• Dietary habits and myocardial infarction in occupationally active men.

      Bortkiewicz, Alicja; Gadzicka, Elżbieta; Siedlecka, Jadwiga; Szyjkowska, Agata; Viebig, Piotr; Wranicz, Jerzy Krzysztof; Kurpesa, Małgorzata; Trzos, Ewa; Makowiec-Dąbrowska, Teresa; Nofer Institute of Occupational Medicine (2019-11-15)
      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
    • Vertigo and severe balance instability as symptoms of Lyme disease - literature review and case report.

      Józefowicz-Korczyńska, Magdalena; Zamysłowska-Szmytke, Ewa; Piekarska, Anna; Rosiak, Oskar; Nofer Institute of Occupational Medicine (2019-11-12)
      Lyme disease is caused by a tick-borne bacterium Borrelia sp. This zoonotic infection is common in the Northern Hemisphere, e.g., Europe. Clinical presentation may involve multisystem symptoms and depends on the stage of the disease. The involvement of nervous system in Lyme disease is commonly referred to as neuroborreliosis. Neuroborreliosis may involve meningitis, mononeuritis multiplex, or cranial neuritis including the inflammation of vestibulocochlear nerve. In the late or chronic stage of Lyme disease, vestibular involvement may be the sole presentation, although such cases are rare. Our study was designed to present our own case and review the available literature reporting cases of neuroborreliosis with vertigo/dizziness and severe balance instability as a main disease symptom. The studies were obtained by searching the following databases: PubMed, Medline, and Embase. We included case reports of Lyme disease presenting with vertigo or gait disorders as the main symptom, written in the English language. Initially, 60 papers were identified. After analyzing the abstracts, seven manuscripts focusing on 13 clinical cases were included in this review. We conclude that the patients with neuroborreliosis sometimes present vertigo/dizziness, but rarely gait ataxia as a sole symptom. These complaints are usually accompanied by a hearing loss. Antibiotic treatment is usually effective. Balance instability in the patients with neuroborreliosis may persist but it responds well to vestibular rehabilitation.
    • Evaluation of agreement between static posturography methods employing tensometers and inertial sensors

      Kotas, R.; Janc, M.; Kamiński, M.; Marciniak, P.; Zamysłowska-Szmytke, Ewa; Tylman, W.; Nofer Institute of Occupational Medicine (2019-11-08)
      This study investigates the agreement between two methods used for the assessment of human balance system. Static posturography based on tensometers, using a commercially available platform, is used as the reference method. An alternative approach is a portable prototype MediPost system that utilises inertial sensors developed by the authors. Both approaches determine the movement of the subject’s centre of mass, quantifying this movement in terms of angular speed. Data for the evaluation of agreement were obtained from 205 subjects, with each subject simultaneously tested with both methods. During the tests, the subject performed a set of standard procedures involving quiet standing in an upright position. In order to verify the agreement between the evaluated methods, the Bland-Altman, concordance correlation and intraclass correlation coefficients were used. In addition, the trajectories of the centre of gravity were compared. The obtained results show good agreement between the verified methods, even though they are based on different physical phenomena.
    • Deriving the Dietary Approaches to Stop Hypertension (DASH) Score in Women from Seven Pregnancy Cohorts from the European ALPHABET Consortium.

      Aubert, Adrien M; Forhan, Anne; de Lauzon-Guillain, Blandine; Chen, Ling-Wei; Polanska, Kinga; Hanke, Wojciech; Jankowska, Agnieszka; Mensink-Bout, Sara M; Duijts, Liesbeth; Suderman, Matthew; et al. (2019-11-08)
      The ALPHABET consortium aims to examine the interplays between maternal diet quality, epigenetics and offspring health in seven pregnancy/birth cohorts from five European countries. We aimed to use the Dietary Approaches to Stop Hypertension (DASH) score to assess diet quality, but different versions have been published. To derive a single DASH score allowing cross-country, cross-cohort and cross-period comparison and limiting data heterogeneity within the ALPHABET consortium, we harmonised food frequency questionnaire (FFQ) data collected before and during pregnancy in ≥26,500 women. Although FFQs differed strongly in length and content, we derived a consortium DASH score composed of eight food components by combining the prescriptive original DASH and the DASH described by Fung et al. Statistical issues tied to the nature of the FFQs led us to re-classify two food groups (grains and dairy products). Most DASH food components exhibited pronounced between-cohort variability, including non-full-fat dairy products (median intake ranging from 0.1 to 2.2 servings/day), sugar-sweetened beverages/sweets/added sugars (0.3–1.7 servings/day), fruits (1.1–3.1 servings/day), and vegetables (1.5–3.6 servings/day). We successfully developed a harmonized DASH score adapted to all cohorts being part of the ALPHABET consortium. This methodological work may benefit other research teams in adapting the DASH to their study’s specificities.
    • Can alveolar hypoventilation due to kyphoscoliosis be a contraindication to driving?

