Acetabular shape and orientation of the spastic hip in children with cerebral palsy.

AIM: To see if three-dimensional (3D) methods could bring new understanding to acetabular changes in shape and orientation in the spastic hip and in which direction(s) acetabular orientation might change, which is crucial for planning appropriate hip correction surgery. METHOD: We performed a retrospective study of pelvic computed tomography (CT) examinations in 20 consecutive patients (10 females, 10 males). The mean age of patients was 12 years 9 months (SD 2y; range: 9-16y) at the time of the CT examination. The control group consisted of 18 consecutive pelvic CT examinations (36 acetabula) of deceased individuals (six females, 12 males) aged 4 to 17 years (mean age: 10y 6mo; SD 5y 2mo) whose whole-body CT scans were taken shortly after their death. We compared 3D CT reconstructions of 28 unstable and dislocated hips in children with bilateral cerebral palsy (Gross Motor Function Classification System levels IV and V) with the unaffected side and typically developing controls to assess spatial orientation (inclination, anteversion, and tilt), acetabular volume, and surface area. Additionally, we analysed the multiple factors that may lead to structural and spatial changes of the acetabulum. RESULTS: Patients with dislocated and spastic hips had significantly lower anteversion (-3.2° and -1.4° respectively, p<0.001), increased inclination (85.2° and 85.3° respectively, p<0.001), and decreased tilt (24.6° [p=0.014] and 20.7° [p=0.013] respectively) compared with typically developing individuals. Regarding acetabular volume and surface area, dislocated and unstable hips had significantly lower volume (17.6ml vs 31.5ml respectively, p<0.001) and surface area (28.9cm2 vs 36.2cm2 respectively, p<0.001) than unaffected hips. Among several factors, only Reimer's migration index had an influence on acetabular orientation (i.e. anteversion, p=0.01), volume (p<0.001), and surface (p=0.004). INTERPRETATION: Acetabula in patients with spastic hip disease were severely retroverted with increased steepness; acetabular orientation was distorted superoposteriorly. In rare cases, acetabular orientation was distorted only superiorly or superoanteriorly. WHAT THIS PAPER ADDS: Acetabular orientation was distorted superoposteriorly in most patients with severe bilateral cerebral palsy. More pronounced acetabular changes were found in hips with a higher Reimer's migration index.

[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.

[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.

[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.

Oxidative DNA damage and oxidative stress in subjects occupationally exposed to nitrous oxide (N(2)O).

OBJECTIVES: Occupational exposure to nitrous oxide (N(2)O) and/or halogenated hydrocarbons has been suggested to induce damage of genetic material, but the underlying mechanisms remain obscure. This study investigated the role of oxidative processes in the genotoxicity associated with exposure to waste anaesthetic gases. METHODS: The study was performed in 36 female nurses and in 36 unexposed female health care workers matched for age and employment duration. Genotoxic effects were examined by Comet test modification employing formamidopyrimidine glycosylase (FPG) that allows assessment of oxidative DNA damage. Reactive oxygen species (ROS) in leukocytes were investigated by fluorescence spectroscopy with 2',7'-dichlorofluorescin diacetate. Oxidative stress markers including 8-iso-prostaglandin F(2α) (8-iso-PGF(2α)), thiobarbituric acid-reacive substances (TBARS), α-tocopherol, and glutathione peroxidise (GPX) activity were measured immuno- or colorimetrically. N(2)O, sevoflurane and isoflurane were monitored by gas chromatography and mass spectrometry. RESULTS: The study documents for the first time the positive correlation between the oxidative DNA damage and the N(2)O levels in the ambient air. By contrast, no association was observed between genotoxic effects and sevoflurane or isoflurane. In addition, ROS generation and plasma and urine concentrations of TBARS and 8-iso-PGF(2α), respectively, were elevated, while GPX activity was reduced in nurses exposed to waste anaesthetic gases. Path analysis pointed to a causal relationship between N(2)O exposure, oxidative stress and DNA damage. CONCLUSION: Occupational exposure to N(2)O is associated with increased oxidative DNA damage and the level of exposure plays a critical role in this regard. Increased oxidative stress may represent a mechanistic link between chronic N(2)O exposure and genotoxicity.

[Certain issues concerning medical certification and driving fitness assessment after craniocerebral traumas]. / Wybrane zagadnienia orzekania o stanie zdrowia i zdolnosci do prowadzenia pojazdów: osób po przebytych urazach czaszkowo-mózgowych.

