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Introduction The study presents the difference between occupational and para-occupational diseases in terms of Polish law, and indicates the fact that cardiovascular diseases (CVDs) are considered to be work-related, and describes the latest reports on the prevalence of cardiovascular risk factors in workplaces. Objective The aim of this study is to present the difference between occupational and para-occupational diseases in terms of Polish law. Also indicated is the fact that cardiovascular diseases (CVDs) are considered to be work-related and the latest reports on the prevalence of cardiovascular risk factors in workplaces are described. Brief description of the state of knowledge Polish law distinguishes two groups of diseases that may arise in connection with work: occupational diseases and work-related diseases (so-called para-occupational diseases). Despite the fact that both groups are connected with the work environment they are not equivalent in legal terms. CVDs are one of the greatest threat to human life. The pathogenesis of these diseases is highly dependent on the compilation of adverse risk factors, which are typically divided into modifiable and non-modifiable. To-date, modifiable factors, i.a. excess weight and high blood pressure, were mainly associated with an unhealthy lifestyle. However, a shift in perspective has taken place and currently researchers focus more on the work environment as a possible factor affecting people's health. It is emphasized that an unhealthy work environment increases the risk of CVD. Research shows that workplaces are rich in risk factors specifically related to work, including psychosocial, physical and chemical factors. Conclusions Legal principles covering para-occupational diseases in Poland seem incomplete. It is suggested that providing detailed legal authorization and defining the bodies that will objectively and reliably engage in the diagnostic process of para-occupational diseases may be beneficial to employees.

Introduction: Most of the burns in children occur at home.The aim: The aim of the study was to determine the relationship between the home environment and chosen parameters of burns in children. Methods: The survey was conducted among caregivers of 200 children (80 girls and 120 boys) who were below 18 years of age and hospitalized due to burns in 5 Polish hospitals. Results: Most often burn injuries occurred in the home environment (85,5%): patient’s house (76,5%), neighbor’s house (2%), or relative’s house (7%). In all, 65% of children were living in the urban areas. Burns were more extensive in children from nonurban areas (p = 0,016). Analyzing of the number of people living with the child in the same household revealed that children living only with their mother were hospitalized longer than children from bigger families (p 0,05). Conclusions: The home environment was related to analyzed parameters of burns in children. The preventive programs should increase the awareness of caregivers about the safe arrangement of housing space.

Background Renalase plays an important role in blood pressure regulation. Obstructive sleep apnea (OSA) is a common respiratory disorder associated with hypertension and cardiovascular complications. The aim of the study was to assess the relationship between sleep apnea and renalase concentration. Material and methods Adult patients (n = 113) were evaluated for OSA in a sleep laboratory using polysomnography. The respiratory events were scored according to the standards developed by the American Academy of Sleep Medicine. The blood renalase concentration was determined by the ELISA (enzyme-linked immunosorbent assay) test. Results OSA (AHI ≥ 5) was diagnosed in 71% (n = 80) of the studied population. Renalase concentration was statistically significantly lower in the group with moderate-to-severe OSA (AHI ≥ 15) compared with the group without OSA (AHI p = 0.042). We have found statistically significant negative correlation between renalase and AHI in hypertensives, but not in normotensives. The statistically significant negative correlation was observed between AHI and renalase in the whole studied group, in males, and in the group of age 60 years old. Based on the regression model, it was shown that lower renalase concentration, hypertension, higher BMI, and male gender are independently associated with higher AHI. Conclusions There is a relationship between the blood renalase concentration and the severity of OSA, which may influence hypertension development in OSA.

Objectives The aim of this paper was to investigate the impact of changes in the students' lifestyle during an examination period on their health condition, as evidenced by changes to the body composition and metabolic rates. Material and methods The study involved 268 Wroclaw Medical University students (second- and third-year students). The study was performed 3 times (at the beginning of a semester, in the middle of a semester, and in the examination period) and included a completion of a questionnaire on the current lifestyle, as well as measurements of the body composition, the basal metabolic rate, and the waist and hip circumferences. The measurements were carried out with the use of a body composition analyzer (Tanita MC-780 MA) and a tape measure with a waist-hip ratio calculator. Results In the examination period, as compared with the rest of the semester, a significant decrease was observed in the metabolic rates, and the body water and muscle mass of the examined students. During that period, there were also more frequent adverse changes in the students' lifestyle. In the studied periods, a correlation was found between changes in the frequency of snacking, consuming sweets and cola drinks, and the alterations of the subjects' body fat mass, i.e., r = 0.161, r = 0.135, and r = 0.143, respectively. In turn, differences in the frequency of drinking wine, physical activity, sleep length, and time devoted to learning correlated with changes in the participants' body water, i.e., r = 0.140, r = 0.152, and r = 0.133 (r = -0.142, r = -0.147), respectively, and muscle mass, i.e., r = 0.141, r = 0.142, and r = 0.126 (r = -0.130, r = -0.142), respectively, and metabolism, i.e., r = 0.127, r = 0.145 and r = 0.135 (r = -0.127, r = -0.135), respectively. Conclusions The analysis of the body composition and metabolic rates of the students during an examination period indicates that the changes occurring in various elements of their lifestyle (e.g., dietary habits, physical activity) can result in deteriorating their health condition. Int J Occup Med Environ Health. 2020;33(3):339-51.

