School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
Risk Anal. 2018 Mar;38(3):442-453. doi: 10.1111/risa.12854. Epub 2017 Jul 11.
Infections among health-care personnel (HCP) occur as a result of providing care to patients with infectious diseases, but surveillance is limited to a few diseases. The objective of this study is to determine the annual number of influenza infections acquired by HCP as a result of occupational exposures to influenza patients in hospitals and emergency departments (EDs) in the United States. A risk analysis approach was taken. A compartmental model was used to estimate the influenza dose received in a single exposure, and a dose-response function applied to calculate the probability of infection. A three-step algorithm tabulated the total number of influenza infections based on: the total number of occupational exposures (tabulated in previous work), the total number of HCP with occupational exposures, and the probability of infection in an occupational exposure. Estimated influenza infections were highly dependent upon the dose-response function. Given current compliance with infection control precautions, we estimated 151,300 and 34,150 influenza infections annually with two dose-response functions (annual incidence proportions of 9.3% and 2.1%, respectively). Greater reductions in infectious were achieved by full compliance with vaccination and IC precautions than with patient isolation. The burden of occupationally-acquired influenza among HCP in hospitals and EDs in the United States is not trivial, and can be reduced through improved compliance with vaccination and preventive measures, including engineering and administrative controls.
医护人员（HCP）的感染是在为患有传染病的患者提供护理的过程中发生的，但监测仅限于少数几种疾病。本研究的目的是确定美国医院和急诊部（ED）中因接触流感患者而导致 HCP 每年感染流感的人数。采用风险分析方法。使用隔室模型来估计单次暴露中接受的流感剂量，并应用剂量反应函数来计算感染的概率。一个三步算法根据以下内容列出了总流感感染人数：职业暴露的总人数（在前一项工作中列出）、有职业暴露的 HCP 总数以及职业暴露中感染的概率。估计的流感感染数量高度依赖于剂量反应函数。鉴于目前感染控制预防措施的遵守情况，我们使用两种剂量反应函数分别估计每年有 151300 和 34150 例流感感染（年发病率分别为 9.3%和 2.1%）。完全遵守疫苗接种和感染控制预防措施比患者隔离更能减少传染性。美国医院和 ED 中因职业接触而感染流感的 HCP 的负担不小，可以通过提高疫苗接种和预防措施的遵守率来减轻，包括工程和行政控制。
