Evaluation of a Fatigue Detector Using Eye Closure-Associated Indicators Acquired from Truck Drivers in a Simulator Study.

This paper presents a camera-based prototype sensor for detecting fatigue and drowsiness in drivers, which are common causes of road accidents. The evaluation of the detector operation involved eight professional truck drivers, who drove the truck simulator twice-i.e., when they were rested and drowsy. The Fatigue Symptoms Scales (FSS) questionnaire was used to assess subjectively perceived levels of fatigue, whereas the percentage of eye closure time (PERCLOS), eye closure duration (ECD), and frequency of eye closure (FEC) were selected as eye closure-associated fatigue indicators, determined from the images of drivers' faces captured by the sensor. Three alternative models for subjective fatigue were used to analyse the relationship between the raw score of the FSS questionnaire, and the eye closure-associated indicators were estimated. The results revealed that, in relation to the subjective assessment of fatigue, PERCLOS is a significant predictor of the changes observed in individual subjects during the performance of tasks, while ECD reflects the individual differences in subjective fatigue occurred both between drivers and in individual drivers between the 'rested' and 'drowsy' experimental conditions well. No relationship between the FEC index and the FSS state scale was found.

Climate conditions and work-related fatigue among professional drivers.

The possible associations between climate parameters and drivers' fatigue have not been subject to specific studies thus far. We have undertaken a study to investigate whether the particular climate parameters are related to fatigue perception by motor vehicle drivers. The study was performed from July to October. Each driver was surveyed four times: before and after workshift on a monotonous route outside the city center (MR), and on a heavy traffic route in the city center (HTR). The study was conducted among 45 city bus drivers aged 31-58 years (43.7 ± 7.9), seniority as driver 3-34 years (14.7 ± 8.6). Data on climate conditions (ambient temperature, air pressure, humidity, wind speed, precipitations) on particular study days was obtained from the Institute of Meteorology and Water Management, National Research Institute Warsaw, Poland. Fatigue was assessed using the Fatigue Assessment Questionnaire, developed at Nofer Institute of Occupational Medicine (Lodz, Poland). The total level of fatigue was significantly (p = 0.045) higher after driving on HTR than on MR. The number of symptoms was also significantly higher (p < 0.05) among drivers working on HTR. After MR, significant correlations were found between wind speed and heavy eyelid feeling, being prone to forgetting, eye strain, frequent blinking, and between ambient temperature and feeling thirsty. After HTR feeling thirsty, tiredness and difficulty in making decisions correlated with ambient temperature and feeling thirsty with wind speed. Climate conditions can modify the drivers fatigue; therefore, we should be aware of their impact on well-being.

Electromagnetic fields exposure assessment among workers at broadcast centers in Poland.

BACKGROUND: In the studies investigating the potential health effects of occupational exposure to electromagnetic fields (EMF), the key problem is the assessment of workers' exposure. Electromagnetic fields exposure assessment requires determining maximum EMF levels, for the acute effect, and the dose absorbed, for the cumulative effect. A study was undertaken to determine EMF exposure in workers at broadcasting centers (BCs) in Poland. It was the first part of a comprehensive project on health effects of occupational exposure to EMF. MATERIAL AND METHODS: The study was conducted in 4 selected BCs. Spot measurements of electric field strength (E), and the results of E measurements that were made in the past for occupational hygiene assessments, were used for determining workers' exposure to electric field. The parameters considered were the maximum E value (Emax), the weighted average E value (Eavg) and the E lifetime dose (Elifetime dose). RESULTS: In the group of workers examined, the E values did not exceed 16.7 V/m for Emax (the occupational exposure limit (OEL) for work shift in Poland is 20 V/m), 2.9 V/m for Eavg and 1 500 000 (V/m)2×h for Elifetime dose. CONCLUSIONS: In view of the lack of dosimetry data, a retrospective assessment of BC workers' exposure to very high frequency and ultra-high frequency EMF was conducted, which made it possible to estimate EMF lifetime dose for the workers. Since the EMF exposure levels at BCs did not exceed the admissible values, they can be considered safe to the workers' health, according to the approach used for developing OELs for EMF exposure. Med Pr 2018;69(5):477-482.

