Diagnostic Accuracy of Specific IgE Against Wheat and Rye in Flour-Induced Occupational Asthma.

BACKGROUND: Assessment of IgE-mediated sensitization to flour allergens is widely used to investigate flour-induced occupational asthma. The diagnostic efficiency of detecting specific IgE antibodies (sIgE) against wheat and rye flour, however, has not been thoroughly compared to other diagnostic procedures. OBJECTIVE: We sought to evaluate the diagnostic accuracy of sIgE against wheat and rye compared to specific inhalation challenge (SIC) with flour as the reference standard. METHODS: This retrospective multicenter study included 264 subjects who completed a SIC with flour in eight tertiary centers, of whom 205 subjects showed a positive SIC result. RESULTS: Compared with SIC, sIgE levels ≥0.35 kUA/L against wheat and rye provided similar sensitivities (84%-85%, respectively), specificities (71%-78%), positive predictive values (91%-93%), and negative predictive value (56%-61%). Increasing the threshold sIgE value to 5.10 kUA/L for wheat and to 6.20 kUA/L for rye provided a specificity ≥95% and further enhanced the positive predictive value to 98%. Among subjects with a positive SIC, those who failed to demonstrate sIgE against wheat and rye (n=26) had significantly lower total serum IgE level and blood and sputum eosinophil counts, and a lesser increase in post-challenge fractional exhaled nitric oxide as compared to the subjects with detectable sIgE. CONCLUSION: High levels of sIgE against wheat and/or rye flour strongly support a diagnosis of flour-induced occupational asthma without the need for performing a SIC. The absence of detectable sIgE against wheat and rye in subjects with a positive SIC seems to be associated with lower levels of TH2 biomarkers.

EAACI guidelines on environmental science for allergy and asthma: The impact of short-term exposure to outdoor air pollutants on asthma-related outcomes and recommendations for mitigation measures.

The EAACI Guidelines on the impact of short-term exposure to outdoor pollutants on asthma-related outcomes provide recommendations for prevention, patient care and mitigation in a framework supporting rational decisions for healthcare professionals and patients to individualize and improve asthma management and for policymakers and regulators as an evidence-informed reference to help setting legally binding standards and goals for outdoor air quality at international, national and local levels. The Guideline was developed using the GRADE approach and evaluated outdoor pollutants referenced in the current Air Quality Guideline of the World Health Organization as single or mixed pollutants and outdoor pesticides. Short-term exposure to all pollutants evaluated increases the risk of asthma-related adverse outcomes, especially hospital admissions and emergency department visits (moderate certainty of evidence at specific lag days). There is limited evidence for the impact of traffic-related air pollution and outdoor pesticides exposure as well as for the interventions to reduce emissions. Due to the quality of evidence, conditional recommendations were formulated for all pollutants and for the interventions reducing outdoor air pollution. Asthma management counselled by the current EAACI guidelines can improve asthma-related outcomes but global measures for clean air are needed to achieve significant impact.

The impact of indoor pollution on asthma-related outcomes: A systematic review for the EAACI guidelines on environmental science for allergic diseases and asthma.

Systematic review using GRADE of the impact of exposure to volatile organic compounds (VOCs), cleaning agents, mould/damp, pesticides on the risk of (i) new-onset asthma (incidence) and (ii) adverse asthma-related outcomes (impact). MEDLINE, EMBASE and Web of Science were searched for indoor pollutant exposure studies reporting on new-onset asthma and critical and important asthma-related outcomes. Ninety four studies were included: 11 for VOCs (7 for incidenceand 4 for impact), 25 for cleaning agents (7 for incidenceand 8 for impact), 48 for damp/mould (26 for incidence and 22 for impact) and 10 for pesticides (8 for incidence and 2 for impact). Exposure to damp/mould increases the risk of new-onset wheeze (moderate certainty evidence). Exposure to cleaning agents may be associated with a higher risk of new-onset asthma and with asthma severity (low level of certainty). Exposure to pesticides and VOCs may increase the risk of new-onset asthma (very low certainty evidence). The impact on asthma-related outcomes of all major indoor pollutants is uncertain. As the level of certainty is low or very low for most of the available evidence on the impact of indoor pollutants on asthma-related outcomes more rigorous research in the field is warranted.

