护理实习生的职业暴露、职业防护现状调查分析

目的 了解护理实习生职业暴露、职业防护现状,为采取干预措施、减少职业暴露提供参考.方法 选取2019年1～12月在我院实习的护理实习生408名为研究对象,采用自行设计调查问卷对护理实习生的职业暴露发生情况、职业暴露类型、职业暴露发生原因、职业防护认知水平、职业防护情况等进行调查,描述护理实习生的职业暴露情况、职业暴露类...     

人类免疫缺陷病毒职业暴露的防护

艾滋病（acquired immunodefieiency syndrome，AIDS）是由人类免疫缺陷病毒（human immunodeficiency virus，HIV）所引起的致命性慢性传染病。病程较长，感染HIV后潜伏期可达2-10年。据2003年，卫生部的调查分析结果表明，中国现有艾滋病病毒感染者约84万，其中艾滋病病人8万例。我国HIV感染者已从高危人群扩展到社会各阶层，感染最多的依次是云南、新疆、广西和广东。大多数HIV携带者不知道他们已经感染了HIV，很少有艾滋病急性感染者被发现，再加上艾滋病发病初期因免疫功能低下所致的系列机会性感染，反复发作，迁延日久，不易引起医务人员的重视。因此，许多HIV携带者和未被检测诊断的AIDS患者，成为医务人员HIV职业暴露的最潜在危险期因素。我国虽无职业暴露感染HIV的报道，但暴露屡有发生。因此重视和做好职业性防护，是避免和预防HIV职业暴露的主要措施。     

云南省HIV/AIDS高发区医务人员职业暴露防护现状调查

目的调查艾滋病病毒/艾滋病(HIV/AIDS)高发区医务人员职业暴露防护现状,探讨潜在的危险因素及干预措施,提高职业暴露防护能力。方法对402名医务人员进行问卷调查。内容包括一般资料、医疗护理过程中的防护措施、锐器伤等。结果医务人员对HIV感染者/AIDS病人的诊治和防病知识知晓率达94%,传播途径的知晓率为98%,但自我防护意识淡漠,防护措施、防护设备不到位。结论在医务人员职业暴露防护方面还存在着潜在的危险因素,应进一步加强职业安全教育及培训,完善相关防护措施及防护设备。     

北京市监狱干警艾滋病职业暴露防护知识调查分析

目的了解北京市监狱干警艾滋病职业暴露相关知识的知晓情况,为今后对监狱干警开展艾滋病职业暴露及防护知识培训提供依据。方法采用自行设计的问卷,对108名监狱干警就艾滋病职业暴露相关知识进行调查。按回答题的正确数计算知晓率/%。结果共调查21道艾滋病职业暴露及防护知识题,总体知晓率为70.37%(1 596/2 268);6道暴露后应急处理措施题的正确掌握率为74.85%(485/648)。性别、文化程度、从警时间、职业类别之间的职业暴露及防护知识知晓率有显著性差异。结论应加强监狱干警艾滋病职业暴露防护知识培训,使之掌握正确的暴露后应急处理措施,提高他们对艾滋病的防护意识和自我保护能力,并将教育重点放在一线工作的监管干警。     

采供血工作中的职业暴露与防护

血站工作人员每天都要面对和接触大量的不明原因的感染性病原体，尤其是在实验室、采血、体检和医疗废物处理等岗位工作人员，这些人员由于长期接触传染源，有很多难免的危险操作和意外暴露。我们通过调查和文献报道，血站大多数工作人员都曾有暴露的经历。笔者结合多年工作实际，就如何做好采供血工作中的职业暴露的预防和处理与同行加以探讨。     

