Work-related diseases in nurses working in a university hospital and its costs

SUMMARY Title: Work-related Diseases in Nurses Working in a University Hospital and its Costs Aim and hypothesis: There are two main objectives of this study. The first is to determine the health problems and complaints that are caused by the occupational risks of the nurses and to calculate their cost. The second objective is to determine the cost effectiveness of the use of the safe injection needles. Methods: The research has three stages. In the cross-sectional phase of the study, disease and symptom-based interventions were used to determine the cost of work-related disease of nurses. Direct expenditures made in the past year have been calculated in determining the costs associated with the work-related diseases and cost of illness analyse was made. In the second phase- six month longitudinal follow-up - , newly identified work-related diseases or symptoms in nurses were identified either through face-to-face interviews or via the hospital information system. The third stage is the intervention study. In the selected units, it was aimed to determine the change due to needlestick injuries by using a safety needles and to show the incidence change of the injector injuries by the intervention. Findings: 29.3% of the nurses stated that they had a unit-based health problem they were working at. The first three health problems were related to the musculoskeletal, nervous and circulatory systems. Also 79.3% of the nurses stated that they took precautions against the risks in the working environment. 46.7% of the nurses have experienced at least one work accident during their occupational life. the first order was needle stick injury with 75.61%, the second was broken drug ampoule (8,26%) and the third was falling (6.61%). In the past year, 68 (15%) nurses had been injured with blood-borne needles. When the processes causing the injuries were asked , the first three orders were recapping the needle cap (30,2%), during implementation (28,9%) and post-implementation transactions (18,4%). The frequency of work-related health problems in nurses was 27.2%. In the last year, the total cost of the work-related health problems had been 90.610,17 TL. In total cost, the first three orders were musculoskeletal system (23,832,69 TL), nervous system (14,562,47 TL) and respiratory system (11,401,54 TL). When the per capita annual cost is calculated, the first three orders were respiratory system (215,12 TL), genitourinary system (187,94 TL) and musculoskeletal system (187,94 TL). General complaints of the nurses in the last 6 months were fatigue (38,7%), weekness (36.7%), vision problems (9.1%), insomnia and sleepiness ( 13.2%). Musculoskeletal system problems were the leading cause of these health problems with 26.5%. The incidence rate of work accidents was 1.72 per 100 person-months whereas the incidence rate of needlestick injury was found to be 1.30 per 100 person-months. The rate of personal protective equipment usage was 73.9% at the time of work accident. The incremental cost effectiveness ratio of the safety needles used in the intervention phase was found to be 148,5 TL / accident. When the risk of HBV contamination after a needlestick injury was assessed, the cost of the accident was calculated at least as 37,5 TL and maximum as 1,476,38 TL. Results: Because the occupational accidents were mostly in the younger age and the shorter working period group, awareness of the issue should be increased. When the financial burden caused by work-related diseases and needle stick injuries were assessed, the regulations that need to be done are very important in terms of reducing health expenditures of the country as well as protecting the employee health. Key words: Cost-Effectiveness Analysis, cost of illness, work-related diseases, nurse Contact address: Adnan Menderes University Faculty of Medicine, Department of Public Health, Aydın, Tel: 0256 212 18 50