職業粉塵相關疾病與其政策因應：台灣近年經驗

Occupational dust-related diseases and policy responses: Taiwan’s recent experience

因新興產業製程出現，粉塵導致的職業性肺部疾病案例增加。本文回顧台灣近年病例報告、流行病學研究、近年職災保險給付統計，並盤點主管部門對此議題的政策因應。以關鍵字搜尋2014年至2024年間台灣學者針對粉塵疾病發表的中英文醫學病例報告與流行病學文獻，檢視近年職業病通報及職災保險統計數據，並蒐集以勞動部職業安全衛生相關機構發布的新聞稿、指引、報告書、宣傳品等資料進行檔案分析。在2014-2024間，台灣學者針對職業性肺部疾病發表24篇醫學病例報告，涵蓋29名案例；罹病者從事的產業類型多元，近期案例則以人造石產業勞工居多。在此期間另針對職業性肺部疾病發表12篇流行病學研究，大多以健保、勞保與醫院病歷資料為材料，分析罹病者地理分佈、高風險產業、趨勢變化、罹病者的共病與預後狀況。職業性肺部疾病的職災給付件數變化幅度大，近年呈現下降趨勢，而整體而言，職災給付件數遠低於流行病學數據。勞動部依據《職業安全衛生法》訂有粉塵危害預防相關規範，政府職業安全衛生部門近年亦積極回應人造石粉塵危害，針對粉塵危害高風險產業進行調查與介入。職業健康學界與勞動主管部門關注職場粉塵危害與其健康風險，然而政策手段能否有效預防職業粉塵疾病，仍有待進一步探究。

The advancement of manufacturing processes has led to the emergence of new occupational dust-related diseases. This systematic review was conducted to review current studies, analyze workers’compensation statistics and policy responses by occupational health authorities regarding occupational dust-related diseases. Data were collected from peer-reviewed medical case reports and epidemiological studies published in Chinese and English by researchers in Taiwan between 2014 and 2024. Workers’compensation statistics from 2000 to 2024 were analyzed. An archival analysis was performed using press releases, official guidelines, reports, and educational materials issued by Taiwan’s Ministry of Labor. Between 2014 and 2024, researchers in Taiwan published 24 medical case reports documenting 29 cases of dust-related diseases among workers from diverse industries, with contemporary cases predominantly occurring in those engaged in the artificial stone industry. During the same period, 12 epidemiological studies were published. These studies were conducted primarily using national health insurance records, labor insurance data, and hospital medical records to identify geographic patterns, high-risk industries, temporal trends, comorbidities, and disease prognoses. The numbers of occupational lung disease cases and compensation claims fluctuated but exhibited a downward trend in recent years. Overall, compensation cases were far fewer than epidemiological data. The Ministry of Labor have issued multiple administrative orders and guidelines on dust hazards under the Occupational Safety and Health Act. Occupational safety and health departments have also actively addressed artificial-stone related hazards through investigations and interventions in high-risk industries. The occupational health community and labor authorities are concerned about dust exposure in the work place and its health implications. However, their effectiveness in preventing dust-related diseases requires further evaluation.