Occupational exposure intensity trends in Healthcare Workers: Joinpoint Regression identifies COVID-19 associated inflection point (2017-2024).

Abstract

Background: Healthcare workers (HCWs) globally face substantial risks from occupational blood and body fluids (BBFs) exposure, with developing countries bearing disproportionate burdens. The COVID-19 pandemic exacerbated these risks due to PPE shortages and increased clinical demands. China's healthcare 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. Data included exposure timing, job roles, service duration (stratified as junior: <5 YoS, mid-career: 5-10 YoS, senior: >10 YoS), and post-exposure management. 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 pre-pandemic exposure intensity growth (APC= 6.76, P < 0.05) to post-2021 decline (APC= -15.55, P < 0.05). junior HCWs accounted for 71.9% of exposures. Doctors and mid-career HCWs were significantly associated with recurrent exposures. Needle stick injuries are the most common type of exposure, accounting for 72.1% of all incidents.

Conclusions: Systemic vulnerabilities in understaffed healthcare 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.