Shimouchi Akira, Hirota Satoshi, Koda Shinichi, Mui Kayo
Osaka City Public Health Office, 1-2-7-1000, Asahimachi, Abeno-ku, Osakashi, Osaka 545-0051, Japan.
Kekkaku. 2007 Sep;82(9):697-703.
To analyze conditions of developing TB among nurses and to discuss preventive measures.
TB patient cards of nurses and other health workers registered in Osaka City from 1999 to 2003 were studied.
Incidence rate of TB among female nurse/ assistant-nurse was 3.0 times higher than that of all female population. The route of case finding were as follows with descending order, visit to medical facilities with symptoms (55.8%), regular health check (35.8%), individual health check (5.8%), and contact examination (2.5%). Among risk factors related to the development of TB work in hospitals account for 55.0% in nurse patients of all ages, 72.5% in 20s, 47.4% in 30s, 37.5% in 40s, 36.4% in 50s and 0% in 60s. Individual risk factors were identified as follows in descending order, "TB patients diagnosed in the hospital." (10.0%), "examined at TB contact examination." (9.2%), "history of TB treatment at 18 years of age and over" (7.5%), "working experience in TB hospital/TB ward." (6.7%), "TB patients diagnosed among colleague." (5.0%), "increased reaction of tuberculin skin test after employment." (2.5%), "diagnosis of 'healed TB lesion" at regular health check." (1.7%), "default of chemoprophylaxis" (1.7%). Among various risk factors, "examined at TB contact examination" and "TB patients diagnosed in the hospital" are the two most common factors and occupied 38.8% in patients in 20s.
Therefore it is important to promote further nosocomial TB infection control with a view to lower incidence rate of TB among nurses, which is 3 times higher than that of all female population.
分析护士群体中结核病的发病情况并探讨预防措施。
对1999年至2003年在大阪市登记的护士及其他医护人员的结核病患者卡片进行研究。
女性护士/助理护士的结核病发病率是全体女性人口的3.0倍。病例发现途径按从高到低顺序如下：因症状就诊于医疗机构（55.8%）、定期健康检查（35.8%）、个人健康检查（5.8%）、接触者检查（2.5%）。在与结核病发病相关的危险因素中，医院工作在各年龄段护士患者中占55.0%，20多岁年龄段占72.5%，30多岁年龄段占47.4%，40多岁年龄段占37.5%，50多岁年龄段占36.4%，60多岁年龄段占0%。个体危险因素按从高到低顺序如下：“在医院诊断为结核病患者”（10.0%）、“接受结核病接触者检查”（9.2%）、“18岁及以上有结核病治疗史”（7.5%）、“在结核病医院/结核病病房工作经历”（6.7%）、“同事中诊断为结核病患者”（5.0%）、“入职后结核菌素皮肤试验反应增强”（2.5%）、“定期健康检查时诊断为‘陈旧性结核病灶’”（1.7%）、“预防性化疗中断”（1.7%）。在各种危险因素中，“接受结核病接触者检查”和“在医院诊断为结核病患者”是最常见的两个因素，在20多岁的患者中占38.8%。
因此，鉴于护士群体中结核病发病率比全体女性人口高3倍，进一步加强医院内结核病感染控制对于降低护士结核病发病率至关重要。
