Comparison of different methods for work accidents investigation in hospitals: A Portuguese case study

BACKGROUND: The hospital environment has many occupational health risks that predispose healthcare workers to various kinds of work accidents. OBJECTIVE: This study aims to compare different methods for work accidents investigation and to verify their suitability in hospital environment. METHODS: For this purpose, we selected three types of accidents that were related with needle stick, worker fall and inadequate effort/movement during the mobilization of patients. A total of thirty accidents were analysed with six different work accidents investigation methods. RESULTS: The results showed that organizational factors were the group of causes which had the greatest impact in the three types of work accidents. CONCLUSIONS: The methods selected to be compared in this paper are applicable and appropriate for the work accidents investigation in hospitals. However, the Registration, Research and Analysis of Work Accidents method (RIAAT) showed to be an optimal technique to use in this context.

Power Law Behavior and Self-similarity in Modern Industrial Accidents

Advances in technology have produced more and more intricate industrial systems, such as nuclear power plants, chemical centers and petroleum platforms. Such complex plants exhibit multiple interactions among smaller units and human operators, rising potentially disastrous failure, which can propagate across subsystem boundaries. This paper analyzes industrial accident data-series in the perspective of statistical physics and dynamical systems. Global data is collected from the Emergency Events Database (EM-DAT) during the time period from year 1903 up to 2012. The statistical distributions of the number of fatalities caused by industrial accidents reveal Power Law (PL) behavior. We analyze the evolution of the PL parameters over time and observe a remarkable increment in the PL exponent during the last years. PL behavior allows prediction by extrapolation over a wide range of scales. In a complementary line of thought, we compare the data using appropriate indices and use different visualization techniques to correlate and to extract relationships among industrial accident events. This study contributes to better understand the complexity of modern industrial accidents and their ruling principles.

Skin lesions in envenoming by cnidarians (Portuguese man-of-war and jellyfish): etiology and severity of accidents on the Brazilian coast

This work attempts to establish dermatological identification patterns for Brazilian cnidarian species and a probable correlation with envenoming severity. In an observational prospective study, one hundred and twenty-eight patients from the North Coast region of São Paulo State, Brazil were seen between 2002 and 2008. About 80% of these showed only local effects (erythema, edema, and pain) with small, less than 20 cm, oval or round skin marks and impressions from small tentacles. Approximately 20% of the victims had long, more than 20 cm, linear and crossed marks with frequent systemic phenomena, such as malaise, vomiting, dyspnea, and tachycardia. The former is compatible with the common hydromedusa from Southeast and Southern Brazil (Olindias sambaquiensis). The long linear marks with intense pain and systemic phenomena are compatible with envenoming by the box jellyfish Tamoya haplonema and Chiropsalmus quadrumanus and the hydrozoan Portuguese man-of-war (Physalis physalis). There was an association between skin marks and probable accident etiology. This simple observation rule can be indicative of severity, as the Cubozoa Class (box jellyfish) and Portuguese man-of-war cause the most severe accidents. In such cases, medical attention, including intensive care, is important, as the systemic manifestations can be associated with death.

EPIDEMIOLOGICAL PROFILE OF SNAKEBITE ACCIDENTS IN A METROPOLITAN AREA OF NORTHEAST BRAZIL

SUMMARY The aim of this study was to describe the epidemiological profile of snakebite accidents reported by the toxicological assistance center in Fortaleza, Ceará, Brazil. Database information on snakebite accidents was analyzed regarding the period from January 2003 to December 2011. A total of 1063 cases were found. The accidents occurred during the rainy months (March, April and May), in urban areas (52.3%), affecting individuals younger than 50 years and predominantly among males (70.7%). The lower limbs were the most frequently affected body area (33.7%). Most accidents involved non-venomous snakes (76.1%). The genus Bothrops was the main one involved in venomous accidents (83%). It is expected that this study can be used as the substrate to improve healthcare surveillance and implementing better measures for the treatment of this population.

Training-related accidents during teacher-student-assistance activities of medical students

A survey was done to determine the most common hospital accidents with biologically contaminated material among students at the Medical College of the Federal University of Minas Gerais. Six hundred and ninety-four students (between fifth and twelfth semesters of the college course) answered the questionnaire individually. Three-hundred and forty-nine accidents were reported. The accident rate was found to be 33.9% in the third semester of the course, and increased over time, reaching 52.3% in the last semester. Sixty-three percent of the accidents were needlestick or sharp object injuries; 18.3% mucous membrane exposure; 16.6% were on the skin, and 1.7% were simultaneously on the skin and mucous membrane exposure. The contaminating substances were: blood (88.3%), vaginal secretion (1.7%), and others (9.1%). The parts of the body most frequently affected were: hands (67%), eyes (18.9%), mouth (1.7%), and others (6.3%). The procedures being performed when the accidents occurred were: suture (34.1%), applying anesthesia (16.6%), assisting surgery (8.9%), disposing of needles (8.6%), assisting delivery (6.3%), and others (25.9%). Forty-nine percent of those involved reported the accident to the accident control department. Of these 29.2% did not receive adequate medical assistance. Eight percent of those involved used antiretroviral drugs and of these 86% discontinued the treatment on receiving the Elisa method applied to the patient (HIV-negative); 6.4% discontinued the treatment due to its side-effects; and 16% completed the treatment.

Venomous mollusks: the risks of human accidents by conus snails (gastropoda: conidae) in Brazil

Mollusks of the genus Conus present a venomous apparatus composed of radulae, a chitin structure linked to glands, which injects potent neurotoxic peptides, causing serious human envenomation and even death, associated with the blockage of certain receptors and muscular paralysis. No reported envenomation has occurred in Brazil, but certain populations are at risk of accidents.

