Incidence Of Occupational Exposure Research Articles

Construction and application of prone position ventilation management scheme for severe COVID-19 patients.

Background: Prone position ventilation (PPV) can significantly improve oxygenation index and blood oxygen saturation in most (70%-80%) patients with acute respiratory distress syndrome. However, although PPV is not an invasive procedure, there are many potential PPV-related complications, such as nerve compression, crush injury, venous stasis (e.g., facial oedema), pressure sores, retinal damage, vomiting, and arrhythmia, with an incidence of up to 56.9%. Nursing managers have focused on reducing the occurrence of PPV-related complications and improving safety. Objective: To construct a prone ventilation management scheme for patients with severe coronavirus disease 2019 (COVID-19) and analyse its application effect. Methods: Based on a previous evidence-based study combined with the COVID-19 Diagnosis and Treatment Protocol (Trial Edition 9), a prone ventilation management protocol for severe COVID-19 was formulated and applied to COVID-19 patients in the intensive care unit of a designated hospital. A prospective self-control study was used to compare changes in the oxygenation index and other outcome indicators before and after the intervention. Results: The oxygenation index of patients after intervention (321.22 ± 19.77mmHg) was significantly higher (p < 0.05) than before intervention (151.59 ± 35.49mmHg). The difference in oxygenation index in different prone position ventilation durations was statistically significant (p < 0.05). Nursing quality evaluation indicators showed that the implementation rate of gastric residual volume assessment was 100% and the incidence of occupational exposure and cross-infection was 0%; the incidences of pressure ulcers, drug extravasation, and facial oedema were 13.64% (3/22), 4.54% (1/22), and 4.54% (1/22), respectively. The incidence of unplanned extubation, aspiration, and falls/falls was 0%.

Blood and Body Fluid Exposure Among Healthcare Workers and Personal Protective Equipment Usage in the United States.

The International Safety Center disseminates the Exposure Prevention Information Network (EPINet) surveillance system to standardize a system for healthcare facilities to track mucocutaneous blood and body fluid exposures. Occupational exposure incidents to blood and body fluids were recorded within the participant health systems and hospitals (N = 41), using the EPINet Blood and Body Fluid Exposure Report Form. Forms include detailed questions about the circumstances surrounding the exposure, including the type of exposure, body part(s) involved, and if the employee reporting the incident was wearing personal protective equipment (PPE). There were statistically significant differences between participants who wore PPE at time of exposure versus those who did not. Differences were noted by job category (χ2 =32.91, p-value = <.001); where the exposure occurred (χ2 = 32.31, p-value = <.001); what the exposure was a result of (χ2 = 50.19, p-value = <.001); and day versus night shift (χ2 = 11.47, p-value = .001). The study found that occupational exposure to blood and body fluids in 2021 remain high risk given the frequency with which they happen, the exposure site (face) and lack of PPE use. The pandemic seemed to matter little in changing frequencies despite high awareness and growing PPE availability and supply. The findings provide robust information about how exposures occur, why they remain high risk, and how important it is to improve reporting and surveillance to prevent occupational exposures and disease in healthcare in future.

1299. Effectiveness of Educational Interventions to Reduce Incidence of Occupational Exposure to Blood and Body Fluid in First-clinical-year Medical Students of A Thai University-based Medical School

Abstract Background Occupational exposures to patients’ blood and body fluid are not uncommon and increase risk of blood-borne infections among medical students during their clinical clerkship. However, existing data on interventions to prevent such exposures are limited in Thailand. We conducted this study to evaluate effectiveness of the study interventions in decreasing incidences of the occupational exposures among first-clinical-year medical students (4th-year students) in a Thai university-based medical school. Methods A quasi-experimental study was conducted to compare the incidence of the occupational exposures between the pre-intervention period (2019 academic year) and the intervention period (2020 academic year). The interventions included an orientation session about occupation exposure prevention and procedure review for the medical students on the first day of each major department rotation and the use of LINE application to send video clips and articles for procedure review, weekly remind the students how to prevent themselves from common occupational exposures via short messages and provide Q&amp;A sessions between the researchers and medical students regarding procedures and occupational exposure prevention. Results A total of 63 medical students, men (57%) and women (43%), and 66 medical students, men (47%) and women (53%) participated in the study during the pre-intervention and intervention periods, respectively. The incidence of occupational exposure among the students was significantly lower in the intervention period compared to the pre-intervention period (7.9 vs. 35.86 per 100 person-years; P&amp;lt; 0.001). The most common exposures were mucosal exposure (44%), needle stick injury (25%), and sharp object injuries (25%). After the exposures, there was no acquisition of syphilis and infections due to human immunodeficiency virus, hepatitis B virus and hepatitis C virus among the students in both periods. Conclusion The study interventions that included focused orientation and the use of LINE application to communicate with the students regarding procedure review and occupational exposure prevention were associated with significant decrease in the incidence of occupational exposure during their clinical clerkship. Disclosures All Authors: No reported disclosures.

