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Choroby zawodowe stwierdzone w Polsce w 2012 r.

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Wilczyńska U., Sobala W., Szeszenia-Dąbrowska N.
Medycyna Pracy
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2013
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vol. 64
|
issue 3
317-326
EN
Background: The aim of the paper was to present basic statistical data on occupational diseases diagnosed in 2012. Material and Methods: The work was based on the data from "Occupational Disease Reporting Forms" received by the Central Register of Occupational Diseases in 2012. The data comprised information on nosologic units, gender and age of patients, duration of occupational exposure, sections of the national economy and voivodeships. The incidence was specified in terms of the number of cases in relation to paid employees or to employed people. Results: The number of occupational diseases accounted for 2402 cases. The incidence rate was 23 cases per 100 000 paid employees. In spite of the general decline in the number of cases, the incidence of infectious and parasitic diseases increased by 8.6%. The highest incidence was noted for infectious and parasitic diseases (6.8/100 000), pneumoconioses (5.5/100 000), hearing loss (2.1/100 000), diseases of: the peripheral nervous system (2/100 000), voice disorders (1.9/100 000) and the musculo-skeletal system pathologies (1.1/100 000). The pathologies specified above accounted in total for 84% of all occupational diseases. The industrial sectors of the national economy characterized by the highest incidence included mining and quarrying (288.3/100 000) and manufacturing (27.8/100 000). The highest incidence was recorded in the Silesian (46.2/100 000) and the lowest in the Opolskie (4.2/100 000) voivodeships. Conclusions: The downward trend in the incidence of occupational diseases continues. Different incidence of voice disorders among teachers in individual provinces suggests that uniform preventive, diagnostic and certification standards are missing. Med Pr 2013;64(3):317–326
PL
Wstęp: W artykule przedstawiono podstawowe dane o chorobach zawodowych stwierdzonych w 2012 r. Materiał i metody: Podstawą opracowania były „Karty stwierdzenia choroby zawodowej” wystawione przez stacje sanitarno-epidemiologiczne w 2012 r. i przesłane do Centralnego Rejestru Chorób Zawodowych w Instytucie Medycyny Pracy im. prof. J. Nofera w Łodzi. Dane przedstawiono z uwzględnieniem jednostek chorobowych, płci i wieku osób chorych, okresu narażenia w miejscu pracy na czynniki szkodliwe, które powodują stwierdzoną patologię, oraz w zależności od sekcji gospodarki narodowej i województw. Zapadalność scharakteryzowano za pomocą współczynników obliczanych w stosunku do liczby zatrudnionych lub liczby pracujących. Wyniki: Stwierdzono 2402 przypadki chorób zawodowych. Współczynnik zapadalności na 100 tys. zatrudnionych wynosił 23. Przy ogólnym spadku liczby chorób zawodowych w 2012 r. wzrosła o 56 (8,6%) liczba przypadków chorób zakaźnych lub pasożytniczych. Najwyższe współczynniki dotyczyły chorób zakaźnych lub pasożytniczych (6,8 na 100 tys. zatrudnionych), pylic płuc (5,5 na 100 tys.), ubytku słuchu (2,1 na 100 tys.), chorób obwodowego układu nerwowego (2 na 100 tys.), narządu głosu (1,9 na 100 tys.) i układu ruchu (1,1 na 100 tys.). Wymienione patologie stanowiły łącznie 84% wszystkich chorób zawodowych. Sekcjami gospodarki o charakterze przemysłowym, których dotyczyła najwyższa zapadalność, były górnictwo i wydobywanie (288,3 na 100 tys.) oraz przetwórstwo przemysłowe (27,9 na 100 tys.). Pod względem terytorialnego rozproszenia najwyższą zapadalność odnotowano w województwie śląskim (46,2 na 100 tys. pracujących), a najniższą w opolskim (4,2). Wnioski: Utrzymuje się tendencja spadkowa zapadalności na choroby zawodowe. Zróżnicowanie zapadalności w województwach na choroby narządu głosu u nauczycieli wskazuje na brak jednolitych standardów profilaktycznych, diagnostycznych i orzeczniczych. Med. Pr. 2013;64(3):317–326
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Ocena ryzyka złamań osteoporotycznych w populacji kobiet w wieku powyżej 50 lat – analiza wskaźników FRAX® BMI i FRAX® BMD

