Latin America
Bibliography of country-specific and regional needlestick, surveillance, and exposure risk studies
The bibliography is arranged by country in alphabetical order; for each country, references are in chronological order, most recent articles first. Each citation includes an abstract, if available. If you would like to add a citation, contact us here.
Countries with articles listed:
ARGENTINA:
Miceli M, Herrera F, Temporiti E, Li D, Vila A, Bonvehí P. Adherence to
an occupational blood borne pathogens exposure management program among
healthcare workers and other groups at risk in Argentina. Brazilian
Journal of Infectious Diseases 2005;9:454-8.
ABSTRACT- We conducted a retrospective review of 130 occupational blood
borne pathogens exposure (BBP-OE) records at Centro de Estudios Médicos
e Investigaciones Clínicas, a university hospital with an ongoing
educational program and a postexposure management program for
healthcare workers (HCWs) since 1995, in order to evaluate adherence to
a hospital BBP-OE management program. We compared HCWs from our
institution (Group 1) and HCWs from independent institutions that
contract our postexposure management program (Group 2). Compliance with
standard precautions in Group 1 was inadequate in 77%, 23%, and 16% of
nurses, physicians, and others, respectively. A greater proportion of
HCWs in Group 1 (74% vs. 40%) reported occupational accidents
within two hours after exposure (p = 0.0001). No difference was
observed regarding compliance with adherence to schedule, partial
adherence, and loss at follow-up (14%, 33%, and 53%; p > 0.05).
Adherence to the standard of care for BBP-OE, including postexposure
prophylaxis, was low (HIV: 53% and HBV: 63%). Knowledge of the
seropositive status of the source patient did not improve adherence. We
conclude that postexposure programs do not guarantee appropriate
behavior by HCWs. General interventions and ongoing personnel education
to modify individual attitudes are needed, as are continued efforts to
assess HCWs' experiences with these programs, as well as the
identification of strategies to improve adherence.
de Figueiredo RM, Maroldi MA. [Home care: health professionals at
risk for biological exposure]. [Article in Portuguese] Rev Esc Enferm
USP 2012 Feb;46(1):145-50.
ABSTRACT: This prospective, exploratory study was performed using a
quantitative approach with the objective of characterizing the
healthcare tasks that involved biological risk for professionals
working with the Home Care Service of the São Carlos Municipal Hospital
(São Carlos, SP, Brazil). We followed 159 visits from June 2008 to
January 2009. A total of 347 procedures were considered to present
risks for biological exposure, categorized as follows: dressings
(31.1%), capillary blood glucose monitoring (14.4%); and vascular
access (3.1%). Of all subjects, 21.5% complied with hand cleansing
prior to performing a procedure, 66.3% wore gloves and 83.5% disposed
of sharps appropriately. In conclusion, these professionals are subject
to biological risks similar to those found in the hospital environment,
because they are also exposed to blood and sharps often and have a poor
adherence to the standard preventive measures. Further studies to
evaluate the influence of the features of the household on the referred
risk should be encouraged.
Moreira Cardoso AC, Moralez de Figueiredo R. Biological risk in nursing
care provided in family health units. Rev Latino-Am Enfermagem 2010
May-Jun; 18(3):368-72.
ABSTRACT: There is very frequent exposure to potentially contaminated
material in procedures performed by nursing professionals. This
exploratory and descriptive study characterizes the potential risk of
biological exposure in procedures performed by nursing professionals in
ten Family Health units in São Carlos-SP, Brazil. We observed 238
procedures involving potential risk of contact with biological
material, in which more than 90% involved the use of needles. The
average rates of adherence to standard precautions were: 27.9% hand
washing prior to procedures; 41.4% use of gloves; and 88.8% adequate
disposal of piercing and cutting instruments. These professionals are
subject to risks similar to those which hospital workers are also
subjected, because they have a high risk of blood exposure and the
frequency with which they handle needles is very high.
Garcia LP, Facchini LA. Exposures to blood and body fluids in
Brazilian primary health care. Occup Med (Lond)
2009;59(2):107-13.
ABSTRACT - BACKGROUND: Primary health care workers (HCWs) represent a
growing occupational group worldwide. They are at risk of infection
with blood-borne pathogens because of occupational exposures to blood
and body fluids (BBF). AIM: To investigate BBF exposure and its
associated factors among primary HCWs. METHODS: Cross-sectional study
among workers from municipal primary health care centres in
Florianópolis, Southern Brazil. Workers who belonged to occupational
categories that involved BBF exposures during the preceding 12 months
were interviewed and included in the data analysis. RESULTS: A total of
1077 workers participated. The mean incidence rate of occupational BBF
exposures was 11.9 per 100 full-time equivalent worker-years (95%
confidence interval: 8.4-15.3). The cumulative prevalence was 7% during
the 12 months preceding the interview. University-level education,
employment as a nurse assistant, dental assistant or dentist, higher
workload score, inadequate working conditions, having sustained a
previous occupational accident and current smoking were associated with
BBF exposures (P <or= 0.05). CONCLUSIONS: Primary Health Care
Centres are working environments in which workers are at risk of BBF
exposures. Exposure surveillance systems should be created to monitor
their occurrence and to guide the implementation of preventive
strategies.
Garcia LP, Blank VLG. Management of occupational exposures to
potentially infectious materials in dentistry. [in Portuguese] Revista
de Saúde Pública 2008;42:279-86.
ABSTRACT- Objective: To evaluate whether post-exposure measures
referred by dentists and dental assistants are in line with those
recommended by Brazilian health authorities. Methods: An
epidemiological survey was carried out in a city of Southern Brazil, in
2003. Subjects (289 dentists and 104 dental assistants) were selected
through random systematic sampling. Data were collected through
self-reported questionnaires. Results: Washing the exposure site was
the most common measure taken by dentists (98.5%) and assistants
(89.2%) after sustaining a percutaneous injury. More dentists asked the
patients if they carried blood-borne viruses after sustaining a
percutaneous injury (44.6%) than a splash to a mucous membrane (14.3%).
Taking post-exposure prophylaxis, notifying the accident and requesting
blood tests to patients were the least remembered and taken measures by
dentists and assistants. After sustaining an occupational exposure to
potentially infectious materials, 10.8% of dentists and 2.7% of dental
assistants sought medical care. Conclusions: Based on the Brazilian
Ministry of Health recommendations, post-exposure management among the
study population was considered, in general, inadequate, especially
among dental assistants.
Chiodi MB, Marziale MH, Robazzi ML. Occupational accidents involving
biological material among public health workers. Revista
Latino-Americana de Enfermagem 2007;15:632-8.
ABSTRACT: This descriptive research aimed to recognize the occurrence
of work accidents (WA) involving exposure to biological material among
health workers at Public Health Units in Ribeirão Preto-SP, Brazil. A
quantitative approach was adopted. In 2004, 155 accidents were notified
by means of the Work Accident Communication (WAC). Sixty-two accidents
(40%) involved exposure to biological material that could cause
infections like Hepatitis and Aids. The highest number of victims (42
accidents) came from the category of nursing aids and technicians.
