Goel Varun, Kumar Dinesh, Lingaiah Raghavendra, Singh Sarman
Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India.
J Lab Physicians. 2017 Jan-Mar;9(1):20-25. doi: 10.4103/0974-2727.187917.
Occupational hazards such as accidental exposure to sharp, cuts, and splashes are common among health-care workers (HCWs).
To determine the occurrence of self-reported occupational exposures to these hazards and to know the prevalent practices following the exposure. The second aim was to know the baseline antibody levels against hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) immediately after these accidents.
An observational prospective study was done in the HCWs of a tertiary care academic health organization of North India from January 2011 to December 2013. At the time of self-reporting of injury, a questionnaire was administered. Blood sample of HCWs and of the source, if identified, was collected for baseline HBV, HCV, and HIV serum markers. The exposed HCWs were followed up and repeat testing was done after 3-4 weeks for seroconversion up to 6 months.
A total of 476 injuries were reported. Needlestick injury of fingers was the most common. Doctors were found to have the highest exposure rate (73.7%) distantly followed by nurses (19.1%). A significant number of the HCWs (125, 26.3%) vaccinated in past had hepatitis B surface antibody (anti-HBs) titers <10 mIU/mL (protection defined as anti-HBs level ≥10 mIU/ml). Only 44 sources were found to be seropositive (11 for HIV, 9 for HCV, and 24 for HBV). No seroconversion was seen in any of the exposed HCWs after 6 months.
The incidence of needlestick and sharp injuries is most often encountered in emergency wards. Anti-HBs titers were suboptimal in many of the HCWs requiring a booster dose of HBV vaccination.
意外接触锐器、割伤和飞溅物等职业危害在医护人员中很常见。
确定自我报告的这些职业暴露的发生率,并了解暴露后的普遍处理措施。第二个目的是了解这些事故发生后医护人员针对乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)和人类免疫缺陷病毒(HIV)的基线抗体水平。
2011年1月至2013年12月,在印度北部一家三级医疗学术健康机构的医护人员中进行了一项观察性前瞻性研究。在自我报告受伤时,发放一份问卷。收集医护人员及其(若已识别)源患者的血样,检测HBV、HCV和HIV血清标志物基线水平。对暴露的医护人员进行随访,并在3 - 4周后重复检测,直至6个月,以检测血清转化情况。
共报告476起伤害事件。手指针刺伤最为常见。发现医生的暴露率最高(73.7%),其次是护士(19.1%)。过去接种过疫苗的医护人员中有相当数量(125人,26.3%)的乙型肝炎表面抗体(抗-HBs)滴度<10 mIU/mL(抗-HBs水平≥10 mIU/ml定义为有保护作用)。仅发现44例源患者血清学阳性(11例HIV阳性,9例HCV阳性,24例HBV阳性)。6个月后,所有暴露的医护人员均未出现血清转化。
针刺伤和锐器伤的发生率在急诊病房最为常见。许多医护人员的抗-HBs滴度不理想,需要加强接种一剂乙肝疫苗。