Search results

1

Potrzeba wdrożenia w Polsce nowych narzędzi do diagnozowania zespołu uzależnienia od tytoniu oraz gotowości i motywacji do rzucenia palenia u osób w wieku produkcyjnym

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Broszkiewicz M., Drygas W.

Medycyna Pracy

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2016

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vol. 67

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issue 1

97-108

EN

High rates of tobacco use is still observed in working-age population in Poland. The present level of the state tobacco control has been achieved through adopting legal regulations and population-based interventions. In Poland a sufficient contribution of health professionals to the diagnosis of the tobacco-addition syndrome (TAS) and the application of the 5A’s (ask, advice, assess, assist, arrange follow-up) brief intervention, has not been confirmed by explicit research results. Systemic solutions of the health care system of the professional control, specialist health care, health professional trainings and reference centres have not as yet been elaborated. The tools for diagnosing tobacco dependence and motivation to quit smoking, developed over 30 years ago and recommended by experts to be used in clinical and research practice, have not met the current addiction criteria. In this paper other tools than those previously recommended − tests developed in the first decade of the 21st century (including Cigarette Dependence Scale and Nicotine Dependence Syndrome Scale), reflecting modern concepts of nicotine dependence are presented. In the literature on the readiness/motivation to change health behaviors, a new approach dominates. The motivational interviewing (MI) by Miller and Rollnick concentrates on a smoking person and his or her internal motivation. Motivational interviewing is recommended by the World Health Organization as a 5R’s (relevance, risks, rewards, roadblocks, repetition) brief motivational advice, addressed to tobacco users who are unwilling to make a quit attempt. In Poland new research studies on the implementation of new diagnostic tools and updating of binding guidelines should be undertaken, to strengthen primary health care in treating tobacco dependence, and to incorporate MI and 5R’s into trainings in TAS diagnosing and treating addressed to health professionals. Med Pr 2016;67(1):97–108

PL

Populację w wieku produkcyjnym w Polsce charakteryzuje wysoka częstość używania tytoniu. Obecny poziom kontroli tytoniu w Polsce osiągnięto poprzez działania legislacyjne i interwencje populacyjne. W Polsce nie ma jednoznacznych wyników badań potwierdzających dostateczny udział profesjonalistów medycznych w diagnozowaniu zespołu uzależnienia od tytoniu (ZUT) i stosowaniu krótkiej interwencji 5A (ask, advice, assess, assist, arrange follow-up – pytaj, poradź, oceń, pomóż, wyznacz kolejną wizytę). Nie ma też rozwiązań systemowych regulujących nadzór merytoryczny, opiekę specjalistyczną, akredytowany system szkoleń i pracę ośrodków referencyjnych. Eksperci rekomendują do stosowania w praktyce klinicznej i badawczej narzędzia do diagnozowania ZUT oraz gotowości i motywacji do zaprzestania używania tytoniu, utworzone ponad 30 lat temu, które nie spełniają współczesnych kryteriów uzależnienia. W niniejszej pracy przedstawiono inne narzędzia niż dotąd rekomendowane – testy stworzone w pierwszej dekadzie XXI w. (w tym Skalę Uzależnienia od Papierosów i Skalę Syndromu Uzależnienia od Nikotyny), które odzwierciedlają współczesne rozumienie uzależnienia. W literaturze przedmiotu w zakresie motywowania do zmiany zachowania zdrowotnego dominuje podejście stosowane w wywiadzie motywującym Millera i Rollnicka, skoncentrowane na osobie palącej i jej motywacji wewnętrznej. Na zasadach wywiadu motywującego opiera się krótka interwencja motywująca – 5R (relevance, risks, rewards, roadblocks, repetition – trafność, ryzyko, nagrody, bariery, powtórzenie), adresowana do osób pozbawionych motywacji do rzucenia palenia, rekomendowana przez Światową Organizację Zdrowia. W Polsce należy podjąć badania nad wdrożeniem nowych narzędzi diagnostycznych, zaktualizować niektóre obecnie obowiązujące wytyczne, dążyć do wzmocnienia roli podstawowej opieki zdrowotnej w leczeniu ZUT oraz włączyć zasady wywiadu motywującego i krótkiej interwencji 5R do programu akredytowanych szkoleń z zakresu rozpoznawania i leczenia ZUT. Med. Pr. 2016;67(1):97–108

2

Health and life style-related determinants of survival rate in the male residents of the city of Łódź

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Śmigielski J., Bielecki W., Drygas 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 3