The impact of outdoor pollution and extreme temperatures on asthma-related outcomes: A systematic review for the EAACI guidelines on environmental science for allergic diseases and asthma.

Air pollution is one of the biggest environmental threats for asthma. Its impact is augmented by climate change. To inform the recommendations of the EAACI Guidelines on the environmental science for allergic diseases and asthma, a systematic review (SR) evaluated the impact on asthma-related outcomes of short-term exposure to outdoor air pollutants (PM2.5, PM10, NO2 , SO2 , O3 , and CO), heavy traffic, outdoor pesticides, and extreme temperatures. Additionally, the SR evaluated the impact of the efficacy of interventions reducing outdoor pollutants. The risk of bias was assessed using ROBINS-E tools and the certainty of the evidence by using GRADE. Short-term exposure to PM2.5, PM10, and NO2 probably increases the risk of asthma-related hospital admissions (HA) and emergency department (ED) visits (moderate certainty evidence). Exposure to heavy traffic may increase HA and deteriorate asthma control (low certainty evidence). Interventions reducing outdoor pollutants may reduce asthma exacerbations (low to very low certainty evidence). Exposure to fumigants may increase the risk of new-onset asthma in agricultural workers, while exposure to 1,3-dichloropropene may increase the risk of asthma-related ED visits (low certainty evidence). Heatwaves and cold spells may increase the risk of asthma-related ED visits and HA and asthma mortality (low certainty evidence).

Recognition COVID-19 as an occupational disease in Poland - definition, criteria and recommendation.

A major challenge over the pandemic period was to establish the criteria for recognizing COVID-19 as an occupational disease. The European Center for Disease Prevention and Control has attempted to estimate the incidence of COVID-19 in individual occupational groups and economy sectors in the European Union and the United Kingdom, and to identify possible factors increasing the transmission of the virus at workplaces. Legal regulations of various countries in the world allow COVID-19 to be recognized as an accident at work and/or an occupational disease. In Poland, an occupational disease is defined as a disease caused by harmful factors occurring in the work environment or connected with performing a given job, included in the official list of occupational diseases. When assessing occupational exposure in the healthcare sector, it should be considered that healthcare workers include all persons in contact with patients or their biological material, as well as employees who are not medical professionals but who share a common space with patients due to the nature of their work. The latter group includes administrative and technical employees, control and rescue service workers, people supporting medical staff, and employees of nursing homes. In the case of non-medical occupations, the decision to recognize COVID-19 as an occupational disease should be made on an individual basis, after confirming a significant risk of contracting a SARS-CoV-2 virus infection at the workplace and in the absence of evidence of a non-occupational source of infection. An assessment of occupational exposure should always include evaluating the possibility of SARS-CoV-2 transmission. Med Pr Work Health Saf. 2023;74(5):435-42.

Recognition of COVID-19 with occupational origin: a comparison between European countries.

OBJECTIVES: This study aims to present an overview of the formal recognition of COVID-19 as occupational disease (OD) or injury (OI) across Europe. METHODS: A COVID-19 questionnaire was designed by a task group within COST-funded OMEGA-NET and sent to occupational health experts of 37 countries in WHO European region, with a last update in April 2022. RESULTS: The questionnaire was filled out by experts from 35 countries. There are large differences between national systems regarding the recognition of OD and OI: 40% of countries have a list system, 57% a mixed system and one country an open system. In most countries, COVID-19 can be recognised as an OD (57%). In four countries, COVID-19 can be recognised as OI (11%) and in seven countries as either OD or OI (20%). In two countries, there is no recognition possible to date. Thirty-two countries (91%) recognise COVID-19 as OD/OI among healthcare workers. Working in certain jobs is considered proof of occupational exposure in 25 countries, contact with a colleague with confirmed infection in 19 countries, and contact with clients with confirmed infection in 21 countries. In most countries (57%), a positive PCR test is considered proof of disease. The three most common compensation benefits for COVID-19 as OI/OD are disability pension, treatment and rehabilitation. Long COVID is included in 26 countries. CONCLUSIONS: COVID-19 can be recognised as OD or OI in 94% of the European countries completing this survey, across different social security and embedded occupational health systems.

