台灣外籍勞工猝死原因之分析

Abstract

自民國 78 年正式開放申請外籍勞工引進以來，猝死時有所聞，為 得知外勞猝死的死因，本研究採回溯性研究，蒐集民國八十九年一月 到民國九十四年十二月，六年間在法務部法醫研究有接受死因調查和 屍體解剖之鑑定案例資料。納入條件為1. 在二十四小時內被目擊證人發現死亡的案件；或是證人看見死者死亡前經過且送醫不治的案件。2.在司法相驗時無法判定死亡方式者。3.經過司法解剖確定死亡原因且有完整毒物學檢查。共有210 個案件納入分析，其中猝死的為143 個，意外死亡的為63 個，未分類的有4 個。在猝死中，男性有117 位，女性有26 位。國籍來說，泰國有66％，菲律賓有17％，印尼有11％，越南5％，柬埔寨有1％，緬甸1％。年齡介於 19-59 歲，發生最高峰為25-44 歲的壯年族群，死亡地點，最多為醫院54％，其次宿舍有34％。器官系統影響最多的為心臟血管系統有66％，神經系統有9％，呼吸系統有8％和成人猝死症候群SUDS 有6％。以單一死亡型態來說，依次為心肌病變，佔猝死中的35.7％，冠狀動脈疾病11.2％，心臟傳導系統問題和成人猝死症候群SUDS5.6％。在台灣外勞的猝死粗死亡率（每十萬人）為，94 年7.9，93 年5.7，92 年4.998。而心臟猝死的心臟重量（387.99±87.46 公克）比非心臟猝死的心臟重量有顯著差異（p＜0.05），至於成人猝死症候群SUDS 的心臟重量（346.13±30.9公克）與心臟猝死的心臟重量則無顯著差異（p＞0.05）。本研究發現臺灣外籍勞工的猝死死亡率。而死因大多為心臟病變，而又以心肌病變最多。對於入境時的健檢應可考慮加上特殊心臟檢查，以提高日後雇主對於勞工健康狀態的注意。 至於意外死亡，發生最多的為落水溺斃，佔了 22％，其次為窒息死亡和高處落下各佔9.5％，這也提供相關單位未來對外勞意外預防提供了一個方向。

The foreign workers in Taiwan have begun to arrive in 1989. Since then there are many problem about sudden death among foreign workers. This retrospective study is to review medicolegal autopsy cases of sudden death about foreign workers in Taiwan from the record of Institute of Forensic Medicine, Ministry of Justice. The cases were collected from January 2000 to December 2005. The criteria of accepted for analysis were：1. eye-witness persons being alive within last 24 hours or the deceased was witnessed to die. 2. inability to determine the manner of death after scene investigation. 3. by forensic autopsy including complete toxicological analysis. There are 210 cases were discussed, 143 sudden death, 63 accident death and 4 undetermined. In sudden death cases, there were 117 men and 26 women. The nationality were Thailand 66%, the Philippines 17%, Indonesia 11%, Vietnam 5%, Combodia 1% and Myanmar 1%. Their age ranged from 19-55 years old, and the peak was at 25-44 middle age group. The most common site of death was hospital(54%), the second was the dormitory(34%). The cardiovascular system(66%) was most common cause of death of organ systems, other were neurological system(9%), respiratory system(8%), Sudden Unexplained Death Syndrome（SUDS）(6%) in order. In sudden cardiac death, Cardiomyopathy was leading cause of death(35.7%), and coronary disease(11.2%), heart conducting system problem(6%) and Sudden Unexplained Death Syndrome(6%) in order. The natural sudden death of mortality rate in foreign workers in 2005 was 7.9, in 2004 was 5.7, in 2003 was 4.998. The heart weight of sudden cardiac death(SCD) were 387.99± 87.46gm, compare to non-SCD group was significantly(p<0.5)；The heart weight of Sudden Unexplained Death Syndrome(346.13±30.90) compare to SCD group was not significantly. We know the natural sudden death of mortality rate of foreign workers in Taiwan. Most cause of death was cardiomyopathy. The health examination of foreigner should take special cardiac examination into account to let employer pay attention to their foreign workers. Besides, accident death was mostly drowning(22%), the second were suffocation and falling. These also give us a hint to prevent foreign worker’s accident.