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There are many occupational risk factors in operating room work. Polymethyl methacrylate (PMMA) , as a kind of common bone filling and repairing material, is widely used in the fixation of artificial joints, oral braces and orthopedic prosthesis. However, PMMA will release methyl methacrylate (MMA) monomer when it is implanted into human tissues and polymerized to harden, which is toxic to the body. This paper analyzes harmful factors in using PMMA bone cement, and then explores corresponding occupational protection knowledge, in order to reduce the occurrence of occupational hazards related to PMMA bone cement and enhance the self-protection ability of the operation room medical staff.
Subject(s)
Humans , Bone Cements/adverse effects , Operating Rooms , Polymethyl Methacrylate/adverse effectsABSTRACT
This article investigated an occupational chronic benzene poisoning incident that occurred in a sealing material factory in Hebei Province in September 2019, analyzed the clinical data of workers, to explore the causes of occupational chronic benzene poisoning, and summarize the diagnosis and treatment characteristics and treatment outcome. According to GBZ 68-2013 "Diagnosis of Occupational Benzene Poisoning", a total of 12 cases of occupational chronic benzene poisoning were diagnosed among the 20 workers, including 2 cases of occupational chronic mild benzene poisoning, 7 cases of moderate benzene poisoning, and 3 cases of severe benzene poisoning. Both mild and moderate poisoning patients had recovered after treatment. Severely poisoned patients had recovered more slowly, and the white blood cell count was still 2.0×10(9)-3.0×10(9)/L during the 1-year follow-up. This benzene poisoning incident was caused by illegal operations. The responsibility of the employer, the supervision of the administrative agency, and the awareness of personal protection of employees should be strengthened to avoid or reduce the occurrence of poisoning incidents and ensure the health of workers.
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Humans , Accidents, Occupational , Benzene/analysis , Chronic Disease , Leukocyte Count , Occupational Diseases/epidemiology , Occupational Exposure/analysis , PoisoningABSTRACT
Objective: To analyze the risk factors of blood-borne occupational exposure among medical staff and explore the relevant intervention measures. Methods: In June 2020, the data of blood-borne occupational exposure and related factors reported by medical staff in a grade Ⅲ, Grade A general hospital from 2011 to 2019 were analyzed by retrospective investigation. Results: Among 431 cases of blood-borne occupational exposure, 69.37% were nurses. It mainly occurred in medical staff with 0-4 years of service, accounting for 63.57%; The main place of occupational exposure was in the ward 47.56%; Sharp instrument injury was the main occupational exposure route 91.65%. Occupational exposure department was mainly surgery department 17.87%; The main source of exposure was hepatitis B virus (HBV) 37.12%, followed by treponema pallidum 20.19%. Statistical analysis results show that: Exposure sites (χ(2)=43.585, P<0.01) , exposure sources (χ(2)=22.693, P<0.01) , treatment methods after exposure (χ(2)=18.866, P<0.01) , Flushing (χ(2)=31.963, P<0.01) and disinfection (χ(2)=14.216, P<0.01) were significantly different. Conclusion: The effective measures to reduce blood-borne occupational exposure are to strengthen occupational protection training of medical staff, standardize operation procedures, strengthen supervision of key groups and departments, improve reporting, monitoring and follow-up systems to realize informatization, and do a good job in risk control.
Subject(s)
Humans , Blood-Borne Pathogens , Medical Staff , Needlestick Injuries , Occupational Exposure/prevention & control , Retrospective Studies , Risk FactorsABSTRACT
Objective:To construct of occupational protection ability system for nursing staff, in order to improve the ability of occupational protection of nursing staff.Method:based on knowledge attitude/belief practice theory, the occupational protection ability system for nursing staff were established by literature review, Delphi method, expert group discussion and semi-structured interviews.Results:The rates of questionnaires return were 19/20 and 15/16 in the first and second round expert consultation. The authority coefficient of expert were 0.892 and 0.921. The coordination coefficient of experts′ opinion were 0.377 and 0.456. The training system included 3 first-level indexes, 11 second-level indexes and 109 third-level indexes.Conclusion:The results of ability system are reliable, which can provide reference for training the nursing staff′s occupational protection ability.
