International Healthcare Worker Safety Center, Division of Infectious Diseases, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA.
J Infect Public Health. 2008;1(2):62-71. doi: 10.1016/j.jiph.2008.10.002. Epub 2008 Nov 26.
In the United States (U.S.), federal legislation requiring the use of safety-engineered sharp devices, along with an array of other protective measures, has played a critical role in reducing healthcare workers' (HCWs) risk of occupational exposure to bloodborne pathogens over the last 20 years. We present the history of U.S. regulatory and legislative actions regarding occupational blood exposures, and review evidence of the impact of these actions. In one large network of U.S. hospitals using the Exposure Prevention Information Network (EPINet) sharps injury surveillance program, overall injury rates for hollow-bore needles declined by 34%, with a 51% decline for nurses. The U.S. experience demonstrates the effectiveness of safety-engineered devices in reducing sharps injuries, and the importance of national-level regulations (accompanied by active enforcement) in ensuring wide-scale availability and implementation of protective devices to decrease healthcare worker risk.
在美国，联邦立法要求使用安全工程设计的锐器，以及一系列其他保护措施，这在过去 20 年中对于降低医疗工作者（HCWs）职业性接触血源性病原体的风险起到了关键作用。我们介绍了美国针对职业性血液暴露的监管和立法行动的历史，并回顾了这些行动的影响证据。在美国一个使用暴露预防信息网络（EPINet）锐器伤害监测项目的大型医院网络中，空心针的总体伤害率下降了 34%，护士的伤害率下降了 51%。美国的经验证明了安全工程设计的器械在减少锐器伤害方面的有效性，以及国家级法规（伴随积极执法）在确保广泛提供和实施保护器械以降低医疗工作者风险方面的重要性。
