| Abstract: | 近年來科技業工程師、客運業駕駛、保全人員及醫師等工作者，接連發生過勞猝死之憾事，使「過勞死」之相關議題日益受到社會大眾的重視。依國際勞工組織(International Labour Organization，ILO) 2005年推估，循環系統疾病可因所從事職業的不同，其發生率高達23%，因此，本研究探討在醫院職場中推行職場過負荷防治方案，及實施健康管理措施後，對醫療從業人員是否有效改善職場疲勞及促進身、心健康。中部某醫學中心之全體員工(含護理、醫師、行政、醫事技術)為研究對象，以勞動部公佈之「異常工作負荷促發疾病預防指引」中，「職場疲勞量表」做為評估疲勞程度的工具。每個月加班時數納入「過負荷危害風險」評估，並計算「WHO十年內腦、心血管疾病風險」比例，綜整成為「職業促發腦心血管疾病風險」結果。共得有效樣本2746份(佔總員工數66%)，以2016、2017年分別為前、後測。在職場疲勞量表與過負荷危害風險具差異性，惟僅「WHO十年內腦、心血管疾病風險評估」未達統計性顯著差異。再針對2016年「職業促發腦心血管疾病風險」評估出，高度風險/需要面談有27個案例。經由勞工健康服務醫師至現場訪視，提供個別化健康改善建議，包含：諮詢、指導、衛教與促進活動之提供、調整工作時間或型態，及開立健康促進處方箋等。該27個案針對WHO十年內腦、心血管疾病風險評估，顯示具顯著性差異。換言之，可有效達到職場過負荷之預防。本研究結果可作為醫療院所領導者投入適當資源及營造職場安全健康之參考，亦是重要的職業安全衛生公共之議題。
Recently, a series of deaths of technology industry engineers, passenger transport drivers, security personnel and physicians catapulted over-labor death into the limelight. According to the International Labor Organization (ILO), the prevalence of occupational causes for circulatory diseases was 23% in 2005. Therefore, workplace overload prevention is introduced in the hospital workplace. This study is to evaluate the performance of implement of health management activity, which is to improve the medical practitioners of the workplace fatigue as well as physical and mental health.Taking all employees (including nursing, physician, administration, medical technology) of a Medical Center in Central Taiwan as the research object.The questionnaire tool, published by the Ministry of Labor, "Abnormal workload promoting disease prevention guidelines", is applied as workplace fatigue scale to measure fatigue levels of "personal-related overwork" and "work-related overwork". At the same time, the hours of overtime each month have put into the "overload hazard risk" assessment and calculated the risk rate of "WHO 10-year brain and cardiovascular disease". The overall results of "occupational brain and cardiovascular disease risk" obtain through comprehensive evaluation. There are 2,746 valid samples (66% of total employees) are analyzed and the pre- and post-measures of intervention measures is discussed.It shows that there are significant differences for "personal-related overwork" (p<0.05), "work-related overwork" (p<0.01), "overload hazard risk" (p<0.01), and "occupational brain and cardiovascular disease risk" (p<0.01). Meanwhile, after the intervention of the physician of labor health service who provides individualized health guidance and education with on-site visit. There are 27 employees, who with high-risk level possess the same results as mentioned above. In addition, the risk rate of "WHO 10-year brain and cardiovascular disease" has significant difference with p<0.01.The results could use as a reference for administration to improve or invest appropriate resources to create workplace safety and health. It is an important occupational safety and health issue as well. |
