Nelsing S, Nielsen T L, Brønnum-Hansen H, Nielsen J O
Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Denmark.
Eur J Epidemiol. 1997 Jan;13(1):1-8. doi: 10.1023/a:1007327031599.
Occupational blood exposures involves a risk of transmission of serious infections. We performed a nation-wide survey, to describe the incidence and risk factors of percutaneous (PCE) and mucocutaneous (MCE) blood exposures among hospital employed doctors in Denmark. Of 9,374 questionnaires, 6,256 (67%) were returned and 6,005 were eligible for analysis. The highest risk per person-risk-year (pry) was found in General surgery, Neurosurgery, Obstetrics-Gynaecology and Orthopaedic surgery (6.2-8.5 PCE/pry and 7.3-8.8 MCE/pry). The second risk group Anaesthesiology and Oto-rhino-laryngology (2.6-3.1 PCE/pry and 6.0-6.9 MCE/pry). Finally Pathology, Internal medicine, Radiology and Paediatrics had a considerable risk (0.8-1.3 PCE/pry and 1.3-2.9 MCE/pry). Potential risk factors were examined by Poisson regression. Employment as senior as compared to junior doctor was associated with a higher risk of PCE (RR 2.2) and MCE (RR up to 2.7 depending on experience) among surgeons and an increased risk of PCE in anaesthetists (RR 1.7). In contrast, senior physicians in Internal medicine, Radiology and Paediatrics had a several fold lower risk of PCE (RR 0.6) and MCE (RR 0.6 in males, 0.3 in females). Only 35% adhered to the basic principles of universal precautions (UP) and non-compliance was associated with a considerably increased risk of both MCE and PCE, especially in non-surgical specialties. In conclusion, we found an unacceptably high incidence of occupational blood exposures among Danish doctors. Non-compliance with UP was associated with an increased risk of exposure and efforts to improve compliance with UP as well as implementation and evaluation of other preventive measures are needed.
职业性血液暴露存在传播严重感染的风险。我们开展了一项全国性调查,以描述丹麦医院在职医生中经皮(PCE)和黏膜皮肤(MCE)血液暴露的发生率及风险因素。在9374份问卷中,6256份(67%)被返还,6005份符合分析条件。每人每年风险(pry)最高的是普通外科、神经外科、妇产科和骨科手术(6.2 - 8.5次PCE/pry和7.3 - 8.8次MCE/pry)。第二风险组是麻醉科和耳鼻喉科(2.6 - 3.1次PCE/pry和6.0 - 6.9次MCE/pry)。最后,病理科、内科、放射科和儿科有相当的风险(0.8 - 1.3次PCE/pry和1.3 - 2.9次MCE/pry)。通过泊松回归分析潜在风险因素。与初级医生相比,担任高级职位的外科医生发生PCE的风险更高(RR 2.2),发生MCE的风险更高(RR最高可达2.7,取决于经验),麻醉医生发生PCE的风险增加(RR 1.7)。相比之下,内科、放射科和儿科的高级医生发生PCE(RR 0.6)和MCE的风险降低数倍(男性RR 0.6,女性RR 0.3)。只有35%的人遵守普遍预防措施(UP)的基本原则,不遵守与MCE和PCE的风险显著增加相关,尤其是在非手术专科。总之,我们发现丹麦医生职业性血液暴露的发生率高得令人无法接受。不遵守UP与暴露风险增加相关,需要努力提高对UP的遵守情况,并实施和评估其他预防措施。