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                              10個上班族,9個頸椎痛 頸椎病等望納入職業病
                              2019-08-12 13:56 來源:新華網

                              近日,健康中國行動推進委員會辦公室在召開新聞發布會時稱,這次職業健康保護行動將頸椎病、肩周炎、腰背痛、骨質增生、坐骨神經痛列為勞動者個人應當預防的疾病。中國疾病預防控制中心研究員孫新在會上說,這些都是與職業活動有關的疾病。

                              接受《法制日報》記者采訪的業內專家分析稱,頸椎病、肩周炎等疾病只是被列為勞動者個人應當預防的疾病,而不是“法定職業病”。即使隨著我國經濟快速發展,社會保障能力不斷提高,這些疾病有可能被列入職業病相關目錄,在操作上也依然存在不少客觀障礙。

                              工作方式不斷改變

                              頸椎病越來越普遍

                              職業病是指企業、事業單位和個體經濟組織等用人單位的勞動者在職業活動中,因為接觸粉塵、放射性物質和其他有毒、有害物質等因素而引起的疾病。在我國,只有被列入職業病目錄的疾病才屬于法定職業病范疇。

                              我國最早期的職業病目錄才包含了14種職業病。隨著社會經濟的不斷發展,這份目錄經歷多次調整,目前施行的《職業病分類和目錄》包含十大類132種疾病。

                              據孫新介紹,這十大類職業病包括:職業性塵肺病及其他呼吸系統疾病、職業性皮膚病、職業性眼病、職業性耳鼻喉口腔疾病、職業性化學中毒、物理因素所致職業病、職業性放射性疾病、職業性傳染病、職業性腫瘤和其他職業病。

                              根據《職業病分類和目錄》,頸椎病、肩周炎、腰背痛、骨質增生、坐骨神經痛等疾病尚未被列入。這就意味著,目前這幾類并非我國法定的職業病。但孫新強調,它們都是與職業活動有關的疾病。

                              隨著工作方式發生改變,對職業病分類與目錄加以調整和擴容,讓其跟上現代上班族的需求,成為很多人的呼聲。在此情境下,頸椎病或將列入職業病,無疑切中了眾多上班族的痛點,因為“10個上班族,9個頸椎痛”。

                              在北京從事金融工作的王榮(化名)深受頸椎病困擾。

                              對于王榮的頸肩部疼痛、右側胳膊偶爾觸電一般銳痛,醫生診斷是“頸椎病”,建議到醫院康復治療,必要時進行手術。

                              王榮分析,自己是企業員工,最近又一直忙于寫工作報告,在電腦前久坐至凌晨,缺乏休息,“這是在從事職業活動中產生的、累出來的病,應該是職業病才對”。不過,王榮后來咨詢了律師,獲得的答復是“不算職業病”,因為頸椎病不在《職業病分類和目錄》之列。

                              據北京律師徐瑩介紹,構成職業病的四要素是:患病主體是企業、事業單位或個體經濟組織的勞動者;必須是在從事職業活動的過程中產生的;必須是因接觸粉塵、放射性物質和其他有毒、有害物質等職業病危害因素引起的;必須是國家公布的《職業病分類和目錄》所列的職業病。

                              職業病被視為工傷

                              用人單位需要賠償

                              據今日頭條與《生命時報》聯合發布的《國人健康關注度大數據》顯示,今年“十大最受關注的疾病”均為慢性病。頸椎病也進入榜單,成為“低頭族”“手機黨”最關注的健康疾病之一,也正因如此,頸椎病等未來有可能被列為法定職業病引起社會輿論熱議。

                              頸椎病被列入職業病,對于勞動者來說意味著什么?

                              在中國勞動關系學院法學系副教授張麗云看來,按照我國工傷保險條例,職業病被自動視為工傷,普通勞動者可享受工傷保險待遇。因此,將頸椎病、肩周炎、腰背痛等全部列入職業病范圍“幾乎不可能”,但頸椎病有可能會被某些群體納入范疇。

                              張麗云分析稱,因為職業病直接對應工傷保險待遇,不僅國家工傷保險基金要承擔支付義務,也會增加用人單位的支付義務。一種疾病是否納入職業病范疇,應從職業病的基本特點來考慮。也就是說,從事某一類職業的工作人員,其身體姿勢或者身體工作狀態會必然導致產生某種疾病。

                              “電腦普及以及辦公久坐等原因,導致遭受頸椎病等疾病困擾的人越來越多,如果將其列入職業病,對勞動者而言,將因此享受工傷保險待遇,包括工傷醫療待遇等。”首都經濟貿易大學勞動經濟學院副院長范圍對《法制日報》記者說,盡管中國疾病預防控制中心相關工作人員稱未來可能將頸椎病等列入職業病相關目錄,但從理論和實踐來看,都存在較大的障礙。

                              在范圍看來,一是難以認定疾病與職業的因果關系;二是即使如今在醫學上明確長期使用電腦、久坐等可能導致頸椎病等疾病,但如何確定使用的程度與患病之間的關系,這將導致用人單位在對崗位的職業病危害界定時面臨很大的困難。目前,很少有崗位不涉及電腦使用和久坐,那么是否所有頸椎病都屬于職業病?

