| Objectives:By investigating the current situation of occupational safety protection and respiratory pathogen exposure of medical staff in general hospitals,this paper discusses the possible problems and risk factors in the occupational safety protection of medical staff in Jiangsu Province.It is hoped to provide theoretical basis and data support for improving the occupational safety protection level of medical staff,reducing occupational exposure and injury,and continuously promoting occupational health.Methods:1.Kunshan Hospital of Chinese Medicine and The Second Affiliated Hospital of Suzhou University were selected as the research sites.The self-designed Questionnaire on occupational Safety protection status of Medical Staff and the Chinese version of The Hospital Safety Atmosphere Scale were used to conduct a questionnaire survey on medical staff of the two hospitals.The main contents include: basic information and general situation of daily work,basic information of occupational protection,occupational exposure and occupational injury,implementation of hand hygiene and hospital safety atmosphere,etc.2.Throat swab samples were collected from some medical staff who participated in the questionnaire survey,and 37 respiratory pathogens including Streptococcus pneumoniae,Haemophilus influenzae,Escherichia coli,Epstein-Barr virus and rhinovirus were detected by real-time PCR/RT-PCR.The distribution of occupational exposure to respiratory pathogens of medical staff was analyzed,and the correlation between occupational exposure to respiratory pathogens and occupational safety protection measures was discussed.Results:1.In daily work,98.6% of medical staff said they could wear masks as required,65.2% could fully and strictly implement hand hygiene measures,97.1% believed that it was necessary for the hospital to carry out occupational protection training for all staff regularly,and 93.1% of them had participated in it within one year,and 96.5% of nursing staff had participated in it.There was no statistically significant difference in the medical personnel with different genders,ages,educational backgrounds and professional titles participating in safety protection training within one year.The total average score of safety atmosphere in the two hospitals is(4.480 ± 0.573),among which the score of obstruction dimension of safety work(4.272 ± 0.764)and cleanliness and tidiness dimension(4.267 ± 0.793)are relatively low.The scores of hospital safety atmosphere were relatively higher for the medical staff who believed that there were no occupational harmful factors at work,the unit attached great importance to occupational safety protection,wore masks and changed frequently,and had good hand hygiene compliance.In addition,the score of hospital safety atmosphere was significantly negatively correlated with occupational exposure and occupational injury(r =-0.156,P < 0.001 and R =-0.134,P = 0.001).2.Of 621 participants in the survey,34.6% reported occupational exposure.Working years: 21-30 years(OR=2.138,95%CI: 1.241～3.685)and 31 years or above(OR=4.095,95%CI: 1.773-9.459),bachelor degree(OR=5.750,95%CI: 1.490-22.188),graduate students or above(OR=14.507,95%CI: 3.058-68.829),nursing occupation(OR=4.723,95%CI: 2.405-9.276),working more than 8 hours per day(OR=1.931,95%CI: 1.265～2.948)were risk factors of occupational exposure.Of 621 individuals,40.6 percent indicated that they had suffered an occupational injury.Working years: 21-30 years(OR=2.170,95%CI:1.268～3.716)and 31 years or more(OR=2.928,95%CI: 1.337～6.411),nursing occupation(OR=2.384,95%CI: 1.530～3.716),working more than 8 hours per day(OR=2.364,95%CI: 1.551～3.604),occupational harmful factors in daily working environment(OR=5.812,95%CI: 3.261～10.359)were risk factors of occupational injury.More attention to occupational safety protection(OR=0.573,95%CI: 0.361-0.909)and strict implementation of hand hygiene measures(OR=0.448,95%CI: 0.305-0.659)were the protective factors of occupational injury.3.Of the 316 throat swab samples of medical staff included in the study,215 cases(68.0%)were detected with respiratory pathogens,including 61.7% of bacteria,22.5% of virus and 4.4% of fungi.There was no significant difference in the overall detection rate of respiratory bacterial or viral infection among medical staff among different institutions,age,professional title,occupation,working place,influenza vaccination,smoking,drinking and chronic diseases(P>0.05).There were significant differences in the detection rates of Haemophilus influenzae,rhinovirus,herpes simplex virus(type 1,2)and human coronavirus OC43 among medical staff samples in different years(P < 0.05).There was a significant positive correlation between respiratory bacterial infection and viral infection(r=0.159,P=0.005).The number of samples detected with more than two pathogens accounted for 50.2%(108/215)of the total samples detected with pathogens.Among the samples infected with more than two pathogens,Streptococcus pneumoniae(SP)infection accounted for 82.4%(89 / 108).The proportion of infection with other respiratory bacteria(40.7%)and virus(29.3%)of the medical staff infected with SP was higher than that of uninfected group(27.1% and 16.3%).The infection rate of more than two other respiratory pathogens in medical staff infected with SP(22.0%)was also higher than that in the uninfected group(11.4%).4.Among the samples,195(61.7%)were positive for respiratory bacteria,and the top three were Streptococcus pneumoniae(47.5%),Haemophilus influenzae(21.2%)and Escherichia coli(7.6%).The detection rate of respiratory tract bacteria in the medical staff who changed the mask every half day(or =0.161,95% CI: 0.053 ～ 0.487),changed the mask every 2-4 hours(or = 0.228,95% CI: 0.071 ～ 0.732),knew the "5" opportunity of all who hand hygiene(or = 0.364,95% CI: 0.209 ～ 0.637)and strictly implemented hand hygiene in daily work(or = 0.315,95% CI: 0.167 ～ 0.593)was lower than that in the corresponding reference group.71 cases(22.5%)were positive for respiratory virus,and the top three were epstein-barr virus(10.4%),rhinovirus(3.8%)and herpes simplex virus(type 1,2)(2.2%).The detection rates of respiratory virus in female(or = 0.497,95% CI: 0.272 ～ 0.908),fully strict implementation of hand hygiene in daily work(or = 0.464,95% CI: 0.249 ～ 0.864)and medical personnel who have participated in occupational safety protection related training within one year(or = 0.076,95% CI: 0.028 ～ 0.204)were lower than those in the corresponding reference group.Conclusions:1.Occupational exposure and injuries are common among medical staff in hospitals.Different institutions,working years,education level,occupation type,daily working hours,and the degree of attention to occupational safety protection work are the influencing factors of occupational exposure or injury.2.Hospital managers should continue to attach importance to occupational safety protection,constantly improve the hospital safety atmosphere,strictly implement relevant systems and measures,and reduce the harm caused by occupational exposure or injury to medical staff.3.The pathogen exposure of the upper respiratory tract of medical staff was common and the proportion of infection with more than two pathogens was also very high.The infection rate of medical staff in different work places was slightly different.Through biosafety training,strengthening hand hygiene of medical staff and promoting correct wearing/replacement of masks can effectively reduce the exposure of medical staff to respiratory pathogens.4.During the regular prevention and control of COVID-19 and even in the future,medical institutions should not only guide and supervise the occupational safety protection of medical staff,and also timely carry out respiratory pathogen monitoring and pneumococcal vaccine vaccination,so as to protect medical staff and promote their occupational health. |
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