Ionizing radiation and volumetric mammographic density.

OBJECTIVES: Mammographic density (MD) refers to the percentage of dense tissue of an entire breast and was proposed to be used as a surrogate marker for breast cancer. High-dose ionizing radiation (IR) has been recognized as a breast cancer risk factor. The aim of our study was to investigate association between lifetime low dose ionizing radiation (LDIR) and MD. MATERIAL AND METHODS: A cross-sectional study included 467 women aged 40-60 years who underwent screening mammography in Lódz, Poland. The digital mammography examination of the breasts included both craniocaudal and mediolateral oblique views. The volumetric breast density (VBD) (%) and fibrograndular tissue volume (FG) (cm3) were determined based on the analysis of mammographic image ("for processing") using Volpara Imaging Software. The exposure to IR was estimated for each individual, based on the data from interviews about diagnostic or therapeutic medical procedures performed in the area of the neck, chest, abdomen and spine, which involved X-rays and γ rays and the data about the doses derived from literature. Linear and logistic regression were fitted with VBD and FG as the outcomes and organ breast dose, effective dose and number of mammographies as the determinants, adjusted for major confounders. RESULTS: The analyses showed no association between VBD or FG and the breast organ dose or the effective dose. The only significant finding observed concerned the association between the number of mammographies and the FG volume with ß coefficient: 0.028 (95% CI: 0.012-0.043), and predicted mean FG volume >13.4 cm3 among the women with >3 mammographies when compared to those with none. CONCLUSIONS: This study does not, in general, provide support for the positive association between LDIR and MD. The weak association of the FG volume with the number of mammographies warrants further verification in larger independent studies. Int J Occup Med Environ Health. 2022;35(5):635-49.

Night shift work and osteoporosis - bone turnover markers among female blue-collar workers in Poland.

Osteoporosis is an important public health problem worldwide. Although many factors relating to bone structure have been described so far, the current knowledge on the occupational factors that may affect bone tissue metabolism is strongly limited. Literature data suggest that night shift work, via circadian rhythm disruption, may be considered a potential risk factor. To this date, only five epidemiological studies addressing this problem have been conducted worldwide. The outcomes of three studies confirmed such relationship, namely, a higher fracture risk was found among nurses with a long lifetime duration of night shift work in one study; and a lower bone mineral density was associated with occupational activity during night-time in two studies. In adults, the bone undergoes constant remodelling through bone resorption followed by bone formation. The various molecules released into the circulatory system during these processes are called bone turnover markers. We investigated the possible associations between night shift work and selected bone turnover markers: N-terminal propeptide of type I procollagen (P1NP), C-terminal cross-linked telopeptide of type I collagen (CTX), osteocalcin, osteopontin, fibroblast growth factor 23 (FGF-23) and osteoprotegerin, measured in plasma of 189 female blue-collar workers. A significantly higher bone turnover rate was noted among the women working night shifts than among those working only during the day. This may potentially lead to a future development of osteoporosis in this population even if the macroscopic changes in the bone structure are not detectable. Night shift work is a prevailing occupational characteristics nowadays. It has been estimated that about 15-20% of the working population in Europe and the USA perform work under this system. Thus, the problem of osteoporosis can affect a large part of the working-age population.

Maternal diet during pregnancy and risk of allergic diseases in children up to 7-9 years old from Polish Mother and Child Cohort study.

