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      OCCUPATIONAL EXPOSURES TO BODY FLUIDS AND BEHAVIORS REGARDING THEIR PREVENTION AND POST-EXPOSURE AMONG MEDICAL AND NURSING STUDENTS AT A BRAZILIAN PUBLIC UNIVERSITY Translated title: Exposições ocupacionais a fluídos corporais e comportamentos em relação à sua prevenção e pós-exposição entre estudantes de medicina e de enfermagem de universidade pública brasileira

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          Abstract

          A cross-sectional study was conducted to assess the frequencies and characteristics of occupational exposures among medical and nursing students at a Brazilian public university, in addition to their prevention and post-exposure behavior. During the second semester of 2010, a self-administered semi-structured questionnaire was completed by 253/320 (79.1%) medical students of the clinical course and 149/200 (74.5%) nursing students who were already performing practical activities. Among medical students, 53 (20.9%) suffered 73 injuries, which mainly occurred while performing extra-curricular activities (32.9%), with cutting and piercing objects (56.2%), in the emergency room (39.7%), and as a result of lack of technical preparation or distraction (54.8%). Among nursing students, 27 (18.1%) suffered 37 injuries, which mainly occurred with hollow needles (67.6%) in the operating room or wards (72.2%), and as a result of lack of technical preparation or distraction (62.1%). Among medical and nursing students, respectively, 96.4% and 48% were dissatisfied with the instructions on previously received exposure prevention; 48% and 18% did not always use personal protective equipment; 67.6% and 16.8% recapped used needles; 49.3% and 35.1% did not bother to find out the source patient's serological results post-exposure; and 1.4% and 18.9% officially reported injuries. In conclusion, this study found high frequencies of exposures among the assessed students, inadequate practices in prevention and post-exposure, and, consequently, the need for training in “standard precautions” to prevent such exposures.

          Translated abstract

          Estudo transversal foi realizado para verificar, entre estudantes de medicina e de enfermagem de universidade pública brasileira, as frequências e características de exposições ocupacionais e seus comportamentos na prevenção e pós-exposição. Durante o segundo semestre de 2010, questionário autoaplicável e semiestruturado foi completado por 253/320 (79,1%) estudantes de medicina do curso clínico e por 149/200 (74,5%) estudantes de enfermagem que já exerciam atividades práticas. Entre os estudantes de medicina, 53 (20,9%) sofreram 73 acidentes, que ocorreram principalmente em atividades extracurriculares (32,9%), com objetos pérfuro-cortantes (56,2%), na sala de emergência (39,7%) e em decorrência de despreparo técnico ou distração (54,8%). Entre os alunos de enfermagem, 27 (18,1%) sofreram 37 acidentes, que ocorreram principalmente com agulhas ocas (67,6%), no centro cirúrgico ou enfermarias (72,2%) e em decorrência de despreparo técnico ou distração (62,1%). Entre os alunos de medicina e de enfermagem, respectivamente, 96,4% e 48% estavam insatisfeitos com orientações previamente recebidas de prevenção de acidentes, 48% e 18% nem sempre utilizam equipamento de proteção individual, 67,6% e 16,8% reencapam agulhas usadas, 49,3% e 35,1% não se preocuparam em conhecer os exames sorológicos do paciente-fonte pós-exposição e 1,4% e 18,9% relataram o acidente oficialmente. Em conclusão, neste estudo verificaram-se altas frequências de exposições entre os estudantes avaliados, práticas inadequadas na prevenção e pós-exposição e, consequentemente, a necessidade de treinamento nas “precauções padrão” para prevenção de tais exposições.

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          Most cited references63

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          Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers.

          The global burden of hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) infection due to percutaneous injuries among health care workers (HCWs) is estimated. The incidence of infections attributable to percutaneous injuries in 14 geographical regions on the basis of the probability of injury, the prevalence of infection, the susceptibility of the worker, and the percutaneous transmission potential are modeled. The model also provides the attributable fractions of infection in HCWs. Overall, 16,000 HCV, 66,000 HBV, and 1,000 HIV infections may have occurred in the year 2000 worldwide among HCWs due to their occupational exposure to percutaneous injuries. The fraction of infections with HCV, HBV, and HIV in HCWs attributable to occupational exposure to percutaneous injuries fraction reaches 39%, 37%, and 4.4% respectively. Occupational exposures to percutaneous injuries are substantial source of infections with bloodborne pathogens among health-care workers (HCWs). These infections are highly preventable and should be eliminated. 2005 Wiley-Liss, Inc.
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            Infection risks following accidental exposure to blood or body fluids in health care workers: A review of pathogens transmitted in published cases

            Hospital staff and all other human or veterinary health care workers, including laboratory, research, emergency service, or cleaning personnel are exposed to the risk of occupational infection following accidental exposure to blood or body fluids (BBF) contaminated with a virus, a bacteria, a parasite, or a yeast. The human immunodeficiency virus (HIV) or those of hepatitis B (HBV) or C (HCV) account for most of this risk in France and worldwide. Many other pathogens, however, have been responsible for occupational infections in health care workers following exposure to BBF, some with unfavorable prognosis. In developed countries, a growing number of workers are referred to clinicians responsible for the evaluation of occupational infection risks following accidental exposure. Although their principal task remains the evaluation of the risks of HIV, HBV, or HCV transmission and the possible usefulness of postexposure prophylaxis, these experts are also responsible for evaluating risks of occupational infection with other emergent or more rare pathogens and their possible timely prevention. The determinants of the risks of infection and the characteristics of described cases are discussed in this article.
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              Update: universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other bloodborne pathogens in health-care settings.

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                Author and article information

                Journal
                Rev Inst Med Trop Sao Paulo
                Rev. Inst. Med. Trop. Sao Paulo
                Revista do Instituto de Medicina Tropical de São Paulo
                Instituto de Medicina Tropical
                0036-4665
                1678-9946
                Mar-Apr 2014
                Mar-Apr 2014
                : 56
                : 2
                : 157-163
                Affiliations
                [(1) ] Postgraduate Program in Health Sciences of the Federal University of Uberlândia Medical School (FAMED/UFU). Uberlândia, MG, Brazil
                [(2) ] Undergraduate medical student of the FAMED/UFU. Uberlândia, MG, Brazil
                [(3) ] Associate professor of the Department of Internal Medicine, FAMED/UFU. Uberlândia, MG, Brazil
                Author notes
                Correspondence to: Dr. Luiz Carlos Marques de Oliveira, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Uberlândia. Av. Pará 1720, Bloco 2H, Campus Umuarama, 38405-320 Uberlândia, MG, Brasil. Phone/fax: +55.34.3218-2246. E-mail: oliveiralcm@ 123456ufu.br

                Author's Contributtions: FRFSB participated in the data collection and analysis and manuscript preparation. LAR participated in the study design, data collection and analysis and manuscript preparation. LCMO participated in the study design, data analysis and manuscript preparation. All authors read and approved the final manuscript.

                Article
                S0036-46652014000200012
                10.1590/S0036-46652014000200012
                4085846
                24626419
                3fc13a75-377a-45f9-81fb-69e64de36a5c

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 January 2013
                : 18 July 2013
                Page count
                Figures: 0, Tables: 2, References: 49, Pages: 7
                Categories
                Public Health

                occupational exposure,medical students,nursing students,needlestick injuries,sharp injuries

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