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一项全国性乳胶过敏跨学科预防计划的成效

Effectiveness of a nationwide interdisciplinary preventive programme for latex allergy.

作者信息

Latza Ute, Haamann Frank, Baur Xaver

机构信息

Occupational Epidemiology, Institute for Occupational Medicine, Hamburg State Department of Environment and Health, University of Hamburg, Seewartenstrasse 10, 20459 Hamburg, Germany.

出版信息

Int Arch Occup Environ Health. 2005 Jun;78(5):394-402. doi: 10.1007/s00420-004-0594-2. Epub 2005 May 11.

Abstract

OBJECTIVES

The increasing prevalence of latex allergy among healthcare workers is a large socio-economical problem for the society and affected individuals. The objective of this study was to describe and evaluate a nationwide, interdisciplinary campaign by the institution for the German workers' compensation scheme for non-public healthcare providers that targeted the reduction of exposure to powdered high-protein latex gloves.

METHODS

The effectiveness of the prevention programme is described and evaluated with a before-and-after design comparing data on compensation claims for latex-related skin and airway diseases of the German statutory compensation scheme for work-related diseases in non-public health services. A survey on change in glove use was conducted after the programme.

RESULTS

The main feature of the campaign among healthcare workers (budget 340,000 Euro ) was to increase awareness by means of educational components on the aetiology of latex hypersensitivity for healthcare workers and their providers, and professional trainers. The number of reported compensation claims for latex-induced skin diseases increased from a pre-measure of 664 in 1996 to 884 during the programme in 1998 and decreased after the programme (post-measure n = 567 in 1999 and n = 204 in 2002). Doctors' assistants in practices and nurses/nurse assistants/midwives filed most claims. Similar decreases were observed for confirmed claims and latex-related respiratory diseases, while two other prevalent occupational diseases in healthcare workers (low-back disorders, infections) increased during this time period. The survey demonstrated a considerable concurrent drop in the use of powdered latex gloves (hospitals 76% vs 37% for unsterile gloves and 86% vs 62% for sterile gloves).

CONCLUSIONS

The campaign against latex allergy in connection with concurrent corresponding recommendations, activities of State authorities for worker protection, and regulations, is an example for the successful incorporation of research results into preventive measures that directly affect the frequency of a work-related disease. This effective programme can be regarded as a model for the reduction of other occupational diseases such as bakers' or isocyanate asthma.

摘要

目的

医护人员中乳胶过敏患病率的不断上升,对社会和受影响个体而言是一个重大的社会经济问题。本研究的目的是描述和评估德国非公立医疗服务提供者工伤赔偿机构开展的一项全国性跨学科活动,该活动旨在减少接触含粉末的高蛋白乳胶手套。

方法

采用前后对照设计,通过比较德国非公立医疗卫生服务中与工作相关疾病法定赔偿计划中乳胶相关皮肤和气道疾病的赔偿申请数据,来描述和评估预防计划的有效性。在该计划实施后,对手套使用情况的变化进行了一项调查。

结果

在医护人员中开展的这项活动(预算34万欧元)的主要特点是,通过向医护人员及其供应商以及专业培训人员提供有关乳胶过敏病因的教育内容,提高他们的认识。1996年乳胶引起的皮肤病报告赔偿申请数量在措施实施前为664例,1998年该计划实施期间增至884例,计划实施后有所下降(1999年测量后为567例,2002年为204例)。诊所的医生助理以及护士/护士助理/助产士提出的赔偿申请最多。确诊的赔偿申请和乳胶相关呼吸道疾病也出现了类似的下降,而在此期间,医护人员中另外两种常见的职业病(腰背痛、感染)有所增加。调查显示,含粉末乳胶手套的使用量同时大幅下降(医院中,非无菌手套从76%降至37%,无菌手套从86%降至62%)。

结论

与同时提出的相应建议、国家当局的工人保护活动和规定相关的乳胶过敏防治活动,是将研究成果成功纳入直接影响与工作相关疾病发病率的预防措施的一个范例。这一有效计划可被视为减少其他职业病(如面包师哮喘或异氰酸酯哮喘)的典范。

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