Changes in Dietary Patterns and the Nutritional Status in Men in the Metallurgical Industry in Poland Over A 21-Year Period.

BACKGROUND/AIMS: The study was carried out to evaluate the changes in the eating habits and lipid parameters in a 21-year follow-up on a group of 435 men living in Poland. METHODS: The studied population was composed of the same subjects: a group of men who were first studied in the years 1987-1989 and in 2008-2010. The following data was gathered: body mass, body mass index (BMI), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride concentration in blood serum. RESULTS: The changes in the eating habits among the studied men registered throughout the 21-year period were positive since they showed a reduction in the caloric content of their diet (p < 0.001), lower total fat content (p < 0.001), total amount of carbohydrates (p < 0.001), sucrose (p < 0.001), iron (p < 0.001), and featured more vitamins: A (p < 0.002), B1 (p < 0.001), and C (p < 0.001). An adverse trend was observed in terms of constant calcium shortages in their food portions (ns). A 21-year follow-up of the studied group showed significant differences in terms of weight (p < 0.001), BMI (p < 0.001), and all cholesterol fractions (p < 0.001) in their blood serum, except cholesterol alone (ns). CONCLUSION: It is important to continue observing the dietary trends in the studied group, with the focus on the occurrence of potential changes in their bodies.

Environmental and socio-economic determinants of infant mortality in Poland: an ecological study.

BACKGROUND: Health status of infants is related to the general state of health of women of child-bearing age; however, women's occupational environment and socio-economic conditions also seem to play an important role. The aim of the present ecological study was to assess the relationship between occupational environment, industrial pollution, socio-economic status and infant mortality in Poland. METHODS: Data on infant mortality and environmental and socio-economic characteristics for the 66 sub-regions of Poland for the years 2005-2011 were used in the analysis. Factor analysis was used to extract the most important factors explaining total variance among the 23 studied exposures. Generalized Estimating Equations model was used to evaluate the link between infant mortality and the studied extracted factors. RESULTS: Marked variation for infant mortality and the characteristics of industrialization was observed among the 66 sub-regions of Poland. Four extracted factors: "poor working environment", "urbanization and employment in the service sector", "industrial pollution", "economic wealth" accounted for 77.3% of cumulative variance between the studied exposures. In the multivariate regression analysis, an increase in factor "poor working environment" of 1 SD was related to an increase in infant mortality of 40 (95% CI: 28-53) per 100,000 live births. Additionally, an increase in factor "industrial pollution" of 1 SD was associated with an increase in infant mortality of 16 (95% CI: 2-30) per 100,000 live births. The factors "urbanization and employment in the service sector" and "economic wealth" were not significantly related to infant mortality. CONCLUSION: The study findings suggested that, at the population level, infant mortality was associated with an industrial environment. Strategies to improve working conditions and reduce industrial pollution might contribute to a reduction in infant mortality in Poland.

Perinatal mortality in urban and rural areas in Poland in 2002-2012.

AIM: The aim of this study was to analyze the level and trends of perinatal mortality by mother's place of residence (urban vs rural area) in Poland in 2002-2012. MATERIAL AND METHOD: This study was based on the data of the Central Statistical Office on the number of live births, infant deaths (0-6 days) and stillbirths by mother's place of residence (urban vs rural area), reported in 2002-2012 in 16 provinces and Poland in general. Joinpoint model was used to analyze perinatal mortality rate trends over time and average annual percent change (APC). Urban/rural ratio was employed to demonstrate the differences in perinatal mortality between urban and rural areas. RESULTS: In the period analyzed, perinatal mortality in Poland decreased by 3.4% (p<0.05) and 2.7% (p<0.05) per year in urban and rural areas, respectively. Having considered urban areas, perinatal mortality rate was decreasing at the fastest pace in the following provinces: Pomorskie (APC) = -6.6%, p<0.05), Warminsko-Mazurskie (APC) = -5.4%, p<0.05), Lubuskie i Swietokrzyskie (APC = -4.5%, p<0.05) while for rural areas - Dolnoslaskie (APC = -4.3%, p<0.05), Wielkopolskie, Zachodniopomorskie (APC = -3.7%, p<0.05) and Slaskie (APC = -3.2%, p<0.05). CONCLUSIONS: In the study period, a decrease in perinatal mortality was reported in Poland, both in urban and rural areas. The level of perinatal mortality rate as well as the pace of these changes differed between provinces.

