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Objective To analyze the characteristics of occupational exposure to bloodborne pathogens during op-eration,and provide reference for making the prevention and control measures.Methods Occupational exposure to bloodborne pathogens during operation in a tertiary first class hospital between June 2016 and January 2017 were surveyed,the survey included general information about health care workers(HCWs),modes of occupational expo-sure,exposure sources,types of sharp injuries,manipulation and so on.Results A total of 100 HCWs sustained occupational exposure to bloodborne pathogens during the operation,64(64.00%)were nurses,followed by doctors (n=30,30.00%).The main mode of exposure were sharp injuries(n=88,88.00%)and ocular mucosa exposure (n=10,10.00%).The main diseases of exposure source were hepatitis B(n=36,36.00%)and syphilis(n=11, 11.00%).The main sharp device that caused sharp injuries was transfusion system needle(n=31,35.23%),fol-lowed by syringe needle (n=24,27.27%)and suture needle(n=14,15.91%).The main manipulation resulting of sharp injury was intraoperative manipulation (n=31,35.23%).Conclusion Training about occupational exposure should be strengthened among HCWs,it is necessary to improve the record and report process of occupational expo-sure,strictly require HCWs,especially nurses in accordance with the standard operating procedure during the oper-ation process,so as to reduce the occurrence of occupational exposure to bloodborne pathogen during operation.
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Objective To understand the characteristics of population distribution,risk factors and risk links of occupational exposure among health care workers(HCWs)in a hospital.Methods Occupational exposure among HCWs between January 2011 and June 2014 were monitored,data about occupational categories of HCWs,expo-sure locations,exposure links and exposure modes were analyzed statistically.Results Among 286 occupational ex-posure 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,nurs-ing 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,dis-carding 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 loca-tions where exposure occurred were wards,operating rooms and injection (treatment)rooms,the constituent ratio was 51 .40%,19.58% and 11 .54% respectively.Conclusion Hospital should establish comprehensive occupational exposure monitoring and risk management system,strengthen standard prevention,enhance the training about occu-pational exposure among high-risk population,and monitor and intervene on risk factors and links,so as to reduce the incidence of HCWs’occupational exposure.
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Objective To investigate the occurrence of intraoperative occupational exposure to blood among sur-geons in a hospital,so as to make effective precaution measures.Methods Combined with questionnaires,the mo-nitoring data of occupational exposure to blood among surgeons from June 2011 to June 2013 were analyzed statisti-cally.Results A total of 49 surgeons sustained 115 times of occupational exposure to blood,including 42 times (36.52%)in general surgery surgeons,36 (31 .30%)in orthopedic surgeons,31 (26.96%)in obstetrics and gyne-cology surgeons,and 6(5.22%)in urinary surgery surgeons.The main occupational exposure were sharp injuries (n=71 ,61 .74%),blood and body fluid splashing were 44 times (38.26%);the top two exposed sites were hands (49.57%)and faces (17.39%).88.70% of exposed cases were given emergent treatment,and 55.65% of exposed cases were reported.The follow-up found no surgeons were infected after the prompt and correct treatment. Conclusion Surgeons are at high risk of occupational exposure.Occupational precaution should be strengthened, occupational awareness and ability of HCWs should be enhanced,and post-exposure treatment should be improved.
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Objective To investigate the causes and treatment measures of an outbreak of Norwegian scabies oc-curred in a hospital.Methods In May 2013,an outbreak of Norwegian scabies among health care workers(HCWs) occurred because of the misdiagnosis of a patient with Norwegian scabies,epidemiological investigation was carried out by healthcare-associated infection(HAI)control department,medical intervention and disinfection and isolation measures were performed.Results A total of 27 HCWs and patients’relatives developed Norwegian scabies.After active medical treatment,patients’condition improved;all appliances used by patients were cleaned and disinfected after being wrapped and sealed with plastic bags for one week.Epidemic trend of infection was under control and no new case was found.Conclusion With highly contagious,Norwegian scabies can be spread in local area,it is neces-sary to improve HCWs’diagnostic ability to this disease and take effective measures to prevent the epidemic once HAI occur.
