关键词: 医务人员；职业暴露；风险识别；影响因素

Abstract: Objective: To investigate the current situation of infectious disease risks associated with occupational exposure of healthcare workers, analyze its influencing factors, and provide a basis for hierarchical control and management of occupational infections. Methods: Using the convenience sampling method, 4 tertiary public hospitals at the county level in Shihezi and Suzhou were selected as sample hospitals, and the data of occupational infections reported by them from January 2018 to December 2022 were adopted for retrospective study. The second-order clustering analysis and the decision tree model were employed to categorize the population with occupational exposure and form the criteria to decide their risk for occupational exposure. Disordered multiclassification logistic regression was utilized to analyze the influencing factors. Results: In the four hospitals, a total of 637 cases of occupational exposure were reported. Which were mainly caused by sharp instrument injuries (87.6%). As to the exposure sources of HBV, HCV, HIV and syphilis, 51.3% were tested to be positive. According to the second-order clustering analysis, the risk of occupational exposure were classified into three categories ranging from high, medium to low in light with the results of the decision tree model. The results of Logistic regression showed that compared with low-level risk, length of service and being supporting staff were risk factors for medium-level risk, while working in the operating room, outpatient and emergency department were protective factors for medium-level risk, while being nurses, and supporting staff, working in outpatient and emergency department, other places, and hands were protective factors for high-level risk. Conclusion: Occupational exposure is mainly associated with sharp instrument injuries, and the risk is at a high level. Management departments should promote the construction of the monitoring and follow-up system for occupational exposure, identify the risk of of health workers and carry out hierarchical management.

Key words: healthcare worker; occupational exposure; risk identification; influencing factor