Risk factors of excessive body mass in children and adolescents in Lódz

Background: Obesity and cardiovascular disease and metabolic disorders are an increasingly common problem worldwide, also in the developmental age population. Inhibiting this process requires identifying risk factors that can be modified. Objective: The aim of the study was to identify the conditions of the occurrence of overweight and obesity in the Lodz youth at school age. Materials and methods: The survey was conducted in 2008-2012 among school students attending primary and secondary schools in the four districts of Lodz (city in Poland). The study involved 622 students aged 12-18: 309 girls (49.7%) and 313 boys (50.3%). The BMI index was calculated based on anthropometric measurements (mass, body height) and was interpreted on the basis of centile charts of Lodz children (overweight ≥ 85-95 centile; obese ≥ 95 centile). Youth health behaviors were analyzed based on a questionnaire of an original interview modeled on the HBSC (Health Behavior in School-aged Children) study. The obtained results were subjected to statistical analysis (single- and multi-factorial logistic regression analysis). Results: An excess of body weight was found in 23.5% of the examined youth. In multivariate logistic regression analysis, the factors significantly affecting the occurrence of overweight or obesity were: non-eating dinner (daily or sometimes, OR = 1.98); not eating fruit and vegetables every day (OR = 1.57), multi-hour passive relaxation time (use of TV, Internet, OR = 3.08) and low physical activity (OR = 1.76). Conclusions: Intensive promotion of a healthy lifestyle - increasing the awareness and knowledge of schoolchildren, encouraging proper eating habits and active leisure activities - can significantly affect the reduction of obesity risk factors. Health education is required at school for children, as well as for parents and teachers.

[The incidence of accidents at work among paramedics in the years 2001-2013 based on the register of one selected hospital]. / Czestosc wystepowania wypadków przy pracy wsród ratowników medycznych w latach 2001-2013 na podstawie rejestru wybranego szpitala.

BACKGROUND: Paramedics are exposed to a number of factors that may have a direct or indirect impact on the risk of an accident at work. The aim of the study was to analyze the incidence of accidents at work among paramedics as well as to discuss risk factors and measures to prevent such cases. MATERIAL AND METHODS: The data on accidents at work were obtained from unpublished internal hospital documentation. The results were subjected to statistical analysis. RESULTS: In the years 2001-2013 there were 40 events, including 6 collective accidents, in which 41 paramedics of the emergency department were injured. On average, around 3 accidents involving paramedics occurred each year. The accidents happened most frequently in the evening and at night and in the winter months (statistically insignificant relationship). Incorrect behavior of the paramedics was the most common cause of an accident (75.6%) and musculoskeletal injuries (75%) most frequently of upper and lower limbs (55%) were the most common effects of an accident. In none of the cases safety regulations were breached by employees or employer. CONCLUSIONS: Accidents among paramedics can be prevented by changing the interior design of and the medical equipment installation in the rear cabin of the ambulance, conducting regular training to upgrade the skills of paramedics and enriching their knowledge about health and safety in their widest meaning. Med Pr 2016;67(2):213-221.

[Estimation of cardiovascular risk in patients with metabolic syndrome]. / Ocena ryzyka sercowo-naczyniowego u chorych z objawami zespolu metabolicznego.

Metabolic syndrome (MS) is a coexistence of metabolic risk factors affecting development of cardiovascular diseases. The SCORE system estimates fatal cardiovascular disease events over a ten-year period. AIM: The aim of the study was to estimate cardiovascular risk in patients with symptoms of MS. MATERIALS AND METHODS: The study included 268 patients with symptoms of MS according to International Diabetes Federation criteria (2005), 136 men and 132 women, mean age 59,62±9,21 years. The cardiovascular risk was estimated on based of pulse pressure and SCORE table in these patients. RESULTS: In subjects with MS the mean value of pulse pressure (pp) was 58,96±2,34 mmHg, increased values of pp was found in 33,21% subjects with MS. High and very high cardiovascular death risk occurred in 80,97% subjects with MS, significantly more often in men than women. CONCLUSIONS: In majority of patients with MS high cardiovascular risk was found. In every three subjects with MS high pulse pressure was stated.

