Venier A G, Vincent A, L'heriteau F, Floret N, Senechal H, Abiteboul D, Reyreaud E, Coignard B, Parneix P
Southwestern France Infection Control Coordinating Center, France.
Infect Control Hosp Epidemiol. 2007 Oct;28(10):1196-201. doi: 10.1086/520742. Epub 2007 Aug 1.
To estimate the incidence rate of reported occupational blood and body fluid exposures among French healthcare workers (HCWs).
Prospective national follow-up of HCWs from January 1 to December 31, 2004.
University hospitals, hospitals, clinics, local medical centers, and specialized psychiatric centers were included in the study on a voluntary basis.
At participating medical centers, every reported blood and body fluid exposure was documented by the occupational practitioner in charge of the exposed HCW by use of an anonymous, standardized questionnaire.
A total of 375 medical centers (15% of French medical centers, accounting for 29% of hospital beds) reported 13,041 blood and body fluid exposures; of these, 9,396 (72.0%) were needlestick injuries. Blood and body fluid exposures were avoidable in 39.1% of cases (5,091 of 13,020), and 52.2% of percutaneous injuries (4,986 of 9,552) were avoidable (5.9% due to needle recapping). Of 10,656 percutaneous injuries, 22.6% occurred during an injection, 17.9% during blood sampling, and 16.6% during surgery. Of 2,065 splashes, 22.6% occurred during nursing activities, 19.1% during surgery, 14.1% during placement or removal of an intravenous line, and 12.0% during manipulation of a tracheotomy tube. The incidence rates of exposures were 8.9 per 100 hospital beds (95% confidence interval [CI], 8.7-9.0 exposures), 2.2 per 100 full-time-equivalent physicians (95% CI, 2.4-2.6 exposures), and 7.0 per 100 full-time-equivalent nurses (95% CI, 6.8-7.2 exposures). Human immunodeficiency virus serological status was unknown for 2,789 (21.4%) of 13,041 patients who were the source of the blood and body fluid exposures.
National surveillance networks for blood and body fluid exposures help to better document their characteristics and risk factors and can enhance prevention at participating medical centers.
估算法国医护人员上报的职业性血液和体液暴露发生率。
对2004年1月1日至12月31日期间的医护人员进行全国性前瞻性随访。
该研究自愿纳入了大学医院、医院、诊所、当地医疗中心和专业精神病中心。
在参与研究的医疗中心，负责涉事医护人员的职业医生使用匿名标准化问卷记录每起上报的血液和体液暴露事件。
共有375个医疗中心（占法国医疗中心的15%，占医院床位的29%）上报了13041起血液和体液暴露事件；其中，9396起（72.0%）为针刺伤。在39.1%的案例中（13020起中的5091起），血液和体液暴露是可以避免的，52.2%的经皮损伤（9552起中的4986起）是可以避免的（5.9%是由于重新盖帽）。在10656起经皮损伤中，22.6%发生在注射期间，17.9%发生在采血期间，16.6%发生在手术期间。在2065起飞溅事件中，22.6%发生在护理活动期间，19.1%发生在手术期间，14.1%发生在静脉输液管放置或拔除期间，12.0%发生在气管切开管操作期间。暴露发生率为每100张医院床位8.9起（95%置信区间[CI]，8.7 - 9.0起暴露），每100名全职等效医生2.2起（95% CI，2.4 - 2.6起暴露），每100名全职等效护士7.0起（95% CI，6.8 - 7.2起暴露）。在13041起血液和体液暴露事件的源头患者中，2789名（21.4%）患者的人类免疫缺陷病毒血清学状态未知。
血液和体液暴露的全国监测网络有助于更好地记录其特征和风险因素，并可加强参与研究的医疗中心的预防工作。
