• 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.
    • Faster health deterioration among nail technicians occupationally exposed to low levels of volatile organic compounds.

      Gresner, Peter; Swiercz, Radosław; Wasowicz, Wojciech; Gromadzinska, Jolanta; Nofer Institute of Occupational Medicine, Łódź, Poland (2017-05-08)
      The study has aimed at investigating the subjective assessment of an individual's health status and comparing the prevalence of selected work-related symptoms among nail technicians occupationally exposed to volatile organic compounds (VOCs) to the one among control subjects. Associations between occupational exposure to VOCs and the incidence of adverse health effects were also analyzed.
    • Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures.

      Jarvinen, Hannu; Farah, Jad; Siiskonen, Teemu; Ciraj-Bjelac, Olivera; Dabin, Jérémie; Carinou, Eleftheria; Domienik-Andrzejewska, Joanna; Kluszczynski, Dariusz; Knežević, Željka; Kopec, Renata; et al. (2018-02)
      The feasibility of setting-up generic, hospital-independent dose alert levels to initiate vigilance on possible skin injuries in interventional procedures was studied for three high-dose procedures (chemoembolization (TACE) of the liver, neuro-embolization (NE) and percutaneous coronary intervention (PCI)) in 9 European countries.
    • Fine mapping of MHC region in lung cancer highlights independent susceptibility loci by ethnicity.

      Ferreiro-Iglesias, Aida; Lesseur, Corina; McKay, James; Hung, Rayjean J; Han, Younghun; Zong, Xuchen; Christiani, David; Johansson, Mattias; Xiao, Xiangjun; Li, Yafang; et al. (2018-09-25)
      Lung cancer has several genetic associations identified within the major histocompatibility complex (MHC); although the basis for these associations remains elusive. Here, we analyze MHC genetic variation among 26,044 lung cancer patients and 20,836 controls densely genotyped across the MHC, using the Illumina Illumina OncoArray or Illumina 660W SNP microarray. We impute sequence variation in classical HLA genes, fine-map MHC associations for lung cancer risk with major histologies and compare results between ethnicities. Independent and novel associations within HLA genes are identified in Europeans including amino acids in the HLA-B*0801 peptide binding groove and an independent HLA-DQB1*06 loci group. In Asians, associations are driven by two independent HLA allele sets that both increase risk in HLA-DQB1*0401 and HLA-DRB1*0701; the latter better represented by the amino acid Ala-104. These results implicate several HLA-tumor peptide interactions as the major MHC factor modulating lung cancer susceptibility.
    • First steps toward harmonized human biomonitoring in Europe: demonstration project to perform human biomonitoring on a European scale.

      Den Hond, Elly; Govarts, Eva; Willems, Hanny; Smolders, Roel; Casteleyn, Ludwine; Kolossa-Gehring, Marike; Schwedler, Gerda; Seiwert, Margarete; Fiddicke, Ulrike; Castaño, Argelia; et al. (2015-03)
      For Europe as a whole, data on internal exposure to environmental chemicals do not yet exist. Characterization of the internal individual chemical environment is expected to enhance understanding of the environmental threats to health.
    • Fish consumption patterns and hair mercury levels in children and their mothers in 17 EU countries.