[Estimation of plasma 25(OH)D vitamin level in residents of Lodz]. / Ocena stezenia witaminy 25(OH)D w osoczu mieszkanców Lodzi.

UNLABELLED: Recent evidence for the pleiotropic differentiated effects of vitamin D, coupled with recognition that vitamin D deficiency is common, has revived interest in this hormone. Vitamin D is produced by skin exposed to ultraviolet B radiation or obtained from dietary sources, including supplements. Persons commonly at risk for vitamin D deficiency include those with inadequate sun exposure, limited oral intake, or impaired intestinal absorption. THE AIM: of this study was to evaluate plasma 25(OH)D level in residents of Lodz. MATERIALS AND METHODS: The study included 326 residents of Lodz, 156 men and 170 women, aged 30-65 years (mean 57,25±8,24 years). The study group was divided according to the age and season. The concentration of 25-hydroxy vitamin D (25-OH-D) was assessed with the application of the LIAISON® test using chemiluminescent immunoassay (CLIA) technology. RESULTS: The mean plasma level of 25(OH)D was 24,96±9,84 ng/ml in studied population and it was not significantly higher in women than men (25,24 ±3,31 ng/ml vs. 23,97±3,71 ng/ml, p>0,05); The highest 25(OH)D concentration was noted in the oldest age group (29,12±2,78 ng/ml)and in summer months (33,21±2,91 ng/ml). CONCLUSIONS: The concentration of vitamin D in the plasma of residents of Lodz was significantly lower than its recommendations. Age and season of the year were the factors strongly affecting the level of 25(OH)D in studied group.

[Evaluation of prevalece of plasma 25(OH)D vitamin deficiency in residents of Lodz]. / Ocena czestosci wystepowania niedoborów witaminy 25(OH)D w osoczu mieszkanców Lodzi.

UNLABELLED: Only scarce data have been published regarding serum vitamin D status in adult population in Poland. Observational studies have suggested relationship between 25(OH)D deficiency and many diseases, such as cardiovascular diseases, autoimmunological diseases or cancers. Still little is known about plasma 25(OH)D deficiency in Polish healthy adults. THE AIM: The aim of the study was to assess plasma 25(OH)D vitamin deficiency in residents of Lodz. MATERIALS AND METHODS: The study included 326 residents of Lodz, 156 men and 170 women, aged 30-65 years (mean 57,25±8,24 years). The study group was divided according to the age and season. The plasma level of 25(OH)D above 30 ng/ml was considered normal, between 21 ng/ml and 30 ng/ml - suboptimal (hypovitaminosis) and below 20 ng/ml - insufficient (deficiency). RESULTS: Plasma 25(OH)D vitamin deficiency was observed in 23,01% participants, hipovitaminosis - in 46,32%, the recommended 25(OH)D concentration in the plasma was observed only in 30,67%. Plasma 25(OH)D vitamin deficiency was observed more often in men than women (25,64% vs. 20,59%, p<0,05);the highest percentage of patients with recommended 25(OH)D vitamin level was observed during summer months (60%). CONCLUSIONS: Plasma 25(OH)D vitamin deficiency was very high in residents of Lodz, especially in men, people over 55 years and during winter months.

[Estimation of plasma 25(OH)D vitamin deficiency in patients with metabolic syndrome]. / Ocena czestosci niedoborów witaminy 25(OH)D w osoczu chorych z objawami zespolu metabolicznego.

