Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore, Singapore.
Nursing Service, Tan Tock Seng Hospital, Singapore, Singapore.
J Hosp Infect. 2018 Apr;98(4):404-411. doi: 10.1016/j.jhin.2017.10.020. Epub 2017 Oct 31.
Healthcare workers (HCWs) may be the inadvertent interface between the healthcare setting and the community for infectious diseases transmission.
To investigate HCWs' contacts during a work day and compare these against working adults from the general population.
Prospective survey of contacts through 24 h self-reported diary in three public sector tertiary care hospitals and community-based working adults in Singapore. Participants were HCWs and working adults from the community.
In all, 211 HCWs and 1028 working adults reported a total of 4066 and 9206 contacts. HCWs reported more work-related contacts than community-based working adults (median of 13 versus 4), and more contacts that were neither household nor work-related (1 versus 0) but fewer household contacts (2 versus 3). HCWs reported more work-related contacts involving physical contacts, and more new contacts particularly with short duration (≤15 min) compared to community-based working adults. Among different HCW types, doctors reported the highest whereas ward-based nurses reported the lowest total work-related contacts. Around half of ward-based and clinic-based nurses' contacts involved physical touch. Work-related contacts reported by clinic-based nurses, doctors, and assorted HCWs were shorter than in ward-based nurses, with a substantial number effectively occurring with new contacts. Institutional effects significant on univariate analyses were much reduced and non-significant after adjusting for confounding by HCW type.
HCWs' contacts differ substantially from those of community-based working adults. HCWs may thus be at higher risk of acquiring and spreading contact-transmissible and respiratory infections due to the nature of their work. Whereas total number of contacts was fairly similar between HCW types, the characteristics of their contacts differed substantively.
医护人员（HCWs）可能是医疗机构与社区之间传染病传播的不经意接口。
调查医护人员在工作日的接触情况，并将其与新加坡一般人群中的在职成年人进行比较。
在三家公立三级保健医院和社区在职成年人中进行 24 小时自我报告日记的前瞻性接触调查。参与者为医护人员和社区在职成年人。
共有 211 名医护人员和 1028 名在职成年人报告了总共 4066 次和 9206 次接触。与社区在职成年人相比，医护人员报告的工作相关接触更多（中位数分别为 13 次和 4 次），且非家庭和工作相关的接触更多（1 次与 0 次），家庭接触更少（2 次与 3 次）。医护人员报告的工作相关接触更多涉及身体接触，且更多新接触（特别是持续时间≤15 分钟）与社区在职成年人相比。在不同类型的医护人员中，医生报告的总工作相关接触最多，而病房护士报告的接触最少。大约一半的病房护士和诊所护士的接触涉及身体接触。诊所护士、医生和各种医护人员报告的工作相关接触时间较短，与新接触的接触次数相当多。在调整了医护人员类型的混杂因素后，单变量分析中具有统计学意义的机构效应大大减少且不再具有统计学意义。
医护人员的接触与社区在职成年人有很大的不同。由于工作性质，医护人员可能因接触传染性和呼吸道感染而面临更高的感染和传播风险。虽然医护人员类型之间的总接触次数相当，但他们接触的特征却有很大的不同。
