2014年-2016年医务人员职业暴露调查分析与防护对策

Investigation,analysis and precautionary measures of occupational exposures among healthcare workers during 2014-2016

目的了解医务人员职业暴露发生现状,为采取针对性职业暴露防护措施提供参考。方法调查分析本院2014年-2016年425例发生职业暴露的医务人员的相关情况。结果护理人员占职业暴露人员的42. 12%,其次为实习、委培和进修人员(31. 76%);年龄<30岁的医务人员的比例高达78. 82%。职业暴露多见于普通病房(61. 88%)。绝大多数(85. 65%)的职业暴露为锐器伤,其中针刺伤占78. 59%;手部是最常见的损伤部位,占93. 65%。主要的职业暴露病原体是乙型肝炎病毒和梅毒螺旋体,分别占34. 35%和11. 76%。经监测随访,全部职业暴露者未发生感染。结论护理人员为职业暴露的高危人群,高危因素为针刺伤。因此,应加强医务人员职业安全教育,提高防护意识,实施标准预防,规范操作行为,强化监管机制,预防或减少职业暴露的发生。

Objective To investigate the current status of occupational exposures among healthcare workers（HCWs） and to gather evidence for developing precautionary measures. Methods Four hundred and twenty-five HCWs from a hospital who experienced occupational exposures during 2014 and 2016 were surveyed. Results Nurses represented 42. 12% of all occupationally exposed HCWs,followed by training staff（31. 76%）; 78. 82% were younger than 30 years old. The most occupational exposures took place in general ward（61. 88%）. The vast majority（85. 65%） of occupational exposures were caused by sharp injuries,and the percentage of needle injuries was 78. 59%; the most common site was hands（93. 65%）. Hepatitis B virus and Treponema pallidum were the main pathogens,accounting for 34. 35% and 11. 76% respectively. All the exposed HCWs were not infected according to following-up. Conclusion Nurses are at high risk of occupational exposures,and needle injuries are the main risk factor. It is therefore important to reinforce the training for HCWs to increase their awareness of protection for occupational exposures,adhere to precautionary principles,standardize operational behavior,and strengthen monitoring system,so as to prevent or reduce occupational exposures.