Exposição ocupacional ao vírus da hepatite B entre trabalhadores de enfermagem no Brasil, 2006-2012

Abstract

Occupational accidents with exposure to biological fluids (AT-BIO) consist of contact with blood and/or other potentially contaminated body fluids, ocurred with health care workers during their work practice. The pathogens that cause the greatest impact to health care workers are the Human Immunodeficiency Virus (HIV), the Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV), among which the highest risk of contamination after percutaneous exposure is the HBV, even if the infection is vaccine-preventable. Stand out the vulnerability of the nursing staff because his work is characterized by direct and continuous care of the patient and implementing risk procedures. The general aim of this study is to describe the serologic status for HBV in occupational exposure to biological material among nursing workers in Brazil in the period from 2006 to 2012. It is a descriptive epidemiological study of cross-sectional survey type, into a time series. The record of research from AT-BIO the Notifiable Diseases Information System (SINAN) was utilized. A total of 104,900 cases of ATBIO among nursing staff in the period was identified. The most injuries occurred among women (87.8%), aged 31-40 years old (31.5%), race/color white (60.0%) among nursing technicians (51.3%). In 76.1% of the cases, the type of exposure was percutaneous, involving blood (81.9%), it was caused by needles (72.4%); Personal Protective Equipment (PPE) mostly used by injured workers were gloves (61.0%), aprons (34.8%) and masks (14.5%). Medication administration intravenously, venous / arterial puncture and inappropriate discarding of sharps were the main types of accidents. In 89.1% of cases, the victims had been vaccinated against hepatitis B.The 63.6% of the cases were negative serology for HBsAg, and in 38.9% of cases confirmed it was found adequate titles of Anti-HBs. The percentage of tests not performed (19.8% for HBsAg 23.2% and for anti-HBs) and ignored (14.0% for both) is worrying. For treatment, the vaccine was used at 4.7% of cases, and the immunoglobulin 2.0% of the cases. These results reveal the need to adopt more effective measures to prevent the AT-BIO. It is important to promote, at the federal, state and municipal levels, permanent education actions, to raise awareness of the both professionals and employers, so they can recognize their role in the reducing of the number of cases of AT-BIO. It is expected that the results obtained contributing to a reassessment of the health situation of nursing workers in Brazil, serving subsidies to the strengthening and consolidation of existing actions and policies in this area.