传染病特色医院血源性传染病职业暴露状况及法律与政策现状分析

Occupational exposure to blood-borne diseases in specialized hospitals for infectious diseases and its legal and policy status

目的了解以传染病为特色综合医院职业暴露状况,对传染病职业暴露防护及暴露后相关政策及法律保护的现状进行探讨,并提出建议。方法回顾性调查首都医科大学附属北京地坛医院2017年1—12月上报的血源性职业暴露资料,包括人员姓名、年龄、性别、职业、暴露时间、暴露源种类、暴露方式、暴露部位、暴露后用药、暴露后随访及暴露后补偿与赔偿的状况等,采用SPSS 19.0软件对资料进行统计分析。结果共424例血源性职业暴露,发生职业暴露人员以护士居多(233例,占54.95%),其次是医生(115例,占27.12%);暴露源种类以HBV为主(197例,占46.46%),其次是HIV(74例,占17.45%);暴露方式以针刺伤为主(307例,占72.41%),其次是黏膜喷溅(78例,占18.40%);暴露部位以手为主(331例,占78.07%),其次是眼及口腔(78例,占18.40%);无职业暴露后感染发生;暴露后的补偿与赔偿机制无相关政策,也无相关数据记录。结论传染病职业暴露防护与暴露及感染后的管理还存在很多问题,相关的政策与法律尚不完善,亟待进一步加强。

Objective To explore occupational exposure in general hospitals specializing in infectious diseases, to discuss occupational exposure protection against infectious diseases and the status quo of relevant policy and legal protection after exposure, and to propose suggestions accordingly. Methods Totally the data of occupational exposure to blood-borne diseases from Beijing Ditan Hospital, Capital Medical University between January and December 2017 were retrospectively investigated, including patients' name, age, gender, occupation, exposure time, type of exposure sources, methods of exposure, parts of exposure, medication after exposure, follow-up after exposure and compensation after exposure. SPSS 19.0 was used for statistical analysis. Results There were 424 cases of exposure to blood-borne diseases, and most of them were nurses (n=233, 54.95%), followed by doctors (n=115, 27.12%);the source of exposure was mainly hepatitis B virus (HBV, n=197, 46.46%), followed by human immunodeficiency virus (HIV, n=74, 17.45%);the method of exposure was mainly prinking wound (n=307, 72.41%), followed by mucosal splash (n=78, 18.40%);the parts of exposure were mainly the hand (n=331, 78.07%), followed by the eye and the oral cavity (n=78, 18.40%);there was no infection after occupational exposure;and there were no policies related to the compensation after exposure, nor relevant data or records. Conclusions Occupational exposure protection against infectious diseases and the management following exposure are problematic. There is a lack of relevant policies or laws, which should be further improved.