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Strugała C., Sobala W., Szubert Z., Hanke W.
Medycyna Pracy
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2013
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vol. 64
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issue 3
327-333
EN
Background: The aim of the project is to identify the risk of osteoporotic fractures in women aged over 50, the evaluation of FRAX® BMD and FRAX® BMI in women with and without osteoporotic fractures and the proposal of therapeutic starting points for treatment of osteoporosis. Material and Methods: A group of 1014 women aged 50-89, living in the Kujawsko-Pomorskie province, was investigated. The analysis was based on the WHO definition of osteoporosis. Calculations of 10-year absolute risk of major osteoporotic fractures (AR-10 MOF Fx) and femoral neck fractures (AR-10 FN Fx) were done using Polish 3.3 version of FRAX® tool. The analysis of fracture risk employed the logistic regression method. Results: A statistically significant relationship was found between the risk of osteoporotic fractures and age, femoral neck BMD, a history of previous osteoporotic fractures, estimated calcaneal BMD and vertebral column BMD. The differences between 10-year absolute risk of major osteoporotic fractures BMD and BMI was small, which means that FRAX® BMI might be a useful tool for GPs and occupational medicine specialists. Conclusions: A high usefulness of the FRAX® BMI tool for evaluating the risk of major osteoporotic fractures provide a new possibility of identifying women at risk of such events. The mean value of 10-year absolute risk of major osteoporotic fractures for FRAX® BMD and BMI was identified as 10% and 12%, respectively and these values were proposed as therapeutic starting points for treatment of osteoporosis in women living in the Kujawsko-Pomorskie province. Med Pr 2013;64(3):327–333
PL
Wstęp: Celem analizy jest wskazanie czynników ryzyka złamań osteoporotycznych u kobiet powyżej 50. roku życia, ocena wskaźników FRAX® BMD i FRAX® BMI u pacjentek z przebytymi złamaniami osteoporotycznymi i bez nich oraz ustalenie progów terapeutycznych leczenia osteoporozy. Materiał i metody: Badaniem objęto 1014 kobiet w wieku 50-89 lat zamieszkałych na terenie województwa kujawsko-pomorskiego. Analizę przeprowadzono w oparciu o definicję osteoporozy WHO, wykonując badanie densytometryczne kręgosłupa L1-L4 i szyjki kości udowej kończyny strony niedominującej oraz dodatkowo badanie ultrasonograficzne kości piętowej strony niedominującej. Do obliczeń 10-letniego prawdopodobieństwa złamania szyjki kości udowej (AR-10 FN Fx) oraz złamań głównych osteoporotycznych (AR-10 MOF Fx) zastosowano polską wersję 3.3 narzędzia FRAX®. Do analizy ryzyka złamań zastosowano model regresji logistycznej. Wyniki: Ryzyko głównych złamań osteoporotycznych w perspektywie 10 lat jest silnie związane z takimi czynnikami, jak wiek, BMD szyjki kości udowej, przebyte złamanie osteoporotyczne, BMD kości piętowej, BMD kręgosłupa L1-L4. Stwierdzono 2- lub nawet 3-krotnie wyższe ryzyko 10-letnie głównych złamań osteoporotycznych i złamań szyjki kości udowej w porównaniu z ryzykiem u kobiet bez złamań. Analiza średnich wartości 10-letniego ryzyka głównych złamań osteoporotycznych FRAX® BMD i BMI pozwala na zastosowanie narzędzia FRAX® BMI w praktyce lekarza rodzinnego i medycyny pracy. Wnioski: Wysoka użyteczność narzędzia FRAX® BMI w określaniu indywidualnego ryzyka głównych złamań osteoporotycznych daje nowe możliwości preselekcji osób zagrożonych tymi złamaniami. Średnie wartości FRAX® BMD i BMI dla głównych złamań osteoporotycznych u pacjentek (odpowiednio: 10% i 12%) mogą stanowić próg terapeutyczny (interwencji farmakologicznej) dla kobiet z woj. kujawsko-pomorskiego. Med. Pr. 2013;64(3):327–333
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Progression of small, irregular opacities in chest radiographs of former asbestos workers

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Świątkowska B., Sobala W., Szubert Z.
International Journal of Occupational Medicine and Environmental Health
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2012
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vol. 25
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issue 4
481-491
EN
Objectives: Pulmonary parenchymal changes appear many years after the start of exposure to asbestos and their progression has been observed to continue many years after cessation of the exposure. The aim of the present analysis is to assess the risk of progression of radiological changes in the respiratory system, based on long-term follow-up of groups of workers occupationally exposed to asbestos dust. Materials and Methods: The analysis included 3144 individuals voluntarily applying for a medical examination in 2000-2010, who had performed at least two radiographs of the chest. Probability of progression in subsequent studies was based on the evaluation of radiographs for the presence of small, irregular type s, t, u opacities in the parenchymal lung tissue with profusion categories as specifi ed in the classifi cation of ILO, 1980. Multistate hidden Markov model was used in the statistical analysis. Results: In the group of patients, small irregular opacities with a profusion of 1/1 or higher occurred in 640 (20%) patients in the fi rst examination, and in 918 (29%) patients in the last examination. No parenchymal changes were observed in 1360 (43%) patients in the fi rst examination (opacity profusion category 0/0), and in 645 (20%) patients in the last examination. The risk of progression of radiographic changes in former workers of asbestos processing plants is higher in smokers, from profusion category 0 to 1 - by 30% (HR = 1.30, 95% CI: 1.15-1.47), from profusion category 1 to 2 - by 50% (HR = 1.50, 95% CI: 0.92-2.45). The risk of progression of parenchymal changes decreases in the workers employed in subsequent calendar years: for category changes from 1 to 2, the decrease is nearly 40% for every 10 years of subsequent employment (HR = 0.60, 95% CI: 0.45-0.80). The probability of the progression increases with longer latency period: for change of category from 1 to 2, the increase is about 20% (HR = 1.19, 95% CI: 1.00-1.42) per 10 years of employment for blue collar workers. The risk of the 1 to 2 category progression is signifi cant, nearly 2.5-fold higher in the workers employed in the asbestos-processing textile industry. Conclusions: Our results show that the risk of progression of pulmonary parenchymal fi brotic processes was higher in the smokers, workers employed during the earlier calendar years of the discussed period, those with longer latency period, blue collar workers involved directly in the production processes, and employees of the asbestos cement and/or textile industries.
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Choroby zawodowe w Polsce w 2013 r. i ich czynniki przyczynowe

