ObjectiveTo enhance the management of occupational exposure, improve post-exposure reporting, promote post-exposure follow-up, reduce blood-borne infections caused by exposure, and ensure occupational safety among medical staff by using comprehensive measures based on nosocomial infection management system.MethodsAll the reported cases of occupational exposure were retrospectively collected from August 2012 to July 2018. The cases were divided into the control group (from August 2012 to July 2015) in which the data were reported in paper, and the observation group (from August 2015 to July 2018) in which the data were reported by nosocomial infection management system. The report and follow up results of occupational exposure in the two groups were compared and analyzed.ResultsAfter three years application of nosocomial infection management system, the occupational exposure report increased 95.8% (increased from 16.7 cases per year to 32.7 cases per year); the follow-up ratio of occupational exposure after one month,3 months and 6 months increased from 65.0% to 93.3% (χ2=15.184, P<0.001), 45.0% to 73.3% (χ2=9.033, P=0.003), and 25.0% to 53.3% (χ2=8.522, P=0.004), respectively.ConclusionApplication of nosocomial infection management system can increase the report of occupational exposure and the follow-up ratio of occupational exposure significantly.
ObjectiveTo explore the risk factors and protective measures of the occupation exposure of probationer nurses in operation room. MethodsThe self-designed questionnaire was used to reveal the risk factors and protective measures of occupation exposure in probationer nurses worked at the operating room during January 2011 and December 2013. ResultsThe female probationer nurses in operating room accounted for 97.7%; the probationer nurses from the secondary specialized school accounted for 53.1%. All the nurses didn't received any occupational protection knowledge training in schools. The practical nurses who failed to follow the regulate operation accounted for 76.8%. The occupational exposure occurred in 457 nurses during the period, which accounted for 44.7% of all the probationer nurses surveyed; the biological occupational exposure accounted for 38.5%. ConclusionTo strengthen the occupation safety education of operation room nurses, strictly regulate the operation procedures, establish the consummation protection measures and regulations, and strengthen their self-protection awareness can effectively reduce the occupation exposure injury in the probationer nurses in operation room.
Objective To explore the influencing factors of medical staff’s preventive behaviors of occupational exposure using health belief model. Methods A questionnaire was used to investigate the health beliefs and prevention-related behaviors of medical staff in Shuguang Hospital Affilliated to Shanghai University of Traditional Chinese Medicine from July 2018 to June 2019. The preventive behaviors and health beliefs of health workers with different occupational categories and working years were analyzed descriptively, and the influence of health beliefs on preventive behaviors was analyzed with multiple linear regression. Results There were 400 copies of questionnaire dispatched and 384 recovered. Among the survey respondents, 258 (67.19%) were females, 169 (44.01%) were aged 20-30 years, and 203 (52.86%) had worked for 5 or less years; 158 (41.15%) had sharp injury experience, 171 (44.53%) had experience of exposure to blood or body fluids, and 290 (75.52%) were actively immunized by injecting vaccines. The total score of compliance with standard preventive behaviors of the 384 respondents was 6.94±3.12. The scores of perceived susceptibility, perceived severity, perceived barriers, perceived benefits, and perceived self-efficacy were 24.87±4.56, 31.27±5.92, 16.50±5.77, 36.06±5.60, and 15.27±2.98, respectively. The total score of health beliefs was 123.97±15.91. The compliance with standard preventive behaviors and total score of health beliefs of logistics staff were lower than those of other respondents (P<0.05). The scores of perceived barriers of medical technicians and clinicians were significantly higher than that of nurses (P<0.05). The scores of perceived benefits and perceived self-efficacy of clinicians were lower than those of nurses (P<0.05). Respondents who had worked for 6-10 years had better compliance with standard preventive behaviors than interns and the ones who had worked for 11-15 years (P<0.05), and had a lower total score of health beliefs than the ones who had worked for over 16 years (P<0.05). Respondents who had worked for over 16 years had better scores of perceived benefits and perceived self-efficacy (P<0.05), and had a lower score of perceived barriers (P<0.05). The results of multiple linear regression analysis showed that gender [nonstandardized partial regression coefficient (b)=–0.644, 95% confidence interval (CI) (–1.162, –0.125), P=0.015], educational background [b=1.367, 95%CI (1.245, 1.587), P<0.001], and score of perceived barriers [b=0.044, 95%CI (0.004, 0.084), P=0.031] were influencing factors of medical staff’s preventive behavior compliance. Conclusions The score of perceived barriers is a main factor that prevents medical staff from implementing standard preventive measures. In the occupational exposure training program, it may be effective to help medical staff establish good standard prevention habits by improving the awareness of obstacles.
