The Frequency of Use and Harm Perception of Heated Tobacco Products (HTPs): The 2019 Cross-Sectional Survey among Medical Students from Poland.

Heated tobacco products (HTPs) are devices for generating a nicotine aerosol by heating the tobacco sticks. This study aimed to assess (1) the prevalence of HTP and tobacco cigarette usage among medical students, (2) to characterize smoking habits and (3) to assess students' awareness and opinions about HTPs. A cross-sectional survey on the frequency and attitudes toward cigarettes, e-cigarettes and HTP use was performed between 2019-2020 at the Medical University of Silesia in Katowice (Poland). The data were obtained from 1344 students aged 21.8 ± 1.9 years (response rate: 66.9%). Current traditional tobacco use was 13.2%, e-cigarettes use 3.5%, and HTP use 2.8% of students. Duration of use was shorter among HTPs users comparing to cigarette smokers (p < 0.001) although the number of tobacco sticks used daily was similar (p = 0.1). Almost 30% of respondents have ever tried HTPs. HTPs were considered safe by 5.3% of respondents (43.2% of HTP users vs. 3.9% of non-HTP users, p < 0.001). HTP users were more likely to report that heating tobacco is not addictive (odds ratio (OR) = 8.9, 95% confidence interval (CI): 1.8-45.8) and disagreed with a public ban on HTP use (OR = 4.9, 95%CI: 2.5-9.8). Among students, HTP use was less popular than cigarette smoking, but awareness of their presence is widespread.

E-cigarette use among young adults in Poland: Prevalence and characteristics of e-cigarette users.

PURPOSE: Electronic cigarette (e-cigarette) use is one of the most popular alternatives to conventional cigarette smoking. This study aimed to investigate the prevalence of cigarette and e-cigarette use among university students from Poland, with particular emphasis on ever and current cigarette and e-cigarette use as well as smoking initiation age. PATIENTS AND METHODS: A cross-sectional survey was conducted between 2017 and 2018 in a group of university students in 5 academic centers in Poland. The questionnaire addressed 46 questions about personal attitudes toward cigarette smoking and e-cigarette use. RESULTS: Data were collected from 7324 participants (67.3% females, aged 21.9 ± 2.1 years), with an overall response rate of 70.1%. Among participants, 71.2% had ever smoked a cigarette, and almost half of the respondents (45%) declared ever use of an e-cigarette. The mean age of first use of a cigarette was significantly lower (16.5 ± 2.5 y-old) than of an e-cigarette (18.6 ± 2.2 y-old; p < 0.001). Exclusive cigarette smoking was declared by 12.9%, 1.3% were e-cigarette users and 1.5% were dual users. Those in the medical field were less likely to try e-cigarettes (odds ratio, OR = 0.73) or to currently smoke conventional cigarettes (OR = 0.82). Older participants were more likely to have ever smoked conventional cigarettes (OR = 1.06), but less likely to have ever used e-cigarettes (OR = 0.88). CONCLUSIONS: In this study, we found a high proportion of young adults who have tried e-cigarettes with both regional and demographic differences. The education profile influences cigarette smoking and e-cigarette use behaviors.

Modes of Early Detection of Breast Cancer in Katowice Region, Poland.

BACKGROUND: Our 2004 survey of breast cancer survivors in the Katowice region (Poland) showed that the detection of the disease was triggered by self-examination in 58.9%, mammography in 19.2%, and clinical examination in 19.7% of cases. The purpose of the current study (2019/2020) was to determine if the implementation of national screening (mammography) in 2007 resulted in an increase of the relative contribution of mammography to detection of cancer. METHODS: Subjects were 215 breast cancer patients, members of self-support groups in Katowice region. The questionnaire included questions on early detection of breast cancer, participation in screening, and socio-economic status. RESULTS: Early detection of cancer was initiated by self-examination in 63.7%, mammography in 22.8%, clinical examination in 13.5% of subjects. Age at detection depended on the method (p < 0.001): 54.1 ± 10.8 years for self-examination, 60.0 ± 7.6 years for mammography, and 58.7 ± 10.8 years for clinical examination. CONCLUSIONS: Both in 2004 and 2020 self-examination is the most frequent method of early detection of breast cancer in the study area. The contribution of mammography remains on a low level (23%). This finding could be explained by a low participation in screening and by age of 50 years used as the entry criterion to national screening of breast cancer in Poland.

