| ObjectivePurpose of this study was to understand current status and risk control status of occupational exposure to blood and body fluid (BBF) in hospital healthcare workers (HCWs), to find evidence for intervention in next step, and to provide basic data for evaluation of interventions.MethodsA retrospective investigation was conducted in all clinical departments and clinical laboratory in a general hospital.Data was collected through self-administered questionnaires which includes essential information of each HCWs and their status on occupational exposure to bloodborne pathogens in the past year.1201 HCWs were surveyed,65.53%,29.14% and 5.33% of them were nurses, doctors and laboratory technicians, respectively. According to the result of investigation and the record of occupational exposure to hospital infection in HCWs, evaluated the status, the enforcement of risk control measurements, report after occupational exposure to BBF were evaluated comprehensively.Results1 Epidemiology of occupational exposure to BBF in HCWs1.1 The status of occupational exposure to BBFThe total incidence and the average number of episodes exposure to BBF in HCWs was 71.19/100 HCWs per year and 3.42 per person per year in the past year, respectively. The incidence of contaminated sharps injuries (CSI),exposure to BBF by damaged skin and mucous-membrane exposure (MME) was 63.78,26.98 and 23.40/100 HCWs per year, respectively. The incidence of exposure to BBF in nurses, doctors, and laboratory technicians was 75.60,67.71 and 35.94/100 HCWs per year, respectively. The leading incidence was occurred in department of gynecology and obstetrics, operation room and surgical department. In doctors, the leading incidence occurred in surgeon, accoucheur and doctors in operation room.In nurses, the leading incidence occurred in nurses of department of gynecology and obstetrics, operation room, department of pediatrics.1.2 Status on needle-stick and other sharps injuriesThe total incidence and the average number of episodes of needle-stick and other sharps injuries in HCWs was 78.85/100 HCWs per year and 3.58 per person per year in the past year, respectively. The incidence of needle-stick and other sharps injuries in nurses,doctors, and laboratory technicians was 88.31,66.29 and 31.25/100 HCWs per year, respectively. The average number of episodes of needle-stick and other sharps injuries in nurses,doctors, and laboratory technicians was 4.14,2.86 and 0.66 per person per year, respectively.The top 3 incidence occurred in department of gynecology and obstetrics,operation room and intensive care unit. The top 3 average number of episodes occurred in emergency room, followed by department of gynecology and obstetrics, and surgical department. Needle-stick and other sharps injuries were mainly happened in ward, operation room, and emergency room.The leading incidence of needle-stick and other sharps injuries was occurred in broken glass preparation (ampoule or vial), followed by withdrawing needles from patients and sorting or disposal of used sharp devices.The leading average number of episodes of needle-stick and other sharps injuries occurred in broken glass preparation (ampoule or vial), followed by surgical operation (suture or cut) and withdrawing needle from patients.Needle-stick and other sharps injuries were mainly caused by hollow needles, broken glass and suture needles.1.3 Status on contaminated sharps injuriesThe total incidence and the average number of episodes of contaminated sharps injuries in HCWs was 63.78/100 HCWs per year and 2.02 per person per year in the past year, respectively. The incidence of contaminated sharps injuries in doctors, nurses,and laboratory technicians was 64.29,66.33 and 29.69/100 HCWs per year, respectively. The average number of episodes of contaminated sharps injuries in doctors, nurses,and laboratory technicians was 2.55,1.89 and 0.63 per person per year, respectively. The leading incidence of contaminated sharps injuries were occurred in HCWs of department of gynecology and obstetrics, operation room and surgical department,as well as leading number of episodes of contaminated sharps injuries. Contaminated sharps injuries were mainly happened in ward, operation room, intensive care unit and emergency room.76.42% of contaminated sharps injuries were occurred in the process of using sharps, the other 23.58% were occurred in the process'after use and before disposal'of needle. The leading number of contaminated sharps injuries were caused by withdrawing needles from patients, the sorting and disposal of used sharp devices, during surgical operation and venepuncture(drawing blood, adding fluid, and transfusion).Contaminated sharps injuries were mainly caused by hollow needles and suture needle.1.4 Status on occupational exposure through damaged skinThe total incidence and the average number of episodes of occupational exposure through damaged skin was 26.91/100 HCWs per year and 0.74 per person per year in the past year, respectively. The incidence of occupational exposure through damaged skin in doctors, nurses,and laboratory technicians was 10,59,36.09 and 29.69/100 HCWs per year, respectively.The leading incidence of episodes of occupational exposure through damaged skin was occurred in emergency room. Occupational exposure through damaged skin was mainly happened in ward, emergency room, operation room and intensive care unit. The leading number of episodes of occupational exposure through damaged skin was caused by insert, remove or manipulate on vein or artery.1.5 Status on MMEThe total incidence and the average number of episodes of MME was 23.40/100 HCWs per year and 0.67 per person per year in the past year, respectively. The incidence of MME in doctors, nurses,and laboratory technicians was 30.57,20.84 and 15.63/100 HCWs per year, respectively. The average number of episodes of MME was 1.00,0.55 and 0.33 per person per year.The leading incidence of episodes of MME was occurred in surgical department. MME was mainly happened in operation room, followed by surgical department, emergency room and department of gynecology and obstetrics.The leading number of episodes of MME was occurred in operation room, ward, emergency room, intensive care unit and delivery room. The leading number of episodes of MME was occurred during surgical operation (including cesarean section).2 Status on implement of risk control measurementThe training rate of occupational health was relatively low; personal protect equipment needed to be improved and strengthened, information communication between HCWs and the institution is deficient. Few healthcare workers were with HBV antigen. Emergency treatment after exposure to BBF was well-done. Evaluation after occupational exposure, evaluation of source patient were better than evaluation of HCWs who exposured to BBF.3 Status on report after occupational exposureReport rate was relatively low after occupational exposure to BBF, little HCWs reported the episodes.The main causes for not to report were thought of no time for report, little risk for infection, and unimportant to report.4 Multifactor analysis of occupational exposure to BBFThe episodes of occupational exposure to BBF in HCWs related to their gender, job categories, work departments, whether took part in any training in occupational health, whether training included harm and protection about BBF, whether the hospital had sought comments and suggestions of occupational health protection, how many hours they work every day and how many days they work every week.ConclusionHealthcare worker are still at risk of exposure to BBF and getting infection. Exposure risks are different in varies working population, workplace, work processes and sharps. Comprehensive measurement of BBF prevent and control should be taken for the key population, workplace, process and the weak procedure, including occupational diseases prevention mechanism fully development and implement, work safety culture building persistenly, occupational training of healthcare workers strengthening, healthcare workers immunization with HBV antigens, sharps injuries and its risk reporting and evaluation procedure conducting, preventive measures taken based on the result of baseline assessment.
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