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OBJECTIVE@#To understand the current cognition of acquired immunodeficiency syndrome (AIDS) occupational protection among the managers of multi-level stomatology medical institutions in efforts to provide a reference for formulating technical standards for occupational protection.@*METHODS@#Eighteen managers of oral medical institutions were individually interviewed in-depth using asemi-structured questionnaire on issues related to AIDS occupational protection using the phenomenological research method. Nvivo 12.0 software was used to code and analyze the interview data, and relevant themes were extracted.@*RESULTS@#Three themes were extracted from the data. Occupational protection measures for AIDS in dental medical institutions mainly based on the aspects of standardized operation, standardized prevention, and post-exposure treatment. However, the implementation of these protective measures was often inadequate. Occupational protection training for AIDS was carried out regularly at dental medical institutions, but the training effect was not generally tracked. Several limitations in AIDS occupational protection management; these limitations included the lack of a specific occupational protection system, the difficulty of AIDS screening for outpatients, and the difficulty of AIDS occupational protection supervision.@*CONCLUSIONS@#Oral medical institutions should strengthen their occupational protection training and supervision approaches and formulate unified occupational protection standards to reduce occupational exposure and improve hospital management quality and efficiency.
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Humans , Acquired Immunodeficiency Syndrome , Cognition , Occupational Exposure , Oral Medicine , Surveys and QuestionnairesABSTRACT
Objective@#To understand the status of blood-borne occupational exposure and protection among health care workers (HCWs) in dental practice, and provide evidence for making effective prevention.@*Methods@#From April 1 to 15, 2019, a stratified random sampling method was conducted to investigate the data of blood-borne occupational exposure among 221 dental HCWs in 2018, and Chi-squared Test was used to evaluate the differences of status on occupational exposure and protection among different professionals, such as nurses, doctors and trainees, and among different-grade hospitals.@*Results@#A total of 166 HCWs were exposed to occupational exposure 269 times, with the annual incidence of 75.11% (166/221) , and 37.55% (101/269) of exposures were reported. However, all source patients of exposures had failed to be traced. 89.59% (241/269) of exposures were sharp injuries. The top three instruments caused injuries were syringe/bilan needles, suture needles and vehicle needles, accounting for 35.68% (86/241) 、16.60% (40/241) and 16.18% (39/241) , respectively; and the top three exposure operations were removal/disposal of needles or instruments, suture/assisting suture and injection of anesthetic, accounting for 37.17% (100/269) 、22.30% (60/269) and 17.84% (48/269) , respectively. There were statistically significant differences among different professionals in occupational exposure frequency, reporting rate, the types of instruments caused injuries, exposure operations and hepatitis B vaccinated time (P<0.01) . The compliance rate of standard precautions, safe operation, post-exposure reporting and prevention, and training on occupational protection were generally poor among HCWs, with significant differences in different-grade hospitals (P<0.01) .@*Conclusion@#There is a high incidence, low reporting rate and poor self-protection of blood-borne occupational exposure among dental HCWs. Strongly suggesting that standard precautions, safe use and disposal of oral instruments, active post-exposure report and prevention must be improved for everyone.
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Sharp injury is a common occupational injury occurs in hospital, it is also an important way for health care workers to be infected with blood-borne pathogens, standardized use of sharps containers can effectively prevent the occurrence of sharp injury.Sharps containers are widely used in China, but the specifications are limited and the products are single, there is still room for improving safety performance.In view of the problems existing in clinical use, Chinese scholars have made a lot of improvements on sharps containers.The author suggests that relevant units should consider the design concept of clinic to develop and popularize more reasonable safe sharps containers for clinical application, and take other comprehensive behavioral control measures, so as to effectively reduce the occurrence of sharp injury.