Smoking Cessation and Vaping Cessation Attempts among Cigarette Smokers and E-Cigarette Users in Central and Eastern Europe.

Our aim is to assess the smoking cessation and vaping cessation activity, including quit attempts and willingness to quit among university students in Central and Eastern Europe, as well as to investigate personal characteristics associated with smoking cessation and vaping cessation attempts. Data were collected by questionnaire which included 46 questions on cigarette and e-cigarette use. Questionnaires were obtained from 14,352 university students (aged 20.9 ± 2.4 years; cooperation rate of 72.2%). For the purposes of this analysis, only data from exclusive cigarette smokers (n = 1716), exclusive e-cigarette users (n = 129), and dual users (216) were included. Of all cigarette smokers, 51.6% had previously tried to quit smoking and 51.5% declared a willingness to quit cigarette smoking in the near future. Among all e-cigarette users only 13.9% had ever tried to quit using the e-cigarette and 25.2% declared a willingness to give up using e-cigarette in the near future. The majority of the group did not use pharmacotherapy to quit cigarette (87.5%) or e-cigarette (88.9%) use. Our results indicate that while most university students have some desire to quit conventional smoking, those who use e-cigarettes do not have the same desire.

New ideas, old problems? Heated tobacco products - a systematic review.

Heated tobacco products (HTPs) are a form of nicotine delivery intended to provide an alternative to traditional cigarettes. The aim of this systematic review was to present the current state of knowledge on HTPs with an emphasis on the potential impact of HTP use on human health. During the preparation of this systematic review, the literature on HTPs available within Medline/PubMed, EMBASE, CINAHL, ScienceDirect, and Google Scholar was retrieved and examined. In the final review, 97 research papers were included. The authors specifically assessed the construction and operation of HTPs, as well as the chemical composition of HTP tobacco sticks and the generated aerosol, based on evidence from experimental animal and cellular studies, and human-based studies.Heated tobacco products were found to generate lower concentrations of chemical compounds compared to traditional cigarettes, except for water, propylene glycol, glycerol, and acetol. The nicotine levels delivered to the aerosol by HTPs were 70-80% as those of conventional combustion. The results of in vitro and in vivo assessments of HTP aerosols revealed reduced toxicity, but these were mainly based on studies sponsored by the tobacco industry. Independent human-based studies indicated that there was a potentially harmful impact of the active and passive HTP smoking on human health. Currently, a large body of knowledge on HTP exposures and health effects is provided by the tobacco industry (52% of identified studies). Based on the available evidence, HTPs produce lower levels of toxic chemicals, compared to conventional cigarettes, but they are still not risk-free. Int J Occup Med Environ Health. 2019;32(5):595-634.

The Prevalence of Cigarette and E-cigarette Smoking Among Students in Central and Eastern Europe-Results of the YUPESS Study.

Electronic cigarettes (e-cigarettes) are an alternative to traditional tobacco cigarette smoking. The aim of this study was to assess the prevalence of cigarette smoking and e-cigarette use among university students from Central and Eastern Europe and to investigate personal characteristics associated with cigarette and e-cigarette smoking. A questionnaire-based cross-sectional survey was performed between 2017-2018 among university students in five European countries: Belarus, Lithuania, Poland, Russia, and Slovakia. The questionnaire included 46 questions related to the frequency and habits of traditional cigarettes and e-cigarettes use. Completed questionnaires were obtained from 14,352 students (8800 medical; aged 20.9 ± 2.4 years) with an overall response rate of 72.2%. Two-thirds of the respondents had smoked a traditional tobacco cigarette and 43.7% had used an e-cigarette. Overall current smoking status included 12.3% traditional cigarette smokers, 1.1% e-cigarette users, and 1.8% were dual users with the remainder being non-smokers. Smoking status differed between the research centres (p < 0.001). Females were less likely to try either cigarettes (OR = 0.83) or e-cigarettes (OR = 0.62) and were less likely to be current cigarette (OR = 0.64), e-cigarette (OR = 0.34), or dual users (OR = 0.33) than males. Perception of e-cigarettes significantly differed between smokers and non-smokers (p < 0.001). Among university students, cigarettes are more popular than e-cigarettes.

E-Cigarettes are More Addictive than Traditional Cigarettes-A Study in Highly Educated Young People.