UNLABELLED: Cardiovascular diseases have been the main cause of mortality in Poland for many years, including premature death and the incidence is systematically growing. These diseases contribute to an increase in the number of disabled people and the cost of medical care. The problem of the so called metabolic syndrome (MS), which includes metabolic risks of atherosclerosis, has been known by doctors for a long time. Results of studies which have been conducted for some years confirm that vitamin D deficiency is a risk factor of MS disorders, including obesity, arterial hypertension, diabetes. AIM: The aim of the study was to assess plasma 25(OH)D vitamin deficiency in patients with MS. MATERIALS AND METHODS: The study included 268 patients with MS, 136 men and 132 women, aged 30-65 years (mean 59,62±9,21 years). The study group was divided according to the age and season. The plasma level of 25(OH)D above 30 ng/ml was considered normal, between 21 ng/ml and 30 ng/ml - suboptimal (hypovitaminosis) and below 20 ng/ml - insufficient (deficiency). RESULTS: Plasma 25(OH)D vitamin deficiency was observed in 80,97% patients with MS, hipovitaminosis - in 17,16%. The recommended 25(OH)D concentration in the plasma was confirmed only in 1,87%. Plasma 25(OH)D vitamin deficiency was detected more often in men than women (93,38% vs. 68,18%, p<0,05);the lowest percentage of patients with 25(OH)D vitamin deficiency was observed during summer months (47,14%). CONCLUSIONS: Plasma 25(OH)D vitamin deficiency was very high in patients with metabolic syndrome, especially in men, people over 55 years and during winter months.

Should antioxidant vitamin supplementation be applied in patients with metabolic syndrome? A case-control study.

INTRODUCTION: All cells in the human body are exposed to reactive oxygen species (ROS), which disturb the metabolic reactions in the organism. The antioxidant system in the human body consists of enzymatic and non-enzymatic mechanisms, among which vitamins A, C, and E play a major role. THE AIM OF THE STUDY: The aim of the study was to evaluate the supply of vitamins A, C, and E from daily food rations (DFR) in postmenopausal women with metabolic syndrome (MS) in relation to current nutrition standards. MATERIAL AND METHODS: The study involved 184 women with MS, aged 45-68 years (mean 57.38 ±8.17 years). The control group comprised 90 women, aged 41-65 years (mean 57.48 ±5.79 years) without MS. The food intake was assessed using 24-hour dietary recalls. RESULTS: The evaluation of intake of vitamins measured with daily food rations (DFR) demonstrated that the optimal level of 90-110% according to standards was achieved only in 3.62% of women with metabolic syndrome for vitamin A, in 8.88% for vitamin C, and in 11.41% for vitamin E, which was significantly less often found than in the control group (p < 0.001). CONCLUSIONS: Women with MS are characterised by diversified intake of vitamins A, C and E, and a subgroup of this patients present low level of antioxidant vitamins intake. Supplementation with antioxidant vitamins should be prescribed individually to postmenopausal women with MS.

[Estimation of plasma 25(OH)D vitamin level in patients with metabolic syndrome]. / Ocena stezenia 25(OH)D w osoczu chorych z objawami zespolu metabolicznego.

UNLABELLED: Cardiovascular diseases are a major public health problem in developed and developing countries. A number of recent studies point to the pleiotropic differentiated effects of vitamin D, the deficiency of which positively correlates with the increased risk for cardiovascular diseases, hypertension, dyslipidemia, obesity or metabolic syndrome (MS). Vitamin D deficiency has also been proven to affect the progression of atherosclerosis. THE AIM: of this study was to evaluate plasma 25(OH)D level in patients with MS. MATERIALS AND METHODS: The study included 268 patients with MS, 136 men and 132 women, aged 30-65 years (mean 59,62±9,21 years). The study group was divided according to the age and season. The concentration of 25-hydroxy vitamin D (25-OH-D) was assessed with the application of the LIAISON® test using chemiluminescent immunoassay (CLIA) technology. RESULTS: The mean plasma level of 25(OH)D was 14,56±7,81 ng/ml in MS patients and it was not significantly higher in women than men (15,14 ±3,29 ng/ml vs. 13,97±3,41 ng/ml, p>0,05). The lowest 25(OH)D concentration was noted in the oldest age group (9,24±4,78 ng/ml). The highest 25(OH)D concentration was noted in summer months (23,71±3,82 ng/ml). CONCLUSIONS: The concentration of vitamin D in the plasma of patients with MS was significantly lower than its recommendations. Age and season of the year were the factors strongly affecting the level of 25(OH)D in MS patients.

[Physical activity in patients with symptoms of metabolic syndrome reduces the concentration of plasma antioxidant vitamins - protective effect of vitamin C]. / Aktywnosc fizyczna u chorych z objawami zespolu metabolicznego zmniejsza stezenia witamin antyoksydacyjnych w osoczu - ochronny efekt witaminy C.

