采供血人员职业暴露原因分析和防范措施探讨

Occupational exposure of blood bank staff: Cause analysis and risk prevention

目的探讨职业暴露发生的原因,防止职业暴露危害采供血机构工作人员的身心健康。方法对2014年5月1日~2020年12月31日台州市中心血站上报的职业暴露案例按照暴露方式和部位、岗位分布、操作人员的年资和操作是否按规定执行进行分类统计和分析。结果 2014年5月1日~2020年12月31日台州市中心血站总体发生23例职业暴露(6.66/10万),各年份间发生比率大致相当。职业暴露的方式中锐器刺伤占65.2%(15/23),伤口暴露和黏膜暴露各占17.4%(4/23);暴露的部位主要是手指,其次为眼和口腔;岗位分布中采血岗位占65.2%(15/23),机采岗位、成分制备岗位、初筛检验岗位分别占21.7%(5/23)、8.7%(2/23)、4.3%(1/23),采血岗位暴露发生率显著高于其余类别(P<0.05);操作人员年资分布中1年内轮转的新进员工占比为43.5%(10/23),1~5年内的定岗员工占比为34.8%(8/23),5年以上的定岗员工占比为21.7%(5/23),新进员工暴露概率显著高于定岗员工(P<0.05);56.5%(13/23)的职业暴露是由员工未按规定操作引起。结论接触针头的每一个环节都存在职业暴露的风险。操作人员的年资越低,发生率越高。未按规定操作容易引起职业暴露的发生。通过建立各种防范措施,能有效降低采供血机构职业暴露的发生率,保障职业安全。

Objective To explore the causes of occupational exposure, so as to prevent occupational exposure that endangering the physical and mental health of staff in blood centers. Methods Occupational exposure cases reported from May 1, 2014 to April 30, 2020 by Taizhou Blood Center were classified and analyzed in terms of the exposure mode, body parts, post distribution, seniority of operators and whether the operation was carried out as required. Results From May 1, 2014 to December 31, 2020, 23 cases of occupational exposure(6.66/100000) occurred in Taizhou Blood Center, and the incidence rate was roughly the same in each year. Among the occupational exposure modes, sharp device puncture, wound exposure and mucosal exposure accounted for 65.2%(15/23),17.4%(4/23) and 17.4%(4/23), respectively. The exposed sites of body were mainly fingers, followed by eyes and mouth. The incidence of occupational exposure of phlebotomist post accounted for 65.2%(15/23),followed by apheresis platelet collection, component preparation and preliminary screening post[ 21.7%(5/23), 8.7%(2/23) and 4.3%(1/23), respectively, P<0.05]. The incidence of occupational exposure of new staff rotated within one year was 43.5%(10/23), followed by fixed-point staff within 1-5 years and over 5 years [34.8%(8/23) and 21.7%(5/23), respectively], P<0.05. 56.5%(13/23) of occupational exposure was due to employees′ failure to obey the operate as required. Conclusion Where there is needle contact there is exposure risk. the newer staff are more likely to suffer occupational exposure, and most exposure are caused by non-compliance with the regulations. The establishment of various preventive measures can effectively reduce the incidence of occupational exposure in blood banks and ensure occupational safety.