Em época de Pandemia: Covid-19 como Doença Profissional- a experiência de um Instituto Português de Oncologia

Abstract

INTRODUCTION The novel coronavirus, called SARS-CoV-2, has as its main factor of the disease spreading the transmission between humans. COVID-19 is the name given by the World Health Organization (WHO) to identify the disease caused by this agent. Portugal is currently experiencing the pandemic Mitigation phase, in which, in addition to community transmission, it is assumed that there is local transmission in a closed environment. This disease was recognized by the WHO and by the Portugal Directorate-General of Health as Occupational Disease in a health care environment. OBJECTIVE Evaluate and characterize the presumed cases of occupational disease caused by SARS-CoV-2, among workers with COVID-19, considering the respective interpretation of the causal nexus, individually. METHODS Retrospective, descriptive, observational study (case-series), carried out between march and july 2020 in workers of a Portuguese oncology institute, dedicated to provide care for patients with cancer, reviewing files in the clinical processes of the occupational health service software (UTILSST®). It was considered the infection of workers with SARS-COV-2, as an inclusion criterion. RESULTS 41 workers were diagnosed with COVID-19, with an average age of 43.70 ± 11.63 years. Of these, 87.80% (n= 36) were female. The professional category with the highest infection rate in the institution was the auxiliaries of nursing [46.34%, n= 19], followed by nurses [39.02%, n = 16]. The most affected service was a Medical Oncology Service [31.4%, n= 11]. In the studied population, the prevalence of cases presumed to be Occupational Disease was 80.49% (n= 33). Of these, 48.5% (n= 16) were by direct contact with an infected patient, 30.3% (n = 10) without a known index case, but with a diagnosis obtained in “Disease mitigation phase” and 21.2% (n=7) by contact with an infected worker. In 19.51% (n= 8) of all the cases, no Occupational Disease was presumed, due to contact with an infected index case in a social/ family environment. CONCLUSION The main sources of nosocomial transmission with an assumed causal nexus are patients with COVID-19. It is essential to put into practice and ensure the maintenance of adequate collective and individual protection measures to combat this disease, as well as ensuring a permanent update of the institution’s infection control program so that the risk of exposure is controlled.