UNLABELLED: Patients with cardiovascular diseases, including those with the symptoms of metabolic syndrome (MS), are recommended regular exercise but many studies indicate its role in the production of reactive oxygen species. Vitamin C supplementation may enhance the antioxidant barrier in MS patients. AIM: The aim of the study was to assess the impact of regular physical activity (PA)and vitamin C supplementation on plasma vitamin A, C and E levels in patients with MS. MATERIALS AND METHODS: The study included 62 patients with MS according to International Diabetes Federation criteria, 32 men and 30 women, aged 38-57 years (mean age 51,24 ± 5,29 years). The patients were divided in two groups: group I (MS+PA) - 31 patients with recommended regular physical activity; group II ( MS+PA+C) - 31 patients with recommended regular physical activity and vitamin C supplementation per os. The control group consisted of 23 healthy individuals without MS, 17 men and 6 women, aged 49-56 years (mean age 53,21 ± 3,6 years), who were not recommended any vitamin supplementation nor physical activity. Plasma vitamin A, C and E levels were estimated in MS patients with spectrophotometry using T60V spectrophotometer (PG Instruments) before and after regular exercise with and without vitamin C supplementation. In the control group plasma levels of antioxidant vitamins were assessed only once. RESULTS: The plasma vitamin A, C and E levels were significantly lower (p<0,05) in MS patients than in the control group. After 6 weeks of regular physical activity a significant fall in plasma levels of antioxidant vitamins was observed in MS patients. In the group of patients with regular physical activity and vitamin C supplementation there was detected a significant rise in the level of all the tested vitamins close to the levels in control group. CONCLUSIONS: Regular physical activity enhances the decrease in plasma antioxidant vitamin level in patients with MS. Vitamin C supplementation conducted in parallel with regular physical activity normalize plasma vitamin A, C and E levels in these patients.

Life satisfaction and work-related satisfaction among anesthesiologists in Poland.

UNLABELLED: The aim of the study was to assess the level of life and job satisfaction of Polish anesthesiologists and to explore the impact of extrinsic-hygiene and intrinsic-motivating determinants. MATERIALS AND METHODS: A cross-sectional questionnaire study was conducted among consultant anesthesiologists in Lodz region. The questionnaire concerned patient care, burden, income, personal rewards, professional relations, job satisfaction in general, and life satisfaction. Respondents were asked to rate their level of satisfaction for each item on a seven-point Likert scale (1: extremely dissatisfied; 7: extremely satisfied). RESULTS: 86.03% of anesthesiologists were satisfied with their economic status, 77.94% found their health status satisfactory, and 52.21% viewed their personal future optimistically. In general, 71.32% of anesthesiologists were satisfied with their current job situation. Among the less satisfying job aspects were work-related stress (2.49; SD = 1.23), administrative burden (2.85; SD = 1.47), workload (3.63; SD = 1.56), and leisure time (3.09; SD = 1.44). CONCLUSIONS: Considerable work-related stress leads to job dissatisfaction among anesthesiologists. There is an association between job satisfaction and health status, social life, and economic status. Working for long hours by anesthesiologists results in a high risk of burnout.

[Estimation of plasma vitamin A, C and E levels in patients with metabolic syndrome]. / Ocena stezenia witamin A, C i E w osoczu chorych z objawami zespolu metabolicznego.

UNLABELLED: Metabolic syndrome (MS) is a coexistence of metabolic risk factors affecting development of cardiovascular diseases. In the pathogenesis of MS there participate reactive oxygen species which are excessively produced in such elements of MS as hyperglycemia, insulin resistance and obesity. Vitamins A, C and E are an important part of the non-enzymatic antioxidative barrier in humans. The aim of the study was to estimate plasma vitamin A, C and E levels in patients with symptoms of MS. MATERIAL AND METHODS: The study included 68 patients with symptoms of MS according to International Diabetes Federation criteria (2005), 37 men and 31 women, aged 34-65 years (mean age 57, 76 +/- 8, 29 years). The control group consisted of 24 healthy individuals without MS, 18 men and 6 women, aged 49-67 (mean age 58, 5 +/- 5, 6 years). Plasma vitamin A, C and E levels were estimated in patients and the control group with spectrophotometry using T60V spectrophotometer (PG Instruments). RESULTS: The plasma vitamin A, C and E levels were significantly lower (p < 0.05) in MS patients than in the healthy individuals without symptoms of MS. The most significant differences in the level of antioxidative vitamins in both groups were related to vitamin C and vitamin E. CONCLUSIONS: The decreased level of vitamins A, C and E points to the weakening of antioxidative barrier in patients with MS.