E-cigarettes are often considered less addictive than traditional cigarettes. This study aimed to assess patterns of e-cigarette use and to compare nicotine dependence among cigarette and e-cigarette users in a group of highly educated young adults. From 3002 healthy adults, a representative group of 30 cigarette smokers, 30 exclusive e-cigarette users, and 30 dual users were recruited. A 25-item questionnaire was used to collect information related to the patterns and attitudes towards the use of cigarettes and e-cigarettes. The Fagerström test for nicotine dependence (FTND) and its adapted version for e-cigarettes were used to analyze nicotine dependence in each of the groups. The nicotine dependence levels measured with FTND were over two times higher among e-cigarette users (mean 3.5) compared to traditional tobacco smokers (mean 1.6; p<0.001). Similarly, among dual users, nicotine dependence levels were higher when using an e-cigarette (mean 4.7) compared to using traditional cigarettes (mean 3.2; p=0.03). Habits and behaviors associated with the use of e-cigarettes did not differ significantly (p>0.05) between exclusive e-cigarette users and dual users. The findings suggest that e-cigarettes may have a higher addictive potential than smoked cigarettes among young adults.

Acute respiratory responses to the use of e-cigarette: an intervention study.

The goal of our study was to assess acute respiratory responses to using e-cigarettes in exclusive e-cigarette users (E-Group) and dual users (T/E-Group) and to compare these effects with responses to smoking tobacco-cigarettes in tobacco smokers (T-Group). The study included 120 adults (age: 21.7 ± 2.1 years) divided into 4 groups (n = 30 each): Controls, T-, E-, T/E-Group. Spirometric status, O2 saturation, exhaled FeNO levels, exhaled CO levels, and airway temperature were assessed before the use of an e-cigarette (E-, T/E-Group) or tobacco cigarette as well as 'minute 1' and 'minute 30' after smoking. Controls used an e-cigarette without e-liquid. Lower (p < 0.05) baseline values of FeNO were found in T-Group (15.4 ppb) and in T/E-Group (15.0 ppb) than in Controls (19.6 ppb). Following exposure, and compared with Controls, T-, and T/E-Group had a significant decrease (p < 0.05) in PEF and MEF75. Mean FeNO values decreased on 'minute 1' in T-Group (by 2.1 ppb), E-Group (by 1.5 ppb) and in T/E-Group (by 2.2 ppb). Other effects included increase in temperature of exhaled air (p < 0.05). The use of e-cigarettes is associated with decreased FeNO and airflow indices (PEF, MEF75), but an increase in airway temperature. These changes are similar to those after exposure to tobacco cigarette smoke.

Dental status in the Polish senior population and its correlates-Results of the national survey PolSenior.

OBJECTIVE: The aim of the study was to assess dental status of Polish seniors having and wearing dentures in relation to demographic, socioeconomic and lifestyle factors. BACKGROUND: Tooth loss is associated with deterioration of general health status. The epidemiological data on dental status in Poland, including Polish seniors, are fragmented. MATERIALS AND METHODS: The study cohort consisted of 4524 randomly selected participants, aged 65 years and over, representative for Polish seniors. Demographic, socioeconomic, lifestyle factors and dental status were collected using standardised questionnaires. RESULTS: The prevalence of partial and complete edentulism in the Polish senior population was estimated at 45.7% and 47.1%, respectively. Fourteen point four per cent (14.4%) of complete edentulous participants and 31.1% with partial edentulism (1-19 natural teeth) did not have dentures, and one-twelfth of respondents having dentures were not wearing them. The independent correlates of complete edentulism were: female sex, advanced age, rural dwelling, lower education level, physical work in the past, smoking and diabetes. Male sex, age 90+, rural dwelling, type of work, dependence in activities of daily living and partial edentulism were independent correlates of not having dentures and denture disuse. Lower than average personal income was only significant for not having dentures. CONCLUSIONS: Complete edentulism is frequent among older Poles and affects almost 50% of them. It is associated with female sex, age, rural dwelling, poor economic status, smoking and diabetes. Rural dwelling and dependence of daily living are significant correlates of not having dentures and denture disuse.

Evaluation of the First Polish Web-Based Intervention Aimed at Improving Cancer Prevention (the PORINA Study).

