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Despite the constantly growing exposure to psychosocial hazards as well as their health and occupational consequences, research on psychosocial risks among musicians is exceptionally scarce. Moreover, previous studies on psychosocial risks and occupational stress among professional musicians have used a wide variety of measurement methods. The questionnaire we have developed assesses both the occurrence and stressfulness of particular work demands. Thus, it includes the “potential harm” caused by particular work aspects, described in the World Health Organization definition of psychosocial risks. Our questionnaire allows for measuring the general index of the occurrence and stressfulness of psychosocial risks in musicians’ work places, but also the occurrence and stressfulness of eight distinct categories of psychosocial risks: Job Content, Work Environment, Work-Home Interference, Relationships, Lack of Stability, Development Possibilities, Home-Work Interference, and Tools. The Psychosocial Risks Questionnaire for Musicians (PRQM) has satisfactory reliability (Cronbach’s alpha for the whole scale is 0.89 and from 0.74 to 0.86 for particular subscales). The PRQM correlates significantly with self-assessed work demands and stress symptoms (positive relationships) as well as with self-assessed physical and mental condition, control at work and coping ability (negative relationships).

International audience; In the context of a new annual eye lens dose limit for occupational exposure equal to 20mSv, European Radiation Dosimetry Group (EURADOS) organized an intercomparison dedicated to eye lens dosemeters, including photon and beta radiations. The objective was to complete the first intercomparison recently organized by EURADOS for photons and to update the overview of eye lens dosemeters available in Europe. The dosemeters provided by the 22 participants coming from 12 countries were all composed of thermoluminescent detectors. The dosemeters were irradiated with photon and beta fields defined in relevant standards. The results, provided by participants in terms of Hp(3), were compared to the reference delivered doses. Results are globally satisfactory for photons since 90% of the data are in accordance to the ISO 14146 standard requirements. The respective values for betas stress the fact that dosemeters designed for Hp(0.07) are not suitable to monitor the eye lens dose in case of betas. © The Author(s) 2018.

Non-small cell lung cancer is the most common type of lung cancer. Both environmental and genetic risk factors contribute to lung carcinogenesis. We conducted a genome-wide interaction analysis between single nucleotide polymorphisms (SNPs) and smoking status (never-versus ever-smokers) in a European-descent population. We adopted a two-step analysis strategy in the discovery stage: we first conducted a case-only interaction analysis to assess the relationship between SNPs and smoking behavior using 13 336 non-small cell lung cancer cases. Candidate SNPs with P-value

Supplemental Digital Content is available in the text., Background: Evidence is limited regarding risk and the shape of the exposure–response curve at low asbestos exposure levels. We estimated the exposure–response for occupational asbestos exposure and assessed the joint effect of asbestos exposure and smoking by sex and lung cancer subtype in general population studies. Methods: We pooled 14 case–control studies conducted in 1985–2010 in Europe and Canada, including 17,705 lung cancer cases and 21,813 controls with detailed information on tobacco habits and lifetime occupations. We developed a quantitative job-exposure-matrix to estimate job-, time period-, and region-specific exposure levels. Fiber-years (ff/ml-years) were calculated for each subject by linking the matrix with individual occupational histories. We fit unconditional logistic regression models to estimate odds ratios (ORs), 95% confidence intervals (CIs), and trends. Results: The fully adjusted OR for ever-exposure to asbestos was 1.24 (95% CI, 1.18, 1.31) in men and 1.12 (95% CI, 0.95, 1.31) in women. In men, increasing lung cancer risk was observed with increasing exposure in all smoking categories and for all three major lung cancer subtypes. In women, lung cancer risk for all subtypes was increased in current smokers (ORs ~two-fold). The joint effect of asbestos exposure and smoking did not deviate from multiplicativity among men, and was more than additive among women. Conclusions: Our results in men showed an excess risk of lung cancer and its subtypes at low cumulative exposure levels, with a steeper exposure–response slope in this exposure range than at higher, previously studied levels. (See video abstract at, http://links.lww.com/EDE/B161.)

BackgroundThe Coronavirus disease 2019 (COVID‐19) has evolved as a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS‐CoV‐)2. Allergists and other health care providers (HCPs) in the field of allergies and associated airway diseases are in the front line, taking care of patients potentially infected with SARS‐CoV‐2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics.MethodThe scientific information on COVID‐19 was analyzed by a literature search in Medline, Pubmed, national and international guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library and the Internet.ResultsBased on diagnostic and treatment standards developed by EAACI, on international information regarding COVID‐19, on guidelines of the World Health Organization (WHO) and other international organizations as well as on previous experience, a panel of experts including clinicians, psychologists, IT experts and basic scientists along with EAACI and the “Allergic Rhinitis and its Impact on Asthma (ARIA)” inititiative have developed recommendations for the optimal management of allergy clinics during the current COVID‐19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies.ConclusionsThis international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients whilst ensuring necessary safety in the current COVID‐19 pandemic.

RationaleSevere fetal malnutrition has been related to an increased risk of respiratory diseases later in life, but evidence for the association of a suboptimal diet during pregnancy with respiratory outcomes in childhood is conflicting. We aimed to examine whether a pro-inflammatory or low-quality maternal diet during pregnancy was associated with child's respiratory health.MethodsWe performed an individual participant meta-analysis among 18 326 mother–child pairs from seven European birth cohorts. Maternal pro-inflammatory and low-quality diets were estimated by energy-adjusted Dietary Inflammatory Index (E-DII) and Dietary Approaches to Stop Hypertension (DASH) scores. Preschool wheezing and school-age asthma were measured using questionnaires and lung function by spirometry.ResultsAfter adjustment for lifestyle and sociodemographic factors, we observed that a higher maternal E-DII score (a more pro-inflammatory diet) during pregnancy was associated only with a lower forced vital capacity (FVC) in children (z-score difference −0.05, 95% CI −0.08– −0.02, per interquartile range increase). No linear associations of the maternal E-DII or DASH score with child's wheezing or asthma were observed. In an exploratory examination of the extremes, a very low DASH score (ConclusionThe main results from this individual participant data meta-analysis do not support the hypothesis that maternal pro-inflammatory or low-quality diet in pregnancy are related to respiratory diseases in childhood.

Long-term exposure to hypercholesterolemia is the cause of atherosclerosis, which in turn causes cardiovascular and cerebrovascular events. In developed countries, including Poland, vascular diseases are the main cause of death. They affect an ever younger part of the population, including the working population. The authors address the problem of epidemiology of cardiovascular diseases, unsatisfactory detection and treatment, economic consequences for the health care system, and the possibilities of using occupational medicine services in the prevention of this health problem. Due to the fact that the early detection of diseases caused by high blood cholesterol levels is relatively low in Poland, obligatory occupational medicine examinations seem to be a key element of the second-line prevention. Therefore, it seems natural to consider the idea of extending the scope of obligatory examinations and introducing tests that allow lipid disorders to be detected at an early stage. This can contribute to a general improvement of the health of the population, and to economic benefits, such as a decrease in the costs of treatment of the disorders that have been detected too late. Broadening the scope of occupational examinations is also important from the perspective of public health and epidemiology of cardiovascular diseases, thus being an element of prevention of civilization diseases. It means improving health and building health awareness, and it should translate into regular health examinations. The performance of these examinations should result not only from the obligation, but also from the patient's conviction about the importance of early detection of disorders, including lipid disorders, for an effective therapy. Int J Occup Med Environ Health. 2019;32(6):865-72.

The aim of the literature review was to describe the environments where the presence of airborne Staphylococcus aureus was confirmed and to catalogue the most often used methods and conditions of bioaerosol sampling to identify the bacteria. The basis for searching of studies on S. aureus in the bioaerosol in different environments was PubMed database resources from the years 1990–2019 (May). The review included studies which were carried on in selected environments: hospitals and other health care facilities, large-scale animal breeding, wastewater treatment plants, residential areas, educational institutions, and other public places. The highest concentrations and genetic diversity of identified S. aureus strains, including MRSA (methicillin-resistant S. aureus), have been shown in large-scale animal breeding. The role of the airborne transmission in dissemination of infection caused by these pathogens is empirically confirmed in environmental studies. Commonly available, well-described, and relatively inexpensive methods of sampling, identification, and subtyping guarantee a high reliability of results and allow to obtain fast and verifiable outcomes in environmental studies on air transmission routes of S. aureus strains.

Road accidents are among the main fatalities worldwide and drowsy driving is a significant cause of road deaths where drivers are at fault. There are well known diseases which impair sensory and cognitive functions and can cause sleepiness during driving. Such diseases can be an important contraindication to driving because they may have an adverse effect on its safety. Thus, medical examinations for drivers should also be directed at identifying any possible conditions posing risks for driving safety. Occupational medicine specialists should look for symptoms of locomotor and sleep-related breathing disorders as these are medical conditions which could preclude a person from driving. In this case report, the authors describe a professional driver with chest deformity and present a pioneering attempt at assessing his medical fitness to drive. It is also explained why scoliosis can impair driving ability and how it should be diagnosed and treated. Finally, the authors describe how they used driving simulator tests as part of their diagnosis and suggest a relevant treatment regimen. Int J Occup Med Environ Health. 2019;32(5):735-45.

