[Psychological examinations in occupational health services: Legal regulations. Part I]. / Badania psychologiczne w sluzbie medycyny pracy ­ regulacje prawne: czesc I.

In Poland psychological assessment for the purpose of fitness-to-work certification is regulated by the law. In the majority of cases, only psychologists registered with the occupational health services are authorized to conduct the assessment procedures. In this study 32 legal documents (17 acts and 15 directives) have been analyzed to identify the most problematic issues pertaining to psychological examination and to suggest certain changes in the regulations, as well as to raise the psychologists' awareness of the legal aspects of their work. Due to the number of the topics explored, the results of the study will be published as two separate, yet related articles. The first one concentrates on the qualifications of psychologists, the examination reference process, the aim and scope of the psychological assessment, and the validity of the assessment results. In part II other issues, not directly related to the diagnostic process, will be discussed. Med Pr 2018;69(5):561-572.

[Psychological examinations in occupational health services: Legal regulations. Part II]. / Badania psychologiczne w sluzbie medycyny pracy ­ regulacje prawne: czesc II.

This paper constitutes a continuation of the critical analysis of legal aspects of psychological examinations in some group of workers. In this part the appeal procedure, documentation, costs of examinations and supervision are discussed. The analysis has shown many deficiencies in regulations related to all aspects of psychological examinations. They arise from incoherence of legal regulations and the lack of regulations of some questions. This legal standing is restricted to occupational work and adversely affects the quality of supplied services. Therefore acts of law and regulations relevant to psychological examinations for the purpose of fitness-to-work certification need necessary adjustments. According to authors it is desirable to end the legal procedure amending the act of law on a profession of psychology and the self-government of psychologists, as well as to develop and implement executive regulations. Med Pr 2018;69(6):673-684.

Evaluating the Effectiveness of New York City Health Policy Initiatives in Reducing Cardiovascular Disease Mortality, 1990-2011.

Beginning in 2002, New York City (NYC) implemented numerous policies and programs targeting cardiovascular disease (CVD) risk factors. Using death certificates, we analyzed trends in NYC-specific and US mortality rates from 1990 to 2011 for all causes, any CVD, atherosclerotic CVD (ACVD), coronary artery disease (CAD), and stroke. Joinpoint analyses quantified annual percent change (APC) and evaluated whether decreases in CVD mortality accelerated after 2002 in either NYC or the total US population. Our analyses included 1,149,217 NYC decedents. The rates of decline in mortality from all causes, any CVD, and stroke in NYC did not change after 2002. Among men, the decline in ACVD mortality accelerated during 2002-2011 (APC = -4.8%, 95% confidence interval (CI): -6.1, -3.4) relative to 1990-2001 (APC = -2.3%, 95% CI: -3.1, -1.5). Among women, ACVD rates began declining more rapidly in 1993 (APC = -3.2%, 95% CI: -3.8, -2.7) and again in 2006 (APC = -6.6%, 95% CI: -8.9, -4.3) as compared with 1990-1992 (APC = 1.6%, 95% CI: -2.7, 6.0). In the US population, no acceleration of mortality decline was observed in either ACVD or CAD mortality rates after 2002. Relative to 1990-2001, atherosclerotic CVD and CAD rates began to decline more rapidly during the 2002-2011 period in both men and women-a pattern not observed in the total US population, suggesting that NYC initiatives might have had a measurable influence on delaying or reducing ACVD mortality.

[History of mandatory (set by decree) preliminary and periodic medical examinations of workers in hazardous work conditions].

The article deals with over a hunderd years history of foundation and pregress in organization and process of mandatory preliminary and periodic medical examinations of workers exposed to hazardous work conditions.

[Problems of practical implementation of legislation basis in organizing and conducting preliminary and periodic medical examinations of workers].

The article deals with problems of implementation of legislation documents in federal medicine, education, purchases for governmental and municipal needs. The authors analyzed and summarized main problems in organizing and conducting preliminary and periodic medical examinations of workers (exemplified by decreed communities in government-financed establishments).

[Contemporary reforms and optimization of medical examination committees in Russian Railways JSC].

The authors considered problems of restructurization and organization of medical examination committees in Russian Railways JSC, and their interlevel interactions. Detailed specification included documents circulation, order and terms of medical examination. Principles of conclusion on occupational fitness examination are specified. The article covers tasks of further development of occupational medical examination work in trade occupational medicine.

[General background and practical implementation of the health management service institution in Korea].

The Korean Occupational Safety and Health Act requires an employer with more than 50 employees to assign a health manager or an occupational physician. However, there are many cases where it is difficult for medium-scale enterprises to perform occupational health practices autonomously because their financial base is weaker than that of large-scale enterprises. The Korean Occupational Safety and Health Act was amended in 1990 so that medium-scale enterprises could entrust a health management service institution with their health management tasks. This system is similar to the outsourcing of medical examinations, occupational physicians, or the measurement of the working environment in Japan, but its legal background and actual activities are korea-specific, and it has some different points. In particular, the quality control of health management service institutions by legal and administrative regulations, and the multidisciplinary provision of services contribute to the development of occupational health in medium-scale enterprises. This will be a good reference for occupational health services in small- and medium-scale enterprises in the future in Japan.