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Acquired immunodeficiency syndrome (AIDS) is an infectious disease caused by human immunodeficiency virus (HIV). The disease is highly infectious, quickly spreads, and has a high fatality rate. Hence, it is a major concern in public health, and an important subject in the prevention and treatment of infectious diseases. The medical staff of stomatological departments, which handle the diagnosis and treatment of oral diseases, are at particularly high risk of occupational exposure to HIV/AIDS. This study summarizes the HIV/AIDS epidemic status, disease transmission routes, oral lesions in HIV/AIDS patients, occupational exposure, and occupational protection in stomatological departments.
Subject(s)
Humans , Acquired Immunodeficiency Syndrome , HIV Infections , Occupational Exposure , Oral MedicineABSTRACT
OBJECTIVE: To analyze the current status of tumor-related occupational protection knowledge among medical staffs in comprehensive hospitals. METHODS: A stratified random sampling method was used to select 572 medical workers from 24 comprehensive hospitals as study subjects, including 289 nurses and 283 medical doctors. The Survey on Occupational Protection Knowledge and Management of Hospital Tumors was used to investigate the research subjects. RESULTS: i) The awareness status of the tumor-related occupational protection knowledge: the awareness rate of sharps injuries that should be included in occupational protection management was as high as 93.7%, while the awareness rate of standard operating procedures for occupational protection in working post was only 32.9%. ii) Evaluation on the management of tumor-related occupational protection in the hospital: most medical personnel think that medical occupational protection is very important to medical quality and safety, and they are not satisfied with personal protective equipment(PPE), various protective facilities and medical devices. The satisfaction scores of subjects in the nursing group on the use of PPE, the convenience of PPE, the reliable quality of PPE, the use of occupational health protection facilities, and the degrees of satisfaction with the occupational protective functions of medical devices and materials were lower than those in the medical group(P<0.05). iii) The awareness status on the knowledge of the management of tumor-related occupational protection in medical staffs of hospital: The awareness rate of items that the hospital′s prominent warning signs for medical waste places, equipment and materials was 89.9%, and the awareness rate of items that the contents of occupational safety and personal protection in the operating procedures of the workplace can meet the protection needs was only 38.1%. The awareness rates of understood that occupational exposure management department has regular inspections and supervision for related work in various departments, and can easily obtain occupational protection standard procedures and emergency treatment plans, the purchase information of work injury insurance, hospital′s prominent warning signs for places, equipment and materials were setting up in the nursing group were higher than that of the medical group(P<0.05). CONCLUSION: Hospitals should strengthen the related training on occupational protection operation specification and protective measures, improve the protection awareness of medical staffs, and make them actively use medical equipment and consumables with occupational protection functions, so as to reduce occupational exposure.
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OBJECTIVE: To strengthen the occupational protection of pharmacy intravenous admixture service (PIVAS) staff, and to ensure the safe and timely delivery of drugs. METHODS: The cytotoxic drug packing bag was made by oxford cloth, velvet cotton, pearl cotton, silica gel, activated carbon, rope, etc. Taking Paclitaxel liposomes for injection as an example, the application effect of packing bags was observed. A total of 156 medical orders of PIVAS formulated Paclitaxel liposomes for injection were selected and divided into test group and control group aoccording to random number table. The dispensing drugs were packed with cytotoxic drug packing bag in trial group, and packed with previous plastic packing bag in control group. The packing time of each drug, the delivery time, leaking and shattering, the breakage processing time and loss amount were compared between 2 groups. RESULTS: There was no statistical significance in the delivery time between 2 groups (P＞0. 05). The packing time of trial group was significantly longer than control group; there were 16 bottles of leaking in the control group, and 8 bottles of shattering; In trial group, 3 bottles were leaking but not spilled over (infiltrated in the silica gel layer), and there was no shattering bottle; the breakage processing time of trial group was significantly shorter than that of control group; the loss amount was significantly less than that of control group, with statistical significance (P＜0. 05). CONCLUSIONS: The cytotoxic drug packaging bag developed in this study can play a spill-proof, anti-seismic role, reduce the loss of valuable drugs, and also strengthen the occupational safety and health protection of medical staff.
