Occupational exposure to sharp instrument injuries in a federal hospital

Introduction

Occupational exposure to potentially contaminated sharp instruments can result in the transmission of several pathogens and diseases. It is therefore necessary to investigate the factors that lead to these events and the interventions that can be used to address them.

Objectives

To assess and describe the frequency of occupational exposure to sharps injury among employees of the Instituto Nacional de Câncer José Alencar Gomes da Silva in 2017 and 2018.

Methods

This was a cross-sectional, exploratory and descriptive study based on the records of occupational accidents involving exposure to biological materials and the reports made to the Institute's Occupational Health Division.

Results

A total of 108 incidents were reported, 87 of which involved sharp instruments. Most accidents occurred in the surgical ward, and involved medical staff. The findings revealed low adherence to clinical and laboratory follow-up protocols. There were several errors in data entry and high rates of missing data for important characteristics of the accidents and victims, which prevented a more thorough description of these incidents.

Conclusions

This study revealed several aspects of occupational accidents, victims and follow-up procedures, allowing for the discussion of strategies that could improve the reporting, prevention and management of these events.

Supporting Occupational Physicians in the Implementation of Workers' Health Surveillance: Development of an Intervention Using the Behavior Change Wheel Framework

Workers’ health surveillance (WHS) is an important preventive activity aimed at prevention of work-related diseases. However, WHS is not regularly implemented in some EU-countries. As occupational physicians (OPs) have to play an important role in implementation of WHS, this study aimed to develop an intervention to support OPs in implementation of WHS. The behavior change wheel framework (BCW) was used to develop the intervention. First, the problem was defined, and target behavior was selected by using results from a survey study among OPs. Subsequently, change objectives in target behavior were specified. Finally, appropriate intervention functions, behavior change techniques, and modes of delivery were identified to develop the intervention. Target behaviors were (1) OPs initiate WHS, and (2) OPs conduct preventive consultations with workers. OPs’ capabilities, and experienced opportunities were identified as change objectives. Intervention functions (education, training, enablement) and behavior change techniques (information about consequences, demonstration, instructions, behavioral practice, feedback on behavior, goal setting, action planning, reviewing goals) were selected to develop the intervention, delivered by face-to-face group training and e-learning. The proposed intervention consists of training and e-learning to support OPs in implementing WHS. Feasibility and effect of the intervention will be evaluated in future studies.

Do workers' health surveillance examinations fulfill their occupational preventive objective? Analysis of the medical practice of occupational physicians in Catalonia, Spain

OBJECTIVES

Although routine workers' health examinations are extensively performed worldwide with important resource allocation, few studies have analyzed their quality. The objective of this study has been to analyze the medical practice of workers' health examinations in Catalonia (Spain) in terms of its occupational preventive aim.

MATERIAL AND METHODS

A cross-sectional study was carried out by means of an online survey addressed to occupational physicians who were members of the Catalan Society of Safety and Occupational Medicine. The questionnaire included factual questions on how they performed health examinations in their usual practice. The bivariate analysis of the answers was performed by type of occupational health service (external/internal).

RESULTS

The response rate was 57.9% (N = 168), representing 40.3% of the reference population. A high percentage of occupational physicians had important limitations in their current medical practice, including availability of clinical and exposure information, job-specificity of tests, and early detection and appropriate management of suspected occupational diseases. The situation in external occupational health services - that covered the great majority of Catalan employees - was worse remarkably in regard to knowledge of occupational and nonoccupational sickness absence data, participation in the investigation of occupational injuries and diseases, and accessibility for workers to the occupational health service.

CONCLUSIONS

This study raises serious concerns about the occupational preventive usefulness of these health examinations, and subsequently about our health surveillance system, based primarily on them. Professionals alongside health and safety institutions and stakeholders should promote the rationalization of this system, following the technical criteria of need, relevance, scientific validity and effectiveness, whilst ensuring that its ultimate goal of improving the health and safety of workers in relation to work is fulfilled. Other countries with similar surveillance systems might be encouraged by our results to assess how their practices fit the intended purpose. Int J Occup Med Environ Health 2017;30(6):823-848.