背景：輪班、夜間工作、長時間工作等異常工作負荷所導致因疲勞或工作壓力促發之 腦心血管疾病逐漸被重視，勞動部職業安全衛生署(職安署)於2013年7月3日公布修正後的職 業安全衛生法，明定雇主應採取保護勞工身心健康之措施。醫療機構肩負照護民眾健康的 重責大任，臨床工作之特性常須輪班、值班及長時間工作，但醫療從業人員之異常工作負 荷卻鮮少被提及。本研究目的以實證為基礎，針對醫療人員之工作負荷進行相關風險評估 管理，並期望所得結果能提供予醫療機構決策者相關健康管理介入之參考。 研究方法：分析2015年桃園市某區域教學醫院員工健康體檢資料，並依據職安署公布 「異常工作負荷促發疾病預防指引」中之「心力量表」公式，計算其員工十年內缺血性心臟 病機率。統計分析使用SPSS 18.0版統計軟體，利用t檢定、卡方檢定及單因子變異數分析 (one-way ANOVA)及事後比較進行分析，p值小於0.05為具有統計上顯著差異。 結果：共計有828人納入本研究，扣除資料不完整無法計算心力分析的83份，共有745 人(90%)進入最後分析。所有個案中，醫師102位(13.7%)、護理師329位(44.2%)、醫事人員 107位(14.4)、行政人員207位(27.7%)。醫師當中男性佔比較高(82.4%)，護理師中女性佔比 較高(99.4%)；各執業別中護理師平均年齡較低，醫師族群之高密度膽固醇平均較低。抽 菸、糖尿病及高血壓在各執業別則無統計上顯著差異。十年內發生缺血性心臟病的機率 中，除60歲以上外，在各年齡層均以醫師之發生機率為最高並達統計上顯著差異 (p<0.001)。60歲以上共17人，十年內發生缺血性心臟病的機率以行政人員最高，但未達統 計顯著差異。 結論：本研究發現醫師在十年內發生缺血性心臟病之機率較其他執業人員為高。鼓勵 醫師勵行健康促進的行為模式，並以身作則告訴病人自我照護，避免高風險的工作環境， 實為當務之急。

Background: The latest Occupational Safety and Health Act clearly specified that the employer should take measures to protect the physical and mental health of laborers. Cardio-cerebrovascular diseases caused by fatigue or stress due to shift working, night working, long working hours, and other exceptional workloads are drawn more attention recently. The Occupational Safety and Health Administration of Ministry of Labor released the amended Occupational Safety and Health Act on July 03, 2013, to response the request for disease prevention of new occupation. Medical professionals are in responsible for taking care the public health, and they usually must do their duty by shift working, night working and long working hours. However, their risk of abnormal workload are rarely to be mentioned. Our study was evidence-based and used medical professionals to evaluate and manage the risk of abnormal workload to current labors. Meanwhile, we expect our results could be the interventional reference for the health management of labors working in medical institutes. Materials and Methods: We analyzed the data of 2015 year health examination of labors of a regional teaching hospital in Taoyuan City. According to the formulation of Framingham Risk Score from the "Guidelines for Preventing Diseases Caused by Exceptional Workload" released by the Occupational Safety and Health Administration of Ministry of Labor, we calculated the rate of ischemic heart diseases in ten years. All statistic analyses were performed with SPSS 18.0, using t-test, chi-squared test and one-way ANOVA. There would be statistic significance when p-value was less than 0.05. Result: There were total 828 participants recruited in this study. We excluded 83 participants whose data were incomplete and were unqualified for Framingham Risk Score analysis and had 745 (90%) participants for final analysis. Among these participants, there were 102 physicians (13.7%), 329 nurse (44.2%), 107 medical professionals (14.4%), and 207 administrators (27.7%). Physician group had more males (82.4%) and nurse had more females(99.4%). The average age of nurse were relatively lower than other occupations. Level of high-density lipoprotein(HDL) was relatively lower than other groups. Smoking, diabetes, and hypertension were no statistical significance across these groups. We found that the incidence rates of ischemic heart diseases in ten years of physicians were the highest in age group of 30-39, 40-49, and 50-59, with statistical significance (p<0.001). There were 17 participants in the group of “above 60.” In this age group, the administrative staffs had the highest rate of ischemic heart diseases in ten years than other occupations. However, there was no statistical significance. Conclusion: These results found that the physicians had the top rate of ischemic heart diseases in ten years in age groups of 30-39, 40-49, and 50-59. To encourage physicians to take behavior model of health promotion in order to prevent from the high-risk working environment is suggested.