What Is Operating Exposure?

Occupational exposure is a Chinese vocabulary and pinyin is zhí yè bào lù, which means a situation that may be harmful to health or life-threatening due to occupational relationships and exposure to risk factors. Occupational exposure of medical personnel refers to a type of occupational exposure in which medical personnel are exposed to toxic, harmful substances, or pathogens of infectious diseases during their diagnosis and treatment and nursing activities, thereby damaging health or endangering life. The occupational exposure of medical personnel is divided into infectious occupational exposure, radioactive occupational exposure, chemical (such as disinfectants, certain chemicals) occupational exposure, and other occupational exposures.

Occupational exposure

Occupational exposure is a Chinese vocabulary and pinyin is zhí yè bào lù, which means a situation that may be harmful to health or life-threatening due to occupational relationships and exposure to risk factors. Occupational exposure of medical personnel refers to a type of occupational exposure in which medical personnel are exposed to toxic, harmful substances, or pathogens of infectious diseases during their diagnosis and treatment and nursing activities, thereby damaging their health or threatening their lives. The occupational exposure of medical personnel is divided into infectious occupational exposure, radioactive occupational exposure, chemical (such as disinfectants, certain chemicals) occupational exposure, and other occupational exposures.

On October 27, 2017, the list of carcinogens published by the International Organization for Research on Cancer of the World Health Organization was initially compiled and referenced. Iron and steel foundry, painters, painters, stucco workers, and chimney cleaners were among the list of carcinogens. ^[1]

(1) Develop and implement guidelines for safe operation and general protective measures in medical laboratories.

(2) Relevant personnel (including medical personnel, police personnel, etc.) to strengthen the publicity and education of AIDS transmission channels and self-protection, as well as relevant knowledge and skills training, improve their knowledge of AIDS prevention and self-protection ability, and maintain a correct attitude Neither excessive fear nor indifference.

(3) Have a special organization and management system.

(4) Implement safety operations and personal protection measures to prevent occupational exposure. Including the layout of medical laboratories, safe operating regulations, disinfection of waste,

(Trial)

Chapter I General Provisions

The first is to formulate these guidelines in order to maintain the occupational safety of medical personnel and to effectively prevent occupational exposure of medical personnel to HIV infection at work.

Article 2 The occupational exposure to HIV as mentioned in this Guiding Principle refers to medical personnel who have accidentally contaminated the skin or mucous membranes with the blood or body fluids of an HIV-infected or AIDS patient during the work of diagnosis, treatment, and nursing, or have been infected with HIV-containing blood Needles and other sharp objects contaminated by body fluids pierce the skin and may be infected by HIV.

Article 3 Medical and health institutions at all levels and at all levels shall strengthen the protection of medical personnel in preventing and controlling HIV infection in accordance with the provisions of these guidelines.

Chapter II Prevention

Article 4 The protective measures taken by medical personnel to prevent HIV infection shall comply with the standard precautionary principles. All patients' blood, body fluids, and articles contaminated with blood and body fluids shall be regarded as infectious pathogenic substances. When medical personnel come into contact with these substances, Protective measures must be taken.

Article 5 When medical personnel come into contact with pathogenic substances, they shall take the following protective measures:

(1) Medical personnel must wear gloves when performing medical treatment and nursing operations that may come in contact with the patient's blood and body fluids. After the operation, wash hands immediately after removing gloves, and disinfect hands if necessary.

(2) During the diagnosis and treatment and nursing operations, when blood and body fluids may splash on the face of medical staff, medical staff should wear gloves, masks and protective glasses with anti-permeability performance; large areas of blood and body fluids may be splashed Or when it is possible to contaminate the medical personnel's body, they should also wear isolation clothing or apron with anti-permeability. (3) The skin of the hand of the medical staff is damaged, and double-layer gloves must be worn when conducting diagnosis and treatment and nursing operations that may contact the patient's blood and body fluids.

Article 6 During the invasive diagnosis and treatment and nursing operations, medical personnel shall ensure sufficient light, and pay special attention to prevent being punctured or scratched by sharp instruments such as needles, suture needles, and blades.

Article 7 The sharps after use should be placed directly into a sharp-proof and leak-proof sharps box, or be safely disposed of with a needle-handling device. Medical sharps such as syringes and infusion sets with safety performance can also be used to prevent puncture hurt.

It is forbidden to re-attach the disposable needle after use. Do not directly touch sharp objects such as needles and blades after use.

Chapter III Treatment Measures after Occupational Exposure

Article 8 After occupational exposure to HIV among medical personnel, the following local treatment measures shall be implemented immediately:

(1) Wash the contaminated skin with soap and flowing water, and rinse the mucous membranes with physiological saline.

