• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.127-133
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• 2016

Tuberculosis (TB) is one of the most important occupational risks for healthcare workers (HCWs) in South Korea. Many policies regarding the control and prevention of TB in healthcare settings recommend that HCWs are tested for latent tuberculosis infection (LTBI) in addition to active TB. Moreover, the Korean Tuberculosis Prevention Act also recommends that HCWs receive regular testing for LTBI. However, there are no specific or detailed guidelines for dealing with LTBI in HCWs. Herein, we discuss the diagnosis and treatment of LTBI in HCWs and focus particularly on the baseline screening of hired HCWs, routine follow-up, and contact investigation.

• Safety and Health at Work
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• 제11권2호
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• pp.125-126
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• 2020

• Journal of Korean Biological Nursing Science
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• 제11권2호
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• pp.120-127
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• 2009

Purpose: The study aimed at monitoring the immune status of health care workers (HCWs) of a tertiary hospital after accidental exposure to Hepatitis B virus (HBV). Methods: Between January 2004 and December 2006, 353 cases of exposure to Hepatitis B virus were reported. The HBV-exposed HCWs were required to undergo follow-up serum tests to analyze their immune status one year after the exposure. The obtained data were then analyzed to determine the incidence of exposure and of sero-conversion. Results: In this hospital, an average of 9.8 cases of Hepatitis B exposure among HCWs was reported in a month. Follow-up tests conducted after exposure revealed that 90.4% of the HBV-exposed HCWs were positive for Hepatitis B antibody and 66.9% of the HBV-exposed HCWs were reported to have antibody levels exceeding 10 mIU/mL. Results of serum tests for the HBV antigen conducted one year after exposure were negative for all the exposed HCWs. Conclusion: Among the 79.6% of the HCWs who underwent serum tests one year after exposure the HBV sero-conversion rate was 0.0%. However, a further investigation in the form of long-term and multi-center studies is required to confirm this result. Furthermore, an active system should be established to ensure that all exposed HCWs undergo follow-up serum tests.

• Pediatric Infection and Vaccine
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• 제26권3호
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• pp.170-178
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• 2019

목적: 인플루엔자 예방접종은 인플루엔자 감염을 예방하고 병원 내 전파를 차단할 수 있는 가장 효과적인 방법이다. 본 연구자들은 국내 병원내 직원들의 인플루엔자 예방 접종률의 현황 및 접종률과 연관된 인자들을 살펴보고자 하였다. 방법: 2017-2018 인플루엔자 시즌 전, 경기도 고양시 내 3개 종합 병원의 인플루엔자 예방접종 캠페인 대상인 병원 직원들이 연구에 포함되었다. 연구대상자의 인구학적인 특성 및 직업적 특성을 후향적으로 수집하였다. 결과: 총 7,180명의 병원내 직원 중 6,994명(97%)이 연구에 포함되었으며 전체 예방 접종률은 85%였다. 의료직종 중에서는 간호직군이 92%로 가장 높았고, 의료기술직군(88%), 의사직군(84%), 비의료직군(79%) 순이었다(P<0.001). 비의료직군에서의 접종률은 환자와의 접촉 정도에 비해 서로 상이하였으며, 환자와 접촉이 빈번한 비의료직군의 접종률은 90%로 덜 빈번한 비의료직군의 73%보다 유의하게 높았다(P<0.001). 결론: 2017-2018 인플루엔자 시즌 병원내 직원의 예방접종률은 85%이었다. 이는 기존의 병원내 직원 대상으로 자발적인 예방접종을 진행하는 여러 국가들의 보고들과 비교했을 때 높은 편에 속한다. 병원내 직원의 특성에 따라 예방 접종률은 서로 상이하며, 병원내 직원의 예방접종률을 보다 높이기 위해서는 이러한 요인들을 포함한 다각적인 접근을 고려해야 한다.

