44卷6期

• Link 政策論壇 Policy Forum
• 台灣青少年電子煙防制應關注同儕網絡與資訊傳播環境Peer networks and information environments as key factors in adolescent e-cigarette prevention in Taiwan
• 何坤霖、官晨怡
  Kun-Lin Ho, Chen-I Kuan
• 無none
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• 531-533
• 10.6288/TJPH.202512_44(6).PF06

• Link 公衛論壇 Public Health Forum
• 職業傷病的通報與監測：丹麥經驗對我國制度改革的啟發Reporting and surveillance of occupational injuries and diseases: insights from the Danish experience for Taiwan's system reform
• 陳宗延、林明瑋、鄭雅文
  Chung-Yen Chen, Ming-Wei Lin, Yawen Cheng
• 無none
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• 無none
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• 534-542
• 10.6288/TJPH.202512_44(6).114082

• Link 公衛論壇 Public Health Forum
• 如果戰爭即將爆發：民用醫院應對戰爭相關複雜人道災難的韌性準備和對策If war will be started: resilience preparedness and countermeasures in war-related complex humanitarian disasters by civilian hospitals
• 吳晉嘉、官哲羽、邱世卿、范文林、林庭光、吳宗憲、陳金城、王健興
  Chin-Chia Wu, Che-Yu Guan, Shih-Ching Chiu, Wen-Lin Fan, Tin-Kwang Lin, Tsung-Hsien Wu, Jin-Cherng Chen, Chien-Hsing Wang
• 無none
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• 543-557
• 10.6288/TJPH.202512_44(6).114017

• Link 綜論 Review Article
• 孕期巨細胞病毒感染與台灣產檢政策建議Cytomegalovirus infection during pregnancy and recommendations for prenatal screening policy in Taiwan
• 周昱青、何建志
  Yu-Ching Chou, Jen-Ji Ho
• 先天性巨細胞病毒感染、巨細胞病毒抗體篩檢、產前檢查、IgG親和力、優生保健法
  congenital cytomegalovirus infection (cCMV), cytomegalovirus antibody screening, prenatal examination, IgG avidity, Reproductive Health Act
• 新生兒先天性CMV感染(cCMV)來自母體孕期，發生率約1/100，其中1/5有神經發展或聽損後遺症，此發生率高於台灣多數公費與自費產檢項目所預防疾病。新近研究證實：對「第一孕期、初次感染」孕婦，抗病毒藥物valacyclovir能減少70%垂直感染；羊水CMV PCR可診斷胎兒感染，valacyclovir能預防、治療胎兒感染。雖然cCMV發生率高、危害大、可檢出、可預防，在台灣卻非公費產檢項目，也缺乏篩檢共識與照護準則。此外在臨床實務上，胎兒感染cCMV常衍生晚期終止妊娠倫理難題，本文就此釐清現行優生保健法施行細則的文字疑慮，並提出建議修改方案。為增進母胎健康，本文參考國際近年相關研究，建議在台灣執行母血CMV抗體篩檢。初步試算可用199.6萬元減少一個胎兒感染，具有相對公共衛生效益。普遍篩檢也可及早用藥預防胎兒感染，減少晚期終止妊娠倫理困境。最後，本文草擬防治cCMV三級防護架構，並提出衛教資料範本：一、全面衛教；二、對第一孕期孕婦全面公費篩檢CMV抗體；三、治療胎兒感染。
  Congenital cytomegalovirus (cCMV) infection in newborns, which is contracted via transmission from the mother during pregnancy, affects approximately 1 in 100 births. Approximately one-fifth of these cases lead to neurological impairment or hearing loss— sequelae more common than those prevented by most publicly or privately funded prenatal screening programs in Taiwan. Recent studies have demonstrated that valacyclovir can reduce vertical transmission by 70% in women with primary infection during the first trimester. CMV PCR testing of amniotic fluid can be used to diagnose fetal infection, and valacyclovir can prevent and treat fetal infections. Despite its high incidence, substantial risks, detectability, and preventability, cCMV screening is not included in Taiwan’s publicly funded prenatal programs, and a consensus on screening or care guidelines has not been established. In practice, diagnosed fetal cCMV often raises ethical dilemmas regarding late-term pregnancy termination. This article clarifies the wording of the Reproductive Health Act and proposes amendments. To improve maternal and fetal health in Taiwan, this article—drawing on recent international research—recommends universal serological screening for CMV antibody in pregnant women. Preliminary calculations suggest that this could reduce the burden of one fetal infection by NT$1.996 million, representing a relative public health benefit. Universal screening can also enable early antiviral intervention for preventing fetal infection, minimizing ethical dilemmas over late-term pregnancy termination. Finally, this paper drafts a three-tiered framework for cCMV prevention and proposes a template for health education materials: 1. comprehensive health education; 2. publicly funded CMV antibody screening for all pregnant women in the first trimester; and 3. treatment of fetal infections.
