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Occupational exposure intensity trends in health care workers: Joinpoint Regression identifies COVID-19 associated
Peiyun Zhou1, Bingyan Zhang1, Zongke Long1
1School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Background:
Health care workers (HCWs) globally face substantial risks from occupational blood and body fluids (BBFs) exposure, with disparities heightened by the COVID-19 pandemic. China's health care system, characterized by low workforce density and chronic HCW fatigue (53.9%-82%), presents a critical context for analyzing exposure dynamics. Existing studies lack longitudinal data across pandemic phases and stratified analyses by years of service (YoS).
Methods:
This longitudinal study (2017-2024) analyzed 860 occupational BBFs exposures from a Chinese tertiary hospital. Trends were assessed via Joinpoint Regression, while risk factors for recurrent exposures were identified through logistic regression.
Results:
A 2021 inflection point (95% CI: 2019-2022) marked a shift from prepandemic exposure intensity growth (Annual Percent Change = 6.76, P < .05) to post-2021 decline (Annual Percent Change = -15.55, P < .05). Junior HCWs accounted for 71.9% of exposures. Doctors and mid-career HCWs were significantly associated with recurrent exposures. Needlestick injuries are the most common type of exposure, accounting for 72.1% of all incidents.
Conclusions:
Systemic vulnerabilities in understaffed health care systems amplify exposure risks, particularly among early-career HCWs. Although pandemic-induced safety measures may have temporarily reduced exposures, workforce shortages and role-specific hazards require tenure-stratified interventions.
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