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中亚地区医护人员职业健康的若干问题(综述)。

Some Issues of Occupational Health of Health Care Workers in Central Asia (Review).

机构信息

International School of Medicine, Bishkek, KG.

出版信息

Ann Glob Health. 2018 Aug 31;84(3):459-464. doi: 10.29024/aogh.2329.

Abstract

INTRODUCTION

In the Global Strategy on Human Resources for Health: Workforce 2030, the World Health Organization (WHO) called for the promotion of decent working conditions for health care workers (HCWs) in all settings. The Central Asian countries (CACs) are low- and middle-income countries with economies past transition and with implemented health care reforms that touch HCWs and occupational health and safety (OHS) at large.

THE AIM

of the present article is to highlight some challenges in OHS regulation and to highlight some of the latest studies on biological health risks to HCWs in CACs.

MATERIALS AND METHODS

The article reviews 18 journal articles in Russian and 3 journal articles in English published since 2004, 3 dissertations, 10 national statistical sources and profiles, and 5 books.

RESULTS

OHS management systems in CACs are built on the principle of responding to insurance cases, not their prevention. Most labor law standards are declarative in nature because many employers ignore labor protection requirements. There has been no study since 2000 on the working conditions, the physical and chemical health risks or the effects of working conditions, mental and physical loads on the health of HCWs. A few studies were found on work-related infectious diseases (viral hepatitis, HIV and tuberculosis) of HCWs in Kyrgyzstan and Kazakhstan. The latest studies showed a high prevalence of viral hepatitis B, C and G and of HIV infection in HCWs in Kyrgyzstan, with much lower rates in Kazakhstan.

CONCLUSIONS

The traditional OHS approach used in soviet times has proven insufficient in CACs with developing market economies. OHS and the health of HCWs in Central Asia is insufficiently studied. The available data indicate a low level of attention to the health of HCWs. Serious studies on OHS in health care settings in this region are needed.

摘要

简介

在《全球卫生人力战略:2030 年工作规划》中,世界卫生组织(世卫组织)呼吁在所有环境中促进医疗保健工作者(HCWs)的体面工作条件。中亚国家(CACs)是经济处于转型后的中低收入国家,并实施了医疗保健改革,这对 HCWs 和职业健康与安全(OHS)产生了广泛影响。

目的

本文旨在强调 OHS 监管方面的一些挑战,并重点介绍 CACs 中针对 HCWs 的生物健康风险的最新研究。

材料和方法

本文综述了自 2004 年以来发表的 18 篇俄语期刊文章和 3 篇英语期刊文章、3 篇论文、10 个国家统计来源和简介以及 5 本书籍。

结果

CACs 的 OHS 管理系统是基于应对保险案例的原则建立的,而不是预防。由于许多雇主忽略了劳动保护要求,大多数劳动法律标准在性质上是宣言性的。自 2000 年以来,一直没有研究针对 HCWs 的工作条件、物理和化学健康风险或工作条件、精神和身体负荷对健康的影响。在吉尔吉斯斯坦和哈萨克斯坦发现了一些关于 HCWs 与工作相关的传染病(病毒性肝炎、HIV 和结核病)的研究。最新的研究表明,吉尔吉斯斯坦的 HCWs 乙型、丙型和戊型肝炎以及 HIV 感染的流行率很高,而哈萨克斯坦的流行率要低得多。

结论

在市场经济不断发展的 CACs 中,前苏联时期使用的传统 OHS 方法已被证明不够充分。对中亚的 OHS 和 HCWs 健康状况的研究不足。现有数据表明,对 HCWs 的健康关注度较低。该地区需要对医疗保健环境中的 OHS 进行认真研究。

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