Experimental studies have shown cardiovascular effects of electromagnetic fields (EMF) emitted by mobile phones (e.g., prolonged QTc interval and abnormal blood pressure [BP] values). Also, stress may have an impact on the cardiovascular function. However, there are practically no data regarding the joint effect of exposure to stress and EMF, with both factors pertaining, e.g., to employees of mobile network operators.Out of 208 subjects who had taken part in survey research, 55 workers agreed to undergo resting ECG, 24-h ECG and ambulatory blood pressure monitoring (ABPM). Their health condition, occupational and life-stress levels and EMF exposure were also assessed.Among the workers using mobile phones for more than 60 min daily, the systolic BP values in office measurement and at night-time in ABPM were significantly higher than among the workers spending less time talking on mobile phones (p = 0.04 and p = 0.036, respectively). The workers with the highest level of occupational stress showed significantly higher systolic 24-h BP (p = 0.007) and at day-time (p = 0.002), both during work (p = 0.010) and after work (p = 0.005), and higher diastolic BP values at day-time (p = 0.028). Cardiovascular response was strongly gender-related: males showed more BP abnormalities while females displayed more impairments in ECG records. The heart rate from 24 h was significantly correlated with the level of occupational stress, after adjusting for gender, life-stress and EMF.The findings obtained thus far have indicated the need to conduct in-depth studies on the impact of stress and EMF emitted by mobile phones on the health effects, in order to clarify the observed gender-related differences in cardiovascular response to the combined exposure to stress and EMF. Med Pr. 2019;70(4):411-24.W badaniach eksperymentalnych zaobserwowano wpływ korzystania z telefonu komórkowego na pracę serca, m.in. wydłużenie odstępu QTc oraz zmiany w wartościach ciśnienia tętniczego. Także stres może wywoływać zmiany w układzie krążenia. Brak jednak badań uwzględniających jednoczesne oddziaływanie stresu i pola elektromagnetycznego (PEM). Oba czynniki dotyczą m.in. pracowników sieci komórkowych.Spośród 208 badanych we wcześniejszych etapach metodą ankietową 55 osób wyraziło zgodę na udział w dalszych badaniach [EKG spoczynkowe, 24-godzinna rejestracja EKG i ciśnienia tętniczego (W przypadku osób rozmawiających przez telefon komórkowy ponad 60 min dziennie ciśnienie skurczowe w pomiarze jednorazowym i ciśnienie skurczowe z nocy w badaniu ABPM były istotnie wyższe niż u rozmawiających krócej (odpowiednio, p = 0,04 i p = 0,036). Badani, u których stwierdzono najwyższy poziom stresu zawodowego, charakteryzowali się istotnie wyższym ciśnieniem skurczowym w okresie doby (p = 0,007) i dnia (p = 0,002), zarówno w pracy (p = 0,010), jak i po niej (p = 0,005), oraz wyższym ciśnieniem rozkurczowym w okresie dnia (p = 0,028). Reakcja układu krążenia była istotnie zależna od płci. U mężczyzn dominowały zaburzenia ciśnienia tętniczego, a u kobiet – zaburzenia przewodzenia w EKG. Częstość skurczów serca w okresie doby z uwzględnieniem wpływu płci, stresu ogólnego i PEM była istotnie skorelowana z poziomem stresu zawodowego.Uzyskane dotychczas wyniki wskazują na potrzebę dalszych badań w celu wyjaśnienia przyczyn różnej u kobiet i mężczyzn odpowiedzi układu krążenia na działanie stresu i PEM emitowanego przez telefony komórkowe. Med. Pr. 2019;70(4):411–424.

Every year in Poland almost 5 million prophylactic examinations (PEs) are carried out by occupational medicine specialists (OMPs) among workers, for the purposes envisaged in the Polish Labour Code. The aim of this study was to collect workers' opinions on the possible extension of these check-ups in the field of prophylaxis and prevention of civilization diseases (CivDs), focusing also on the "healthy lifestyle" recommendations.The study group comprised 325 employees who filled out an anonymous questionnaire containing questions about the possible extension of the PE scope for CivD and cancer prophylaxis. During medical check-ups, evaluation of the incidental glucose (IG) and total cholesterol (TCh) levels, waist circumference measurement and electrocardiography (ECG) were proposed. The respondents were asked about the most interesting issues for discussing with OMPs.Screening tests for some cancers (69.5%) and risk factors for CivDs (61.5%) were indicated as the most interesting topics to discuss with OMPs. The possibility for evaluating the levels of IG and TCh during PEs was approved by approx. 94.8% and 95.3% of the respondents, respectively. Almost 96% accepted having ECG and 80% agreed to waist circumference measurement. As many as 89.5% of the respondents supported the idea of organizing physical activities at their workplaces, and 77.8% were eager to learn about "healthy lifestyles" during training sessions conducted at their workplaces.Restricting the aim of PEs just to certifying the ability to work, or identifying certain medical contraindications, means losing a chance for implementing the prophylaxis and prevention of diseases' development among active working subjects. The kinds of activities proposed by the authors of this publication have been approved by the employees. Med Pr. 2019;70(4):425-33.Każdego roku w Polsce wykonuje się w celach przewidzianych w Kodeksie pracy prawie 5 mln badań profilaktycznych osób pracujących. Celem badania przeprowadzonego przez autorów artykułu było uzyskanie opinii pracowników na temat celowości poszerzenia zakresu tych badań o profilaktykę chorób cywilizacyjnych (m.in. działania edukacyjne dotyczące zdrowego stylu życia).Anonimową ankietę na temat rozszerzenia opieki o działania profilaktyczne dotyczące chorób cywilizacyjnych i nowotworowych wypełniło 325 pracowników. Zaproponowano uzupełnienie badań przeprowadzanych w celach przewidzianych w Kodeksie pracy o oznaczenie we krwi pobranej z opuszki palca glikemii przygodnej i cholesterolu całkowitego oraz wykonanie pomiaru obwodu brzucha i zapisu elektrokardiograficznego (EKG). Zapytano o najbardziej interesujące tematy, które powinien omówić lekarz służby medycyny pracy (SMP).Jako interesujące tematy najczęściej wskazywano badania przesiewowe w kierunku chorób nowotworowych (69,5%) oraz czynniki ryzyka chorób cywilizacyjnych (61,5%). Rozszerzenie zakresu badania profilaktycznego o EKG zaakceptowało 95,7% osób, pomiar stężenia cholesterolu całkowitego − 95,3%, oznaczenie glikemii przygodnej − 94,8%, pomiar obwodu brzucha − 80%. Aż 89,5% ankietowanych poparło organizację zajęć sportowych w miejscu pracy i/lub dofinansowanie przez pracodawcę dostępu do obiektów sportowych, a 77,8% badanych wyraziło chęć uczestniczenia w szkoleniach nt. zdrowego stylu życia w miejscu pracy.Ograniczenie badań lekarskich wskazanych w Kodeksie pracy do certyfikowania zdolności lub istnienia przeciwwskazań zdrowotnych do wykonywania określonej pracy skutkuje utratą szansy na wdrożenie profilaktyki schorzeń u osób aktywnych zawodowo, które mają poczucie pełnego zdrowia. Zaproponowane przez autorów publikacji rodzaje działań spotkały się z aprobatą pracowników. Med. Pr. 2019;70(4):425–433.

Professional drivers are exposed to a number of factors that have a negative influence on their health status. These include vibrations, noise, the lack of fresh air in the car cabin, shift work (frequently at night), monotony resulting from permanent repetition of certain actions, static loads due to immobilization in a sitting position, stress resulting from the need to ensure safety in heavy traffic, as well as air pollution (dust, volatile organic substances, nitrogen and sulfur oxides, polycyclic aromatic hydrocarbons, heavy metals, dioxins, furans and others). Factors associated with the specificity of the profession of a driver, including exposure to chemical substances, result in an increased risk of the development of many diseases, i.e., obesity, diabetes, heart disease, hypertension, extensive genitourinary pathology experienced by taxi drivers, lung cancer and other forms of cancer. In the case of drivers, especially those covering long distances, there are also actual difficulties related to ensuring a proper diet. Although attempts at interventional research that would change the principles of nutrition, as well as ensure physical activity and weight reduction, have been made, their results have not been satisfactory. The paper focuses on the discussion on the role of a diet and dietary phytochemicals in the prevention of adverse health effects of such chemicals as a mix of chemicals in the polluted air, benzo(a)pyrene, benzene and metals (lead, cadmium, chromium, nickel), which are the main sources of exposure in the case of transport workers. Int J Occup Med Environ Health. 2019;32(4):441-64.

OBJECTIVES: This study aimed at assessment of the perceived barriers and motivators to smoking cessation among socially-disadvantaged populations in Poland. It is hypothesized that different factors can be considered depending on the level of smoking addiction. Therefore, a comparison between light and heavy smokers was performed. MATERIAL AND METHODS: Data collected during the second wave of a cross-sectional study carried out in the Piotrkowski District in October 2016 - February 2017 among 1668 socio-economically disadvantaged persons constituted the source of information for the present study. Barriers and motivators to smoking cessation among daily smokers were identified via face-to face interviews. RESULTS: About one-third of the studied population admitted to being current daily smokers, almost 75% of whom were heavy smokers. The most common barriers to quitting smoking were related to difficulties in quitting (62%), the lack of willingness to quit (56%), as well as addiction and withdrawal symptoms (craving cigarettes [65%], habit [56%], stress and mood swings [55%]). A significantly higher proportion of such barriers was noted among heavy smokers compared to light smokers (p < 0.05). The following motivations to quit were pointed out by the respondents: available pharmacotherapy (47%), access to a free-of-charge cessation clinic (40%), and encouragement and support provided by their doctor (30%), with no differences between various levels of smoking addiction (p > 0.05). CONCLUSIONS: Developing effective interventions targeted at unique deprived populations requires understanding the barriers and motivators to quitting smoking. Social support and financial issues, including free-of-charge pharmacotherapy and cessation clinics, as well as doctor's encouragement and support, are crucial for successful smoking cessation in this vulnerable population

Objectives In the contemporary Western culture, working population health issues, stressed in various publications, have been perceived as a crucial part of public health. To deal with occupational health issues properly, occupational health services (OHS), aiming at the protection of the workers' health, are organized in many countries. The survey was to find the differences in occupational health systems that the European Economic Area countries use in order to execute prophylactic activities focused on diseases of affluence and how the OHS are used for health promotion actions. Material and methods The survey was conducted with the use of an on-line expert questionnaire. No deep statistical analysis was performed as for the designed aims of the study simple statistics were sufficient. Results All the reviewed countries have organized OHS. The funding mechanisms are based mainly on the financial involvement of employers. In the majority of countries, the main goal of the OHS is certification of the ability to work. Workplace surveillance aiming at the occupational risk assessment and health promotion activities that focus on work-related and/or occupational diseases are the most popular services provided within national systems. Conclusions Occupational health professionals are well placed to perform actions directed at health promotion and prophylactics of a wide range of diseases - not only occupational/work-related, but also non-communicable, particularly life-style-related diseases of affluence. The engagement of the occupational medical services (OMS) in prevention of the non-work-related health issues would be valuable. However, it would be inevitable for employers to finance a wider range of services to a greater extent. Int J Occup Med Environ Health. 2019;32(3):353-61.