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Szeszenia-Dąbrowska N., Wilczyńska U., Sobala W.
Medycyna Pracy
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2014
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vol. 65
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issue 4
463-472
EN
Background: The paper presents the incidence of occupational diseases in Poland (2013). Material and Methods: Occupational disease reporting forms, supplied to the Central Register of Occupational Diseases, were used as the study material. The incidence was specified in terms of rates per 100 000 employed people. Results: The number of new cases was 2214 with the incidence rate of 15.6. The downward trend recorded over several years continues; compared to 2012, the number of new cases decreased by 7.8%. Exposure to dusts (35% cases), mostly inorganic (carbon, asbestos, and industrial dusts containing free crystalline silica) was the most common cause of occupational diseases. Among the organic dusts allergenic effects of flour and vegetable dusts predominated. Every 3rd case of occupational disease was attributable to physical agents, mainly the way the work is done, excessive vocal effort and noise. The sections of national economy with the highest incidence comprised mining and quarrying (271.1), manufacturing (24.3), education (22.4), agriculture, forestry, hunting and fishing (21.0), human health and social assistance (20.5). Conclusions: The decreased incidence of ‘traditional’ diseases observed over the recent 15 years and the analysis of the 2013 incidence indicate a need to revise the Polish list of occupational diseases by exposures found in the modern work environment. Particular attention should be paid to conditions prevailing in workplaces with high exposures to industrial dusts containing free crystalline silica. A considerable variation in the incidence of voice disorders in teachers between individual voivodeships (provinces) points to the need for harmonization of the standards of preventive, diagnostic and certification procedures. Med Pr 2014;65(4):463–472
PL
Wstęp: W doniesieniu przedstawiono sytuację epidemiologiczną chorób zawodowych stwierdzonych w 2013 r. Materiał i metody: Podstawą opracowania były „Karty stwierdzenia choroby zawodowej” przesłane do Centralnego Rejestru Chorób Zawodowych. Zapadalność scharakteryzowano za pomocą współczynników na 100 tys. pracujących. Wyniki: Stwierdzono 2214 przypadków chorób zawodowych. Współczynnik zapadalności wynosił 15,6. Utrzymuje się notowana od kilkunastu lat tendencja spadkowa zapadalności, przy czym w stosunku do roku 2012 liczba przypadków zmniejszyła się o 7,8%. Najczęstszymi przyczynami chorób zawodowych było narażenie na pyły (35% ogółu przypadków), w większości nieorganiczne (węgla, azbestu oraz pyły przemysłowe z zawartością wolnej krzemionki). Wśród pyłów organicznych dominujące znaczenie w rozwoju patologii miało alergizujące działanie pyłu mąki i pyłów roślinnych. Co 3. przypadek patologii zawodowej przypisano działaniu czynników fizycznych, głównie sposobowi wykonywania pracy, wysiłkowi głosowemu i hałasowi. Najwyższa zapadalność dotyczyła górnictwa i wydobywania (271,1), na kolejnych miejscach znalazły się: przetwórstwo przemysłowe (24,3), edukacja (22,4), rolnictwo, leśnictwo, łowiectwo i rybactwo (21,0), opieka zdrowotna i pomoc społeczna (20,5). Wnioski: Zmniejszanie się od 15 lat przypadków „klasycznych” chorób zawodowych i wyniki analizy zapadalności w 2013 r. wskazują na konieczność weryfikacji krajowego wykazu chorób uznanych za zawodowe pod kątem czynników szkodliwych i uciążliwych, które występują we współczesnym środowisku pracy. Szczególnej uwagi wymagają warunki pracy na stanowiskach, na których występuje narażenie na pyły przemysłowe zawierające wolną krzemionkę. Obserwowane znaczne zróżnicowanie w województwach zapadalności na choroby narządu głosu u nauczycieli ujawnia potrzebę ujednolicenia standardów profilaktycznych, diagnostycznych i orzeczniczych. Med. Pr. 2014;65(4):463–472
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Predictors of short- and long-term sickness absence in female post office workers in Poland

