COVID-19 in the Czech Republic 2020 and 2021: comparative analysis of probable work-related transmission of the coronavirus SARS-CoV-2.

OBJECTIVES: The aim of the analysis was to determine the probable places of coronavirus transmission in association with the work and compare the situation between 2020 and 2021. METHODS: The work analysed data from the Information System of Infectious Diseases managed by the Institute of Health Information and Statistics of the Czech Republic in the period from March 2020 - December 2021. RESULTS: 2,483,219 COVID-19 cases were officially confirmed (732,202 during 2020 and 1,338,790 in 2021), from them 140,368 (6%) represented work-related disease, 520,830 cases (21%) work-related contact, and 1,822,021 (73%) out-of-work contact. There were identified 13 occupations with the highest incidence of COVID-19 in the observed period (458,341 cases), in descending order - clerk, machinist, teacher, craftsman, worker/agency worker, driver, sales worker/cashier, warehouse worker/expediter, nurse, manager, food worker, paramedic, and social worker. Comparing 2020 and 2021, there was a difference in the ranking of occupations by incidence of disease. In 2021, the risk of infection acquiring increased for the occupations clerk, machinist, craftsman, worker/agency worker, manager, and food worker, while it decreased for the health professions (nurse, other paramedic, physician) and for social worker; 5,514 cases of COVID-19 were recognized as an occupational disease in 2020 and 2021, from them 5,483 cases (99.4%) in the health and social care economic activity sector. CONCLUSION: The available data show probable exposures to an infectious agent (without proof of specific contact with the source of the infection), of which 27% cases of COVID-19 are related to work (cases of work-related disease and work-related contact represented together the closest relationship to work). Different relevant anti-epidemic measures in the workplace have considerable practical importance for epidemic control. The use of personal protection of the mouth and nose with respirators/muffs is essential to reduce the risk of airborne transmission.

Occupational diseases arising in the area of the Ministry of Defence in the Czech Republic and their relationship to work categorization.

OBJECTIVE: The article deals with occupational health protection and identification of health risks in the work environment of the Ministry of Defence (MoD) of the Czech Republic (CR). It focuses on the assessment of the incidence of occupational diseases (OD) in high-risk and risk-free occupational categories in the years 2010-2019 and compares them with data from the civilian sector. It identifies the differences between military staff and civilian employees of the MoD. METHODS: From the records of OD at the Department of Occupational Diseases of the Central Military Hospital in Prague, the data on acknowledged OD from the years 2010 to 2019 were obtained and then a retrospective analysis focusing on the classification of work at risk was performed. The obtained data were compared with the data from the Czech National Registry of Occupational Diseases (NROD), which are published annually by the National Institute of Public Health. RESULTS: In the years under review, 191 OD were confirmed at the area of MoD, 26% of all OD occurred in employees classified in the occupational risk category. Compared with the data in the NROD, where 50% of OD were found to have been caused by high-risk work, the incidence of OD caused by high-risk work in professional soldiers is lower. Only 1.6% of all OD occurred in professional soldiers whose work was classified as high-risk one. In civilian employees of MoD 24.6% of all OD were connected with high-risk work. On the contrary, the proportion of OD occurring in professional soldiers working in risk-free categories was 57.6%, in civilian employees of MoD was the ratio much lower - 16.2%. CONCLUSION: Work at the Ministry of Defence was not adequately categorized, therefore, in 2020 a new categorization of work was introduced, which together with preventive measures could contribute to reducing the incidence of OD at the Ministry of Defence.

COVID-19 in the Czech Republic 2020: probable transmission of the coronavirus SARS-CoV-2.

OBJECTIVES: The aim of the study was to determine the probable places of coronavirus transmission in association with the work. METHODS: The work analysed data from the Information System of Infectious Diseases managed by the Institute of Health Information and Statistics of the Czech Republic in the period March-December 2020. RESULTS: 732,202 COVID-19 cases were officially confirmed, from them 64,587 (9%) represented work-related disease, 184,384 cases (25%) work-related contact, and 483,231 cases (66%) out-of-work contact. There were identified 13 occupations with the highest incidence of COVID-19 in the observed period (42,072 cases), in descending order nurse, paramedic, teacher, machinist, clerk, social worker, physician, worker/agency worker, craftsman, policeman, manager, food worker, and miner; 150 cases of COVID-19 were recognized as an occupational disease in 2020, from them 148 cases in the health and social care economic activity sector. CONCLUSION: The available data show probable exposures to an infectious agent (without proof of specific contact with the source of the infection), of which at least one third are related to work, so different relevant anti-epidemic measures in the workplace have considerable practical importance for epidemic control.