The appropriate level of the society's health-oriented knowledge is essential for improving the effectiveness of actions to reduce the number of new cases and deaths caused by cancer. The aim of this study was to identify the role of web-based educational campaigns in the field of cancer prevention in Poland. From 14.05.2015 to 13.11.2016 readers of Polish scientific websites were invited to participate in the "PORINA" prospective interventional study. A total of 1118 volunteers (unrepresentative sample) were recruited and randomized (interventional and control groups). After applying the inclusion and exclusion criteria, 463 participants (41.4% of the recruited) qualified for the final analysis; 207 were allocated to the interventional and 256 to the control group. A specially designed internet platform, a self-reported questionnaire (validated during the study) and educational materials which were prepared by a physician specialized in clinical oncology were used. Assessments of participants' knowledge were based on the authors Cancer Knowledge Index (CKI). The number of subjects with an increase in CKI score was significantly higher for the interventional group with minor changes in the control (p < 0.001). The highest increase in CKI scores was obtained in the following demographic groups: females, younger participants, those living in smaller villages and also among the less educated. An overall impact of presented web-based educational intervention was moderate. However, the results obtained confirmed that well-organized intervention supported by oncologists may be useful in cancer prevention.

Between-occasion repeatability of fractional exhaled nitric oxide measurements in children / Repetibilidade de medidas da fração de óxido nítrico exalado em crianças em duas ocasiões

ABSTRACT The aim of the study was to assess short-term repeatability of measurements of fractional exhaled nitric oxide (FENO) and its correlates in children in the 6- to 9-year age bracket participating in a respiratory epidemiological survey. FENO was measured in two sessions one week apart in 101 children. Participants were divided into three groups: asymptomatic (n = 76); symptomatic (n = 14); and asthma (n = 11). Absolute and relative differences between the measurements, as well as concordance correlation coefficients, were used in order to assess repeatability. The two FENO measurements were strongly correlated (0.98). Although intragroup comparisons of the two measurements were not significantly different (p = 0.2), intergroup comparisons were. FENO measurements are reproducible in children in epidemiological settings.

RESUMO O objetivo do estudo foi avaliar a repetibilidade em curto prazo de medidas da fração de óxido nítrico exalado (FENO) e seus correlatos em crianças de 6-9 anos participantes de uma pesquisa epidemiológica respiratória. A FENO foi medida em duas sessões, com uma semana de intervalo, em 101 crianças. Os participantes foram divididos em três grupos: assintomático (n = 76), sintomático (n = 14) e asma (n = 11). A repetibilidade foi avaliada por meio de diferenças absolutas e relativas entre as medidas, bem como por coeficientes de correlação de concordância. As duas medidas da FENO correlacionaram-se fortemente (0,98). Embora as comparações entre as duas medidas em um mesmo grupo não tenham sido significativamente diferentes (p = 0,2), as comparações entre os grupos o foram. Medidas da FENO são reprodutíveis em crianças em cenários epidemiológicos.

Childhood asthma in Batumi, Georgia: Prevalence and environmental correlates.

OBJECTIVE: A relative lack of data for Eastern Europe and unknown epidemiology of childhood asthma in Batumi (Georgia) justified a study aimed at determining the prevalence of physician-diagnosed asthma and related respiratory conditions, a comparison of the prevalence of these conditions between urban and rural children, and identification of their environmental correlates. METHODS: Subjects of the cross-sectional population-based study were 3238 urban and 2081 rural children aged 5-17 years whose respiratory status was assessed using the ISAAC questionnaire. RESULTS: The overall prevalence of asthma was larger in rural children than in urban children (2.8% vs. 1.8%, respectively; p = 0.01). Spastic bronchitis occurred with similar frequency in urban (7.8%) and rural children (6.5%). Compared with urban children, rural subjects had dry cough at night (13.1 vs 8.2%, p < 0.001) and attacks of dyspnea (4.7 vs 2.4%, p < 0.001) more often. The prevalence of other symptoms did not differ significantly between urban and rural subjects. Results of multivariate analyses showed that both asthma and spastic bronchitis were associated (p < 0.05) with parental history of asthma, dampness in the house, and poor financial standing of the family. In addition, asthma was related to coal/wood-based heating whereas spastic bronchitis was associated with passive smoking and lower parental education. CONCLUSIONS: The findings show a low prevalence of ever-diagnosed asthma in the examined population. Nosological tradition and similar correlates of asthma and spastic bronchitis suggest that some cases of asthma might be included in the diagnostic category of spastic bronchitis.