BACKGROUND: The impact of maternal diet during pregnancy on the risk of allergic diseases in childhood is an increasing scientific and public health concern. We evaluated the associations of maternal type of diet and essential elements and vitamins intake during pregnancy with offspring allergic and respiratory outcomes. METHODS: The study population included 557 mother-child pairs from Polish Mother and Child Cohort (REPRO_PL). Based on the Food Frequency Questionnaire filled in between the 20th-24th week of pregnancy, overall maternal diet was evaluated as the difference between the Prudent Dietary Pattern (PDP) score and Western Dietary Pattern (WDP) score ((PDP-WDP) score) and maternal achievement of dietary recommendations (estimated average requirement, EAR) for essential elements and vitamins was assessed. Children's health examination at age of 1, 2, and 7-9 years covered the following symptoms: infections, wheezing/asthma, food allergy, allergic rhinitis, and atopic dermatitis. At age of 7-9 years, children underwent spirometry and skin-prick tests. RESULTS: Children of the mothers who were not achieving adequate intake of vitamin C during pregnancy had a higher risk of wheezing and having more than two infections within the first two years of life comparing to those who met EAR (OR = 2.6, p = 0.05, and OR = 2.3, p = 0.04, respectively). Inadequate intake of vitamin E during pregnancy was related to a higher risk of atopic dermatitis (OR = 2.7, p = 0.04), whereas inadequate intake of magnesium during pregnancy was associated with the risk of wheezing in the offspring at age of two years (OR = 3.7, p = 0.03). A lower (PDP-WDP) score during pregnancy (indicating unhealthier diet) was associated with a higher risk of infections (OR = 1.5, p = 0.007) but a lower risk of atopic dermatitis (OR = 0.7, p = 0.02) at age of 7-9 years. CONCLUSIONS: These results may contribute to the body of evidence for the impact of maternal diet during pregnancy for children's optimal health, however further studies are needed before drawing conclusions and recommendations for clinical practice.

Cigarette smoking and mammographic breast density among Polish women.

OBJECTIVES: High mammographic breast density (MBD) is one of the strongest breast cancer risk factors. The results of some epidemiological studies suggest that one of the lifestyle factors likely altering breast density is cigarette smoking. The aim of this study was to assess the association between active smoking, considering in detail the duration and intensity of smoking, and MBD among Polish women. MATERIAL AND METHODS: A cross-sectional study included 467 women aged 40-60 years who underwent screening mammography in Lódz, Poland. Volumetric mammographic density, fibroglandular tissue volume and non-fibroglandular tissue volume were determined based on the analysis of mammographic image (in the "for processing" format) using Volpara Imaging Software. Current and lifetime intensity of cigarette smoking was assessed based on the data from interviews. Linear and logistic regressions were fitted with estimated MBD parameters as the outcomes, and life-long smoking duration and intensity as the determinants, adjusted for major confounders. RESULTS: The former smokers had a significantly lower volumetric mammographic density compared to the non-smokers in the crude analysis (p = 0.022). However, the associations became insignificant after adjustments for important confounding factors. The analyses adjusted for important confounders revealed an inverse statistically significant association between the number of pack-years and volumetric mammographic density among the current smokers (p = 0.048). CONCLUSIONS: The observed result is consistent with the majority of previous studies that analyzed the associations between mammographic density and life-long smoking duration. Int J Occup Med Environ Health. 2021;34(6):805-15.

Urinary Bisphenol A Concentrations and Parameters of Ovarian Reserve among Women from a Fertility Clinic.

BACKGROUND: Human exposure to environmentally widespread endocrine disruptors, especially bisphenol A (BPA), has been suggested to affect reproductive health. Animal studies indicate that BPA may play a role in the process of reproduction and impact on maturing oocytes, meiotic cell division or fertilization rate. Nevertheless, data regarding the effects of exposure to BPA on women's ovarian function are still limited. Therefore, the aim of the current study is to assess the effects of environmental exposure to BPA on ovarian reserve. METHODS: The study participants consisted of 511 women in reproductive age (25-39 years) who attended an infertility clinic for diagnosis, due to the couples' infertility. BPA urinary concentrations were assessed by the validated gas chromatography ion-trap mass spectrometry method. The ovarian reserve was assessed using ovarian reserve parameters: Hormones concentrations: E2 (estradiol), FSH (follicle stimulating hormone), AMH (anti-Müllerian hormone), and AFC (antral follicle count). RESULTS: In the present study, the negative association between BPA urinary concentrations and AMH (p = 0.02) and AFC (p = 0.03) levels was found. Exposure to BPA was not related to other examined parameters of ovarian reserve (FSH, E2). CONCLUSIONS: Our results suggest that BPA exposure may affect women ovarian reserve parameters and reduce ovarian reserve. As this is one of the first studies of its kind, the findings need confirmation in a further investigation.