Risks of Occupational-Related Adverse Events (ORAEs) and Effect of Bundled Interventions Among Health Care Workers in Novel Coronavirus Pneumonia Wards.

The aims of the study were to investigate the burden for health care workers (HCWs) who suffer from occupational-related adverse events (ORAEs) while working in contaminated areas in a specialized hospital for novel coronavirus pneumonia, to explore related risk factors, to evaluate the effectiveness of bundled interventions, as well as to provide scientific evidence regarding the reduction of risks concerning ORAEs and occupational exposure events. The study was completed using a special team of 138 HCWs assembled for a specialized hospital for novel coronavirus pneumonia in Wuhan, dated from February 16 to March 26, 2020. The incidence of occupational exposure was determined by data reported from the hospital, while the prevalence of ORAEs was derived from questionnaire results. The relation coefficients of ORAEs and the variable potential risk factors are analyzed by logistic regression. After the risk factors were identified, targeted organized intervention was implemented and chi-square tests were performed to compare the incidence of occupational exposure and the prevalence of ORAEs in contaminated areas before and after the interventions. Ninety one out of 138 (65.94%) had reported ORAEs with 300 (27.96%) cases of ORAEs being recorded in a total of 1073 entries into contaminated areas. The prevalence of different ORAEs include 205 tenderness (24.73%), 182 headache/dizziness (21.95%), 138 dyspnea (16.65%), 130 blurred vision (15.68%), and 95 nausea/vomiting (11.46%). Personal protective equipment (PPE) is significantly associated with ORAEs in contaminated areas (P < 0.05). Among non-PPE-related factors, insomnia is associated with the majority of ORAEs in contaminated areas. Significant differences were achieved after organized interventions in the incidence of occupational exposure of HCWs (χ2 = 39.07, P < 0.001) and the prevalence of ORAEs in contaminated areas (χ2 = 22.95, P < 0.001). During the epidemic period of novel severe respiratory infectious disease, the burden of the ORAEs in contaminated areas and the risk of occupational exposure of HCWs were relatively high. In time, comprehensive and multi-level bundled interventions may help decrease the risk of both ORAEs and occupational exposure.

Post exposure prophylaxis for HIV among healthcare workers due to occupational exposure: a record based study at a tertiary care teaching hospital of Kolkata

Background: Healthcare workers (HCWs) regularly face the risk of exposure to sharp injuries and splashes as an occupational hazard, which presents major risk for acquiring blood-borne infectious agents like human immunodeficiency virus (HIV) which can be minimized by taking post exposure prophylaxis (PEP) measures. There are limited studies from India documenting details of PEP for HIV. This record-based study aimed to determine the occurrence of needle stick injuries (NSIs) and other high-risk occupational exposures to blood and body fluids (BBFs) among HCWs in a tertiary care hospital, Kolkata. We aimed to study details of PEP regimens used among HCWs exposed to HIV.Methods: Hospital record was analyzed from reported incidences of occupational exposures to BBFs occurred during the period of October 2013 to March 2019. Information on self-reported incidence of occupational exposure, and post-exposure management were collected.Results: A total of 105 incidents of occupational exposure were registered during study period. Interns (37, 35.2%) were most frequently exposed, followed by physicians (22, 21.0%) and nurse (21, 20.0%). 88 (83.8%) of the personnel sustained NSIs, and 17 (7.2%) had splashes to skin, mucus membranes. There was no significant difference between subjects with splashes to skin, mucus membranes and needle-stick cases regarding discontinuation of post exposure prophylaxis (PEP) (11.8% versus 19.3%, p&lt;0.548). No cases of sero-conversion were reported.Conclusions: In spite of high incidences of exposures to HIV source, good efficacy of PEP was observed with no sero-conversion. PEP for HIV was well tolerated. Study emphasized the need for creating awareness about timely reporting of incidence.

