• Health effects of Radiofrequency Electromagnetic Fields (RF EMF).

      Bortkiewicz, Alicja; Nofer Institute of Occupational Medicine (2019-09-01)
    • [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
    • 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.
    • [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.
    • 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
    • [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
    • Physical activity and features of the environment in which school children grow up as low mood determinants.

      Kleszczewska, Dorota; Siedlecka, Jadwiga; Mazur, Joanna; Nofer Institute of Occupational Medicine (2019)
      Introduction: Reduced wellbeing and low mood also apply to young people and may lead to serious mental problems. Aim of the study: The purpose of the study was to analyse the prevalence of depression threat symptoms depending on the level of physical activity of young people, taking into account environmental factors and the quality of social relations. Material and methods: The survey conducted within the framework of the last round of international Health Behaviour in School-aged Children (HBSC) studies in the academic year 2017/2018 covered 5225 students aged 11–15 years from all over Poland. The mental wellbeing of young people measured by the WHO-5 screen test was the dependent variable. Sixteen independent variables were taken into account, in blocks related to the assessment of demographic features, physical activity, social and economic position, and social relations. Results: The study demonstrated that 14.2% of respondents had depression threat symptoms. After a mul- tidimensional analysis the main risk factors were low level of family support (OR = 3.20), maladjustment to school (OR = 2.79), inability to cope in social situations (OR = 2.52), and low physical activity (OR = 2.15). Factors associated with living conditions do not have a direct effect on depression risk but moderate the impact of physical activity on its symptoms. Conclusions: The protective effect of physical activity on the mental health of teenagers is maintained after taking into account several other predictors of reduced wellbeing. Factors associated with living conditions do not have a direct influence on depression risk but moderate the effect of physical activity on its symptoms. The protective effect of physical activity is particularly visible in single-parent families, in poor families, and in large cities. It is important to design programs providing equal opportunities to children growing up in a less favourable environment by providing young people from the poorest families with the ability to participate in free of charge sports activities, particularly team sports
    • 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.
    • Work Ability Index (WAI) values in a sample of the working population in Poland.

      Juszczyk, Grzegorz; Czerw, Aleksandra Izabela; Religioni, Urszula; Olejniczak, Dominik; Walusiak-Skorupa, Jolanta; Banas, Tomasz; Mikos, Marcin; Staniszewska, Anna; Nofer Institute of Occupational Medicine (2019-03-22)
      Introduction: Ability to work is most often defined as a relationship between a person’s resources and requirements specific to a particular type of work. It is the result of interaction between job requirements in terms of physical and mental strain, capabilities and skills of the employee, as well as his/her health condition and own evaluation of functioning in a given organizational and social situation. Objective: The primary objective of the study was to evaluate the current value of the Work Ability Index (WAI) in a sample of employees in Poland. Material and methods: The study sample was selected purposefully from 422,000 employees covered by the largest occupational health provider in Poland. The standard WAI questionnaire provided by CAWI (Computer-Assisted Web Interview) methodology was voluntary and completed anonymously by 688 employees within 12 months (0.16% response rate). The results were statistically analyzed using the Pearson’s chi-squared test and correlation coefficient, independent-sample T test and one-way analysis of variance (p<0.05). Results: It was found that the average value of WAI was 37.5 ± 7.7, and 37% of the participants represented low to moderate ability to work. The results showed no significant correlation between the WAI value and its 7 compounds and demographic variables. Nonetheless, a dependency between WAI level and industrial branch was observed.
    • 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 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.
    • [Health promotion in medium-sized and large companies in Poland in 2017 - activities, implementation, effects and difficulties].

      Puchalski, Krzysztof; Korzeniowska, Elżbieta; Nofer Institute of Occupational Medicine (2019-06-14)
      Background: The paper presents the state of workplace health promotion in Poland as of December 2017. Material and Methods: Standardized computer-assisted personal interviews (CAPI) were conducted on a representative sample of 1000 companies employing over 50 people. Results: Few companies (37%) actually know the health needs of their employees, whereas 25% admit that they care about health more than it is required by law, and declare their increased involvement in that area. At the same time, 55% of companies sponsor sports tickets, and 52% cover the costs of medical care. Every second company supports physical activity in other ways and improves the working environment. Every third offers medical prophylaxis, takes care of stress reduction and healthy eating habits, or solves the problems of alcohol consumption. The main reasons for such activities are the company’s image (79%), good social atmosphere (72%) and employee’s work performance (69%), while the prevention of health problems is rarely indicated (43%). The effects of workplace health promotion measures include improved productivity (50%), a better health condition (49%) and an increased identification with the company (47%). As for the obstacles, these is a shortage of financial resources (53%), the lack of favorable fiscal and legal solutions (48%), low interest among employees (45%), the lack of skilled people to manage health promotion (42%) and low awareness of its benefits (37%). Companies that are consciously involved in health promotion and monitor the actual health needs implement more activities, evaluate them more often, recognize their positive effects, and are able to better motivate their employees. Conclusions: There is a need to develop systemic solutions that foster health promotion in companies, to disseminate knowledge about the benefits associated with it, and to train the staff responsible for employee health management.
    • 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.
    • Perceived barriers and motivators to smoking cessation among socially-disadvantaged populations in Poland.

