Occupational Risks of Health Professionals in Turkey as an Emerging Economy

BACKGROUND

Health services are one of the work areas that contain important risks in terms of the occupational health and safety of the laborer. Professionals in various areas of health services encounter biological, chemical, physical, ergonomic, and psychosocial risks, particularly in hospitals.

OBJECTIVES

This study has been performed to evaluate the impacts of the occupational risks on health of health professionals in Turkey.

FINDINGS

In Turkey, as an emerging economy, the history of studies on health professionals is not longstanding. There have been various regulations intended for the occupational health and safety of health professionals in line with the Regulation of the Provision on Patient and Staff Safety prepared in 2012. However, applications can differ from region to region, institution to institution, and person to person.

CONCLUSIONS

We believe that this review will lead health professionals to be aware of occupational risks and contribute to planning health services for health professionals.

Application of the Extreme Value Distribution to Estimate the Uncertainty of Peak Sound Pressure Levels at the Workplace

OBJECTIVES

The purpose of this article is to develop a method for the statistical inference of the maximum peak sound pressure level and of the associated uncertainty. Both quantities are requested by the EU directive 2003/10/EC for a complete and solid assessment of the noise exposure at the workplace.

METHODS

Based on the characteristics of the sound pressure waveform, it is hypothesized that the distribution of the measured peak sound pressure levels follows the extreme value distribution. The maximum peak level is estimated as the largest member of a finite population following this probability distribution. The associated uncertainty is also discussed, taking into account not only the contribution due to the incomplete sampling but also the contribution due to the finite precision of the instrumentation.

RESULTS

The largest of the set of measured peak levels underestimates the maximum peak sound pressure level. The underestimate can be as large as 4 dB if the number of measurements is limited to 3-4, which is common practice in occupational noise assessment. The extended uncertainty is also quite large (~2.5 dB), with a weak dependence on the sampling details.

CONCLUSIONS

Following the procedure outlined in this article, a reliable comparison between the peak sound pressure levels measured in a workplace and the EU directive action limits is possible. Non-compliance can occur even when the largest of the set of measured peak levels is several dB below such limits.

Work-Related Upper Limb Disorders: A Case Report

In this study the complex interrelationship between physical factors, job stress, lifestyle and genetic factors on symptoms of work-related musculoskeletal disorders of the upper limbs is demonstrated by a case report and discussion of the literature. A 58 year old woman with long lasting complaints of the upper limbs with increasing intensity and duration, generalisation, combined with skin thickness, Raynaud's phenomenon, joint disorders, arterial and pulmonary hypertension, metabolic lipid dysfunctions is presented. Occupational history proves continuous duration of service at a job with occupational physical static load with numerous repetitive monotonous systematic motions of fingers and hands as a weaver of Persian rugs followed by work at an automated loom and variable labour activities. Though the complaints dated since the time she was a manual weaver, the manifestations of generalized joint degenerative changes, system sclerosis with Raynaud's phenomenon with similar upper extremities signs and symptoms discount upper limbs musculoskeletal disorder as caused only or mainly by occupational risk factors. The main principles and criteria for occupational diagnosis of musculoskeletal upper limb disorders and legislative requirements for their reglamentation are discussed.

Retained intracorneal human hair fragment: An unusual case of occupational trauma

A 32-year old male hairdresser presented with redness and irritation of the left eye for past 15 days. A fragment of hair was found embedded in deep corneal stroma with minimal scarring. No evidence was found of previous or current inflammation incited by this foreign body. The position and depth of the hair fragment was documented by anterior segment optical coherence tomography (AS-OCT) and its effect on the corneal endothelium was assessed by specular microscopy. Hairdressers should take adequate precautions to prevent ocular injury although human hair appears to be well tolerated by the cornea.

Hepatitis B vaccination for healthcare personnel in American Samoa: pre-implementation survey for policy decision

American Samoa does not have a hepatitis B vaccination policy for healthcare personnel (HCP). Consequently, hepatitis B has remained a health threat to HCP. In this study, we performed a cross-sectional study and examined demographic and risk information and hepatitis B vaccination, testing, and serostatus in hospital employees in American Samoa. Of 604 hospital employees, 231 (38·2%) participated, and of these, 158 (68·4%) were HCP. Of HCP participants, 1·9% had chronic hepatitis B infection, 36·1% were susceptible, and 60·8% were immune. Nearly half of HCP participants reported history of needlestick injury. Overall, participants' knowledge of their hepatitis B infection and vaccination status was low. These data support the adoption of a hepatitis B vaccination policy for HCP by American Samoa, as currently recommended by the World Health Organization and the US Centers for Disease Control and Prevention. Adherence to the policy could be monitored as a way to measure protection.