Assessment of 25(OH)D vitamin concentration in plasma of residents of Lodz with metabolic syndrome in pre- and postmenopausal period.

INTRODUCTION: Vitamin D deficiency is a risk factor for metabolic syndrome disorders and the occurrence of these disorders greatly contributes to the deficiency of vitamin D. Postmenopausal women are particularly prone to that deficiency. AIM: The aim of the study was to assess vitamin D concentration in the plasma of pre- and postmenopausal women, with or without metabolic syndrome. MATERIAL AND METHODS: The study included 141 women aged 26-77 (the mean age 58.74 years old), divided into 4 groups depending on the pre- or postmenopausal period and diagnosed or not with metabolic syndrome according to the International Diabetes Federation criteria (2005). Vitamin D concentration was assessed by LIAISON(®) test using chemiluminescent immunoassay (CLIA) technology. RESULTS: The mean vitamin D concentration was the highest among premenopausal women without metabolic syndrome (24.32 ng/ml), it was insignificantly higher than in postmenopausal women without metabolic syndrome (23.52 ng/ml) and significantly higher than in both groups with metabolic syndrome - premenopausal (19.86 ng/ml) and postmenopausal women (9.32 ng/ml). The recommended plasma 25(OH)D concentration was not found in any of postmenopausal women with diagnosed metabolic syndrome. CONCLUSIONS: Postmenopausal women with metabolic syndrome had a significantly lower 25(OH)D vitamin concentration in plasma than postmenopausal women without metabolic syndrome. The frequency of vitamin D deficiency in women with metabolic syndrome was very high, significantly higher than in women without metabolic syndrome.

[Percutaneous exposures in medical personnel]. / Ekspozycje przezskórne personelu medycznego.

INTRODUCTION: Medical personnel having daily contacts with patients and, consequently, with their blood and other body fluids constitute a group of an increased risk of percutaneous exposure. The aim of the study was to determine the frequency of medical personnel's contacts with blood and other body fluids as well as to analyze the attitudes of patients infected with blood-borne pathogens and procedures after an occupational exposure to infectious material. MATERIAL AND METHODS: A questionnaire survey of 151 persons. RESULTS: The survey revealed that 77.5% of physicians and 98.2% of nurses experience contacts with infectious material at least several times a week. Simultaneously, 45% of physicians and only 18.9% of nurses stated that they had never been injured with a contaminated needle or other medical instruments. Disconcerting is also the fact that only 45.5% of physicians and 66.7% of nurses report such incidents to their superiors. CONCLUSIONS: The study proved that medical personnel form an occupational group regularly exposed to contacts with patients' blood, body fluids, secretions and excretions. Despite such frequent contacts with patients' body fluids and frequent injuries with medical instruments, their knowledge of blood-borne infections is inadequate. The awareness of giving care to an infected patient makes the majority of medical personnel modify their behavior.

[Legal aspects of the health care institution liability for nosocomial infections]. / Aspekty prawne odpowiedzialnosci zakladów opieki zdrowotnej za zakazenia szpitalne.

In this paper, the basic concepts concerning the liability of health care institution for nosocomial infections are presented. The principles of ex contracto and ex delicto liabilities, as well as the concept of so-called anonymous guilt are discussed. The range of duties for both the health care institution and the employed medical personnel is indicated, the duties and the consequences of their non-fulfillment are systematized, and the obligatory jurisdiction concerning the functioning of prima facie evidence is considered. The author aimed at explaining the principles governing the civil liability of health care institutions and their employees.

Did legal regulations change the reporting frequency of sharp injuries of medical personnel? Study from 36 hospitals in Lódz Province, Poland.

