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 (sIgEs) against wheat and rye flour, however, has not been thoroughly compared with other diagnostic procedures. OBJECTIVE: We sought to evaluate the diagnostic accuracy of sIgE against wheat and rye compared with specific inhalation challenge (SIC) with flour as the reference standard. METHODS: This retrospective multicenter study included 264 subjects who completed an SIC with flour in eight tertiary centers, of whom 205 subjects showed a positive SIC result. RESULTS: Compared with SIC, sIgE levels of 0.35 kUA/L or greater against wheat and rye provided similar sensitivities (84% to 85%, respectively), specificities (71% to 78%), positive predictive values (91% to 93%), and negative predictive values (56% to 61%). Increasing the threshold sIgE value to 5.10 kUA/L for wheat and to 6.20 kUA/L for rye provided a specificity of 95% or greater 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 postchallenge FeNO compared with subjects with a 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 to perform an 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.

[Individual dosimetry as an element of health prevention for employees exposed to ionizing radiation]. / Dozymetria indywidualna jako element profilaktyki zdrowotnej pracowników narazonych na promieniowanie jonizujace.

The paper presents the current radiation protection standards, in line with the recommendations of the International Commission on Radiological Protection (ICRP), and their evolution over the years based on new knowledge about the biological effects of ionizing radiation and the changing attitude of people to the accepted risk. The work takes into account in particular the role of the dose limit principle and individual dose measurements in activities aimed at health prevention of individual people occupationally exposed to ionizing radiation. Med Pr Work Health Saf. 2023;74(6):527-39.

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.

[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.

Monkeypox (Mpox) and Occupational Exposure.

Recently, there has been a significant increase in interest in biological risk factors, which are increasingly perceived as an important problem in occupational medicine. Exposure to harmful biological agents may be associated with the deliberate use of microorganisms in the work process or with unintentional exposure resulting from the presence of biological risk factors in the work environment. Monkeypox (mpox) is a viral infectious disease that may afflict humans and non-human primates. Since May 2022, mpox has occurred in Europe, North and South America, Asia, Australia and Africa, with some 76,713 cases (75,822 in locations that have not historically reported mpox) and 29 total deaths reported to date. Between 2018 and 2021, several cases of mpox were reported worldwide in high-income countries (Israel, Singapore, United Kingdom, United States: Texas and Maryland). We conducted a literature search in PubMed and Google Scholar web databases for occupational exposure to mpox. The highest work-related risk for mpox transmission has been noted among healthcare professionals, people working with animals, and sex workers. There is general agreement that a paramount issue to avoid transmission of infection in occupational settings is an appropriate decontamination of often-touched surfaces and usage of appropriate personal protective equipment by the workers at high risk of infection. The group that should especially protect themselves and be educated in the field of early symptoms of the disease and prevention are dentists, who are often the first to detect the symptoms of the disease on the oral mucosa.

[A dancer, a groomer, a folk artist and a viola player - case reports of occupational musculoskeletal and peripheral nervous system diseases]. / Tancerka, groomerka, twórczyni ludowa i altowiolistka ­ opisy przypadków chorób zawodowych ukladu ruchu i obwodowego ukladu nerwowego.

Work-related diseases of the musculoskeletal and the peripheral nervous system are classified as overload cumulative microtrauma diseases, resulting from chronic overload and/or damage of specific neuromusculoskeletal structures. Occupational activities which predispose to them are characterised by monotypy (repetition of movements during a significant part of the working shift). Authors described 4 cases of women with musculoskeletal and peripheral nervous system disorders qualified as occupational background just in the 2nd instance of medical certification. Detailed analysis of occupational exposure and medical interview with individual diagnostic approach allowed to determine the occupational etiology of diseases, regardless of non-occupational risk factors in some cases, even if the workstation was not common. Difficulties in estimating the probability of disease process induction on the background of occupational exposure are caused by frequent coexistence of non-occupational risk factors. The 2-tier system of certification provides an independent evaluation of medical history and occupational exposure. Med Pr. 2022;73(1):71-8.

Health effects of exposure to chlorination by-products in swimming pools.

Concerns have been raised regarding the potential negative effects on human health of water disinfectants used in swimming pools. Among the disinfection options, the approaches using chlorine-based products have been typically preferred. Chlorine readily reacts with natural organic matter that are introduced in the water mainly through the bathers, leading to the formation of potentially harmful chlorination by-products (CBPs). The formation of CBPs is of particular concern since some have been epidemiologically associated with the development of various clinical manifestations. The higher the concentration of volatile CBPs in the water, the higher their concentration in the air above the pool, and different routes of exposure to chemicals in swimming pools (water ingestion, skin absorption, and inhalation) contribute to the individual exposome. Some CBPs may affect the respiratory and skin health of those who stay indoor for long periods, such as swimming instructors, pool staff, and competitive swimmers. Whether those who use chlorinated pools as customers, particularly children, may also be affected has been a matter of debate. In this article, we discuss the current evidence regarding the health effects of both acute and chronic exposures in different populations (work-related exposures, intensive sports, and recreational attendance) and identify the main recommendations and unmet needs for research in this area.

