臺灣農民特定疾病盛行率之健保資料庫比較分析

Comparative Analysis of Disease Prevalence among Taiwanese Farmers Using Health Insurance Database

我國農民的職業失能傷害頻率歷年均相對較高，雖現已有農民職業災害保險制度與已相當程度的保障，然在農民職業病的認定上，仍有待更多的研究，本研究嘗試透過全國性的資料庫分析，掌握農民確實具較高風險之疾病做為未來相關研究可關注之重點。本研究以健保資料庫中的身分屬性區分農民與一般國人，鎖定腫瘤、眼睛、皮膚、骨骼肌肉等4個疾病系統，進行比較分析，比較農民相對一般國人是否在特定疾病上有較高的患病風險。我國農民在全國性與農業人口前6多的縣市（臺南市、彰化縣、高雄市、臺中市、屏東縣、雲林縣），結果顯示有6種疾病之勝算比高於一般民眾，具體為口底惡性腫瘤、骨關節病及有關疾患、其他背部疾患、肢體之其他後天性變形、脊柱彎曲、其他後天性變形。我國農民相對一般國人，在特定疾病上有更高的患病風險。口底惡性腫瘤或許與其個人的不良生活習慣（如吸菸、飲酒）有關，然有待更多的研究證實。而骨骼肌肉疾病的部分，或可結合過往針對農民骨骼肌肉疾病的研究推測，係因農民從事農作時可能長時間暴露於各種職業衛生危害因子中所導致。

The disabling injury frequency rate among farmers in Taiwan has remained relatively high over the years. Although there is now“Farmer Occupational Insurance”that provides considerable protection, more research is needed to identify occupational diseases among farmers. This study attempts to analyze national databases to identify diseases with higher risks among farmers, which can serve as focal points for future research. This study used the National Health Insurance Database to distinguish farmers from the general population based on their occupational attributes. It focuses on four disease systems: neoplasms, eyes, skin, and musculoskeletal disorders. Comparative analyses are conducted to determine whether farmers have a higher risk of specific diseases compared to the general population. In Taiwan, farmers in the top six counties and cities with the largest agricultural populations (Tainan City, Changhua County, Kaohsiung City, Taichung City, Pingtung County, Yunlin County) have a higher odds of six diseases compared to the general population. These diseases include malignant neoplasm of the mouthfloor, osteoarthritis and related disorders, other back disorders, other acquired deformities of the limbs, spinal curvature, and other acquired deformities. Farmers in Taiwan have a higher risk of certain diseases compared to the general population. The higher incidence of malignant neoplasm of the mouth floor may be related to personal unhealthy habits (such as smoking and drinking), but further research is needed to confirm this. As for musculoskeletal disorders, it can be inferred from previous studies on farmers’musculoskeletal diseases that these may be caused by prolonged exposure to occupational during farming activities.