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題名:石綿暴露工作者的職業健檢:職業醫學專科醫師的觀點
書刊名:臺灣公共衛生雜誌
作者:蕭汎如陳宗延李俊賢鄭雅文
作者(外文):Hsiao, Fan-juChen, Chung-yenLee, Lukas Jyuhn-hsiarnCheng, Yawen
出版日期:2018
卷期:37:1
頁次:頁24-33
主題關鍵詞:石綿職業病職業醫學專科醫師職業健檢AsbestosOccupational diseasesOccupational health physiciansOccupational health examination
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
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  • 點閱點閱:13
目標:職業健檢機制的制度缺失之一,為特殊健檢的對象僅限在職者,因而難以早期偵測潛伏期漫長的職業病。有鑑於職業醫學專科醫師(職醫)在職業健檢制度中扮演重要角色,本研究以石綿相關疾病為例,探討職醫對於石綿作業工作者離職後健檢機制必要性、可行性與影響的觀點。方法:研究者在2017年1月至8月間個別訪談15位職醫,訪談主題為:(1)對於目前石綿作業特殊健檢機制的看法,(2)對於建立職業石綿暴露工作者離職後追蹤檢查機制的看法。結果:受訪者都同意現有的職業健檢制度無法對職業石綿相關疾病發揮提早偵測的功能,因此有必要改善。然而,受訪者對於建立石綿職後健檢機制持有疑義,可歸納為以下五個面向:(1)界定石綿暴露工作者的困難,(2)確認石綿暴露的困難,(3)缺乏合適的篩檢工具與專業判讀人員,(4)缺乏明確的財源機制與配套措施,(5)可能引發道德危害疑慮。結論:受訪的職醫皆同意政府應針對石綿暴露工作者建立職後健檢機制,並同意其他可能導致職業病罹病風險的職業危害也應比照,然而在執行層面上之制度設計與配套措施,仍需就上述問題作進一步研商。
Objectives: One of the many shortcomings of the current occupational health examination (OHE) system in Taiwan is that only on-the-job workers are eligible to participate, making it difficult for the early detection of workers who develop occupational diseases with long disease latencies. We used occupational asbestos-related diseases (OARDs) as an example to explore the opinions of occupational health physicians (OHPs), who play important roles in the OHE system, regarding the necessity, feasibility, and potential impact of post-exposure OHEs involving asbestos-exposed workers. Methods: Fifteen OHPs were interviewed individually during the period from January to August 2017, with questions on the following two themes: (1) opinions about the current OHE system for asbestos-exposed workers; and (2) opinions on the establishment of post-exposure OHEs for asbestos-exposed workers. Results: All of the interviewees agreed that the current OHE system fails to detect OARDs, thus reforms are needed; however, the interviewees had concerns regarding the establishment of a post-exposure OHE system, which were summarized in the following 5 dimensions: (1) problems of identifying asbestos-exposed workers; (2) difficulties in verifying asbestos exposure; (3) uncertainty in choosing a suitable screening tool and in ensuring qualified personnel; (4) lack of financial resources and administrative support; and (5) problems of moral hazards. Conclusions: All of the interviewed OHPs agreed that the establishment of a post-exposure OHE system is needed, not just for asbestos-exposed workers, but for workers exposed to other types of hazardous substances with long disease latencies. To design the system and its implementation procedures, more discussions are needed, especially with respect to the aforementioned issues.