• 558-573
• 10.6288/TJPH.202512_44(6).113106

• Link 評論 Commentary
• 評論：孕期巨細胞病毒感染與台灣產檢政策建議 Commentary: cytomegalovirus infection in pregnancy and recommendations for prenatal screening policy in Taiwan
• 陳涵英、林芯伃
  Han-Ying Chen, Shin-Yu Lin
• 無none
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• 無none
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• 574-575
• 10.6288/TJPH.202512_44(6).11310601

• Link 原著 Original Article
• 台灣國小學童高脂、高糖、高鹽食品網紅行銷媒體素養教育介入之成效研究 Effectiveness of a media literacy intervention targeting influencer marketing of HFSS foods among Taiwanese elementary school children
• 陳沛瑜、張晏蓉、張鳳琴
  Pei-Yu Chen, Yen-Jung Chang, Fong-Ching Chang
• 網紅行銷、HFSS食品、媒體素養、教育介入
  influencer marketing, HFSS foods, media literacy, educational intervention
• 目標：本研究旨在探討透過網紅行銷HFSS(High in Fat, Sugar, and Salt)食品的媒體素養教育介入課程，對國小高年級學童網紅行銷HFSS食品的認知素養、態度素養與因應效能的影響，並評估其減少HFSS食品攝取行為意圖的成效。方法：本研究採用群集隨機化設計，並以班級為單位進行分派。於2025年招募新北市某國小六年級學生為研究對象，實驗組接受4次網紅行銷HFSS食品媒體素養教育介入課程；對照組僅實施前後測問卷測量。四個網紅行銷HFSS食品媒體素養教育課程單元包括：「網紅行銷大解密」、「網紅行銷亮紅燈：HFSS食品危機」、「行銷誘惑我可擋」、「網紅行銷停看聽：拒絕HFSS食品大挑戰」。實驗組與對照組各75人，透過前後測問卷並利用廣義估計方程式(Generalized Estimating Equations)進行分析評價介入之成效。結果：網紅行銷HFSS食品媒體素養教育能顯著提升學生網紅行銷HFSS食品的認知素養、態度素養及抵抗行銷的因應效能，且在HFSS食品攝取行為意圖上顯著下降。結論：將網紅行銷HFSS食品議題納入國小階段之媒體素養教育，有助於提升兒童的批判性思考與抵抗HFSS食品行銷的能力。
  Objectives: The effects of an educational media literacy intervention targeting influencer marketing of foods high in fat, sugar, and salt (HFSS) on conceptual and attitudinal advertising literacy, resistance efficacy, and behavioral intention to consume HFSS foods were investigated among elementary school children. Methods: A cluster-randomized design was employed, with intact classes of sixth-grade students at an elementary school in New Taipei City, Taiwan, allocated to groups at the class level. The intervention group completed a series of four weekly modules focused on influencer marketing of HFSS foods, whereas the comparison group completed only the baseline and follow-up surveys. The intervention curriculum comprised four modules: (1) “Influencer Marketing Uncovered,” (2) “Recognizing the Health Risks of HFSS Foods,” (3) “Resisting the Lure of Persuasion,” and (4) “The HFSS Food Refusal Contest.” The intervention and comparison groups included 75 students each. Generalized estimating equations were used to evaluate intervention effectiveness. Results: The media literacy intervention significantly increased children’s conceptual and attitudinal advertising literacy and resistance efficacy in response to influencer marketing of HFSS foods and reduced their behavioral intention to consume HFSS foods. Conclusions: The integration of content on influencer marketing of HFSS foods into media literacy education at the elementary school level can foster critical thinking in children and empower them to recognize and resist persuasive HFSS food marketing.
