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1.
Rev. Pesqui. Fisioter ; 10(4): 683-691, Nov. 2020. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1247726

ABSTRACT

Trabalhadores de saúde, incluindo fisioterapeutas, estão sob maior risco de acidentes de trabalho com exposição à material biológico (At-bio), quando comparados a outros. OBJETIVO: Descrever perfil epidemiológico dos At-bio em fisioterapeutas, segundo vínculo de trabalho. MÉTODOS: Estudo de casuística das notificações de At-bio em fisioterapeutas registradas no Sistema de Informação de Agravos de Notificação, Brasil, 2008 a 2018. RESULTADOS: Foram 2.565 registros At-bio em fisioterapeutas, com crescimento de notificações (169,2%) no período, maioria entre os de vínculo formal (68,3%). Entre formais, a maioria foi do sexo feminino (82,7%), com idade entre 30 a 39 anos (46,8%) e raça/cor branca (69,6%). Entre informais, a maioria também foi feminina (85,3%), mais jovens, de 18 a 29 anos (62,2%) e raça/cor branca (69,8%). Em ambos os grupos, a ocupação específica foi fisioterapeuta geral, com casos evoluindo para alta paciente fonte negativa. Os formais tinham 1 a 6 anos de experiência ocupacional (44,8%) e registro de Comunicação do Acidente de Trabalho (CAT) em 58,1% dos casos. Nos informais, o tempo de experiência era menor que 1 ano (47,7%) e apenas 28,6% tiveram o registro da CAT. O uso dos Equipamentos de Proteção Individual (EPI) teve pequena diferença entre grupos, sendo luva, avental e máscaras os mais utilizados. CONCLUSÃO: Embora os At-bio sejam mais notificados em fisioterapeutas com vínculo formal, entre informais acontecem em mais jovens, com menor tempo de experiência e sem registro da CAT, além de pior registro de informações e abandono de evoluções, indicando maior vulnerabilidade, especialmente em relação às medidas de proteção social.


Health workers, including physiotherapists, are at greater risk of occupational injuries involving exposure to biological material (OI-bio), when compared to others. OBJECTIVE: To describe the epidemiological profile of OI-bio in physiotherapists, according to their work contracts (formal/informal). METHODS: A case study of work-related notifications by biological material in physiotherapists, registered in the Information System Notifiable Diseases, Brazil, from 2008 to 2018. RESULTS: There were 2,565 OI-bio records in physiotherapists, with an increase in notifications (169.2%) in the period. The majority among those with formal contracts (68.3%). Among formals, the majority were female (82.7%), aged between 30 and 39 years (46.8%) and white people (69.6%). Among the informal, the majority were also female (85.3%), younger, 18 to 29 years old (62.2%) and white people (69.8%). In both groups, the specific occupation was general physiotherapist, cases evolving to discharge from a negative patient/source. Formals had 1 to 6 years of occupational experience (44.8%) and record of Communication of Occupational Injury (COI) in 58.1% of cases. Among the informal, the work experience time was less than 1 year (47.7%) and only 28.6% had COI registration. The use of Personal Protective Equipment (PPE) had little difference between groups, with gloves, aprons and masks being the most used. CONCLUSION: Although OI-bio are more reported in physiotherapists with formal contract, among informal ones they occur in younger people, with less experience and without COI registration, in addition to worse information registration and abandonment of developments, indicating greater vulnerability, especially in relation to social protection measures.


Subject(s)
Accidents, Occupational , Biocompatible Materials , Physical Therapists
2.
Emerg Infect Dis ; 23(1): 46-55, 2017 01.
Article in English | MEDLINE | ID: mdl-27983505

ABSTRACT

Health officials lack field-implementable tools for forecasting the effects that a large-scale release of Bacillus anthracis spores would have on public health and hospitals. We created a modeling tool (combining inhalational anthrax caseload projections based on initial case reports, effects of variable postexposure prophylaxis campaigns, and healthcare facility surge capacity requirements) to project hospitalizations and casualties from a newly detected inhalation anthrax event, and we examined the consequences of intervention choices. With only 3 days of case counts, the model can predict final attack sizes for simulated Sverdlovsk-like events (1979 USSR) with sufficient accuracy for decision making and confirms the value of early postexposure prophylaxis initiation. According to a baseline scenario, hospital treatment volume peaks 15 days after exposure, deaths peak earlier (day 5), and recovery peaks later (day 23). This tool gives public health, hospital, and emergency planners scenario-specific information for developing quantitative response plans for this threat.


