臺灣外籍勞工胸部X光篩檢肺結核之成效

Efficacy of Chest X-rays for Screening Pulmonary Tuberculosis for Alien Workers in Taiwan

外籍勞工入境時及隨後每年都要到指定醫院進行身體檢查，以確保身體健康，沒有感染結核。這個政策行之有年，它的成效如何？自2001至2002年共有外藉勞工80325人在本院作體檢，以標準的胸部X光片（14”x17”）作為肺結核的篩選檢查，並分別由兩位專科醫師判讀。判讀報告分兩類：（1）若X光片上發現有開放性肺結判定為不合格；（2）若胸部X光片呈現其他異常者，尤其無法確定是否「假影」造成疑似肺結核等，則需覆檢。結果顯示不合格的病例計64人；胸部X光呈現其他異常者有192人，覆檢後不合格的病例數有9人；兩年不合格病例共計73人（平均0.091%）。不合格率僅比全台灣地區2001年肺結核病的盛行率0.065%稍高卻遠比這些外藉勞工原居留地的發病率低3-9倍。其中入境時體檢不合格率為0.124%，較本地盛行率稍高。而工作滿六個月接受體檢的不合格率為0.081%，已與本地役男體檢的不合格率相近。我們認為這個政策具有實質的成效。

Abstract: Alien workers are obligated to receive health examination when they enter Taiwan and were followed up each year before they leave. Chest x-rays are used to screen for pulmonary tuberculosis. Although this policy has been carried out for years, the efficacy of chest x-rays screening has seldom been reported. Between 2001 and 2002, there were 80325 alien workers received annual health examination in our hospital. We used standard chest films (14”X 17”) for screening pulmonary tuberculosis for these alien workers. Interpretation of the x-rays were categorized into two types: (1) Failed case was defined as radiographic findings suggesting open pulmonary tuberculosis; (2) Cases with other lung anomalies, including artifacts, were called back for repeated x-rays and re-analysis. Our screening results revealed that 64 workers were categorized as failed cases. 192 workers were found with other lung anomalies initially, nine of them were re-classified as failed cases after call-back for confirmation. Therefore, a total of 73 alien workers (0.091 %) were categorized as failed cases. Of these, the failed cases at entry accounted 0.124% that was higher than that in their countries; 0.081% failed cases were diagnosed in 6 month after entry that was similar to the prevalence of the pulmonary tuberculosis among military conscripts in Taiwan. The overall prevalence of pulmonary tuberculosis of alien workers was slightly higher than that of the Prevalence (0.065%) in Taiwan, but much lower than that in their countries. Our data may suggest the successfulness of this policy.