      Kania, Aleksander; Nastałek, Paweł; Celejewska-Wójcik, Natalia; Sładek, Krzysztof; Kosobudzki, Marcin; Bortkiewicz, Alicja; Siedlecka, Jadwiga; Nofer Institute of Occupational Medicine (2019-10-16)
      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.
    • Predictors of E-Cigarette Use Susceptibility-A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland.

      Kaleta, Dorota; Niedzin, Mirosław; Jankowska, Agnieszka; Polańska, Kinga; Nofer Institute of Occupational Medicine (2019-10-16)
      Identification of the youth at risk of e-cigarette use is crucial for development of effective prevention strategies. The current study aims at evaluation of predictors of susceptibility to e-cigarette initiation and experimentation among adolescents. This cross-sectional study included 1693 students (non-current users of e-cigarettes) attending 21 schools in Piotrkowski district (a socially disadvantaged rural area in central Poland). The regression models were applied so as to study factors linked to susceptibility to e-cigarette use among never users (n = 1054) and ever users (n = 639) of e-cigarettes, with susceptibility defined as the absence of a firm decision not to use these products. A high proportion of the youth was susceptible to e-cigarette use (68% of never and 78% of ever e-cigarette users). The adjusted model confirmed the following risk factors: smoking parents and friends (never users: OR = 3.0; p < 0.001; OR = 2.0; p < 0.05; ever users: OR = 2.2; OR = 2.2; p < 0.01), alcohol consumption (never users: moderate drinking OR = 2.9; p < 0.001; binge drinking OR = 2.2; p < 0.01; ever users: moderate drinking OR = 4.2; p < 0.001), cigarette smoking (never users: OR = 14.1; ever users: OR = 11.3; p < 0.001), and perception that e-cigarettes are less harmful than traditional cigarettes (never users: OR = 1.8; p < 0.001). The youth whose mothers had a medium and high educational level (never users: OR = 2.7; p < 0.01; OR = 2.7; p < 0.05; ever users: OR = 5.4; OR = 4.4; p < 0.001), those who perceived girls who use e-cigarettes as more attractive (never users: OR = 4.1; p < 0.001; ever users: OR = 2.9; p < 0.01), and secondary school students (ever users: OR = 5.6; p < 0.001) had higher odds of susceptibility to e-cigarette use. The youth who had more money per month were less susceptible to e-cigarette experimentation (OR = 0.4; p < 0.001). A multi-level intervention approach, considering vulnerable populations, is required to prevent the youth from e-cigarette initiation and experimentation.
    • Occupational exposure to ionizing radiation and lens opacity in interventional cardiologists.

      Domienik-Andrzejewska, Joanna; Kałużny, Paweł; Piernik, Gabriela; Jurewicz, Joanna; Nofer Institute of Occupational Medicine (2019-10-16)
      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
    • Validation of the Polish version of the <i>Dizziness Handicap Inventory</i>.

      Szostek-Rogula, Sylwia; Zamysłowska-Szmytke, Ewa; Nofer Institute of Occupational Medicine (2019-09-18)
      Background: The Dizziness Handicap Inventory (DHI) was established to assess the impact of dizziness and balance problems on the quality of life. The aim of the study was to validate the Polish version of DHI for patients with vestibular disorders. Material and Methods: Two hundred and thirty patients diagnosed with vestibular impairment and/or positional vertigo were included in the study. The mean age of the study group was 56.2 years (SD = 13.6). The factor structure (the principal component analysis − PCA), internal consistency (Cronbach’s α), and discrimination ability (the receiver operating characteristic [ROC] curve) were examined. Results: A satisfactory internal consistency was found (Cronbach’s α coefficient = 0.92), while no floor or ceiling effect was revealed. The Dizziness Handicap Inventory demonstrated a good ability to discriminate between patients with and without the handicap (sensitivity and specificity about 80%, the cutoff point = 56). In PCA a 3-factor solution was obtained, with the factors related to restrictions in daily life, positional symptoms and visual-vestibular symptoms, which was not in agreement with the subscales provided in the original version. Conclusions: The Polish version of DHI demonstrates satisfactory measurement properties and can be used to assess the impact of dizziness on handicap and the quality of life. The functional, emotional, and physical subscales were not confirmed. In particular, the functional subscale revealed no satisfactory internal consistency which provides an indication for further studies.
    • [Workplace health promotion as a tool for reducing the consequences of ageing of the working population].

