急診部護理人員罹患結核病之危險性

A Study of the Risk of Tuberculosis in Nurses Working at the Emergency Department of a Medical Center

楊大羽(Dar-Yu Yang) ； 周碧瑟(Pesus Ghou) ； 洪東榮(Dong-Zong Hung) ； 張文道(Wen-Dau Chang) ； 胡為雄(Wei-Hsiung Hu) ； 王玉潯(Yuh-Shyun Wang)

《中華民國急診醫學會醫誌》 4卷2期 (2002/06) Pp. 71-81

摘要

目的：獲得急診基層護理人員肺結核病盛行率與發生率，以釐清其罹患肺結核病的危險性。
方法：採橫斷式研究設計(cross sectional study)，從員工體檢資料、病歷紀錄與自填之結構式問卷，得知護理人員之結核病危險因子暴露情況，並輔以電話或面談訪問當事人加以再確認。
結果：急診部比非急診部基層護理人員有較高之活動性肺結核盛行率，以多變項對數回歸分析法顯示「曾暴露於急診室之工作環境」罹患「胸部Ｘ光可偵測到之肺結核」的勝算比為2.59(P=0.037，95%CI=[1.06,6.34])。結論：急診部基層護理人員有較高罹患肺結核之危險性。

關鍵字

結核病 ； 急診護理人員 ； 高危險群

並列摘要

Background and objective: Workers in an Emergency Department (ED) are reputed to have a higher risk of becoming infected with tuberculosis (TB). This study was carried out to obtain epidemiological data on TB among nurses of TCVGH. This was then used to develop strategies to prevent TB infection in this group and allow an estimation of the relative risk of TB infection among nurses working in an ED versus nurses working in other environments at TCVGH.
Subject and Methods: The study design was a cross sectional study. Their chest x ray (CXR) reports and TB status in 1998 were collected from their routine physical checkups and chart records. The exposure of the nurses to risk factors for TB infection were collected by a structured questionnaire. This asked for the basic data, whether they had cared for TB patients while working at other hospitals and their smoking habits.
Results: Compared with non-ED nurses, ED nurses had a higher prevalence of active pulmonary TB, a higher prevalence of CXR detectable pulmonary TB. By multiple logistic regression analysis, the odds ratio of CXR detectable pulmonary TB for nurses with versus nurses without working exposure to ED was 2.59 (p=0.037, 95% Cl= [1.06, 6.34] ).
Conclusion: (1) In TCVGH, compared with non-ED nurses, ED nurses had a higher risk of pulmonary TB. (2) It is clear that it is necessary that continual monitoring of this high-risk professional group for pulmonary TB be carried out.

並列關鍵字

tuberculosis ； epidemiology ； prevention and control