Dyslipidaemia, carbohydrate metabolism disorders and arterial hypertension detected in academic employees during examinations in occupational medicine.

INTRODUCTION: Many people have CVD risk factors without realising it and it is important to recognise the risk factors as soon as possible. Periodic examinations are a mandatory form of control for all employes in Poland. They provide an excellent opportunity to screen for the most common civilization diseases in the population. OBJECTIVE: The aim of this study is to evaluate the prevalence of dyslipidaemia, hyperglycaemia and hypertension among academics in a Polish university, and to compare the results between postdoctoral fellows and other academics. MATERIAL AND METHODS: The study group were postdoctoral fellows (HAB; N=135, 53 females) and other academics (NHAB; N=286, 179 females) over the age of 40 who reported for a periodic occupational medical check-up. Fasting blood samples were drawn, serum glucose, lipids and blood pressure (BP) were measured. RESULTS: The mean age was 56.7 (SD 9.8) in HAB and 49.8 (SD 8.1) in NHAB. Mean systolic BP and glycaemia were significantly higher in male HAB group than male NHAB (135.8 vs 130.9 mmHg and 6.0 vs 5.6 mmol/l, respectively). The relationship in females was non-significant. The age-adjusted odds ratios (OR [95% CI]) of having elevated low density lipoprotein cholesterol, total cholesterol, glucose and blood pressure in male HAB vs male NHAB were 0.61 [0.32. 1.16], 0.64 [0.33, 1.23], 1.52 [0.80, 2.88] and 2.11 [0.88, 5.23], and in female HAB vs female NHAB - 0.59 [0.31, 1.12], 0.64 [0.32, 1.26], 0.87 [0.40, 1.79] and 1.86 [0.70, 4.68], respectively. CONCLUSIONS: Adequately planned occupational medicine examinations provide an opportunity to diagnose dyslipidaemia, hyperglycaemia, or high BP in all groups of employees, including highly educated academics.

Determinants of the Essential Elements and Vitamins Intake and Status during Pregnancy: A Descriptive Study in Polish Mother and Child Cohort.

The study objective was to identify determinants of essential elements and vitamins intake, and microelements and vitamins concentration in blood among pregnant women from Poland. Based on the data from food frequency questionnaires and information about supplements taken (n = 1252), daily supply of six elements (calcium, magnesium, iron, zinc, copper, selenium) and nine vitamins (folate, vitamins A, E, C, B1, B2, B3, B6, B12) was calculated. Zinc, copper, selenium (n = 340), vitamin A and E (n = 358) concentration was determined in blood collected during pregnancy. Most of the women did not meet the demand for essential elements and vitamins with a diet. About 94% of the respondents declared supplements use. The women with higher education, indicating leisure-time, physical activity and multiparity had a higher chance of meeting the average demand for the majority of the analyzed nutrients. On the other hand, factors such as BMI < 18.5kg/m2, a higher level of stress, and late first medical-care visit were associated with a lower chance of meeting the recommendations. Higher socio-economic status was a determinant of a higher selenium concentration in plasma (ß = 3.1; 95%CI: 0.2-5.9), whereas BMI ≥ 25 kg/m2, and multiparity of a higher copper concentration in plasma (ß = 0.2; 95%CI: 0.03-0.4; ß = 0.2; 95%CI: 0.1-0.4). Higher plasma concentration of vitamin E was noted among women older than 30 years of age comparing to those who were 30 or younger (ß = 1.5; 95%CI: 0.6-2.4). Although more studies are required, especially such based on laboratory measures, our results indicate target groups for dietary interventions during pregnancy for children's optimal health and development.

Dietary Quality and Dietary Inflammatory Potential During Pregnancy and Offspring Emotional and Behavioral Symptoms in Childhood: An Individual Participant Data Meta-analysis of Four European Cohorts.