临床医护人员HIV职业暴露及其防护—附5例分析

目的：对临床医护人员HIV职业暴露的原因，方式及危险程度进行评价，并探讨可能的防护方法。方法：对5位HIV职业暴露的临床医护人员的暴露原因，危险程度及防护方法进行分析。结果：（1）5位临床医护人员中，口腔医生1人（1／5），护士4人（4／5），其中艾滋病专业临床护士2人，外科护士1人，急诊科护士1人。（2）暴露方式及危险程度：4人为针刺伤并穿过皮肤，1人为长时间无保护接触病人血液；（3）暴露后处理及预防治疗；暴露后5人均用清水冲洗，共挤压伤口，用碘酊及75％酒精消毒，4人在24小时内接受ZDV＋3TC＋IDV治疗两周，其中2人在2小时之内接受治疗，1人未接受治疗，（4）HIV抗体检测，5人在3－6个月后HIV抗体检测均阴性。结论：临床医护人员，尤其是临床护理人员，容易遭受HIV暴露，因此，应加强对医护人员HIV暴露的防护，防止医护人员感染HIV。     

北京市两所三甲医院医务人员血液和体液职业暴露及HIV相关防护知识调查

目的了解北京市两所三甲医院医务人员的血(体)液艾滋病病毒(HIV)职业暴露情况,防护知识、态度情况,培训情况及培训意愿。方法采用方便抽样的方法,对两所医院的392名医务人员采取自填式问卷调查。结果有81.2%(311/383)的医务人员被锐器刺伤过,有62.7%(240/383)被病人的血(体)液溅到过黏膜或破损皮肤。近一年内暴露密度中位数为1.0次/人年;相关防护知识的知晓率在51.4%～95.4%之间。42.3%(166/392)的医务人员接受过HIV职业暴露防护培训,94.6%(368/389)表示希望得到HIV职业暴露防护培训。结论医务人员HIV相关暴露普遍存在,防护知识缺乏,相关部门应加大培训力度,为医务人员创造良好的防护环境。     

北京郊区医务人员艾滋病职业暴露与防护现况

目的了解北京郊区医务人员艾滋病职业暴露及防护情况。方法采取现况调查的方法,按多阶整群抽样的原则,于2005年12月-2006年1月抽取北京郊区的医务人员进行问卷调查。结果2 021名医务人员中有21.8%参与过艾滋病诊疗服务,5.6%一年内接触过HIV阳性病人,38.9%一年内曾被医疗器械(皿)刺破皮肤,52.0%一年内经常接触引起血液、体液飞溅的操作;职业暴露防护不规范率为12.3%~62.1%;职业暴露后局部处理、预防性用药知识知晓率分别为4.6%、15.3%。结论北京郊区医务人员普遍存在艾滋病职业暴露危险,防护相关行为有待进一步培训、规范,推广普遍性防护原则势在必行。     

医护人员的艾滋病职业暴露及防护措施

艾滋病（AIDS）是由于感染了人类免疫缺陷病毒（HIV）而引起以免疫系统损害和感染为主要特征的一组综合征,是一种严重威胁人类健康的传染病。据中国疾病预防控制中心对艾滋病疫情的评估报告,截至2011年底,中国存活HIV感染者和AIDS患者约78万人,疫情呈低流行态势,但部分地区疫情严重。而广西的疫情在全国排在第三位,我院从2005年7月就开始成立了艾滋病专科,目前是全国收治艾滋病患者最多的治疗点之一,同时也发生了不少的职业暴露,现根据多年来的一些案例分析,从中吸取教训、总结经验,探讨行之有效的防护措施,以减少艾滋病职业暴露的发生。     

儿科护士职业暴露危险因素分析与防护对策

目的 探讨儿科护理人员职业暴露的危险因素及防护措施.方法 分析儿科护理人员职业暴露的危险因素,并提出切实有效的防护措施.结果 危险因素主要有针具、刀片、玻璃碎片损伤以及血液、分泌物污染等.结论 强化儿科护理人员职业暴露防护意识是有效防止职业感染发生的关键, 采取有效的防护措施是非常必要.     