• 576-592
• 10.6288/TJPH.202512_44(6).114069

• Link 原著 Original Article
• 母親原生國籍與青少年健康之相關：家庭社會排斥經歷的中介效果 Maternal nationality and adolescent health: the mediating effect of families’ social exclusion experiences
• 林怡伶、江宛霖
  Yi-Ling Lin, Wan-Lin Chiang
• 母親原生國籍、青少年健康、社會排斥、心理困擾、健康行為
  maternal nationality, adolescent health, social exclusion, psychological distress, health behavior
• 目標：本研究旨在探討母親原生國籍與青少年健康之關係，並分析家庭社會排斥經歷的中介效果。方法：採分層叢集抽樣法，針對台灣就讀大學一年級的18-19歲青少年進行線上匿名問卷調查，共回收313份有效問卷。依變項為青少年健康，包含自覺健康、心理困擾和健康行為。其中，心理困擾和健康行為分別採用簡式健康量表(Brief Symptom Rating Scale, BSRS-5)和健康促進生活型態中文簡式量表(Health-Promoting Lifestyle Profile-short-form, HPLP-S)測量。自變項為母親原生國籍，母親為中國/港澳或東南亞籍者定義為新住民子女。中介變項為家庭社會排斥經歷，由本研究自編「家庭社會排斥經歷量表」進行測量，涵蓋經濟、文化生活、社會和政治面向。首先以多元迴歸分析檢驗母親原生國籍、家庭社會排斥經歷與青少年健康之關係，接著以拔靴法檢視家庭社會排斥經歷的中介效果。結果：在313位樣本中，母親為外國籍者佔11.2%。迴歸分析顯示，母親為外國籍者比起母親為本國籍者，自覺健康較差(β=-0.081, p=0.151)、心理困擾程度較高(β=0.125，p=0.026)且健康行為較少(β=-0.134, p=0.018)。中介分析結果發現，家庭社會排斥經歷在母親原生國籍與青少年健康關係間具顯著完全中介效果。結論：新住民子女成長過程中經歷與感受較多的家庭社會排斥，進而提高其青少年時期的健康風險。政府應關注新住民家庭的困境，提供多面向的社會支持或補助以確保新住民子女的健康發展。
  Objectives: This study examined the relationship between maternal nationality and adolescent health and explored the mediating effects of families’ social exclusion experiences. Methods: A stratified cluster sampling approach was used to conduct an anonymous online survey on first-year university students aged 18 to 19 years enrolled in Taiwanese universities. A total of 313 valid responses were collected. The dependent variable was adolescent health, measured through self-rated health, psychological distress, and health behaviors. Psychological distress and health behaviors were measured using the Brief Symptom Rating Scale and the Chinese version of the Health Promoting Lifestyle Profile, Short Form, respectively. The independent variable was maternal nationality. Participants whose mothers were from China or Southeast Asia were categorized as the offspring of newcomer families. The mediator was families’ social exclusion experiences, measured using the proposed Family Social Exclusion Experiences Scale, which covers economic, cultural, social, and political dimensions. Multiple regression analysis was conducted to evaluate the associations between maternal nationality, social exclusion experiences, and adolescent health. A bootstrapping approach was used to test the mediating effects of social exclusion experiences. Results: Of the 313 adolescents surveyed, 11.2% had mothers who were foreign nationals. Compared with adolescents with Taiwanese mothers, those with foreign-born mothers reported poorer self-rated health (β= −0.081, p = .151), higher psychological distress (β = 0.125, p = .026), and fewer health-promoting behaviors (β= −0.134, p = .018). Mediation analysis revealed that families’ social exclusion experiences fully mediated the relationship between maternal nationality and adolescent health. Conclusions: Adolescents from newcomer families are likely to experience and perceive social exclusion, which increases their risk of adverse health outcomes. The Taiwanese government should recognize the challenges faced by these families and provide multidimensional social support and subsidies to promote the healthy development of their children.
