Medycyna Pracy (Occupational Medicine) 2020/02

  • Telemedical Maritime Assistance Service at the University Center of Maritime and Tropical Medicine in Gdynia. The analysis of 6 years of activity
    In the 1960s, the International Labour Organization passed a convention under which all countries with national shipping were obliged to create a 24-h telemedicine center for ships. In accordance with the convention, Telemedical Assistance Service centers were to provide permanent access to medical advice given by qualified doctors and to create an international platform for the exchange of information and experience. In Poland, the Telemedical Maritime Assistance Service (TMAS) was established in 2012, and its duties in a 24-h system are carried out by doctors from the University Center of Maritime and Tropical Medicine (UCMTM) in Gdynia. The aim of this work was to determine the reasons for medical officers reporting for help from the TMAS doctor on duty and to create a database of the most common diagnoses and actions undertaken, and in particular evacuation. In the 6-year period, UCMTM doctors provided TMAS advice 225 times, recommending evacuation in over 20% of these cases. Infectious diseases were the most common cause of contact in the entire period under analysis – 61 cases were recorded, accounting for as many as 27% of all applications. Injuries were the second most frequent reason for seeking help from TMAS, and 20% of TMAS applications (44 cases) were related to trauma. The obtained data show that TMAS doctors face various medical problems; therefore, providing proper medical assistance to patients requires a close multidisciplinary cooperation between medical officers, TMAS doctors and emergency services.
  • The measurement of state engagement in actions beyond basic professional duties
    The goal of this paper is to present the phenomenon of engagement in actions that go beyond basic professional duties, and the factor structure and other psychometric properties of the daily measurements of this construct, which corresponds with the growing interest of researchers in the phenomenon of employee engagement, extra-role behaviors and the factors that affect them on a daily basis. The obtained results have shown that the adapted version of the SWE questionnaire is a reliable and valid measure which can be used to measure daily fluctuations in beyond-duties engagement. The 3-factor multilevel model has a satisfactory fit. The study contributes to the current body of literature by examining state engagement in actions that go beyond basic professional duties and the validity of its measurement. It also shows that giving employees more autonomy and feedback may positively influence their beyond-duties engagement.
  • The value system of Polish drivers and road safety. Research report
    The main goal of the research was to describe the hierarchy of drivers' values with particular emphasis on values important from the point of view of road safety, i.e. personal and social safety as well as humility and adaptation to the rules, as well as the relationship between them and the number of accidents and collisions in which they participated. An additional goal was to determine the significance of sociometric variables (age, sex, seniority in driving, education, relationship, number of children) for the hierarchy of drivers' values. The surveyed drivers greatly appreciated kindness and safety, but the need for self-determination prevailed over the value of discipline, especially among men and young drivers. The number of accidents and collisions turned out to be important for assessing safety in a social context, with the observed interdependence being two-way. Of the variables controlled for the hierarchy of values, the age and sex of drivers were of particular importance. The hierarchy of the values of the tested drivers indicates that the value of kindness and safety is highly valued, but the need for self-determination (self-determination), especially for men and young drivers, prevails over the value of discipline (humility, respect for the rules). The main limitation of research was the method of collecting data solely on the basis of self-description - for this reason the results obtained may be burdened with the need for social approval.
  • Health promotion in workplaces with a large share of older workers. Situation in Poland
    Over the next decades, the aging process of the Polish population will increase significantly. This will shrink labor resources. Increasing the share of older employees with poorer health among staff may weaken some operating parameters of workplaces (e.g. lead to an increase in sickness absence). One way to deal with such challenges is to promote employee health. The article checked whether companies with a high percentage of older employees, i.e. aged ≥55 years, are more aware of the aging of the population and interested in promoting crew health than organizations employing mainly younger staff. Organizations with the highest participation of older employees are the most aware of the aging process and its consequences, they have a great sense of sense in investing in the health of subordinates, more willingly than establishments not employing people ≥55 years of age. analyze the health needs of staff of all ages, increase commitment to health promotion in recent years, and implement such activities more widely. The problem is that they are weaker compared to establishments with no employees ≥55 years of age. interest in evaluating pro-health projects and understanding their effects. Despite the relatively widespread awareness of the aging of the population and the implementation of health promotion, a large group of organizations employing mainly older employees underestimates the demographic process in question. In addition, many companies promoting crew health do so for reasons other than limiting the effects of aging. This leads to the conclusion about the need to make employers aware of the inevitability of an aging population and to show them health promotion as a tool to limit the effects of this process. It is also important to encourage the management to evaluate pro-health projects.