BACKGROUND: The incidence of craniocerebral traumas increases with a growing number of road accidents. It should be emphasized that it is rather difficult to determine precisely the craniocerebral traumas incidence rate, however, it is well known that road accidents are the major cause of these injuries. MATERIAL AND METHODS: The study embraced 43 men (mean age: 47.1; SD: 11.4) after craniocerebral traumas. Of the 43 men, 23 drivers had driving license of the following classes: A, Al, A2, AM, B, B1 and BE without professional driving permit, and 20 men worked as professional drivers licensed according to the following classes: C, CE, C1, C1E, D, DE, D1 and DIE. The duration of drivers' employment ranged from 4 to 33 years (mean: 19 years; SD: 7.7). The clinical diagnosis was based on the patient's medical history, medical records, neurological examination complemented with other specialist examinations. RESULTS: Posttraumatic encephalopathy diagnosed in 23 (53.5%) patients was characterized by varied clinical symptoms. Posttraumatic simple encephalopathy diagnosed in 13 patients was the most frequent contradiction to run motor vehicles. Posttraumatic epilepsy was a contradiction in 5 and posttraumatic subarachnoid haemorrhage in 2 patients (one with neurological deficiency hemiparesis, the other with frontal lobe syndrome. Following the treatment 46.5% of men under study did not show neurological deficits and were allowed to run motor vehicles. CONCLUSIONS: The certification procedure in cases of past craniocerebral traumas should not follow the routine and careful examination of each individual case is required prior to assessing a driver's ability to run motor vehicles.

The inflammatory response in lungs of rats exposed on the airborne particles collected during different seasons in four European cities.

Epidemiological studies have reported associations of ambient particulate air pollution, especially particulate matter (PM) less than 10 µm with exacerbations of asthma and chronic obstructive pulmonary disease. In an in vivo model, we have tested the toxicity of urban airborne particles collected during spring, summer, and winter seasons in four cities (Amsterdam, Lodz, Oslo, and Rome) spread across Europe. The seasonal differences in inflammatory responses were striking, and almost all the study parameters were affected by PM. Coarse fractions of the urban particle samples were less potent per unit mass than the fine fractions in increasing cytokine [macrophage inflammatory protein (MIP)-2 and tumor necrosis factor (TNF)-α] levels and in reducing Clara-cell secretory protein (CC16) levels. This study shows that PM collected at 4 contrasting sites across Europe and during different seasons have differences in toxic potency. These differences were even more prominent between the fine and coarse fractions of the PM.

[Aggravating factors in teachers' work and fatigue]. / Czynniki obciazajace w pracy nauczycieli a zmeczenie.

BACKGROUND: Teachers are a occupational group in which, due to the type and specificity of work, it can be expected that the feeling of fatigue will be very intense. However, there has been little research into this problem. The aim of the research was to assess the level of fatigue after work and chronic fatigue in teachers, and to determine whether and to what extent it depends on occupational and non-occupational loads. MATERIAL AND METHODS: The stratified sampling model was used to select the sample, where the layers were the type of school and its location (size of a town/city). All teachers from selected schools were invited to participate. Overall, 650 questionnaires were distributed and 403 teachers returned completed questionnaires. Fatigue after work was assessed on the basis of answers to the following question: "Do you feel tired after work?" and chronic fatigue using the Fatigue Assessment Scale. A special questionnaire was developed to assess other factors that might affect the level of fatigue. The Subjective Stress Assessment at Work Questionnaire, Cohen's Perceived Stress Scale, a part of the Questionnaire of Professional Loads of the Teacher and a list of additional factors disturbing the work were used. RESULTS: The study involved 70 men aged 35-63 years and 333 women (24-64 years). The groups did not differ significantly in terms of mean age. The level of fatigue, regardless of gender, was mostly influenced by time pressure, rush, mismanagement of the pace of work to individual abilities, increasing workload, an excess of responsible tasks, a lack of support from superiors, a low prestige of the profession, a lack of pedagogical successes, a sense of the lack of meaning in work, and the negative impact of work on family life, as well as non-occupational loads and insufficient rest. CONCLUSIONS: The conducted study allowed for determining the profile and frequency of occupational and non-occupational factors affecting the level of fatigue in teachers. Med Pr. 2021;72(3):283-303.

Evaluation of annoyance from low frequency noise under laboratory conditions.

