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Post-acute COVID-19 syndrome (PCS) is a multisystem disorder degrading the quality of life. The study determined characteristics and predictors of PCS in unvaccinated healthcare workers (HCWs) suffering from PCS based on a comparison with their fully recovered counterparts.305 HCWs were examined at least 12 weeks post COVID-19 symptom onset to obtain data about their acute phase of COVID-19 and current health status and tested for complete blood count, C-reactive protein (CRP), electrophoresis of plasma proteins and SARS-CoV-2-specific immunoglobulin (Ig) G and M.181 (59.3%) HCWs reported persisting symptoms attributable to PCS during the examination and 124 (40.7%) HCWs stated no symptoms. In the entire sample, the mean CRP level slightly exceeded the normal range (6.63 mg/L, 95% confidence interval [CI] 5.96-7.3) while all other laboratory results were within the normal range. No statistically significant differences in laboratory results were revealed between both subgroups except for the mean Ig levels, which were higher in HCWs with PCS. The average number of symptoms of PCS was 1.9 (median 2). The most frequent symptoms of PCS were fatigue that interfered with daily life (47.5%), shortness of breath (38.1%), muscle or joint aches (16%), loss of smell (14.9%), headache (14.9%) and sleep disorders (11%). The only statistically significant predictors of PCS were female sex (odds ratio [OR] 1.48, 95% CI 1.059-2.067,PCS appears to be a prevalent condition determined by female sex and increasing age.

Maintaining cleanrooms in a hospital is a key part of preventing healthcare-associated infections (HAIs). The aim of this work was to verify the effectiveness of anti-epidemic measures to ensure air quality in cleanrooms in a tertiary care hospital.The study was based on the application of anti-epidemic measures and verification of their effectiveness by regular indoor air monitoring between the years 2014-2019. Monitoring was performed according to a recommended procedure based on European standards for cleanrooms.The results demonstrate a reduction in the number of airborne particles and the number of colonies, as well as the elimination of fungi and conditioned pathogens in air samples.The authors emphasize the importance of established anti-epidemic measures and regular monitoring for the prevention of HAIs.

The presence of neutralizing SARS-CoV-2-specific antibodies indicates protection against (re)infection, however, the knowledge of their long-term kinetics is limited. This study analyzed the presence of COVID-19-induced antibodies in unvaccinated healthcare workers (HCWs) over the period of 1-8 months post symptom onset (SO) and explored the determinants of persisting immunoglobulin (Ig) seropositivity. Six hundred sixty-two HCWs were interviewed for anamnestic data and tested for IgG targeting the spike protein (S1 and S2) and IgM targeting the receptor-binding domain. A Cox regression model was used to explore potential predictors of seropositivity with respect to the time lapse between SO and serology testing. 82.9% and 44.7% of HCWs demonstrated IgG and IgM seropositivity, respectively, with a mean interval of 83 days between SARS-CoV-2 detection and serology testing. On average, HCWs reported seven symptoms in the acute phase lasting 20 days. IgG seropositivity rates among HCWs decreased gradually to 80%, 50%, and 35% at 3, 6, and 8 months after SO, while IgM seropositivity fell rapidly to 60%, 15%, and 0% over the same time intervals. The number of symptoms was the only predictor of persisting IgG seropositivity (odds ratio [OR] 1.096, 95% confidence interval [CI] 1.003-1.199, p = 0.043) and symptom duration a predictor of IgM seropositivity (OR 1.011, 95% CI 1.004-1.017, p = 0.002). Infection-induced anti-SARS-CoV-2 IgG rates drop to a third in seropositive participants over the course of 8 months. Symptom count and duration in the acute phase of COVID-19 are both relevant to the subsequent kinetics of antibody responses.

COVID-19 has led to an unprecedented strain on healthcare workers (HCWs). This study aimed to determine the prevalence of burnout in hospital employees during a prolonged pandemic-induced burden on healthcare systems. An online survey among employees of a Czech and Slovak university hospital was conducted between November 2021 and January 2022, approximately when the incidence rates peaked in both countries. The Maslach Burnout Inventory—Human Services Survey was applied. We obtained 807 completed questionnaires (75.1% from Czech employees, 91.2% from HCWs, 76.2% from women; mean age of 42.1 ± 11 years). Burnout in emotional exhaustion (EE) was found in 53.2%, depersonalization (DP) in 33%, and personal accomplishment (PA) in 47.8% of respondents. In total, 148 (18.3%) participants showed burnout in all dimensions, 184 (22.8%) in two, and 269 (33.3%) in at least one dimension. Burnout in EE and DP (65% and 43.7%) prevailed in physicians compared to other HCWs (48.6% and 28.8%). Respondents from COVID-19-dedicated units achieved burnout in the EE and DP dimensions with higher rates than non-frontline HCWs (58.1% and 40.9% vs. 49.9% and 27.7%). Almost two years of the previous overloading of healthcare services, caused by the COVID-19 pandemic, resulted in the relatively high prevalence of burnout in HCWs, especially in physicians and frontline HCWs.