  • Presence of musculoskeletal disorders in policemen serving on motorcycles
    Riding a motorcycle is associated with the risk of complaints from the locomotor system, which may be caused by, among others prolonged maintenance of an unfavorable body position, vibration or the need to wear a protective helmet. Traffic police officers are one of the professional groups that use motorcycles during their service. Few studies have been devoted to the ailments associated with riding a motorcycle, especially regarding police officers serving on these vehicles. The main purpose of this work was to investigate whether among the officers of the Polish Police serving on motorcycles there were ailments from the musculoskeletal system during or after the ride. Factors that may affect the occurrence and characteristics of these ailments were checked. 57.37% of the officers surveyed had a motor-related discomfort associated with riding, which most often appeared after a long time since driving (53.46%) and usually resolved within a few hours of its completion (60.65 %). Most often they occurred in the lumbosacral region (76.17%) and cervical spine (50.93%). Their greatest intensity concerned the lumbosacral spine (5.86%) and knee joints (5.11%). A relationship was also found between the occurrence of ailments and the number of years of service on a motorcycle (p = 0.014), average distance covered during a month (p = 0.036) and motorcycle accidents (p = 0.001) or other (p = 0.002). Officers of the Polish Police serving on motorcycles experience related ailments from the government's traffic. Factors affecting their occurrence are experience in driving a motorcycle, the average distance traveled per month and accidents.
  • Chemical substances and technological processes with carcinogenic or mutagenic effect in the work environment in Poland in 2013–2017
    The purpose of the work was to present data on occupational exposure to carcinogenic and mutagenic agents in Poland in 2013–2017 on the basis of information sent to the 'Central Register of Data on Exposure to Chemical Substances, Mixtures, Factors or Technological Processes of Operation carcinogenic or mutagenic ", run by the Institute of Occupational Medicine prof. J. Nofera in Łódź. The legal bases and the purpose of keeping the register as well as the scope of collected data were also discussed. Since 2013, the number of chemical substances reported to the central register has been growing systematically. In 2017, 368 substances were notified, which is an increase of 21.1% compared to 2013. The number of plants submitting notifications also increased (to over 4,000 plants in 2017). Formaldehyde, individual polycyclic aromatic hydrocarbons, benzene and chromium (VI) compounds were the most common chemical factors in these years. Among technological processes, most plants reported works exposed to hardwood dust (approximately 800 plants every year and from over 10,000 to almost 15,000 exposed employees). For the purposes of keeping records in workplaces, it is necessary to legally define the concept of exposure and its quantification to avoid doubts by employers and supervisors about the number of people exposed in the workplace. Exposure spatial distribution maps are a transparent and easy to understand way of presenting data on exposure to carcinogens and occupational mutagens.
  • 2-naphthylamine toxicity
    In the past, 2-naphthylamine (2-NA) was used for the production of azo dyes, as an antioxidant in the cable industry and in the rubber industry. Despite the fact that 2-NA is not produced on an industrial scale, it is still used in small quantities as a model bladder carcinogen in laboratories, and also for sewage control, water analysis and oxytocinase assays. In addition, it is detected in the air in coke ovens, where it is formed as one of the pyrolysis products. The main aim of this work is to provide an actual literature review for health risk assessments related to 2-NA which is still used in laboratories. Occupational exposure to 2-NA is important for the respiratory tract, mucous membranes and the skin, and, to a lesser extent, for absorption from the gastrointestinal tract. It is absorbed into the body through the skin and by inhalation, and then undergoes metabolic changes. Most of the absorbed 2-NA dose is excreted in the urine, in the form of metabolites, metabolites conjugated to acids, and even in an unchanged form. Based on literature data, the effects of 2-NA toxicity in sub-chronic and chronic exposure include contact dermatitis, chronic cystitis and bladder cancer. The authors have concluded that it is recommended to determine the occupational exposure limit which will allow preparing the exposure assessment of people at work.
