Lee Ju Hyun, Cho Junhyeon, Kim Yung Jung, Im Sang Hyuk, Jang Eun Sun, Kim Jin-Wook, Kim Hong Bin, Jeong Sook-Hyang
Department of Internal Medicine, College of Medicine, Seoul National University, Seongnam, Republic of Korea.
Occupation Safety and Health Office, College of Medicine, Seoul National University, Seongnam, Republic of Korea.
BMC Public Health. 2017 Oct 18;17(1):827. doi: 10.1186/s12889-017-4844-0.
Health care workers (HCWs) are at high risk for occupational blood exposures (OBEs) and transmission of bloodborne pathogens. This study elucidated the incidence rate and epidemiological characteristics of OBEs among HCWs and investigated the pathogen transmission rate for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV).
Self-reported OBEs from January 1, 2011 to December 31, 2015 were obtained from the electronic recording system. OBE incidence densities per 100 person-years and per 100 bed-years were calculated with a 5-year trend analysis. OBE characteristics and pathogen transmission rates were evaluated.
Among 10,452 HCWs and 1072 average yearly beds, 1076 OBEs were reported. OBE incidence rate was 5.6 cases per 100 person (full-time equivalent)-years and 20.3 per 100 bed-years. Incidence rate decreased and was significantly associated with a decrease of beds served per HCW. Housekeeping showed the highest OBE rate (14.8%) followed by doctors (8.5%) and nurses (6.2%). OBEs occurred in wards, emergency rooms, and operating rooms (38.1%, 13.3% and 12.2%, respectively) via percutaneous (86.7%) and mucocutaneous exposures (13.2%). Of OBEs associated with HBV (n = 133), HCV (n = 126), and HIV (n = 25), only one led to an infection (HCV; transmission rate of 0.8%). Neither HBV nor HIV infection occurred.
OBE incidence rate in a Korean university hospital was 5.6 cases per 100 person-years and 20.3 per 100 bed-years and was related to HCW workload and work proficiency. Though the actual bloodborne pathogen transmission rate was low, efforts to prevent OBE should be made for hospital safety.
医护人员职业性血液暴露（OBE）及血源性病原体传播的风险较高。本研究阐明了医护人员中OBE的发病率及流行病学特征，并调查了乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）的病原体传播率。
从电子记录系统中获取2011年1月1日至2015年12月31日期间自我报告的OBE情况。通过5年趋势分析计算每100人年和每100床年的OBE发病密度。评估OBE特征和病原体传播率。
在10452名医护人员和平均每年1072张床位中，报告了1076例OBE。OBE发病率为每100人（全职等效）年5.6例，每100床年20.3例。发病率下降，且与每名医护人员服务床位的减少显著相关。保洁人员的OBE发生率最高（14.8%），其次是医生（8.5%）和护士（6.2%）。OBE发生在病房、急诊室和手术室（分别为38.1%、13.3%和12.2%），通过经皮暴露（86.7%）和黏膜暴露（13.2%）。在与HBV（n = 133）、HCV（n = 126）和HIV（n = 25）相关的OBE中，仅1例导致感染（HCV；传播率为0.8%）。未发生HBV和HIV感染。
韩国一家大学医院的OBE发病率为每100人年5.6例，每100床年20.3例，与医护人员工作量和工作熟练度有关。尽管实际血源性病原体传播率较低，但为了医院安全仍应努力预防OBE。