Protection of healthcare workers (HCWs) against influenza is essential for patient health and a functional health system. The study aimed to analyze the demand for seasonal influenza vaccination (SIV) among various groups of HCWs in a tertiary care hospital before and during the COVID-19 pandemic and to identify their motives for this season’s SIV. Before this influenza season (2020/21), the hospital management offered free SIV to all HCWs and promoted it on the internal network. Out of 4,167 HCWs, 630 HCWs expressed interest in SIV and were vaccinated in the hospital. They filled in a total of 603 self-administered pen-and-paper questionnaires. The mean age of the respondents (374 females and 229 males) was 45 ± 12 years. Physicians accounted for 48% of the vaccinated persons but for only 24% (p

Psychosocialni a socioekonomicke faktory přispivaji k riziku rozvoje kardiovaskularnich onemocněni, zhorsuji jejich klinický průběh i prognozu. Stres se pak významně uplatňuje na několika urovnich - ovlivňuje rizikove faktory kardiovaskularnich nemoci, vznik a vývoj aterosklerotickeho procesu, může být spoustěcem kardiovaskularni přihody. Modifikuje chovani a životni styl, ktere zpětnovazebně ovlivňuji psychicke a fyzicke zdravi. Clanek pojednava o stresu, jeho vlivu na kardiovaskularni system a poukazuje na to, jak akutni stres a chronicky působici stresory mohou ovlivňovat vznik a vývoj kardiovaskularnich onemocněni ve světle epidemiologických a patofyziologických důkazů a jak tyto poznatky využit v praxi.

Due to the limited availability of COVID-19 vaccines, occupational groups with priority access were identified prior to vaccination. The study aimed to analyze motives for vaccination in these occupational groups. Methods: Members of occupational groups, who were vaccinated at the vaccination center of University Hospital Olomouc before 30 April 2021, were asked to fill in an online questionnaire. Results: A total of 3224 completed questionnaires were obtained from 1332 healthcare workers, 1257 school employees, 363 social service workers, 210 security force members, and 62 critical infrastructure workers. The most frequent motive for vaccination was the effort to protect family members (76.2%), the effort to prevent the spread of COVID-19 in one’s profession (72.3%), followed by concerns about COVID-19 itself (49.1%) and exemptions from anti-epidemic measures (36.8%). Only for social services, the motive focused on one’s profession was mentioned more often (75.2%) than the motive focused on the family (71.1%). At the level of detailed profession-oriented motives, a collegial effort of security force members to protect co-workers and not to endanger the workplace was dominant. Conclusions: The effort to prevent the spread of COVID-19 in the professional environment is a strong motive for vaccination, and strongest among social service workers.

High vaccination coverage among healthcare workers (HCWs) is crucial for managing the COVID-19 pandemic. The aim was to determine the demand for vaccination among all employees (n = 4553) of a tertiary care hospital after several weeks of the vaccine’s availability, and to analyze motives for acceptance and reasons for hesitancy through an anonymous online questionnaire. Upon the completion of data collection, the hospital’s vaccination coverage was at 69.8%. A total of 3550 completed questionnaires were obtained (2657 from vaccinated, 893 from unvaccinated employees). Significant predictors of vaccine acceptance were: age (odds ratio (OR) 1.01, 95% confidence interval (CI) 1.01–1.02), sex (OR (females) 0.58, 95% CI 0.45–0.75), job type (OR (non-physician HCWs) 0.54, 95% CI 0.41–0.72, OR (non-HCWs) 0.51, 95% CI 0.37–0.71), fear of COVID-19 (OR 1.4, 95% CI 1.34–1.46), history of COVID-19 (OR 0.41, 95% CI 0.34–0.49) and of influenza vaccination (OR 2.74, 95% CI 2.12–3.57). The most frequent motive for acceptance was the effort to protect family members (84%), while concerns about vaccine safety and side effects (49.4%), followed by distrust in the vaccine’s efficacy (41.1%) were the top reasons for hesitancy. To increase vaccination coverage among HCWs, it is necessary to raise awareness of vaccine safety and efficacy.