[Artificial Intelligence and employee's health - new challenges]. / Sztuczna inteligencja a zdrowie pracownika ­ nowe wyzwania.

BACKGROUND: The presence of artificial intelligence (AI) in many areas of social life is becoming widespread. The advantages of AI are being observed in medicine, commerce, automobiles, customer service, agriculture and production in factory settings, among others. Workers first encountered robots in the work environment in the 1960s. Since then, intelligent systems have become much more advanced. The expansion of AI functionality in the work environment exacerbates human health risks. These can be physical (lack of adequate machine control, accidents) or psychological (technostress, fear, automation leading to job exclusion, changes in the labour market, widening social differences). MATERIAL AND METHODS: The purpose of this article is to identify, based on selected literature, possible applications of AI and the potential benefits and risks for humans. RESULTS: The main area of interest was the contemporary work environment and the health consequences associated with access to smart technologies. A key research area for us was the relationship between AI and increased worker control. CONCLUSIONS: In the article, the authors emphasize the importance of relevant EU legislation that guarantees respect for the rights of the employed. The authors put forward the thesis that the new reality with the widespread use of AI, requires an analysis of its impact on the human psycho-social and health situation. Thus, a legal framework defining the scope of monitoring and collection of sensitive data is necessary. Med Pr. 2023;74(3):227-33.

Is exposure to pollen a risk factor for moderate and severe asthma exacerbations?

Limited number of studies have focused on the impact of pollen exposure on asthma. As a part of the EAACI Guidelines on Environment Science, this first systematic review on the relationship of pollen exposure to asthma exacerbations aimed to bridge this knowledge gap in view of implementing recommendations of prevention. We searched electronic iPubMed, Embase, and Web of Science databases using a set of MeSH terms and related synonyms and identified 73 eligible studies that were included for systemic review. When possible, meta-analyses were conducted. Overall meta-analysis suggests that outdoor pollen exposure may have an effect on asthma exacerbation, but caution is needed due to the low number of studies and their heterogeneity. The strongest associations were found between asthma attacks, asthma-related ED admissions or hospitalizations, and an increase in grass pollen concentration in the previous 2-day overall in children aged less than 18 years of age. Tree pollen may increase asthma-related ED visits or admissions lagged up to 7-day overall in individuals younger than 18 years. Rare data show that among subjects under 18 years of age, an exposure to grass pollen lagged up to 3 days may lower lung function. Further research considering effect modifiers of pollen sensitization, hay fever, asthma, air pollution, green spaces, and pre-existing medications is urgently warranted to better evaluate the impacts of pollen on asthma exacerbation. Preventive measures in relation to pollen exposure should be integrated in asthma control as pollen increase continues due to climate change.

Cannabis-related allergies: An international overview and consensus recommendations.

Cannabis is the most widely used recreational drug in the world. Cannabis sativa and Cannabis indica have been selectively bred to develop their psychoactive properties. The increasing use in many countries has been accelerated by the COVID-19 pandemic. Cannabis can provoke both type 1 and type 4 allergic reactions. Officially recognized allergens include a pathogenesis-related class 10 allergen, profilin, and a nonspecific lipid transfer protein. Other allergens may also be relevant, and recognition of allergens may vary between countries and continents. Cannabis also has the potential to provoke allergic cross-reactions to plant foods. Since cannabis is an illegal substance in many countries, research has been hampered, leading to challenges in diagnosis since no commercial extracts are available for testing. Even in countries such as Canada, where cannabis is legalized, diagnosis may rely solely on the purchase of cannabis for prick-to-prick skin tests. Management consists of avoidance, with legal issues hindering the development of other treatments such as immunotherapy. Education of healthcare professionals is similarly lacking. This review aimed to summarize the current status of cannabis allergy and proposes recommendations for the future management of this global issue.

EAACI position paper on the clinical use of the bronchial allergen challenge: Unmet needs and research priorities.

