[Occupational accidents at an Acute Care Hospital]. / Accidentes de trabajo en un hospital de agudos.

BACKGROUND: To obtain a better knowledge of the determining factors and circumstances giving rise to occupational accidents will foster the implementation of corrective measures. The aim of this study is that of describing the trend of occupational accidents (OA's) over the course of time and of determining the risk factors regarding workers being forced to take time off for sick leave at the "Dr. Peset" Hospital in Valencia. METHODS: Description and retrospective analysis of the occupational accidents having occurred at the "Dr. Peset" Hospital in Valencia throughout the 1992-1995 period. The trend and seasonality of the series (seasonal indexes, SI's) were estimated by deterministic methods. A logistic regression model was employed to identify the factors providing a prior indication workers being off on sick leave and to determine the probability of the occurrence thereof. RESULTS: The highest OA rates were found among the kitchen and laundry workers (10.00 OA's per 100 workers/year). The OA's involving sick leave continued to show a trend of around zero, February being the months showing the highest SI (SI = 139.8). Those processed without sick leave showed an upward trend (r2 = 0.23, p < 0.0001), May being the month involving the largest number of casualties (SI = 134.2). The probability of an accident resulting in a worker being forced to take time of for sick leave increases significantly with age, when the accident in question takes place in the afternoon/evening, if it takes place in the kitchen/laundry, and if a sprain or tendinitis is involved. CONCLUSIONS: The measures taken involving the number of casualties entailing OA's which result in temporary incapacity should revolve around the less-skilled positions and the kitchen and laundry departments.

[Factors associated with inadequate response to hepatitis B vaccination in health care personnel]. / Factores asociados a una respuesta inadecuada a la vacunación contra la hepatitis B en personal sanitario.

BACKGROUND: The recombinant hepatitis B vaccine provides immunity in approximately 95% of all cases, but there is a certain percentage which responds insufficiently. The purpose of this work consists of assessing the factors which are linked to an inadequate immune response. METHODS: This is an observational, analytical study in which a retrospective follow-up is made of a group of subjects vaccinated to prevent against hepatitis B (HBV). The variables of interest of the health care personnel meeting the requirements to be included in this study in Health Care District No. 9 of the Autonomous Region of Valencia (No. 827) were gathered. Following vaccination, the titration of surface antibodies (antiHB's) was determined for checking the response, levels of over 10 m UI/ml being considered to provide protection. RESULTS: An adequate serum changeover was achieved in 94.4% of those vaccinated. The low-degree or zero response to the vaccine was significantly linked independently to variables such as male gender, age, the body mass index (BMI) and the habit of smoking. Drinking alcohol and the levels of GPT, although they did not react significantly with the response to the vaccine, were possibly misleading factors. CONCLUSION: The immunogenicity of this vaccine is satisfactory. It is important to quantify the levels of antiHB's, especially when factors predicting a poor response are involved. Therefore, it is possible to identify those which require a booster shot and those showing no response, hence avoiding situations involving a false sense of being protected against HBV.