BACKGROUND: The impact of maternal diet during pregnancy on child neurodevelopment is of public health and clinical relevance. We evaluated the associations of dietary quality based on the Dietary Approaches to Stop Hypertension (DASH) score and dietary inflammatory potential based on the energy-adjusted Dietary Inflammatory Index (E-DII) score during pregnancy with emotional and behavioral symptoms of offspring at 7 to 10 years of age. METHODS: Individual participant data for 11,870 mother-child pairs from four European cohorts participating in the ALPHABET project were analyzed. Maternal antenatal DASH and E-DII scores were generated from self-completed food frequency questionnaires. Symptoms of depression and anxiety, aggressive behavior, and attention-deficit/hyperactivity disorder in children were assessed using mother-reported tests and classified within the normal or borderline/clinical ranges using validated cutoffs. Adjusted odds ratios were determined by multivariable logistic regression models and aggregated by the two-level individual participant data meta-analysis method. RESULTS: Higher maternal DASH scores (indicating better dietary quality) were associated with lower risk of depressive and anxiety symptoms, aggressive behavior symptoms, and attention-deficit/hyperactivity disorder symptoms within the borderline/clinical ranges: odds ratio [OR] 0.97, 95% confidence interval [CI], 0.95-0.99; OR 0.97, 95% CI, 0.94-0.99; OR 0.97, 95% CI, 0.95-0.98, per one-unit DASH score increase, respectively. For depression and anxiety, aggressive behavior, and attention-deficit/hyperactivity disorder symptoms, a one-unit increase in E-DII scores (a more proinflammatory diet) was associated with a 7% increased risk of all three analyzed emotional and behavioral symptoms: OR 1.07, 95% CI, 1.03-1.11; OR 1.07, 95% CI, 1.02-1.13; OR 1.07, 95% CI, 1.01-1.13, respectively. CONCLUSIONS: Our findings suggest that a maternal low-quality and proinflammatory diet may increase the risk of emotional and behavioral symptoms in children.

Exposure to pyrethroid pesticides and ovarian reserve.

INTRODUCTION: Synthetic pyretroids are among the most common pesticides currently used worldwide. Animal studies suggest that exposure to pyrethroids could dysregulated the function of the ovary, mainly follicular development and/or synthesis of the reproductive hormone. Nevertheless data regarding the effect of exposure on female ovarian function is limited. So the aim of the present study is to assess the effect of exposure to synthetic pyrethroids on ovarian reserve. MATERIALS AND METHODS: The study population consists of 511 females aged 25-39 years attending infertility clinics for diagnostic purposes, because of couples' infertility. Validated gas chromatography ion-tap mass spectrometry method was used to assess the urinary concentrations of pyrethroid metabolites (CDDCA (cis-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid), TDDCA (trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid), 3PBA (3-phenoxybenzoic acid) and DBCA (cis-2,2-dibromovinyl-2,2-dimethylcyclopropane-1-carboxylic acid)). Ovarian reserve was assessed using parameters of ovarian reserve (antral follicle count and concentrations of hormones: AMH (anti-Mullerian hormone), FSH (follicle stimulating hormone) and E2 (estradiol)). RESULTS: In the present analysis the association was found between urinary concentrations of 3-PBA and levels of AMH (p = 0.03), FSH (p = 0.04) and antral follicle count (p = 0.02). Urinary level of CDCCA, TDCCA and DBCA was not associated with any examined parameters of ovarian reserve. CONCLUSIONS: Synthetic pyrethroids may affect female ovarian reserve. As this is the first, preliminary study the results need confirmation in a further detailed investigations.

Cadmium and volumetric mammographic density: A cross-sectional study in Polish women.

INTRODUCTION: Cadmium (Cd) is a heavy metal, which is widespread in the environment and has been hypothesized to be a metalloestrogen and a breast cancer risk factor. Mammographic density (MD) reflects the composition of the breast and was proposed to be used as a surrogate marker for breast cancer. The aim of our study was to investigate association between cadmium concentration in urine and mammographic density. METHODS: A cross-sectional study included 517 women aged 40-60 years who underwent screening mammography in Lódz, Poland. Data were collected through personal interviews and anthropometric measurements. Spot morning urine samples were obtained. The examination of the breasts included both craniocaudal and mediolateral oblique views. Raw data ("for processing") generated by the digital mammography system were analysed using Volpara Imaging Software, The volumetric breast density(%) and fibrograndular tissue volume(cm3) were determined. Cadmium concentration in urine was analysed using the standard ICP-MS method. RESULTS: After adjusting for key confounders including age, BMI, family breast cancer, mammographic device, season of the year of mammography, and age at menarche, an inverse association of Cd and volumetric breast density was found, which was attenuated after further adjustment for smoking. Associations of Cd with dense volume were null. CONCLUSIONS: These findings suggest that Cd is not positively associated with breast density, a strong marker of breast cancer risk, when examined in a cross-sectional fashion.