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Szubert Z., Makowiec-Dąbrowska T., Merecz D., Sobala W.
International Journal of Occupational Medicine and Environmental Health
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2016
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vol. 29
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issue 4
539-562
EN
Background The aim of this study was to highlight major predictors of the frequency of sickness absence in a group of workers directly involved in customer service. Material and Methods The study was carried out on a random sample of 229 women employed as assistants and clerks in post offices. The survey was based on the Subjective Work, Health Status and Life Style Characteristics Questionnaire, and sickness absence data for the years 2004–2006. Results The negative binominal regression model of sickness absence risk revealed the following significant predictors of short-term absence spells (1–29 days): 1) marital status, sickness absence risk for single women was (rate ratio (RR)) = 1.56 (95% confidence interval (CI): 1.01–2.39) vs. married women; 2) post offices employing 7 workers had a rate ratio of sickness absence of 1.6 (95% CI: 1.04–2.42); 13–25 workers – RR = 2.03 (95% CI: 1.41–2.93); > 25 workers – RR = 1.82 (95% CI: 1.15–2.88) compared with an average number of 8–12 workers; 3) shift work, RR = 1.57 (95% CI: 1.14–2.14); 4) breaks from work – the risk of absence in the case of any breaks amounted to RR = 1.5 (95% CI: 1.07–2.07) in comparison with the statutory breaks; 5) self-rated health reported as moderate relative to good health, RR = 1.71 (95% CI: 1.26–2.32); and 6) occurrence of respiratory diseases resulted in the risk of RR = 1.51 (95% CI: 1.08–2.08). The Poisson regression model of long-term sickness absence spells (≥ 30 days) revealed the following significant predictors: 1) number of clients per shift: 51–100 clients, RR = 3.62 (95% CI: 1.07–22.6) compared with a lower number of clients; 2) self-rated health, assessed as moderate, RR = 1.97 (95% CI: 1.06–3.78) and 3) household chores performed for at least 4 h a day, RR = 0.4 (95% CI: 0.18–0.79). Conclusions Association between sickness absence and workload as well as work organization indicates directions of corrective actions, which could reduce the scale of the problem.
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Endotoxin exposure and changes in short-term pulmonary function among sewage workers

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Cyprowski M., Sobala W., Buczyńska A., Szadkowska-Stańczyk I.
International Journal of Occupational Medicine and Environmental Health
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2015
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vol. 28
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issue 5
803-811
EN
Objectives The inhaled endotoxin is considered as a causative factor in the process of acute bronchial obstruction, which can be measured by a decrease in forced expiratory volume in 1 s (FEV₁). The aim of this study was to assess endotoxin exposure among sewage treatment plant workers (STPW) and its effect on across-shift changes in respiratory airflow. Material and Methods A group of 78 STPW from a large sewage treatment plant was studied. Inhalable dust for endotoxin assessment was collected using personal aerosol samplers. Endotoxin was assayed with the kinetic, chromogenic Limulus amebocyte lysate test. Across-shift spirometric measurements were performed on Mondays, after 2-days absence from work, with the use of portable spirometer. The forced vital capacity (FVC), and FEV₁ parameters were analyzed. Multifactor regression modeling was performed to determine parameters significantly associated with endotoxin exposure. Results The concentration of inhalable dust and endotoxin ranged from 0.01–1.38 mg/m³ and 0.68–214 endotoxin units per cubic meter of air (EU/m³), respectively. Endotoxins were characterized with the skewed distribution (arithmetic mean (AM) = 38.8 EU/m³, geometric mean (GM) = 15.4 EU/m³, geometric standard deviation (GSD) = 4.21). Through the use of multifactor analysis, which excluded the main confounders (inhalable dust and smoking habit) it was found that, despite low levels of endotoxin, it had significant impact on the observed across-shift decline in FEV₁ (p = 0.044). For this parameter, the regression slope was additionally calculated (r = –0.017, p = 0.071). Conclusions Relatively low levels of endotoxin among sewage treatment plant workers may cause small, but significant across-shift declines in FEV₁. The observed relationship was independent of organic dust concentrations and smoking habit. The respiratory protection should be provided for STPW.
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Effect of environmental phthalate exposure on pregnancy duration and birth outcomes

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Polańska K., Ligocka D., Sobala W., Hanke W.
International Journal of Occupational Medicine and Environmental Health
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2016
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vol. 29
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issue 4
683-697
EN
Objectives The objective of this study was to evaluate the impact of phthalate exposure on pregnancy duration and birth outcomes based on the Polish Mother and Child Cohort (REPRO_PL). Material and Methods Phthalate exposure was determined by measuring 11 phthalate metabolites (mono-ethyl phthalate (MEP), mono-iso-butyl phthalate (MiBP), mono-n-butyl phthalate (MnBP), 3OH-mono-n-butyl phthalate (OH-MnBP), mono-benzyl phthalate (MBzP), mono‑ (2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-hydroxy-iso-nonyl phthalate (MHiNP), mono-oxo-iso-nonyl phthalate (MOiNP), and mono-n-octyl phthalate (MOP)) in the urine collected from 165 mothers during the third trimester of pregnancy by high performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS). The following measures at birth were considered: gestational age, birth weight, length as well as head and chest circumference. Results Pregnancy duration was inversely associated with natural log concentrations (μg/g creatinine) of MEP (standardized regression coefficient (β) = –0.2, p = 0.04) after adjustment for a variety of confounders. Significant impact of MOiNP on head circumference (β = –0.1, p = 0.05) was also observed. Conclusions The study findings add further support to the hypothesis that phthalate exposure may be associated with shorter pregnancy duration and a decreased head circumference, and underscore importance of public health interventions to reduce that exposure.
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Observance of hand washing procedures performed by the medical personnel before patient contact. Part I