The aim of the study was to investigate the annoyance of low frequency noise (LFN) at levels normally prevailing at workplaces in control rooms and office-like areas. Two different laboratory experiments were carried out. The first experiment included 55 young volunteers and the second one comprised 70 older volunteers, categorized in terms of sensitivity to noise. The subjects listened to noise samples with different spectra, including LFNs at sound pressure level (SPL) of 45-67 dBA, and evaluated annoyance using a 100-score graphical rating scale. The subjective ratings of annoyance were compared to different noise metrics. In both the experiments, there were no differences in annoyance assessments between females and males. A significant influence of individual sensitivity to noise on annoyance rating was observed for some LFNs. Annoyance of LFN was not rated higher than annoyance from broadband noises without or with less prominent low frequencies at similar A-weighted SPLs. In both the experiments, median annoyance rating of LFN highly correlated with A-weighted SPL (L(Aeq,T)), low frequency A-weighted SPL (L(LFAeq,T)) and C-weighted SPL (L(Ceq,T)). However, it is only the two latter noise metrics (i.e. L(LFAeq,T) and L(Ceq,T)) which seem to be reliable predictors of annoyance exclusively from LFN. The young and older participants assessed similar annoyance from LFN at similar L(LFAeq,T) or L(Ceq,T) levels. Generally, over half of the subjects were predicted to be highly annoyed by LFN at the low frequency A-weighted SPL or C-weighted SPL above 62 and 83 dB, respectively.

[Evaluation of the relation between Doppler flow in maternal and fetal vessels and the risk of adverse neonatal outcome]. / Ocena zaleznosci miedzy przeplywami w naczyniach u matki i plodu w badaniu metoda Dopplera a ryzykiem zlego stanu urodzeniowego noworodka.

AIM: The study aimed at: 1. Analysis of the relationship between Doppler flow in the selected maternal and fetal vessels and the risk of adverse perinatal outcome (APO); 2. Multivariate logistic regression model for the assessment the risk of APA. MATERIAL AND METHODS: The study population covered 216 pregnant women from Lodz and Kalisz between 2003-2006. RESULTS: In univariate logistic regression model PI_UA significantly influenced the risk of APO. That risk was increasing 1.2 times, if the PI_UA value was 1/10th higher than the measured unit. Abnormal cardiotocography (CTG) pattern was related to 12-times higher risk of APO. In cases of abnormal PI_MCA, the risk of APO was 2.5 times higher than when PI_MCA was within the normal range. Abnormal PI_UA was related to 11.5-times higher risk of APO. Similarly when PIV_DV was abnormal, the risk of APO was 2.3-times higher. Low birth weight (LBW) was connected with the 6-times higher risk of APO. In multivariate logistic regression model, CTG and LBW were the risk factors significantly associated with APA. Abnormal CTG pattern was related to more than 6-times higher increase of the risk of APO, however LBW with nearly 4-times higher risk of APO. CONCLUSION: Abnormal values of PI in UA and in MCA, abnormal flow in DV and abnormal CTG pattern, as well as low birth weight, had significant influence on the risk of APO. In multivariate analysis only abnormal CTG and low birth weight were the significant factors of APO.

Return to work after myocardial infarction: a retrospective study.

OBJECTIVES: To evaluate the occupational functioning and identify health-related determinants of the continuation of occupational activity in workers with a recent myocardial infarction. MATERIAL AND METHODS: The project was a retrospective study concerning 183 male workers, aged 39-65 years, who had suffered a primary uncomplicated myocardial infarction approximately three years prior to the study. The study group comprised both the persons who returned to work after the incident and those who did not. The subjects' mental health as well as quality of life and occupational functioning were evaluated using NHP scale, Beck Depression Inventory, STAI questionnaire by Spielberger et al., WAI, and own questionnaire "My work". RESULTS: Data analysis revealed that the persons who returned to work after myocardial infarction were characterized by a younger age and a higher level of education, self-rated health and quality of life than the persons who did not resume their occupational activity. The occupationally active individuals showed a varying degree of readaptation to work. In the maladapted group, such disturbances occurred as depression, anxiety and lowered work ability. CONCLUSIONS: The study results indicate that in workers with a recent myocardial infarction, the current procedure for assessment of work ability, which is based solely on the evaluation of physical health, is insufficient and should be supplemented with the assessment of their mental health. The employers should also undertake activities for a better adjustment of working conditions to the abilities of workers who have experienced a cardiac incident.

[Quantitative methods of cancer risk assessment in exposure to chemicals]. / Ilosciowe metody oceny ryzyka raka bedacego skutkiem narazenia na substancje chemiczne.

