Employee Health Unit, Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Office of Faculty Affairs, American University of Beirut Medical Center, Beirut, Lebanon.
Ann Work Expo Health. 2021 May 3;65(4):475-484. doi: 10.1093/annweh/wxaa117.
Despite numerous initiatives, occupational exposure to blood-borne pathogens (BBP) caused by percutaneous injuries or mucosal contamination remain common among healthcare workers (HCWs). These exposures were decreasing at the American University of Beirut Medical Center (AUBMC) in the previous decades. Recently, the medical center activity has been increasing with higher number of interventions performed and shorter hospital stay. Our aim was to determine the trend of incidents resulting from BBP exposures at AUBMC from 2014 till 2018 and identify whether the increase in hospital activity affected the rate of these exposures. We also aimed to assess the risk factors associated with needle stick injuries (NSIs).
A retrospective observational descriptive study of all exposures to BBPs among HCWs reported to the Environmental Health, Safety, and Risk Management department at the AUBMC between 2014 and 2018 was performed.
There were 967 exposures reported among which 84% were due to needlesticks. Residents (40%), followed by nurses (30%), and then by attending physicians (16%) were the top three most exposed occupational groups. Half of the participants injured themselves using either a syringe or a suture needle; and mostly during or after use. Occupation and incident location were associated with NSIs. The mean BBP exposure incidence rate was 5.4 per 100 full-time employees, 65.6 per 100 bed-years, and 0.48 admission-years. The BBP exposure rate per 100 occupied beds per year decreased between 2014 and 2017 then increased in 2018 (P < 0.001). The number of BBP exposures showed a strong, though non-significant negative correlation with the average length of hospital stay (Spearman correlation coefficient = -0.9, P = 0.083).
BBP exposure remains a serious occupational hazard. Our study shows that the BBP exposure rate per 100 occupied beds per year started decreasing during the study period before increasing again in 2018. Only the nursing department showed a consistent decrease of exposures. The occupation and incident location were found to be risk factors associated with NSIs. In addition to providing education and training, additional steps such as providing safety equipment and future interventions directed towards adjusting to higher workload should be all considered.
尽管采取了多项举措，但由于经皮损伤或黏膜污染导致的医护人员（HCW）职业性血源性病原体（BBP）暴露仍很常见。在过去几十年中，美国贝鲁特大学医学中心（AUBMC）的此类暴露呈下降趋势。最近，随着干预措施数量的增加和住院时间的缩短，该医疗中心的活动量有所增加。我们的目的是确定 2014 年至 2018 年期间 AUBMC 因 BBP 暴露导致的事件趋势，并确定医院活动量的增加是否会影响这些暴露的发生率。我们还旨在评估与针刺伤（NSI）相关的危险因素。
对 2014 年至 2018 年期间向 AUBMC 环境卫生、安全和风险管理部门报告的所有 HCW 发生的 BBP 暴露事件进行回顾性观察性描述性研究。
共报告了 967 例暴露事件，其中 84%是由于针刺伤。居民（40%）、护士（30%）和主治医生（16%）是前三个暴露风险最高的职业群体。有一半的参与者使用注射器或缝线针伤害了自己；且大多发生在使用过程中或之后。职业和事件地点与 NSI 有关。平均 BBP 暴露发生率为每 100 名全职员工 5.4 例，每 100 个床位年 65.6 例，每 100 个入院年 0.48 例。2014 年至 2017 年间，每 100 张占用病床的 BBP 暴露率逐年下降，然后在 2018 年上升（P<0.001）。BBP 暴露数量与平均住院时间呈强但无统计学意义的负相关（Spearman 相关系数=-0.9，P=0.083）。
BBP 暴露仍然是一个严重的职业危害。我们的研究表明，每 100 张占用病床的 BBP 暴露率在研究期间开始下降，然后在 2018 年再次上升。只有护理部门的暴露人数持续下降。职业和事件地点被发现是与 NSI 相关的危险因素。除了提供教育和培训外，还应考虑提供安全设备和未来的干预措施，以适应更高的工作量。
