Chen J W, Wang J, Wang A Q, Zhang J, Han L H
Department of Nosocomial Infection, Binzhou Medical University Hospital, Binzhou 256603, China.
Department of Somatology, Binzhou Medical University Hospital, Binzhou 256603, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020 Jan 20;38(1):29-32. doi: 10.3760/cma.j.issn.1001-9391.2020.01.006.
To understand the status of blood-borne occupational exposure and protection among health care workers (HCWs) in dental practice, and provide evidence for making effective prevention. From April 1 to 15, 2019, a stratified random sampling method was conducted to investigate the data of blood-borne occupational exposure among 221 dental HCWs in 2018, and Chi-squared Test was used to evaluate the differences of status on occupational exposure and protection among different professionals, such as nurses, doctors and trainees, and among different-grade hospitals. A total of 166 HCWs were exposed to occupational exposure 269 times, with the annual incidence of 75.11% (166/221) , and 37.55% (101/269) of exposures were reported. However, all source patients of exposures had failed to be traced. 89.59% (241/269) of exposures were sharp injuries. The top three instruments caused injuries were syringe/bilan needles, suture needles and vehicle needles, accounting for 35.68% (86/241) 、16.60% (40/241) and 16.18% (39/241) , respectively; and the top three exposure operations were removal/disposal of needles or instruments, suture/assisting suture and injection of anesthetic, accounting for 37.17% (100/269) 、22.30% (60/269) and 17.84% (48/269) , respectively. There were statistically significant differences among different professionals in occupational exposure frequency, reporting rate, the types of instruments caused injuries, exposure operations and hepatitis B vaccinated time (<0.01) . The compliance rate of standard precautions, safe operation, post-exposure reporting and prevention, and training on occupational protection were generally poor among HCWs, with significant differences in different-grade hospitals (<0.01) . There is a high incidence, low reporting rate and poor self-protection of blood-borne occupational exposure among dental HCWs. Strongly suggesting that standard precautions, safe use and disposal of oral instruments, active post-exposure report and prevention must be improved for everyone.
为了解口腔医疗机构医护人员血源性职业暴露及防护现状，为制定有效预防措施提供依据。采用分层随机抽样方法，对2018年221名口腔医护人员血源性职业暴露资料进行调查，运用χ²检验比较护士、医生、实习生等不同专业及不同等级医院职业暴露与防护现状的差异。共166名医护人员发生职业暴露269次，年发生率为75.11%（166/221），上报率为37.55%（101/269），但所有暴露源患者均未追踪到。89.59%（241/269）的暴露为锐器伤。造成锐器伤的前三位器械为注射器/碧蓝针、缝合针、车针，分别占35.68%（86/241）、16.60%（40/241）、16.18%（39/241）；前三位暴露操作是拔针/器械处理、缝合/辅助缝合、注射麻醉剂，分别占37.17%（100/269）、22.30%（60/269）、17.84%（48/269）。不同专业在职业暴露频次、上报率、致伤器械种类、暴露操作及乙肝疫苗接种时间方面差异有统计学意义（<0.01）。医护人员标准预防、安全操作、暴露后上报及预防、职业防护培训依从性普遍较差，不同等级医院间差异有统计学意义（<0.01）。口腔医护人员血源性职业暴露发生率高、上报率低、自我防护意识差，急需加强全员标准预防、口腔器械安全使用及处理、暴露后主动上报及预防措施。
