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埃塞俄比亚东部公立医院卫生工作者职业伤害及相关因素分析:一项改进的泊松回归模型分析。

Occupational injuries and associated factors among sanitary workers in public hospitals, eastern Ethiopia: A modified Poisson regression model analysis.

机构信息

Haramaya University College of Health and Medical Sciences, Harar City, Ethiopia.

Faculty of Public Health, Medical University of Plovdiv, Plovdiv City, Bulgaria.

出版信息

PLoS One. 2024 Nov 15;19(11):e0310970. doi: 10.1371/journal.pone.0310970. eCollection 2024.

DOI:10.1371/journal.pone.0310970
PMID:39546541
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11567533/
Abstract

BACKGROUND

Occupational or work-related injuries are mostly common among hospitals' sanitary workers (SWs) in developing countries like Ethiopia. This is due to improper practiced of devices, unhygienic workplace, neglected and undermined risk factors, as well as due to lack of policy initiatives; but not studied well.

OBJECTIVE

The aim of the study was to assess the occupational injuries and its associated factors among SWs in public hospitals, eastern Ethiopia: A Modified Poisson regression Model Analysis.

METHODS

An institution-based cross-sectional study was conducted in eight public hospitals in eastern Ethiopia from May 2023 to August 30th, 2023. Out of fourteen hospitals, eight of them were selected randomly. Eight data collectors and 4 supervisors were assigned. Face-to-face interview was conducted. Eight hundred hospital SWs were recruited for the study. Occupational injury was measured using Boolean logic questionnaire either YES [1] or NO [0] for the last 12 months and the 7 days. Descriptive statistical was used for means, medians, standard deviations, and frequencies, proportions, and percentages. Modified Poisson regression was used to explore the relationship of outcome and independent variables. Accordingly, bi-variable analysis was performed to estimate unadjusted prevalence ratio (UPR). While, multi-variable model was used adjusted PR(APR) for those variables have significant values of p ≤0.20 at bi-variate analysis with confidence interval of 95% (CI:95%).

RESULT

Out of eight hundred nine SWs, 729(90.1%) were participated on the study. Self-reported occupational injuries among SWs in the last 12 months were 44.0% (95% CI: 40.4, 47.7). Of these, 92.2% (95%CI: 88.7,94.90%) and 7.8% (95%CI: 5.1, 11.3%) occupational injuries was reported from the cleaners and waste collectors, respectively. The model found that SWs those acquired diseases after recruited in the hospitals (APR:1.3;95%CI:1.1,1.6), those had sleeping disorder (APR:1.2;95%CI:1.0,1.), those had workload (APR:1.3; 95%CI:1.0, 1.8), those exposed with occupational hazards (APR:1.4; 95%CI:1.3, 1.7) were at the risk of occupational injuries as compared to their counter parts. Meanwhile, SWs those didn't get supervision (APR: 1.0;95%CI: 1.0, 1.2) and those non-adherence to personal protective equipment (PPE) (APR:1.3;95%CI:1.0,1.5) were more likely to at the risk of occupational injuries.

CONCLUSION

The current study concluded that there was a high prevalence of occupational injuries among SWs in the current selected public hospitals. The study also found that non-compliant with PPE, work load, sleeping disorders, attitude towards workplace safety and unsupervised activities and working in high-risk environment tends to increase the risk for occupational injuries. In addition to occupational injuries the study found that SWs those acquired occupational diseases such as asthma, respiratory tract problems, allergy, infections, kidney problems and dermatology problems after recruited in hospitals.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b95/11567533/a1f10995813f/pone.0310970.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b95/11567533/e4a056b05e00/pone.0310970.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b95/11567533/a1f10995813f/pone.0310970.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b95/11567533/e4a056b05e00/pone.0310970.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b95/11567533/a1f10995813f/pone.0310970.g002.jpg
摘要

背景

在埃塞俄比亚等发展中国家,医院卫生工作者(SWs)的职业或工作相关伤害最为常见。这是由于设备使用不当、工作场所不卫生、忽视和破坏危险因素以及缺乏政策举措造成的;但尚未得到充分研究。

目的

本研究旨在评估埃塞俄比亚东部公立医院卫生工作者的职业伤害及其相关因素:一项修正泊松回归模型分析。

方法

2023 年 5 月至 8 月 30 日,在埃塞俄比亚东部的八所公立医院进行了一项基于机构的横断面研究。在 14 家医院中,随机选择了 8 家。指定了 8 名数据收集员和 4 名主管。进行了面对面的访谈。共有 800 名医院卫生工作者参加了这项研究。职业伤害使用布尔逻辑问卷进行衡量,在过去 12 个月和过去 7 天内,回答为“是”[1]或“否”[0]。使用描述性统计方法计算平均值、中位数、标准差、频率、比例和百分比。使用修正泊松回归来探讨结果与自变量之间的关系。因此,进行了双变量分析以估计未调整的患病率比(UPR)。同时,对于在双变量分析中 p 值≤0.20 的那些变量,使用多变量模型进行调整后的 PR(APR)分析,并使用 95%置信区间(CI:95%)。

结果

在 809 名 SWs 中,有 729 名(90.1%)参加了研究。SWs 在过去 12 个月内自我报告的职业伤害发生率为 44.0%(95%CI:40.4,47.7)。其中,清洁工和废物收集者分别报告了 92.2%(95%CI:88.7,94.9)和 7.8%(95%CI:5.1,11.3)的职业伤害。模型发现,与对照组相比,在医院招聘后感染疾病的 SWs(APR:1.3;95%CI:1.1,1.6)、有睡眠障碍的 SWs(APR:1.2;95%CI:1.0,1.2)、工作量大的 SWs(APR:1.3;95%CI:1.0,1.8)、暴露于职业危害的 SWs(APR:1.4;95%CI:1.3,1.7)患职业伤害的风险更高。同时,未得到监督的 SWs(APR:1.0;95%CI:1.0,1.2)和不遵守个人防护设备(PPE)的 SWs(APR:1.3;95%CI:1.0,1.5)更有可能面临职业伤害的风险。

结论

本研究得出的结论是,在所选择的当前公立医院中,SWs 中存在职业伤害高发的情况。研究还发现,不遵守 PPE、工作量、睡眠障碍、对工作场所安全的态度以及无监督活动和在高风险环境中工作,都可能增加职业伤害的风险。除了职业伤害,研究还发现,SWs 在医院招聘后出现了哮喘、呼吸道问题、过敏、感染、肾脏问题和皮肤病等职业疾病。

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