337-348

EN

Introduction: The article presents a selected part of an analysis of health- and lifestyle-related determinants of the longevity of male residents of the city of Łódź. The WHO strategy for the European region assumes that the term ‘lifestyle' refers to the way of life based on the association between conditions of life understood in a broad sense and individual patterns of behaviour determined by socio-cultural factors and individual features. On this basis, the aim of this study is to identify the multiple statistical relationships on the mortality of men living in Łódź, particularly the influence of the following variables on the probability of survival: age, subjective health assessment, nutritional habits, alcohol consumption and tobacco smoking. Materials and Methods: The study sample (1004 respondents) was selected, and the study was carried out, based on the standards of the CINDI WHO Programme. The investigations included socio-demographic data, health status, lifestyle and anthropometric measurements. Results: From the results of the first- study performed in Poland of the longevity of men with identified risk factors of cardiovascular diseases, it has been found that: 1) Tobacco smoking has a negative influence on male longevity; 2) Alcohol consumed in moderate amounts favours male longevity; 3) The level of physical activity observed among the studied men was too low to affect longevity; 4) A diet rich in fish and consumption of yellow cheese are positive predictors of longevity, while additional use of table salt at meals and consumption of sweets (cakes) are negative ones. Conclusions: Risky lifestyles and a reluctance to abandon them are responsible for a shorter lifespan among men in Poland. Reducing this difference between women and men is a real challenge for public health professionals and preventive medicine specialists.

3

Rozpowszechnienie palenia tytoniu oraz palenie bierne w populacyjnych badaniach polskiego programu cindi w latach 1991–2007 – analiza porównawcza

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Bielecki W., Kwaśniewska M., Dziankowska-Zaborszczyk E., Drygas W.

Zdrowie Publiczne i Zarządzanie

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2009

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vol. 7

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issue 2

PL

Prevalence of tobacco use and environmental tobacco smoke in polish population research. WHO-CINDI Programme in 1991–2007This article is a report from comparison surveys, carried out in connection with WHO-CINDI Programme during the years 1991–2007. The analysis was based on random sampling tests concerning big Polish cities’ inhabitants, all in all almost 11.5 thousand respondents. Taking everything into consideration, it has been established, that:1. Regular smoking frequency becomes smaller (the effect of implemented prophylactic programmes, a so-called ‘intervention variable’).2. Still, propagation of environmental smoking is an alarming phenomenon, however it is definitely improving. Despite the fact, that more and more respondents are living in a free-smoking zone, each 5-6 adult city inhabitant spends over 5 hours a day in a room full of smoke.3. Within time passing, as a result of quitting an addiction, a belief concerning harmful smoking consequences grows. This tendency is not yet sufficiently justified. Becoming alarmed with the concerning phenomenon is definitely not enough when making an opinion in this matter.

4

Determinants of premature mortality in a city population: An eight-year observational study concerning subjects aged 18–64

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Maniecka-Bryła I., Dziankowska-Zaborszczyk E., Bryła M., Drygas 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

724-741

EN

Background: Premature deaths constitute 31.1% of all deaths in Łódź. Analysis of the causes of premature deaths may be helpful in the evaluation of health risk factors. Moreover, findings of this study may enhance prophylactic measures. Material and Methods: In 2001, 1857 randomly selected citizens, aged 18-64, were included in the Countrywide Integrated Noncommunicable Diseases Intervention (CINDI) Programme. In 2009, a follow-up study was conducted and information on the subjects of the study was collected concerning their health status and if they continued to live in Łódź. The Cox proportional hazards model was used for evaluation of hazard coefficients. We adjusted our calculations for age and sex. The analysis revealed statistically significant associations between the number of premature deaths of the citizens of Łódź and the following variables: a negative self-evaluation of health - HR = 3.096 (95% CI: 1.729-5.543), poor financial situation - HR = 2.811 (95% CI: 1.183‑6.672), occurring in the year preceding the study: coronary pain - HR = 2.754 (95% CI: 1.167-6.494), depression - HR = 2.001 (95% CI: 1.222-3.277) and insomnia - HR = 1.660 (95% CI: 1.029-2.678). Our research study also found a negative influence of smoking on the health status - HR = 2.782 (95% CI: 1.581-4.891). Moreover, we conducted survival analyses according to sex and age with Kaplan-Meier curves. Conclusions: The risk factors leading to premature deaths were found to be highly significant but possible to reduce by modifying lifestyle-related health behaviours. The confirmed determinants of premature mortality indicate a need to spread and intensify prophylactic activities in Poland, which is a post-communist country, in particular, in the field of cardiovascular diseases.

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Czy nowotwory złośliwe przyczyniły się do nadumieralności mężczyzn w wieku 65 lat i więcej w województwie łódzkim w latach 1999–2014?

