本研究旨在探究果菜市場重體力負荷之中高齡人工物料搬運勞工的核心工作、就業困境與職務再設計，以及職業災害發生後，因應工作需求及體力退化之核心工作、就業困境與職務再設計（本研究採廣義職務再設計定義，亦即，排除職場上任何障礙之方式）。透過質性研究法之個案研究方式蒐集相關資料，輔以研究者訪談札記、參與現場拍照、錄影，並以質性研究軟體NVivo第十版進行分析，研究結果如下：
任職果菜市場重體力負荷之中高齡人工物料搬運勞工之就業困境包括：(一)生理因素困境：工作時間久，亦即，搬運量多、超負荷搬運因想早點回家休息故一次搬兩箱。(二)心理因素困境：怕沒搬完失去工作、節慶或過年前搬運數量增加兩倍。壓力大沒時間喝水。(三)職場因素困境如：雇主沒有為其加保沒有任何保險、就業環境不佳、薪資受季節氣候影響。因應上述困境，所考慮的職務再設計包括:生理因素造成身體勞累之職務再設計主要以調整工作方法，亦即，分裝運送過程中與同事間輪流分擔搬運。因沒搬完而失去工作，乃屬於個人心理因素，因為該職場常缺勞工不會因此失去工作。針對壓力大沒時間喝水建議研究參與者搬運前補充適量水份，請雇主在每個中盤商攤位擺放礦泉水或杯水，讓現場人工物料搬運勞工可以適時補充水份。職場因素之就業困境與整體大環境相關，並非職務再設計能改善部分。
職災後，重體力負荷之中高齡人工物料搬運勞工之就業困境包括：(一)生理因素困境如：工作時間久導致疲累、晚班工作到凌晨對身體過勞影響、職災後加上中高齡因素體力更差。(二)心理因素困境如：職災後想要告雇主，怕告不贏且無法回去原職場工作、職災發生時恐懼失去生命、職災後想換更適合工作但難找。(三)職場因素困境如：雇主沒有為研究參與者投保，故無法申請職災理賠以及中高齡職務再設計服務、研究參與者每月所賺費用不足支付家庭開銷，連健保費都繳不起；以及就業環境不佳等困境。
職業災害發生後，因應生理因素造成身體勞累之職務再設計主要以:
(一)調整工作方法：與同事間輪流分擔搬運，讓研究參與者在沒有輪替搬運時有足夠休息時間，以減緩身體勞累。(二)提供就業輔具：提供日本護腰服以減輕搬運、負重、堆疊腰部及膝蓋負擔。因應心理因素造成之困境，其職務再設計主要為家人支持部分，其他因雇主或職場所造成心理困境則建議雇主改善僱用條件。然而職場因素所造成就業困境與整體大環境因素相關，並非職務再設計能改善部分。
研究結果發現調整工作方法應該被審慎思考(而非僅考慮輔具而已)、職場工作條件亟待提升、環境個人因素交互作用影響職場工作者健康與工作表現、大多數勞工均不知自己權益、且現行法規對勞工權益之保障亦不足。最後本研究針對個人工作者、職場(環境)、政府相關單位提出職務再設計的建言。

The purpose of this study was to explore the employment dilemma and job accommodation of elderly material handling workers with the heavy workload in the fruit and vegetable market, as well as the employment dilemma and job accommodation in response to job demand and physical deterioration after their occupational disasters. Through the case study method of qualitative research , and collecting relevant materials, researcher's interview notes, photographing and video recording onsute situation, and analyzing through the qualitative research software NVivo. The research results were as：The employment dilemma of the elderly manual material handling workers in the heavy load included：(1) Physical fatigue such as：long working hours, heavy handling, and increacing the speed in order to finish the job earilier；
(2) Psychological pressures such as：the fear to loose the job, the increase of work during the important holidays, and the lack of rest time to consume water；(3) Poor employment conditions such as：no insurance, poor employment environment, and salary affected by the climate.
The employment pressure of the elderly manual material handling workers in the heavy physical load after the occupational disaster includes：(1) Physical fatigue such as:long working hours, physical impact due to night shift, and the worse physical conditions after the occupational disaster；(2) Psychological stress such as：fear to loose job and life, unable to find a more suitable and easier job；(3) Poor employment conditions such as：unable to apply for compensation or job accommodation services for middle and old ages and senior workers, unable to afford the health insurance, and poor employment environment. In response to the above difficulties, the redesign of the position to be considered included: the redesign of the position of the physical fatigue caused by physiological factors was mainly to adjust the working method - the sharing of work between the colleagues during the packaging and transportation process. Psychological factors was the fear to lose their jobs. Because the employer usually hav’en enough workers, the emploees would not lose their jobs. It was just a personal psychological factor. For those who have no time to drink water, it was recommended for the participants to replenish the right amount of water before workingand the employer place mineral water or glass of water, so that the manual workers could replenish water when doing their work; the employment dilemma of the workplace factors was related to the overall environment, and it could not be done just by the job redesign.