Needles were responsible for 80.6% of accidents and blood was the
biological material involved in a majority of occupational exposure
cases. This subject needs greater attention, so that prevention
measures can be implemented, which consider the peculiarities of the
activities carried out by the different professional categories.
de Almeida CAF, Benatti MCC. Occupational exposure of health care
workers to organic fluids and adhesion to chemoprophylaxis. [in
Portuguese] Revista da Escola de Enfermagem da USP 2007;41:120-6.
ABSTRACT- This study was aimed at investigating the characteristics of
occupational accidents and of the workers that suffered them, and at
evaluating the adhesion to chemoprophylaxis and to control and follow
up tests after occu-pational accidents with risk of contamination by
the human immunodeficiency virus and of the hepatitis B and C virus.
This is a descriptive epidemiological study whose data was collected
from the notifications of one of the administrative regions of the
State of São Paulo's Secretary of Health between 2000 and 2001. It was
observed 7.3% of refusals for chemoprophylaxis against human
immunodeficiency virus by antiretrovirals, and that 40.6% of the care
workers who accepted the chemoprophylaxis did not complete the
treatment in the four weeks estimated for it. This diagnosis highlights
the need for the institutions involved to establish strategies that
make possible an increase in the adherence of health workers to these
care procedures.
Garcia LP, Blank VLG, Blank N. Adherence to personal protection
against hepatitis B among dentists and dental assistants. [in
Portuguese] Revista Brasileira de Epidemiologia 2007;10:525-35.
ABSTRACT- Objective: The Hepatitis B virus poses arecognized
occupational risk to dental careworkers. All dental care workers must
beprotected through immunization, withcompletion of vaccine series, and
monitoring of vaccine response. This study examined the adherence to
personal protectionagainst hepatitis B, including vaccinationand use of
personal protective equipment,among dentists and dental assistants in
the city of Florianopolis, South of Brazil. Methods: In this
cross-sectional study, datawere collected through self-reported
questionnaires. Responses were obtained from 289 dentists and 104
dental assistants. Results: The prevalence of complete hepati-tis B
series vaccination was 73.4% amongdentists and 39.4% among dental
assistants. Only 32.1% and 21.9% of them, respectively, monitored
vaccine response. Acomplete vaccine series was associatedwith year of
graduation as of 1997 (PR =1.16; IC95% = 1.01-1.33) and working
mainlyin a surgical specialty (PR = 1.24; IC95% =1.02-1.51) among
dentists, and with attending a training program among assistants (PR =
1.96; IC95% = 1.23-3.14). The proportion of always wearing gloves,
masks,and protective eyewear was higher amongdentists than assistants.
Conclusion: Campaigns are necessary to vaccinate thosewho neither have
been vaccinated norhave completed vaccine series and to inform about
the need of vaccine responsemonitoring. Educational training is
recom-mended to improve adherence to personalprotection, specially
focused on dental assistants.
Machado-Carvalhais HP, Martins TC, Ramos-Jorge ML, Magela-Machado D,
Paiva SM, Pordeus IA. Management of occupational bloodborne exposure in
a dental teaching environment. J Dent Educ. 2007;71(10):1348-55.
ABSTRACT- The aims of this cross-sectional study were to investigate
the prevalence of reporting occupational accidents regarding exposure
to biological material among undergraduate students of dentistry at an
institution of higher education and to estimate risk factors associated
with underreporting. Data were collected by means of a questionnaire,
which had an 86.4 percent rate of return. The sample was made up of 286
undergraduate dental students enrolled in the clinical component of the
curriculum, corresponding to the final six semesters of study. The
average age of the subjects was 22.4 years. Descriptive, bivariate,
simple logistic regression and multiple logistic regression (Stepwise
Forward Procedure) analyses were performed, with the significance level
set at p< or =0.05. Of the total 167 individuals who had been
exposed to biological material, 120 (71.9 percent) failed to report the
accidents. The variables that were statistically associated with the
nonreporting of occupational accidents were nonexposure to blood
(OR=4.0; CI 95%: 1.7-10.0) and the fact that the students considered
the exposure to be minor or of low risk (OR=8.8; CI 95%: 3.5-23.0) or
considered the protocol adopted by the institution to be inadequate
(OR=5.2; CI 95%: 1.2-17.1). The development of a procedure review
policy is recommended with the aim of establishing continuous vigilance
and encouraging the reporting of bloodborne exposure.
Medeiros EA, Servolo, Bakowski E, Sassi SJG et al. Adverse events
relating to antiretroviral prophylaxis for occupational accidents. Rev.
Saúde Pública 2007;41(2):294-6.
ABSTRACT: The objective of the study was to describe adverse events
detected clinically or in the laboratory that were secondary to the use
of antiretroviral agents among individuals undergoing antiretroviral
prophylaxis. Evaluations were performed on 37 teaching hospital
employees who underwent prophylaxis using four regimens of
antiretroviral medication following occupational exposition to
contaminated fluids from patients with human immunodeficiency virus
infection. Thirty-two (86.5%) developed adverse events detected
clinically or in the laboratory. The prophylaxis administered to two
professionals (5.4%) had to be suspended because of the reactions that
occurred. Adverse events relating to prophylaxis for HIV infection in
health care workers who were victims of occupational accidents were
frequent. However, it was rarely necessary to withdraw the
antiretroviral medication.
Rapparini C, Saraceni V, Lauria LM, Barroso PF, Vellozo V, Cruz M,
Aquino S, Durovni B. Occupational exposures to bloodborne pathogens
among healthcare workers in Rio de Janeiro, Brazil. Journal of Hospital
Infection 2007;65:131-7.
ABSTRACT- Healthcare workers (HCWs) frequently face the risk of
occupational infection from bloodborne pathogens following exposure to
blood and body fluids. This study describes the results of a
surveillance system of occupational exposure to bloodborne pathogens
among HCWs in Rio de Janeiro, Brazil, during an eight-year period. A
total of 15 035 exposures reported from 537 health units were reviewed.
Six circumstances comprised nearly 70% of the reported exposures:
recapping needles (14%), performing surgical procedures or handling
surgical equipment (14%), handling trash (13%), during disposal into
sharps containers (13%), performing percutaneous venepuncture (10%) and
during blood drawing (5%). Easily preventable exposures, such as
incidents related to recapping needles, handling trash, and sharps left
in an inappropriate place, represented 30% of the exposures reported.
Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV)
was initiated for 46% of exposed HCWs. Although Brazilian guidelines
indicate that PEP is usually not recommended for exposures with
insignificant or very low risk of HIV infection, PEP was prescribed to
a large proportion of exposed HCWs under these circumstances. The
prevention of occupational exposure to bloodborne pathogens among HCWs
and their safety must be considered as a public health issue. Although
infection-preventative measures such as antiretroviral drugs and rapid
tests are available, this study shows that there are still a high
number of easily preventable exposures. The implementation of more
effective prevention strategies is urgently required in this
country.
