Occupational Exposure to Blood-Borne Pathogens among Healthcare Workers in a Tertiary Care Center in Lebanon

Source avec lien : Annals of Work Exposures and Health, (wxaa117), . 10.1093/annweh/wxaa117

Malgré de nombreuses initiatives, l’exposition professionnelle à des agents pathogènes transmissibles par le sang (PTS), due à des blessures percutanées ou à une contamination des muqueuses, reste courante chez les travailleurs de la santé. Ces expositions ont diminué au Centre médical de l’Université américaine de Beyrouth (AUBMC) au cours des décennies précédentes. Récemment, l’activité du centre médical a augmenté avec un nombre plus élevé d’interventions effectuées et une durée d’hospitalisation plus courte. Notre objectif était de déterminer la tendance des incidents résultant des expositions aux PTS à l’AUBMC de 2014 à 2018 et d’identifier si l’augmentation de l’activité hospitalière a affecté le taux de ces expositions. Une étude descriptive observationnelle rétrospective de toutes les expositions aux PTS parmi les travailleurs de la santé déclarés au département de la santé environnementale, de la sécurité et de la gestion des risques de l’AUBMC entre 2014 et 2018 a été réalisée.

Despite numerous initiatives, occupational exposure to blood-borne pathogens (BBP) caused by percutaneous injuries or mucosal contamination remain common among healthcare workers (HCWs). These exposures were decreasing at the American University of Beirut Medical Center (AUBMC) in the previous decades. Recently, the medical center activity has been increasing with higher number of interventions performed and shorter hospital stay. Our aim was to determine the trend of incidents resulting from BBP exposures at AUBMC from 2014 till 2018 and identify whether the increase in hospital activity affected the rate of these exposures. We also aimed to assess the risk factors associated with needle stick injuries (NSIs).A retrospective observational descriptive study of all exposures to BBPs among HCWs reported to the Environmental Health, Safety, and Risk Management department at the AUBMC between 2014 and 2018 was performed.There were 967 exposures reported among which 84% were due to needlesticks. Residents (40%), followed by nurses (30%), and then by attending physicians (16%) were the top three most exposed occupational groups. Half of the participants injured themselves using either a syringe or a suture needle; and mostly during or after use. Occupation and incident location were associated with NSIs. The mean BBP exposure incidence rate was 5.4 per 100 full-time employees, 65.6 per 100 bed-years, and 0.48 admission-years. The BBP exposure rate per 100 occupied beds per year decreased between 2014 and 2017 then increased in 2018 (P < 0.001). The number of BBP exposures showed a strong, though non-significant negative correlation with the average length of hospital stay (Spearman correlation coefficient = −0.9, P = 0.083).BBP exposure remains a serious occupational hazard. Our study shows that the BBP exposure rate per 100 occupied beds per year started decreasing during the study period before increasing again in 2018. Only the nursing department showed a consistent decrease of exposures. The occupation and incident location were found to be risk factors associated with NSIs. In addition to providing education and training, additional steps such as providing safety equipment and future interventions directed towards adjusting to higher workload should be all considered. Consultez la page de l’article

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