Allergic asthma (AA) is a common asthma phenotype, and its diagnosis requires both the demonstration of IgE-sensitization to aeroallergens and the causative role of this sensitization as a major driver of asthma symptoms. Therefore, a bronchial allergen challenge (BAC) would be occasionally required to identify AA patients among atopic asthmatics. Nevertheless, BAC is usually considered a research tool only, with existing protocols being tailored to mild asthmatics and research needs (eg long washout period for inhaled corticosteroids). Consequently, existing BAC protocols are not designed to be performed in moderate-to-severe asthmatics or in clinical practice. The correct diagnosis of AA might help select patients for immunomodulatory therapies. Allergen sublingual immunotherapy is now registered and recommended for controlled or partially controlled patients with house dust mite-driven AA and with FEV1 ≥ 70%. Allergen avoidance is costly and difficult to implement for the management of AA, so the proper selection of patients is also beneficial. In this position paper, the EAACI Task Force proposes a methodology for clinical BAC that would need to be validated in future studies. The clinical implementation of BAC could ultimately translate into a better phenotyping of asthmatics in real life, and into a more accurate selection of patients for long-term and costly management pathways.

The role of occupational health services in cancer prevention - which factors determine the implementation of preventive measures?

OBJECTIVES: Epidemiological data on cancer diseases are alarming. The workplace has become an increasingly important site for disseminating health information and implementing health promotion activities. Occupational medicine physicians (OMPs) have the opportunity to carry out primary and secondary preventive activities focused on civilization diseases, especially cancer. The aim of this study was to evaluate the potential of OMPs in cancer prevention, including the analysis of factors determining the implementation of preventive measures, as part of standard healthcare for employees. MATERIAL AND METHODS: The study was conducted among 362 OMPs. The interviews were carried out by the computer assisted telephone interview (CATI) method. RESULTS: Over 60% of the surveyed OMPs are ready to implement cancer preventive activities among employees. The doctors with the longest seniority in occupational health services are more likely to declare unwillingness to implement cancer preventive activities. Patient's consent, informing women about the program and adjusting the time of the medical visit are the most important conditions for introducing cancer prevention programs by OMPs. Neither seniority nor the number of examinations performed by a physician influenced the currently implemented cancer preventive activities as part of occupational health services (including the evaluation of cancer risk factors occurrence among employees). CONCLUSIONS: In Poland, OMPs are willing to implement cancer preventive activities among employees, but their current activity in this area is limited and needs development. The most specific actions should be addressed to doctors with the longest seniority in occupational health services, who are frequently unwilling to implement cancer preventive activities. Strengthening the preventive potential of Polish occupational health services requires a systemic approach to the scope and way of action of healthcare professionals. Int J Occup Med Environ Health. 2021;34(6):723-36.

Dyslipidaemia, carbohydrate metabolism disorders and arterial hypertension detected in academic employees during examinations in occupational medicine.

INTRODUCTION: Many people have CVD risk factors without realising it and it is important to recognise the risk factors as soon as possible. Periodic examinations are a mandatory form of control for all employes in Poland. They provide an excellent opportunity to screen for the most common civilization diseases in the population. OBJECTIVE: The aim of this study is to evaluate the prevalence of dyslipidaemia, hyperglycaemia and hypertension among academics in a Polish university, and to compare the results between postdoctoral fellows and other academics. MATERIAL AND METHODS: The study group were postdoctoral fellows (HAB; N=135, 53 females) and other academics (NHAB; N=286, 179 females) over the age of 40 who reported for a periodic occupational medical check-up. Fasting blood samples were drawn, serum glucose, lipids and blood pressure (BP) were measured. RESULTS: The mean age was 56.7 (SD 9.8) in HAB and 49.8 (SD 8.1) in NHAB. Mean systolic BP and glycaemia were significantly higher in male HAB group than male NHAB (135.8 vs 130.9 mmHg and 6.0 vs 5.6 mmol/l, respectively). The relationship in females was non-significant. The age-adjusted odds ratios (OR [95% CI]) of having elevated low density lipoprotein cholesterol, total cholesterol, glucose and blood pressure in male HAB vs male NHAB were 0.61 [0.32. 1.16], 0.64 [0.33, 1.23], 1.52 [0.80, 2.88] and 2.11 [0.88, 5.23], and in female HAB vs female NHAB - 0.59 [0.31, 1.12], 0.64 [0.32, 1.26], 0.87 [0.40, 1.79] and 1.86 [0.70, 4.68], respectively. CONCLUSIONS: Adequately planned occupational medicine examinations provide an opportunity to diagnose dyslipidaemia, hyperglycaemia, or high BP in all groups of employees, including highly educated academics.