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.

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.

[Recommendations for performing specific inhalation challenge tests: Polish experience in relation to the European Respiratory Society guideliness]. / Wytyczne do przeprowadzania swoistych wziewnych testów prowokacyjnych: stanowisko Europejskiego Towarzystwa Chorób Ukladu Oddechowego (ERS) w kontekscie polskich doswiadczen.

A diagnosis of occupational diseases implicates some medical and legal consequences; therefore, the most specific and objective methods are needed in the diagnostic process. Specific inhalation challenge (SIC) tests currently play an irreplaceable role in diagnosing allergic airway diseases (e.g., allergic rhinitis, asthma) as well as allergic conjunctivitis and systemic reactions, also the occupational ones. In 2014, a team of the European Respiratory Society experts published a statement that provides practical recommendations for performing SIC tests in diagnosing occupational asthma. In the current publication, the authors discuss the European guidelines in the context of Polish experience of the reference center - the Department of Occupational Diseases and Environmental Health, the Nofer Institute of Occupational Medicine in Lódz. The article describes the procedures and diagnostic criteria employed during SIC tests in diagnosing occupational asthma. Med Pr. 2020;71(3):381-97.

[An assessment of the role of the Social Insurance Institution in the occupational activation of people with health problems, conducted by issuing decisions on the appropriateness of vocational retraining]. / Ocena roli Zakladu Ubezpieczen Spolecznych w aktywizacji zawodowej osób z problemami zdrowotnymi, realizowanej poprzez wydawanie orzeczen o celowosci przekwalifikowania zawodowego.

BACKGROUND: The new training allowance policy has been put in the Social Insurance Institution to bring back to employment workers with health problems unfit for their previous occupation. These people, following specific vocational training, may acquire new skills and competencies to stay on the labor market. The aim of this study was to assess the role of the Social Insurance Institution in the activation of persons with health problems, which was carried out by issuing opinions about the appropriateness of vocational retraining. MATERIAL AND METHODS: The analysis included 460 cases in which decisions on the appropriateness of vocational retraining, due to the inability to work in the current profession, were issued in 2009. RESULTS: It was found that 40.9% of the analyzed cases were not in accordance with the principles of adjudicating on the incapacity for work and applicable law. The majority of the study group (72.4%) were people with basic vocational education. No significant changes were found as regards gender, age and the place of residence between the retrained (N = 89) and not retrained subjects (N = 252). In the retrained group including 89 persons, 13 subjects started to collect pension again within 6 months; and 1 person collected pension while working. In addition, 51 (57.3%) retrained subjects were unemployed. After 12 months, the number of unemployed subjects decreased to 31. CONCLUSIONS: The effectiveness of the training allowance as a tool for the activation of people with health problems, expressed as the number of retrained people who returned to the labor market, is low. More than 80% of the people fail to get retrained and some of them again submit pension applications. A large number of incorrect vocational retraining opinions, as well as the lack of cooperation between institutions conducting retraining (the Social Insurance Institution and labor offices) resulted in a limited effectiveness of the training allowance. In order to enhance the effectiveness of the training allowance, it is necessary to carry out organizational and legislative changes, with particular emphasis on expanding the knowledge of medical examiners representing the Social Insurance Institution and occupational health physicians, as well as to improve cooperation between all institutions involved in the occupational activation of people with health problems. Med Pr. 2020;71(3):309-23.

Mannitol vs. methacholine in the evaluation of airway responsiveness in bakers' asthma.