Night shift work and osteoporosis among female blue-collar workers in Poland - a pilot study.

Osteoporosis is an important public health problem worldwide. Although a number of factors that affect bone structure have been described; thus far, the current knowledge of occupational factors that may have an influence on bone tissue metabolism is strongly limited. Published studies indicate night shift work and the related circadian rhythm disruption may be considered as plausible underlying factors. The aim of the present study was to assess the potential association between night shift work and bone mineral density (BMD) among female blue-collar workers in Poland. A cross-sectional study was carried out among 194 female blue-collar workers >40 years of age employed in industrial plants. The operating system of work consisted of three work shifts clockwise rotation: morning (06:00-14:00 h), afternoon (14:00-22:00 h), and night (22:00-06:00 h), with five consecutive shifts per week followed by a free weekend. A questionnaire survey, based on a Polish version of The European vertebral osteoporosis study (EVOS) questionnaire, a validated instrument, was administered. Data on current job characteristics, job seniority, and lifetime duration of night shift work were also collected. BMD of the lumbar spine and hip (both total femur and femoral neck) was measured using dual-energy X-ray absorptiometry. Multivariate linear regression models were run, with bone mineralization parameters as dependent variables, as well as night work characteristics and important confounders. Statistical analysis was performed separately for premenopausal and postmenopausal women. The analyses adjusted for confounders did not reveal any significant differences between current or lifetime experience of night shift work and BMD among both premenopausal and postmenopausal women. However, the outcomes supported the well-established correlation with factors, such as age, BMI, and menopausal status. BMD at the three sites measured was significantly associated with BMI (p < .001) and inversely associated with age (p < .001) in the total study population. Postmenopausal women had significantly lower BMD than did premenopausal women (p < .001). The study findings indicate that in the population of Polish female blue-collar workers, the system of work does not seem to be associated with the development of osteoporosis.

Parameters of ovarian reserve in relation to urinary concentrations of parabens.

BACKGROUND: Parabens are synthetic chemicals commonly used in cosmetics, pharmaceuticals, food and beverage processing as antimicrobial preservatives. In experimental animals, parabens exposure was associated with adverse effects on female reproduction. Despite the widespread use of parabens little is known about their effect on female fecundity. The objective of the current analysis was to evaluate the associations of urinary parabens concentrations with parameters of ovarian reserve among women undergoing treatment in a fertility clinic. METHODS: Five hundred eleven female aged 25-39 years who attended the infertility clinic in central region of Poland for diagnostic purposes were recruited between September 2014 and February 2019. Urinary concentrations of parabens were measured by a validated gas chromatograohy ion-tap mass spectrometry method. Parameters of ovarian reserve were: antral follicle count (AFC), anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH) and estradiol (E2) levels. RESULTS: The geometric mean of specific gravity adjusted urinary concentrations of methyl (MP), ethyl (EP), propyl (PP), butyl (BP) and izobutyl paraben (iBuP) were 107.93 µg/L, 12.9 µg/L, 18.67 µg/L, 5.02 µg/L and 2.80 µg/L. Urinary concentrations of PP in the third quartile of exposure ((50-75] percentyl) were inversely associated with antral follicle count (p = 0.048), estradiol level (p = 0.03) and positively with FSH concentration (p = 0.026). MP, EP, BP and iBuP parabens were not associated any with parameters of ovarian reserve. CONCLUSIONS: Chronic exposure to PP may potentially contributing to reduced fecundity and impair fertility. As this is one of the first study to investigate the potential effect of parabens on ovarian reserve further epidemiological studies with longer duration of observation are needed.