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Garus-Pakowska A., Sobala W., Szatko F.
International Journal of Occupational Medicine and Environmental Health
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2013
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vol. 26
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issue 1
113-121
EN
Introduction: According to the Centers for Disease Control and Prevention (CDC) as well as the World Health Organization (WHO) recommendations, medical staff are obliged to decontaminate the skin of the hands before every single patient contact. Materials and Methods: The study was performed by quasi-observation among the group of 188 medical staff (nurses and physicians) working in three selected hospitals of the Łódź province. The procedure of hand washing and disinfection performed directly before the patient contact according to the CDC and WHO recommendations were observed. The results was subject to statistical analysis (p < 0.05). Results: During 1544 hours of observation 4101 activities requiring hand washing were recorded. The medical staff obeyed the hand washing procedure before the patient contact only in 5.2% of the situations. There was no activity observed before which hand hygiene was maintained in 100% of cases. Observance of hand hygiene depended signifi cantly on the type of the performed activity, the professional group, and the workload index. A decrease in percentage observance of hand hygiene according to the time of the day was found to be of statistical signifi cance. The mean time of hand washing was 8.5 s for physicians and 6.6 s for nurses. Conclusion: The level of observance of hand washing procedures among the medical staff prior to the patient contact appears to be alarmingly below the expectations.
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Observance of hand washing procedures performed by the medical personnel after the patient contact. Part II

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Garus-Pakowska A., Sobala W., Szatko F.
International Journal of Occupational Medicine and Environmental Health
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2013
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vol. 26
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issue 2
257-264
EN
Objectives: The Centers for Disease Control and Prevention (CDC) as well as the World Health Organization (WHO) state that adequate hand hygiene maintained by medical personnel is an indispensable prerequisite for controlling nosocomial infections. The recommendations of CDC and WHO emphasize the obligation to wash hands after each contact with a patient, after the exposure to a potentially infectious material or upon the contact with objects surrounding the patient. Materials and Methods: The study was performed by quasi-observation among the group of 188 medical staff members (nurses and physicians) working in three selected hospitals of the Łódź Province. The procedure of hand washing/disinfection performed directly after the patient contact according to the recommendations of CDC and WHO was observed. The results were subject to statistical analysis (p < 0.05). Results: During 1544 h of observations, 4101 activities requiring hand washing were recorded. The medical personnel followed the hand hygiene procedures after the patient contact in 26.4% of the situations that require hygiene according to the guidelines. The level of observance of the hand washing procedures depended significantly on the type of performed activity, profession, degree of workload, index of activity, and time of duty hours. The mean time of hand washing after patient contact was 9.2 s for physicians and 6.7 s for nurses. Conclusion: Both the level of observance of hygienic procedures after the contact with patients as well as the time of hand washing are insufficient. There is an urgent need to work out educational programs on maintaining proper hand hygiene for medical personnel.
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The use of protective gloves by medical personnel

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Garus-Pakowska A., Sobala W., Szatko F.
International Journal of Occupational Medicine and Environmental Health
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2013
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vol. 26
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issue 3
423-429
EN
Introduction: To minimize the risk of cross-infection between the patient and the medical staff, it is necessary to use individual protective measures such as gloves. According to the recommendations of the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), protective gloves should always be used upon contact with blood, mucosa, injured skin or other potentially infectious material. Materials and Methods: The aim of the study was to evaluate, through quasi-observation, the use of protective gloves by medical staff according to the guidelines issued by the CDC and WHO. The results were subject to statistical analysis (p < 0.05). Results: During 1544 hours of observations, 3498 situations were recorded in which wearing protective gloves is demanded from the medical staff. The overall percentage of the observance of using gloves was 50%. The use of gloves depended significantly on the type of ward, profession, performed activity, number of situations that require wearing gloves during the observation unit and the real workload. During the entire study, as many as 718 contacts with patients were observed in which the same gloves were used several times. Conclusion: Wearing disposable protective gloves by the medical staff is insufficient.
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Predictors of environmental exposure to polycyclic aromatic hydrocarbons among pregnant women - Prospective cohort study in Poland

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Polańska K., Hanke W., Sobala W., Brzeźnicki S., Ligocka D.
International Journal of Occupational Medicine and Environmental Health
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2011
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vol. 24
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issue 1
8-17
EN
Objectives: The aim of the study was to characterize the PAH exposure level based on 1-hydroxypyrene (1-HP) in urine of Polish pregnant women and to assess the relationship between PAH and factors such as smoking, environmental tobacco smoke exposure, place of residence, heating and cooking method. Materials and Methods: The study population included in this analysis consisted of 449 pregnant women who had been the subjects of the prospective Polish Mother and Child Cohort study performed in 8 regions of Poland. The women were interviewed three times during pregnancy (once in each trimester). 1–HP concentration in urine was chosen as the biomarker of exposure to PAH. The urine sample was analysed using high performance liquid chromatography (HPLC). The active and passive smoking exposure was verified by saliva cotinine, analysed by high performance liquid chromatography coupled with tandem mass spectrometry (LC-MSMS) and isotope dilution method. Results: 1-HP concentration in urine ranged from 0.02 to 10.2 μg/g creatinine with the geometric mean (GM) 0.4 μg/g creatinine. The significantly higher concentration of urinary 1-HP in pregnant women was observed for summer collection (GM ratio: 1.1; p = 0.01), among smokers (GM ratio: 1.7; p < 0.001) and for the women living in big cities (GM ratio: 1.3; p = 0.001). Conclusions: The significantly higher concentration of urinary 1-HP in pregnant women was observed for summer collection, among smokers and those living in big cities.
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Environmental asbestos pollution - Situation in Poland

