2019-2023年某三级医院医务人员职业暴露流行病学调查

Epidemioloical survey on occupational exposure of health care workers in a tertiary hospital from 2019 to 2023

目的调查某三级医院医务人员职业暴露现状。方法采用回顾性调查方法对2019-2023年联勤保障部队第926医院上报的206例医务人员职业暴露事件进行分析,包括职业暴露人群基本情况、暴露场所、暴露方式、暴露部位、暴露环节、暴露原因和暴露后应急处理及随访情况。结果医务人员职业暴露以护士为主(57.28%),多数为首次发生职业暴露(83.98%);暴露科室最多的为骨科(15.53%),暴露人群集中在25岁左右,发生频次随工作年限增加而降低;暴露例数呈逐年降低趋势,集中在7~8月份;职业暴露发生最多的场所为病房(37.38%),暴露最多的方式是头皮针刺伤(23.30%),暴露部位最多的是手部(80.10%),原因最主要是本人操作不慎(60.19%),38.83%的人群暴露于血源性传播病原体的危险中,病原体最多的是乙型肝炎病毒(HBV);大部分(83.01%)能在职业暴露后采取规范的应急处理措施,并在暴露当天(64.56%)进行血液检测。结论医务人员职业暴露影响因素复杂,应加强对重点人群、重点场所和重点部位的关注,并采取针对性防控措施,预防职业暴露的发生。

OBJECTIVE To investigate the occupational exposure status of health care workers(HCWs)in a tertiary hospital.METHOD A retrospective survey method was used to analyze 206 cases of occupational exposure incidents of HCWs reported by the No.926 Hospital of the United Logistics Support Force from 2019 to 2023,including the basic situation of occupationally exposured population,the place,the modes,the sites,the link and the causes of occupational exposure,and the post-exposure emergency treatment and follow-up.RESULTS The occupational exposure of HCWs were mainly nurses(57.28%),most of them were the first time occurring occupational exposure(83.98%).The most exposed departments were orthopedics(15.53%),and the exposed people were concentrated in the mid-20s,and the frequency of occurrence decreased with the increase of working years.The number of exposed cases showed a decreasing trend year by year,concentrated in the months of Jul.and Aug.The place where occupational exposure occurred the most was the ward(37.38%),and the most common modes of exposure was needle puncture(23.30%),and the site of exposure was the hand(80.10%),and the main reason was careless operation(60.19%).38.83% of the population was exposed to the risk of blood-borne transmitted pathogens,most common of which was HBV.Most people(83.01%)were able to take standardized emergency management measures after occupational exposure,and blood tests were performed on the day of exposure(64.56%).CONCLUSION The factors affecting occupational exposure of HCWs were complex,and attention should be paid to key groups,places and locations,and targeted prevention and control measures should be taken toprevent occupational exposure.