[近年来日本女护士和男医生的结核病感染和患病风险]。

Kekkaku : [Tuberculosis] Pub Date : 2017-01-01
Yuko Yamauchi, Yoko Nagata, Noriko Kobayashi, Toru Mori
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引用次数: 0

摘要

【目的与材料】基于2010年结核病监测数据库,观察女护士和男医生与普通人群的结核病感染和活动性疾病发病率。[结果]2010年20 ~ 69岁女护士活动性结核病的相对危险度(RR)为4.86(95%可信区间4.31 ~ 5.45),较1987 ~ 1997年的2.30有所上升。20 ~ 29岁护士RR最高,为8.84;50 ~ 59岁护士RR随年龄增长而下降,为3.60,但RR仍显著高于1。男性医生的RR仅在39岁及以下的人群中显著高于1。在卫生保健工作者中,需要治疗潜伏性结核感染(LTBI)的比率明显较高;女护士的RR为32.7 (95% CI: 30.5-35.0),从20-29岁的最高水平62.8到60-69岁的11.6。对于男性医生来说,20-69岁的RR也很高,为9.7(7.9- 11.7),从20- 29岁的14.5到60-69岁的5.3。[讨论]与普通人群相比,护士和医生的结核病病例更有可能通过定期筛查和接触者调查等主动病例发现措施被发现,这表明目前在解决卫生保健机构的职业暴露方面所做的努力。卫生保健专业人员结核病和LTBI的高危险性及其可能的上升趋势。在女护士中看到的情况值得进一步加强对问题的监测,并在其工作场所采取全面对策。
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[RISK OF TUBERCULOSIS INFECTION AND DISEASE AMONG JAPANESE FEMALE NURSES AND MALE DOCTORS IN RECENT YEARS].

[Objectives and Materials] Based on the tuber- culosis (TB) surveillance database, the incidence rates of TB infection and active disease among healthcare workers were observed for female nurses and male doctors in 2010 in comparison with those of the general population. [Results] The relative risk (RR) of active TB among female nurses aged 20-69 years was 4.86 (95% confidence interval: 4.31-5.45) for 2010, which has increased from 2.30 observed in 1987-1997. The RR was highest for nurses aged 20-29 years at 8.84 and declined with age until 3.60 for those aged 50-59 years that was still significantly higher than 1. For male doctors the RR was significantly higher than 1 only for those aged 39 years or younger. The rates of those who were -indicated for treatment of latent TB infection (LTBI) were clearly higher among healthcare workers; for female nurses the RR was 32.7 (95% CI: 30.5-35.0), ranging from the highest level of 62.8 among those aged 20-29 years down to 11.6 for those aged 60-69 years. For male doctors also, the RR was high at 9.7 (7.9- 11.7) for 20-69 years, ranging from 14.5 for those aged 20- 29 years down to 5.3 for those aged 60-69 years. [Discussion] TB cases of nurses and doctors were more likely to be detected by the active case finding measures such as periodic screening and contact investigations than cases in the general population, which indicates the current effort of addressing the occupational exposure in the healthcare set- tings. The high level of risk of TB disease as Iwell as LTBI among healthcare professions and its possibly increasing trend as. seen in female nurses warrants further strengthening of monitoring of the problem and overall countermeasures in their workplaces.

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