Objectives: Asbestos-related diseases are still a current problem worldwide. What is their occurrence in the Czech Republic? The answer is the subject of this study, which aims to provide a general and regional overview of the situation over the last 20 years with a more detailed focus on mesothelioma, the development of which is highly associated with asbestos exposure and the issue of their recognition as an occupational disease. Methods: In its retrospective reviews, the study is based on analyses of data from the Institute of Health Information and Statistics of the Czech Republic and data from the Czech National Cancer Registry, which also interconnects. Results: In the last 20 years, 512 new cases of occupational diseases from asbestos have been reported, namely 228 cases of pleural thickening, 133 mesotheliomas, 92 asbestoses, and 59 cases of lung cancer. In the last 5 years, mesotheliomas (n = 39) predominated among the reported diseases with a 45% proportion in the total number of 86 cases. The trend in their incidence, as the only one among asbestos-related diseases, is not declining. There was a significant difference in the overall incidence of mesothelioma in a general population and the incidence of occupational mesotheliomas. At the national level, occupational aetiology was acknowledged in only 11.3% of cases of mesothelioma on average. The highest proportion of occupational mesotheliomas and the highest incidence of all asbestos-related diseases were found in regions where the largest asbestos processing plants were located. Conclusion: The authors emphasize the importance of work history for the diagnostic process of asbestos-related diseases and also the need to perform follow-up examinations for their early detection.

Objectives: Low cardiorespiratory fitness (CRF) is related to higher risk of cardiovascular diseases, increase in all-cause mortality and higher risk of different tumors. The reverse is also true; improvement in CRF is related to decrease in mortality. Cardiopulmonary exercise testing (CPET) is a standard and also the most precise test for determination of CRF - the best possibility is the maximal test measuring different parameters including maximal oxygen consumption. Healthcare professionals throughout the developed world have markedly high rates of sickness absence, burnout, and distress compared to other sectors and this leads to higher risk factors. The study aimed to assess CRF in a group of nurses in a big hospital and compare it with population norms and available published results. Methods: Nurses over 50 years of age working in one faculty hospital were gradually included in the study from the beginning of 2018. These nurses work in physically demanding positions. A CPET was carried out following the Bruce protocol. Results: 90 nurses (84 females and 6 males), mean age 55.7 years, were evaluated by CPET. The resting blood pressure was within the norm in 58 persons (64.44%), maximal oxygen consumption in 61 persons (67.8%), W/kg in 25 persons (46.2%). We detected a hypertension reaction in 28 persons (31.1%), some types of arrhythmia in 17 persons (18.9%) and signs of ischaemia in 8 persons (8.9%). The result of CPET led to further examination in 42 persons (46.6%). Detailed examination resulted in change of medication in 21 nurses (23.3%). New diseases were diagnosed in 15 nurses (hypertension, atrial fibrillation, mitral valve prolapse indicated for cardiac surgery, coronary artery stenosis, and lipid disorders). Conclusions: It was concluded that the usage of CPET during the regular medical check-ups significantly increases detection of hidden diseases and thus improves the care for nurses.

Given the increasing incidence of measles, the aim was to assess the seroprevalence of measles immunity among employees of a Czech tertiary care hospital and to assess their willingness to revaccination.3027 hospital employees (2421 females, 606 males) underwent a serological analysis of their measles antibody levels with an option of revaccination in case of an insufficient level.The median age of participants was 42 years. Seropositivity was noted in 54% of the participants, with the antibody values higher in the oldest study participants and with a decrease around the birth year 1968. Logistic regression analysis confirmed a significant relationship of seropositivity with age (odds ratio 0.97, p 0.005). Out of the seronegative, 80.9% individuals got revaccinated.46% of the participants did not reach a sufficient antibody level set by the assay's manufacturer. Although the routine vaccination system is well established it may be ineffective.

Prediabetes is a glucose metabolism disorder considered as a distinct nosological entity which strongly predicts the development of type 2 diabetes mellitus. This nosological entity itself is a serious condition indicating an increased risk of atherosclerotic and oncological complications. In patients with prediabetes, other components of metabolic syndrome are usually present, such as arterial hypertension, obesity or dyslipidaemia, further increasing an individual's risk of morbidity and mortality. Prediabetes is a long-developing disorder which offers enough time for early diagnosis and intervention; it may even be reversible. This review summarizes current knowledge on the definition, detection, epidemiology, cardiovascular and other consequences of prediabetes. It also gives suggestions for future research, along with recommendations for clinical practice.

Objective: As a part of regular revision of the List of Occupational Diseases in the Czech Republic, efforts have been made to add a new item so that lumbar spine disease caused by overload may be recognized as occupational one, with adherence to the valid national rules, that is, clinical criteria are met and objective assessment confirms working conditions under which, according to recent scientific knowledge, such an occupational disease develops. The aim is to provide information on the use of a proposed method for working condition assessment in a real setting, based on the initial experiences gained from a pilot study carried out to validate the method. Methods: Working conditions were assessed in 55 individuals with chronic low back pain (25 males, 30 females; mean age 45.6 years; mean length of employment 15.6 years). The assessment was based on estimating compressive force on the L4/L5 intervertebral disc when performing potentially high-risk work tasks which were entered into four types of checklists throughout their work shifts. The compression values were calculated using a special module that was developed. Results: In 24 cases comprehensive assessment of all tasks performed showed fulfillment of the proposed criteria of working conditions needed for recognition of occupational disease. Those included healthcare, foundry and forest workers, production operators, cabinetmakers, locksmiths, bricklayers, etc. In all the cases, lumbar spine overload was associated with work tasks requiring combinations of manual handling of objects and trunk rotation or bending. The criteria were not met in 31 subjects. The mean length of employment was 15.4 and 15.8 years in patients who met and did not meet the proposed criteria, respectively. Conclusion: The proposed method proved to be applicable in occupational hygiene evaluation in a real setting.