OBJECTIVES: Various indirect or direct airway challenge tests are used to measure nonspecific bronchial hyper-responsiveness (NSBHR). The evaluation of NSBHR in diagnosing occupational asthma (OA) is performed, e.g., to monitor the specific inhalation challenge test (SICT). The aim of this study was to preliminarily compare the results of methacholine and mannitol inhalation challenge tests in SICT monitoring in bakers with work-related airway symptoms. MATERIAL AND METHODS: Four bakery workers with a suspicion of OA underwent single-blind placebo-controlled SICTs involving workplace allergens, accompanied by the evaluation of NSBHR with mannitol and methacholine, both before and after SICTs. Clinical examinations, spirometry tests, skin prick tests (SPTs) to common aeroallergens and occupational allergens, as well as tests to determine serum specific IgE antibodies to occupational aeroallergens were also performed. RESULTS: Positive SPTs results to occupational aeroallergens were found in all bakery workers, and specific IgE antibodies to flour were detected in 2 subjects. Three patients displayed positive SICT reactions. In all of these 3 patients, airway responsiveness to methacholine increased significantly. In 2 patients, airway reaction to mannitol was significant, whereas in 1 subject there was no increase in NSBHR after mannitol inhalation. The patient with a negative SICT result did not reveal any changes in NSBHR before and after the test, either to methacholine or mannitol. CONCLUSIONS: The data obtained by the authors show that there is no clear correlation between the methacholine and mannitol inhalation challenge tests in SICT monitoring. Preliminary results indicate the need for further investigations to evaluate the usefulness of the mannitol challenge test in the diagnostics of OA. Int J Occup Med Environ Health. 2020;33(2):235-9.

[Rare occupational respiratory diseases]. / Rzadkie choroby ukladu oddechowego o etiologii zawodowej.

This paper reviews rare occupational respiratory diseases with uncommon causes. Among others, it refers to the Ardystil syndrome characterized by the occurrence of organizing pneumonia in the textile printing sprayers, as a result of inhalation of substances used in aerographic textile printing. Furthermore, secondary pulmonary alveolar proteinosis due to exposure to chemical and organic dusts was described, and so was the occurrence of the "vineyard sprayer's lung" in farm workers in Portugal. Eosinophilic bronchitis, showing a strong resemblance to bronchial asthma, was found to occur, among others, in a baker, a nurse and workers exposed to acrylates, α-amylase or welding gases. Occupational exposure to diacetyl in popcorn production workers might also create a threat to their respiratory system. A newly recognized factor that may cause bronchitis and lung diseases is the fiberglass used by workers building small boats and ships. An increased risk for respiratory ailments is observed in people employed in the textile industry, exposed to commodities or cotton dust. Even the resources used to protect different surfaces against moisture have been recognized as the causative agents of lung diseases. The rare occurrence of some occupational respiratory diseases enables a detailed analysis of the epidemiology and evaluation of the relationship between the etiologic agents and the development of the disease. This literature review highlights the fact that most respiratory diseases require a special analysis of occupational and environmental exposure. Med Pr. 2020;71(1):89-104.

Bronchial Response to High and Low Molecular Weight Occupational Inhalant Allergens.

PURPOSE: Occupational asthma may be induced by high- or low-molecular weight allergens (HMWA or LMWA, respectively). The study was conducted to compare the pattern of bronchial response in 200 HMWA-induced asthmatics (n = 130) and LMWA-induced asthmatics (n = 70). METHODS: The study participants underwent a single-blind, placebo-controlled specific inhalation challenge (SIC) with workplace allergens, accompanied by evaluation of non-specific bronchial hyperresponsiveness (NSBHR) with methacholine before and after the SIC. RESULTS: A single early bronchial response more frequently occurred in HMWA-induced asthmatics than in LMWA-induced asthmatics (86.2% vs. 20%). An isolated late bronchial response or atypical patterns were more frequently observed in LMWA-induced asthmatics than in LMWA-induced asthmatics (45.7% vs. 3.8% or 34.3% vs. 10%, respectively). Baseline NSBHR before SIC was more often detected in LMWA-induced asthmatics than in HMWA-induced asthmatics (81.4% vs. 54.6%), and the median value of the provocation concentration of methacholine was relevantly lower in these patients before and after SIC. A significant 3-fold increase in NSBHR after SIC was observed more often in LMWA-induced asthmatics than in HMWA-induced asthmatics (82.8% vs. 66.1%). In addition, compared to LMWA-induced asthmatics, HMWA-induced asthmatics were older, were more frequently active smokers, showed lower level of NSBHR, and more frequently continued their work in harmful occupational exposure. CONCLUSIONS: The results of this study suggest that HMWA-induced asthmatics may have milder clinical courses and that there is a possibility of job continuation despite asthma exacerbation requiring medical surveillance.