ObjectiveTo evaluate the occupational exposures and protective condition of medical staff in operating room for interventional therapy. MethodsFrom September to November in 2014, 46 medical staff in the operating room for interventional therapy were adopted to complete the occupational exposures and protection situation survey. After that, we analyzed and scored all the questionnaires. ResultsThe awareness of the medical staff about occupational exposures and occupational protection in the operating room was low; the awareness rates of doctors, nurses, and radiology technicians were 74.2%, 63.0% and 66.7%, respectively. The general condition of implement of occupational protection measures of the medical staff was bad, and the average rate of the doctors, nurses and radiology technicians was 51.3%, 43.9%, and 15.2%. ConclusionThe implement rates of occupational protection measures of the medical staff in Operating Room for interventional therapy differ much from the awareness rates. The rates in doctors and nurses are higher than that in radiology technicians. We should strengthen the education of radiation damage and protection measures in doctors, and enhance the training of iatrogenic injuries related knowledge in clinical radiology technicians to reduce occupational hazards.
ObjectiveTo explore the risk factors for hematogenous occupational exposure by analyzing hematogenous occupational exposure in medical workers, and discuss countermeasures in order to reduce the occurrence of hematogenous occupational exposure in medical workers. MethodsWe summarized and analyzed the hematogenous occupational exposure reported by registered medical personnel in the First People's Hospital of Yibin City from January 2012 to December 2014. ResultsThere were 129 cases of hematogenous occupational exposure, and nurses were at high risk of such exposure (65.12%).The exposure occurrence focused in medical personnel with working time shorter than 5 years.The top three high-risk operational procedures were needle injection, puncture, and medical waste disposal; sharp instrument injuries (109 cases, 84.50%) were the main factor leading to hematogenous occupational exposure in medical workers.Sources of exposure were detected and confirmed in 92 cases (71.32%); after testing, 79 cases (61.24%) of infections were confirmed in the source patients with one or more blood-borne pathogens.Through scientific treatment, no infection after hematogenous occupational exposure was detected in the medical workers. ConclusionMonitoring and analysis of hematogenous occupational exposure can facilitate identification of key departments, target population and risk factors, which is important for taking appropriate interventions.
【Abstract】Objective To investigate the contribution of occupational exposure to dusts / gases / fumes to chronic obstructive pulmonary disease( COPD) and respiratory symptoms in China. Methods Based on the crosssectional survey of COPD which was conducted in urban and rural areas of Beijing, Shanghai, Guangdong,Liaoning, Tianjin, Chongqing and Shanxi for residents aged 40 years or older, the association between the occupational exposure to dusts/ gases/ fumes and COPD and respiratory symptoms was analyzed. The recruited populations were interviewed with questionnaire and were tested with spirometry. The post-bronchodilators FEV1 /FVC lt; 70% was used as diagnostic criteria of COPD. Having any cough, sputum, wheezing and dyspnea was defined as having respiratory symptoms. Results The prevalence of occupational exposure to dusts/ gases /fumes was 20. 5% . As shown by multiple-variables Logistic regression analyses, occupational exposure to dusts / fumes /gases [ OR = 1. 20 ( 1. 04, 1. 39) ] and dusts of grain [ 1. 48 ( 1. 18, 1. 86) ] were associated with COPD;occupational exposure to dusts / fumes / gases [ OR = 1. 37( 1. 25, 1. 49) ] , hard-rock mining [ OR = 2. 31( 1. 67,3. 20) ] , coal mining [ OR = 1. 71( 1. 09, 2. 70) ] , dusts of cement [ OR = 1. 92( 1. 47, 2. 52) ] , chemical or plastics manufacturing [ OR =1. 58( 1. 37, 1. 83) ] , spray painting [ OR= 1. 46( 1. 16, 1. 84) ] , and other dusts or fumes [ OR = 1. 46 ( 1. 29, 1. 64 ) ] were associated with the respiratory symptoms. Smoking and occupational exposure to dusts / gases / fumes had synergic effects on the increasing risk of respiratory symptoms. The populationattributable risk ( PAR) of exposure to dusts / gases / fumes was 3. 94% and 7. 05% for COPD and respiratory symptoms respectively. Conclusions Occupational exposure to dusts /gases /fumes is associated with COPD and respiratory symptoms. Smoking and occupational exposure to dusts/ gases /fumes may have synergic effects on respiratory symptoms.
ObjectiveTo investigate the economic burden of the disposal of medical personnel after occupational exposure in medical institution.MethodA retrospective survey method was used to investigate and analyze the costs of inspection, treatment, and vaccination of 112 medical personnel after occupational exposure from January 2014 to December 2016.ResultsAfter the occupational exposure, the per capita economic burden on the medical institution for the exposed personnel was (331.80±66.16) yuan; the main expenditure item was the inspection expenses (93.53%); and the expenditure after the exposure of hepatitis B virus accounted for 75.40%, which ranked the top one in the expenditures of blood-derived infectious diseases. Occupational exposure was most likely to occur when dealing with sharps, and the cost of hospital spending accounted for 47.26%. After strengthening interventions such as standard prevention, the per capita cost of occupational exposures in the hospital from 2015 to 2016 showed a downward trend (P<0.05).ConclusionsOccupational exposure of medical personnel may cause a certain economic burden on medical institution. It is necessary to strengthen occupational protection, raise awareness of standard prevention, and reduce occupational exposure.