Registros de Acidentes com Material Biológico na Prática Odontológica no Estado de Goiás, 1996-2010
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Data
2012-05-07
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Universidade Federal de Goiás
Resumo
The dental care practice is characterized by the constant possibility of the staff and
patients exposure to biological material (BM) potentially contaminated with infectious
various agents, and requiring the epidemiology expertise of these exposures in order
to develop the risk management procedures. The present study aimed to analyze
the epidemiology of occupational accidents with exposure to BM among dental
professionals and students in the State of Goias, and as specific goals, to ferify the
frequency and profile of the accidents with biological material exposure among the
dental care students and professionals enrolled in a reference hospital with service in
compliance with occupational exposure to BM, to characterize the pre-and postexposure
behavior and monitoring program recommended for this population and to
analyze the socio-demographic and labor factors related to the accidents with BM by
percutaneous exposure between dental care professionals and students assisted in a
reference service. This is an epidemiological, retrospective and analytical study
developed in a referral hospital for the treatment of occupational accidents with
exposure to BM of the State of Goiás. All records of the accidents with BM between
dental care professionals and students attended in this institution by December 2010
were analysed. Data were collected by completing a standardized form containing
personal information, description of the accident, time elapsed between the accident
and the first service, and post-exposure and prophylaxis procedures. The data were
analyzed by SPSS 15.0 and the OpenEpi 2.3.1., Statistical analysis was performed
by descriptive frequency measures and univariate analysis using qui-square and
Fisher exact test. 628 accidents were recorded between dental care professionals
and students from 1996, the year of first registration, to 2010, in which 77.1% were
women. Some individuals reported more than one accident, totalling 701 accidents
with exposure to BM that comprise the study population. Among the accidents, the
majority (97, 13.8%) occurred in 2008 and 48.6% between dentists. In 92.2% of
cases, hepatitis B vaccination status of the victims was described, and out of these,
70.8% received all three doses. In 84.9% of cases there was no record of the
completion of anti-HBs by the victims. The accidents were predominantly (658,
93.9%) percutaneous, being the needle the instrument that caused the injury in
49.7%. Performing any dental care procedure was the most comum circumstance in
which the accidents occurred most frequently (388, 55.4%), and the finger, the body
area most affected (493, 70.3%). We highlight the lack of information in many cases,
especially in relation to BM involved in the accident, the use of personal protective
equipment at the time of the accident, where the victims performed their activities at
the time of the accident and / or were linked and fullfilling of Work Accident
Communication form. With the post-exposure procedures, the majority (635, 90.6%)
of the institution accidents enrollments occurred within 72 hours, however only 44.9%
were in the first two hours. The use of chemoprophylaxis and prophylaxis of hepatitis
B in 14.8% and 12.8% of the cases, respectively were recommended. In 82.6% of
the accidents, the patients were identified, and their HIV, HBV and HCV condition
ignored in 93.6% of records. Among the accidents in which the victim must return to
the intitution for the post-exposure follow up (264, 37.7%), only 20.8% returned and
3.8% were discharged. Accidents by percutaneous exposures showed a high
prevalence for all variables analysed. It was observed that the higher is the demand
for the service the less is the individual chance to undergo a percutaneous exposure
(p = 0.000). The occurrence of accidents among dental auxiliaries was significant (p
= 0.016) compared to dentists. The lack of data in the records of the institution
reveals the need for greater disclosure of ministerial protocols for caring the victims
of occupational accidents by BM among professionals responsible for this service.
The integration of biosafety, infection control procedures for dental care practice and
prevention and prophylaxis for BM accidents issues with undergraduate, graduate
courses should develop and provide effective behavior changes.
Descrição
Palavras-chave
Exposição Ocupacional , Odontologia , Exposição a agentes biológicos , Notificação de acidentes de trabalho , Ferimentos penetrantes produzidos por agulha , Patógenos transmitidos pelo sangue , Occupational exposure , Dentistry , Exposure to biological agents , Occupational accidents registry , Needlestick injuries , Blood-borne pathogens
Citação
LIMA, Liwcy Keller de Oliveira Lopes. Registros de Acidentes com Material Biológico na Prática Odontológica no Estado de Goiás, 1996-2010. 2012. 138 F. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2012.