Sailer GC, Marziale MHP. Living experience of nursing workers faced
with the use of antiretrovirals after occupational exposure to
biological material. [in Portuguese] Texto & Contexto - Enfermagem
2007;16:55-62.
ABSTRACT- This study is based on the Health Belief Model, using a
quanti-qualitative approach by means of percentage calculations as
quantitative data, while presenting qualitative data through content
analysis. This study aims to analyze significant beliefs among nursing
workers who were victims of occupational accidents while exposed to
biological material, either adhering to chemoprophylactic treatment or
not with antiretroviral medication. This study evidenced and reveals
the need to consider physical, personal, and emotional aspects of
worker injuries when providing them care and to implement actions that
minimize the occurrence of such injures.
Balsamo AC, Felli VE. Study of work accidents related to human body
fluids exposure among health workers at a university hospital. [in
Portuguese] Revista Latino-Americana de Enfermagem
2006;14:346-53.
ABSTRACT- This descriptive and exploratory study from a quantitative
approach aimed to characterize workers who were victims of work
accidents related to human body fluids exposure and to evaluate the
accident victim care protocol. The population consisted of 48 workers
who were victims of work accidents involving exposure to human body
fluids, from July 2000 to June 2001. Data were collected through a form
and interviews. Results showed that nursing workers presented higher
accident risk levels and that 87.50% involved piercing and cutting
material, such as needles and butterflies (70%). As to the
accident-related situation/activity, the workers indicated that 25%
were due to an "inadequate act during the procedure"; 19.64% mentioned
that "it happened" and 29.17% answered that they did not have any
suggestion. This study provided important tools to review and elaborate
strategies to prevent accidents involving exposure to human body
fluids.
Rapparini C. Occupational HIV infection among health care workers
exposed to blood and body fluids in Brazil. American Journal of
Infection Control 2006;34:237-40.
ABSTRACT- Background: Exposure to bloodborne pathogens poses a serious
risk to health care workers (HCWs). Surveillance systems of
occupationally acquired human immunodeficiency virus (HIV) infection
have been developed in several countries, mainly in the developed
world. The purpose of this study was to identify cases of
occupationally acquired HIV infection among HCWs in Brazil. Methods: A
systematic literature review was conducted. The databases searched were
MEDLINE and LILACS (1981 to 2004), academic dissertations and theses
(1987 to 2004), abstracts from national and international meetings
during the last 10 years, and local and national bulletins. Reference
lists to identify other relevant articles were checked. Results: The
database searches generated a total of 60,770 titles. Two hundred and
nineteen references were finally analyzed. Four documented cases of
occupational HIV infection were identified. All of the cases involved
nursing staff and were percutaneous exposures. Seventy-five percent
occurred after a procedure involving a needle placed directly into a
vein or artery. Most (75%) had source patients with probable high viral
load and low CD4 count. Two cases represented HIV seroconversion
despite initiation of postexposure prophylaxis. Only one case (1/4;
25%) presented acute retroviral illness. Conclusion: After an extensive
literature search, 4 documented occupational HIV infection cases were
identified, only 1 of which had been published in a scientific journal.
Our findings were consistent with the majority of documented infections
worldwide. Surveillance systems are indispensable to establish and
formulate rational policies for minimizing the risk of occupational
infection, not only from HIV but also from hepatitis B and C viruses
and other bloodborne pathogens.
Caixeta RD, Barbosa-Branco A. Work-related accidents in health care
workers from public hospitals in Brasilia, Brazil, 2002/2003. Cadernos
de Saúde Pública 2005;21(3):737-46.
ABSTRACT- This study evaluates the knowledge and acceptance of
biosafety measures by health care professionals in light of the
potential risk of occupational transmission of HIV. The survey assessed
570 health care workers from 6 hospitals, randomly selected from all
hospitals in the Federal District (Brasilia), Brazil. The sample
corresponds to 15.0% of the all health professionals in the selected
hospitals. These professionals answered a semi-structured questionnaire
on knowledge of biosafety and universal precautions, risk of
occupational HIV transmission, work-related accidents, use of personal
protective equipment (PPE), and acceptance of chemoprophylaxis and HIV
testing. The overall accident coefficient was 39.1. Dentists,
physicians, and laboratory technicians were those who most frequently
suffered such accidents. The accident coefficient was inversely
proportional to the hospital capacity. The professionals' knowledge of
biosafety concepts and the fact that written norms were displayed in
their workstations did not positively affect the work accident
coefficient.
Canini SR, Gir E, Machado AA. Accidents with potentially hazardous
biological material among workers in hospital supporting services.
Revista Latino-Americana de Enfermagem 2005;13:496-500.
ABSTRACT- Descriptive study was carried out to characterize the
occupational accidents involving potentially contaminated material
among workers of hospital supporting services. The study reviewed
records of workers involved in these accidents and attended at a
specialized outpatient clinic of a large tertiary care hospital between
January 1997 and October 2001. A total of 2814 workers from different
professional categories were attended during this period. Of these, 147
(5.2%) belonged to the hospital supporting services and were the
victims of 156 accidents, auxiliary cleaning personnel (80.2%), and
over a third of the workers had not received any dose of hepatitis B
vaccine (35.4%). Most accidents were due to sharp injuries (96.8%)
caused by inadequately discarded hollow needles. Chemoprophylaxis for
HIV was not indicated in only 23.1% of cases. We conclude that these
workers are also exposed to the possibility of acquiring blood-borne
pathogens and that periodical education programs are needed.
de Almeida CB, Pagliuca LM, Leite AL. Labor accidents involving the
eyes: assessment of occupational risks involving nursing workers. [in
Portuguese] Revista Latino-Americana de Enfermagem
2005;13:708-16.
ABSTRACT- The study aimed at identifying nursing workers who were
victims of eye accidents and the type of accident; describing the
measures taken and proposing Health Education methods. A descriptive
and exploratory study was carried out at a public maternity hospital
from September 2002 to January 2003. Data were collected through direct
observation of the environment and interviews with workers. Subjects
were ten professionals (one nurse, two technicians and seven nursing
auxiliaries) who were victims of work accidents involving the eye. The
accidents were grouped according to the type of material that caused
the trauma: chemical substances (4), medication (3), mechanical trauma
(1), scalp (1) and urine (1). The results reveal that hospital workers
are vulnerable to labor accidents because the environment presents
biological, chemical and physical risks. An important step to prevent
the occurrence of new accidents would be the prevention of human
mistakes through permanent training and the use of protection
glasses.
Rissi MRR, Machado AA, Figueiredo MA. Health care workers and AIDS:
a differential study of beliefs and affects associated with accidental
exposure to blood. Cadernos de Saúde Pública 2005;21:283-91.
ABSTRACT- The aim of this study was to analyse the affective and
cognitive determinants of the professional work of individuals caring
for patients with HIV/AIDS, in view of the risk and/or experience of
accidental exposure to blood. We used the theoretical-methodological
references of Fishbein & Ajzen and Maslow's theory. Fifty health
care workers at the Special Unit for Treatment of Infectious Diseases
Department, University of Sao Paulo, Sao Paulo, Brazil were evaluated
using an attitudes questionnaire, and a needs and motivations
instrument [date not given]. The differences between the answers by
health care workers who had never suffered accidents and those who had
already experienced accidental exposure to blood, were determined.