      Castaño, Argelia; Cutanda, Francisco; Esteban, Marta; Pärt, Peter; Navarro, Carmen; Gómez, Silvia; Rosado, Montserrat; López, Ana; López, Estrella; Exley, Karen; et al. (2015-02-06)
      The toxicity of methylmercury (MeHg) in humans is well established and the main source of exposure is via the consumption of large marine fish and mammals. Of particular concern are the potential neurodevelopmental effects of early life exposure to low-levels of MeHg. Therefore, it is important that pregnant women, children and women of childbearing age are, as far as possible, protected from MeHg exposure. Within the European project DEMOCOPHES, we have analyzed mercury (Hg) in hair in 1799 mother-child pairs from 17 European countries using a strictly harmonized protocol for mercury analysis. Parallel, harmonized questionnaires on dietary habits provided information on consumption patterns of fish and marine products. After hierarchical cluster analysis of consumption habits of the mother-child pairs, the DEMOCOPHES cohort can be classified into two branches of approximately similar size: one with high fish consumption (H) and another with low consumption (L). All countries have representatives in both branches, but Belgium, Denmark, Spain, Portugal and Sweden have twice as many or more mother-child pairs in H than in L. For Switzerland, Czech Republic, Hungary, Poland, Romania, Slovenia and Slovakia the situation is the opposite, with more representatives in L than H. There is a strong correlation (r=0.72) in hair mercury concentration between the mother and child in the same family, which indicates that they have a similar exposure situation. The clustering of mother-child pairs on basis of their fish consumption revealed some interesting patterns. One is that for the same sea fish consumption, other food items of marine origin, like seafood products or shellfish, contribute significantly to the mercury levels in hair. We conclude that additional studies are needed to assess and quantify exposure to mercury from seafood products, in particular. The cluster analysis also showed that 95% of mothers who consume once per week fish only, and no other marine products, have mercury levels 0.55μg/g. Thus, the 95th percentile of the distribution in this group is only around half the US-EPA recommended threshold of 1μg/g mercury in hair. Consumption of freshwater fish played a minor role in contributing to mercury exposure in the studied cohort. The DEMOCOPHES data shows that there are significant differences in MeHg exposure across the EU and that exposure is highly correlated with consumption of fish and marine products. Fish and marine products are key components of a healthy human diet and are important both traditionally and culturally in many parts of Europe. Therefore, the communication of the potential risks of mercury exposure needs to be carefully balanced to take into account traditional and cultural values as well as the potential health benefits from fish consumption. European harmonized human biomonitoring programs provide an additional dimension to national HMB programs and can assist national authorities to tailor mitigation and adaptation strategies (dietary advice, risk communication, etc.) to their country's specific requirements.
    • For the sake of linguistic and scientific appropriatness - How to translate presenteeism into Polish?

      Wezyk, Agata; Merecz-Kot, Dorota; Nofer Institute of Occupational Medicine, Lodz, Poland (2015)
    • Fullerenes: Characteristics of the substance, biological effects and occupational exposure levels

      Swidwinska-Gajewska, Anna; Czerczak, Slawomir; Nofer Institute of Occupational Medicine, Lodz, Poland (2016)
      Fullerenes are molecules composed of an even number of carbon atoms of a spherical or an ellipsoidal, closed spatial structure. The most common fullerene is the C60 molecule with a spherical structure - a truncated icosahedron, compared to a football. Fullerenes are widely used in the diagnostics and medicine, but also in the electronics and energy industry. Occupational exposure to fullerene may occur during its production. The occupational concentrations of fullerenes reached 0.12–1.2 μ/m3 for nanoparticles fraction (< 100 nm), which may evidence low exposure levels. However, fullerene mostly agglomerates into larger particles. Absorption of fullerene by oral and respiratory routes is low, and it is not absorbed by skin. After intravenous administration, fullerene accumulates mainly in the liver but also in the spleen and the kidneys. In animal experiments there was no irritation or skin sensitization caused by fullerene, and only mild irritation to the eyes. Fullerene induced transient inflammation in the lungs in inhalation studies in rodents. Oral exposure does not lead to major adverse effects. Fullerene was not mutagenic, genotoxic or carcinogenic in experimental research. However, fullerene may cause harmful effects on the mice fetus when administered intraperitoneally or intravenously. Pristine C60 fullerene is characterized by poor absorption and low toxicity, and it does not pose a risk in the occupational environment. The authors of this study are of the opinion that there is no ground for estimating the maximum allowable concentration (NDS) of pristine fullerene C60. Fullerene derivatives, due to different characteristics, require separate analysis in terms of occupational risk assessment.
    • Funkcjonowanie placówek wsparcia dziennego z regionu łódzkiego. Bariery i potrzeby.

