2003, Number 3
<< Back Next >>
Rev Biomed 2003; 14 (3)
Identification of risk factors associated with the handling of hazardous biological infectious waste (HBIW) in employees of level III hospìtals in Mexico city
Valdovinos-Núñez GR
Language: Spanish
References: 32
Page: 131-142
PDF size: 81.84 Kb.
ABSTRACT
Introduction. The objective of this study was to identify the origin of the labour risks of the personnel handling Hazardous Biological Infectious Waste (HBIW), generated in three departments of level III medical institutions of the health system in Mexico city.
Materials and Methods. The methodology consisted in designing and applying questionnaires to workers of the departments of pathology, clinical analysis laboratory, and blood bank laboratory of level III medical institutions. This allowed for an evaluation of the compatibility between 1) The knowledge of the regulation NOM-087-ECOLSSA1-2002 and 2) the appropriate performance of the personnel at different tasks related to the handling of HBIW.
A chi –square test of goodness of fit was applied for more than two categories and was followed by a Yate´s correction for continuity, between groups in order to test the statistical significance.
Results. A lack of compatibility between knowledge of the regulation and tasks related with the process of work was evident. Therefore, there was a wide divergence between the legal theoretical aspects and the real performance of the task.
Discussion. It is established that, in general, the knowledge of the regulation is precarious. Therefore, the workers of level III hospitals in Mexico City may not be able to accomplish their tasks under the appropriate conditions of safety and hygiene. This situation makes the worker prone to higher risks as well as the respective department.
A systematic program is recommended, aimed at identifying and correcting the weak profile of the workers due to a lack of knowledge of the regulations on HBIW management. This will eventually lead to a reduction of the risks at work in level III hospitals, in Mexico City.
REFERENCES
Turnberg WL, Frost F. Survey of occupational exposure of waste industry workers to infectious waste in Washington State. Am J Pub Health 1990; 80: 1262-64.
Lee CC, Huffman GL, Nalesnik RP. Medical waste management. Environ Sci Technol 1991; 25: 360-3.
Rutala WA, Weber DJ. Infectious waste. N Engl J Med 1991; 325: 578-82.
Garcia RBS. Effective cost reduction strategies in the management of regulated medical waste. Am J Infect Control 1999; 27: 165-75.
Cocchiarella L, Deitchman SD, Young DC. Report of the Council on Scientific Affairs: Biohazardous waste management : what the physicians needs to know. American Medical Association. Arch Fam Med 2000; 9:26-9.
SEMARNAT. Anteproyecto de Modificaciones a la Norma Oficial Mexicana NOM-087-ECOL-2000. Protección ambiental–residuos peligrosos biológico-infecciososclasificación y especificaciones de manejo. 2000. Disponible en : http://www.adm.org.mx/normas/nom-087-ecol-2000.html
SEMARNAT-SSA. Norma Oficial Mexicana NOM-087-ECOL-SSA1-2002, Protección ambiental –Salud Ambiental-Residuos peligrosos biológico-infecciosos-Clasificación y especificaciones de manejo. Diario Oficial de la Federación 2003 Febrero 17; Sección 1:10-20.
INEGI. GIIS. Boletín de Información Estadística No. 20. Recursos y Servicios.2000. Disponible en: http://www.inegi.gob.mx/difusion/espanol/fdesinf.html
Valdovinos-Nuñez GR. Propuesta de sistematización integral en el control de los residuos peligrosos biológico infecciosos generados en una unidad médica de nivel II en la ciudad de México (Tesis de Maestría ). México DF: Instituto Politécnico Nacional;1999.
INE-SEMARNAT Dirección de Investigación sobre Sustancias Químicas y Riesgos Ecotoxicológicos. 2002. Disponible en: http://www.ine.gob.mx/dgicurg/sqre/sustancias_amb.html#top
Booth JCL, Brown JL, Thomas HC. The management of chronic hepatitis C virus infection. Int J Gast Hepa 1995; 37: 449-54.