• 593-608
• 10.6288/TJPH.202512_44(6).114066

• Link 原著 Original Article
• 知識、態度與社區意識對協助失智者意願之關係：以台北市為例 Relationships among dementia knowledge, attitudes, sense of community, and helping intentions: a case study of Taipei City
• 魏如儀、陳端容、林皓陽
  Ru-Yi Wei, Duan-Rung Chen, Hao-Yang Lin
• 失智症知識、失智症態度、社區意識、助人行為意圖、調節式中介模型
  dementia knowledge, dementia attitudes, sense of community, intention to help, moderated mediation model
• 目標：隨著全球高齡化加劇，失智症已成為重要的公共衛生議題。台灣邁向超高齡社會， 社區中失智症患者人數日增，社會對失智症的識能與態度對失智友善環境的建構至關重要。然而，相關研究仍有限。本研究調查台北市18歲以上居民的失智症知識、態度、社區意識與對失智症患者的助人意願的關係，並探討態度的中介作用角色與社區意識的調節效應。方法：研究採橫斷式設計，以網路問卷收集3,259份資料，涵蓋台北市12區。問卷內容包括：失智症知識量表(DKAS-s)、失智症態度量表(DAS-6)、社區意識量表(SCI-2)、對失智症患者的助人意願以及人口學資料等。結果：結果顯示，失智症知識、態度、社區意識與助人行為意圖彼此有正相關。態度在知識與助人行為意圖間具有完全中介作用；社區意識則一方面提升助人行為意圖，另一方面也小幅度減弱態度對助人行為意圖的影響。結論：提升民眾的失智症知識，以及與失智症者相處時的舒適感和正向認知，皆有助於促進助人意願，營造社區支持氛圍亦同樣關鍵。政策應強化教育與社區營造，推動失智友善社會的發展。
  Objectives: With the acceleration of global population aging, dementia has become a major public health concern. Taiwan is rapidly transitioning into a super-aged society, with a growing number of individuals with dementia living in community settings. The public’s dementia literacy and attitudes play a critical role in fostering dementia-friendly environments. However, relevant empirical studies remain limited. Accordingly, using a sample of Taipei residents aged 18 years or older, this study investigated the relationships among dementia knowledge, attitudes, sense of community, and intentions to engage in helping behaviors toward individuals with dementia. Furthermore, it examined the mediating role of attitudes and the moderating effect of community awareness. Methods: A cross-sectional study was conducted using an online survey, which yielded 3,259 valid responses from residents of 12 Taipei districts. The questionnaire comprised the Dementia Knowledge Assessment Scale–Simplified, the Dementia Attitudes Scale–6, the Sense of Community Index 2, measures of prosocial behavioral intentions toward individuals with dementia, and questions on demographic variables. Results: Dementia knowledge, attitudes, sense of community, and intentions to help were all positively correlated. Attitudes fully mediated the relationship between knowledge and behavioral intentions. A sense of community enhanced helping intentions and slightly weakened the effect of attitudes on behavioral intentions. Conclusions: Enhancing public knowledge of dementia and strengthening individuals’ comfort and capacity to adopt a positive attitude when interacting with people with dementia are both crucial for promoting dementia-friendly behaviors. Additionally, fostering a supportive community environment is crucial. To promote a more dementia-inclusive society, policymakers should prioritize public education and community engagement.