[Effect of stress and intesity of mobile phone using on the health and subjective symptoms in GSM workers]. / Wplyw stresu i intensywnosci rozmów przez telefon komórkowy na stan zdrowia i dolegliwosci subiektywne pracowników sieci GSM.

BACKGROUND: There are no available data on the health consequences that may result from the synergistic effects of electromagnetic fields (EMF) and stress. Understanding the mechanisms of the simultaneous exposure will make it possible to develop procedures to minimize adverse health effects in professionals using mobile phones. MATERIAL AND METHODS: A questionnaire survey was conducted in 600 randomly selected people to obtain data on their health status and the prevalence of subjective symptoms related to the mobile phones using. Among them, there were 208 GSM Network employees, to whom the Perceived Stress Scale and Assessment of Stress at Work Questionnaire were sent. Eighty-nine completed questionnaires were returned (response rate - 42.8%). RESULTS: The mean age of respondents was 30.3 years (standard deviation (SD) = 7.7), time of occupational use of mobile phone - 4.1 years (SD = 1.7), the level of occupational stress - 95.3 (SD = 19.1). A significant percentage of people (62.8%) complained of the frequent difficulties in coping with problems of everyday life, and 57.4% had a fairly frequent problems with managing their own affairs. Significant differences in the life stress were detected between groups with different time of phone use (p = 0.03), and in occupational stress level, significant differences were noted between the 2 groups differing in the length of the conversation (p = 0.05). The risk of headache, associated (odds ratio (OR) = 4.2, p = 0.008) or not associated (OR = 2.97, p = 0.04) with calls on mobile phone, adjusted for stress, was significantly higher in people speaking via mobile more than 60 min/day than in those talking less. CONCLUSIONS: The study indicates that both stressors acting at the same time (EMF from cell phone and stress) adversely affect the well-being of workers and increase the risk of subjective symptoms. Med Pr 2017;68(5):617-628.

[Prevention of cardiovascular diseases - Prophylactic program in a selected enterprise]. / Zapobieganie chorobom ukladu krazenia ­ program profilaktyczny wdrozony w wybranym przedsiebiorstwie.

BACKGROUND: In Poland cardiovascular diseases (CVD), classified as work-related diseases, are responsible for 25% of disability and cause 50% of all deaths, including 26.9% of deaths in people aged under 65 years. The aim of the study was to analyze employee expectations regarding CVD- oriented prophylactic activities in the selected enterprise. MATERIAL AND METHODS: A questionnaire, developed for this study, consists of: socio-demographic data, job characteristics, occupational factors, and questions about the respondents' expectations concerning the prevention program. The study group comprised 407 multi-profile company employees aged (mean) 46.7 years (standard deviation (SD) = 9.1), including 330 men (81.1%), mean age = 46.9 (SD = 9.2) and 77 women (18.9%), mean age = 45.9 (SD = 8.2) The study was performed using the method of auditorium survey. RESULTS: Employees declared the need for actions related to physical activity: use of gym, swimming pool, tennis (56.5%), smoking habits - education sessions on quitting smoking (24.6%). A few people were interested in activities related to healthy diet. According to the majority of the study group, the scope of preventive examinations should be expanded. Based on our own findings and literature data CVD- -oriented preventive program, addressed to the analyzed enterprise was prepared. The program will be presented in another paper. CONCLUSIONS: The results showed significant quantitative and qualitative differences in the classic and occupational CVD risk factors between men and women, as well as in preferences for participation in prevention programs. Therefore, gender differences should be taken into account when planning prevention programs. Med Pr 2017;68(6):757-769.

[Effects of radio- and microwaves emitted by wireless communication devices on the functions of the nervous system selected elements]. / Wplyw pól elektromagnetycznych zakresu radiowego i mikrofalowego, emitowanych przez urzadzenia lacznosci bezprzewodowej, na funkcjonowanie wybranych elementów ukladu nerwowego.