Association of the bitter taste genes TAS2R38 and CA6 and breast cancer risk; a case-control study of Polish women in Poland and Polish immigrants in USA.

It is known that the perception of bitterness is mediated by type 2 bitter taste receptors (TAS2Rs). However, recent reports have suggested that the carbonic anhydrase 6 (CA6) gene may also influence bitterness sensing. Genetic variants in these genes could influence dietary intake of brassica vegetables, whose increased consumption has been observed in the literature, though inconsistently, to decrease breast cancer (BC) risk. We hypothesized that the estimated odds ratios (ORs) for the association between BC and taster diplotype (PAV/PAV) and/or genotype A/A, will be in the direction of increased BC risk, potentially due to reduced consumption of brassica vegetables. Using a case-control study of BC in Polish women in Poland (210 cases and 262 controls) and Polish immigrant women to USA (78 cases and 170 controls) we evaluated the association of the taster diplotypes in TAS2R38 gene and genotypes in the CA6 gene and BC risk in these two populations individually and jointly. No significant increase in risk was observed for the TAS2R38 PAV/PAV diplotype (tasters) in each population individually or in the joint population. For the CA6 gene, in the joint population, we observed an increased BC risk for the combined G/A and G/G genotypes (non-tasters) vs A/A (tasters), OR = 1.41 (95% CI 1.04-1.90, p = 0.026) which after adjustment for False Discovery Rate (FDR), was not significant at p≤0.05 level. However, for the joint population and for the combined genotype of the two genes AVI/AVI+G* (non-tasters) vs. PAV/*+A/A (tasters), we observed a significant increase in BC risk, OR = 1.77 (95%CI 1.47-2.74, p = 0.01), for the non-tasters, which remained significant after FDR adjustment. In conclusion for the joint population and the joint effect for the two bitter sensing genes, we observed an increase in BC risk for the bitterness non-tasters, association which is in the opposite direction to our original hypothesis.

Emigration preferences and plans among medical students in Poland.

BACKGROUND: Migration and ethical recruitment of health care workers is receiving increased attention worldwide. Europe's aging population is creating new opportunities for medical doctors for finding employment in other countries, particularly those of a better standard of living. METHODS: We conducted a survey among 1214 medical students in five out of eleven universities in Poland with medical schools in October 2008. A series of statistical tests was applied to analyse the characteristics of potential migrants. Projections were obtained using statistical analyses: descriptive, multifactorial logistic regression and other statistical methods . RESULTS: We can forecast that 26-36% of Polish medical students will emigrate over the next few years; 62% of respondents estimated the likelihood of emigration at 50%. Students in their penultimate year of study declared a stronger desire to migrate than those in the final year. At the same time, many students were optimistic about career opportunities in Poland. Also noted among students were: the decline in interest in leaving among final year students, their moderate elaboration of departure plans, and their generally optimistic views about the opportunities for professional development in Poland. CONCLUSIONS: The majority of Polish students see the emigration as a serious alternative to the continuation of their professional training. This trend can pose a serious threat to the Polish health care system, however the observed decline of the interest in leaving among final year students, the moderate involvement in concrete departure plans and the optimistic views about the opportunities for professional development in Poland suggest that the actual scale of brain drain of young Polish doctors due to emigration will be more limited than previously feared.

Determinants of all cause mortality in Poland.