This is a methodology paper--it contains a review of different quantitative risk assessment methods and their comparison. There are two aspects of cancer risk modeling discussed here: 1. When there is one effective dose only. There were compared two models in this evaluation: one proposed by the Dutch Expert Committee on Occupational Standards and the other--a classical two-stage model. It was taken into account that in both models the animals were exposed for less than two years. An exposure period and a study period of animals were considered in the Dutch methodology. If we use as an exposure measure average lifespan dose estimated with different coefficients of exposure time in an experiment, we get two different dose-response models. And each of them will create different human risk models. There is no criterion that would let us assess which of them is better. 2. There are many models used in the BenchMark Dose (BMD) method. But there is no criterion that allows us to choose the best model objectively. In this paper a two-stage classical model and three BMD models (two-stage, Weibull and linear) were fit for particular data. Very small differences between all the models were noticed. The differences were insignificant because of uncertainties in the risk modeling. The possibility of choice of one model from a bigger set of models is the greatest benefit of this comparison. If the examined chemical is a genotoxic carcinogen, nothing more is needed than to estimate the threshold value.

[Occupational diseases in Poland, 2008]. / Choroby zawodowe stwierdzone w Polsce w 2008 r.

BACKGROUND: The aim of the paper was to present basic statistical data on occupational diseases diagnosed in 2008. MATERIAL AND METHODS: The work was based on the data compiled from "Occupational Disease Reporting Forms" received by the Central Register of Occupational Diseases in 2008. The data comprised information on nosologic units, gender and age of patients, and duration of occupational exposure to harmful agents responsible for the development of specified pathologies. These data were further classified by sectors of the national economy and voivodeships. The incidence was specified in terms of the number of cases in relation to paid employees or to employed persons. RESULTS: The number of occupational diseases diagnosed in 2008 accounted for 3546 cases. The incidence rate was 34.7 cases per 100,000 paid employees. The highest incidence rates were noted for infectious and parasitic diseases (9.4/100,000), chronic voice disorders (7.9) and pneumoconioses (6.8). As many as 77.9% of patients affected by occupational diseases had been exposed to harmful agents for longer than 20 years. In industrial sectors of the national economy, the highest incidence rate was noted in the coal mining industry (416.3 cases per 100,000). The highest incidence rates were recorded in the Lubelskie (75.5), Silesian (66.3) and Podlaskie (60.7) voivodeships. CONCLUSIONS: An increase of 261 (7.9%) cases of occupational diseases and an increase of 3.6% in their incidence rate over the previous year were noted in 2008. The greatest increase was noted in infectious and parasitic diseases (of 285 cases, i.e. 42.5%) and chronic diseases of the locomotor system (of 22 cases i.e. 22.4%).

[Comparison of Doppler flow in selected maternal and fetal vessels in pregnancies with fetal intrauterine growth restriction]. / Porównanie przeplywów mierzonych metoda Dopplera w wybranych naczyniach matczynych i plodowych u ciezarnych z opóznieniem wzrostu wewnatrzmacicznego plodu.

OBJECTIVES: The aim of the study was to compare Doppler flows in materno-fetal circulation in pregnancies with IUGR and small for gestational age (SGA) neonatal weight or normal weight, as well as in uncomplicated pregnancies. MATERIAL AND METHODS: The study population comprised 216 pregnant women from Lodz and Kalisz between 2003-2006. In the group I we included 68 women with IUGR observed in prenatal ultrasound examination and SGA neonates, in the group II--29 women with IUGR observed in US but normal neonatal weight and in the group III--110 women with normal fetal and neonatal weight. RESULTS: Mean fetal weight in the group II was (2035 g +/- 400 g) and in the group I (1947 g +/- 414 g) and it was lower than in the group III (2765 g +/- 543 g) (p<0.0005). Notch in UTA was found more often in the group I (39.7%), than in the groups III (8.4%) and II (10.3%), (p< 0.0005). The mean PI in the right UTA in the group I (0.957 +/- 0.440) was higher than in the groups II (0.718 +/- 0.259) and III (0.730 +/- 0.215), (p<0.001). Abnormal Doppler flows in MCA in the groups I (39.7%) and II (34.5%) were observed more often than in the group III (6.4%), (p<0.0005). Similarly abnormal Doppler examination in DV in the groups I (45.5%) and II (46.4%) were observed more often than in the group III (17.8%), (p<0.0005). PI in UA in the groups I (1.061+/- 0.325) and II (0.965 +/- 0.184) was higher than in the group III (0.848 +/- 0.166), (p<0.0005).