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Objective · To conduct a survey on the current status of professionalism and personal protection in Central Sterile Supply Department (CSSD) practitioners in Shanghai, analyze the existing problems and provide suggestions, in order to improve work quality and management level of CCSD. Methods · Cluster sampling was used to extract 23 different level hospitals with CSSDs among 4 districts in Shanghai including Jing'an, Jinshan,Qingpu and Jiading. A total of 147 participants consisted of 104 employees and 43 heads of CSSDs. Field investigation and questionnaire survey were applied into CSSD practitioners for investigating their essential information, professionalism and personal protection status. Results · Practitioners in different hospitals showed different professional knowledge, especially practitioners in private hospital performed worse than those in secondary and tertiary-level hospitals in this survey of professionalism. Daily protection measures were defective due to lacking of consciousness of personal protection.Conclusion · There was problem of personal professionalism and protection consciousness in CSSD practitioners. It is important to optimize the allocation of CSSD human resource, reinforce skill training and improve quality management.
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Objective To understand the occupational exposure among medical laboratorians in a hospital,and put forward prevention and control measures.Methods Occupational exposure among medical laboratorians in the department of laboratory medicine of a hospital from January 2011 to December 2014 were analyzed statistically.Results A total of 72 cases of occupational exposure occurred among 217 laboratorians during 4 years,occupational exposure rate was 33.18％,the occupational exposure rate in interns was 46.23％,and in laboratorians with working seniority＜ 1 years was 49.56％.Occupational exposure mainly occurred in outpatient blood collection room(accounting for 38.89 ％),the main occupational exposure types were injuries by blood collection needles,skin contaminated by blood and body fluid(76.39 ％).Occupational exposure rates in medical laboratorians in this hospital during 2011-2014 were 53.66％(22/41),41.67％(20/48),26.23％(16/61),and 20.90％(14/67),respectively,which presented a declining tendency(x2 =12.286,P＜0.01).After occupational exposure,only 23 cases were reported according to the requirements of infection management department,the missing report rate was 68.06％ (49/72),correct handling rate was 80.56％ (58/72).Conclusion Laboratorians should strengthen education and training of healthcare-associated infection management,improve safety and prevention consciousness,standardize handling process,improve consciousness of reporting,so as to reduce the occurrence of occupational exposure and post exposure infection.
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Objective@#To investigate blood-borne occupational exposure and related protection in the medical staff of a traditional Chinese medicine hospital, and to provide a reference for reducing the risk of blood-borne occupational exposure.@*Methods@#Forty-eight medical workers with blood-borne occupational exposure in 2015 were selected to analyze the incidence of blood-borne occupational exposure, influencing factors, operations that caused blood-borne occupational exposure, pathogens, and occupational protection.@*Results@#The incidence rate of blood-borne occupational exposure in the medical staff of the traditional Chinese medicine hospital in 2015 was 3.30% (48/1 455) , and the frequency was 0.04 time/person/year. The workers with blood-borne occupational exposure were mostly nurses, females, workers aged <30 years, workers with <5 working years, and workers with a junior professional title. There was a significant difference in the incidence rate of blood-borne occupational exposure between workers with different ages and working years. The main way of blood-borne occupational exposure was sharp injury (96.08%) . The main operations that caused blood-borne occupational exposure were covering or separating the syringe needle after injection and disposing used sharp instruments. The main exposure site was the hand (96.08%) , with the thumb and index finger for the left hand and the middle finger and index finger for the right hand; there was no significant difference in the exposure site distribution between the two hands (P<0.05) . The main pathogen that caused blood-borne occupational exposure was hepatitis B virus (68.96%) . The rate of correct local treatment for blood-borne occupational exposure was 88.24%. The rate of prophylactic medication was 74.51%, and hepatitis B immunoglobulin (HBIG) plus hepatitis B vaccine was the main way, followed by HBIG. In all workers with blood-borne occupational exposure, 62.74% did not wear gloves.@*Conclusion@#The medical workers with few working years have a high risk of blood-borne occupational exposure, so the training on protection against blood-borne occupational exposure should be strengthened to reduce the risk of blood-borne occupational exposure and infection.
