營造職災因果關係與影響模型之發展

Development of Construction Accident Causation and Influence Model

臺灣傳統的職業災害預防方法主要注重在立法規定雇主應設置和採取之職業安全衛生（以下簡稱職安衛）設備和措施並予以執法，以減少工作者之危害暴露。這些減災方法包括檢查、提出誘因、宣導和輔導，以提高營造業利害關係人的能力和強調其責任。儘管這些方法有助於降低職災發生率，但它們缺乏藉由高階控制層級來實施職災的因果分析，以進一步的預防職災。本文從職安衛控制層級、現有的職災因果關係模型理論、臺灣營造業職災死亡報告書分析、以及對工程設計考量工作者安全之問卷調查分析結果等得出結論，對營造業提出概念性但具實用性的職災因果關係與影響模型（Accident Causation and Influence Model, ACIM）。ACIM由起源影響、貢獻因子及職業災害所組成，起源影響是職災貢獻因子的性質、程度和存在的高階決定因素，在工程開始時，它們可以作為職災的安全預防措施；貢獻因子可以協助識別死亡職災的發生。起源影響會相互作用並影響貢獻因子，各貢獻因子會依序的相互影響並導致職業災害的發生；另本文中的2個職災個案研究用於說明和測試ACIM。ACIM展示職災發生的方式和原因，因此預期ACIM可增加對職災因果過程的暸解、有助於對職災進行系統性的調查、並提供有效的職災預防措施之指導。

The traditional approaches to accident prevention in Taiwan concentrated on prescribing health and safety equipment and measures and enforcing them to decrease workers' exposure to hazards. These accident mitigation approaches included inspections, motivations, promotion, and guidance to improve and highlight stakeholders' competence and liability. Although these approaches have contributed to the reduction of accident rates, they have lacked accident causation analysis by high-level hierarchy of controls to further prevent accidents. This paper draws findings from the hierarchy of controls, existing accident causation model theories, construction fatality reports in Taiwan, and the results of survey about Design for Construction Worker Safety; a conceptual but practical model-the Accident Causation and Influence Model(ACIM)has been proposed for the construction industry. ACIM is composed of ''Originating influences'', ''Contributing factors'', and ''Occupational accidents''. The Originating influences are the high-level determinants of the nature, extent and existence of contributing factors of accidents. They can serve as a safety precaution in accident prevention at the beginning of projects. Contributing factors can help identify the occurrence of fatality accidents. Originating influences interact and affect Contributing factors, and Contributing factors influence each other in sequence and lead to Occupational accidents. Two case studies in the paper were used to illustrate and test the ACIM. ACIM demonstrates how and why accidents happen and is thus expected to improve the understanding of the accident causation process, to aid in the systematic investigation of accidents, and to provide guidance on effective accident prevention measures.