Greene E S, Berry A J, Jagger J, Hanley E, Arnold W P, Bailey M K, Brown M, Gramling-Babb P, Passannante A N, Seltzer J L, Southorn P, Van Clief M A, Venezia R A
Department of Anesthesiology, Albany Medical College, New York 12208, USA.
Anesthesiology. 1998 Dec;89(6):1362-72. doi: 10.1097/00000542-199812000-00013.
Anesthesia personnel are at risk for occupational infection with bloodborne pathogens from contaminated percutaneous injuries (CPIs). Additional information is needed to formulate methods to reduce risk.
The authors analyzed CPIs collected during a 2-yr period at 11 hospitals, assessed CPI underreporting, and estimated risks of infection with human immunodeficiency virus and hepatitis C virus.
Data regarding 138 CPIs were collected: 74% were associated with blood-contaminated hollow-bore needles, 74% were potentially preventable, 30% were considered high-risk injuries from devices used for intravascular catheter insertion or obtaining blood, and 45% were reported to hospital health services. Corrected for injury underreporting, the CPI rate was 0.27 CPIs per yr per person; per full-time equivalent worker, there were 0.42 CPIs/yr. The estimated average 30-yr risks of human immunodeficiency virus or hepatitis C virus infection per full-time equivalent are 0.049% and 0.45%, respectively. Projecting these findings to all anesthesia personnel in the United States, the authors estimate that there will be 17 human immunodeficiency virus infections and 155 hepatitis C virus infections in 30 yr.
Performance of anesthesia tasks is associated with CPIs from blood-contaminated hollow-bore needles. Thirty percent of all CPIs would have been high-risk for bloodborne pathogen transmission if the source patients were infected. Most CPIs were potentially preventable, and fewer than half were reported to hospital health services. The results identify devices and mechanisms responsible for CPIs, provide estimates of risk levels, and permit formulation of strategies to reduce risks.
麻醉工作人员面临因污染的经皮损伤（CPls）而职业感染血源性病原体的风险。需要更多信息来制定降低风险的方法。
作者分析了11家医院在2年期间收集的CPls，评估了CPl的漏报情况，并估计了感染人类免疫缺陷病毒和丙型肝炎病毒的风险。
收集了138例CPls的数据：74%与血液污染的空心针有关，74%是潜在可预防的，30%被认为是来自用于血管内导管插入或采血的设备的高危损伤，45%已报告给医院卫生服务部门。校正损伤漏报后，CPl发生率为每人每年0.27例；按全时当量工作人员计算，每年有0.42例CPl。每全时当量工作人员感染人类免疫缺陷病毒或丙型肝炎病毒的估计30年平均风险分别为0.049%和0.45%。将这些结果推算到美国所有麻醉工作人员，作者估计30年内将有17例人类免疫缺陷病毒感染和155例丙型肝炎病毒感染。
麻醉任务的执行与血液污染的空心针导致的CPls有关。如果源患者被感染，所有CPls中有30%可能是血源性病原体传播的高危因素。大多数CPls是潜在可预防的，不到一半报告给了医院卫生服务部门。结果确定了导致CPls的设备和机制，提供了风险水平估计，并允许制定降低风险的策略。
