Determination of Respiratory Disability in Taiwanese Coal Miners

吸入煤塵會造成煤礦工塵肺症，而塵肺症會損害呼吸功能。當呼吸功能減低到一定程度時，患者的工作能力及日常活動就會受到限制。呼吸功能檢查在塵肺症時之功能損失的評定上非常重要。為瞭解目前台灣煤礦工之呼吸障害等級的狀況，吾人對125位由勞保局轉介來院申請呼吸功能檢查之煤礦工進行肺量測定及肺瀰散量測定。結果發現：胸部X光片上無塵肺症跡象者43位，其肺量測定均為正常；單純塵肺症患者68位，其中31位(45.6%) 之肺量測定符合勞保局呼吸障害標準，若再加上肺瀰散量測定，則有另外7人符合標準；至於進行性重度纖維化患者其肺量測定全部符合標準，而且其中88.4%的患者至少有2項肺量參數達到標準。本文的結論是：除肺量測定外，單純塵肺症患者值得另外加作肺瀰散量試驗，而進行性重度纖維化患者則無此必要。

關鍵字

煤礦工塵肺症；呼吸障害鑑定；肺量測定；肺瀰散量測定

並列摘要

Coal workers’ pneumoconiosis (CWP) is a common occupational lung disease which may be associated with demonstrable pulmonary impairment and can potentially cause disability in miners exposed to coal dust. To promote a better understanding of respiratory disability among Taiwanese coal miners, and to estimate their ventilatory function, conventional spirometry and tests for diffusing capacity (DLCO) were conducted on 125 working or retired miners who had been referred to the hospital by the Bureau of Labor Insurance. Our results show that the 43 miners without radiological evidence of pneumoconiosis had normal ventilatory capacity, and 31 out of the 68 (45.6%) subjects with simple CWP had spirometric indices meeting the extant criteria for disability. Seven additional disabled miners were detected as the result of supplementing DLCO measurement. All of the 14 miners with progressive massive fibrosis (PMF) met the spirometric criteria for disability. Among them, 12 (88.4%) had more than 2 indices of ventilatory capacity that would qualify the subjects for disability benefits. We conclude that it may be worthwhile to carry out DLCO measurement, in addition to spirometry, in workers with simple CWP who are claiming disability compensation, while this is unnecessary for miners with PMF.

並列關鍵字

coal workers' pneumoconiosis ； determination of respiratory disability ； spirometry ； measurement of diffusing capacity

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