Subject(s)
Anthrax/epidemiology , Anthrax/prevention & control , Clinical Decision-Making/methods , Decision Support Techniques , Disease Management , Disease Outbreaks , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control , Animals , Anthrax/mortality , Anthrax/transmission , Anti-Bacterial Agents/therapeutic use , Bacillus anthracis/pathogenicity , Bacillus anthracis/physiology , Humans , Incidence , Respiratory Tract Infections/mortality , Respiratory Tract Infections/transmission , Survival Analysis , Time Factors , Uncertainty , United States/epidemiology
3.
Disaster Med Public Health Prep ; 11(2): 155-159, 2017 04.
Article in English | MEDLINE | ID: mdl-27640728

ABSTRACT

The purpose of this communication is to explore the implications of genome editing techniques, such as CRISPR/Cas9, on public health-related responses to outbreaks of disease. The recent commercialization of genome editing techniques makes the creation and release of genetically altered pathogens a much easier task, increasing the possibility to the point of needing discussion. Three areas need to be addressed: predictions concerning potential genetic alterations, predictions and implications concerning the release of genetically altered pathogens, and the short- and long-term implications of the release of genetically altered pathogens. Full discourse on these topics among professionals in the area of public health will help to combat harm from the use of any genetically altered biologic weapons. The topics covered here include a review of the CRISPR/Cas9 gene editing technique, including a discussion of which possibilities utilize genome editing. We then address predictions about the application of gene alterations in the context of bioweapons. We discuss a few basic concepts about the evolution of an intentionally released genetically altered organism based on circumstances and patterns gleaned from observing nature in the hope that this will aid in the public health response to bioterrorism attack. (Disaster Med Public Health Preparedness. 2017;11:155-159).


Subject(s)
Biological Warfare Agents , CRISPR-Cas Systems , Disease Outbreaks/prevention & control , Gene Editing/trends , Public Health/standards , Humans , Inventions/trends , Public Health/trends
4.
Medwave ; 16(7): e6514, 2016 Aug 11.
Article in English, Spanish | MEDLINE | ID: mdl-27571394

ABSTRACT

OBJECTIVE: To determine the frequency and characteristics of biological accidents in last-year medical students from three hospitals in Lima. METHODS: Cross-sectional study performed at three Public Health Insurance hospitals in Lima, in December 2014. The study population comprised last-year medical interns. Biological accidents were recorded with a questionnaire of exposure to blood and body fluids based on the formats used by the Exposure Prevention Information Network system and the Centers for Disease Control and Prevention. We inquired about occurrence and number of biological accidents as well as the characteristics of the last accident. Categorical data are presented as absolute and percentage frequencies and numeric data, as median and interquartile ranges. RESULTS: We collected 100 respondents; 85% of them had had a biological accident during the last year, with a median of 2 and interquartile range of 3. The most frequent type of exposure was percutaneous (71.8%) and the most common device was the hollow needle (54.1%). The most frequent place of occurrence and activities at the moment of exposure were at the delivery room (44.7%), while supervising a vaginal delivery (24.7%), and during suturing (24.7%). Three accidents involved high-risk patients, but only one student received antiviral prophylaxis; 49.4% attributed the cause of the accident to fatigue, and 75.3% of accidents are not reported. Gloves are the most used protective barrier (95%). CONCLUSIONS: The frequency of biological accidents among last-year medical students is high. Underreporting and inappropriate use of protective barriers increase the risk of medical students for biological accidents.