      Goszczyńska, Eliza; Nofer Institute of Occupational Medicine (2019-09-18)
      Prognozowana na najbliższe lata intensyfikacja procesu starzenia się polskiego społeczeństwa spowoduje poważne konsekwencje gospodarczo-społeczne. W skali makro będą obserwowane mniejsze wpływy do budżetu państwa (w związku ze zmniejszaniem liczebności siły roboczej) i wyższe wydatki publiczne (na emerytury, opiekę medyczną, opiekę długoterminową). Następstwa w skali mezo, tj. dotyczące zakładów pracy, polegają na kurczeniu i starzeniu się zasobów pracy, co spowoduje poważne trudności w rekrutacji. Prawdopodobny jest też spadek produktywności starzejącej się załogi powiązany z absencją chorobową i prezentyzmem. Państwo może sprostać tym wyzwaniom, wspierając jak najdłuższą, utrzymywaną na wysokim poziomie aktywność społeczną i zawodową społeczeństwa. Narzędziem takiej polityki uczyniono m.in. promocję zdrowia w miejscu pracy (PZwMP). W literaturze – choć w wielu pozycjach wskazuje się różnorodne zalety tej promocji – brakuje kompleksowego opracowania podsumowującego jej osiągnięcia w kontekście starzenia się ludności. Dlatego celem artykułu jest przedstawienie dowodów naukowych przemawiających za skutecznością promocji zdrowia w miejscu pracy w przeciwdziałaniu lub łagodzeniu skutków tego procesu demograficznego (kurczenia się zasobów pracy oraz spadku produktywności starzejącego się personelu powiązanego z zachowaniami absencyjnymi). Przeprowadzono narracyjny przegląd literatury (polsko- i angielskojęzycznej, zidentyfikowanej w bazach EBSCO, PubMed, za pomocą wyszukiwarki Google oraz metodą „śnieżnej kuli”). Potencjał PZwMP w omawianym zakresie polega na jej skuteczności we wzmacnianiu zdrowia i przeciwdziałaniu problemom zdrowotnym personelu. Dobra kondycja zdrowotna, poprzez wzmacnianie zdolności do pracy oraz podtrzymywanie aktywności zawodowej, ogranicza kurczenie się zasobów pracy. Zmniejsza skalę absencji i prezentyzmu. Szeroko rozumiane problemy zdrowotne mają z kolei działanie odwrotne. Chociaż analizy skuteczności PZwMP we wzmacnianiu zdolności do pracy, wydłużaniu aktywności zawodowej, redukcji absencji, prezentyzmu czy spowodowanych nimi strat produktywności należą do słabo rozwiniętych obszarów badawczych, to zgromadzone systematyczne przeglądy literatury wskazują na jej potencjał w tym zakresie. Med. Pr. 2019;70(5):617–631
    • Allergen-specific IgE to recombinant latex allergens in occupational allergy diagnostics.

      Nowakowska-Świrta, Ewa; Wiszniewska, Marta; Walusiak-Skorupa, Jolanta; Nofer Institute of Occupational Medicine (2019-09-01)
      Objectives Specific challenge tests (SICs) are considered reference tests for allergic occupational diseases diagnosis. However, in numerous cases, SICs cannot be carried out in the diagnosis of allergy to latex due to the risk of generalized reactions. The aim of the study was to evaluate the usefulness of sIgE determination to recombinant latex allergens in diagnostics of occupational respiratory allergy. Materials and Methods The study group comprised 44 healthcare workers (HCW) suspected of suffering from occupational respiratory allergy to latex (they underwent a physical examination, skin‐prick tests (SPTs) to common and latex allergens, spirometry and SIC) and 17 controls not occupationally exposed to latex, with a positive sIgE against latex. Each serum was tested for allergen‐specific IgE to aeroallergens, latex, eight recombinant latex allergens and CCD‐markers. Results Specific IgE against Hev b5, 6.01, and 6.02 were significantly more frequently detected in HCWs and their mean serum levels were higher compared with the control group. In 26 HCWs with occupational asthma (OA), sensitization to Hev b5, Hev b6.01, Hev b6.02 was significantly more frequent than in 18 HCWs with work‐exacerbated asthma (WEA); they had positive results SPT to latex significantly more frequently in comparison with subjects with WEA. Conclusions Test for recombinant latex allergens is much more accurate in recognition of latex allergy than test for latex extract, which seems to produce false‐positive results in patients with pollen allergy. The measurements of sIgE against recombinant latex allergens Hev b 6.01, 6.02, 5, and 8 are useful in differentiating OA from WEA.
    • Health effects of Radiofrequency Electromagnetic Fields (RF EMF).

