Highlights
- •Blood-borne occupational exposure among midwives in China: A cross-sectional survey
- •A total of 2,743 midwives were investigated in this study; the incidence rate of blood-borne occupational exposure was 46.77%
- •Midwives are at high risk of blood-borne occupational exposure, and midwives with ≤5 years of service had the highest risk
- •The treatment after occupational exposure is not standardized
Background
Methods
Results
Discussion
Conclusion
Key Words
Material and methods
Subjects
Measures
Data collection
Statistical analyses
Results
The basic situation of blood borne occupational exposure of midwives
Variable | Number | Proportion (%) | Variable | Number | Proportion (%) |
---|---|---|---|---|---|
Reason for not wearing gloves | Cause of occupational exposure | ||||
Busy, too late | 76 | 59.84% | Operational inattention | 527 | 41.08% |
Unconscious gloving | 15 | 11.81% | No safe injection device in hospital | 254 | 19.80% |
Inconvenient operation | 87 | 68.50% | Safe injection device in hospital but not used | 145 | 11.30% |
Departmental cost control | 31 | 24.41% | Operation environment disorder or insufficient light | 359 | 27.98% |
Other | 5 | 3.94% | Improper sharps handling | 780 | 60.80% |
Occupational exposure site | Nonstandard operation | 414 | 32.27% | ||
Hand | 1253 | 97.66% | Uncooperative patient | 710 | 55.34% |
Foot | 105 | 8.18% | Other | 68 | 5.30% |
Eye | 276 | 21.51% | Mode of occupational exposure | ||
Forearm | 144 | 11.22% | Needle double cap | 539 | 42.01% |
Other | 17 | 1.33% | When disposing of waste sharps | 715 | 55.73% |
Reasons for not timely reporting | Upon needle removal | 669 | 52.14% | ||
Not aware of an escalation process | 33 | 6.76% | At suture | 358 | 27.90% |
Cumbersome procedure | 173 | 35.45% | When passing sharps | 217 | 16.91% |
Definitely not an infectious disease | 339 | 69.47% | Accidental injury by others | 352 | 27.44% |
Patient fluke psychology, will not infect | 128 | 26.23% | Secretion/blood splashing | 660 | 51.44% |
Fear of being criticized | 30 | 6.15% | Patient scratch | 361 | 28.14% |
Fear of discrimination | 8 | 1.64% | Other | 27 | 2.10% |
Other | 33 | 6.76% | Routes of occupational exposure | ||
Dermal exposure | 1242 | 96.80% | |||
Mucosal exposure | 662 | 51.60% | |||
Other | 20 | 1.56% |
A 1-factor analysis of blood-borne occupational exposure in midwives
Variable | Yes | No | χ2 | P | Variable | Yes | No | χ2 | P |
---|---|---|---|---|---|---|---|---|---|
n = 1283 (%) | n = 1460 (%) | n = 1283 (%) | n = 1460 (%) | ||||||
Title | For how long the prophylactic medication should be given after HIV blood-borne occupational exposure | ||||||||
Primary | 825 (42.6) | 1110 (57.4) | 46.459 | .000 | 2 h | 554 (44.2) | 669 (55.8) | 22.508 | .000 |
Intermediate | 402 (56.0) | 316 (44.0) | 4 h | 160 (41.6) | 225 (58.4) | ||||
Sub-high and above | 56 (62.25.5) | 34 (37.8) | 24 h | 452 (50.4) | 444 (49.6) | ||||
Years of work | The maximum duration of prophylaxis after blood-borne occupational exposure to HIV | ||||||||
≤5 | 305 (35.9) | 544 (64.1) | 70.571 | .000 | 2 h | 72 (46.2) | 84 (53.8) | 23.712 | .000 |
5-10 | 444 (48.4) | 473 (51.6) | 4 h | 26 (40.0) | 39 (60.0) | ||||
10-20 | 336 (52.3) | 307 (47.7) | 24 h | 603 (43.6) | 779 (56.4) | ||||
>20 | 198 (59.3) | 136 (40.7) | 72 h | 435 (48.8) | 457 (51.2) | ||||
Hospital nature | Unknown | 147 (59.3) | 101 (40.7) | ||||||
Public hospital | 1240 (46.8) | 1412 (53.2) | 0.013 | .994 | Correct handling of wounds after needle stick exposure | ||||
Private hospital | 32 (47.1) | 36 (52.9) | Unknown | 338 (52.0) | 312 (48.0) | 0.514 | .473 | ||
Other | 11 (47.8) | 12 (52.2) | Aware | 1122 (53.6) | 971 (46.4) | ||||
Awareness standard prevention | Correct handling of wounds after mucosal exposure | ||||||||
No | 94 (48.5) | 100 (51.1) | 0.236 | .627 | Unknown | 643 (45.4) | 773 (54.6) | 2.187 | .139 |
Yes | 1189 (46.6) | 1360 (53.4) | Aware | 640(48.2) | 687(51.8) | ||||
Standard prevention can be achieved | Working hours per day | ||||||||
No | 284 (59.2) | 196 (40.8) | 35.899 | .000 | 8 h | 608 (42.5) | 824 (57.5) | 3.000 | .000 |
Yes | 999 (44.1) | 1264 (55.9) | 8-10 h | 555 (52.1) | 511 (47.9) | ||||
Process for handling occupational exposure to AIDS | 10-12 h | 85 (51.5) | 80 (48.5) | ||||||
Unknown | 188 (57.0) | 142 (43.0) | 15.642 | .000 | More than 12 h | 35 (43.8) | 45 (56.3) | ||
Aware | 1095 (45.4) | 1318 (54.6) | Job Hazard Level | ||||||
