Keita-Perse O, Pradier C, Rosenthal E, Altare J, Cassuto J P, Dellamonica P
Centre d'Information et de Soins de l'Immunodéficience Humaine (CISIH), Hôpital l'Archet 1, Nice.
Presse Med. 1998 Nov 7;27(34):1723-6.
Infections transmitted by blood such as viral hepatitis B and C or human immunodeficiency virus (HIV) are a true threat to health care workers. As medical students are exposed to accidental contamination during their hospital activities, we conducted a survey among medical students in Nice France to determine the frequency and circumstances of needle prick accidents and how the risk of blood exposure is managed.
A survey was conducted between December 1 and December 15, 1996 among second cycle medical students. An anonymous questionnaire was proposed to all students attending mandatory faculty classes. A blood-exposure accident was defined as a needle prick or a cut caused by another sharp object which occurred in the hospital.
Among the 237 students enrolled in the classes, 200 (84%) responded to the survey. Among these, one-quarter had experienced a blood-exposure accident by needle prick. For students terminating their second cycle, this rate was 37%. In 58% of the cases, the accidents had occurred when the students were on duty (excepting hospital training courses). Blood drawing for gas measurements was the most frequent circumstance (44%). Only 39% of the students had declared the accident and 51% had had a serology control within 2 months. The serological status of the source patient was unknown to the students in nearly half the cases. Only one out of two students applied elementary safety measures systematically (gloves, not recapping the needle). Only 13% of the students stated they had received information about blood-exposure accidents and their prevention and less than 50% had a correct notion of the risk of hepatitis B and C and HIV transmission by needle pricks.
The incidence of blood-exposure accidents in hospital medical students is high and probably underestimated by official statistics due to the low declaration rate. Measures should rapidly implemented to inform and train students on prevention. Our units are currently working with students, the medical faculty and the occupational medicine unit to reach these objectives.
诸如乙型和丙型病毒性肝炎或人类免疫缺陷病毒（HIV）等通过血液传播的感染对医护人员构成了真正的健康威胁。由于医学生在医院活动期间会接触到意外污染，我们在法国尼斯的医学生中进行了一项调查，以确定针刺事故的发生频率和情况，以及如何管理血液暴露风险。
1996年12月1日至12月15日期间，对二年级医学生进行了一项调查。向所有参加必修教师课程的学生发放了一份匿名问卷。血液暴露事故定义为在医院发生的针刺或由其他尖锐物体造成的切割。
在参加课程的237名学生中，200名（84%）对调查做出了回应。其中，四分之一的学生曾经历过针刺导致的血液暴露事故。对于完成二年级学业的学生，这一比例为37%。在58%的案例中，事故发生在学生值班时（医院培训课程除外）。采集血样进行气体测量是最常见的情况（44%）。只有39%的学生报告了事故，51%的学生在2个月内进行了血清学检查。在近一半的案例中，学生不知道源患者的血清学状态。只有二分之一的学生系统地采取了基本安全措施（戴手套、不回套针头）。只有13%的学生表示他们接受过关于血液暴露事故及其预防的信息，不到50%的学生对针刺传播乙型和丙型肝炎及HIV的风险有正确的认识。
医院医学生血液暴露事故的发生率很高，由于报告率低，官方统计可能低估了这一情况。应迅速采取措施，对学生进行预防方面的宣传和培训。我们的单位目前正在与学生、医学院和职业医学单位合作以实现这些目标。