71%

Ciabiada-Bryła B., Drygas W., Pikala M., Bryła M., Maniecka-Bryła I.

Acta Universitatis Lodziensis. Folia Oeconomica

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2019

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vol. 3

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issue 342

167-182

EN

The aim of the study is the analysis of mortality due to cancer diseases of men and women aged 65+ in the Lodz region in the period 1999-2014, with particular emphasis on the phenomenon of excess male mortality. The analysis included information on 501,124 deaths reported in the Lodz region from 1999 to 2014. Crude and standardized death rates according to the causes of death based on ICD–10 and excess mortality rates were calculated. An analysis of time trends was performed with the use of joinpoint models. In the period under study a slight decrease in standardized mortality rates (per 10,000) caused by cancer among people aged 65 and more was observed – from 171.7 to 166.8 among males and from 83.9 to 81.7 among females. The excess mortality rate at the beginning and end of the study period was 2.0. The main causes of deaths in the C00‑C97 class among men aged 65+ in 2014 were cancers of (rates per 10,000): trachea, bronchus and lung (46.0); colon, rectum and anus (19.0); prostate (18.4). While among women aged 65 and more, these were cancers of: trachea, bronchus and lung (12.6); colon, rectum and anus (11.3); breast (8.8). The phenomenon of excess mortality of males aged 65 and more due to cancer diseases in the Lodz region in 2014 was determined mainly by malignant neoplasms of: bladder; trachea, bronchus and lung; stomach.

PL

Celem artykułu jest analiza umieralności z powodu chorób nowotworowych mężczyzn i kobiet w wieku 65+ w województwie łódzkim w latach 1999-2014, ze szczególnym uwzględnieniem zjawiska nadumieralności mężczyzn. Analizą objęto informacje o 501 124 zgonach odnotowanych w województwie łódzkim w latach 1999-2014. Obliczono rzeczywiste i standaryzowane współczynniki umieralności szczegółowej według przyczyn zgonów na podstawie ICD–10 oraz wskaźniki nadumieralności. Analizę trendów czasowych przeprowadzono za pomocą modeli joinpoint. W badanym okresie zaobserwowano nieznaczne obniżenie standaryzowanych współczynników umieralności (na 10 000 ludności) z powodu nowotworów złośliwych wśród osób w wieku 65+: w grupie mężczyzn z 171,7 do 166,8, a w grupie kobiet z 83,9 do 81,7. Wskaźnik nadumieralności na początku i na końcu ba danego okresu wynosił 2,0. W klasie C00‑C97 najważniejszymi przyczynami zgonów wśród mężczyzn w wieku 65+ w 2014 roku były nowotwory złośliwe (wskaźnik na 10 000 ludności): tchawicy, oskrzela i płuca (46,0); jelita grubego, odbytnicy i odbytu (19,0); gruczołu krokowego (18,4). Natomiast wśród kobiet powyżej 65 roku życia były to nowotwory: tchawicy, oskrzela i płuca (12,6); jelita grubego, odbytnicy i odbytu (11,3); piersi (8,8). Zjawisko nadumieralności mężczyzn w wieku 65 lat i więcej z powodu chorób nowotworowych w województwie łódzkim w 2014 roku było determinowane w największym stopniu nowotworami złośliwymi: pęcherza moczowego, tchawicy, oskrzela i płuca oraz żołądka.

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Trendy nadumieralności mężczyzn w wieku produkcyjnym w województwie o najwyższych współczynnikach zgonów w Polsce

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Ciabiada-Bryła B., Pikala M., Burzyńska M., Drygas W., Maniecka-Bryla I.