(2) If there is a wound, it should be squeezed gently at the side of the wound to squeeze as much blood as possible from the wound, and then rinse with soap and flowing water; local compression of the wound is prohibited.

(3) After rinsing the wound at the injured site, disinfectant should be used, such as: 75% ethanol or 0.5% iodine, and the wound should be bandaged; exposed mucous membranes should be repeatedly rinsed with normal saline.

Article 9 After occupational exposure to HIV among medical personnel, medical and health institutions shall evaluate and determine the level of exposure and the viral load level of the source of exposure.

Article 10 There are three levels of occupational exposure to HIV.

A primary exposure is determined when:

(1) The source of exposure is bodily fluids or blood or medical devices or articles containing bodily fluids or blood;

(2) The type of exposure is that the exposed source is contaminated with damaged skin or mucous membranes, the exposure is small and the exposure time is short.

A secondary exposure is determined when:

(1) The source of exposure is bodily fluids or blood or medical devices or articles containing bodily fluids or blood;

(2) The type of exposure is contaminated skin or mucous membranes exposed by the source, and the exposure is large and the exposure time is long; or the type of exposure is stabbing or cutting the skin, but the degree of damage is minor, which is epidermal bruising or Needle stab wound.

Tertiary exposure is determined when:

(1) The source of exposure is bodily fluids or blood or medical devices or articles containing bodily fluids or blood;

(2) The type of exposure is stab wounds or cuts to the skin of the exposure source, but the degree of damage is serious, and there is obvious blood in deep wounds or cuts.

Article 11 The viral load levels of exposure sources are divided into three types: mild, severe and unknown.

After inspection, the source of exposure was HIV-positive, but those with low titers, no clinical symptoms of HIV infection, and normal CD4 counts were mild.

After inspection, the source of exposure was HIV positive, but those with high titers, clinical symptoms of HIV infection, and low CD4 counts were severe types.

Can not determine whether the source of exposure is HIV-positive, the source is unknown.

Article 12 Medical and health institutions shall implement preventive medication programs for medical personnel who have had occupational exposure to HIV according to the level of exposure and the viral load level of the source of exposure.

Article 13 Preventive medication programs are divided into basic medication procedures and intensive medication procedures. The basic medication procedure is two reverse transcriptase preparations, using conventional therapeutic doses for 28 consecutive days. The intensive medication procedure is based on the basic medication procedure, and at the same time, a protease inhibitor is added, and the conventional therapeutic dose is used for 28 consecutive days.

Preventive medication should start as soon as possible after occupational exposure to HIV, preferably within 4 hours, and no later than 24 hours; even if it exceeds 24 hours, preventive medication should also be implemented.

Preventive medication may not be used when primary exposure occurs and the source viral load level is mild; when primary exposure occurs and the source viral load level is severe or secondary exposure occurs and the source viral load level When the level is mild, the basic medication procedure is used.

When secondary exposure occurs and the source viral load level is severe or tertiary exposure occurs and the source viral load level is mild or severe, an intensive medication program is used.

When the source's viral load level is unknown, basic medication procedures can be used.

Article 14 After occupational exposure of HIV to medical personnel, medical and health institutions shall provide follow-up and consultation. The follow-up and consultations include: testing for HIV antibodies at 4 weeks, 8 weeks, 12 weeks, and 6 months after exposure, monitoring and managing the toxicity of taking drugs, observing and recording HIV infection Early symptoms, etc.

Chapter IV Registration and Reporting

Article 15 Medical and health institutions shall register the occupational exposure to HIV. The contents of the registration shall include: the time, place and process of occupational exposure to HIV; the method of exposure; the specific location of the exposure and the extent of the damage; the type and content of the source of exposure. The status of HIV; treatment methods and treatment process, whether to implement preventive medication, the first time of medication, toxic and side effects of drugs and compliance with medication; regular testing and follow-up.

Article 16 Medical and health institutions shall summarize the occupational HIV exposures in their units every six months and report them to the provincial CDC on a level-by-level basis. The provincial CDCs shall then report to the CDC.

Chapter V Supplementary Provisions

Article 17 The medical and health institutions referred to in these Guiding Principles refer to the institutions that have obtained the Medical Institution Practice Permits, disease prevention and control institutions, and blood collection and supply institutions in accordance with the Regulations for the Administration of Medical Institutions.

Public security, judicial and other relevant departments can refer to this guideline in the treatment of HIV occupational exposure.

Article 18 The body fluids referred to in this Guiding Principle include amniotic fluid, pericardial fluid, pleural fluid, abdominal fluid, cerebrospinal fluid, synovial fluid, vaginal secretions and other human substances.

Article 19 These guiding principles will be implemented as of June 1, 2004.