Hepatite B e C em profissionais que coletam resíduos de serviço de saúde e domiciliares

Mol, Marcos Paulo Gomes; Greco, Dirceu Bartolomeu; Cairncross, Sandy; Heller, Leo

doi:10.1590/0102-311X00083814

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BRIEF COMMUNICATION • Cad. Saúde Pública 31 (suppl 1) • Nov 2015 • https://doi.org/10.1590/0102-311X00083814 copiar

Hepatite B e C em profissionais que coletam resíduos de serviço de saúde e domiciliares

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

O contato humano com os resíduos implica riscos biológicos, químicos e físicos à saúde dos trabalhadores envolvidos com a coleta, o transporte e o armazenamento. O potencial de risco para a saúde humana decorrente do contato com os resíduos de saúde ou domiciliares ainda gera muita polêmica. Sendo assim, a proposta deste trabalho foi de identificar o contexto das discussões científicas sobre risco/infecção pelos vírus das hepatites B e C em trabalhadores que coletam resíduos de serviço de saúde ou domiciliares. As buscas abrangeram publicações até 2013 em bancos de dados nacionais e internacionais, sendo selecionados 11 artigos através de uma revisão da literatura, dos quais seis concluem que há maior risco de infecção nos trabalhadores que coletam resíduos domiciliares se comparados com os não expostos aos resíduos, três estudos apontam haver maiores riscos entre os profissionais que coletam os resíduos de saúde se comparados com aqueles que coletam os resíduos comuns, e outros dois concluem não haver diferenças entre expostos e não expostos.

Resíduos Sólidos; Hepatite B; Hepatite C; Saúde Urbana

Reference	Date of study	Country	Sample size	Study groups		Outcome measure *	Findings
Anagaw, et al. ²⁷	April- June 2011	Ethiopia	200	100 collectors of health care waste (hospital) & 100 cleaning staff (who collect ordinary waste)		HBV (HBsAg), HCV (Anti-HCV)	HBV (OR: 6.3; p = 0.04); HCV (OR: 7.5; p = 0.02). Prevalence of HBV & HCV significantly higher in workers collecting health care waste
Rachiotis et al. ²¹	2007-2008	Greece	210	102 collectors of urban solid waste and 108 gardeners		HBV (HBsAg, Anti-HBc and Anti-HBs)	HBV (OR: 4.05; 95%CI: 1.23-13.33) – progressive increase risk for infection with age. Accidents with sharps (RR: 2.64; 95%CI: 1.01-6.96)
Shiferaw et al. ²⁶	May- July 2010	Ethiopia	252	126 collectors of health care waste (hospital) & 126 who collect normal non-clinical waste in a hospital		HBV (HbsAg and Anti-HBcAg)	HBsAg (OR: 8; 95%CI: 1.02-63.02); Anti-HBcAg (OR: 1.5; 95%CI: 1.1-2.1). High prevalence of HBV in workers collecting health care waste compared with those who do not
Graudenz ⁵	September 2007/ February 2008	Brazil	217	64 (landfill), 41 (urban solid waste collection), 35 (sweepers), 45 (drivers) & 32 controls (railway maintenance)		HBV (Anti-HBc)	No difference in prevalence of hepatitis B between study groups (percentage positive varied between groups from 6.3 to 20, with p = 0.439)
Franka et al. ²⁸	January-December 2004	Libya	600	300 collectors of health care waste (medical center) and 300 who collect only ordinary waste (urban solid waste)		HIV, HBV (HBsAg), HCV (Anti-HCV)	HBV (OR: 7.14; p < 0.04); HCV (OR: not given; p < 0.005). HIV not detected. Higher prevalence of HBV & HCV in health care waste group than in urban solid waste group
Luksamijarulkul et al. ²⁵	Not stated	Thailand	354	169 collectors of urban solid waste & 185 public cleansing workers (not in direct contact with waste)		HAV, HBV (HBsAg, Anti-HBs and Anti-HBc)	49.4% seropositive for HBV, 5.9% for HBsAg, 37.3% for anti-HBs, 6.2% only for anti-HBc, & 85% with anti-HAV antibodies (p = 0.0058 most exposed collectors). For HAV no significant difference was found
Squeri et al. ²³	March- May 2005	Italy	327	All were workers who collected urban solid waste	HBV (HBsAg and Anti-HBc), HCV (Anti-HCV)			183 (55.96%) protected from HBV by the presence of HBsAb (98 by immunization and 85 by previous contact). 120 (36.7%) at risk of infection. 24 (7.34%) infected by HBV and 5 (1.52%) had contact with HBV and HCV
Mariolis et al. ²⁴	Not stated	Greece	69	All were workers who collected urban solid waste	HAV, HBV (HBsAg, Anti-HBs and Anti-HBc), HCV (Anti-HCV)			37 (53.6%) were HAV positive; 15 (21.7%) had been exposed to HBV. Of the whole study group, 7 (10.1%) had been immunised against HBV. 4.3% were HBV chronically infected. One was found to be HCV positive
Dounias et al. ²²	September 1999/ December 2001	Greece	159	71 collectors of urban solid waste & 88 office workers (not in direct contact with waste)	HBV (HBsAg, Anti-HBs and Anti-HBc)			Prevalence of HBsAg was higher in exposed (11.3%) than in non-exposed (4.5%), but difference was not significant. Prevalence of anti-HBc was 24% among exposed and 8% in non-exposed, also not significant
Ferreira et al. ²⁹	May- July 1996	Brazil	186	31 collectors de health care waste (hospitals) & 155 collectors of domestic urban solid waste	HBV (Anti-HBc)			HBV (OR: 0.9; 95%CI: 0.24-3.05;). No significant difference in risk found between the groups of workers studied
Corrao et al. ¹⁹	Not stated	Italy	93	45 sweepers, 21 waste collectors, 19 machine operators, 5 sewer workers and 3 office workers	HAV, HBV (HBsAg, Anti-HBs and Anti-Hbc)			Positive for HBV in each group were: 9 (20.0%) sweepers, 6 (28.6%) waste collectors, 1 (5.3%) machine operator, 2 (40.0%) sewer workers and 0 (0.0%) among the office workers

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[1] Correspondence. M. P. G. Mol Centro de Pesquisas e Desenvolvimento Fundação Ezequiel Dias Rua Conde Pereira Carneiro 80, Belo Horizonte, MG 30510-010, Brasil. marcos_mol@yahoo.com.br