北京市两家三级综合医院医务人员艾滋病职业暴露防护知识调查与影响因素分析

目的了解医务人员艾滋病知识以及艾滋病职业防护知识知晓现状,为开展医务人员艾滋病相关培训提供依据。方法采用整群抽样方法,于2013年11月对北京市两家三级综合医院的医务人员进行艾滋病基础知识和职业暴露相关知识知晓情况问的卷调查,分析医务人员艾滋病职业暴露知识的影响因素。结果两家医院共获取有效问卷1077份,对艾滋病职业暴露相关知识知晓率为57.9%（624/1077）,发生职业暴露后伤口处理措施和艾滋病病毒（HIV）职业暴露后抗体检测时间的知晓率分别为29.3%（316/1077）和35.0%（377/1077）。以前接受过艾滋病相关培训、职称、学历、工作年限等因素影响医务人员对艾滋病职业暴露防护知识的了解,其中接受过艾滋病相关培训对知晓率的影响最大[比值比（OR）=2.32,95%可信区间（CI）1.80-2.99]。结论此两家综合医院医务人员的艾滋病职业暴露知识知晓率偏低,应加强对新入职、学历低的医务人员的艾滋病及职业暴露防护知识的相关培训。     

2005--2011年传染病医院职业暴露情况调查及分析

目的通过对地坛医院近7年发生职业暴露的医务人员情况的追踪调查,探讨目前的职业防护措施是否安全有效,以便为临床医务人员提供全方位更好的防护。方法采用前瞻性监测方法,对该院2005年4月～2011年12月,医务人员职业暴露的特征及预后进行统计分析。结果近7年里,全院医务人员职业暴露共272人次,以30岁以下的护士为主,占70．59％;针刺伤占76．1％（207／272）;受伤部位主要为手指（220例,80．9％）,其次为眼睛（39例,14．3％）;HIV的职业暴露呈现逐年上升趋势。对于乙型肝炎（乙肝）病毒（HBV）职业暴露者抗乙肝病毒表面抗原抗体（抗一HBs）阳性的个体,暴露后不做任何防护是安全可行的。结论目前的职业暴露防护措施安全有效,在现有基础上还可进一步完善。     

Effects of occupational exposure to noise and dust on blood pressure in Chinese industrial workers

Along with the rapid development of economy and urbanization, noise and air pollution are becoming major occupational health hazards in the process of industrial production. In this study, we collected data from 7293 industrial workers in China. The association between occupational exposure of noise and dust and blood pressure was investigated. Controlling for demographic variables, including sex, age, and length of service, a stepwise regression model with backward elimination was constructed. The results showed that both noise and dust decreased the level of systolic blood pressure (p < 0.001). This finding prompted the manufacturing industry to reduce noise and dust hazards and protect the occupational health of workers. Prospective studies in different populations are still required to verify the net contribution of noise and dust to the decrease in blood pressure.     

Occupational exposure,attitude to HIV-positive patients and uptake of HIV counselling and testing among health care workers in a tertiary hospital in Nigeria

Health care workers (HCWs) are at risk of occupational exposure to HIV. Their attitude to HIV-positive patients influences patients’ willingness and ability to access quality care. HIV counselling and testing (HCT) services are available to inform HCWs and patients about their status. There is little information about HCT uptake and attitude to HIV-positive patients among HCWs in tertiary health facilities in Nigeria. The aim of this study was to determine occupational exposure and attitude to HIV-positive patients and level of uptake of HCT services among HCWs in a tertiary hospital in Nigeria. A cross-sectional design was utilized. A total of 977 HCWs were surveyed using semi-structured, self-administered questionnaires. Nurses and doctors comprised 78.2% of the respondents. Their mean age was 35?±?8.4 years. Almost half, 47.0%, reported accidental exposure to blood and body fluids (BBFs) in the preceding year. The main predictor of accidental exposure to BBFs in the last year was working in a surgical department, OR?=?1.7, 95% CI (1.1–2.6). HCWs aged <40 years, OR?=?5.5, 95% CI (1.9–15.9), who had worked for >5 years, OR?=?3.6, 95% CI (1.4–9.3) and who work in nursing department, OR?=?6.8, 95% CI (1.7–27.1) were more likely to be exposed to BBFs. Almost half, 52.9%, had accessed HCT services. Predictors for HCT uptake were age <40 years OR?=?1.6, 95% CI (1.1–2.4), having worked for >5 years OR?=?1.5, 95% CI (1.03–2.2) and working in medical department OR?=?1.7, 95% CI (1.1–2.8). Respondents in nursing departments were more likely to require routine HIV test for all patients, OR?=?3.9, 95% CI (2.4–6.2). HCWs in the laboratory departments were more likely to believe that HIV patients should be on separate wards, OR?=?3.6, 95% CI (1.9–7.0). HCWs should be protected and encouraged to access HCT services in order to be effective role models in the prevention of HIV/AIDS.     