Proposal of a new risk assessment method for the handling of powders and nanomaterials

A new approach to assess the risks inherent in the implementation of powders, including nanomaterials, has been developed, based on the OHB (Occupational Hazard Band) method which is widely spread in the chemical industry. Hazard classification has not been modified; only the control of exposure has been worked at. The method applies essentially to the prevention of the exposures to airborne materials, whatever their particle size. The method considers exposure based on seven parameters which take into account the characteristics of the materials used, their emission potential, the conditions of use, as well as classic parameters of exposure characterization like duration and frequency. The method is a pragmatic exploitation of the state-of-art and of available data, bearing in mind that a lot of them are not easily accessible to factory operators. The result of the reflection is then positioned on a hazard versus exposure matrix from which 4 levels of priority of action are defined, as in the classical OHB method used to manage pure chemical risk. This approach fills a gap in terms of risk assessment and avoids jeopardizing all that has been set up for years, while introducing new elements of decision making accessible to all operators.

The reality of waste management in primary health care units in Brazil

A large number of users are serviced in primary health care units in Brazil, both in health facilities and in households. These services generate waste that must be managed safely, but there is no legislation that regulates this type of waste management in Brazil. The objective of this study was to analyse the production and management of waste in primary health care. A direct observation was performed of the stages in the handling and weighing of waste generated in primary health care units in the municipality of Goiânia (Brazil). The units generated infectious, chemical, and common waste, as well as sharp objects. The generation of waste ranged between 0.027 and 0.075 kg user-day. The generated waste was classified mostly as common and recyclable. Flaws were observed in the management of all types of waste. The critical point is segregation. Only 34.1% of the waste disposed of as infectious actually belonged to this group, the rest was ordinary waste. Flaws at this stage increase the volume of infectious waste, the occupational and environmental risks, and associated costs. Intervention to change this reality is needed and it requires the careful preparation of a waste management plan, corroborating structural changes to the implementation of this plan, and professional training and public policies to guide waste management in primary care, especially those generated in households.

A study on occupational exposure of Sicilian farmers to Giardia and Cryptosporidium

INTRODUCTION

A cross-sectional study was undertaken to determine the prevalence of Giardia and Cryptosporidium in calves of Palermo area (Sicily) and to evaluate the occupational risk associated with occurrence of zoonotic genotypes.

METHODS

A total of 217 faecal samples, from 149 calves (between 2 and 240 days of age) and 68 farmers, were collected in 19 cattle-farms of Palermo area. A questionnaire regarding demographic characteristics and personal hygienic measures was submitted to all farmers. All faecal samples were analyzed by Immunofluorescence assay and Polimerase Chain Reaction (PCR); genotypes were determined by DNA sequencing of Triose Phosphate Isomerase gene for Giardia and Small Subunit Ribosomal RNA gene for Cryptosporidium.

RESULTS

None farmer tested was positive for Giardia and Cryptosporidium, whereas these protozoa were respectively detected in 53 (including 5 with zoonotic G. duodenalis genotype A) and 17 (of which 1 with zoonotic C. ubiquitum) of the examined calves.

DISCUSSION

The results indicate that the risk of transmitting both protozoa to farmers in Palermo area is negligible although it cannot be considered null because of identification of human genotypes/species in calves.

Assessment of Reporting, Attitudes and Knowledge About the Stab Incidents and Professional Risk of Viral Infection among Health Care Professionals in Primary Health Care

Conflict of interest: none declared.

Non-compliance with health surveillance is a matter of Biosafety: a survey of latent tuberculosis infection in a highly endemic setting

Objective This study aimed at identifying demographic, socio-economic and tuberculosis (TB) exposure factors associated with non-compliance with the tuberculin skin test, the management and prevention of non-compliance to the test. It was carried out in the context of a survey of latent TB infection among undergraduate students taking healthcare courses in two universities in Salvador, Brazil, a city highly endemic for TB. Methods This is a cross-sectional study of 1164 volunteers carried out between October 2004 and June 2008. Bivariate analysis followed by logistic regression was used to measure the association between non-compliance and potential risk factors through non-biased estimates of the adjusted OR for confounding variables. A parallel evaluation of occupational risk perception and of knowledge of Biosafety measures was also conducted. Results The non-compliance rate was above 40% even among individuals potentially at higher risk of disease, which included those who had not been vaccinated (OR 3.33; 95% CI 1.50 to 7.93; p=0.0018), those reporting having had contact with TB patients among close relatives or household contacts (p=0.3673), or those whose tuberculin skin test status was shown within the survey to have recently converted (17.3% of those completing the study). In spite of the observed homogeneity in the degree of Biosafety knowledge, and the awareness campaigns developed within the study focussing on TB prevention, the analysis has shown that different groups have different behaviours in relation to the test. Family income was found to have opposite effects in groups studying different courses as well as attending public versus private universities. Conclusions Although the data presented may not be directly generalisable to other situations and cultural settings, this study highlights the need to evaluate factors associated with non-compliance with routine testing, as they may affect the efficacy of Biosafety programs.

