臺灣博碩士論文加值系統

輪班、夜間工作、長時間工作等異常工作負荷所引起的疲勞感或工作壓力皆是促發腦心血管疾病的重要因子且逐漸被重視。根據勞工保險局保險給付統計，2017-2022年間，勞工罹患腦心血管疾病而獲得傷病、失能、死亡給付的有387件，其中死亡者共103件。餐飲從業人員人數眾多，涵蓋年齡層廣闊，其工作型態多元，輪班、夜間工作、長時間工作等皆在工作範疇之內，而工作內容除食材(食品)處理外，還需面對消費者需求，這些皆是造成工作者身心壓力與過勞的因素之一。
本研究探討連鎖餐飲業員工在輪班、長工時造成的工作負荷對健康的影響，採用「異常工作負荷促發疾病預防指引」中的過勞量表及搭配簡式健康量表，採線上問卷調查方式，分別於2018年及2022年針對所有在職員工進行調查並收集其健康檢查數據，共收集715份完整數據進行統計分析，對2018年及2022年罹患心血管疾病風險兩年都具備的數據資料進行比較。
本研究發現，性別、年齡及工作屬性是影響罹患心血管疾病風險的關鍵因子，而輪班或疲勞造成心血管疾病風險並未達統計上差異。其中男性罹患心血管疾病風險平均為4.59%，高於女性的2.01%，在心力量表≧10%及BMI≧27男生的比例都明顯高於女性，其他心力量表相關生理數據及抽菸行為在男女分佈無特別顯著差異。在工作屬性方面，計時人員罹患心血管疾病風險平均為4.24%，月薪人員罹患心血管疾病風險平均為2.23%，辦公室行政人員罹患心血管疾病風險平均為3.25%，具有顯著差異。計時人員罹患心血管疾病風險顯著高於月薪人員及辦公室行政人員，因餐廳計時人員在50歲以上比例最高占62.5%，因此年齡仍是罹患心血管疾病風險的最關鍵且無法改變的因素，故50歲以上且二度就業的計時人員是本研究風險最高的族群。工作班別方面白班人員罹患心血管疾病風險平均為2.74%，夜班人員罹患心血管疾病風險平均為2.97%，輪班人員罹患心血管疾病風險平均為2.77%。

Fatigue or stress caused by exceptional workloads such as shift work, night work, and long hours are important factors that contribute to the development of cerebral and cardiovascular diseases and are increasingly being emphasized. According to the insurance coverage statistics of the Bureau of Workers' Compensation, during the period of 2017-2022, there were 387 cases of workers suffering from cerebral and cardiovascular diseases and receiving benefits for injuries, incapacities, and deaths. Among those cases, there were 103 cases of deaths. Most of cases are from the food and beverage industry. It covers a wide range of ages. The types of their works are diverse, including shift work, night work, and long hours, etc. Their work involves not only food processing but also the customers’ demands, which is one of the factors contributing to the physical and mental stress on the workers.
This study investigates the health effects of workload caused by shift work and long working hours of employees in the chain restaurant industry. Applying the overwork scale and the short-form health scale in the Guidelines for the Prevention of Diseases Caused by Abnormal Workload, an online questionnaire survey was conducted in 2018 and 2022 to collect the health check data of all the employees. In total, there were 715 copies of complete data which collected and analyzed for the purpose of statistical analysis. Those data were collected and analyzed to compare with the data on the risk of CVD in 2018 and 2022, which were available in these two years.
The study found that gender, age and job attributes were the key factors affecting the risk of CVD. While the risk of CVD due to shift work or fatigue was not statistically different. The average CVD risk of men was 4.59%, which is higher than that of women (2.01%). The proportion of men with heart rate ≧10% and BMI ≧27 was significantly higher than that of women, while there was no statistically significant difference between men and women in the distribution of other physiological data related to heart rate and smoking behavior. In terms of job attributes, the average CVD risk for part-time workers was 4.24%. For full-time staff, the average was 2.23%. For office administrators, it was 3.25%. There are significant differences. The risk of cardiovascular disease among timekeepers was significantly higher than that of monthly paid workers and office administrators. Since the proportion of timekeepers over 50 years old in restaurants accounted for 62.5%, age is still the most crucial and unchangeable factor in the risk of cardiovascular disease. Therefore, timekeepers over 50 years old and employed for the second time were the riskiest ethnic group in this study. The average CVD risk for day shift workers was 2.74%, night shift workers 2.97%, and shift workers 2.77%. There is no significant difference.

