[Ergonomics and organization of remote work - health aspect and recommendations for home office organization]. / Ergonomia i organizacja pracy zdalnej ­ aspekt zdrowotny i zalecenia dotyczace organizacji biura domowego.

Analyses of the economic activity of the Polish population indicate that in 2023, about 7% of all employees performed, usually or sometimes, their work in the form of remote work. The purpose of this publication is to analyze the impact of working with screen-monitor devices on computer vision syndromes, musculoskeletal disorders, circadian rhythm, and to identify recommendations for the proper organization of the home office. A narrative review of the existing literature on the impact of work with the use of devices equipped with screen monitors on the health of employees was performed, as well as recommendations in the above-mentioned area were presented. The most important factors determining the load on the visual organs and musculoskeletal system and affecting the overall health and well-being of employees during remote work are the proper arrangement of the workstation (in accordance with ergonomic principles) and the organization of work (limiting the time spent working at the computer/laptop, systematic active breaks) and healthy sleep habits. It is crucial that both employers, occupational health professionals and employees themselves are aware of the importance to their health of correct preparation of the home office, and have adequate knowledge in this regard. Med Pr Work Health Saf. 2024;75(1):69-80.

Distribution of sleep components while working remotely.

OBJECTIVES: The circadian system is the main regulator of almost all human physiological processes. The aim of this study was to assess sleep in the working population, in relation to the share of remote working. MATERIAL AND METHODS: An online survey was conducted among students and staff representing 3 universities in Lódz, Poland (N = 1209). The participants were divided into 3 groups according to the percentage of time they worked remotely. Group I consisted of respondents performing tasks remotely for ≤45% of their working time; group II included respondents performing their duties remotely for >45-75% of their working time, and group III included those working >75% of their time remotely. RESULTS: performing their duties remotely for >45-75% of their working time, and group III included those working >75% of their time remotely. Results: In the study, the authors found the association between the length of time spent on a computer, the percentage of time working remotely, and the occurrence of physical symptoms and the prevalence of sleep disorders. The most significant difference between working days and days off in terms of the mid-point of sleep (1.5 h) was observed in group I, where there was the greatest variability in the form of work performance. The participants who worked most of their time remotely (group III) shifted their bedtime to midnight, both on working days and on days off. CONCLUSIONS: The study highlights that increased remote computer use leads to a shift in sleeping patterns towards midnight. The participants with later midpoint of sleep hours were found to have a higher incidence of sleep disorders. The prevalence of sleep disorders was significantly impacted by prolonged mobile phone use before bedtime and long hours of computer use. Thus, limiting both the time spent in front of a computer and the use of mobile phones before bedtime is recommended. Int J Occup Med Environ Health. 2024;37(1):34-44.

Relationship between prenatal and postnatal exposure to BPA and its analogues (BPS, BPF) and allergic diseases.

Bisphenols, endocrine disrupting chemicals, are widely used in daily life. Continued exposure during key developmental periods of life (pregnancy, infancy and early childhood) can contribute to adverse health consequences such as decreased lung function, wheezing/asthma, the occurrence of allergies or changes in immune system responses. The purpose of this review is to present the current state of knowledge on the effects of prenatal or postnatal exposure to bisphenol A (BPA), bisphenol S (BPS) and bisphenol F (BPF) on the development of allergic diseases in childhood. A com- prehensive and systematic search of PubMed, Scopus and Web of Science databases was conducted. The review is restricted to studies published since 2015, in English in peer-reviewed journals. Based on keywords, 2648 studies were identified and reviewed for eligibility. Finally, 8 epidemio- logical studies were found to be appropriate for inclusion in this publication. The data collected in this review suggests that there is an associa- tion between maternal exposure during pregnancy or childhood to BPA and the development of allergic diseases. Most studies reported positive relationships between BPA exposure and at least one of the types of allergic disease. The paucity of studies and the observed differences in findings regarding the association between prenatal/postnatal exposure to BPS and/or BPF do not allow firm conclusions to be drawn. Further research is needed to identify the vulnerable population and the mechanisms responsible for the development of undesirable health consequences. Int J Occup Med Environ Health. 2023;36(5):575-86.