The shift work system may affect the temporal distribution of eating and diet quality. The paper aimed at reviewing a body of research examining the associations between night shift work and dietary habits among nurses. Data from the PubMed and Google Schoolar databases, as well as references lists in selected papers were searched. The authors used the following keywords: nurses, shift work, diet, nutrition. Papers published in English or Polish were selected for the review, and as many as 19 papers published in 2000-2017 were eventually identified. The studies varied greatly with respect to the study size, subjects' age and the duration of night shift work. The major problem was the heterogeneity of the tools used for dietary assessment. Self-administered questionnaires were used and analyses were rarely adjusted for confounders. Alcohol consumption was the most frequently analyzed aspect (N = 8 studies), followed by the total energy (N = 7), protein, fat (N = 6), and carbohydrate intake, coffee and fruit consumption (N = 5). The results showed quite a consistent association of night work with higher coffee (caffeine) consumption, as well as lower alcohol, and fruit and vegetables consumption. Few studies also reported more frequent snacks consumption, later time of the last meal, eating at night, meals irregularity, and a poorer diet quality among night shift nurses when compared to the reference. The review showed some poor nutritional habits among nurses working night shifts. However, the topic warrants further attention, owing to the relatively small number of the studies performed so far, and their numerous methodological limitations. Med Pr. 2019;70(3):363-76.The shift work system may affect the temporal distribution of eating and diet quality. The paper aimed at reviewing a body of research examining the associations between night shift work and dietary habits among nurses. Data from the PubMed and Google Schoolar databases, as well as references lists in selected papers were searched. The authors used the following keywords: nurses, shift work, diet, nutrition. Papers published in English or Polish were selected for the review, and as many as 19 papers published in 2000−2017 were eventually identified. The studies varied greatly with respect to the study size, subjects’ age and the duration of night shift work. The major problem was the heterogeneity of the tools used for dietary assessment. Self-administered questionnaires were used and analyses were rarely adjusted for confounders. Alcohol consumption was the most frequently analyzed aspect (N = 8 studies), followed by the total energy (N = 7), protein, fat (N = 6), and carbohydrate intake, coffee and fruit consumption (N = 5). The results showed quite a consistent association of night work with higher coffee (caffeine) consumption, as well as lower alcohol, and fruit and vegetables consumption. Few studies also reported more frequent snacks consumption, later time of the last meal, eating at night, meals irregularity, and a poorer diet quality among night shift nurses when compared to the reference. The review showed some poor nutritional habits among nurses working night shifts. However, the topic warrants further attention, owing to the relatively small number of the studies performed so far, and their numerous methodological limitations. Med Pr. 2019;70(3):363–76.

Cytostatics not only induce significant side-effects in patients treated oncologically but also pose a threat to the health of occupationally exposed healthcare workers: pharmacists, physicians, nurses and other personnel. Since the 1970s numerous reports from various countries have documented the contamination of working areas with cytostatics and the presence of drugs/metabolites in the urine or blood of healthcare employees, which directly indicates the occurrence of occupational exposure to these drugs. In Poland the significant scale of occupational exposure to cytostatics is also confirmed by the data collected in the central register of occupational carcinogens/mutagens kept by the Nofer Institute of Occupational Medicine. The assessment of occupational exposure to cytostatics and health risks constitutes employers' obligation. Unfortunately, the assessment of occupational risk resulting from exposure to cytostatics raises a number of concerns. Provisions governing the problem of workers' health protection are not unequivocal because they derive from a variety of law areas, especially in a matter of hazard classification and safety data sheets for cytostatics. Moreover, no legally binding occupational exposure limits have been set for cytostatics or their active compounds, and analytical methods for these substances airborne and biological concentrations are lacking. Consequently, the correct assessment of occupational exposure to cytostatics, the evaluation of health hazards and the development of the proper preventive strategy appear difficult. The authors of this article described and discussed the amendments to the European provisions concerning chemicals in the light of employers' obligations in the field of employees' heath protection against the consequences of exposure to cytostatics. Some modifications aimed at a more effective health protection of workers occupationally exposed to cytostatics were also proposed. Int J Occup Med Environ Health. 2019;32(2):141-59.

Objectives The objective of this study was to evaluate the association between breastfeeding duration and child neurodevelopment based on the Polish Mother and Child Cohort Study. Material and Methods The current analysis included 501 mother–child pairs. The analysis evaluating the association between the length of breastfeeding and child neurodevelopment considered the following variables: maternal age and body mass index, weight gain during pregnancy, parental level of education, marital status, socioeconomic status, child gender, birthweight, type of delivery, preterm delivery, pre- and postnatal exposure to tobacco constituents and child day care attendance. Psychomotor development was assessed in 1-year-olds on the Bayley Scales of Infant and Toddler Development . Results The length of breastfeeding correlated positively with maternal age at delivery (ρ = 0.13), maternal and paternal level of education (ρ = 0.2 and ρ = 0.14 respectively), birthweight (ρ = 0.1) and marital status (ρ = 0.16) (p < 0.05). A negative correlation between the length of breastfeeding and maternal smoking status during the first year after delivery (ρ = –0.19) and weight gain during pregnancy (r = –0.1) was observed (p < 0.05). The association between the duration of breastfeeding and child development was not statistically significant in the model with the inclusion of confounding variables. A significant association between language development and maternal level of education (p = 0.004), gender of the child (p = 0.0007) and maternal weight gain during pregnancy (p = 0.01) was found. A negative association between cognitive development and maternal salivary cotinine during pregnancy (p = 0.03) and a negative association between motor development and maternal smoking status during the first year after delivery (p = 0.007) were also found. Conclusions This study found no significant association between the duration of breastfeeding and child development after adjustment for confounders. Int J Occup Med Environ Health. 2019;32(2):175–84

Background: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from cardiovascular disease attributable to exposure to occupational noise, to inform the development of the WHO/ILO joint methodology. Objectives: We aim to systematically review studies on exposure to occupational noise (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational noise on cardiovascular diseases (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. Data sources: Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science and CISDOC. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand search reference list of previous systematic reviews and included study records; and consult additional experts. Study eligibility and criteria: We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (

Objective: Evidence on the impact of leisure time physical activity (LTPA) in pregnancy on birth size is inconsistent. We aimed to examine the association between LTPA during early and late pregnancy and newborn anthropometric outcomes.Design: Individual level meta‐analysis, which reduces heterogeneity across studies.Setting: A consortium of eight population‐based studies (seven European and one US) comprising 72 694 participants.Methods: Generalised linear models with consistent inclusion of confounders (gestational age, sex, parity, maternal age, education, ethnicity, BMI, smoking, and alcohol intake) were used to test associations between self‐reported LTPA at either early (8–18 weeks gestation) or late pregnancy (30+ weeks) and the outcomes. Results were pooled using random effects meta‐analyses.Main outcome measures: Birth weight, large‐for‐gestational age (LGA), macrosomia, small‐for‐gestational age (SGA), % body fat, and ponderal index at birth.Results: Late, but not early, gestation maternal moderate to vigorous physical activity (MVPA), vigorous activity, and LTPA energy expenditure were modestly inversely associated with BW, LGA, macrosomia, and ponderal index, without heterogeneity (all: I2 = 0%). For each extra hour/week of MVPA, RR for LGA and macrosomia were 0.97 (95% CI: 0.96, 0.98) and 0.96 (95% CI: 0.94, 0.98), respectively. Associations were only modestly reduced after additional adjustments for maternal BMI and gestational diabetes. No measure of LTPA was associated with risk for SGA.Conclusions: Physical activity in late, but not early, pregnancy is consistently associated with modestly lower risk of LGA and macrosomia, but not SGA.Tweetable abstract: In an individual participant meta‐analysis, late pregnancy moderate to vigorous physical activity modestly reduced birth size outcomes.

Noise in entertainment industry often reaches high sound pressure levels. Nevertheless, the risk of hearing loss in this sector is insufficiently recognized. The aim of this study was the assessment of the relationship between noise exposure and temporary threshold shifts (TTS) for people working as bartenders at a variety of entertainment venues.The study comprised a total of 18 bartenders (mean age was 25±7 years old) employed at a music club (N = 8), pub (N = 5) and discotheque (N = 5). Personal dosimeters were used for determining noise levels and frequency characteristics. Hearing was evaluated by pre- (before work) and post-exposure (up to 15 min after the end of work) pure tone audiometry. Hearing tests were carried out for bartenders during 2 or 3 sessions while working on weekends.The mean personal noise exposure level normalized to a nominal 8-hour working day was 95 dBA, above 4 times higher than the accepted legal limit. The TTS values (10 dB HL or more) were significant at 4 kHz for both ears for 77% of bartenders.People working as bartenders represent a professional group with an increased risk of hearing loss. Raising awareness of this fact and implementing hearing protection programs in this group of workers is urgently needed, in line with the European Commission Directive (EU Directive 2003/10/EC). Med Pr. 2019;70(1):17-25.W przemyśle rozrywkowym hałas często osiąga wysokie poziomy ciśnienia akustycznego, jednak ryzyko uszkodzenia słuchu w tym sektorze nie zostało jeszcze dokładnie ocenione. Celem pracy była ocena związku między ekspozycją na wysoki poziom dźwięku a czasowym przesunięciem progu słuchu u osób pracujących na stanowisku barmana w lokalach rozrywkowych.Badaniem objęto 18 barmanów (średni wiek: 25±7 lat) zatrudnionych w klubie muzycznym (N = 8), pubie (N = 5) i dyskotece (N = 5). Poziomy dźwięków oraz charakterystyka częstotliwościowa hałasu były określane za pomocą dozymetrii indywidualnej. Progi słuchu oceniano za pomocą audiometrii tonalnej przeprowadzanej przed rozpoczęciem dnia pracy oraz bezpośrednio (do 15 min) po jego zakończeniu. Badania słuchu przeprowadzono u barmanów w czasie 2 lub 3 sesji badawczych podczas pracy w weekendy. Uzyskano 92 audiogramy przed- i poekspozycyjne.Uśrednione równoważne poziomy dźwięku odniesione do 8-godzinnego dnia pracy w ocenianych 3 lokalach muzycznych wynosiły 95 dBA, przekraczając ponad czterokrotnie dopuszczalne prawnie normy. U 77% badanych osób wykazano przynajmniej w 1 sesji pomiarowej czasowe przesunięcia progów słuchu ≥ 10 dB HL dla częstotliwości 4 kHz.Osoby pracujące na stanowisku barmana stanowią grupę zawodową o podwyższonym ryzyku utraty słuchu. Niezbędne jest zwiększanie świadomości tego faktu oraz wdrażanie u tych pracowników programów ochrony słuchu, zgodnie z dyrektywą Komisji Europejskiej (EU 2003/10/WE). Med. Pr. 2019;70(1):17–25.

