Objective: To investigate blood-borne occupational exposure and related protection in the medical staff of a traditional Chinese medicine hospital, and to provide a reference for reducing the risk of blood-borne occupational exposure. Methods: Forty-eight medical workers with blood-borne occupational exposure in 2015 were selected to analyze the incidence of blood-borne occupational exposure, influencing factors, operations that caused blood-borne occupational exposure, pathogens, and occupational protection. Results: The incidence rate of blood-borne occupational exposure in the medical staff of the traditional Chinese medicine hospital in 2015 was 3.30% (48/1 455) , and the frequency was 0.04 time/person/year. The workers with blood-borne occupational exposure were mostly nurses, females, workers aged <30 years, workers with <5 working years, and workers with a junior professional title. There was a significant difference in the incidence rate of blood-borne occupational exposure between workers with different ages and working years. The main way of blood-borne occupational exposure was sharp injury (96.08%) . The main operations that caused blood-borne occupational exposure were covering or separating the syringe needle after injection and disposing used sharp instruments. The main exposure site was the hand (96.08%) , with the thumb and index finger for the left hand and the middle finger and index finger for the right hand; there was no significant difference in the exposure site distribution between the two hands (P<0.05) . The main pathogen that caused blood-borne occupational exposure was hepatitis B virus (68.96%) . The rate of correct local treatment for blood-borne occupational exposure was 88.24%. The rate of prophylactic medication was 74.51%, and hepatitis B immunoglobulin (HBIG) plus hepatitis B vaccine was the main way, followed by HBIG. In all workers with blood-borne occupational exposure, 62.74% did not wear gloves. Conclusion: The medical workers with few working years have a high risk of blood-borne occupational exposure, so the training on protection against blood-borne occupational exposure should be strengthened to reduce the risk of blood-borne occupational exposure and infection.
目的： 了解某中医院医务人员血源性职业暴露与职业防护情况，为降低血源性职业暴露的风险和制定职业防护措施提供参考。 方法： 选择2015年1至12月发生血源性职业暴露的48名医务人员作为研究对象，分析其血源性职业暴露发生率、影响因素、发生环节、暴露源以及职业防护情况等。 结果： 该中医院2015年医务人员血源性职业暴露发生率为3.30%（48/1 455），发生强度为0.04次/（人·年）。血源性职业暴露人群中护士、女性、年龄<30岁、工龄<5年以及初级职称医务人员较多；不同年龄和工龄血源性职业暴露发生率差异有统计学意义（χ(2)=15.597、8.944，P<0.05）。血源性职业暴露最主要的方式是锐器伤（96.08%），主要环节是注射后回套针帽或分离针头、集中处置用过的锐器物。暴露部位以手为主（96.08%），左手暴露部位主要为拇指和食指，右手暴露部位主要为中指和食指，两手暴露部位分布差异无统计学意义（P>0.05）；暴露源病原体主要为乙型肝炎病毒（HBV，占68.96%）；血源性职业暴露发生后局部正确处理率为88.24%，接受预防用药处理占74.51%，最主要的方式为乙肝免疫球蛋白（HBIG）+乙肝疫苗，其次为HBIG治疗；血源性职业暴露中未戴手套占62.74%。 结论： 低年资医务人员是血源性职业暴露的高危人群，应加强其血源性职业暴露和防护培训，降低血源性职业暴露和感染的风险。.
Keywords: Blood; Medical staff; Occupational exposure; Occupational protection.