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Szeszenia-Dąbrowska N., Sobala W., Świątkowska B., Stroszejn-Mrowca G., Wilczyńska U.
International Journal of Occupational Medicine and Environmental Health
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2012
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vol. 25
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issue 1
3-13
EN
Objectives: Environmental exposure of the general population to asbestos in Poland is mainly due to degradation of very popular asbestos-cement products and the resultant release of the elementary asbestos fibres into the ambient air. Assessments of environmental pollution by asbestos were based on the volume of the raw material used, amount of manufactured asbestos products, and measuring the concentration of fibres in the air. Material and Methods: Under the governmental program intended to remove asbestos, measurements of the concentration of asbestos fibres were performed in 2004–2010 in all provinces of Poland. Considering that potential sources of asbestos dust emissions were present in residential areas, 1634 sampling sites were designated. From 2 to 4 air samples were collected at each sampling site. A total of 5962 samples were collected during seven years. A single dose of air collected by 25 mm 0.8 μm pore Sartorius filter was 1,300 litres. The fibres were counted using optical microscopy with phase contrast (PCM) on a polarizing microscope (PLM) at a total magnification of 600×.; method was adapted to determine the concentration of asbestos fibres in non-occupational environment. Results: Mean concentration of asbestos fibres was 492 f/m³ (95% CI: 467–518). In 82% of the sampling sites, the mean concentrations did not exceed 800 f/ m³. As much as 25.8% of the samples were found to be below the detection limit of the method. Estimated mean concentrations of fibres in different provinces ranged from 146 (95% CI: 106–203) to 709 f/m³ (95% CI: 591–851). In the areas affected by former asbestos-processing plants, mean concentration was 732 f/m³ (95% CI: 527–1016) and was significantly higher than levels recorded in other areas of Poland. Conclusion: Asbestos consumption per capita and the recorded moderate levels of asbestos fibres concentration in atmospheric air point to a relatively low level of environmental asbestos pollution in Poland.
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Asbestos related diseases among workers of asbestos processing plants in relation to type of production and asbestos use

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Szeszenia-Dąbrowska N., Świątkowska B., Sobala W., Szubert Z., Wilczyńska U.
Medycyna Pracy
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2015
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vol. 66
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issue 1
1-9
PL
Wstęp: Azbest jest jednym z najbardziej niebezpiecznych czynników pylico- i rakotwórczych. Celem pracy była ocena występowania azbestozy i międzybłoniaka opłucnej wśród byłych pracowników zakładów przetwórstwa azbestu w Polsce w zależności od zużycia azbestu i typu wytwarzanych produktów. Materiał i metody: Badaniem objęto pracowników 18 dużych państwowych zakładów przetwórstwa azbestu, funkcjonujących w Polsce w latach 1945–1998. Badanie oparto na danych uzyskanych z dokumentacji zakładów i danych Centralnego Rejestru Chorób Zawodowych dotyczących przypadków azbestozy i międzybłoniaka opłucnej, zarejestrowanych w latach 1970–2012, a także danych z programu Amiantus. Analizę przeprowadzono dla 5 branż przemysłu azbestowego, grupując zakłady według typu wyrobów i stosowanej technologii. Wyniki: W okresie objętym badaniem stwierdzono 2160 przypadków azbestozy i 138 międzybłoniaków. W zakładach przetworzono łącznie ok. 2 mln ton azbestu, w tym ok. 7.5% krokidolitu. Ogólna ilość zużytego w danej branży azbestu okazała się silnym predyktorem zapadalności na azbestozę (R2 = 0,68, p = 0,055). Najwyższe ryzyko wystąpienia azbestozy zaobserwowano przy produkcji wyrobów włókienniczych i uszczelniających. Międzybłoniak wystąpił tylko u pracowników zakładów, w których kiedykolwiek stosowano krokidolit. Wnioski: Stwierdzono znaczne zróżnicowanie ryzyka występowania azbestozy w zależności od ilości zużytego azbestu. Analiza potwierdziła zależność między narażeniem na azbest krokidolitowy a pojawianiem się międzybłoniaków, niezależnie od produkowanych wyrobów, oraz sugeruje brak tego typu powiązań między ogólną ilością zużytego azbestu. Med. Pr. 2015;66(1):1–9
EN
Background: Asbestos dust is one of the most dangerous pneumoconiotic and carcinogenic agents. The aim of this study was to assess the occurrence of asbestosis and pleural mesothelioma, depending on asbestos consumption and the type of manufactured products, among former asbestos workers in Poland. Material and Methods: The study subjects included employees of 18 large state-owned asbestos processing enterprises operating in the Polish market in 1945–1998. The study is based on data obtained from asbestos company records and the Central Register of Occupational Diseases data on the cases of asbestosis and mesothelioma for the period from 1970 till 2012 as well as data from Amiantus Programme. The analysis was performed for 5 sectors comprising plants classified according to the products manufactured and applied production technology. Results: In the study period, 2160 cases of asbestosis and 138 cases of mesothelioma were reported. The plants processed a total of about 2 million tonnes of asbestos, including about 7.5% of crocidolite. Total asbestos consumption was a strong predictor of the rate of asbestosis incidence (R2 = 0.68, p = 0.055). The highest risk occurrence of asbestosis was observed in the production of textiles and sealing products. Mesothelioma occurred only in plants where crocidolite had been ever processed. Conclusions: Total asbestos consumption was a strong predictor of the rate of asbestosis incidence. The observation confirms the relationship between exposure to crocidolite and the occurrence of mesothelioma, regardless of the manufactured products, and suggests the absence of such a link for the total volume of asbestos consumption. Med Pr 2015;66(1):1–9
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Visible fungi growth and dampness assessed using a questionnaire versus airborne fungi, (1→3)-β-d-glucan and fungal spore concentrations in flats

