本研究目的在於探討工業化先進國家的肌肉骨骼傷害防制體系，以做為我國建置防制體系之參考。先進國家的防制體系主要是由三個功能組織構成：政府機關制定法令及強制執行；研究機構支援政策制定與技術發展；民間組織負責實際的政策推動、教育推廣與輔導諮詢。在這三個組織之上，成立一個諮詢委員會負責審核政策及監控政策執行，它是由政府、勞方、資方與社會賢達的代表組成的。目前台灣只有試行體系，包含管制平台、服務聯繫平台、與三個執行平台。管制平台由勞動及安全衛生研究所擔綱。服務聯繫平台執行管制平台的指令並且負責聯繫三個執行平台，為試行體系的核心。三個執行平台分別為人因工作平台，負責人因工程介入改善；職衛服務平台，負責衛生的改善；診治中心，負責疾病的治療。這個試行體系並不完整，主要原因是勞動及安全衛生研究所只是一個研究機構，並非執法的強制性機構；同時也沒有政策諮詢單位足以代表各方利益。
本研究探討美國、加拿大、歐盟等工業先進國家的肌肉骨骼傷害防制體制，分析其組織分工與運作方式，以建構我國的組織架構。經過比較各國體制之完備性與運作的合理性，本研究認為加拿大安大略省的防制體系為最完善有效的系統，值得借鏡。如今，我國已經正式通過重複性肌肉骨骼傷害防止法案(職安法6.2.1)，依此，職業安全衛生署必然是制定法令及強制執行的機關。勞動及安全衛生研究所則是政策支援的主導單位。民間團體執行教育宣導與現場輔導，建議籌組4種專業團隊，分別負責政府與軍事機構、國家基礎建設、交通事業單位、與一般民間事業單位。以及，一個由政府、勞方、與資方代表所組成的諮詢委員會，以建構一個健全、專業的肌肉骨骼傷害防制體系。本研究祈望，這個組織架構可以作為台灣的肌肉骨骼傷害防制試車體系。

關鍵字：肌肉骨骼傷害、WMSD、肌肉骨骼傷害防制體系、肌肉骨骼傷害防制推動

The purpose of this study is to examine the organizational structure for preventing work-related musculoskeletal disorders in industrialized countries, for serving as a reference for our organization. In general, the basic structure of the organization consists of three functional entities: governmental agency for law making and enforcement；research organizations for providing technical support for the governmental agency in policy making；Civilian groups for practicing training education and in-site consultation。On top of these three entities, there is an advisory committee which is formed by representatives from the sectors of workers, employers, government, and general public, in charging of policy review and enforcement scrutiny. To date, the pilot organization in Taiwan is assembled from a control office, a call center and 3 service platforms。The control office is administered by the Institute for Occupational Safety and Health (IOSH)；the call center accepts call-ins and effects call-outs for industry and conveys services requests between 3 service platforms, which is the core of this organization. The 3 service platforms are Human factors for ergonomics improvement, Industrial Hygiene for safety and health, and Occupational Medicine for disease diagnosis and treatment. This organization is not complete for the fact that ILOSH is not really a law enforcement agency.
This study examines the organizational structure of U.S. Canada and Europe Union, and analyzes their functional segmentation and operational methods. Based on the comparison of completeness of the organization and rational of operational method, it is suggested that the organization of the Ontario of Canada is indeed the most suitable organization for us in terms of the size of population and territory. Now, the Act for Preventing Repetitive Work-related Musculoskeletal Disorders (OSHA Act 6.2.1) has been effected. Accordingly, OSHA is the legal enforcement agency responsible for law making and enforcement. ILOSH is the leading research organization for supporting policy making. Civilian groups serve as task force for implementing the policy, and it is also suggested that the task force is better segmented into 4 expertise divisions, one for governmental agencies and military services, one for public infrastructure construction, one for transportation services, and one for civilian industry. And also, an advisory committee in charging of policy review and law enforcement scrutiny. It is hoped that this could serve as prototype organization for preventing of repetitive work-related musculoskeletal disorders in Taiwan.

Keywords: musculoskeletal disorder, WMSD, WMSD prevention system, WMSD prevention promotion

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