                              事實上,在2012年,現行《職業病分類和目錄》進行增補時,曾有消息稱,有望將頸椎病等白領一族高發的疾病納入職業病范疇,當時支持的呼聲很高,也不乏反對意見。有人認為,和別的有毒有害物質引起的職業病不同,頸椎病的發病在許多辦公群體中都很常見,而且因為娛樂方式的轉變,許多人在脫離辦公環境后,仍在進行以低頭為主的娛樂方式,如上網玩游戲、低頭玩手機等,很難區分是因工作還是因娛樂形成的頸椎病。

                              范圍分析稱,職業病強調疾病的職業關聯性,即勞動者患病是因為職業危害導致的。然而,很難認定頸椎病等疾病與職業的關聯性是否緊密,職業中長期使用電腦或者久坐可能導致頸椎病,個人生活習慣中不正確的坐姿、長期低頭使用手機等也有可能導致頸椎病。

                              企業或將加大支出

                              優化管理重在預防

                              在采訪中,也有不少用人單位提出了相似的質疑,比如若簡單地將頸椎病等疾病納入職業病范疇,將增加用人單位壓力,且用人單位可能要為員工自身的不良生活習慣買單。考慮到當下的勞資博弈格局,壓力向資方轉嫁,很可能使得對頸椎病的職業病認定虛置,削弱其可操作性。

                              同時,另一個問題也是不少用人單位擔憂的——一旦頸椎病納入法定職業病范疇,就意味著賠償,面對廣泛存在的頸椎病人群,企業的負擔該如何化解?

                              在張麗云看來,如果不能在因果關系上認定是職業病,用人單位不應當承擔相應的工傷賠償責任,“不建議草率的把這些疾病直接拉進來”。張麗云同時建議,充分利用國家現有較好的醫療保險制度。事實上,我國現在的醫療保險全民覆蓋,幾種保險相互交叉,轉移接續,一般類型的、廣泛意義上的頸椎疼、肩周炎都可以享受相應的醫療保險待遇,大幅緩解了患者的支付壓力。

                              “從企業的角度來看,如果將頸椎病列入職業病范疇,將導致企業增加以下幾方面的負擔:一是可能增加工傷保險的繳費;二是用人單位需要承擔相應的醫療期間的工資;三是用人單位對于患病員工的管理成本將增加,包括預防以及勞動關系的解除等。”范圍認為,對于這些負擔,企業只能通過加大預防力度,減少員工罹患頸椎病可能性等措施來予以降低,首先是優化崗位設置和工作內容,減少員工久坐或者使用電腦的頻率;其次是改善辦公條件;此外,安排更加科學合理的工間休息、鼓勵和引導員工多運動、強化體檢和醫療保健等。

                              不少業內人士也對《法制日報》記者稱,政策從醞釀到落地,大多需要較長的時間,但從此次健康中國行動推進委員會辦公室提出的新理念不難看出,未來我國也將與國際接軌,在頸椎腰椎疾病的診療過程中著重于預防。

                              據專業醫師介紹,雖然七成市民均有相關疾病困擾,但需要接受手術治療的僅為5%至10%,藥物、物理、微創、介入等中西醫結合手段都可針對不同病癥程度予以緩解,及時就醫即可。

                              此外,《法制日報》記者查閱相關資料發現,國際勞工組織也有一個《國際職業病目錄》,現行的《國際職業病目錄》是2010年調整實施的,2010版《國際職業病目錄》共四大類106種。“與我國《職業病分類和目錄》不一樣,《國際職業病目錄》是一個預防目錄,把預防的重點放在對勞動者健康危害最嚴重的疾病上,例如社會心理因素導致的工作壓力、不良工效學因素導致的肌肉骨骼損傷等疾病。”上海市第六人民醫院針推傷科主任吳耀持在接受媒體采訪時說,至今尚未有國家正式將頸椎病等疾病納入職業病范疇。

                              作者:趙麗 編輯:劉韞雅 責任編輯:胡潔
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