医务人员职业暴露监测与危险因素分析

Occupational exposure and its risk factors among medical staff

目的了解发生职业暴露医务人员的人群分布、暴露环节以及暴露源等情况,为减少职业暴露提供参考依据。方法选择陕西中医药大学附属医院2014年1月-2015年12月上报感染管理科的76名职业暴露医务人员作为研究对象,描述性分析其人群特征和职业暴露情况。结果 76名职业暴露医务人员共发生80次职业暴露,发生部位主要为左手占70.00%,其次为右手占26.25%。职业暴露人群中女性较多占78.75%,职业以护士为主占65.00%,年龄20~30岁发生职业暴露最多占65.00%,工龄<3年比例最高占50.00%。血液是最主要的暴露物质占91.25%;暴露方式主要是针刺伤占82.50%;职业暴露的主要环节为注射后回套针帽或分离针头占22.50%。暴露源病原体以HBV为主占71.74%。结论职业暴露多发生于低年资医务人员,职业以护士为主,血液是最主要的暴露物质,暴露方式主要为锐器伤,可通过推行安全的医疗器具、规范医疗废物管理、持续强化的职业防护培训等降低职业暴露的风险。

Objective To investigate the population distribution, exposure section and exposure sources among medical staff with occupational exposure so as to provide evidence for reducing occupational exposure. Methods We selected 76 medical professionals with occupational exposure that reported to Department of Infection Control, the Affiliated Hospital of Shaanxi University of Chinese Medicine from January 2014 to December 2015. They served as the research objects, their population characteristics and occupational exposure were descriptively analyzed. Results A total of 80 times of occupational exposure occurred among the 76 medical professionals. The main exposure position was the left hand （70.00%）, followed by the right hand （26.25%）. Among the 76 medical professionals with occupational exposure, women accounted for 78.75%, nurses for 65.00%, the age of 20 to 30 years for 65.00%, and the working years less than three years for 50.00%. Blood was the principal exposure material （91.25%）. The main way of exposure was needle stick injury （82.50%）. The main section of occupational exposure were recapping the needles or withdrawing the needles after injection （22.5%）. The main pathogen in exposure sources was HBV （71.74%）. Conclusions Occupational exposure mainly occurs in junior medical staff, and nurses are the dominant group. Blood is the principal exposure substance, and sharp injuries are the main exposure mode. It is necessary to implement the safe medical equipment, standardize medical waste management and continuously strengthen occupational protection training so as to reduce the risk of occupational exposure.