occupational risk exposure

  • 文章类型: Journal Article
    介绍针头和锐器伤(NSI)继续对工作场所的医护人员(HCW)构成重大风险。医院NSI的发生率取决于多种危险因素。本研究旨在分析HCWs中NSI的流行病学特征以及影响NSI发生率的危险因素,为二级保健医院NSI的预防提供进一步的指导。方法本研究纳入了阿卜杜勒阿齐兹国王医院HCW报告的所有NSI病例,麦加从2005年到2017年。所有病例均记录在暴露预防信息网络(EPINet™)数据库中(国际医疗工作者安全中心,弗吉尼亚大学,夏洛茨维尔,美国)。该研究是通过使用EPINet™程序中加载的数据执行的,医院电子记录系统MedicaPlus,并由社会科学计划统计软件包(SPSSInc.2007年发布。SPSSforWindows,版本15.0。芝加哥,SPSSInc.)。结果在研究期间,报告了524例NSI病例。在95%CI的情况下,每100张床位的平均发病率为25.43(22.05-28.81),从2005年到2017年观察到NSI发病率在统计学上无统计学意义的下降。2010年登记的年发病率最高(每100张床位35.63张),2013年登记的年发病率最低(每100张床位14.84张)。受伤报告主要在病房/病房(30.2%),护士最常见(56.1%)。24小时内事件报告的平均值为74.0,95%CI(67.19-80.73)。该比率显示出统计学上显著(p=0.01)的每年5.0%的增加趋势。确定的来源患者的平均值-83.5,95%CI(79.13-87.23)-在2005-2017年期间每年增长2.1%,在统计学上无统计学意义(p=0.7)。病例发生在使用后/处置前的物品占45.0%,使用期间的物品占44.7%。在46.5%的事件中,空心针头造成了伤害。血液样本采集-23.2%和IV或动脉管线插入/取出/操作(19.1%)-存在暴露倾向的程序,风险最高。结论本研究结果显示医院NSI发生率较高。医院的NSI率受到一组相关风险因素的影响,特别是,风险的位置(病房/病房,重症监护病房(ICU),和急诊室(ER)取决于工作强度,易暴露程序的种类和频率(血液样本采集,IV或动脉管线插入/移除/操作)并处理连接到处于危险中的主要医疗保健专业人员组(护士)的空心孔和实心针。NSI预防的未来方向需要一种复杂的持续员工教育方法,以及使用具有安全功能的设备。
    Introduction Needlestick and sharp injuries (NSI) continue to pose a significant risk for healthcare workers (HCWs) at their workplace. The incidence rate of NSI in hospitals depends on multiple risk factors. This study aimed to analyze the epidemiological characteristics of NSI among HCWs and the risk factors influencing NSI rates and to provide further direction for NSI prevention in secondary care hospitals. Methods This study included all the NSI cases reported by HCWs in King Abdul Aziz Hospital, Makkah from 2005 to 2017. All the cases were recorded in the Exposure Prevention Information Network (EPINet™) database (International Healthcare Worker Safety Center, University of Virginia, Charlottesville, USA). The study was executed by using data loaded in the EPINet™ Program, the hospital electronic recording system Medica Plus, and analyzed by the Statistical Package for the Social Sciences program (SPSS Inc. Released 2007. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). Results During the period of study, 524 NSI cases were reported. The mean incidence rate per 100 occupied beds with 95% CI was 25.43 (22.05-28.81) and a statistically insignificant decline in NSI incidence rate was observed from 2005 to 2017. The maximal annual incidence rate (35.63 per 100 occupied beds) was registered in 2010 and the minimal value (14.84 per 100 occupied beds) in 2013. Injuries were mainly reported in patient rooms/wards (30.2%) and most frequently by nurses (56.1%). The mean of incident reporting within 24 hours was 74.0, 95% CI (67.19-80.73). This rate showed a statistically significant (p=0.01) increasing trend of 5.0% per annum. The mean of identified source patients - 83.5, 95% CI (79.13- 87.23) - possessed an annual 2.1% rise during 2005-2017 which was statistically insignificant (p=0.7). Cases occurred after the use/before disposal of items in 45.0% of cases and during the use of items in 44.7%. Hollow-bore needles caused injuries in 46.5% of incidents. Blood sample taking - 23.2% and IV or arterial line insertion/removal/manipulation (19.1%) - presented exposure-prone procedures posing the highest risk. Conclusions The results of this study revealed a high rate of NSI in the hospital. NSI rate in hospitals was impacted by a group of related risk factors, particularly, the location of risk (patient room/ward, intensive care unit (ICU), and emergency room (ER) depending on job intensity, the kind and frequency of exposure-prone procedures (blood sample taking, IV or arterial line insertion/removal/manipulation) and handling of hollow-bore and solid needle connected to the main healthcare professional group at risk (nurses). Future direction in NSI prevention requires a complex approach of continuous staff education along with the usage of devices with safety features.
