Mallon D F, Shearwood W, Mallal S A, French M A, Dawkins R L
Department of Clinical Immunology, Royal Perth Hospital, WA.
Med J Aust. 1992 Nov 2;157(9):592-5. doi: 10.5694/j.1326-5377.1992.tb137397.x.
To determine the incidence and nature of occupational exposures to blood and body fluids in health care workers.
332 reports of occupational exposure were analysed and are presented.
A major teaching hospital.
All staff at Royal Perth Hospital who reported an occupational exposure to blood or body fluids to the Department of Clinical Immunology between 1 January 1990 and 31 August 1991.
The rate of reported occupational exposure according to staff category, nature of exposure, HIV status of source patient, activity at the time of exposure and compliance with infection control measures.
332 reports from 323 health care workers were received, giving an overall incidence of 6.1 per 100 full time equivalent (FTE) years. Nursing staff (9.4/100 FTE years) and medical staff (9.0/100 FTE years) reported exposure more frequently than housekeeping staff (2.5/100 FTE years) or paramedical staff (2.3/100 FTE years) (P < 0.001). The rate of exposure to HIV antibody positive patients was only 0.24/100 FTE years. Needlestick or other blood contaminated sharps injuries accounted for 83.4% (277/332) of reports and failure to observe universal precautions for 34.0% of reports. Insertion and operation of parenteral lines (24%) and performing operations (15.4%) were the activities most often associated with occupational exposure. No occupationally acquired infections were observed. Despite the immediate availability of zidovudine, acceptance by health care workers with high risk occupational exposure was low (18.8%).
Occupational exposure to blood and body fluids is common among health care workers but most exposures confer a low risk of blood borne infection. The introduction of an occupational exposure assessment program has many benefits, including optimal management of injuries and acquisition of data on infection control measures, and may protect health care institutions from false claims for compensation.
确定医护人员职业性接触血液和体液的发生率及性质。
对332份职业暴露报告进行分析并呈现。
一家大型教学医院。
1990年1月1日至1991年8月31日期间向临床免疫科报告职业性接触血液或体液的珀斯皇家医院所有工作人员。
根据工作人员类别、暴露性质、源患者的HIV状态、暴露时的活动以及对感染控制措施的遵守情况报告的职业暴露率。
收到来自323名医护人员的332份报告，总体发生率为每100个全时当量（FTE）年6.1例。护士（9.4/100 FTE年）和医务人员（9.0/100 FTE年）报告的暴露频率高于家政人员（2.5/100 FTE年）或辅助医务人员（2.3/100 FTE年）（P<0.001）。接触HIV抗体阳性患者的发生率仅为0.24/100 FTE年。针刺伤或其他血液污染锐器伤占报告的83.4%（277/332），34.0%的报告存在未遵守通用预防措施的情况。静脉输液管的插入和操作（24%）以及进行手术（15.4%）是最常与职业暴露相关的活动。未观察到职业性获得性感染。尽管齐多夫定随时可用，但职业暴露风险高的医护人员接受率较低（18.8%）。
医护人员职业性接触血液和体液很常见，但大多数暴露导致血源性感染的风险较低。引入职业暴露评估计划有许多益处，包括对损伤的最佳管理以及获取感染控制措施的数据，还可保护医疗机构免受虚假赔偿索赔。