Instrumental and Non-Instrumental Measurements in Patients with Peripheral Vestibular Dysfunctions.

Vestibular dysfunction is a disturbance of the body's balance system. The control of balance and gait has a particular influence on the quality of life. Currently, assessing patients with these problems is mainly subjective. New assessment options using wearables may provide complementary and more objective information. Posturography makes it possible to determine the extent and type of posture dysfunction, which makes it possible to plan and monitor the effectiveness of physical rehabilitation therapy. This study evaluates the effectiveness of non-instrumental clinical tests and the instrumental mobile posturography MediPost device for patients with unilateral vestibular disorders. The study group included 40 patients. A subjective description of the symptoms was evaluated using a questionnaire about the intensity of dizziness using the Dizziness Handicap Inventory (DHI) and Vertigo Syndrome Scale-short form (VSS-sf). The clinical protocol contained clinical tests and MediPost measurements using a Modified Clinical Test of Sensory Interaction on Balance. All patients underwent vestibular rehabilitation therapy (VRT) for four weeks. The non-instrumental measurement results were statistically significant, and the best was in the Timed Up and Go test (TUG). In MediPost, condition 4 was the most valuable. This research demonstrated the possibilities of using an instrumental test (MediPost) as an alternative method to assess balance.

[The influence of working/learning remotely on the prevalence of musculoskeletal complaints in a group of university staff and students]. / Wplyw pracy/nauki zdalnej na wystepowanie dolegliwosci miesniowo-szkieletowych w grupie pracowników i studentów uczelni wyzszych.

BACKGROUND: The COVID-19 pandemic has led to a fundamental change in the lifestyle and the ways of learning and working patterns which in turn might lead to health consequences including musculoskeletal disorders. The aim of this study was to evaluate the conditions of e-learning and remote working and the impact of the learning/working modality on the occurrence of musculoskeletal symptoms among university students and workers in Poland. MATERIAL AND METHODS: This study covered 914 students and 451 employees who filled in an anonymous online questionnaire. The questions covered 2 periods: before the COVID-19 pandemic and during the period from October 2020 to June 2021 and were aimed at obtaining information about lifestyle (including physical activity, perceived stress and sleep pattern), ergonomic of computer workstations, the incidence and severity of musculoskeletal symptoms and headaches. RESULTS: During the outbreak, the severity of musculoskeletal complaints increased significantly in the teaching staff group (3.2±2.5 vs. 4.1±3.0 VAS pts), in the administrative staff group (3.1±2.5 vs. 4.0±3.1 VAS pts), and in the student group (2.8±2.4 vs. 3.5±2.8 VAS pts). The average level of burden and risk of musculoskeletal complaints was revealed by the assessment using the ROSA method, in all 3 study groups. CONCLUSIONS: In light of current results, it is very important to educate people on the rational use of new technology devices, including the appropriate design of computer workstations, planning breaks and time for recovery and physical activity. Med Pr. 2023;74(1):63-78.

Ergonomics of E-Learning Workstations and the Prevalence of Musculoskeletal Disorders-Study among University Students.

The prevalence of musculoskeletal disorders (MSD) has increased significantly in recent years. The COVID-19 pandemic has led to a fundamental change in the lifestyles, ways of learning and working patterns of the general population, which in turn, might lead to health consequences. The aim of this study was to evaluate the conditions of e-learning and the impact of the learning modality on the occurrence of musculoskeletal symptoms among university students in Poland. This cross-sectional study included 914 students who completed an anonymous questionnaire. The questions covered two time periods (before and during the COVID-19 pandemic) and were aimed at obtaining information about lifestyle (including physical activity using the modified International Physical Activity Questionnaire, 2007 (IPAQ), perceived stress and sleep patterns), the ergonomics of computer workstations (by Rapid Office Strain Assessment, 2012 (ROSA) method), the incidence and severity of musculoskeletal symptoms (by the Nordic Musculoskeletal Questionnaire, 2018 (NMQ)) and headaches. The main differences between the two periods were statistically significant according to the Wilcoxon test in terms of physical activity, computer use time, and severity of headaches. During the COVID-19 pandemic, there was a significant increase in MSD (68.2% vs. 74.6%) and their intensity (2.83 ± 2.36 vs. 3.50 ± 2.79 points) among the student population (p < 0.001). In the group of students with MSD, there was a high musculoskeletal load, due to the lack of ergonomic remote learning workstations. In future, a thorough study should be carried out, and there is an urgent need to raise students' awareness of arranging learning workstations according to ergonomic principles in order to prevent the occurrence of musculoskeletal problems.

