Accidentes biológicos en quirófanos y salas de parto. Proyecto EPINETAC 1996–2000

Fundamento y objetivo

Se considera que en las áreas quirúrgicas existe mayor riesgo de exposicionesocupacionales con riesgo hemático. El objetivo del estudio es describir y evaluar el riesgode áreas de quirófano y salas de parto, a partir de los accidentes percutáneos declarados porprofesionales sanitarios.

Sujetos y método

Estudio transversal de accidentes percutáneos ocurridos en quirófanos y salasde parto y notificados al sistema EPINETAC (Exposure Prevention Information Network Accidents)entre 1996 y 2000. En cada accidente se recogen datos del trabajador, exposición y pacientefuente. El riesgo de exposición se calculó mediante regresión logística y la variable dependientefue el área quirúrgica/sala de parto. Se calcularon las tasas de accidente, global y porcategorías laborales, por 10.000 intervenciones en diferentes tipos de cirugía.

Resultados

Se declararon 3.625 accidentes percutáneos. El riesgo de accidente fue mayor enmatronas (odds ratio [OR] = 36,6; intervalo de confianza [IC] del 95%, 19,61–68,52), médicos(OR = 12,6; IC del 95%, 10,21–15,71) y médicos residentes (OR = 12,8; IC del 95%, 10,34–15,98). El mayor riesgo acontece durante la utilización del material (OR = 1,37; IC del 95%,1,05–1,79) y al preparar el material para reutilizar (OR = 1,81; IC del 95%, 1,27–2,59). Latasa de accidentes por cada 10.000 intervenciones fue de 34,36 en obstetricia-ginecología,24,61 en cirugía general y 18,92 en traumatología.

Conclusiones

El riesgo de exposiciones ocupacionales con material hemático en quirófanos/salasde parto es mayor para médicos y residentes que en otras áreas. La cirugía obstetricoginecológicaes desde la que se declara mayor número de exposiciones.

Background and objective

Surgical areas have long been considered risky with regard to occupationalexposures to blood-borne pathogens. The objective of study was to describe and evaluatethe risk of occupational exposure to blood-borne pathogens at operating and delivery rooms,from reports of injuries in healthcare workers.

Subjects and method

Transversal study of percutaneous injuries occurring in operating and deliveryrooms which were registered in the Spanish surveillance system EPINETAC (Exposure PreventionInformation Network Accidents) between 1996 and 2000. We recorded data from theexposed healthcare worker, from the accident itself and from the exposure source. The risk ofexposition was calculated by logistic regression. The dependent variable was the exposition inoperating/delivery rooms. We calculated the rate of exposure, total and by occupational categories,per 10,000 surgical procedures in 3 surgical specialties.

Results

There were 3,625 percutaneous injuries reported. The exposure risk was higher inmidwives [OR 36.6 (CI 95% 19.61–68.52)] than in staff [OR 12.6 (CI 95% 10.21–15.71)] ortraining doctors [OR 12.8 (CI 95% 10.34–15.98)]. The highest risk turned up during use ofmaterial [OR 1.37 (CI 95% 1.05–1.79)] and during preparation of material for reuse [OR 1.81(CI 95% 1.27–2.59)]. The exposure rate, in gynecologic procedures, was 34.36 injuries per10,000, in digestive surgery it was 24.61 per 10,000, and in trauma surgery it was 18.92 per10,000 surgical procedures.

Conclusions

The risk of occupational exposure to blood-borne pathogens in staff and trainingdoctors was higher in operating and delivery rooms than in others areas. Obstetric and gynecologicprocedures exhibited the highest risk of exposure.