This study aimed to assess the relationship between chosen antioxidants, namely selenoprotein P (SELENOP), peroxiredoxin-5 (Prdx-5), renalase and selected cardiovascular consequences tested in ambulatory blood pressure monitoring (ABPM) and echocardiography (ECHO). In our work, cardiovascular consequences refer to higher mean blood pressure (MBP) and pulse pressure (PP) on ABPM, as well as to left atrial enlargement (LAE), left ventricular hypertrophy (LVH) and lower left ventricular ejection fraction (LVEF%) on ECHO. The study group consisted of 101 consecutive patients admitted to the Department of Internal Medicine, Occupational Diseases and Hypertension to verify the diagnosis of Obstructive Sleep Apnoea (OSA). Each patient underwent full polysomnography, blood tests, ABPM and ECHO. Both selenoprotein-P and renalase levels correlated with different ABPM and ECHO parameters. We found no correlation between the peroxiredoxin-5 level and none of the tested parameters. We point to the possible application of SELENOP plasma-level testing in the initial selection of high cardiovascular-risk patients, especially if access to more advanced examinations is limited. We further suggest SELENOP measurement as a possible indicator of patients at increased left ventricular hypertrophy risk who should be of particular interest and may benefit from ECHO testing.

The purpose of this study was to determine the relationship between cadmium exposure and the likelihood of developing or exacerbating symptoms of inflammatory arthritis (IA). The study included 51 IA patients and 46 control subjects. Demographic and lifestyle data were collected. Haematological and biochemical parameters and blood cadmium levels (Cd-B) were determined. Cd-B correlated positively with age, smoking, living in a high-traffic area, and serum levels of inflammatory markers and negatively with mean corpuscular haemoglobin concentration (MCHC). The binary logistic regression model implied that high Cd-B (≥0.65 μg/L) is linked with an increased risk of IA in the studied population (odds ratio: 4.4). High levels of DNA oxidative damage marker (8-hydroxy-2’-deoxyguanosine) (≥7.66 ng/mL) and cyclooxygenase-2 (≥22.9 ng/mL) and frequent consumption of offal was also associated with increased risk of IA. High Cd-B was related to increased risk of disease symptoms onset in the group of IA patients, decreased the level of interleukin 10, and positively correlated with the disease activity. Increased Cd-B is associated with intensified inflammatory processes and decreased haemoglobin levels; in IA patients with decreased anti-inflammatory interleukin 10. These changes partly explain why cadmium exposure and a high cadmium body burden may raise the risk of IA and of disease symptoms exacerbation.

The aim of the study was to determine the relationship between the serum selenium concentration (Se-S) and the blood concentrations of osteoprotegerin (OPG), receptor activator of nuclear factor kappa-Β ligand (RANKL) and the OPG/RANKL ratio in patients with arterial hypertension. The study group comprised 138 patients with arterial hypertension (age: 56.04 ± 11.59 years). Se-S was determined in all the subjects. Based on the Se-S, the following subgroups were distinguished: a subgroup of patients with a lower Se-S ("low-Se", Se-S median) and a subgroup of patients with a higher Se-S ("high-Se", Se-S ≥ median). Moreover, the blood concentrations of the parameters of bone metabolism and extraskeletal calcification were assessed: OPG and RANKL. The OPG/RANKL ratio was calculated. In the "low-Se" subgroup, the RANKL concentration was statistically significantly lower, and the OPG/RANKL ratio was statistically significantly higher than in the patients in the "high-Se" subgroup. The correlation analysis showed the negative linear relationships between Se-S and OPG (r = - 0.25, p 0.05) and between Se-S and OPG/RANKL (r = - 0.47, p 0.05). Moreover, Se-S positively correlated with RANKL (r = 0.33, p 0.05). In regression analysis, higher body mass index (BMI), smoking and lower Se-S were independently associated with a higher OPG/RANKL ratio, while lower BMI, use of diuretics, β-blockers and ACE inhibitors and lower OPG/RANKL ratio with effective blood pressure control. In summary, in the group of patients with arterial hypertension, lower Se-S is associated with an unfavourable prognostic panel of parameters of bone metabolism and extraskeletal calcification. Lower Se-S is an independent risk factor for a higher OPG/RANKL ratio, which is an independent prediction factor of ineffective blood pressure control in patients with hypertension.