International audience; Systemic mastocytosis (SM) is a hematologic neoplasm with abnormal accumulation of mast cells in various organ systems such as the bone marrow, other visceral organs and skin. So far, only little is known about epigenetic changes contributing to the pathogenesis of SM. In the current article, we provide an overview of epigenetic changes that may occur and be relevant to mastocytosis, including mutations in genes involved in epigenetic processes, such as TET2, DNMT3A and ASXL1, and global and gene-specific methylation patterns in neoplastic cells. Moreover, we discuss methylation-specific pathways and other epigenetic events that may trigger disease progression in mast cell neoplasms. Finally, we discuss epigenetic targets and the effects of epigenetic drugs, such as demethylating agents and BET-targeting drugs, on growth and viability of neoplastic mast cells. The definitive impact of these targets and the efficacy of epigenetic therapies in advanced SM need to be explored in future preclinical studies and clinical trials.

Background Mounting evidence suggests that maternal diet influences pregnancy and birth outcomes, but its contribution to the global epidemic of childhood obesity has not as yet been definitively characterized. We investigated whether maternal whole diet quality and inflammatory potential influence childhood adiposity. Methods We harmonized and pooled individual participant data from 16,295 mother-child pairs in seven European birth cohorts. Maternal pre-, early-, late-, and whole-pregnancy (any time during pregnancy) dietary quality and inflammatory potential assessed with the Dietary Approaches to Stop Hypertension (DASH) score and the energy-adjusted Dietary Inflammatory Index (E-DII™) score, respectively. Primary outcome was childhood overweight and obesity (OWOB) (age-and-sex-specific BMI z-score > 85th percentile). Secondary outcomes were sum of skinfold thickness (SST), fat mass index (FMI) and fat-free mass index (FFMI). We used multivariable regression analyses (adjusting for maternal lifestyle and sociodemographic factors) to assess the associations of maternal DASH and E-DII scores with offspring adiposity outcomes in cohort-specific analyses, with subsequent random-effect meta-analyses. Results The study mothers had a mean (SD) age of 30.2 (4.6) years and a mean BMI of 23.4 (4.2) kg/m2. Higher early-pregnancy E-DII scores (more pro-inflammatory diet) tended to be associated with a higher odds of late-childhood [10.6 (1.2) years] OWOB [OR (95% CI) 1.09 (1.00, 1.19) per 1-SD E-DII score increase], whereas an inverse association was observed for late-pregnancy E-DII score and early-childhood [2.8 (0.3) years] OWOB [0.91 (0.83, 1.00)]. Higher maternal whole pregnancy DASH score (higher dietary quality) was associated with a lower odds of late-childhood OWOB [OR (95% CI) 0.92 (0.87, 0.98) per 1-SD DASH score increase]; associations were of similar magnitude for early and late-pregnancy [0.86 (0.72, 1.04) and 0.91 (0.85, 0.98), respectively]. These associations were robust in several sensitivity analyses and further adjustment for birth weight and childhood diet did not meaningfully alter the associations and conclusions. In two cohorts with available data, a higher whole pregnancy E-DII and lower DASH scores were associated with a lower late-childhood FFMI in males and a higher mid-childhood FMI in females (P interactions Conclusions A pro-inflammatory, low-quality maternal antenatal diet may adversely influence offspring body composition and OWOB risk, especially during late-childhood. Promoting an overall healthy and anti-inflammatory maternal dietary pattern may contribute to the prevention of childhood obesity, a complex health issue requiring multifaceted strategy.

The German Social Accident Insurance supported this study (grant number FP 271)., Hovanec J, Siemiatycki J, Conway DI, Olsson A, Guenel P, Luce D, Jöckel KH, Pohlabeln H, Ahrens W, Karrasch S, Wichmann HE, Gustavsson P, Consonni D, Merletti F, Richiardi L, Lorenzo S, Fortes C, Parent MÉ, McLaughlin JR, Demers P, Landi MT, Caporaso N, Fernández-Tardón G, Zaridze D, Świątkowska B, Pándics T, Lissowska J, Fabianova E, Field JK, Mates D, Bencko V, Foretova L, Janout V, Kromhout H, Vermeulen R, Boffetta P, Straif K, Schüz J, Casjens S, Pesch B, Brüning T, Behrens T.

The etiology of cancer is multifactorial. Malignant tumors caused by factors occurring in the work environment, classified as carcinogenic in humans, can be recognized as an occupational disease. Analysis of epidemiological data indicates a significant underestimation of occupational cancer, mainly due to long latency period of these diseases. This publication provides guidance to certify occupational etiology of malignant tumors, based on the reviews of existing legislation and medical literature, as well as on the experience of their authors. The publication presents the epidemiology of cancers, including occupational cancers, risk factors, occupational carcinogens and presents the principles of occupational cancer certification. Med Pr 2018;69(1):93-108. Etiologia chorób nowotworowych jest wieloczynnikowa. Nowotwory złośliwe powstałe w następstwie działania czynników występujących w środowisku pracy, uznanych za rakotwórcze dla ludzi, mogą być rozpoznane jako choroba zawodowa. Analiza danych epidemiologicznych wskazuje na istotne niedoszacowanie nowotworów zawodowych, czego główną przyczyną jest długi okres latencji tych schorzeń. Publikacja zawiera wytyczne do orzekania o zawodowej etiologii nowotworów złośliwych przygotowane na podstawie obowiązujących aktów prawnych, publikacji medycznych i doświadczeń własnych autorów pracy. W publikacji przedstawiono epidemiologię chorób nowotworowych, w tym pochodzenia zawodowego, czynniki ryzyka chorób nowotworowych i czynniki rakotwórcze w miejscu pracy. Podano też zasady orzekania o nowotworach zawodowych. Finansowanie / Funding: projekt pn. „Paszport zdrowej kobiety w profilaktyce chorób nowotworowych” nr IS-2/94/NCBR/2015, finansowany przez Narodowe Centrum Badań i Rozwoju w ramach programu Innowacje Społeczne (II konkurs). Wartość projektu: 798 419,43 zł, wartość dofinansowania: 725 000 zł. Kierownik projektu: dr hab. n. med. Marta Wiszniewska, prof. IMP.

The aim of the article was to summarize the results offered in the research on occupational functioning of women with endometriosis. We followed PRISMA guidelines. Database search was done in November 2017 using EBSCO. In the review were included the articles clearly referring to the relationships between endometriosis and work or any aspect of work (e.g., work productivity, work ability, absenteeism). Eight papers were included in the final review. Seven studies were cross-sectional, 1 retrospective. The majority of researchers used standardized research measures, such as Work Ability Index, Work Productivity and Activity Impairment Questionnaire or Health Related Productivity Questionnaire. Only in 2 studies the reference group was considered, one of them consisted of healthy women. The results clearly indicate that endometriosis is a disease that causes major disturbance in occupational functioning of the suffering women. In the future the researchers should search for individual and organizational correlates of the improvement of occupational functioning in this group of patients. The methodology of the existing studies has been evaluated and the methodological cues for future research has been given. Med Pr 2018;69(6):663-671. The aim of the article was to summarize the results offered in the research on occupational functioning of women with endometriosis. We followed PRISMA guidelines. Database search was done in November 2017 using EBSCO. In the review were included the articles clearly referring to the relationships between endometriosis and work or any aspect of work (e.g., work productivity, work ability, absenteeism). Eight papers were included in the final review. Seven studies were cross-sectional, 1 retrospective. The majority of researchers used standardized research measures, such as Work Ability Index, Work Productivity and Activity Impairment Questionnaire or Health Related Productivity Questionnaire. Only in 2 studies the reference group was considered, one of them consisted of healthy women. The results clearly indicate that endometriosis is a disease that causes major disturbance in occupational functioning of the suffering women. In the future the researchers should search for individual and organizational correlates of the improvement of occupational functioning in this group of patients. The methodology of the existing studies has been evaluated and the methodological cues for future research has been given. Med Pr 2018;69(6):663–671.