[The reaction of the circulatory system to stress and electromagnetic fields emitted by mobile phones - 24-h monitoring of ECG and blood pressure]. / Reakcja ukladu krazenia na stres i pole elektromagnetyczne emitowane przez telefony komórkowe ­ 24-godzinne monitorowanie EKG i cisnienia tetniczego.

BACKGROUND: Experimental studies have shown cardiovascular effects of electromagnetic fields (EMF) emitted by mobile phones (e.g., prolonged QTc interval and abnormal blood pressure [BP] values). Also, stress may have an impact on the cardiovascular function. However, there are practically no data regarding the joint effect of exposure to stress and EMF, with both factors pertaining, e.g., to employees of mobile network operators. MATERIAL AND METHODS: Out of 208 subjects who had taken part in survey research, 55 workers agreed to undergo resting ECG, 24-h ECG and ambulatory blood pressure monitoring (ABPM). Their health condition, occupational and life-stress levels and EMF exposure were also assessed. RESULTS: Among the workers using mobile phones for more than 60 min daily, the systolic BP values in office measurement and at night-time in ABPM were significantly higher than among the workers spending less time talking on mobile phones (p = 0.04 and p = 0.036, respectively). The workers with the highest level of occupational stress showed significantly higher systolic 24-h BP (p = 0.007) and at day-time (p = 0.002), both during work (p = 0.010) and after work (p = 0.005), and higher diastolic BP values at day-time (p = 0.028). Cardiovascular response was strongly gender-related: males showed more BP abnormalities while females displayed more impairments in ECG records. The heart rate from 24 h was significantly correlated with the level of occupational stress, after adjusting for gender, life-stress and EMF. CONCLUSIONS: The findings obtained thus far have indicated the need to conduct in-depth studies on the impact of stress and EMF emitted by mobile phones on the health effects, in order to clarify the observed gender-related differences in cardiovascular response to the combined exposure to stress and EMF. Med Pr. 2019;70(4):411-24.

Analysis of bus drivers reaction to simulated traffic collision situations - eye-tracking studies.

OBJECTIVES: The aim of the study was to establish whether the driver's visual strategy may influence a driver's behavior to avoid a crash in a high-risk situation. Any published papers on drivers' visual strategies just before a crash were not found. MATERIAL AND METHODS: Tests were performed using a high-tech driving bus simulator. Participants comprised 45 men drivers, aged 43.5±7.9 years old, seniority as a bus driver of 13.3±8.6 years. The tests were preceded by medical examinations: general, neurological and ophthalmological. Each participant drove the same city route for approximately 40 min (entire route - ER). In the final phase, a collision situation was simulated (a phantom car blocked the participant's right of way). Driver's visual strategy was analyzed using the FaceLab device with 2 cameras during ER and just before collision. The field-of-view covered by camera 1 was divided into 8 regions, by camera 2 into 10 regions. The distribution of gazes in regions was a criterion of visual strategy. RESULTS: Thirty-five drivers completed the simulated driving test, 14 escaped the collision, 21 crashed. These groups differed only in resting systolic blood pressure before the test. The analysis of covariance, after adjusting to this factor, indicated that during the ER visual strategy recorded by camera 1 did not differ between groups, in camera 2 the drivers in the crash group fixed their gaze more frequently (p = 0.049) in region 3 (close part of the road in front of the windshield). Just before the collision drivers who escaped the collision fixed their gaze significantly more often in region 6 (left side of the road) in camera 1 and in region 6 (in front of the windshield,) and region 10 (right side) in camera 2. CONCLUSIONS: The visual strategy has an impact on the road safety. The analysis of visual strategies may be a useful tool for the training of drivers. Int J Occup Med Environ Health. 2019;32(2):161-74.

Independent prognostic factors in patients with liver cirrhosis.