Musculoskeletal disorders and working risk factors.

OBJECTIVES: The authors evaluate situation in the field of musculoskeletal disorders (MSDs) and working risk factors in the Czech Republic. METHODS: Analysis of selected data from the Czech National Registry of Occupational Diseases during 2008-2018, description of criteria for recognition of occupational MSDs and risk factors associated with MSDs. RESULTS: 6,152 cases of 6 selected recognized occupational musculoskeletal diseases represent 47% of all recognized occupational diseases. The main proportion formed diseases of peripheral nerves in the extremities in terms of compressive neuropathies due to long-term and stereotyped overload, diseases of tendons, tendon capsules or insertions of muscles or joints in the extremities due to long-term and stereotyped overload and diseases of peripheral nerves in the upper extremities in terms of ischaemic and compressive neuropathies due to work with vibrating tools and devices. The authors discussed decreasing trend of the exposure time in three main diagnoses and association of the incidence of MSDs with the risky work related to overload of the musculoskeletal system of the upper extremities. CONCLUSIONS: Important factors for the prevention of MSDs are directly related to the technical provision of production, the organization of work and the regime of work and rest, the length of working hours and the setting of production standards, and generally to the work related stress.

Study design, size, and adequate exposure data as the crucial aspects in cancer risk assessment and implementation of the precautionary principle.

Traditional approaches and study design in cancer epidemiology have not been very successful in identifying and evaluating adequately the potential risk and/or protective factors associated with the disease. The main reasons for the failure are often due the small study sample size, and inadequate exposure information. In this paper, issues and approaches relevant to these two challenges are discussed. Multicentre study is proposed as a way to increase study size and to mitigate criticism about meta-analysis of independent studies. A multicentre study of large cohort or case-control studies also offer an exciting opportunity to study the contribution of epigenetic events that may be associated with lifestyle and environmental risk factors for human health. Optimizing methods for exposure assessment and how to reduce exposure to misclassification represent a difficult component in epidemiological studies. A potentially useful approach for improving exposure estimation is to rely on biomarkers of exposures. An example is provided to demonstrate how biomarkers of exposures could provide valuable information in addition to exposure measurements in traditional epidemiological studies. Finally, it is argued that risk assessment and the precautionary principle should not be viewed as conflicting paradigms but, rather, as a complementary approach for developing appropriate policies to address risks posed by exposure to carcinogens and a wide spectrum of other health hazards.

Fatty acids profile, atherogenic and thrombogenic indices in freshwater fish common carp (Cyprinus carpio) and rainbow trout (Oncorhynchus mykiss) from market chain.

OBJECTIVE: The study examined the fatty acids composition and main nutrients composition in two freshwater fish species in the Czech Republic during one year. METHODS: Samples of common carp and rainbow trout were taken from a market chain during a year. All samples were homogenized and analyzed for lipid, protein, water, and ash contents. Energy value (E), sum of polyunsaturated fatty acids (PUFA), monounsaturated fatty acids (MUFA) and saturated fatty acids (SFA), atherogenic index (AI) and thrombogenic index (TI) were then calculated. RESULTS: The freshwater fish on the Czech market chain have beneficial average value content of unsaturated fatty acids, Σ MUFA+PUFA in carp is 69.46% of all fatty acids, similar average value of Σ MUFA+PUFA - 70.83% is in rainbow trout. The calculated average value of AI in carp is 0.52 (SD = 0.06), AI in rainbow trout is 0.63 (SD = 0.07), the average TI in carp is 0.63 (SD = 0.09), TI in rainbow trout is 0.49 (SD = 0.05). CONCLUSION: Freshwater fish in the Czech market chain have beneficial value of PUFA, so AI and TI indices are low in both species of analysed fish. Regular consumption of fish meat is important in the prevention of cardiovascular diseases.

The presence of fine and ultrafine particulate matter in the work environment.

This study presents the results of pilot measurement, where the exposure of fine and ultrafine particulate matter was monitored. The measurement was performed in welding workplace, where these particles are produced unintentionally. The measurement consisted of collecting information and measuring the concentration of particles in the workplace, where data collection was focused only on inhalation exposure. During welding, primarily 300 nm size particles are produced, and their concentration is strongly influenced by the welding material, type of welding and suction. The particles are amorphous in terms of morphology and contain manganese, iron and silicon, which can cause neurodegenerative diseases. Furthermore, the results indicate the importance of monitoring oral exposure.

Comparison of selected risk factors in cardiovascular diseases in two different populations of the Czech Republic.

