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Veille documentaire Médecine du travail du personnel hospitalier - Juin 2006 - CHU Rouen
Veille documentaire
Médecine du travail du personnel hospitalier
- Literature Follow-up : occupational health for Healthcare Workers -
Juin 2006
Objectif
L'objectif de ce travail est de fournir un outil de veille aux médecins du travail concernant les nouvelles
connaissances scientifiques relative à la santé au travail des personnels de soins. La priorité est
donnée aux documents en français. Ce travail est réalisé par les documentalistes de l'équipe CISMeF
et le service de médecine du travail et de pathologie professionnelle du CHU de Rouen (Dr JF
Gehanno), dans le cadre d'un projet financé par la CNRACL (Caisse Nationale de Retraites des
Agents des Collectivités Locales). Les résultats proposés sont issus de la surveillance mensuelle
d'une sélection de périodiques, de sites Internet d'organismes spécialisés et des bases de données
CISMeF, PubMed et BDSP.
La veille juridique est réalisée par l’ISTNF (Institut de santé du nord de la France).
Pour obtenir un document, vous pouvez vous adresser à la BIUM (http://www.bium.univ-paris5.fr/) ou
à l'INIST-CNRS (http://www.inist.fr/).
Sommaire
1. Allergies
2. Bonnes pratiques
3. Conditions de travail et santé psychologique ........................................................................ p. 2
4. Hygiène et gestion des risques ............................................................................................. p. 5
5. Infections nosocomiales
6. Risques biologiques .............................................................................................................. p. 6
6.1 Accident d'exposition au sang ................................................................................ p. 8
6.2 Contamination soignant-soigné
6.3 Transmission aérienne
6.4 Transmission de contact
6.5 Vaccination ........................................................................................................... p. 10
7. Risques chimiques .............................................................................................................. p. 11
8. Risques physiques .............................................................................................................. p. 13
8.1 Rayonnements ionisants
8.2 Troubles musculo-squelettiques
9. Violence ............................................................................................................................... p. 14
10. Autres ................................................................................................................................ p. 15
Veille juridique
1
1. Allergies
2. Bonnes pratiques
3. Conditions de travail et santé psychologique
- Documents en français :
Fondation canadienne de la recherche sur les services de santé, Mars 2006
Les maux qui affligent nos infirmières : Examen des principaux facteurs qui portent une
incidence sur les ressources humaines infirmières au Canada
"Le rapport Les maux qui affligent nos infirmières : Examen des principaux facteurs qui portent une
incidence sur les ressources humaines infirmières au Canada vise à susciter les discussions et à
orienter les initiatives à venir ayant pour but de réduire la pénurie actuelle de personnel infirmier dans
l’ensemble du pays. Il propose un examen, une analyse et une discussion de six importants rapports
de recherche qui ont été publiés au cours des cinq dernières années sur diverses questions liées aux
ressources humaines infirmières au Canada."
http://www.chsrf.ca/research_themes/pdf/What_sailingourNurses-f.pdf
In Objectif Prévention, VOL. 29, NO 2, 2006
Urgence 9-1-1 ! Risques chez les préposés des centres d’urgence du Québec
Georges Toulouse, Louise Saint-Arnaud
"Les préposés des centres d’ur-gence 9-1-1 appartiennent à une profession qui, bien qu’étant une
fonction clé dans les services d’urgence aux citoyens, est encore assez mal connue. À l’image de ce
travail, les statistiques sur les risques entourant cette profession restent dans l’ombre. Devant cette
carence d’information, une étude1 a été réalisée à la demande de l’Association paritaire pour la santé
et la sécurité du travail, secteur « affaires municipales » (APSAM). Objectif prévention reprend en
grande partie l’article publié par l’APSAM2."
Article de périodique
Accès au texte intégral : http://www.asstsas.qc.ca/documentation/op/op292004.pdf
- Documents en anglais :
Occup Environ Med. 2006 May;63(5):326-34.
Development and implementation of a participative intervention to improve the psychosocial
work environment and mental health in an acute care hospital.
Bourbonnais R, Brisson C, Vinet A, Vezina M, Lower A.
Rehabilitation Department, Medecine Faculty, Laval University, Quebec, QC, Canada.
[email protected]
OBJECTIVES: To describe the development and implementation phases of a participative intervention
aimed at reducing four theory grounded and empirically supported adverse psychosocial work factors
(high psychological demands, low decision latitude, low social support, and low reward), and their
mental health effects. METHODS: The intervention was realised among 500 care providers in an
acute care hospital. A prior risk evaluation was performed, using a quantitative approach, to determine
the prevalence of adverse psychosocial work factors and of psychological distress in the hospital
compared to an appropriate reference population. In addition, a qualitative approach included
observation in the care units, interviews with key informants, and collaborative work with an
intervention team (IT) including all stakeholders. RESULTS: The prior risk evaluation showed a high
prevalence of adverse psychosocial factors and psychological distress among care providers
compared to a representative sample of workers from the general population. Psychosocial variables
at work associated with psychological distress in the prior risk evaluation were high psychological
demands (prevalence ratio (PR) = 2.27), low social support from supervisors and co-workers (PR =
1.35), low reward (PR = 2.92), and effort-reward imbalance (PR = 2.65). These results showed the
empirical relevance of an intervention on the four selected adverse psychosocial factors among care
providers. Qualitative methods permitted the identification of 56 adverse conditions and of their
solutions. Targets of intervention were related to team work and team spirit, staffing processes, work
organisation, training, communication, and ergonomy. CONCLUSION: This study adds to the scarce
2
literature describing the development and implementation of preventive intervention aimed at reducing
psychosocial factors at work and their health effects. Even if adverse conditions in the psychosocial
environment and solutions identified in this study may be specific to the healthcare sector, the
intervention process used (participative problem solving) appears highly exportable to other work
organisations.
MeSH Terms: Adaptation, Psychological - Adolescent - Adult - Cohort Studies - Female - Hospitals* Humans - Job Satisfaction - Male - Medical Staff, Hospital* - Mental Health - Middle Aged Occupational Diseases/prevention & control* - Occupational Health* - Research Support, Non-U.S.
Gov't - Risk Assessment/methods - Social Support - Stress, Psychological/prevention & control* Work Schedule Tolerance - Workload
Effectiveness of a participative intervention on psychosocial work factors to prevent mental
health problems in a hospital setting.
Bourbonnais R, Brisson C, Vinet A, Vezina M, Abdous B, Gaudet M.
Rehabilitation Department, Medecine Faculty, Laval University, Quebec, QC, Canada.
[email protected]
OBJECTIVES: To assess the effectiveness of a workplace intervention aimed at reducing adverse
psychosocial work factors (psychological demands, decision latitude, social support, and effort-reward
imbalance) and mental health problems among care providers. METHODS: A quasi-experimental
design with a control group was used. Pre-intervention (71% response rate), and one-year postintervention measures (69% response rate) were collected by telephone interviews. RESULTS: One
year after the intervention, there was a reduction of several adverse psychosocial factors in the
experimental group, whereas no such reduction was found in the control group. However, there was a
significant deterioration of decision latitude and social support from supervisors in both experimental
and control groups. There was also a significant reduction in sleeping problems and work related
burnout in the experimental hospital, whereas only sleeping problems decreased in the control group
while both client related and personal burnout increased in this hospital. The comparison between the
experimental and control groups, after adjusting for pre-intervention measures, showed a significant
difference in the means of all psychosocial factors except decision latitude. All other factors were
better in the experimental group. CONCLUSION: Results suggest positive effects of the intervention,
even though only 12 months have passed since the beginning of the intervention. Follow up at 36
months is necessary to evaluate whether observed effects are maintained over time. In light of these
results, we believe that continuing the participative process in the experimental hospital will foster the
achievement of a more important reduction of adverse psychosocial factors at work. It is expected that
the intensity of the intervention will be directly related to its beneficial effects. Long term effects will
however depend on the willingness of management and of staff to appropriate the process of
identifying what contributes to adverse psychosocial factors at work and to adopt means to reduce
them.