誌謝I
摘要II
ABSTRACTIV
目錄VI
圖目錄VII
表目錄VIII
第壹章 緒論1
第一節 研究背景1
第二節 研究動機與目的3
第貳章 文獻探討5
第一節 餐飲業工作特性5
第二節 輪班制度及長時間工作對健康的影響7
第三節 工作異常負荷對腦心血管疾病的影響13
第參章 研究方法17
第一節 研究流程與架構17
第二節 研究對象與研究工具19
第三節 資料收集及分析23
第肆章 結果與討論25
第一節 連鎖餐飲業員工基本資料25
第二節 2018及2022健康風險比較29
第三節 罹患心血管疾病風險之相關性32
第四節 小結35
第伍章 結論與建議39
參考文獻44
附 錄50

[1]勞保局(2023)。職業災害統計資料。2023年6月20號，取自https://www.bli.gov.tw/0019152.html。
[2]行政院主計處(2023)。國情統計通報。2023年7月14日。取自https://www.dgbas.gov.tw/Advanced_Search.aspx?q=%E9%A4%90%E5%BB%B3%E5%8F%8A%E6%97%85%E9%A4%A8%E6%94%AF%E5%87%BA#gsc.tab=0&gsc.q=%E9%A4%90%E5%BB%B3%E5%8F%8A%E6%97%85%E9%A4%A8%E6%94%AF%E5%87%BA&gsc.page=1。
[3]Anne Chou (2021)。台灣外食習慣問卷調查。2023年7月14日。取自
https://www.pollread.com/2021/11/05/%E5%8F%B0%E7%81%A3%E4%BA%BA%E5%A4%96%E9%A3%9F%E7%BF%92%E6%85%A3%E5%95%8F%E5%8D%B7%E8%AA%BF%E6%9F%A5/。
[4]張偉雄、林子堯(2015)。以主管觀點探討餐飲業外場服務人員之中業職能-以高雄市A美式主題餐廳為例。休閒運動期刊，14，27-44。
[5]陳成裕、陳秋蓉(2019)。過勞預防政策與對策之比較及推動措施研究(108年度研究計畫ILOSH108-A307)。新北市：勞動部勞動及職業安全衛生研究所。
[6]謝宜儒(2023)。餐飲業發展趨勢。2023年4月20日。檢自https://www.twtrend.com/trend-detail/food-and-beverage-service-activities-2023/。
[7]鄒孟婷、黃偉新(2013)。社區職場之過勞相關因素分析及執行困難之探討。中華職業醫學雜誌，20(1)，25-38。
[8]Jang, Taewon, HyoungRyoul Kim, Hye-Eun Lee, Jun-Pyo Myong, Jung-Wan Koo, Byeong-Jin Ye, and Jong-Uk Won. 2015. Overwork and cerebrocardiovascular disease in Korean adult workers. Journal of Occupational Health 57:51‐57.
[9]Park, Jungsun, Yangho Kim, and Naomi Hisanga. Work-related cerebrovascular and cardiovascular diseases (WR-CVDs) in Korea. Industrial Health 49:3-7.
