Polato R, Bacis M, Belotti L, Biggi N, Campagna M, Carrer P, Cologni L, Gattini V, Lodi V, Magnavita N, Micheloni G, Negro C, Placidi D, Puro V, Tonelli F, Porru S
Servizio di Prevenzione e Protezione, Azienda Ospedaliera di Padova, Italy.
G Ital Med Lav Ergon. 2010 Jul-Sep;32(3):240-4.
The hospital risk assessment (VdR) is certainly a relevant issue concerning the activities of prevention for the health of healthcare workers in relation to biological risk. The aim of this paper is to provide an up-date of the issue, based on the suggestions of recent literature about the rules ratified by the new legislative decree and data supplied by the Group of 10 Hospitals participated in this multicenter study. From the analysis of data on healthcare settings (HCS) participating in the project the following considerations can be formulated: i) All HCS considered VdR from biological agents. The method recommended in the Guidelines SIMLII 2005 is the most followed ii) To grading the risk, the use of invasive procedures for carrying out the analysis results is a necessary element iii) the operators classified as exposed to biological risk, and therefore subject to health surveillance, represent almost all of workforce in 7 out of 10 HCS. The subgroup believes that VdR must be conducted in close collaboration with the occupational physician and should represent a worthwhile investment with spin-off character on prevention, decision making, empowering. The presence of environmental requirements and organizational procedures should be considered, so that HCS is enabled for an effective risk management, without which risk assessments cannot be performed. The method of VdR mentioned in the guidelines MLIS 2005, besides being the most widely used by the company participating in the study, still has practical reasons and opportunities to justify its use. The HCS group felt the need to propose an implementation of the definition of invasive procedures and EPP, together with individual assessment. Flexibility was suggested in identifying different levels of risk with the involvement of occupational physicians, especially in the presence of EPP, also in order to plan content and frequency of health surveillance.
医院风险评估（VdR）无疑是与医护人员健康预防活动相关的一个重要问题，涉及生物风险。本文旨在根据近期关于新立法令批准的规则的文献建议以及参与这项多中心研究的10家医院提供的数据，对该问题进行更新。通过对参与该项目的医疗环境（HCS）数据的分析，可以得出以下结论：i）所有HCS都考虑了来自生物制剂的VdR。2005年SIMLII指南中推荐的方法是被遵循最多的方法；ii）为了对风险进行分级，使用侵入性程序来进行分析结果是一个必要因素；iii）被归类为接触生物风险并因此接受健康监测的操作人员，在10家HCS中的7家几乎占了所有劳动力。该小组认为，VdR必须与职业医生密切合作进行，并且应该是一项具有预防、决策、赋权等附带效益的有价值投资。应考虑环境要求和组织程序的存在，以便HCS能够进行有效的风险管理，否则无法进行风险评估。2005年MLIS指南中提到的VdR方法，除了是参与研究公司使用最广泛的方法外，仍然有实际理由和机会证明其使用的合理性。HCS小组认为有必要提出对侵入性程序和暴露后预防（EPP）定义的实施，以及个人评估。建议在职业医生的参与下灵活确定不同的风险水平，特别是在存在EPP的情况下，以便规划健康监测的内容和频率。