Health care workers did their work activities as motivated by the need
for self-fulfillment, and valued their own performance when they were
able to meet the patients' emotional needs. Among health professionals
who had never experienced accidental exposure to blood, the predominant
beliefs was that patients feel remorse over having expose themselves to
HIV. Accidental exposure to blood raises difficulties in personal life.
Technical aspects are also associated with the possibility of
accidental exposure to blood.
Marziale MHP, Nishimura KYN, Ferreira MM. Contamination risks caused
by occupational accidents with cutting and piercing material among
nursing workers. Revista Latino-Americana de Enfermagem
2004;12:36-42.
ABSTRACT: This study aimed to identify, among nursing workers from four
hospitals in the region of Ribeirão Preto-SP, Brazil, victims of
occupational accidents with cutting and piercing material, who were
sent for evaluation at a service specialized in treating infectious
diseases, individuals who were contaminated and the conduct adopted as
a result of the accidents. This is a descriptive field research. The
sample consisted of 30 subjects and data were collected by consulting
the workers' medical files. The results showed that none of the workers
had been contaminated by HBV, HCV or HIV. However, it was observed that
only 23.33% of them had kept all the scheduled appointments in order to
verify a possible serum conversion. Concerning the conducts adopted as
a result of the accident, the use of chemoprophylaxis was recommended
in 76.67% of the cases, serological tests in 100% and immunization
against Hepatitis in 9.99%. Due to the high occurrence of percutaneous
accidents, according to official estimates from other countries, it was
concluded that more attention must be given to the prevention of these
accidents, as well as to the strict follow-up of workers after
occupational exposure.
Nishide VM, Benatti MCC, Alexandre NMC. [The occurrence of work
accidents at an intensive care unit.] [in Portuguese] Revista
Latino-Americana de Enfermagem 2004;12:204-11.
ABSTRACT- This descriptive study identified the work accidents that
occurred among nursing staff working at an intensive care unit and
correlated the accidents with the procedure being executed by the
worker at the time of the accident. Data were collected through
individual interviews realized with 68 workers during 2001. It was
verified that the accidents were primarily due to contact of blood and
secretions with skin and mucosa, injuries due to perforating objects,
falls and vertebral column lesions. The accidents were related to
orotracheal tube aspiration, handling of excreta/secretions,
preparation of medication, blood collection, wet floor and patient
transport. It was concluded that changes in the work environment and
prevention programs are needed to reduce accidents during patient care
procedures.
Reis RK, Gir E, Canini SR. Accidents with biological material among
undergraduate nursing students in a public Brazilian university.
Brazilian Journal of Infectious Diseases 2004;8:18-24.
ABSTRACT- During their academic activities, undergraduate nursing
students are exposed to contamination by bloodborne pathogens, as well
as by others found in body fluids, among which are the Human
Immunodeficiency (HIV), Hepatitis B and C viruses. We developed a
profile of victimized students, characterizing accidents with
biological material occurring among undergraduate nursing students at a
public university in São Paulo State, Brazil. We identified the main
causes and evaluated the conduct adopted by students and their
reactions and thoughts concerning the accidents. Seventy-two accidents
were identified, of which 17% involved potentially contaminated
biological material. Needles were the predominant cause of accidents.
The most frequently involved topographic areas were the fingers. Only
five students reported the accidents and sought medical care. Among
these, two students were advised to begin prophylactic treatment
against HIV infection by means of antiretroviral drugs. It was found
that the risk of accidents is underestimated and that strategies such
as formal teaching and continual training are necessary in order to
make students aware of biosafety measures.
Reis JM, Lamounier Filho A, Rampinelli CA, Soares EC, Prado Rda S,
Pedroso ER. [Training-related accidents during
teacher-student-assistance activities of medical students.] [in
Portuguese] Revista da Sociedade Brasileira de Medicina Tropical
2004;37:405-8.
ABSTRACT- A survey was done to determine the most common hospital
accidents with biologically contaminated material among students at the
Medical College of the Federal University of Minas Gerais. Six hundred
and ninety-four students (between fifth and twelfth semesters of the
college course) answered the questionnaire individually. Three-hundred
and forty-nine accidents were reported. The accident rate was found to
be 33.9% in the third semester of the course, and increased over time,
reaching 52.3% in the last semester. Sixty-three percent of the
accidents were needlestick or sharp object injuries; 18.3% mucous
membrane exposure; 16.6% were on the skin, and 1.7% were simultaneously
on the skin and mucous membrane exposure. The contaminating substances
were: blood (88.3%), vaginal secretion (1.7%), and others (9.1%). The
parts of the body most frequently affected were: hands (67%), eyes
(18.9%), mouth (1.7%), and others (6.3%). The procedures being
performed when the accidents occurred were: suture (34.1%), applying
anesthesia (16.6%), assisting surgery (8.9%), disposing of needles
(8.6%), assisting delivery (6.3%), and others (25.9%). Forty-nine
percent of those involved reported the accident to the accident control
department. Of these 29.2% did not receive adequate medical assistance.
Eight percent of those involved used antiretroviral drugs and of these
86% discontinued the treatment on receiving the Elisa method applied to
the patient (HIV-negative); 6.4% discontinued the treatment due to its
side-effects; and 16% completed the treatment.
Robazzi MLC, Marziale MHP. Regulatory standard 32 and its
implications for nursing workers. [in Portuguese] Revista
Latino-Americana de Enfermagem 2004;12:834-6.
ABSTRACT- Workers in health care institutions often face inappropriate
work situations without considering them as dangerous, however, even if
scientific evidence demonstrates the presence of various occupational
risk agents in work environments. This text aimed to present Regulatory
Standard (RS) 32, about Safety and Health at Work in Health Care
Institutions. This RS is important in the Brazilian scenario, due to
the absence of federal legislation about work safety and health issues
in the health sector and due to the fact that existing regulations are
dispersed and joined with other RS and resolutions, which were not
developed specifically for this purpose. It is concluded that the
implantation of this RS may result in beneficial changes, since
protection procedures and measures will have to be taken, promoting
safety at work and occupational accident prevention among health
workers.
Brevidelli MM, Cianciarullo TI. Analysis of needlestick
injuries at a university hospital: occurrence situations and
tendencies. [in Portuguese] Revista Latino-Americana de Enfermagem
2002;10:780-6.
ABSTRACT- Needlestick injuries remain the major source of risk of
acquiring bloodborne diseases (AIDS, hepatitis B and C). Therefore, it
is a priority discussing strategies of intervention based in sources of
risk. The purpose of this study was to analyze needlestick injuries
occurred at a university hospital. A data base construction made
possible to identify the situations in which those accidents occur and
standards of tendencies along the years. The data pointed out that the
majority of needlestick injuries occurred while performing or assisting
procedures. The introduction of the first prevention measures
(universal precautions) reduced the total number of needlestick
injuries. However, changes in needlestick-injury rates related to the
recapping were not observed. Authors discussed the use of different
prevention strategies: introduction of safety devices, changing the
training focus, and the reorganization of the work environment and work
practices.