OBJECTIVES: The aim of the study has been to analyze the epidemiological data on sharp injuries among health care workers before and after the implementation of regulations related to the conduct of the register of sharp injuries. MATERIAL AND METHODS: We hypothesized that the introduction of legislation would change the existing low reportability of sharp injuries and reporting incidents would increase. In Poland the binding regulations, dating back to 2013, require the employer to keep a record of sharp injuries. Therefore, we compared the data from before and after the entry regulations. Data was collected from the records of occupational exposure/accidents at work in hospitals in the Lódz Province during 2010-2014. The feedback came from 36 hospitals (return index = 51.5%), representing a total annual average of 13 211 medical workers. RESULTS: The incidence of injuries did not change significantly over the period 2010-2014, and the number of reported injuries in 2014 (the year when the Regulation had already been effective) was even lower than in the previous years. The average annual injury index was 12.31 injuries per 1000 employees (95% confidence interval: 11.48-13.16/1000). The incidence of injuries among nurses was significantly higher than in other groups of medical professionals (p < 0.05). These injuries most often occur while using needles (p < 0.05). CONCLUSIONS: The obligation to record occupational exposures set forth in current regulations is not likely to improve the reliability of reporting the incidents actually taking place. Further research should focus on identifying barriers to reporting cases of exposure to potentially infectious material. Action should be taken to raise awareness of medical personnel about the possible effects of exposure to infectious material, in particular, the benefits of the implementation of early post-exposure procedures. Perhaps it will increase the reporting frequency of sharp injuries of medical personnel. Int J Occup Med Environ Health 2018;31(1):37-46.

Gender, age, social disadvantage and quitting smoking in Argentina and Uruguay.

INTRODUCTION: Cessation of tobacco use has the potential to provide the greatest immediate benefits for tobacco control. Understanding the social determinants of smoking cessation is an essential requirement for increasing smoking cessation at the population level. The purpose of this study was to analyze the socio-economic dimensions associated with cessation success among adults in Argentina and Uruguay. MATERIAL AND METHODS: Data from the Global Adult Tobacco Survey (GATS), a cross-sectional, population-based, nationally representative survey conducted in Argentina (n=5,383) and Uruguay (n=4,833) was utilized. Univariable and multivariable logistic regression analyses with results being presented as odds ratios (OR) with 95% confidence intervals were applied to study differences among those respondents who sustained smoking abstinence (≥1 year) and those who continued smoking. RESULTS: The GATS study revealed that social gradients in tobacco quitting exist in Argentina and Uruguay. Being aged 25-34, particularly men in Uruguay, women in Argentina, low educated men in Argentina and having a lower asset index were associated with reduced odds for quitting. CONCLUSIONS: Factors that are driving differences in smoking cessation between diverse social groups in Latin America countries need to be considered when implementing relevant interventions to ensure tobacco control strategies work effectively for all population segments.

A comparison of native and non-urate Total Antioxidant Capacity of fasting plasma and saliva among middle-aged and older subjects.

OBJECTIVES: As plasma and salivary total antioxidant capacity (TAC) is mainly contributed by uric acid (UA), the present study measures non-urate TAC (Nu-TAC). The aim of the study was to correlate plasma native TAC, Nu-TAC and UA with their salivary analogues, and compare the UA contribution in both body fluids using two different methods. METHODS: The study involved 55 middle-aged and older subjects (66.7 ± 4.5 years). TAC was determined simultaneously with two methods (ferric reducing ability of plasma - FRAP, 2.2-diphenyl-1-picryl-hydrazyl - DPPH and countertypes for saliva - FRAS and DPPHS test), with and without UA (native TAC and Nu-TAC, respectively). Plasma UA and salivary UA (SUA) were assessed. RESULTS: Subjects with increased FRAP, DPPH and UA had higher FRAS, DPPHS and SUA, respectively (P < 0.05). Plasma Nu-TAC indices did not correlate with salivary Nu-TAC. The contribution of UA to the plasma and salivary DPPH tests was similar: 75.7 ± 10.3% and 75.2 ± 14.0%, respectively. However, the contribution of UA to FRAS was higher than that for FRAP (71.6 ± 13.9% vs. 64.0 ± 8.1%; P < 0.001). DISCUSSION: Our findings suggest that saliva is a good predictor for native plasma TAC but not for Nu-TAC. UA level is comparably dominant in saliva and in plasma according to DPPH, but lower in plasma according to FRAP.

