职业性血液暴露超出针刺伤：在埃塞俄比亚北部政府医院的医护人员中进行的基于医院的横断面研究。
Occupational blood exposure beyond needle stick injuries: hospital-based cross-sectional study among healthcare workers in governmental hospitals of Northern Ethiopia.
机构信息
Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
出版信息
BMC Health Serv Res. 2021 Oct 22;21(1):1136. doi: 10.1186/s12913-021-07167-9.
BACKGROUND
Occupational blood exposure is one of the major public health problems that healthcare workers (HCWs) are encountering. Most previous occupational blood exposure studies are delimited to needle stick injury, which could underestimate the real level of blood exposure. On the other hand, others deal with crude blood and body-fluids exposure, which possibly overestimate the magnitude of blood exposure. Therefore, this study aimed at determining the prevalence of occupational blood exposure and identifying associated factors among HCWs in the Southern Tigrai zone governmental hospitals of Northern Ethiopia considering all the potential means of blood exposure (needle stick injury, sharp medical equipment injury, and blood splash) while excluding blood-free body-fluids.
METHODS
A hospital based cross-sectional study design was employed to gather data from randomly selected HCWs in three governmental hospitals from February to March, 2020. A multivariable logistic regression model was used to identify the independent factors associated with the outcome variable.
RESULTS
From the total of 318 HCWs, 148 (46.5 %) were exposed to blood at least once in their lifetime. Working for more than 40 h per week (AOR= 9.4; 95 % CI: 7.61, 11.41), lack of adequate personal protective equipment (PPE) (AOR=3.88; 95 % CI: 1.64, 5.42), Hepatitis B virus vaccination (AOR=0.54; 95 % CI: 0.12,0.78), recapping used needle sticks (AOR=3.18; 95 % CI: 1.28, 8.83), and lack of infection prevention and patient safety (IPPS) training (AOR=13.5; 95 % CI: 8.12,19.11) were detected to significantly increase the likelihood of occupational blood exposure.
CONCLUSIONS
As nearly half of the HCWs were exposed to blood, reducing work load below 40 h per week by employing additional staff members, supplying adequate PPE, avoiding recapping of used needle sticks, and providing IPPS training for the HCWs should be practiced.
背景
职业性血液暴露是医护人员（HCWs）面临的主要公共卫生问题之一。大多数先前的职业性血液暴露研究都局限于针刺伤，这可能低估了实际的血液暴露水平。另一方面，其他研究涉及的是未经处理的血液和体液暴露，这可能高估了血液暴露的程度。因此，本研究旨在确定在埃塞俄比亚北部南提格雷地区政府医院的医护人员中，考虑到所有潜在的血液暴露途径（针刺伤、锐器医疗设备伤和血液喷溅），同时排除无血液的体液，职业性血液暴露的发生率，并确定其相关因素。
方法
采用医院横断面研究设计，于 2020 年 2 月至 3 月期间从三家政府医院中随机抽取医护人员进行数据收集。采用多变量逻辑回归模型确定与结局变量相关的独立因素。
结果
在总共 318 名医护人员中，有 148 名（46.5%）至少在其一生中曾接触过血液。每周工作超过 40 小时（AOR=9.4；95%CI：7.61，11.41）、缺乏足够的个人防护设备（PPE）（AOR=3.88；95%CI：1.64，5.42）、乙型肝炎病毒疫苗接种（AOR=0.54；95%CI：0.12，0.78）、回套使用过的针头（AOR=3.18；95%CI：1.28，8.83）和缺乏感染预防和患者安全（IPPS）培训（AOR=13.5；95%CI：8.12，19.11）被发现显著增加职业性血液暴露的可能性。
结论
由于近一半的医护人员接触过血液，通过增加额外的工作人员来减少每周工作时间低于 40 小时、提供足够的 PPE、避免回套使用过的针头、并为医护人员提供 IPPS 培训，应在实践中实施。
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