Jelle Asdis Elfarsdóttir, Hafsteinsdottir Elin J G, Gudlaugsson Olafur, Kristjansson Mar
Laeknabladid. 2013 Dec;99(12):559-64. doi: 10.17992/lbl.2013.12.521.
Needlesticks, bodyfluid exposure and bites (incident) put healthcare workers (HCWs) at risk of hepatitis B, C and HIV particularly if patients are infected (high risk incident). The risk of infection is greatest from bore-hollow needles. The aim of the study was to describe the epidemiology of reported incidents and evaluate underreporting by HCWs at Landspítali University Hospital (LUH).
A retrospective descriptive study of reported incidents during 1986-2011. The ratio of incidents was calculated according to the HCWs age and profession and distribution by source and wards. The ratio of high risk incidents and vaccination status against HBV at time of incident was determined as well as underreporting during 01.01.2005-31.12.2011.
At least 4089 incidents occured during the study period but 3587 were reported and blood samples taken from 2578 patients. Approximately a third of the incidents were associated with non-compliance with standard precaution and 54,7% of needlesticks were associated with bore-hollow needles. Few reports came from physicians and medical students (17,9%). During the study period 50,3% HCWs were vaccinated against HBV at time of incident. High risk incidents were 94 (2.6%), mostly related to hepatitis C (64,9%). Two HCWs became infected with HCV. During 2005-2011 underreporting was estimated to be 28,0%.
Improved education of standard precaution when handling needles and sharps at LUH may reduce the number of incidents. Introduction of safety-needles and safety-devices may greatly reduce needlesticks as a large number of incidents were associated with hollow needles. Improved HBV vaccination among HCWs and reporting incidents should be encouraged.
针刺伤、体液暴露及咬伤（事件）会使医护人员面临感染乙型、丙型肝炎及艾滋病毒的风险，尤其是当患者被感染时（高风险事件）。感染风险最大的是空心针。本研究的目的是描述所报告事件的流行病学情况，并评估冰岛国家大学医院（LUH）医护人员的漏报情况。
对1986年至2011年期间所报告的事件进行回顾性描述性研究。根据医护人员的年龄和职业以及按来源和病房分布计算事件发生率。确定高风险事件的发生率以及事件发生时针对乙肝的疫苗接种状况，同时确定2005年1月1日至2011年12月31日期间的漏报情况。
在研究期间至少发生了4089起事件，但报告了3587起，并从2578名患者身上采集了血样。约三分之一的事件与未遵守标准预防措施有关，54.7%的针刺伤与空心针有关。来自医生和医学生的报告很少（17.9%）。在研究期间，50.3%的医护人员在事件发生时接种了乙肝疫苗。高风险事件有94起（2.6%），大多与丙型肝炎有关（64.9%）。两名医护人员感染了丙型肝炎病毒。在2005年至2011年期间，漏报率估计为28.0%。
在LUH改善处理针头和锐器时标准预防措施的教育可能会减少事件数量。引入安全针和安全装置可能会大大减少针刺伤，因为大量事件与空心针有关。应鼓励医护人员加强乙肝疫苗接种并报告事件。