• 609-620
• 10.6288/TJPH.202512_44(6).114080

• Link 原著 Original Article
• 事故車輛與環境因素對台灣高齡機車騎士於事故後三十天內死亡影響之流行病學研究 Epidemiological study on the impact of vehicle-related and environmental factors on 30-day mortality after motor vehicle crashes among older motorcycle riders in Taiwan
• 許名鵑、張雅惠、李中一、許以霖
  Ming-Chuan Hsu, Ya-Hui Chang, Chung-Yi Li, I-Lin Hsu
• 交通事故、高齡機車騎士、死亡風險、階層分析
  motor vehicle crash, older rider, mortality risk, hierarchical analysis
• 目標：本研究旨在評估人口學、受傷嚴重度、共病、駕駛行為、環境、與車輛等因素對高齡機車騎士在事故後30天內死亡的獨立貢獻度，並探討環境與車輛因素是否對死亡風險具有額外的解釋力。方法：本研究從2019-2021年內政部警政署之交通事故資料中共擷取92,140名發生機車事故且有就醫的高齡機車騎士，其中1,274人於事故後30天內死亡。採階層式多元邏輯斯迴歸分析進行對數概似比檢定，評估各類風險因素對事故死亡風險的獨立貢獻和額外解釋力。結果：駕駛行為因素為死亡風險的最主要解釋因素。經控制其他因素後，可藉由非個體層面介入的車輛與道路環境因素仍具有顯著的額外貢獻，其中，事故發生於國道∕省道(aOR=1.39)、縣道∕鄉道(aOR=1.96)、一般鄉鎮市區地區(aOR=2.05)、高齡化市鎮(aOR=1.66)、農業市鎮(aOR=2.16)，以及撞擊部位於側面車身(aOR=1.52)等因素都與事故死亡風險有顯著正相關。結論：本研究發現，在考量其他已知影響車禍死亡因素後，事故發生時的環境與車輛因素仍與高齡機車騎士的死亡風險呈顯著相關。
  Objectives: This study examined the independent contributions of demographic characteristics, injury severity, comorbidities, and behavioral, environmental, and vehicle-related factors to 30-day mortality in older motorcycle riders involved in motor vehicle crashes. It also explored whether environmental and vehicle-related factors provide additional explanatory power for mortality risk. Methods: Data for the period between 2019 and 2021 were obtained from the Police-Reported Traffic Accident Registry. These data pertained to 92,140 older motorcycle riders who were involved in motor vehicle crashes and received medical care. Among these riders, 1,274 died within 30 days of the crash. Hierarchical multiple logistic regression analyses with likelihood ratio tests were used to assess the independent contribution of each risk factor and evaluate the additional explanatory power of each risk factor group for crash mortality. Results: Behavior was identified as the strongest predictor of 30-day mortality. After other covariates were adjusted for, vehicle- and road-environment-related factors amenable to non-individual-level interventions remained significantly associated with the risk of mortality. Crashes occurring on national or provincial roads (adjusted odds ratio [aOR] = 1.39), country or rural roads (aOR = 1.96), general townships (aOR = 2.05), areas with aging populations (aOR = 1.66), agricultural areas (aOR = 2.16), and areas involving side-impact collisions with other vehicles (aOR = 1.52) were all significantly associated with an increased risk of mortality. Conclusions: At the time of a motor vehicle crash, environmental and vehicle-related factors remain significantly associated with the risk of mortality among older riders.
• 621-634
• 10.6288/TJPH.202512_44(6).114071

• Link 原著 Original Article
• 單一地區醫院病房終期環境消毒落實度-以ATP檢測探討清潔時間與人力模式之影響 Assessment of terminal room disinfection in a regional hospital: adenosine triphosphate (ATP)-based bioluminescence evaluation of cleaning time and staffing models
• 陳坤志、賴志宗、陳柔均、陳志弘、陳穎霈、朱麗容、陳曉慧、簡美金
  Kun-Chih Chen, Chih-Tsung Lai, Jou-Chun Chen, Chih-Hung Chen, Ying-Pei Chen, Li-Jung Chu, Hsiao-Hui Chen, Mei-Chih Chien
• ATP生物冷光檢測法、環境清潔、人力模式、醫院終期消毒
  ATP bioluminescence assay, environmental cleaning, staffing models, terminal room disinfection
• 目標：醫療環境的清潔品質是感染控制與病人安全的關鍵。本研究旨在評估醫院病床終期消毒作業的落實度，並探討清潔時間與人力模式對清潔品質的影響。方法：本研究採用ATP生物冷光檢測法(adenosine triphosphate bioluminescence technique)作為稽核工具，於2024年1月至2024年10月，在南部某市立地區醫院之一般病房與加護病房(ICU)進行隨機床位抽測，探討清潔時間及人力模式(醫院自聘正職與外包人員)對終期消毒落實之影響。結果：檢測一般病房(N = 65)、加護病房(N = 24)，研究顯示清潔時間顯著影響清潔成效(p < 0.001)。當作業時間小於20分鐘時，清潔異常率超過50%；超過25分鐘則合格率達 95% 以上。此外，人力模式亦具顯著影響(p = 0.005)，自聘正職清潔人員合格率為 100%，明顯優於外包人員的75.4%。結論：醫療機構應確保足夠的清潔作業時間，並慎重規劃人力模式，以提升環境清潔品質，降低醫療照護相關感染的風險。