Bronchial Response to High and Low Molecular Weight Occupational Inhalant Allergens

PURPOSE: Occupational asthma may be induced by high- or low-molecular weight allergens (HMWA or LMWA, respectively). The study was conducted to compare the pattern of bronchial response in 200 HMWA-induced asthmatics (n = 130) and LMWA-induced asthmatics (n = 70). METHODS: The study participants underwent a single-blind, placebo-controlled specific inhalation challenge (SIC) with workplace allergens, accompanied by evaluation of non-specific bronchial hyperresponsiveness (NSBHR) with methacholine before and after the SIC. RESULTS: A single early bronchial response more frequently occurred in HMWA-induced asthmatics than in LMWA-induced asthmatics (86.2% vs. 20%). An isolated late bronchial response or atypical patterns were more frequently observed in LMWA-induced asthmatics than in LMWA-induced asthmatics (45.7% vs. 3.8% or 34.3% vs. 10%, respectively). Baseline NSBHR before SIC was more often detected in LMWA-induced asthmatics than in HMWA-induced asthmatics (81.4% vs. 54.6%), and the median value of the provocation concentration of methacholine was relevantly lower in these patients before and after SIC. A significant 3-fold increase in NSBHR after SIC was observed more often in LMWA-induced asthmatics than in HMWA-induced asthmatics (82.8% vs. 66.1%). In addition, compared to LMWA-induced asthmatics, HMWA-induced asthmatics were older, were more frequently active smokers, showed lower level of NSBHR, and more frequently continued their work in harmful occupational exposure. CONCLUSIONS: The results of this study suggest that HMWA-induced asthmatics may have milder clinical courses and that there is a possibility of job continuation despite asthma exacerbation requiring medical surveillance.

[Workers' view on the preventive needs for civilization diseases' in prophylactic care taken on employees]. / Potrzeba dzialan prewencyjnych dotyczacych chorób cywilizacyjnych w opiece profilaktycznej sprawowanej przez sluzbe medycyny pracy ­ opinia pracujacych.

BACKGROUND: Every year in Poland almost 5 million prophylactic examinations (PEs) are carried out by occupational medicine specialists (OMPs) among workers, for the purposes envisaged in the Polish Labour Code. The aim of this study was to collect workers' opinions on the possible extension of these check-ups in the field of prophylaxis and prevention of civilization diseases (CivDs), focusing also on the "healthy lifestyle" recommendations. MATERIAL AND METHODS: The study group comprised 325 employees who filled out an anonymous questionnaire containing questions about the possible extension of the PE scope for CivD and cancer prophylaxis. During medical check-ups, evaluation of the incidental glucose (IG) and total cholesterol (TCh) levels, waist circumference measurement and electrocardiography (ECG) were proposed. The respondents were asked about the most interesting issues for discussing with OMPs. RESULTS: Screening tests for some cancers (69.5%) and risk factors for CivDs (61.5%) were indicated as the most interesting topics to discuss with OMPs. The possibility for evaluating the levels of IG and TCh during PEs was approved by approx. 94.8% and 95.3% of the respondents, respectively. Almost 96% accepted having ECG and 80% agreed to waist circumference measurement. As many as 89.5% of the respondents supported the idea of organizing physical activities at their workplaces, and 77.8% were eager to learn about "healthy lifestyles" during training sessions conducted at their workplaces. CONCLUSIONS: Restricting the aim of PEs just to certifying the ability to work, or identifying certain medical contraindications, means losing a chance for implementing the prophylaxis and prevention of diseases' development among active working subjects. The kinds of activities proposed by the authors of this publication have been approved by the employees. Med Pr. 2019;70(4):425-33.

Allergen-specific IgE to recombinant latex allergens in occupational allergy diagnostics.

OBJECTIVES: Specific challenge tests (SICs) are considered reference tests for allergic occupational diseases diagnosis. However, in numerous cases, SICs cannot be carried out in the diagnosis of allergy to latex due to the risk of generalized reactions. The aim of the study was to evaluate the usefulness of sIgE determination to recombinant latex allergens in diagnostics of occupational respiratory allergy. MATERIALS AND METHODS: The study group comprised 44 healthcare workers (HCW) suspected of suffering from occupational respiratory allergy to latex (they underwent a physical examination, skin-prick tests (SPTs) to common and latex allergens, spirometry and SIC) and 17 controls not occupationally exposed to latex, with a positive sIgE against latex. Each serum was tested for allergen-specific IgE to aeroallergens, latex, eight recombinant latex allergens and CCD-markers. RESULTS: Specific IgE against Hev b5, 6.01, and 6.02 were significantly more frequently detected in HCWs and their mean serum levels were higher compared with the control group. In 26 HCWs with occupational asthma (OA), sensitization to Hev b5, Hev b6.01, Hev b6.02 was significantly more frequent than in 18 HCWs with work-exacerbated asthma (WEA); they had positive results SPT to latex significantly more frequently in comparison with subjects with WEA. CONCLUSIONS: Test for recombinant latex allergens is much more accurate in recognition of latex allergy than test for latex extract, which seems to produce false-positive results in patients with pollen allergy. The measurements of sIgE against recombinant latex allergens Hev b 6.01, 6.02, 5, and 8 are useful in differentiating OA from WEA.

[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.