Uvod: Prevalence Martin-Gruberovy anastomozy (MGA), spojky n. medianus a ulnaris na předlokti se uvadi v rozmezi 15– 39 %. Existuji tři různe typy MGA, kdy motoricka vlakna jsou v oblasti paže a lokte vedena skrze n. medianus a zasobuji svaly ruky inervovane n. ulnaris (m. abductor digiti minimi, m. interosseus dorsalis primus ci m. adductor pollicis). Soubor a metodika: V pěti EMG laboratořich bylo unifi kovanou technikou vysetřeno 292 zdravých osob ve věku 20– 67 let, průměr 39,4 let: 166 žen (256 rukou) a 126 mužů (201 rukou), celkem 457 rukou. Byla provedena motoricka a senzitivni neurografie n. ulnaris a n. medianus. Pro detekci MGA mělo zasadni význam hodnoceni amplitudy CMAP pro n. ulnaris a n. medianus při stimulaci z oblasti lokte a zapěsti. Výsledky: V nasem souboru 457 vysetřených rukou jsme na 90 rukou nasli 109 výskytů MGA. U 30 rukou se jednalo o MGA-I, u 57 rukou o MGA-II a u 22 rukou o MGA-III. Izolovane typy MGA se vyskytly v 73 připadech, Na 17 rukou se vyskytla kombinace dvou, ojediněle dokonce vsech tři typů MGA soucasně. Zavěr: V souboru 292 osob zdravých osob jsme na 457 hodnocených rukou nasli MGA v 19,7 %. Nejcastěji se vyskytoval typ MGA-II (12,5 %).

Silicosis, caused by inhaling dust containing free crystalline silica, typically has a chronic course, with the numbers of silicosis patients declining globally. Much rarer are the acute and subacute forms. Presented is a case of severe subacute (accelerated) silicosis. The condition resulted from ~2 years of very intense exposure without appropriate personal protective equipment while sandblasting. The patient's initial symptoms were progressive cough, dyspnoea and weight loss. Given his occupational history, typical clinical manifestations and radiological findings, an initial diagnosis of accelerated silicosis was proposed and histologically confirmed. The patient was a candidate for lung transplantation. The case demonstrates a rare but largely preventable disease with serious health effects and a poor prognosis.

Medical and allied health professions are characteristic of an everyday intense contact with patients and clients. However, these interactions also bring about increased danger of psychosocial risks. Psychosocial risks involve job content, its organization and management, as well as its social context. As such they may pose serious consequences for health and well-being of the professionals. The European Agency for Safety and Health at Work counts among major psychosocial risks: stress at work, burnout syndrome, mobbing/bullying, violence at work, working hours and substance abuse. The aim of the presented article is to give a brief survey of the basic psychosocial risks and their consequences for both health care workers and their patients. Keywords: psychosocial risks, psychosocial deprivation, mobbing, bullying, working hours, violence, drug abuse, workplace stress, occupational burnout, occupational safety.

Objectives. Occupational carpal tunnel syndrome (CTS) due to upper extremity overuse has in recent years been the most commonly recognized occupational disease in the Czech Republic and its prevalence has steadily increased. This pilot observation aimed to assess the effects of exercise techniques and oral enzyme therapy in automotive plant workers with early CTS. Patients and Methods. The observation comprised automotive plant assembly line workers in whom nerve conduction study revealed incipient CTS. The subjects were divided into three groups: a group practicing exercise techniques (exercising; N=15), a group receiving oral enzyme therapy (N=16), and a group of controls (N=14). Subjects in the control group were only observed without any specific intervention, which is a common procedure in incipient CTS. Throughout 9-week observation, the workers did their jobs. Prior to and after that period, the workers’ CTS-related symptoms were ascertained through structured interviews with a physician and the following median nerve parameters were measured: sensory conduction velocity (SCV) and distal motor latency (DML). Results. In both the exercise and enzyme therapy groups, statistically significant decreases in the total score for symptoms were achieved (p Conclusion. The results showed the efficiency of both exercise and oral enzyme therapy in incipient CTS. These methods may be recommended for preventing more severe forms of CTS.

