Tuberculosis in health workers as an occupational disease
Tuberculosis in health workers as an occupational disease
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DOI：
10.1080/23323256.2018.1539624
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发表时间：
2018-01-01
影响因子：
0.6
通讯作者：
Yassi, Annalee
中科院分区：
文献类型：
--
作者：
Ehrlich, Rodney;van de Water, Nick;Yassi, Annalee
在南非，在有传染性结核病患者的环境中，卫生工作者的结核病在法律上被认为是一种职业病。这篇评论借鉴了作者以前的工作和卫生工作者的声音，考虑这种法律的地位对卫生工作者的经验和保护他们免受职业性结核病的影响。尽管有赔偿和预防立法以及许多关于保护做法的准则，但职业性结核病的统计数字仍然不足，控制措施的执行也不够。重要的背景原因是公共部门设施的预算、人员配置和管理限制，以及国家提供有效执法和赔偿服务的能力有限。这些因素影响了卫生工作者的反应，例如缺乏对自己作为工作者的权利的认识;如果确诊，担心保密，不愿透露自己的病情，以及有被系统和同事抛弃的感觉。显然需要动员卫生工作者更多地参与结核病控制工作。然而，还需要动员卫生工作者了解他们作为工作者的权利和责任，尽管在提供保健方面有许多负担，职业压力迫使他们接受风险，并在诊断后要求实际和心理社会支持。
Tuberculosis in health workers is legally accepted as an occupational disease in South Africa in settings where there are infectious tuberculosis patients. This commentary draws on the authors' previous work and the voices of health workers to consider the implications of this legal status for the experience of health workers and their protection from occupational tuberculosis. Despite compensation and prevention legislation and numerous guidelines on protective practices, occupational tuberculosis is undercounted and the implementation of control measures inadequate. Important contextual causes are budgetary, staffing and managerial constraints in public sector facilities, and the limited ability of the state to deliver effective enforcement and compensation services. These factors shape the responses of health workers, such as lack of awareness of their rights as workers; and if diagnosed, fear for confidentiality, reluctance to disclose their illness and a sense of abandonment by the system and colleagues. Mobilisation of health workers for greater involvement in tuberculosis control practices is clearly needed. However, also needed is mobilisation of health workers to understand their rights and responsibilities as workers, despite the many burdens on health care delivery and vocational pressures to accept risk, and to demand both practical and psychosocial support if diagnosed.