MeSH Terms: Adolescent - Adult - Analysis of Variance - Case-Control Studies - Female - Follow-Up
Studies - Humans - Job Satisfaction - Male - Medical Staff, Hospital* - Mental Health - Middle Aged Occupational Diseases/prevention & control* - Occupational Health* - Research Support, Non-U.S.
Gov't - Sleep Disorders/prevention & control - Social Support - Stress, Psychological/prevention &
control* - Work Schedule Tolerance
Publication Types: Evaluation Studies
Am J Nurs 2006 Apr; 106(4):60-71
How long and how much are nurses now working? Too long, too much, and without enough
rest between shifts, a study finds
Extended work schedules-those that vary from the standard eight hours per day, 35 to 40 hours per
week-are common in nursing and contribute to problems with nursing recruitment and retention, in
addition to compromising patient safety and the health and well-being of nurses. This study describes
the nature and prevalence of such schedules across nursing settings. Quantitative survey data
collected as part of the Nurses Worklife and Health Study were analyzed. The sample consisted of
2,273 RNs. Demographic data, information about respondents' primary jobs (position, workplace, and
specialty), and specific work schedule variables were analyzed, including data on off-shifts, breaks,
overtime and on-call requirements, time off between shifts, and how often respondents worked more
than 13 hours per day and on scheduled days off and vacation days. Respondents were also asked
about activities outside of work, commuting time, and other non-nursing activities and chores. More
than a quarter of the sample reported that they typically worked 12 or more hours per day, as did more
than half of hospital staff nurses and more than a third of those with more than one job. A third of the
total sample worked more than 40 hours per week, and more than a third worked six or more days in a
row at least once in the preceding six months. Nearly a quarter rotated shifts.Almost one-quarter of
nurses with more than one job worked 50 or more hours per week, and they were more likely to work
3
many days consecutively, without sufficient rest between shifts, and during scheduled time off. Single
parents were as likely as those with more than one job to work 13 to 15 hours per day, 50 to 60 hours
or more per week, and many days consecutively. Seventeen percent of all nurses worked mandatory
overtime, as did almost a quarter of the single parents. Nearly 40% of the total sample and more than
40% of hospital staff nurses had jobs with on-call requirements. The proportion of nurses who reported
working schedules that exceed the recommendations of the Institute of Medicine should raise industrywide concerns about fatigue and health risks to nurses as well as the safety of patients in their care.
KW: Nurses; Nursing; Health-care-personnel; Medical-personnel; Workers; Worker-health;
Quantitative-analysis; Shift-work; Shift-workers; Sampling; Job-analysis; Risk-factors; Risk-analysis;
Fatigue
Acad Med. 2006 Apr;81(4):374-84.
Personal life events and medical student burnout: a multicenter study.
Dyrbye LN, Thomas MR, H untington JL, Lawson KL, Novotny PJ, Sloan JA, Shanafelt TD.
Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55906, USA.
[email protected]
PURPOSE: Burnout, a marker of professional distress prevalent among residents and physicians, has
been speculated to originate in medical school. Little is known about burnout in medical students. The
authors sought to identify the prevalence of burnout, variation of its prevalence during medical school,
and the impact of personal life events on burnout and other types of student distress. METHOD: All
medical students (n = 1,098) attending the three medical schools in Minnesota were surveyed in
spring 2004 using validated instruments to assess burnout, quality of life, depression, and alcohol use.
Students were also asked about the prevalence of positive and negative personal life events in the
previous 12 months. RESULTS: A total of 545 medical students (response rate 50%) completed the
survey. Burnout was present in 239 (45%) of medical students. While the frequency of a positive
depression screen and at-risk alcohol use decreased among more senior students, the frequency of
burnout increased (all p < .03). The number of negative personal life events in the last 12 months also
correlated with the risk of burnout (p = .0160). Personal life events demonstrated a stronger
relationship to burnout than did year in training on multivariate analysis. CONCLUSIONS: Burnout
appears common among U.S. medical students and may increase by year of schooling. Despite the
notion that burnout is primarily linked to work-related stress, personal life events also demonstrated a
strong relationship to professional burnout. The authors' findings suggest both personal and curricular
factors are related to burnout among medical students. Efforts to decrease burnout must address both
of these elements.
MeSH Terms: Adult - Alcohol Drinking - Burnout, Professional*/epidemiology - Data Collection Female - Humans - Life Change Events* - Male - Prevalence - Quality of Life - Schools, Medical Stress, Psychological* - Students, Medical/psychology*
Risk of affective and stress related disorders among employees in human service professions.
Wieclaw J, Agerbo E, Mortensen PB, Bonde JP.
Department of Occupational Medicine, Aarhus University Hospital, Aarhus C, Denmark.
[email protected]
OBJECTIVES: To examine the risk of affective and stress related disorders among men and women
employed in human service professions. METHODS: Population based case-control study using data
from national registers. Cases (n = 28 971) were identified in the Danish Psychiatric Central Research
Register among all hospitalised patients and outpatients aged 18-65 who received a first time ever
diagnosis of affective (ICD-10, F30-39) or stress related (ICD-10, F40-48) disorder from 1 January
1995 to 31 December 1998. Each case was assigned five never admitted referents (n = 144 855) of
the same gender and age, randomly drawn from a 5% sample of the Danish population obtained from
Statistics Denmark's Integrated Database for Labour Market Research. Occupation held the year
before matching was classified according to the Danish version of the International Classification of
Occupation. Health care, education, social work, and customer services were defined as human
service professions and constituted 21% of all employed in the study. Adjusted risks (hazard ratios)
relative to all other occupations were calculated for 24 human service occupations. RESULTS: The
relative risk of depression in human service professions was 1.35 (95% CI 1.24 to 1.47) for women
and 1.49 (95% CI 1.29 to 1.73) for men. The risk of stress was 1.18 (95% CI 1.11 to 1.26) for women
and 1.49 (95% CI 1.32 to 1.67) for men. Specific professions contributed differentially to the magnitude
of risk, with education and social services displaying the highest risks. No increase in risks was found
in customer service occupations. Gender was a significant modifying factor with the highest risk levels
in men. CONCLUSIONS: There was a consistent association between employment in human service
occupations and the risk of affective and stress related disorders. Risks were highest for men working
in these typically female professions. More work is needed to distinguish work hazards from effects
attributable to selection mechanisms and personality characteristics.
4
MeSH Terms: Adult - Case-Control Studies - Denmark - Female - Health Personnel* - Humans - Male
- Middle Aged - Mood Disorders/etiology* - Occupational Diseases/etiology* - Occupational Health* Proportional Hazards Models - Research Support, Non-U.S. Gov't - Risk Assessment - Sex Factors Stress Disorders, Traumatic/etiology*
Acta Anaesthesiol Scand. 2006 Jan;50(1):58-63.
Significance of working conditions on burnout in anesthetists.
Lederer W, Kinzl JF, Trefalt E, Traweger C, Benzer A.
Department of Anaesthesiology and Critical Care Medicine, University of Innsbruck, Innsbruck,
Austria. [email protected]
BACKGROUND: The influence of working conditions on the development of burnout syndrome was
assessed in anesthetists working at a university hospital. METHODS: Self-reporting questionnaires
were used to assess physical health and emotional well-being (Health and Stress Profile), burnout
syndrome (Maslach Burnout Inventory) and working conditions (Instrument for Stress-Oriented Task
Analysis) in anesthetists. RESULTS: Twenty-three anesthetists (25.8%) appeared to be at risk for
burnout, and three anesthetists (3.4%) had already developed full-blown burnout syndrome.
Anesthetists at risk for burnout more frequently suffered from limited complexity of work (P=0.001),
lacking individual time control (P=0.004), lack of participation possibilities (P=0.012), and had more
physical complaints (P=0.017) and greater job dissatisfaction (P=0.002) than did their colleagues with
no burnout symptoms. CONCLUSION: Job conditions providing little opportunity to influence work
pace and participation contribute to the development of burnout syndrome. Communication and
contact with colleagues appear to be an important preventive regulative.
