Table 1_Trends and risk factors of bloodborne occupational exposure among healthcare workers in a Chinese tertiary hospital (2012–2022).docx

ObjectiveThis study aimed to evaluate the epidemiological characteristics and long-term trends of bloodborne occupational exposure (BOE) among healthcare workers (HCWs) in a tertiary hospital in China from 2012 to 2022 (11 years) and evaluate BOE-associated factors during COVID-19 pandemic.
MethodsA total of 1,725 self-reported cases of BOE were analyzed. The study comprised: (1) Descriptive analysis of demographic and professional variables; (2) Trend analysis of exposure events by season, month, sex, age, professional role, department, exposure source and occupational factors; and (3) Logistic regression analysis, with BOEs during the COVID-19 pandemic as the dependent variable.
ResultsBOEs were most prevalent among female, formally employed staff, nurses, 25-year-olds, those with 1–5 years of experience, and junior-title holders. High-risk settings included the neurosurgery department and wards; common exposure types were needlestick injuries (mostly to ungloved hands) and first-time exposures. Hepatitis B virus (HBV) was the primary exposure source, with most exposed individuals having a prior HBV vaccination history. Exposure frequency peaked in December and the fourth quarter of the year. (1) Longitudinal trends showed rising BOE incidence in December, spring, and among specific groups: females, 25-year-olds, hospital doctors (including postgraduate/doctoral trainees), nurses (including interns), and staff with 10–15 years of experience. Syphilis/suspected syphilis-related exposures also demonstrated an upward trend. (2) Logistic regression identified exposure month, occupation, length of service as independent factors associated with BOE during the COVID-19 pandemic (p<0.05).
ConclusionTargeted prevention and control strategies that focus on high-risk personnel, clinical departments, and specific procedures are essential to reduce the incidence of BOE among healthcare workers. Particular attention is required during public health emergencies (e.g., the COVID-19 pandemic), especially in addressing the January exposure peak, protecting physicians and mid-career staff with 16–20 years of service, and establishing cross-institutional mechanisms for coordinated BOE reporting and follow-up of support staff, in order to further minimize occupational risks. In addition, preventive measures such as targeted training programs, simulation-based exercises, and routine monitoring of HBV immunization status should be systematically implemented for trainees and newly recruited personnel.

研究目的：本研究旨在评估中国某三级医院2012至2022年（共11年）医护人员（healthcare workers, HCWs）血源性职业暴露（bloodborne occupational exposure, BOE）的流行病学特征与长期趋势，并分析新冠疫情（COVID-19 pandemic）期间血源性职业暴露的相关影响因素。研究方法：本研究共纳入1725例自我报告的血源性职业暴露病例进行分析。研究内容包括：(1) 人口学与职业学特征的描述性分析；(2) 按季节、月份、性别、年龄、职业角色、科室、暴露源及职业相关因素划分的暴露事件趋势分析；(3) 以新冠疫情期间血源性职业暴露为因变量的Logistic回归分析。研究结果：血源性职业暴露高发人群为女性、正式聘用员工、护士、25岁年龄段群体、拥有1~5年工作经验者及初级职称人员。高风险暴露场景包括神经外科病房及病区；常见暴露类型为针刺伤（多发生于未佩戴手套的手部）及首次暴露。乙型肝炎病毒（hepatitis B virus, HBV）为主要暴露源，多数暴露个体既往有乙型肝炎疫苗接种史。暴露频次在每年12月及第四季度达到峰值。(1) 纵向趋势分析显示，12月、春季及特定群体的血源性职业暴露发生率呈上升趋势，具体包括女性、25岁年龄段群体、医院医生（含硕士、博士研究生规培人员）、护士（含实习生）及拥有10~15年工作经验的员工。梅毒/疑似梅毒相关暴露也呈现上升趋势。(2) Logistic回归分析显示，暴露月份、职业、工龄为新冠疫情期间血源性职业暴露的独立影响因素（p<0.05）。研究结论：针对高风险人群、临床科室及特定操作制定靶向防控策略，对降低医护人员血源性职业暴露发生率至关重要。在公共卫生突发事件（如新冠疫情）期间需格外关注，尤其应应对1月暴露峰值，保护拥有16~20年工龄的医师及职业中期员工，并建立跨机构协作机制以统筹血源性职业暴露报告与后勤支持人员的后续跟进工作，从而进一步降低职业暴露风险。此外，应针对培训学员及新入职人员系统性开展靶向培训、模拟演练及乙型肝炎免疫状态常规监测等预防措施。