• Journal of Preventive Medicine and Public Health
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• 제53권4호
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• pp.236-244
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• 2020

Objectives: Although the World Health Organization (WHO) initiative "My 5 Moments for Hand Hygiene" has been lauded as effective in preventing hospital-associated infections, little is known about healthcare workers (HCWs)' hand hygiene behavior. In this study, we sought to assess knowledge and attitudes towards the concepts in this initiative, as well as associated factors, among Vietnamese HCWs at a general hospital. Methods: A structured questionnaire was administered to HCWs at a central Vietnamese general hospital in 2015. Multiple logistic regression analysis was used to identify factors associated with HCWs' knowledge and attitudes towards hand hygiene. Results: Of 120 respondents, 65.8% and 67.5% demonstrated appropriate knowledge and a positive attitude, respectively, regarding all 5 hand hygiene moments. Logistic regression indicated better knowledge of hand hygiene in workers who were over 30 years old, who were direct HCWs (rather than managers), who had frequent access to clinical information, and who received their clinical information from training. Those who worked in infectious and tropical disease wards, who had frequent access to clinical information, and who received information from training were more likely to have a positive attitude towards hand hygiene than their counterparts. Conclusions: Although many Vietnamese HCWs displayed moderate knowledge and positive attitudes towards the WHO hand hygiene guidelines, a key gap remained. Regular education and training programs are needed to increase knowledge and to improve attitudes and practices towards hand hygiene. Furthermore, a combination of multimodal strategies and locally-adapted interventions is needed for sustainable hand hygiene adherence.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제26권3호
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• pp.17-26
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• 2020

Purpose: This paper presents research evidence that the environmental design of the doffing area in a biocontainment unit (BCU) can have a measurable impact on increasing the safety of frontline healthcare workers (HCW) during doffing of high-level personal protective equipment (PPE), and proposes optimized biocontainment unit design. Methods: From 2016 to 2019, The SimTigrate Design Lab conducted 3 consecutive studies, focusing on ways in which the built environment may support or hinder safe doffing. In the first study, to identify the risky behaviors, we observed 56 simulation exercises with HCWs in 4 BCUs and 1 high-fidelity BCU mockup. In the second study, we tested the effectiveness of a redesigned doffing area on improving the HCWs performance and used simulation, observation, and rapid prototyping in 1 high-fidelity mockup of a doffing area. In a follow-up study, we used simulation and co-design with HCWs to optimize the design of a safer doffing area in a full-size pediatric BCU mock-up. Results: We identified 11 specific risky behaviors potentially leading to occupational injury, or contamination of the PPE, or of the environment. We developed design strategies to create a space for safer doffing. In the second study, in a redesigned doffing area, the overall performance of HCW improved, and we observed a significant decrease in the number of risky behaviors; some risky behaviors were eliminated. There was a significant decrease in physical and cognitive load for the HCWs. Finally, we propose an optimized layout of a BCU for a safer process of PPE doffing. Implications: The proposed BCU design supports better staff communication, efficiency, and automates safer behaviors. Our findings can be used to develop design guidelines for spaces where patients with other highly infectious diseases are treated when the safety of the patient-facing HCWs is of critical importance.

• Journal of Korean Medical Science
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• 제33권50호
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• pp.321.1-321.7
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• 2018

Background: Pertussis is highly contagious respiratory disease. Healthcare workers (HCWs) can be an important mediator of the disease. A seroprevalence of pertussis was investigated in HCWs to determine the immune status against pertussis and to detect the unidentified pertussis. Methods: This study was conducted for HCWs at a hospital located in Korea in 2011. After obtaining written informed consent for HCWs voluntarily participating in the study, 10 mL of blood was collected from each subject. Demographic and medical data were collected using questionnaire. Data on the underlying disease and vaccination history were reviewed again through medical records. The presence of anti-pertussis toxin (anti-PT) immunoglobulin G (IgG), and immunoglobulin A (IgA) was detected by quantitative analysis using a commercially available ELISA kit (EUROIMMUN, $L{\ddot{u}}beck$, Germany). Results: A total of 412 HCW participated in the study. Among them, 14 were excluded due to the inadequate sample amount or medical history not secured. Of the 398 HCWs analyzed, 16.6% (66/398) were men and the mean age was $33.82{\pm}9.10years$ (range, 21-67). The mean anti-PT IgG titer was $8.32{\pm}20.40IU/mL$ (range, 0.4-287.5 IU/mL). The overall seroprevalence (rate of anti-PT IgG antibody [Ab] titer > 5 IU/mL) was 33.7%. Three (0.8%) HCWs had the Ab level > 100 IU/mL indicated acute infection. There was no statistically significant difference in the seroprevalence and mean titer of anti-PT IgG Ab according to age group, type of occupation, patient-facing position, or working in the pediatric department. Conclusion: The seroprevalence of pertussis of the HCWs of a university hospital in Korea was low, and there were some unrecognized acute infections. Therefore, booster immunization of pertussis to HCWs should be actively considered.

