農業從業者職業傷害保險相關之傷病分析

Analysis of Injuries and Illnesses Associated with Occupational Insurance among Agricultural Farmers

農業從業者面臨許多職業暴露，衍生諸多職業傷害與職業病。然而，職場上的災害大都是可以防範的，針對職業災害優先順序加強預防宣導，不但可以避免農民發生職業災害，更可減少農業勞動力及罹災農民之補償損失。但目前農民職業災害保險剛試辦，即便內容對於因果關係明確的「職業傷害」進行保障，仍無法有效了解優先關注與預防之職業傷病類型。因此，本研究目的為探討農民在目前的職災給付規範下，農民職業災害保險保障之「職業傷害」與一般國人之差異情形，以及從主要農業縣市來探討該職災事故的一致性。本研究使用以國家基礎之大樣本族群，分析自1985 年後農保開辦後所有農民被保險人，並與相同年齡、性別、鄉鎮別居住地區1:1 配對的國人相比（ 皆為1,816,306 人），具有全國農民代表性。結果發現現有的農民職業傷害範疇下，相較於國人配對組，疾病類殺蟲劑中毒為國人配對組的2.30 倍風險（95%CI: 2.16-2.45），其他特定氣體、燻煙和蒸氣之中毒意外為2.10 倍風險（95%CI: 1.99-2.22）。傷害類則以接觸農機具之意外傷害為2.42 倍風險（95%CI: 1.42-4.13），接觸含毒動物中毒意外為2.31 倍（95%CI: 2.17-2.47）。除了接觸含毒液動物中毒意外之外，各縣市在農藥中毒、特定氣體與蒸氣中毒和農機具受傷意外呈現一致性有風險較高的結果。最後，建議針對農藥中毒、特定氣體、燻煙和蒸氣之中毒、農機具之意外傷害與接觸含毒動物中毒意外，加強事前職業安全教育，讓農民先有職業安全保護意識，避免農民發生職業災害，如萬一發生職災時，農民也可以知道如何獲得相關權益的保障。

Agricultural workers face many occupational exposures, resulting in many occupational injuries anddiseases. However, most of the disasters in the workplace can be prevented. Strengthening prevention andadvocacy for the priority of occupational disasters can not only avoid occupational disasters for farmers,but also reduce losing for agricultural labor compensate. However, the occupational injury insurance forfarmers has just been piloted in Taiwan, and it is still not possible to completely understand the all typesof occupational injuries and diseases that are needed to pay the priority attention. Therefore, the aim ofthis study is to explore the difference of the occupational injury between farmers and general population,and to discuss the consistency of occupational accidents among the main agricultural counties and cities.We used a large population-based study to analyze all the insured farmers since the start of thefarmer insurance in 1985, and compared with the general population with the same age, sex, and thetownship (both n= 1,816,306).It was found that farmers have 2.30 times health risk (95%CI: 2.16-2.45) with pesticide poisoningcompared to the general population. Other specific gas, smoke and vapor poisoning accidents are 2.10times risk (95%CI: 1.99-2.22) relative to the general population. In the injury category, the accidentsfrom agricultural machinery are 2.42 times risk (95%CI: 1.42-4.13) compared to the general population,and the relative risk of the accidents from poisonous animals' bites was 2.31 times (95%CI: 2.17-2.47). Itis recommended to strengthen the pre-occupational safety education for pesticide poisoning, specific gas,smoke and steam poisoning, agricultural machinery safety and animal's bite poisoning. It will be helpfulto avoid occupational disasters among farmers, and provide them with the information of obtain relatedrights and interests.