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Objectives The aim of the study was to establish whether the driver's visual strategy may influence a driver's behavior to avoid a crash in a high-risk situation. Any published papers on drivers' visual strategies just before a crash were not found. Material and methods Tests were performed using a high-tech driving bus simulator. Participants comprised 45 men drivers, aged 43.5±7.9 years old, seniority as a bus driver of 13.3±8.6 years. The tests were preceded by medical examinations: general, neurological and ophthalmological. Each participant drove the same city route for approximately 40 min (entire route - ER). In the final phase, a collision situation was simulated (a phantom car blocked the participant's right of way). Driver's visual strategy was analyzed using the FaceLab device with 2 cameras during ER and just before collision. The field-of-view covered by camera 1 was divided into 8 regions, by camera 2 into 10 regions. The distribution of gazes in regions was a criterion of visual strategy. Results Thirty-five drivers completed the simulated driving test, 14 escaped the collision, 21 crashed. These groups differed only in resting systolic blood pressure before the test. The analysis of covariance, after adjusting to this factor, indicated that during the ER visual strategy recorded by camera 1 did not differ between groups, in camera 2 the drivers in the crash group fixed their gaze more frequently (p = 0.049) in region 3 (close part of the road in front of the windshield). Just before the collision drivers who escaped the collision fixed their gaze significantly more often in region 6 (left side of the road) in camera 1 and in region 6 (in front of the windshield,) and region 10 (right side) in camera 2. Conclusions The visual strategy has an impact on the road safety. The analysis of visual strategies may be a useful tool for the training of drivers. Int J Occup Med Environ Health. 2019;32(2):161-74.

Teachers are a occupational group in which, due to the type and specificity of work, it can be expected that the feeling of fatigue will be very intense. However, there has been little research into this problem. The aim of the research was to assess the level of fatigue after work and chronic fatigue in teachers, and to determine whether and to what extent it depends on occupational and non-occupational loads.The stratified sampling model was used to select the sample, where the layers were the type of school and its location (size of a town/city). All teachers from selected schools were invited to participate. Overall, 650 questionnaires were distributed and 403 teachers returned completed questionnaires. Fatigue after work was assessed on the basis of answers to the following question: "Do you feel tired after work?" and chronic fatigue using theThe study involved 70 men aged 35-63 years and 333 women (24-64 years). The groups did not differ significantly in terms of mean age. The level of fatigue, regardless of gender, was mostly influenced by time pressure, rush, mismanagement of the pace of work to individual abilities, increasing workload, an excess of responsible tasks, a lack of support from superiors, a low prestige of the profession, a lack of pedagogical successes, a sense of the lack of meaning in work, and the negative impact of work on family life, as well as non-occupational loads and insufficient rest.The conducted study allowed for determining the profile and frequency of occupational and non-occupational factors affecting the level of fatigue in teachers. Med Pr. 2021;72(3):283-303.Nauczyciele są grupą zawodową, w której ze względu na rodzaj pracy i specyfikę obciążeń można spodziewać się występowania nasilonego zmęczenia. Jednak niewiele badań dotyczy tego problemu. Celem niniejszych była ocena poziomu zmęczenia po pracy i zmęczenia przewlekłego u nauczycieli oraz ustalenie, czy i w jakim stopniu są one zależne od obciążeń zawodowych i pozazawodowych.W doborze grupy zastosowano model losowania warstwowego, gdzie warstwami były szkoły (szkoła podstawowa, gimnazjum, liceum, technikum, szkoła zawodowa, szkoła specjalna) i ich lokalizacja (miasto wojewódzkie, miasto5 tys. mieszkańców, miasto ≤5 tys. mieszkańców, wieś). Do udziału w badaniu zaproszono wszystkich nauczycieli zatrudnionych w wylosowanych placówkach. Rozdano 650 ankiet – kompletne ankiety zwróciło 403 nauczycieli. Oceniano zmęczenie po pracy na podstawie odpowiedzi na pytanie „Czy odczuwa Pani/Pan zmęczenie po pracy?” i zmęczenie przewlekłe z zastosowaniemW badaniu udział wzięło 70 mężczyzn w wieku 35–63 lat i 333 kobiety (24–64 lata). Średnia wieku kobiet i mężczyzn nie różniła się istotnie. Na poziom zmęczenia nauczycieli, bez względu na płeć, w największym stopniu wpływały cechy pracy decydujące o jej stresogenności (presja czasu, pośpiech, niedostosowanie tempa pracy do indywidualnych możliwości, wzrastające stale obciążenie, nadmiar odpowiedzialnych zadań, brak wsparcia przełożonych, niski prestiż zawodu, brak sukcesów pedagogicznych mimo wysiłku wkładanego w nauczanie, poczucie braku sensu pracy oraz negatywny wpływ pracy na życie rodzinne) oraz obciążenia pozazawodowe i niewystarczający wypoczynek.Przeprowadzone badanie pozwoliło określić profil i częstość występowania czynników zawodowych i pozazawodowych, które kształtują poziom zmęczenia u nauczycieli. Med. Pr. 2021;72(3):283–303.

