Teses e Dissertações

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Occupational exposures to blood and body fluids among primary health care workers in Brazil

Background: Primary health care workers represent a growing work force group around the world. Those workers are at risk of infection with bloodborne pathogens because of occupational exposures to blood and body fluids (BBF). This study investigated BBF occurrence and its associated factors among primary health care workers.

Methods: A cross-sectional study was conducted among all workers from Municipal Primary Health Care Centers in Florianópolis, Southern Brazil (n=1,249). Of those, 1,077 workers who belonged to occupational categories that presented BBF exposures during the 12 months preceding the interview were included in data analysis.

Results: The mean incidence rate of occupational BBF exposures was 11.88 per 100 FTE workers-year (95% CI: 8.44; 15.32). The cumulative prevalence was 6.96% during the 12 months preceding the interview. University-level education, occupation as nurse assistant, dental assistant or dentist, higher workload score, inadequate working conditions, having sustained a previous occupational accident, and current smoking were associated to BBF exposures at the adjusted analysis (p _ 0,05).

Conclusions: Primary Health Care Centers are unique and unpredictable environments, which put their workers at risk of BBF exposures. Exposure surveillance systems should be created to monitor its occurrence and to guide the implementation of preventative strategies.

Occupational accidents and associated factors among workers from primary health care centers in Brazil

Objectives: To describe the occupational accidents, to estimate its rates and cumulative prevalence during an one-year period among workers from Primary Health Care Centers, and to identify its associated factors.

Methods: A cross-sectional study was conducted among all workers from Municipal Primary Health Care Centers in Florianópolis, Southern Brazil (n=1,249). Data were collected through interviews using standardized questionnaires. Accident rates per 100 FTE workers-year and cumulative prevalences of occupational accidents for the previous 12 months were calculated. Multivariate analyses were conducted through Poisson regression.

Results: The cumulative prevalence of occupational accidents was 21.6%. The mean incidence rate of occupational accidents was 47.2 per 100 FTE workers-year (95% CI: 39.4; 55.0). The most frequent types of accidents were blood and body fluid exposures (22.0%), followed by falls (15.5%). In the adjusted analysis, a higher incidence of occupational accidents was associated with occupation as cleaning personnel (IRR: 2.20; 95%CI: 1.03; 4.69), nurse assistant (IRR: 2.52; 95%CI: 1.64; 3.87) or dental assistant (IRR: 3.68; 95%CI: 1.93; 7.01) compared to community health agents, length of employment of two years or less (IRR: 1.62; 95%CI: 1.14; 2.32), higher work load score (IRR: 1.58; 95% CI: 1.21; 2.07), inadequate work environment conditions (IRR: 1.35; 95% CI: 1.05; 1.74), previous occupational accident (IRR: 4.33; 95%CI: 3.28; 5.71), current smoking (IRR: 1.38; 95% CI: 1.07; 1.77) and job dissatisfaction (IRR: 1.55; 95% CI: 1.03; 2.32).

Conclusions: Primary Health Care Centers present a wide range of hazardous situations. The community environment also presents hazards in terms of infrastructure and violence. Previous occupational accident was the strongest predictor of occupational accident, supporting the assumption that workers who sustained previous accidents have greater risk for sustaining another accident at the workplace. These findings have implications in the implementation of strategies to improve workplace health and to reduce occupational accidents.

Keywords: Accidents, Occupational. Occupational Health. Primary Health Care.

Vacinação contra a hepatite b entre trabalhadores da Atenção Básica à Saúde

A vacinação dos trabalhadores da saúde contra a hepatite B é fundamental para evitar a transmissão ocupacional do vírus nas unidades de atenção básica à saúde. Os objetivos deste inquérito epidemiológico foram verificar a prevalência da vacinação completa contra a hepatite B, estimar a prevalência da confirmação da imunidade e investigar os fatores associados à realização do esquema vacinal completo entre trabalhadores de Unidades de Saúde do município de Florianópolis, SC. Participaram do estudo 1249 trabalhadores. A prevalência da vacinação completa contra a hepatite B foi 64,61% e 29,82% dos trabalhadores indicaram saber que estavam imunizados após a realização de exame sorológico para confirmação da imunidade. Na análise ajustada, a vacinação foi positivamente associada com maior escolaridade e contato com material biológico ou materiais perfurocortantes durante o trabalho e negativamente associada com regimes de trabalho precários e fumo atual. São recomendadas medidas educativas visando a vacinação daqueles que não o fizeram ou não completaram o esquema vacinal e informação sobre a necessidade do monitoramento da resposta vacinal.

Palavras-chave: Vacinas contra hepatite B. Hepatite B, prevenção & controle. Atenção Primária à Saúde. Recursos Humanos em Saúde. Saúde do Trabalhador.