The aim of the study was to investigate the effect of physical training on bone parameters of rats exposed to alcohol (Al) and/or cadmium (Cd). Young female rats were divided into one control group and six groups exposed to Cd and/or Al. Al (36% calories of diet) and Cd (20 mg Cd/kg feed) were administered with liquid diet. Half of the rats from the treated groups were subjected to treadmill training (20 m/min for 0.5 h, 4 days a week). The experiment was carried out for 5 months. Al decreased the concentration of calcium (Ca) and iron (Fe) in the femur, whereas Cd and Cd + Al intake reduced the contents of Ca, Fe and zinc. Al and/or Cd caused an increase in both C-terminal telopeptide of type I collagen (CTX1; bone resorption marker) and osteocalcin (OC; formation indicator) and enhanced the degree of porosity and flexural strength of the femur. Al partially prevented the loss of Fe from the bone caused by Cd, but intensified the inhibition of growth of body weight in comparison with separate exposure to Cd. In rats co-exposed to Cd + Al, the levels of CTX1 were greater compared with those treated with Al or Cd separately, and the density was less than that in rats exposed to Al separately. The training caused increases of magnesium and Ca contents, decreases in CTX1, as well as increases in OC and bone density, decreasing their porosity. The effect of training on the bone status, however, was limited (especially in rats co-exposed to Cd and Al) because of the increase in their mineralization, stimulated by exercises, was insufficient in relation to collagen production intensity. In conclusion, training had favourable effects on some bone parameters, but did not compensate for the negative effects of Al and/or Cd exposure on the poor mineralization and histopathological and morphological changes in the femur.

Breakfast is considered one of the crucial elements of a healthy diet. Most studies evaluate breakfast consumption with the risk of obesity and other health effects. Less attention is paid to the evaluation of breakfast composition and patterns. Thus, this study aimed to describe the most frequently observed breakfast patterns and to assess breakfast composition and quality in a group of Polish early school-age children. The cross-sectional survey study was conducted in school years 2017/2018 and 2018/2019. Information regarding breakfast was obtained with the use of an original paper-based weekly observation diary, and breakfast quality was assessed with a special scoring designed to be used together with the diary. In total, 223 schoolchildren of the second and third grades participated in the study, and 200 diaries were analyzed. More than ¾ of the participants consumed breakfast every day. Nearly 68% of meals were classified as well balanced, but only 16.5% of children eat a well-balanced breakfast every day. The number of children who usually (≥5 times per week) eat a sandwich for breakfast was 94 (47%), and that of those who habitually eat cereal and milk or porridge was 29 (14.5%). Only 7% of children consumed fruit or vegetables for breakfast daily, and 26.5% never eat fruit or vegetables for breakfast. Concluding, most children eat breakfast regularly, but the meal composition and quality might be improved.

The after-school period may play a critical role in the accumulation of children’s physical activity and sedentary time. The study aimed to characterize familial correlates of early school-age children’s leisure time activities. A cross-sectional study was conducted among a group of 223 children (mean age 8.7 ± 0.5) and their parents. The percentage of children with daily leisure time physical activity (LTPA) &gt, 1 h was 23.32%, and with daily screen time &lt, 2 h was 32.74%. The average children’s leisure time physical activity was significantly higher on weekend days than on weekdays (114.85 vs. 89.43 min, p = 0.005). Similarly, the average screen time was higher on weekend days than on weekdays (95.50 vs. 66.10 min, p &lt, 0.001). The multivariate regression analysis revealed that independent predictors of children’s leisure time physical activity were the father’s education level and the father’s occupational status, whereas at least one parent with higher education correlated negatively with children’s longer screen time. The study showed that children’s leisure time activities are associated with parental education and differ significantly between weekdays and weekend days. These findings underline the need for screening for unfavorable health behaviors among early school-age children, and indicate that health promotion programs should be oriented on both parents and children aiming to improve parental health consciousness, reduce screen time and increase physical activity, especially during the weekend.

BACKGROUND Aortic valve stenosis is among the most common valvular defects in developed countries. In the assessment of eligibility for transcatheter aortic valve implantation (TAVI), multidetector row computed tomography (MDCT) is performed to determine the precise dimensions of the aortic valve, the topography of the aortic ostium and the ability to use various arterial access routes. OBJECTIVES To evaluate the relationships between the radiation dose and the repeatability of measurements of dimensions of the aortic valve in MDCT performed before TAVI. MATERIAL AND METHODS The study involved a group of 60 consecutive patients undergoing MDCT before TAVI. The radiation dose was expressed as computed tomography dose index volume (CTDIvol) and dose length product (DLP). The coefficient of variation (CV) of each measurement was defined as the standard deviation (SD) of the measurements/mean measurement × 100%, based on the measurements performed independently by 2 radiologists. RESULTS A statistically significant negative linear correlation was observed between the DLP value of the MDCT before TAVI, and the CV of the measurement of the minimum dimension of the aortic annulus (r = -0.25; p < 0.05). Lower DLP doses of the MDCT before TAVI constitute an independent factor associated with a higher CV for the measurement of the minimum dimension of the aortic annulus. CONCLUSIONS It is proposed that tests using lower radiation doses should be followed by an assessment of the degree of repeatability of the aortic valve sizing.

The growing awareness of air quality in our country has triggered a keen interest in its impact on human health. Much of the interest has focused on the concentration of particulate matter. This work is an attempt to synthetically present the significance of particulate matter and the most important health effects. Suspended dust in the air is pollution of special epidemiological significance. It is indicative of air quality and is also the basis for estimating the effect of air pollution on health. This paper presents a short historical overview of suspended dust measurements and its significance in epidemiological research. Its impact on health in terms of short-term exposure as well as long-term exposure is presented according to the meta-analysis conducted by the World Health Organization. The remainder of the paper gives a review of the literature on the impact of particulate matter on respiratory and cardiovascular diseases as the most important health effect of particulate matter.

