Search

Abstract: Occupational exposure to biological fluids through mucocutaneous contact and related factors was determined through a descriptive study using a sample of 156 medical technicians working in public clinical laboratories in the metropolitan area of Zulia. A survey for data collection was designed which explored exposure and related factors such as compliance with post biological exposure measures. The age average of the bioanalysts was 41.9± 9.7; 87.2% were female. Results evidenced occupational exposure through mucocutaneous accidents, with a prevalence rate of 172.6 accidents for every 100 workers, represented primarily by splashes 44.3% and spray 32.7%, detected at a moderate level involving female workers with age ranges 54-60 and 26-32, 1-8 years on the job, during day shifts. Biological accidentality according to associate factors showed moderate exposure levels for all the biological fluids investigated in small volumes, at the level of the ocular mucosa, in sample processing and waste disposal areas. A medium compliance level was recorded for post-exposure handling, with a statistically significant difference (p>0.01) among the measures investigated. The magnitude and characteristics of exposure to biological fluids poses a problem that could impact personnel health, and it should be addressed institutionally to achieve effective prevention and risk control management. Resumen: Se determinó la exposición laboral accidental a fluidos biológicos por contacto muco-cutáneo y factores asociados, mediante un estudio descriptivo dirigido a una muestra de 156 bioanalistas adscritos a laboratorios clínicos públicos del área metropolitana del estado Zulia. Para la recolección de datos se diseñó un instrumento que explora la exposición y factores vinculados, así como el cumplimiento de medidas post exposición biológica. El promedio de edad de los Bioanalistas fue de 41.9 ± 9.7 años con predominio del sexo femenino 87,2%. Se evidencia exposición por accidentes muco-cutáneos con una tasa de prevalencia de 176,2 accidentes por cada 100 trabajadores, representados principalmente por salpicaduras 44,3% y spray 32,7% detectados en razón de su ocurrencia en un nivel de exposición moderado, en las edades, 54-60 y 26-32 años, en sexo femenino, entre 1-8 años de antigüedad, durante la jornada diurna. La accidentabilidad en relación a los factores asociados, se registra en un nivel de exposición moderado, con todos los fluidos biológicos indagados, en pequeño volumen, a nivel de mucosa ocular, en áreas de procesamiento de muestras y disposición de desechos en el laboratorio. Un nivel de mediano cumplimiento se obtuvo para el manejo post exposición identificándose diferencia estadísticamente significativa entre las medidas indagadas (p> 0.01). La magnitud y características de la exposición a fluidos biológicos revisten una problemática que puede impactar en la salud del personal y debe ser abordada institucionalmente para una efectiva gestión de prevención y control de riesgo.

Abstract: In order to determine the management of biological waste generated in teaching and research laboratories in the Faculty of Medicine, a two phase, cross-sectional, descriptive study was carried out; the first study was to determine number, type and distribution of the laboratories; and the second consisted in the elaboration and application of an instrument to collect information concerning management of biological waste, according to what is established in the Venezuelan National Decree No. 2218-92. Of the total sample of 43 laboratories, 81.4% responded, 71,4% of which generate biological waste, with a higher prevalence of types B and C, followed by type D (44%). Of these the more frequent sources were blood (64%), serum (32%) and urine (28%). The harvesting and primary storage most utilized was type 1 (44%). There does not appear to be uniformity in the frequency of internal transport. In 56% of the laboratories modality of processing before final disposition is not implemented. This research revealed that laboratories in university faculties generated biological waste that can cause adverse effects on health and the environment if corrective measures are not employed in their management, and for this reason it is necessary to implement a biological waste management system. Resumen: Con el objeto de determinar el manejo de desechos biológicos generados en laboratorios de docencia, asistencia e investigación de una Facultad de Medicina, se realizó un estudio descriptivo, transversal en dos fases, la primera para determinar número, tipo y distribución de los laboratorios; la segunda consistió en la elaboración y aplicación de un instrumento de recolección de información concerniente al manejo de desechos biológicos, según lo establecido en el Decreto Nacional venezolano 2218-92. Del total de 43 laboratorios, respondieron el 81,4%, de los cuales el 71,4% genera desechos biológicos, prevaleciendo los tipos B y C, seguido de los tipos D (44%). De estos los más frecuentes fueron sangre (64%), suero (32%) y orina (28%). La recolección y almacenamiento primario más utilizado fue el tipo 1 (44%). No se apreció uniformidad en la frecuencia del transporte interno. El 56% de los laboratorios no implementan modalidad de tratamiento antes de su disposición final. Esta investigación revela que los laboratorios de la Facultad estudiada generan desechos biológicos que pueden causar efectos adversos a la salud y al ambiente si no se toman medidas correctivas en el manejo de los mismos, siendo por ello necesario implementar un sistema de gestión de desechos biológicos.