REPRO_PL-Polish Mother and Child Cohort-Exposure, Health Status, and Neurobehavioral Assessments in Adolescents-Design and Cohort Update.

Early life is a crucial window of opportunity to improve health across the life course. The prospective cohort study design is the most adequate to evaluate the longitudinal effects of exposure, the notification of changes in the exposure level and evaluation of the simultaneous impact of various exposures, as well as the assessment of several health effects and trajectories throughout childhood and adolescence. This paper provides an overview of the Polish Mother and Child cohort (REPRO_PL), with particular emphasis on Phase IV of this study. REPRO_PL is conducted in central Europe, where such longitudinal studies are less frequently implemented. In this population-based prospective cohort, which was established in 2007, three phases covering pregnancy (I), early childhood (II), and early school age (III) periods have already been completed. Phase IV gives a uniform opportunity to follow-up children during adolescence in order to evaluate if the consequences of prenatal and early postnatal exposures still persist at the age of 14. Moreover, we will be able to investigate the associations between simultaneous exposures to a broad spectrum of environmental factors, adolescents' health and neurobehavioral outcomes, and their trajectories within life, which is a novel framework of high scientific, public health and clinical priority.

Innovative System for Evaluation and Rehabilitation of Human Imbalance.

<b>Introduction:</b> Mobile posturography is based on wearable inertial sensors; it allows to test static stability (static posturography) and gait disturbances. </br> </br> <b>Aim:</b> The aim of this work was to present the results of research on the innovative MEDIPOST system used for diagnosis and rehabilitation of balance disorders. </br> </br> <b>Material and methods:</b> Fourteen articles published in influenced foreign journals were presented and discussed. The deve-lopment and construction of the device was preceded by a literature review and methodological work. The Dizziness Handi-cap Inventory (DHI) questionnaire was translated and validated. The methodology of posturography with head movements with a frequency of 0.3 Hz was also developed in the group with chronic vestibular disorders. Simultaneous measurements were performed (static posturogrphy vs. MEDIPOST) in the CTSIB-M (Modified Clinical Test of Sensory Interaction in Balance) test in healthy subjects and patients with unilateral peripheral dysfunction.</br> </br> <b>Results:</b> In the posturography with head movements the improvement of sensitivity (67 to 74%) and specificity (65 to 71%) was noted. In the CTSIB-M test the intraclass correlation coefficients for both methods were 0.9. The greatest differences between examinations were observed for the mean angular velocity in the tests on the foam (trials no. 3 and 4), in particular on the foam with eyes closed (trial no. 4 - sensitivity 86.4%, specificity 87.7%). Two functional tests were analyzed: the Swap Seats test and the 360 degree turn test. In the former, the results are studied from 6 sensors - 86% of the true positives and 73% of the true negatives for the fall/ no-fall group classification. The second test differentiates people with vestibular impairment and healthy people. It can be analyzed with 1 (sensitivity 80%) and 6 sensors (sensitivity 86%, specificity 84%). Currently, the MEDIPOST device is in the development and certification phase.

Detection of balance disorders using rotations around vertical axis and an artificial neural network.

