Occupational Risk Prevention Research Articles

Accidentes biológicos percutáneos en el personal sanitario: análisis de factores de riesgo no prevenibles mediante precauciones estándares

Objective To identify potential risk factors of occupational needlestick injuries that were not prevented despite adherence to standard precautions. Patients and method Multicentre case control study. Cases were defined as any workers who reported a needlestick injury despite documented use of standard precautions. Controls were workers of the same hospital who had performed procedures similar to matched cases and who reported a needlestick injury without correct use of standard precautions (control 1) or who did not report a needlestick injury during the previous 6 months (control 2). Results A total of 512 injuries were included (256 cases and 256 controls 1), and 256 controls 2. Analyses based on controls 1 showed an increased risk for physicians (ORa 2.22; 95% CI: 1.07-4.60) and those working in the operating theatre (ORa 2.87; 95% CI: 1.26-6.55). Regarding controls 2, increased risks were found for those younger than 25 years (ORa 2.58; 95% CI: 1.20-5.58), physicians (ORa 5.24; 95% CI: 1.50-18.28), those working in operating theatres (ORa 6.00; 95% CI: 2.07-17.36), emergency services, intensive and life-support units (ORa 3.48; 95% CI: 1.37-8.85) and those exposed to poor lighting (ORa 1.67; 95% CI: 1.02-2.82). Education in occupational risk prevention was found to be a protecting factor when controls 1 were analyzed (ORa 0.61; 95% CI: 0.39-0.97). Conclusions Despite adherence to standard precautions, working as a physician, in operating theatres, emergency and life-support units, being younger than 25 years, and being exposed to poor visibility and training in occupational risk prevention appear to be independent risk factors for occupational needlestick injuries.

“You will only see it, if you understand it” or occupational risk prevention from a management perspective

AbstractEvidence of a managerial influence on occupational risk prevention is largely lacking. The incidence of major accidents in high‐hazard sectors of industry does not show a downward trend. Also, the decline of fatal occupational accidents in industrialized Western countries may well be attributed to the growing employment in the relatively safe service sectors and to a phenomenon known as export of hazards. Looking more closely at accidents and disasters, we now believe they are not only caused by direct physical events, nor by human errors alone. They have their roots in organizational settings and in the sociotechnical system companies are active in. Whatever their cause, we know that (major) accidents almost always take us by surprise. Despite all our efforts and systems, we seem unable to foresee or predict these events. It seems our management systems are looking at the wrong items. Critics from small‐ and medium‐sized enterprises also point in that direction; management systems are too bureaucratic and lack a focus on hazard and risk identification. Apparently, we fail to incorporate the main ingredients of accident causation in our management systems. This article will discuss current models and presentations. In reference to the title of this article, the possibility to integrate these presentations into management systems will be discussed. This article is based on the presentation given at the 4th International Conference on Occupational Risk Prevention, Sevilla, Spain, May 10–12, 2006. © 2008 Wiley Periodicals, Inc.

Riscos à saúde de equipe de enfermagem em unidade de terapia intensiva: proposta de abordagem integral da saúde

In this study we discuss about risks to health of intensive care unity staff and suggest a proposal of integral approach of health. Literature review, from 1997 to 2007, at Bireme database about "health education", "intensive care unity", "nursing" and "occupational health", regardless of design of study. All studies show that the environment of intensive care unity is unhealthy, which is also due to habits and attitudes of ICU health professionals. An approach to health education would be beneficial to minimize the problem. Strategies for continuing education are appropriate both in the prevention of occupational and environmental risks in intensive care units.

Representações do trabalho informal e dos riscos à saúde entre trabalhadoras domésticas e trabalhadores da construção civil

During the past few decades, the Brazilian labor market has been characterized by an increase of unregistered workers, earning lower wages, not covered by social insurance or occupational risk prevention programs. This study describes the representations and perceptions about informal work contracts and job-related health risks, analyzed in a group of injured unregistered workers. This was a qualitative study based on in-depth interviews carried out with seventeen laborers, nine housemaids and eight construction workers. The findings indicate that workers recognize the importance of formal jobs, mainly because of legal guarantees of labor rights, mentioning the symbolic downgrading of informal jobs that undermines their self-esteem. Both work groups tended to minimize occupational health risks in the work environment, and did not recognize associations between informal job contracts and occupational accidents or diseases. It was clear that workers want to have job contracts. The findings of the study demonstrate the need for broader dissemination and discussion about labor rights and the construction of public policies that encompass health and safety programs for these workers.