Medycyna Pracy

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2020

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vol. 71

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issue 3

325-335

EN

BackgroundThe intensity of premature deaths in the Łódź region in 2014 amounted to 40 per 10 000, and was the highest in the country (the average rate for Poland was 32). Excess mortality of men aged <65 continues to be a major medical and social problem. The aim of the study is to analyze time trends of excess male mortality in the working age population in the Łódź region, both in general and due to the most important causes of deaths.Material and MethodsThe research material consists of information on 144 589 deaths of the Łódź region inhabitants aged 20–64 in 1999–2014. Crude and standardized mortality rates were calculated, as well as excess male mortality rates both in general and by cause of death. Standardization was carried out using the direct method according to the standard European population. A study of time trends was performed with the use of the joinpoint regression analysis. Average annual percentage rates of changes were estimated.ResultsThe excess mortality rate of men at the productive age decreased from 2.9 to 2.8 in the Łódź region in 1999–2014. The most important causes of death among men aged 20–64 in 2014 were (rates per 10 000): cardiovascular diseases (19.1), malignant neoplasms (16.6) and external causes of death (12.3). Among women, the most significant were malignant neoplasms (11.1), cardiovascular diseases (5.1) and diseases of the digestive system (2.1). The excess mortality rate of men aged 20–64 in the analyzed period reached the highest values due to external causes of death (5.1–7.3) and cardiovascular diseases (3.0–3.7). The highest rate of the decline in excess male mortality in 1999–2014 was recorded due to malignant neoplasms, on average 1.4% per year (p < 0.05). Meanwhile, the fastest growth concerned external causes of death, on average 1.0% per year (p < 0.05).ConclusionsDespite the decline in the mortality rates among both sexes, excess male mortality due to external causes of death and cardiovascular diseases increased.

PL

WstępW 2014 r. natężenie przedwczesnych zgonów w województwie łódzkim wynosiło 40 na 10 000 osób i było najwyższe w kraju (średnia dla Polski: 32). Nadumieralność mężczyzn przed 65 r.ż. pozostaje poważnym problemem medycznym i społecznym. Celem pracy była analiza trendów czasowych nadumieralności mężczyzn w wieku produkcyjnym w województwie łódzkim ogółem i według najważniejszych przyczyn zgonów. Celem pracy jest analiza trendów czasowych nadumieralności mężczyzn w wieku produkcyjnym w województwie łódzkim ogółem i według najważniejszych przyczyn zgonów.Materiał i metodyMateriał badawczy stanowią dane o 144 589 zgonach mieszkańców województwa łódzkiego w wieku 20–64 lat w latach 1999–2014. Obliczono rzeczywiste i standaryzowane współczynniki umieralności, a także wskaźniki nadumieralności mężczyzn ogółem i według przyczyn. Do standaryzacji posłużyła metoda bezpośrednia według standardowej populacji europejskiej. Badanie trendów czasowych przeprowadzono za pomocą analizy regresji joinpoint. Oszacowano średnioroczne procentowe tempa zmian.WynikiW latach 1999–2014 w województwie łódzkim wskaźnik nadumieralności mężczyzn w wieku produkcyjnym zmniejszył się z 2,9 do 2,8. W 2014 r. głównymi przyczynami zgonów mężczyzn w wieku 20–64 lat były choroby układu krążenia (19,1 na 10 000 osób), nowotwory złośliwe (16,6) i przyczyny zewnętrzne (12,3). U kobiet były nimi nowotwory złośliwe (11,1), choroby układu krążenia (5,1) i choroby układu trawiennego (2,1). W badanym okresie wskaźnik nadumieralności mężczyzn w wieku 20–64 lat osiągał najwyższe wartości z powodu zewnętrznych przyczyn zgonu (5,1–7,3) i chorób układu krążenia (3,0–3,7). Największe tempo spadku wskaźnika nadumieralności w latach 1999–2014 odnotowano w przypadku nowotworów złośliwych, średnio 1,4% rocznie (p < 0,05). Najszybszy wzrost dotyczył natomiast zewnętrznych przyczyn zgonu, średnio 1,0% rocznie (p < 0,05).WnioskiMimo redukcji natężenia zgonów w obu grupach płci zwiększyła się nadumieralność mężczyzn z powodu zewnętrznych przyczyn zgonu i chorób układu krążenia.

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The effect of selected lifestyle factors and diet on mortality of men with documented physical fitness in the city of Łódź

71%

Śmigielski J., Jeger A., Hanke W., Bielecki W., Drygas 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 4

535-544

EN

Introduction: It is still uncertain if having at least moderate physical fitness is a necessary and sufficient condition for lowering the risk of death. The aforementioned statement constituted the basis for undertaking the study concerning the effect of particular health-related behaviours on the likelihood of survival in subjects with a moderate and high physical fitness. Materials and Methods: The study sample, i.e. 204 men aged 30-59 years living in Łódź, Poland, was selected within the CINDI WHO Programme and examined over the years 1980-1990 and 2003-2004. In each subject approximate values of one week energy expenditures associated with performing physical exercise of at least moderate intensity (> 1000 kcal/week) were estimated. Physical efficiency in the study group was evaluated basing on the results of the submaximal effort test. Information about selected socio-demographic characteristics, consumption of alcohol, cigarette smoking and diet was gathered. The vital status of the examined sample was checked in 2009. The Cox proportional hazards regression model was used to identify factors which influence the survival of examined population. Results: The probability of death was more than fourfold higher in the case of individuals who eat "beef or pork meat", as compared to those who consumed these products rarely or never. On the other hand, the subjects who declared regular consumption of yellow cheese had nearly fourfold lower death probability. Current smoking was found to be a significant negative risk factor while moderate consumption of beer a protective one. The level of physical fitness ($\text{V}_\text{O2max}$) did not significantly influence mortality. Conclusions: The results of the performed analyses indicate negative effect associated with consumption of beef/pork meat and smoking. Furthermore, the data pertaining to the consumption of yellow cheese as a potent protective factor for men's health requires further verification. The possibility that it is some lifestyle proxy rather than a causal factor can not be excluded.