Canini SR, Gir E, Hayashida M, Machado AA. Needlestick injuries
among nursing staff members at a university hospital in the interior of
São Paulo State. [In Portuguese] Revista Latino-Americana de Enfermagem
2002;10:172-8.
ABSTRACT- The risk presented by health care workers of acquiring
bloodborne pathogens is well documented by the literature, which shows
that Aids and Hepatitis acquired in the work setting is a real fact.
This descriptive retrospective study was conducted in a university
hospital in 1998 and aimed at analyzing needlestick injuries in nursing
workers. Results showed that of the 398 officially reported
occupational accidents, 125 (30.40%) were needlestick injuries and that
89 (71.20%) occurred among nursing workers. The most frequent
occurrences took place during medication administration (25.78%).
Authors concluded that nursing workers were the most frequently
victimized workers by occupational accidents involving needlestick
injuries.
Marziale MHP, Rodrigues CM. The scientific production on
occupational accidents with needlestick materials among members of the
nursing team. [in Portuguese] Revista Latino-Americana de Enfermagem
2002;10:571-7.
ABSTRACT- This study has the purpose to identify methodological
approaches used in research articles published in the last 16 years by
periodicals indexed to the Lilacs and Medline databases. Its authors
searched for studies on occupational accidents involving needlestick
materials in order to identify the facts that predispose this kind of
accident among nursing workers. Fifty-five articles were analyzed, of
which thirty-nine were international and sixteen were national. The
most frequently used methodological approaches were field description,
action research and bibliographic research. Among the factors that
predispose this kind of accident in various countries, the inadequate
practice of recapping needles and inadequate material disposal can be
distinguished.
Brevidelli MM, Cianciarullo TI. Application of the health belief
model to the prevention of occupational needlestick injuries. [in
Portuguese] Revista de Saúde Pública 2001;35:193-201.
ABSTRACT- Objective: To prevent health care professionals from
acquiring blood-borne diseases (AIDS, hepatitis B and C), it is
recommended that needles should not be recapped. However, these
professionals frequently do not comply with this recommendation. The
main purpose of this study was to assess this problem by using the
Health Belief Model (HBM) to correlate the compliance with the
recommendation of not recapping needles with: (1) these professionals'
perceptions regarding one's susceptibility and severity to blood-borne
infections; (2) their perceptions regarding the benefits and barriers
to comply with this recommendation; and (3) the cues received to comply
with this recommendation. Methods: Nursing staff at a hospital were
asked: (1) how frequently they have recapped needles in the previous
month; and (2) their HBM beliefs. To quantify and measure these
beliefs, Likert scales were created and went through a validation
regarding their content (referees) and construct (exploratory factorial
analysis) and their reliability analysis (correlation of two halves and
Cronbach's alpha coefficients). The relationship of beliefs and
compliance with the recommendation of not recapping needles was
obtained through regression analysis. Results: A nursing staff sample
was obtained through voluntary cooperation (n=319). In this group, 75%
admitted recapping needles at least once. Nursing professionals who
most frequently follow the recommendation of not recapping needles have
less than two years of professional experience and they are the group
who perceive less barriers and more benefits to follow the
recommendation. These results initiated a discussion on restructuring
the professional training provided by the hospital.
Grande Gimenez Marino C, El-Far F, Barsanti Wey S, Servolo Medeiros
EA; Hospital Epidemiology Committee, Federal University at Sao Paulo,
SP, Brazil. Cut and puncture accidents involving health care workers
exposed to biological materials. Brazilian Journal of Infectious
Diseases 2001;5:235-42.
ABSTRACT- The first report of occupational acquisition of HIV appeared
in 1984, and, by June, 1997, the Centers for Disease Control and
Prevention (CDC) had reported 52 documented cases of sero-conversion
following occupational exposure to HIV-1 by health care workers of
those cases. 47 (90.3%) were exposed to blood. The most frequent type
of accident reported was percutaneous needlestick injury. Prospective
studies have estimated that the risk of HIV transmission following
percutaneous exposure to infected blood is 0.3% (Confidence Interval
95% = 0.2% to 0.5%). Following a mucous membrane exposure, the risk is
0.09% (CI 95% = 0.006% to 0.5%). The risk of hepatitis B acquisition
ranges from 6% to 30%, and hepatitis C acquisition, 3% to 10%. Since
1992, the São Paulo Hospital's Hospital Infection Prevention and
Control Service (SPCIH) has notified and treated all workers exposed to
accidents involving biological materials. In the last six years, we
have handled approximately 1,300 cases of reported accidents, of which
90% were percutaneous, most involving needlesticks. Such cases were
frequently caused by the inadequate disposal and recapping of needles.
In these accidents, 20% of the source patients were HIV positive, 10%
were hepatitis C positive, and 7.6% were hepatitis B positive. This
review summarizes the guidelines for a standardized response when
dealing with accidents involving health care workers. Transmission of
hepatitis B and HIV can be reduced if adequate preventive measures are
taken in advance. If proper prophylaxis is not being done, it should be
initiated immediately.
Machado AA, Martinez R, Haikal AA, Rodrigues da Silva MC. Advantages
of the rapid HIV-1 test in occupational accidents with potentially
contaminated material among health workers. Revista do Instituto de
Medicina Tropical de São Paulo 2001;43:199-201.
ABSTRACT- In occupational accidents involving health professionals
handling potentially contaminated material, the decision to start or to
continue prophylactic medication against infection by Human
Immunodeficiency Virus (HIV) has been based on the ELISA test applied
to a blood sample from the source patient. In order to rationalize the
prophylactic use of antiretroviral agents, a rapid serologic diagnostic
test of HIV infection was tested by the enzymatic immunoabsorption
method (SUDS HIV 1+2, MUREX®) and compared to conventional ELISA
(Abbott HIV-1/ HIV-2 3rd Generation plus EIA®). A total of 592 cases of
occupational accidents were recorded at the University Hospital of
Ribeirão Preto from July 1998 to April 1999. Of these, 109 were
simultaneously evaluated by the rapid test and by ELISA HIV. The rapid
test was positive in three cases and was confirmed by ELISA and in one
the result was inconclusive and later found to be negative by ELISA. In
the 106 accidents in which the rapid test was negative no prophylactic
medication was instituted, with an estimated reduction in costs of US$
2,889.35. In addition to this advantage, the good correlation of the
rapid test with ELISA, the shorter duration of stress and the absence
of exposure of the health worker to the adverse effects of
antiretroviral agents suggest the adoption of this test in Programs of
Attention to Accidents with Potentially Contaminated Material.
