Occupational health surveillance system in Taiwan: Historical origin and its current conditions and problems

Background: The occupational health surveillance system in Taiwan was established in the mid-1970s after a series of mass industrial poisonings that caused great public's concern. In this study, we traced the historical origin of the system and its transformation over the past three decades, and examined its current conditions and problems.

Methods: We first conducted a historical review based on existing literature and official statistics, followed by in-depth interviews with 15 stakeholders, including union representatives, managers of enterprises, and executives or managers of medical care facilities. We also organized a workshop to solicit experts' opinions, with participation of 3 senior occupational physicians and 1 senior occupational safety officer.

Results�FMany problems existed with the current system, including vicious market competition in the health care sector, poor coordination with the health examination services provided by the universal National Health Insurance, lacking in documentation of workers' occupational risk profiles, poor management of health data, lacking in follow-up programs, passive or even no participation of occupational health professionals, and inadequate privacy protection.

Conclusions�FWe identified several problems with the current system of the occupational health surveillance, and made recommendations for its reform.

Learning Objectives:

1.Describe the historical origin and transformation of the occupational health surveillance system in Taiwan;

2.Describe and identify major problems of the occupational health surveillance system in Taiwan.