Process for handling occupational exposure to HBV | Low | 29 (35.4) | 53 (64.6) | 42.486 | .000 | ||||
Unknown | 54 (39.1) | 84 (60.9) | 3.444 | .067 | General | 289 (37.8) | 476 (62.2) | ||
Aware | 1229 (47.2) | 1376 (52.8) | High | 965 (50.9) | 931 (49.1) | ||||
Process for handling occupational exposure to HCV | Wearing gloves when contacting patient's body fluid and blood | ||||||||
Unknown | 399 (49.1) | 414 (50.9) | 2.461 | .117 | No | 78 (61.4) | 49 (38.6) | 78.929 | .000 |
Aware | 884 (45.8) | 1046 (54.2) | Occasionally | 370 (60.6) | 241 (39.4) | ||||
Process for handling occupational exposure to RPR | Yes | 835 (41.6) | 1170 (58.4) | ||||||
Unknown | 251 (52.6) | 226 (47.4) | 7.912 | .005 | |||||
Aware | 1032 (45.5) | 1234 (54.5) |
Multifactorial analysis of blood-borne occupational exposure in midwives
Variable | β | SE | Wald | P | OR | 95% CI | |
---|---|---|---|---|---|---|---|
constants | –0.048 | 0.438 | 0.012 | .912 | 0.953 | ||
Title | Primary | 3.884 | .143 | ||||
Intermediate | –0.414 | 0.278 | 2.213 | .137 | 0.661 | 0.383-1.140 | |
Sub-high and above | –0.190 | 0.257 | 0.550 | .458 | 0.827 | 0.500-1.367 | |
Years of work | ≤5 | 15.941 | .001 | ||||
5-10 | –0.663 | 0.375 | 3.125 | .077 | 0.515 | 0.247-1.075 | |
10-20 | –0.183 | 0.354 | 0.268 | .605 | 0.833 | 0.416-1.666 | |
>20 | 0.018 | 0.328 | 0.003 | .957 | 1.018 | 0.535-1.935 | |
Awareness standard Prevention | No | 25.259 | .000 | ||||
Yes | 0.749 | 0.141 | 28.183 | .000 | 2.115 | 1.604-2.788 | |
Process for handling occupational exposure to AIDS | Unknown | 11.135 | .000 | ||||
Aware | 0.379 | 0.129 | 8.705 | .003 | 1.461 | 1.136-1.880 | |
Working hours per day | 8 h | 14.393 | .002 | ||||
8-10 h | –0.148 | 0.247 | 0.356 | .551 | 0.863 | 0.531-1.401 | |
10-12 h | 0.139 | 0.249 | 0.312 | .577 | 1.149 | 0.705-1.873 | |
More than 12 h | 0.300 | 0.290 | 1.071 | .301 | 1.349 | 0.765-2.380 | |
Job hazard level | Low | 34.968 | .000 | ||||
General | -0.582 | 0.248 | 5.528 | .019 | 0.559 | 0.344-0.908 | |
High | -0.524 | 0.093 | 31.879 | .000 | 0.592 | 0.494-0.710 | |
Wearing gloves when contacting patient's body fluid and blood | No | 50.378 | .000 | ||||
Occasionally | 0.656 | 0.197 | 11.109 | .001 | 1.928 | 1.310-2.836 | |
Yes | 0.671 | 0.100 | 44.550 | .000 | 1.956 | 1.606-2.381 |
Discussion
Midwives are at high risk of blood-borne occupational exposure, and midwives with ≤5 years of service are the focus group
Failure to achieve standard prevention at work and contact with patient's body fluids and blood without wearing gloves is a high-risk behavior during which blood-borne occupational exposure occurs
UK Health Departments. Guidance for clinical health care workers: protection against infection with blood-borne viruses; 2000. Accessed July 7, 2022.https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/382184/clinical_health_care_workers_infection_blood-borne_viruses.pdf.
World Health Organization. The state of the world's midwifery 2014. Accessed July 7, 2022. https://www.unfpa.org/sowmy-2014.
The length of working hours in midwifery and the high degree of job risk have a certain impact on the occurrence of blood-borne occupational exposure
The treatment after occupational exposure is not standardized, and the ignorance of the treatment process of AIDS has a certain impact on the occurrence of blood-borne occupational exposure
Conclusion
Acknowledgments
References
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Article info
Publication history
Footnotes
Funding: None.
Conflicts of interest: The authors declare that they have no competing interests.
Ethical statement: This study complied with the requirements of the Declaration of Helsinki. Human research ethics approval was obtained from Beijing Ditan Hospital affiliated with Capital Medical University. Consent was implied through the completion of the survey. The anonymity of participants was assured as no name-related data were collected.
Availability of data and materials: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Authors’ contributions: Jing Li and Haixia Zhang carried out the studies, participated in collecting data, and drafted the manuscript. Meiling Chen and Li Li performed the statistical analysis and participated in its design. Yanhua Zhang and Lijuan Wang participated in acquisition, analysis, or interpretation of data and draft the manuscript. All authors read and approved the final manuscript.
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