Occupational Asthma Caused by Quaternary Ammonium Compounds: A Multicenter Cohort Study.

BACKGROUND: Quaternary ammonium compounds (QACs) are used extensively for cleaning and disinfection and have been documented in scattered reports as a cause of occupational asthma (OA) through bronchoprovocation tests (BPTs). OBJECTIVE: To examine the clinical, functional, and inflammatory profile of QAC-induced OA compared with OA caused by other low-molecular weight (LMW) agents. METHODS: The study was conducted in a retrospective multicenter cohort of 871 subjects with OA ascertained by a positive BPT. Subjects with QAC-induced OA (n = 22) were identified based on a positive BPT to QACs after exclusion of those challenged with cleaning products or disinfectants that contained other potential respiratory sensitizers. They were compared with 289 subjects with OA caused by other LMW agents. RESULTS: Most subjects with QAC-induced OA were working in the health care sector (n = 14). A twofold or greater increase in the postchallenge level of nonspecific bronchial hyperresponsiveness was recorded in eight of 11 subjects with QAC-induced OA (72.7%) and in 49.7% of those with OA caused by other LMW agents. Although sputum assessment was available in only eight subjects with QAC-induced OA, they showed a significantly greater median (interquartile) increase in sputum eosinophils (18.1% [range, 12.1% to 21.1%]) compared with those with OA caused by other LMW agents (2.0% [range, 0% to 5.2%]; P < .001). CONCLUSIONS: This study indicates that QAC-induced OA is associated with a highly eosinophilic pattern of airway response and provides further evidence supporting the sensitizing potential of QACs. The findings highlight the heterogeneous nature of the pathobiologic pathways involved in OA caused by LMW agents.

[Epidemiology, diagnosis, and prevention of tick-borne encephalitis in Poland and selected European countries - a position statement of the Polish group of experts]. / Epidemiologia, diagnostyka i profilaktyka kleszczowego zapalenia mózgu w Polsce i wybranych krajach europejskich ­ stanowisko polskiej grupy ekspertów.

Tick-borne encephalitis (TBE) is one of the most common viral neuroinfections in Poland. Detection of specific IgM and IgG anti- TBE antibodies in the serum or cerebrospinal fluid with enzyme-linked immunosorbent assay (ELISA) is a method of choice in TBE diagnostics. No effective antiviral treatment is available for TBE. Increased intracranial pressure, epileptic seizures, and other neurological symptoms in the course of TBE are managed with standard procedures. A routine use of corticosteroids is not recommended. Adults with TBE-related neurological sequelae should undergo physical mobilization and periodic neurological assessments. All patients ought to control their psychological condition and visit a physician in case of worrisome symptoms. Additionally, children need to undergo regular psychological and otolaryngologic consultations. Notably, TBE cases are reported across Poland; therefore, the entire country must be considered as a TBE risk region. The degree of endemicity can be variable in particular parts of the country. Immunization against TBE containing a European subtype of the virus is the most effective prophylactic method. In areas where the disease is highly endemic (according to the WHO definition of ≥5 cases/100 000 population/year), immunization needs to be offered to all ages. Vaccination is recommended in the communities living in areas of moderate TBE endemicity (1-5 cases/100 000/ year), in particular for individuals at high risk of a TBE infection as well as children and the elderly. Vaccination should also be offered to subjects living in areas where TBE occurrence is rare (<1 case/100 000/year) but who are at high risk of infection. A TBE vaccine is recommended to the following populations at high risk of TBE: a) individuals undertaking outdoor leisure activities, b) all professionals working outdoors, particularly in green areas, and c) individuals traveling to endemic areas, if activities during their visit may pose a risk of a tick bite. Post-exposure immunization is not recommended. Med Pr. 2021;72(2):193-210.