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Sowiak M., Jeżak K., Kozajda A., Sobala W., Szadkowska-Stańczyk I.
International Journal of Occupational Medicine and Environmental Health
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2015
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vol. 28
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issue 1
130-146
EN
Introduction: The study aimed at determination of the usefulness of the subjective assessment of selected signs of fungi growth in flats and microclimate parameters to indicate the actual air contamination with culturable fungi, (1→3)-β-D-glucans and fungal spores. Material and methods: This analysis covered 22 flats, the inhabitants of which declared in a questionnaire interview the presence of the developed mycelium on solid surfaces in the flat. Air samples for determination of the culturable fungi, (1→3)-β-D-glucans and (viable and non-viable) fungal spores concentrations indoor and outdoor the flats during the heating period were collected. During bioaerosol sampling microclimate parameters were measured. Predictive models for concentrations of the tested biological agents with regard to various ways to assess fungal contamination of air in a flat (on the basis of a questionnaire or a questionnaire and microclimate measurements) were built. Results: The arithmetic means of temperature, relative humidity, CO₂ concentration and air flow velocity in the flats were respectively: 20.5°C, 53%, 1431.6 ppm and 0 m/s. The geometric mean concentrations of airborne fungi, (1→3)-β-D-glucans and fungal spores in these premises amounted to 2.9×10² cfu/m³, 1.6 ng/m³ and 5.7×10³ spores/m³, respectively. The subjective assessment of fungi growth signs and microclimate characteristics were moderately useful for evaluation of the actual airborne fungi and (1→3)-β-D-glucan concentrations (maximum percent of explained variance (VE) = 61% and 67%, respectively), and less useful in evaluation of the actual fungal spore concentrations (VE < 29%). In the case of fungi, higher usefulness was indicated of the questionnaire evaluation supported by microclimate measurements (VE = 61.2%), as compared to the evaluation only by means of a questionnaire (VE = 46.9%). Conclusions: Subjective evaluation of fungi growth signs in flats, separately or combined with microclimate measurements, appeared to be moderately useful for quantitative evaluation of the actual air contamination with fungi and their derivatives, but more extensive studies are needed to strengthen those findings.
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Polish mother and child cohort study (REPRO_PL) - Methodology of follow-up of the children

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Polańska K., Hanke W., Jurewicz J., Sobala W., Madsen C., Nafstad P., Magnus P.
International Journal of Occupational Medicine and Environmental Health
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2011
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vol. 24
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issue 4
391-398
EN
Background: A prospective cohort study design gives the opportunity for identifi cation, update of different exposures and their verifi cation by biomarker measurements. The aim of The Polish Mother and Child Cohort Study (REPRO_PL) is to evaluate the impact of exposure to different environmental factors during pregnancy and, after birth, on the pregnancy outcome, children’s health and neurodevelopment. Materials and Methods: REPRO_PL cohort was established in 2007. From the cohort of 1300 mother-child pairs, 300 children are followed-up until they are two years old to asses the exposure, health status and neurodevelopment. Children are examined twice: at one and two years of age by a pediatrician and a psychologist/child development specialist. During each visit, detailed questionnaire is conducted with the mothers and supplemented with the information from the medical charts to have appropriate recognition of the child’s health and development. Additionally, the current health status of the child is checked and his/her biometry is performed. A urine sample is collected from each child for the verifi cation of environmental tobacco smoke (ETS) and polycyclic aromatic hydrocarbons (PAH) exposure. Some children have a blood sample collected for the assessment of the lead and cadmium levels. Child’s neurodevelopment is assessed based on Bayley Scales for Infant and Toddler Development (Bayley-III). Results and Conclusions: The results of the study will become available within the next few years and will help to determine the impact of the environmental exposures on children’s health and neurodevelopment. REPRO_PL cohort is a middle-sized cohort, very much focused on specific research questions with the potential for future extension and cooperation.
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Night shift work and modifiable lifestyle factors

