妇科医生在手术烟雾环境中 HPV 感染的流行率。

Prevalence of HPV infections in surgical smoke exposed gynecologists.

机构信息

Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 Xueyuan Xi Road, Wenzhou, 325027, Zhejiang, China.

出版信息

Int Arch Occup Environ Health. 2021 Jan;94(1):107-115. doi: 10.1007/s00420-020-01568-9. Epub 2020 Sep 1.

DOI:10.1007/s00420-020-01568-9

PMID:32870342

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7826298/

Abstract

OBJECTIVES

Human papillomavirus (HPV) has been reported recently in surgical smoke generated by gynecological operations. The objective of this study was to investigate whether gynecologists who have performed electrosurgery including loop electrosurgical excision procedure (LEEP), are at risk of acquiring HPV DNA through surgical smoke.

METHODS

A related questionnaire was designed and 700 gynecologist nasal swab samples were collected in 67 hospitals. In addition, the flow fluorescence hybridization technique was used to detect HPV DNA, and the Chi-square test was applied to analyze whether related risk factors including electrical surgery, were correlated with HPV infection in surgeons' nasal epithelial cells.

RESULTS

The HPV infection rate in the nasal epithelial cells of the participants who performed electrosurgery (8.96%, 42/469) or LEEP (10.11%, 36/356) was significantly higher than that in the remaining participants who did not perform electrosurgery (1.73%, 4/231) or LEEP (2.91%, 10/344), respectively. The most prevalent HPV genotype in the electrosurgery group was HPV16 (76.19%, 32/42). The HPV-positive rate was increased in the group that had a longer duration of electrosurgery (P = 0.016). Additionally, the HPV detection rate was significantly lower in electrosurgery operators who used surgical mask (7.64%, 33/432) than in those who did not use protective masks (24.32%, 9/37). Furthermore, the N95 mask (0%, 0/196) significantly reduced the risk for HPV infection compared to that with the general mask (13.98%, 33/236, P < 0.001). Furthermore, 46 participants infected with HPV were followed-up for 3-24 months, and approximately 43.48% (20/46) and 100% (41/41) became negative for HPV DNA, respectively.

CONCLUSIONS

Gynecologists who performed electrosurgery including LEEP were at risk of acquiring HPV infection. Surgical masks, especially the N95 mask, significantly decreased the hazard of HPV transmission from surgical smoke.

摘要

目的

最近有研究报道称，妇科手术产生的手术烟雾中存在人乳头瘤病毒（HPV）。本研究旨在调查行电外科手术（包括环形电切术）的妇科医生是否有通过手术烟雾感染 HPV 的风险。

方法

设计了一份相关问卷，在 67 家医院收集了 700 名妇科医生的鼻拭子样本。此外，采用流式荧光杂交技术检测 HPV DNA，应用卡方检验分析电外科手术等相关危险因素与手术医生鼻上皮细胞 HPV 感染的关系。

结果

行电外科手术（8.96%，42/469）或 LEEP（10.11%，36/356）的参与者鼻上皮细胞 HPV 感染率明显高于未行电外科手术（1.73%，4/231）或 LEEP（2.91%，10/344）的参与者（分别为 76.19%，32/42；24.32%，9/37）。电外科组最常见的 HPV 基因型是 HPV16（76.19%，32/42）。电外科时间较长的组 HPV 阳性率增加（P=0.016）。此外，使用手术口罩的电外科操作人员 HPV 检测率（7.64%，33/432）明显低于未使用防护口罩的操作人员（24.32%，9/37）。与普通口罩相比，N95 口罩（0%，0/196）显著降低了 HPV 感染的风险（13.98%，33/236，P<0.001）。进一步对 46 例 HPV 感染患者进行了 3-24 个月的随访，HPV DNA 分别有 43.48%（20/46）和 100%（41/41）转为阴性。