台灣中部地區郵務士的職業傷害之流行病學調查

摘 要 本文主要探討郵務士在戶外工作時所面臨職業上的危害，包括結膜眼疾和 狗咬傷。本研究是屬於橫斷型研究，整個研究過程是配合1994年台灣中部 地區11個郵局的年度勞工體檢而進行，其研究對象為郵局受檢人員共394 人，其中郵務士248人，室內辦事員146人。研究方法是採問卷調查和眼科 學檢查的方式，詳實地記錄個人工作史、個人相關基本資料，以及經眼科 專科醫師診斷是否罹患結膜黃斑和眼翳。工作時陽光累積暴露的量化方式 是將戶外工作年資、平均每日戶外工作時數和眼鏡的使用情形納入考量。 研究結果為郵務士罹患結膜黃斑和眼翳的盛行率分別為62.9%和7.3%，務 士顯著地比 郵局室內辦事員較易罹患結膜黃斑和眼翳。應用邏輯 迴歸分析，經年齡調整後，陽光累積暴露量與結膜黃斑有顯著的關聯。郵 務士在戶外工作時每增加１年×小時/天的陽光暴露量，其罹患結膜黃斑 和眼翳的危險性分別增加2.09%和0.8%。在本研究亦發現，有71.7%的郵務 士曾在送信途中遭狗咬傷，且在鄉鎮地區遭狗咬傷的危險性是在都市地區 的2.8倍(95%信賴區間為2.1至3.4)。 長期陽光暴露對罹患結膜黃斑和眼翳有顯著的影響，且隨著陽光暴露量的 增加，其罹患結膜黃斑與眼翳之危險性亦隨之增加。所以郵務士在戶外工 作時，採取適當地保護眼睛的措施，以避免陽光曝曬，對郵務士而言似乎 相當重要。此外，在本文中亦發現，郵務士在送信途中的確存在著遭狗咬 傷的威脅。 關鍵字：狗咬傷，郵務士，結膜黃斑，眼翳，陽光

Epidemiological Investigation on Occupational Diseases among Postmen in Middle TaiwanAbstract To investigate the outdoor hazards including conjunctival disorders and dog bites of postmen, we undertook a cross- sectional survey of 394 employees (248 postmen and 146 officers) of post offices who worked in middle Taiwan. The subjects were investigated on the annual labor health examination in 1994. Pinguecula and pterygium were diagnosed by the ophthalmologist. Detailed personal and occupational information was obtained through a structured qustionnaire for each postman by considering the duration of their employment as postmen, the average working hours per day and spectacles use. Among the postmen, the prevalences of pinguecula and pterygium were 62.9% and 7.3%, respectively. There was a significant association between outdoor working as postman and the occurrence of pinguecula. There was a similar association for pterygium. Logistic regression analysis when adjusted for age showed a statistically significant association between cumulative occupational sunlight exposure and pinguceula. Whenthe cumulative occupational sunlight exposure increased one unit (one yr×hr/day), the risk of developing pinguecula and pterygium were raised 2.09% and 0.8%, respectively. It was also found that 71.7% of the postmen had the experience of dog bites during working. Postmen who worked in the rural areas had dog bites of 2.8 on odds ratio(95% confidence interval 2.1 to 3.4) when compared with postmen in the urban areas. We concluded that there are associations between chronic exposure to sunlight and the development of pinguecula or pterygium, which high-lighted the importance of ocular protection from sunlight. With the augmentation of cumulative occupational sunlight exposure, the risks of pinguecula and pterygium increase. Dog bites indeed threaten the postmen during working. keywords: dog bites, postmen, pinguecula, pterygium, sunlight