COVID-19 pandemic and allergen immunotherapy-an EAACI survey.

BACKGROUND: As in many fields of medical care, the coronavirus disease 2019 (COVID-19) resulted in an increased uncertainty regarding the safety of allergen immunotherapy (AIT). Therefore, the European Academy of Allergy and Clinical Immunology (EAACI) aimed to analyze the situation in different countries and to systematically collect all information available regarding tolerability and possible amendments in daily practice of sublingual AIT (SLIT), subcutaneous AIT (SCIT) for inhalant allergies and venom AIT. METHODS: Under the framework of the EAACI, a panel of experts in the field of AIT coordinated by the Immunotherapy Interest Group set-up a web-based retrospective survey (SurveyMonkey® ) including 27 standardized questions on practical and safety aspects on AIT in worldwide clinical routine. RESULTS: 417 respondents providing AIT to their patients in daily routine answered the survey. For patients (without any current symptoms to suspect COVID-19), 60% of the respondents informed of not having initiated SCIT (40% venom AIT, 35% SLIT) whereas for the maintenance phase of AIT, SCIT was performed by 75% of the respondents (74% venom AIT, 89% SLIT). No tolerability concern arises from this preliminary analysis. 16 physicians reported having performed AIT despite (early) symptoms of COVID-19 and/or a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). CONCLUSIONS: This first international retrospective survey in atopic diseases investigated practical aspects and tolerability of AIT during the COVID-19 pandemic and gave no concerns regarding reduced tolerability under real-life circumstances. However, the data indicate an undertreatment of AIT, which may be temporary, but could have a long-lasting negative impact on the clinical care of allergic patients.

Evaluation of selected risk factors for cardiovascular diseases and diabetes as a background for the prevention program in occupational healthcare.

OBJECTIVES: Cardiovascular and metabolic disorders constitute major health problems in the working populations in Europe. The aim of this project was to evaluate the health condition of workers employed in a Polish research and medical institution, and then to establish the necessary preventive actions by creating a modern model of occupational healthcare integrated with civilization disease (CivD) prevention. MATERIAL AND METHODS: Overall, 100 workers voluntarily participated in a health program for CivD prevention during mandatory prophylactic examinations. Data from these examinations was collected in a system of electronic documentation to enable the analysis of the workers' health condition and risk factors of CivDs. RESULTS: Women accounted for 72% of the employees who voluntarily participated in the prevention program, and 80% of the subjects had university education. As regards the health condition, 27% of the patients had elevated systolic, and 23% diastolic, blood pressure, and 21% had an abnormal fasting glucose level. Stressful job was an important factor correlated with an excessive body mass index, diastolic blood pressure, as well as total and low-density lipoprotein cholesterol levels. Smoking, sedentary work and a lack of physical activity were significant factors for abdominal obesity. Generally, 94% of the program participants required some further interventions in lifestyle, diagnostics or treatment. CONCLUSIONS: Civilization disease prevention should focus on increasing physical activity both in leisure time and at the workplace as far as practicable. There is a need for implementing projects leading to occupational stress reduction and smoking cessation. Men as well as workers with vocational and elementary education need to be recruited for prevention programs dedicated to employees. Int J Occup Med Environ Health. 2021;34(3):403-13.

Characterization of Occupational Eosinophilic Bronchitis in a Multicenter Cohort of Subjects with Work-Related Asthma Symptoms.