      Bortkiewicz, Alicja; Nofer Institute of Occupational Medicine (2019-09-01)
    • Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review.

      Phillips, Catherine M; Chen, Ling-Wei; Heude, Barbara; Bernard, Jonathan Y; Harvey, Nicholas C; Duijts, Liesbeth; Mensink-Bout, Sara M; Polanska, Kinga; Mancano, Giulia; Suderman, Matthew; et al. (2019-08-12)
      There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed to characterize the inflammatory potential of habitual diet. Subsequently, a large and rapidly growing body of research investigating associations between dietary inflammatory potential, determined by the DII, and risk of a wide range of NCDs has emerged. In this narrative review, we examine the current state of the science regarding relationships between the DII and cancer, cardiometabolic, respiratory and musculoskeletal diseases, neurodevelopment, and adverse mental health outcomes. We synthesize the findings from recent studies, discuss potential underlying mechanisms, and look to the future regarding novel applications of the adult and children's DII (C-DII) scores and new avenues of investigation in this field of nutritional research.
    • [Ten years of the application of REACH and CLP - assessing the knowledge and implementation of these regulations by Polish users of chemicals].

      Konieczko, Katarzyna; Czerczak, Sławomir; Kupczewska-Dobecka, Małgorzata; Nofer Institute of Occupational Medicine (2019-07-16)
      Wstęp: Celem pracy było przeprowadzenie oceny świadomości dalszych użytkowników i dystrybutorów chemikaliów w Polsce na temat obowiązujących regulacji prawnych [rozporządzenia dotyczącego rejestracji, oceny i udzielania zezwoleń w zakresie chemikaliów (Registration, Evaluation, Authorisation and Restriction of Chemicals − REACH) i rozporządzenia w sprawie klasyfikacji, oznakowania i pakowania (classification, labelling and packaging − CLP)] w zakresie chemikaliów oraz określenie na tej podstawie potrzeby szkoleń i akcji informacyjnych skierowanych do tych grup zawodowych za pomocą badania ankietowego. Materiał i metody: Do przeprowadzenia ankiety wybrano internetowe oprogramowanie SurveyMonkey. Badaniami objęto 2 grupy respondentów. Pierwszą grupę osób, do których skierowano ankietę, stanowili dalsi użytkownicy i dystrybutorzy substancji chemicznych i ich mieszanin, 2 grupę – konsumenci. Wyniki: Uzyskano odpowiedzi od 65 dalszych użytkowników i dystrybutorów chemikaliów oraz od 98 konsumentów. Aż 23% respondentów nie znało obowiązków, jakie nakładają na ich przedsiębiorstwo rozporządzenia REACH i CLP. Ponad 59% badanych (dalszych użytkowników i dystrybutorów) nie miało możliwości uczestniczenia w szkoleniach dotyczących zarządzania bezpieczeństwem chemicznym w ostatnich 5 latach. Osiemdziesiąt procent respondentów było zainteresowanych uczestnictwem w nieodpłatnych kursach umożliwiających poszerzenie wiedzy z zakresu klasyfikacji, oznakowania i wprowadzania chemikaliów do obrotu. Wnioski: Pomimo 10 lat obowiązywania REACH i CLP wiele osób pracujących w przedsiębiorstwach nadal nie zna obowiązków swojej firmy określonych w tych rozporządzeniach. Odsetek pracowników pozytywnie oceniających swoje kompetencje rośnie wraz z wielkością przedsiębiorstwa. Wyniki badania ankietowego wskazują na potrzebę organizowania ustawicznych szkoleń dla osób stosujących chemikalia w działalności zawodowej oraz dla dystrybutorów. Bardzo istotne jest przeszkolenie na podstawowym poziomie dystrybutorów chemikaliów. Szkolenia powinny zapewnić im elementarną wiedzę na temat zagrożeń stwarzanych przez chemikalia, tak aby mogli te informacje w przystępny sposób przekazać konsumentom
    • [The reaction of the circulatory system to stress and electromagnetic fields emitted by mobile phones - 24-h monitoring of ECG and blood pressure].

      Szyjkowska, Agata; Gadzicka, Elzbieta; Szymczak, Wiesław; Bortkiewicz, Alicja; Nofer Institute of Occupational Medicine (2019-07-16)
      Wstęp: 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. Materiał i metody: 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 (ambulatory blood pressure monitoring − ABPM)]. Oceniono u nich także stan zdrowia, poziom stresu zawodowego i ogólnego oraz ekspozycję na PEM. Wyniki: 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. Wnioski: 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.
    • [Workers' view on the preventive needs for civilization diseases' in prophylactic care taken on employees].