Occupational exposure to ionizing radiation and lens opacity in interventional cardiologists.

OBJECTIVES: Interventional cardiologists (ICs) are occupationally exposed to low or moderate doses of ionizing radiation from repeated exposures. It is not clear whether these occupational conditions may affect their eye lens. Therefore, the risk of radiation-induced cataract in the cohort of Polish interventional cardiologists is analyzed in this paper. MATERIAL AND METHODS: The study group consisted of 69 interventional cardiologists and 78 control individuals occupationally unexposed to ionizing radiation. The eye lens opacities were examined using a slit camera and evaluated with Lens Opacities Grading System III. Cumulative eye lens doses were estimated retrospectively using a questionnaire including data on occupational history. RESULTS: The average cumulative dose to the left and right eye lens of the ICs was 224 mSv and 85 mSv, respectively. Nuclear opalescence and nuclear color opacities in the most exposed left eye were found in 38% of the ICS for both types, and in 47% and 42% of the controls, respectively. Cortical opacities were found in 25% of the ICS and 29% of the controls. Posterior subcapsular opacities were rare: about 7% in the ICs group and 6% in the control group. Overall, there was some, but statistically insignificant, increase in the risk for opacity in the ICs group, relative to the control group, after adjusting for the subjects' age, gender, smoking status and medical exposure (adjusted OR = 1.47, 95% CI: 0.62-3.59 for the pooled "any-eye any-type" opacity). There was also no evidence for an increased opacity risk with an increase in the dose. CONCLUSIONS: The study found no statistically significant evidence against the hypothesis that the risk of cataract in the group of the ICs occupationally exposed to low doses of ionizing radiation is the same as in the control group. Nevertheless, the adverse effect of ionizing radiation still cannot be excluded due to a relatively small study sample size. Int J Occup Med Environ Health. 2019;32(5):663-75.

Rotating night shift work and nutrition of nurses and midwives.

Previous research points to some inappropriate nutritional habits among nurses working night shifts. However, the knowledge of specific nutritional components of their diet has been limited. In the present study, we aimed to investigate the association between rotating night shifts of nurses and midwives and their usual dietary intake of energy and nutrients. A cross-sectional study was conducted among 522 Polish nurses and midwives: 251 working rotating night shifts (i.e. working night shift followed by a day off on a subsequent day) and 271 day workers. Polish adaptation of the Food Frequency Questionnaire, regarding 151 food items, was used to assess the usual dietary energy and nutrient intake. Data on occupational history and potential confounders were collected via face-to-face interviews. Body weight, height, waist and hip circumference were measured. Linear regression models: univariate (crude) and multivariate (adjusted) were run, with the nutrient intake as dependent variables, night work characteristics, and important confounders. Among nurses and midwives working rotating night shifts, a significantly higher adjusted mean intake was found for the total energy (2005 kcal vs 1850 kcal) and total fatty acids (77.9 g vs 70.4 g) when compared to day workers, as well as for cholesterol (277 mg vs 258 mg), carbohydrates (266 g vs 244 g) and sucrose (55.8 g vs 48.6 g). Night shift work duration was inversely related to the consumption of calcium, phosphorus, vitamin A, vitamin C and % energy from proteins. The higher energy consumption may contribute to increase risk of overweight and obesity among nurses working night shifts.

Sociodemographic, Lifestyle, Environmental and Pregnancy-Related Determinants of Dietary Patterns during Pregnancy.

