Gallardo López M T, Masa Calles J, Fernández-Crehuet Navajas R, de Irala Estévez J, Martínez de la Concha D, Díaz Molina C
Servicio de Medicina Preventiva, Hospital Universitario Reina Sofía, Córdoba.
Rev Esp Salud Publica. 1997 Jul-Aug;71(4):369-81.
Accidents resulting from percutaneous exposure account for approximately one third of all accidents suffered at work by health workers in hospitals. Their importance lies in the illnesses caused by pathogens that can be transmitted in this way (hepatitis B, hepatitis C, HIV virus). The aims are to describe accidents of this type notified in a tertiary level hospital, identify factors associated with these accidents in nursing staff and build a predictive model for the individual risk of having an accident.
A descriptive study of a retrospective cohort made up of all the people who notified having suffered an accident between 1-1-93 and 30-6-96. A study of cases and controls in nursing staff during the period 1-1-95 to 30-6-96, analysed through multiple logistical regression.
The cumulative incidence of cases of accidents in one year was 0.078 for male and female nurses. In 57.3% of cases, disposable or pre-loaded syringes were involved. The cumulative incidence of cases in one year was greater for intravenous catheterisation (8.5% per 100,000). The risk of having an accident, adjusted on account of confusing variables, was greater for female and male nurses (OR = 3.22; I.C.95% = 1.96-5.27), or workers in the Haemodialysis Unit (OR = 35.21; I.C.95% = 3.74-331.16) and for those employed on a temporary contract (OR = 4.50; I.C.95% = 2.24-9.04).
Accidents resulting from percutaneous exposure at this hospital are more frequent among nursing staff and are basically caused by any type of hollow needles. Factors associated with these accidents were identified, allowing specific prevention programmes to be targeted at those workers at greater risk. The model obtained is valid to estimate the degree of individual accident probability for the subjects studied.
经皮暴露导致的事故约占医院医护人员工作中所遭遇事故总数的三分之一。其重要性在于由此类方式传播的病原体所引发的疾病(乙型肝炎、丙型肝炎、艾滋病毒)。目的是描述一家三级医院通报的此类事故,确定护理人员中与这些事故相关的因素,并构建个体事故风险预测模型。
对1993年1月1日至1996年6月30日期间所有通报遭遇事故的人员组成的回顾性队列进行描述性研究。对1995年1月1日至1996年6月30日期间护理人员进行病例对照研究,通过多元逻辑回归分析。
男女护士一年中事故病例的累积发病率为0.078。57.3%的病例涉及一次性或预装注射器。静脉插管一年中病例的累积发病率更高(每10万人中8.5%)。经混淆变量调整后,男女护士发生事故的风险更高(比值比=3.22;95%置信区间=1.96 - 5.27),血液透析科工作人员(比值比=35.21;95%置信区间=3.74 - 331.16)以及临时合同工(比值比=4.50;95%置信区间=2.2 — 9.04)发生事故的风险也更高。
该医院经皮暴露导致的事故在护理人员中更为频繁,主要由任何类型的空心针引起。确定了与这些事故相关的因素,从而能够针对高风险工作人员制定具体的预防方案。所获得的模型对于评估所研究对象的个体事故概率程度是有效的。