| Preventing and controlling the occupational injury issue are hot spots of field of public health research. Although a series available measures focus on this hard nut were taken all over the world, occupational injury is still a threaten to whole hospital staff. Especially it plays a key role in pathopoiesis and even more to causing death.By recent years, the research of occupational injury both domestic and abroad have got some achievements and established three-tier system of preventive measures. But there are still many works worth to be considerate. The hospital is a special place, where occupational injury happens and where we research to prevent and handle it. Hospital staff is an important part of the labor force in the society, is a wealth of knowledge and skills of the groups on the diagnosis and treatment of disease, and it is occupational health service workers to protect human health and shoulder the noble mission of saving lives. Hospital staff's occupational hazards, consist of long-term impact of chronic, acute and unexpected hazards. Because they need to face to patients whom suffering from various diseases in the course of their work, often exposed to biological, chemical, physical factors such as occupational hazards, and psychology in a highly nervous and over-emergency status. While encountered in public health emergencies, Hospital staff needs to face and deal with the individual with the brink of jeopardy, and sometimes should? occupying in dangerous environment. Hospital staffs identity is double, with infectious diseases and infection-prone. High-intensity, high-risk, high-response, high input, low output of the job status, and multiple stress such as physiological, psychological, social et al, lead to occupational injury happening among Hospital hospital staff. This not only undermines the Hospital staff in good health, but also affects the health of the survival and development units. However, how to define occupational injury in Hospital staff, how to compensate that occupational risk factors to results in the harm, there is no a unified standard at home and abroad, and no economy reimbursement mechanism of occupational injury to Hospital staff all the more. Until nearly 10 years, some danger emerge unceasing such as Hospital staff with "Die fatigue", disability, death and other serious incidents because of the hospital violence.This led to think highly of health administration officials all over the world, and given more positive attention to occupational injuries with Hospital staff.Even though science and technology of the health has made great progress over the years in China, and disease provention has also achieved great success, but it is worth notes that, the health care system is still concerned about tending to maintain of lives and good health with patients, but concerned to Hospital staff's health seldom, the large number of existing related research is limited to the risk factors of occupational injuries to Hospital staff, a deeper level of organizational management factors and individual characteristics and other factors on the impact of occupational injuries has rarely reported, and also rare in many areas, many medical institutions and joint research.Because of this, we conducted to penetrating study and research in order to understand the prevalence of occupational injuries in Hospital staff, comprehensive analysis deep-rooted cause of occupational injuries, defined operational definition of occupational injuries and high-risk groups. We procure some beneficial and useful information, which is helpful to set up defense reimbursement mechanism of occupational injuries to Hospital staff, and to establish an effective resource to which to form one assessment scale of occupational injury data to at the same time.Objective:Based on the above research needs, we will be to plan to collect the various kinds of information which it effected epidemic of occupational injury of medical staff (such as the sociology of population characteristics, organizational management of the environment, personal characteristics, risk factors for occupational exposure, circumstance of the occupational injuries, et al).We will use of epidemiological survey methods and statistical analysis, and comprehensive analysis factors of occupational injuries, identify definition of operation that about of occupational injuries of medical staff. We have had to screening the risk factors which led to the occupational injury of the hospital how to happened, in order to caging high-risk crowd. This study acquired information and data will help us to establish the measuring scale of occupational injury of medical staff, and to institute the mode of occupational protection and work management in the next time.Methods:We used the Multi-stage stratified cluster sampling method, and according to different regions, provinces and cities, hospital grades to stratify sampling.We have adopted a self-designed questionnaire based on previous studies, by the pre-survey and expert consultation to determine. The questionnaire have part 4,that is including the respondents in general, lifestyle, occupational risk factors, and the type of occupational injury part. Part 1: general state of health consist of the sociological characteristics of respondents, such as units of nature, the knid of department, gender, age, title, position, education, work experience and so on. Part 2 is lifestyle, including smoking, drinking, diet, sleep, recreational activities, defecation, and physical exercise. Part 3: Occupational risk factors is based on occupational status of the medical establishment and Gimeno's questionnaire of occupational injury. They include 3 tables 49 items, there are organizational management factors (sub-table 1) 18 items (the first item has 5 sub-items), personal factors (sub-Table 2) 10 items, occupation factors (Table 3 points) 21 items. The last part that is type of occupational injury, it is divided into three types of sub-table, the first is: sub-health state self-assessment table, the second is: work-related injuries table, and third is: work-related disease table. Using Likert 5 class score method of assessment of the degree of risk. A survey was conducted from 1 May to 1 November, 2008. Hospitals in China are divided into three sizes by the number of beds (i.e., III≥500 beds, II 100-499 beds, and I 20-99 beds). To obtain a representative sample, we used multi-stage stratified cluster sampling method. First, the country was divided into six regions including Eastern, Northern, Northeastern, Middle-southern, Southwestern and Northwestern (excluding Hong Kong, Macao and Taiwan regions). Secondly, 13 level III hospitals, 5 level II, and 5 level I hospitals were separately drawn from each region according to the method of proportional allocation. In