過勞難釐清 醫師：留病歷自保

[phocux]

過勞難釐清 醫師：留病歷自保
http://udn.com/NEWS/HEALTH/HEA1/6309906.shtml
【聯合報╱記者蔡容喬／高雄報導】
2011.05.02 03:15 am

過勞似乎已成現代文明病，但高醫開設過勞門診一個月以來，確診為過勞症狀的個案僅個位數。醫師指出，求診民眾跟醫師說他工作到快「爆肝」，其實是不正確的，因為真正的過勞標準，其實是「爆心」、「爆腦」，其他包括疲勞、胸悶、肝指數高、失眠等非致命性症狀，並不在醫師認定的過勞症狀內。

高醫過勞門診醫師莊弘毅表示，勞委會委託開設過勞門診後，上門求診者多從事工時較長的業務、司機、工程師等須輪班的行業，主訴症狀為疲倦、胸悶、失眠、肝指數高等，醫師須花上1至2小時問診，確認工作時間、生活習慣及健康狀況，才能評估是否為因工作造成的過勞症狀。

不過在問診和調查後，大部分幾乎都排除過勞可能。莊弘毅說，勞委會針對過勞規範的目標疾病包括嚴重心律不整、冠心病、腦血管阻塞、腦出血、主動脈剝離等，若非上述致命性疾病，那就不是過勞。有工人來說他胸悶，醫師為他照X光、做心電圖和消化系統檢查都沒問題，也只能請他回家。

莊弘毅強調，過勞診斷包括三部分，首先是確認本身是否有高血糖、高血脂、高血壓等三高症候群，其次是調閱工時紀錄，也須了解最近是否遭遇異於尋常的壓力，如須在兩周內完成一個大報告等。最重要的是，若民眾自身有疾病卻未認真治療，即使工時長、壓力大，也難以認定是因工作過勞。

莊弘毅舉例說，有名50多歲電腦工程師上班途中突然心肌梗塞，將車停到路邊就死了，醫院調閱過去病歷，發現他有高血壓病史，十多年來都定期到醫院拿藥持續控制，而最近也有超時加班現象，便認定為過勞，家屬也獲得合理撫恤。

【2011/05/02 聯合報】@ http://udn.com/

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