[10]行政院主計處(2023)。國情統計通報。2023年7月14日。取自https://www.dgbas.gov.tw/Advanced_Search.aspx?q=%E4%BA%BA%E5%8A%9B%E8%B3%87%E6%BA%90%E8%AA%BF%E6%9F%A5%20%E5%8B%9E%E5%8B%95%E5%8A%9B%E8%AA%BF%E6%9F%A5%20%E5%B0%B1%E6%A5%AD%E5%A4%B1%E6%A5%AD%E7%B5%B1%E8%A8%88%20%E5%8B%9E%E5%8B%95%E5%8A%9B%E7%B5%B1%E8%A8%88#gsc.tab=0&gsc.q=%E4%BA%BA%E5%8A%9B%E8%B3%87%E6%BA%90%E8%AA%BF%E6%9F%A5%20%E5%8B%9E%E5%8B%95%E5%8A%9B%E8%AA%BF%E6%9F%A5%20%E5%B0%B1%E6%A5%AD%E5%A4%B1%E6%A5%AD%E7%B5%B1%E8%A8%88%20%E5%8B%9E%E5%8B%95%E5%8A%9B%E7%B5%B1%E8%A8%88&gsc.page=1。
[11]行政院主計處(2021)。行業統計分類。2023年3月10日。取自https://www.stat.gov.tw/News_Content.aspx?n=3144&s=90015。
[12]郭曼忻(2019)。餐飲業發展趨勢。2023年3月11日。檢自https://www.twtrend.com/trend-detail/food-and-beverage-service-activities-2019/。
[13]高秋英與林玥秀（2004）。餐飲管理理論與實務(第四版)。台北市：揚智。
[14]陳信憲、吳菊(2005)。多元化入學方式對學生專業能力認知之探討。觀光研究學報，11(2)，165-187。
[15]王瑤芬、洪久賢（2004）。我國觀光餐旅業員工離職傾向研究之內容分析。觀光研究 學報，10（4），125-143。
[16]劉翠華、李銘輝、余守媚（2009）。溫泉旅館員工工作壓力、性別歧視知覺與生涯轉 換傾向關係之研究。台灣觀光學報，6，47-64。
[17]川人博(2017)。日本的過勞死及其預防對策。2023年7月5日，取自https://www.nippon.com/hk/currents/d00310/。
[18]勞動部勞動及職業安全衛生研究所(2008)。輪班作業危害預防手冊。新北市：勞動部勞動及職業安全衛生研究所。
[19]勞動基準法(2023)。第四章 工作時間、休息、休假。2023年7月5日，取自https://law.moj.gov.tw/LawClass/LawAll.aspx?PCode=N0030001。
[20]勞動部職業安全衛生署(2020)。異常工作負荷促發疾病預防指引(第二版)。2023年5月13日，取自https://www.osha.gov.tw/48110/48713/48735/60211/。
[21]ILO, "Shift work," Information Sheet No. WT-8, 2004.
[22]EU, "concerning certain aspects of the organisation of working time," Official Journal of the European Union, 2003. HSE, "Managing shiftwork," HSE Books, 2006.
[23]IARC, "Night Shift Work," IARC monographs on the identification of carcinogenic hazards to humans, vol. 124, 2020.
[24]HSE, "Managing shiftwork," HSE Books, 2006.
[25]N. A. S. Mohd Azmi, N. Juliana, N. I. Mohd Fahmi Teng, S. Azmani, S. Das, and N. Effendy, "Consequences of Circadian Disruption in Shift Workers on Chrononutrition 184 and their Psychosocial Well-Being," (in eng), Int J Environ Res Public Health, vol. 17, no. 6, Mar 19 2020.
[26]M. J. Eum and H. S. Jung, "Association between Occupational Characteristics and Overweight and Obesity among Working Korean Women: The 2010-2015 Korea National Health and Nutrition Examination Survey," (in eng), Int J Environ Res Public Health, vol. 17, no. 5, Feb 29 2020.
[27]Y. Tanikawa, M. Kimachi, M. Ishikawa, T. Hisada, S. Fukuhara, and Y. Yamamoto, "Association between work schedules and motivation for lifestyle change in workers with overweight or obesity: a cross-sectional study in Japan," (in eng), BMJ Open, vol. 10, no. 4, p. e033000, Apr 30 2020.
[28]V. M. O'Brien et al., "Overweight and obesity in shift workers: associated dietary and lifestyle factors," (in eng), Eur J Public Health, vol. 30, no. 3, pp. 579-584, Jun 1 2020.