From our previous research among bus drivers, in difficult, but not extreme situations, we observed an increase in blood pressure (up to 200mm Hg), cardiac arrhythmias, ischemia, etc. Such reactions may be dangerous to healthy people, but they are extremely risky for drivers with a history of cardiovascular or cerebrovascular incidents. Thus, certifying driving ability of such persons is a serious problem for the medical expert. In this case, tests in a driving simulator, where it is possible to arrange a variety of stressful situations and also to monitor the reaction of the cardiovascular system and brain electrical activity may be a great advantage. Therefore we developed a first-in-Poland integrated system for examination and training of road vehicle drivers, including model stand for simulating of driving vehicle under conditions of road traffic, and a set of methods of psychological and physiological tests to be applied for testing drivers. This simulator enables to assess physiological response to different traffic situations, to analyze the effects of work environment on psychical and physical abilities of drivers, to test the feasibility of the physiological methods for assessing the fatigue and drowsiness, to evaluate the effect of monotony and static loads on the development of driver's fatigue, to assess changes in psychomotor abilities of drivers resulting from exposure to harmful and noxious agents at workplace.

A group of professional bus drivers have done two rides on a city bus simulator – the fist one into the city centre and the other one in the suburbs. One dangerous incident was simulated during each ride. The visual strategy was evaluated by the FaceLab system comprising two pairs of cameras, one facing the road and the other to the left side. The main selected criteria of the visual strategy included the number and duration of gaze fixations. Furthermore, eyelid movements (PERCLOS index) and pupil diameter were recorded. The results were subjected to a statistical analysis.