MeSH Terms: Adult - Anesthesiology* - Burnout, Professional/diagnosis - Burnout,
Professional/psychology* - Depersonalization - Female - Health Status - Humans - Interprofessional
Relations - Job Satisfaction - Male - Medical Staff, Hospital* - Research Support, Non-U.S. Gov't Risk Factors - Stress, Psychological – Workload
4. Hygiène et gestion des risques
In Objectif Prévention, vol 29, n 2, 2006
Lavage des mains et le port de gants (Le) : deux pratiques de base
Renée Julien
Voilà deux pratiques de base en prévention des infections qui suscitent, malgré tout, encore plusieurs
questionnements. Objectif prévention fait le point à ce sujet.
Article de prévention
Accès au texte intégral : http://www.asstsas.qc.ca/documentation/op/op292032.pdf
SFHH, 2006
Liste positive désinfectants 2006
produits détergents-désinfectants et désinfectants utilisés en milieu hospitalier
http://www.sfhh.net/telechargement/recommandations_LPD2006.pdf
Am J Infect Control. 2006 Feb;34(1):18-24.
Mentor's hand hygiene practices influence student's hand hygiene rates.
Snow M, White GL Jr, Alder SC, Stanford JB.
Department of Family and Preventive Medicine, University of Utah, USA. [email protected]
BACKGROUND: There were 3 objectives for this prospective quasiexperimental study. The first was
to determine the effect of mentor's hand hygiene practices on student's hand hygiene rates during
clinical rotations. The second was to assess the difference in hand hygiene rates for students with and
without prior medical experience. The third was to assess the student's opinion and beliefs regarding
hand hygiene. METHODS: Sixty students enrolled in a certified nursing program were selected to
participate in the study. Each study group was observed twice during the 30-day span. The first
observational period was conducted on day 1 of clinical rotation. The second observational period was
conducted on day 30 of clinical rotation. Students were observed for hand hygiene. Also assessed
were medical experience, sex, gloving, age, and mentor's hand hygiene practices. After observational
period 2, a brief questionnaire was given to students to determine their opinion and beliefs regarding
hand hygiene. The questionnaire was divided into 5 sections: student's commitment to hand hygiene,
their perception of hand hygiene inconvenience, the necessity of hand hygiene, the student's ability to
5
perform hand hygiene, and their opinion on the frequency of medical staff's hand hygiene. RESULTS:
The mentor's practice of hand hygiene was the strongest predictor of the student's rate of hand
hygiene for both observational periods (P < .01). Furthermore, students without prior medical
experience had a significant increase in hand hygiene rates when comparing observational period 1 to
observational period 2 (P < .01). Glove usage was associated with increased hand hygiene rates by
50% during observational period 1 (P = .01) and 44% during observational period 2 (P < .01). Male
students during observational period 1 practiced hand hygiene 30% less often than female students (P
< .01); however, during observational period 2, there was no significant difference between hand
hygiene rates for males and females (P = .82). Questionnaires were completed by 47 students, who
reported a strong commitment to hand hygiene, belief in its necessity, and ability to perform hand
hygiene (with scores in the high 90s on a 10 to 100 rating scale). CONCLUSION: Mentor's use of
hand hygiene and glove usage was associated with increased hand hygiene among students. Even
though students reported strongly positive attitudes toward hand hygiene, students had a low overall
rate of hand hygiene.
MeSH Terms:Adolescent - Adult - Cross Infection/prevention & control* - Education, Nursing/methods*
- Female - Gloves, Surgical - Handwashing* - Health Knowledge, Attitudes, Practice* - Humans - Male
- Mentors* - Prospective Studies - Questionnaires - Students, Health Occupations*
5. Infections nosocomiales
6. Risques biologiques
INRS, mai 2006
Guide Eficatt, exposition fortuite à un agent infectieux et conduite à tenir en milieu de travail
GERES, Groupe d'étude sur le risque d'exposition des soignants aux agents infectieux
Département Etudes et assistance médicales, INRS
guide destiné aux médecins du travail concernant les expositions accidentelles à un agent biologique
pathogène, éléments pour évaluer le risque, définir la conduite à tenir immédiate, définir les actions à
entreprendre et le suivi médical à mettre en place, accès par pathologies ou par agents infectieux
mots clés : bordetella pertussis; coqueluche; corynebacterium diphtheriae; cytomégalovirus; diphtérie;
*exposition professionnelle /prévention et contrôle \recommandation professionnelle ; gale; grippe;
hépatite B; hépatite C; hépatovirus; infections à cytomégalovirus; infections à rotavirus; infections à
virus respiratoire syncytial; légionella; légionellose; leptospira interrogans; leptospirose; lutte contre
maladie contagieuse; maladie de Lyme; médecine travail; méningite à méningocoques;
mycobacterium tuberculosis; Neisseria meningitidis; orthomyxoviridae; *pathogènes transmissibles par
le sang \recommandation professionnelle ; rage (maladie); rotavirus; rougeole; rubéole; rubivirus;
sarcopte scabiei; syndrome d'immunodéficience acquise; tuberculose; varicelle; varicellovirus; VIH;
virus rage; virus respiratoire syncytial humain; virus varicelle zona; zona
type : *guide ; *recommandation professionnelle
http://www.inrs.fr/eficatt/
Ministère de la Santé et des Services sociaux [québécois], 2006
Guide pour la prophylaxie postexposition (PPE) aux personnes exposées à des liquides
biologiques dans le contexte du travail
premiers soins, évaluation de l'exposition, évaluation du risque, hépatite B (VHB), hépatite C (VHC),
infection au VIH, aspects psychologiques, consentement et confidentialité, aspects organisationnels,
annexes ; 59 pages [Canada
*chimioprévention\recommandation professionnelle - confidentialité - consentement éclairé contaminations par piqûre d'aiguille - évaluation risque - *exposition professionnelle\recommandation
professionnelle - hépatite B/diagnostic - hépatite B/prévention et contrôle - hépatite B/transmission hépatite C/diagnostic - hépatite C/prévention et contrôle - hépatite C/transmission - infections à
VIH/diagnostic - infections à VIH/prévention et contrôle - infections à VIH/transmission - *liquide
biologique - liquide biologique/virologie - *pathogènes transmissibles par le sang\recommandation
professionnelle - stress psychologique - traitement urgence
algorithme; questionnaire; *recommandation professionnelle; tableau;
Accès au texte intégral :
http://msssa4.msss.gouv.qc.ca/fr/document/publication.nsf/LienParId/24578EA647005722852571480
070070F
6
Health and Safety Executive (HSE), 05/06
Biological agents: The principles, design and operation of containment level 4 facilities
Advisory Committee on Dangerous Pathogens
"Biological agents: The principles, design and operation of containment level 4 facilities is aimed at
those responsible for working with the highest hazard pathogens.
It is based on the principles contained in the Control of Substances Hazardous to Health Regulations
(COSHH) 2002. These regulations place a duty on employers to identify the hazards in the workplace,
assess the risk posed and put control measures in place to control these risks.
The guidance, which has been developed in partnership with experts from ACDP, the biotechnology
industry, HSE and other Government Departments, is intended for all laboratories in which high
hazard human pathogens may be handled; prevention of exposure and potential infection from these
highly pathogenic organisms is important for both workers health and safety and public health."
http://www.hse.gov.uk/pubns/web09.pdf
Press release : http://www.hse.gov.uk/press/2006/e06058.htm
J Am Acad Dermatol. 2005 Dec;53(6):1010-9.
Infectious occupational exposures in dermatology--a review of risks and prevention measures.
I. For all dermatologists.
Nori S, Greene MA, Schrager HM, Falanga V.
Department of Dermatology and Skin Surgery, Roger Williams Medical Center, Providence, Rhode
Island 02908, USA.