OBJETIVO: Determinar la frecuencia y características de los accidentes biológicos en estudiantes del último año de medicina de tres hospitales de Lima. MÉTODOS: Estudio transversal, realizado en tres hospitales del Seguro Social de Salud de Lima, en diciembre de 2014. La población de estudio la constituyen los internos de medicina. Los accidentes biológicos se registraron aplicando un cuestionario sobre exposición a sangre y fluidos corporales, elaborado sobre la base de los formatos utilizados por el sistema Exposure Prevention Information Network y Centers for Disease Control and Prevention. Se interrogó sobre la ocurrencia y número de accidentes biológicos presentados, además de las características del último accidente. Los datos categóricos se presentan como frecuencias absolutas y porcentuales, en tanto los datos numéricos se muestran como mediana y rango intercuartílico. RESULTADOS: En total fueron 100 encuestados. El 85% de ellos presentó algún accidente biológico durante el año, con una mediana de 2 y un rango intercuartílico de 3. El tipo de exposición más frecuente fue el percutáneo (71,8%), siendo el dispositivo más común la guja hueca (54,1%). El lugar y las actividades más frecuentes al momento de la exposición fueron la sala de partos (44,7%), atención de parto (24,7%) y sutura (24,7%). Tres accidentes ocurrieron con pacientes de alto riesgo, pero sólo uno recibió profilaxis antiviral. El 49,4% consideró como causa el cansancio o fatiga. El 75,3% de los accidentes no se reportaron. Los guantes son la medida de protección más utilizada (95%). CONCLUSIÓN: La frecuencia de accidentes biológicos presentados es alta. El escaso reporte y uso inadecuado de barreras de protección, son eventos que elevan el riesgo de los estudiantes de medicina.


Subject(s)
Accidents, Occupational/statistics & numerical data , Needlestick Injuries/epidemiology , Students, Medical/statistics & numerical data , Adult , Cross-Sectional Studies , Female , Hospitals , Humans , Male , Peru , Surveys and Questionnaires , Young Adult
5.
Article in Korean | WPRIM (Western Pacific) | ID: wpr-168304

ABSTRACT

PURPOSE: The aim of this study was to evaluate the characteristics of Emergency Medical Service (EMS) provider responded chemical, biological, radiological, and nuclear (CBRN) incidents in Korea. METHODS: Nationwide EMS rescue records from Jan 2012 to Dec 2014 were analyzed. All EMS rescue records were integrated according to the unique accident ID. Cases related to animal rescue, hive removal, and suicide-related were excluded. CBRN-associated keywords were extracted by literature review and pilot survey. In-depth review of cases containing CBRN-associated keywords in the activity summary were conducted by trained emergency medical technicians, and predefined information was abstracted. Descriptive analyses were performed to characterize the EMS provider responded CBRN incidents. RESULTS: A total of 1,571,293 cases were included, and 1,335,205 cases had a unique accident ID; 515,417 cases were excluded because of their association with animal rescue, hive removal, and suicide attempts; 19,663 cases contained CBRN-associated keywords in the activity summary, and in-depth review identified 1,862 cases as CBRN incidents. Among them 1,856 cases were chemical incidents, and 6 cases were radiological incidents; 144 cases were resulted to victims. In chemical incidents, ammonia, hydrogen chloride, sulfuric acid, hydrogen fluoride, and nitric acid were the top 5 toxic substances. In chemical incidents with victims, the proportion of explosion/implosion, and suffocation in sealed space was more prevalent than chemical incidents without victims. Median scene time of all CBRN incidents was 41 minutes (interquartile range 18.0-57.0). CONCLUSION: We evaluated the characteristics of CBRN incidents responded by EMS in Korea.