Objectives Welding processes that generate fumes containing toxic metals, such as hexavalent chromium (Cr(VI)), manganese, and nickel (Ni), have been implicated in lung injury, inflammation, and lung tumor promotion in animal models. Bronchiolar epithelium Clara cells/club cells, coordinate these inflammatory responses. Clara cells secretory protein (CC16) with ant-inflammatory role. Material and methods The pulmonary toxicity of welding dust (WD) was assessed for Wistar rats exposed to 60 mg/m3 of respirable-size welding dust (mean diameter 1.17 μm for 1 and 2 weeks (6 h/day, 5 days/week)) or the aerosols of soluble form (SWD) in the nose-only exposure chambers. Additionally the effect of antiinflammatory betaine supplementation was assessed. Clara cells secretory protein, differential cell counts, total protein concentrations and cellular enzyme (lactate dehydrogenase - LDH) activities were determined in bronchoalveolar lavage fluid, and corticosterone and thiobarbituric acid reactive substances (TBARS) and prolactin concentrations were assessed in serum. Histopathology examination of lung, brain, liver, kidney, spleen was done. Additionally slices of brain and lung were exanimated in laser ablation inductively coupled plasma mass spectrometry. Results Both WD and SWD exposure evoked large bronchiolar infiltration shoved in histopathology examination. In this study, TBARS inversely correlated with a significant decrease of CC16 concentration that occurred after instillation of both WD and SWD indicating decreased anti- inflammatory potential in the lung. In WD exposed rats prolactin correlated with nuclear factor-kappa B (NF-κB), LDH, TBARS and serum levels Cr, Ni and inversely with c-Jun. In SWD exposed rats prolactin correlated with CC16 indicated effect of prolactin on the population of epithelial cells. Conclusions In the current study, deleterious effects of repeated inhalation stainless steel welding dust form on club (Clara) cell secretory protein (CC16) were demonstrated. Clara cells secretory protein relation with prolactin in exposed rats to welding dust were shown and explored whether the NF-κB and c-Jun/activator protein 1 related pathway was involved. Int J Occup Med Environ Health 2018;31(5):613-632.

Paper presents the intentional use of biological agents for industrial, diagnostic and research purposes in enterprises in Poland.The source of data is the National Register of Biological (in Polish KRCB) - the type of the database that gathers data about the intentional use of biological agents at work in Poland. The analysis includes tabular summaries of the data as of December 2017.Notifications were sent by 598 enterprises for: diagnostic - 67.5%, research - 25% and industrial purposes - 75%. Those mostly were hospital diagnostic laboratories - 36%, entities other than hospitals - 32% and higher education and research units - 13%. In total, 4477 workers (91.3% women, 8.7% men) were exposed to biological agents. Agents from 2nd and 3rd group of risk were used in 581 and 106 enterprises, respectively.The network organization, legal base and central nature cause that the KRCB is a unique database that allows for diagnosis of the situation and tracking of dynamics in the context of occupational exposure to biological agents used intentionally in enterprises in Poland. Med Pr 2018;69(4):413-424.Publikacja prezentuje zamierzone użycie czynników biologicznych w celach przemysłowych, diagnostycznych oraz naukowo- badawczych w przedsiębiorstwach w Polsce według stanu na grudzień 2017 r.Dane pochodzą z Krajowego Rejestru Czynników Biologicznych (KRCB) – bazy danych, w której gromadzone są informacje o celowym użyciu czynników biologicznych w procesach pracy w Polsce.Od 598 polskich przedsiębiorstw uzyskano zgłoszenia użycia czynników biologicznych w celach: diagnostycznych – 67,5%, naukowo-badawczych – 25% i przemysłowych – 7,5%. Najwięcej zgłoszeń przesłały laboratoria diagnostyczne przyszpitalne – 36% i inne niż przyszpitalne – 32% oraz szkoły wyższe i jednostki naukowo-badawcze – 13%. Ogółem wskazano 4477 narażonych pracowników (91,3% kobiet, 8,7% mężczyzn). Czynniki z 2. i 3. grupy zagrożenia stosowało odpowiednio 581 i 106 zakładów. Najczęściej wykorzystywano bakterieSposób organizacji, umocowanie prawne oraz centralny charakter powodują, że KRCB stanowi unikalną bazę danych, umożliwiającą diagnozę sytuacji oraz śledzenie dynamiki w czasie w kontekście zawodowej ekspozycji na szkodliwe czynniki biologiczne celowo stosowane w zakładach pracy w Polsce. Med. Pr. 2018;69(4):413–424.

Cadmium (Cd) is regarded as a potential endocrine disruptor. However, the exact mechanism by which this metal may interfere with the reproductive system has not yet been elucidated. The present study aimed to investigate the effect of subacute Cd oral administration at daily doses of 0.09, 1.8, and 4.5 mgCd/kg b.w. and the impact of Cd on sex hormones (estradiol (E2) and progesterone (P)) in the plasma and uterus, as well as on estrous cyclicity and histopathological changes in uterine and ovary in female rats after terminating the exposure and after a prolonged observation period (3 months). Moreover, Cd bioaccumulation in the uterine and brain tissue of rats was analyzed. The study revealed that oral Cd exposure induced changes in the plasma levels of steroid hormones: decrease in E2 and increase in P after the highest dose of Cd. Probably, for the first time, it was evidenced that circulation sex hormone disturbances in Cd-exposed rats caused irregular estrous cycle, persisting for 3 months after exposure termination; no alterations in these hormone levels in uterine tissue were noted. Cd did not induce estradiol-like hyperplasia of endometrium, but resulted in endometrial edema irrespective of the dose, and caused damage of the ovaries after the highest dose. In summary, subacute oral exposure of female rats to Cd may lead to long-term disturbances in reproductive system.

Morphine and related drugs, which are the most effective analgesics for the relief of severe pain, act through activating opioid receptors. The endogenous ligands of these receptors are opioid peptides which cannot be used as antinociceptive agents due to their low bioactivity and stability in biological fluids. The major goal of opioid research is to understand the mechanism of action of opioid receptor agonists in order to improve therapeutic utility of opioids. Analgesic effects of morphine are mediated mostly through activation of the mu opioid receptor. However, in the search for safer and more effective drug candidates, analogs with mixed opioid receptor profile gained a lot of interest. Recently, the concept of biased agonists able to differentially activate GPCR downstream pathways, became a new approach in the design of novel drug candidates. It is hypothesized that compounds promoting G-protein signaling may produce analgesia while β-arrestin recruitment may be responsible for opioid side effects. In this report we showed that replacement of the tyrosine residue in the mu-selective ligand Tyr-c[d-Lys-Phe-Asp]NH2 with 2',6'-dimethyltyrosine (Dmt) produced a cyclopeptide Dmt-c[d-Lys-Phe-Asp]NH2 with mu/delta opioid receptor agonist profile. This analog showed improved antinociception in the hot-plate test, probably due to the simultaneous activation of mu and delta receptors but also significantly inhibited the gastrointestinal transit. Using the bioluminescence resonance energy transfer (BRET) assay it was shown that this analog was a mu receptor agonist biased toward β-arrestin. β-Arrestin-dependent signaling is most likely responsible for the observed inhibition of gastrointestinal motility exerted by the novel cyclopeptide. This work was supported by the Polpharma Scientific Foundation grant (11/XIII/2014 to KG) and grants from the Medical University of Lodz (No 503/1-156-02/503-11-002 and 502-03/1-156-02/502-14-301) and from the University of Ferrara (FAR grant to G.C.). KG is recipients of the Polish L’Oréal UNESCO Awards for Women in Science.

Introduction. The exact level of exposure experienced by nuclear medicine personnel, whose work often requires performing manual procedures involving radioactive isotopes, is associated with the form of radiation source used. The variety of radionuclides and medical procedures, and the yearly increase in the number of patients, as well as the change of the individual dose limit for the lens of the eye from a value of 150 mSv yr−1 to 20 mSv yr−1, mean that issues of eye lens routine dosimetry become interesting from the radiation protection point of view. Objective. This paper presents an analysis of the exposure of the eye lenses of nuclear medicine department personnel, as well as those of personnel in the facilities that produce radiopharmaceuticals for the purpose of diagnosis by positron emission tomography, from the viewpoint of the advisability of routine eye lens exposure monitoring, taking into account changes in the dose limit for the lens of the eye. Materials and methods. The paper considers the two most commonly used radionuclides for diagnostic purposes 99mTc, 18F, and—for therapeutic purposes—131I. Dose measurements were made using thermoluminescent detectors. Results. The estimated exposure analysis identifies the cases when the maximum annual value of the personal dose equivalent, in terms of Hp(3), exceeds threefold the new limit value (20 mSv yr−1). Conclusions. It is recommended that Hp(3) doses be routinely monitored in the group of radiopharmacists who label pharmaceuticals with the radionuclide 99mTc and in chemists working in 18F-FDG quality control departments in production units, where this is carried out manually.

Background: Due to high prevalence, insufficient recognition, and ineffective treatment, hypertension (HT) still remains a major medical and socio-economic problem. There is a real necessity to develop effective prophylaxis for cardiovascular disorders (CVD), based on strategies that support compliance during long-term therapy. The Polish scheme of occupational health services with mandatory periodical employee check-ups creates a unique opportunity for effective HT prophylaxis. As a result, visiting a doctor is required not only due to health ailments but also by law, which is especially important for those feeling well. It enables an improvement in tertiary prevention, including actions taken not only by the doctors of the occupa­tional health services, but also by the physicians in charge of treating the patients. Aim: Evaluation of the usefulness of mandatory health check-ups of employees concerning frequency of diagnosis and im­provement of treatment outcomes of HT. Methods: The study group comprised 1010 Polish workers referred by their employers for mandatory medical examinations. All of the study participants filled in a questionnaire focused on self-assessment of their health, current blood pressure (BP) mea­surements, and in cases where HT had been previously detected — compliance with medical recommendations. Then in the doctor’s office BP measurements were taken twice. Workers who fulfilled a criterion indicating a need for intervention were educated on optimal diet, physical activity, and risk factors for CVD. They also received medical instructions for three-step action. The first recommendation: measure BP three times a day for one week and record the results. The second: visit a gen­eral practitioner (GP) for a professional assessment of those results. The third: re-visit the occupational health physician within three months. The criterion for intervention was prior HT and a mean of two BP measurements ≥ 180/110 mmHg — in each case, or ≥ 140/90 mmHg — in the case of occupational exposure to risk factors for CVD. Results: The mean age of the study participants was 41.7 years (similar in both genders). A previous diagnosis of HT was declared by 20.1% of patients. 11% of patients involved in the intervention did not comply with medical advice. The current HT therapy of all of the subjects with HT (100% of those with abnormal BP, who visited their GP) was modified. Conclusions: Prophylactic medical check-ups of workers gives improved compliance and medical surveillance of HT in patients with an uncontrolled clinical course of this disease. Obligations and periodic examinations encourage both patients and physicians to improve compliance and reduce the risk of therapeutic inertia.