Dermatologists are at risk for exposure to infectious agents from a variety of sources throughout their
workday. We review occupational infectious risks from percutaneous exposures, aerosolized infectious
particles (eg, with laser surgery and dermabrasion), instrumentation, and cryotherapy. We also
discuss current guidelines for management and postexposure prophylaxis of the more common
occupational exposures, and conclude with an overview of means to minimize them.
MeSH Terms: Dermatology* - HIV Infections/prevention & control* - Hepatitis B/etiology* - Hepatitis
B/prevention & control* - Hepatitis C/etiology* - Hepatitis C/prevention & control* - Humans Occupational Diseases/etiology* - Occupational Diseases/prevention & control* - Occupational
Exposure/adverse effects* - Occupational Exposure/prevention & control* - Risk Factors
Publication Types: * Review
J Am Acad Dermatol. 2005 Dec;53(6):1020-6.
Infectious occupational exposures in dermatology--a review of risks and prevention measures.
II. The pregnant dermatologist.
Nori S, Greene MA, Schrager HM, Falanga V.
Department of Dermatology and Skin Surgery, Roger Williams Medical Center, Providence, Rhode
Island 02908, USA.
The number of women of childbearing age (i.e. physicians, registered nurses, physician assistants,
nurse practitioners, and medical assistants) working in the field of dermatology is increasing steadily.
In part II of our review of the occupational infectious risks in dermatology, we address the special
concerns for pregnant health care workers.
MeSH Terms: Cross Infection/etiology - Cross Infection/prevention & control - Dermatology* - Female Humans - Occupational Diseases/etiology* - Occupational Diseases/prevention & control* Occupational Exposure/adverse effects* - Occupational Exposure/prevention & control* - Pregnancy Pregnancy Complications, Infectious/etiology* - Pregnancy Complications, Infectious/prevention &
control* - Risk Factors - Virus Diseases/etiology - Virus Diseases/prevention & control*
Publication Types: *Review
Clin Infect Dis. 2005 Jan 15;40(2):e16-8. Epub 2004 Dec 17.
Seroprevalence of anti-H5 antibody among Thai health care workers after exposure to avian
influenza (H5N1) in a tertiary care center.
Apisarnthanarak A, Erb S, St ephenson I, Katz JM, Chittaganpitch M, Sangkitporn S, Kitphati R,
Thawatsupha P, Waicharoen S, Pinitchai U, Apisarnthanarak P, Fraser VJ, Mundy LM.
Infectious Diseases Division, Thammasart University Hospital, Klong Luang, Pratumthani, Thailand
12120. [email protected]
After the initial atypical presentation of a patient with avian influenza (H5N1) infection, paired acutephase and convalescent-phase serum samples obtained from 25 health care workers (HCWs) who
were exposed to the patient were compared with paired serum samples obtained from 24 HCWs who
worked at different units in the same hospital and were not exposed to the patient. There was no
serologic evidence of anti-H5 antibody reactivity or subclinical infection in either of the groups.
MeSH Terms: Adult - Antibodies, Viral/blood* - Cohort Studies - Female - Health Personnel - Humans
- Influenza A Virus, H5N1 Subtype/immunology* - Influenza, Human/immunology* - Influenza,
7
Human/virology* - Male - Occupational Exposure - Seroepidemiologic Studies - Thailand
Substances: Antibodies, Viral
6.1 Accident d'exposition au sang
LE JOURNAL DU SIDA, vol. 179, p.24-26, 2005/09
Le risque de contamination en milieu médical : VIH et VHC à l'hôpital.
LAMBERT (S.)
Le risque de contamination par les virus de l'hépatite C et du sida en milieu médical est faible mais il
existe. Cet article fait le point sur ces transmissions accidentelles, et explique les raisons de la sous
déclaration des accidents d'exposition au sang par le personnel médical. Il rappelle également
l'opposition du CNS et de la DGS au dépistage obligatoire des soignants et des patients.
Mots-clés BDSP : Profession médicale, Profession santé, Infection nosocomiale, VIH, Hépatite virale
C, Hépatite virale B, France, Sida
Parlement européen, 20/04/2006
Protéger les travailleurs contre les risques d'infection par piqûre accidentelle
Chaque année en Europe environ un million de travailleurs, principalement dans le milieu médical, se
blessent malencontreusement en manipulant des aiguilles usagées. Ces piqûres peuvent entraîner de
graves conséquences comme des infections par le HIV ou les virus des hépatites B et C. La
commission des Affaires sociales du PE recommande une amélioration de la législation européenne
pour mieux protéger ces travailleurs.
Communiqué de presse
http://www.europarl.europa.eu/news/expert/infopress_page/048-7413-110-04-16-90820060411IPR07234-20-04-2006-2006-false/default_fr.htm
Rapport complet
http://www.europarl.europa.eu/omk/sipade3?PUBREF=-//EP//NONSGML+REPORT+A6-20060137+0+DOC+PDF+V0//FR&L=FR&LEVEL=0&NAV=S&LSTDOC=Y
NORA Symposium 2006: Research Makes a Difference! April 18-26, 2006, Washington, DC.
Washington, DC: National Institute for Occupational Safety and Health, 2006 Apr; :169-170
A safety information campaign to reduce sharps injuries: preliminary results from the "stop
sticks campaign"
Sinclair-RC; Harney-AG; Smallwood-SW; Christianson-AL
CDC estimates that more than 350,000 contaminated needlesticks occur every year among hospital
workers in the U.S. As many as half of those injuries are not reported to the employer. The risk of
acquiring a bloodborne pathogen infection from needlestick injuries varies according to a number of
factors and the type of pathogen. Nevertheless, every injury may cost both the employee and the
employer time and money for employee testing, post-exposure prophylaxis, and stress from the fact
that illnesses resulting from such infections are serious and sometimes life-threatening. Needlestick
injuries occur with many occupational groups in hospitals. Although most occur among clinical-care
workers, non-clinical workers such as housekeepers, maintenance workers, and laundry workers may
also be injured. Sharps devices with safety features are a major component of most needlestick
prevention programs. Frontline workers with patient care responsibilities must be involved in the trial
and selection of the most appropriate devices for each procedure in each facility. However,
comprehensive exposure control plans, adequately-sized and placed sharps disposal containers,
improved work practices, diligent injury reporting, and post-exposure follow-up are important parts of
the prevention effort. Training and information activities are critical for maintaining prevention
awareness and skills among all health care workers. Although the health care industry has substantial
infrastructure for conducting training and awareness activities, the primary focus is frequently on
patient care and safety rather than both that and worker health and safety. Clinical training and
information staff are often inexperienced at communicating about worker safety and health.
Occupational safety and health staff may be inexperienced at communicating about clinical issues.
Our research investigated methods of increasing sharps injury prevention behaviors among health
care workers using information and training activities and both occupational safety and health and
clinical expertise. We were interested in learning: What are the most effective ways to conduct
communications activities around this issue in health care facilities? What are the best predictors of
8
safer clinical behaviors? We conducted a five-year, community-focused information campaign in a
U.S. city of under one million population. Training and information activities were conducted at various
health care facilities in the community using campaign blitz tactics. Blitzes lasted four to six weeks and
included the use of multiple media (posters, demonstrations, safety device fairs, information sessions,
games, promotional items) multiple times to cover a small group of repeated messages that were
determined by an analysis of sharps injuries at the facility. Pre and post tests were collected from
convenient samples of employees. Five blitzes were conducted in high-injury departments (usually
OR). One blitz was conducted at the community’s largest hospital. One was conducted at a state-run
nursing care facility. We found that, while reported exposure to safety messages increased, safety
attitudes and knowledge did not change over time. Posters were the most-remembered channel of
safety information in all cases but one, but remembering other channels varied due to differences
across blitzes. Some safety behaviors increased (self-report), and virtually no safety behaviors
decreased. Our most important findings were a) that safety behaviors improved most after blitzes
conducted at the department (rather than facility) level, and b) that a perceived positive safety climate
was, overall, the best predictor of safety behaviors. We conclude that clinical-care and occupational
safety and health staff should collaborate to conduct sharps injury prevention training and awareness
blitzes, and that the scope of the blitz should be matched to available resources. Focus blitzes in highrisk departments if there are insufficient resources to adequately cover the entire facility. Employers
can best influence safety behaviors by cultivating a positive safety climate.
