Smoliński Patryk, Serafińska Sylwia, Gładysz Andrzej
Katedra i Klinika Chorób Zakaźnych, Chorób Watroby i Nabytych Niedoborów Odpornościowych, Akademia Medyczna, Wrocław.
Med Pr. 2006;57(6):507-16.
Analyses of exposure rates among health care workers comprise both risk and epidemiology of blood borne pathogenic factors. In Poland, a possible extent of underestimation of such incidents has not yet been widely studied in the population of this group of employees. The aim of the study was to observe a group of population chosen as an example to assess the actual exposure incidence rates, especially those not subjected to registration.
A prospective six-month survey covered 319 Lower Silesia health care workers: physicians, nurses and auxiliary staff. Statistical methods were used to analyze the obtained data, especially those concerning the job performance, the number of medical procedures performed and frequency of exposures, both registered in each case and not registered in the post-exposure prophylaxis log.
Finally, 269 persons were under observation. Actual exposure incidence rate was several fold higher than that officially registered and differed depending on the department and subgroup of health care workers. In summary, the ratio of all the registered cases to those not registered was 1: 6. An overall proportion of not registered cases of exposure was as high as 86%. Most frequent job activities of exposed health care workers comprised preparatory procedures like parenteral drug administration or injections. Post-procedure activities were less frequently the cause of exposure. Non-registration of such exposures were motivated by a self-assessment of a low infection risk or a conviction that self-protection on the incidence site was optimal. Lack of current knowledge was rather rarely admitted as a reason for underreporting.
医护人员暴露率分析涵盖血源性病原体因素的风险和流行病学。在波兰，这类事件可能被低估的程度在这群员工中尚未得到广泛研究。本研究的目的是观察一组作为示例选取的人群，以评估实际暴露发生率，尤其是那些未进行登记的暴露情况。
一项为期六个月的前瞻性调查涵盖了319名下西里西亚的医护人员：医生、护士和辅助人员。使用统计方法分析所获得的数据，尤其是那些与工作表现、所执行的医疗程序数量以及暴露频率有关的数据，这些数据既有每次都登记的，也有未登记在暴露后预防日志中的。
最终，观察了269人。实际暴露发生率比官方登记的高出数倍，并且因医护人员的科室和亚组不同而有所差异。总之，所有登记病例与未登记病例的比例为1:6。未登记的暴露病例总体比例高达86%。暴露的医护人员最常见的工作活动包括诸如胃肠外给药或注射等准备程序。程序后的活动较少成为暴露的原因。此类暴露未登记的原因是自我评估感染风险较低或认为在事发地点的自我保护是最佳的。很少有人承认缺乏最新知识是报告不足的原因。