OBJECTIVES: The aim of this work is to compare the current prevalence of selected risk factors in cardiovascular diseases in the Czech general population in a particular region with a selected population of Czech soldiers in a particular military unit. METHODS: Within medical preventive examinations, data from 684 civilians aged between 30-60 years were obtained (405 men and 279 women). Within compulsory medical preventive examinations, data from 659 soldiers from a particular military unit aged between 30-60 years were obtained (576 men and 83 women). Anthropometric parameters such as height and body weight were monitored and then used to calculate the values of Body Mass Index (BMI) and waist circumference. From biochemical parameters the following values were monitored: glycaemia, uric acid, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, ALT, and GGT. As for the demographic data, age and gender were processed. In the cohort of male soldiers a questionnaire was used to find the extent of cigarette smoking, frequency of using alcoholic drinks and performance of regular physical activities such as aerobic exercises. RESULTS: As for cardiovascular risk, assessed anthropometric parameters in monitored female age categories are statistically significantly lower (p < 0.05) in women in the Army of the Czech Republic (ACR) compared to the female civilian population. Most of the biochemical parameters also display values that indicate the female military population is healthier than the civilian in these parameters. On the other hand, assessed anthropometric parameters in monitored male age categories are statistically significantly lower (p < 0.001) in civilian men compared to the male military population. Most of the assessed biochemical parameters show statistically significant health-indicative values in the male civilian population as well. CONCLUSION: This work revealed differences in anthropometric and biochemical parameters between the examined civilian and military populations. As for cardiovascular risk, the main findings are significantly worse anthropometric and biochemical parameters in the selected male military cohort compared to the male civilian cohort.

Exposure to mercury from dental amalgam: actual contribution for risk assessment.

OBJECTIVE: Mercury dental amalgam restorations are an important source of chronic exposure to mercury in the whole population and special attention should be paid not only to occupational exposure to mercury during the preparation and administration of amalgam. The authors' report is an up-to-date contribution to the health risk assessment of mercury use in dentistry, namely occupational exposure to mercury in dentists working with dental amalgam and exposure to mercury in persons treated with amalgam dental restorations. METHODS: Determination of total mercury in samples of biological material (urine, hair) was performed during 2017 and 2018 in 50 persons by the AAS method using the mercury vapour generation technique at 254.6 nm. RESULTS: Current dental exposures based on the most recent findings do not exceed acceptable risk levels and are below the biological limit of mercury in urine valid for occupationally exposed persons (100 µg.g-1 of creatinine), namely median value was 1.48 (min. < limit of detection (LOD), max. 17.14) µg.g-1 of creatinine (40 persons), total mercury content in hair of dental personnel expressed as median value was 0.340 (min. 0.060, max.1.628) µg.g-1. In controls (10 persons) was total mercury content in urine expressed as median value 0.36 (min. < LOD, max. 2.74) µg.g-1 of creatinine, in hair was median value 0.224 (min. 0.059, max. 0.453) µg.g-1. CONCLUSIONS: Authors support opinion that amalgam fillings in the oral cavity are a permanent source of mercury for the body itself.

Alcohol, drugs and psychotropic medication at work: guidelines for medical fitness.

Alcohol and illicit drug use in the workplace is a relatively widespread but still insufficiently recognised phenomenon. The reliability of judgement and performance of workers especially undertaking safety-critical tasks must not be influenced by physical, mental and/or behavioural disturbances. It is the responsibility of a company to define and implement proper policy for managing safety risks related to the influence of alcohol, drugs and/or psychotropic medication. Occupational physicians are already involved in the process of prevention in these matters. Authors describe basic recommendations of two biggest international associations of occupational physicians in this field because workers may not perform safety-critical tasks under the influence of psychotropic substances such as alcohol, illicit drugs and psychotropic medication.

Prevalence of risk factors in cardiovascular diseases in selected population of the Czech Republic.