Subject(s)
Animals , Humans , Ammonia , Asphyxia , Biohazard Release , Chemical Hazard Release , Emergencies , Emergency Medical Services , Emergency Medical Technicians , Hydrochloric Acid , Hydrofluoric Acid , Korea , Nitric Acid , Radioactive Hazard Release , Suicide , Sulfur
6.
Rev. bras. oftalmol ; 74(5): 284-287, set.-out. 2015. tab
Article in Portuguese | LILACS | ID: lil-757449

ABSTRACT

Objetivo:Analisar a ocorrência e as características dos acidentes com material biológico em um hospital oftalmológico no nordeste do Brasil.Métodos:Estudo transversal, com análise retrospectiva dos dados dos pacientes, realizada por meio de um levantamento dos acidentes com material biológico notificados à Comunicação de Acidentes de Trabalho (CAT) durante o período de 2010 a 2013.Resultados:Foram notificados 34 acidentes, sendo 26 (76,5%) em trabalhadores do gênero feminino e 8 (23,5%) masculino. A média de idade foi 30,0 ± 5,9 anos. Quarenta e oito (82,3%) acidentes aconteceram no bloco cirúrgico da sede do hospital, 15 (44,1%) foram com auxiliares/técnicos de enfermagem, 8 (23,5%) com instrumentadores, 5 (14,7%) com médicos em treinamento, 4 (11,8%) com médicos formados e 2 (5,9%) com equipe de profissionais de limpeza. Os acidentes foram do tipo percutâneo em 30 (88,2%) casos e por contato com mucosa em 4 (11,7%). Em 28 (82,4%) casos o acidente foi no membro superior, 4 (11,8%) na face e 2 (5,9%) em membros inferiores. O acidente ocorreu durante o ato cirúrgico em 12 (35,3%) e 10 (29,4%) durante a manipulação do material após o procedimento cirúrgico. Os acidentes aconteceram com funcionários que possuíam média de dois anos de experiência e após 5,5 horas trabalhadas.Conclusão:Os acidentes com material biológico em um hospital oftalmológico foram mais frequentes em profissionais auxiliares/técnicos de enfermagem, durante o ato cirúrgico e manipulação do instrumental após cirurgia. Este trabalho, portanto, demonstrou a importância de identificar riscos de acidentes laborais entre profissionais de saúde na área de oftalmologia.


Objective:To analyze the incidence and characteristics of accidents with biological material in an ophthalmology hospital in the Northeast of Brazil.Methods:Retrospective descriptive study on ducted through a survey of biological material accidents notified by Comunicação de Acidentes de Trabalho (CAT) during 2010-2013.Results:34 accidents were reported, 26 (76.5%) workers were females and 8 (23.5%) were males. The mean age was 30.0 ± 5.9 years. Forty-eight (82.3%) accidents occurred in the surgical room of the hospital, 15 (44.1%) were with auxiliary / practical nurses, 8 (23.5%) with surgical technologists, 5 (14.7%) with training physicians, 4 (11.8%) with trained physicians and 2 (5.9%) with cleaning staff. Accidents were with percutaneus in 30 (88.2%) cases, and contact with mucosa in 4 (11.7%). In 28 (82.4%) cases the accident was in the upper limb, 4 (11.8%) in the face, and 2 (5.8%) in the lower limbs. The accident occurred during surgery in 12 (35.3%) and 10 (29.4%) during manipulation of the material after surgery. The injuries occurred with employees who had an average of two years of experience and after 5.5 hours worked.Conclusion:Occupational accidents with biological material in an ophthalmology hospital were more frequent with auxiliary/practical nurses, during surgery and in the manipulation of instruments after surgery.This study demonstrated the importance of identifying risks of occupational accidents among health professionals in ophthalmology.


