【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.
目的 了解医院内血源性职业暴露高风险人群，有针对性采取防护措施，降低血源性职业暴露的发生率。 方法 对2008年1月－2011年12月四川省妇幼保健院52例血源性职业暴露医务人员，按照暴露人群、暴露方式、暴露病种、暴露地点的不同进行调查分析。 结果 52例职业暴露人群中护士27例（占51.9%）；产房和手术室为高发职业暴露场所，共32例，分别为17例（占32.7%）和15例（占28.8%）；职业暴露病种主要为乙型肝炎，共27例（占51.9%）；暴露方式主要为针刺伤，共37例（占71.2%）。 结论 提高医务人员职业防护意识，规范操作流程，加强自身防护是减少职业暴露的根本所在。
目的:探讨口腔科医务人员职业暴露的危险因素,提高防护意识,减少职业暴露。方法:通过2007年1月至2008年12月对口腔科医务人员职业暴露的危险因素进行回顾性调查分析。结果:易造成口腔科医务人员职业暴露的危险因素有:生物方面因素、物理方面因素、化学方面因素、环境方面因素。结论:加强学习和培训,提高防护意识。完善防护制度,严格执行操作规程,落实标准预防措施,加强监督管理,是减少职业暴露的关键。
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 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 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.
ObjectiveTo study the effect of new bundle interventions on medical staff’s cognition of occupational exposure protection and exposure rate, and provide evidence for reducing medical staff’s occupational exposure.MethodsThe 1 435 medical practitioners in 37 clinical/technical departments of Nanchong Central Hospital were selected as the research objects. Bundle intervention strategies about occupational exposure for whole population and high risk population were implemented, and the medical staff’s cognition of occupational exposure, occurrence of occupational exposure, and post-exposure reporting in 2017 (before intervention) and 2018 (after intervention) were investigated and compared to evaluate the intervention effects.ResultsThe numbers of valid survey forms collected before intervention and after intervention were 1 160 and 1 421, respectively. The total awareness rate increased from 91.10% before intervention to 96.10% after intervention (P<0.001). The exposure rate and average rank of exposure frequency after intervention were lower than those before intervention (10.98% vs. 17.50%, 1 250.74 vs. 1 340.32), the reporting rate of initial exposure after intervention (69.23%) was higher than that before intervention (57.64%), and the differences were all statistically significant (P<0.05).ConclusionThrough gradually implementing the new bundle interventions, medical staff can improve the cognition of occupational exposure, reduce the occurrence of occupational exposure, improve the enthusiasm of reporting, and create a safe atmosphere.