Desenvolvimento de competências para evacuação aeromédica em emergências e desastres: protocolo de revisão de escopo / Skill development for aeromedical evacuation in emergencies and disasters: a scoping review protocol

OBJETIVO: mapear a produção técnico-científica sobre as competências necessárias para o desenvolvimento de evacuações aeromédicas em situações de emergências e desastres envolvendo agentes químicos, biológicos, radiológicos e nucleares. MÉTODO: protocolo de revisão de escopo. A elaboração deste protocolo foi baseada nas recomendações do Instituto Joanna Briggs, atendendo às recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Este protocolo orientará o processo de identificação de fontes de informação, extração de dados e análise de resultados, a partir da necessidade de dar suporte à análise das ações de capacitação de equipes de saúde frente às demandas clínicas e gerenciais a serem criteriosamente observadas em tais situações.

OBJECTIVE: to map the technical-scientific production on the skills necessary for aeromedical evacuation in emergency and disaster situations involving chemical, biological, radiological, and nuclear agents. METHOD: scoping review protocol. The elaboration of this protocol was based on the Joanna Briggs Institute's recommendations, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). This protocol will guide the identification of the sources of information, data extraction, and the analysis of the results based on the need to support the analysis of training actions for health teams facing clinical and managerial demands that must be carefully considered in such situations.

Desenvolvimento de vídeo educativo para educação da equipe de enfermagem sobre a norma regulamentadora - 32 riscos biológicos / Development of an educational video to educate the nursing team about regulatory norm 32 - biological risks

Os profissionais da equipe de enfermagem são os profissionais da saúde mais expostos a Acidente de Trabalho com exposição a Material Biológico (ATMB) no ambiente hospitalar. O tipo mais frequente é relacionado aos materiais perfurocortantes, seguidos da contaminação por contato da pele e da mucosa com sangue, fluidos e/ou secreções. Os ATMB representam um problema de saúde pública mundial, tanto pela frequência com que ocorrem, quanto pela gravidade da repercussão na saúde dos profissionais. A Norma Regulamentadora 32 preconiza diretrizes básicas para a implementação de medidas de proteção à segurança e à saúde dos trabalhadores dos serviços de saúde, porém estudos evidenciam baixa ou parcial adesão a essas diretrizes. Objetivo: Desenvolver e avaliar vídeo educativo para instruir a equipe de enfermagem sobre a NR 32 - Riscos biológicos Método: Trata-se de um estudo metodológico, de construção e validação de um vídeo educativo. Para a construção do vídeo foi utilizado o Design Instrucional Contextualizado que é composto por cinco etapas: análise, design, desenvolvimento, implementação e avaliação. Na etapa de Análise foi realizado o levantamento dos dados das Comunicações de Acidente de Trabalho (CAT) dos profissionais da enfermagem na instituição em que o estudo foi desenvolvido, no design foi elaborado o roteiro do vídeo, definido o formato de animação, na etapa de desenvolvimento ocorreu a elaboração propriamente do vídeo tendo como referencial a Teoria Cognitiva da Aprendizagem Multimídia (TCAM) de Richard Mayer (2009). Na fase da Implementação, o vídeo foi disponibilizado na plataforma do Google Drive para que o material fosse avaliado. Na etapa de avaliação, deu-se a validação do conteúdo do vídeo, primeiramente, por juízes especialistas na área de saúde ocupacional e de profissionais de saúde e, posteriormente, pelo público-alvo. Resultados: No período analisado, os técnicos de enfermagem foram os profissionais que mais registraram ATMB, média de 64%, porém foi observado aumento de 80% dos registros das CATs com o profissional enfermeiro quando comparado o período anterior à pandemia (2019) e durante a pandemia (2020). Dos acidentes, 80% foram do tipo percutâneos, 17% envolvendo mucosas e 3% cutâneos. Foi considerado aceitável para validação de conteúdo o valor de Índice de Validação de Conteúdo (IVC) mínimo de 80%. Dessa forma, o vídeo foi considerado válido pelos juízes especialistas com IVC geral de 91% e pelo público-alvo IVC geral de 100%. Conclusões: O vídeo educativo elaborado "NR 32 a sua segurança em primeiro lugar" demonstrou-se válido tanto pelos juízes quanto pelo público-alvo, com potencial para contribuir com ações educativas em contexto hospitalar, podendo integrar programas de promoção da saúde do trabalhador e incentivar a adesão da equipe de enfermagem às recomendações e diretrizes da NR 32