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Objective To investigate the current situation of radiation protection capability and personal protection in the clinical practice of interventional radiology in grade-Ⅲ hospital.Methods A total of 108 medical staffs including physicians,technicians and nurses,who worked in interventional room,CT/ MR room,interventional catheterization room,radiotherapy department or radiology department in a grade-Ⅲ hospital of Guangdong province during the period from June 2014 to November 2015,were enrolled in this questionnaire investigation.The contents of self-mnade questionnaire included general demographic data,personal radiation exposure and protection.By using self-made questionnaire about the radiation protection capability of interventional work (both I-CVI and S-CVI being 0.9) the interventional radiation protection capability of the hospital was evaluated.Results In a certain grade-Ⅲ hospital of Guangdong province,the protection capability in shielding facilities,operating time and distance protection was quite strong,but the health-care leave system was lack,the occupational hazard detection was insufficient,and the protection and training system was poorly executed.In aspect of personal protection,the usage rate of lead apron in interventional procedures was only 72.2％,moreover,the rate of not wearing a radiation detector was up to 4.6％,and 9.3％ of medical staff didn't know the correct wearing position of a radiation detector.Conclusion The medical institution is lack of enough attention to the personal radiation protection as well as to the occupational health of interventional medical staff.In part of the medical staff,the consciousness of radiation protection is weak and the protection knowledge is insufficient,they are lack of adequate attention to occupational protection.All these issues need to be further improved.
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Objective:To explore the shortages of chemotherapy occupational protection for pharmacist in our hospital through the contrast and analysis of the occupation protection status of pharmacists in two groups.Methods:Chemotherapy Occupational Protection Status Questionnaire for Medical Staff was used,and totally 30 pharmacists from PIVAS and 30 ones from OUIVA were selected as the research objects according to the random number table.The main contents of the questionnaire included the basic information of respondents,protection conditions in drug preparation rooms,pharmacist protection status and pharmacist training conditions,etc.The results of the questionnaire were statistically analyzed.Results:In general,the understanding of pharmacists for the harm of chemotherapy drugs and protective measures was poor.PIVAS group was obviously better than OUIVA group in the use of protective equipment and relavant measures with statistically significant differences (P<0.05).Conclusion:Pharmacists have insufficient understanding for the danger of chemotherapy drugs and their harmful ways with low performance of chemotherapy occupational protection,and our hospital has no perfect protection system and adequate protective equipment yet.
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Objective To study the intervention effectiveness of intensive training in medical interns’occupational exposure protection.Methods Medical interns in seven colleges and universities in Wuhan between 2011 and 2015 were chosen and divided into control group (675 medical interns in 2011 - 2013,comprehensive training about healthcare-associated infection control was conducted for once before internship )and intervention group (682 medical interns in 2014 - 2015,hospital-department-tutor three steps of intensive training was conducted),the occurrence of occupational exposure and exposure knowledge awareness between two groups were compared. Results The awareness rate of knowledge about occupational exposure protection and the implementation rate of protective measures in intervention group were both higher than control group (all P <0.05).Incidence of occupa-tional exposure in intervention group was lower than control group (21 .70%[n=148]vs 65.33%[n=441 ],χ2 =262.91 ,P <0.01);percentage of interns who conducted active serological virus detection and intensified vaccination of hepatitis B virus were both higher than control group (14.66%[n=100]vs 2.96%[n=20];11 .73%[n=80]vs 2.67%[n=18],respectively).Occupational exposure before and after intervention occurred most frequently when interns were preparing medicine,occupational exposure reporting rate in intervention group was higher than control group (72.97%[108/148]vs 50.11 % [221/441 ],χ2 =52.78,P <0.01 ).Conclusion The intensive training of occupational exposure protection among medical interns can improve the awareness and skills of occupational protec-tion,and reduce the occurrence of occupational exposure.