Work-Related Accidents and Sharp Injuries in Paramedics-Illustrated with an Example of a Multi-Specialist Hospital, Located in Central Poland.

(1) Background: An analysis of work-related accidents in paramedics in Poland by presenting the model and trend of accidents, accident rates and by identifying causes and results of accidents; (2) Methods: A retrospective analysis of medical documentation regarding work-related accidents in a multi-specialist hospital, located in central Poland, in the period 2005-2015. The study group included paramedics who had an accident while being on duty; (3) Results: According to hospital records, 88 paramedics were involved in 390 accidents and 265 injuries caused by sharp instruments. The annual accident rate was 5.34/100 employed paramedics. Most of the accidents occurred at night. The most common reason for the accident was careless behaviour of the paramedic, which resulted in joint sprains and dislocations. Injuries accounted for a huge portion of the total number of events. As many as 45% of injuries were not officially recorded; (4) Conclusion: High rates of work-related accidents and injuries caused by sharp instruments in paramedics are a serious public health problem. Further studies should be conducted in order to identify risk factors of accidents, particularly injuries, and to implement preventative programmes, aiming to minimise rates of occupational hazards for paramedics.

Awareness of the Risk of Exposure to Infectious Material and the Behaviors of Polish Paramedics with Respect to the Hazards from Blood-Borne Pathogens-A Nationwide Study.

(1) Background: To determine paramedics' frequency of contact with blood and other body fluids, as well as the analysis of knowledge of paramedics about blood-borne infections, their attitudes to patients infected with blood-borne viruses, and the post-exposure procedures implemented by paramedics; (2) Methods: An anonymous questionnaire among 190 paramedics working in various health care facilities in Poland (adjusted response rate, 76.3%); (3) Results: 78% of paramedics had contact with potentially infectious material at least several times a week. Paramedics' knowledge on transferring infection was insufficient. Paramedics with longer employment time and better professional experience suffered fewer injuries with used needles/medical tools (p = 0.079). Most frequently reported factors that prevented the use of personal protective equipment were emergency situations (19.5%), skin irritations and contact allergies (19%) and, in the case of protective gloves, reduced manual dexterity (16%). In total, 82% of paramedics were concerned about the risk of being infected with HIV, HBV or HCV as a result of performing their job. In total, 97% of paramedics behaved more carefully while caring for infected patients. In total, 90% of the paramedics never refrained from performing the specific procedures necessary to help the patient whom they knew to be infected; (4) Conclusions: Despite the paramedics' insufficient theoretical knowledge about the risk of blood-borne infections, the emphasis in the training of future paramedics should be on classes perfecting practical skills, because growing experience significantly reduces the risk of injury.

Knowledge and Attitudes of Dentists with Respect to the Risks of Blood-Borne Pathogens-A Cross-Sectional Study in Poland.

Background: To analyze dentists' knowledge of blood-borne infections, their attitudes towards infected patients, and to determine the frequency of the contact with infectious material; Methods: We surveyed 192 dentists using an anonymous questionnaire. Results: Only a quarter of dentists responded correctly to all questions. 96% of the examined dentists confirmed that they were more cautious during treatment of patients with HBV, HCV and HIV. 25% of all respondents refuse to help infected patients due to concerns about their own health. The dentists occasionally removed protective clothing to make it "easier" to perform specific procedures. The dentists experienced contact with infectious material most frequently by splashes onto the conjunctiva or as a result of superficial injuries. The risk of injury by a medical tool increased with the years of employment. Re-capping needles was associated with an increased risk of injury; Conclusions: Despite the widespread tolerance of people infected with blood-borne viruses and the well-proven low infection risk to medical personnel, dentists continue to be prejudiced and concerned about their own health and may refuse to treat infected patients. It may be assumed that the proportion of refusing treatment is even greater. This attitude should imply the implementation of training in the field of pathogen transmission and the real risk of infection.