摘要
目的 了解皮肤病专科医院医务人员感染性职业暴露的发生特征,为防控感染性职业暴露提出可行性建议。方法 回顾性收集2020年1月1日—2023年12月31日某三甲皮肤病专科医院医务人员感染性职业暴露数据,分析暴露者的人群、科室、暴露方式和部位、防护情况,以及暴露场所、暴露源和暴露时间分布等特征。结果 该院4年间医务人员感染性职业暴露共97例,年发生率总体呈先上升后下降趋势,不同年份发生率差异有统计学意义(χ~2=4.09,P=0.043)。暴露者以医生为主(59.79%),年龄≤35岁(85.56%)、工龄≤5年(71.13%)者发生职业暴露占比较高;暴露场所以门诊为主(59.79%);暴露发生方式多为针刺伤或锐器伤(86.60%);暴露部位以手部为主(84.54%);暴露时机以注射及穿刺(39.17%)为主;本人操作不慎/未做好个人防护是暴露发生的主要原因(92.78%);暴露源以不明病原体(27.84%)占比最高,其次是乙型肝炎病毒(13.40%)、梅毒螺旋体(8.25%)、人类免疫缺陷病毒(2.06%)。结论 皮肤病专科医院医务人员感染性职业暴露的年发生率较高,尤其易发生于医生和年龄较小、工龄较短人员中,职业暴露风险较综合医院有其专科特色。建议采取加强培训、做好标准防护、完善暴露后处置流程、建立信息化上报系统、关怀医务人员心理状态等措施,以有效防控职业暴露的发生。
Objective To investigate the characteristics of occupational exposure to infectious diseases in dermatology hospital in order to provide feasible recommendations to the prevention and control of occupational exposure to infectious diseases.Methods We retrospectively analyzed the 4-year data(2020 to 2023)on occupational exposure to infectious diseases from a tertiary dermatology hospital.Results A total of 97 medical staff had work-related infectious diseases.The prevalence of work-related infectious diseases appeared a parabolic curve during that period(2=4.09,P=0.043).Large portion of the infected staff were doctors(59.79%),aged≤35 years(85.56%),with working experience of≤5 years(71.13%).The outpatient department was the main exposure site(59.79%),while 86.60%of infections were caused by sharp injury.Hand was the main affected site(84.54%).Injection and puncture were the main procedures causing infections(39.17%).Uncareful procedures and inappropriate personal protection were the major causes of work-related infections(92.78%).The common pathogens were hepatitis B(13.40%),treponema pallidum(8.25%)and human immunodeficiency virus(2.06%)while 27.84%of infections were with unknown pathogens.Conclusions The annual rate of occupational exposure to infectious diseases among medical staff is high in specialized hospitals for dermatology,especially among doctors,younger and less experienced personnel.In comparison to general hospital,the risk of occupational exposure to infectious diseases displays specialty-related characteristics.To effectively prevent and control occupational exposure to infectious diseases,it is necessary to strengthen training,standardize protection,properly manage post-exposure,establish information reporting system,and take care of mental health of medical personnel.
作者
罗开元
邱慧
李济宾
燕翼
安宁波
LUO Kaiyuan;QIU Hui;LI Jibin;YAN Yi;AN Ningbo(Third Affiliated Hospital,Guangzhou Medical University,Guangzhou 510150,China;Dermatology Hospital,Southern Medical University,Guangzhou 510091,China;Sun Yat-sen University Cancer Center,Guangzhou 510060,China)
出处
《皮肤性病诊疗学杂志》
2024年第7期489-495,共7页
Journal of Diagnosis and Therapy on Dermato-venereology
基金
广州市科技局临床研究专项(202201020189)。
关键词
皮肤病专科医院
感染性职业暴露
医务人员
乙型肝炎病毒
dermatology hospital
infectious occupational exposure
healthcare worker
cross-sectional study