Investigation of 603 medical staff occupational exposure with blood-borne pathogens

Objective: To investigate the occupational exposure with blood-borne pathogens of medical staff, and explore the protective strategy. Methods: Using cluster sampling method, 603 medical staff with occupational exposure with blood-borne pathogens were analyzed, from July 2014 to July 2018 in a tertiary hospital. Results: In total of 603 occupational exposure incidents, 70.98% (428/603) were freshmen younger than 30 years old. 48.92% (295/603) nurses. The most cases of occupational exposure were in surgery (35.16%, 212/603) . Sharp injury was the major contact manner (86.90%, 524/603) . Hands were the main contact parts (90.38%, 545/603) . Ward (53.57%, 323/603) and the operating room (22.72%, 137/603) were the high-risk place. The most dangerous actions were needle injection (34.83%, 210/603) , surgery (20.89%, 126/603) and finishing/cleaning items (19.73%, 119/603) . The main items lead to injuries were scalp needles (34.73%, 182/524) . The most exposure source was hepatitis B virus (HBV) which occupied 39.30% (237/603) . Exposure source mainly comes from medical devices containing blood (81.92%, 494/603) . To compared the groups (χ(2)=19.940, P<0.01) and titer (t=-8.592, P<0.01) of hepatitis B surface antibody (HBsAb) before and after used prophylactics, the differences were statistically significant. Conclusion: Comprehensive strategies of occupational exposure protection education, operation norms and monitoring management were effective methods to reduce the occupational exposure in the medical staff with blood-borne pathogens.

Prevalence of occupational exposure and its influence on job satisfaction among Chinese healthcare workers: a large-sample, cross-sectional study

ObjectivesThis study had three objectives: (1) describe the prevalence of occupational exposure among Chinese medical personnel in detail, (2) verify the partial mediating role of work environment satisfaction in the...

Clinical application of self-developed nasointestinal tube with the bedside ultrasound guiding technology in patients

Objective To explore the clinical effect of self-made new nasointestinal tube in bedside ultrasound-guided nasointestinal tube implantation. Methods By convenience sampling, a total of 274 patients implanted by nasointestinal tube guided by bedside ultrasound from January 2018 to January 2019 in Department of Gastroenterology, the First Affiliated Hospital of Zhengzhou University were selected and divided into the observation group and control group based on the randome number table, with 137 cases in each group. The new nasointestinal tube was used in the observation group and the conventional nasointestinal tube was used in the control group. The time of catheterization, the success rate of one-time catheterization, the number of cases of body fluid exposure during catheterization, the number of cases of environmental and medical staff pollution caused by the withdrawal of the guide wire, the number of cases of medical staff or cleaning staff pollution caused by the withdrawal of the guide wire at the end of the treatment, and the difference of additional treatment cost and time-consuming were compared between the two groups. Results The catheterization time of the observation group was (24.30±2.32) min, that of the control group was (24.0±02.29) min, there was no statistically significant difference (P>0.05) ; the success rate of one-time catheterization in the observation group was 98.5% (135/137) , and that of the control group was 97.8% (134/137) , there was no statistically significant difference (P>0.05) ; the number of cases of body fluid exposure, withdrawal of the guide wire and pollution caused by the treatment of the guide wire were found in the two groups and the differences were statistically significant (P<0.05) ; the additional cost of the observation group was (30.00±0.00) yuan, the control group was (129.31±5.32) , the difference was statistically significant (P<0.05) ; the additional time of the observation group was (15.00±0.00) min, the control group was (23.45±2.04) min; the difference was statistically significant (P<0.05) . Conclusions The new nasointestinal tube used in this study can effectively reduce the incidence of occupational exposure, avoid cross infection in the hospital, reduce the waste of medical resources, and reflect the connotation of human-oriented quality nursing services, which is worthy of clinical application. Key words: Diffusion renovation; Nasointestinal tube; Bedside ultrasound guiding; Occupational exposure

