Epidemiologia dos acidentes com material biológico entre trabalhadores da limpeza e conservação de serviços de saúde

• Autor(a) principal: Ream, Priscilla Santos Ferreira
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• dARK ID: ark:/38995/0013000006qd3
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/3463
• topic: Serviço hospitalar de limpeza; Acidentes de trabalho; Exposição a agentes biológicos; Saúde do trabalhador; Epidemiologia; Hospital housekeeping; occupational accidents; Exposure to biological agents; Occupational health; Epidemiology; CIENCIAS DA SAUDE::ENFERMAGEM

Hospital housekeepers (HH) in healthcare services, while not working in direct patient care situations, are at risk of suffering accidents with biological material (ABM) as they are responsible for the management of waste. Objectives of this study were: to identify the frequency and profile of accidents with biological material among hospital housekeepers, characterize conduct pre and post-accidents, and compare the profile between the first and the last accidents among workers with repeated exposure. Epidemiological retrospective study of records of ABM with HH in the State of Goias, Brazil, between 1989 and June, 2012. Two sources of information were used to generate a database: medical records of all professionals who suffered ABM treated at the Hospital for Tropical Diseases, and the state database for notifications of ABM from the Information System for Notifiable Accidents referencing all records of labor ABM reported. For probabilistic record linkage of these databases, LinkPlus® was used. After selecting records of interest, referring to the HH, data were analyzed using Statistical Package for the Social Sciences, with descriptive and inferential statistics. Ethical guidelines were followed in all stages of the study (Approved in Ethics Committee, case: 033/2010 e 414.258/2013). The study examined 8,568 records of ABM, 996 (11.6%) occurring among HH. In 57 (6.1%) workers, more than one record was found, totalling 938 accidents. Among these HH, (65.6%) were aged 21-40 years, with an average of 35.6 years of age. Most common injuries were percutaneous, (98.5%), involved blood (85.5%) caused by hypodermic needles (75.1%), and due to improper sharps disposal (70.8%). In 48.2% of cases, the HH completes a vaccination program against hepatitis B (HBV) and of those, 81.7% were immune; 39.1% indicated no records of this vaccine. The difference between the number of HBV in the vaccinated HH first and last accidents was statistically significant, however, 24.5% were not vaccinated before both accidents. In most records, post-exposure prophylaxis and immunoprophylaxis were not recommended. In 86.4%, records had no accompanying clinical and laboratory information, or indicated abandonment of the HH. Given the profile and circumstances of accidents, it can be inferred that health services share responsibility for mismanagement of these injuries with this injury in terms of waste management, especially in proper segregation of waste by health professionals, the generators of the waste. Measures that can make waste management safer are presented as strategies for the prevention of accidents in this population: proper management, safety devices, and continuing education for all professionals involved. Greater accountability of health services in the management of biological risk is required for policies establishing monitoring of vaccinations as well as clinical and laboratory status is considered due to high rates of non-immunization and abandonment of monitoring found post-accident. Some analyses were limited by lack of records, reinforcing the need for improved management of biohazard waste in health services.