april 1997
ISSN: 0252-7987
 Fulltext documents |
Health risks of hospital workers are a topic that is gaining increasing importance. There are studies describing the existence of physical, chemical, biological, ergonomic, and psychosocial hazards that in an overt or concealed way affect the professionals who deliver health services.
Biological risks caused by live organisms, usually microscopic, pose serious threats. The epidemic of AIDS and hepatitis B have influenced the medical and assistance practice and are considered a labor exposure due to the possible contact with viruses through direct treatment of patients and manipulation of contaminated fluids.
The risk of acquiring AIDS virus in the work environment ranges from 0.5 to 0.7%, mainly due to inadequate manipulation of fluids or puncture with contaminated needles. Hepatitis B is the most frequent of occupational infectious diseases and the probability of acquiring it accidentally is three times greater than AIDS. Hence, it is important to protect workers' health, to emphasize biosafety standards, while at the same time promoting the care of the patient.
The prevention of tuberculosis among hospital staff requires a rigorous control of nurses, laboratory workers, and physicians before, during and after the contracting of personnel through medical examinations, thoracic X-rays, and verification of immunity levels with the tuberculin test and the BCG vaccine.
Chemical risks play an important role in the hospitalization services, since the personnel can absorb chemical substances when they manipulate them or because they are near them. The anesthetic gases, antiseptics, cytotoxic reagents, drugs, and pharmaceuticals induce biological effects on the worker, depending on the concentration, manipulation, exposure, susceptibility of the worker, the agent, and the protective measures adopted by the personnel.
Physical risks most common among health workers are ionizing radiation, noise exposure, temperature, and electricity. Ionizing radiation are X-rays and radioactive elements from the departments of radiology, radiation therapy, clinical and dental laboratories, and operating room. Regarding noise, dentists, maximum facial surgeons, surgeons of orthopedics, traumatology and otorhinolaryngology, and bacteriologists are the most exposed.
Ergonomic risks are manifested in weary and injuries due to overloads or incorrect positions in the work. Raising patients is a demanding taks for nurses and they present a relatively high rate of backaches, neurological symptoms, and ackes and pains due to strains.
Psychosocial risks may be present due to the physical work environment, characteristics of the tasks, schedule organization, technological changes, rigid hierarchical structure, and human and interprofessional relationships.
The need to offer information about the risks health workers are exposed to and the scarcity of information on this subject has motivated the preparation of this REPINDEX. The references retrieved, 319 records, describe experiences dealing with prevention up to international guidelines that should be applied to minimize occupational risks in this sector. These references have been grouped under the following subtitles:
001 Generalities (Part 1)
Fifty one per cent of the documents selected are in Spanish, 41% in English, and 8% in Portuguese. This REPINDEX includes 10 full texts of high interest. The article "Hepatitis B y SIDA: prevención en el personal sanitario", by José Ramón de Juan, indicates preventive measures to avoid contagion of hepatitis B before and after an accident with blood, examines preventive measures against AIDS, and includes disinfection and sterilization methods.
The chapter "Seguridad e higiene del trabajo en los servicios médicos y de salud" extracted from the book "Empleo y condiciones de trabajo en los servicios médicos y de salud", published by ILO, examines occupational hazards and focuses on communicable diseases, chemical, physical and psychosocial risks, and accidents.
The "Manual de bioseguridad en la práctica odontoestomatológica", by Eduardo Chauca Edwards, summarizes protective measures, disinfection and sterilization methods, decontamination of ultrasound equipment, manipulation of specimens and biopsies, decontamination of surfaces, environments and laboratory materials, waste management and procedures for handling linen.
The article "Riesgo biológico ocupacional y medidas de seguridad en los laboratorios médicos", by Roberto Alonso Fernández Llanes and Fernando De la Cruz Castillo, discusses the most frequent risks in medical laboratories emphasizing biological hazards.
The article "Contaminación ambiental en sala de operaciones y sus consecuencias para el anestesiólogo y personal que laboran en ellas", by Ramón De Lille Fuentes, reviews the evidence of occupational diseases among staff of operating rooms that are continually exposed to low doses of volatile agents, such as halogenated hydrocarbons and other gases, in addition to exposure to radiation and fatigue.
Two works dealing with stress have been selected. "Estrés en los trabajadores de salud", by Beverly Raphael and Brian Kelly, comments that health professionals bear anxiety associated with their interaction with people in misfortune. The other work, "Prevención de las lesiones de espalda en el trabajo hospitalario", of Rosa María Josa Armengol and Josep Dern Cavalle, remarks that health personnel are one of the high-risk groups that suffer back injuries. It includes the study conducted in the Hospital de Mutua de Terrassa, Spain, which has 181 nurses.
The chapter "Control de la transmisión de la tuberculosis en el personal sanitario", by V. Moreno Celda, explains epidemiological factors, transmission routes, control measures and monitoring of health workers. "Higiene de la ropa hospitalaria", by Etienne Hars, describes contamination risks for hospital perssonel form de collection of linen up to the selection, transportation, and treatment in the
laundry. Finally, the article "Riesgo ocupacional de los fármacos antineoplásicos" by E. Albiol Biosca and J. Vaqué, is reproduced.
In the issue of this REPINDEX participated Mr. Alejandro Borda, Advisor in Occupational Health of the Instituto Peruano de Seguridad Social, IPSS, who collaborated in the selection and collection of information.
For their special contribution in the preparation of this REPINDEX, gratitude is acknowledge to Dr. Maritza Tennassee, Advisor on Occupational Health of the Pan- American Health Organization, Washington, DC, and to Dr. Gerry Eijkemans, Advisor on Occupational Health of the PAHO/WHO Representative Office in Peru.
Actualizado el 19/Nov/98