The aim of the study was to compare the musculoskeletal system load assessed using the rapid office strain assessment (ROSA) and rapid upper limb assessment (RULA) methods in computer operators, and to determine the correlation of the obtained results with the occurrence and intensity of musculoskeletal complaints (MSCs) in these individuals.In a group of 72 persons (38 women and 34 men) working with a computer for4 h/day, the ROSA and RULA methods were used to assess the load, while a questionnaire modeled on theiStandardized Nordic Questionnary/iwas used to assess the frequency and severity of MSCs.Musculoskeletal complaints occurred in about 66% of the investigated women and 62% of the investigated men within the previous year. The results of the ROSA and RULA methods were not convergent. The final result of the ROSA method (scale 1-10 pts) was 2-6 pts (M = 3.51±1.09), while the final result of the RULA method (scale 1-7 pts) ranged 2-4 pts (3.00±0.17). The values of partial and final scores in the ROSA method were correlated with the number of concurrent ailments and intensity of complaints in various regions of the musculoskeletal system. The assessment of the position of particular parts of the body during work, performed using the RULA method, in people with or without MSCs was almost identical.The use of the ROSA method has shown that it is a useful and easy-to-use tool for assessing computer workstations and can be successfully disseminated. Med Pr. 2019;70(6):675-99.Celem pracy było porównanie obciążenia układu mięśniowo-szkieletowego ocenianego za pomocą metody szybkiej oceny obciążenia fizycznego na stanowiskach w pracy biurowej (irapid office strain assessment/i− ROSA) i metody szybkiej oceny obciążenia fizycznego ze szczególnym uwzględnieniem kończyn górnych (irapid upper limb assessment/i− RULA) u operatorów komputerowych oraz określenie korelacji wyników z występowaniem i nasileniem dolegliwości mięśniowo-szkieletowych (imusculoskeletal complaints/i− MSCs) u tych osób.W grupie 72 osób (38 kobiet i 34 mężczyzn) pracujących przy komputerze4 godz./dobę do oceny obciążenia wykorzystano metody ROSA i RULA. Kwestionariusz wzorowany naiStandardized Nordic Questionnary/isłużył do oceny częstotliwości i nasilenia MSCs.Dolegliwości mięśniowo-szkieletowe wystąpiły u ok. 66% kobiet i 62% mężczyzn badanych w ciągu ostatniego roku. Wyniki uzyskane za pomocą obu metod nie były zbieżne. Końcowy wynik metody ROSA (skala 1−10 pkt) wynosił 26 pkt (M±SD = 3,51±1,09), a metody RULA (skala 1−7 pkt) – 2−4 pkt (M±SD = 3,00±0,17). Wartości ocen cząstkowych i oceny końcowej w metodzie ROSA były skorelowane z liczbą jednocześnie występujących dolegliwości oraz nasilenia dolegliwości w różnych okolicach układu mięśniowo-szkieletowego. Ocena pozycji poszczególnych części ciała podczas pracy u osób z dolegliwościami i bez nich, przeprowadzona za pomocą metody RULA, była prawie identyczna.Wykazano, że metoda ROSA jest użytecznym i łatwym w użyciu narzędziem do oceny komputerowych stacji roboczych, którego stosowanie może być rozpowszechniane. Med. Pr. 2019;70(6):675–699.

Objectives Only a few studies have been undertaken to analyze the dietary habits of people with cardiovascular diseases. The aim of this study was to evaluate the dietary behaviors of working people who were hospitalized due to experiencing the first acute cardiovascular incident. Material and Methods In the study, the Functional Activity Questionnaire was used. The study was conducted in 2 groups. The first group included all the men hospitalized during 1 year (January–December 2009) in 2 clinics of cardiology, who were professionally active until the first myocardial infarction (MI). It comprised 243 men aged 26–70 years. The reference group consisted of 403 men, blue- and white-collar workers, aged 35–65 years. Results The body mass index of the MI patients was significantly higher (p = 0.006). The frequency of consumption of particular products in the MI group and in the reference group differed significantly for 11 of 21 products. The MI patients significantly less frequently reported the daily consumption of fruit, raw vegetables, cheese, vegetable oils and fish. In this group, the consumption of salty (p = 0.0226) or fatty (p < 0.0001) foods was significantly higher. It was shown that, after adjusting for age, education and the type of work, the daily consumption of fish, salads and cooked vegetables, as well as fruit and vegetable oils, significantly reduced the risk of myocardial infarction. An increased MI risk was, in turn, associated with obesity and preference for fatty foods. Conclusions The authors found that diet significantly modified the MI risk in the examined workers. This indicates that an important aspect of prevention activities among working people should involve education about proper dietary habits. Int J Occup Med Environ Health. 2019;32(6):853–63