Objectives Malignant mesothelioma (MM) is the most serious asbestos-related disease. Its increasing incidence is alarming, suggesting the need for as early diagnosis as possible. This 4.5-year prospective longitudinal study aimed at assessing the benefit of measuring serum mesothelin as a marker for diagnosing malignant mesothelioma in individuals with previous occupational exposure to asbestos, as a part of their clinical follow-up care. Material and methods The study comprised 309 participants (235 males, 74 females) with a mean age of 58.9 years (standard deviation (SD) = 9.8) and a mean duration of exposure to asbestos dust of 13.4 years (SD = 9.3). From 2009 to June 2013, all subjects were followed at a department of occupational medicine in Olomouc. Apart from the standard parts of medical examination (history, physical examination, simple chest radiographs and spirometry), the patients' serum mesothelin levels were determined by the Mesomark immunoenzymatic diagnostic assay. Statistical analysis of the validity of serum mesothelin level measurement was carried out with respect to the diagnosis of MM. Results Among the participants, 16 (5.2%) individuals (14 males and 2 females) were diagnosed with malignant mesothelioma. Based on the detected mesothelin levels, their validity for prediction of malignant mesothelioma was calculated as follows: sensitivity - 0.75, specificity - 0.962, positive predictive value - 0.706, negative predictive value - 0.969, positive and negative likelihood ratios - 19.95 and 0.26, respectively, and diagnostic odds ratio - 76.8, at a 95% confidence interval. Conclusions The high specificity was identified indicating the low false positivity as well. In the case of detecting elevated soluble mesothelin-related peptides (SMRP) levels in formerly asbestos-exposed individuals, the possibility of the presence of MM should be included into the clinical consideration. The high negative predictive value denotes a lower probability of the presence of MM in patients with normal SMRP levels but due to the limiting lower sensitivity this possibility cannot be entirely excluded.

Aims: Pleural mesothelioma is a highly aggressive and difficult-to-treat form of cancer induced by asbestos in 80-90% of cases. The population group most at risk of the condition are asbestos-exposed workers. Mesothelin or soluble mesothelin-related protein (SMRP) is studied as a potential marker of mesothelioma in the at-risk population. Methods: The study comprised 239 subjects with a mean duration of occupational exposure to asbestos of 19.9 years. In all of them, a complete medical history was taken, focused on exposure duration and a physical examination, a chest X-ray or other imaging investigations and a lung function test were performed. Their serum SMRP levels were measured and biopsy samples were taken to diagnose pleural disease. Based on the above examinations, the subjects were classified into subgroups and serum SMRP concentrations were statistically analyzed with respect to individual parameters. Results: In asbestos-exposed individuals, mesothelin levels were significantly higher in those with pathological X-ray findings than in those with normal X-ray results (0.78 ± 0.63 vs. 0.50 ± 0.35, P

Background: The authors review pulmonary aluminosis caused by exposure to dust containing aluminium and its compounds, mainly oxides. Special attention is paid to various factors of occupational exposure as to an important etiologic issue. The condition has a rich and interesting history dating back to the 1930s. The most significant occupational exposures are associated with processes in bauxite smelting, the use of fine aluminium powder, exposure to aluminium welding fumes, grinding and polishing of aluminium materials. Methods and Results: A literature search for relevant scientific studies in English was performed using the following internet databases: relevant sections of The Cochrane Library, EBSCO Discovery Service, Ovid, ProQuest Science Journals, PubMed, ScienceDirect, Scopus and Web of Knowledge. The initial clinical manifestations of pulmonary aluminosis are exertional dyspnea with dry, non-productive cough. Depending on the type and length of the occupational exposure, ventilatory defects may vary considerably from restrictive to obstructive pattern. Radiographic findings commonly showing nodular or slightly irregular opacities are predominantly located in the upper, less frequently in the lower lung fields, or can have a diffuse pattern. In advanced stages, severe pulmonary fibrosis with honeycombing occured. Conclusions: Although pulmonary aluminosis is a very rare disease, it still occurs. Since the industrial importance and use of aluminium continue to rise, lung damage from exposure to respirable aluminium particles should not be overlooked but monitored and prevented. Even today, the pathophysiology of pulmonary aluminosis has not been explained as yet.

