2006, Number 4
<< Back Next >>
Bol Med Hosp Infant Mex 2006; 63 (4)
Sharp object related accident involving health personnel in a pediatric hospital.
Morales-Aguirre JJ
Language: Spanish
References: 28
Page: 247-254
PDF size: 136.64 Kb.
ABSTRACT
Introduction. The needle-stick and sharp device injuries constitute a risk to which health personnel is exposed. Objective. To describe the frequency and mechanisms of exposition to infectious biological products in health care personnel.
Material and methods. It was an observational and descriptive study from the reports of the epidemiological surveillance program concerning to the exposition to infectious biological products in the health care personnel from Hospital Infantil de Mexico Federico Gomez in Mexico City, happened from January 1, 1991, to December 31, 2004.
Results. We observed 848 laboral accidents during this period. The average of accidents per 100 beds/year was 29.9 with a variation from 4.6 to 56.4. There were 8.29 accidents for 1 000 outcomes/year, with a limit from 1.6 to 14.4. The events appeared mainly in the nursery personnel with 345 episodes (40.6%), followed by resident doctors with 220 events (25.9%). The most frequent mechanism was needle pinch in 616 (72.6%), being the hands the anatomical site most commonly affected in 677 cases (79.8%). The areas most affected were: Emergency with 109 events (12.8%), Pediatric Intensive Care Unit with 96 (11.3%), and Neonatal Intensive Care Unit with 80 (9.4%), being in the matutinal turn the greater number of accidents, 507 events (59.7%). The standard precautions made by the injured personnel were: use of gloves 488 (57.5%); hand washing 404 (47.6%), use of mouth covers 304 (35.8%), use of gown 253 (29.8%), use of lenses 134 (15.8%), none 144 (16.9%). Concerning to the background of vaccine administration against hepatitis B, only 445 (52.4%) had been applied at least one dose and 403 (47.5%) none.
Conclusions. The occupational exposition to biological product is an important problem in health care personnel, specially in hospitals that offer attention to pediatric patients, due the difficulties implied in taking care of children. Reinforcing the educative strategies about use of standard precautions in the appropriate sampling techniques and the use of biosafe equipment could help to reduce the frequency of the accidents with sharp devices.
REFERENCES
Gerberding JL. Occupational exposure to HIV in health care settings. N Engl J Med. 2003; 348: 826-33.
CDC. Updated US Public Health Service Guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR Morb Mortal Wkly Rep. 2001; 50 (RR-11): 1-52.
Eakin JM, Taylor KM. The psychosocial impact of AIDS on health workers. AIDS. 1990; 4 Supl 1: S257-S62.
Zuger A, Miles SH. Physician AIDS and occupational risk: historic traditional and ethical obligation. JAMA. 1987; 258: 1924-8.
Moor RM, Kazczmarek RG. Occupational hazard to health care workers: diverse ill defined and not fully appreciated. Am J Infect Control. 1990; 18: 316-27.
Centers for Disease Control. Recommendations for prevention of HIV prevention of HIV transmission in health care settings. MMWR Morb Mortal Wkly Rep. 1987; 36 Supl 2: 1-18.
Centers for Disease Control. Update: Universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus and other bloodborne pathogens in health care settings. MMWR Morb Mortal Wkly Rep. 1988; 37: 377-82, 387-8.
Bolyard EA, Tablan OC, Williams WW. Guidelines for infection control in health care personnel. Am J Infect Control. 1998; 26: 289-354.
Yassy A, McGill M. Determinats of blood and body fluid exposure in a large teaching hospital: hazard of the intermittent intravenosu procedure. Am J Infect Control. 1991; 19: 129-35.
Jagger J, Hunt EH, Brand-Elnaggar J, Pearson RD. Rates of needle-stick injury caused by various devices in an university hospital. N Engl J Med. 1988; 319: 284-8.
Shen C, Jagger J, Pearson RD. Risk of needle stick and sharp object injuries among medical students. Am J Infect Control. 1999; 27: 435-7.
Nelsing S, Nielsen TL, Nielsen JO. Occupational blood exposure among health care workers. Scand J Infect. 1993; 25: 193-8.
Romero OC, Báez MR, Ibarra J. Epidemiología de las lesiones punzocortantes en trabajadores de la salud. (Cartel EP-1888). Presentado en el XXIII Congreso Anual de la Asociación Mexicana de Infectología y Microbiología Clínica. V Congreso Nacional de Antimicrobianos y Quimioterapia. San Luis Potosí, 21 al 24 de Octubre de 1998.
Torres HM, Cesar PV, González RR, Solórzano SF. Vigilancia epidemiológica para el control de infecciones por material punzocortante (Cartel C18). Presentado en el XXIII Congreso Anual de la Asociación Mexicana de Infectología y Microbiología Clínica. V Congreso Nacional de Antimicrobianos y Quimioterapia. San Luis Potosí, 21 al 24 de Octubre de 1998.
Mendoza C, Barrientos C. Occupational exposure to blood and body fluids. Experience in a children hospital. Rev Chil Infectol. 2001; 18: 17-85.
Panizza V. Accidentes con material potencialmente contaminado por el VIH en personal sanitario de la comunidad de Madrid. Boletín Epidemiológico de la Comunidad de Madrid. N7 Vol. 8 Jul. 2002.
Ippolito G, de Carli G, Puro V. Device-specific risk of needle sticks injury in Italian health care workers. JAMA. 1994; 272: 607-10.
Ippolito G, Puro V, Heptonstall J. Occupational human immunodeficiency virus infection in health care workers: Worldwide cases through september 1997. Clin Infect Dis. 1999; 28: 365-83.
Maclan AK, Raafat A, Hunt JP. Barrier precautions in trauma: is knowledge enough? J Trauma. 2002; 52: 540-3.
Kim LE, Evanoff BA, Parks RL. Compliance with universal precautions among emergency department personnel: Implications for prevention programs. AJIC. 1999; 27: 453-5.
Shapiro CN. Occupational risk of infection with hepatitis B and hepatitis C virus. Surg Clin North Am. 1995; 75: 1047-56.
Risk to health care workers in developing countries. N Engl J Med. 2001; 345: 538-41.
Mann JM, Francis H, Quin TC. Seroprevalence among hospital workers in Kinshasa, Zaire. JAMA. 1986; 256: 3099-12.
McGeer A, Simor E, Low DE. Epidemiology of needlestick injuries in house officers. J Infect Dis. 1990; 162: 961-4.
Mangione CM, Gerberding JL, Cummings SR. Occupational exposure to HIV: frequency and rates of underreporting of percutaneous and mucocutaneus exposures by medical house staff. Am J Med. 1991; 90: 85-90.
Marcus R. Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus. N Engl J Med. 1988; 319: 1118-23.
Sepkowitz KA. Occupationally acquired infection in health care workers. Part two. Ann Intern Med. 1996; 125: 917-28.
Puro V, Petrosillo N, Ippolito G. Risk of hepatitis C seroconversion after occupational exposure in health care workers. Italian study group on occupational risk of HIV and other bloodborne infections. Am J Infect Control. 1995; 23: 273-7.