The employment distress of the traditional manual material handling labor among the heavy physical load after the occupational disaster included: (1) The physical factors such as the long working hours, the long night shift, the physical impact, and the employment after the occupational disaster is even worse. (2) Psychological factors such as: After the disaster, the worker wanted to sue the employer but was afraid to lose the trail. As a result, he will not be able to go back to the original workplace. When the occupational disaster occured, he might lose his life. After the disaster, he wanted to change to a more suitable job but has difficulties to find. (3) Difficulties in the workplace factors: employers did not offer insurance so the workers could not apply for claims and re-design services, some people earn less than the monthly expenses, and the family expenses could not be paid even by the health insurance. Some employees got the insurance by the unions because their employers did not offer it.
After the occurrence of occupational disasters, the job accommodation of physical exertion due to physiological factors was mainly related to:(1) Adjusting the working method - taking turns to carry and carry it with colleagues, so that the research participants had enough rest time to slow down the body when there was no rotation. (2) Providing employment aids - providing Japanese belts to reduce waist and knee burden. Due to psychological factors, the redesign of their duties was mainly for family support. Others considerations were advised to improve their employment conditions due to the psychological dilemma caused by employers or the workplace. The employment dilemma caused by workplace factors was related to the overall environmental factors, and it could not be done just by the job accommodation
The study found that the adjustment work methods should be carefully considered (not just the auxiliary tools), the workplace conditions need to be improved, and the interaction of environmental and personal factors affects the health and work performance of the workers. Most workers do not know their own rights, and the current regulations dose not offer protections,either. Finally, this study is focused on an individual worker, the workplace (environment), and the suggestions to the related government departments.

丁玉珍(2009)。中高齡者失業問題分析與因應策略。臺灣勞工季刊20，30-41。
李涓鳳(2012)。我國職業災害勞工保護法之回顧與展望。臺灣勞工季刊，06，62-71。
吳亭芳、陳明聰、王曉嵐(2006)。輔助性科技服務模式之探討。特殊教育季刊，103，32-40。
吳惠林、杜英儀(2014)。改善研究者國中高齡與高齡者勞動參與之因應對策。中華經濟研究院研究報告。PG10401-0347。臺北市：勞動部。
邱憶惠(1999)。個案研究:質性取向。教育研究，07，113-127。
邱滿艷、陳由娣、呂沅峻、傅玉燕、陳冠良(2015)。從三個故事探討職務再設計措施。就業安全半年刊，01，85-92。
邱滿艷、陳由娣(2016)。從多元觀點探討職業災害勞工之福利服務需求。社區發展季刊，05，440-453。
杜信宏、陳志勇、劉立文(2014)。我國重大職業災害之人因工程分析與檢核表。勞工安全衛生研究季刊，22，124-135。
林久翔、陳宏瑞、黃正龍(2002)。輔助搬運背帶對於抬舉瞬間及全程手部施力之影響。中原學報，30，349-355。