AIM: The study objective was to evaluate quantitatively the relationship between demographic characteristics, socio-economic status and medical care resources with all cause mortality in Poland. MATERIALS AND METHOD: Ecological study was performed using data for the population of 66 subregions of Poland, obtained from the Central Statistical Office of Poland. The information on the determinants of health and all cause mortality covered the period from 1st January 2005 to 31st December 2010. Results for the repeated measures were analyzed using Generalized Estimating Equations GEE model. In the model 16 independent variables describing health determinants were used, including 6 demographic variables, 6 socio-economic variables, 4 medical care variables. The dependent variable, was age standardized all cause mortality rate. RESULTS: There was a large variation in all cause mortality, demographic features, socio-economic characteristics, and medical care resources by subregion. All cause mortality showed weak associations with demographic features, among which only the increased divorce rate was associated with higher mortality rate. Increased education level, salaries, gross domestic product (GDP) per capita, local government expenditures per capita and the number of non-governmental organizations per 10 thousand population was associated with decrease in all cause mortality. The increase of unemployment rate was related with a decrease of all cause mortality. Beneficial relationship between employment of medical staff and mortality was observed. CONCLUSIONS: Variation in mortality from all causes in Poland was explained partly by variation in socio-economic determinants and health care resources.

Taste preferences of preschoolers and parents' contribution to shaping their children's eating habits in the context of obesity development.

INTRODUCTION AND OBJECTIVE: Improper diet of children and their preference for sweet taste may be risk factors for the development of obesity and childhood caries. The aim of the study was to evaluate the taste preferences of preschoolers and to estimate the methods used by parents to shape the nutritional behaviour of their children. MATERIAL AND METHODS: The research covered 108 preschool children and 86 parents. All children completed a pictorial questionnaire containing images of 32 food products. The children expressed their preferences (I really like, I like, I don't like) by choosing the appropriate emoji. The questionnaire for parents concerned the diet of children on days off from kindergarten. The nutritional status of children was evaluated on the basis of the BMI. Children with normal weight/underweight and those overweight / obese were compared using χ2 or the exact Fisher test. RESULTS: Most preschoolers indicated that they liked the most crisps, jam, sweets, chocolate and sweet drinks. They also enjoyed fruits which are naturally sweet: apples (97%) and bananas (94%). The favourite vegetables were cucumbers (84%), potatoes (83%), and carrots (77%). Children had a tendency to make incorrect food choices. Fast food was very popular, while fish was disliked. Parents reported that children like meatless sweet dishes (crêpes, pancakes, dumplings). Such factors as unlimited access to sweets at home (p=0.05) and rewarding/motivation with sweets (p=0.013) were significantly associated with a child's overweight/obesity status. Excess body weight was found in 22.1% of children (overweight - 3.5 %; obesity -18.6%). CONCLUSIONS: Children had a clear preference for sweet taste. Reducing the consumption of sweets and increasing the nutritional awareness of parents and children may prevent the development of childhood obesity.

Patient's Perspective of Telemedicine in Poland-A Two-Year Pandemic Picture.

The outbreak of the COVID-19 pandemic caused the healthcare system to drastically reduce in-person visits and suddenly switch to telemedicine services to provide clinical care to patients. The implementation of teleconsultation in medical facilities was a novelty for most Polish patients. In Poland, the main telehealth services were provided in the form of telephone consultations. The aim of this study is to determine patients' perceptions of telemedicine in the context of their experiences with the healthcare system during the COVID-19 pandemic. In this study, we presented how the evaluation of telemedicine services from the perspective of patients in Poland changed in the context of the ongoing pandemic. We conducted two surveys (year by year) on a representative quota sample of the Polish population (N = 623). This ensured that our observations took into account the evolution of views on telemedicine over time. We confirmed the well-known relationship that innovations introduced in the healthcare sector require a longer period of adaptation. We also identified significant concerns that limit the positive perception of telemedicine and compared them with experiences described in other countries.

