In order to analyze the multiple causes of occupational accidents with biological exposure among nursing staff was carried out a descriptive and exploratory research in a medium-sized hospital in the State of Paraná, in the period between January 2008 and January 2009. The population was 26 nursing staff of the medical clinic. Data collection was performed by semi-structured interviews with five of the eight injured in the period and its contents were analyzed by Causes and Effects Diagram. The categories of causes material, organizational, institutional and worker's behavior, showed the inappropriate disposal of sharps, work overload, no use of bio-security standards and poor supervision and training of workers, as factors for the occurrence of these accidents. The adoption of the tool of Causes and Effects Diagram provided an analysis of accidents in its multiple causes, showing the interaction between them.
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