Work Related Injuries among Hospital Workers in Iringa, Tanzania 2013

Godbless Lucas – FELTP TanzaniaAFENET Conference

17-22 November 2013

.

Introduction [1/2]• Work related injury (WRI) - self reported injuries

experienced by a healthcare worker 12 months prior to the study

• WRI expose hospital workers to diseases - HIV/AIDS, HBV, HCV infections

• WRI should be identified and controlled

– at the source- Eliminate unsafe procedures

– at the path- Procedures, training, supervision

– at a person- Personal protective equipments, procedures2

Introduction [2/2] • Globally, injury from sharps

– 37% of HBV infections; 39% of HCV infections; 4.4% of HIV infections

• Study of HCWs exposed to blood from HIV infected patients [1]– 80% had needle stick injury; 8% from sharp object; 7% from contaminated mucus membrane.

• Tanzania: WRIs accounted for 52.9% [2]• Study was done to determine the prevalence of WRI after

various interventions been introduced in Tanzania in 2006

31. Marcus et al2. Manyele et al.2008

Objectives 1. To determine prevalence of work related injuries

among hospital workers.

2. To identify form of injuries suffered by hospital workers based on nature of injuries, and working conditions.

3. To identify factors for occurrence of work related injuries among workers in their specific work environments.

4

Methods • Study design - Cross-sectional study

• HCW at risk of injury - eligible for the study

• HCW who never come into contact with patients or byproducts from patients care were excluded

• Sample size - 300 hospital workers (Kish and Lisle formula - 1965)

• Study sample derived from 4 hospitals in Iringa region5

Methods

• Selection of study subjects - simple random sampling

• Self administered questionnaires - Interview study

subjects

• Data analysis – Epi info & SPSS software

• Chi square test – Statistical significance

• Multivariate logistic regression - Control for

confounding

• Alpha - 5% level

6

Description of Study ParticipantsVariable Category Frequency PercentSex Male 99 38.4

female 159 61.1Age (Years) < 28 73 28.3

28 - 35 92 35.8> 35 93 36.0

Education Primary/secondary 112 43.4Post Secondary 146 56.6

Cadre Medical officer 26 10.0Nurse officer 155 60.1Dental personnel 11 4.3Laboratory personnel

15 5.8

Medical Attendants 51 19.87

Results• Response rate – 86%, 258 study participants

– 27.9% had encountered an episode of injury

– 65.1% had access to health and safety guidelines

– 29.7 % had attended training on health and safety

– No significant difference in injury experience between the cadres of HCWs; X2(5) = 9.27; P= 0.09

8

9

Description of Injury among Study Participants

Factors Influencing Occurrence of Injuries

Variable *AOR 95% CI P-Value

Lower Limit Upper Limit

Guidelines Has no access 1.00

Has access 0.52 0.28 0.96 0.03

Safety training Never Attended 1.00

Attended 0.41 0.19 0.91 0.02

Waste containers color coded

No 1.00

Yes 0.61 0.24 1.55 0.30

Length of shift > 8 hours 1.00

<= 8 hours 2.32 0.78 6.85 0.13

*controlled for age and sex10

Discussion • Magnitude of injuries

– They were frequent (27.9%)– But lower than previous findings in TZ (52.9%)

• Health/safety training and access to IPC guidelines -Associated with occurrence of injuries– WRIs occur to health care workers - (Nsubuga etal,

2005) – Not involved in health and safety issues – Not appropriately trained in procedures for risk

control 11

Conclusion

• Injuries mostly needle stick injuries were frequent

• Lack of training and access to guidelines on health and safety - major factors to injuries

• Reporting bias - relied on information given by study participants

12

Public Health Impact

• Reduction of injury prevalence - – 52.9% (2008)– 27.9%

• The MoHSW and OSHA-Tanzania– Orientation of HCWs to the guidelines– Increase knowledge and adherence to universal

precautions– Establish surveillance system of cases of WRI

13

Acknowledgement

• TFELTP• MUHAS• MoHSW-TANZANIA• AFENET• CDC• TFELTP RESIDENTS

14