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Psychospołeczne uwarunkowania nałogu palenia w populacji polskiej. Wyniki Ogólnopolskiego Badania Stanu Zdrowia Ludności Polski – WOBASZ

61%

Polakowska M., Broda G., Drygas W., Głuszek J., Kozakiewicz K., Pająk A., Wyrzykowski B.

Zdrowie Publiczne i Zarządzanie

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2009

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vol. 7

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issue 2

PL

Psycho-social factors related with smoking in the Polish populationAim of the study is to examine the relationship between smoking and psychosocial factors – in the Polish population aged 20–74 years. Methodology: Results are based on data from WOBASZ. Survey covered a representative sample of men and women aged 20–74 years. Data was collected from the response to the questions from the questionnaire. Smoker was defined as the person who regularly smokes at least 1 cigarette per day.Results: From the drawn sample 13,285 people were examined – 6291 men and 6994 women. Smokers were 42% of men and 25% of women. Most smokers were pointed out in the groups aged 35–44 (44% M, 32% W) and 45–54 years (46% M and 31% W). The least smokers were in the oldest group aged 65–74 22% M and 5% W. The average age of initiation is low – 18 ± 3.6 years for men and 20 ± 4.9 years for women. Most smokers have primary education (69% M and 53% W), several times more in compare to those with higher education (6% M and 10% W). Most often smoker is a person doing physical work (43% M and 29% W). Single men smoked more often (43% M). Most smokers were in the lowest income group (44% M and 27% W) compared to those with the highest income (25% M, 18% W). People with low social support have a higher frequency of smoking (35% M, 41% W), and persons with depressive symptoms (23% M, 30% W). Most of the smokers declared intention to quit smoking (85% M and 83% W). The most common reasons for quitting were self-motivation (more than 40% of smokers), and fear of disease (17% W, 18% M).

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The relationship between physical activity level and selected cardiovascular risk factors and mortality of males ≥ 50 years in Poland – The results of follow-up of participants of National Multicenter Health Survey WOBASZ

61%

Śmigielski J., Ruszkowska J., Piotrowski W., Polakowska M., Bielecki W., Hanke W., Drygas 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

633-648

EN

Objectives The role of leisure-time physical activity in reducing all-cause and cardiovascular mortality is well explored. The knowledge on occupational and commuting physical activity continues to be ambiguous and misleading. The aim of the study is to assess the influence of different kinds of physical activity on cardiovascular mortality risk in men. Material and Methods Data analysis on physical activity level and other selected cardiovascular risk factors acquired from 3577 men in the age between 50–80 years who participated in the National Multicenter Health Survey WOBASZ (Wieloośrodkowe Ogólnopolskie Badanie Stanu Zdrowia), Poland (2003–2005) was linked with male mortality in 2004–2009. Data about causes of deaths were obtained from the Central Statistical Office and the Population Electronic Register. Results Among males aged 50–59 years, the strongest risk factor was living in large settlements and provincial capitals as a place of residence and the most protective factor was occupational physical activity. In the age group 60–69 years and 70–80 years, the strongest protective effect was observed for leisure-time physical activity. In men aged between 70–80 years (unlike in the 50–59 years age group), the protective effect of large settlements and provincial capitals as a place of residence was noted. Conclusions Occupational physical activity significantly reduced cardiovascular mortality in men aged 50–69 years, while for leisure-time activity the positive effect was observed in age group 60–69 years and 70–80 years. On the other hand, for the inhabitants of large settlements and provincial capitals, significantly higher risk of cardiovascular mortality in the age group 50–69 years and lower risk in the age group ≥ 70 years was noted, both in comparison with smaller places of residence.

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Wieloletni systematyczny wysiłek fizyczny jako czynnik modyfikujący występowanie miażdżycy subklinicznej u mężczyzn aktywnych zawodowo

52%

Kwaśniewska M., Rębowska E., Jegier A., Kostka T., Pietruszyński R., Lesiak T., Kozińska J., Drygas W.