OBJECTIVES: The aim of the study is to describe current prevalence of selected risk factors in the Czech general population in a particular region and to compare the data with recently published results in the selected population of Czech soldiers. The work also deals with the advantages and disadvantages of methods determining overweight and obesity. METHODS: Within medical preventive examinations the data of 1,051 individuals (482 men, 569 women) were obtained. In this group anthropometric parameters such as height, body weight, Body Mass Index (BMI), and waist circumference were monitored. From biochemical parameters the following values were monitored: glycaemia, uric acid, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides. Demographic data such as age, gender and achieved education were processed. RESULTS: Average BMI values in men were in the overweight range. Monitored average BMI values in women were up to standards. Monitored anthropometric parameters significantly increased with the age of examined individuals. The highest values of BMI and waist circumference were found in the over-50 age group. Selected biochemical parameters also increased with the age of examined individuals. Education did not have significant influence on the values of selected parameters. A statistically significant positive correlation was found between the values of BMI and waist circumference. The correlation coefficient in men was r = 0.804, p < 0.001, and in women r = 0.858, p < 0.001. CONCLUSION: The work confirmed differences in anthropometric parameters between the civilian and military Czech male population due to a higher muscle mass percentage in the military population. The work also confirmed the significance of further anthropometric methods in diagnostics of overweight and obesity. The number of individuals with anthropometric and biochemical parameters out of the physiological range is increasing in the over-50 age category.

Occupational medicine and disease prevention.

Occupational medicine studies the impact of work and working conditions on the health of workers. It deals with the prevention, diagnostics, treatment, and medicolegal aspects of diseases caused or exacerbated by working conditions. This specialization comprehensively deals with relations between work and health. It prescribes procedures for building a safe and healthy working environment, handles the problem of adapting the work to the abilities of workers with regard to their physical and mental health, it is concerned about health promotion in workers, including evaluation and promotion of their working capacity, and studies the impact of work and working conditions on the occurrence of chronic non-infectious diseases, the progression of which may be significantly influenced by work and working conditions. The information obtained by studying the level of exposure to adverse factors in working settings, and their impact on the health and well-being of workers is used for setting regulatory measures aimed at ensuring health protection at work, optimization of working conditions and preservation of working capacity. Keywords: occupational medicine, risk assessment, health surveillance, disease prevention.

Pressure Pain Sensitivity: Marker for Stress Affecting General Health.

OBJECTIVE: The study examined the links between pressure pain sensitivity (PPS) measured during preventive medical examination of men, their health status and occupation. METHOD: A one year (2015-2016) convenience sampling technique was used to gain primary data from actual medical examination, health records (personal and occupational history) and pressure pain sensitivity (PPS) measured by Ull Meter equipment during preventive medical examination of 371 men of different occupations (average age 43.6±10.4 years, range 19-66 years). Measured PPS values of 60 or more indicate high PPS, contrary PPS values to 40 indicate low PPS. RESULTS: 345 men (93%) were considered healthy (without diagnosis of a disease), 26 men (7%) had positive personal history/symptoms of disease. The average of measured PPS values for the whole group was 36.6±9.5 (first measurement) and 36.7±8.5 (second, repeated measurement), suggesting a high reproducibility of the measurements (r=0.80). Decreased PPS values were measured in men without reported diagnosis of a disease compared to men with diagnosed diseases. Elevated PPS values were measured in men with symptoms of neurocirculatory asthenia (NCA) compared to asymptomatic men and also to men with different diagnosis. The group of men with other than NCA symptoms did not differ significantly in PPS values compared to group of asymptomatic men. Road drivers (177 men) did not differ significantly compared to other occupations (194 men). CONCLUSION: The increased neuropsychological load/stress is connected with increased pain sensitivity to pressure. The PPS method is objective, reliable, simple, and noninvasive evaluation of the impact of stress and may be helpful in assessing medical fitness to work.

SARS-CoV-2 wastewater surveillance in the Czech Republic: Spatial and temporal differences in SARS-CoV-2 RNA concentrations and relationship to clinical data and wastewater parameters.

This study presents the results of systematic wastewater monitoring of SARS-CoV-2 RNA and basic wastewater parameters from four different wastewater treatment plants (WWTPs) in the Czech Republic over the 2020-2022 epidemic. Two-step reverse-transcription quantitative PCR targeting genes encoding the N and Nsp12 proteins was employed to detect SARS-CoV-2 RNA loading in 420 wastewater samples. The results obtained were used to evaluate the potential of wastewater analysis for describing the epidemiological situation in cities of different sizes and determining temporal differences based on the prevailing SARS-CoV-2 variant. Strong correlations between the number of active and hospitalised COVID-19 cases in each WWTP catchment area and the concentration of SARS-CoV-2 RNA detected in the wastewater clearly demonstrated the suitability of this wastewater-based epidemiological approach for WWTPs of different sizes and characteristics, despite differences in SARS-CoV-2 variant waves, with some WWTPs showing high predictive potential. This study demonstrated on the data from the Czech Republic that targeted systematic monitoring of wastewater provides sufficiently robust data for surveillance of viral loads in sample populations, and thus contributes to preventing the spread of infection and subsequent introduction of appropriate measures.