塵肺在臺灣和中國大陸發生的情況及其意涵

Prevalence of Pneumoconiosis in Taiwan and Mainland China and Its Implications

本文討論二十世紀中葉以來塵肺症在臺灣和中國大陸發生的情況。塵肺症成為法定職業病在中國大陸始於1957年，在臺灣始於1958年。在近六十年間，塵肺症一直是臺灣和中國大陸職業病的最大宗，約佔職業病總數的70－80％。在2007年中國大陸累積塵肺病例達627,405例，是全世界塵肺病例最多的地區。在臺灣，塵肺症相關的調查研究始於1950年代初，但一直以個案研究為主，尚未有全面性的調查研究。塵肺症出現在各行業中，但除矽肺和石綿肺外，臺灣大多數的塵肺病例歸類為礦工塵肺。中國大陸於1987－1990年間進行第一次全國塵肺流行病學調查，以後持續有全國性的塵肺病例統計，各省區也有不少調查研究。在分類上，中國大陸列為法定職業病的有12種塵肺，相關的行業分為15個系統，各地區塵肺的種類分布因工業重點而異。近年在中國大陸雖已採用治療塵肺的技術和藥物，然而，塵肺是不可逆的、慢性而持續發展的疾病，要控制塵肺病的繼續發生，除醫藥治療外，更重要的是藉著早期病兆的發現立即停止暴露，並且積極改善環境及加強勞工職業衛生和安全措施，以達到預防的效果。

This paper discusses the prevalence of pneumoconiosis in Taiwan and Mainland China since the mid-twentieth century. Pneumoconiosis was legally recognized as an occupational disease in Mainland China in 1957 and in Taiwan in 1958. During the past sixty years, the incidence of pneumoconiosis always ranked top among various occupational diseases in both Taiwan and Mainland China, constituting a share around 70-80% of all occupational diseases. In 2007, the cumulative cases of pneumoconiosis reached 627,405 in Mainland China, the highest incidence around the world. In Taiwan, survey research on pneumoconiosis began in the early 1950s, with most works being case studies. There has not been any comprehensive survey conducted. Pneumoconiosis is prevalent in various occupations. In Taiwan, except for the few cases of silicosis and asbestosis, the majority of cases were classified as 'miner's pneumoconiosis'. In Mainland China, the first nation-wide epidemiological survey of pneumoconiosis was conducted in 1987-1990, followed by several national statistical reports thereafter. Moreover, in 1987, pneumoconiosis was legally classified into 12 categories and the distribution of these categories varied with both localities and industries. In recent years, new technologies and medicines have been adopted in Mainland China for treating pneumoconiosis. However, as pneumoconiosis is chronic and lasting disease with no cure yet, it is more important to improve the occupational environment and safety measures for preventing and controlling further prevalence of this disease.