KW: Safety-education; Injuries; Injury-prevention; Needlestick-injuries; Health-care-personnel;
Medical-personnel; Bloodborne-pathogens; Risk-factors; Risk-analysis; Occupational-hazards;
Occupational-health; Clinical-pathology; Safety-measures; Training; Safety-programs; Occupationalhealth-programs; Occupational-safety-programs
Int J Nurs Pract. 2006 Apr;12(2):71-7.
Needlestick and sharps injuries among nurses in a tropical Australian hospital.
Smith DR, Smyth W, Leggat PA, Wang RS.
Department of Hazard Assessment, National Institute of Industrial Health, Kawasaki, Japan.
[email protected]
Although needlestick and sharps injuries (NSI) represent a major hazard in nursing practice, most
studies rely on officially reported data and none have yet been undertaken in tropical environments.
Therefore, we conducted a cross-sectional NSI survey targeting all nurses within a tropical Australian
hospital, regardless of whether they had experienced an NSI or not. Our overall response rate was
76.7%. A total of 39 nurses reported 43 NSI events in the previous 12 months. The most common
causative device was a normal syringe needle, followed by insulin syringe needles, i.v. needles or kits
and blood collection needles. Half of the nurses' NSI events occurred beside the patient's bed:
drawing up medication was the most common reason. Nurses working in the maternity/neonatal wards
were only 0.3 times as likely to have experienced an NSI as their counterparts in the medical or
surgical wards. Overall, our study has shown that NSI events represent an important workplace issue
for tropical Australian nurses. Their actual rate might also be higher than official reports suggest.
MeSH Terms: Accidents, Occupational/prevention & control - Accidents, Occupational/statistics &
numerical data* - Adult - Age Distribution - Attitude of Health Personnel - Causality - Cross-Sectional
Studies - Epidemiologic Studies - Female - Health Knowledge, Attitudes, Practice - Hospital
Departments/statistics & numerical data - Hospitals, Teaching - Humans - Incidence - Male - Middle
Aged - Needlestick Injuries/epidemiology* - Needlestick Injuries/prevention & control - Nursing Staff,
Hospital/psychology - Nursing Staff, Hospital/statistics & numerical data* - Occupational Health Population Surveillance - Prevalence - Questionnaires - Research Support, Non-U.S. Gov't - Safety
Management - Tropical Medicine
AORN J. 2006 Feb;83(2):391, 393-7.
Perceived barriers to implementation of a successful sharps safety program.
Hagstrom AM.
Hartford Hospital, Conn, USA
IN RESPONSE TO INCREASING needle sticks and sharps injuries at a large, urban trauma center in
the northeastern United States, a nurse educator assembled a focus group of OR staff members to
determine what they perceived to be barriers to successful implementation of a sharps safety program.
THE FOCUS GROUP IDENTIFIED inadequate communication, powerlessness, resistance to change,
intimidation, inconsistencies in practice, negative attitudes, inexperienced staff members, and time
constraints as barriers to a successful change implementation. USING THIS INFORMATION, the
nurse educator identified strategies to implement a practice change to decrease the rate of needle
sticks and sharps injuries.
MeSH Terms: Focus Groups - Health Knowledge, Attitudes, Practice* - Humans - Needlestick
Injuries/prevention & control* - New England - Occupational Diseases/prevention & control* Perioperative Nursing* - Safety Management*
9
6.2 Contamination soignant-soigné
6.3 Transmission aérienne
6.4 Transmission de contact
6.5 Vaccination
Infect Control Hosp Epidemiol. 2006 Jan;27(1):77-9. Epub 2006 Jan 6.
Increased influenza vaccination of healthcare workers at a pediatric cancer hospital: results of
a comprehensive influenza vaccination campaign.
McCullers JA, Speck KM, Williams BF, Liang H, Mirro J Jr.
Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105-2794,
USA. [email protected]
A comprehensive influenza vaccination campaign improved vaccination rates among healthcare
workers with direct patient care responsibilities from 45% during the 2003-2004 influenza season to
80% during the 2004-2005 season. A strategy of weekly feedback to unvaccinated employees was the
most important factor in enhancing the rate of vaccination acceptance and was particularly effective
among the nursing staff.
MeSH Terms: Cancer Care Facilities/statistics & numerical data - Health Personnel* - Health
Promotion* - Hospitals, Pediatric/statistics & numerical data - Humans - Influenza
Vaccines/administration & dosage* - Research Support, N.I.H., Extramural - Research Support, NonU.S. Gov't - Tennessee/epidemiology - Vaccination/utilization*
Substances: Influenza Vaccines
Vaccine. 2006 May 11; [Epub ahead of print]
Influenza vaccination in German health care workers: Effects and findings after two rounds of a
nationwide awareness campaign.
Leitmeyer K, Buchholz U, Kramer M, Schenkel K, Stahlhut H, Kollstadt M, Haas W, Meyer C.
Robert Koch-Institut, Seestrasse 10, 13353 Berlin, Germany.
In Germany, despite longstanding recommendations for influenza vaccination, uptake among health
care workers (HCW) is poor. We conducted and evaluated a 2-year nationwide campaign to increase
influenza vaccination rates among German HCW. The campaign was tailored to the results of a
baseline survey and included the distribution of information material to all German hospitals (n
approximately 2000) and engagement of stakeholders, such as professional HCW associations.
Human and financial resources consisted of one full-time public health scientist (2 months) and
approximately USD 45,000 to produce and distribute materials. We evaluated the intervention in a
survey among a systematic sample of HCW in a sample of selected 20 hospitals. HCW were stratified
by profession and asked to self-administer a questionnaire inquiring about self-perceived risk for
influenza, belief of effectiveness of the vaccine, and influenza vaccination before the starting season
(2003/2004) as well as the previous two seasons (2001/2002, 2002/2003). Three hundred and ninetysix of 800 (50%) HCW who were addressed in the evaluated hospitals participated in the evaluation
survey. The overall influenza vaccination rate among respondents increased from 21% (2001/2002) to
26% (2003/2004), which was mostly due to a significant increase among physicians (2001/2002: 21%;
2003/2004: 31%; nurses: 20% and 22%, respectively). Significantly more physicians than nurses felt
at increased risk for influenza and believed that the vaccine is very effective. Increased uptake among
physicians (compared to nurses) was likely due to physicians' higher awareness of their risk and trust
in the vaccine. In the future it may be necessary to address nurses differently than physicians. We
conclude that a national campaign with very limited resources is feasible and capable of achieving
measurable results in a short time frame.
10
Can J Public Health. 2006 Mar-Apr;97(2):136-8.
Influenza vaccination: a call for a multiple intervention approach.
Pierrynowski Gallant DM, Murray MA, McNeil S.
School of Nursing, Saint Francis Xavier University, Antigonish, NS. [email protected]
Influenza seriously impacts the health and well-being of individuals and communities and has
significant implications for the health care system. Despite known benefits of influenza vaccination,
inoculation rates among health care providers remain low. Close proximity to patients, the potential to
act as an infection vector and their role in patient education has focussed attention on how health care
professionals make personal vaccination decisions. This commentary explores the inherent complexity
of vaccination decision-making and offers suggestions for a multiple intervention approach to address
health care providers' vaccination uptake needs. Directions for future research are also discussed.
MeSH Terms: Canada - Delivery of Health Care - Disease Transmission, Patient-toProfessional/prevention & control - Disease Transmission, Professional-to-Patient/prevention & control
- Health Personnel* - Humans - Immunization Programs/utilization* - Influenza Vaccines/administration
& dosage* - Influenza, Human/prevention & control*
Infect Control Hosp Epidemiol. 2006 Jan;27(1):73-7. Epub 2006 Jan 6.