Bredt CS, Monteiro AL, Ramalho M, Orrico G, Santos NJ, Ruiz EA,
Felipo E, Caminada S. Rate of underreporting needle stick exposures in
a referral center for treatment of patients infected with HIV. 2000 Int
Conf AIDS (Jul 9-14);13: abstract no. ThPpC1456.
ABSTRACT- Background: After the official CDC recommendation to use
chemoprophylaxis for post exposures injures with needle sticks, there
is no data referring rates of underreported exposures. In the last
year, only 18 exposures were reported in our institution, but the
underreporting rate is not known. Objective: To evaluate the rate of
underreporting exposures with needle stick injuries, possible factors
related to this rate and the characteristics of the exposures. Methods:
The Center for Referral and Training STD/ AIDS is a public health care
facility for treatment of patients with AIDS . Data were collected
within a month (10/1/99-10/31/99). Anonymous and voluntary
questionnaires were answered by health care workers (HCW) ( physicians,
registered nurses, nursing auxiliaries, dentists, lab technicians and
housekeepers) Results: 164 HCW answered the questionnaire (67.5%, N =
243). 24 exposures were reported in the last year (14.6%); 79% of the
exposures occurred in HCW admitted more than 1 year before; 91% of the
exposures occurred during daytime and only 54% of the exposures were
reported on the same day. 3/6 HCW didn't report their exposures because
they judged that there was no risk. From the exposures reported, 58.3%
occurred among nurses, 17% among housekeepers, 12.5% among lab
technicians and 12.5% among physicians and dentists. Conclusions:
Others authors report rates of underreporting between 70 and 90% among
HCW. We found 21% of underreporting exposures. We believe that this
rate is very high in an institution where 100% of the patients are
infected with HIV. Educational efforts also must be carried out to
reduce the time of reporting after the exposure.
Toledo ACC, Ribeiro FA, Ferreira FGF, Greco RMF. Knowledge,
attitudes and behavior in relation to occupational risk for HIV among
medical students of the School of Medicine Universidade Federal de
Minas Gerais. [in Portuguese] Revista da Sociedade Brasileira de
Medicina Tropical 1999;32:509-15.
ABSTRACT- The objectives of this study were to evaluate the
occupational risk of medical students, their knowledge and practice of
universal biosafety measures and hepatitis B immunization coverage. A
specific questionnaire was applied to 136 medical students of the
Universidade Federal de Minas Gerais: 87 (64%) students were involved
in surgical procedures, 68 (50%) had been exposed to blood, 90 (66.2%)
knew the universal biosafety measures and 33 (24.3%) knew the procedure
in case of blood exposure. Thus, this population has a high risk of
blood exposure and although there is a low formal knowledge about
universal biosafety measures, most of these were generally used. New
strategies, such as formal teaching of universal biosafety measures, in
loco supervision, and biosafety teams, are necessary to change this
situation.
Brandi S, Benatti MC, Alexandre NM. [Accidents with sharp instruments in nurses in a university hospital in Campinas, Sao Paolo] [Portuguese] Revista da Escola de Enfermagem - USP 1998;32:124-33.
Machado AA, da Costa JC, Gir E, Moriya TM, Figueiredo FC. [Risk of
infection by the human immune deficiency virus (HIV) among health
professionals.] [in Portuguese] Revista de Saúde Pública
1992;26:54-6.
ABSTRACT- To investigate the occupational risk of infection by HIV
among health professionals, 36 cases of occupational accidents
involving exposure to material potentially infected with HIV, reported
at a Brazilian General Hospital (HCFMRP), were studied. Of the injured
workers 75% were female and 25% male (ranging from 23 to 49 years old)
and just one of them had high-risk behavior of HIV infection. Of these
health professionals, 52.8% were nursing auxiliaries, 19.4%, nurses,
13.9%, nursing attendants, 5.5%, laboratory technicians, 2.8% surgery
instrumentalist, 2.8% accountants and 2.8% nursing technicians. In
47.2% of cases the workers had a parenteral exposure to blood
(needlestick injuries). The right hand and fingers were the body areas
most effected. The serologic test to detect HIV antibodies by the ELISA
method was required of all the workers. The results were negative and
no seroconversion was registered during the one year follow-up period.
The professionals were retested one month, 2 months, 6 months and one
year after the exposure. In conclusion, the risk of infection by HIV
among health professionals of HCFMRP seems to be very low. Continuing
education should be provided for health care workers with a view to
reinforcing the use of universal precaution, especially those to
prevent injuries cause by needles or other sharp instruments.
Fica CA, Jemenao P MI, Ruiz RG, Larrondo LM, Hurtado HC, Muñoz GG,
Sepulveda CC. [Biological risk accidents among undergraduate healthcare
students: five years experience][article in Spanish] Rev Chilena
Infectol 2010 Feb;27(1):34-9. Epub 2010 Feb 3.
ABSTRACT: Undergraduate healthcare students are exposed to bloodborne
pathogens, and data from developing countries is scarce. We report the
experience of a comprehensive program dedicated to the management of
this risk. The program includes financial coverage, a 24-hour attention
system, HIV, HBV, HCV testing, and free provision of post-exposure
antiretroviral drugs. During 2003-2007, incidence rates of these
exposures reached 0.9 per 100 student-years. Events were only observed
among medicine, nursing, and midwifery students, with rates highest
among nursing students (RR 3.5 IC95 1.93 - 6.51). Cuts and needle stick
injuries predominated (74.7% of accidents). Three students were exposed
to HIV patients (1.9%), all of them received prophylactic drugs,
infection was discarded after follow up, and also discarded after
exposures to HBV or HCV (0.6% of all accidents). Cost per 1000
student-year was less than 2000 USD. Healthcare students are exposed to
biological risks during their studies and a comprehensive program is
feasible in a developing country.
Alfonso LR, Torres HD, Caballero ALL, RZM García. Vigilancia del
personal de laboratorio expuesto al VIH y otros virus de transmisión
sanguínea [Surveillance of laboratory personnel exposed to HIV and
other blood-borne viruses.] [Spanish] Rev Cubana Med Trop
2002;54(2):158-60.
Abstract: Se reportaron los resultados de 15 años de vigilancia
del personal de laboratorio con diferentes grados de exposición al
virus de inmunodeficiencia humana (VIH) y otros virus de transmisión
sanguínea como el virus de hepatitis C, virus de hepatitis B y el virus
linfotrópico de células T humanas (HTLV-I). Se emplearon diferentes
medidas de bioseguridad y como técnica de laboratorio fundamentalmente
el ELISA. De 628 muestras analizadas para VIH y 354 para el resto de
los virus no se encontraron infecciones adquiridas del laboratorio, lo
que confirma la baja incidencia de la infección por VIH en trabajadores
de la salud expuestos y el gran valor de las medidas de bioseguridad en
la prevención y detección temprana de estas infecciones.
Junco DRA, Olivia PS, Barroso UI, Guanche GH. Riesgo ocupacional por
exposición a objetos cortopunzantes en trabajadores de la salud
[Occupational risk for exposure to sharp objects in health workers]
[Spanish]. Rev Cub Hig Epi 2003; 41(2).