Spatial and temporal variability of idiopathic pulmonary fibrosis cases in Silesian Voivodeship in years 2006-2010.

OBJECTIVES: Idiopathic pulmonary fibrosis (IPF) (J84.1 by the International Statistical Classification of Diseases and Related Health Problems, 10th revision - ICD-10) is a rare disease of unknown cause. Among many risk factors, occupational exposure to metal dust is enumerated. Because of metal industry concentration in the Silesian Voivodeship, Poland, an attempt of spatial and temporal variability of the idiopathic pulmonary fibrosis occurrence evaluation in 2006-2010 is made. MATERIAL AND METHODS: The research is a descriptive analysis. Data of the number of new treated cases and firsttime hospitalization due to idiopathic pulmonary fibrosis in the years 2006-2010 was obtained from the National Health Found (Narodowy Fundusz Zdrowia - NFZ). We also assessed spatial and temporal variability of both rates. Data concerned adults aged ≥ 19 years old inhabited the Silesian Voivodeship. RESULTS: The standardized incidence rate due to idiopathic pulmonary fibrosis increased in the study period and was in the range of 2.9-3.8/100 000 population. The highest values of incidence were observed in districts localized in the centre of the Silesian Voivodeship. CONCLUSIONS: Incidence of idiopathic pulmonary fibrosis is not so high in the Silesian Voivodeship but the number of newly treated cases slightly increased in 2006-2010. Spatial and temporal variability of incidence rates for treated registered cases of idiopathic pulmonary fibrosis in the Silesian Voivodeship was observed. It could be an effect of occupational exposure to metal dust, however, final conclusions need more precise studies to the extent of analytical epidemiology. Int J Occup Med Environ Health 2017;30(4):593-601.

E-smoking: Emerging public health problem?

E-cigarette use has become increasingly popular, especially among the young. Its long-term influence upon health is unknown. Aim of this review has been to present the current state of knowledge about the impact of e-cigarette use on health, with an emphasis on Central and Eastern Europe. During the preparation of this narrative review, the literature on e-cigarettes available within the network PubMed was retrieved and examined. In the final review, 64 research papers were included. We specifically assessed the construction and operation of the e-cigarette as well as the chemical composition of the e-liquid; the impact that vapor arising from the use of e-cigarette explored in experimental models in vitro; and short-term effects of use of e-cigarettes on users' health. Among the substances inhaled by the e-smoker, there are several harmful products, such as: formaldehyde, acetaldehyde, acroleine, propanal, nicotine, acetone, o-methyl-benzaldehyde, carcinogenic nitrosamines. Results from experimental animal studies indicate the negative impact of e-cigarette exposure on test models, such as ascytotoxicity, oxidative stress, inflammation, airway hyper reactivity, airway remodeling, mucin production, apoptosis, and emphysematous changes. The short-term impact of e-cigarettes on human health has been studied mostly in experimental setting. Available evidence shows that the use of e-cigarettes may result in acute lung function responses (e.g., increase in impedance, peripheral airway flow resistance) and induce oxidative stress. Based on the current available evidence, e-cigarette use is associated with harmful biologic responses, although it may be less harmful than traditional cigarettes. Int J Occup Med Environ Health 2017;30(3):329-344.

[Profile of adults suffering from COPD in Poland].

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases in adults. It is estimated, that in Poland around two million people suffer from COPD. THE AIM: The aim of this study, was to characterize population of patients with COPD in Poland. MATERIAL AND METHODS: The study, established and coordinated by the Polish Respiratory Society, included a representative sample of 500 GPs where were asked to fill questionnaires on diagnosis and treatment of their COPD patients. The questions dealt with disease history and clinical presentation, COPD severity stage, diagnostic and therapeutic procedures. RESULTS: Altogether 298 physicians (59.6% of invited) provided information about 2756 COPD patients aged 61.6 ± 11.1 years (36.3% were women). According to GOLD recommendations 16.6% of patients had mild, 57.0% moderate, 18.6% severe and 2.1% very severe COPD. Smoking history was declared by 97.8% of respondents. 51.4% of COPD patients had continued smoking. Over the last year Ambulance Service intervened in 19.7% of patients and 29.1% of respondents required hospital treatment of COPD. Among more than 80% of patients, doctor diagnosed limitation in exercise tolerance, and shortness of breath at rest, and in approximately 60% of the respondents were presented productive cough, weakened vesicular murmur and prolonged phase of exhalation. CONCLUSIONS: Despite the diagnosis, more than half of men and women had continued smoking. The number of hospitalizations and emergency intervention positively correlated with the severity of the disease. The survey results emphasize the urgent need for health education in patients with COPD.