BACKGROUND: Occupational eosinophilic bronchitis (OEB) has been described only as anecdotal case reports. OBJECTIVE: We investigated the clinical and inflammatory characteristics of subjects with OEB identified in a cohort of subjects who completed a specific inhalation challenge (SIC) with occupational agents. METHODS: In this retrospective multicenter study, OEB was defined by (1) a fall in FEV1 less than 15% during the SIC and the absence of nonspecific bronchial hyperresponsiveness both before and after the SIC and (2) a postchallenge increase of 3% or more in sputum eosinophils. The subjects who fulfilled these criteria were compared with 226 subjects with a negative SIC and 30 subjects with a positive SIC who failed to show baseline nonspecific bronchial hyperresponsiveness. RESULTS: An isolated increase in postchallenge sputum eosinophils was documented in 33 of 259 subjects (13%) with a negative SIC. These subjects reported significantly more often an isolated cough at work compared with the negative and positive SIC controls. When compared with positive SIC controls, the subjects with OEB experienced less frequently work-related wheezing and reported a shorter duration of symptoms at work. The sensitivity of the post-SIC increase in fractional exhaled nitric oxide in identifying OEB among subjects with a negative SIC was low, ranging from 43% to 24% using cutoff values of 8 ppb to 17.5 ppb, whereas the specificity was high (90%-97%). CONCLUSIONS: This study highlights the relevance of induced sputum analysis in the investigation of work-related asthma symptoms to identify isolated increases in sputum eosinophils that are consistent with a diagnosis of OEB.

COVID-19 pandemic: Practical considerations on the organization of an allergy clinic-An EAACI/ARIA Position Paper.

BACKGROUND: The coronavirus disease 2019 (COVID-19) has evolved into a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Allergists and other healthcare providers (HCPs) in the field of allergies and associated airway diseases are on the front line, taking care of patients potentially infected with SARS-CoV-2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics. METHOD: The scientific information on COVID-19 was analysed by a literature search in MEDLINE, PubMed, the National and International Guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library, and the internet. RESULTS: Based on the diagnostic and treatment standards developed by EAACI, on international information regarding COVID-19, on guidelines of the World Health Organization (WHO) and other international organizations, and on previous experience, a panel of experts including clinicians, psychologists, IT experts, and basic scientists along with EAACI and the "Allergic Rhinitis and its Impact on Asthma (ARIA)" initiative have developed recommendations for the optimal management of allergy clinics during the current COVID-19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies. CONCLUSIONS: This international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients while ensuring the necessary safety measures in the current COVID-19 pandemic.

[Health protection of employees against SARS-CoV-2 coronavirus infection causing the COVID-19 disease - the current state of knowledge and recommendations]. / Ochrona zdrowia pracujacych przed zakazeniem koronawirusem SARS-CoV-2 wywolujacym COVID-19 ­ aktualny stan wiedzy i zalecenia.

The COVID-19 pandemic, despite the restrictions and preventive measures applied, has rapidly spread and reached Poland. The adaptation to the dynamically changing epidemiological situation requires a prompt implementation of effective preventive measures. The aim of the publication is to provide current knowledge to all persons involved in the preventive care system, i.e., employees, employers and professionals of occupational medicine, about the epidemiological situation related to SARS­CoV- 2, as well as recommendations and possible solutions. In order to analyze these issues, a review of literature was conducted based on medical research databases: PubMed, SCOPUS, and the Web of Science Core Collection. The literature was supplemented with studies found on websites of the Ministry of Health and the World Health Organization. Data on the cases of and deaths due to COVID-19 come from reports provided by the Ministry of Health, data published on the websites of the European Center for Disease Prevention and Control, and ourworldindata.org. By the time of submitting the publication, 34 154 cases and 1444 deaths due to coronavirus had been recorded in Poland. Data from published studies suggest that the virus is mainly transmitted via droplets or through contact with contaminated objects and surfaces. Therefore, in the absence of an effective vaccine, preventive actions are based mainly on strategies that minimize the risk of pathogen transmission. In addition to discussing the current epidemiological situation, diagnostic procedures, risk groups and COVID-19 characteristics, the paper presents recommendations and proposed solutions for employers and employees regarding the prevention of SARS­CoV- 2, along with currently applicable laws and recommendations on employee prophylactic examinations during the pandemic. Subsequently, COVID-19 was discussed in the aspect of an occupational disease and other health threats related to the pandemics. The epidemiological situation regarding coronavirus indicates the need to take immediate and effective actions to minimize infection transmission among employees, and to develop procedures for a quick and effective ability to locate the COVID-19 outbreaks in workplaces. Med Pr. 2021;72(1):69-87.