fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2025-10-2-32-43fcmedicine-1017Research ArticleЭПИДЕМИОЛОГИЯEPIDEMIOLOGYРиски профессионального инфицирования медицинских работников гемоконтактными инфекциями и направления для управления рискамиOccupational risk of bloodborne infections among healthcare workers and strategies for their risk managementhttps://orcid.org/0000-0001-7004-2204ЮжанинаТ. С.YuzhaninaT. S.

Южанина Татьяна Сергеевна, врач-эпидемиолог отдела клинической эпидемиологии

ул. Ясная, д. 46, г. Екатеринбург, 620102

Dr. Tatiana S. Yuzhanina, MD, Epidemiologist, Department of Clinical Epidemiology

Yasnaya Street, 46, Yekaterinburg, 620102

https://orcid.org/0000-0002-9723-8116КукаркинаВ. А.KukarkinaV. A.

Кукаркина Вера Анатольевна, кандидат медицинских наук, заведующая отделом клинической эпидемиологии

ул. Ясная, д. 46, г. Екатеринбург, 620102

Dr. Vera A. Kukarkina, MD, Cand. Sci. (Medicine), Head of the Department of Clinical Epidemiology

Yasnaya Street, 46, Yekaterinburg, 620102

https://orcid.org/0000-0003-4812-2165ГолубковаА. А.GolubkovaA. A.

Голубкова Алла Александровна, доктор медицинских наук, профессор, ведущий научный сотрудник лаборатории инфекций, связанных с оказанием медицинской помощи; профессор кафедры госпитальной эпидемиологии, медицинской паразитологии и тропических болезней

ул. Новогиреевская, д. 3А, г. Москва, 111123

ул. Баррикадная, д. 2/1, стр. 1, г. Москва, 125993

Prof. Alla А. Golubkova, MD, Dr. Sci. (Medicine), Professor, Leading researcher, Laboratory of healthcare-associated infections; Professor, Department of Hospital Epidemiology, Medical Parasitology and Tropical Diseases

Novogireevskaya Street, 3А, Moscow, 111123

Barrikadnaya Street, 2/1, Building 1, Moscow, 125993

 

https://orcid.org/0000-0001-7345-0801ПодымоваА. С.PodymovaA. S.

Подымова Анжелика Сергеевна, доктор медицинских наук, главный врач

ул. Ясная, д. 46, г. Екатеринбург, 620102

Dr. Anzhelika S. Podymova, MD, Dr. Sci. (Medicine), Chief Physician

Yasnaya Street, 46, Yekaterinburg, 620102

Свердловский областной центр профилактики и борьбы со СПИДРоссияSverdlovsk Regional Center for Prevention and Control of AIDSRussian FederationЦентральный научно-исследовательский институт эпидемиологии Роспотребнадзора; Российская медицинская академия непрерывного профессионального образованияРоссияCentral Research Institute of Epidemiology of Rospotrebnadzor; Russian Medical Academy of Continuous Professional EducationRussian Federation2025300620251023243Copyright © Южанина Т.С., Кукаркина В.А., Голубкова А.А., Подымова А.С., 20252025Южанина Т.С., Кукаркина В.А., Голубкова А.А., Подымова А.С.Yuzhanina T.S., Kukarkina V.A., Golubkova A.A., Podymova A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/1017

Работники здравоохранения в силу особенностей лечебно-диагностического процесса подвержены высокому риску заражения гемоконтактными инфекциями. Их инфицирование может произойти при любой аварийной ситуации, связанной с экспозицией крови. Цель. Установить риски профессионального заражения гемоконтактными инфекциями медицинских работников для управления рисками. Материалы и методы. Акты расследования и оперативные донесения на 3256 случаев аварийных ситуаций у медицинских работников Свердловской области за 2013–2023 гг. Результаты. В период с 2013 по 2023 гг. частота аварийных ситуаций, связанных с экспозицией крови, у медицинских работников составляла 6,6‰ (95% ДИ: 6,1-7,1) и зависела от профиля отделения, характера оказываемой медицинской помощи, профессии, стажа работы сотрудника, дня недели и времени суток. Наибольшему риску заражения гемоконтактными инфекциями были подвержены врачи-хирурги и травматологи, акушеры-гинекологи, анестезиологи-реаниматологи, медицинские сестры, выполнявшие инвазивные манипуляции, а также сотрудники, занимавшиеся сбором и транспортировкой медицинских отходов. Аварийные ситуации чаще возникали во время оперативных вмешательств, постановки инъекций, а также при работе с медицинскими отходами. По характеру травмирующего фактора преобладали уколы кистей рук (81,6%), в том числе в 72,3% инъекционными иглами. В среднем 44,1% аварийных ситуаций были сопряжены с умеренным риском инфицирования ВИЧ и вирусными гепатитами и 9,2% - с высоким. Охват постконтактной антиретровирусной терапией от ВИЧ-инфекции всех нуждавшихся в ней сотрудников составлял 91,0%. Заключение. Анализ аварийных ситуаций у медицинских работников является одним из важнейших инструментов контроля за рисками профессионального инфицирования гемоконтактными инфекциями. Необходим комплексный и разнонаправленный подход в стратегии минимизации рисков травм и инфицирования

Aim. To identify occupational risks of bloodborne infections among healthcare workers in order to develop effective risk management strategies. Materials and methods. Investigation reports and incident records were analyzed for 3,256 occupational exposure events involving healthcare workers in Sverdlovsk Region from 2013 to 2023. Results. From 2013 to 2023, the incidence rate of blood exposure incidents among healthcare workers was 6.6 per 1,000 (95% CI: 6.1– 7.1). The risk varied depending on the type of medical department, the nature of medical procedures, job role, length of professional experience, day of the week, and time of day. The highest risk of occupational infection was observed among surgeons, traumatologists, obstetrician-gynecologists, anesthesiologists-resuscitators, nurses performing invasive procedures, and staff involved in medical waste collection and transportation. Incidents most commonly occurred during surgeries, injections, and waste handling. The most frequent injury type was hand needlestick injury (81.6%), with 72.3% caused by injection needles. On average, 44.1% of incidents posed a moderate risk of HIV or viral hepatitis transmission, and 9.2% carried a high risk. Post-exposure antiretroviral prophylaxis for HIV was provided to 91.0% of those who required it. Of the healthcare workers, those at the highest risk of contracting blood-borne infections were surgeons and traumatologists, obstetricians and gynecologists, anesthesiologists and resuscitators, nurses performing invasive procedures, and employees involved in the collection and transportation of medical waste. Emergencies most often occurred during surgical interventions, injections, and when working with medical waste. By the nature of the traumatic factor, hand pricks were predominant (81.6%), including 72.3% with injection needles. On average, 44.1% of emergency situations were associated with a moderate risk of HIV and viral hepatitis infection, and 9.2% with a high risk. Coverage of post-exposure antiretroviral therapy for HIV infection among all employees who needed it was 91.0%. Conclusion. The analysis of blood exposure incidents is a critical tool for monitoring and managing occupational risks of bloodborne infections among healthcare workers. A comprehensive, multifaceted strategy is required to reduce the risk of injuries and infections.

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The authors declare that there are no conflicts of interest present.