Nervous system is the most "electric" system in the human body. The research of the effects of electromagnetic fields (EMFs) of different frequencies on its functioning have been carried out for years. This paper presents the results of the scientific literature review on the EMF influence on the functioning of the human nervous system with a particular emphasis on the recent studies of the modern wireless communication and data transmission systems. In the majority of the analyzed areas the published research results do not show EMF effects on the nervous system, except for the influence of GSM telephony signal on resting EEG and EEG during patients' sleep and the influence of radiofrequency EMF on the cardiovascular regulation. In other analyzed areas (EMF impact on sleep, the evoked potentials and cognitive processes), there are no consistent results supporting any influence of electromagnetic fields. Neurophysiological studies of the effect of radio- and microwaves on the brain functions in humans are still considered inconclusive. This is among others due to, different exposure conditions, a large number of variables tested, deficiencies in repeatability of research and statistical uncertainties. However, methodological guidelines are already available giving a chance of unifying research that definitely needs to be continued in order to identify biophysical mechanisms of interaction between EMFs and the nervous system. One of the EMF research aspects, on which more and more attention is paid, are inter-individual differences. Med Pr 2016;67(3):411-421.

[Do hearing threshold levels in workers of the furniture industry reflect their exposure to noise?]. / Czy progi sluchu u pracowników przemyslu meblarskiego wynikaja z ich narazenia na halas?

BACKGROUND: The aim of the study was to analyze the hearing status of employees of a furniture factory with respect to their exposure to noise and the presence of additional risk factors of noise-induced hearing loss (NIHL). MATERIAL AND METHODS: Noise measurements, questionnaire survey and assessment of hearing, using pure tone audiometry, were carried out in 50 male workers, aged 20-57 years, directly employed in the manufacture of furniture. The actual workers' hearing threshold levels (HTLs) were compared with the predictions calculated according to PN-ISO 1999:2000 based on age, gender and noise exposure. RESULTS: Workers under study were exposed to noise at daily noise exposure levels of 82.7-94.8 dB (mean: 90.9 dB) for a period of 3-14 years. In all subjects, mean HTL at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz did not exceed 25 dB. Nevertheless, high frequency notches were found in 11% of audiograms. The actual workers' HTLs at 3000-6000 Hz were similar to those predicted using PN-ISO 1999:2000. There were statistical significant differences between HTLs in subgroups of people with higher (> 78 mm Hg) and lower (≤ 78 mm Hg) diastolic blood pressure, smokers and non-smokers, and those working with organic solvents. Hearing loss was more evident in subjects affected by the additional risk factors specified above. CONCLUSIONS: The results confirm the need to consider, in addition to noise, also some other NIHL risk factors, such as tobacco smoking, elevated blood pressure, and co-exposure to organic solvents when estimating the risk of NIHL and developing the hearing conservation programs for workers. Med Pr 2016;67(3):337-351.

[Work fatigue in urban bus drivers]. / Zmeczenie praca u kierowców autobusów miejskich.

BACKGROUND: Bus drivers are a special group of professional drivers who are at a very high risk of fatigue. The aim of the study was to examine whether the driver's subjective assessment of fatigue allows for the determination of its level and identification of its causes. MATERIAL AND METHODS: The study group comprised 45 randomly selected bus drivers (mean age - 43.7 ± 7.9 years, period of employment as drivers - 14.7 ± 8.6 years). Examinations were performed in all subjects four times - before and after work on the "easy" route (outside the city center, small traffic intensity) and before and after work on the "difficult" route (city center, heavy traffic). The fatigue test questionnaire, based on the list of symptoms of fatigue prepared by the Japan Research Committee of Fatigue, was used in the study. RESULTS: The rating of fatigue after the work was significantly higher than that before the work. The profile of fatigue after work was not influenced by the type of route, but the assessment of most symptoms of fatigue reached a higher level after the "difficult" routes and the differences were statistically significant for 7 symptoms. Only the ratings of leg fatigue, feeling of heaviness, and the necessity to squint eyes and gaze with effort reached the higher levels after driving the "easy" routes. It has been found that the level of fatigue was significantly correlated with the job characteristics (driving time, the length of the route, number of stops, etc.) and with the abundance of food ingested and type of beverage (coffee vs. others) drunk prior to driving. CONCLUSIONS: The questionnaire used in our study to assess the subjective feeling of fatigue has proved to be a sensitive and useful tool for indicating the level and causes of fatigue. The relationship between the symptoms of fatigue and the characteristics of job and lifestyle shows that actions must be taken by both the employers and employees to prevent fatigue in bus drivers.