The built environment, which refers to human-made or modified features of the physical neighbourhood, such as homes, schools, workplaces, or parks and recreational areas, undoubtedly has a great impact on our lifestyles and health behaviours. The objective of this paper is a review of the literature on the correlations between neighbourhood environment and weight status of local residents. This paper presents factors in the built environment which may be related to overweight and obesity prevalence among local residents, resulting in changes in energy balance and affecting BMI. The focus is especially on the relationship between the distance from home to parks and green spaces and physical activity levels, and between the access to fast food restaurants and BMI status or obesity prevalence among residents. The results of recent studies are inconsistent, primarily because of several limitations and methodological problems, and due to multifactorial and complex relationships between the built environment and lifestyle. However, with the still unsolved problem of the increasing prevalence of overweight and obesity, even small changes in individual health behaviour may be important and have a positive impact on the reduction in BMI over time. Therefore, all activities aimed at shaping neighbourhood environments in ways which facilitate healthy food choices and create opportunities for as well as encourage physical activity should be supported.

Climbing is becoming an increasingly popular sport. Therefore, indoor climbing facilities are also frequently visited. To improve friction between the hands and the holds, athletes apply magnesia alba [Mg5(OH)2(CO3)4] on their hands. It is available in various forms. The most commonly used form – powdered – is stored in a bag attached to the waist. Unfortunately, a lot of dust gets into the air during its application. Although data on the harmfulness of the compound itself is not entirely clear, there are reports of a deterioration in the function of the respiratory tract due to magnesium dust suspended in the air. Therefore, methods of reducing the pollution of climbing objects were sought. One of them is certainly the replacement of the powdered form of magnesia with its liquid form (suspension in ethyl alcohol). Because of the constant exposure of the skin to magnesium hydroxycarbonate, its impact on the user’s health has also been analyzed. It has been shown that the effect of magnesium dust at the cellular level can lead to skin pigmentation changes. A separate issue raised in the study is the influence of magnesium on the course of atopic dermatitis. The need for further research has also been underlined, as it may provide new information on the effects of magnesium on atopic skin as well as on the development of contact allergy. Another problem is the increased risk of colonization of magnesia bags by pathogenic microorganisms. In view of that, the study highlights the importance of respecting the rules of personal hygiene in the prevention of infections that threaten people practicing sports climbing.

Poczucie wlasnej skuteczności a zachowania zdrowotne i satysfakcja z zycia studentow dietetyki

Air pollution is one of the main environmental problems. Health consequences of smog exposure apply in particular to people who spend a lot of time outdoors, including cyclists. The aim of the work was to evaluate the occurrence of symptoms associated with air pollution among the Wroclaw cyclists. The study was conducted via an internet questionnaire. The survey group consisted of 599 respondents - Wrocław cyclists. While cycling or short after cycling, 83.14% of cyclists reported symptoms connected with the respiratory system (such as hoarseness, cough, sore throat pain, or dyspnoea), eyes (such as redness, dryness, watering, strain) and other symptoms (for example, concentration deficiency, headache, fatigue), which they associated with air pollution. Problems with the eyes were the most common. There was no correlation between the frequency of symptom occurrence and the distance or cycling frequency. People who chose low-traffic routes were less likely to suffer from cough, hoarseness, or dyspnoea than people who chose high-traffic routes. Only 9.8% of the respondents used protection measures such as masks. Choosing a proper route and avoiding high-traffic seem to be crucial when it comes to symptom occurrence, and perhaps also to long-term health effects. City councils should plan cycling routes in low-traffic areas to minimize negative smog effects. Protection measures, such as the use of masks, should also be more actively promoted.

Human exposure to methylmercury (MeHg) has long been known to produce disorders in various organ systems. The aim of this paper is to present current information about the risk of neurodevelopmental disorders due to pre- and post-natal exposure to MeHg via consumption of fish or marine mammals. Special attention is paid to long-term consequences of prenatal exposure on child development in communities with chronic highlevel dietary exposure to MeHg. This exposure is significantly associated with motor disorders, attention deficit, and mental retardation. Despite extensive research, the threshold dose for MeHg neurotoxic effect is still unclear, particularly when it comes to subtle effects on neurodevelopmental disorders. There are some economic consequences of prenatal MeHg exposure. A reduction of this exposure will bring large-scale social benefits to Europe, mainly to southern countries.

