广东省39所医院医务人员锐器伤调查

Survey on sharps injuries among health care workers at 39 hospitals of Guangdong province

摘要:

目的了解广东省医务人员血源性职业暴露的发生情况，为制定预防措施提供科学的依据。方法采用问卷调查方法，对广东省39所医院医务人员2011年6月锐器伤的发生情况进行横断面调查。结果发放调查表32 617份，回收32 297份，回收率为99.02%；实际有效问卷32 007份，有效率为99.10%。发生锐器伤1 460例，1 909例次，锐器伤发生率为4.56%，例次率为5.96%，平均月发生密度为0.06次/（人月）。发生污染锐器伤1 495例次，污染锐器伤例次发生率为4.67%（1 495/32 007）；污染锐器伤占锐器伤总例次的78.31%（1 495/1 909），其中61.67%(922/1 495)能追踪到暴露源，38.33%（573/1 495）不能确定其是否具有传染性。血源性污染器械中，81.71%（67/82）为乙型肝炎暴露源，14.63%（12/82）为梅毒暴露源，3.66%（3/82）为丙型肝炎暴露源，无艾滋病暴露源。锐器伤发生的地点主要为普通病房（47.72%）与手术室(20.27%)；频率最高的操作是加药(15.92%)，其次为医疗废物处置(12.78%)和拔除动（静）脉针（12.21%）；主要医疗器具为一次性注射器 (35.99%)、头皮钢针 (19.43%)和手术缝针(13.41%)。医务人员职业暴露相关知识培训率为93.25%。结论锐器伤是导致血源性传播疾病感染的主要职业因素, 医疗机构应建立健全职业病防治组织机构和规章制度，规范医务人员的血源性职业暴露预防与控制行为，降低血源性职业暴露伤害风险。

Abstract:

ObjectiveTo investigate occupational exposure to blood among health care workers (HCWs) in Guangdong province, and provide scientific basis for developing preventive measures.MethodsA crosssectional survey on sharps injuries among HCWs at 39 hospitals in Guangdong province in June 2011 was conducted through questionnaires.ResultsA total of 32 617 questionnaires were distributed, and 32 297 (99.02%) were responded; and 32 007(99.10%) questionnaires were available for analysis. 1 460 HCWs had suffered 1 909 times of sharps injuries, and the incidence was 4.56% , the injury episode rate was 5.96%; the average number of injury per month was 0.06/person. 1 495 (4.67%,1 495/32 007) injury episodes were caused by contaminated sharps; contaminated sharps injuries accounted for 78.31%(1 495/1 909) of total sharps injuries, and 61.67%(922/1 495) of which could trace to the exposure sources, while 38.33%(573/1 495) couldn’t determine the infectivity. Among bloodcontaminated devices, 81.71%(67/82) were hepatitis B exposure, 14.63% (12/82) were syphilis exposure； 3.66%(3/82) were hepatitis C exposure, there was no HIV exposure. The locations where sharps injuries occurred mostly were general wards (47.72%) and operating rooms (20.27%); the procedures involved in high injury rates were dispensing(15.92%) , medical waste disposal (12.78%), and syringe needle removal(12.21%); the main medical devices that caused sharps injuries were disposable syringe needles(35.99%), scaple needles(19.43%) and suturing needles(13.41%). HCWs’ training rate of knowledge about bloodborne occupational exposure was 93.25%.ConclusionSharps injury is the main professional factor that cause bloodborne diseases. In order to reduce the risk of injuries caused by occupational exposures, medical institutions should establish corresponding organization and rules, and HCWs should standardize preventive and control behavior towards occupational exposures.