Nursing team professionals are the health professionals most exposed to Occupational Accidents with exposure to Biological Material (ATMB) in the hospital environment. The most frequent type is related to sharps, followed by contamination by contact of the skin and mucosa with blood, fluids and/or secretions. ATMBs represent a global public health problem, both because of the frequency with which they occur and the severity of the repercussions on the health of professionals. The Regulatory Norm 32 recommends basic guidelines for the implementation of measures to protect the safety and health of health service workers, but studies show low or partial adherence to these guidelines. Objective: To develop and evaluate an educational video to instruct the nursing team on NR 32 - Biological Risks Method: This is a methodological study, for the construction and validation of an educational video. Contextualized Instructional Design was used, which is composed of five stages: analysis, design, development, implementation and evaluation. In the Analysis stage, data from the Work Accident Reports (CATs) of nursing professionals at the institution where the study was developed were collected, the video script was designed in the design, the animation format, the actual video was elaborated using the Cognitive Theory of Multimedia Learning (TCAM) by Richard Mayer (2009) as a reference. In the Implementation phase, the video was made available on the Google Drive platform so that the material could be evaluated first. The evaluation stage involved the validation of the video content, firstly, by expert judges in the field of occupational health and health professionals, and later by the target audience. Results: An 80% increase in CAT records with nurses was observed when comparing the period before the pandemic (2019) and during the pandemic (2020). Of the accidents analyzed, 80% were percutaneous, 17% involved mucosal and 3% cutaneous. A minimum Content Validation Index (CVI) value of 80% was considered acceptable for content validation. Thus, the video was considered valid by the expert judges with an overall CVI of 91% and by the target audience with a general CVI of 100%. Conclusions: The educational video "NR 32 your safety in the first place" proved to be valid both by the judges and by the target audience, with the potential to contribute to educational actions in a hospital context, being able to integrate programs to promote the health of the worker and encourage the adherence of the nursing team to the recommendations and guidelines of NR 32

Exposição a materiais biológicos: acidentes de trabalho entre os profissionais de saúde do estado de Pernambuco / Exposure to biological materials: work accidents among health professionals in the state of Pernambuco / Exposición a materiales biológicos: accidentes laborales entre profesionales de la salud en el estado de Pernambuco

Justificativa e Objetivos: Os impactos resultantes dos acidentes ocupacionais provocam riscos evitáveis à saúde dos trabalhadores. Dessa forma, o objetivo deste estudo foi descrever os acidentes de trabalho por exposição a materiais biológicos que ocorrem entre profissionais da área de saúde. Métodos: Trata-se de estudo epidemiológico, transversal e descritivo, com análise de distribuição bivariada dos dados secundários acerca da caracterização pessoal, das características do acidente e do desfecho, fornecidos pelo Sistema de Informação de Agravos de Notificação do estado de Pernambuco, Brasil, no período de 2014 a 2016. A população foi composta por todos os casos de acidente de trabalho envolvendo profissionais dos serviços de saúde. A análise foi realizada mediante estatística descritiva e teste qui-quadrado para comparar as proporções percentuais de cada grupo de variável, assim como por teste qui-quadrado para independência, por meio do software Statistical Package for Social Science. Resultados: Entre as4.260 notificações, o perfil prevalente da amostra analisada foi o de profissionais do sexo feminino (83,53%),com nível de formação técnica (62,21%),cuja via preponderante de exposição aos acidentes foi a percutânea(75,0%) e o principal agente causal a agulha com lúmen (56,1%).Em relação ao desfecho dos casos, 61,3% foram fechados sem registro da informação. Quanto às distribuições bivariadas, as exposições por via percutânea e pele íntegra apresentaram pior desfecho (soroconversão), 22 e 10 casos, respectivamente. Conclusão: A partir dos resultados obtidos, evidenciam-se falhas no processo de notificação e acompanhamento dos acidentes de trabalho em Pernambuco, além de valores elevados e semelhantes de casos em todos os anos pesquisados, indicando a necessidade de aprimorar as estratégias que envolvem prevenção de acidentes e vigilância contínua nos serviços de saúde.(AU)

Justification and Objectives: The impacts of work accidents cause avoidable risks to workers' health. Thus, the aim of this study was to describe accidents caused by the exposure to biological materials that occur among health professionals. Methods: This is an epidemiological, cross-sectional and descriptive study, with bivariate distribution analysis of secondary data on personal characterization, accident characteristics and outcome, provided by the Information System for Notifiable Diseases of the state of Pernambuco, Brazil, from 2014 to 2016. The population consisted of all cases of work accidents involving health service professionals. The analysis was performed using descriptive statistics and chi-square test to compare the percentage proportions of each variable group, chi-square test was also used for independence, using the software Statistical Package for Social Science. Results: Among the 4,260 notifications, the prevalent profile of the analyzed sample was female professionals (83.53%), with technical training level (62.21%), whose predominant route of exposure to accidents was percutaneous (75.0%) and the main causal agent was the lumen needle (56.1%). Regarding the outcome of the cases, 61.3% were closed without registering the information. Regarding bivariate distributions, percutaneous exposures and intact skin presented the worst outcome (seroconversion), 22 and 10 cases, respectively. Conclusion: Based on the obtained results, the flaws in the process of notification and monitoring of work accidents in Pernambuco are clear. The high and stable number of cases in all surveyed years indicates the need to improve strategies that involve accident prevention and continuous surveillance in health services.(AU)

