Kuruüzüm Ziya, Elmali Zübeyde, Günay Sevinç, Gündüz Sükriye, Yapan Zeynep
Dokuz Eylül Universitesi Tip Fakültesi, Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Anabilim Dali, Izmir.
Mikrobiyol Bul. 2008 Jan;42(1):61-9.
The major concern following occupational exposures of the health care workers is the possible transmission of blood-borne pathogens, especially hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). This questionary survey was undertaken to determine the frequency and epidemiological characteristics of incidents involving biological exposures to blood and body fluids among health care workers (HCWs), at a University Hospital, in Izmir, Turkey. The survey was conducted using a questionnaire including questions related to demographics and epidemiological information. A total of 350 HCWs [162 physicians (academicians, seniors and juniors), 71 nurses, 55 interns of medical faculty, 45 cleaning staff, 12 nurse's aides, five technical/ managerial staff] were included to the survey. Of them, 203 (58%) have reported at least one exposure, 108 (%53.2) of them were physicians (p < 0.000) and 53 (26.1%) were nurses. The highest injury rate was reported by the nurse group (74.6%) followed by physicians (66.7%), cleaning staffs (57.8%) and interns (23.6%). Most of the occupational injuries (62.5%) have eventuated in the last one year. Types of exposure included percutaneous injury (97%) which was commonly caused by needle recapping (36%), suturing (25.6%) and handling of garbage bags (10.3%). Of the exposed HCWs, 138 (68%) have reported to use a protective equipment during the exposure and only 51.7% sought for medical assistance from the related department. Among 350 HCWs, 291 (83.1%) had been previously vaccinated against HBV, while two (0.6%) HCWs were chronically infected with HBV, unrelated with exposures. No transmission was reported following 16 incidents, in which the index patient was HBV, HCV or HIV carrier. In conclusion, percutanenous injuries are still common among HCWs. The results support the importance of the use of universal precautions and safety-enhanced devices, introducing effective training and efficient vaccination programs against HBV, in the clinical settings.
医护人员职业暴露后主要关注的是血源性病原体的可能传播,尤其是乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)和人类免疫缺陷病毒(HIV)。本次问卷调查旨在确定土耳其伊兹密尔一所大学医院中医护人员发生血液和体液生物暴露事件的频率及流行病学特征。该调查通过一份包含人口统计学和流行病学信息相关问题的问卷进行。共有350名医护人员[162名医生(院士、 senior医师和 junior医师)、71名护士、55名医学院实习生、45名清洁人员、12名护工、5名技术/管理人员]纳入调查。其中,203人(58%)报告至少有一次暴露,其中108人(53.2%)是医生(p<0.000),53人(26.1%)是护士。护士组报告的受伤率最高(74.6%),其次是医生(66.7%)、清洁人员(57.8%)和实习生(23.6%)。大多数职业伤害(62.5%)发生在过去一年。暴露类型包括经皮损伤(97%),常见原因是针头回套(36%)、缝合(25.6%)和处理垃圾袋(10.3%)。在暴露的医护人员中,138人(68%)报告在暴露期间使用了防护设备,只有51.7%的人向相关部门寻求医疗帮助。在350名医护人员中,291人(83.1%)以前接种过乙肝疫苗,而两名(0.6%)医护人员慢性感染乙肝,与暴露无关。16起事件中,索引患者为HBV、HCV或HIV携带者,但均未报告有传播情况。总之,经皮损伤在医护人员中仍然很常见。结果支持在临床环境中使用普遍预防措施和安全增强设备、开展有效的培训以及针对乙肝的高效疫苗接种计划的重要性。