      Pyżalski, Jacek; Korzeniowska, Elzbieta; Plichta, Piotr; Puchalski, Krzysztof; Michalowska-Knol, Kamila; Petrykowska, Alicja; Nofer Institute of Occupational Medicine, Lodz, Poland (Regionalne Centrum Polityki Społecznej w Łodzi, 2016)
      Raport pn. Funkcjonowanie placówek wsparcia dziennego z regionu łódzkiego. Bariery i potrzeby przygotowany został przez Instytut Medycyny Pracy im. prof. J. Nofera w Łodzi na zlecenie Regionalnego Centrum Polityki Społecznej w Łodzi. Opracowanie prezentuje wyniki diagnozy sytuacji prawnej placówek wsparcia dziennego (PWD), ich zasobów, dostępności, oferty usług, współpracy z otoczeniem społecznym oraz potrzeb, barier i problemów, jakich doświadczają w swoim funkcjonowaniu. Diagnoza powstała w oparciu o badania ilościowe oraz jakościowe, obejmujące zarówno analizy dokumentów, sondaże, jak i wywiady przeprowadzone wśród kierowników i personelu PWD, podopiecznych oraz ich rodziców/opiekunów prawnych.
    • Gene set enrichment analysis and expression pattern exploration implicate an involvement of neurodevelopmental processes in bipolar disorder.

      Mühleisen, Thomas W; Reinbold, Céline S; Forstner, Andreas J; Abramova, Lilia I; Alda, Martin; Babadjanova, Gulja; Bauer, Michael; Brennan, Paul; Chuchalin, Alexander; Cruceanu, Cristiana; et al. (2018)
      Bipolar disorder (BD) is a common and highly heritable disorder of mood. Genome-wide association studies (GWAS) have identified several independent susceptibility loci. In order to extract more biological information from GWAS data, multi-locus approaches represent powerful tools since they utilize knowledge about biological processes to integrate functional sets of genes at strongly to moderately associated loci.
    • Genetic Contributions to The Association Between Adult Height and Head and Neck Cancer: A Mendelian Randomization Analysis

      Pastorino, Roberta; Puggina, Anna; Carreras-Torres, Robert; Lagiou, Pagona; Holcátová, Ivana; Richiardi, Lorenzo; Kjaerheim, Kristina; Agudo, Antonio; Castellsagué, Xavier; Macfarlane, Tatiana V.; et al. (2018-03-14)
      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.
    • Genetic interaction analysis among oncogenesis-related genes revealed novel genes and networks in lung cancer development.

      Li, Yafang; Xiao, Xiangjun; Bossé, Yohan; Gorlova, Olga; Gorlov, Ivan; Han, Younghun; Byun, Jinyoung; Leighl, Natasha; Johansen, Jakob S; Barnett, Matt; et al. (2019-03-05)
      The development of cancer is driven by the accumulation of many oncogenesis-related genetic alterations and tumorigenesis is triggered by complex networks of involved genes rather than independent actions. To explore the epistasis existing among oncogenesis-related genes in lung cancer development, we conducted pairwise genetic interaction analyses among 35,031 SNPs from 2027 oncogenesis-related genes. The genotypes from three independent genome-wide association studies including a total of 24,037 lung cancer patients and 20,401 healthy controls with Caucasian ancestry were analyzed in the study. Using a two-stage study design including discovery and replication studies, and stringent Bonferroni correction for multiple statistical analysis, we identified significant genetic interactions between SNPs in
    • Genome-wide association analyses identify new susceptibility loci for oral cavity and pharyngeal cancer.