Subject(s)
Humans , Male , Female , Adult , Accidents, Occupational , Hospitals, Special , Occupational Health , Ophthalmology , Biohazard Release , Wounds, Stab , Cross-Sectional Studies , Retrospective Studies
7.
Rev. Col. Bras. Cir ; 40(4): 287-292, jul.-ago. 2013. ilus, tab
Article in Portuguese | LILACS | ID: lil-690327

ABSTRACT

OBJETIVO: avaliar os acidentes com material biológico entre estudantes de medicina estagiando em um pronto-socorro de trauma e identificar as principais situações relacionadas, causas atribuídas e prevenção. MÉTODOS: estudo com abordagem quantitativa. Os dados foram coletados através de um questionário, aplicado via internet, contendo perguntas fechadas de escolha múltipla, referentes a acidentes com material biológico. A amostra obtida foi 100 estudantes. RESULTADOS: trinta e dois se acidentaram com materiais biológicos. As atividades de maior risco foram anestesia local (39,47%), sutura (18,42%) e recapeamento de agulha (15,79%). As principais vias de exposição ao material biológico foram contato com olho ou mucosa, com 34%, através de seringa com agulha com 45%. Após a contaminação, apenas 52% notificaram o acidente ao setor responsável. CONCLUSÃO: as principais causas de acidente encontradas e vias de exposição podem ser atribuídas a diversos fatores, como falta de treinamento e ao não uso de equipamentos de proteção individual. Ações preventivas e educativas são de extrema importância para diminuir a incidência dos acidentes com materiais biológicos e melhorar a conduta pós-exposição. É preciso entender as principais causas atribuídas e situações relacionadas a fim de implantar medidas gerais e eficazes.


OBJECTIVE: To evaluate the accidents with biological material among medical students interning in a trauma emergency room and identify key related situations, attributed causes and prevention. METHODS: we conducted a study with a quantitative approach. Data were collected through a questionnaire applied via internet, with closed, multiple-choice questions regarding accidents with biological material. The sample comprised 100 students. RESULTS: thirty-two had accidents with biological material. Higher-risk activities were local anesthesia (39.47%), suture (18.42%) and needle recapping (15.79%). The main routes of exposure to biological material were the eyes or mucosa, with 34%, and syringe needle puncture, with 45%. After contamination, only 52% reported the accident to the responsible department. CONCLUSION: The main causes of accidents and routes of exposure found may be attributed to several factors, such as lack of training and failure to use personal protective equipment. Educational and preventive actions are extremely important to reduce the incidence of accidents with biological materials and improve the conduct of post-exposure. It is important to understand the main causes attributed and situations related, so as general and effective measures can be applied.


Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Accidents, Occupational/statistics & numerical data , Occupational Exposure/statistics & numerical data , Students, Medical , Biohazard Release , Emergency Service, Hospital
8.
Article in Korean | WPRIM (Western Pacific) | ID: wpr-214887

ABSTRACT

PURPOSE: Personal protection equipment (PPE) is compulsory for the safety of physicians and patients in the presence of biological hazards. In particular, such equipment is required for airway management of patients with highly contagious respiratory diseases. However, there are only a few studies about the effect of PPE on airway management with various advanced airway devices including the newly developed video-laryngoscope. We conducted a study on the effect of PPE level C on airway management with five different types of advanced airway devices including the laryngeal mask airway (LMA), direct laryngoscope (DL), airwayscope (AWS), video-laryngoscope made by Stortz (DCI), and the Levitanscope (LE). METHODS: Twenty-two emergency physician and residents in two emergency centers were trained to do trials with PPE and without PPE while performing airway management with five different airway devices. The procedures were done on two types of manikins. We compared the time from the start of the procedure to the first successful ventilation for each device and for each type of manikin. A short questionnaire was used to examine participants' subjective experiences. RESULTS: For both types of manikin, there were no significant differences in performance time between the group not wearing PPE and the PPE wearing group for any device. However, when compared with the other devices, the performance time for the LMA was faster than the other devices, and the Levitanscope(R) took a significantly longer time in both groups. According to the questionnaires, the most comfortable & uncomfortable airway devices were the LMA and the Levitanscope(R). CONCLUSION: When PPE level C was compared with the no protection state, there were no significant statistical time differences for performing advanced airway management with any particular airway device.


Subject(s)
Humans , Airway Management , Biohazard Release , Emergencies , Laryngeal Masks , Laryngoscopes , Manikins , Protective Clothing , Surveys and Questionnaires , Ventilation
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