With the aim to dissect the effect of adult height on head and neck cancer (HNC), we use the Mendelian randomization (MR) approach to test the association between genetic instruments for height and the risk of HNC. 599 single nucleotide polymorphisms (SNPs) were identified as genetic instruments for height, accounting for 16% of the phenotypic variation. Genetic data concerning HNC cases and controls were obtained from a genome-wide association study. Summary statistics for genetic association were used in complementary MR approaches: the weighted genetic risk score (GRS) and the inverse-variance weighted (IVW). MR-Egger regression was used for sensitivity analysis and pleiotropy evaluation. From the GRS analysis, one standard deviation (SD) higher height (6.9 cm; due to genetic predisposition across 599 SNPs) raised the risk for HNC (Odds ratio (OR), 1.14; 95% Confidence Interval (95%CI), 0.99–1.32). The association analyses with potential confounders revealed that the GRS was associated with tobacco smoking (OR = 0.80, 95% CI (0.69–0.93)). MR-Egger regression did not provide evidence of overall directional pleiotropy. Our study indicates that height is potentially associated with HNC risk. However, the reported risk could be underestimated since, at the genetic level, height emerged to be inversely associated with smoking.

Apelin is a novel peptide of wide expression and multiple biological functions including the crucial role in cardiovascular homeostasis. The apelin role in the pathophysiology of heart rhythm disorders is considered, although the reports are scarce so far. The purpose of this study is to investigate the potential utility of apelin as a marker of arrhythmia recurrence after direct-current cardioversion (DC). The prospective, observational study included 60 patients (aged 41–86; 30% female) with nonvalvular, persistent atrial fibrillation from the group of 204 consecutive patients scheduled for DC during the 12-month period (from May 2010 to May 2011) in the Cardiology Clinic Medical University of Lodz, Poland. The study group was divided into SCD (successful DC), 45 (75%) patients, and NDC (nonsuccessful DC), 15 (25%) patients. Within the SCD group, the subgroups were distinguished depending on the time sinus rhythm maintenance after DC: up to 7 days (SDC-7), 11 patients; 7 to 30 days (SDC-30), 12 patients; over 90 days (SDC-90), 22 patients. Patients were evaluated during the hospitalization and within the 3-month follow-up period. The apelin level was determined within the plasma samples collected at the admission, using the commercially available enzyme-linked immunosorbent assay (ELISA) Kit for apelin-36. It was found that the median value of initial apelin in the subset of patients from groups NDC + SDC-7 + SDC-30 is significantly higher than from group SDC-90 (p=0.0463); there was no relationship between NDC and SCD overall. Neither of the compared subgroup pairs revealed statistically significant correlation between the proBNP concentration and the DC effectiveness in our population. In conclusion, in our study, proBNP was not a marker of arrhythmia recurrence whereas higher apelin concentration at the admission indicated patients in whom DC was not effective or they had an arrhythmia recurrence within a month-period observation.

Introduction The development of patient rights and increasing number of lawsuits based on medical malpractice make medical doctors constantly improve knowledge regarding the acceptability of changing the scope of operation. This is particularly important when patients have expressed their refusal to changing the scope and type of procedure (ESTP) or no informed consent (IC) has been obtained from the patient prior to the procedure. Material and methods The method of study comprised content analysis of existing legislation. The current jurisprudence and doctrine were confronted with existing regulations. An algorithm of correct formal procedures was elaborated. Results The doctor has right to realize ESTP when the patient has not given the consent to it or the refusal expressed by him was not fully conscious. Healthcare providers are absolutely prohibited from realizing ESTP when patient objected to any changes being thoroughly informed by the physician prior to the operation. When patient refuses possible ESTP, the doctor has the right to withdraw from performing surgery but should inform the patient about other places, where a similar procedure can be provided.

Chronic sleep restriction may affect metabolism, hormone secretion patterns and inflammatory responses. Limited reports suggest also epigenetic effects, such as changes in DNA methylation profiles. The study aims to assess the potential association between poor sleep quality or sleep duration and the levels of 5-methylcytosine in the promoter regions of selected tumor suppressor genes. A cross-sectional study was conducted on 710 nurses and midwives aged 40-60 years. Data from interviews regarding sleep habits and potential confounders were used. The methylation status of tumor suppressor genes was determined via qMSP reactions using DNA samples derived from leucocytes. No significant findings were observed in the total study population or in the two subgroups of women stratified by the current system of work. A borderline significance association was observed between a shorter duration of sleep and an increased methylation level in CDKN2A among day working nurses and midwives. Further studies are warranted to explore this under-investigated topic. This project was supported by the Norway Grants, under the Polish-Norwegian Research Programme (Grant no. PNRF – 243 – AI – 1/07 and Pol-Nor/196940/22/2013-clockshift).

Manicurists are exposed to various chemicals in nail and skin care products and may develop ocular, nasal, respiratory or skin adverse reactions to them. To investigate the occurrence of ocular, nasal, respiratory and skin problems among manicurists and to identify their causal factors, particularly allergic etiology and occupational origin. Manicurists employed in beauty salons in the central region of Poland were invited to fill in the questionnaire and undergo medical examination, skin prick tests with common aeroallergens, patch tests with European Baseline Series and (Meth)Acrylates Series-Nails and spirometry. In the questionnaire adverse nasal symptoms were reported by 70%, ocular - by 58%, respiratory - by 42%, hand eczema - by 43% of manicurists. In the medical interview, the frequency of those complaints was lower: nasal ones - 41%, ocular - 24%, cough - 18%, hand skin dryness - 20%, hand eczema - 6%. Cough and hand skin dryness occurred significantly more frequently than in the case of controls. Contact allergy was found for 41% of manicurists and 35% of controls. The prevalence of nickel sensitization was high in both groups (38% and 27%, respectively). Only 3 manicurists reacted to (meth)acrylates. The frequency of atopic diseases was similar in compared groups. Irritant nasal and respiratory reactions were significantly more prevalent among manicurists (nasal - 18% vs. 2%, p < 0.01; respiratory - 18% vs. 1%, p < 0.001). Work-related nasal irritant reactions were finally diagnosed for 19%, ocular ones - for 13%, respiratory - for 18% and within hand skin - for 23% of manicurists. The frequency of workattributed irritant mucosal and skin symptoms among manicurists is high. Exposure to acrylates is an important source of mucosal irritant reactions while occlusive gloves cause irritation of hand skin. The prevalence of nickel allergy among Polish females is high. Int J Occup Med Environ Health 2017;30(6):887-896. Funding: financial support for this work was obtained from local statutory funds IMP 11.2 entitled “Skin and respiratory diseases in employees of beauty salons – the type and prevalence of lesions, diagnosis, predisposition, prevention” from Nofer Institute of Occupational Medicine, Łódź, Poland. Grant/Project manager: Prof. Marta Kieć-Świerczyńska, M.D., Ph.D.

It is generally accepted that maternal factors are important in maintaining the adequate nutritional status of young children. This study was aimed at verifying whether mother's socio-demographic (age and relationship status) and socio-economic features (education and professional status) differentiate the child's nutritional status. A cross-sectional study was conducted between April and October 2013. Five hundred thirty mothers of preschool children from 5 different regions of Poland were interviewed. Mothers were interviewed on their socio-demographic and socio-economic status. To assess the child's nutritional status, body mass index (BMI) z-score and the diet indicators were calculated, such as the percentage of the estimated average requirement for energy (%EAR), the percentage of energy coming from carbohydrates (%EC), fat (%ET) and proteins (%EP). Percentage of the estimated average requirement for energy, %EC, %ET and %EP was obtained from 24-h dietary recalls conducted with the mothers. The results showed that mother's education and professional status did not differentiate any of the indices of the child's nutritional status. However, maternal age and her relationship status occurred significant (ANOVA; p < 0.05). Children of younger mothers had higher BMI z-score and higher %EC as compared to children of older mothers. Moreover, %EAR was higher among children of single mothers and it was closer to the recommended nutrition standards as compared to children of mothers with a partner. When a child is diagnosed with any type of malnutrition, it is worth assessing various factors that might influence the nutritional status, such as child's social background (e.g., maternal factors). Int J Occup Med Environ Health 2017;30(5):811-821. Funding: IMP 21.3. project “Relationship between maternal attitudes and child-feeding practices: importance of attachment style, eating competence and beliefs about combining work and family responsibilities.” Project manager: Adrianna Potocka, M.A.