      Lesseur, Corina; Diergaarde, Brenda; Olshan, Andrew F; Wünsch-Filho, Victor; Ness, Andrew R; Liu, Geoffrey; Lacko, Martin; Eluf-Neto, José; Franceschi, Silvia; Lagiou, Pagona; et al. (2016-12)
      We conducted a genome-wide association study of oral cavity and pharyngeal cancer in 6,034 cases and 6,585 controls from Europe, North America and South America. We detected eight significantly associated loci (P < 5 × 10(-8)), seven of which are new for these cancer sites. Oral and pharyngeal cancers combined were associated with loci at 6p21.32 (rs3828805, HLA-DQB1), 10q26.13 (rs201982221, LHPP) and 11p15.4 (rs1453414, OR52N2-TRIM5). Oral cancer was associated with two new regions, 2p23.3 (rs6547741, GPN1) and 9q34.12 (rs928674, LAMC3), and with known cancer-related loci-9p21.3 (rs8181047, CDKN2B-AS1) and 5p15.33 (rs10462706, CLPTM1L). Oropharyngeal cancer associations were limited to the human leukocyte antigen (HLA) region, and classical HLA allele imputation showed a protective association with the class II haplotype HLA-DRB1*1301-HLA-DQA1*0103-HLA-DQB1*0603 (odds ratio (OR) = 0.59, P = 2.7 × 10(-9)). Stratified analyses on a subgroup of oropharyngeal cases with information available on human papillomavirus (HPV) status indicated that this association was considerably stronger in HPV-positive (OR = 0.23, P = 1.6 × 10(-6)) than in HPV-negative (OR = 0.75, P = 0.16) cancers.
    • Genome-wide association analyses identify new susceptibility loci for oral cavity and pharyngeal cancer.

      Lesseur, Corina; Diergaarde, Brenda; Olshan, Andrew F; Wünsch-Filho, Victor; Ness, Andrew R; Liu, Geoffrey; Lacko, Martin; Eluf-Neto, José; Franceschi, Silvia; Lagiou, Pagona; et al. (2016-12)
      We conducted a genome-wide association study of oral cavity and pharyngeal cancer in 6,034 cases and 6,585 controls from Europe, North America and South America. We detected eight significantly associated loci (P < 5 × 10(-8)), seven of which are new for these cancer sites. Oral and pharyngeal cancers combined were associated with loci at 6p21.32 (rs3828805, HLA-DQB1), 10q26.13 (rs201982221, LHPP) and 11p15.4 (rs1453414, OR52N2-TRIM5). Oral cancer was associated with two new regions, 2p23.3 (rs6547741, GPN1) and 9q34.12 (rs928674, LAMC3), and with known cancer-related loci-9p21.3 (rs8181047, CDKN2B-AS1) and 5p15.33 (rs10462706, CLPTM1L). Oropharyngeal cancer associations were limited to the human leukocyte antigen (HLA) region, and classical HLA allele imputation showed a protective association with the class II haplotype HLA-DRB1*1301-HLA-DQA1*0103-HLA-DQB1*0603 (odds ratio (OR) = 0.59, P = 2.7 × 10(-9)). Stratified analyses on a subgroup of oropharyngeal cases with information available on human papillomavirus (HPV) status indicated that this association was considerably stronger in HPV-positive (OR = 0.23, P = 1.6 × 10(-6)) than in HPV-negative (OR = 0.75, P = 0.16) cancers.
    • Genome-wide association study identifies multiple risk loci for renal cell carcinoma.

      Scelo, Ghislaine; Purdue, Mark P; Brown, Kevin M; Johansson, Mattias; Wang, Zhaoming; Eckel-Passow, Jeanette E; Ye, Yuanqing; Hofmann, Jonathan N; Choi, Jiyeon; Foll, Matthieu; et al. (2017-06-09)
      Previous genome-wide association studies (GWAS) have identified six risk loci for renal cell carcinoma (RCC). We conducted a meta-analysis of two new scans of 5,198 cases and 7,331 controls together with four existing scans, totalling 10,784 cases and 20,406 controls of European ancestry. Twenty-four loci were tested in an additional 3,182 cases and 6,301 controls. We confirm the six known RCC risk loci and identify seven new loci at 1p32.3 (rs4381241, P=3.1 × 10(-10)), 3p22.1 (rs67311347, P=2.5 × 10(-8)), 3q26.2 (rs10936602, P=8.8 × 10(-9)), 8p21.3 (rs2241261, P=5.8 × 10(-9)), 10q24.33-q25.1 (rs11813268, P=3.9 × 10(-8)), 11q22.3 (rs74911261, P=2.1 × 10(-10)) and 14q24.2 (rs4903064, P=2.2 × 10(-24)). Expression quantitative trait analyses suggest plausible candidate genes at these regions that may contribute to RCC susceptibility.
    • Genome-wide interaction study of smoking behavior and non-small cell lung cancer risk in Caucasian population