[Occupational health services as the insurance product and insurance economic instruments]. / Swiadczenia medycyny pracy jako produkt ubezpieczeniowy i ubezpieczeniowe instrumenty ekonomiczne.

BACKGROUND: One of the most controversial issues in restructuring the Polish health insurance system is the implementation of private voluntary insurance and creation within it a new insurance product known as occupational health services (OHS). In this article some opportunities and dilemmas likely to be faced by providers and employers/employees, when contracting with insurance institutions, are considered as a contribution to the discussion on private insurance in Poland. The basic question is how private insurance institutions could influence the promotion of different preventive activities at the company level by motivating both OHS providers and employers. MATERIAL AND METHODS: The descriptive qualitative method has been applied in the analysis of legal acts, scientific publications selected according to keywords (Pubmed), documents and expert evaluations and research project results. RESULTS: Taking into account the experiences of European countries, described in publications, international experts' opinions and results of research projects the solution proposed in Poland could be possible under the following several prerequisites: inclusion of a full scope of occupational health services into the insurance product, constant supervision of occupational medicine professionals, monitoring of the health care quality and the relations between private insurers and OHS provider and implementation of the economic incentives scheme to ensure an adequate position of OHS providers on the market. CONCLUSIONS: The proposed reconstruction of the health insurance system, comprising undoubtedly positive elements, may entail some threats in the area of health, organization and economy. Private voluntary health insurance implementation requires precisely defined solutions concerning the scope of insurance product, motivation scheme and information system.

[Occupational lung diseases caused by exposure to chrysotile asbestos dust and the preventive measures].

To reveal major principles in system of occupational lung diseases prevention among workers engaged into extraction and usage of chrysotile asbestos, the authors specified main criteria for diagnosis of asbestos-related pulmonary diseases and signs of exposure to chrysotile dust, with identification of risk groups for occupational diseases development. The authors formulated main principles of prevention and rehabilitation for workers with asbestos-related pulmonary diseases. Special attention was paid to harmonization of all medical and technical measures aimed at prevention and liquidation of occupational asbestos-related diseases.

[The occupational physician in France].

The French Labor law defines the role and its allocation criteria of the occupational physician (OP) the same as in Japan. In France, occupational medicine is one of the medical specialties. The OP resident must follow the 4 years clinical training before certification. After having finished their residency, they are entitled to work for the occupational health service office of a company or company association (in the case of small and medium sized companies). The most important characteristics of the French system is that they cover all workers regardless of company size. The main role of the OP is prevention of work related diseases and accidents. They are not allowed to do clinical services except for emergency cases. Their main activities are health examinations, health education, patrol and advice for better working condition. Formerly, it was rather difficult to attract the medical students for OP resident course because of its prevention oriented characteristics. A growing concern about the importance of health management at the work site, however, has changed the situation. Now, the number of candidates for OP resident course is increasing. Their task has expanded to cover mental health and other life style related diseases. The 2011 modification of law redefines the role of the OP as a director of an occupational health service office who has a total responsibility of multidisciplinary services. The French and Japanese occupational health systems have many of similarities. A comparative study by researchers of UOEH is expected to yield useful information.

[Legislation concerning alcohol and drug intake in the workplace]. / Regulacje prawne dotyczace konsumpcji alkoholu i narkotyków w pracy.

It is likely that the complex law concerning alcohol and drugs in the workplace is one of the reasons for unwillingness to resolve the problem of intake of such psychoactive substances by employees. 'Iherefore, the author made an attempt to depict Polish legislation in this field based on the review of legal acts and regulations, as well as on their extensive judiciary interpretation. Such an information can be used by employers in developing their workplace policy of diminishing the intake of psychoactive substances by employees. This information can also be helpful for the bodies supporting workplaces in solving problems derived from alcohol and drugs consumption, such as occupational medicine specialists and local governments.

[Reformation of occupational health in France: state of the problem and new law].

The state of the problem and new law of France No 2011-867 on occupational health organization and two decrees are described. These introduce services of health at work mainly with prophylactic tasks and whose functions are performed by interdisciplinary teams including doctors, assistants and specialists on occupational risk prevention. The documents are based on ILO Convention No 161 "Occupational health services".

[Comparative analysis of occupational health services practice of international companies of oil and gas industry and ILO Convention "Occupational Health Services"].

A comparative analysis of current work practices of occupational health services of international companies of Russian oil & gas industry and provisions of ILO Convention 161 and Recommendation 171 "Occupational Health Services" has been carried out. Proposals for improvement and harmonization of labor legislation related to this problem have been formulated.

[Development of social hygienic research in industrial medicine].

The article covers history of establishment and development of social hygienic research in Industrial Medicine Research Institute with RAMSc over last 90 years. The materials deal with founders and leaders of Social Hygienic research laboratory in various periods, with history of occupational morbidity studies, with development and results of social hygienic studies, organization of occupational therapy service in Russia, studies concerning remote effects of occupational hazards through analytic epidemiology methods, with considerably restricted possibilities in studies of relationships (especially remote) between work conditions and workers' health nowadays due to implemented law on personal data and new approaches to evaluation of industrial hazards effects on health.

