檢視職業傷害的趨勢、分布與社會不平等：勞保現金給付之分析

Trends, distribution, and social inequality of occupational injury: analysis of labor insurance compensation data

目標：社會經濟地位可能影響職業傷害風險，然而台灣對此議題的探討仍不多。本研究旨在檢視職業傷害的近年趨勢、分布與社會不平等現象。方法：分析2016至2018年間勞保職業災害現金給付資料，比較不同性別、年齡、投保薪資、投保單位與產業之職業傷害發生率。結果：2016至2018年間有30,809,863投保人年，共發生1,617件致死性及150,026件非致死性職業傷害|平均致死性及非致死性職業傷害發生率分別為每十萬人年5.25及486.94件。非致死性職業傷害發生率有下降趨勢，但通勤事故佔比為36.3％且比例有上升趨勢。不論是致死性與非致死性職業傷害，男性均顯著高於女性，而60歲以上及20歲以下顯著高於其他年齡層。投保薪資最高的族群，職業傷害發生率最低，但投保薪資與職業傷害發生率之相關未呈現階層化分布。依產業類型分析，可發現營造業的致死性與非致死性職業傷害發生率最高，運輸倉儲、農林漁牧及土石礦業的致死性職業傷害發生亦顯著偏高。結論：勞動主管機關應檢視職業安全保護措施，並針對高風險族群加以改善，有關投保薪資與社會經濟地位之關聯則需進一步探究。（台灣衛誌2020|39(3)：326—336）
Objectives: Workers' socioeconomic positions may influence the risk of occupational injury. However, in Taiwan, research on this issue remains limited. This study examined the recent trends, distribution, and social inequalities of occupational injury. Methods: We obtained data from the workers' compensation insurance during 2016–2018. Incidence rates of occupational injuries were compared by gender, age, level of insured salary, employment type, and industry. Results: From 2016 to 2018, 1617 fatal and 150,026 no nfatal occupational injury benefit claims were granted in 30,809,863 insured person-years. Incidence rates of fatal and nonfatal occupational injuries were 5.25 and 486.94 per 100,000 person-years, respectively. Although the incidence rates of fatal occupational injury were declining, the proportion of commute injury accounted for 36.3% of total occupational injury claims, and this proportion was increasing steadily. For both fatal and nonfatal occupational injuries, men and those aged >60 or <20 years had a significantly high risk. Those in the highest salary bracket had the lowest incidence of occupational injury, but no apparent pattern was observed between insured salary and occupational injury rate. However, construction workers showed significantly high incidences of both fatal and nonfatal occupational injuries. Workers in transport, logistics, and primary industrial sectors, including agriculture, fishery, forestry and mining were also observed to have high incidence rates of fatal occupational injuries. Conclusions: Labor authorities should examine and improve regulations and measures for occupational safety and health protection, particularly for high-risk groups. In addition, the relationship between insured salary and socioeconomic position deserves further research. (Taiwan J Public Health. 2020|39(3):326-336)