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Objective:To explore the effect of occupational protection compensation education carried out in nursing students practice in department of orthopedic on the occupational protection knowledge level and occupational injuries. Methods:From 2013 to 2014, nursing students practice in department of orthopedics did not receives occupational protection compensation education, from 2014 to 2015, nursing students received occupational protection compensation education before practice. Questionnaire investigation of nursing students at the end of practice was done. Results:Compared with nursing students practice in department of orthopedic from 2013 to 2014,occupational protection knowledge score was higher and the number of occupational injuries occurred during internship people was significantly lower in nursing students practice in department of orthopedic from 2014 to 2015 (P<0.05 and 0.01) . Conclusion:To strengthen the occupational protection compensation education in nursing students, can improve knowledge of occupational safety and protective ability,reduce occurred rate of the occupational injuries.
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Objective To understand current status of occupational protection awareness and behavior among dif-ferent professional medical interns,and provide basis for strengthening the education about occupational protection among medical interns .Methods Questionnaire survey was used to survey medical interns at the end of their clini-cal internship.Results A total of 385 cases of occupational exposure occurred during internship period,occupation-al exposure rate was 42.31 % (385/910),occupational exposure mainly occurred in nursing interns (n =190).358 (39.34%)medical interns understood self-protective antibody (hepatitis B surface antibody);difference in occupa-tional exposure rates and awareness of self-protective antibody among different professional medical interns was sta-tistically significant (all P <0.05);222 (57.66%)medical interns sustained occupational exposure more than once, 45.45% of occupational exposure occurred during the process of diagnostic and therapeutic procedure,exposure mainly occurred in the wards (32.21 %).After occupational exposure,46.75% of medical interns felt nervous, 35.06% were worried,18.18% appeared serious psychological reaction,only 14.03% sought support and help from others.Conclusion Awareness of occupational protection among medical interns is insufficient,education and awareness of occupational protection should be intensified,psychological behavioral after occupational exposure should be paid attention among medical students.
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Objective To evaluate the application effect of UK manual moving & handling skills in the training of preventing occupational lower back pain among nursing professionals,and explore effective ways of training on preventing occupational lower back pain to nursing professionals.Methods 86 nursing students,94 nurses with 12 months' work experience,and 88 nurses with work experience over 5 years were randomized selected,and they each were divided into the experimental group and the control group.For 86 nursing students,43 students in each group; For 94 nurses with 12 months' work experience,47 nurses in each group; For 88 nurses with work experience over 5 years,44 nurses in each group.A routine taught training was given to both groups,while the experimental group received an extra 25 academic hours' structured OLBP prevention training.Comprehensive proposition was used to assess theoretic learning outcome of all participants,and practical skills of all participants were tested through institutional cases.Ressults There was significant statistical difference between scores of participants from two groups,and the scores of the experimental group in nurses with 12 months' work experience were different from the experimental groups of nursing students and nurses with work experience over 5 years.Conclusions Structured OLBP prevention training should lead occupational health prevention and health promotion concepts,apply numerous teaching approaches,emphasize the content of maintaining physical and psychiatric health and occupational protection management,set new-enrolled nurses as the main focused group of training.
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Objective To investigate the cognition level and education demand of occupational protection knowledge among nursing students in clinical practice in the hospitals of Shanghai and analyze its related factors.Methods A cross-sectional survey involving 360 nursing students was conducted in Shanghai.The survey content included occupational protection knowledge,demand and suggestions about setting up occupational protection curricula.Results The mean knowledge score was 5～13 points,with an average of (9.33±1.62)points.In multiple regression models,the level of hospital and educational status were related factors for knowledge level.The occupational protection knowledge mainly from school education accounted for 59.4％,considering it necessary to set up occupational protection curricula accounted for 60.5％.Ways of acquiring occupational protection were:teachers integrating related knowledge into teaching,receiving related education before clinical practice,and being given warning before dangerous operation,accounting for 43.7％,30.8％ and 16.2％.Conclusions Nursing students require a comprehensive foundation course in occupational protection before they enter the clinical practice.This will help to ensure their physical and mental health.