Background The relationship between environmental exposure of non-smokers to cigarette smoke and the coronary artery calcium scores has not been sufficiently documented. The aim of the study was to identify the relationship between environmental exposure to cigarette smoke and the risk of coronary artery disease (CAD) estimated non-invasively through measurement of coronary artery calcium score by computed tomography in patients with essential hypertension. Material and methods The study was conducted on 67 patients with essential hypertension, non-smokers environmentally exposed to cigarette smoke (group A) and on 67 patients with essential hypertension, non-smokers not exposed to cigarette smoke (group B), selected using the case to case. Environmental exposure to cigarette smoke was evaluated using a questionnaire. The risk of development of coronary artery disease was estimated non-invasively through measurement of coronary artery calcium score (CA CS ) by computed tomography. Results Group A was characterised by significantly higher CA CS and left anterior descending (LAD CS ) calcium scores than group B. Compared to group B, group A had significantly higher percentage of patients with significant risk of CAD estimated on the basis of CA CS values, and significantly lower percentage of patients with practically no risk of CAD estimated with the same method. Advanced age, peripheral artery diseases and environmental exposure to cigarette smoke are independent risk factors associated with increased CA CS and LAD CS values. In addition, higher BMI and hypercholesterolemia are independent risk factors for increased values of LAD CS . Conclusions In patients with essential hypertension environmental exposure to cigarette smoke may result in elevated risk of coronary artery disease estimated non-invasively through measurement of coronary artery calcium score by computed tomography.

eases and a factor which contributes to disease exacerbation. Emotional stress before the disease onset is reported by up to 80% of patients suffering from autoaggressive diseases. A significant increase in the prevalence of autoimmune diseases in recent years and the growing number of stressors in our daily lives, including the work environment, raise a question about a link between psychological stress and autoimmune disorders. Therefore, the objective of this paper is to highlight the potential role of stress in both development and exacerbation of autoimmune diseases. The potential mechanisms by which stress can affect autoimmunity are characterised. In particular, the focus is on rheumatic diseases, autoimmune endocrine disorders, multiple sclerosis, and psoriasis. In addition, the role of post-traumatic stress disorder is underlined, as well as the possible association between stress present in the work environment and the development of autoimmune diseases among employees.

Wstęp. Popularność napojów energetycznych w Polsce rośnie odkąd zostały wprowadzone na rynek europejski w 1987 roku. Zawierają one substancje bioaktywne, takie jak kofeina i tauryna, które znacząco poprawiają wydolność organizmu. Celem pracy była ocena spożycia napojów energetycznych, a także ich wpływu na samopoczucie studentów największych wrocławskich uczelni wyższych. Materiał i metody. Badania przeprowadzono w miesiącach styczeń–luty 2015 roku we Wrocławiu wśród 1263 studentów w wieku 18–28 lat. W pracy wykorzystano autorski kwestionariusz internetowy, który uwzględniał płeć i uczelnię wyższą. Pytania dotyczyły częstotliwości i okoliczności stosowania napojów energetycznych, celu i efektów ich stosowania, oceny szkodliwości i skutków ubocznych. Wyniki. Ponad połowa badanych spożywała napoje energetycznie okazjonalnie (50,7%), natomiast zaledwie co szósty badany deklarował, że nie spożywa ich wcale (16,0%). Z kolei 52,2% badanych przyznało, że to sesja egzaminacyjna, a zatem czas zwiększonej ilości nauki był okresem nasilenia spożywania tych napojów. W uzasadnieniu badani argumentowali to głównie chęcią dodania sobie energii (68,3%) oraz zmniejszenia senności (55,5%). Spośród badanych spożywających napoje energetyczne 54,7% zauważyło występowanie skutków ubocznych, a za najczęstsze podawali uczucie kołatania serca (63,3%), zaburzenia snu (45,3%) i drżenie rąk (41,2%). Natomiast zdecydowana większość studentów spożywających napoje energetyczne uznała, że są one szkodliwe (94,5%). Wnioski. Dostępność i różnorodność napojów energetycznych powoduje, że stały się one bardzo popularne wśród studentów. W związku z występowaniem efektów ubocznych spożywania napojów energetycznych należałoby się zastanowić nad wprowadzeniem ostrzeżeń o niepożądanych efektach i podawania maksymalnej dziennej dopuszczalnej dawki.

Wstęp. Zapoczątkowane przez Herberta J. Freudenbergera pojęcie „wypalenie zawodowe” służy do określenia stanu wyczerpania jednostki, spowodowanego przez negatywne czynniki związane z pracą. Do grup zawodowych szczególnie na nie narażonych należą osoby wykonujące zawody związane z zaspokajaniem potrzeb ludzkich. Do tej grupy niewątpliwie należą lekarze, u których wypalenie stanowi poważny problem. Celem naszej pracy była odpowiedź na pytanie, czy objawy towarzyszące temu zjawisku można zaobserwować już u studentów kierunku lekarskiego, podczas ich studiów medycznych. Materiały i metody. Za pomocą autorskiej ankiety internetowej uzyskaliśmy odpowiedź zwrotną od 2388 studentów wydziałów lekarskich z całej Polski, z największym odsetkiem studentów Uniwersytetu Medycznego we Wrocławiu. Wyniki. Objawy towarzyszące wypaleniu były zgłaszane przez niepokojąco wysoki odsetek studentów, przy czym wzrost częstości ich występowania osiągał w większości przypadków kumulację na VI roku studiów lekarskich. Opinia o studiach lekarskich uległa u większości pogorszeniu po ich rozpoczęciu. Studenci są niezadowoleni ze sposobu prowadzenia zajęć na swoich uczelniach oraz wyrażają obawy o przyszłą pracę w zawodzie. Spory odsetek osób myśli również o wyjeździe za granicę po ukończeniu kierunku. Na pytanie o możliwość ponownego wyboru studiów, prawie 1/3 ankietowanych odpowiedziała, iż nie wybrałaby medycyny po raz kolejny. Wnioski. Niepokojące objawy występujące u studentów wymagają dokładniejszej analizy oraz wprowadzeniu prewencji wypalenia wśród tej populacji.

