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      Prevenção relacionada à exposição ocupacional do profissional de saúde no cenário de COVID-19 Translated title: Prevention related to the occupational exposure of health professionals workers in the COVID-19 scenario Translated title: Prevención relacionada cone la exposición ocupacional de profesionales de la salud en el escenario COVID-19

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          Abstract

          RESUMO Objetivo descrever as principais recomendações sobre ações de prevenção de contágio relacionadas à exposição ocupacional dos profissionais de saúde atuantes frente à COVID-19, disponíveis até março de 2020. Conteúdo A atual pandemia da doença causada pelo novo coronavírus SARS-CoV-2 tem transmissão favorecida pelo contato próximo e desprotegido com secreções ou excreções de pacientes infectados, principalmente por meio de gotículas salivares. Práticas organizacionais de prevenção devem ser previstas antes da chegada do paciente ao serviço de saúde, reduzindo o fluxo de atendimento, no primeiro atendimento e durante as ações assistenciais, para minimizar a exposição ocupacional ao agente biológico. Profissionais de saúde classificados como grupo de risco devem ser afastados de atividades de risco de contaminação. Aqueles contaminados ou adoecidos devem permanecer em quarentena para minimizar a propagação da COVID-19. Considerações finais os cuidados para prevenção de contaminação de trabalhadores nesta pandemia pelo novo coronavírus devem ser priorizados, evitando impactos negativos na assistência à população que busca atendimento nos serviços de saúde.

          Translated abstract

          ABSTRACT Objective to describe the main recommended actions on prevention actions related to occupational exposure of health professionals working at COVID-19, available until March 2020. Content The current pandemic disease caused by the new SARS-CoV-2 coronavirus has its transmission favored by close and unprotected contact with secretions or excretions from infected patients, mainly through salivary droplets. Organizational prevention practices should be prioritized, since patient's arrival at the health service, optimizing the flow of care, the first care and during health care actions, to minimize occupational exposure to the biological agent. Health professionals classified as a risk group should be removed from activities at risk of contamination. Those contaminated or adulterated must remain in quarantine to minimize the spread of COVID-19. Final considerations care to avoid contamination of workers in this pandemic by the new coronavirus must be prioritized, prevented from affecting the assistance to the population that seeks assistance in health services.

          Translated abstract

          RESUMEN Objetivo describir las principales acciones recomendadas sobre acciones de prevención relacionadas con la exposición ocupacional de los profesionales de la salud que trabajan en COVID-19, disponible hasta marzo de 2020. Contenido La enfermedad pandémica actual causada por el nuevo coronavirus SARS-CoV-2 tiene su transmisión favorecida por contacto cercano y sin protección con secreciones o excreciones de pacientes infectados, principalmente a través de gotas salivales. Se deben priorizar las prácticas de prevención organizacional, desde la llegada del paciente al servicio de salud, optimizando el flujo de atención, la primera atención y durante las acciones de atención de salud, para minimizar la exposición ocupacional al agente biológico. Los profesionales de la salud clasificados como grupo de riesgo deben ser retirados de las actividades en riesgo de contaminación. Las personas contaminadas o adulteradas deben permanecer en cuarentena para minimizar la propagación de COVID-19. Consideraciones finales se debe priorizar la atención para evitar la contaminación de los trabajadores en esta pandemia por el nuevo coronavirus, evitando que afecte la asistencia a la población que busca asistencia en los servicios de salud.

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

            Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
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              Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

              Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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                Author and article information

                Journal
                reuerj
                Revista Enfermagem UERJ
                Rev. enferm. UERJ
                Universidade do Estado do Rio de Janeiro (Rio de Janeiro, RJ, Brazil )
                0104-3552
                2020
                : 28
                : e49596
                Affiliations
                [1] Rio de Janeiro orgnameUniversidade do Estado do Rio de Janeiro orgdiv1Faculdade de Enfermagem Brazil cristiane.gallasch@ 123456gmail.com.
                [2] Rio de Janeiro orgnameUniversidade do Estado do Rio de Janeiro orgdiv1Faculdade de Enfermagem Brazil marcialima-23@ 123456hotmail.com.
                [3] Rio de Janeiro orgnameUniversidade do Estado do Rio de Janeiro orgdiv1Faculdade de Enfermagem Brazil larissia_adma@ 123456yahoo.com.br.
                [4] orgnameCentro Universitário São Camilo. São Paulo orgdiv1Departamento de Medicina Brasil silvajunior.js@ 123456gmail.com.
                Article
                S0104-35522020000100504 S0104-3552(20)02800000504
                10.12957/reuerj.2020.49596
                3c58317f-7e05-4a7e-82fa-40e2a9d8e35f

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 28 March 2020
                : 02 April 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 31, Pages: 0
                Product

                SciELO Revista de Enfermagem

                Categories
                Artigos de Atualidades

                salud pública,riesgos laborales,saúde do trabalhador, riscos ocupacionais,Epidemia,occupational health,salud labora,saúde pública,contención de riesgos biológicos,public health,containment of biohazards,Epidemics,occupational risks,contenção de riscos biológicos

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