Background: Characterization of dietary patterns represents a valid and meaningful measure of overall diet quality and nutrient intake. The study aims at evaluating the sociodemographic, lifestyle, environmental, and pregnancy-related determinants of maternal dietary patterns during pregnancy. Methods: The analysis was conducted on a group of pregnant women from the Polish Mother and Child Cohort (REPRO_PL). During the second trimester of pregnancy, 1306 women filled in a modified version of the validated food frequency questionnaire (FFQ). Dietary patterns were estimated using an exploratory factor analysis. Potential dietary determinants were assessed via a questionnaire or biomarker measurements (saliva cotinine level). Results: Two dietary patterns were identified. The Prudent dietary pattern was characterized by high consumption of fruit, vegetables, legumes, whole grains, poultry, and low-fat dairy products, while the Western dietary pattern included high intake of refined grains, processed meat, potatoes, and very low intake of whole grains. Clear sociodemographic, environmental, lifestyle, and pregnancy-related determinants of diet quality were established. Older age (ß = 0.2; p < 0.01), higher educational level (ß = 0.3; p < 0.01), and socioeconomic status (SES) (ß = 0.2; p < 0.01), overweight/obesity before (ß = 0.3; p < 0.01), as well as physical activity during pregnancy (ß = 0.2; p = 0.01) were positive determinants of a healthier diet (increasing Prudent⁻Western difference in dietary pattern scores). On the other hand, parity (ß = -0.2; p = 0.04) and living in small cities (ß = -0.3; p = 0.02) were significantly related to a rather Western dietary pattern. Conclusions: The current study presents evidence on specific factors influencing dietary patterns. They need to be accounted for in educational programs and interventions focused on healthy diet recommendations during pregnancy.

Human Semen Quality, Sperm DNA Damage, and the Level of Urinary Concentrations of 1N and TCPY, the Biomarkers of Nonpersistent Insecticides.

The aim of the study was to evaluate the association between environmental exposure to nonpersistent insecticides and semen quality (concentration, motility, morphology, computer-aided semen analysis [CASA] parameters, and sperm DNA damage). Urine samples ( n = 315) collected from men who attended the infertility clinic with normal semen concentration of 15 to 300 mln/ml and age under 45 years were analyzed for two metabolites (1-naphthol [1N] and 3,5,6-trichloro-2-pyridinol [TCPY]) of nonpersistent insecticides. Participants provided semen, blood, and saliva samples; additionally, men filled a detailed questionnaire. The results identified that urinary TCPY concentration was significantly associated with a decrease in motility; also there was a positive association between TCPY and DNA fragmentation index (DFI). 1N concentration was negatively associated with a percentage of sperm with normal morphology and positively with one of the CASA parameters (curvilinear velocity [VCL]). The results suggest that environmental exposure to nonpersistent insecticides may have an impact on semen quality parameters and sperm DNA damage.

Urinary Bisphenol A Levels and Male Fertility.

Bisphenol A (BPA) is a high-production volume industrial chemical found in many consumer products. BPA is a suspected potent endocrine disruptor, with endocrine-disrupting properties demonstrated in animal studies. Few human studies have examined bisphenol A exposure in relation to male fertility and, results are divergent. The aim of the study is to examine the associations between urinary BPA concentration and male fertility. Bisphenol A urinary concentrations were measured using gas chromatography coupled with tandem mass spectrometry in 315 men under 45 years of age with normal sperm concentration (⩾15 mln/ml) recruited from a male reproductive health clinic. Participants were interviewed and provided a semen sample. BPA was detected in 98.10% of urine samples, with a median concentration of 1.87 µg/l (1.63 µg/ g creatinine). A multiple linear regression analysis identified a positive association between the urinary concentrations of bisphenol A 25th-50th percentile and total sperm sex chromosome disomy ( p = .004). Also when modeled as continuous variable urinary BPA concentration increased total sperm sex chromosome disomy ( p = .01). Urinary concentration of BPA also increase the percentage of immature sperm (HDS) ( p = .018) and decrease motility ( p = .03). The study provides evidence that exposure to BPA is associated with poorer semen quality. Future studies are needed to confirm these findings.

Can Periodical Examinations of Employees Be Useful in Detection of Glycaemia Impairment and Improving Patients' Adherence to Medical Recommendations?