  Objectives: Environmental cleanliness in health-care settings is crucial for infection control and patient safety. This study investigated compliance with terminal room disinfection in hospital wards and analyzed the effects of cleaning duration and staffing models on cleaning quality. Methods: Audits were performed using an ATP-based bioluminescence test. From January to October 2024, random bed units were sampled in the general wards and intensive care units of a municipal regional hospital in southern Taiwan. The effects of cleaning time and staffing models—specifically, in-house full-time employees versus outsourced staff—on the quality of terminal disinfection were analyzed. Results: In total, 65 general ward beds and 24 intensive care unit beds were examined. Cleaning duration significantly influenced disinfection outcomes (p < .001). When cleaning was completed within 20 min, the failure rate exceeded 50%. However, when the cleaning duration was more than 25 min, the compliance rate exceeded 95%. Furthermore, staffing models significantly influenced compliance (p = .005): the compliance rate was 100% among in-house full-time employees but only 75.4% among outsourced staff. Conclusions: Health-care institutions should ensure adequate cleaning duration and adopt appropriate staffing models to enhance environmental hygiene and prevent health-care-associated infections.
• 635-641
• 10.6288/TJPH.202512_44(6).114085

• Link 原著 Original Article
• 相對剝奪感及社經地位與新冠肺炎疫苗接種行為之關聯 Associations of relative deprivation and socioeconomic status with COVID-19 vaccination behavior
• 鄭昀瑄、陳珮青
  Yun-Xuan Zheng, Pei-Ching Chen
• 新冠肺炎、疫苗接種、相對剝奪感、社經地位
  COVID-19, vaccine, relative deprivation, socioeconomic status
• 目標：本研究旨在探討主觀社會感受(相對剝奪感)及客觀社會條件(社經地位)與台灣民眾新冠肺炎疫苗接種行為之關聯。方法：資料取自中央研究院2021年「幸福溫度計追蹤調查_panel2」。以主觀相對剝奪感與社經地位為自變項，新冠疫苗接種狀態為依變項，分為「未接種疫苗」、「已接種第一劑」與「已接種第二劑」三類。使用多項羅吉斯迴歸分析與疫苗接種相關之因素。結果：共納入1,592位有效樣本，相對剝奪感分數越高者，第一劑疫苗接種機率增加，第二劑接種機率則下降。高教育、高個人月收入及居住直轄市者的第一劑接種機率增加，高教育與高個人月收入者於第二劑接種機率亦增加。此外，未觀察到主觀相對剝奪感與社經地位之交互作用。結論：主觀相對剝奪感對接種行為具階段性影響，初期受防衛性動機與社會規範驅動，後期則因信任缺失而降低接種傾向。即使在免費與普及政策下，教育與收入差距仍透過健康識能與制度信任影響接種，顯示政策需兼顧心理與社會層面以促進接種公平。
  Objectives: This study investigated the associations of subjective (relative deprivation) and objective (socioeconomic status) social conditions with COVID-19 vaccination behavior among adults in Taiwan. Methods: Data were obtained from Academia Sinica’s The Happiness Thermometer Project 2021: Project_Panel2. The independent variables were subjective relative deprivation and socioeconomic status, and the dependent variable was COVID-19 vaccination status, which was classified as unvaccinated, received first dose, or received second dose. Multinomial logistic regression was performed to identify key factors associated with vaccination. Results: A total of 1,592 valid responses were included in the analysis. A higher level of relative deprivation was associated with a higher likelihood of having received the first vaccine dose but a lower likelihood of having received the second dose. Urban residents with higher educational and personal monthly income levels were more likely to have received the first vaccine dose. Furthermore, individuals with higher educational and income levels were more likely than other groups to have received the second dose. No significant interaction was observed between subjective relative deprivation and socioeconomic status. Conclusions: Relative deprivation exerted a stage-specific effect on vaccination behavior. In the early stage, vaccination was driven by social norms and the motivation to receive protection. By contrast, in the later stage, diminishing trust reduced willingness to receive a vaccine. Even under free and universal vaccination policies, disparities in education and income affected vaccination behavior through health literacy and institutional trust, suggesting that policies should address both psychological and social factors to promote equitable vaccine uptake.
