서울·경기지역 병원직원의 혈액매개 감염노출에 대한 다기관 조사연구

Abstract

Background : The purpose of this study was to establish effective measures and preventive managements to the cases of bloodborne exposures among the health care workers Method : We reviewed 331 cases that were reported to the infection control services of five hospitals from March 2000 to February 2002. The SPSS PC 10.0 was used to analyze the data. Result : The proportion of registered nurses. doctors. housekeepers. nurse aid. and technicians were 48.0%, 27.8%, 10.0%, 6.0% and 5.4% in order. The proportion of female exposures was 75.2%. Fifty six point eight percent of exposure have been working less than 3 years. The data also indicated that there were differences by their occupations. Thirty nine point six percent of the exposures occurred at the general ward. and 16.6% of them occurred at the operation room and 13.0% of them occurred at the intensive care unit. Most of the bloodborne exposures occurred during blood sampling(26.3%) putting away the needle including the recapping(18.4%) and giving injection(14.5%) The major instruments of exposures were syringe-needle(79.6%) blade(7.3%) suture needle(6.1%) and direct contact with blood(2.7%) The hands were the most common body parts of exposures(95.2%). The bloodborne pathogens were hepatitis B virus(HBV. 38.1%(126/331) hepatitis C virus(10.3%) syphilis(4.5%) and human immuno-deficiency virus(2.7%). Forty one point three percent(52/127) of health care workers (HCWs) usually didn´t realize whether they had antibody to the HBV or not at the time of exposure : Seventy five percent(39/52) of them found out later to be positive for HBV antibody. Only 48.7%(19/39) of them could get the medical treatment since they didn´t know about immunity before the test. The cases with completion of management at the time of exposure. those of follow-up evaluations. and the cases with lost follow-up were 40.7%, 38.6% and 20.7% in order. None of the cases were led to actual infections. Conclusion : The results from this study can be applied to establish effective measures of prevention and managements of the bloodborne exposures among the HCWs. If the laboratory data of HCWs were available at the time of exposure.more effective management would be possible. Also the results from this study emphasized the need for the systematic and practical follow-up.