Introduction One of the most important parameters of interest in the study of drivers on the driving simulator is the oculometric data obtained during driving. Using this method we have a direct view of the driver’s eye path and ability to analyse it. The purpose of the study was to trace the places where the driver’s eyes focus when driving on a bus simulator. Materials and methods The study was conducted in a group of randomly selected 45 city bus drivers. Thanks to the use of appropriate infrared cameras, scene cameras and specialised software, data has been obtained and selected using special programs and statistical analysis. By collecting this data we are able to analyse the driver’s eye-path in different situations on the road (urban driving, off-road driving, and stress-based driving). Methods FaceLab was used to track the visual path with infrared cameras. We also use scene cameras and Eyeworks (Record, Analyse) and Captive programs. These programs enabled the visual path to be taken in the form of saccades and fixations applied to a video file with recorded driving data and data from the simulator. Then the image from the scene camera (what the driver saw) was divided into regions (areas in front of the driver’s eye or side mirror surfaces) so it was possible to analyse the individual regions of all the drivers taking part in the experiment. Results The driver during 28.77% of the driving time on the simulator focused on the area of the road directly in front of the vehicle and on the right-hand mirror it was 2.27% of the driving time. Discussions The obtained data confirm that the driver is most likely to look at the road ahead and the area surrounding the right mirror (which is affected by stops at the bus stops).

Introduction After myocardial infarction (MI) only 50% to 60% of people still work and the time to stay out of work is in Poland often 9 months. The aim of the project was to elicit factors that have an impact on the return to work after the first myocardial infarction. Methods A questionnaire survey was performed among all patients occupationally active till the time of the MI. The questionnaire covered recent data on work, working environment, health status, lifestyle. 306 people received the questionnaire. The analysis included 150 surveys. Results As much as 76.7% (115) people returned to work. The average age of workers prior to infarction was 52.6±7.1 years, and was significantly lower than that of people who did not return (55.3±6.8). The subjects returned to work after an average of 6.5 months (range 0.5–48). The group of people who returned/did not return to work did not differ in respect to education, place of residence, classical risk factors, type of MI, ejection fraction and undertaken rehabilitation. Subjects who returned to work significantly more likely used to undertake physical activity. People who did not return to work significantly more often rated their health as ‘worse than before the MI’ (p=0.026) complained the chest pain (71.4% vs 38.6%, p=0.026), suffered from neurosis (25, 7% vs 10.4%, p=0.047) and were anxious about re-infarction (71.4% vs 49.6%, p=0.023). As many as 20.9% of subjects claimed that the work was too heavy, while for 49.6% the job was too stressful. Discussion The results indicate that age, subjective health status and the presence of pain in the chest, neurosis and anxiety play an important role in the return to work after MI. For people who restarted working, work heaviness and stress occurring at work were the major problems.

Introduction Only a few studies have been undertaken to analyse the dietary habits of people with cardiovascular diseases. The aim of this study was to evaluate the dietary behaviours of working people after the first acute cardiovascular incident. Methods In the study Functional Activity Questionnaire (FAQ) was used. The study was performed in two groups: the first group were all men hospitalised during one year in two clinics of cardiology, professionally active until the first myocardial infarction (MI). It comprised 243 men, aged 26–70 years. The reference group consisted of 403 men, blue- and white-collar workers aged 35–65 years. Frequency of consumption of each product among patients with acute myocardial infarction and in the reference group was calculated using basic methods of descriptive statistics. Multivariate logistic regression model was used to determine the risk factors for myocardial infarction. All statistical analyses were performed using the STATISTICA version 8MR 3 c software. Results Body mass index of MI patients was significantly higher (p=0.006).The frequency of consumption of particular products in MI group and in the reference group differed significantly for 11 of 21 products. Patients with MI significantly less frequently reported daily consumption of fruits, raw vegetables, cheese, vegetable fats and fish. In this group consumption of salty (p=0.0226) or fatty (p Discussion It has been shown that after adjusting for age, education and type of work, the daily consumption of fish, salads and cooked vegetables, fruits and vegetable oils significantly reduced the risk of myocardial infarction. Increased MI risk was associated with obesity and preference for fatty foods. We found, that the diet significantly modified risk of MI in examined workers. This indicates that an important part of prevention activities among working people should be an education about proper dietary habits.