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Pepłońska B., Burdelak W., Krysicka J., Bukowska A., Marcinkiewicz A., Sobala W., Klimecka-Muszyńska D., Rybacki M.
International Journal of Occupational Medicine and Environmental Health
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2014
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vol. 27
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issue 5
693-706
EN
Objectives: Night shift work has been linked to some chronic diseases. Modification of lifestyle by night work may partially contribute to the development of these diseases, nevertheless, so far epidemiological evidence is limited. The aim of the study was to explore association between night shift work and lifestyle factors using data from a cross-sectional study among blue-collar workers employed in industrial plants in Łódź, Poland. Material and Methods: The anonymous questionnaire was self-administered among 605 employees (236 women and 369 men, aged 35 or more) - 434 individuals currently working night shifts. Distribution of the selected lifestyle related factors such as smoking, alcohol drinking, physical activity, body mass index (BMI), number of main meals and the hour of the last meal was compared between current, former, and never night shift workers. Adjusted ORs or predicted means were calculated, as a measure of the associations between night shift work and lifestyle factors, with age, marital status and education included in the models as covariates. Results: Recreational inactivity (defined here as less than one hour per week of recreational physical activity) was associated with current night shift work when compared to never night shift workers (OR = 2.43, 95% CI: 1.13-5.22) among men. Alcohol abstinence and later time of the last meal was associated with night shift work among women. Statistically significant positive relationship between night shift work duration and BMI was observed among men (p = 0.029). Conclusions: This study confirms previous studies reporting lower exercising among night shift workers and tendency to increase body weight. This finding provides important public health implication for the prevention of chronic diseases among night shift workers. Initiatives promoting physical activity addressed in particular to the night shift workers are recommended.
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Children’s residential exposure to selected allergens and microbial indicators: endotoxins and (1→3)-β-D-glucans

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Kozajda A., Bródka K., Sowiak M., Sobala W., Polańska K., Jurewicz J., Hanke W., Szadkowska-Stańczyk I.
International Journal of Occupational Medicine and Environmental Health
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2013
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vol. 26
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issue 6
870-889
EN
Objectives: The study was aimed at assessment of exposure to endotoxins, (1→3)-β-D-glucans and mite, cockroach, cat, dog allergens present in settled dust in premises of children as agents which may be significantly correlated with the occurrence of allergic symptoms and diseases in children. Materials and Methods: The study covered 50 homes of one- or two-year-old children in Poland. Samples of settled dust were taken from the floor and the child's bed. The levels of (1→3)-β-D-glucans (floor), endotoxins (floor) and allergens of mite, cat, dog and cockroach (floor and bed) were analyzed. Results: Average geometric concentrations (geometric standard deviation) of endotoxins, (1→3)-β-D-glucans, Der p1, Fel d1, Can f1 and Bla g1 in children homes were on the floor 42 166.0 EU/g (3.2), 20 478.4 ng/g (2.38), 93.9 ng/g (6.58), 119.8 ng/g (13.0), 288.9 ng/g (3.4), 0.72 U/g (4.4) and in their beds (only allergens) 597.8 ng/g (14.2), 54.1 ng/g (4.4), 158.6 ng/g (3.1) 0.6 U/g (2.9), respectively. When the floor was covered with the carpet, higher concentrations of endotoxins, (1→3)-β-D-glucans and allergens (each type) were found in the settled dust (p < 0.05). The trend was opposite in case of allergens (except dog) analyzed from bed dust and significantly higher concentrations were found in the rooms with smooth floor (p < 0.05). Conclusions: Among the analyzed factors only the type of floor significantly modified both the level of biological indicators and allergens. The results of this study could be the base for verifying a hypothesis that carpeting may have a protective role against high levels of cockroach, dog and cat allergens.
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Association between a biomarker of exposure to polycyclic aromatic hydrocarbons and semen quality

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Jurewicz J., Radwan M., Sobala W., Brzeźnicki S., Ligocka D., Radwan P., Bochenek M., Hanke W.
International Journal of Occupational Medicine and Environmental Health
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2013
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vol. 26
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issue 5
790-801
EN
Objectives: Growing evidence supports the reproductive and developmental toxicity of polycyclic aromatic hydrocarbons (PAHs) from prenatal and postnatal exposure, but the results of epidemiological studies regarding harmful effects of PAHs exposure on male reproductive system still remain limited and inconclusive. The aim of the present study was to investigate the relationship between 1-hydroxypyrene, a biomarker of polycyclic aromatic hydrocarbons exposure and semen quality. Materials and Methods: The study population consisted of 277 men attending an infertility clinic for diagnostic purposes and having normal semen concentration of 20-300 mln/ml or slight oligozoospermia (semen concentration: 15-20 mln/ml) (WHO 1999). All the men were healthy and under 45 years of age. All participants were interviewed and provided a semen sample. The interview included questions concerning demographics, socio-economic status, medical history related to past diseases which may have an impact on semen quality, lifestyle factors and occupational information. Concentrations of 1-hydroxypyrene (1-OHP) in the urine samples were analyzed using high performance liquid chromatography (HPLC). Results: A positive association was found between the level of 1-OHP in urine and sperm neck abnormalities as well as the percentage of static sperm cells (p = 0.001, p = 0.018, respectively). Additionally, exposure to PAHs measured by 1-OHP in urine decreased semen volume and the percentage of motile sperm cells (p = 0.014, p = 0.0001, respectively). Conclusions: Presented findings indicate that the environmental level of PAHs exposure adversely affects male semen quality. The future large-scale studies should incorporate different biomarkers to generate a more accurate and full assessment of the effects of PAHs exposure on male fertility.
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