Prevalence of methicillin-resistant and methicillin-susceptible s. aureus in the saliva of health professionals

INTRODUCTION

S. aureus is one of the main agents of nosocomial infection and is sometimes difficult to treat with currently available active antimicrobials.

PURPOSE

To analyze the prevalence of methicillin-susceptible S.aureus (MSSA) and methicillin-resistant S. aureus (MRSA) as well as the MRSA antimicrobial susceptibility profile isolated in the saliva of health professionals at a large public education hospital.

MATERIALS AND METHODS

The project was approved by the research and ethics committee of the institution under study. Three samples of saliva from 340 health professionals were collected. The saliva analysis used to identify S. aureus was based on mannitol fermentation tests, catalase production, coagulase, DNAse, and lecithinase. In order to detect MRSA, samples were submitted to the disk diffusion test and the oxacillin agar screening test. In order to identify the minimum inhibitory concentration, the Etest technique was used.

RESULTS

The prevalence of MSSA was 43.5% (148/340), and MRSA was 4.1% (14/340). MRSA detected by the diffusion disk test, was 100% resistant to penicillin and oxacillin, 92.9% resistant to erythromycin, 57.1% resistant to clindamycin, 42.9% resistant to ciprofloxacin and 57.1% resistant to cefoxetin.

CONCLUSION

This subject is important for both the education of health professionals and for preventative measures. Standard and contact-precautions should be employed in professional practice.

Risk of hepatitis C virus transmission from patients to surgeons: model based on an unlinked anonymous study of hepatitis C virus prevalence in hospital patients in Glasgow

BACKGROUND

The risk of a surgeon acquiring the hepatitis C virus (HCV) through occupational exposure is dependent on the prevalence of HCV infection in the patient population, the probability of a percutaneous injury transmitting HCV, and the incidence of percutaneous injury during surgery.

AIMS

To estimate the prevalence of HCV infection in the adult surgical patient population in North Glasgow and thereafter estimate the risk of HCV transmission to surgeons through occupational exposure.

METHODS

The prevalence of HCV infection was estimated through the unlinked anonymous testing of samples from male surgical patients, aged 16-49 years, in two North Glasgow hospitals from 1996 to 1997, and adjusting these data for age and sex. Using published estimates of the incidence of percutaneous injury during surgery and percutaneous injury transmitting HCV, the risk of occupational transmission of HCV to surgeons was then derived.

RESULTS

The estimated prevalence of anti-HCV infection for all adult patients in the two hospitals combined was 1.4% (cardiothoracic/cardiology 0.8%, orthopaedics/rheumatology 1.4%, general surgery/ENT 2.0%). The estimated probability of HCV transmission from an HCV infected patient to an uninfected surgeon was 0.001-0.032% per annum (0.035-1.12% risk over a 35 year professional career).

CONCLUSIONS

The risk of an individual surgeon acquiring HCV through occupational exposure is low, even in an area with an extremely high prevalence of HCV among its injecting drug using population. Surgeons however should be encouraged to observe universal precautions and present for assessment after needlestick injuries to protect themselves and their patients from this insidious infection.

Work-related assaults on nursing staff in riyadh, saudi arabia

OBJECTIVE

To determine the extent of work-related violence against nurses in hospitals in Riyadh.

MATERIALS AND METHODS

Through a cross sectional approach, a self administered questionnaire was offered to 500 active-duty nurses selected randomly. In addition to the demographic characteristics, the questionnaire inquired about exposure to workplace violence, hospital and department of employment at the time of exposure, characteristics of the assailant and nurses' perception of the causes of violence.

RESULTS

Out of 434 respondents, 93 (21.4%) were males, and 341 (78.6%) females. The mean age was 36.1 ± 7.97 years. Workplace violence was experienced by 235 (54.3%) nurses. Of these 93.2% were exposed to harsh insulting language, 32.8% to verbal threat, 28.1% to attempts of physical assault, 17.4% to sexual harassment and 16.2% to actual physical assault. Nurses working in psychiatry and emergency units had the highest rate of exposure to violence (84.3% & 62.1% respectively) Nurses perceived shortage in security personnel (82%), shortage in nursing staff (63%), language barrier (36.3%) and unrestricted movement of patients in hospitals (21.5%) as causes of their exposure to violence.

RECOMMENDATIONS

improve security in hospitals by increasing the number of security officers on duty and increase the community's awareness of the problem.