[29]Q. Liu et al., "Is shift work associated with a higher risk of overweight or obesity? A systematic review of observational studies with meta-analysis," (in eng), Int J Epidemiol, vol. 47, no. 6, pp. 1956-1971, Dec 1 2018.
[30]Q. Liu et al., "Is shift work associated with a higher risk of overweight or obesity? A systematic review of observational studies with meta-analysis," (in eng), Int J Epidemiol, vol. 47, no. 6, pp. 1956-1971, Dec 1 2018.
[31]Sun M, Feng W, Wang F, Zhang L, Wu Z, Li Z, Tse L A. Night shift work exposure profile and obesity：Baseline results from a Chinese night shift worker cohort. PloS one 2018; 13(5): e0196989.
[32]S.Manohar, C. Thongprayoon, W. Cheungpasitporn, M. A. Mao, and S. M. Herrmann, "Associations of rotational shift work and night shift status with hypertension: a systematic review and meta-analysis," (in eng), J Hypertens, vol. 35, no. 10, pp. 1929- 1937, Oct 2017.
[33]Ohlander J, Keskin M C, Stork J,Radon K. Shift work and hypertension： Prevalence and analysis of disease Pathways in a German car manufacturing company. American journal of industrial medicine 2015; 58(5): 549-560.
[34]Bannai, Akira and Akiko Tamakoshi. 2014. The association between long working hours and health: A systematic review of epidemiological evidence. Scandinavian Journal of Work, Environment & Health 40:5-18.
[35]Kim, Beom-Joon, Seung-Hoon Lee, Wi-Sun Ryu, Chi Kim, Jong-Won Chung, Dohoung Kim, Hong-Kyun Park, Hee-Joon Bae, Byung-Joo Park, and Byung-Woo Yoon. 2013. Excessive work and risk of haemorrhagic stroke: A nationwide case‐ control study. International Journal of Stroke 8(Suppl. A100):56‐61.
[36]Shin, Kyong-sok, Yun Chung, Young-Jun Kwon, Jun-Seok Son, and Se-hoon Lee. 2017. The effect of long working hours on cerebrovascular and cardiovascular disease: A case‐crossover study. American Journal of Industrial Medicine 60(9):753-61.
[37]Muhlbauer, Varda and AharonTzine. 2017. Overwork in contemporary organizations: An interdisciplinary analysis. International Studies of Management & Organization 47(4):307-310.
[38]Iwasaki, Kenji, Masaya Takahashi, and Akinori Nakata. 2006. Health problems due to long working hours in Japan: working hours, workers' compensation (Karoshi), and preventive measures. Industrial Health 44:537-40.
[39]Bannai, Akira and Akiko Tamakoshi. 2014. The association between long working hours and health: A systematic review of epidemiological evidence. Scandinavian Journal of Work, Environment & Health 40:5-18.
[40]職業安全衛生法(2013)。第6條。2013年7月15日。取自https://law.moj.gov.tw/LawClass/LawSingle.aspx?pcode=N0060001&flno=6。
[41]職業安全衛生設施規則(2014)。第324-2。2013年7月15日。取自https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=N0060009。
[42]李貞嫺、朱柏青(2020)。我國勞工從事輪班、夜間即長時間及其他工作者罹患腦心血管疾病之先導研究。勞動部勞動及職業安全衛生研究所，1-240。
[43]Viswanathan A N, Hankinson S E,Schernhammer E S. Night shift work and the risk of endometrial cancer. Cancer research 2007; 67(21): 10618-10622
[44]職業安全健康局電子及通訊業安全及健康委員會,電子及通訊業第二十八期2002年12月,安全健康通訊；http://www.oshc.org.hk/oshc_data/files/bulletins/ibsh/2016/Telecom28.pdf。
[45]WHO. 2019. “Burn-out an ‘occupational phenomenon’: International Classification of Diseases.” https://www.who.int/mental_health/evidence/burn-out/en/.