海南省公共服务场所感染传播乙型肝炎危险性的调查

目的 了解与评估公共服务场所感染传播乙肝病毒(HBV)的危险性及其影响因素.方法 选择大、中、小三种类公共服务场所,采用随机抽样的方法对从业人员和顾客开展乙肝预防知识、态度、行为(KAP)问卷调查和采集血标本,应用放射免疫法(RIA)检测HBsAg和抗-HBc,计算HBV感染率；同时检测服务器械的乙肝病毒标志物(HbsAg)污染状况. 结果 调查从业人员135名,HBV感染率为35.6％,大型和中小型场所HBV感染率分别为43.5％和18.6％,两者差异有统计学意义x2=7.85,P＜0.01)；从业未满2年者和2年以上者HBV感染率分别为50.8％和23.8％,两者差异有统计学意义(x2=10.62,P＜0.01).102名从业人员工作5个月后其HBV感染率增加了8.8个百分点；调查顾客179名,HBV感染率为33.0％,经常接受服务者HBV感染率高于偶尔接受服务者,两者差异有统计学意义(x2=4.73,P＜0.05)；134名问卷调查者中,69.4％了解乙肝疫苗(HepB)能预防乙肝,但仅27.6％接种过HepB;23.1％从业人员在服务过程中曾划破顾客皮肤和粘膜；公共服务场所器械HbsAg检出率为2.5％,剪刀检出率最高,为8.8％.结论 美容美发、洗脚等服务行业的公共服务场所存在感染传播HBV的可能,加强公共服务场所从业人员的健康防护知识宣传教育、HepB接种和服务器械消毒管理是防范感染传播HBV的重要环节.

Study of the risk of HBV infection in the public service place in Hainan province.

Objective To know and evaluate the risk and its influencing factors of HBV transmission which affected in public service places（PSP）. Methods Staffs and customers which were chosen from large-, mid- and small-sized PSP respectively were investigated in questionnaire about knowledge, attitude and practice（KAP）, also collected blood samples to detect ttBsAg and HBc,Ab by RIA,from which we could calculate the HBV infection rate. At the same time, to detect the HBSAg on the service equipment. Results The ttBV infection rate in those 135 staffs investigated accounted for 35.6%; the HBV infection rate in the large-sized,med-small-sized PSP was 43.5% and 18.6% respectively, whose difference had statistical significance （X^2=7.85,P〈0.01）;the HBV infection rate in staffs who have worked for less than two years and those have worked for more than two years was 50.8% and 23.8% respectively, whose difference had statistical significance （X^2=10.62,P〈0.01）.The HBV infection rate in 102 staffs who has worked for five months increased 8.8 percent. The HB~ infection rate in 179 customers investigated accounted for 33.0% ;the HBV infection rate in customers who accepted service frequently was higher than those customers who accepted service occasionally, whose difference had statistical significance （~2=-4.73 ,P〈0.05 ）. 69.4% of the 134 questionnaire investigators recognize that HepB can prevent HBV, but only 27.6% have vaccinated HepB;23.1% of the staffs have cut customers＇skin and mucosa in their service; the HBsAg detection rate of the apparatus used in the PSP was 2.5%, and the detection rate of scissors was the highest, accounted for 8.8%. Conclusion The results show that PSP, such as beauty parlors, haireuting parlors, footbathing inns and so on,have the risk of HBV infection and dissemination. Strengthen the propaganda and education of health protection knowledge and HepB vaccination in staffs worked in PSP,and management on service equipment disinfection,these are the important links against ttBV infection and dissemination.