Lu Y, Senthilselvan A, Joffe A M, Beach J
School of Public Health, University of Alberta, Edmonton, Alberta T6G 1C9, Canada.
Infection Prevention and Hospital Epidemiology, Royal Alexandra Hospital and University of Alberta, Edmonton, Alberta T5H 3V9, Canada.
Occup Med (Lond). 2015 Jan;65(1):39-44. doi: 10.1093/occmed/kqu152. Epub 2014 Oct 24.
Sharps injuries remain a common factor in occupational exposure of healthcare workers to blood-borne viruses. The extent to which the introduction of safety-engineered devices has been effective in reducing such injuries among healthcare workers is unclear.
To investigate the incidence of sharp object injury among healthcare workers in the Capital Health Region of Alberta, Canada and to determine the effectiveness of the introduction of safety- engineered devices in preventing these.
All reports of sharp object injuries to Capital Region Workplace Health and Safety offices from healthcare workers 2003-10 were analysed. Rates of sharp object injury were compared before (2006), during (2007-08) and after (2009-10) the introduction of safety-engineered devices, adjusting for other potential risk factors using Poisson regression and log-linear models.
Between 2003 and 2010, a total of 4707 sharp object injuries were reported from 15 healthcare facilities. The sharp object injury rate per 1000 full-time equivalent employees per year declined from 35 before the introduction period to 30 during the introduction period (rate ratio [RR]: 0.88, 95% confidence interval [CI]: 0.78, 0.99) among most healthcare workers, but then rebounded again slightly after the intervention. Physician risks showed little change during the period of introduction (odds ratio [OR]: 0.99, 95% CI: 0.85, 1.14) but decreased significantly after the intervention (OR: 0.83, 95% CI: 0.71, 0.97).
The introduction of safety-engineered devices was associated with a modest reduction in reported sharp object injuries but this appeared to be relatively short-lived for most workers.
锐器伤仍是医护人员职业暴露于血源性病原体的常见因素。具有安全设计的器械在降低医护人员此类伤害方面的有效程度尚不清楚。
调查加拿大艾伯塔省首府地区医护人员锐器伤的发生率,并确定引入具有安全设计的器械在预防锐器伤方面的有效性。
分析了2003年至2010年期间医护人员向首府地区职业健康与安全办公室报告的所有锐器伤事件。比较了引入具有安全设计的器械之前(2006年)、期间(2007 - 2008年)和之后(2009 - 2010年)的锐器伤发生率,并使用泊松回归和对数线性模型对其他潜在风险因素进行了调整。
2003年至2010年期间,15家医疗机构共报告了4707起锐器伤事件。在大多数医护人员中,每年每1000名全职等效员工的锐器伤发生率从引入期之前的35降至引入期期间的30(率比[RR]:0.88,95%置信区间[CI]:0.78,0.99),但在干预后又略有反弹。医生的风险在引入期内变化不大(优势比[OR]:0.99,95% CI:0.85,1.14),但在干预后显著降低(OR:0.83,95% CI:0.71,0.97)。
引入具有安全设计的器械与报告的锐器伤适度减少相关,但对大多数工作人员而言,这种减少似乎相对短暂。