Prevalence of hepatitis B virus markers and exposure to occupational risks likely to be associated with acquisition of hepatitis B virus among health care workers in Stockholm.

The prevalence of hepatitis B virus (HBV) markers and exposure to risks possibly associated with HBV transmission were investigated in 797 health care workers (HCW) from Stockholm. Altogether, 31/797 (3.9%) persons were positive for at least one HBV marker, 8.0, 7.9 and 6.4% respectively of children's nurses, laboratory assistants and psychiatric assistant nurses. A history of exposure to needle-stick injuries from any patient, was more often obtained from HCW with HBV markers than from HCW without such markers. The prevalence of HBV markers increased with age and duration of occupation in health care. Most HCW had been exposed to at least one occupational risk for HBV transmission early in their professional careers. Although the risk of acquiring HBV at present is low, the virus constitutes a potential occupational hazard for non-vaccinated HCW in Stockholm, a risk which may increase in the future since the number of chronic HBsAg carriers is increasing in Sweden.     

6种支原体的检测在一般人群和非淋菌性尿道炎患者中的调查研究

目的为了探讨一般人群和非淋菌性尿道炎(NGU)患者在咽部和尿道(宫颈)的解脲脲原体(Uu)、人型支原体(Mh)、生殖支原体(Mg)、穿透支原体(Mpe)、发酵支原体(Mf)及梨支原体(Mpi)的携带情况,其致病范围、分布特点及临床意义。方法采集151名体检人员及65例NGU患者的咽部和尿道(宫颈)分泌物,应用套式PCR法进行检测,靶基因分别为6种支原体的16SrRNA基因的特异性片断。结果体检人员咽拭子标本6种支原体的总阳性率为9.9%,而NGU患者的则为47.7%,两类人员支原体阳性率有非常显著性差异(P<0.0001)。性别的支原体阳性率差异无显著性(P>0.05)。两类人群中有12例(5.6%)在咽部和尿道(宫颈)检出同种支原体,两类人群在两个部位检出同种支原体的阳性率也有显著性差异(P<0.01)。结论一般人群中咽部可能携带常见支原体,但携带率很低。Mg感染可能是NGU常见的致病因素。Mpe感染也值得引起重视。提示两部位检出同种支原体的现象可能是由于口交性行为引起,值得进一步研究。     

Challenges to ART scale‐up in a rural district in Tanzania: stigma and distrust among Tanzanian health care workers,people living with HIV and community members

Objective To explore attitudes, perceptions and practices among health care workers, antiretroviral treatment (ART) patients and community members regarding ART care and the social consequences of ART roll‐out in rural Tanzania. Methods We performed focus group discussions and in‐depth interviews with health care workers, community members, ART patients, religious leaders, as well as social workers. Field observations and ethnographic assessments were conducted in parallel. Results We found widespread negative attitudes and perceptions of ART care HIV testing and the ART programme, a lack of trust in its sustainability, as well as lack of community and health worker involvement in the programme planning and treatment. HIV‐positive individuals on ART reported risky behaviours with the aim of revenge and were feared by community members. We also found that the ART availability was seen as an incentive to engage in HIV testing among some community members. Conclusion Our findings underline the importance of involving health workers and the community at a high level and their important role in promoting trust in the ART programme. There is an immense need to adjust interventions focusing on stigma reduction in the direction of ART scale‐up and to build awareness among ART patients so they understand how risky behaviours affect their personal well‐being and the community at large.