Liang TJ, Reheman B, Seef LB, Hoofnagle J. Pathogenesis, natural history, treatment, and prevention of hepatitis C. Ann Inter Med 2000; 132: 296-305.
Rutala, WA, Odette RL, Samsa, GP. Management of infectious waste by US hospitals. JAMA 1989; 262:1635-40.
Fishman M, Mikolich DJ, Fort GG, Cataldo D. Medical records contaminated with dried blood: A quality issue. Am J Infect Control 1999; 27: 438-43.
Zar JH. Biostatistical Analysis. 4ªEd. New Jersey :Prentice Hall;1999. p. 464-9.
Moreno Sánchez F. Residuos peligrosos biológico infecciosos: Un punto de vista médico. Medicina Interna-Infectología. Hospital ABC, Ciudad de México. La Jornada Ecológica. 1999. Disponible en: http://www.laneta.apc.org/emis/jornada/may-jun99/medico.htm
Sarri C, Eng E, Runyan C. Injuries among medical laboratory housekeeping staff: Incidence and worker perceptions. J Occup Med 1991; 33: 52-6.
Seef LB, Buskell-Bales Z, Wrigth EC, Durako SJ, Alter HJ, Iber FL, et al. Long term mortality after transfusionassociated non-A, non-B hepatitis. N Engl J Med 1992; 327: 1906-11.
Henderson DK, Fahey BJ, Willy M, Schmitt JM, Carey K, Kosiol DE, et al. Risk for occupational transmission of Human Immunodeficiency Virus type 1(HVI-1) associated with clinical exposures. Am Coll Physicians 1990;113: 740-6.
Petrosillo N, Puro V, Jagger J, Ippólito G. The risks of occupational exposures and infection by human immunodeficiency virus, hepatitis B virus, and Hepatitis C virus in the dyalisis setting. Am J Infect Control 1995; 23: 278-85.
Zuckerman AJ. Occupational exposure to hepatitis B virus and human immunodeficiency virus: A comparative risk analysis. Am J Infect Control 1995; 286-9.
Kiel FW, Khan MY. Brucellosis among hospital employees in Saudi Arabia. Infect Control Hosp Epidemiol 1993; 14:268-72.
Vinetz JM. Leptospirosis. Infect Dis 2001; 14: 527-38.
Haworth FLM, Cook GC. Needlestick malaria. Lancet 1995; 346: 1361.
Varma AJ. Malaria acquired by accidental inoculation. Canad Med J 1982; 126:1419-20.
Warren JP, Nairn DS, Robertson MH. Cold abscess after accidental BCG inoculation. Lancet 1984; 2: 289.
Maloney SA, Pearson ML, Gordon MT, Del Castillo R, Boyle JF, Jarvis WR. Efficacy of control measures in preventing nosocomial transmission of multidrug resistant tuberculosis to patients and health care workers. Ann Intern Med 1995; 122:90-5.
Sobel E, Sherertz RJ, Streed SA, Brown V, Bishop C, Rutala W, et al. HEPA Respirators and tuberculosis in hospitals workers. N Engl J Med 1994; 331:1658-60.
Sepkowitz, KA. Ocupationally acquired infections in health care workers: Part II. Ann Intern Med 1996;125: 917-28.
Pinkerton SD, Holtgrave DR, Pinkerton HJ, Milwaukee W. Cost-effectiveness of Chemoprophylaxis after occupational exposure to HIV. Arch Inter Med 1998; 158: 1470-1
Hagen DL, Al-Humaidi F, Blake MA. Infectious waste surveys in a Saudi Arabian hospital: An important quality improvement tool. Am J Infect Control 2001; 29: 198-202.
Holtgrave DR, Crosby RA. Social capital, poverty, and income inequality as predictors of gonorrhoea, syphilis, Chlamydia and AIDS case rates in the United States. J Sex Health HIV 2003; 79: 62-4.