Predisposing, reinforcing, and enabling factors influencing influenza vaccination acceptance
among healthcare workers.
Bautista D, Vila B, Uso R, Tellez M, Zanon V.
Department of Preventive Medicine, University Hospital, Dr Peset, Valencia, Spain.
[email protected]
According to the present case-control study about influenza vaccine acceptance among hospital
workers, vaccination campaigns should focus mainly on predisposing and enabling factors,
emphasizing the likelihood of acquiring influenza and the positive benefits to patients, addressing
concerns about vaccine efficacy or safety, and minimizing the time required for the worker to undergo
vaccination.
MeSH Terms: Attitude of Health Personnel* - Case-Control Studies - Epidemiologic Factors - Female Humans - Influenza Vaccines*/administration & dosage - Male - Patient Acceptance of Health
Care/psychology* - Patient Acceptance of Health Care/statistics & numerical data Spain/epidemiology - Vaccination/psychology* - Vaccination/utilization
7. Risques chimiques
MEDECINE DU TRAVAIL ET ERGONOMIE, Vol. 42, 2, p. 57-65, 39, 2005
Mesures de prévention au poste de préparation des cytostatiques.
REITLER (I.), MOSSELMAN (C.H.)
Semesotra asbl. Service externe de prévention et protection au travail. Tournai. BEL
Les services d'oncologie se sont développés rapidement au cours des dernières années et l'utilisation
régulière des cytostatiques est devenue courante dans la plupart des institutions hospitalières. Si les
effets de ces médicaments sont connus chez les patients, il n'en est pas de même pour le personnel
exposé (pharmacien, personnel soignant).
L'évaluation des risques est donc primordiale. Malgré les incertitudes sur les effets à long terme d'une
faible exposition, ces produits doivent être considérés comme dangereux et des mesures de
prévention pertinentes, basées sur les connaissances actuelles, doivent pouvoir être proposées par le
médecin du travail, en donnant la priorité aux mesures techniques : aménagement des locaux,
préparation centralisée, équipements de protection individuelle.
Mots-clés BDSP : Prévention, Médicament anticancéreux, Utilisation, Pharmacie hospitalière,
Infirmier, Homme, Profession santé, Pharmacien, Risque, Exposition professionnelle, Belgique,
Europe, Accessoire protection, Protection individuelle
11
Anesth Analg. 2006 May;102(5):1573-7.
A comparison of sister chromatid exchanges in lymphocytes of anesthesiologists to
nonanesthesiologists in the same hospital.
Eroglu A, Celep F, Erc iyes N.
Department of Anesthesiology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey.
[email protected]
An increased incidence of sister chromatid exchanges (SCEs) in peripheral lymphocytes of operating
room personnel exposed to waste anesthetic gases has been reported. We investigated whether the
increase of SCEs in anesthesiologists was reversible. Twenty-five anesthesiologists exposed to waste
anesthetic gases such as sevoflurane and nitrous oxide were compared with nonexposed internists
working in the same hospital. The concentrations of sevoflurane and nitrous oxide in the operating
rooms were measured. The incidence of SCE was measured in lymphocytes cultures of
anesthesiologists before and after a 2-mo leave from the operating room. These values of SCE were
compared with those of nonexposed physicians. Occupational exposure to sevoflurane and nitrous
oxide in the operating rooms were above the threshold values. There was a significant difference in
SCE values of the anesthesiologists compared with the nonexposed physicians (11.9 +/- 4.4 versus
4.2 +/- 1.1, P < 0.001). After a 2-mo leave from the operating room, the SCE values of the
anesthesiologists were significantly lower compared with those taken before the leave (4.8 +/- 1.8 and
11.9 +/- 4.4, respectively, P < 0.001). We conclude that the increase of SCE in anesthesiologists
exposed to increased environmental concentrations of waste anesthetics gases, such as sevoflurane
and nitrous oxide, are reversible if they work free from exposure for 2 mo.
MeSH Terms: Adult - Anesthesia Department, Hospital/statistics & numerical data* - Anesthetics,
Inhalation*/adverse effects - Chi-Square Distribution - Comparative Study - Female - Humans Lymphocytes/physiology* - Male - Occupational Exposure/adverse effects - Occupational
Exposure/statistics & numerical data - Physicians/statistics & numerical data* - Prospective Studies Sister Chromatid Exchange/genetics*
Occup Med (Lond). 2006 Jan;56(1):51-4.
Olfactory sensitivity in medical laboratory workers occupationally exposed to organic solvent
mixtures.
Zibrowski EM, Robertson JM.
Department of Epidemiology and Biostatistics, Kresge Building, University of Western Ontario,
London, Ontari o, Canada N6A 5C1. [email protected]
BACKGROUND: Published epidemiological information relating the effects of occupational exposure
to organic solvents (OS) to olfaction is limited. AIMS: The objectives of this pilot study were to
measure the chemosensory abilities of medical laboratory employees occupationally exposed to OS
mixtures, to compare these with control workers employed within the same occupational setting and to
correlate chemosensory performance with OS exposure history and with employees' hedonic
(pleasantness) perceptions about workplace OS odors. METHODS: Twenty-four medical laboratory
employees (OS-exposed technicians plus control workers minimally exposed to OS) completed a
health-related questionnaire, a test of pyridine odor detection threshold, along with a gustatory
detection threshold test involving aqueous quinine solutions. Estimates of cumulative hours of OS
exposure (CSI) were calculated from self-reports. RESULTS: OS-exposed laboratory technicians
detected weaker concentrations of pyridine odor. Positive correlations were detected between CSI
estimates to both pyridine detection and the degree that participants reported that OS odors were
present in the workplace. However, no association was detected between pyridine detection and how
unpleasant workplace OS odors were perceived. The OS-exposed participants were able to detect
weaker concentrations of quinine. Compared to controls, OS-exposed workers complained more of
experiencing several symptoms while working, including headaches, nasal irritation and mild cognitive
impairment. CONCLUSIONS: The results of this cross-sectional pilot study indicated that, compared to
controls, medical laboratory technicians exposed to low-level OS mixtures displayed evidence of
elevated olfactory sensitivity (hyperosmia) to pyridine odor. The relation of this study's results to
chemical intolerance warrants further investigation.
MeSH Terms: Adult - Cross-Sectional Studies - Female - Humans - Laboratory Personnel* - Male Middle Aged - Occupational Exposure/adverse effects* - Odds Ratio - Pilot Projects Pyridines/toxicity* - Questionnaires - Quinine/toxicity* - Research Support, Non-U.S. Gov't - Sensory
Thresholds - Smell* - Solvents/toxicity*
Substances: - Pyridines - Solvents - pyridine - Quinine
J Occup Environ Hyg. 2006 Apr;3(4):182-93; quiz D45.
Pollution prevention--occupational safety and health in hospitals: alternatives and
interventions.
Quinn MM, Fuller TP, Bello A, Galligan CJ.
Department of Work Environment and the Lowell Center for Sustainable Production, University of
12
Massachusetts Lowell, Lowell, Massachusetts 01854, USA. [email protected]
An integrated pollution prevention (P(2)) and occupational safety and health (OSH) worksite
intervention and alternatives assessment strategy was developed in hospitals. It was called the
Pollution Prevention-Occupational Safety and Health (P(2)OSH) assessment for the "Sustainable
Hospitals Project." Methods included (a) developing a participatory intervention model for introducing
more environmentally sound, healthy, and safe materials and work practices for specific hospital
procedures; (b) developing an integrated P(2)OSH survey to evaluate environmental and occupational
impacts of the intervention; and (c) conducting and evaluating interventions by applying the P(2)OSH
assessment pre- and post-intervention. Eleven interventions were performed in six hospitals: an
aliphatic fixative replaced xylene in three histology laboratories; a mercury reduction plan was
implemented in three clinical laboratories; digital imaging replaced wet chemical film processing in
three radiology departments; a less toxic aldehyde replaced formaldehyde in one hospital
histopathology laboratory; and conventional mopping was replaced by microfiber mopping in one
hospital. Occupational and environmental health and safety impacts were observed for all
interventions. The alternatives generally were beneficial, although each had limitations that resulted in
process and task changes with potentially negative P(2) and/or OSH impacts. When these were
identified in the pilot phase they could be addressed before full-scale implementation. The P(2)OSH
method shifts the focus of occupational and environmental hygiene from hazard control to substitution.