Justificación y objetivos: Los impactos derivados de los accidentes laborales provocan riesgos evitables para la salud de los trabajadores. El objetivo de este estudio fue describir los accidentes laborales con exposición a materiales biológicos entre los profesionales de la salud. Métodos: Se trata de un estudio epidemiológico, transversal, descriptivo con análisis de distribución bivariada de datos secundarios sobre caracterización personal, características del accidente y el desenlace, proporcionado por el Sistema de Información de Enfermedades Notificables del estado de Pernambuco, Brasil, en el período de 2014 a 2016. La población estuvo compuesta por todos los casos de accidentes laborales que involucraron a profesionales de los servicios de salud. El análisis se realizó utilizando estadística descriptiva y la prueba de Chi-cuadrado para comparar las proporciones porcentuales de cada grupo de variables, así como las pruebas de Chi-cuadrado para la independencia utilizando el software StatisticalPackagefor Social Science. Resultados: De las 4.260 notificaciones, el perfil prevalente de la muestra analizada fue el de mujeres profesionales (83,53%), con nivel de formacióntécnica (62,21%), en las que la vía de exposición a accidentes prevalente fue la percutánea (75,0%), y el agente causal lumen aguja (56,1%).En relación al desenlace de los casos, el 61,3% se cerraron sin registrar la información. En cuanto a las distribuciones bivariadas, las exposiciones percutáneas y la piel intacta presentaron peor evolución (seroconversión), con 22 y 10 casos, respectivamente. Conclusión: Con base en los resultados obtenidos, se evidencian fallas en el proceso de notificación y seguimiento de accidentes laborales en Pernambuco, además de altos valores y similares casos en todos los años encuestados, lo que indica la necesidad de mejorar las estrategias de prevención de accidentes y vigilancia continua en los servicios de salud.(AU)

[Tracing the origins of SARS-COV-2 in coronavirus phylogenies]. / Retrouver les origines du SARS-CoV-2 dans les phylogénies de coronavirus.

SARS-CoV-2 is a new human coronavirus (CoV), which emerged in People's Republic of China at the end of 2019 and is responsible for the global Covid-19 pandemic that caused more than 540 000 deaths in six months. Understanding the origin of this virus is an important issue and it is necessary to determine the mechanisms of its dissemination in order to be able to contain new epidemics. Based on phylogenetic inferences, sequence analysis and structure-function relationships of coronavirus proteins, informed by the knowledge currently available, we discuss the different scenarios evoked to account for the origin - natural or synthetic - of the virus. On the basis of currently available data, it is impossible to determine whether SARS-CoV-2 is the result of a natural zoonotic emergence or an accidental escape from experimental strains. Regardless of its origin, the study of the evolution of the molecular mechanisms involved in the emergence of this pandemic virus is essential to develop therapeutic and vaccine strategies.

TITLE: Retrouver les origines du SARS-CoV-2 dans les phylogénies de coronavirus. ABSTRACT: Le SARS-CoV-2 est un nouveau coronavirus (CoV) humain. Il a émergé en Chine fin 2019 et est responsable de la pandémie mondiale de Covid-19 qui a causé plus de 540 000 décès en six mois. La compréhension de l'origine de ce virus est une question importante et il est nécessaire de déterminer les mécanismes de sa dissémination afin de pouvoir se prémunir de nouvelles épidémies. En nous fondant sur des inférences phylogénétiques, l'analyse des séquences et les relations structure-fonction des protéines de coronavirus, éclairées par les connaissances actuellement disponibles, nous discutons les différents scénarios évoqués pour rendre compte de l'origine - naturelle ou synthétique - du virus.

