Twitchell Katherine T
Occupational Health Services, Brigham and Women's Hospital, Boston, MA, USA.
AAOHN J. 2003 Jan;51(1):38-45; quiz 46-7.
Since the emergence of the AIDS epidemic in the early 1980s, progressive regulatory strategies have been aimed at decreasing the risk of bloodborne pathogen exposures in health care workers. It is important to understand the evolution of these bloodborne pathogen strategies that have been vital to maintaining the health and safety of workers in potentially high risk environments. Occupational health clinicians need to communicate to employees how each of these strategies has helped decrease the day to day risks health care workers potentially face. Standard precautions remain one of the best ways health care workers can protect themselves against exposures. It has been more than 15 years since standard precautions were first introduced. Some health care workers have become lax in using these very simple techniques. Occupational health clinicians need to remind employees of the importance of taking care of themselves by using proper protective equipment. Recent federal and state needle safe legislation has heightened employee and employer awareness about the importance of new, safer medical devices. These devices [table: see text] must be used properly to truly decrease the potential risks to health care workers. Occupational health care clinicians can be pivotal in the forefront of needle safety initiatives in their institution. Occupational health nurses in health care settings should be active members of needle safe and bloodborne pathogen committees and participate in product evaluation. Clinicians should advocate for employees to be properly trained to use new devices and reinforce the importance of using safety devices properly to employees. The risks of transmission for HIV, HBV, and HCV are indisputable in environments where workers are potentially exposed to blood or body fluids. Knowledge about how exposure occurs, the risks of transmission in health care workers, and preventive strategies available can assist the employee to work safely without unnecessary fear or anxiety. Part II of this article (February 2003) is a more indepth discussion about each of the three bloodborne pathogens of greatest concern to health care workers. The general prevalence, risk groups, prophylaxis, and treatment of HBV, HCV, and HIV are elaborated. Common blood tests for each of these pathogens are also explained.
自20世纪80年代初艾滋病疫情出现以来，逐步实施的监管策略旨在降低医护人员接触血源性病原体的风险。了解这些血源性病原体策略的演变过程非常重要，这些策略对于维护处于潜在高风险环境中的工作人员的健康与安全至关重要。职业健康临床医生需要向员工传达这些策略中的每一项是如何帮助降低医护人员日常可能面临的风险的。标准预防措施仍然是医护人员保护自己免受感染的最佳方法之一。自首次引入标准预防措施以来，已经过去了15年多。一些医护人员在使用这些非常简单的技术时变得松懈。职业健康临床医生需要提醒员工使用适当的防护设备来照顾自己的重要性。最近的联邦和州针具安全立法提高了员工和雇主对新型、更安全医疗设备重要性的认识。这些设备[表格：见正文]必须正确使用，才能真正降低医护人员面临的潜在风险。职业健康护理临床医生在其所在机构的针具安全倡议中可以发挥关键作用。医疗机构中的职业健康护士应成为针具安全和血源性病原体委员会的积极成员，并参与产品评估。临床医生应倡导员工接受正确使用新设备的培训，并向员工强化正确使用安全设备的重要性。在工作人员可能接触血液或体液的环境中，艾滋病毒、乙肝病毒和丙肝病毒的传播风险是无可争议的。了解暴露是如何发生的、医护人员中的传播风险以及可用的预防策略，可以帮助员工在没有不必要恐惧或焦虑的情况下安全工作。本文的第二部分（2003年2月）对医护人员最关注的三种血源性病原体进行了更深入的讨论。阐述了乙肝病毒、丙肝病毒和艾滋病毒的总体流行情况、风险群体、预防和治疗方法。还解释了针对每种病原体的常见血液检测。