E-smoking among students of medicine - frequency, pattern and motivations.

INTRODUCTION: E-smoking has become a public health problem. The objectives of this study were to assess the prevalence of e-cigarette and tobacco cigarette use; to compare the patterns of smoking; to assess the attitudes and motivations for e-cigarette use. MATERIAL AND METHODS: All 1,700 students from Faculty of Medicine (Medical University of Silesia) were invited to questionnaire based cross-sectional study about the frequency and attitudes towards the use of traditional and electronic cigarettes. RESULTS: The data were obtained from 1,318 medical students (response 77.5%) aged 22.1 ± 2.2 years. Traditional tobacco smoked 18.1%, e-cigarettes 1.3% and 2.2% were dual smokers. The overall frequency of e-smokers was 4.9% among men and 2.8% among women (p = 0.05). Compared to tobacco users in e-smokers duration of smoking was shorter (p < 0.001), the intensity of smoking was larger (p = 0.01), the number of e-cigarettes smoked daily was higher (p < 0.001). Dual smokers more frequently used tobacco cigarettes than e-cigarettes (p = 0.01) but smoked more e-cigarettes daily (p = 0.003). The choice of e-liquid depended on the flavour (50.0%), nicotine concentration (21.7%) and price (7.6%). No-nicotine e-cigarettes were used by 6.5% smokers. Dual smokers more frequently chose e-liquids with high nicotine concentration (p = 0.01). Motivations leading to e-smoking were: quitting tobacco (58.7%), less harmful impact on health (43.5%) and the price (34.8%). E-smoking as safe for health was perceived by 6.0% of respondents (35.5% in e-smokers vs. 4.9% in non e-smokers; p < 0.001). CONCLUSION: Among students of medicine, e-smoking is apparently less popular than smoking tobacco cigarettes. Respondents considered e-cigarettes to be harmful and addictive.

Socioeconomic determinants of prostate-specific antigen testing and estimation of the prevalence of undiagnosed prostate cancer in an elderly Polish population based on the PolSenior study.

INTRODUCTION: Socioeconomic determinants of prostate-specific antigen (PSA) testing and prevalence of undiagnosed prostate cancer (PCa) in the Polish population are poorly understood. The aim of this study was to identify factors associated with PSA testing in elderly Polish men, and estimate the size of the population at risk of PCa related to PSA non-testing. MATERIAL AND METHODS: We analyzed questionnaire-derived data concerning PSA testing, obtained in 2567 elderly and 332 younger (age: 55-59) participants of the population-based PolSenior study. Additionally, PSA was measured in 2414 subjects. RESULTS: The PSA had previously been tested in 41.2% of elderly and in 24.8% of younger participants. Non-smoking status (OR = 2.06, p < 0.001), higher personal income (OR = 1.56, p < 0.001), better education (OR = 1.49, p = 0.001), previous white-collar work (OR = 1.37, p = 0.005), alcohol abstinence (OR = 1.28, p = 0.02), married status (OR = 1.24, p = 0.04), dependence in Instrumental Activities of Daily Living (IADL) but not in Activities of Daily Living (ADL) (OR = 0.65, p < 0.001), and dependence in ADL (OR = 0.55, p < 0.001) were independent predictors of previous PSA testing in elderly participants. There were 31 elderly previously treated for PCa (calculated standardized prevalence: 935 per 100,000 elderly population). The PSA levels > 4 ng/ml were found in 12.8% of 65-74-year-old and 4.5% of 55-59-year-old previously non-tested participants. We calculated the standardized prevalence rate of undiagnosed PCa as approximately 1370 and 2352 cases per 100,000 population aged 55-59 and 65-74 years, respectively. CONCLUSIONS: In Poland, 58.8% of elderly men have never had PSA tested. These were less likely to be functionally independent, married, better educated, non-smokers or to have previous office employment or higher than average personal income. Our data suggest substantial underdiagnosis of prostate cancer among Polish men.

Spatial and temporal variability of bronchiectasis cases in Silesian voivodeship in 2006-2010.

