[Health criteria and scope of workers' periodic health check-ups for selected types of work and exposure factors - Nofer Institute of Occupational Medicine guidelines]. / Kryteria zdrowotne i zakres badan profilaktycznych dla wybranych rodzajów prac i czynników narazenia ­ wytyczne Instytutu Medycyny Pracy w Lodzi.

Workers' medical prophylactic examinations referred to in the Labor Code are one of the tasks of the occupational medicine services. They are regulated by law which has been in force for more than 20 years in unchanged form. During this period, new harmful, burdensome or dangerous to health factors appeared in the workplaces, for which no preventive health check-up standard was defined. In the meantime, the health criteria for drivers and persons applying for driving licenses have also been significantly liberalized. The above changes, the authors' own experience, comments and problems reported by physicians who provide workers' prophylactic health care and employers as well as analysis of literature related to workers' health care in other countries have created the need to harmonize and update guidelines on health requirements for selected types of work. In addition the scope and frequency of prophylactic examinations for exposures, which are not included in applicable legal acts, has been developed. Med Pr. 2019;70(1):125-37.

Analysis of bus drivers reaction to simulated traffic collision situations - eye-tracking studies.

OBJECTIVES: The aim of the study was to establish whether the driver's visual strategy may influence a driver's behavior to avoid a crash in a high-risk situation. Any published papers on drivers' visual strategies just before a crash were not found. MATERIAL AND METHODS: Tests were performed using a high-tech driving bus simulator. Participants comprised 45 men drivers, aged 43.5±7.9 years old, seniority as a bus driver of 13.3±8.6 years. The tests were preceded by medical examinations: general, neurological and ophthalmological. Each participant drove the same city route for approximately 40 min (entire route - ER). In the final phase, a collision situation was simulated (a phantom car blocked the participant's right of way). Driver's visual strategy was analyzed using the FaceLab device with 2 cameras during ER and just before collision. The field-of-view covered by camera 1 was divided into 8 regions, by camera 2 into 10 regions. The distribution of gazes in regions was a criterion of visual strategy. RESULTS: Thirty-five drivers completed the simulated driving test, 14 escaped the collision, 21 crashed. These groups differed only in resting systolic blood pressure before the test. The analysis of covariance, after adjusting to this factor, indicated that during the ER visual strategy recorded by camera 1 did not differ between groups, in camera 2 the drivers in the crash group fixed their gaze more frequently (p = 0.049) in region 3 (close part of the road in front of the windshield). Just before the collision drivers who escaped the collision fixed their gaze significantly more often in region 6 (left side of the road) in camera 1 and in region 6 (in front of the windshield,) and region 10 (right side) in camera 2. CONCLUSIONS: The visual strategy has an impact on the road safety. The analysis of visual strategies may be a useful tool for the training of drivers. Int J Occup Med Environ Health. 2019;32(2):161-74.

[The importance of sight for drivers]. / Znaczenie stanu narzadu wzroku dla kierowcy.

Sight is the basic sense for drivers. Condition of the eye determines correct, comfortable and safe performance of the work as drivers. This article presents various factors influencing the sight condition. There are two groups of factors, external (environment, the kind and time of work, stress caused by work) and internal (systemic and local disorders). All these factors can reduce significantly visual functions, such as visual acuity, field of vision, color vision, strereoscopic vision, twilight vision and glare sensitivity. There are also presented actual requirements for drivers and causes of the car accidents in various age groups. Impairments in vision functions can be dangerous for both the driver and other road users.

Contact blepharoconjunctivitis due to black henna--a case report.

Para-phenylenediamine (PPD) can induce immediate or - more often - delayed hypersensitivity. We report the case of 48-year old female admitted to the out-patient allergy clinic a day after her visit in a beauty parlour, where she had her eyelashes and eyebrows dyed with henna. Physical examination revealed prominent edema of the upper part of the face including forehead, cheeks and eyes causing severe narrowing of the palpebral chink. Skin prick tests (SPT) with common allergens were positive for Dermatophagoides pteronyssinus, Dermatophagoides farinae and moulds, while the SPT with PPD was negative. Patch test to PPD was positive. Further investigations revealed eosinophilia in the tear fluid. To our knowledge, this is the first case of PPD-induced contact blepharoconjunctivitis (CB) with concomitant increased eosinophilia in the tear fluid.