Investigation and analysis of the status of blood-borne occupational exposure of medical staff in a top three hospital and intervention measures

Objective: To understand the current situation of blood-borne occupational exposure among health care workers and evaluate the intervention effect of PDCA. Methods: Retrospective survey was adopted to investigate and analyze the blood-borne occupational exposure incidents in a hospital from January 2015 to December 2018, and to compare the intervention effects after PDCA management. Results: A total of 82 cases of occupational exposure occurred from 2015 to 2017, and only 9 cases happened after the implementation of PDCA intervention. The exposed population was mainly consisted of nurses (59 cases, 64.83%) , and mainly with low-working age (1-5 years) (56 cases, 61.54%) , and the main source of exposure was hepatitis B (34 cases, 37.36%) . In addition, after the implementation of PDCA, the vaccination rate of personnel was 77.78%, the standardized field treatment rate was 100%, the preventive drug use rate was 88.89%; The qualified rate of occupational protection assessment was higher than that before intervention, which all shows the difference was statistically significant (P<0.05) . Conclusion: With the guide of PDCA management, Strengthen the training of new employees or ones with low working years as well as their awareness of protection, and standardize the relevant operational procedures, which can significantly improve the prevention of blood-borne occupational exposure and stress management of medical staff.

Evaluation of The Occupational Exposures Among Residents in a Tertiary Hospital

Objective: Occupational exposures, can lead to decreased employee productivity, increased cost of health expenses and temporary or permanent suspension from working life. The most common cause of illness and death due to occupational exposures are blood-borne infections. In this study, it was aimed to evaluate the occupational exposures among residents in a tertiary hospital that provides health care in a region where the Crimean–Congo hemorrhagic fever disease is endemic. Methods: A questionnaire consisting of 18 questions distributed to the residents of internal, surgery and basic medical sciences working at a tertiary hospital between February and March 2016. In the relevant departments, 330 residents were reached and 210 of them answered the questionnaire. Results: In our study; 160(76.2%) of the residents reported occupational exposure in their working life and 74(35.2%) of them had occupational exposure in the recent year. The incidence of occupational exposures in the comparison of medical sciences was statistically higher in surgical sciences. Of the participants working in the surgical sciences, 22(42.3%) residents stated that they received in-service training in the recent year on the prevention, treatment, and follow-up of occupational exposures. Among participants who had occupational exposure in recent year, only 8(11.4%) residents declared that they have reported about their exposure. Conclusion: To prevent occupational exposures, it is required to make more effective interventions of protection measures in the light of current information and assessment of post-exposure attitudes of residents. We hope that the risks that our study has identified may help to take necessary preventive measures.

The status of occupational blood and infectious body fluids exposures in five blood centres in China: a 5-year review.

Little information about the occupational exposures to blood and body fluid (BBF) among blood service workers (BSWs) in blood stations in China is available currently. To assess current status of occupational exposure to BBF and assess the knowledge about occupational blood-borne pathogen exposures and universal precaution among BSWs in blood donations in China. To understand the incidence of occupational exposure in five blood centres in China. A cross-sectional study was conducted from January 2008 to December 2013. There were a total of 99 BBF exposures reported during the study period. The total incidence of BBF exposures was 4.4 per 100 person-years. Higher rates were observed for persons employed less than five years and persons less than 45 years old. Nurses have the highest percentage (49.5%) of BBF exposures. BBF exposures occurred most commonly during the afternoon (62.7%). Percutaneous injuries were the most common BBF exposures. Most incidents occurred during sharps use (73.4%). The major cause of occupational exposure was that there was no continuous training (48.4%) and improper use of equipment (23.2%). Only 56.6% of BBF exposures had appropriate first aid measures. During this research work, one staff member was reported to have seroconverted to syphilis after BBF exposure. To reduce BBF exposures, it is urgent to take several effective actions in China, including improved occupational health systems, adequate education, administrative support, increased use of standard precautions, better safety devices/products and work practices.

Incidence of occupational exposure to blood and body fluids and measures taken by health care workers before and after exposure in regional hospitals of a developing country: A multicenter study

This cross-sectional study was conducted on 371 health care workers working in government hospitals in the Northern Khorasan province of Iran. Exposure to sharp objects was 44% and 31% of participants had a history of being in contact with blood or body fluids of patients. Among health care workers who had needlestick injuries, 82 had a positive hepatitis B surface antibody titer measured after injury.

