A large scale survey on sharp injuries among hospital based healthcare workers in China 1Scientific RepoRts | 7 42620 | DOI 10 1038/srep42620 www nature com/scientificreports A large scale survey on s[.]
www.nature.com/scientificreports OPEN received: 04 November 2015 accepted: 10 January 2017 Published: 16 February 2017 A large-scale survey on sharp injuries among hospital-based healthcare workers in China Xiaodong Gao1, Bijie Hu1, Yao Suo2, Qun Lu3, Baiyi Chen4, Tieying Hou5, Jin’ai Qin6, Wenzhi Huang7 & Zhiyong Zong7 A multi-center survey on sharp injuries (SIs) among hospital-based healthcare workers (HCWs) in seven provinces of China between August and December 2011 was performed In each province, HCWs from at least 30 hospitals were surveyed by completing a SI report form adapted from the EPINet The HCWs who declared SIs during the period were interviewed by local infection control practitioners The survey included 361 hospitals and 206,711 HCWs, most of whom were nurses (47.5%) or doctors (28.4%) In the previous month, 17,506 SI incidents were declared by 13,110 (6.3%) HCWs, corresponding to 1,032 incidents per 1,000 HCWs per year and 121.3 per 100 occupied beds per year The majority of the SIs was caused by a hollow-bore needle (63.0%) The source patient was identified in 73.4% of all SIs but only 4.4% of all exposures involved a source patient who tested positive for HBV (3.3%), HCV (0.4%) or HIV (0.1%) Only 4.6% of SIs were reported to the infection control team in the hospitals In conclusion, the rate of SI among HCWs is high in China and SI represents a severe but largely neglected problem Awareness and safety climate should be promoted to protect the safety of HCWs in China Occupational exposure to blood-borne viruses (BBVs) such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) is a major threat to healthcare workers (HCWs) during their daily works The Centers for Disease Control and Prevention (CDC) estimated that about 385,000 percutaneous injuries occurred among HCWs in USA every year1 The actual number is likely to be much higher due to widespread underreporting of incidents in USA workplaces2 In East Asia, up to 8,319 percutaneous injuries were estimated among HCWs in Taiwan3 and a survey on 3,079 registered nurses in 60 hospitals in South Korea revealed that 70.4% of those surveyed declared sharp injuries (SIs)4 Occupational exposure can lead to infections of BBVs It was estimated that about 66,000 HBV, 16,000 HCV and about 1,000 HIV infections might have occurred among HCWs worldwide due to percutaneous injuries in a single year5 Therefore, occupational exposure to BBVs resulting from SIs among HCWs is a global problem and represents an often-preventable hazard for HCWs Preventing SI and subsequent BBV exposure requires a comprehensive approach to prevention and control6,7 China has a large population of HCWs However, unlike developed countries, the rate of SIs among HCWs in China remains largely unknown due to a lack of large-scale occupational incident surveillance programs5 A retrospective large-scale multi-site survey on SIs among HCWs was therefore organized and conducted in China Results A total of 361 hospitals with 173,219 beds in seven provinces (Guangdong, Guangxi, Liaoning, Shaanxi, Shanghai, Sichuan and Zhejiang) participated in the survey Among 253,555 HCWs who were eligible for the survey, 206,711 responded to the invitation and completed the survey form, corresponding to an 81.5% overall response Department of Infection Control, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China Department of Infection Control, The Second Affiliated Hospital, Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, Shaanxi,China 3Department of Infection Control, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, China 4Department of Infection Control, The First Hospital, China Medical University, 155 Nanjing Road, Shenyang, Liaoning, China 5Department of Infection Control, Guangdong Provincial Hospital, 106 Zhongshan No Road, Guangzhou, Guangdong, China 6Department of Infection Control, The First affiliated Hospital, Guangxi Medical University, Shuangyong Road, Nanning, Guangxi, China 7Center of Infectious Diseases and Department of Infection Control, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu, China Correspondence and requests for materials should be addressed to B.H (email: hubijie@vip.sina com) or Z.Z (email: zongzhiy@scu.edu.cn) Scientific Reports | 7:42620 | DOI: 10.1038/srep42620 www.nature.com/scientificreports/ HCW group SI rate, 1,000 SI rate, 100 occupied Reporting Source patients being Number Number of HCW SI Reported SI SI rate, % beds per month rate (%)4 identified, cases (%) surveyed declared SIs incidents incidents of HCWs2 HCWs per month Doctors 58,766 3,223 4,239 170 5.5 72.1 2.4 4.0 3,375 (79.6) Nurses 98,118 7,642 10,195 446 7.8 103.9 5.9 4.4 7,568 (74.2) Technicians 9,936 328 418 13 3.3 42.1 0.2 3.1 293 (70.1) Logistic workers1 15,118 575 854 50 3.8 56.5 0.5 5.9 380 (44.5) Trainees 14,523 1,113 1,480 15 7.7 101.9 0.9 7.8 1,089 (73.6) Others3 10,250 229 320 11 2.2 31.2 0.2 3.4 151 (47.2) Total 206,711 13,110 17,506 805 6.3 84.7 10.1 4.6 12,856 (73.4) Table 1. SI incidents and reporting rates among HCWs 1Logistic workers refer to those who deal with medical wastes 2SI rates (% HCWs) between different HCW groups were statistically significant (p