Abstract: In order to determine the knowledge and application of bio-security norms on the part of nursing professionals in the intensive care unit in a type IV public hospital in Zulia, a questionaire was applied to 60 professional nurses, and corroborated through direct observation of their daily activity. All had knowledge of biological risk factors and their supreme importance, and of preventative measures and their importance, however 76.66% identified erroneously the graveness of such risks. Also, they responded that the most frequent techniques used were hand washing and the use of gloves with ratings of 100% and 98.33% respectively. However, observation evidenced that the practice of handwashing before and after each procedure and between patients was only completed respectively by 10%, 53% and 10% respectively. The time employed in hand-washing was determined to be insufficient at less than one minute. Germicides were not used before sealing discarded cutting and puncturing devices, however 76.66% of them were deposited in appropriate containers. A low execution of compliance with immunization guidelines was observed. The results evidenced the need for continuing in-service education and strict supervision of the norms. Resumen: A objeto de determinar el conocimiento y aplicación de normas de bioseguridad en profesio- nales de enfermería de una Unidad de Cuidados Intensivos de un hospital público tipo IV del esta- do Zulia, se aplicó a 60 profesionales un cuestionario, corroborado mediante la observación direc- ta del ejercicio laboral. Todos manifestaron conocimiento sobre el riesgo biológico como el más importante, de las medidas de prevención y su importancia, sin embargo, el 76.66% identificó in- correctamente la gravedad del riesgo. Asimismo, respondieron que las barreras más utilizadas eran el lavado de manos y el uso de guantes correspondiéndoles el 100% y el 98.33% respectiva- mente. Sin embargo, la observación evidenció que la práctica del lavado de manos antes y después de cada procedimiento y entre paciente y paciente, sólo fue cumplida por el 10, 53 y 10% respecti- vamente. El tiempo empleado para el lavado de manos determinó que era insuficiente por ser me- nor de un minuto. No se utilizó germicida antes del sellado del material corto-punzante a descar- tar, aunque el 76.66% de ellos lo deposito en envases adecuados. Se confirmó bajo cumplimiento del esquema de inmunización. Resultados que evidencian necesidad de l educación continúa en el Servicio y la supervisión estricta del cumplimiento normativo.