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  • 文章类型: Journal Article
    鼻窦(SN)恶性肿瘤很少见。在SN腺癌中,最常见的是肠型腺癌(ITAC).ITAC与木材和皮革粉尘职业接触和TP53突变有关。关于其表征和治疗的信息不多。这项研究的目的是描述在我们三级医院接受治疗的鼻窦腺癌(SNACs)患者的临床病理和预后因素。回顾,我们进行了包括2004-2023年间诊断的SNAC患者在内的连续研究.收集临床病理资料,并在肿瘤标本中评估p53状态。p53状态与临床病理变量之间的关联,以及它们对生存的影响,进行了评估。总的来说,包括35个,他们中的大多数患有ITAC(91.4%)和乳头状亚型(37.5%);大多数人遭受职业风险暴露(82.9%)。在48.6%的肿瘤中发现p53过表达。乳头状和结肠亚型的中位无进展生存期(mPFS)高于粘液性和实性亚型(mPFS37个月,95%CI,20.0-54.0,与9个月,95%CI,7.15-10.85,p=0.01);前者还与较高的中位总生存期(mOS)(mOS64个月,95%CI,37.18-90.81与14个月,95%CI,0-41.58,p=0.02)。组织学1-2级和宏观完全切除与较高的PFS相关(五个月的PFS为90.9%与33.3%,p=0.01;mPFS为37个月,95%CI,4.93-69.07vs.10个月,95%CI,分别为6.43-13.57,p=0.04)。远处转移的疾病复发与较低的OS(11个月,95%CI,6.1-15.9vs.53个月,95%CI,22.70-83.30,p=0.04)。这项研究加强了保护性职业措施的重要性。未来的研究对于验证该疾病晚期的最佳治疗策略以及识别SNAC中的新的预后和/或治疗靶标生物标志物将是重要的。
    Sinonasal (SN) malignancies are rare. Within SN adenocarcinomas, the most frequent are intestinal-type adenocarcinomas (ITACs). ITAC has been associated with wood and leather dust occupational exposure and TP53 mutations. Not much information is available regarding its characterization and treatment. The aim of this study is to characterize the clinicopathologic and prognostic factors of patients with sinonasal adenocarcinomas (SNACs) treated in our tertiary-level hospital. A retrospective, consecutive study including SNAC patients diagnosed between 2004-2023 was conducted. Clinicopathological data was collected, and p53 status was assessed in the tumor specimens. The association between p53 status and clinicopathological variables, as well as their impact on survival, was evaluated. In total, 35 were included, most of them having ITAC (91.4%) with papillary subtype (37.5%); the majority were subjected to occupational risk exposure (82.9%). Overexpression of p53 was identified in 48.6% of the tumors. Papillary and colonic subtypes were associated with higher median progression-free survival (mPFS) than mucinous and solid subtypes (mPFS 37 months, 95% CI, 20.0-54.0, vs. 9 months, 95% CI, 7.15-10.85, p=0.01); the former was also associated with higher median overall survival (mOS) (mOS 64 months, 95% CI, 37.18-90.81 vs. 14 months, 95% CI, 0-41.58, p=0.02). Histologic grade 1-2 and macroscopic complete resection were associated with higher PFS (PFS of five months of 90.9% vs. 33.3%, p=0.01; mPFS of 37 months, 95% CI, 4.93-69.07 vs. 10 months, 95% CI, 6.43-13.57, p=0.04, respectively). Disease recurrence with distant metastases was associated with lower OS (11 months, 95% CI, 6.1-15.9 vs. 53 months, 95% CI, 22.70-83.30, p=0.04). This study reinforces the importance of protective occupational measures. Future studies will be important to validate the best treatment strategy in the advanced stages of this disease and also to identify new prognostic and/or therapeutic target biomarkers in SNAC.
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