      Li, Yafang; Xiao, Xiangjun; Han, Younghun; Gorlova, Olga; Qian, David; Leighl, Natasha; Johansen, Jakob S; Barnett, Matt; Chen, Chu; Goodman, Gary; et al. (2018-03)
      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 13336 non-small cell lung cancer cases. Candidate SNPs with P-value <0.001 were further analyzed using a standard case-control interaction analysis including 13970 controls. The significant SNPs with P-value <3.5 × 10-5 (correcting for multiple tests) from the case-control analysis in the discovery stage were further validated using an independent replication dataset comprising 5377 controls and 3054 non-small cell lung cancer cases. We further stratified the analysis by histological subtypes. Two novel SNPs, rs6441286 and rs17723637, were identified for overall lung cancer risk. The interaction odds ratio and meta-analysis P-value for these two SNPs were 1.24 with 6.96 × 10-7 and 1.37 with 3.49 × 10-7, respectively. In addition, interaction of smoking with rs4751674 was identified in squamous cell lung carcinoma with an odds ratio of 0.58 and P-value of 8.12 × 10-7. This study is by far the largest genome-wide SNP-smoking interaction analysis reported for lung cancer. The three identified novel SNPs provide potential candidate biomarkers for lung cancer risk screening and intervention. The results from our study reinforce that gene-smoking interactions play important roles in the etiology of lung cancer and account for part of the missing heritability of this disease.
    • Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania.

      Santos, Susana; Eekhout, Iris; Voerman, Ellis; Gaillard, Romy; Barros, Henrique; Charles, Marie-Aline; Chatzi, Leda; Chevrier, Cécile; Chrousos, George P; Corpeleijn, Eva; et al. (2018-11-05)
      Gestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies. We used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape. We observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4-17.4) for underweight women, 14.5 kg (11.5-17.7) for normal weight women, 13.9 kg (10.1-17.9) for overweight women, and 11.2 kg (7.0-15.7), 8.7 kg (4.3-13.4) and 6.3 kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications. Gestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.
    • Good practice in occupational health services – Certification of stroke as an accident at work. Need for secondary prevention in people returning to work after acute cerebrovascular events

      Marcinkiewicz, Andrzej; Walusiak-Skorupa, Jolanta; Nofer Institute of Occupational Medicine, Lodz, Poland (2015)
      The classification of an acute vascular episode, both heart infarct and stroke, as an accident at work poses difficulties not only for post accidental teams, but also to occupational health professionals, experts and judges at labor and social insurance courts. This article presents the case of a 41-year-old office worker, whose job involved client services. While attending a very aggressive customer she developed solid stress that resulted in symptoms of the central nervous system (headache, speech disturbances). During her hospitalisation at the neurological unit ischemic stroke with transient mixed type aphasia was diagnosed. Magnetic resonance imaging (MRI) scan of the head revealed subacute ischemia. After an analysis of the accident circumstances, the employer’s post accidental team decided that ischemic stroke had been an accident at work, because it was a sudden incident due to an external cause inducing work-related traumatic stroke. As a primary cause tough stress and emotional strain due to the situation developed while attending the customer were acknowledged. During control medical check up after 5 months the patient was found to be fit for work, so she could return to work. However, it should be noted that such a check up examination of subjects returning to work after stroke must be holistic, including the evaluation of job predispositions and health education aimed at secondary prevention of heart and vascular diseases with special reference to their risk factors.
    • Good practice in occupational health services – The influence of hazardous conditions and nuisance coexisting in the work environment and at home on the course and outcome of pregnancy