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Objective To investigate the incidence and influencing factors for sharp injuries occurred in workers in central sterile supply departments (CSSDs).Methods In October-November 2012,a multicenter cross-sectional survey was conducted,a total of 95 workers in CSSDs of 16 hospitals in Hunan Province were surveyed through questionnaires.Results A total of 89 workers (93.68%)in CSSDs sustained sharp injuries,46 (48.42%)of whom sustained 1 -5 times of sharp injuries,22(23.16%)sustained 6-10 times of sharp injuries,and 11 (11 .58%)sus-tained for at least 10 times of sharp injuries.81 workers (85.26%)sustained at least one time of sharp injuries one year before survey,52 (54.73%)of whom were injured by contaminated needles or other sharps.Logistic regression analysis revealed that higher educational background was protective factor for sharp injuries(OR 90%CI :0.05-0.87);while poor sleep quality(OR 90%CI :1 .03-17.94),frequent touching sharps(OR 90%CI :1 .11 -12.15),and irrational placing of objects by the other medical stuff (surgeons and nurses in operating rooms)(OR 90%CI :1 .23-16.98)were the risk factors for sharp injuries.Conclusion The incidence of sharp injuries among workers in CSSDs is high,which is related to personal factors and environmental factors.It is suggested to strengthen staff training to enhance their awareness of precaution.
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Objective To realize basic status of occupational exposure among medical postgraduates,and provide theoretical evidence for making occupational precaution measures.Methods Data about occupational exposure among medical postgraduates in a teaching hospital between January 2011 and December 2013 were analyzed retro-spectively.Results A total of 3 362 medical postgraduates were monitored,56 (1 .67%)sustained occupational ex-posure.The most common occupational exposure sites were left hand thumbs(n=15,26.79%),occupational expo-sure most frequently occurred during operation(n=29,51 .79%),a total of 40(71 .43%)occupational exposure oc-curred during the process of operation and invasive procedure,all were sharp injuries.46(82.14%)exposure sources were with bloodborne-transmitted diseases.Surgery students accounted for 66.07%(n =37)of students sustained occupational exposure,exposure rate in master’s candidates was higher than doctoral candidates(2.31 % vs 0.28%,χ2 =18.325,P <0.001 ).After timely treatment and preventive medication,none of the students were infected. Conclusion It is necessary to strengthen the occupational safety education for medical postgraduates,improve pre-caution awareness,standardize all kinds of procedures,and implement standard precaution;timely and effective treatment after exposure is important for reducing occupational injury among medical postgraduates.
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Objective To investigate occupational exposure among health care workers (HCWs)in a tertiary comprehen-sive hospital,and analyze the causes and preventive measures of occupational exposure.Methods 134 cases of occupational exposure among HCWs in a hospital from January 2010 to December 2013 were analyzed.Results Of HCWs sustained oc-cupational exposure,doctors,nurses,and technicians accounted for 59.70%,19.40%,and 9.70% respectively.The main cause for occupational exposure was non-standardized management of the sharps (46.27%,n=62),followed by unex-pected operation(42.54%,n=57)and inadequate protective measures (11.19%,n=15);The main exposure mode was sharp injury(94.78%,n=127),mucosal exposure accounted for 5.22% (n= 7);42.54% of exposure sources were not clear,57.46% of exposure sources were clear,35.82%,12.69%,3.73%,and 2.24% of which were hepatitis B virus (HBV),hepatitis C virus(HCV),Treponema pallidum(TP),and human immunodeficiency virus(HIV);2.24%(n=3)of exposure sources were co-infection of HBV and HCV;0.74% (n = 1 )was co-infection of HIV,HBV,HCV,and TP. 95.52%of occupational exposures were treated correctly.Conclusion The high-risk population for occupational exposure are nurses,standard occupational precautions and management of the sharps can reduce the occurrence of occupational expo-sure among HCWs.