Assessment of dermal exposure to chemicals in the work environment is problematic, mainly as a result of the lack of measurement data on occupational exposure to chemicals. Due to common prevalence of occupational skin exposure and its health consequences it is necessary to look for efficient solutions allowing for reliable exposure assessment. The aim of the study is to present predictive models used to assess non-measured dermal exposure, as well as to acquaint Polish users with the principles of the selected model functioning. This paper presents examples of models to assist the employer in the the assessment of occupational exposure associated with the skin contact with chemicals, developed in European Union (EU) countries, as well as in countries outside the EU. Based on the literature data dermal exposure models EASE (Estimation and Assessment of Substance Exposure), COSHH Essentials (Control of Substances Hazardous to Health Regulations), DREAM (Dermal Exposure Assessment Method), Stoffenmanager , ECETOC TRA (European Centre for Ecotoxicology and Toxicology of Chemicals Targeted Risk Assessment), MEASE (Metal's EASE), PHED (Pesticide Handlers Exposure Database), DERM (Dermal Exposure Ranking Method) and RISKOFDERM (Risk Assessment of Occupational Dermal Exposure to Chemicals) were briefly described. Moreover the characteristics of RISKOFDERM, guidelines for its use, information on input and output data were further detailed. Problem of full work shift dermal exposure assessment is described. An example of exposure assessment using RISKOFDERM and effectiveness evaluation to date were also presented. When no measurements are available, RISKOFDERM allows dermal exposure assessment and thus can improve the risk assessment quality and effectiveness of dermal risk management. Med Pr 2017;68(4):557-569.Ocena narażenia dermalnego na substancje chemiczne w środowisku pracy jest zagadnieniem problematycznym. Wynika to w pierwszej kolejności z braku danych na temat wielkości narażenia zawodowego, pochodzących z pomiarów stężeń chemikaliów. Ze względu na powszechność potencjalnego narażenia przez kontakt ze skórą w środowisku pracy i jego konsekwencje zdrowotne konieczne jest szukanie skutecznych rozwiązań umożliwiających wiarygodną ocenę narażenia. Celem pracy jest przybliżenie bezpomiarowej oceny narażenia dermalnego na substancje chemiczne za pomocą modeli predykcyjnych i bliższe przedstawienie zasad działania wybranego modelu polskim użytkownikom. W pracy przedstawiono przykładowe modele wspomagające pracodawcę w ocenie narażenia zawodowego związanego z kontaktem substancji chemicznych ze skórą pracownika, opracowane w krajach Unii Europejskiej, jak również poza Unią. Na podstawie danych literaturowych w artykule krótko opisano wybrane modele do szacowania narażenia dermalnego: EASE (Estimation and Assessment of Substance Exposure – oszacowanie i ocena narażenia na substancję), COSHH Essentials (Control of Substances Hazardous to Health Regulations – utrzymywanie pod kontrolą substancji niebezpiecznych dla zdrowia), DREAM (Dermal Exposure Assessment Method – metoda oceny narażenia dermalnego), Stoffenmanager, ECETOC TRA (European Centre for Ecotoxicology and Toxicology of Chemicals Targeted Risk Assessment – ukierunkowane szacowanie ryzyka Europejskiego Centrum ds. Ekotoksykologii i Toksykologii Chemikaliów), MEASE (Metal’s EASE), PHED (Pesticide Handlers Exposure Database – baza danych na temat narażenia użytkowników pestycydów), DERM (Dermal Exposure Ranking Method – metoda rankingu narażenia dermalnego) i RISKOFDERM (Risk Assessment of Occupational Dermal Exposure to Chemicals – ocena ryzyka wynikającego z narażenia dermalnego na chemikalia). Ponadto bardziej szczegółowo zaprezentowano charakterystykę modelu RISKOFDERM, wskazówki dotyczące korzystania z narzędzia oraz informacje na temat danych wejściowych i wyjściowych tego modelu. Opisano problem oceny narażenia dermalnego w ciągu całego dnia roboczego, a także przedstawiono przykładowe szacowanie narażenia za pomocą modelu RISKOFDERM i dotychczasową ocenę skuteczności tego modelu. W przypadku braku danych z pomiarów stężeń chemikaliów stwarzających zagrożenie dla pracownika w wyniku kontaktu ze skórą użycie modelu RISKOFDERM umożliwia ocenę potencjalnego dermalnego narażenia zawodowego, co może podnieść jakość oceny ryzyka, a przez to skuteczność sterowania ryzykiem wynikającym z narażenia przez skórę. Med. Pr. 2017;68(4):557–569.

The aim of this study was to evaluate the hearing status in young adults using portable audio players (PAPs) in relation to their listening habits. The study included 58 subjects, aged 22.8±2.8 years, non-occupationally exposed to noise. Questionnaire inquiry aimed at collecting personal data, the information on PAPs usage habits, self-assessment of hearing status and identification of risk factors for noise-induced hearing loss (NIHL) were performed in study subjects. Hearing tests included pure-tone audiometry (PTA) and transient-evoked otoacoustic emission (TEOAE). All subjects were PAPs users. Depending on listening habits they were divided into the subgroups of “frequent” users (>1 h/day) and “non-frequent” users (≤1 h/day). There were no significant differences between subgroups in prevalence of NIHL risk factors and self-assessment of hearing status. However, frequent users more often complained of tinnitus and hyperacusis. Majority (81.9%) of participants had normal hearing. Nevertheless, 6.9% of audiograms showed high- frequency notches typical for NIHL. Both, the PTA and TEOAE indicated worse hearing in non-frequent users compared to frequent users. No significant differences in prevalence of high-frequency notches be- tween subgroups were noted. The outcomes do not support some previous studies results that the excessive exposure to music listened through PAPs might result in accelerating of development of NIHL loss in young adults.

Results of epidemiological studies on the association between use of mobile phone and brain cancer are ambiguous, as well as the results of 5 meta-analysis studies published to date. Since the last meta-analysis (2009), new case-control studies have been published, which theoretically could affect the conclusions on this relationship. Therefore, we decided to perform a new meta-analysis. We conducted a systematic review of multiple electronic data bases for relevant publications. The inclusion criteria were: original papers, case-control studies, published till the end of March 2014, measures of association (point estimates as odds ratio and confidence interval of the effect measured), data on individual exposure. Twenty four studies (26 846 cases, 50 013 controls) were included into the meta-analysis. A significantly higher risk of an intracranial tumor (all types) was noted for the period of mobile phone use over 10 years (odds ratio (OR) = 1.324, 95% confidence interval (CI): 1.028-1.704), and for the ipsilateral location (OR = 1.249, 95% CI: 1.022-1.526). The results support the hypothesis that long-term use of mobile phone increases risk of intracranial tumors, especially in the case of ipsilateral exposure. Further studies are needed to confirm this relationship. Int J Occup Med Environ Health 2017;30(1)27-43. Funding: this study was supported by the National Committee for Scientific Research (KBN) in Poland (project number IMP 10.3). Title of the project: “The association between EMF emitted by mobile phones and the occurrence of intracranial tumors-meta-analysis.” Project manager: Prof. Wiesław Szymczak.

Background: Trihalomethanes (THMs) are widespread disinfection by-products (DBPs) in drinking water, and long-term exposure has been consistently associated with increased bladder cancer risk. Objective: We assessed THM levels in drinking water in the European Union as a marker of DBP exposure and estimated the attributable burden of bladder cancer. Methods: We collected recent annual mean THM levels in municipal drinking water in 28 European countries (EU28) from routine monitoring records. We estimated a linear exposure-response function for average residential THM levels and bladder cancer by pooling data from studies included in the largest international pooled analysis published to date in order to estimate odds ratios (ORs) for bladder cancer associated with the mean THM level in each country (relative to no exposure), population-attributable fraction (PAF), and number of attributable bladder cancer cases in different scenarios using incidence rates and population from the Global Burden of Disease study of 2016. Results: We obtained 2005-2018 THM data from EU26, covering 75% of the population. Data coverage and accuracy were heterogeneous among countries. The estimated population-weighted mean THM level was 11.7 μg/L [standard deviation (SD) of 11.2]. The estimated bladder cancer PAF was 4.9% [95% confidence interval (CI): 2.5, 7.1] overall (range: 0-23%), accounting for 6,561 (95% CI: 3,389, 9,537) bladder cancer cases per year. Denmark and the Netherlands had the lowest PAF (0.0% each), while Cyprus (23.2%), Malta (17.9%), and Ireland (17.2%) had the highest among EU26. In the scenario where no country would exceed the current EU mean, 2,868 (95% CI: 1,522, 4,060; 43%) annual attributable bladder cancer cases could potentially be avoided. Discussion: Efforts have been made to reduce THM levels in the European Union. However, assuming a causal association, current levels in certain countries still could lead to a considerable burden of bladder cancer that could potentially be avoided by optimizing water treatment, disinfection, and distribution practices, among other possible measures. https://doi.org/10.1289/EHP4495. This work was funded by the EU Seventh Framework Programme EXPOsOMICS Project (grant agreement no. 308610), Human Genetics Foundation agreement 17-080 ISG, and CIBER Epidemiología y Salud Pública (CIBERESP). ISGlobal is a member of the Centres de Recerca de Catalunya (CERCA) Programme, Generalitat de Catalunya. We would like to thank the members of the European Programme for Intervention Epidemiology Training (EPIET) Alumni Network (EAN) for their assistance in identifying appropriate national focal points in specific countries. We would also like to thank the people from the national and local authorities and universities for the provision of THM data: Sofie Dewaele (Leefmilieu Brussel-BIM/Bruxelles Environnement–IBGE Afd. Inspectie en verontreinigde bodems, Dpt. Geïntegreerde controles, Brussels, Belgium), Steven Vanderwaeren (Team Watervoorziening-en gebruik, Vlaamse Milieumaatschappij, Afdeling Operationeel Waterbeheer, Brussels, Belgium), Jurica Štiglić (Croatian National Institute of Public Health, Zagreb, Croatia), Outi Zacheus (National Institute for Health and Welfare, Kuopio, Finland), Carmelo Massimo Maida (University of Palermo, Italy), Anna Norata (Agenzia di Tutela della Salute Citta’ Metropolitana Milano, Italy), Marco Chiesa (Agenzia di Tutela della Salute della Val Padana-Sede Territoriale di Mantova, Italy), Vincenzo Clasadonte (Agenzia di Tutela della Salute della Val Padana-Sede Territoriale Cremona, Italy), Emilia Guberti (Local Health Authority, Bologna, Italy), Cinzia Govoni (Local Health Authority, Ferrara, Italy), Paolo Pagliai (Local Health Authority Romagna, Italy), Daniela de Vita (Local Health Authority, Reggio Emilia, Italy), Danila Tortorici (Regional Health and Social Agency, Emilia Romagna, Italy), Marco Schintu (University of Cagliari, Italy), Paolo Montuori (University of Napoli Federico II, Italy), Audrius Dedele (Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Kaunas, Lithuania), Stefan Cachia (Water Services Corporation, Malta), Roel C.H. Vermuelen (Institute of Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands), the Chief Sanitary Inspectorate (Poland), Luís Simas (Water Quality Department, Entidade Reguladora, Dos Serviços De Águas e Resíduos, Lisboa, Portugal), and Christina Forslund (Food Control Department, National Food Agency, Uppsala, Sweden). Finally, we would like to thank Charles F. Lynch (University of Iowa, USA), Sylvaine Cordier (Université de Rennes, Inserm, École des hautes études en santé Publique (EHESP), Rennes, France), Will D. King (Queen’s University, Kingston, Ontario, Canada), and Kenneth P. Cantor (National Cancer Institute, National Institutes of Health, Bethesda, USA) for allowing us to use the dose–exposure data from their study. We are grateful to Xavier Basagaña (ISGlobal) for statistical assistance.