      Milcarz, Katarzyna; Polańska, Kinga; Balwicki, Łukasz; Makowiec-Dąbrowska, Teresa; Hanke, Wojciech; Bąk-Romaniszyn, Leokadia; Kaleta, Dorota; Nofer Institute of Occupational Medicine (2019-06-14)
      OBJECTIVES: This study aimed at assessment of the perceived barriers and motivators to smoking cessation among socially-disadvantaged populations in Poland. It is hypothesized that different factors can be considered depending on the level of smoking addiction. Therefore, a comparison between light and heavy smokers was performed. MATERIAL AND METHODS: Data collected during the second wave of a cross-sectional study carried out in the Piotrkowski District in October 2016 - February 2017 among 1668 socio-economically disadvantaged persons constituted the source of information for the present study. Barriers and motivators to smoking cessation among daily smokers were identified via face-to face interviews. RESULTS: About one-third of the studied population admitted to being current daily smokers, almost 75% of whom were heavy smokers. The most common barriers to quitting smoking were related to difficulties in quitting (62%), the lack of willingness to quit (56%), as well as addiction and withdrawal symptoms (craving cigarettes [65%], habit [56%], stress and mood swings [55%]). A significantly higher proportion of such barriers was noted among heavy smokers compared to light smokers (p < 0.05). The following motivations to quit were pointed out by the respondents: available pharmacotherapy (47%), access to a free-of-charge cessation clinic (40%), and encouragement and support provided by their doctor (30%), with no differences between various levels of smoking addiction (p > 0.05). CONCLUSIONS: Developing effective interventions targeted at unique deprived populations requires understanding the barriers and motivators to quitting smoking. Social support and financial issues, including free-of-charge pharmacotherapy and cessation clinics, as well as doctor's encouragement and support, are crucial for successful smoking cessation in this vulnerable population
    • Health risk in road transport workers. Part I. Occupational exposure to chemicals, biomarkers of effect.

      Gromadzińska, Jolanta; Wąsowicz, Wojciech; Nofer Institute of Occupational Medicine (2019-06-14)
      Motor vehicle emissions constitute a mixture of different chemicals: volatile organic solvents, polycyclic aromatic hydrocarbons, heavy metals, isocyanates, etc. Drivers working in car cabins are exposed to chemicals deriving from incomplete combustion of fuels, exhaust emissions from working engines and fuel evaporation. Concentrations of these substances are rather low and do not exceed the applicable hygiene standards, but some of them pose, or are suspected to pose, carcinogenic risk. The interaction of chemical substances with human cells and tissues can lead to a number of modifications of metabolic pathways at a cellular level. The first biological mechanism of metabolic modulation is an inflammatory state and oxidative stress generation. The aim of this review is to analyze biomarkers of effect and to assess the hazard of occupational exposure of drivers. Int J Occup Med Environ Health. 2019;32(3):267–80
    • Determinants of phthalate exposure and risk assessment in children from Poland.

      Garí, Mercè; Koch, Holger M; Pälmke, Claudia; Jankowska, Agnieszka; Wesołowska, Ewelina; Hanke, Wojciech; Nowak, Dennis; Bose-O'Reilly, Stephan; Polańska, Kinga; Nofer Institute of Occupational Medicine (2019-04-16)
      Phthalates are a group of widely used chemicals and humans are exposed to them in their daily life. Some phthalates may affect the hormonal balance in both children and adults. The aim of this study was to assess the phthalate exposure and its determinants among children at age of 7 years from the Polish Mother and Child Cohort Study (REPRO_PL). 250 urine samples collected in 2014-2015 were analysed for 21 metabolites of 11 parent phthalates using on-line high performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS/MS). This represents the most extensive set of phthalate metabolites ever determined for Poland. Ten metabolites were quantifiable in 100% of the samples, another eight in >90%. The highest median concentrations were found for the primary monoester metabolites of di-iso-butyl (MiBP, 72.4 μg/l), di-n-butyl (MnBP, 56.3 μg/l) and diethyl (MEP, 42.0 μg/l) phthalate, followed by the sum of di-2-ethylhexyl (ΣDEHP, 89.3 μg/l) and di-iso-nonyl (ΣDiNP, 21.9 μg/l) phthalate metabolites. Metabolite concentrations were higher in children at 7 years than in the same children at age 2 or in their mothers during pregnancy. Generally, phthalate exposures in this study were much higher than exposures reported in other European populations. Multivariate regression models showed that body mass index, place of residence, breastfeeding duration, socio-economic status and parental education were associated with the metabolite levels in the 7-year old children. Daily intake and hazard index calculations revealed that a small percentage of children (around 3-10%) exceeded the tolerable daily intakes established by international institutions such as EFSA and U.S. EPA indicating that these children might be at risk of anti-androgenic effects from the individual and cumulative exposure to phthalates. Thus, further monitoring of this population, by educational programs and follow-up interventions, is required.
    • 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
    • Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: An individual participant data meta-analysis.