Subnotificação de acidentes de trabalho com material biológico de técnicos de enfermagem em hospital universitário / Subinforme de accidentes laborales con material biológico de técnicos de enfermería en un hospital universitario / Underreporting of occupational accidents with biological material of nursing technicians in a university hospital

Objetivo: quantificar a subnotificação e motivos do não registro dos acidentes de trabalho com material biológico de técnicos de enfermagem em hospital universitário. Método: pesquisa de corte transversal quantitativa com proporção amostral de 25%. Participaram 275 profissionais de 9 unidades que responderam questionário sobre risco ocupacional. Resultados: foram relatados 747 acidentes, sendo 71% não notificados. As variáveis: horário de trabalho, unidades e tipos de exposição foram correlacionadas estatisticamente à subnotificação (p < 0,05). Os motivos para não registro: "Quem trabalha na enfermagem sofre acidente com material biológico" apresentou 3,5 vezes mais chances de subnotificar acidente percutâneo com sangue; e "A saída pode sobrecarregar colegas de trabalho" teve 2,3 vezes mais chances de subnotificar acidente mucocutâneo. Conclusão: as subnotificações dos acidentes foram 2,4 vezes maiores que as notificações, com predomínio da exposição mucocutânea e os principais motivos foram relacionados à pouca percepção sobre o risco ocupacional e a sobrecarga de trabalho.

Objetivo: cuantificar la sub-notificación y las razones para no registrar accidentes de trabajo con material biológico de técnicos de enfermería en un hospital universitario. Método: investigación transversal cuantitativa con una proporción de muestra del 25%. Los participantes fueron 275 profesionales de nueve unidades que respondieron un cuestionario sobre el riesgo laboral. Resultados: se notificaron 747 accidentes, 71% de los cuales no fueron reportados. Las variables: horas de trabajo, unidades y tipos de exposición se correlacionaron estadísticamente con la sub-notificación (p< 0.05). Las razones para no registrar: "Quienes trabajan en enfermería sufren accidentes con material biológico" fueron 3,5 veces más propensas a sub-reportar accidente de sangre percutáneo; y "La producción puede sobrecargar a los compañeros de trabajo" era 2,3 veces más probable que notificara un accidente mucocutáneo. Conclusión: la sub-notificación de accidentes fue 2,4 veces mayor que las notificaciones, con predominio de la exposición mucocutánea y las principales razones estaban relacionadas con la baja percepción del riesgo laboral y la sobrecarga de trabajo.

Objective: to quantify the underreporting and reasons for not recording occupational accidents with biological material of nursing technicians in a university hospital. Method: quantitative cross-sectional research with a sample proportion of 25%. Participants were 275 professionals from nine units who answered a questionnaire about occupational risk. Results: 747 accidents were reported, 71% of which were not reported. The variables: working hours, units and types of exposure were statistically correlated with underreporting (p< 0.05). The reasons for not recording: "Nursing work leads to accidents with biological material" were 3.5 times more likely to underreport percutaneous blood accident; and "Leaving the unit can overload co-workers" was 2.3 times more likely to report mucocutaneous accident. Conclusion: the underreporting of accidents was 2.4 times higher than the notifications, with predominance of mucocutaneous exposure and the main reasons were related to the low perception of occupational risk and work overload.

Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) Science and the CBRNE Science Medical Operations Science Support Expert (CMOSSE).

A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.

Evaluación del riesgo biológico en laboratorios de Control de la Calidad del Instituto Finlay / Evaluation of biological risk in quality control laboratories of the Finlay Institute

El Instituto Finlay dedicado a producir vacunas empleando agentes biológicos, durante años, viene capacitando al personal de las áreas que presentan mayor potencial de riesgos, dada la importancia de proteger a sus trabajadores, instalaciones, equipos y producciones. Por ello se comenzaron a realizar evaluaciones de riesgos según métodos empleados por otros países, como España. Este trabajo tuvo como objetivo principal evaluar el riesgo biológico en laboratorios de Control de la Calidad, tales como el laboratorio de Bacteriología y el laboratorio de Pruebas Biológicas. Otros objetivos fueron, analizar la aplicación de la legislación nacional vigente de Bioseguridad y proponer un programa de acciones. El estudio se realizó en el último trimestre del año 2011 y primer semestre del año 2012. Se utilizaron como instrumentos de calidad, el método de la observación, listas de chequeo, entrevistas, tormentas de ideas y análisis documental. Los resultados mostraron que: ambos laboratorios cumplieron la legislación vigente de Bioseguridad, se identificaron los factores de riesgos más frecuentes, de ellos los de mayor nivel de riesgo y se obtuvo un programa de acciones correctivas encaminado a la solución de problemas detectados. Se demostró la posibilidad de la aplicación de un método cuantitativo, escogido para evaluar el riesgo y la implementación del programa de acciones correctivas con resultados satisfactorios(AU)

