Innovating Occupational Health and Safety Practices in OR services in the Tropics; A perspective presentation for a scholarly or research based educational qualification. Print

Name :  Admin

Date  :  06-May-2013

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My background of Anesthesia, MBA and MPH (Occupational and environmental Health) and having been erstwhile President of LUTH ARD (Association of Resident doctors) have culminated in the experiences that now drive my passion in this area of research work.

In our tropical region there is little or no attention paid to the occupational health of medical and health personnel; this situation is worse amongst Operating room staff, yet this area of practice is fraught with many hazards. There are many fire and explosion hazards in surgical theatres, exposure potential to bio-hazards (Hepatitis B, HIV and respiratory pathogens), and environmental pollutants like the volatile Anaesthetic agents mixed with Nitrous oxide gas. There are gravity energy hazards like trips and falls, varicose veins and also electrical energy exposure which can lead to electrocution apart from already mentioned fire hazard. Of course, ergonomic hazards can lead to problems with lumbo-sacral and other musculoskeletal issues.

It was discovered that in spite of all these hazards, there are no elaborate control programs put in place to manage them in order to reduce impact on health of such workers in the tropical setting. Engineering controls in the form of scavenging systems to conduct away anesthetic mixtures from the operating suits are non-existent in most facilities; and yet, only very few facilities have circle absorber closed system as their patients’ anesthetic breathing systems. The latter is a low flow rebreathing system that keeps environmental pollution to acceptable minimum. Administrative controls are also less than adequate: pre-employment health screening tailored at specific job functions are hardly done in most places. Periodic health surveillance and monitoring of such exposed workers are not done, hence the effect of occupation on personnel health is not known until disaster strikes. It is also pertinent to add that PPE (Personal Protective Equipment) which is even the last line of defense is less than adequate. Surgical face mask is designed as a unidirectional protective filter of pathogens from theatre personnel so as not to contaminate patients’ surgical wounds. It does not protect OR personnel from patients’ pathogens and the environmental pollutants. The fall out of all these lapses is that the OR worker is extremely exposed.

This paper is aimed at creating or increasing awareness of these tropical challenges and proffering creative ways of solving them. We utilized questionnaires administration, site visits of Operating suits at various settings, using a checklist, in this study. Findings are discussed, conclusions reached and recommendations made to reduce occupational exposures of theatre workers in the tropics. This is an initial step in a series of efforts in this direction.