Ho Jiune-Jye, Hwang Jing-Shiang, Wang Jung-Der
College of Public Health, National Taiwan University, No 17, Hsu-Chow Road, Taipei, Taiwan, R.O.C.
Scand J Work Environ Health. 2006 Apr;32(2):91-8. doi: 10.5271/sjweh.984.
This study attempts to estimate life expectancy and explore the determinants of survival for workers with permanent occupational disabilities.
A database on permanent occupational disabilities occurring between 1986 and 2000 was linked with the national death registry database to construct the survival function. A method with Monte Carlo simulation was used to extrapolate survival for up to 600 months to derive the life expectancy for different disability grades (N=81249). A Cox (proportional hazard) regression was carried out to explore the determinants and to estimate the hazard ratios. Demographic variables, including age, gender, insured wage, severity of disability, injury causes, and organ-system disability, were included in the model as covariates.
The results indicate that the survival period for workers suffering permanent occupational disabilities is shorter than that of the general population, amounting to an estimated loss of life expectancy ranging from 5 to 19 years. After adjustment for age and gender, a higher severity of disability, impairment of vital organs or lower extremities, and a lower insured wage had a significant association with shorter survival. Injury types, including transportation incidents, being struck by sliding objects, or a trip, slip or stumble, and collapse injury, indicated hazard ratios of between 1.24 and 1.34, as compared with injuries such as being trapped or caught in machinery.
The findings identify major determinants for predicting survival for workers with permanent occupational disabilities; these determinants may be of use in improving the equity of the compensation system for workers.
本研究旨在估算永久性职业残疾工人的预期寿命,并探究其生存的决定因素。
将1986年至2000年间发生的永久性职业残疾数据库与国家死亡登记数据库相链接,以构建生存函数。采用蒙特卡洛模拟方法外推长达600个月的生存情况,以得出不同残疾等级的预期寿命(N = 81249)。进行Cox(比例风险)回归以探究决定因素并估算风险比。人口统计学变量,包括年龄、性别、参保工资、残疾严重程度、受伤原因和器官系统残疾,作为协变量纳入模型。
结果表明,永久性职业残疾工人的生存期短于普通人群,估计预期寿命损失为5至19年。在对年龄和性别进行调整后,较高的残疾严重程度、重要器官或下肢损伤以及较低的参保工资与较短的生存期显著相关。与被困或卷入机器等伤害相比,包括交通事故事故、被滑动物体撞击、绊倒、滑倒或跌倒以及坍塌伤害等伤害类型的风险比在1.24至1.34之间。
研究结果确定了预测永久性职业残疾工人生存情况的主要决定因素;这些决定因素可能有助于提高工人赔偿制度的公平性。