Abstract: In order to determine the application of Universal Precautions against Human Immunodeficiency Virus (HIV) in hospitals belonging to the Venezuelan Social Security Institute, a survey was carry out with 155 nurses (male and female) and 94 physicians, including interviews with directors, epidemiologist and educational coordinators. It was observed that doctors had received less education in the handling of needles and other puncture-cutting objects (72,3%), codes of safe practice (67,0%), and procedures for putting on and taking off gloves than the nursing personnel (p  0.01). Of doctors, 61,0% referred to parenteral exposition to blood and corporal fluids of which only 38,8% was reported. Sharp cutting implements are disposed of in strong non-breakable recipients not designed for that purpose, and 50,2% of the needles were reinserted into their original sheaths before being discarded. Medical personnel who use gloves when attending patients with skin injuries were (91,9%) and when handling blood or fluids (87,5%). Only 35,3% use gloves when they place or remove venous lines. More than half of the personnel never use double gloves (61,4%). The nursing and medical staff wash their hands more frequently after contact with blood and corporal fluids (92,7%) than they do after taking off the gloves (87,9%). Both groups use more than one barrier of personal protection, however, a low percent use waterproof suits and ocular protectors (28,5% and 26,9% respectly). The hospitals do not have preventive programs, occupational medicine services, or records of accidents and treatment thereof after exposure. Only the use of gloves and hand washing are performed by the nursing and medical staff. Hospital management does not have a program for the application of Universal Precautions, for this reason it is necessary to elaborate and apply such programs in these centers. Resumen: Aplicación de las Precauciones Universales contra el Virus de Inmunodeficiencia Humana en hospitales del Instituto Venezolano del Seguro Social. Para determinar la aplicación de las Precauciones Universales contra el virus de inmunodeficiencia humana (VIH) en hospitales del Instituto Venezolano del Seguro Social, se aplicó una encuesta a 155 enfermeras (os) y 94 médicos, entrevistas a directores, epidemiólogos y coordinadores docentes de estos centros. Se encontró que los médicos han recibido menos educación en manejo de agujas y objetos punzocortantes (72,3%), códigos de buena práctica (67,0%) y procedimiento de colocación y retiro de guantes que el personal de enfermería (p 0,01). El 61.0% refirió exposición parenteral a sangre y fluidos corporales, sólo el 38.8% lo reportó. Los objetos punzo cortantes son desechados en recipientes resistentes a rupturas no diseñados para tal fin, el 50.2% coloca la funda a las agujas antes de desecharlas. El personal usa guantes al atender pacientes con lesiones de piel (91,9%) y al manipular sangre o fluidos (87,5%), sólo el 35,3% los usa al colocar o retirar líneas venosas. Más de la mitad del personal nunca utiliza doble guante (61,4%). El personal lava las manos con mayor frecuencia luego del contacto con sangre y fluidos corporales (92,7%), luego de retirarse los guantes (87,9%). Ambos grupos utilizan más de una barrera de protección personal, sin embargo, un bajo porcentaje usa monos impermeables y protectores oculares, 28,5% y 26,9% respectivamente. Los hospitales no cuentan con programas preventivos contra VIH, servicio medico-ocupacional, registros de accidentes y tratamiento postexposición. Se evidencia que sólo el uso de guantes y el lavado de las manos en al- gunas actividades son cumplidas por el personal médico y de enfermería. La gerencia de los hospi- tales no cuentan con un programa para la aplicación de las Precauciones Universales, siendo nece- sario elaborar e implementar dicho programa en estos centros.

In order to determine the management of biological waste generated in teaching and research laboratories in the Faculty of Medicine, a two phase, cross-sectional, descriptive study was carried out; the first study was to determine number, type and distribution of the laboratories; and the second consisted in the elaboration and application of an instrument to collect information concerning management of biological waste, according to what is established in the Venezuelan National Decree No. 2218-92. Of the total sample of 43 laboratories, 81.4% responded, 71,4% of which generate biological waste, with a higher prevalence of types B and C, followed by type D (44%). Of these the more frequent sources were blood (64%), serum (32%) and urine (28%). The harvesting and primary storage most utilized was type 1 (44%). There does not appear to be uniformity in the frequency of internal transport. In 56% of the laboratories modality of processing before final disposition is not implemented. This research revealed that laboratories in university faculties generated biological waste that can cause adverse effects on health and the environment if corrective measures are not employed in their management, and for this reason it is necessary to implement a biological waste management system. [ABSTRACT FROM AUTHOR]

Objective: Determining the occupational exposure to biological fluids of medical technicians working in public clinical laboratories caused by accidental percutaneous contact, associated factors and compliance with post-exposure biological measures., Methods: This was a descriptive cross-sectional study. The sample consisted of 156 medical technicians assigned to clinical laboratories in the metropolitan area of Zulia state in Venezuela. Data was collected by applying an instrument for exploring exposure and related factors, as well as compliance with established post-biological exposure measures., Results: There was evidence of exposure caused by percutaneous accidents, mainly represented by a moderate level of needle-pricks and cuts (2-3.99 mean). There was a moderate level of factors regarding percutaneous injury in the hands and fingers associated with hollow needles, blood and blood products and superficial severity in sample taking and processing areas when recapping needles or handling sharp or cutting objects. A medium level (2-3.99 mean) of compliance was obtained for post-exposure handling. A significant correlation was found (p<001) between percutaneous exposure and level of compliance with post-exposure management., Conclusion: The magnitude and characteristics of exposure to biological fluids detected in this work represents a problematic situation which can affect staff health and must be approached by institutions to ensure effective prevention management and risk control.