Medycyna Pracy

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2013

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vol. 64

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issue 6

785-795

EN

Background: Optimal dose of physical activity in the prevention of atherosclerosis remains unclear. The purpose of the study was to investigate the influence of leisure-time physical activity (LTPA) on selected indices of atherosclerosis in the working-age population of men. Materials and Methods: The study was carried out in a cohort of asymptomatic men participating in follow-up examinations in the Healthy Men Clinic, Medical University of Lodz. Of the 132 men who responded to the invitation to participate in this study, 101 men were eligible for the non-invasive assessment of subclinical atherosclerosis indices. Self-reported PA was assessed by interviewer-administered validated questionnaires. During the latest follow-up subclinical atherosclerosis was measured by assessing the coronary artery calcification (CAC), the carotid intima-media thickness (IMT) and the reactive hyperemia index (RHI) using peripheral arterial tonometry (EndoPAT2000). Results: Preliminary results have been elaborated in the group of 60 men (mean age: 61.3±8.85 years). The participants were predominantly white collar workers with low occupational LTPA. The cohort was divided into 3 groups according to the LTPA level. Both dose and energy expenditure of recreational PA significantly correlated with CA, IMT and RHI in the whole cohort. The majority of men maintained their baseline PA throughout the observation period. Men with the highest LTPA level had significantly lower mean CAC, IMT (p < 0.01), and significantly higher mean RHI (p < 0.05) compared to the least active group. On final examination men with high PA had also the most favorable cardiovascular profile. Conclusions: The preliminary results indicate the protective effect of high LTPA level in the context of subclinical atherosclerosis in men. Med Pr 2013;64(6):785–795

PL

Wprowadzenie: Optymalna dawka wysiłku fizycznego w profilaktyce miażdżycy jest przedmiotem badań. Celem analizy jest ocena zależności między wieloletnim poziomem aktywności fizycznej a wybranymi wskaźnikami subklinicznej miażdżycy w grupie aktywnych zawodowo mężczyzn. Materiał i metody: Do udziału w projekcie zaproszono wieloletnich podopiecznych Poradni Zdrowego Człowieka Uniwersytetu Medycznego w Łodzi bez objawów chorób układu krążenia. U wszystkich uczestników przeprowadzano wywiad, przedmiotowe badanie lekarskie i badania dodatkowe. Poziom AF był oceniany za pomocą standaryzowanych kwestionariuszy. Spośród 132 mężczyzn, którzy odpowiedzieli na zaproszenie, do nieinwazyjnej oceny wskaźników subklinicznej miażdżycy zakwalifikowano 101 osób. Przeprowadzono ocenę grubości kompleksu intima-media tętnic szyjnych (IMT), wskaźnika uwapnienia naczyń wieńcowych (CAC) i wskaźnika reaktywnego przekrwienia (RHI) metodą endoPAT 2000. Wyniki: Wyniki wstępne opracowano w grupie 60 mężczyzn w wieku 61,3±8,8 lat. Badani najczęściej deklarowali małą aktywność fizyczną, związaną z pracą zawodową. Badaną kohortę podzielono na 3 grupy w zależności od wyjściowego poziomu rekreacyjnej aktywności fizycznej (leisure-time physical activity - LTPA). Większość badanych utrzymała wyjściowy poziom LTPA trakcie całej obserwacji. W ostatnim badaniu kontrolnym grupa o najwyższym poziomie LTPA charakteryzowała się najkorzystniejszym profilem ryzyka sercowo-naczyniowego. Zarówno dawka AF, jak i wydatek energetyczny istotnie korelowały z CAC, IMT oraz RHI. W grupie o wysokim poziomie LTPA odnotowano istotnie niższy średni wskaźnik CAC, IMT (p < 0,01) oraz istotnie wyższy średni RHI (p < 0,05) w porównaniu z grupą o najmniejszym wydatku energetycznym. Wnioski: Analiza wstępna wskazuje na protekcyjny efekt wieloletniego wysokiego poziomu LTPA w zakresie występowania subklinicznej miażdżycy u mężczyzn. Med. Pr. 2013;64(6):785–795

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Ocena postępowania w zespole uzależnienia od tytoniu (ZUT) w podstawowej opiece zdrowotnej (POZ). Wyniki ogólnopolskiego badania zrealizowanego w ramach Programu Ministerstwa Zdrowia POLKARD

52%

Szafraniec K., Pająk A., Cichocka I., Frejek M., Broda G., Drygas W., Gąsior Z., Grodzicki T., Zdrojewski T.

