影响医务人员感染甲型H1N1流行性感冒因素的病例-对照研究

目的 探讨影响医务人员感染甲型H1N1流行性感冒(简称流感)的因素.方法 搜集2009年8月30日至2010年1月31日北京市公立医院中医务人员甲型H1N1流感确诊病例.按1:4配对的病例-对照研究设计,在医院内分别选择感染过和未感染过甲型H1N1流感的医务人员做为病例组(54例)和对照组(216名).通过问卷调查,收集其工作和家庭卫生信息.运用条件logistic回归分析医务人员感染甲型H1N1流感的影响因素.结果 研究对象年龄为(29.6±7.4)岁,其中男性占17.4%(47/270).病例组和对照组医务人员中,分别有3例(5.6%)和74名(34.3%)接种了甲型H1N1流感疫苗,10例(18.5%)和88名(40.1%)在甲流期间使用了防护级别更高的口罩,33例(61.1%)和161名(74.5%)延长了戴口罩的时间,13例(24.1%)和85名(39.4%)使用一次性纸巾擦手,24例(44.4%)和46名(21.3%)认为根据以往经验自己比他人更易患呼吸道传染病.单因素条件logistic回归分析显示使用一次性纸巾擦手(OR=0.15,95%CI=0.04～0.57)、延长戴口罩的时间(OR=0.43,95%CI=0.20～0.92)、使用防护级别更高的口罩(OR=0.26,95%CI=0.11～0.58)、接种甲型H1N1流感疫苗(OR=0.04,95%CI=0.01～0.32)、据以往经验自己比别人更易患呼吸道传染病(OR=2.85,95%CI=1.44～5.62)等与感染甲型H1N1流感有关.多因素条件logistic回归分析结果表明,甲型H1N1流感疫苗接种史(OR=0.18,95%CI=0.06～0.51)、使用防护级别更高的口罩(OR=0.05,95%CI=0.01～0.35)、据以往经验自己比别人更易患呼吸道传染病(OR=3.69,95%CI=1.58～8.63)等3个因素与感染甲型H1N1流感有关.结论 接种甲型H1N1流感疫苗、疾病流行期间使用更高防护级别的口罩、提高自身对呼吸道疾病的抵抗能力等措施是医务人员预防甲型H1N1流感的重要手段.

Pandemic influenza A (H1N1) virus infection factors among healthcare workers - a case-control study

Objective To explore factors related to pandemic influenza A (H1N1)virus infection among healthcare workers. Methods H1 N1 influenza confirmed cases of health workers in hospital of Beijing from Aug 30th 2009 to Jan 31st 2010 were included. A 1:4 matched case-control study was conducted with 54 healthcare workers who were infected by influenza A(H1N1) virus and 216 matched controls who were not infected. Face-to-face interview with questionnaires was used to collect information of work and family aspects of the study participants. Conditional logistic regression was used to analyze the H1N1 infection factors. Results The age was 29.6 ± 7. 4 years old and male subjects accounted for 17.4% (47/270).There were 5.6% (3/54) and 34.4% (74/216) of the cases get the influenza A (H1N1) vaccine immunization separately in the case group and control group. Among 18.5% (10/54) and 40. 1% (88/216)of the cases and controls used high protection level masks during the epidemic. Besides,33(61.1%)and 161 (74. 5%) cases lengthening the time of mask wearing separately. There were 13(24. 1%) and 85(39.4%)cases using disposable tissue to clean hands in the case group and control group, 24 (44. 4%) and 46 (21.3%) cases feel they were much easier to get infected in respiratory disease than others based on experience in the case and control group. Univariate analysis showed that factors such as using disposable tissue to clean hands(OR = 0. 15,95% CI=0.04 -0.57),lengthening the time of mask wearing(OR=0. 43,95% CI = 0. 20 - 0. 92), using high protection level masks (OR = 0. 26,95% CI = 0. 11 - 0. 58),getting influenza A(H1N1) vaccine immunization (OR = 0. 04,95% CI = 0. 01 - 0. 32), much easier to get infected in respiratory disease than others based on experience(OR =2. 85,95% CI = 1.44 -5. 62) ,were all associated with influenza A(H1N1) infection. Results of multivariate logistic regression analysis showed that variables such as history of influenza A (H1N1) virus immunization (OR = 0. 18,95% CI = 0. 06 - 0. 51),using high protection level masks (OR = 0. 05, 95% CI = 0. 01 - 0. 35), much easier to get infected in respiratory disease than others based on experience (OR = 3.69,95% CI = 1.58 - 8. 63) were all correlated immunization,using high protection level masks and improving respiratory health can protect healthcare workers from infection of influenza A(H1N1).