Évolution de l'offre de service en matière d'évaluation et de prévention des risques psychosociaux au travail

A new set of occupational risks has emerged with the evolution of work's organization: psychosocial risks. They are at the origin of various professional pathologies (stress, anxiety, burn-out syndrome, et cetera). Based on the authors' experience as consultants in the prevention of occupational risks, they bear witness to the evolution of the availability of services in evaluation and prevention of psychosocial risks. The authors emphasize the necessity of adopting a continuous and flexible evaluation approach in order to select the most effective prevention strategies.

L'expologie ou la nécessité d'articuler les données relatives aux dangers, à l'homme et à son activité

Résumé To optimise the prevention of occupational risks, it seems necessary to revise existing methodological approaches by organizing and better articulating the data concerning hazards, the worker and, his activity. In the context of occupational health, exposure science offers the opportunity to regroup and link knowledge and know-how in order to fully characterise hazardous occupational exposure. The authors illustrate the interest of this approach using the example of a field study on the characterisation of occupational exposures to polycyclic aromatic hydrocarbons.

L'expologie ou la nécessité d'articuler les données relatives aux dangers, à l'homme et à son activité

To optimise the prevention of occupational risks, it seems necessary to revise existing methodological approaches by organizing and better articulating the data concerning hazards, the worker and, his activity. In the context of occupational health, exposure science offers the opportunity to regroup and link knowledge and know-how in order to fully characterise hazardous occupational exposure. The authors illustrate the interest of this approach using the example of a field study on the characterisation of occupational exposures to polycyclic aromatic hydrocarbons.

Percepción del personal médico de atención primaria de salud acerca de sus funciones, formación y conocimientos en materia de salud laboral

To evaluate the perception of primary health care medical staff (PHCMS) have on their functions in occupational risk prevention (ORP), as well as their knowledge and skills on the subject of occupational health (OH).Descriptive cross-sectional study.Health Department 20 of Alicante province, Spain.All PHCMS (N=104), with a participation of 80% (N=83).The participants self-completed a questionnaire specifically developed for the study. Sixteen questions were established and covered functions in ORP and skills for developing them, as well as the amount and usefulness of training received on the subject of OH.The PHCMS did not perceive that they had functions as regards ORP (median [Me], 2; interquartile range [IR], 1-3). To a greater extent they considered themselves capable of identifying whether an illness seen in their clinic was of work origin or not (Me, 3; IR, 3-4). Training in OH as a medical student and in their medical internship (MIR) was identified as of minor importance (55.4% and 60%, respectively, of those surveyed scored a value of 1 in the questionnaire). The PHCMS obviously considered that better training in OH would help them in their daily professional activity. High scores were obtained for this (response options greater than or equal to 4) in more than 70% of the interviewees.Training in OH must be encouraged so that PHCMS are seen to be health personnel with functions in ORP and are able to acquire the necessary knowledge and skills in OH for their routine medical practice.

La vigilancia de la salud de los trabajadores 12 años después

Most, if not all the companies, have started some kind of prevention activity since the new regulation of occupational risk prevention was issued on 1996. However, difficulties have been detected in the implementation of the new model of health surveillance. The aim of this paper is to promote discussion and improvement of health surveillance by describing who is making health surveillance, what and how it is been done.

Weakness of scientific and technical culture of the public and consequences for the development of prevention actions

It has been known since the Platonician myth of the cave that people are slaves to appearance, that one only has access to a pale reflection of the truth. All knowledge necessarily begins by a rupture with habits, by not accepting things at face value and by systematic doubt, as Descartes recognized. However, to arrive at elements of perception of new risks, there has to be a distance between the worker who may be subjected to the risk and the risk itself or what conditions it. Until now, society has been able to develop occupational risk prevention methods and practices on relatively ‘simple’ subjects by imposing rules and by communicating on targeted subjects via different media forms. To do this, the relays which exist, for example in France inside the ‘Institution Prévention’ of the Social Security, have been able to promote useful activities alongside changes to the legislation. The change in society at work, which is exploring complexity and more specific work situations, has led to more and more enterprises and in certain cases employees themselves being asked to express an opinion concerning the risks they are likely to encounter. However, as pointed out for example by Miller, ∼95% of society is either indifferent to science or is interested but does not feel competent: how then is a risk analysis to be constructed without external assistance? What place should be given to experts who give advice and consequently what prevention can be proposed? Different ways forward based on extending the scope of expert evaluation or the application of the precautionary principle are described in this paper, which is not intended to contribute safe, ready-made solutions. During the consideration given to the preparation of this document, it appeared necessary to reposition the prevention culture of citizens as early as the training process of young people. The problems are discussed and areas with potential are described, but as for the solutions, prior experimentation is necessary within a framework of social confidence or modest interest.

