事業單位職業健康管理人員對於職業傷病補償與職業健康促進之看法

Abstract

背景與目的：事業單位內部的職業健康管理人員是職業健康服務制度的重要角色，但常面臨來自雇主及勞工的雙重壓力，不僅需居中協調災後選工復工之問題，尚須負責推行職場健康促進活動面臨各方壓力。本研究旨在探討職業健康管理人員的困境與角色衝突，以及對於過勞相關職業病的預防與補償之看法。 方法：本研究以半結構式面訪收集資料。共訪談14位事業單位職業健康管理人員(包含職護、職安人員、健康管理顧問)。 結果：本研究共分以下五大主題呈現：第一主題為事業單位職業健康管理人員在職場中的工作定位，研究發現，受到企業文化與管理制度影響，其角色的影響力有強弱之差別；第二主題為事業單位職業健康管理人員對於企業員工健康的看法，發現僅2位事業單位職業健康管理人員認為整體員工健康還不錯，1位認為尚可，其餘人員皆認為員工健康狀態不佳，而三高（高血壓、高血脂、高三酸肝油脂）是每位職業健康管理人員都特別關注的健康問題；第三主題為不同企業體之職災情形，所有事業單位職業健康管理人員皆提及通勤職災與工作時間交通意外，而依企業的型態不同又會有其特定的職業傷病；第四主題為工作者申請公傷病假與職業傷病補償之概況，又分為三小節，分別討論申請者理由的合理性、工傷病假與復工的爭議及對於過勞職業傷病的看法；第五主題為職場健康促進的現況與困境，發現現行職場健康促進之推行活動以減重比賽、運動課程最為普遍，而主管不支持、員工不參與活動、經費有限是造成健康促進窒礙難行的原因。 結論：事業單位職業健康管理人員在執行業務時所面臨的困境，與整體企業文化、管理制度密切相關，而事業單位職業健康管理人員自身的職業認知及現行法律政策，也與其密不可分。

Background and purpose: Occupational health managers play an important role in occupational health system. However, they often face pressures from both the employer and the workers. They are the mediators in the return-to-wok process of injured workers, and also the initiators of workplace promotion activities, thus may face pressure from different sources. This study was designed to explore their work conditions, difficulties encountered at work and potential role conflicts, as well as their attitudes toward the prevention and compensation of overwork-related occupational diseases. METHODS: This study collected data through semi-structured interviews. A total of 14 occupational health managers (including occupational health nurse, occupational health and safety professional, and health management consultants) were interviewed. RESULTS: The study was divided into the following five themes. The first theme was about the position of the occupational health managers in the workplace. Findings showed that their functions were influenced by corporate culture and management system. The second theme was about their evaluation of workers’ health in their company. It was found that two occupational health managers considered their workers had good health, one considered their workers had fair health, while the rest considered their workers had poor health. Hypertension, hyperlipidemia and diabetes were the main health concerns mentioned by all the occupational health managers. The third theme was about the types of occupational injuries. All of the interviewed occupational health managers mentioned the occurrence of commuting injuries and traffic accidents occurring during working hours. According to the type of industry, they also have industry-specific occupational injuries. The fourth theme was about the utilization of general sickness benefits and workers’ compensation sickness benefits. This part was further divided into three sub-sections, including: their views on the appropriateness of workers’ application, disputes concerning the application of sickness leave and return to work, and their views specific on over-work related health problems. The fifth theme was about workplace health promotion activities they promoted and obstacles they encountered. The most commonly held workplace health promotion activities were weight loss and exercise programs. Lack of supervisors’ support, lack of active participation of employees, and lack of financial resources were cited as major obstacles. Conclusion: Difficulties faced by occupational health managers of enterprises were closely related to the corporate culture and management system, and were also related to their own perception of the work role and legal framework and policies.