临床医学实验室职业暴露事件回顾分析

Retrospective analysis of occupational exposure in clinical medical laboratory

目的分析临床医学实验室职业暴露事件,找到有效的职业暴露管理切入点,提高实验室安全管理效能。方法分析2011~2015年发生于昆明市第一人民医院检验科实验室内职业暴露事件中暴露人员的履职信息、生物安全理论培训记录和职业暴露事件经过记录,找出趋势性规律并进行职业暴露原因的回顾性分析。结果实验室近5年职业暴露人员共计24人,工龄≤5年的占95.8%,其中在第1年内发生职业暴露的人员占66.7%。初级职称及以下员工占100.0%,其中实习学生占45.8%。实验室内职业暴露发生概率与工作人员累计接受职业暴露理论授课培训的次数没有相关性。职业暴露类型中锐器伤占79.2%;接触锐器工作岗位(包括采血岗、血气分析岗和血培养转种岗)发生职业暴露概率约是其他岗位的1.67倍。结论实验室内低年资员工和实习学生是发生职业暴露的主要人群,风险教育和职业暴露理论培训对其预防职业暴露效果不佳。通过实验室内现场实际安全操作示范培训、实验操作流程风险环节认识学习和考核,可能是降低实验室职业暴露的有效途径之一。

Objective To analyze occupational exposure events in clinical laboratory, find the strategy for the reduction of occupational exposure, in order to improve laboratory safety management. Methods The performance information of the exposed personnel, training records of biosafety theory and occupational exposure events from 2011 to 2015 in Department of Clinical Laboratory, the First Hospital of Kunming were analyzed, to find out possible factors associated with occupational exposures. Results There were 24 staffs involved in occupational exposures in the laboratory for nearly 5 years, account for 95.8% of which who have less than 5 years of working experience. Less than one year of working experience led to 66.7% of all occupational exposures. 100.0% of staffs involved in occupational exposures own junior titles, account for 45.8% of which were the intern students. There was no correlation between the incidence of occupational exposure in the laboratory and the number of theoretical trainingsand risk education that the staff had received about professional exposures. Acute injuries accounted for 79.2% of occupational exposures. Jobs with sharp devicesare 1.67 times of occupational exposures compared with other jobs, including blood collection, analysis of blood gas and blood culture transfer. Conclusion The junior staff and students in the laboratory are the majorpersons potentially involved in occupational exposures. The theoreticaltraining is not sufficient for preventing occupational exposures.Therefore, one of the effective ways to reduce the occupational exposures in the laboratory is to give junior staffs multiple on-the-job trainings, including operations, risk assessment and examinations.