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Objective To investigate the activities associated with nurses’occupational exposure to bloodborne pathogens and the source patients’infection status during blood collection process,so as to provide a basis for developing occupational exposure prevention strategies.Methods Data about occupational exposure to bloodborne pathogens during blood collection process in a hospital from August 2011 to September 2013 were monitored.Results A total of 89 times of bloodborne ex-posure occurred among HCWs,including 75 times of arterial blood collection and 14 venous blood collection.The top three procedures of occupational exposures were rebounding of needles after needles were pulled out (28.09%,n=25),concen-trated cleaning up of rubbish at the end of blood collection (20.22%,n=18),and touching blood and body fluids by skin and mucous membrane (14.61%,n=13).48.31% (n=43)source patients infected with at least hepatitis B virus,hepati-tis C virus ,hepatitis E virus,Treponema pallidum,and human immunodeficiency virus ,51.69%(n=46)source patients were not infected ,after proper handling,none of nurses were infected during blood collection .Conclusion Developing safe blood-withdraw needle,putting sharp instrument into sharp instrument container,wearing gloves,and intensifying training of standard and occupational precaution are important strategies for the reducing of the occurrence of bloodborne exposure of clinical nurses during blood collection process .
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Objective To investigate the incidence of sharp injury (SI)among health care workers(HCWs)in dif-ferent levels of hospitals in Gansu Province,so as to improve HCWs’precaution awareness,standardize behavior, and provide guide for making occupational precaution measures.Methods From January to December 2012,HCWs in 38 medical institutes in Gansu Province were selected with stratified random sampling,HCWs were surveyed through questionnaires and interview.Results A total of 11 358 questionnaires were received,the incidence of SI was 9.87%(n=1 121),case rate was 12.60%(n=1 431),the frequency of SI was 1.05 times/(person·month).SI rates of different genders,positions and years of working were statistically different (all P <0.05).The main medical devices cau-sing SI were syringe needle,venous transfusion scalp needle and surgical suture .SI caused by known sources were 1 099 times (76.80%);980 times (68.48%)of SI were induced by contaminated sources,474 (48.37%)of which were blood-borne diseases,bloodborne disease exposure accounted for 33.12%.Among bloodborne disease exposure,hepatitis B virus accounted for 74.25%,Treponema pallidun 13.10%,hepatitis C virus 12.01% ,and human immunodeficiency virus 0.64%.Conclusion There is a high incidence rate of SI among HCWs in Gansu Province,it is a very important public health problem which needs to be solved.
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Objective To realize the current situation of glove perforation during surgical operation process,and provide basis for preventing surgical glove perforation.Methods In January 2014,an investigation on glove perfo-ration was conducted among operation personnel in 9 operating rooms in a hospital,glove perforation rates,sites, causes and noticed ways were analyzed.Results A total of 2 909 person-time was investigated,147 person-time oc-curred glove perforation,person-time rate of glove perforation was 5.05%;153 of 5 818 gloves (2.63%)were per-forated,6 person-time occurred perforation of double gloves;gloves perforation rates of each specialized surgery were significantly different (χ2=87.945,P<0.001),cardiac surgery(11.84%)and plastic surgery(10.78%)had the hight perforation rates.The common sites of perforation were index finger,thumb,and middle finger,the main cause of perforation was sharp damage by stitches and devices.Most perforations were noticed intraoperatively,and seldom found postoperatively by naked eyes;gloves of different brands had different perforation rates(χ2=33.845, P<0.001).Conclusion In order to reduce and prevent the perforation during operation process,glove brands with good quality should be chosen,and measures for the prevention of glove perforation should be formulated according to the types of surgery.
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Objective To investigate the current status of knowledge,attitude and practice of occupational expo-sure to blood and precaution among health care workers (HCWs),and to evaluate the factors affecting wearing gloves and isolation gowns.Methods HCWs in a hospital on October 16,2102 were investigated through question-naires.Results A total of 374 HCWs were investigated,the average training per HCW were(1.47±1.54)times, HCWs in internal medicine department were (2.00±2.12)times,which was higher than HCWs in the other depart-ments (P0.05).The main factors affecting wearing gloves and isolation gowns were inconvenient for manipulation and inadequate facility.Conclusion The knowledge,attitude and practice of occupational blood exposure and precaution among HCWs are not desirable.Measures should be taken to improve HCWs’occupational precaution standard.