勞工職業性燒傷流行病學初探

The Epidemiological Study of Work-related Burn Injury in Taiwan-- A Preliminary Report

我國自1960年代開始現代化、工業化以來，職業傷病報告，層出不窮，儘速建立職業傷病監控系統，以確實掌握職業傷病，已是勞工安全衛生主管機關的共識。本計畫嘗試利用收集全國17家燒傷中心三年間之燒傷住院個案，分析整理燒傷原因，教育程度、年齡、性別與職業等因素，探討以此種方式建立我國勞工職業燒傷監控系統的可行性，結果如下：全國十七家醫學中心分佈全省北中南東四區，共有病歷5454份，調閱4751份，調閱率為87.11％，具有代表性，其中工作相關之燒傷個案有1201人（25.28％），男女比例為8.76:1。職業性燒傷以火燒傷、燙傷、化學燒傷及電傷最常見，共占96.34％，職業燒傷個案中，若是因電傷入院者63.83％為工作相關，因化學燒傷入院者45.63％為工作相關：職業燒傷半數以上（53.29％）發生於21～40歲之間，61.1％具有勞保身份，但也有17.6％為自費勞工，值得重視，燒傷勞工教育程度以高中，國小及國中程度共佔63.78％，職業燒傷事件最多的月份為7月，最少的月份為2月，燒傷住院後死亡率為2.5％，但若包括病情轉變自動出院者為推定死亡案例，則職業燒傷推定死亡率為9.16％。監控計畫是動員勞工安全衛生人力與整合各項資料的一門科學與藝術，本計畫經由與各燒傷中心醫療人員及病歷室管理人員之互動，藉由回溯燒傷個案病歷，充份溝通與瞭解我國各燒傷中心之職業性燒傷案例，不但可迅速瞭解過去三年職業性燒傷情況，更重要的是與各燒傷中心之人員建立了良好互動關係，約須三至五年逐步建立通報制度，即可初步建立我國職業性燒傷監控系統。

Because of the rapid industrialization and modernization of Taiwan since 1960, many work-related diseases were reported. For early recognition and management the Labor Safety and Health Authorities have a high consensus of establishing the Work-Related Injury and Disease Surveillance Program as soon as possible. In order to establish the work-related burn injury surveillance program, we cooperated with 17 burn centers islandwide to collect the discharge notes of admitted burn patients and analyzed the cause, educational level, age, sex and occupation from June 1989 to June 1992. The results are showed below: 5454 burn injury records were found from the register offices of 17 burn centers, of which 4751 records were collected. The sampling rate was 87.11%. It is quite representative because the burn centers are located islandwide. The number of work-related burn patients were 1201(25.28%), the male to female ratio was 8.76:1. Flame, scald, electrical and chemical burns were the four most common burn injuries(96.36%). Among them, 63.83% of electrical burn injuries and 45.63% of chemical burns were work-related. Over half (53.29%) of the work-related burn patients were between the ages of 21 to 40. Although 61.1% of the patients were covered by labor insurance, it is interesting to note that 17.6% workers paid the bills themselves. The educational level of work-related burn workers were high school (26.3%), junior high school (20.4%), and primary school (17.1%). The work-related burn events occurred mostly in July, and least in February. It is probably due to less working days in February and the influx of plenty new hands in July. The crude admission mortality rate (expired in hospital) was 2.5%. Supposing that those critical patients who discharges against advice did not survive, the estimated mortality rate of work-related burn injuries raised to 9.16%. Surveillance program is the science and art of mobilizing the safety and health workforce to target and solve a problem. Through this project we have a well interaction and mutual understanding with the first line staffs at different burn centers island wide. We believe that under good cooperation and well interaction with these staffs who are the sources of reports, the work-related burn injury surveillance program will be established step by step within five years.