High incidence of occupational exposures among healthcare workers in Erbil, Iraq.

The current status of percutaneous injury and mucous exposures (PMEs) of hospital workers and factors associated with the injuries have not been studied in Iraq. This study aimed to evaluate the epidemiology of PMEs with blood or body fluids that leads serious risks for healthcare workers (HCWs). An analytic, cross-sectional survey study was conducted among HCWs in Erbil city center, Iraq. The study was performed at sevenhospitals, and 177 participants were included. The dependent variable was the occurrence of PMEs in the last year, and the independent variables were age, sex, occupation of HCWs, working site, and work duration. A total of 177 HCW participants included 57 nurses/midwives (32.2%), 59 doctors (33.3%), 27 laboratory workers (15.3%), and 34 paramedics/multipurpose workers (19.2%) from seven hospitals. The study concluded that 67.8% of the participants reported at least one occupational PME in the last year. In all, 13.3/person/year PME incidents were reported for nurses, 9.74/person/year for paramedics/multipurpose workers, 6.71/person/year for doctors, and 3.37/person/year laboratory workers. The mean number of PME incidents was 8.91/person/year. HCWs showed 85.0% compliance with wearing mask in risky situations. The most dangerous action for occupational exposure was blood taking (39.0%). In the univariate analysis, none of the investigated variables were found to be significantly related to PME. Occupational injuries and exposures in Iraqi HCWs are extremely common; awareness about protection is not sufficient. Nurses were found to be the highest risk group among HCWs. Preventive actions should be taken to avoid infection.

Case studies of hydrogen sulphide occupational exposure incidents in the UK

The UK Health and Safety Executive has investigated several incidents of workplace accidents involving hydrogen sulphide exposure in recent years. Biological monitoring has been used in some incidents to determine the cause of unconsciousness resulting from these incidents and as a supporting evidence in regulatory enforcement. This paper reports on three case incidents and discusses the use of biological monitoring in such cases. Biological monitoring has a role in identifying hydrogen sulphide exposure in incidents, whether these are occupational or in the wider environment. Sample type, time of collection and sample storage are important factors in the applicability of this technique. For non-fatal incidents, multiple urine samples are recommended at two or more time points between the incident and 15h post-exposure. For routine occupational monitoring, post-shift samples should be adequate. Due to endogenous levels of urinary thiosulphate, it is likely that exposures in excess of 12ppm for 30min (or 360ppm/min equivalent) would be detectable using biological monitoring. This is within the Acute Exposure Guideline Level 2 (the level of the chemical in air at or above which there may be irreversible or other serious long-lasting effects or impaired ability to escape) for hydrogen sulphide.

Summary of: Reporting of occupational exposures to blood and body fluids in the primary dental care setting in Scotland: an evaluation of current practice and attitudes.

Objectives To evaluate experience, practice and beliefs regarding occupational exposures to blood and oral fluids among a random sample of 300 dentists working in Scotland's NHS primary dental services. Method A cross-sectional postal survey assessed occupational exposure policies and procedures, recent occupational exposure incidence and current management. Beliefs were measured using constructs from the theory of planned behaviour, shown to influence behaviour in this population. Results Forty-two percent of dentists responded. Fourteen percent had sustained an occupational exposure in the previous 12 months; of those, 35% did not report their exposure. All respondents' practices had protocols in place for managing and reporting dental team member sharps injuries. Most (82%) had protocols for mucocutaneous exposures. Less than half (48%) had a protocol for managing and reporting patient exposures to blood or saliva. Dentists placed significantly more importance (z-score −4.44, p value <0.001) and necessity (z-score −4.17, p value <0.001) on reporting patient exposure than dentist occupational exposure. Conclusion This study suggests that while dentists generally have positive beliefs about reporting occupational exposures, there are gaps in practice.

