天津市某三级甲等综合医院医疗废物相关职业暴露情况及漏报影响因素

Occupational exposure to medical waste and influencing factors of underreporting in a grade-A tertiary general hospital in Tianjin

目的了解天津市某三级甲等综合医院医疗废物相关职业暴露的流行情况,并分析漏报的影响因素.方法2021年10-12月对医院内随机抽取的369名工作人员进行问卷调查,并对数据进行分析.结果过去1年内医疗废物相关职业暴露发生率和漏报率分别为27.37%和59.41%.漏报原因前3位依次是:"认为自己感染风险很低"(36.7%);"工作繁忙,没时间上报"(31.7%);"不知晓或不熟悉上报流程"(20.0%).实习(OR=7.988,95%CI:1.357~46.954)是医疗废物相关职业暴露漏报的危险因素,高级职称(OR=0.359,95%CI:0.164~0.784)、知晓报告流程(OR=0.203,95%CI:0.074~0.561)、暴露源阳性或无法追踪(OR=0.171,95%CI:0.043~0.676)是保护因素.结论天津市某三级甲等综合医院工作人员医疗废物相关职业暴露发生率较高,漏报现象严重.实习情况、职称水平、报告流程知晓情况和暴露源情况是主要影响因素.需通过多种方式降低医疗废物职业暴露发生率,提高上报依从性,保障医院工作人员的职业安全.

Objective To analyze the prevalence of occupational exposure to medical waste in a grade-A tertiary general hospital in Tianjin,analyze the influencing factors of underreporting. Methods 369 workers randomly selected from the hospital were investigated by questionnaire from October to December 2021,and the data were analyzed. Results The incidence of occupational exposure related to medical waste and the underreporting rate in the past year was 27.37% and 59.41% respectively. The top three reasons for underreporting were: “I think my risk of infection is very low”(36.7%), “Busy work,no time to report”(31.7%),“Unknown or unfamiliar with the report process”(20.0%). The practice(OR=7.988,95%CI:1.357-46.954) was a risk factor for underreporting of medical waste related occupational exposure, while senior professional titles(OR=0.359,95%CI:0.164-0.784),awareness of the reporting process(OR=0.203,95% CI:0.074-0.561),and positive exposure sources or inability to track(OR=0.171,95%CI:0.043-0.676) were protective factors. Conclusion The incidence of occupational exposure related to medical waste in a grade-A tertiary general hospital in Tianjin is high,and the situation of underreporting is serious. The main influencing factors are the practice,professional title,awareness of reporting process and exposure sources. It is necessary to reduce the incidence of occupational exposure to medical waste in various ways,and improve the reporting compliance,to ensure the occupational safety of hospital staff.