Zdrowie Publiczne i Zarządzanie

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2009

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vol. 7

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issue 2

PL

Evaluation the effectiveness of primary care in professional assistance for smoking patientsAbout 40% of men and 25% of women in Poland are smokers and smoking causes approximately 50 000 premature deaths annually. According to the WHO experts, a tobacco cessation short intervention program provided by primary care physicians is one of the most important prevention measures. In 2004 National Cardiovascular Disease Prevention Program was launched as a procedure funded by National Health Funds (NFZ), which included the identification of smokers, assessment and treatment of smoking habit. In 2007, the Polish Forum of Prevention issued guidelines that can serve as an effective framework for tobacco cessation intervention in primary care clinics. The aim of this paper is: 1) evaluation the effectiveness of primary care in professional assistance for smoking patients, 2) evaluation of the impact of the NFZ program on frequency of professional consultations on smoking cessation and evaluation of the impact of the NFZ program on smoking prevalence. There were 66 primary care clinics which were recruited to participate the project; 33 clinics participated in NFZ program, the remaining 33 constituted a control group.Random sample of persons at age 35–55 years was selected from all persons registered in each clinic. Eligible for the study were patients free of cvd for whom medical records were available from January 1st 2005 at least. Finally 3940 patients in NFZ clinics, 3162 patients in control clinics were included. For each eligible patient medical records were reviewed and information was collected using a standard questionnaire.All patients were invited for a visit in the clinic. Finally, 2314 persons from the NFZ clinics and 2107 persons from the control clinics participated were examined.That effectiveness of the routine management of smoking cessation in primary care practices was very low. Equally in the NFZ clinics and the control group about 45% of participants were current smokers. Only 15% of patients had recorded information on smoking status in medical documentation and no significant difference between the NFZ clinics and the control group was observed. The NFZ program increased identification of smoking patients (up to about 80%). Physicians and nurses provided advising to 80% and 30% patients, respectively and the other measures to facilitate smoking cessation were used in small proportion of patients. For instance nicotine replacement therapy, including bupropion, was advised to less than 10% of smokers.With the exception to distribution of leaflets which were distributed more frequently in patients of clinics which participated in the NFZ program (22.5%) as compared to control clinics (12.8%), there were no statistical differences in proportion of patients getting professional assistance or other intervention measures between the studied groups. The NFZ program appeared to play important role in identification of smokers. However, the program was not effective enough in treatment of patients addicted to smoking. There is a need to supply the NFZ program by more effective procedure, a kind of structured intervention, which would allow to lower smoking prevalence in primary care patients.

12

Epidemiology of physical activity in adult Polish population in the second decade of the 21st century. Results of the NATPOL 2011 study

52%

Drygas W., Sakłak W., Kwaśniewska M., Bandosz P., Rutkowski M., Bielecki W., Rębowska E., Prusik K., Zdrojewski T.

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

846-855

EN

Objectives: The aim of the study was to assess physical activity (PA) level in a representative sample of Polish adults.Materials and Methods: A cross-sectional analysis was performed among 2413 randomly selected individuals (51.5% women) aged 18-79 years, who participated in the Nationwide Study of Occurrence of Risk Factors of Cardiovascular Diseases NATPOL 2011 (March-July 2011). The study procedures consisted of a questionnaire as well as of anthropometric, blood pressure and biochemical measurements. Leisure-time, occupational and commuting PA were assessed by the use of a questionnaire interview. Results: About 48.2% of adults do exercise for at least 30 minutes on most days of a week. About 11% of the respondents declare a sedentary lifestyle. About 26.5% of working population report hard physical work, while sedentary work is reported by 47.6% of the employed participants. Active commuting is declared by 27.3% of working/studying population. About 47.2%, 36.6%, and 15.3% spend < 15, 15-30, and > 30 min per day, respectively, on this kind of PA. Conclusions: PA level of more than half of Polish adults is still not satisfactory. Promotion of an active lifestyle should concern mainly leisure-time and commuting PA with paying special attention to substantial differences in various socio-demographic groups.

13

The level of knowledge of diabetic prevention in Poland – is there a phenomenon of pluralistic ignorance?

52%

Pawlak-Sobczak K., Drygas W., Kwaśniewska M., Dziankowska-Zaborszczyk E., Pająk A., Kozakiewicz K., Zdrojewski T., Rutkowski M., Tykarski A., Bielecki W.