Abstract: We performed a cross-sectional epidemiological study in
healthcare workers at the Boyeros Municiple Hospital in Havana, from
September to December, 1999, with the aim of determining needlestick
and sharp-object injury risk. During the study period, 412 workers
sustained sharps injuries (120 physicians, 162 nurses, 56 technicians,
26 assistants, and 48 workers in sterilization unit. Of workers
surveyed, 28.2% reported having experienced at least one percutaneous
injury in the 12 months prior to the study. During that same period, no
injuries were reported to the occupational health department. This
shows lack of knowledge and good practices in relation to handling of
sharp objects.
DOMINICAN REPUBLIC:
Moro PL, Moore A, Balcacer P, Montero A, Diaz D, Gómez V,
Garib Z, Weniger BG. Epidemiology of needlesticks and other sharps
injuries and injection safety practices in the Dominican Republic.
American Journal of Infection Control 2007;35:552-9.
ABSTRACT- Background: Contaminated sharps, such as needles, lancets,
scalpels, broken glass, specimen tubes, and other instruments, can
transmit bloodborne pathogens such as HIV, hepatitis B (HBV), and
hepatitis C viruses (HCV). Methods: Observation of facilities and
injections and questionnaire-guided interviews were conducted in 2005
among health care workers (HCWs) in 2 public hospitals in Santo Domingo
and 136 public immunization clinics (IC) in the Dominican Republic.
Injection practices and sharps injuries (SIs) in health care facilities
in the Dominican Republic were assessed in cross-sectional surveys to
identify areas in which preventive efforts might be directed to make
injection practices safer. Results: Of the 304 hospital HCWs and 136
ICs HCWs interviewed, 98 (22.3%) reported > or =1 SIs during the
previous 12 months. ICs had a lower incidence (13 per 100 per
person-years [p-y]) of SIs than hospitals (65 per 100 p-y) (P <
.0001). Unsafe needle recapping was observed in 98% of all injections
observed at hospitals but in only 12% of injections at ICs (P <
.0001). Sharps were observed improperly disposed in regular waste
containers in 24 (92%) of 26 areas at which injections are prepared at
the hospitals but in only 11 (8%) of 136 ICs (P < .0001). Training
in injection safety was received by 4% of HCWs in hospitals but by 77%
in ICs (P < .001). Of 425 HCWs, 247 (58%) were fully immunized
against hepatitis B. There was a higher risk of SIs among staff
dentists (adjusted relative risks [aRR], 5.9; 95% confidence interval
[CI]: 2.8-12.6), resident physicians (aRR, 3.5; 95% CI: 1.8-6.9), and
those who gave > or =11 therapeutic injections per day (aRR, 1.6;
95% CI: 1.1-2.4). Conclusion: Injection practices at ICs were safer
than those found at public hospitals. Preventive strategies to lower
SIs in public hospitals should include regular training of hospital
staff to minimize needle recapping and improper disposal, among other
interventions to reduce the dangers of needles.
Kato-Maeda M, Ponce-de-Leon S, Sifuentes-Osornio J, Rangel-Frausto
MS, Calva-Mercado J, Infante-Surez L, Villareal FM, Ponce-de-León S.
Bloodborne viral infections in patients attending an emergency room in
Mexico City: estimate of seroconversion probability in healthcare
workers after an occupational exposure. Infection Control and Hospital
Epidemiology 2000; 21:600-2.
ABSTRACT: The frequency of hepatitis C (HCV), hepatitis B (HBV), human
immunodeficiency virus (HIV), and human T-cell lymphotropic virus
(HTLV) I/II was determined in the emergency room of a teaching
hospital. Of 909 patients, 19% had at least one infection; 7.8% had
HCV, 6.9% HBV, 3.3% HIV, and 2.8% HTLV I/II. The probability that a
healthcare worker would have an accident with an infected patient and
seroconvert was 4.99 to 24.9 per 100,000 venipunctures for HBV, 5.6 to
8.4 for HCV, and 0.12-0.16 for HIV in our emergency room.
Olivares-Lopez F, Terreros-Jimenez JSF, Juárez-Ortega M. Riesgo de
contaminación con sangre durante cirugía gineco-obstétrica [Risk of
contamination with blood during gynecologic-obstetric surgery]. Ginec
Obst Mex 1996;64:223-6.
Abstract: Con el objeto de conocer el riesgo de exposición a sangre y
otros fluidos corporales potencialmente contaminados, se llevó a cabo
un estudio prospectivo de 100 cirugías ginecológicas practicadas en el
Hospital General Regional del IMSS en Puebla, Pue. En ocho de 100
cirugías (8 por ciento) ocurrió exposición a sangre de la paciente. Se
encontró ruptura de guantes quirúrgicos en ocho ocasiones (8 por
ciento). Se registraron heridas percutáneas con agujas de sutura en 6
por ciento de las operaciones. La frecuencia de contaminación con
sangre, ruptura de guantes y heridas de piel, es elevada. Los miembros
del equipo quirúrgico tienen riesgo de adquirir enfermedades del tipo
de la infección por VIH y del hepatitis viral de tipo B y C. para
reducir la exposición a sangre de la paciente es necesario seguir las
medidas universales de precaución en todos los procedimientos
quirúrgicos.
Fajardo Velázquez R, Barriga Angulo G, González Sánchez SM, Anaya
Flores V, Pilar Mondragón M. Vigilancia de trabajadores expuestos al
virus de inmunodeficiencia humana [Surveillance of workers exposed to
HIV]. Rev Med IMSS 1995;33:289-92.
Summary: 191 healthcare workers exposed to HIV-1 over an eight-year
period were monitored; 57% of exposed workers were nurses, 20.4% were
agency staff, and other 22.6% other worker categories, such as medical,
laboratory, etc. As in other reports, the highest proportion of
injuries (70.5%) was caused by hypodermic needles; 13.2% of injuries
were from sharp objects contaminated with HIV-positive patients.
Ninety-five percent of injuries could be attributed to carelessness on
the part of staff, and 5% due to missing or faulty equipment. To date,
none of the HIV-exposed workers has developed HIV infection.
Huertas M, Rivera-Morales I, Romero C, Ponce-de-León-R S. Accidentes
laborales e incidencia de infección por VIH y hepatitis B y C en una
institución mexicana [Occupational accidents and incidence of HIV,
hepatitis B and hepatits C infection in a Mexican institution.] [in
Spanish] Rev Invest Clin 1995; 47:181-187.