Introduction The aim of the study was to evaluate the effect of the test on the simulator on the bioelectric activity of the brain of professionally active drivers. Methods Electroencephalography registration was performed with the 32-channel recorder. Electrodes locations were specified by the International 10–20 system. The records were performed before the start of the test on the simulator, which enables full simulation of real road conditions (Exam I) and after its completion (Exam II). A recording was performed, with eyes closed, for 30 min. At 2,5,6,23,25 min of the test, the eye was opened and closed, at the 8th min. – a test of deep breathing (hyperventilation test – 3 min) and intermittent photic stimulation. We used stimulation with frequencies of 3, 6, 9, 12, 15, 18, 21, 24, 27, 30 Hz and back. 45 subjects were enrolled to study. All subjects were bus drivers aged 31–58 years (43.5±7.9 years), seniority as a bus driver of 13.3±8.6 years. The frequency and amplitude of the basic activity of the brain was analysed and compared between left and right homologous EEG channels in Exam I and II. Results The basic activity brain parameters were analysed at rest, 2–3 min hyperventilation and after activation attempts. In the Exam I hyperventilation revealed a statistically significant difference between basic rhythm frequencies (p=0.043). In the left-side channels, the mean value was significantly higher than in the right-side channels (10.49±1.34 vs 10.30±1.19), the difference was not observed in the Exam II (10.46±1.66 vs 10.29±1.64, p=0.397). Discussion This difference could not be explained by the physiological response to hyperventilation. There were no differences between the baseline rhythm recorded at rest at both the first and second test. The explanation of these results requires further studies.

Bus drivers are a special group of professional drivers who are at a very high risk of fatigue. The aim of the study was to examine whether the driver's subjective assessment of fatigue allows for the determination of its level and identification of its causes.The study group comprised 45 randomly selected bus drivers (mean age - 43.7 ± 7.9 years, period of employment as drivers - 14.7 ± 8.6 years). Examinations were performed in all subjects four times - before and after work on the "easy" route (outside the city center, small traffic intensity) and before and after work on the "difficult" route (city center, heavy traffic). The fatigue test questionnaire, based on the list of symptoms of fatigue prepared by the Japan Research Committee of Fatigue, was used in the study.The rating of fatigue after the work was significantly higher than that before the work. The profile of fatigue after work was not influenced by the type of route, but the assessment of most symptoms of fatigue reached a higher level after the "difficult" routes and the differences were statistically significant for 7 symptoms. Only the ratings of leg fatigue, feeling of heaviness, and the necessity to squint eyes and gaze with effort reached the higher levels after driving the "easy" routes. It has been found that the level of fatigue was significantly correlated with the job characteristics (driving time, the length of the route, number of stops, etc.) and with the abundance of food ingested and type of beverage (coffee vs. others) drunk prior to driving.The questionnaire used in our study to assess the subjective feeling of fatigue has proved to be a sensitive and useful tool for indicating the level and causes of fatigue. The relationship between the symptoms of fatigue and the characteristics of job and lifestyle shows that actions must be taken by both the employers and employees to prevent fatigue in bus drivers.Kierowcy autobusów miejskich są grupą zawodową, w której ryzyko wystąpienia zmęczenia jest szczególnie duże. Celem badania było sprawdzenie, czy subiektywna ocena kierowców dotycząca zmęczenia pozwala na określenie jego poziomu, uwarunkowań i przyczyn.Badanie przeprowadzono w grupie losowo dobranych 45 kierowców autobusów (średni wiek – 43,7±7,9 lat, staż na stanowisku kierowcy – 14,7±8,6 lat), zatrudnionych w przedsiębiorstwie komunikacji miejskiej w dużej aglomeracji. U wszystkich badanie wykonano 4-krotnie – przed pracą i po pracy na trasie „łatwej” (poza centrum miasta, małe natężenie ruchu) oraz przed pracą i po pracy na trasie „trudnej” (centrum miasta, duże natężenie ruchu). Zastosowano „Kwestionariusz do badania zmęczenia” wzorowany na liście objawów zmęczenia przygotowanej przez Japan Research Committee of Fatigue.Kierowcy ocenili, że ich zmęczenie po pracy było znacząco większe niż przed pracą. Rodzaj zmęczenia po pracy nie był zależny od rodzaju trasy, ale oceny większości symptomów zmęczenia były wyższe po trasach „trudnych” (dla 7 symptomów różnice były statystycznie istotne). Jedynie oceny zmęczenia nóg, uczucia ociężałości, mrużenia oczu i konieczności wytężania wzroku osiągały wyższy poziom po pracy na trasach „łatwych”. Stwierdzono, że poziom zmęczenia był istotnie skorelowany z cechami pracy (czas pracy, długość trasy, liczba przystanków itp.) oraz z obfitością posiłku i rodzajem spożywanego napoju (kawa vs inne) przed pracą.Zastosowany „Kwestionariusz do badania zmęczenia” okazał się narzędziem czułym i przydatnym do oceny poziomu i przyczyn zmęczenia. Związek symptomów zmęczenia z cechami pracy i stylem życia wskazuje, że w zapobieganiu zmęczeniu kierowców autobusów niezbędne są działania zarówno pracodawcy, jak i pracowników. Med. Pr. 2015;66(5):661–677.