The Finlay Institute, dedicated to producing vaccines using biological agents, has for years been training personnel in the areas with the greatest risk potential, given the importance of protecting its workers, facilities, equipment and production. Therefore, risk assessments were started according to methods used by other countries, such as Spain. The main objective of this work was to evaluate the biological risk in Quality Control laboratories, such as the Bacteriology laboratory and the Biological Testing laboratory. Other objectives were to analyze the application of the current national Biosecurity legislation and propose a program of actions. The study was conducted in the last quarter of 2011 and the first semester of 2012. The observation method, checklists, interviews, storms of ideas and documentary analysis were used as quality instruments. The results showed that: both laboratories complied with the current Biosafety legislation, the most frequent risk factors were identified, including those with the highest level of risk and a program of corrective actions aimed at solving problems detected was obtained. The possibility of the application of a quantitative method, chosen to evaluate the risk and the implementation of the program of corrective actions with satisfactory results was demonstrated(AU)

Sentimentos vivenciados por trabalhadores de saúde na ocorrência de acidentes com material biológico / Feelings experienced by health workers in occurrence of accidents with biological material / Sentimentos vivenciados por trabalhadores de saúde na ocorrência de acidentes com material biológico

Este estudo tem como objetivo de conhecer os sentimentos vivenciados por trabalhadores da saúde\r\nque sofreram acidente com material biológico e relatar a experiência vivenciada por estes ao utilizar\r\nantirretroviral. Pesquisa qualitativa, desenvolvida em um hospital, com oito trabalhadores que sofreram\r\nacidente grave com material biológico. Os dados foram coletados por meio de entrevistas semiestruturadas e analisados com base na técnica de análise de conteúdo. Observou-se que a maioria dos sujeitos\r\ndemonstrou medo e preocupação com si e com seus familiares quando da ocorrência do acidente. Alguns\r\nconseguiram transcender as adversidades sofridas

This study aims to know the feelings experienced by health workers who suffered accidents with\r\nbiological material and report the experience lived by them when using antiretroviral therapy.\r\nQualitative research conducted in a hospital, with eight workers who have suffered serious accident\r\nwith biological material. Data were collected through structured interviews and analyzed based on\r\nthe technique of content analysis. It was observed that the majority of subjects demonstrated fear\r\nand concern with themselves and their relatives when the accident occurred. Some get to transcend\r\nadversity suffered.

Este estudio tiene como objetivo de conocer los sentimientos vivenciados por trabajadores de la salud\r\nque sufrieron accidente con material biológico y relatar la experiencia vivenciada por éstos al utilizar\r\nantirretroviral. Investigación cualitativa, desarrollada en un hospital, con ocho trabajadores que sufrieron\r\nun accidente grave con material biológico. Los datos fueron recolectados por medio de entrevistas semiestructuradas y analizadas con base en la técnica de análisis de contenido. Se observó que la mayoría de los sujetos demostraron miedo y preocupación con usted y sus familiares cuando ocurrió el accidente.\r\nAlgunos consiguieron trascender las adversidades sufridas

Crenças da equipe multiprofissional da atenção primária à saúde sobre o risco biológico ocupacional / Creencias del equipo multidisciplinario de atención primaria de salud en el trabajo de riesgo biológico / Beliefs of the multidisciplinary team of primary health care on occupational biohazard

RESUMO Introdução: A saúde do trabalhador tem despertado preocupação, uma vez que quanto maior a elucidação do risco e a adoção de medidas de biossegurança, menor a possibilidade de doenças ocupacionais adquiridas por meio da exposição a material biológico. Objetivo: Caracterizar as crenças da equipe multiprofissional do trabalhador da atenção primária à saúde frente ao risco biológico. Métodos: Estudo descritivo qualitativo em sete unidades de atenção primária à saúde de Goiânia-GO, em 2014, por meio de entrevistas na técnica do incidente crítico, analisados segundo Bardin, e como referencial o Modelo de Crenças em Saúde. Resultados: A susceptibilidade percebida sobre os riscos biológicos surgiu a partir da exposição ao sangue, evidenciando falta de percepção; a severidade foi percebida a partir da vivência de situações concretas de acidentes com perfurocortantes; as barreiras percebidas à adoção das medidas preventivas relacionaram-se à indisponibilidade de equipamentos de proteção individual, qualificação na temática e estrutura física adequada. Benefícios foram percebidos pela adoção de comportamentos seguros. Conclusão: As crenças dos trabalhadores expressaram conceitos elementares, inconsistentes, inseguros, com desvalorização dos riscos intrínsecos ao processo de trabalho e ao ambiente laboral(AU)

