Highlights
- •Blood-borne occupational exposure among midwives in China: A cross-sectional survey
- •A total of 2743 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
Abstract
Background
Methods
Results
Discussion
Conclusion
Keywords
Background
- Abere G
- Yenealem DG
- Wami SD.
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 | Non-standard 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 one-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 | 0.000 | 2 hours | 554 (44.2) | 669 (55.8) | 22.508 | 0.000 |
Intermediate | 402 (56.0) | 316 (44.0) | 4 hours | 160(41.6) | 225(58.4) | ||||
Sub-high and above | 56 (62.25.5) | 34 (37.8) | 24 hours | 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 | 0.000 | 2 hours | 72 (46.2) | 84 (53.8) | 23.712 | 0.000 |
5-10 | 444 (48.4) | 473 (51.6) | 4 hours | 26 (40.0) | 39 (60.0) | ||||
10-20 | 336 (52.3) | 307 (47.7) | 24 hours | 603 (43.6) | 779 (56.4) | ||||
>20 | 198 (59.3) | 136 (40.7) | 72 hours | 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 | 0.994 | 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 | 0.473 | ||
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 | 0.627 | Unknown | 643(45.4) | 773(54.6) | 2.187 | O.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 | 0.000 | 8 hours | 608 (42.5) | 824 (57.5) | 3.000 | 0.000 |
Yes | 999 (44.1) | 1264 (55.9) | 8-10 hours | 555 (52.1) | 511 (47.9) | ||||
Process for Handling Occupational Exposure to AIDS | 10-12 hours | 85 (51.5) | 80 (48.5) | ||||||
Unknown | 188 (57.0) | 142 (43.0) | 15.642 | 0.000 | More than 12 hours | 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 | 0.000 | ||||
Unknown | 54 (39.1) | 84 (60.9) | 3.444 | 0.067 | 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 | 0.117 | No | 78(61.4) | 49(38.6) | 78.929 | 0.000 |
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 | 0.005 | |||||
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 | 0.912 | 0.953 | ||
Title | Primary | 3.884 | 0.143 | ||||
Intermediate | -0.414 | 0.278 | 2.213 | 0.137 | 0.661 | 0.383-1.140 | |
Sub-high and above | -0.190 | 0.257 | 0.550 | 0.458 | 0.827 | 0.500-1.367 | |
Years of work | ≤5 | 15.941 | 0.001 | ||||
5-10 | -0.663 | 0.375 | 3.125 | 0.077 | 0.515 | 0.247-1.075 | |
10-20 | -0.183 | 0.354 | 0.268 | 0.605 | 0.833 | 0.416-1.666 | |
>20 | 0.018 | 0.328 | 0.003 | 0.957 | 1.018 | 0.535-1.935 | |
Awareness Standard Prevention | No | 25.259 | 0.000 | ||||
Yes | 0.749 | 0.141 | 28.183 | 0.000 | 2.115 | 1.604-2.788 | |
Process for Handling Occupational Exposure to AIDS | Unknown | 11.135 | 0.000 | ||||
Aware | 0.379 | 0.129 | 8.705 | 0.003 | 1.461 | 1.136-1.880 | |
Working hours per day | 8 hours | 14.393 | 0.002 | ||||
8-10 hours | -0.148 | 0.247 | 0.356 | 0.551 | 0.863 | 0.531-1.401 | |
10-12 hours | 0.139 | 0.249 | 0.312 | 0.577 | 1.149 | 0.705-1.873 | |
More than 12 hours | 0.300 | 0.290 | 1.071 | 0.301 | 1.349 | 0.765-2.380 | |
Job Hazard Level | Low | 34.968 | 0.000 | ||||
General | -0.582 | 0.248 | 5.528 | 0.019 | 0.559 | 0.344-0.908 | |
High | -0.524 | 0.093 | 31.879 | 0.000 | 0.592 | 0.494-0.710 | |
Wearing gloves when contacting patient's body fluid and blood | No | 50.378 | 0.000 | ||||
Occasionally | 0.656 | 0.197 | 11.109 | 0.001 | 1.928 | 1.310-2.836 | |
Yes | 0.671 | 0.100 | 44.550 | 0.000 | 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
Departments RJDoH, Richmond House, 79 Whitehall, London SW1A 2NJ, UK, [email protected] Guidance for clinical health care workers: protection against infection with blood-borne viruses. 2000.
- Moralejo D
- El Dib R
- Prata RA
- Barretti P
- Corrêa I.
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
Funding
Availability of data and materials
Ethical statement
Authors' contributions
Declaration of Competing Interest
Acknowledgements
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