      Lipińska-Ojrzanowska, Agnieszka; Magnuska, Jadwiga; Świerczyńska-Machura, Dominika; Walusiak-Skorupa, Jolanta; Marcinkiewicz, Andrzej; Wiszniewska, Marta; Nofer Institute of Occupational Medicine (2019-07-16)
      Wstęp: 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). Materiał i metody: 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). Wyniki: 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. Wnioski: 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.
    • Are platinum nanoparticles safe to human health?

      Czubacka, Ewelina; Czerczak, Sławomir; Nofer Institute of Occupational Medicine (2019-07-16)
      Platinum nanoparticles (PtNPs) have been widely used not only in industry, but above all in medicine and diagnostics. However, there are disturbing reports related to the toxic effects of nanoplatinum, which is the main reason why the authors of this study have decided to review and analyze literature data related to its toxicity and impact on human health. While PtNPs may be absorbed by the respiratory and digestive tract, and can penetrate through the epidermis, there is no evidence concerning their absorption through the skin. Platinum nanoparticles accumulate mainly in the liver and spleen although they also reach other internal organs, such as lungs, kidneys or heart. Toxicokinetics of platinum nanoparticles depends strongly on the particle size. Only few studies regarding platinum nanoparticles toxicity have been conducted. Animals intratracheally exposed to platinum nanoparticles have demonstrated an increased level of proinflammatory cytokines in bronchoalveolar lavage which confirms inflammatory response in the lungs. Oral administration of PtNPs can cause inflammatory response and induce oxidative stress. Nanoplatinum has been found to induce hepatotoxicity and nephrotoxicity via the intravenous route. It can cause DNA damage and cellular apoptosis without significant cytotoxicity. There are no research studies on its carcinogenicity. Fetal or maternal toxicity has not been observed, but an increased mortality and a decreased growth of the offspring have been demonstrated. Platinum nanoparticles may permeate the skin barrier but there is no evidence for their absorption. Due to the insufficient number of tests that have been carried out to date, it is not possible to clearly determine the occupational exposure limit value; however, caution is recommended to employees exposed to their effects.
    • Health risk in transport workers. Part II. Dietary compounds as modulators of occupational exposure to chemicals.

      Kozłowska, Lucyna; Gromadzińska, Jolanta; Wąsowicz, Wojciech; Nofer Institute of Occupational Medicine (2019-07-15)
      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
    • Family, school and neighborhood factors moderating the relationship between physical activity and some aspects of mental health in adolescents.

      Kleszczewska, Dorota; Mazur, Joanna; Siedlecka, Jadwiga; Nofer Institute of Occupational Medicine (2019-07-15)
      The impact of physical activity on mental health is widely described in literature. Less attention is given to factors which may modify this correlation, except for gender. The aim of this study was to conduct a qualitative assessment of such papers relating to children and young people. Selected papers were evaluated with regard to additional factors related to family, school and neighborhood. Attention was drawn to the definitions of these variables, the methods of analysis, and the content of the discussion. The starting point for this study included 7 systematic reviews published in 2006–2018. A total of 161 full articles described in detail in those reviews, and representing different research patterns, were selected for qualitative analysis. They met the criteria for the type of publication, mental health outcome, the direction of association, and the age group. A supplementary section of this paper contains a review of Polish literature from the Polish Medical Bibliography, and an analysis of national studies and some more recent papers not included in the analyzed reviews. It was demonstrated that 33 papers analyzed environmental variables to a greater degree than the characteristics of the sample. Twenty-three papers containing the results of statistical analyses were considered to be of particular interest. Almost 50% of these included both the socio-economic position of the family and the characteristics of the neighborhood. However, only 1 featured stratification of the sample with regard to contextual environmental variables. The obtained results are of great practical importance. Firstly, development of the research into environmental moderators should be advocated. Secondly, the social context in which adolescents grow up should be taken into account when designing intervention programs.
    • The association between night shift work and nutrition patterns among nurses: a literature review.

      Pepłońska, Beata; Nowak, Paulina; Trafalska, Elżbieta; Nofer Institute of Occupational Medicine (2019-06-14)
      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.
    • Health promotion and prevention in occupational health systems in Europe.

      Sakowski, Piotr; Marcinkiewicz, Andrzej; Nofer Institute of Occupational Medicine (2019-06-14)
      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.