      Voerman, Ellis; Santos, Susana; Patro Golab, Bernadeta; Amiano, Pilar; Ballester, Ferran; Barros, Henrique; Bergström, Anna; Charles, Marie-Aline; Chatzi, Leda; Chevrier, Cécile; et al. (2019-02-01)
      Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact. We conducted an individual participant data meta-analysis of data from 162,129 mothers and their children from 37 pregnancy and birth cohort studies from Europe, North America, and Australia. We assessed the individual and combined associations of maternal pre-pregnancy BMI and gestational weight gain, both in clinical categories and across their full ranges, with the risks of overweight/obesity in early (2.0-5.0 years), mid (5.0-10.0 years) and late childhood (10.0-18.0 years), using multilevel binary logistic regression models with a random intercept at cohort level adjusted for maternal sociodemographic and lifestyle-related characteristics. We observed that higher maternal pre-pregnancy BMI and gestational weight gain both in clinical categories and across their full ranges were associated with higher risks of childhood overweight/obesity, with the strongest effects in late childhood (odds ratios [ORs] for overweight/obesity in early, mid, and late childhood, respectively: OR 1.66 [95% CI: 1.56, 1.78], OR 1.91 [95% CI: 1.85, 1.98], and OR 2.28 [95% CI: 2.08, 2.50] for maternal overweight; OR 2.43 [95% CI: 2.24, 2.64], OR 3.12 [95% CI: 2.98, 3.27], and OR 4.47 [95% CI: 3.99, 5.23] for maternal obesity; and OR 1.39 [95% CI: 1.30, 1.49], OR 1.55 [95% CI: 1.49, 1.60], and OR 1.72 [95% CI: 1.56, 1.91] for excessive gestational weight gain). The proportions of childhood overweight/obesity prevalence attributable to maternal overweight, maternal obesity, and excessive gestational weight gain ranged from 10.2% to 21.6%. Relative to the effect of maternal BMI, excessive gestational weight gain only slightly increased the risk of childhood overweight/obesity within each clinical BMI category (p-values for interactions of maternal BMI with gestational weight gain: p = 0.038, p < 0.001, and p = 0.637 in early, mid, and late childhood, respectively). Limitations of this study include the self-report of maternal BMI and gestational weight gain for some of the cohorts, and the potential of residual confounding. Also, as this study only included participants from Europe, North America, and Australia, results need to be interpreted with caution with respect to other populations. In this study, higher maternal pre-pregnancy BMI and gestational weight gain were associated with an increased risk of childhood overweight/obesity, with the strongest effects at later ages. The additional effect of gestational weight gain in women who are overweight or obese before pregnancy is small. Given the large population impact, future intervention trials aiming to reduce the prevalence of childhood overweight and obesity should focus on maternal weight status before pregnancy, in addition to weight gain during pregnancy.
    • Analiza lotnych składników wybranych olejków eterycznych o działaniu relaksacyjnym.

      Kucharska, Małgorzata; Szymańska, Jadwiga A; Wesołowski, Wiktor; Frydrych, Barbara; Bruchajzer, Elżbieta; Nofer Institute of Occupational Medicine (2019-04-19)
      Stress is a result of disturbed homeostasis and can contribute to the development of many diseases. One of the methods of combating stress is aromatherapy, which uses essential oils with a calming and relaxing effect. The aim of the work was to perform a qualitative analysis of selected essential oils with a relaxing effect. The research concerned 6 preparations available on the Polish market, which are attributed with anti-stress activity. The qualitative analysis was carried out by gas chromatography with mass spectrometry, which allows the determination of both main and trace substances in the tested oils. The components of individual samples were compared with data from the literature. In the samples tested 9-36 substances were identified. The following substances had the largest share in the composition of the studied samples: limonene (0.5-91%), linalool acetate (16.8-39.2%), citronellal (0.1-28.7%), linalool (0.8-46.5%), valerianol (17.6%), geraniol (16.4%), and citronellol (14%). According to literature data, the main components of the studied essential oils have low acute toxicity. They can be safely used as intended and in the quantities recommended by the manufacturer. However, one should remember the potential synergistic effect (as a result of exposure to the abovementioned substances from various sources, such as: food, cosmetics, cleaning agents, etc.), as well as sensitizing effects of some compounds contained in oils. Despite the different chemical structure of active substances contained in the tested oils, it is suggested that the mechanism of the relaxing effect is identical and is associated with the inhibition of glutamatergic neurotransmission, similar to the action of benzodiazepines. Med Pr. 2019;70(2):229-47.