Objectives Carpal tunnel syndrome (CTS) is a common occupational disease. The aim was to assess the effect of preventive measures in automotive assembly workers. Material and methods The analysis summarizes data from annual crosssectional studies. The 7-year analysis of data was based on medical records obtained from an occupational physician and inspections carried out at the workplace where targeted preventive measures were introduced, including better ergonomic arrangement of the workplace, technical adjustments facilitating the work, preventive nerve conduction studies (NCS) testing of the median nerve once a year, switching of workers and their targeted rotation within the workplace. The NCS testing of median nerve conduction at the wrist was the basic objective method for assessment of the prevalence and severity of CTS. Over the study period, the sample comprised 1804 workers at risk for repetitive overuse of the upper extremities, of whom 281 were females with a mean age of 38.5 years and 1523 were males with a mean age of 31.4 years. Results Over the study period, a total of 13 cases of CTS were recognized as an occupational disease in the plant, 8 of which occurred within the first 2 years from the initiation of production. Introduction of preventive measures decreased the prevalence of median neuropathy from 18.3% of examined extremities in 2011 to 10.5% in 2013 (p = 0.003). In early 2014, the production pace increased and this was accompanied by a rise in abnormal NCS findings to 16.9%. Over the study period, the rate of sensorimotor neuropathy decreased in favor of merely sensory neuropathies, which have been most frequent since 2013. The percentage of employees whose contracts were terminated due to median neuropathy decreased steadily from 5.5% to 0.4%. Conclusions Targeted prevention of work-related CTS is effective as evidenced by the decrease in the prevalence of median neuropathy detected by NCS. Int J Occup Med Environ Health 2017;30(1):45-54.

The authors present a case of occupational lung damage from exposure to dust containing aluminium. The first detected objective pathological finding was that of dispersed micronodules in the lungs seen in a chest radiograph. The final diagnosis of pulmonary aluminosis was established after three years of gradual exclusion of other interstitial lung diseases. The diagnosis was supported by the occupational history confirmed by hygiene assessment of the patient's workplace and especially by histological examination with elemental analysis of the lung tissue. The possibility of development of this rare condition should not be underestimated in workers at high-risk jobs.

Background and objectives: The visceral adiposity index (VAI), estimating visceral adiposity dysfunction through a simple formula, could serve as a useful tool for identifying individuals at higher cardiometabolic risk. Its relationship with insulin resistance (IR), assessed using the homeostasis model assessment of IR (HOMA-IR), and metabolic syndrome (MetS) components remains unclear. The study aimed to investigate the association of VAI with both HOMA-IR and MetS. Materials and Methods: After undergoing anthropometric and biochemical studies, 783 individuals were divided into three groups according to a number of present MetS components. The VAI cut-offs signaling MetS and HOMA-IR were determined by maximizing the sum of the sensitivity and specificity. Correlation analysis was performed to explore the associations between VAI and other tested parameters. A logistic stepwise regression analysis was applied to identify statistically significant determinants of HOMA-IR. Given the variability of reference values, two thresholds of HOMA-IR were applied, namely 2.0 and 3.8. Results: VAI increased significantly between the groups with a rising number of MetS components. The VAI cut-off for MetS was 2.37, with a sensitivity of 0.86 and a specificity of 0.78. The same cut-off point identified subjects with HOMA-IR = 3.8, with a sensitivity of 0.79 and a specificity of 0.66. The VAI cut-off for HOMA-IR = 2.0 was 1.89, with a sensitivity of 0.74 and a specificity of 0.68. The strongest correlations of VAI were noted with HOMA-IR (r = 0.51) and insulin (r = 0.49), respectively, while the strongest correlation of HOMA-IR was with waist circumference (r = 0.54). Not one of the routine parameters was a significant predictor in the regression analysis. Conclusions: The obtained results show an existing association of VAI with HOMA-IR. The high sensitivity and specificity of the cut-offs may allow the application of VAI in common clinical practice.

V poslednich letech se zvysuje spolecenska prestiž povolani zdravotni sestry. Jeji profese vyžaduje poměrně vysokou kvalifikaci a ma prospěsnost pro spolecnost. To vyžaduje, aby byla zvysovana pracovni saturace a snižovana fluktuace vseobecných sester. Motivacni strategie by proto měly vychazet z trendů jejich pracovni spokojenosti. Herzbergova motivacni teorie srozumitelně objasňuje, "co clověka motivuje k praci", a je metodologicky podrobně rozpracovana. Zakladnim principem výzkumneho designu bylo dvoji hodnoceni 16 faktorů pracovniho prostředi. Ty byly vytvořeny podle Herzbergovy teorie a doplněny experty v osetřovatelstvi v pilotnich výzkumech. Nejprve je vseobecne sestry řadily podle vlastnich hodnotových preferenci, nasledně podle stupně jejich naplněni ze strany zaměstnavatele. Vzajemna komparace aritmetických průměrů jednotlivých faktorů pak přehledně ukazuje největsi divergence mezi přanim a realitou vseobecných sester v pracovnim prostředi. Prvni rozsahle dotaznikove setřeni bylo uskutecněno v roce 2006, druhe - reprezentativni - v roce 2011 pomoci tazatelskeho archu. Opakovani výzkumu ukazuje trendy pracovni spokojenosti vseobecných sester. Cilovou skupinu výzkumu tvořily vseobecne sestry pracujici v nemocnicich CR. V roce 2006 se výzkumu ucastnilo 3 081 respondentů, v roce 2011 rozhovor neodmitlo 1 992 respondentů. Prvni ctyři faktory (Mzda/Plat, Pece o pacienty, Jistota pracovniho mista a Spoluprace) jsou preferovany u obou výzkumů ve stejnem pořadi. Výrazný posun v roce 2011 je u faktoru Prestiž povolani. Důležitost profese vnimana samotnými vseobecnými sestrami je v souladu s tradicni i soucasnou preferenci vlastniho obsahu prace (pece o pacienta) a se zvýsenou vzdělanosti vseobecných sester a je take v souladu s trendem zvysovani spolecenske prestiže sester.