The incidence of occupational exposures among health care workers and students at Istanbul University Faculty of Dentistry

Background/objectivesThe aim of this study is to determine the incidence of occupational exposures, the immunization status and the rate of injuries being reported among health care workers (HCWs) and students at the dental school. MethodsA questionnaire was applied to all academic staff, dental students and nurses. The questionnaire included the sections about frequency of sharp injuries, type of instrument that caused the injury, and whether or not the injury was reported. Data from the questionnaires was analyzed using SPSS® 17.0 statistical software and assessed in each group. ResultsThe number of persons reporting one or more percutaneous injury was 415 (74.6%). 448 (80.5%) respondents reported saliva/blood splashes into skin and eyes. The majority of the respondents failed to report the exposure incidents. Common reasons for not reporting included lack of information about reporting and not to worry about the injury. The most common injuries were reported as needlesticks and dental probe injuries. 86% of respondents followed post-exposure protocol after the injury and 96% of them reported the regular usage of masks to prevent risk of infection. The immunization status of students, academic staff and nurses were 89.5%, 78.6% and 72%, respectively. ConclusionThe high incidence of occupational injuries among health care workers reveals a necessity to raise awareness and to provide periodical training in infection prevention.

Knowledge, attitudes, and practices regarding blood-borne occupational exposure among reproductive health staff in Tianjin

To investigate the knowledge, attitudes, and practices regarding blood-borne occupational exposure among reproductive health staff in Tianjin, China. By random, stratified, and clustered sampling, 507 reproductive health-related medical workers in Tianjin were selected. A Self-Administered KAP Questionnaire on blood-borne occupational exposure was employed to gauge the general characteristics, awareness of knowledge, attitudes to occupational exposure, implementation of pre-exposure protection, incidence of occupational exposure, and demands for continuing education. Among all respondents, 63.15% (305/483) were aware of the reporting procedures and related departments after the incidence of occupational exposure. The awareness rate of classification of HIV occupational exposure was 48.45% (234/483). About preventive medication time after HIV and hepatitis B virus exposure, the awareness rates were 37.89% (183/483) and 31.47% (152/483), respectively. The average score of occupational exposure knowledge among respondents was 74.45±14.00. The multivariate analysis indicated that medical staff of obstetrics and gynecology, females, doctors and high-level medical institutions showed significantly higher awareness than urology professionals, males, nurses, and medical staff of primary health care institutions, respectively (t = 12.140, t = 5.428, t = 2.582, F = 4.218, P<0.05). Of the respondents, 93.17% (450/483) and 94.41% (456/483) thought that washing hands properly and wearing protective glasses were effective methods for the prevention of occupational exposure, but only 15.94% (89/483) and 3.93% (19/483) adhered to proper hand washing and wearing protective glasses within nearly one year in practical work. Of the respondents, 60.46% (292/483) had experienced the occupational exposure during their vocation, and 95.65% (462/483) needed respective trainings. The awareness of occupational exposure among reproductive health-related medical staff is lacking, especially in preventative medication and reporting procedures after the incidence of occupational exposure. The implementation of protective measures is inadequate and incidence of occupational exposure is higher. Therefore, continuing education is necessary to improve the knowledge and attitudes towards occupational exposure in medical staff. At the same time, strict and effective supervision and management system should be established.

The incidence of occupational exposures among health care workers and students at Istanbul University Faculty of Dentistry

The incidence of occupational exposures among health care workers and students at Istanbul University Faculty of Dentistry

Causes analysis on eye occupational exposure in medical workers

Objective To investigate the factors causing eye occupational exposure among health care,so as to develop protective measures.Methods Data on eye occupational exposure reported to infection management division were collected and retrospectively analyzed from January 2004 to December 2011.Results 30 cases were reported,including 28 cases in surgical Branch.26 cases were among staffs with primary professional and technical titles,accounting for 86.7％.19 cases were found in nursing staff,accounting for 63.3％.Blood was the main substance causing eye occupational exposure,there were 12 cases accounting for 40％.Cesarean section was easy to cause eve occupational exposure,there were 11 cases accounting for 36.7％.Conclusion Measures to prevent eye occupational exposure are:occupational exposure education to young technical staff should be strengthened; operating techniques and protection awareness should be improved; suitable eye hospital supplies should be provided,to reduce the incidence of occupational exposure in health care workers. Key words: Health care workers; Eye; Occupational exposure; Protection

A comment on Incidence of occupational exposures in a tertiary health care center.

A comment on Incidence of occupational exposures in a tertiary health care center.