A descriptive, retrospective study of 567 accidental blood exposures in healthcare workers in three West African countries

We conducted a multi-centre study in West African hospital wards to document accidental blood exposure (ABE) risks in these settings, and assessed the incidence of ABE in participating healthcare workers (HCWs) retrospectively. In total, 1241 HCWs participated in the survey from 43 hospital wards. Among them, 567 (45.7%) had sustained at least one ABE with an estimated incidence of 0.33 percutaneous injuries (PCIs) and 0.04 mucocutaneous contacts (MCCs)/HCW/year in medical or intensive care personnel and 1.8 PCIs/HCW/year in surgeons. The ABE was a needlestick in 454 (80.1%) of 567 cases, a cut in 19 cases (3.4%), a splash or contact with non-intact skin in 87 cases (15.3%), and was undocumented in seven cases (1.2%). The source patient's human immunodeficiency virus (HIV) serostatus was positive in 74 cases (13.1%), negative in 65 cases (11.5%), and unknown in 416 cases (73.4%). The ABE was not notified in the ward in 392 cases (69.1%). Healthcare structures can improve HCWs' safety and reduce the stigma against HIV-infected patients by improving access to training, information, primary prevention (ABE prevention equipment) and secondary prevention (postexposure prophylaxis) of occupational infection risks.

Trends of research and practice in "occupational risk prevention" as seen in Germany.

Hypothesis and scenarios of future developments in ORP and ORP research are derived. Based on an analysis of events in the past, on the content and process of research projects in the German "humanization" program, on literature analysis and expert interviews 19 anamnesis to diagnosis relationships are formulated concentrating on the following topics: 1. Innovation potentials and value systems of ORP research, 2. Fields and topics of ORP research of the future, 3. Service-oriented systems of actors in ORP, 4. Demands and limits for research transfer. So the creative potential of the ORP community in Germany was used to conclude on recommendations for ORP developments.

Joint adoption of ISO 14000-ISO 9000 occupational risk prevention practices in Spanish industrial companies: A descriptive study

This paper intends to analyse the advisability of combining the three management standards (quality, environment and risk prevention) in Spanish industrial companies, and also to study with which particular standards this combination is considered adequate. Besides, our objective is to study if aspects like the size of the company, the level of demand of the environmental legislation or the field of activity of the companies are elements that affect the tendency of the companies to integrate the standards.

Under the Constraints of Societal Changes, Media, Ethics and a More Top-Down Approach: What Does Prevention Research Have to Offer the Working Environment?

The rapid change in the world of work requires permanent revision of research strategies in the field of occupational risk prevention. These must take the following factors into account: - technological development and development of linked organisations, - the reinforcement of the relations between individuals and their “bodies”, - the shift from the causal to the probable not to say the possible with regard to increasingly multifactorial occupational risks, - exploration of the effects of standard deviations (and not only statistical averages) on the harmful consequences of work, - links between work and the environment.

Régulation de la carrière d’un instrument de santé. Les parcours de l’usage du test du VIH dans l’emploi en France et aux États-Unis

As a knowledge condensed into a technique worked out in biology, applied in medicine and guaranteed by laws on bioethics, the HIV test is a ‘hot’ topic. The demand for this test is strong in many sectors having to do with risk assessment: employment, the prevention of occupational risks, insurance, etc. The ways this test has been put to use in France and the United States are compared in the field of employment. This test is part of quite distinct public regulations in each land: its uses are defined, in France, through agreements by sector but, in the United States, by law in a ‘globalizing’ fashion. Differences in how this test has been used are interpreted as the consequence of its social-technical properties and of the private/public levels of action wherein it is run.