林仲廉、劉國青(2016)。物料搬運功能與安全性強化研究。104年度研究計畫ILOSH104-S307。臺北市：勞動部勞動及職業安全衛生研究所。
林冠宇(2008)。老化對中高齡勞工的影響。勞工安全衛生簡訊，91，17。
林軒丞(2016)。人工物料搬運行為之OX對決。勞動及職業安全衛生簡訊，10，1-4。
秦唯珊、林冠含、郭育良、蕭淑銖(2013)。勞工發生職業傷害後12個月復工狀況之探討。台灣衛誌，10，576-585。
秦唯珊、謝月慈、吳雪菁、郭育良、蕭淑銖(2013)。影響供職業傷害後心理健康的原因。勞工安全衛生研究季刊，06，179-190。
張仁履、陳安哲(2002)。倉儲作業人工搬運器具人因工程改善。臺北市：勞動部勞動及職業安全衛生研究所。
張其恆(2011)。上下班交通事故應否視為職災情理法的探討。台灣勞工季刊，27，79-83。
張原道(2008)。下背痛與全身振動和人工物料搬運相關探討-以宅配業勞工為例。臺北醫學大學公共衛生碩士論文，臺北市。
張彧、徐雅媛(2009)。探討職場復健計畫：文獻回顧。勞工安全衛生研究季刊，11，467-479。
曹常成、邱馨瑩、高崇洋、卓育賢(2011)。營造業中高齡勞工職災特性分析。勞工安全衛生研究季刊，19，502-515。
曹常成、劉國青(2014)。物料搬運開發研究。臺北市：勞動部勞動及職業安全衛生研究所。
莊正中(2010)。日本勞工職災補償制度之初探。東亞論壇季刊，467，1-14。
郭振昌(1995)。推動中高齡者職務再設計之理念與作法。就業與訓練期刊，11，3-7。
郭振昌(2013)。臺灣地區中高齡者低勞參率及其人力充分運用之展望。國家與社會，15，37-61。
陳宏瑞、林久翔(2003) 。新型抬舉背帶對身體穩定性與背部、上臂肌肉負荷之影響。中原學報，31，211-219。
陳志勇(1997) 。人工搬運作業省力化可行性研究。臺北市：勞動部勞動及職業安全衛生研究所。
陳金茂(1999)。中高齡勞工職業意外事故預防之探討。勞工行政，136，46-52。
傅懷慧(1998) 。物料搬運對人體生理之影響。和春學報，1，63-72。
勞動部勞動及職業安全衛生研究所(2008)。人因工程肌肉骨骼傷害預防指引。臺北市：勞動部勞動及職業安全衛生研究所。
勞動部勞動及職業安全衛生研究所(2014)。台灣中高齡勞動力分析之研究。臺北市：勞動部勞動及職業安全衛生研究所。
游宗龍(2015)。企業如何協助勞工降低上下班機車交通職災危害之研究。工業安全衛生月刊，316，33-67。
黃曼聰、賴金鑫、張彧、李文淑、黃小玲、鄭淑心、褚增輝(1996)。職業災害復建研究-探討影響職災殘障勞工重返工作之因素。中華復健醫誌，24，67-78。
潘淑滿(2003)。質性研究理論與應用。臺北市:心理。
潘儀聰、劉俊杰、黃耀新、盧士一、李正隆、游志雲(2013)。工作現場人因工程危害預防效益個案評估。勞工安全衛生研究季刊，21，345-355。
盧瑞琴、陳致維、陳維中、林國欽(2009)。不同起始高度卸貨時對員工腰椎受力之探討。商業現代化學刊，5，127-133。
薛承泰(2000)。當前中高齡就業困境與因應。國政研究報告。臺北市：財團法人國家政策研究基金會。
謝依純(2012)。影響台灣中高齡者退休年齡之因素。台灣老年學論壇，14，1-33。
簡秀華(2016)。職業災害重建服務現況與未來展望。台灣勞工季刊，06，32-42。
龔文廣(1998)。中高齡者就業問題分析。勞工行政，118，43-50。
中華民國統計資訊網(OOOO)。失業率統計。取自https：//www.stat.gov.tw/public/Attachment/6122283142MKFOK1MR.pdf
勞動部(2016)，中高齡勞工統計105年版。取自http：//www.mol.gov.tw/statistics/2462/2466/
行政院經濟建設委員會人力規劃處(2010)。2010年至2060年臺灣人口推計。取自http：//iknow.stpi.narl.org.tw/Post/Files/policy/2012/policy_12_017_1.pdf
勞動部(2010)。職業災害勞工保護法。取自https：//www.bli.gov.tw/sub.aspx？a=OwN2uTPsALE%3D
勞動部(2013)。職業安全衛生法。取自https：//laws.mol.gov.tw/FLAW/FLAWDAT0201.aspx？lsid=FL015013
勞動部(2014)。職業安全衛生設施規則。取自https：//laws.mol.gov.tw/FLAW/FLAWDAT0201.aspx？lsid=FL015021
勞動力發展署(2016)。中高齡者職務再設計作業手冊。取自https://www.wda.gov.tw/News_Content.aspx?n=7FAD35606C219599&sms=C61580640A6257EF&s=4BD2D29B72CA27F8
勞動力發展署(2017)。修正推動身心障礙者職務再設計服務實施計畫。取自https://www.wda.gov.tw/News_Content.aspx?n=74963F5F05BDB4FB&s=51954D6AB42BECBF
西文部分
(SNEF).(2013)Age Management Toolkit(2013)，Singapore National Employers Federation。
Beveridge, S., & Fabian, E. (2007). Vocational rehabilitation outcomes: Relationship between individualized plan for employment goals and employment outcomes.Rehabilitation Counseling Bulletin,50(4), 238-246.
Boshuizen, H.C., Verbeek, J., Broersen, J.P.J., Weel, A.N.H., 1993. Do Smokers Get More Back Pain? Spine 18
Chang, T. W., & Chen, J. J. G. (2004). Biomechanical analysis of dynamic manual materials handling model.Journal of the Chinese Institute of Industrial Engineers,21(5), 475-483.