[Migrant vaccinations in Poland]. / Szczepienia ochronne migrantów w Polsce.

After the European Union accession in 2004, Poland has been perceived by foreigners as an attractive destination of their migration, and also as a popular transit country for people going further to the Western Europe countries. The Nofer Institute of Occupational Medicine is involved in the implementation of the international project PROMOVAX (Promote Vaccinations among Migrant Populations in Europe). The objective of the project is to promote immunizations among migrant populations in Europe. This article presents the up-to-date legal regulations that are effective in Poland, taking into account their relevance to the issue of vaccinations in migrant population. The analysis of the Polish legislation concerning this problem shows that there are no specific regulations addressed to migrant population staying in our country. This issue seems to be popular in the European Union, where immunization of migrants is given high priority. From the point of view of health care professionals it is important to be aware of the fact that EU open borders favor the increased flow of people between countries. The scale of migration from outside the EU to its member states also contributes to the increase in potential contacts between health care workers and migrants working in Poland.

[Occupational health and early detection of depression].

The Ministry of Health, Labor and Welfare is planning to conduct a stress check for employees, using the opportunity of the periodical health check. In this paper, the author summarizes some problems with the plan, and refers to the meaning of detecting mental disorders in the workplace. Just like psychiatric treatment and other mental health activities, occupational mental health should be discussed from the historical point of view, excluding shortsighted judgment and improvised measures.

Managing the risks of on-site health centers.

This review sought to assess compliance concerns, determine risk management strategies, and identify opportunities for future research to contribute to employers' understanding of the laws and regulations that apply to on-site care. A comprehensive review of databases, professional organizations' websites, and journals resulted in 22 publications reporting on the consequences of noncompliance among on-site health centers accepted for inclusion. None of those studies reported a study design or quantifiable outcome data. Two noncompliance themes were repeated among the publications. First, direct penalties included fines, civil actions, loss of licensure, and, potentially, criminal charges. Second, noncompliance also resulted in indirect costs such as employee mistrust and lowered standards of care, which jeopardize on-site health centers' ability to demonstrate a return on investment. Further research with rigorous methodology is needed to inform employer decisions about on-site health services and associated risk management.

[Regulation and methodic background for safe controlled usage of chrysotile asbestos in Russia].

The article covers main results of regulation and methodic background for safe controlled usage of chrysotile asbestos in Russia. The authors consider that now Russian Federation has contemporary regulation and methodic background aimed to safe, controlled and responsible usage of chrysotile asbestos. The background covers all stages of complete industrial cycle of chrysotile from its extraction to utilization.

Prevalence and utilization of company integration management in Germany: Results of the 2018 BiBB/BAuA survey of employed persons.

OBJECTIVES: This secondary analysis aims to investigate the implementation of the legally required company integration management ("BEM") in case of an incapacity for work of at least six weeks and to identify predictors. METHODS: Database is the representative randomized 2018 BIBB/BAuA Employment Survey of 20 012 employed persons in Germany. RESULTS: Of the 1367 employees entitled to company integration management, 40% received an offer from their employer and 27% accepted it. In the public sector, half of those who were entitled reported an offer. Among those entitled to company integration management, employees under the age of 30, at risk of dismissal, or with fixed-term employment contract received an offer particularly rarely. Entitled employees with disabilities or in companies with works/staff councils received disproportionately often an offer of company integration management. Logistic regression analyses reveal strong associations between company integration management offer and the duration of incapacity to work. The probability of receiving an offer is almost halved for those entitled in medium-sized compared to small companies. The higher the level of educational qualification, the higher are odds ratios for an offer. In companies in which employees were less or not satisfied with their work overall, the chance of a company integration management offer is significantly reduced almost by half. The chance of an offer is more than three times higher in companies with workplace health promotion compared to those without. CONCLUSIONS: Only a minority of eligible employees received an offer that is closely associated with health-promoting corporate culture and job satisfaction.

Management system of occupational diseases in Korea: statistics, report and monitoring system.

The management system of occupational diseases in Korea can be assessed from the perspective of a surveillance system. Workers' compensation insurance reports are used to produce official statistics on occupational diseases in Korea. National working conditions surveys are used to monitor the magnitude of work-related symptoms and signs in the labor force. A health examination program was introduced to detect occupational diseases through both selective and mass screening programs. The Working Environment Measurement Institution assesses workers' exposure to hazards in the workplace. Government regulates that the employer should do health examinations and working conditions measurement through contracted private agencies and following the Occupational Safety and Health Act. It is hoped that these institutions may be able to effectively detect and monitor occupational diseases and hazards in the workplace. In view of this, the occupational management system in Korea is well designed, except for the national survey system. In the future, national surveys for detection of hazards and ill-health outcomes in workers should be developed. The existing surveillance system for occupational disease can be improved by providing more refined information through statistical analysis of surveillance data.