Developing regional workplace health and hazard surveillance in the Americas

An objective of the Workers' Health Program at the Pan American Health Organization (PAHO) is to strengthen surveillance in workers' health in the Region of the Americas in order to implement prevention and control strategies. To date, four phases of projects have been organized to develop multinational workplace health and hazard surveillance in the Region. Phase 1 was a workshop held in 1999 in Washington, D.C., for the purpose of developing a methodology for identifying and prioritizing the top three occupational sentinel health events to be incorporated into the surveillance systems in the Region. Three surveillance protocols were developed, one each for fatal occupational injuries, pesticide poisoning,<A NAME="top2"></A>4 and low back pain, which were identified in the workshop as the most important occupational health problems. Phase 2 comprised projects to disseminate the findings and recommendations of the Washington Workshop, including publications, pilot projects, software development, electronic communication, and meetings. Phase 3 was a sub-regional meeting in 2000 in Rosario, Argentina, to follow up on the progress in carrying out the recommendations of the Washington workshop and to create a Virtual Regional Center for Latin America that could coordinate the efforts of member countries. Currently phase 4 includes a number of projects to achieve the objectives of this Center, such as pilot projects, capacity building, editing a compact disk, analyzing legal systems and intervention strategies, software training, and developing an internet course on surveillance. By documenting the joint efforts made to initiate and develop Regional multinational surveillance of occupational injuries and diseases in the Americas, this paper aims to provide experience and guidance for others wishing to initiate and develop regional multinational surveillance for other diseases or in other regions

International collaboration to protect health workers from infectious diseases in Ecuador Colaboración internacional para proteger al personal sanitario de las enfermedades infecciosas en Ecuador

The Healthy Hospital Project, an international collaboration, aimed to strengthen Ecuador's capacity to promote healthier and safer hospitals by reducing occupational transmission of infectious diseases. Team members conducted a needs assessment to identify workplace hazards and health risks in three hospitals. A survey of health care workers' knowledge and practices of occupational health (OH) and infection control (IC) revealed positive practices such as a medical waste disposal program and widespread dissemination of health information. Challenges identified included a high frequency of recapping needles and limited resources for workers to apply consistent IC measures. The survey revealed underreporting of needlestick injuries and limited OH and safety (OHS) training. Therefore, project collaborators organized a training workshop for health care workers that aimed to overcome the identified obstacles by integrating interdisciplinary local, national, and international stakeholders to build capacity and institutionalize work-related infection prevention and control measures. The knowledge transferred and experience gained led to useful hospital-based projects and serves as a basis for implementation of other OHS projects nationwide. International interdisciplinary, interinstitutional collaboration in OHS and IC can build capacity to address OHS concerns in health care.<br>El objetivo del Proyecto Hospitales Saludables, resultado de una colaboración internacional, fue fortalecer la capacidad del Ecuador de promover hospitales más saludables y seguros al reducirse la transmisión ocupacional de las enfermedades infecciosas. Los miembros del equipo realizaron una evaluación en tres hospitales para detectar los peligros y los riesgos para la salud en el lugar de trabajo. Tras llevar a cabo una encuesta de conocimientos y prácticas de los trabajadores sanitarios en lo que se refiere a salud ocupacional y control de infecciones, se encontraron aspectos positivos, como un programa de eliminación de desechos médicos y la difusión generalizada de información sanitaria. En cuanto a los retos, se detectó una alta frecuencia de volver a colocar el protector de la punta de la aguja antes de desecharla y recursos limitados para que los trabajadores puedan aplicar uniformemente medidas de control de infecciones. En esa misma encuesta se reveló que se notificaba una cantidad menor de la real de pinchazos en los dedos y una capacitación limitada en salud y seguridad ocupacionales. Por consiguiente, como parte del proyecto y con miras a superar los obstáculos señalados, se organizó un taller de capacitación para los trabajadores sanitarios en el cual participaron los interesados directos locales, nacionales e internacionales en diferentes disciplinas, a efectos de desarrollar capacidades e institucionalizar medidas de control y prevención de infecciones relacionadas con el trabajo. Los conocimientos transferidos y la experiencia adquirida dieron lugar a proyectos útiles basados en hospitales y sirven de base para ejecutar otros proyectos de salud y seguridad ocupacionales en todo el país. La colaboración interdisciplinaria e interinstitucional a nivel internacional en salud y seguridad ocupacionales y control de infecciones tiene el potencial de desarrollar capacidades para atender estos problemas en las actividades de atención de la salud