針刺しによる医療従事者の ... - jrgoicp.umin.ac.jp

1 By Japan-EPINet Survey Working Group (JESWG) Of Research Group of Occupational Infection Control Prevention in Japan (JRGOICP) 1 Challenges by needle stick and sharps injury prevention for securing patient safety and eliminating occupational infectious diseases in healthcare settings 22390108 25293122 Janine Jagger - - 22 2 | 2013/7/18 | | 2 1. ( needle stick and sharps injury 2. 3. | 2013/7/18 | | 3 5 C B HIV 3 1 C 7 8 8 25 C 2 8 30 ( 2002 24 10 7 8 17 8 20))

2 AST 1,755U/l ALT 854U/l 8 21 20-30 8 25 C ( 16 4 12 1867 81 ) #news01 19 5 C / (1999 2009 ) IDWR 2011 21 | 2013/7/18 | | 7 3954 1999 3 1994 4 18 21 HCV 2 742 1614 2046 8461 1000 3046 8461 10 C | 2013/7/18 | | 8 etc | 9 (Injury)

3 B 1981 C 1990 HIV ( ) | | 25 1984 1980 HIV | 2013/7/18 | | 11 HBV HBV 0501001502002503003501985198719891990199 119931995199619971999 10 CDC HBV 83 10 386 95 B 1991 OSHA (Data source: Center for Disease Control and Prevention) | 326 % /10 /10 (University of Virginia Hospitals Jan-Oct 1986 n=326injuries) * N Engl J Med.

4 1988; 319(5): 284-288 10 | Jagger J et al: Rates of needlestick injury caused by various devices in a university hospital. N England J. Med. 319(5) 284-288 1988 | 14 Source: International Healthcare Worker Safety Center University of Virginia | 10 1986 ConventionalCatheterConventional CatheterSafety catheter10 1 hospital 3 hospitals **Jagger J. Bentley M. J Intraven Nurs 1997;20(6):S33-S39 *Jagger J, Hunt EH, Brand-Elnaggar J, Pearson NEJM 1988; 319(5):284-288. state legislatures 1998 national law 2000 2000 11 6 guidelines regulations legislation FDA 1992 1999 OSHA 1991 CDC 1987 | 2013/7/18 | | 17 2001 2000 10 2000 11 2001 4 100 100 (Figure 1: Annual Rates of Percutaneous Injuries per 100 Full-Time Equivalent (FTE)) ( )Phillips EK, Conaway MR, Jagger JC.

5 Percutaneous injuries before and after the Needlestick Safety and Prevention Act. N Engl J Med. 2012;366(7):670-1. 2010 3 ( ) EPSU 2010 3 9 2010 1-3 4-6 WHO Susan Wilburn, WHO | 2013/7/18 | | 20 8 30

6 2012 2000 500 22 1996 JES 23 1996, 2000, 2002 | 24 0201004 17 2 1 6 02040 %96-9900-0304-0809-1096-99 n=14,62900-03 n=13,18904-08 n=13,91809-10 n= 5.

7 38925 4 27 1) - - 2) - (SESIPS) 3) ( ) - 4) (10 ) 2001 4 OSHA (1991) OSHA ICT.

8 2007:2(3):314-318. ( ) Needlestick accident Needlestick injury ( Safety site: Injury Prevention Policy 8 30 31 8 3 0 8 30 - - 8 30 201?)

9 201? HBV/HCV HIV guidelines regulations legislation 2013 8 30 2005 2004 | 2013/7/18 | | 33 B (Injury) 8 30 | 2013/7/18 | | 34 ACC: AIDS Clinical Center ACC.