  • Selected chronic diseases and their risk factors in teachers
    Chronic diseases are a big problem in the individual, social and economic dimensions and cause 60% of deaths in the world, and it is estimated that in 2020 this percentage will increase to 72%. Among chronic diseases, the largest group is cardiovascular disease (30%), cancer (13%), respiratory disease (7%) and diabetes (2%). Their main risk factors are unhealthy diet, lack of physical activity and smoking. Professional and environmental factors also play an important role - for teachers, this is the noise that 25% of men and 38% of women complain about. In Poland, there are no databases on chronic diseases and their risk factors in individual professional groups, including in the group of teachers. Only the problem of voice disorders as an occupational disease is well recognized. Few studies of health and lifestyle were conducted among teachers in Poland, but their results cannot be generalized, as the research was conducted using various methods, in small groups and in different regions of the country. From a representative CSO survey of employees of the Education department (no data on the group of teachers themselves), musculoskeletal system disorders (back pain - 21.9%, neck, shoulder, arms or arms, hips, legs) dominated among health problems. and rates - about 10% each). Headache or eye strain occurred in 14.6% of subjects, stress, depression and anxiety in 7.3%, and cardiovascular disease in 4.6%. In order to limit the occurrence of chronic diseases among teachers and their negative effects, it is necessary to take multidirectional actions, the first stage of which should be to prepare a diagnosis regarding the teachers' health situation and risk factors for chronic diseases. Identifying the health problems of such an important professional group is an important public health issue.
  • Medical management in obstructive sleep apnea in persons driving vehicles - recommendations of the Polish Society of Occupational Medicine, Polish Society of Lung Diseases, Institute of Occupational Medicine in Łódź and Polish Society for Sleep Research
    Based on the results of many studies and analyzes carried out in different countries, it was confirmed that obstructive sleep apnea (OSA) negatively affects the psychophysical abilities of drivers. Therefore, in the European Union Directive of 1 July 2014, OBS was recognized as one of the most important risk factors for car accidents. The implementation of this directive in the Member States is expected to contribute to its reduction. The result of its implementation in Poland is the ordinance of the Minister of Health of December 23, 2015 amending the ordinance on medical examinations of applicants for driving licenses and drivers. Although Annex 2 to this regulation provides detailed conditions for medical examination in case of suspected OBS, the issue of tools and methods for suspecting moderate or severe disease in the examined patient has not been regulated or explained. Therefore, it was necessary to develop for physicians authorized for medical examinations drivers and applicants for a driving license standards of conduct in case of suspected OBS. The article presents a streamlining case-law algorithm of conduct, which was developed by the Polish Society of Occupational Medicine, the Polish Society of Lung Diseases, the Institute of Occupational Medicine in Łódź and the Polish Sleep Research Society.
  • Determinants of population exposure to the electromagnetic field related to the use of 5G radiocommunication networks in Poland
    In 2017, preparations were started in Poland to provide all citizens with internet access at a speed of at least 30 Mb / s, and 50% of households - with a speed of at least 100 Mb / s. This goal is to be achieved thanks to, among others fifth generation (5G) radio communications network. The article presents issues related to the assumptions for the construction of 5G networks and estimated the level of population exposure to electromagnetic fields associated with the rational use of these networks. It was also analyzed whether from a technical point of view the implementation of the 5G network can ensure compliance with the currently acceptable level of electric field strength in Poland (7 V / m), while taking into account the exposure currently present in the environment caused by antennas of cellular base stations. This is a contribution to the ongoing discussion on the need to change the requirements in Poland that limit the level of exposure of the population to electromagnetic fields. The theoretical analysis of environmental exposure to electromagnetic fields emitted by 5G systems, carried out on the basis of available documentation of the proposed technical standards, shows that with rational power management to achieve the expected (consistent with 5G standards) quality of connections via base stations installed outside buildings and using intelligent systems controlled beam antennas, it will be possible to maintain electric field strength and power density below current limit values in places accessible to the public.
  • Letter to the Editor (December 23, 2019) regarding the article "The role of the hospital environment and the hands of medical staff in the spread of Clostridioides (Clostridium) diffici-le infections"
  • Reply of the authors (23 January 2020) to the letter to the editors regarding the article "The role of the hospital environment and the hands of medical staff in the spread of Clostridioi-des (Clostridium) difficile infections"

Medycyna Pracy (Occupational Medicine) - full list