• Tuberculosis and Respiratory Diseases
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• 제81권4호
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• pp.274-280
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• 2018

Background: The risk of tuberculosis (TB) infection among health care workers (HCWs) is higher than as noted among workers in the general population. The prevalence and risk factors of TB infection among HCWs were assessed in a tertiary hospital in South Korea, resulting in a conclusion of an intermediate TB burden within the country. Methods: This cross-sectional study enrolled HCWs who underwent a QuantiFERON-TB Gold In-Tube (QFT-GIT) test to detect the presence of a latent TB infection (LTBI), in patients admitted to a tertiary hospital in South Korea in 2017. The departments of the hospital were divided into TB-related and TB-unrelated departments, which were based on the risk of exposure to TB patients. In this sense, the risk factors for LTBI, including current working in the TB-related departments, were analyzed. Results: In this case, a total of 499 HCWs (54 doctors, 365 nurses and 80 paramedical personnel) were enrolled in this study. The median age of the subjects was 31 years (range, 20-67 years), 428 (85.8%) were female, and 208 (41.7%) were working in the TB-related departments. The prevalence of LTBI was 15.8% based on the QFT-GIT. Additionally, the prevalence of experience of exposure to pre-treatment TB patents was higher among HCWs working in the TB-related departments, than among HCWs working in the TB-unrelated departments (78.8% vs. 61.9%, p<0.001). However, there was no significant difference in the prevalence of LTBI between the two groups (17.3% vs. 14.8%, p=0.458). On a review of the multivariate analysis, only the factor of age was independently associated with an increased risk of LTBI (p=0.006). Conclusion: Broadly speaking, the factor of age was associated with an increased risk of LTBI among the HCWs in South Korea. However, those workers current working in the TB-related departments was not associated with an increased risk of LTBI.

• Safety and Health at Work
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• 제6권1호
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• pp.35-38
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• 2015

Background: Organizational changes that involve healthcare hospital departments and care services of health districts, and ongoing technological innovations and developments in society increasingly expose healthcare workers (HCWs) to work-related stress (WRS). Minimizing occupational exposure to stress requires effective risk stress assessment and management programs. Methods: The authors conducted an integrated analysis of stress sentinel indicators, an integrated analysis of objective stress factors of occupational context and content areas, and an integrated analysis between nurses and physicians of hospital departments and care services of health districts in accordance with a multidimensional validated tool developed in Italy by the National Network for the Prevention of Work-Related Psychosocial Disorders. The purpose of this retrospective observational study was to detect and analyze in different work settings the level of WRS resulting from organizational changes implemented by hospital healthcare departments and care services of health districts in a sample of their employees. Results: The findings of the study showed that hospital HCWs seemed to incur a medium level risk of WRS that was principally the result of work context factors. The implementation of improvement interventions focused on team development, safety training programs, and adopting an ethics code for HCWs, and it effectively and significantly reduced the level of WRS risk in the workplace. Conclusion: In this study HCW resulted to be exposed to occupational stress factors susceptible to reduction. Stress management programs aimed to improve work context factors associated with occupational stress are required to minimize the impact of WRS on workers.

• 한국산업보건학회지
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• 제30권4호
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• pp.353-363
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• 2020

Objectives: Occupational diseases that occur due to or aggravated by work have commonly been recognized in the manufacturing industry, but there are now more incidences happening in the service industry due to changes in the industrial structure. Health workers are exposed to direct factors and various other causes of occupational disease at work, such as physical, chemical, biological, and psyco-social factors. This study aims to identify work-related diseases affecting health workers that are recognized as occupational diseases. Methods: The research is based on the data of workers whose diseases were accepted as work-related by the Industrial Accidents Compensation Insurance, and filed by the Korean Occupational Safety and Health Agency. Amongst the approved claims during 2011 to 2015, we focused on healthcare workers and health-related workers of the Korean Standard Classification of Occupations. Descriptive statistics were performed. Results: The number of health workers(HWs) with approved work-related disease was 1,707 over 5 years. The number of healthcare workers(HCWs) excluding caregivers was 370 (21.7%) and of health-related workers (HRWs) it was 736 (43.1%). Out of HWs who were approved for their illnesses, females were 80% of HCWs and 88% of HRWs. The most common occupational disease in HWs was musculoskeletal diseases, while that of nurses was infectious disease. Conclusions: HWs are exposed to various risks from their profession and are affected by occupational diseases. It is necessary to focus on this issue and provide preventive measures.