Rai Rajni, El-Zaemey Sonia, Dorji Nidup, Rai Bir Doj, Fritschi Lin
School of Public Health, Curtin University, Bentley, WA 6102, Australia.
Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu 11001, Bhutan.
Int J Environ Res Public Health. 2021 Mar 5;18(5):2603. doi: 10.3390/ijerph18052603.
Health care workers are exposed to numerous workplace hazards. The implementation of safety measures in high-income countries has largely mitigated these risks. However, in many low- and middle- income countries (LMICs), resources to institute safety measures are lacking, increasing the risk of occupational exposures to these hazards. The aim of this scoping review is to map and synthesize the available research on occupational hazards among health care workers in LMICs, identify research gaps and inform policy. Searches for relevant articles were conducted in five electronic databases using a broad range of search terms. The inclusion criteria were: quantitative observational or experimental studies which examined exposure to one or more occupational hazards among health care workers in a LMCI; and the article was published in English in a peer-reviewed journal. A total of 99 studies met the inclusion criteria, and data were extracted from these studies. Large proportions of health care workers in LMICs were exposed to biological hazards (bloodborne pathogens, tuberculosis), psychosocial hazards (workplace violence, burnout, job dissatisfaction), ergonomic hazards (musculoskeletal complaints), and chemical hazards (exposure to latex and antineoplastic drugs). The implementation of risk reduction strategies was suboptimal. The majority of the literature was on biological hazards (48%), and research on other hazards was limited in comparison. Occupational safety needs to become a priority public health issue to protect health care workers in LMICs. More research is needed to understand the magnitude of the problem in these countries.
医护人员面临众多工作场所危害。高收入国家实施的安全措施在很大程度上降低了这些风险。然而，在许多低收入和中等收入国家（LMICs），缺乏实施安全措施的资源，这增加了医护人员职业暴露于这些危害的风险。本范围综述的目的是梳理和综合关于LMICs医护人员职业危害的现有研究，识别研究空白并为政策提供信息。使用广泛的搜索词在五个电子数据库中搜索相关文章。纳入标准为：定量观察性或实验性研究，其考察了LMCI中医护人员暴露于一种或多种职业危害的情况；且文章以英文发表在同行评审期刊上。共有99项研究符合纳入标准，并从这些研究中提取了数据。LMICs中很大比例的医护人员暴露于生物危害（血源性病原体、结核病）、心理社会危害（工作场所暴力、职业倦怠、工作不满）、人体工程学危害（肌肉骨骼不适）和化学危害（接触乳胶和抗肿瘤药物）。降低风险策略的实施效果欠佳。大多数文献关注生物危害（48%），相比之下，关于其他危害的研究有限。职业安全需要成为保护LMICs医护人员的优先公共卫生问题。需要更多研究来了解这些国家该问题的严重程度。