ABSTRACT: The risk of developing parenterally transmitted infections in
health-care personnel has become a challenge because of high costs,
potential for morbidity and mortality in workers, and social
stigmatization. OBJECTIVES: To understand the incidence of occupational
exposure in our institution, determine the type of personnel affected
and the circumstances of the injuries, and assess the serologic
follow-up of these employees. METHODS: The occupational injuries
spontaneously reported to our infection control program from June 1987
to December 1993 were reviewed. Personnel categories, type of accident,
instrument and circumstances of the injury were reviewed, as well as
serologic follow-up for hepatitis B virus (HBV), hepatitis C virus
(HCV) or human immunodeficiency virus (HIV) infections, baseline and
every three months during the first year were evaluated. RESULTS. In
6.5 years 260 injuries were registered in 240 workers. Two cases were
registered in the second semester of 1987, 23 in 1988, 25 in 1989, 23
in 1990, 36 in 1991, 90 in 1992, and 61 in 1993. Housekeeping and
maintenance staff were mainly affected (32%), nursing staff in second
place (27%), followed by senior medical students (20%). Eighty-eight
percent were sharp injuries (20% considered deep injuries). Most of the
injuries occurred after instrumental utilization: sharp devices
disposed without the use of adequate containers (18%), inappropriate
handling of sharp containers (14%) and recapping needles (11%); 36% of
the injuries occurred during specific procedures. One HBV
seroconversion occurred in 10 surface antigen exposures, one in nine
exposures with an HCV contaminated source, and none in 54 accidents
involving an HIV-contaminated source. CONCLUSIONS: The increase in the
annual incidence of occupational exposures is due most probably to more
awareness to report the injuries. Eighty-eight percent were sharp
injuries and at least 43% could have been prevented. Our main
educational and preventive efforts should be directed to housekeeping
staff, nursing staff, and medical students of our institution.
Panduro-Barón G, Gamboa R, Galaxiola-Castro R, Acevedo-López JA.
Perforación de guantes quirúrgicos en cesarean [Perforation of surgical
gloves in caesarean section]. [Spanish] Ginec Obst Mex
1995;64:430-4.
Abstract : Con el objetivo de demostrar la frecuencia de
perforación de guantes durante la operación cesárea, el miembro del
equipo quirúrgico con mayor afección y la importancia del uso de doble
guante durante la cirugía, se realizó un estudio prospectivo en 258
cesáreas realizadas en Tococirugía en el Nuevo Hospital Civil de
Guadalajara, de septiembre 1993 a enero 1994. En las 258 cesáreas se
utilizaron 1052 pares de guantes y se perforaron 118 (11.2 por ciento).
Los guantes se perforaron en una sola ocación: 60.1 por ciento, en dos
ocasiones: 26.2 por ciento, en tres ocasiones: 6.8 por ciento, en
cuatro ocasiones: 1.7 por ciento y en cinco ocasiones: 5.2 por ciento.
De los guantes rotos, en 74 por ciento se habían utilizado guantes
simples y en 26 por ciento guantes dobles, únicamente se perforó el
guante externo. De los integrantes del equipo quirúrgico, el más
afectado con perforación de guantes fue el cirujano en 83 por ciento,
el ayudante en 13.5 por ciento y el instrumentista en 3.5 por ciento.
La mano más afectada fue la izquierda en 70.3 por ciento y la derecha
en 29.7 por ciento. La perforación de guantes fue producida por aguja
en 62.7 por ciento y por otros instrumentos en 37.3 por ciento. Se
concluye que debido a la frecuencia de perforación de guantes
transcirugía, es recomendable un mayor cuidado en la realización de los
procedimientos quirúrgicos, así como el uso de guantes dobles para una
mayor protección.
Flores-Calderon J, Alvarez-Muñoz MT, Bustamante-Calvillo ME, Vázquez-Rosales G, Reyes-Morales H. Prevalencia de marcadores sexológicos para el virus de la hepatitis B en personal de un hospital pediátrico. Bol Med Hosp. Infant Mex 1994;51(2):99-104.
Navarrete-Navarro S, Alvarez-Munoz MT, Bustamante-Calvillo ME,
Vallejo-Aguilar OJ, Munoz O, Santos-Preciado JI, Avila-Figueroa C.
[Protection of health personnel against hepatitis B by DNA recombinant
vaccine.] [Spanish] Boletin Medico del Hospital Infantil de Mexico
1992;49(11):739-42.
ABSTRACT: Hepatitis B (HVB) is a worldwide spread health problem. It
has been assessed that there are more than 300 millions of carriers.
HVB has a special concern for health care workers (HCW's) due to the
high risk among them of getting the infection in clinic-setting areas.
According to some estimation, the risk for hepatitis B among HCW's is 2
to 10 times higher than the risk for general population. The risk is
related to the degree of direct contact with blood and body fluids, as
well as, with the frequency of traumatic exposure in the work place.
The control of this infection is based on the observance of universal
precautions and the vaccination, since there is not treatment against
this disease. The results of an efficacy-evaluation of DNA recombinant
vaccine against hepatitis B are reported; 174 HCW's were studied; three
dosages of vaccine were administered (0.1st and 6th month) by I.M. via.
In addition, three serum samples were collected at 0, 1st and 9th month
after vaccine administration. We did not find carriers of surface
antigen of hepatitis B. With regards to seroconverted individuals we
observed the following results: there were a satisfactory response to
the vaccine in 163 individuals (93.7%); however, 8 (4.6%) persons did
not reach titles of protective antibodies and 3 (1.7%) did not show
seroconversion at all. Therefore, 11 persons (6.3% of the total) did
not result immunized. The secondary reactions to the vaccines were low
in frequency and mainly of local presentation. Among the study
population we did not find chronic carries of hepatitis B.
Panunzio A, Nuñez-Barboza M, Molero-Zambrano T, Sirit Y, Zambrano M,
Fuentes B, Parra-Cepeda I. [Biological fluid-related accidents amongst
professionals working in clinical laboratories in Maracaibo,
Venezuela]. [Article in Spanish] Rev Salud Publica (Bogota). 2010
Feb;12(1):93-102.
OBJECTIVE: Determining the occupational exposure to biological fluids
of medical technicians working in public clinical laboratories caused
by accidental percutaneous contact, associated factors and compliance
with post-exposure biological measures. METHODS: This was a descriptive
cross-sectional study. The sample consisted of 156 medical technicians
assigned to clinical laboratories in the metropolitan area of Zulia
state in Venezuela. Data was collected by applying an instrument for
exploring exposure and related factors, as well as compliance with
established post-biological exposure measures. RESULTS: There was
evidence of exposure caused by percutaneous accidents, mainly
represented by a moderate level of needle-pricks and cuts (2-3.99
mean). There was a moderate level of factors regarding percutaneous
injury in the hands and fingers associated with hollow needles, blood
and blood products and superficial severity in sample taking and
processing areas when recapping needles or handling sharp or cutting
objects. A medium level (2-3.99 mean) of compliance was obtained for
post-exposure handling. A significant correlation was found (p<001)
between percutaneous exposure and level of compliance with
post-exposure management. CONCLUSION: The magnitude and characteristics
of exposure to biological fluids detected in this work represents a
problematic situation which can affect staff health and must be
approached by institutions to ensure effective prevention management
and risk control.
Galíndez L, Rodríguez Y. Riesgos Laborales de los Trabajadores de la Salud [Occupational hazards of health workers] [in Spanish]. Salud de los Trabajadores, Dic 2007;15(2):67-9. [ISSN 1315-0138]
