Workplace accidents among hospital cleaning professionals at a hospital in the city of Maranhão, Brazil

Gomes, Sâmea Cristina Santos; Mendonça, Isabela Vieira dos Santos; Oliveira, Luana Pontes; Caldas, Arlene de Jesus Mendes

doi:10.1590/1413-812320182411.26752017

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ARTICLE • Ciênc. saúde coletiva 24 (11) • Nov 2019 • https://doi.org/10.1590/1413-812320182411.26752017 copy

Workplace accidents among hospital cleaning professionals at a hospital in the city of Maranhão, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The goal of this study was to investigate the prevalence and factors associated with workplace accidents among hospital cleaning professionals. This is a cross-sectional, analytical study of a sample of 199 cleaning workers at six hospitals in São Luís, Maranhão, Brazil. We first ran a univariate analysis, and later the Poisson regression analyzes with robust variance were used, with hierarchized modeling of the data in order to estimate the prevalence ratios (PR) between the independent variables and the outcome (workplace accidents). The prevalence of workplace accidents is 13.57%, 81.48% of them with sharps. At the end of the multivariate analysis the following were found to be associated with workplace accidents: age between 18 and 30, not having a high-school degree, on the job for 2 to 5 years, inadequate segregation of health service waste (HSW), training only on admission, failure to consider the health hazards of hospital waste and failure to use personal protective equipment (PPE). Our findings reinforce the importance of continued health education, stressing periodic training and the use of PPE.

Key words
Occupational health; Hospital housekeeping; Workplace accidents; Waste health services

Workplace Accidents
Variáveis	N	%	No	Yes	Non-adjusted analysis
Variáveis	N	%	n = 172(%)	n = 27(%)	PR	CI 95%	p-value
Distal variables
Age (years)
18 -30	77	38,69	52 (30,23)	25 (92,60)	1,15	1,02- 1,21	<0,001^* * Variables with p <0.20; PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.
31-40	79	39,70	78 (45,34)	1 (3,70)	0,15	0,08-0,42	0,005^* * Variables with p <0.20; PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.
>40	43	21,61	42 (24,41)	1 (3,70)	1
Gender
Male	115	57,79	97 (56,40)	18 (66.67)	1,46	0,68-3,09	0,323
Female	84	42,21	75(43,60)	9 (33,33)	1
Years of schooling
No Secondary School Diploma	29	14,57	59 (34,30)	22(81,48)	2,88	1,82-4,78	<0,001^* * Variables with p <0.20; PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.
Secondary School Diploma	170	85,43	113(65,70)	5 (18,52)	1
Time on the Job (years)
< 2	83	41,70	76 (44,18)	7 (25,92)	1,58	1,72-4,76	0,002^* * Variables with p <0.20; PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.
2 -5	89	44,70	79 (45,93)	10 (37,03)	1,79	1,98-4,37	0,004^* * Variables with p <0.20; PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.
6-10	19	9,58	10 (5,81)	9 (33,33)	0,87	0,12-0,98	0,034^* * Variables with p <0.20; PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.
>10	8	4,02	7 (4,08)	1 (3,72)	1
Intermediate variables
HSW^ HSW= Health Service Waste Definition and Classification
Yes	35	17,77	34 (19,76)	1 (3,71)	1
No	162	82,23	136(80,24)	26 (96,29)	5,61	0,78-40,2	0,086^* * Variables with p <0.20; PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.
HSW Legislation
Yes	85	42,71	70 (40,70)	15 (55,55)	1
No	114	57,29	102(59,30)	12 (44,45)	1,23	0,81-40,2	0,320
HSW Segregation
Yes	187	93,97	164(95,34)	23 (85,18)	1
No	12	6,03	8 (4,66)	4 (14,82)	2,71	1,11-6,59	0,028^* * Variables with p <0.20; PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.
HSW Final Destination and Treatment
Yes	73	36,87	64 (37,20)	10 (37,03)	1
No	125	63,13	108(62,80)	17 (62,97)	0,99	0,47-2,05	0,984
Proximal variables
HSW Training
On admission	46	23,12	31 (18,03)	15 (55,55)	4,15	2,09-8,25	<0,001^* * Variables with p <0.20; PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.
Annual	24	12,06	19 (11,04)	5 (18,52)	1,65	0,69-3,97	0,258
Monthly/Half-yearly	95	47,74	89 (51,74)	6 (22,22)	1
No training	34	17.09	33 (19,19)	1 (3,71)	1,18	0,02-1,33	0,395
HSW Hazards
Yes	175	87,94	158(91,86)	17(62,96)	1
No	24	12,06	14(8,14)	10(37,04)	1,59	1,38-2,91	0,019^* * Variables with p <0.20; PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.
Use of PPE^* ***** PPE = Personal Protective Equipment.
Yes	170	85,43	164(95,34)	6 (22,22)	1
No	29	14,57	8 (4,66)	21 (77,78)	4,28	1,76-28,8	0,005^* * Variables with p <0.20; PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.
	199	100,0	172(100,0)	27(100,0)

Variables	PR	CI 95%	p-value
Aged 18 to 30	1.16	0.77-0.92	< 0.001
Aged 31 to 40	0.18	0.03-0.93	< 0.001
No Secondary School Diploma	2.98	1.87-4.75	< 0.001
2 to 5 years on the job	1.16	1.03-1.21	0.001
6 to 10 years on the job	0.09	0.06-0.31	0.005
Inadequately segregated HSW^* * HSW = Health service waste;	2.31	1.02-4.96	0.009
Training on admission	2.63	1.38-4.99	< 0.001
HSW^* * HSW = Health service waste; health hazards	1.61	1.45-5.83	0.002
Failure to use PPE^ PPE: Personal Protective Equipment. PR: Prevalence Ratio; CI: Confidence Interval; p: value of p calculated based on Poisson's Regression Model using robust variance.	5.10	1.62-15.90	0.005

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[1] Collaborations

The authors SCS Gomes and AJM Caldas participated in the conception, study planning, data analysis and interpretation and writing of the manuscript. Authors IVS Mendonça and LP Oliveira participated in the interpretation, final writing and critical review. All authors approved the final version of the submitted manuscript.