[Effect of visual work on the tear film and degree of the eye strain]. / Wplyw pracy wzrokowej na film Lzowy i stopien zmeczenia oczu.

BACKGROUND: The aim of this study was to assess the impact of the visual work on the tear film and the degree of eye strain. MATERIALS AND METHODS: The survey was conducted among 50 people working 4 h with different types of monitors (CRT, LCD) and without a monitor. Schirmer's test and evaluation of the degree of eye strain were performed in all subjects before and after work. RESULTS: The studies revealed no significant change in Schirmer's test. Most people reported eye fatigue after every kind of visual work. The highest degree of eye strain was noted after work with the CRT display screen, especially among people with dry eye syndrome. CONCLUSION: The studies revealed no significant impact of various visual works on the tear film. However, they showed that any kind of intense eye work may cause eye irritation and strain, particularly in the people affected by dry eye syndrome.

[Assessment of the impact of the visual work with display monitors on the eye temperature and intraocular pressure]. / Ocena wplywu pracy wzrokowej z monitorami na temperature powierzchni oka i cisnienie wewnatrzgalkowe.

BACKGROUND: The aim of this study was to assess the impact of the visual work with display monitors on the eye surface temperature, intraocular pressure and on the eye moisturizing condition. MATERIALS AND METHODS: The study was conducted among 50 people working with display monitors (CRT, LCD) and without monitor. The temperature of the eye surface via thermo camera and intraocular pressure were measured, as well as Schirmer's test was performed before and after 4 h of visual work. Thermography was also performed after 1 h. RESULTS: The studies revealed no significant effect of all visual works in patients with normal tear secretion. Only among those with dry eye syndrome, statistically significant increase in the eye surface temperature was found and averaged 0.5 degrees C after 4 h of all visual works. CONCLUSION: The studies revealed that intensive visual work with CRT and LCD display monitors and without monitor causes changes in the eye surface temperature, especially after the first hour of visual work and in patients with dry eye syndrome. The results of tonometry showed that all visual works at a short distance lead to the decreased intraocular pressure, resulting from the improved aqueous humor outflow. Finally, no negative effects of the visual work with the display monitor on the eye was found. However, the appropriate duration of work and application of tear substitutes play an important role in people with the symptoms of dry eye syndrome.

Challenge testing in the diagnosis of occupational allergic conjunctivitis.

BACKGROUND: Providing evidence for the allergic aetiology of ocular symptoms developing as a result of occupational exposure is important for compensation procedures in many countries. AIM: To perform cellular analysis of tear fluid before and after a specific challenge test with high-molecular weight allergens in symptomatic subjects. METHODS: The subjects were 23 bakers with a history of conjunctivitis or rhinoconjunctivitis associated with occupational exposure to wheat flour and positive skin prick test with this allergen. A specific inhalation challenge test with wheat flour and a placebo test were performed. The symptom score (SS) and cellular changes in tear fluid and nasal washings were assessed. RESULTS: Specific provocation test induced significant eosinophil influx in tear fluid in only six patients. No changes in the proportion of other cells could be observed. Cytological changes in tear fluid did not correlate with either ocular SS (Pearson r = 0.18, P = 0.40) or changes in the nasal lavage fluid or SS (Pearson r = 0.13, P = 0.56). However, an analysis of SS results obtained at 30 min and at 24 h after the challenge revealed that cellular changes in tear fluid correlated significantly both with the early and late changes in SS (Pearson r = 0.52, P < 0.05 and Pearson r = 0.81, P < 0.001, respectively). CONCLUSIONS: Analysis of cellular changes in tear fluid during specific inhalation challenge test seems to be a valuable diagnostic tool in occupational ocular allergy. However, the discrepancy between the findings of cellular analysis and SS revealed by the present study requires further research.