La identificación y registro de enfermedades laborales neurológicas en el Sistema Nacional de Salud

There are reasons to believe that in Spain, as in other countries, the number of professional occupational diseases in general and neurological disorders in particular is underestimated. Many workers with illness due to their work are attended by Primary Care and Specialist doctors of the National Health Service. Every day patients with neurological disorders which may possibly be related to their occupation go to see Primary Care and Specialist doctors of the Health Service. For the recognition and consequent recording of neurological occupational diseases, it is essential that there be collaboration between the Occupational Risk Prevention Service and the National Health Service, so that lesions occurring at work are brought to light and suitably handled. In this article we describe the neurological occupational disorders, the occupations and agents which may produce them and their recognition as occupational diseases in the current Spanish legal code. We also give details as to the channels for declaration and registration of occupational diseases at the present time, and the way in which the specialist in Neurology can help to make the neurological occupational diseases more evident. Finally, we describe the outbreaks of polyneuropathy due to n-hexane which occurred in Spain in 1998. In the management of these outbreaks it became evident that satisfactory communication between the Primary Care, Specialist Attention, epidemiological vigilance and occupational health services led to suspicion of an 'occupational toxin' in relation to the cases of polyneuropathy within a brief period of time. This also led to the establishment of the relevant investigation and coordination between health and labor authorities, which in turn led to adoption of measures of prevention and control to prevent the occurrence of further cases.

Prevention of Risks from Occupational Exposures to Antineoplastic Drugs: Consensus Document

Ever-increasing numbers of cancer patients have been treated with antineoplastic drugs in the past few years. Among patients treated with these drugs, an increased risk of a "second neoplasm" has been observed, mainly as a function of increased life expectancy. On the basis of this observation, the International Agency for Research on Cancer has classified a number of antineoplastic drugs as carcinogenic or probably carcinogenic for humans. Various categories of workers are at risk for exposure to antineoplastic drugs, absorbing these substances mainly through inhalation or dermal contact. Although the absorbed doses are notably lower than those administered to patients, review of the literature reveals increased risks of spontaneous abortions and chromosomal aberrations in subjects who have worked without adequate protection. A working group, Prevention of Occupational Risks Due to Handling Antineoplastic Drugs in Health Care, was established by the Italian Institute of Prevention and Safety at Work (Istituto Superiore per la Prevenzione e Sicurezza sul Lavoro-ISPESL) in February 1995. This group reviewed the epidemiologic studies and research on cytogenetic indicators of genotoxicity in occupationally exposed subjects. In addition, the group made recommendations for environmental and biological monitoring of exposure and health surveillance, and developed guidelines for primary and secondary prevention. The group's recommendations are summarized in a consensus document, but cannot be considered definitive, since work practices continue to evolve and will have to be examined further in the future. Thus, more research is needed to achieve answers to the questions raised by the working group. The main topics to be addressed are indicated in the consensus document. In particular, it will be necessary to evaluate working conditions nationwide, using standardized protocols for risk assessment, to achieve precise estimates of workers' exposures.

On the substitution for carcinogens in the working environment.

The ultimate solution in prevention of occupational cancer risks would be to remove carcinogens from the working environment. Elimination of carcinogenic substances can be achieved by replacement of the carcinogen with non-carcinogen(s) having the same functionality, or by using a different process that produces adequate results without the use of carcinogenic agents. This paper presents selected methods and tools, which have been used for substitution purposes in practice. These are: 1. a strategy for substitution, 2. a tool for creating ideas on how to substitute, 3. a software package, SUBTEC, for solving some technical and industrial hygiene problems, and 4. a proposal for a strategy to deal with organizational and psychological barriers encountered when changes are to be introduced.

Overuse Syndromes in the Upper Limb

Overuse syndromes, or cumulative trauma disorders, are a major health concern to business, industry, government, and the medical and legal professions. It has been estimated that as many as 15 to 20% of employees are at risk of developing a cumulative trauma disorder. These disorders account for a large source of lost income, lost work time, and overuse of health care resources. This article explores the epidemiology, occupational risk factors, management, and prevention of overuse or cumulative trauma disorders of the upper limb.

Vibration at work—3rd international symposium of the international section for research on prevention of occupational risks, Vienna, Austria, April 19–21, 1989

Vibration at work—3rd international symposium of the international section for research on prevention of occupational risks, Vienna, Austria, April 19–21, 1989