Because few ideal alternatives exist, the emphasis is on a continuous process to identify, implement,
and evaluate alternatives, rather than on a particular alternative. Occupational and environmental
health and safety professionals have an important role as agents in hospital organizational change
and in the search for healthier and safer alternatives. Through these activities they can become
involved in the design/redesign of products, materials, and processes, thus expanding their traditional
role.
MeSH Terms: Air Pollution, Indoor/prevention & control* - Data Collection - Facility Design and
Construction - Hospitals* - Humans - Intervention Studies - Laboratories - Occupational
Exposure/prevention & control* - Occupational Health* - Program Development - Program Evaluation Radiology Department, Hospital - Research Support, N.I.H., Extramural - Research Support, U.S.
Gov't, Non-P.H.S. - Safety
8. Risques physiques
may 2006
Safe Lifting Portal
In hospitals, nursing homes and related facilities hundreds of caregivers injure themselves each and
every day, while handling patients. In fact, more than 38% of nurses incur lifting-related injuries at
some time during their career, and 12% of the nurses who leave their profession do so because of a
back injury.
SafeLiftingPortal.com offers you instant access to a broad array of information, resources and services
designed to support your safe patient handling and caregiver injury prevention programs. Welcome to
the site, and please remember to register for the Safe Lifting Newsletter, the interactive user
communities, and on-going educational programs.
The Safe Lifting Portal is sponsored by Liko Inc.
http://safeliftingportal.com/
AFT Healthcare, March 2006
Safe Patient Handling: A Report
Peter D. Hart Research Associates, Inc
"This study of hospital nurses and radiology technicians reveals that their work has become extremely
physically demanding, often resulting in job-related injury or chronic pain. Indeed, it is no exaggeration
to say that employment as a health professional in a hospital today is backbreaking work. Many
nurses and radiology technicians report that they have considered leaving patient care because of the
physical demands of the job, which would only exacerbate the current shortage in those professions."
http://www.aft.org/topics/no-lift/download/PeterHartSurvey-final-03-16-06.pdf
8.1 Rayonnements ionisants
8.2 Troubles musculo-squelettiques
13
9. Violence
In Archives des Maladies Professionnelles et de l'Environnement, Vol 67, N 2, p. 276 - 293, Mai
2006
Agression et violence en milieu de soins
F. DEBBABI , M. BSILA , S. CHATTI , S. GHANNOUCHI , G. GHANNOUCHI , N. MRIZAK
"Le stress et la violence au service des urgences sont de plus en plus reconnus comme des
symptômes de malaise de la vie professionnelle. Ils constituent un danger inhérent et un problème qui
nécessite la mise en place d'une stratégie d'action basée sur la connaissance de la violence, de ses
facteurs de risque afin de les prévenir."
In Archives des Maladies Professionnelles et de l'Environnement, Vol 67 - N 2, p. 276 - 293, Mai
2006
Facteurs liés aux épisodes violents dans les soins. Résultats de l'enquête européenne
PRESST-NEXT
M. ESTRYN-BEHAR , N. DUVILLE , M. MENINI , S. LE FOLL , O. LE NEZET , R. BOCHER
"La violence, qui peut avoir des conséquences dramatiques, se retrouve plus souvent dans certaines
circonstances. Elle nécessite des stratégies spécifiques de prévention dans le secteur des soins"
2006
Violence à l'hôpital (La): perception du risque par le personnel soignant dans un Centre
Hospitalier Universitaire
M. KROLL, N. BROESSEL, A. HAUG, M. GONZALEZ, A. CANTINEAU
"Face à l'importance donnée à la violence à travers les médias et surtout face à l'impact qu'a la
perception du risque dans la gestion de celui-ci, l'objectif était de mieux connaître la perception réelle
de la violence chez les soignants les plus exposés dans l'hôpital afin d'adapter les actions de
prévention de cette violence."
2006
Violences aux urgences : mythe ou réalité ? Étude rétrospective multicentrique départementale
A. DAMBLEMONT , S. MOLENDA , N. ASSEZ , P. DEVOS , P. GOLDSTEIN , A. SOBASZEK , P.
FRIMAT
"Dans notre pays, les actes graves de violences hospitalières sont souvent stigmatisés, médiatisés.
Mais la violence permanente est rarement évaluée de manière scientifique. Qu'en est-il au quotidien
dans les services d'urgences ? L'objectif principal de notre étude est d'estimer de manière quantitative
et qualitative, les actes de violence au sein des services d'urgences du département du Nord sur une
période de 12 mois. Les objectifs secondaires sont de mettre en évidence les conséquences de ces
actes de violence, mais également une éventuelle sous-estimation de ces actes, et enfin les causes
de cette sous-estimation"
article de périodique
Dimens Crit Care Nurs. 2006 Mar-Apr;25(2):82-5.
He's got a gun! Weapons in the emergency room--you can survive!
May WA Jr.
Criminal Justice Program, Jefferson Community and Technical College, 727 W. Chestnut Street,
Louisville, KY 40203, USA. [email protected]
With the increasing amount of violence prevalent in our society, it is inevitable that this violence will
enter emergency departments. Nurses are increasingly likely to see guns and other deadly weapons in
the emergency department. The purpose of this article is to explain how a firearm works and how to
safely handle and store the weapon until someone with more training can take possession of the
weapon.
14
MeSH Terms: Emergency Service, Hospital/organization & administration* - Equipment Design Equipment Safety - Firearms*/classification - Humans - Nursing Staff, Hospital/organization &
administration - Nursing Staff, Hospital/psychology - Occupational Health* - Safety
Management/organization & administration* - Security Measures/organization & administration* Violence/prevention & control*
Psychiatry Clin Neurosci. 2006 Feb;60(1):29-36.
Psychological impact of verbal abuse and violence by patients on nurses working in
psychiatric departments.
Inoue M, Tsukano K, Muraoka M, Kaneko F, Okamura H.
Graduate School of Health Sciences, Hiroshima University, Hiroshima, Japan
The aim of this study was to assess the psychological impact of verbal abuse or violence by patients
on nurses working in psychiatry departments and to identify factors related to their impact. Survey
sheets were distributed to a total of 266 nurses working at two hospitals, and replies were obtained
from 232 of them. Because three of them had less than 1 month of experience working in the
psychiatry department and four of them failed to answer all the questions, valid replies were obtained
from 225 nurses. Among the 225 whose replies were valid, 141 nurses who replied that they had
experienced verbal abuse or violence that left an impression on them remained as the subjects of the
final analysis. The Impact of Event Scale-Revised (IES-R) was used to evaluate psychological impact.
Of the nurses who had been exposed to verbal abuse or violence that left an impression, 21% had
scores that exceeded the IES-R cut-off point (24/25), and low satisfaction with family support, and
neuroticism on the Eysenck Personality Questionnaire-Revised were shown to have contributed to the
psychological impact. Nurses working in psychiatry departments were shown to experience a severe
psychological impact when exposed to verbal abuse or violence. These results suggest the need for
mental care approaches for nurses working in psychiatry departments.
MeSH Terms: Adaptation, Psychological - Adult - Aggression/psychology* - Anxiety/diagnosis Anxiety/nursing* - Anxiety/psychology - Data Collection - Depression/diagnosis - Depression/nursing* Depression/psychology - Female - Humans - Japan - Job Satisfaction - Life Change Events - Male Mental Disorders/nursing* - Middle Aged - Nurse-Patient Relations* - Occupational Diseases/nursing*
- Occupational Diseases/psychology - Personality Inventory - Psychiatric Department, Hospital Questionnaires - Risk Factors - Schizophrenia/nursing - Social Support - Stress Disorders, PostTraumatic/diagnosis - Stress Disorders, Post-Traumatic/nursing* - Stress Disorders, PostTraumatic/psychology - Violence/psychology*
10. Autres
Sante Publique. 2006 Mar;18(1):55-62.
