産業医学および健康問題

抽象的な

Assessing Work Stressors in the Health Care Sector by Combining External Observation and Health Professionals' Self-report in a Cross-sectional Study Design

Peter K, Hahn S, Stadelmann E, Halfens RJG, Schols JMGA

Background: Occupational exposure to needle stick injuries, blood or other body fluids in healthcare facilities poses healthcare workers (HCWs) at to risk of acquiring blood-borne infectious diseases such as human immunodeficiency virus (HIV) infection. Approximately 1,000 HIV infections are transmitted annually to healthcare workers (HCWs) worldwide through occupational exposures, and in Tanzania HCWs experience one to nine needle stick injuries per year. The use of HIV post-exposure prophylaxis (HIV-PEP) can reduce the rate of HIV infection from workplace exposures by 81%. In Tanzania, there is limited knowledge on the usage of HIV-PEP among HCWs particularly in rural settings. We assessed the prevalence of occupational exposure among HCWs and the use of HIV-PEP at a referral hospital in rural Tanzania.

Methods: A cross-sectional study was conducted from September to December 2018 at St Francis Referral Hospital, Ifakara in Kilombero District. Self-administered questionnaire was provided to HCWs who had direct contact with patients to collect information on risk of exposure to blood/body fluids and the use of HIV-PEP among healthcare workers. Data were analyzed using SPSS version 20.

Results: A total of 254 Health Care Workers participated in this study. Among 254 participants, 181 (71.3%) had been exposed to blood/body fluids and 87 (48.1%) both sustained needle prick/cut by sharps and blood/body fluids. Among the exposed HCWs, 136 (75.1%) did not use HIV-PEP. The reasons for low utilization of PEP were mostly reported to be knowledge of the HIV status of the source patient 52 (38.2%), assumption that HIV status of the source patient was negative 40 (29.4%), negligence 17 (12.5%) and lack of information about the existence of post-exposure prophylaxis service 12 (8.8%).

Conclusion: Our findings revealed low utilization of HIV-PEP despite the high rates of occupational exposure of HCWs. The findings highlighted the need to decrease risks of exposure to blood/body fluids so as to minimize occupational exposure to blood-borne diseases among HCWs. Thus, interventions to enhance occupational safety are required. In addition, the need to reinforce knowledge among HCWs through proper training of HCWs on HIV- PEP in our settings is emphasized.