期刊論文
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2.Collegium, Ramazzini(2016)。The 18th Collegium Ramazzini statement: the global health dimensions of asbestos and asbestos-related diseases。Scand J Work Environ Health,42,86-90。  new window
3.Sen, D.(2015)。Working with asbestos and the possible health risks。Occup Med (Lond),65,6-14。  new window
4.Carton, M.、Bonnaud, S.、Nachtigal, M.(2011)。Postretirement surveillance of workers exposed to asbestos or wood dust: first results of the French national SPIRALE Program。Epidemiol Prev,35,315-323。  new window
5.蕭汎如、鄭雅文、李俊賢(20170400)。石綿暴露工作者的職業健康檢查制度與惡性間皮瘤監測機制:國際經驗與臺灣現況。臺灣公共衛生雜誌,36(2),187-196。new window  延伸查詢new window
6.Hung, Mei-chuan、Lai, Wu-wei、Chen, Helen H. W.、Lee, Jenq-chang、Lin, Yih-jyh、Hsiao, Jenn-ren、Cheng, Ya-min、Shan, Yan-shen、Su, Wu-chou、Wang, Jung-der(20160800)。Cost Effectiveness of Cancer Treatment in Taiwan。Journal of the Formosan Medical Association,115(8),609-618。  new window
7.Tossavainen, A.(2010)。Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution。Scand J Work Environ Health,23,311-316。  new window
8.張火炎(19880900)。臺灣地區石綿工廠工業衛生普查。中華民國公共衛生學會雜誌,8(3),161-171。  延伸查詢new window
9.Wolff, H.、Henrik, T.、Oksa, P.、Rantanen, J.、Vainio, H.(2015)。Asbestos, asbestosis, and cancer, the Helsinki criteria for diagnosis and attribution 2014: recommendations。Scand J Work Environ Health,41,5-15。  new window
10.張火炎(19880300)。臺灣地區石綿工廠空氣中石綿濃度測定。中華民國公共衛生學會雜誌,8(1),28-35。  延伸查詢new window
11.葉慧容、毛義方、陳美蓮、陳連輝(20031200)。以相位差顯微鏡法測定石綿工廠周界環境空氣中石綿濃度之研究。嘉南學報. 科技類,29,184-192。  延伸查詢new window
12.Chang, H. Y.、Chen, C. R.、Wang, J. D.(1999)。Risk assessment of lung cancer and mesothelioma in people living near asbestosrelated factories in Taiwan。Arch Environ Health,54,194-201。  new window
13.Ahrens, W.、Jockel, K. H.、Brochard, P.(1993)。Retrospective assessment of asbestos exposure--I. Case-control analysis in a study of lung cancer: efficiency of job-specific questionnaires and job exposure matrices。Int J Epidemiol,22(Suppl 2),S83-S95。  new window
14.Orlowski, E.、Pohlabeln, H.、Berrino, F.(1993)。Retrospective assessment of asbestos exposure--II. At the job level: complementarity of job-specific questionnaire and job exposure matrices。Int J Epidemiol,22(Suppl 2),S96-S105。  new window
15.Choi, S.、Kang, D.、Park, D.、Lee, H.、Choi, B.(2017)。Developing asbestos job exposure matrix using occupation and industry specific exposure data (1984-2008) in Republic of Korea。Saf Health Work,8,105-115。  new window
16.Kauppinen, T.、Toikkanen, J.、Pukkala, E.(1998)。From crosstabulations to multipurpose exposure information systems: a new job-exposure matrix。Am J Ind Med,33,409-417。  new window
17.Ollier, M.、Chamoux, A.、Naughton, G.、Pereira, B.、Dutheil, F.(2014)。Chest CT scan screening for lung cancer in asbestos occupational exposure: a systematic review and metaanalysis。Chest,145,1339-1346。  new window
18.Świątkowska, B.、Szeszenia-Dąbrowska, N.、Wilczyńska, U.(2016)。Medical monitoring of asbestos-exposed workers: experience from Poland。Bull World Health Organ,94,599-604。  new window
19.萬文隆(20040501)。深度訪談在質性研究中的應用。生活科技教育月刊,37(4),17-23。  延伸查詢new window
圖書
1.International Labour Organization(1997)。Technical and Ethical Guidelines for Workers' Health Surveillance Report。Geneva:ILO。  new window
其他
1.Furuya, S.,Takahashi, K.,Movahed, M.,Jiang, Y.。National asbestos profile of Japan (ILO/WHO),http://envepi.med.uoeh-u.ac.jp/NAPJ.pdf。  new window
2.Health and Safety Executive(2017)。Guidance for appointed doctors on the Control of Asbestos Regulations,http://www.hse.gov.uk/pubns/ms31.htm。  new window
3.BAuA(2017)。National asbestos profile for Germany,https://www.baua.de/DE/Angebote/Publikationen/Berichte/Gd80.pdf?__blob=publicationFile。  new window
4.Hazardous chemicals requiring health monitoring,https://www.safeworkaustralia.gov.au/system/files/documents/1702/hazardous-chemicals-requiringhealth-monitoring.pdf。  new window
圖書論文
1.李俊賢、鄭雅文、蕭汎如、王榮德(2017)。台灣的石綿危機。《致命粉塵》:石綿疾病,工業發展史中的職業病風暴。台北:社團法人台灣職業安全健康連線。  延伸查詢new window
2.鄭雅文、鍾佩樺、蕭汎如、李俊賢、王榮德(2017)。職業病被個人化的台灣社會。《致命粉塵》:石綿疾病,工業發展史中的職業病風暴。台北:社團法人台灣職業安全健康連線。  延伸查詢new window
3.胡幼慧、姚美華(1996)。一些質性方法上的思考:信度與效度?如何抽樣?如何收集資料、登錄與分析?。質性研究:理論、方法及本土女性研究實例。巨流圖書股份有限公司。  延伸查詢new window
 
 
 
 
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