北部礦工、石工之比例死亡比研究

A Proportionate Mortality Study of Coal-Miners and Stone -Workers in Northern Taiwan

煤礦的發展在台灣已有相當長的歷史，但因為煤層的品質不佳、工作環境不良，使得礦工的健康受到相當的影響。雖然政府有關單位已自民國七十年代中期開始輔導礦工轉業，但是塵肺症在近五年（76-80年）來還是一個申請職業病補償案例最多（362/421）的職業病，可見曾從事礦業工作人員的健康問題十分嚴重。在台灣，關於礦工塵肺症或其肺功能的橫斷性研究不少，但缺乏整體性的世代研究。因此，目前勞委會勞工安全衛生研究所正委託慢性病防治局著手進行「礦工世代之建立及其世代追蹤之先驅研究」。本研究即是以比例死亡比（PMR）的研究方法來初步了解北部礦工、石工死亡情形，以作為未來的世代研究之先趨指標。結果發現在七年（74-80年）間，台灣北部（北縣與基隆市）男性居民共死亡50,671人，其中礦工、石工死亡人數共1,003人（平均年齡：58.7歲）。因呼吸器官系疾病死亡的礦石工有162人，與當地非礦石工居民的死亡原因分布進行比較後也發現因呼吸疾病死亡的比例死亡比最高（PMR-233），其他的比例較高的死因包括：傳染病及寄生蟲病方面死亡75人（PMR-158）、意外災害死亡181人（PMR-141）等，此結果與國外文獻報告類似。本研究所描述的各種疾病死因之發生情形，顯示出礦工與石工的健康情形值得重視。雖然目前從事礦坑工作的人數已減少，但是基於對已轉業或退休礦工的健康照護責任，建立一個完整的礦工世代作追蹤研究，以進一步估計對這些曾從事礦業人口的健康照護資源需求是有其重要性的。

With a poor quality of coal mine and inadequate equipment of mining industry, the working condition in mines has been unsatisfactory. In Taiwan, since the first documented pneumoconiosis cases reported in 1950s, pneumoconiosis has became the leading cause of claims to the real benefit payments for occupational diseases to the Labor Insurance in recent years. Although several studies had been focused on pulmonary function of miners, and prevalence of pneumoconiosis with relation to dust exposure, there was no large-scale cohort study to address the overall health problems of miners. To fill up this gap, the Institute of Occupational Safety and Health and the Taiwan Provincial Chronic Disease Control Bureau are initiating a historical cohort study to study the health status of ex-coal-miners. This study, as a pilot study to provide a preliminary estimation of the size of the health problems for the project, using the proportionate mortality ratio (PMR) approach, is to examine the causes and numbers of deaths of miners and stone workers in northern Taiwan. From 1985 to 1991, a total of 50,671 males deaths were registered in Taipei and Keelung counties. Among them, 1,003 deaths (mean age of death: 58.7) had a job code as ‘miner and stone worker’. By comparing to other residents in the same area, the proportionate mortality ratio (PMR: 233, n=162) for the respiratory diseases of ‘miners and stone workers’ was the highest among causes of deaths, followed by deaths from ‘infectious and parasitic diseases’ (PMR: 158, n=75) and ‘injury and poisoning’ (PMR: 141, n=181). These results are compatible with other studies. With an increased risk for respiratory diseases, and the large number of deaths of ‘miners and stone workers’ occurred in these years, the findings of this study urge a comprehensive follow-up study to address this problem more clearly. Although the mining industry is no longer important in Taiwan's economy, a responsible health care for retired miners or stone workers is still needed.