Cil: Cilem prace bylo poznani osobnich priorit faktorů pracovniho prostředi vseobecných sester a stupeň jejich saturace zaměstnavatelem. Vzajemnou komparaci zjistěneho pak přehledně ukazat největsi divergence mezi přanim a realitou vseobecných sester v pracovnim prostředi. Cilem bylo take vytvořeni měřiciho nastroje, který by byl využitelný ke splněni akreditacniho standardu, jež sleduje pracovni spokojenost zaměstnanců ve zdravotnictvi.Metody: Na principech Herzbergovy dvoufaktorove motivacni teorie a po diskuzich s manažery nemocnic byl v roce 2004 vytvořen zakladni material pro dotaznikove setřeni. V roce 2005 byl proveden pilotni výzkum. Ověřený dotaznik byl v průběhu roku 2006 rozeslan do 25 nemocnic, v průběhu roku 2007-2008 byl zpracovavan. Z distribuovaných 10 791 dotazniků do konecneho zpracovani postoupilo 3081.Výsledky: U vseobecných sester maji nejvyssi pracovni hodnotu faktory mzdy, pece o pacienty a jistoty pracovniho mista. Mezi nejvice divergujici faktory patřila mzda, jistota pracovniho mista a uznani osobnich výsledků. Nejvice harmonicke byly tyto faktory: vztahy k přimým nadřizeným, poskytovane socialni výhody a spoluprace s jinými profesemi (faktory jsou uvedeny v řadě podle důležitosti).Zavěry: Výzkumným týmem byl vytvořen dotaznik jako měřici nastroj, kterým lze jednoduse zjisťovat ucinnost motivacnich intervenci, aniž by doslo ke zbytecnemu plýtvani lidskými i financnimi zdroji. Lze jim take naplnit požadavky akreditacniho standardu, zaměřeneho na spokojenost zaměstnanců, a provadět srovnavaci setřeni mezi jednotlivými nemocnicemi.

Cil: Cilem prace bylo zhodnotit výskyt rizikových faktorů (RF) kardiovaskularnich onemocněni (KVO) u zaměstnanců velkeho zdravotnickeho zařizeni a srovnat jejich výskyt s dostupnými udaji v literatuře.Metody: Soubor tvoři 3124 zaměstnanců průměrneho věku 36,18 let (median 34,0, SD 11,44), 562 mužů (M) (18,0 %) průměrneho věku 37,10 let (34,0; 12,26) a 2562 žen (Ž) (82,0 %) průměrneho věku 35,98 let (34,0; 11,24), kteři byli vysetřeni při preventivnich prohlidkach. Při vysetřeni zaměstnanci vyplnili dotaznik na zakladni RF KVO a sestry doplnily objektivni udaje. Lekař provedl vyhodnoceni protokolu a doporucil cilenou intervenci rizik. Výsledky byly statisticky srovnany s udaji v dostupne literatuře pomoci chi kvadratu- kontingencnich tabulek s Yatesovou korekci na pětiprocentni hladině významnosti.Výsledky: Kouři celkem 857 zaměstnanců (27,4 %), 164 M (29,2 %) a 693 Ž (27,1 %). Nejvice kuřaků je v kategorii ostatni (pomocný personal) a to 41,39 %; v kategorii vysokoskolak kouři pouze 14,76 % osob. Muži se ve výskytu RF kouřeni nelisi od ceske populace (p = NS), ženy kouři statisticky významně vice (p < 0,05). Přiměřenou pohybovou aktivitu udava 1862 osob (59,6 %) a tento RF je statisticky významně lepsi ve srovnani s literaturou a ceskou populaci. Hypertenze se vyskytuje u 60 M (10,7 %) a 151 Ž (5,9 %). 290 zaměstnanců je obeznich (9,2 %), z toho 57 M (10,2 %) a 349 Ž (9,1 %), výskyt je statisticky významně lepsi než u ceske populace (p < 0,05). Vysoke riziko KVO v 60 letech věku (nad 20 %) mělo 175 osob (5,7 %) (128 M, 47 Ž), vysoke riziko podle SCORE za 10 let mělo 675 osob (21,6 %) (347 M, 328 Ž).Zavěry: Vzhledem k vysokemu výskytu rizikových faktorů KVO by měla být primarni prevence soucasti zakladnich preventivnich prohlidek.