RESUMEN Introducción: El trabajador de la salud ha despertado preocupación, ya que cuanto mayor es la elucidación de riesgo y la adopción de medidas de bioseguridad, menor será la posibilidad de enfermedades profesionales adquiridas a través de la exposición a material biológico. Objetivo: Caracterizar las creencias del equipo multidisciplinario de trabajadores de la salud primaria sobre riesgo biológico. Métodos: Estudio descriptivo cualitativo en siete unidades de atención primaria de salud en Goiânia-GO en 2014, a través de entrevistas en la técnica del incidente crítico, según Bardin, y como referencia el Modelo de Creencias de Salud. Resultados: La susceptibilidad percibida de los riesgos biológicos surgió de la exposición a la sangre, que muestra la falta de conciencia; la severidad fue percibido de la experiencia de situaciones concretas de lesiones cortopunzantes; barreras percibidas para la adopción de medidas preventivas relacionadas con la disponibilidad de equipo de protección personal, calificación en la estructura física sujeto y apropiada. Los beneficios fueron percibidos por la adopción de comportamientos seguros. Conclusión: Las creencias de los trabajadores expresan conceptos elementales, inconsistente, insegura, con la depreciación de los riesgos inherentes al proceso de trabajo y el entorno de trabajo(AU)

ABSTRACT Introduction: The health worker has aroused concern, since the higher the elucidation of risk and adoption of biosecurity measures, the lower the possibility of occupational diseases acquired through exposure to biological material. Objective: Characterize the beliefs of the multidisciplinary team of workers of primary health in the biological risk. Methods: Qualitative descriptive study in seven units of primary health care in Goiânia-GO in 2014, through interviews in the technique of critical incident, analyzed according to Bardin, and as a reference the Health Belief Model. Results: The perceived susceptibility of the biological risks arose from exposure to blood, showing lack of awareness; the severity was perceived from the experience of concrete situations of sharps injuries; perceived barriers to the adoption of preventive measures related to the availability of personal protective equipment, qualification in the subject and appropriate physical structure. Benefits were perceived by the adoption of safe behaviors. Conclusion: The beliefs of workers express elementary concepts, inconsistent, insecure, with depreciation of the risks inherent to the work process and working environment(AU)

Work incidents with biological material in the nursing team of a hospital in Mid-Western Brazil / Trabajar accidentes con material biológico en el personal de enfermería en un hospital de la región central de Brasil / Acidentes de trabalho com material biológico na equipe de enfermagem de um hospital do Centro-Oeste brasileiro

Abstract Objectives: To investigate and describe the occurrence and characteristics of Work Incidents (WI) with Potentially Contaminated Biological Material (PCBM), the frequency and variables related to this occurrence among nursing categories. Methods: A descriptive and cross-sectional study with a quantitative approach was performed at a referral hospital in the State of Mato Grosso, Mid-Western Brazil. Results: Women represented 90.5% of all participants and the mean age was 42.59 years. A total of 46.6% of professionals reported having undergone exposure to PCBM, 60.9% stated not having made a report, and 42.6% reported having participated in training courses on this subject. Comparing the occurrence of WI between nursing assistants and nurses, nursing assistants were more affected (p = 0.022). Conclusions: Among nursing professionals, the number of WI is high, recurrent and underreported. Continuing education on this theme is required to ensure the quality of care and promote workers' health.

Resumen Objetivos: Evaluar y describen la ocurrencia y características de los accidentes industriales (AT) potencialmente contaminados con material biológico (MBPC), la frecuencia y las variables relacionadas con la aparición de la categoría de enfermería. Método: Estudio descriptivo transversal, con abordaje cuantitativo, realizado en Hospital referencia en el Estado de Mato Grosso, Brasil. Resultados: Las mujeres representaban el 90,5% de los participantes; la edad media fue de 42,59 años. Un total de 46,6% de los encuestados reportó haber sufrido exposición a MBPC, y el 60,9% no había hecho la notificación, el 42,6% dijo que había participado en una formación sobre el tema. La comparación de la ocurrencia de AT entre los grupos de las enfermeras y auxiliares de enfermería, auxiliares fueron los más afectados (p = 0,022). Conclusión: En los profesionales de enfermería, el número de AT es elevado, recurrente y subnotificado. La educación permanente relacionada con la temática es necesaria para garantizar la calidad de la asistencia y promover la salud del trabajador.