Accidents caused by Bothrops and Bothropoides in the State of Paraiba: epidemiological and clinical aspects

INTRODUCTION: Bothrops and Bothropoides snakes cause 70% of the ophidic accidents in Brazil. The species that cause ophidic accidents in State of Paraíba are Bothropoides erythromelas, Bothrops leucurus and Bothropoides neuwiedi. METHODS: This is a prospective and transverse study, following a quantitative approach of accidents involving Bothrops and Bothropoides admitted to the Toxicological Assistance and Information Centers of Campina Grande and João Pessoa (Ceatox-CG and Ceatox-JP), aimed at identifying the epidemiological and clinical profile of such accidents. All of the patients admitted had medical diagnoses and were monitored at Ceatox-CG or Ceatox-JP. RESULTS: The genera Bothrops and Bothropoides caused 91.7% of the ophidic accidents reported. Snake bites were frequent in men (75.1%), rural workers (65.1%), literate individuals (69%) between 11 and 20 years-old (21.7%), and toes the most common area attacked (52.7%). Most (86.6%) patients were admitted within 6 hours after the accident/bite, with a predominance of mild cases (64.6%). The annual occurrence in Paraíba was 5.5 accidents/100,000 inhabitants and lethality was 0.2%. CONCLUSIONS: Positive changes in the profiles of these accidents were verified, such as the non-application of inadequate solutions, including the use of tourniquet, coffee grounds, garlic, suction and/or cutting the bitten area. Moreover, the Itinerant Laboratory project, linked to Paraíba State University in partnership with Ceatox-CG, has contributed positively, providing several cities of the state with information regarding the prevention of accidents involving venomous animals. The local press has also contributed, reporting the educational work developed by the centers.

Lowering blood alcohol content levels to save lives: The european experience

Road safety has become an increasing concern in developed countries due to the significant amount of mortal victims and the economic losses derived. Only in 2005 these losses rose to 200.000 million euros, a significant amount - approximately the 2% of its GDP- that easily justifies any public intervention. One tool used by governments to face this challenge is the enactment of stricter policies and regulations. Since drunk driving is one of the most important concerns of public authorities on this field, several European countries decided to lower their illegal Blood Alcohol Content levels to 0.5 mg/ml during the last decade. This study evaluates for the first time the effectiveness of this transition using European panel-based data (CARE) for the period 1991-2003 using the Differences-in-Differences method in a fixed effects estimation that allows for any pattern of correlation (Cluster-Robust). My results show the existence of positive impacts on certain groups of road users and for the whole population when the policy is accompanied by some enforcement interventions. Moreover, a time lag of more than two years is found in that effectiveness. Finally, I also assert the importance of controlling for serial correlation in the evaluation of this kind of policies.

Como conducimos después de un programa formativo de seguridad vial?

Evaluación del estilo de conducción y del estado psicológico de los participantes en programas formativos en delitos de tráfico

Accidents and Safety - Ageing in Ireland Fact File No. 14

Accidents and SafetyAlthough the number of deaths caused by accidents has fallen by 37% across all age groups in Ireland over the past twenty years, accidents and falls continue to be relatively common causes of death and injury among older people, often resulting in serious longterm difficulties and even premature death. Consequently, the reduction of accidents in the older population is considered to be an important factor in promoting the general well-being of older people. The 1998 Health Promotion Strategy for Older People, Adding years to life, life to years, which was formulated by the National Council on Ageing and OlderPeople in co-operation with the Department of Health and Children, set a target to reduce the death rate from all accidents and their adverse effects in people aged 65 and over by at least 17% in the year 2005. It also set a target of reducing hospital admissions due to falls in people aged 65 and over by at least 17% in the same year.����

Neuropsychiatrie de l'épilepsie, des accidents vasculaires cérébraux, de la maladie de Parkinson et de la sclérose en plaques [Neuropsychiatry of epilepsy, stroke, Parkinson's disease and multiple sclerosis]

L'étude du comportement au sens large fait partie intégrante de l'examen neurologique classique. Cet article présente une revue des manifestations comportementales et thymiques dans l'épilepsie, l'accident vasculaire cérébral, la maladie de Parkinson et la sclérose en plaques. The assessement of behavior is common part of the neurological examination. This article reviews the behavioral and mood manifestations in four classical syndroms: Epilepsy, stroke, Parkinson's disease and multiple sclerosis

Pla especial per accidents marins a Formentera (PEPAMF)

El projecte és un Pla Especial per accidents marins a l’ illa de Formentera. El principal objectiu és estudiar el risc davant d’ accidents com l’ abocament de substàncies nocives a les costes de Formentera per accidents de bucs o d’ emissaris i estudiar també la vulnerabilitat i la perillositat. El pla pretén una millor gestió en cas d’ abocaments marins, creant així un pla d’ actuació gestionat des de l’ illa per a una més ràpida i eficient actuació. El treball està estructurat en: un estudi de l’ illa de Formentera, els factors que afecten al pla i el disseny d’ aquest pla especial

Hypertension. La pression artérielle dans la phase aiguë des accidents cérébrovasculaires [Hypertension. Arterial pressure in the acute phase of cerebrovascular accidents]

Blood pressure is abnormally elevated in acute stroke in most patients. This blood pressure increase is usually transient and associated with a poor prognosis. Lowering blood pressure too importantly during this period may worsen the outcome of the patient. Antihypertensive therapy is therefore required only when blood pressure is severely increased, especially in the presence of intracerebral haemorrhage. Initiating treatment before admission to the hospital is not recommended. The medications to be preferred are the blockers of the renin-angiotensin system, the beta-blocker labetalol (which possesses also alpha-blocking properties) and NO donors.