Does place of residence affect patient satisfaction with hospital health care?

INTRODUCTION AND OBJECTIVE: Measuring the level of patient satisfaction is a useful tool in delivering quality care that is responsive to consumer preferences. Various socio-demographic factors might be considered as potential predictors of patient satisfaction. The aim of the study was to assess whether place of residence (rural/urban) affects patient satisfaction with hospital health care. MATERIAL AND METHODS: Data were obtained using face-to-face questionnaire, administered in five large, urban hospitals in Podlaskie Province, north-eastern Poland, during 2014-2018. The study sample comprised of 1,624 participants (585 rural, 1039 urban) who assessed satisfaction with 28 hospital health care items. The means and standard deviations were presented to compare 28 satisfaction items between the rural and the urban samples. Regression analysis was used to determine whether location difference (rural vs urban) affected patient satisfaction with various domains of hospital health care. RESULTS: The mean results of 28 satisfaction items on the 1-5 scale were similar among the rural and the urban samples, and generally skewed towards positive experiences. In the univariate analysis, significant associations between place of residence and patient satisfaction were identified with regard to three components of inpatient care: 1) hospital settings and staff care, 2) doctors' professional skills, and 3) hospitalization outcomes. After adjusting for socio-demographic variables, the association remained significant only with respect to satisfaction with hospitalization outcomes (b = 0.121; SE = 0.055; p = 0.028). CONCLUSIONS: Some evidence for differences in patient satisfaction by place of residence was found. Study findings may be helpful in implementing care quality improvement programmes.

Socioeconomic inequalities in use and non-use of dental services in Poland.

OBJECTIVES: To assess the impact of classical socioeconomic factors on the use and non-use of dental services on a representative sample of Polish population. METHODS: The study was based on face-to-face surveys conducted by GUS (Statistics Poland) on 13,376 respondents in 2010 and 12,532 individuals in 2013. RESULTS: The percentage of people using dental services in the highest income group was approximately twice as high as that in the lowest one (Q1: 7.0% vs. Q5: 16.4%), with the same being true for education (the lowest education group: 8.3% vs. the highest education group: 18.0%), and place of residence (inhabitants of rural areas: 9.2% vs. inhabitants of largest cities: 15.9%) in 2013. The analysis has shown the disparities in not using dental services when in need to be less clear-cut. CONCLUSIONS: The conducted research, based on two independent periods, a representative population sample, univariate analysis and the multivariate regression model has revealed pronounced social inequalities in dental care use. It is a challenge to determine the factors which contribute most to health inequalities and the interventions which are most effective in reducing them.

[Evaluation of nutrition and physical activity of students in Gastronomic School in Bialystok]. / Ocena sposobu zywienia i aktywnosci fizycznej uczniów Zespolu Szkól Gastronomicznych w Bialymstoku.

The aim of this study was to estimate nutrition and physical activity of students in Gastronomic School in Bialystok. Questionnaire about nutrition and physical activity took on April 2008 in 74 students. The content of energy and main nutrition values were calculated and compared to the recommended values. Students diet included normal of energy, protein, fats and carbohydrates. Only 58% girls and 61% boys had intensive physical activity. Change of nutrition and moderate in physical activity is recommended for the students.

Is socio-economic status associated with adverse birth outcomes in Poland?

