郑州地区医务人员职业暴露情况研究

Study on the occupational exposure of medical staff in Zhengzhou

目的调查郑州地区医务人员职业暴露发生情况,为制定有效的干预措施提供参考依据。方法于2021年10月采用方便抽样方法抽取郑州地区不同辖区内的4家二级医院和4家三级医院的医务人员作为调查对象进行职业暴露情况调查,采用描述性流行病学分析方法对医务人员的职业暴露情况进行分析,再经过单、多因分析方法对医务人员职业暴露的影响因素进行分析。结果最终纳入有效调查对象931名医务人员,男性435名,女性496名;年龄22~56岁,平均年龄(38.9±9.6)岁;有护士354名,医生372名,检验技师130名,麻醉师75名。发生职业暴露91例,发生率9.77%,共发生职业暴露事件118例次,其中锐器伤57例次、皮肤黏膜接触暴露39例次、呼吸道/血液/体液暴露22例次。多因素Logistic回归分析显示学历(OR=0.779)、职称(OR=0.751)、医院级别(OR=0.364)、工作性质(检验技师OR=0.670、麻醉师OR=0.585)、工龄(OR=0.689)、编制性质(OR=3.904)、工作疲劳(OR=2.368)、应对方式(OR=2.691)、近1年是否参加相关培训(OR=0.481)是医务人员职业暴露的影响因素。结论医院人员发生职业暴露受到学历、职称、医院级别、工作性质、工龄、编制性质、近1年是否参加相关培训多方面因素影响,应针对以上各项采取有效的干预措施,加强医务人员的自我防护意识、提高防护能力,降低职业暴露风险。

Objective To investigate the occupational exposure of medical staff in Zhengzhou,and provide a reference for formulating effective intervention measures.Methods In October 2021,the convenience sampling method was used to select the medical staff of 4 secondary hospitals and 4 tertiary hospitals in different jurisdictions of Zhengzhou as the survey subjects for occupational exposure investigation.The descriptive epidemiological analysis method was used to analyze the occupational exposure of medical staff,and univariate and multivariate analysis methods were used to analyze influencing factors of occupational exposure in medical staff.Results Finally,931 medical staff were included in the effective survey,including 435 males and 496 females;aged 22-56 years,with an average age of(38.9±9.6)years;there were 354 nurses,372 doctors,130 laboratory technicians,and 75 anesthesiologists.Occupational exposure occurred in 91 cases,with an incidence rate of 9.77%.A total of 118 occupational exposure incidents occurred,including 57 cases of sharp injury,39 cases of skin and mucous membrane exposure,and 22 cases of respiratory/blood/body fluid exposure.Multivariate Logistic regression analysis showed that educational background((OR=0.779),professional title(OR=0.751),hospital level(OR=0.364),work nature(OR=0.670 for laboratory technicians,OR=0.585 for anesthesiologists),length of service(OR=0.689),establishment nature(OR=3.904),work fatigue(OR=2.368),coping style(OR=2.691),whether to participate in relevant training in the past year(OR=0.481)were the influencing factors of occupational exposure of medical staff.Conclusion The occurrence of occupational exposure is affected by many factors,such as educational background,professional title,hospital level,work nature,length of service,establishment nature,and whether they participate in relevant training in the past year.Effective intervention measures should be taken to strengthen the self-protection awareness of medical staff and improve their protection ability,to reduce the occupational exposure risk.