[Neurological symptoms and syndromes in municipal transport drivers]. / Objawy i zespoly neurologiczne u kierowców pojazdów komunikacji miejskiej.

BACKGROUND: The way the municipal transport drivers perform their job contributes to varied burdens linked with the body posture at work, stress, shift work, vibration, noise and exposure to chemical agents. The aim of the study was to assess the condition of the nervous system (NS) in municipal transport drivers. MATERIAL AND METHODS: The study covered 42 men, aged 43.4 years (standard deviation (SD): 8.3), employed as bus drivers in the municipal transport enterprise. The duration of employment was 11.8 years on average (SD: 8.6). The condition of the nervous system was assessed on the basis of clinical neurological examinations. RESULTS: Chronic lumbosacral syndrome was found in 54.8% of the subjects. A significant relationship between the incidence of lumbosacral syndrome and the duration of employment (p=0.032) was observed; significantly higher in drivers employed for 11-15 years (90.9%) in comparison to the remaining groups. Nervous system functional disorders were characterized by the increased emotional irritability (47.6%), sleep disorders manifested by excessive sleepiness (33.3%) or insomnia (28.6%) and headaches (3%), mostly tension headaches. Excessive daytime sleepiness was significantly age-dependent (p=0.038). CONCLUSIONS: The evidenced NS disorders indicate the need to undertake preventive measures tailored for the occupational group of bus drivers.

[Cardiopulmonary exercise testing--its application in cardiology and occupational medicine]. / Spiroergometryczna próba wysilkowa--zastosowanie w kardiologii i medycynie pracy.

Cardiopulmonary exercise testing is a method used to assess the exercise capacity. It is used in cardiology to define the diagnostic and prognostic information, the treatment and its effectiveness. This method is also useful in sport medicine and in occupational medicine. The cardiopulmonary exercise test involves measuring of gas exchange during exercise testing. The article presents the main parameters assessed during the test and the indications and contraindications for conducting the test. It also reveals the results of recently published clinical trials on the use of cardiopulmonary exercise test in patients with cardiovascular disease and in the working population. The study included variability of respiratory parameters during the cardiopulmonary exercise test and after its completion, as well as their impact on the prognostic value. In addition, the results of a study involving an optimal choice of interval training on the basis of oxygen consumption at peak exercise are summarized.

[New methods for determining the relative load due to physical effort of the human body]. / Nowe metody wyznaczania wzglednego obcazenia wysilkiem fizycznym organizmu czlowieka.

BACKGROUND: The relative physical load (% VO2max) is the quotient of oxygen uptake (Vo2) during physical effort and maximum oxygen uptake (VO2max) by the human body. For this purpose the stress test must be performed. The relative load shows a high correlation with minute ventilation, cardiac output, heart rate, stroke volume, increased concentrations of catecholamines in the blood, inner temperature, weight, height and human body surface area. The relative load is a criterion for the maximum workloads admissible for healthy and sick workers. Besides, the classification of effort can be more precise when based on the relative load than on the energy output. MATERIAL AND METHODS: Based on our own and international empirical evidence and the laws of heat transfer and fluid mechanics, a model of temperature control system has been developed, involving the elements of human cardiovascular and respiratory systems. Using this model, we have been able to develop our own methods of determining the relative load, applying only the body core temperature (Tw) or heart rate within one minute (HR), body mass (m), height (H), and body surface area (AD) instead of VO,max. RESULTS: The values of the relative physical load (% VO2max) obtained by using our own methods do not differ significantly from those obtained by other methods and by other researchers. CONCLUSIONS: The developed methods for determining the relative physical load (% VO2max) do not require the exercise test to be performed, therefore, they may be considered (after verification in an experimental study) a feasible alternative to current methods.