INTRODUCTION: Low birth weight (LBW) is an important indicator of the healthy of the population and reflects the living conditions, health and health behaviours of pregnant women. OBJECTIVE: To assess the relationship between Gross Enrollment Rate at the Tertiary Education Level, average salary, Gross Domestic Product per capita, unemployment, housing area, urbanization and low birth weight in Polish sub-regions. MATERIAL AND METHODS: An ecological study was undertaken using data on socio-economic and demographic features and LBW in 2005-2014. The units of observation were 66 Polish sub-regions according to the NUTS-3 classification. Two models were used to assess the influence of SES variables on LBW incidence rate in a 10-year study period. The first was the Poisson regression model adjusted for density of population, which was followed by the multivariable model using the GEE method of model parameters estimation. RESULTS: In Poland, significant slow changes in the LBW incidence rate were observed in 2005-2014 (AAPC = -0.44%/year). In model 1, the increase in LBW was associated with an increase in unemployment (1.005) and decrease of average salary (0.987), GERTEL (0.990) and housing area (0.991). In model 2, an unfavorable association was detected between the density of population (1.068) and a still existing relationship with unemployment (1.004), average salary (0.990) and GERTEL (0.991). CONCLUSIONS: Protective factors for newborns' health were a higher level of education and income. The results indicate the need to take actions to reduce the risk factors of LBW among pregnant women living in densely populated areas.

Concentration of Selected Elements and Antioxidative Potential in a Group of Males Working in the Metal Industry: Elements And Antioxidative Potential In Men.

The purpose of this study was to show that some elements have a proven antioxidative effect and are essential for the proper development and functioning of the human body. The study also assessed the concentration of selected elements and total antioxidant status (TAS) in a group of male inhabitants of Bialystok, Poland, who are professionally active in the metal industry. The study group comprised 163 men aged 55-64 years. The concentration of the analyzed elements was determined using flame (Zn and Cu) and electrothermal (Se, Cd, and Pb) atomic absorption spectrometry. Spectrophotometric test kits were used to assay the TAS and glutathione reductase (GR) activity in serum. The results suggested the mean concentration of Se in serum was 54.04 ± 12.10 µg/L, which was below the reference range. A significant negative correlation was observed between the concentration of Se in the serum and Pb and Cd concentrations in the whole blood of the studied men. The concentrations of the other elements, antioxidant potential, and GR activity were within the reference range. A statistically significant positive correlation was observed between Pb and Cd, indicating combined exposure and a considerable negative correlation between lead and selenium as well as between lead and TAS. Selenium and TAS are likely to modify the adverse effects of Pb in the bodies of the studied men. The results indicate that it is necessary to constantly monitor men who are occupationally exposed to heavy metals, maintain a healthy lifestyle, and introduce effective preventive measures at a local level.

Inequalities in breast cancer incidence and stage distribution between urban and rural female population in Swietokrzyskie Province, Poland.

INTRODUCTION AND OBJECTIVE: One of the main factors determining the burden of breast cancer is the effectiveness of measures taken to combat this cancer including urban-rural differences. The aim of the study was to analyse the differences in breast cancer incidence and disease stage distribution among urban and rural women in the Swietokrzyskie Province as a part of a strategy for breast cancer control. MATERIAL AND METHODS: The study of disease stage distribution included 483 female residents of Swietokrzyskie Province who were diagnosed in 2013 with invasive breast cancer, and reported to Swietokrzyskie Office for Cancer Registration. Urban-rural differences in breast cancer incidence in 2002-2013 were presented using Range Ratio (RR). Changes in incidence trends in urban and rural areas were analysed using joinpoint models. Annual Percentage Change (APC) of the rates was calculated for each time trend. RESULTS: Breast cancer incidence rate in the urban female population was higher than in rural women with RR, amounting to 1.43. However, the analysis of trends showed that the pace and direction of change were developing negatively among inhabitants of rural areas. In 2002-2013, in rural women, the age-standardized rate (ASR) values increased by 2.8% per year (p<0.05). The course of ASR trends showed statistically significant urban-rural differences (p=0.004). Analysis of urban-rural differences in disease stage distribution revealed a non-significantly higher proportion of cases with localised stage in urban than in rural areas, amounting to 51.0% and 43.9%, respectively. CONCLUSIONS: Existing health inequalities indicate the need to intensify activities in rural areas and should be the starting point for making key decisions in combating breast cancer.

The changes in the contents of 137Cs in bottom sediments of some Masurian lakes during 10-15 y observation (Poland).

