Acidentes ocupacionais por exposição a material biológico entre trabalhadores do serviço de atendimento pré-hospitalar móvel de Minas Gerais

Abstract

Occupational accidents due to exposure to biological material (BM) represent a frequent concern, considering their high prevalence and prevention strategies. Among emergency care professionals, Mobile Emergency care professionals stand out, as they deliver Prehospital care (PhC) to emergencies in adverse conditions. As occupational accidents involving exposure to BM are only known locally and this team is constantly active in high-risk occupational conditions, the aim is to determine their prevalence, characteristics and post-accident conducts and to analyze the vaccine coverage for hepatitis B, tetanus and diphtheria among these workers. An epidemiological study with a cross-sectional design was carried out, involving professionals from the public PhC service in the State of Minas Gerais. Data were collected between December 2011 and July 2012, using a structured questionnaire, and then typed and analyzed in SPSS statistical software, version 18.0. To characterize the population, descriptive analysis was applied and, to check for possible associations between occupational accidents and the other variables, the multinomial logistic regression technique was used, with statistical significance set at p<0.05 and a 95% CI. Study participants were 487 workers, with 124 physicians (25.5%), 60 nurses (12.3%), 173 nursing technicians (35.5%) and 130 drivers (26.7%). A predominance of male professionals was verified (62.8%), 58.5% over 36 years of age (22 60 years), 56.5% working less than 40 hours per week (12 48hours), and 67.3% with more than one job contract. It was verified that the global prevalence of occupational accidents involving exposure to biological material corresponded to 17.0% (83/487), 47.9% percutaneous exposure; 39.7% mucosal exposure; and 12.4% non-intact skin. Among accident victims, nursing technicians stood out (44.6%), followed by physicians (24.1%). With respect to immediate post-accident conducts, 35.5% of professionals went through medical assessment, the occupational accident report was completed in 29.7% of cases and, in 13.2%, serology was collected from the source and the professional for hepatitis B; in 9.1% for HCV and in 10.7% for HIV. Serology monitoring for one year was informed by 4.9% of accident victims for hepatitis B, by 2.5% for hepatitis C and by 5.8% for HIV. As for the vaccine coverage, 66.1% of the professionals indicated they had completed the basic immunization scheme for hepatitis B and 75.8% for tetanus and diphtheria. Regarding serology for hepatitis B, 41.9% of the workers confirmed this procedure. Occupational accidents with percutaneous exposure to biological material were associated with the weekly workload over 40 hours variable (OR = 1,42; IC 95%: 1,22 1,79; p < 0,005); and accident involving contact with mucosal to the weekly workload over 40 hours variable (OR = 2,26; IC 95%; 1,06 4,83; p < 0,005) and sex variable (OR = 2,02; IC 95%; 1,01 4,04; p < 0,034). These study results evidence the need to put in practice an effective surveillance and control system for professionals with occupational exposure to biological material, as well as for the vaccine and serology coverage of all PhC professionals.