[The importance of sight for drivers]. / Znaczenie stanu narzadu wzroku dla kierowcy.

Sight is the basic sense for drivers. Condition of the eye determines correct, comfortable and safe performance of the work as drivers. This article presents various factors influencing the sight condition. There are two groups of factors, external (environment, the kind and time of work, stress caused by work) and internal (systemic and local disorders). All these factors can reduce significantly visual functions, such as visual acuity, field of vision, color vision, strereoscopic vision, twilight vision and glare sensitivity. There are also presented actual requirements for drivers and causes of the car accidents in various age groups. Impairments in vision functions can be dangerous for both the driver and other road users.

[Assessment of musculoskeletal load in refuse collectors]. / Ocena obciazenia ukladu ruchu uladowaczy nieczystosci stalych.

BACKGROUND: The aim of this work was to assess the load on the musculoskeletal system and its effects in the collectors of solid refuse. The rationale behind this study was to formulate proposals how to reduce excessive musculoskeletal load in this group of workers. MATERIAL AND METHODS: The study group comprised 15 refuse collectors aged 25 to 50 years. Data about the workplace characteristics and subjective complaints of workers were collected by the free interview and questionnaire. During the survey the photorecording of the workpostures, the distance and velocity by GPS recorders, measurements of forces necessary to move containers, energy expenditure (lung ventilation method), workload estimation using the Firstbeat system and REBA method and stadiometry were done. RESULTS: The distance walked daily by the collectors operating in terms of 2 to 3 in urban areas was about 15 km, and in rural areas about 18 km. The most frequent musculoskeletal complaints concerned the feet (60% subjects), knees, wrists and shoulders (over 40% subjects). After work-shift all examined workers had vertebral column shorter by 10 to 14 mm (11.4 mm mean). CONCLUSIONS: The results of our study show that the refuse collectors are subjected to a very high physical load because of the work organization and the way it is performed. To avoid adverse health effects and overload it is necessary to undertake ergonomic interventions, involving training of workers to improve the way of their job performance, active and passive leisure, technical control of the equipment and refuse containers, as well as the renegotiation of contracts with clients, especially those concerning non-standard containers.

[Cardiovascular risk factors and life and occupational stress among policemen]. / Czynniki ryzyka chorób ukladu krazenia (CVD) a stres zyciowy i zawodowy u policjantów.

BACKGROUND: Several studies have shown an association between work-related stress and risk factors for cardiovascular disease. ever, only a few studies concerned the police. The aim of this study was to assess the relationship between the general and work-related stress, and the functioning of the circulatory system in the police staff. MATERIAL AND METHODS: The study group consisted of 126 policemen (aged 37.8 +/- 7.3 years), with average employment duration of 14.4 +/- 7 years. The study comprised the assessment of health status based on the medical examination and medical history of identified diseases, cardiovascular risk factors and symptoms, dietary habits, physical activity, intake of drugs, data on the family history, determinations of serum total cholesterol, HDL and LDL fractions, triglycerides, and fasting glycemia . The stress level was assessed using the Questionnaire for the Subjective Assessment of Work and Perceived Stress Scale. RESULTS: On medical examination hypertension was found in 36% of the people under study. Chest discomfort was reported by 60% of the subjects. Average body mass index (BMI), serum cholesterol and LDI, were elevated (22.7 +/- 4.1, 222.6 +/- 41.7 mg/dl and 142.7 +/- 39.7 mg/dl, respectively). Mean triglyceride, HDL fraction and fasting glucose levels were normal in the whole group. The levels of general and occupational stress were 34.914.8 and 128.0+33.3, respectively, being higher than in other occupational groups. In the group with the highest level of stress, there were significantly more people with circulatory problems (81%), drinking strong alcohol at least once a week (27%), working in a 3-shift system (40.5%) and working overtime (44%). CONCLUSIONS: The results show that the police are a group at high risk of developing cardiovascular diseases due to work-related stress.

