Underreporting of work accidents associated with blood-borne risk factors

Main Article Content

Cláudia Vieira
Joaquim Góis
Paulo Laranjeira
Paulo Pinho
Pedro Norton

Keywords

Biological risks, Healthcare workers, Needlestick injuries, Underreporting, Work accidents

Abstract

Background: Work accidents (WA) due to percutaneous or mucocutaneous injury are extremely frequent among health professionals. The notification of these accidents ensures not only the compliance with legal requirements, but it also enables health institutions to develop, implement and evaluate strategies to prevent them. This study aimed to estimate the proportion of underreporting of work accidents caused by percutaneous and mucocutaneous lesions in a hospital setting, as well as its determinants. Methods: A self-administered questionnaire was made available to all hospital employees. Age, gender, professional category and type of service adjusted odds ratios (OR) and 95% confidence intervals (95%CI) were computed by multivariate logistic regression models. Results: Underreporting of WA associated with biological risk factors was high, particularly in accidents by mucocutaneous injury (80.9%). Physicians were the professional category that least reported this type of work accidents (OR=4.64; 95%CI 2.20-9.78). The main determinants of underreporting were the underestimation of the risk of transmission and the excessive bureaucracy. Conclusions: The underreporting of work accidents associated with biological risk factors was considerable and it contributes to a high degree of uncertainty on accidents’ characterization.

Abstract 436 | PDF Downloads 346

References

1. American Federation of State Country and Municipal Employees. Needle points: an AFSCME guide to sharps safety. 2002 [16 Feb 2015]; Available from: http://www.afscme.org/news/publications/workplace-health-and-safety/needle-points-an-afscme-guide-to-sharps-safety.
2. Marziale MHP. Subnotificação de acidentes com perfurocortantes na enfermagem. Rev bras enferm [online]. 2003;56(2):164-8.
3. Zaidi MA, Griffiths R, Beshyah SA, Myers J. Blood and body fluid exposure related knowledge, attitude and practices of hospital based health care providers in United arab emir-ates. Saf Health Work. 2012 Sep;3(3):209-15.
4. Facchin LT. Prevalência de subnotificação de acidentes com material biológico pela equipa de enfermagem de um hospital de urgência. São Paulo: Universidade de São Paulo; 2009.
5. American Nurses Association. Needlestick and Sharps Injuries. 2012 [18 Aug 2014]; Available from: http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety/SafeNeedles/NeedlestickPrevention.pdf.
6. Elder A, Paterson C. Sharps injuries in UK health care: a review of injury rates, viral transmis-sion and potential efficacy of safety devices. Occup Med (Lond). 2006 Dec;56(8):566-74.
7. Bilski B, Kostiukow A, Ptak D. [Risk bloodborne infections in health care workers]. Med Pr. 2006;57(4):375-9.
8. Brusaferro S, Calligaris L, Farneti F et al. Educational programmes and sharps injuries in health care workers. Occup Med (Lond). 2009 Oct;59(7):512-4.
9. Doebbeling BN, Vaughn TE, McCoy KD, et al. Percutaneous injury, blood exposure, and ad-herence to standard precautions: are hospital-based health care providers still at risk? Clin In-fect Dis. 2003 Oct 15;37(8):1006-13.
10. Leone A, Magrini A, Pietroiusti A, Vinci F. [Role of the occupational health physician in the evaluation of biological risk and cancer in a hospital setting]. G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl):843-4.
11. Faria A. Caracterização e Análise dos Acidentes de Trabalho com Profissionais de Enferma-gem numa Unidade Hospitalar: University of Minho; 2008.
12. Cubillos AF, Jemenao I, Ruiz G, et al. Biological risk accidents among undergraduate healthcare students. Five years experience. Rev Chil Infect. 2010;27(1):34-9.
13. Benatti MCC. Acidentes do trabalho entre trabalhadores de enfermagem de um hospital universitário. Rev esc enferm USP [online]. 2001;35(2):155-62.
14. Napoleão AA, Robazzi ML, Marziale MHP, Hayashida M. Causas de subnotificação de aci-dentes de trabalho entre trabalhadores de enfermagem. Revista Latino-Americana de Enfermagem. 2000;8(3).
15. Falagas ME, Karydis I, Kostogiannou I. Percutaneous exposure incidents of the health care personnel in a newly founded tertiary hospital: a prospective study. PLoS One. 2007 Feb 7;2(2):e194.
16. Efstathiou G, Papastavrou E, Raftopoulos V, Merkouris A. Prevalence of Occupational Ex-posure to Pathogens and Reporting Behaviour among Cypriot Nurses. International Journal of Caring Sciences. 2013;6(3):420-30.
17. Kennedy R, Kelly S, Gonsalves S, Mc Cann PA. Barriers to the reporting and management of needlestick injuries among surgeons. Ir J Med Sci. 2009 Sep;178(3):297-9.
18. Elmiyeh B, Whitaker IS, James MJ, Chahal CA, Galea A, Alshafi K. Needle-stick injuries in the National Health Service: a culture of silence. J R Soc Med. 2004 Jul;97(7):326-7.
19. Mbaisi EM, Ng'ang'a Z, Wanzala P, Omolo J. Prevalence and factors associated with percu-taneous injuries and splash exposures among health-care workers in a provincial hospital, Kenya, 2010. Pan Afr Med J. 2013;14:10.
20. Ekwobi CC. Under-reporting of needlestick injuries is a universal problem. Rapid Response to: Most US surgeons in training get needlestick injuries, few report them. BMJ. 2007;335(10).
21. Au E, Gossage JA, Bailey SR. The reporting of needlestick injuries sustained in theatre by surgeons: are we under-reporting? J Hosp Infect. 2008 Sep;70(1):66-70.
22. Lee LK, Hassim IN. Implication of the prevalence of needlestick injuries in a general hospital in Malaysia and its risk in clinical practice. Environ Health Prev Med. 2005 Jan;10(1):33-41.
23. Valim MD, Marziale MHP, Hayashida M, Richart-Martínez M. Occurrence of occupational accidents involving potentially contaminated biological material among nurses. Acta Paul Enferm. 2014;27(3):280-6.