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四川省医务人员抗肿瘤药职业暴露调查分析
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| 篇名： | 四川省医务人员抗肿瘤药职业暴露调查分析 |
| TITLE： | Investigation and Analysis of Exposure to Antineoplastic Drugs of Medical Staff in Sichuan Province |
| 摘要： | 目的：调查四川省医务人员抗肿瘤药的职业暴露情况及结局，为其安全提供保障。方法：采用问卷调查法。调查对象为以四川省人民医院为主的4家三级甲等医院、6家四川省内二级及以下医院共10家医院肿瘤科、血液科、静脉药物配制中心、药学部（药剂科）等11个相关科室的医师、护士、技师、药师等，使用自行设计的问卷对医务人员的一般资料、对职业暴露危害的认知现状、暴露情况、暴露结局及防护行为现状进行调查，并提出建议。结果：共发放问卷350份，有效回收304份，有效回收率为86.86％。304例受访人员中，女性253例（83.22％），男性51例（16.78％），年龄以20～29岁最多（43.42％），学历以本科最多（66.78％）；以护士（55.26％）和药学部（药剂科）人员（21.71％）居多；平均工作时长以8h/d为主（84.21％）；工作年限＜5年最多（39.47％）。有121例（39.80％）受访者知道职业暴露存在潜在危害，131例（43.09％）为“有所了解”；静脉药物配置中心中有15例（71.43％）为“知道”，在所有调查科室中占比最高；不知道有职业暴露危害的人员以技师和其他医务人员为最高，均为60％；总工作时间越长的医务人员对职业暴露危害的认知程度越高（P＝0.0358）。有165例（54.28％）接触了环磷酰胺，为最多；有57例（18.75％）接触了培美曲塞二钠，为最少；不同科室医务人员职业暴露总时间均以短期暴露为主，其中以血液科暴露人数最多（85.71％）。有67例（22.04％）在排除其他身体疾病的影响后，自述出现过身体不适，以脱发增多（73.13％）为主；血液科医务人员出现不适的占比最大（50.00％）；护士出现不适的人数（31.55％）最多。有155例（50.99％）受访者不了解抗肿瘤药的防护措施，41例（13.49％）受访者接受过相关培训，108例（35.53％）为了解；静脉药物配制中心人员对防护措施的认知程度最高，仅有14.29％的人员为不了解；职业中以护士接受过相关培训的占比最高（19.05％）。结论：医务人员对抗肿瘤药职业暴露危害及自我防护措施的了解度较低；相关部门应加强对医务人员职业防护法规和标准规范体系的建设，医院应强化内部管理，高度重视医院职业防护管理工作，医务人员应增强意识，提高技能，以减少职业暴露的发生风险。 |
| ABSTRACT： | OBJECTIVE： To investigation occupational exposure and exposure outcome of antineoplastic in medical staff ，to provide support for their safety in Sichuan Province. METHODS：The respondents included doctors ，nurses，technicians and pharmacists from 11 related departments including tumor department ，hematology department ，PIVAS and pharmacy department in 4 third-level class A hospitals mainly in Sichuan Provincial People ’s Hospital and 6 second-level and below hospitals. Self-designed questionnaires were adopted to investigate general information of medical staff ，cognitive status to occupational exposure hazards ， occupational exposure and exposure outcome and protective behaviors and make suggestions of the investigation. RESULTS：A total of 350 questionnaires were sent out and 304 were recovered ，with effective recovery rate of 86.86％. Among 304 investigated pharmacentical staff ，involving 253 female（83.22％），51 male（16.78％），the most of persons aged 20-29 years old （43.42％）. The most of persons （66.78％）had a bachelor degree. The largest number of occupation was nurses （55.26％）；the pharmacy department had the largest number （21.71％）；working hours were mainly 8 h/day（84.21％）；working years were the most less than 5 years（39.47％）. 121 persons（39.80％）were aware of the potential hazards of occupational exposure to antineoplastic drugs，and 131 persons（43.09％）only knew a little about the Δ 项目基金：国家临床重点专科建设项目；四川省科研院所基本科 exposure hazards ；in PIVAS ，15 persons （71.43％） were 研业务项目（No.2018YSKY0017） ＊药师，硕士研究生。研究方向：临床药学。E-mail：370951417@ aware of the potential hazards of occupational exposure to qq.com antineoplastic drugs ，accounting the highest proportion among # 通信作者：主任药师，硕士生导师。研究方向：国家药物政策、药 all departments ； the proportion of technicians and other 事管理、医院药学。电话：028-87393436。E-mail：289302309@qq.com medical staff who did not know the occupational exposure 中国药房 2020年第31卷第8期 China Pharmacy 2020Vol. 31 No. 8 ·1009· hazard was the highest ，being 60％；the longer the total working time ，the higher the cognition degree of occupational exposure hazards （P＝0.035 8）. The most exposed antineoplastic drug was cyclophosphamide 165 persons（54.28％） and pemetrexed disodium 57 persons（18.75％）was the least. The total time of occupational exposure of medical staff in different departments was mainly short-term exposure ，among which the number of exposed persons in hematology department was the most （85.71％）. 67 persons（22.04％）reported that they had physical discomfort after excluding the influence of other physical diseases ，mainly the increase of alopecia （73.13％）；the propertion of medical staff who had physical discomfort in hematology department was the most（50.00％）；the number of nurses who had physical discomfort （31.55％）was the most. 155 persons（50.99％）could not understand the antineoplastic drug protection measures ，41 persons （13.49％） had received relevant training ，108 persons （35.53％）understood the occupational protection of antineoplastic drugs. The highest level of awareness of protective measures was found among the medical staff in PIVAS ，and only 14.29％ of the staff did not understand the protective measures. In term of occupation，the proportion of nurses who had received relevant training was the highest （19.05％）. CONCLUSIONS ：Medical staffs have a low level of knowledge about occupational exposure hazards and self-protection measures of antineoplastic drugs. The government should strengthen the construction of occupational protection regulations and standards for medical staff ；hospitals should strengthen internal management and attach great importance to the management of occupational protection in hospitals ； medical staff should increase awareness ，skills and reduce the risk of occupational exposure. |
| 期刊： | 2020年第31卷第08期 |
| 作者： | 郝梦琳，边原，朱九群，陈珉，陈璐，闫峻峰 |
| AUTHORS： | HAO Menglin ，BIAN Yuan，ZHU Jiuqun ，CHEN Min，CHEN Lu，YAN Junfeng |
| 关键字： | 四川省；抗肿瘤药；职业暴露；医务人员；问卷调查 |
| KEYWORDS： | Sichuan province ；Antineoplastic drugs ；Occupational exposure ；Medical staff ；Questionnaire investigation |
| 阅读数： | 435 次 |
| 本月下载数： | 12 次 |
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