V praci je zhodnocen vliv expozice azbestu v pracovnim prostředi na hladinu totalniho antioxidacniho stavu jako ukazatele možne budouci manifestace onemocněni z azbestu. Byl vysetřen soubor 112 osob dřive pracujicich v riziku azbestu a 113 osob kontrolniho souboru. Bylo zjistěno, že exponovani azbestu maji 10,64 krat větsi pravděpodobnost než neexponovani, že jejich hladina antioxidantů bude snižena, což je statisticky významne. Autoři diskutuji preventivni podavani antioxidantů a zdůrazňuji důležitost mezioborove spoluprace při peci o pracovniky dřive exponovane azbestu.

Ucel: Ucelem studie bylo vypracovani pocitacoveho modulu k výpoctu kompresivni sily v oblasti plotenky L4/L5 pro použiti v praxi. Metody: Předpoklada se, že hodnota kompresivni sily je použije jako nahradni hodnota mechanicke zatěže bederni pateře v průběhu pracovni aktivity. Kompresivni sila predikovana pomoci modulu u konkretniho pracovnika musi být porovnana s NIOSH (americke normy) limitni hodnotou 3 400 N pro zhodnoceni zatěže bederni pateře v průběhu manualnich ukonů se zvedanim předmětů. Přestoupeni limitni hodny bude posouzeno jako naplněni hygienických kriterii, ktere musi být dosaženy, aby mohla být porucha bederni pateře hodnocena jako nemoc z povolani. Ve vývoji pocitacoveho modulu jsme použili ergonomický software TECNOMATIX Classic Jack, který zohledňuje antropometricke parametry pracovnika i ergonomicke parametry jeho pracovni aktivity. Výsledky: Vypocetli jsme kompresivni sily působici na plotenku L4-L5 ve 1 300 simulovaných kombinacich různých faktorů ovlivňujicich kompresivni sily. Parametry, ktere se ukazaly rozhodujici pro kompresi disku L4/L5 byly zařazeny do pocitacem zpracovaneho algoritmu. Zavěr: Nase studie byla primarně zaměřena na zhodnoceni poruch bederni pateře jako nemoci z povolani. Navic se nase studie může podilet na doporuceni preventivnich opatřeni ke sniženi zdravotnich rizik povolani spojených s přetiženim bederni oblasti. Graficke mapy generovane pocitacovým modulem umožňuji rychlou a přesnou analýzu konkretniho pracovniho zařazeni.

Sandblasting is traditionally known as a high-risk profession for potential development of lung silicosis. Reported is a case of a sandblaster with confirmed accelerated silicosis, a condition rather rarely diagnosed in the Czech Republic. Initially, the patient presented with progressive dry cough and exertional dyspnoea. In the early diagnostic process, a possible occupational aetiology was considered given his occupational history and known high-risk exposure to respirable silica particles confirmed by industrial hygiene assessment at the patient’s workplace. The condition was confirmed by clinical, histological and autopsy findings. The patient died during lung transplantation, less than five years from diagnosis.

Objectives: Health care workers constitute a high-risk occupational category owing to the character of their work that includes high-risk environment, shift work and mental as well as physical stress. In occupational medicine, caring for their health condition should be a priority and include measures aimed at preventing cardiovascular diseases. The study aimed at determining the prevalence of cardiovascular disease (CVD) risk factors in employees of a large hospital and assessing their effect on the incidence of cardiovascular events. Materials and Methods: The group comprised 3124 employees with a mean age of 36.1 years (SD = 11.4), out of whom 562 were males (mean age of 37.1 years, range: 18-72; SD = 12.26) and 2562 were females (mean age of 35.9 years, range: 18-68; SD = 11.24). At their initial examination, the employees filled in a questionnaire on basic CVD risk factors (according to valid recommendations). This was supplemented with objective data to determine the risk of CVD using valid charts. From this group, a subset of persons at a high or intermediate risk was selected, comprising 247 individuals with a mean age of 54.1 years (SD = 5.73). After 5-9 years (mean 7.24±1.38 years), they either underwent another examination or their health status was ascertained by phone or in a computer database. The end point was the incidence of cardiovascular events (sudden death, acute myocardial infarction, unstable angina pectoris, percutaneous coronary intervention, cardiac failure, stroke or transient ischemic attack). Results: The end point was noted in a total of 15 males (6.07%) and 6 females (2.42%), being statistically significantly present in managers (males p < 0.00007, females p < 0.00001), male physicians/surgeons (p < 0.025), tertiary-educated males (p < 0.0095), female smokers (p < 0.015), male ex-smokers (p < 0.007), overweight or obese males (p < 0.02) and those with the waist-to-hip ratio above 1.0 (p < 0.005). Conclusions: Cardiovascular events are most likely to occur in obese male physicians/surgeons holding managerial positions and in female managers.