Determinant factors and procedures post accident with biological material among professionals in Emergency Medical Services

Background: Considering that occupational accidents, their occurrence, incidence and notification are not known and that emergency team works with a high level of occupational risk. 

Objective: analyze post accident procedures and demographic data that determine accidents and estimate their incident due to exposure to biological material.

Methods: This cross-sectional study was carried out with the multiprofessional team of an Emergency Medical Service in Minas Gerais, Brazil between June and December 2006. A structured questionnaire was used, and descriptive analysis, computation of incidents and logistic regression were conducted.

Results: Among the 116 participants, 15.5% were physicians, 7.8% nurses, 55.2% nursing technicians and auxiliaries and 21,5% were drivers. The majority (56.0%) were male; 57.1% graduated before 2000; 59.5% worked at the hospital for more than one year and 70.7% were assigned to the basic support unit. The general incidence of accidents with biological material was of 19.8%, 39.1% occurred due to contact with piercing cutting material and 56.5% due to body fluid contact with mucosa; 33.3% occurred among physicians, 24.0% drivers, 15.6% nursing technicians/auxiliaries and 11.1% among nurses. Post accident procedures: no medical evaluation 69.6%; under notification 91.3%; no procedure 52.2%; no serological follow-up 52.2% (Table 1). Variables associated with accidents: being older than 31 years p=0.014 (OR= 3.0; CI95%: 1.2–7.3) and being assigned to the Basic Support Unit, p=0.010 (OR=5.4; CI95%: 1.5–19.1).

Conclusions: The implementation of post accident protocols aiming to reduce under notification and to increase post accident serological follow-up is suggested. The importance to sensitize professionals regarding the need to develop safe practices and seek new alternatives to minimize occupational risks is highlighted.

Table 1: Percentage distribution of occupational accidents with exposure to biological material and post accident procedures according to professional category from the emergency medical services.

Occupational accidents	Physician (n=18)	Nurse (n=09)	Nursing tech/aux (n=64)	Drive (n=25)
Occupational accident in the last year	33.3	11.1	15.6	24.0
Vehicles of transmission
Body fluids	66.7	100.0	60.0	33.3
Piercing cutting material	16.7		40.0	66.7
Both	16.7
Medical evaluation post accident	16.7		30.0	50.0
Reporting Occupational Accidents			10.0	16.7
Immediate post accident procedure
Quick HIV test in HIV-positive patients: retroviral in less than two hours post accident			10.0	16.7
Quick HIV test in HIV-negative patients	33.3		40.0	50.0
No, patients seemed healthy	66.7	100.0	50.0	33.3
Post-accident serological monitoring
Immediately post accident, 3 and 6 months and 1 year	33.3		30.0	16.7
Immediately post accident and after 3 months				16.7
Only one exam post accident	16.7		10.0	33.3
No exam	50.0	100.0	60.0	33.3