Vestibular impairments affect patients' movements and can result in difficulties with daily life activities. The main aim of this study is to answer the question whether a simple and short test such as rotation about a vertical axis can be an objective method of assessing balance dysfunction in patients with unilateral vestibular impairments. A 360˚ rotation test was performed using six MediPost devices. The analysis was performed in three ways: (1) the analytical approach based only on data from one sensor; (2) the analytical approach based on data from six sensors; (3) the artificial neural network (ANN) approach based on data from six sensors. For approaches 1 and 2 best results were obtained using maximum angular velocities (MAV) of rotation and rotation duration (RD), while approach 3 used 11 different features. The following sensitivities and specificities were achieved: for approach 1: MAV-80% and 60%, RD-69% and 74%; for approach 2: 61% and 85% and RD-74% and 56%; for approach 3: 88% and 84%. The ANN-based six-sensor approach revealed the best sensitivity and specificity among parameters studied, however one-sensor approach might be a simple screening test used e.g. for rehabilitation purposes.

[Use of the posturography in balance system evaluation in occupational medicine]. / Zastosowanie posturografii dla oceny ukladu równowagi dla potrzeb medycyny pracy.

BACKGROUND: The posturography test allows assessment of the entire function of balance system and quantitative, device-based verification of the clinical Romberg test. Therefore, the aim of this study is assessment of usefulness of posturography as primary test for balance disorders in occupational medicine. MATERIAL AND METHODS: The study is cross-sectional, analyzing anonymous results of 1030 patients reporting dizziness and balance disorders. Based on symptoms, clinical examination and videonystagmography patients were classified into subgroups: benign paroxysmal positional vertigo (BPPV [N = 130]), non compensated (NS [N = 82]) and compensated (S [N = 174]) peripheral vestibular, bilateral vestibular (BV [N = 63]), Ménière's disease (MD [N = 53]), central dizziness (central [N = 293]), migraine (migr. [N = 132]), psychogenic dizziness (psychog. [N = 232]), Persistent postural-perceptual dizziness (PPPD [N = 150]). Besides, 129 healthy people were included in the study. RESULTS: Ninety nine percent of abnormal static posturography (SP) and 94% of abnormal dynamic posturography (PD) results were found in diseased patients. Normal results were found both in healthy group (59% PS, 67% PD) and in diseased group (24% PS, 31% PD). Static posturography's abnormal results were more frequent in NS, BV and PPPD patients. In PD the differences were visible in the central, psychog. and PPPD subgroups. In NS subgroup the high negative predictive values of static and dynamic tests (82-87%) were calculated in relation to caloric test. CONCLUSIONS: Static tests are the basic test used in examinations of employees for occupational medicine purposes. Posturography is a quantitative record of sways in relation to normative values. Abnormal posturography results most likely indicate the presence of pathologies of the balance system, including psychofunctional disorders. Normal posturography results do not indicate the lack of pathology of balance system what should be included in the work ability assessment. Med Pr. 2022;73(2):143-50.

Utility of the Novel MediPost Mobile Posturography Device in the Assessment of Patients with a Unilateral Vestibular Disorder.

Balance disorders are a growing problem worldwide. Thus, there is an increasing need to provide an inexpensive and feasible alternative to standard posturographic platforms (SP) used for the assessment of balance and to provide a possible solution for telemonitoring of patients. A novel mobile posturography (MP) MediPost device was developed to address these issues. This prospective study used a Modified Clinical Test of Sensory Interaction on Balance to evaluate healthy individuals and patients with a unilateral vestibular disorder through SP and MP simultaneously. The control group included 65 healthy volunteers, while the study group included 38 patients diagnosed with a unilateral vestibular deficit. The angular velocity values obtained from both methods were compared by intraclass correlation coefficients (ICC) and Bland−Altman plot analysis. Diagnostic capabilities were measured in terms of sensitivity and specificity. The ICC between the two methods for conditions 2−4 was indicative of excellent reliability, with the ICC > 0.9 (p < 0.001), except for Condition 1 (standing stance, eyes open) ICC = 0.685, p < 0.001, which is indicative of moderate reliability. ROC curve analysis of angular velocity for condition 4 represents the most accurate differentiating factor with AUC values of 0.939 for SP and 0.953 for MP. This condition also reported the highest sensitivity, specificity, PPV, and NPV values with 86.4%, 87.7%, 80%, and 90.5% for SP, and 92.1%, 84.6%, 77.8%, and 94.8% for MP, respectively. The newly developed MediPost device has high sensitivity and specificity in distinguishing between healthy individuals and patients with a unilateral vestibular deficit.