Objective: To establish the prevalence of Metabolic Syndrome and other factors of cardiovascular risk in a population of masculine workers of the operative area of the plant of vinyl poly chloride of a petrochemical complex, in the occident of Venezuela., Method: An analytical cross sectional study was performed in 84 workers, they was determined size, weight, arterial pressure, abdominal circumference, body mass index, smoke, alcoholic habits and medicaments consumption. Additionally, 10 ml fasting venous blood sample was taken to determine glycemia, total cholesterol, HDL-C, LDL-C and VLDL-C. The diagnosis of the metabolic syndrome was carried out under the approaches of NCEP/ATP III criteria's., Results: The prevalence of metabolic syndrome was of 27 cases (32 ,1 %), 21 cases (77,7 %) in ages among 26-40 years. The alcohol consumption (91 ,6 %), LDL-C (64,3 %), high systolic arterial pressure (59,5 %), obesity (56,6 %) and high triglycerides (55,9 %) were the principal's cardiovascular factors risk detected. The biochemical parameters were significantly higher in the men with clinical diagnosis of metabolic syndrome in comparison with those that didn't present the syndrome (p < 0.05)., Conclusion: To weigh that the prevalence of metabolic syndrome was not so high, the factors of cardiovascular risk in an individual way were high, considering that the hard-working population is young is necessary to implement programs of prevention and changes of lifestyles to minimize the risk of coronary illness and vascular brain that lead to labour s disability.

Objective: Determining the profile of health for people working in an olefin plant., Methods: This was an observational, descriptive study carried out on 142 workers from technical-administrative, operator and maintenance areas. Each worker's employment and medical history was examined; they had a physical examination and laboratory, audiometric and visual tests. The degree of obesity was determined by WHO classification; cardiovascular risk was classified by using the European Societies' risk table., Results: The workers had a mean age of 36,2+/-6,9. The operators presented mean weight and systolic pressure which was higher than that of the rest of the workers. A high risk factor frequency was determined for cardiovascular pathologies: alcohol consumption (89,4 %), obesity (62,7 %), hypertriglycerides in the blood (46,5 %) and high systolic pressure (45,1 %); operators were the most affected workers. A moderate frequency of workers having altered hepatic enzymes, AST (38 %) and GGT (29,6 %) were observed The most frequently encountered pathologies were ametropia (64,1 %), dyslipidaemia (57,8 %), obesity (50 %) and hypertension (45,1 %). Workers aged more than 40 presented higher systolic pressure. A significant correlation between IMC and systolic pressure was found., Conclusion: A high prevalence of cardiovascular risk factors was found. Health-care should be designed and promoted and action should be taken towards modifying lifestyles, aimed at reducing the risk of cardiovascular disease.

The objective of this study was to determine the physical, chemical and cytomorphologic characteristics of semen obtained from workers exposed to cholinesterase inhibitor insecticides and compare them with samples of the same nature obtained from unexposed subjects, and in addition, to correlate those findings with blood levels of cholinesterase. The study group consisted of 29 adult males, age range 20-54, that were exposed to cholinesterase inhibitor insecticides during 4 hours per day for a variable lapse (one year minimum), whereas the control group consisted of 30 unexposed individuals of the same gender, and similar age range. A thorough medical examination was performed in every individual. It consisted of an occupational medical history and complete physical exam. A blood sample was obtained in all the subjects in order to determine total cholinesterase levels by the modified S. Hestrin Hydroxamate method. Semen analysis was done in specimens collected after recent masturbation following a 3-day abstinence period. The data was processed and analyzed by the SAS computerized statistics program. The results revealed significant differences between both groups (p < 0.05) for the following variables: sperm count per mL., percentage of fast, mobile and immobile, live and dead spermatozoids. Spermatozoa morphology was found to be within normal limits as established by the WHO. Nevertheless, the differences related to the percentage of big head and amorphous spermatozoids was significant (p < 0.05). The results indicate that cholinesterase inhibitor insecticides affect certain variables of the semen analysis and hence the quality of the semen.