Resumo Objetivos: Investigar e descrever a ocorrência e as características dos Acidentes de Trabalho (AT) com Material Biológico Potencialmente Contaminado (MBPC), a frequência e as variáveis relacionadas à ocorrência entre as categorias de enfermagem. Método: Estudo descritivo, transversal, de abordagem quantitativa, realizado em um hospital referência no estado de Mato Grosso, Brasil. Resultados: As mulheres representaram 90,5% dos participantes e a média de idade foi de 42,59 anos. Um total de 46,6% dos profissionais relatou já ter sofrido exposição a MBPC, e 60,9% referiram não ter realizado a notificação e 42,6% afirmaram terem participado de treinamentos sobre a temática. Na comparação entre a ocorrência de AT entre os grupos de enfermeiros e auxiliares de enfermagem, os auxiliares foram mais acometidos (p = 0,022). Conclusão: Nos profissionais de enfermagem, o número de AT é elevado, recorrente e subnotificado. A educação permanente relacionada à temática é necessária para garantir a qualidade da assistência e promover a saúde do trabalhador.

Análise epidemiológica dos acidentes com material biológicos em um hospital oftalmológico / Epidemiological analysis of accidents with biological material in an eye hospital

Objetivo:Analisar a ocorrência e as características dos acidentes com material biológico em um hospital oftalmológico no nordeste do Brasil.Métodos:Estudo transversal, com análise retrospectiva dos dados dos pacientes, realizada por meio de um levantamento dos acidentes com material biológico notificados à Comunicação de Acidentes de Trabalho (CAT) durante o período de 2010 a 2013.Resultados:Foram notificados 34 acidentes, sendo 26 (76,5%) em trabalhadores do gênero feminino e 8 (23,5%) masculino. A média de idade foi 30,0 ± 5,9 anos. Quarenta e oito (82,3%) acidentes aconteceram no bloco cirúrgico da sede do hospital, 15 (44,1%) foram com auxiliares/técnicos de enfermagem, 8 (23,5%) com instrumentadores, 5 (14,7%) com médicos em treinamento, 4 (11,8%) com médicos formados e 2 (5,9%) com equipe de profissionais de limpeza. Os acidentes foram do tipo percutâneo em 30 (88,2%) casos e por contato com mucosa em 4 (11,7%). Em 28 (82,4%) casos o acidente foi no membro superior, 4 (11,8%) na face e 2 (5,9%) em membros inferiores. O acidente ocorreu durante o ato cirúrgico em 12 (35,3%) e 10 (29,4%) durante a manipulação do material após o procedimento cirúrgico. Os acidentes aconteceram com funcionários que possuíam média de dois anos de experiência e após 5,5 horas trabalhadas.Conclusão:Os acidentes com material biológico em um hospital oftalmológico foram mais frequentes em profissionais auxiliares/técnicos de enfermagem, durante o ato cirúrgico e manipulação do instrumental após cirurgia. Este trabalho, portanto, demonstrou a importância de identificar riscos de acidentes laborais entre profissionais de saúde na área de oftalmologia.

Objective:To analyze the incidence and characteristics of accidents with biological material in an ophthalmology hospital in the Northeast of Brazil.Methods:Retrospective descriptive study on ducted through a survey of biological material accidents notified by Comunicação de Acidentes de Trabalho (CAT) during 2010-2013.Results:34 accidents were reported, 26 (76.5%) workers were females and 8 (23.5%) were males. The mean age was 30.0 ± 5.9 years. Forty-eight (82.3%) accidents occurred in the surgical room of the hospital, 15 (44.1%) were with auxiliary / practical nurses, 8 (23.5%) with surgical technologists, 5 (14.7%) with training physicians, 4 (11.8%) with trained physicians and 2 (5.9%) with cleaning staff. Accidents were with percutaneus in 30 (88.2%) cases, and contact with mucosa in 4 (11.7%). In 28 (82.4%) cases the accident was in the upper limb, 4 (11.8%) in the face, and 2 (5.8%) in the lower limbs. The accident occurred during surgery in 12 (35.3%) and 10 (29.4%) during manipulation of the material after surgery. The injuries occurred with employees who had an average of two years of experience and after 5.5 hours worked.Conclusion:Occupational accidents with biological material in an ophthalmology hospital were more frequent with auxiliary/practical nurses, during surgery and in the manipulation of instruments after surgery.This study demonstrated the importance of identifying risks of occupational accidents among health professionals in ophthalmology.

Federal Funding for Health Security in FY2016.

This article assesses US government funding in 5 domains critical to strengthening health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs. This year's article also highlights the emergency funding appropriated in FY2015 to enable the international and domestic response to the Ebola outbreak in West Africa.

Understanding public responses to chemical, biological, radiological and nuclear incidents--driving factors, emerging themes and research gaps.