The possible associations between climate parameters and drivers’ fatigue have not been subject to specific studies thus far. We have undertaken a study to investigate whether the particular climate parameters are related to fatigue perception by motor vehicle drivers. The study was performed from July to October. Each driver was surveyed four times: before and after workshift on a monotonous route outside the city center (MR), and on a heavy traffic route in the city center (HTR). The study was conducted among 45 city bus drivers aged 31–58 years (43.7 ± 7.9), seniority as driver 3–34 years (14.7 ± 8.6). Data on climate conditions (ambient temperature, air pressure, humidity, wind speed, precipitations) on particular study days was obtained from the Institute of Meteorology and Water Management, National Research Institute Warsaw, Poland. Fatigue was assessed using the Fatigue Assessment Questionnaire, developed at Nofer Institute of Occupational Medicine (Lodz, Poland). The total level of fatigue was significantly (p = 0.045) higher after driving on HTR than on MR. The number of symptoms was also significantly higher (p

Objectives: The aim of the study was to find out which occupational factors account for the risk of the myocardial infarction. Material and Methods: A questionnaire survey was performed during the period of one calendar year in all patients (1053 sub- jects, 692 men and 361 women) hospitalized at the Medical University of Łodź because of the first myocardial infarction. The questionnaire was prepared especially for the purpose of this study and consisted of two parts. The first part comprised: demographic data, health status at admittance, traditional risk factors for the ischaemic heart disease and was filled-in by physi - cians. Part II was done by occupational hygiene specialists and referred to education, job title and characteristics, employment data, self assessment of work-related and general stress, fatigue, socio-economic status, physical activity, alcohol intake, tobacco smoking, dietary habits. Results: Mean age in the study group was 59.9±10.4 years (26-85 years), 58.7±10.0 (26-84 years) for men and 62.3±10.7 (32-85 years) for women, employment duration was 32.9±8.8 (4-65 years), for men 34.0±8.6 (5-65 years), for women 30.7±8.8 (4-60 years. Most of myocardial infarction cases both in the group of men and women were noted in the age interval 56-60 years, 22.3% vs. 17.4%, respectively. The majority of examined men were farmers, low and middle management and self-employed workers. Among women prevailed clerks, seamstresses and farmers. The most frequent oc- cupational risk factors were: work-related stress, experienced by 54.2% of the examined subjects, occupational noise (45,5%), dust (41,7%) and various chemical factors (33%). A majority of the study group (76.5% women and 54.4% men) linked the cardiac infarction with stress, while 39.1% men vs. 16.5% women correlated it with physical effort. Conclusion: Our studies indicate that, among a wide spectrum of occupational factors, stress, noise and fine particulate dust are major contributors to the increased risk of myocardial infarction.