• 642-653
• 10.6288/TJPH.202512_44(6).114049

• Link 實務 Public Health Practice
• 安全針具導入對醫療人員尖銳物傷害之影響分析 Effect of safety-engineered device implementation on the risk of sharps injuries among health-care workers
• 劉千玉、賴玉玲、姜美慈、陳秀珍、謝明儒
  Chien-Yu Liu, Yu-Ling Lai, Mei-Tzu Chiang, Hsiu-Chen Chen, Ming-Ju Hsieh
• 安全針具、針扎率、針扎樣態
  safety-engineered devices, the incidence of sharps injuries, sharps injuries patterns
• 目標：尖銳物傷害對醫療人員不僅帶來感染風險(如B型肝炎、C型肝炎、HIV等)，也增加工作時的心理壓力，因此成為醫療院所職安管理的重要指標。為了降低尖銳物所造成的傷害並提供醫療人員更安全的工作環境，台北市某醫學中心自2012年起依衛福部規定分階段導入安全針具，本研究旨在評估導入安全針具後對醫療人員尖銳物扎傷樣態的影響。方法：本研究採回溯性分析，統計2012年1月至2023年12月某醫學中心員工尖銳物扎傷案件，並分析比較安全針具全面導入前後之差異，探討安全針具導入對扎傷事件之影響。結果：針對2012至2023年間共2，695件尖銳物扎傷事件的分析結果，導入安全針具後，整體扎傷率由2012年的3.18%降至2023年的1.59%，尤以年資未滿兩年人員下降幅度最為顯著。此外，針對特定醫療行為如注射及抽血的扎傷事件亦有明顯改善。然而，手術過程中扎傷事件佔總數比例逐年增加，使得開刀房成為主要發生地點，反映手術器械尚未安全化之現況。研究同時發現錯誤使用安全針具可能產生反效果，突顯持續教育訓練的重要性。結論：安全針具有效降低尖銳物傷害風險，未來應強化使用普及率及教育訓練，並聚焦於提高手術器械安全化與提升住院醫師於手術過程的防護能力，進一步降低醫療院所整體風險。
  Objectives: Health-care workers are at a high risk of sharps injuries, which expose them to not only bloodborne diseases such as hepatitis B, hepatitis C, and HIV but also psychological stress at work. Thus, sharps injuries safety is a key indicator of occupational safety management in health-care facilities. To reduce sharps injuries and enhance workplace safety, since 2012, a medical center in Taipei has implemented safety-engineered devices, adhering to the regulations of Taiwan’s Ministry of Health and Welfare. This study investigated the effect of safety-engineered device implementation on the patterns of sharps injuries among health-care workers. Methods: This retrospective study analyzed sharps injuries among health-care workers at a medical center between January 2012 and December 2023. To evaluate the effect of safety-engineered device implementation on sharps injuries by comparing data before and after full adoption. Results: During the study period, 2,695 incidents of sharps injury were reported. The incidence of sharps injuries decreased from 3.18% in 2012 to 1.59% in 2023. Implementation of safety-engineered devices significantly reduced sharps injuries, particularly among health-care workers with less than two years of experience. In addition, sharps injuries related to specific medical procedures, including injections and blood collection showed notable improvement. However, the proportion of sharps injuries occurring during surgical procedures increased annually, identifying operating rooms as the leading locations of occurrence. This finding indicates that surgical instruments remain to be fully adapted for safety. Furthermore, improper use of safety-engineered devices led to adverse outcomes, highlighting a need for ongoing training and education. Conclusions: The implementation of safety-engineered devices effectively reduced the incidence of sharps injuries. To further reduce sharps injuries in health-care facilities, efforts should focus on increasing the adoption of safety-engineered devices, enhancing training, expanding the use of safe surgical instruments, and strengthening intraoperative protective measures for resident physicians.
• 654-665
• 10.6288/TJPH.202512_44(6).114036