Diagnóstico de la gestión del riesgo físico a los programas territoriales de enfermedades transmitidas por vectores de las direcciones territoriales de salud en Colombia 2021

Abstract

In Colombia, approximately 1,500 workers (technicians and auxiliaries) carry out activities for the promotion, prevention, control, and elimination of ETV Vector-Transmitted Diseases, being exposed to physical risk factors (noise, lighting, extreme temperatures, non-ionizing radiation, and vibrations). of occupational origin, requiring a diagnosis that contributes to improve risk management. Objective: To carry out a diagnosis of physical risk management in VBD territorial programs in Colombia 2021. Methodology: A descriptive, quantitative study is developed, following the reference guidelines established in the ISO 31000 standard for risk management. 65% (n=24) of the THD Territorial Health Departments participated, carrying out an analysis of the internal and external context, identification of hazards using the Risk Analysis by Trade (ARO) methodology, risk assessment using the methodology established in the Colombian technical guide GTC 45 in 14 THD and recommendations are generated from a logical framework. A descriptive analysis of frequencies, a concordance analysis of risk assessment and a comparison of proportions of the results by region, size and DTS category are performed. Results: When evaluating the level of lighting risk, it was found that for chemical product storage warehouses, 42.8% of the THD are at risk level I and 50% at risk level II, inside rural locations. 64.28% of the THD are at risk level I and 35.71% at risk level II, within locations of municipalities and cities 50% of the THD are at risk level I and the remaining 50% at risk level II, and in the offices or meeting venues, 21.42% of the THD are at risk level I and 71.42% at risk level II, these risk levels, I critical situation and II correct and adopt immediate control measures, correspond to the highest levels of risk within the assessment scale of the GTC 45, which require immediate intervention. On the other hand, when assessing the noise level, it was found that when evaluating the perception of noise when driving or mobilizing in fluvial transport vehicles, the risk level is at risk level II for 85.71% of the THD, When driving or mobilizing in land transport vehicles, the level of risk is at risk level I for 14.28% and at risk level II for 78.57% of the THD, when operating the portable equipment of ultra-low volume cold nebulization (motorbike), the level of risk is at risk level I for 28.57% and at risk level II for 71.43% of the THD, when operating the portable pump of compression for intra-domiciliary spraying (Hudson pump), the risk level is at risk level II for 78.57% of the THD, when operating heavy ultra-low volume cold nebulization equipment, the risk level is in risk level I for 35.71% and in risk level II for 64.29% of THD, finally Before operating the portable thermonebulizer equipment, a risk level I was found for 21.42% and a risk level II for 64.28% of the THD. When assessing the level of risk for vibrations, it was found that when evaluating the perception of vibration when driving or mobilizing in fluvial transport vehicles, the level of risk is at risk level III for 71.42% and at a level of IV risk for 28.58% of THD, when driving or mobilizing in land transport vehicles, the risk level is at risk level II for 50% and at risk level III for 35.71% of the THD, when operating the ultra-low volume cold nebulization portable equipment (motorbike), the level of risk is at risk level II for 85.71% and at risk level III for 7.14% of the THD, when operating the portable compression pump for intradomiciliary spraying (Hudson pump), the level of risk is at risk level II for 28.57% and at risk level III for 50% of the THD When operating heavy ultra-low volume cold fogging equipment, the level of risk is in risk level II for 42.85% and in risk level III for 50% of the DTS, finally when operating the portable thermonebulizer equipment a risk level II was found for 35.71% and in a level of risk III for 64.29% of THD, risk level III and IV on the GTC 45 scale correspond to tolerable risk levels in which it is necessary to improve if possible or maintain existing control measures respectively . When assessing the level of risk of non-ionizing radiation by time of exposure to solar radiation, it was found that 28.57% of THD are at risk level I and 71.43% are at risk level II. Finally, when assessing the level of risk due to thermo-hygrometric conditions (extreme heat), it was found that 35.71% are at risk level II and 64.29% are at risk level III in summer. Conclusions: According to the comparisons and evaluations carried out, it is possible to determine that the management of the physical risk factors is inadequate. The intervention of the physical risk factors of the technical workers and Auxiliary Auxiliaries of the prevention programs and control of Vector-Transmitted Diseases (VTD) of the Territorial Health Directorates (THD) of Colombia, considering that the risk levels obtained through the evaluation obtained for carried out show a deficiency in management since the vast majority show levels of risk are high, which puts the health and well-being of the program workers at risk, which consequently determined that the qualification obtained from the risk levels corresponded to an assessment in risk levels I and II, the highest levels of risk. risk consistent with the parameters of the GTC 45 in the vast majority of THD, likewise, the measures of control expected in the risk matrices of the THD are not well established or are not consistent with the needs of the technical and auxiliary workers of the program, since the proposed measures are focused on office personnel and which is far from reality of these workers who develop most of their activities in field work. Keywords: Occupational health, Occupational risks, Vector control, Occupational exposure, Physical risks.