The measurements of radioactive caesium contents in bottom sediments were carried out in four lakes. First samples (47) were taken in 1992-95. The repeat sampling (109) was performed from the same places in 2005. We examined eight chosen areas in these lakes. In six of them, we observed statistically significant differences in the level of radioactive caesium. It indicates the permanent decrease in the level of 137Cs. The mean annual decrease in the level of radioactive caesium, taking into consideration the radioactive decay, was from 4.2 to 7.8%. In two areas of the profundal zone, we did not observe statistically significant differences in the level of radioactive caesium (lakes Garbas and Rogale Wielkie). Taking into consideration the radioactive decay of caesium, it means about the appearance of the process of accumulation of 137Cs in these areas.

Study on changing patterns of reproductive behaviours due to maternal features and place of residence in Poland during 1995-2014.

INTRODUCTION: The sharp decline in the total fertility rate in Poland coincided with broader socio-economic changes, which resulted in its reduction to the lowest level observed among the countries of Central and Eastern Europe. Objective. The aim of the study was to investigate and evaluate the changing patterns of reproductive behaviour in rural and urban areas, depending on the demographic and socio-economic features in Poland. MATERIAL AND METHODS: Information about live births in Poland in the years 1995-2014 were obtained from the Central Statistical Office. Registered cases of live births in rural and urban areas were analyzed considering the maternal features (age, marital status, main source of income). To evaluate the changes in fertility and comparisons between rural and urban areas, Joinpoint Regresssion was used. RESULTS: In 1995-2014, a shift in the age of highest fertility from 20-24 years to 25-29 years was observed. This occurred at the same time as a reduction in the fertility rate per 1,000 women aged 15-29 years, more pronounced in rural areas (95.8 to 60.0) than in urban areas (63.4 to 51.5), while in women aged 30-49 years, a faster increase in fertility was observed in urban areas (16.4 to 32.0) than in rural areas (27.5-29.2). Fertility trends between rural and urban areas differed significantly. A significant increase in live births for employed mothers was shown mainly in 2005-2009; later, the growth rate in rural areas was slower and in urban areas the growth trend stopped. CONCLUSIONS: The postponement of births and reduction of fertility in women aged 15-29 requires active measures aimed at creating favourable conditions for achieving economic independence for the younger generation, as well as combining work with raising children, especially in rural areas. ABBREVIATIONS: APC - annual percentage change; AAPC - average annual percentage change; CSO - Central Statistical Office; TFR - total fertility rate.

Socio-economic inequalities in the use of dental care in urban and rural areas in Poland.

INTRODUCTION: The issue of inequalities in the use of health services and health inequalities between urban and rural dwellers is a subject of numerous scientific reports, but similar publications on dental health are scarce. OBJECTIVE: The aim of this study is to assess the correlations between the use or non-use of dental services and the classical socio-economic factors (SES) in urban and rural groups in a representative population of Poland. MATERIAL AND METHODS: The analysis consisted in desk research based on a questionnaire survey conducted by the Central Statistical Office of Poland on 12,532 individuals (urban areas - 6411, rural areas - 6121) in 2013. The chi-squared test, multivariate and univariate logistic regression models were applied. RESULTS: There were major differences in the use of dental services depending on income level, education and source of income among rural and urban populations, as well as differences between these populations. Urban dwellers had 1.34 times greater odds of using dental services than rural ones (95% CI: 1.20-1.51). In the case of the highest income group, the odds were 3.26 (95% CI 2.21-4.83) times greater in cities and 2.07 (95% CI 1.51-2.85) times greater in villages than the odds in the lowest income group. In the highest education group, the odds were 1.58 (95% CI 1.17-2.13) times greater in urban areas and 2.08 (95% CI 1.48-2.91) times greater in rural areas than the odds in the lowest education group. CONCLUSIONS: There are considerable inequalities in the use of dental services, yet the differences in non-use, despite such a need, are less evident. This could imply that health disparities arise not only from economic constraints and unavailability of health care, but also from health attitudes and behaviours.

