職業健康服務制度乃是國家勞動保護制度中重要的一環；其中，健康檢查與偵測不僅可積極地預防職業疾病的發生，也是促進雇主改善工作環境的重要依據；勞工健康檢查的資料，也是流行病學探究因果關係以及政府發展職業傷病防治策略的基礎。我國職業健康服務制度自1974年「勞工安全衛生法」頒布以來已有30多年歷史，但此制度問題重重，未能充分發揮上述功能。我國制度沿襲自日本，而日本制度又深受西方工業國家影響，因此，考察先進國家制度發展過程與精神有其必要。本文回顧歐美與日本職業健康服務制度之歷史緣起與內容，並回顧國際勞動組織有關職業健康服務之相關報告書所彰顯的制度精神，接著我們回顧台灣職業健康服務制度的發展沿革，並分析檢討目前制度現況，最後對現行制度提出改善建議。從國際制度的發展歷程與制度內容可發現，雇主責任乃是職業健康服務制度的核心原則，而政府政策是否積極介入，以及勞工是否積極參與，乃是該制度能否發揮保護勞工功能之關鍵。

A system of occupational health services is required by the nation's labor protection provisions. Use of data from routine health examinations and surveillance is meant to provide empirical evidence for proactively preventing work-related illness and improving working conditions. Occupational health data also serve as the basis for epidemiologic research that evaluates the link between work hazards and health outcomes, as well as for the development of adequate occupational health policies. The system, in Taiwan, which has been operational since the implementation of the Occupational Safety and Health Act in 1974, has been criticized as problematic and poorly functioning. In this paper, we first reviewed the historical development and principles of occupational health services in Western countries as well as in Japan (as the current system in Taiwan used the Japanese system as a model, which in turn was greatly influenced by Western experiences). We also reviewed related documents published by the International Labor Organization. Finally, we reviewed the development of Taiwan’s system, examined its current condition, and proposed some recommendations for its improvement. On the basis of this review, we conclude that the occupational health service system imposes on employers the responsibility to protect the health of their employees. Nevertheless, enforcement of this obligation is greatly determined by the extent of government’s involvement and workers' participation.

職業健康服務;職場健康檢查;歷史沿革;國際比較

occupational health services, workplace health examination, historical development, international comparison