Medical staff in interventional procedures are among the professionals with the highest occupational doses. Appropriate dosimetric follow up is very important, so that the doses can be kept as low as possible. Active personal dosemeters (APDs) can help in optimizing the exposure during the interventional procedures. However, there can be problems when using APDs during interventional procedures, due to the specific energy and angular distribution of the radiation field, and because of the pulsed nature of the radiation. Many parameters influence the occupational exposure and the scattered radiation around the patient. These include, among others, the type of interventional procedure, personal habits and working technques, protection tools used and X-ray field characteristics. In this paper, we describe the results of an experiment of EURADOS WG12. We compare the results from 3 types of APDs with a passive personal dosimetry system while being used in real clinical environment by the interventional staff. The results show that there is a large spread in the ratios of the passive and active devices. Not all results can be explained by laboratory experiments, showing that there are many parameters that influence the response of these devices.

Background Acute pesticide poisonings constitute an important toxicological problem in numerous countries. This report refers to patients treated for poisonings at the Toxicology Unit, Łodź, Poland, in the period 2004-2014. Material and methods Data to be analyzed were obtained from medical records of hospitalized people. A group of 24 301 patients aged ≥ 15 were selected. In the group of 149 people poisoned with pesticides (0.61% of all poisoning cases), there were 40 women and 109 men. Logistic regression analysis was used to evaluate the impact of age on suicide attempts using pesticides. Results Suicide attempts significantly more frequently concerned younger people. In this type of behavior, coumarin derivatives were significantly more often used than organophosphorus compounds or pesticides classified as "others." The patients with suicidal pesticide poisonings stayed in the ward significantly longer than those poisoned unintentionally. Conclusions In the analyzed population inhabiting an area with a high degree of urbanization, in terms of the place of residence and employment, pesticide poisonings were more common in men than in women. Suicide attempts using pesticides more frequently concerned younger people. Information found in this study may prove useful for education purposes, and also in informing clinicians. Med Pr. 2019;70(6):655-67.

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

Despite the fact that asbestos is no longer used in production in Poland, there are still new cases of asbestos-related diseases among workers previously exposed to asbestos dust. This situation is related to the specificity of the biological activity of this mineral; the health consequences of asbestos can manifest not only during the exposure but also many years after exposure cessation. The aim of the analysis was to assess the occurrence of occupational diseases among people exposed to asbestos dust, who were examined under the Amiantus program.The research material consisted of the program cards filled by the doctors conducting the examinations as well as radiological images stored on the International Labour Organization form. The analysis covered 8049 people, including 37% of women surveyed in the years 2000-2017.In the group of former employees of asbestos processing plants, the occupational disease was diagnosed in 1993 people (25%), including 584 women (19%). The most common was asbestosis (76% of occupational diseases) and pleural disease (17%). Malignant neoplasms accounted for 7% of all cases in this group. The analysis showed an increase in the incidence of respiratory system diseases along with the age of the surveyed persons, their seniority at asbestos processing plants and an increase in cumulative exposure. The chest radiographs revealed radiological changes among 75% of the examined cases, whereas the changes entitling to diagnose asbestosis, according to the criteria applicable in Poland, occurred in 23% of the workers. The adoption of international criteria would increase the incidence of asbestosis as an occupational disease by 19% in the study group.The increase in the percentage of people with a diagnosed occupational disease provides evidence for the worsening health status of the former workers as well as a good detection of asbestos-related diseases among employees exposed to asbestos dust in the past. The results of the analysis indicate the need for undertaking a discussion in Poland on the implementation of international criteria for the diagnosis of asbestosis. Med Pr. 2019;70(6):723-31.Pomimo że w Polsce w produkcji nie stosuje się już azbestu, wciąż odnotowywane są nowe przypadki chorób azbestozależnych wśród pracowników narażonych w przeszłości na pył azbestu. Sytuacja ta jest związana ze specyfiką biologicznego działania tego minerału: następstwa zdrowotne ekspozycji na azbest mogą się ujawniać nie tylko podczas trwania narażenia, ale także wiele lat po nim. Celem analizy była ocena występowania chorób uznanych za zawodowe u osób narażonych na pył azbestu, które zgłosiły się na badania lekarskie w ramach ogólnopolskiego programu Amiantus.Materiał badawczy stanowiły karty badania programu wypełniane przez lekarzy przeprowadzających badania, jak również wyniki odczytu zdjęć radiologicznych płuc zapisane na formularzu Międzynarodowego Biura Pracy (International Labour Organization − ILO). Analizą objęto 8049 osób, w tym 37% kobiet przebadanych w latach 2000−2017.W badanej grupie byłych pracowników zakładów przetwórstwa azbestu chorobę zawodową stwierdzono u 1993 osób (25%), w tym u 584 kobiet (19%). Najczęstszą chorobą zawodową była pylica azbestowa (76% schorzeń zawodowych) oraz choroby opłucnej (17%). Nowotwory złośliwe stanowiły 7% przypadków w tej grupie. Analiza wykazała wzrost częstości występowania chorób układu oddechowego wraz z wiekiem badanych, ich stażem pracy w zakładach przetwórstwa azbestu, jak również ze zwiększaniem się skumulowanego wskaźnika narażenia. Ocena radiogramów klatki piersiowej wykazała zmiany radiologiczne wśród 75% badanych, przy czym zmiany upoważniające do rozpoznania azbestozy zgodnie z obowiązującymi w Polsce kryteriami wystąpiły u 23% badanych osób. Przyjęcie kryteriów międzynarodowych zwiększyłoby częstość występowania azbestozy jako choroby zawodowej o 19% w badanej grupie.Wzrost odsetka osób ze stwierdzoną chorobą zawodową świadczy o pogarszającej się kondycji zdrowotnej pracowników objętych badaniami, jak również o dobrej wykrywalności schorzeń azbestozależnych w ramach opieki nad pracownikami narażonymi w przeszłości na pył azbestu. Wyniki analizy wskazują na konieczność podjęcia w Polsce dyskusji nad wdrożeniem międzynarodowych kryteriów rozpoznawania pylicy azbestowej. Med. Pr. 2019;70(6):723–731.

The aim of the study was to assess whether general practitioners (GPs) monitor and evaluate the health behavior of their patients in the field of a diet, physical activity, and weight control, and whether they provide appropriate counselling as part of this evaluation. Predictors of those activities among physicians were also determined. The cross-sectional study was conducted in the Piotrkowski district among 200 GPs. The questionnaire covered socio-demographic data and lifestyle characteristics of the physicians, their role as healthy lifestyle providers, and whether they assess lifestyle characteristics of their patients and perform healthy lifestyle counselling. More than 60% of the GPs did not evaluate lifestyle features during their patients&rsquo, examination. In total, 56% of the GPs provided healthy lifestyle recommendations among patients who have not been diagnosed with chronic lifestyle-related diseases but who do not follow healthy recommendations, and 73% of GPs provided recommendations to patients with chronic diseases related to lifestyle. The study showed that the chance to assess lifestyle characteristics of the patients was significantly higher for the GPs who believed that they were obliged to do so (OR = 6.5, p = 0.002). The chance to recommend a healthy lifestyle among patients who have not been diagnosed with chronic lifestyle-related diseases but who do not follow healthy recommendations was 5.9 times higher among the GPs working in the public sector (p &lt, 0.001) and 16.3 times higher for these who believed that they had sufficient knowledge to provide the advice (p = 0.02). The following predictors of providing a healthy lifestyle counselling among patients with diagnosed chronic lifestyle-related diseases were identified: conviction that a GPs is obligated to provide it (OR = 4.4, p = 0.02), sufficient knowledge (OR = 8.7, p = 0.01), and following health recommendations by themselves (OR = 3.9, p = 0.04). Conclusions: The identified predictors are crucial for the development of appropriate strategies aiming at increasing GPs&rsquo, involvement in preventive measures and consequently at improving the population&rsquo, s health.

Objectives Interventional cardiologists (ICs) are occupationally exposed to low or moderate doses of ionizing radiation from repeated exposures. It is not clear whether these occupational conditions may affect their eye lens. Therefore, the risk of radiation-induced cataract in the cohort of Polish interventional cardiologists is analyzed in this paper. Material and methods The study group consisted of 69 interventional cardiologists and 78 control individuals occupationally unexposed to ionizing radiation. The eye lens opacities were examined using a slit camera and evaluated with Lens Opacities Grading System III. Cumulative eye lens doses were estimated retrospectively using a questionnaire including data on occupational history. Results The average cumulative dose to the left and right eye lens of the ICs was 224 mSv and 85 mSv, respectively. Nuclear opalescence and nuclear color opacities in the most exposed left eye were found in 38% of the ICS for both types, and in 47% and 42% of the controls, respectively. Cortical opacities were found in 25% of the ICS and 29% of the controls. Posterior subcapsular opacities were rare: about 7% in the ICs group and 6% in the control group. Overall, there was some, but statistically insignificant, increase in the risk for opacity in the ICs group, relative to the control group, after adjusting for the subjects' age, gender, smoking status and medical exposure (adjusted OR = 1.47, 95% CI: 0.62-3.59 for the pooled "any-eye any-type" opacity). There was also no evidence for an increased opacity risk with an increase in the dose. Conclusions The study found no statistically significant evidence against the hypothesis that the risk of cataract in the group of the ICs occupationally exposed to low doses of ionizing radiation is the same as in the control group. Nevertheless, the adverse effect of ionizing radiation still cannot be excluded due to a relatively small study sample size. Int J Occup Med Environ Health. 2019;32(5):663-75.