Epidemiologic Techniques to Mitigate Traumatic Injuries
Trauma is a global problem with various consequences to an individual and to the community at large.Traumatic injury is a pandemic disease and affects everyone without regard to the social and economic status. It is acute in onset but often results in chronic, debilitating health problems that have effects on an individual victimized. Penetrating trauma can result in high death rate of about 60%, usually from sepsis complications, but reduced to 30% with rapid surgical treatment and wound care. Modern trauma care and antibiotics have played an important role by reducing traumatic injuries by about 4%. Epidemiology is a discipline that is most applied in the preventive medicine and public health.
Firstly, using epidemiologic techniques to evaluate epidemic resulting from occupational injuries has great impact, because these injuries seem to result from the interaction of a susceptible host and etiological agents in the environment. Epidemiology is essential in identification, evaluation, and control of activities that are important to prevent traumatic injuries. Descriptive epidemiology helps to identify high risk exposure and factors that affects human beings. Analytical epidemiology assists in testing validity of these hypotheses. Thus, epidemiology helps in evaluation of different potential risk factors. Surveillance is a major epidemiologic factor in controlling occupational traumatic injury. Epidemiology serves to state the incidence and commonness of some disorders and also helps in the establishment of working causal models of a disorder, including the elucidation of risk and protective factors.
Risk factors for sharp injuries among health professionals
Various parameters are used to estimate risk factor for sharp injuries among health professional. These include the number of health-care workers and other workers who are at risk, the annual number of sharps injuries, and the dominance of active infection in the community. The proportion of susceptible health-care workers at risk depended mostly upon past infection and immunization. Professionals who are mostly exposed to sharp injuries include laboratory technicians, nursing aids, medical assistants, traditional health professionals and acupuncturists. Health-care workers are at an increased risk of infection with blood borne pathogens due to exposure to blood and other body fluids. These exposures are mostly due percutaneous injuries with sharp objects contaminated with blood or body fluids. Sharp objects include needles, scalpels, lancets and broken glass. Pathogens usually transmitted to health-care workers in occupational settings are the hepatitis B and C viruses (HBV, HCV) and the human immunodeficiency virus (HIV). Health-care workers may also be predisposed to other infections from blood borne pathogens, airborne pathogens for example; tuberculosis, varicella, influenza and fecal-oral pathogens like hepatitis A and salmonellosis.
The risk of infection from pathogens is lower than that from HBV, HCV and HIV. Blood borne pathogens introduced in the body by contaminated needle-sticks cause a high deaths and disability among health-care workers. Unsafe injections may also have indirect impact on health-care delivery, mostly in areas where qualified personnel are less compared to the disease burdens in the population. HBV, HCV and HIV infections attributable to sharps injuries are indicated by background mortality, deaths from acute hepatitis, hepatocellular hepatitis, end-stage liver disease and AIDS.
Strategies for each of these risk factors
Occupational exposures to blood borne pathogens can be barred by strategies that include: immunization against HBV; prevention procedures against percutaneous injuries and post exposure prophylaxis (PEP) that would help in prevention of the development of disease. A separate guide is being prepared to assist in assessing the national or local disease burden from sharps injuries in health care workers. PEP with antiretroviral agents after occupational exposure reduces HIV by approximately 81%. For HBV and HIV, average PEP efficacies is 90% and 81%, respectively, to the incidences of HBV and HIV infections due to sharps injuries. Some simple preventive measures of HCV and HIV infection associated with sharps injuries are as indicated below. Avoid unnecessary injections which will reduce the opportunities for needle-stick injuries, as fewer sharps are handled. Safely manage sharps waste by collecting contaminated sharps waste immediately after use and also using puncture-proof sharps containers that will not leak liquids.
In conclusion, immunization may be of health-care workers against hepatitis B i.e. those at risk of sharps injuries, immunization will reduces the proportion of workers susceptible to infection. Engineering controls, such as auto disposable syringes, needle-free devices, and retractable or sheathed needles should be used by health workers. Personal protective equipment, such as gloves, gowns, masks should be providing when working. Proper Training and education should be given to workers on the risks of transmission of blood borne pathogens and on safe practices to combat transmission.