我國職業性皮膚疾病的通報成果與挑戰

Reporting of Occupational Skin Diseases in Taiwan and its Challenges

職業性皮膚疾病是重要的職業病，一般情況下不會致命或導致失能，但是盛行率高，而且大多能預防與控制。分析國內職業傷病防治中心及其網絡醫院所通報的職業性皮膚疾病個案，以探討我國職業性皮膚疾病的流行情況，並討論我國職業疾病通報系統面臨的挑戰。依據2006年至2013年的職業性皮膚疾病通報資料，分析並探討其人口學特徵與其他變項的分布情形。2006年至2013年我國職業性皮膚疾病通報個案數逐年增加，通報系統的電子化提升了通報率。罹病勞工的職業前三名分別為餐飲22.1％，機械維修與洗床機械、五金加工10.7％，以及美髮美體推拿8.6％。現有通報系統收集的資料有限，通報來源分布不均，對於高危險因子與勞工族群的辨識、疾病的預防與控制策略的擬定等用途幫助有限。建議重新審視職業性皮膚疾病通報系統的通報內容，修訂通報資料欄位，並提升通報誘因，才能獲得更有用的通報資料。

Background: Occupational skin diseases are important occupational diseases. The diseases are not often fatal nor often lead to disability, but the prevalence rates are high. However, the diseases are preventable and controllable most of the time. Objectives: To describe the epidemiology of occupational skin diseases in Taiwan based on the data from the Taiwan's occupational injury and disease notification system and discuss challenges that the system is facing. Methods: We obtained the data on occupational skin diseases from Taiwan's occupational injury and disease notification system between 2006 and 2013 and study the distributions of demographic characteristics and other variables of the cases. Results: The reported cases of occupational skin diseases in Taiwan have been increasing from 2006 to 2013. The use of the electronic reporting system has greatly improved the reporting rate. Occupations with the highest rates of occupational skin diseases are catering (22.1%), mechanical maintenance, milling machines, and metal processing (10.7%), and hairdressers and cosmetologists (8.6%). Conclusion: The data reported through the system are sufficient, and the sources of reporting are unevenly distributed. Consequently their use is limited in the identification of risk factors and high risk occupations, development of prevention and control strategies, etc. In order to obtain more useful reporting data, we suggest reviewing the information reported, modifying revise the reporting form, and increasing the incentives.