a follow-up procedure for post-improvement evaluation. The result shows that the U.S. procedure is good at its ergonomics awareness checklist which is able to determine improvement priority quickly; the UK is good at its ‘work filter’ which can screen out unfavorable force, posture, and repetition for lifting operation quickly and efficiently; the Australia are good at its two-step screening mechanisms, initial screening and risk factor confirmation, and logical improvement alternatives generation. The common drawback of these three countries: the worksite observation does not guide the observers to record complete and sufficient information, such as facility layout, work pieces and tools, and the worker’s characteristics, operation and task description, and so forth. They demand significant ergonomics knowledge to identify risk factors, and therefore not suitable for field health and safety engineers (HSE). In worksite improvement, the US strongly requires experienced engineer expertise; the UK is a better off by providing simple rules of thumb toward specific risk factor individually, but there is no systematic approach, in other words, improvement alternatives cannot be generated logically. Although, the design alternatives of Australia are presented in logical manner, they are not presented visually. The procedure of Taiwan has a better improvement procedure, it consists of a pick-and-choose flow chart and 3 SOP worksheets which assists the practitioner in recoding complete worksite information in an easy fashion, identified risk factors with certain, proposing all possible improvement alternatives logically, and finally evaluates the effectiveness of improvement efficiently. In all, Taiwan has a slightly better improvement procedure , it is more logical and demands less ergonomic expertise, and therefore, only with a brief training, HSE personnel can do it DIY. Nevertheless, to make it more user-friendly for HSE personnel in the field, it is suggested that a ‘work filter’ of the UK and the two-step checklists of Australia are fused into the Taiwan procedure. Keywords：Work injury, WMSD, CTD, Musculoskeletal disorder, prevention technique , Musculoskeletal disorder Improvement Procedure , Ergonomic technique

參考文獻

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