      Marcinkiewicz, Andrzej; Wezyk, Agata; Muszynski, Paweł; Polanska, Kinga; Makowiec-Dabrowska, Teresa; Wiszniewska, Marta; Walusiak-Skorupa, Jolanta; Hanke, Wojciech; Nofer Institute of Occupational Medicine, Lodz, Poland (2015)
      The key activity in good practice of occupational medicine is to control, on a regular basis, the workers’ health and how it is affected by the work environment and – consequently – to provide the employers and employees with advice regarding the organization, ergonomics, physiology and psychology of work. Occupational medicine practitioners should remember that certain duties are performed both at work and at home. This issue is particularly important in preventive healthcare of pregnant working women. Taking the above into consideration, we reviewed the literature with respect to nuisance and occupational risk factors, which might be associated with professional and household duties. The research indicates the need to reduce activities that require frequent bending or lifting, put a women at risk of falling or cause excess occupational stress for pregnant women. We would like to draw the doctors’ attention to the possibility of exceeding a 4-hour limit of work at video display terminals and negative effects of low physical exercise and sitting for a long time both at work and at home. Since long working hours (over 40 h/week) affect the course of pregnancy negatively, total working time at work (including any additional jobs) and at home must be taken into account in the occupational risk assessment. To sum up, we emphasize that preventive healthcare of pregnant working women should mainly include education programmes. Women need to know how to perform their work safely and pay attention to the scope and frequency of household tasks (duties).
    • [Health criteria and scope of workers' periodic health check-ups for selected types of work and exposure factors - Nofer Institute of Occupational Medicine guidelines].

      Rybacki, Marcin; Wiszniewska, Marta; Wdówik, Paweł; Marcinkiewicz, Andrzej; Pas-Wyroślak, Alicja; Śliwińska-Kowalska, Mariola; Walusiak-Skorupa, Jolanta; Nofer Institute of Occupational Medicine (2019-02-28)
      Workers' medical prophylactic examinations referred to in the Labor Code are one of the tasks of the occupational medicine services. They are regulated by law which has been in force for more than 20 years in unchanged form. During this period, new harmful, burdensome or dangerous to health factors appeared in the workplaces, for which no preventive health check-up standard was defined. In the meantime, the health criteria for drivers and persons applying for driving licenses have also been significantly liberalized. The above changes, the authors' own experience, comments and problems reported by physicians who provide workers' prophylactic health care and employers as well as analysis of literature related to workers' health care in other countries have created the need to harmonize and update guidelines on health requirements for selected types of work. In addition the scope and frequency of prophylactic examinations for exposures, which are not included in applicable legal acts, has been developed. Med Pr. 2019;70(1):125-37. Badania profilaktyczne pracowników, o których mowa w Kodeksie pracy, to jedno z zadań służby medycyny pracy. Są one regulowane przepisami prawa obowiązującymi w niezmienionej formie już od ponad 20 lat. W tym okresie na wielu stanowiskach pracy pojawiły się nowe czynniki szkodliwe, uciążliwe lub niebezpieczne dla zdrowia, dla których nie określono standardu badania profilaktycznego. Znacznie zliberalizowano także kryteria zdrowotne dla kierowców i osób ubiegających się o uprawnienia do prowadzenia pojazdów silnikowych. Powyższe zmiany, doświadczenia własne autorów, uwagi i problemy zgłaszane przez lekarzy sprawujących opiekę profilaktyczną i pracodawców oraz analiza piśmiennictwa związanego z ochroną zdrowia pracujących w innych krajach stworzyły konieczność ujednolicenia i uaktualnienia wytycznych dotyczących wymagań zdrowotnych dla wybranych rodzajów prac. Ponadto opracowano zakres i częstotliwość badań profilaktycznych dla narażeń, które nie są ujęte w obowiązujących aktach prawnych. Med. Pr. 2019;70(1):125–137.