Epidemie de malaises survenus dans un hôpital : une enquête qualitative.
Bentz L, Benmansour EH, Pradier C.
Departement de Sante Publique, Hopital l'Archet Route de St Antoine de Ginestiere, Nice, France.
An outbreak of non-specific complaints of illness and poor health occurred among 40% of the staff at
the Archet 2 Hospital in Nice, France, between October 26 and November 26, 2000. This study utilises
a psychosocial approach to describe how health-care workers experienced this unusually extensive
phenomenon, and aims to contribute useful findings to the management of this type of emergency
situation. A qualitative survey was conducted through face to face personal interviews with the first
twelve staff members concerned; moreover, articles published in the press during that period were
analysed in order to asses the impact of the media on this event. The study demonstrates that,
although the source of the problem originated from an issue possibly related to questionable air
quality, there were actually an array of factors which contributed to generate a mass psychogenic
phenomenon: substantial collective societal complaints and staff members' perceived nonacknowledgement of the reality of their symptoms, lack of an obvious cause to account for those
symptoms and collective representation regarding toxic gases, which were all claims promulgated by
articles in the press. In addition to the need for technical improvements on the building and premises,
the study underlines the relevance of simultaneously addressing related issues with the social
structure, represented by the community of concerned hospital personnel, in order to facilitate a
solution to the problem and avoid its potential recurrence in the future.
MeSH Terms: Disease Outbreaks* - English Abstract - Environmental Pollutants/adverse effects* France/epidemiology - Humans - Personnel, Hospital* - Psychophysiologic Disorders/epidemiology* Questionnaires - Sick Building Syndrome/epidemiology*- Substances: Environmental Pollutants
15
In Archives des Maladies Professionnelles et de l'Environnement, Vol 67 - N 2 - p. 260 - 267 - Mai
2006
Symposium de la CNRACL : l'évaluation des risques dans les établissements de santé, réseau
des médecins du travail du personnel hospitalier des CHU
"Réseau inter C.H.U. d'échanges et de mutualisation des informations en médecine du travail des
personnels des établissements de santé.
Un contrat signé en 2005 entre 14 CHU et la CNRACL (Fonds de prévention de la Caisse nationale de
retraite des agents des collectivités locales) a permis, par un financement conjoint, la mise en place
d'un programme triennal de développement d'outils méthodologiques spécifiques à l'évaluation des
risques professionnels dans les hôpitaux.
Ce symposium a pour objectif de faire le point sur l'avancée des 7 groupes de travail associant
chacun plusieurs équipe de médecine et santé au travail de CHU, après un an de fonctionnement.
Au terme de ce contrat triennal, l'ambition de tous les acteurs est de définir un cahier des charges
détaillé des outils d'évaluation retenus dans chacune des thématiques ; ces outils seront conçus pour
les CHU mais aussi adaptables aux autres structures hospitalières."
article de périodique
Am J Epidemiol. 2006 Apr 15;163(8):726-30. Epub 2006 Feb 22.
A prospective study of night shift work, sleep duration, and risk of Parkinson's disease.
Chen H, Schernhammer E, Schwarzschild MA, Ascherio A.
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of
Health, Research Triangle Park, NC 27709, USA. [email protected]
The authors prospectively investigated whether working rotating night shifts was associated with the
risk of Parkinson's disease among 84,794 female nurses who reported years of night shift work in
1988 (the US Nurses' Health Study). After 975,912 person-years of follow-up (1988-2000), 181
incident Parkinson's disease cases were documented. Compared with nurses who never worked
rotating night shifts, those with 15 years or more of night shift work had a 50% lower risk of
Parkinson's disease after adjustment for age and smoking (95% confidence interval: 0.26, 0.97;
p(trend) = 0.01). Sleep duration was positively associated with Parkinson's disease risk: The relative
risk was 1.84 (95% confidence interval: 0.99, 3.42) when comparing nurses who reported 9 or more
hours of sleep per day with those who slept 6 hours or less (p(trend) = 0.005). These data suggest
that working night shifts may be protective against Parkinson's disease or that low tolerance for night
shift work is an early marker of Parkinson's disease. Conversely, habitual longer sleep duration may
be an earlier marker of Parkinson's disease. Because of the novelty and the exploratory nature of
these findings, confirmation is needed.
MeSH Terms: Alcohol Drinking/epidemiology - Anti-Inflammatory Agents, Non-Steroidal/administration
& dosage - Body Mass Index - Circadian Rhythm* - Coffee - Female - Humans - Incidence Nurses/statistics & numerical data - Parkinson Disease/epidemiology* - Proportional Hazards Models Prospective Studies - Research Support, N.I.H., Extramural - Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't - Risk Assessment - Risk Factors - Sleep
Deprivation/complications* - Work Schedule Tolerance*
Substances: Anti-Inflammatory Agents, Non-Steroidal
Am J Nurs 2006 Apr; 106(4):96
Health care workers and asthma
Filios-MS; Pechter-E
Asthma can develop at any time during a person’s life, even without a history of allergies or asthma; at
least 15% of adult asthma cases may be work-related, according to the American Thoracic Society.
But nurses and other health care workers don’t expect to get sick from work and often don’t make the
connection between their work and their symptoms - nor do their primary care providers. Asthma
among health care workers has not been well recognized, with the exception of latex-associated
asthma. Nonetheless, occupational asthma should be suspected whenever a working adult is
diagnosed.
KW: Occupational-health; Health-care; Health-care-personnel; Workers; Worker-health; Bronchialasthma; Occupational-diseases; Diseases
http://www.nursingworld.org/ajn/2006/apr/health.pdf
MMWR 2006 Apr; 55(16):449-452
Nonfatal occupational injuries and illnesses among workers treated in hospital emergency
departments - United States, 2003
16
CDC's National Institute for Occupational Safety and Health (NIOSH) collects data on nonfatal
occupational injuries and illnesses through the National Electronic Injury Surveillance System (NEISS),
an emergency department (ED)-based surveillance system. This report summarizes data for 2003.
The overall number and rate of occupational injuries and illnesses did not change substantially during
the 5-year period since data were last reported in 1998. In 2003, age-, sex-, and diagnosis-related
patterns of injury and illness among workers treated in EDs (ED-treated injuries/illnesses) were similar
to those reported in 1998. To achieve substantial decreases in these injuries and illnesses, prevention
efforts must focus on effective, targeted workplace-safety interventions for diverse occupations. The
Consumer Product Safety Commission (CPSC) administers NEISS, a national stratified probability
sample of U.S. hospitals with 24-hour EDs that tracks product-related injuries/illnesses that are not
work related. In addition, CPSC collaborates with CDC to collect data for two adjunct programs: the
NIOSH work-related injuries/illnesses program (NEISS-Work) and the NEISS All-Injury Program
(NEISS-AIP). NEISS-Work tracks nonfatal work-related injuries and illnesses by using the CPSC ED
surveillance system. These cases are in addition to the CPSC product-related cases, and the cases
are mutually exclusive. NEISS-AIP collects data on all injuries, regardless of consumer-product
involvement or work relatedness (i.e., it tracks all other types of injuries in addition). The case-capture
criteria are similar but not identical for the two adjunct programs (e.g., NEISS-Work includes illnesses
whereas NEISS-AIP does not). This report presents data solely from NEISS-Work, which tracks cases
reported at 67 of the 101 hospitals in the CPSC NEISS sample.
KW: Occupations; Injuries; Emergency-treatment; Health-care-facilities; Information-retrieval-systems;
Statistical-analysis; Surveillance-programs; Occupational-accidents; Occupational-diseases
http://www.cdc.gov/mmwr/PDF/wk/mm5516.pdf
Veille juridique
- Pas de nouveaux textes.
17

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