[Health behaviour of students attending secondary school in the sokolski district. Part II. Smoking cigarettes and drinking alcoholic beverages]. / Zachowania zdrowotne mlodziezy szkól ponadgimnazjalnych w powiecie sokólskim. Cz. II. palenie papierosów i picie napojów alkoholowych.

The purpose of this research was the evaluation of the use of cigarettes and alcohol among secondary school students in the sokolski district. Information about the sample, date and method of research was presented in the first part of the study. This part analyses answers to questions concerning: alcohol and smoking initiation, and the frequency of smoking, drinking and being under the influence of alcohol (intoxication). The research showed that 44.09% of the students in the 17 to 19 age range tried smoking cigarettes. 52.42% of them smoke somehow frequently, 26.49% smoke daily. 80.4% of students declared to have experimented with alcohol. 17.34% of students were under the influence of alcohol (intoxication) at least once during their lifetime. The most frequently consumed alcoholic beverage was beer.

[Health behaviour of students attending secondary school in the Sokolski district. Part I physical activity and sedentary activity]. / Zachowania zdrowotne mlodziezy szkól ponadgimnazjalnych w powiecie sokólskim. Cz. I. Aktywnosc fizyczna i zajecia sedenteryjne.

The purpose of this research was to determine the level of physical activity, and free time spent in the sitting position by secondary school students in the sokolski district. The research was conducted on 796 students who were in the 17 to 19 age range. It was carried out in March and April of the 2005-2006 school year using the diagnostic poll method. The students filled out an anonymous questionnaire (modified in 2001, part of an international research regarding youth's health behavior). The results showed not enough physical activities, a lot of sedentary activities. There was a great disproportion between these two types of activities.

Social costs of loss in productivity-related absenteeism in Poland.

OBJECTIVES: The aim of this study was to estimate indirect costs associated with losses in productivity due to sickness absence among registered workers in Poland. MATERIAL AND METHODS: Data on sick leave durations in 2013 was obtained from the Social Insurance Institution (SII) (Zaklad Ubezpieczen Spolecznych - ZUS). Based on the number of assumptions, this data was used for calculating absence durations. The costs of lost productivity were estimated on the basis of the measure of gross value added. RESULTS: Estimated losses in productivity due to absenteeism in 2013 together accounted for 4.33% of gross domestic product (GDP) (17.09 billion euro). In the female population, the total value of losses amounted to 9.66 billion euro, but excluding the costs of pregnancy, childbirth, and puerperium (2.96 billion euro), it was 6.7 billion euro. In the male population, the loss amounted to 7.43 billion euro. The highest overall costs of sickness absence based on age were found in the age group of 30-39 years (5.14 billion euro, including pregnancy, childbirth, and puerperium - 1.474 billion euro; respiratory diseases - 0.632 billion euro, injuries and poisonings - 0.62 billion euro). In the group of people aged > 40 years, the highest cost was generated by bone-muscular diseases (1.553 billion euro) and injuries and poisoning (1.251 billion euro). Higher losses in the productivity of women in addition to pregnancy, childbirth, and puerperium were due to mental and behavioral disorders (0.71 billion euro), diseases of the genitourinary system (0.38 billion euro), and neoplasms (0.35 billion euro). At the same time, in men, compared to women, we observed higher losses due to injuries and poisoning (1.65 billion euro), and diseases of musculoskeletal (1.26 billion euro), nervous (0.79 billion euro), circulatory (0.65 billion euro), and digestive (0.41 billion euro) systems. CONCLUSIONS: Improvement and further development of effective strategies for prevention of complications of pregnancy and chronic diseases in the workplace are necessary. Policies aimed at reduction of sickness absence could potentially increase prosperity and the socioeconomic situation in Poland. Int J Occup Med Environ Health 2017;30(6):917-932.