This paper discusses the management of public responses to incidents involving chemical, biological, radiological and nuclear materials (CBRN). Given the extraordinary technical and operational challenges of a response to a CBRN release including, but not limited to, hazard detection and identification, casualty decontamination and multi-agency co-ordination, it is not surprising that public psychological and behavioural responses to such incidents have received limited attention by scholars and practitioners alike. As a result, a lack of understanding about the role of the public in effective emergency response constitutes a major gap in research and practice. This limitation must be addressed as a CBRN release has the potential to have wide-reaching psychological and behavioural impacts which, in turn, impact upon public morbidity and mortality rates. This paper addresses a number of key issues: why public responses matter; how responses have been conceptualised by practitioners; what factors have been identified as influencing public responses to a CBRN release and similar extreme events, and what further analysis is needed in order to generate a better understanding of public responses to inform the management of public responses to a CBRN release.

Medical countermeasures after a radiological event: an update from the CATO project.

PURPOSE: As part of the European project 'CBRN crisis management: Architecture, Technologies and Operational Procedures' (CATO), an open Toolbox is in development that will address the needs of all stakeholders from first responders to decision makers. A database on chemical, biological, radiological and nuclear (CBRN) threats, including information on medical countermeasures, will be integrated in this Toolbox. RESULTS AND CONCLUSIONS: After a radiological accident, review of national and international recommendations for the major countermeasures (stable iodine, Prussian Blue, and diethylenetriaminepentaacetic acid [DTPA]) showed that discrepancies in treatment protocols and open questions remain: How to proceed in case of repeated release of radioiodines? Which dosage for Prussian Blue? For which radionuclides is DTPA really effective? This paper brings elements to answer these questions.

Psychosocial care to affected citizens and communities in case of CBRN incidents: a systematic review.

Disasters are associated with a substantial psychosocial burden for affected individuals (including first responders) and communities. Knowledge about how to address these risks and problems is valuable for societies worldwide. Decades of research into post-disaster psychosocial care has resulted in various recommendations and general guidelines. However, as CBRN (chemical, biological, radiological, nuclear) events form a distinctive theme in emergency planning and disaster preparedness, it is important to systematically explore their implications for psychosocial care. The aim of this study is to answer two questions: 1). To what extent does psychosocial care in the case of CBRN events differ from other types of events? 2). How strong is the scientific evidence for the effectiveness of psychosocial care interventions in the context of a CBRN event? A systematic literature review was conducted. Searches were performed in Medline, PsychINFO, Embase and PILOTS. Studies since January 2000 were included and evaluated by independent reviewers. The 39 included studies contain recommendations, primarily based on unsystematic literature reviews, qualitative research and expert opinions. Recommendations address: 1) public risk- and crisis communication, 2) training, education and exercise of responders, 3) support, and 4) psychosocial counselling and care to citizens and responders. Although none of the studies meet the design criteria for effectiveness research, a substantial amount of consensus exists on aspects relevant to CBRN related psychosocial care. Recommendations are similar or complementary to general post-disaster psychosocial care guidelines. Notable differences are the emphasis on risk communication and specific preparation needs. Relevant recurring topics are uncertainty about contamination and health effects, how people will overwhelm health care systems, and the possibility that professionals are less likely to respond. However, the lack of evidence on effectiveness makes it necessary to be careful with recommendations. More evaluation research is absolutely needed.

Managing mass casualties and decontamination.

Careful planning and regular exercising of capabilities is the key to implementing an effective response following the release of hazardous materials, although ad hoc changes may be inevitable. Critical actions which require immediate implementation at an incident are evacuation, followed by disrobing (removal of clothes) and decontamination. The latter can be achieved through bespoke response facilities or various interim methods which may utilise water or readily available (dry, absorbent) materials. Following transfer to a safe holding area, each casualty's personal details should be recorded to facilitate a health surveillance programme, should it become apparent that the original contaminant has chronic health effects.

Recent advances to address European Union Health Security from cross border chemical health threats.

The European Union (EU) Decision (1082/2013/EU) on serious cross border threats to health was adopted by the European Parliament in November 2013, in recognition of the need to strengthen the capacity of Member States to coordinate the public health response to cross border threats, whether from biological, chemical, environmental events or events which have an unknown origin. Although mechanisms have been in place for years for reporting cross border health threats from communicable diseases, this has not been the case for incidents involving chemicals and/or environmental events. A variety of collaborative EU projects have been funded over the past 10 years through the Health Programme to address gaps in knowledge on health security and to improve resilience and response to major incidents involving chemicals. This paper looks at the EU Health Programme that underpins recent research activities to address gaps in resilience, planning, responding to and recovering from a cross border chemical incident. It also looks at how the outputs from the research programme will contribute to improving public health management of transnational incidents that have the potential to overwhelm national capabilities, putting this into context with the new requirements as the Decision on serious cross border threats to health as well as highlighting areas for future development.