传染病医院手术职业暴露的流行病学：一项为期5年的回顾性研究

摘要(中文译文)

分析某传染病医院近5年手术相关职业暴露的流行病学特征及单因素相关因素，为制定针对性预防策略提供依据。回顾性收集某传染病医院2020年1月至2024年12月的手术职业暴露报告，共纳入104例有效病例。采用R 4.4.2软件进行统计分析，描述时间、人口学、科室、角色及暴露类型的分布特征，并进行单因素分析。职业暴露发生率呈逐年上升趋势，2024年显著升高。男性占暴露者的71.2%，多数年龄为25~39岁。手术助手暴露比例最高（50.0%），暴露最多的科室为感染外科和骨科（各占18.3%）。主要暴露类型为锐器伤（60.6%）。不同手术角色在性别、年龄、学历和科室方面差异均有统计学意义（P<0.001）。急诊手术暴露集中于骨科（46.2%）和产科（15.4%），主要涉及2~3级手术。本研究揭示了传染病医院手术职业暴露的异质性风险模式。手术助手及骨科/感染外科构成核心高风险集群，证实岗位角色和科室专业比个人经验更是暴露风险的关键决定因素。值得注意的是，近半数暴露事件的重复发生提供了有力证据，表明当前以培训和个人防护装备为主的预防策略在有效阻断暴露链条方面存在结构性失效。因此，有效的风险控制必须超越个人行为自律，转向以工程控制和系统性工作流程干预为锚点的精准预防体系。

Abstract

To analyze the epidemiological characteristics and associated factors at the univariate level of surgical occupational exposures in an infectious disease hospital over the past 5 years, and to provide evidence for developing targeted prevention strategies. We retrospectively collected surgical occupational exposure reports from an infectious disease hospital between January 2020 and December 2024, including 104 valid cases. Statistical analysis was performed using R 4.4.2 software to describe the temporal, demographic, departmental, role-based, and exposure-type distributions, along with a univariate analysis. The incidence of occupational exposure showed an increasing trend year by year, with a significant rise in 2024. Males accounted for 71.2% of the exposures, with the majority aged 25-39 years. Surgical assistants had the highest exposure proportion (50.0%), and the departments with the most exposure were Infectious Surgery and Orthopedics (18.3% each). The primary type of exposure was sharp injuries (60.6%). Significant differences were observed among the different surgical roles in terms of sex, age, education, and department ( < 0.001). Emergency surgery exposure was concentrated in Orthopedics (46.2%) and Obstetrics (15.4%), predominantly involving grade 2-3 surgeries. This study revealed a heterogeneous risk pattern for surgical occupational exposure in an infectious disease hospital. Surgical assistants and the Orthopedics/Infectious Disease Surgery departments constituted the core high-risk cluster, confirming that job role and departmental specialty are more critical determinants of exposure risk than individual experience. Notably, the recurrence of nearly half of all exposure events provides compelling evidence that current prevention strategies-centered predominantly on training and personal protective equipment-exhibit structural failure in effectively breaking the chain of exposure. Therefore, effective risk control must transcend individual behavioral discipline and shift toward a precision prevention system anchored in engineering controls and systemic workflow interventions.

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