Worldwide epidemiological data indicates insufficient diagnosis of diabetes as an increasing public health problem. In the search for solutions to this disadvantageous situation, occupational medicine health services seem to open up a unique opportunity to recognize some abnormalities in the early stages, especially among the asymptomatic working-age population. 316 workers underwent obligatory prophylactic examinations. In patients with twice assayed FGL ≥ 126 mg/dL (7.0 mmol/L) an additional intervention was implemented, including further diagnostic processes and therapy in General Practice (GP), followed by examination by an occupational health specialist within 3 months. The diagnosis of previously unknown diabetes was established among 2.5% of examined workers. All patients referred to the GP due to detected glycaemia impairment visited their doctor and finished the diagnostic process, took up therapy constrained by the occupational health physician to show the effects of intervention within 3 months. Prophylactic medical check-ups allow improved compliance and medical surveillance over glycaemia impairment in patients with prediabetes states, unknown diabetes or uncontrolled clinical course of diabetes. Considering fasting glucose level during mandatory prophylactic examination helps effective prevention of diabetes and its complications and thus provides public health system benefits.

Is it possible to improve compliance in hypertension and reduce therapeutic inertia of physicians by mandatory periodic examinations of workers?

BACKGROUND: Due to high prevalence, insufficient recognition, and ineffective treatment, hypertension (HT) still remains a major medical and socio-economic problem. There is a real necessity to develop effective prophylaxis for cardiovascular disorders (CVD), based on strategies that support compliance during long-term therapy. The Polish scheme of occupational health services with mandatory periodical employee check-ups creates a unique opportunity for effective HT prophylaxis. As a result, visiting a doctor is required not only due to health ailments but also by law, which is especially important for those feeling well. It enables an improvement in tertiary prevention, including actions taken not only by the doctors of the occupa-tional health services, but also by the physicians in charge of treating the patients. AIM: Evaluation of the usefulness of mandatory health check-ups of employees concerning frequency of diagnosis and im-provement of treatment outcomes of HT. METHODS: The study group comprised 1010 Polish workers referred by their employers for mandatory medical examinations. All of the study participants filled in a questionnaire focused on self-assessment of their health, current blood pressure (BP) mea-surements, and in cases where HT had been previously detected - compliance with medical recommendations. Then in the doctor's office BP measurements were taken twice. Workers who fulfilled a criterion indicating a need for intervention were educated on optimal diet, physical activity, and risk factors for CVD. They also received medical instructions for three-step action. The first recommendation: measure BP three times a day for one week and record the results. The second: visit a gen-eral practitioner (GP) for a professional assessment of those results. The third: re-visit the occupational health physician within three months. The criterion for intervention was prior HT and a mean of two BP measurements ≥ 180/110 mmHg - in each case, or ≥ 140/90 mmHg - in the case of occupational exposure to risk factors for CVD. RESULTS: The mean age of the study participants was 41.7 years (similar in both genders). A previous diagnosis of HT was declared by 20.1% of patients. 11% of patients involved in the intervention did not comply with medical advice. The current HT therapy of all of the subjects with HT (100% of those with abnormal BP, who visited their GP) was modified. CONCLUSIONS: Prophylactic medical check-ups of workers gives improved compliance and medical surveillance of HT in patients with an uncontrolled clinical course of this disease. Obligations and periodic examinations encourage both patients and physicians to improve compliance and reduce the risk of therapeutic inertia.

Environmental levels of triclosan and male fertility.

Triclosan is a synthetic chemical with broad antimicrobial activity that has been used extensively in consumer products, including personal care products, textiles, and plastic kitchenware, although the exposure which is widespread evidence from human studies is scarce. Our study aims to investigate the relationship between triclosan exposure and male fertility. Triclosan (TCS) urinary concentrations were measured using gas chromatography coupled with tandem mass spectrometry in 315 men recruited from a male reproductive health clinic with normal sperm concentration (≥ 15 mln/ml) (WHO 2010) under 45 years of age. Participants were interviewed and provided a semen sample. TCS was detected in 84.13% of urine samples, with a median concentration of 2.83 µg/l (2.57 µg/g creatinine). A multiple linear regression analysis showed a positive association between the urinary concentrations of triclosan 50th-75th percentile and ≥ 50 percentile and percentage of sperm with abnormal morphology (p = 0.016 and p = 0.002, respectively). The study provides evidence that exposure to triclosan is associated with poorer semen quality. Future studies are needed to confirm these findings.