The rising prevalence of overweight and obesity in children and teenagers is a major challenge for public health. Obesity is a complex and heterogeneous disorder, affected by many interacting genetic and non-genetic factors. The aim of this article was to focus on the environmental risk factors for childhood obesity. Among different factors contributing to an increase in BMI, we highlighted the role of exposure to cigarette smoke, DDT, bisphenol A, pesticides, and noise. The correlation between exposure to environmental toxins during prenatal period and obesity development in later life was underlined. According to obesogenic environment hypothesis, some features of distal and proximal neighbourhood also have a pivotal impact on children's behaviour and may contribute to increasing the risk for overweight. The area of residence (urban or rural) may affect access to sports facilities or other opportunities for physical activity. Therefore, for designing adequate prophylaxis, it is essential to take into account modifiable risk factors present in residential neighbourhood. Prevention of childhood obesity should integrate activities for both micro- and macro-environment surrounding the child.

Cadmium exposure contributes to internal organ dysfunction and the development of chronic diseases. The aim of the study was to assess the alleviating effect of &alpha, lipoic acid and/or magnesium on cadmium-induced oxidative stress and disorders in bone metabolism, kidney and liver function, and hematological and biochemical parameters changes. Male rats were exposed to cadmium (30 mg Cd/kg of feed) for three months. Some animals exposed to Cd were supplemented with magnesium (150 mg Mg/kg of feed) and/or with &alpha, lipoic acid (100 mg/kg body weight, four times a week). Cd intake inhibited body weight gain and lowered hemoglobin concentration, whereas it increased the activities of liver enzymes, as well as the level of oxidative stress, CTX-1 (C-terminal telopeptide of type I collagen, bone resorption marker), and CRP (C-reactive protein, marker of inflammation), it decreased vitamin D3, GSH (reduced glutathione), and the serum urea nitrogen/creatinine index. Mg and/or &alpha, lipoic acid supplementation increased the antioxidant potential, and partially normalized the studied biochemical parameters. The obtained results show that both magnesium and &alpha, lipoic acid decrease oxidative stress and the level of inflammatory marker, as well as normalize bone metabolism and liver and kidney function. Combined intake of &alpha, lipoic acid and magnesium results in reinforcement of the protective effect, especially, it increases antioxidant defense.

Celem artykułu jest przedstawienie roli szkodliwości środowiskowych w rozwoju zaburzeń hiperkinetycznych z zaburzeniami koncentracji uwagi u dzieci (ADHD) w świetle aktualnego piśmiennictwa. Te neurorozwojowe behawioralne zmiany często rozpoznawane w XX w. charakteryzują się zaburzeniami koncentracji uwagi, nadpobudliwością psychoruchową, impulsywnością. Nadpobudliwość maleje z wiekiem, zaburzenia koncentracji uwagi utrzymują się. ADHD rozpoznaje się u 8–12% dzieci w skali świata. W przebiegu ADHD występują: obniżenie sprawności intelektualnej, trudności w nauce szkolnej oraz w późniejszym życiu zawodowym, skłonności do antyspołecznych zachowań. Badania prowadzone na parach bliźniąt potwierdziły genetyczne uwarunkowania ADHD, a szkodliwości środowiskowe przyczyniają się do wzrostu częstości występowania zaburzeń. Zalicza się do nich: niska masa urodzeniowa, otyłość matki, zły stan zdrowia, stres i depresja, palenie papierosów podczas ciąży, krwawienia przedporodowe, prenatalna ekspozycja na alkohol, metale ciężkie, pestycydy fosforoorganiczne. Powyższe czynniki ryzyka sprzyjają rozwojowi ADHD w organizmie z genetyczną predyspozycją.

Introduction and objective: This paper is concerned with the harmful impact of nitric oxides (NOx) and particulate matter (PM) on humans. The objective was to determine which source of emission is the most urgent in terms of its reduction.Abbreviated description of the state of knowledge: In published epidemiological studies multiple notifications indicating the harmful impact of particulate matter on human health can be found. The harmful impact is underscored by the increase in the number of hospitalisations owing to diseases of respiratory and cardio-vascular systems, as well as by the rise in general fatality rate. The analysis of the PM impact on the human body is prompted by the fact that its detrimental effects are not clearly defined. Additionally, nitric oxides contribute to the increased number of exacerbations of respiratory disease and are a factor increasing susceptibility to development of local inflammation. Conclusions: The following study is meant to show that the air pollution which derives from vehicles (NOx and PM) has a significant impact on human health. This applies particularly to residents of cities and big towns. This issue has gained special importance in Poland. According to the data from the Central Statistical Office, the increasing number of vehicles in use and their age lead to increased emission of the pollutants considered.