BACKGROUND/AIMS: Evaluation of the urgency of the liver transplantation in individual patients may help to prioritize patients at risk of death. Consequently we undertook the search for independent prognostic factors in patients with liver cirrhosis. METHODOLOGY: The study group was composed of 219 patients with liver cirrhosis, treated in our Department, from 1996 to 2005. Patients' files were examined for details of physical findings, results of laboratory examinations, and patients' survival. Prognostic significance of 15 variables was analyzed. All prognostic factors which turned out to be statistically significant in univariate analysis were included in the Cox proportional hazard model. RESULTS: Child-Turcotte-Pugh (CTP) score B (p<0.001; hazard ratio (HR): 13.33), CTP score C (p<0.001; HR=7.45), presence of hepato-renal syndrome (p<0.001; HR=3.54), history of esophageal bleeding (p=0.048; HR=1.63) and presence of peripheral edema (p=0.034; HR=1.61) were found to be independently associated with survival. Model of End-stage Liver Disease score, etiology of cirrhosis, sex, ascites, bacterial spontaneous peritonitis, encephalopathy, serum creatinine concentration, INR and serum bilirubin concentration were shown to be significantly associated with patients' prognosis, however not independently. CONCLUSIONS: Analysis of presence of common clinical symptoms is crucial for evaluation of patients' prognosis.

Comparison of the in vitro hemolytic effects produced by alkoxyacetic acids on human and rat erythrocytes.

OBJECTIVES: The alkoxyacetic acids (AAAs) are urinary metabolites of alkoxyethanol solvents. It is well documented that these chemicals can cause acute hemolytic anemia in humans and laboratory animals. There are scarce data on the relative hemolytic activity of these acids. Likewise, information is lacking on the relationship between their hemolytic activity and physicochemical properties. The aim of this study was to compare the hemolytic activity of five AAAs in red blood cells (RBCs) derived from donors' blood and male Wistar rats. Moreover, the possible relationship between lipophilic and hemolytic activity of AAAs was also investigated. MATERIALS AND METHODS: The RBCs washed in TRIS buffer, pH 7.4, were adjusted to a packed cell volume (PCV) of about 20% and incubated in a water bath at 37 degrees C for 0-3 h in the presence of different concentrations of AAAs. The hemolytic effects, in terms of the changes in RBCs, PCV, mean corpuscular volume (MCV) and free hemoglobin (HGBfree) in incubation medium, were evaluated. Based on the dose-response relationship for RBCs, PCV and MCV, the effective concentration values (EC50) and their 95% confidence intervals (95% CI) were calculated. The octanol-water partition coefficient (log P) and distribution coefficient (log D) of AAAs were computed using PALLAS software. The correlation between log P and log D values for AAAs at pH 7.4 and their EC50 was analyzed. RESULTS: Human RBCs were 1.9-3.1 times more resistant to the hemolytic activity of AAAs than rat erythrocytes. Also, the hemolytic activity of individual AAAs did not differ considerably; the maximum differences ranging from 2.0 to 3.3. The EC50 values of AAAs highly correlated with their log P and log D values. CONCLUSIONS: The relatively small differences between the hemolytic effects of AAAs on rat and human erythrocytes may be associated with the strong acidity and relatively similar lipophilicity of these chemicals.

[Occupational diseases in Poland, 2007]. / Choroby zawodowe stwierdzone w Polsce w 2007 r.

BACKGROUND: The aim of the paper was to present basic statistical data on occupational diseases diagnosed in 2007. MATERIAL AND METHODS: The work was based on the data compiled from "Occupational Disease Reporting Forms" received by the Central Register of Occupational Diseases in 2006. The data comprised information on nosologic units, gender and age of patients, and duration of occupational exposure to harmful agents responsible for the development of specified pathologies. These data were further classified by sectors of the national economy and voivodships. The incidence was specified in terms of the number of cases in relation to paid employees or to employed persons. RESULTS: In 2007, 3285 cases of occupational diseases were diagnosed. The incidence rate was 33.5 cases/100 000 paid employees. The highest incidence rates were noted for chronic voice disorders (8.1/100 000), pneumoconioses (7.1), infectious and parasitic diseases (6.8) and hearing loss (2.6). As many as 77.3% of patients affected by occupational diseases had been exposed to harmful agents for more than 20 years. In industrial sectors of the national economy, the coal mining industry showed the highest incidence rates (404.1 cases/100 000). The highest incidence rates were recorded in the Lubelskie (73.1), Silesian (68.4), Swietokrzyskie (66.5) and Malopolskie (60.7) voivodships. CONCLUSIONS: Compared with 2006, the number of cases of occupational diseases increased by 156 cases (5%), the incidence rate increased by 2.1%. The greatest rise was noted in infectious and parasitic diseases (by 68 cases, 11.3%) and chronic diseases of peripheral nervous system (by 50 cases, 46.3%). At the same time the number of hearing loss cases apparently decreased (by 43 cases, 14.6%).