鑄造業勞工健康危害狀況分析

The Analysis of Healthy Hazards for Foundry Workers

鑄造業號稱「工業之母」，台灣鑄造業年產值高達840億台幣，從業人員多暴露於高溫、噪音、非游離輻射及含結晶型游離二氧化矽之粉塵等危害工作環境，且多屬中小型企業，雇主投入大量資金改善設施環境有其困難性，使得勞工健康危害風險不容忽視。過去多篇研究指出鑄造業勞工為罹患矽肺症之高風險族群之一，惟我國對所有鑄造業勞工罹患矽（塵）肺症之實況尚未有一全貌，特規劃利用現行勞保與健保資料庫瞭解鑄造業勞工罹患矽（塵）肺症現況，利於勞動部進行後續防治策略之規劃與推動。本研究串檔分析勞保資料庫之2000~2011年職災給付檔並未發現鑄造業勞工因塵肺症或矽肺症申請給付個案。串檔分析2001~2011年健保資料庫發現，鑄造業勞工因塵肺症或矽肺症進行就醫的盛行率分別為1.98/每千人、0.12/每千人，發生率為0.06~0.38/每千人、0.0~0.11/每千人，就醫者在研究期間工作年齡均以45~60歲占6-7成；4-5成勞工均在工作5年以上就醫確診。建議未來應結合健保資料庫加強對特別危害健康作業勞工之健康與職業病進行監測，並建立通報系統加強個案管理；職安署宜針對離職後之鑄造業勞工賡續提供健檢服務與追蹤管理，並優先以「其他金屬加工用機械製造修配業」、「未分類其他機械製造修配業」、「鋼鐵鑄造業」等三大業別廠家為對象，輔導其落實定期勞工暴露評估、辦理特殊健康檢查、防護具使用及教育訓練等預防措施。

The foundry industry is known as 'the mother of industries.' There are more than NTD 84 billion annual value of production in Taiwan. The working environment of foundry industry is full of high-temperature, noise, non-ionizing radiation, free silica and other dusts. Since most foundry plants in Taiwan belong to small and medium enterprises, they are less willing to invest large amount of money to improve the aforementioned environmental hazards, which in effect causes the working environment to degenerate. Thus, the health of workers in the foundry industry is worth further discussion and understanding. Studies have thus far indicate that workers in the foundry industry are among the high-risk groups suffering from silicosis, but there is no clear picture on the actual situation of workers suffering from silicosis in the foundry industry. The purpose of this study is to use the existing database to analyze the situation of workers suffering from silicosis, estimate their risks, and provide prevention strategies for workers in the foundry industry. Data from the Bureau of Labor Insurance between 2000 and 2011 indicates that no foundry worker had been hospitalized or had applied for benefits due to pneumoconiosis or silicosis. However, the National Health Insurance data reveals that the prevalence rates for foundry workers seeking medical attention due to pneumoconiosis or silicosis are 1.98 per thousand and 0.12 per thousand, respectively, while incidence rates are 0.06-0.38 per thousand and 0-0.11 per thousand, respectively. 60-70% of those who sought attention for pneumoconiosis and silicosis are aged 45 to 60 during the study period; 40-50% of workers sought medical attention for pneumoconiosis and silicosis after 5-10 years of foundry work. We recommend that future health insurance databases can be combined to strengthen the monitoring of workers’ health condition and occupational disease, and to establish a notification system to strengthen case management. Also, the Occupational Safety and Health Administration of Ministry of Labor is to continue to provide health examination services and track workers who have left the industry, and to give priority to counsel the steel foundry industry in their implementation of exposure assessment, special health examination, protective equipment and education and training.