The incidence of infantile autism due to developmental brain disorders has been permanently increasing in many parts of the world. Autism is characterized by impairments of communication and reciprocal social interaction and by restricted repetitive behaviours or interests. The causes of these disorders are not yet known. Experimental studies and clinical observation suggest that genetic and environmental factors could converge to result in neurotoxic mechanisms. These may lead to the development of autistic spectrum disorders (ASD). Several recent studies have indicated that perinatal exposure to environmental toxins may be the risk factor for ASD, among them: polybrominated diphenyl, esters, phthalates, bisphenol A, tetrabrombisphenol A, solvents, pesticides, and heavy metals. They can easily pass the placental and blood brain barriers and affect brain development.

This study aimed at evaluation of a relationship between blood selenium concentration (Se-B) and blood cystatin C concentration (CST) in a randomly selected population of healthy children, environmentally exposed to lead and cadmium. The studies were conducted on 172 randomly selected children (7.98 ± 0.97 years). Among participants, the subgroups were distinguished, manifesting marginally low blood selenium concentration (Se-B 40–59 μg/l), suboptimal blood selenium concentration (Se-B: 60–79 μg/l) or optimal blood selenium concentration (Se-B ≥ 80 μg/l). At the subsequent stage, analogous subgroups of participants were selected separately in groups of children with BMI below median value (BMI

Cardiovascular diseases often linked with lifestyle are among the main causes of death, especially in the elderly population. The role of trace elements in health and disease has been emphasized in multiple scientific research. Moreover, supplementation of trace elements to improve health is becoming increasingly popular. The following paper presents current views on the relationship between the concentration of trace elements such as selenium and zinc in the body, as well as morphology and function of the cardiovascular system. Research discussing the effect of selenium and zinc supplementation on the function of the heart and blood vessels was also reviewed. The relationship between selenium and zinc concentration and morphology and function of the cardiovascular system is equally unclear, and therefore there is currently no scientific evidence for its supplementation for preventing cardiovascular diseases. It seems justified to continue scientific research on this subject due to the small number of experimental studies available on the topic of selenium and zinc deficiency and their impact on the cardiovascular system.

The objective of the study was to determine the relationship between serum concentrations of selenium (SeS) and zinc (ZnS), total antioxidant status (TAS) and endothelial function assessed by ultrasonographic method of dilatation of the brachial artery in 141 hypertensive patients. Patients with SeS < median were characterized by a statistically significantly lower flow-mediated dilation (FMD) than patients with SeS ≥ median. Patients with TAS < median were characterized by a significantly lower FMD than patients with TAS ≥ median. Older age, higher BMI, male gender, higher blood total cholesterol, ischemic heart disease, smoking and lower SeS constitute independent predictors of inferior endothelial function, expressed in lower FMD values. Smoking is an independent predictor of lower TAS, and the use of β-blockers and higher serum selenium levels are independent predictors of higher TAS. In summary, a decrease in TAS should be considered as a mechanism of inferior endothelial function in hypertensive patients conditioned by a decrease in SeS.

The paper presents some information about selenium (Se) and its biological role in the ecosystem. Se is a trace element for mammals. It has been shown to be a natural component in the enzyme glutathione peroxydases and other selenoproteins. Se participates in various biological processes, such as antioxidant defence, thyroid hormone production, and immune responses. The concentration of Se in organisms varies widely between geographical areas, depending on its content in the soil, plants, and dietary intake. In larger amounts it can be toxic (acute or chronic selenosis). Its deficit in diet can trigger the development of some chronic diseases (Keshan, Kashin- Beck).

Noise is ubiquitous in human environment. Paper presents current knowledge on extra- aural health effects of exposure to environmental noise. noise is not solely annoyance, but more and moreresearches show that this pollution is a risk factor for different health disorders: sleep, hypertension, cardiovascular diseases and others that challenge for public health. Moreover it has social and economical dimensions.

This paper presents information on the growing application and possible impacts of nanosilverparticles on human health and environment. Silver nanoparticles are the most frequent commercialized nanomaterial. They are used in a number of strategic areas including energy, electronics, medicine and biotechnology. Currently little is known about the toxicity of silver nanoparticles or about the mechanism of adverse effect. The potential risk associated with the application of engineered silver nanoparticles have been videly delated in recent years.

Meteorological conditions have an impact on the human body on a permanent basis and lead to numerous of physiological and behavioural reactions. To a large extent, the meteorological conditions have shaped the civilisations, way of life, architecture and art. Nowadays, where dynamic changes of climate and frequent and violent weather anomalies are observed, the meteorological conditions are becoming a factor which directly influence the quality of life and which are often hazardous to the human health. In this range, heat and cold waves which cause a rapid increase in mortality are of the significant importance. Large diurnal changes in atmospheric pressure which lead to a worse well-being and tendency to aggression or weakened concentration are also significant. Due to more frequent weather anomalies, more and more people is exposed to the weather’s effects and elderly people constitute the most endangered group. In this regard, it is crucial to create an early warning system for unfavourable meteorological conditions altogether with providing a thorough information regarding the way of an effective protection against their influence. The mechanism of the impact of high and low temperatures to the human body has been presented in the thesis, including the life-threatening condition. A description of health effects of the influence of significant changes of the diurnal atmospheric pressure has been also provided.