Cheung, Z., Feletto, M., Galante, J., Waters, T., & Centers for Disease Control and Prevention. (2007). Ergonomic guidelines for manual material handling. InNIOSH Publication(No. 2007-131). NIOSH.
Cheung, Z., Feletto, M., Galante, J., Waters, T., & Centers for Disease Control and Prevention. (2007). Ergonomic guidelines for manual material handling. InNIOSH Publication(No. 2007-131). NIOSH.
Council, W. S. H. (2014). Workplace Safety and Health Guidelines Improving Ergonomics in the Workplace.Workplace Safety and Health Council in collaboration with the Ministry of Manpower.
Ciriello, V. M., & Snook, S. H. (1999). Survey of manual handling tasks. International Journal of Industrial Ergonomics, 23(3), 149-156.
Crawford, J. O. (2007). The Nordic musculoskeletal questionnaire.Occupational medicine,57(4), 300-301.
Deakin, J. M., Stevenson, J. M., Vail, G. R., & Nelson, J. M. (1994). The use of the Nordic Questionnaire in an industrial setting: a case study. Applied ergonomics,25(3), 182-185.
Ghista, D. N., Subbaraj, S., Mazumdar, J., & Rezaian, S. M. (1998). The biomechanics of back pain.IEEE Engineering in Medicine and Biology Magazine,17(3), 36-41
Halpern, M. (2003). The costs of job accommodations for employees with low back pain.Work,21(3), 271-278.
Heran-Le Roy, O., Niedhammer, I., Sandret, N., & Leclerc, A.(1999). Manual materials handling and related occupational hazards: a national survey in France. International Journal of Industrial Ergonomics,24(4), 365-377
Hursh, N., Lui, J., & Pransky, G. (2006). Maintaining and enhancing older worker productivity. Journal of Vocational Rehabilitation, 25(1), 45-55.
Jäger, M., Jordan, C., Luttmann, A., Laurig, W., & Dolly Group. (2000). Evaluation and assessment of lumbar load during total shifts for occupational manual materials handling jobs within the Dortmund Lumbar Load Study–DOLLY. International Journal of Industrial Ergonomics, 25(6), 553-571.
Muslim, K., & Nussbaum, M. A. (2015). Musculoskeletal symptoms associated with posterior load carriage：An assessment of manual material handling workers in Indonesia. Work, 51(2), 205-213.
Öztürkoğlu, Ö. (2016). The Effects of Manual Material Handling Equipment on Loading and Unloading Time of a Case in a Pallet. Journal of Yaşar University, 11(44), 278-290.
Papazoglou, I. A., Aneziris, O., Bellamy, L., Ale, B. J. M., & Oh, J. I. (2015). Uncertainty assessment in the quantification of risk rates of occupational accidents. Risk analysis,35(8), 1536-1561.
Perera, S., Sardeshmukh, S. R., & Kulik, C. T. (2015). In or out: job exits of older workers. Asia Pacific Journal of Human Resources,53(1), 4-21.
Plouvier, S., Gourmelen, J., Chastang, J. F., Lanoë, J. L., & Leclerc, A. (2011). Low back pain around retirement age and physical occupational exposure during working life.BMC Public Health,11(1), 268.
Saha, P., Basu, B., & Devashish, S. D. (2017). Ergonomic evaluation of physiological stress of building construction workers associated with manual material handling tasks.Progress in Health Sciences,7(1), 54.
Sanders, J., Dorenbosch, L., Gründemann, R., & Blonk, R. (2011). Sustaining the work ability and work motivation of lowereducated older workers: Directions for work redesign.management revue, 132-150.
Scherer, M. J. (2004). Connecting to learn: Educational and assistive technology for people with disabilities. Washington, DC: American Psychological Association.
Scherer, M. J., & Galvin, J. C. (1996). An outcome perspective of quality pathways to most appropriate technology. In J. C. Galvin & M. J. Scherer (Eds.), Evaluating, selecting, and using appropriate assistive technology (pp. 1-26). Gaithersburg, MD: Aspen.
Shojaei, I., Vazirian, M., Croft, E., Nussbaum, M. A., & Bazrgari, B. (2016). Age related differences in mechanical demands imposed on the lower back by manual material handling tasks.Journal of biomechanics,49(6), 896-903.
Slijper, H., & Latash, M. (2000). The effects of instability and additional hand support on anticipatory postural adjustments in leg, trunk, and arm muscles during standing.Experimental brain research,135(1), 81-93.
Vercillo, A. E. (2008).Job retention success for individuals receiving vocational services after a work-related injury(Vol. 69, No. 10).
Waters, T. R., & Putz-Anderson, V. (1996). Manual materials handling.OCCUPATIONAL SAFETY AND HEALTH-NEW YORK-,27, 329-350.