A comparison of head movements tests in force plate and accelerometer based posturography in patients with balance problems due to vestibular dysfunction.

This study compares HS posturography on inertial sensors (MediPost) with force platform posturography in patients with unilateral vestibular dysfunction. The study group included 38 patients (age 50.6; SD 11.6) with unilateral vestibular weakness (UV) and 65 healthy volunteers (48.7; SD 11.5). HS tests were performed simultaneously on the force plate and with MediPost sensor attached at L4. Four conditions applied: eyes open/closed, firm/foam. The tests were performed twice, with the head moving at the frequency of 0.3 Hz (HS 0.3) and 0.6 Hz (HS 0.6). Mean sway velocity was significantly lower for MediPost than force plate in 4th condition both in UV and healthy group. For HS 0.3 the differences between devices were marginal; the highest sensitivity (87%) and specificity (95%) were in 4th condition. For HS 0.6 MediPost revealed lower sensitivity than force plate although the surface parameter improved results. MediPost IMU device and force platform posturography revealed a similar ability to differentiate between patients with balance problems in course of vestibular pathology and healthy participants, despite the differences observed between measuring methods. In some tests surface parameter may be more appropriate than sway velocity in improving MediPost sensitivity.

Fully Automatic Fall Risk Assessment Based on a Fast Mobility Test.

This paper presents a fall risk assessment approach based on a fast mobility test, automatically evaluated using a low-cost, scalable system for the recording and analysis of body movement. This mobility test has never before been investigated as a sole source of data for fall risk assessment. It can be performed in a very limited space and needs only minimal additional equipment, yet provides large amounts of information, as the presented system can obtain much more data than traditional observation by capturing minute details regarding body movement. The readings are provided wirelessly by one to seven low-cost micro-electro-mechanical inertial measurement units attached to the subject's body segments. Combined with a body model, these allow segment rotations and translations to be computed and for body movements to be recreated in software. The subject can then be automatically classified by an artificial neural network based on selected values in the test, and those with an elevated risk of falls can be identified. Results obtained from a group of 40 subjects of various ages, both healthy volunteers and patients with vestibular system impairment, are presented to demonstrate the combined capabilities of the test and system. Labelling of subjects as fallers and non-fallers was performed using an objective and precise sensory organization test; it is an important novelty as this approach to subject labelling has never before been used in the design and evaluation of fall risk assessment systems. The findings show a true-positive ratio of 85% and true-negative ratio of 63% for classifying subjects as fallers or non-fallers using the introduced fast mobility test, which are noticeably better than those obtained for the long-established Timed Up and Go test.

Posturography with head movements in the assessment of balance in chronic unilateral vestibular lesions.

The aim of our study was to validate the method of head-shake static posturography (HS-posturography) in healthy individuals and to establish the value of this novel method in the diagnostics of patients with unilateral vestibular lesion (UV). The study included 202 participants divided into two groups, one consisting of 133 patients with canal paresis CP > 19% and one of 69 healthy subjects. Participant was tested according to the standard protocol of static posturography (SP), and with head movements of 0.3 Hz (HS 40), 0.6 Hz (HS 70) in random order controlled by a metronome. HS-posturography revealed a similar repeatability and internal consistency as the standard posturography. In patients with UV, 4th condition revealed higher sensitivity (74%) and specificity (71%) in HS 40 than in the standard posturography (67%, 65% respectively) and HS 70 (54%, 70% respectively). Static posturography and HS- posturography revealed a high reliability of the testing method. The head movements added to static posturography improve the sensitivity and specificity of the method in group with vestibular impairment. The most important test for that purpose seems to be the one on unstable surface with the eyes closed, with low frequency of head movements.