某院医务人员职业暴露监测

Occupational exposure among health care workers in a hospital

摘要:

目的了解医务人员发生职业暴露人群的分布特征、危险因素与风险环节。方法对某院所有医务人员2011年1月—2014年6月发生的职业暴露进行风险监控，分别从发生职业暴露者的职业类别，暴露的地点、环节以及方式进行数据统计。结果286例次职业暴露者中，男性63例（22.03%），女性223例（77.97%）；2011年111例次（38.81%），2012年75例次（26.22%），2013年67例次（23.43%），2014年1—6月份33例次（11.54%）；对不同人群发生职业暴露者统计数据显示，各年度不同人群发生职业暴露所占百分比相似，由高到低依次为护士（31.97）%、医师（19.90%）、护工（15.79%）、技师（7.64%）、护师（4.17%）和保洁员（2.84%）；整理废物、拔针或更换针头、丢弃锐器入利器盒、手术缝合或器械传递、各种穿刺(含抽血)操作时的锐器伤是医务人员发生职业暴露损伤的主要风险环节，其构成比分别为22.38%、19.58%、14.34%、12.94%和11.19%；各年度职业暴露发生地点相似，主要是病房、手术室和注射(治疗)室，其构成比分别为51.40%、19.58%和11.54%。结论医院应建立完善的职业暴露监控与风险管理体系，强化标准预防，加强对职业暴露高危人群的培训，对风险环节及危险因素进行监控和干预，以有效降低医务人员职业暴露发生率。

Abstract:

ObjectiveTo understand the characteristics of population distribution, risk factors and risk links of occupational exposure among health care workers(HCWs)  in a hospital. MethodsOccupational exposure among HCWs  between January 2011 and June 2014 were monitored, data about occupational categories of HCWs, exposure locations, exposure links and exposure  modes were analyzed statistically. ResultsAmong 286 occupational exposure cases, the female and  male HCWs accounted for 22.03% (n=63) and 77.97% (n=223) respectively;  the  incidence of occupational exposure in 2011,2012,2013 and JanuaryJune of 2014 was 38.81%(n=111), 26.22% (n=75), 23.43% (n=67) and 11.54% (n=33) respectively; occupational exposure of junior nurses, doctors, nursing attendants,technicians, senior nurses and cleaners was 31.97%,19.90%, 15.79%, 7.64%, 4.17%, and 2.84% respectively; exposure mainly occurred at the time of sorting waste, withdrawing or changing needles, discarding sharps into sharps containers, surgical suturing or instruments passing, and puncturing (including drawing blood), the constituent  ratio was 22.38%, 19.58%, 14.34%, 12.94% and 11.19%, respectively; the main locations where exposure occurred were wards, operating rooms and injection (treatment) rooms, the constituent  ratio was 51.40%, 19.58% and 11.54% respectively. ConclusionHospital should establish comprehensive occupational exposure monitoring and risk management system, strengthen standard prevention, enhance the training about occupational exposure among highrisk population, and monitor and intervene on risk factors and links, so as to reduce the incidence of  HCWs’ occupational exposure.