Ageing and its consequences - the use of virtual reality (VR) as a tool to visualize the problems of the elderly.

BACKGROUND: The population ageing phenomenon is mainly attributable to the increasing proportion of people >60 years of age. This demographic situation requires more attention to the needs of the elderly. Given the lack of effective methods to expand the knowledge of and increase sensitivity to elderly people's problems, especially among the younger generation, an attempt has been made to use virtual reality (VR) to prepare an educational tool focused on these problems. This paper will focus on the use of VR in depicting fundamental problems in the daily live of older people. MATERIAL AND METHODS: For project purposes, a questionnaire (26 question) was developed, concerning data on socio-demographic situation, health and physical conditions; social, living and housing support needs. Additionally, qualitative interviews were conducted with elderly people regarding their needs about housing arrangements and daily activities. It was distributed to 100 people, 34 completed questionnaires were obtained from 30 women and 4 men. The study results were intended as information that would provide the basis for developing VR scenarios, not for the epidemiological purposes. RESULTS: The mean age of the respondents was 73.7±7.5 (60‒86 years). Different situations, as heavy housework, lifting/carrying heavy objects, lifting hands above the shoulder level, bending and squatting were identified that pose problems for elderly people. Based on these results, 3 scenario proposals were prepared, including situations: in the bathroom, in the supermarket, on a trip to the city. These scenarios were used to prepare the exercises in VR in the frame of European project - the Mixed Reality on Universal Design's Secret Service (Mr. UD) Project. CONCLUSIONS: The use of immersive technology such as VR can be beneficial for young people to be able to see perspectives of the elderly. Students from various fields (medicine, nursing, future engineers, designers, sociologists, etc.) may feel like the elderly and experience their daily challenges. Med Pr. 2023;74(3):159-70.

[Impact of infrasound and low frequency noise on human health and well-being. Part I: Review of experimental studies]. / Wplyw infradzwieków i halasu niskoczestotliwosciowego na zdrowie i samopoczucie czlowieka. Czesc I: przeglad badan eksperymentalnych.

This paper summarizes the currently available knowledge on the impact of infrasound and low frequency noise (LFN) on human health and well-being. This narrative review of the literature data was based on the selected, mostly, peer-reviewed research papers, review articles, and meta-analyses that were published in 1973-2022. It has been focused on infrasound perception, annoyance attributed to infrasound and low-frequency noise, as well as their effects on the cardiovascular system and sleep disorders. Particular attention was also paid to the latest research results and specific sources of infrasound and LFN, i.e., wind turbines. Med Pr Work Health Saf. 2023;74(4):317-32.

[Impact of infrasound and low frequency noise on human health and well-being. Part II: Review of epidemiological studies]. / Wplyw infradzwieków i halasu niskoczestotliwosciowego na zdrowie i samopoczucie czlowieka. Czesc II: przeglad badan epidemiologicznych.

This paper summarizes the currently available knowledge on the impact of infrasound (IS) and low frequency noise (LFN) on human health and well-being. This narrative review of the literature data was based on the selected, mostly, peer-reviewed research papers, review articles, and meta-analyses that were published in 1971-2022. It has been focused on the results of epidemiological studies concerning the annoyance related to infrasound and low frequency noise, as well as their impact on the cardiovascular system and sleep disorders. Particular attention was also paid to the latest research results and specific sources of IS and LFN, i.e., wind turbines. Med Pr Work Health Saf. 2023;74(5):409-23.

[Driving simulators in risk assessment of traffic accident among drivers with obstructive sleep apnea]. / Zastosowanie symulatorów jazdy samochodem w ocenie ryzyka wypadku u kierowców z obturacyjnym bezdechem sennym.

