江苏省医疗卫生机构医务人员传染病防治安全防护现况调查

Investigation on the current situation of safety protection of medical staffs for the prevention and treatment of infectious diseases in medical institutions in Jiangsu Province

目的了解江苏省医疗卫生机构医务人员安全防护现况,为强化医疗卫生机构传染病防治安全防护工作,保护医务人员的职业健康提供科学依据。方法于2020年9至10月,随机抽取43家医疗卫生机构1274名医务人员为调查对象,使用自制传染病防治安全防护调查问卷进行调查,分析调查对象岗前培训情况和职业性有害因素暴露情况,并采用二元logistic回归分析其防护用品使用和职业损伤发生的影响因素。结果共回收1216份有效问卷,有效回收率为95.4%,男性312人(25.7%),女性904人(74.3%),平均年龄(35.8±9.2)岁,平均工作年限(13.6±9.9)年;其中1143人(94.0%)参加过岗前培训,535人(44.0%)认为自身暴露于传染病防治职业性有害因素,1082人(89.0%)在日常操作中使用防护用品,462人(38.0%)发生过职业损伤。二元logistic回归分析发现,疾病预防控制中心(OR=2.473,95%CI:1.327~4.607,P=0.004),30~39岁(OR=1.586,95%CI:1.038~2.426,P=0.033)、40~49岁(OR=2.257,95%CI:1.243~4.098,P=0.007)、50岁及以上(OR=5.879,95%CI:1.755~19.692,P=0.004)以及参加岗前培训(OR=2.580,95%CI:1.301~5.116,P=0.007)的医务人员防护用品使用率较高,研究生及以上学历(OR=0.342,95%CI:0.167~0.699,P=0.003)的医务人员防护用品使用率较低;女性(OR=1.902,95%CI:1.364~2.654,P<0.001)、30~39岁(OR=1.589,95%CI:1.157~2.181,P=0.004)、本科(OR=2.070,95%CI:1.419~3.021,P<0.001)、职业性有害因素暴露(OR=2.753,95%CI:2.086~3.634,P<0.001)是医务人员发生职业损伤的危险因素,疾病预防控制中心(OR=0.129,95%CI:0.086~0.194,P<0.001)和按规定佩戴防护用品(OR=0.597,95%CI:0.431~0.827,P=0.002)是医务人员发生职业损伤的保护因素。结论因传染病防治工作中多种因素影响,江苏省医务人员职业损伤发生率较高,应持续重视其职业安全防护工作,强化岗前培训、积极提倡"标准预防",从而降低有害因素暴露风险,促进医务人员职业健康。

Objective To investigate the current situation of safety protection of medical staffs in medical institutions in Jiangsu Province,and to provide scientific basis for strengthening the safety protection of infectious diseases and protecting the occupational health of medical staffs.Methods From September to October 2020,1274 medical staffs in 43 medical and health institutions were randomly selected as the subjects.The self-made questionnaire for infectious disease prevention and protection was used to analyze the pre-job training and exposure to occupational harmful factors of the respondents.The influencing factors of using protective equipment and occupational injury were analyzed by binary logistic regression.Results A total of 1216 valid questionnaires were collected with effective recovery of 95.4%.There were 312 males(25.7%)and 904 females(74.3%),with an average age of(35.8±9.2)years and average working years of(13.6±9.9)years.Among them,1143(94.0%)had participated in pre-job training,535(44.0%)thought they were exposed to occupational harmful factors of infectious disease prevention,1082(89.0%)used protective equipment in daily operation,and 462(38.0%)had occupational injury.According to binary logistic regression analysis,the utilization rates of protective equipment for medical staffs in Centers for Disease Control and Prevention(OR=2.473,95%CI:1.327-4.607,P=0.004),30-39 years old(OR=1.586,95%CI:1.038-2.426,P=0.033),40-49 years old(OR=2.257,95%CI:1.243-4.098,P=0.007),50 years old and above(OR=5.879,95%CI:1.755-19.692,P=0.004)and pre-job training(OR=2.580,95%CI:1.301-5.116,P=0.007)were higher than their respective control groups.And medical staffs with graduate degree or above(OR=0.342,95%CI:0.167~0.699,P=0.003)had lower utilization rate of protective equipment.Female(OR=1.902,95%CI:1.364-2.654,P<0.001),30-39 years old(OR=1.589,95%CI:1.157-2.181,P=0.004),bachelor degree(OR=2.070,95%CI:1.419-3.021,P<0.001),exposure to occupational harmful factors(OR=2.753,95%CI:2.086-3.634,P<0.001)were the risk factors for occupational injury of medical staffs.Centers for Disease Control and Prevention(OR=0.129,95%CI:0.086-0.194,P<0.001)and wearing protective equipment according to regulations(OR=0.597,95%CI:0.431-0.827,P=0.002)were the protective factors for occupational injury of medical staffs.Conclusion At present,the occupational injury rate of medical staffs in Jiangsu Province is high due to various factors in the prevention and control of infectious diseases.It is necessary to pay attention to occupational safety protection,strengthen pre-job training and actively advocate"standard prevention",so as to reduce the exposure risk of harmful factors and promote occupational health of medical staffs.