[Analysis of notifications of suspicions of diseases caused by the way the job is performed in the context of pathologies regarded as occupational diseases]. / Analiza zgloszei podejrzenia chorób wywolanych sposobem wykonywania pracy w kontekscie patologii uznanych za choroby zawodowe.

BACKGROUND: In this report the increase in the number of notifications of suspicions of diseases caused by the way the job is per formed, observed recently in the Regional Center of Occupational Medicine in Wroclaw, is highlighted. The problem stems from the recognition of medical certification of such diseases as occupational diseases only in one third of all notifications of suspicions. MATERIAL AND METHODS: The case study was based on statistical data concerning notifications of suspected occupational diseases collected in the Branches of the Regional Center of Occupational Medicine in Wroclaw in the years 2006-2011, as well as on medical certificates issued by the Center's Out-patient Clinics of Occupational Diseases. More than 700 reports of suspected chronic occupational diseases of the musculoskeletal system and chronic diseases of the peripheral nervous system caused by the way the job is performed were analyzed, taking into account gender, age and how the work had been done. On the basis of the analysis of medical certificates issued by physicians, decision-making procedures and the recognition of occupational disease certification are discussed. RESULTS: The analysis of the data collected in the Regional Center of Occupational Medicine, Wroclaw, in the years 2006-2011 showed a significant increase in the percentage of notifications of suspicions of diseases caused by the way the job is performed. At the same time it was shown that only about one third of reported suspicions were concluded with issuing medical certification of an occupational disease and the administrative confirmation of the decision. CONCLUSIONS: The results of the study revealed significant certification problems in the group of diseases caused by the way the job is performed in terms of the recognition of this type of pathology as an occupational disease. These issues are ambiguous because of a large number of non-occupational factors involved in the pathogenesis of these diseases.

[Working conditions of community nurses]. / Warunki pracy pieleigniarek srodowiskowo-rodzinnych.

BACKGROUND: To ensure the most efficient workplace health promotion it is essential to identify and monitor health conditions of employees and all components of the work process, as well as to recognize their cause-effect relationships. Community nurses form an occupational group with a specific type of workplace that is usually located in the patient's place of residence and thus not inspected in terms of safety and hygiene. The aim of the study was to identify working conditions of community nurses with special reference to occupational hazards. MATERIAL AND METHODS: An anonymous questionnaire was used as a major tool of this survey. It contained 33 questions, concerning the work process, working conditions, work loads and arduousness, hazards and work-related complaints. The questionnaire was completed by 86 community nurses working in the Upper Silesia region. RESULTS AND CONCLUSIONS: Community nurses generally assessed their work as hard. A more thorough analysis revealed that nursing and curative care, nursing and hygienic care and rehabilitation were regarded by community nurses as hard, whereas social diagnostics and curative diagnostics were assessed as much easier tasks. Excessive physical load, forced position at work, aggressive patients, patients' aggressive family members, dangerous domestic animals, low quality of technical devices in patients' homes were reported as the greatest hazards. The obtained results reveal that working conditions of community nurses do not ensure their safety at work.

[Prophylactic examinations of workers formerly employed in asbestos processing plants: outcome of the Amiantus project in 2000-2004]. / Badania profilaktyczne bylych pracowników zakladów przetwórstwa azbestu--wyniki realizacji programu Amiantus w latach 2000-2004.

BACKGROUND: Prophylactic examinations of workers formerly employed in asbestos processing plants were performed by virtue of the Act, dated 19 June 1997, putting a ban on the production of asbestos-containing products. To enforce the provisions of the Act, the Ministry of Health has initiated the Amiantus project implemented by 13 Occupational Medicine Centers throughout the country and coordinated by the Nofer Institute of Occupational Medicine (IMP) in Lódz. MATERIAL AND METHODS: All the Centers perform diagnostic procedures according to the same criteria (clinical, radiological, spirometric and histological), based on the 1997 Helsinki criteria, to diagnose asbestos-related diseases. A specific "Examination Form", developed for the needs of the Amiantus project, is completed by an occupational physician during examinations and sent to the IMP, where health effects in the whole population covered by the project are monitored. Periodical medical examinations are performed at least every three years and they include: general examination, chest x-ray, resting spirometric examination and supplementary examinations (e.g., resting gasometric examination) or other diagnostic examinations if necessary (e.g., computed tomography). RESULTS: Owing to the project implementation, it was possible to collect in the database information on 5466 persons who underwent 8763 prophylactic examinations in 2000-2004. Of the total population examined during a five-year period, occupational disease was certified in 728 (13%) persons. Asbestosis was diagnosed in 790 persons, lung cancer in 19 persons and pleural mesothelioma in 12 persons. Pleural changes in x-ray imaging were found in 1662 (30%) persons and opacities in pulmonary parenchyma in 2088 (38%) persons. Having compared these results with those from previous examinations, the total health condition deterioration was observed in 882 (16%) persons, including worsening of the lung x-ray imaging in 512 (9%) persons. An analysis showed the highest incidence of asbestos-related pathologies in workers of asbestos-cement plants. The collected data also confirmed an upward trend in the incidence of asbestosis and changes in the lung x-ray imaging related to age, duration of employment and latency. CONCLUSION: The implementation of the Amiantus project has contributed to an increased detection of pathologies related with exposure to asbestos fibers. A growing proportion of radiograms, which indicate worsening of health condition provides evidence that morbid processes in the respiratory system are progressing in persons who in the past were occupationally exposed to asbestos dust.

The position of a leader nurse.

Traditionally, nursing's leading role is considered as an indirect function, i.e. the professional function, which is aimed at nurse development rather than the patient. In contemporary medicine both therapeutic as well as nursing tasks are performed by a team rather than an individual, being it a doctor or a nurse, respectively. No teamwork can be effective without a leader; this is also true for good nursing in which the leadership is of a very special nature. The paper particularly concentrates on these characteristics of the nurse's leading role, which are related to the fact that the patient, according to the autonomy principle, is recognized as a central person in the therapeutic/nursing team.