the third and last stage, 100, 50 and 30 staff members were randomly selected from the level III, II and I hospitals, respectively. All specialized hospitals (children's hospital, women and children's health hospital, cancer hospital and psychiatric hospital) were excluded in the evaluation program.Results:1. The subjects were 10,560 hospital staff members from a variety of disciplines (doctors, nurses, technicians, administrators, and logistics staff) working at 138 public hospitals. Our respondents were drawn from 74 Level 3 hospitals, 26 Level 2 hospitals, and 27 Level I hospitals in 26 provinces. The response rate was 90.06% (9,510 respondents). Among them, 9,066 questionnaires were used for analysis because of missing data for some of the studied variables. Hospital staff are : 2823 male, 6243 female, age include 17-63(32.8±8.5). Career: nurse-4263(47.0%), doctor-3604(39.8%), technologist-627(6.9), administrative personnel -212(2.3%), logistics staff 360(4.0%).Professional title: primary-4516(49.8%), middle level-2561(28.2%), high-grade 1-191(13.1%), others-798(8.8%).2. The reliability and validity tests showed that the risk factors of occupational injuries questionnaire's Cronbach'αcoefficient is 0.947.Sub-health status survey meters Cronbach'a coefficient is 0.926.It suggests the questionnaire has good reliability and validity.3. Medical personnel can not be optimistic about the situation of occupational injuries, according to the degree of injury is divided into three kinds of types, of which, I -type performance for the sub-health state injuries, the incidence rate was 54.7%, and 32.4% is level lightly, 19.5% is level midrange, 2.9% is level heavy. 5 before the performance of the sub-health symptoms are poor sleep quality, many dream of, easy to wake up (60.8%); back pain, dizziness (60.4%); irritating symptoms such as coughing, crying, sneezing (59.0% ); repeatedly check things, energy diminishing (58.1%); immunity decline, easy getting cold (57.5%).4. Type 2 of injury for work-related injury, the occurrence rate of 16.24%. Hospital staff before the job-related injury were 10 needle stick injuries(49.4%), oral ulcers(38.4%), genital injuries(28.5%), collision injuries(28.5%), menstrual abnormalities(20.5%), sprains(20.5%), chapped skin(18.4%), atopic dermatitis(16.8%), skin rashes(15.7%) and fall (14.3%) and so on.5. Type 3 of injury-related occupational disease, the sick rate of 6.06%. The top 10 of the hospital staff of occupational-related diseases are chronic pharyngitis(25.7%), neurasthenia(22.1%), lumbar cervical spondylosis(20.9%), chronic rhinitis(17.6%), ulcers(14.3%), varicose veins of lower extremity(11.4%), depression(7.5%), auditory nerve damage(3.1%), carpal tunnel syndrome(2.7%), pneumonia(2.7%) and so on.6,. The medical risk factors lead to different degrees of occupational injuries include: sociology of hospital staff characteristics of population, occupational environment, organization and management of environmental and personal characteristics such as specific as follows: Levels of hospitals, and their locations, the regional environment, job, title and academic qualifications, working hours, life, environmental organizations, human resources and work load, safe working environment and safe operation of such acts.7. Medical personnel management status of occupational injury in health care management are lack of management of occupational safety and health awareness of the importance; hospital occupational injury prevention policy and improve laws and regulations, protection and monitoring facilities are not in place; the hospital staff has not yet been incorporated into the occupational injury disease management; hospital staff of occupational injury and occupational studies do not have a profound protection; there is lack of effective protection of hospital staff and occupational health professional education, guidance and management.Conclusion:1. The survey research shows that happening in the domestic hospital staff occupational injuries are more serious, medical personnel are of high risk of occupational injury, according to the degree of injury the hospital staff of occupational injury should be classified as three kinds of types, one type of injury sub-health status, 2-type of injury for work-related injury, 3 types of injury-related diseases as a career.2. Causes of occupational injury factors for medical personnel are complex and multifaceted. they are intertwined with each other, the combined effect, eventually causing the occurrence of occupational injury. Risk factors for occupational injuries, including hospital staff sociological characteristics, occupational environment, organization and management of environmental and personal characteristics such as specific as follows: Level of hospital, and their locations, the regional environment, jobs, titles and qualifications, hours of work, lifestyle, organizational environment, human resources and work load, safe working environment and safe operation of such acts. To reduce risk factors for a variety of professional medical personnel on the importance of occupational injuries, we must adopt effective methods of health management, including the establishment of the Occupational Health and Safety Commission, setting up an effective occupational reporting system to improve the way of life, providing an effective and reasonable protection of occupational to meet the clinical human resources.3. In the sub-health status of the hospital, hospital staff should be of great importance to the management of such people's health through effective guidance and intervention to avoid further increase of occupational injury. In the event of work-related injury, strictly occupational risk factors for the effective identification and management should be taken to strengthen the protection of occupational risk factors to reduce the incidence of occupational diseases. And employment-related diseases happen, the hospital management decision-making should be fully aware of occupational injuries on the health hazards of hospital staff and the timely provision of appropriate financial compensation, given the buffer body of humanity cycle, so that employment-related disease caused by the loss of to minimize.4. Occupational injuries are a global, very important public health problem, and while medical personnel take the responsibility to ensue the human life and the health, and the promotion of the social mission of rehabilitation, their occupational health and safety issues did not get attention.5. According to the study, we hope to arouse the attention and concern from the adminstive institutions. Strengthenning management of occupational injury protection and occupational health research will be conducted in the future. |
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