The feature which characterizes Wroclaw city is the lack of heavy industry. The main sources of air pollutants are road transport, low emission from households and power plant. Road transport is particularly burdensome for residents of Wroclaw, as evidenced by the speed of passing traffic through the city amounting to 36 km/h, which leads to a significant concentration of the particulate matter (PM) and nitrogen oxides (NOx) along the main thoroughfares of the city. Air pollution from households is particularly noticeable within the densely populated downtown area where a significant part of flats is not connected to district heating. Emission from heat and power plant in Wroclaw city also contribute significantly to the level of PM10 especially during the heating season. The paper presents a summary of the number of days when PM10 concentration is exceeded. At the same time discussion took place on the potential impact of these air pollutants on human health.

Polymorphisms in the δ-aminolevulinic acid dehydratase (ALAD) and the vitamin D receptor (VDR) genes may modify lead metabolism and neurotoxicity. Two cohorts of children were examined for hearing [pure-tone audiometry (PTA), brain stem auditory evoked potentials (BAEP)], acoustic otoemission (transient emission evoked by a click) and blood-lead concentrations (B-Pb). The children were genotyped for polymorphisms in ALAD and VDR. The median B-Pbs were 55 and 36μg/L in the two cohorts (merged cohort 45μg/L). B-Pb was significantly associated with impaired hearing when tested with PTA (correlation coefficient rS=0.12; P

Exposure to tobacco smoke is a significant problem of environmental medicine. Tobacco smoke contains over one thousand identified chemicals including numerous toxicants. Cardiovascular system diseases are the major cause of general mortality. The recent development of diagnostic imaging provided methods which enable faster and more precise diagnosis of numerous diseases, also those of cardiovascular system. This paper reviews the most significant scientific research concerning relationship between environmental exposure to tobacco smoke and the morphology and function of cardiovascular system carried out using diagnostic imaging methods, i.e. ultrasonography, angiography, computed tomography and magnetic resonance imaging. In the forthcoming future, the studies using current diagnostic imaging methods should contribute to the reliable documentation, followed by the wide-spreading knowledge of the harmful impact of the environmental tobacco smoke exposure on the cardiovascular system.

The aim of this study was to assess the effects of chronic combined exposure to low, environmental doses of Cd, Pb, and Mn on oxidative stress in the liver and heart of rats and on their liver function parameters. Male Wistar rats were divided randomly into eight groups. For nine months controls were receiving drinking water alone, whereas the exposed groups were receiving drinking water with Pb (0.2 mg L-1), Cd (1 mg L-1), and Mn (2 mg L-1) alone or in combinations. Malondialdehyde (MDA) significantly increased in both heart and liver of the animals after combined exposure to metals. Heart MDA correlated with blood Cd, Pb, and Mn and liver MDA with blood Cd. Aspartate aminotransferase (AST) activity and bilirubin concentration also increased significantly in the animal group exposed to all three metals and correlated positively with blood Cd, Pb, and Mn. Our study has confirmed the synergistic effect of the Cd, Mn, and Pb combination on the increase in heart MDA. A similar synergy was observed for Pb+Mn in the increase of serum alanine aminotransferase (ALT) activity as an indicator of liver function.

The paper presents some information about current state of knowledge of the risk due to exposure to endocrine disrupting chemicals (EDCs). Endocrine disruptors are defined as chemicals substances with either agonist or antagonist endocrine effects in human and wildlife. Exposure to EDCs in animals models correlate positively with an increased incidence of malformations of genital tract, on neoplasmas, obesity, alternations on male and female reproduction and changes in neuroendocrinology and behavior. Results from animal models, human clinical observations and epidemiological studies converge to implicate EDCs as a significant risk to public health.

The study aimed at defining the relationship between blood selenium concentration (Se-B) and levels of oxidative stress and antioxidative capacity in healthy children. The studies were conducted on 337 children (mean age: 8.53±1.92 years). The groups of individuals with Se-B1st quartile (group I, Se-B70μg/L), with Se-B fitting the range of 1st quartile and median (group II, Se-B: 70-76.9μg/L), with Se-B between the median and 3rd quartile (group III, Se-B: 77-83.9μg/L) and those with Se-B above the 3rd quartile (group IV, Se-B≥84μg/L) were distinguished. Level of oxidative stress was defined using determination of urine malonyldialdehyde concentration (MDA) and urine 8-hydroxy-2-deoxyguanosine concentration (8-OHdg). Urine total antioxidant status (TAS) was determined. In group IV TAS was significantly higher than in groups I-III. A positive correlation was detected between Se-B and TAS. In healthy children an appropriately high Se-B seems to ensure higher total antioxidative status.