2012-2016年四川省妇幼保健院工作人员血源性职业暴露监测与分析

Analysis and Surveillance of Blood-borne Occupational Exposure for Medical Staffs Working in Maternal and Child Health Care From 2012 to 2016

目的了解妇幼保健院工作人员血源性职业暴露现状及高危因素,为采取针对性防控措施提供科学依据。方法对四川省妇幼保健院2012-01/2016-12在职的864名医务人员进行职业暴露监测,并对其中发生职业暴露的102名医务人员进行分析及干预。结果高危人群主要是护理人员(57.84%),3年以下工作经历医务人员血源性职业暴露发生率较(55.88%)。暴露源以乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、梅毒螺旋体(TP)和人类免疫缺陷病毒(HIV)为主,锐器伤是主要的暴露方式(76.47%),暴露部位以手部居多(81.37%)。监测并追踪102名职业暴露者均未发生感染。结论妇幼保健机构工作人员血源性职业暴露的主要高危因素为针刺伤,应加强医务人员职业防护教育及落实防护措施,规范高危环节操作流程,强化监督机制,降低其职业暴露及暴露后感染的发生。

Objective To understand the maternal and child health care medical staffs＇ current situation of blood - borne occupational exposure and high risk factors, and to provide scientific basis for targeted prevention and control measures. Methods There was an occupational exposure monitoring for 864 medical staffs between January 2012 and December 2012 in Sichuan Province Maternity and Child Care. Meanwhile, an analysis for 102 medical staffs of occupational exposure was conducted. Results Nursing staffs were the high risk groups, accounted for 57.84%, among occupational exposure population, medical staffs who were less than 3 years working experience had high occupational exposure, the result was 55.88%. Main sources of exposure were Hepatitis B virus （HBV）, hepatitis C virus （HCV）, Treponema pallidum （TP） and Human immunodeficiency virus （HIV）. Sharp instrument injury counted for 76. 5%, for medical staffs＇ injure, hands as main injured part counted for 81.37%. There was no infection incidence by surveillance and follow - up of 102 medical staffs that were occupational exposure. Conclusion Pricking wound was mainly high risk factors of blood -borne occupational exposure of maternal and child health care medical staffs. Occupational protection education for medical staffs should be strengthened. At the same time, protective measures should be implemented, operation process of high risk should be normalized, and the supervision mechanism should be strengthen in order to reduce the occupational exposure and exposed infection.