Sleep disorders in the form of obstructive sleep apnea (OSA) are still underdiagnosed and insufficiently treated in drivers. This is a very important problem, because chronic sleepiness during the day and episodes of sleep during driving a road vehicle are now regarded as one of the main causes of traffic accidents, including fatal ones, caused by professional drivers. For many years driver fatigue has been considered a major risk factor of traffic accidents, while obstructive sleep apnea has remained almost completely disregarded. In the late 1980s and early 1990s epidemiological data began to indicate sleepiness and sleep deficit as the cause of up to 20% of road accidents. Later studies conducted in many countries in different groups of drivers have confirmed that people with breathing problems during sleep are much more likely to cause accidents than healthy ones. These accidents often result from sleep disorders experienced by drivers while driving, during both long monotonous journeys and in heavy urban traffic. The application of treatment involving continuous positive airway pressure (CPAP) reduces the rate of accidents among drivers. In the recent years, the studies of this problem has been expanded by the use of drive simulators that quite accurately simulate real driving conditions. This approach allows to assess the driver's reactions and behaviors in different situations on the road, including the most dangerous ones. By comparing the results from the simulator with those in real conditions it will be possible to see to what extent the risk of accident in simulated conditions correlates with the risk of accident in real life settings.

[Ambulatory blood pressure monitoring (ABPM) and its usefulness in occupational medicine]. / Ambulatoryjne monitorowanie cisnienia tetniczego (ABPM) i jego zastosowanie w medycynie pracy.

The application of long-term blood pressure monitoring (ABPM) in the occupational medicine practice, its advantages and disadvantages and the diagnostic and prognostic values of the parameters determined during the test were reviewed. The circumstances (e.g., social meeting, phone call) in which blood pressure value significantly differs from its resting value were identified. The methodology and reference values of systolic and diastolic blood pressure proposed by the European Society of Hypertension and the European Society of Cardiology were discussed as well as the recommended values of the blood pressure load. Ihe use of ABPM in the assessment of circadian blood pressure rhythm and the prognostic value of insufficient nocturnal drop (in non-dippers) or excessive nocturnal drop of ABP (in extreme dippers), and inverted circadian ABP variation (in reverse-dippers) was discussed. Attention was paid to the prognostic value of BP variability over short periods of time, which is specified in terms of standard deviation or coefficient of variance. This variability is considered as a factor capable of modifying the course, complications and prognosis of the hypertensive disease. The phenomena of "white coat hypertension" and masked hypertension were also described. It was demonstrated that the use of ABPM in occupational medicine is feasible, especially for preventive purposes, in workers exposed to different adverse work-related factors (noise, electromagnetic fields, shift work).

[Effect of fatigue on the fitness to drive]. / Wplyw zmeczenia na zdolnosc prowadzenia pojazdów.

The 1995 U.S. Department of Transportation files contain a statement that driver fatigue has been a major problem among road vehicle professional drivers, while the consequences of participation in public road traffic of drivers affected by fatigue represent a serious threat to the public safety. Therefore, studies on the causes and consequences of fatigue in drivers are of significant practical value. The authors of this work discuss definitions of fatigue and fatigue classifications relative to the location of the functional changes (physical and mental fatigue, general and local - muscular, ocular, auditory) and relative to intensity (acute, sub-acute, chronic fatigue and weariness), and duration Particular attention has been paid to the factors contributing to fatigue in drivers. These may be classified into two groups: 1. sleep-related (SR), i.e. cumulative sleep deficit, long wake time, and time of the day; 2. task-related (TR), i.e. factors related with vehicle driving and working (driving) time. Studies on the effect of fatigue on driving performance (longer reaction time, poorer vigilance, slower information processing, impaired recent memory) have been analyzed. The major effect of driver fatigue is that he/she becomes gradually diverted from the road and road traffic, with the resultant poorer driving performance. Thus, the effects of fatigue in a driver are comparable to those after alcohol intake. This paper also discusses the methods used to counteract and prevent fatigue.