International Journal of Occupational Medicine and Environmental Health

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2021

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vol. 34

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issue 5

667-678

EN

ObjectivesThe main aim of this work is to assess the level of knowledge about diabetes prevention and the consequences of untreated diabetes in the Polish society, as well as to indicate the variables that have a significant impact on that knowledge.Material and MethodsThe analysis is based on the results of the National Multicenter Health Survey – WOBASZ II. The number of subjects surveyed was 6170, including 2760 men and 3410 women, aged 20–74 years. Data on socio-demographic variables, lifestyle and subjective health assessment were collected using the face-to-face technique.ResultsThe results obtained in the WOBASZ II project showed that >85% of the respondents had an unsatisfactory level of knowledge about diabetes prevention methods and approximately to 85% of the respondents – about the consequences of untreated diabetes. Moreover, one-fourth of the respondents were unable to identify a single way of preventing diabetes, and more than one-third could not identify a single disease caused by diabetes. The risk of a lack of knowledge about diabetes prevention and the consequences of untreated diabetes is more common for men, people with a low level of education, not married, non-diabetic, and without diagnosed diabetes in the family.ConclusionsThe presented results indicate that there is an prevailing lack of knowledge about diabetes prevention and the consequences of untreated diabetes in the Polish society. It is associated with several variables like: sex, level of education, age, marital status, subjective health assessment and diabetes diagnosed in the respondent and/or in the respondent’s family.

14

Vitamin D – dietary intake, supplementation and metabolic status of Polish adults

52%

Kamińska S., Pikala M., Dziankowska-Zaborszczyk E., Bielecki W., Rębowska E., Kozakiewicz K., Nadrowski P., Drygas W., Kwaśniewska M.

International Journal of Occupational Medicine and Environmental Health

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2020

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vol. 33

|

issue 1

107-118

EN

ObjectivesContrary to popular opinion on the preventive properties of vitamin D, results of previous studies have been inconclusive. The aim of this research was to evaluate the associations between the intake of vitamin D and metabolic abnormalities in a representative sample of Polish adults.Material and MethodsWithin the framework of the Multi-Center National Population Health Examination Survey (referred to as WOBASZ), a random sample of 2381 adult residents of Poland (53.8% of whom were women) was examined. All the study subjects were extensively reviewed, including 24-h dietary recall. The intake of vitamin D was assessed on the basis of dietary and supplements reviews. Metabolic abnormalities were evaluated using measurements of waist circumference (WC), blood pressure (BP), serum triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and fasting glycemia. Metabolic syndrome was defined according to the International Diabetes Federation.ResultsOf all the study participants, about 4.4 % of women and 2.6% of men declared a regular supplementation of vitamin D. Among women, a significant inverse correlation between vitamin D supplementation and the mean systolic BP was found (p < 0.01). A more substantial relationship was noted after dividing the study subjects according to their body mass. Among obese men, there was a significant inverse relationship between vitamin D intake and the mean systolic BP (p < 0.01) and diastolic BP (p < 0.05), as well as a positive correlation with HDL-C (p < 0.05). Among obese women, a negative correlation was found between vitamin D supplementation and the mean systolic BP (p < 0.01) and diastolic BP (p < 0.05), and a positive correlation with TG (p < 0.05). Among non-obese male subjects, a negative correlation between vitamin D intake and WC was observed.ConclusionsThe obtained findings suggest that the correlation between vitamin D intake and metabolic abnormalities may depend on the obesity status. A higher vitamin D intake may reduce BP and increase HDL-C in obese subjects. The positive relationship between vitamin D intake and TG concentration in women needs further investigation.

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Potrzeba wdrożenia w Polsce nowych narzędzi do diagnozowania zespołu uzależnienia od tytoniu oraz gotowości i motywacji do rzucenia palenia u osób w wieku produkcyjnym

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Psychospołeczne uwarunkowania nałogu palenia w populacji polskiej. Wyniki Ogólnopolskiego Badania Stanu Zdrowia Ludności Polski – WOBASZ

The relationship between physical activity level and selected cardiovascular risk factors and mortality of males ≥ 50 years in Poland – The results of follow-up of participants of National Multicenter Health Survey WOBASZ

Wieloletni systematyczny wysiłek fizyczny jako czynnik modyfikujący występowanie miażdżycy subklinicznej u mężczyzn aktywnych zawodowo

Ocena postępowania w zespole uzależnienia od tytoniu (ZUT) w podstawowej opiece zdrowotnej (POZ). Wyniki ogólnopolskiego badania zrealizowanego w ramach Programu Ministerstwa Zdrowia POLKARD

Epidemiology of physical activity in adult Polish population in the second decade of the 21st century. Results of the NATPOL 2011 study

The level of knowledge of diabetic prevention in Poland – is there a phenomenon of pluralistic ignorance?

Vitamin D – dietary intake, supplementation and metabolic status of Polish adults