Department of Family Medicine, University of the Witwatersrand, Johannesburg.
S Afr Fam Pract (2004). 2020 May 14;62(1):e1-e7. doi: 10.4102/safp.v62i1.5027.
Healthcare workers (HCWs) are at risk of bloodborne infections from sharp instrument injuries and skin and mucous membrane exposures to contaminated blood and body fluids (BBF). While these have clinical and occupational health implications, little is known about BBF exposure and its reporting pattern in South African primary healthcare (PHC). The aim of this study was to determine the rate of BBF exposure, the extent of reporting and the reasons for not reporting among HCWs in PHC facilities in Johannesburg, South Africa.
In a cross-sectional study involving 444 participants, an 18-item, self-administered questionnaire was used to collect information on socio-demographic characteristics, HCWs' exposures to BBF in the last year, whether the exposure was reported and the reasons for not reporting. Analysis included descriptive statistics and chi-square test.
Most participants were nurses (87.4%) and female (88.1%). About a quarter of participants (112) reported having at least one BBF exposure in the last year. Overall, there were 355 exposures, resulting in 0.8 BBF exposure per HCW per year. Of these exposures, 291 (82.0%) were not reported. Common reasons for not reporting include lack of time (42.72%), perception that the source patient was at low risk for human immunodeficiency virus (24.7%) and concerns about confidentiality (22.5%). Blood and body fluids exposures involving nurses (p 0.001), sharp instrument (p 0.001) and HCWs aged 50 years (p = 0.02) were significantly more likely to be reported.
This study found a high rate of underreporting of BBF exposures among HCWs in PHC facilities in Johannesburg, suggesting an urgent need for interventions to improve reporting.
医护人员（HCWs）在工作中面临因锐器伤和接触污染血液和体液（BBF）而感染血源性传染病的风险。虽然这些情况具有临床和职业健康方面的影响，但我们对南非初级保健（PHC）中 BBF 暴露及其报告模式知之甚少。本研究旨在确定约翰内斯堡 PHC 设施中 HCWs 的 BBF 暴露率、报告程度和未报告的原因。
在一项涉及 444 名参与者的横断面研究中，使用了一份包含 18 个项目的自我管理问卷，收集了有关社会人口统计学特征、HCWs 在过去一年中 BBF 暴露情况、暴露是否报告以及未报告的原因等信息。分析包括描述性统计和卡方检验。
大多数参与者是护士（87.4%）和女性（88.1%）。约四分之一的参与者（112 人）报告在过去一年中至少有一次 BBF 暴露。总体而言，共发生 355 次暴露，导致每位 HCW 每年发生 0.8 次 BBF 暴露。其中，291 次（82.0%）未报告。未报告的常见原因包括缺乏时间（42.72%）、认为源患者感染人类免疫缺陷病毒的风险较低（24.7%）以及对保密性的担忧（22.5%）。护士（p<0.001）、锐器（p<0.001）和 50 岁（p=0.02）的 HCWs 中，血液和体液暴露更有可能被报告。
本研究发现，约翰内斯堡 PHC 设施中 HCWs 对 BBF 暴露的报告率较低，这表明迫切需要采取干预措施来提高报告率。