OBJECTIVES: Reports on an increasing number of hospitalizations in other European countries and the lack of epidemiological data on the prevalence of bronchiectasis in Poland constituted motivation for the authors to investigate temporal changes of the registered incidence and hospitalization due to bronchiectasis in Silesian voivodeship, and to evaluate spatial variability of the disease in the study region. MATERIAL AND METHODS: The study is a descriptive epidemiological project. Temporal and spatial variability of coefficients describing numbers of newly diagnosed cases and first time hospitalizations due to bronchiectasis (code J47 according to International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10)) were evaluated based on the registered data available from the National Health Found (2006-2010) and the data from MZ/Szp-11 reports (2000-2011). The data concerned adults aged ≥ 19 years, inhabitants of Silesian voivodeship. Maps of incidence or hospitalization rates due to bronchiectasis were constructed by the use of a geographical information system ArcGIS. RESULTS: The obtained results show a stable trend of reported new diseases, whereas the number of first time hospitalizations is increasing. Values of the standardized incidence were 19.9-25.1/100 000 inhabitants, and values of the standardized first-time hospitalization were 1.2-2.9/100 000 inhabitants. The reported rates of bronchiectasis indicate significant spatial differences in epidemiological situation in the study region. CONCLUSIONS: The findings showed territorial variability of the incidence and hospitalization of bronchiectasis recorded in Silesian voivodeship. The observed variability might result from regional differences in the availability of specialized medical services.

Rural Dwelling and Temporal Trends in Relation to Childhood Asthma and Related Conditions in Belarus: A Repeated Cross-sectional Survey.

There is a lack of asthma research in Belarus, with no investigation of temporal trends. The purpose of the study was to determine the prevalence of asthma and related conditions comparing urban and rural children while investigating temporal changes in the region of Grodno, Belarus. A repeated cross-sectional survey design was used. Parents completed surveys on behalf of the child. Data collection was based on the International Study of Asthma and Allergies in Children (ISAAC) survey and included 5020 urban and rural children aged 7-15 years in 2009-2010 and 4953 children in 2014 from the Grodno Region. Asthma prevalence in 2009 was 1.4% compared with 1.8% in 2014, whereas spastic bronchitis prevalence was higher (2009: 6.8%; 2014: 8.5%). After adjustment for confounders, rural dwelling showed a statistically significant inverse association with each of the allergic conditions or symptoms. However, asthma (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 0.69-1.50) was not associated with rural dwelling. A diagnosis of asthma was more likely in 2014 compared with 2009 (OR = 1.57, 95% CI = 1.05-2.33), as was spastic bronchitis (OR = 1.26, 95% CI = 1.06-1.51). Maternal smoking was associated with the presence of respiratory symptoms. The data showed that the prevalence of diagnosed asthma was comparable between urban and rural areas but lower than other regions, there was generally an increase in the prevalence of asthma and related conditions, and that temporal changes did not vary by urban-rural status. The prevalence of spastic bronchitis was over 3 times higher than that of asthma. These findings also suggest that the presence of undiagnosed asthma in children is occurring in the Grodno Region.

[Children environmental health--Polish epidemiological publications in the global literature on the topic]. / Srodowiskowe zagrozenia stanu zdrowia dzieci--polskie doniesienia epidemiologiczne na tle swiatowej literatury przedmiotu.

Environmental hazards in children are subject to many research programs and public health priority, also in Poland. Assessment of the publication output in this field can be used to evaluate the level of general scientific activity in epidemiology. "Medline"-based review (topic: environmental exposure) showed that in the examined period the percentage of Polish publications concerning children aged 0-18 years reached 1,67%, and a half of the articles was published in English. Following the period of a visible increase in annual numbers of Polish publications two recent years revealed a marked decrease of the output. Review of the contents showed a number of broad thematic categories: occurrence and risk factors of allergic diseases including asthma, effects of passive smoking, impact of exposure to lead and other metals including biomonitoring, waste site-related exposures, environmental correlates of physical development, risk related to ionizing radiation and electromagnetic fields. Results suggest an average status of Polish activity in the light of global scientific publications, within the analyzed topic. Moreover, Polish publications cover a narrow spectrum of environmental health issues. The review helped to identify a number of problems that could be addressed to improve scientific activity of Polish environmental epidemiology centers. Those are universal and reflect well recognized problems of the current status of the Polish science, in general.