Mortality Trends Due to Skin Melanoma in Poland in the Years 2000-2020.

The aim of this article is to assess mortality trends due to skin melanoma in Poland between the years 2000 and 2020, taking into account gender and place of residence (urban, rural). The subject of the analyses was data on 25,061 deaths that occurred between 2000 and 2020 due to skin melanoma (C43 according to ICD-10). Mortality rates due to this cancer, both crude (CDR) and standardised (SDR), were calculated. Trends on the calculated rates were analysed using the annual percentage change (APC) and average annual percentage change (AAPC), obtained from joinpoint regression models. Over the study period, the standardised death rate (SDR) due to skin melanoma in Poland increased from 3.60 to 4.03 per 100,000 population (AAPC = 1.1; p < 0.05), for urban residents it increased from 3.56 to 3.91 (APC = 1.2; p < 0.05) and for rural residents it increased from 3.00 to 4.24 (APC = 2.2; p < 0.05). A higher growth rate in terms of the SDR value between the years 2000 and 2020 was recorded in men compared to women and in rural when compared to urban residents. In Poland, mortality due to skin melanoma is on the rise. The early diagnosis of this cancer should become common practice in the Polish population.

Risk Factors and Clinicopathological Features for Developing a Subsequent Primary Cutaneous Squamous and Basal Cell Carcinomas.

BACKGROUND: Patients with diagnosed keratinocyte carcinomas (KCs) have an increased risk of subsequent skin cancers development. Current studies indicate that patients with subsequent tumors should be followed up regularly. However, none of the studies indicate the connection between the specific subtypes and an increased risk for further KCs development. The study assesses the differences in the risk of developing a subsequent skin cancer after a previous diagnosis of KC, especially considering individual types of skin malignances, and identifies potential factors associated with an increased risk of new cutaneous tumor describing non-invasive diagnosis and monitoring. METHODS: Pathology and medical records were examined to identify the characteristics of patients with multiple KCs diagnosed between 1999 and 2019. RESULTS: The study group comprised 13,913 KCs occurring in 10,083 patients. Multiple KCs were observed in 2300 patients (22.8%). The analysis showed aggressive subtypes, multiple tumors, and male sex as significant prognostic factors. CONCLUSIONS: The most crucial risk factors for developing subsequent KC are being of a male gender, an aggressive tumor subtype, and previous history of multiple skin cancers. Basal cell carcinoma subtypes, such as infiltrative basosquamous, with aggressive growth patterns predispose not only to increased risk for the recurrence but are also expected to be at higher risk of subsequent KCs.

Physical Activity versus Selected Health Behaviors, Subjective Physical and Psychological Health and Multimorbidity in a Large Cohort of Polish Seniors during the COVID-19 Pandemic (Results of the National Test for Poles' Health ).

National Test for Poles' Health is an online study conducted on a large group of Polish Internet users. For the purpose of this study, 64,732 subjects (48.8% female) over 65 years old were included. Subjects provided answers on the level of physical activity (PA) they engage in, prevalence of non-communicable diseases (obesity, hypertension, diabetes, heart diseases, chronic obstructive pulmonary disease (COPD), depression, cancer) and subjective physical and psychological health. Additionally, their Body Mass Index (BMI) and prevalence of multimorbidity was assessed. We found that older people who engage in at least 2 h of physical activity/week had significantly lower prevalence of hypertension, obesity and heart diseases than those who engaged in 1-1.5 h/week or less than 1 h/week. Multimorbidity was present in 33.2% of subjects from the most active group and 52.6% of the least active ones. Subjective physical and psychological health was rated as "very good" by 26.6% and 41.2%, respectively, by subjects from the most active group. Only 9.1% of the least active subjects rated their physical health as "very good" and only 27.4% rated their psychological health as such. Regular physical activity may be a helpful tool in combating the reduced well-being of older people affected by the isolation caused by the COVID-19 pandemic. Unfortunately, over 65% of respondents claimed to engage in less than 1 h of PA a week or less.

The level of knowledge of diabetic prevention in Poland - is there a phenomenon of pluralistic ignorance?

OBJECTIVES: The main aim of this work is to assess the level of knowledge about diabetes prevention and the consequences of untreated diabetes in the Polish society, as well as to indicate the variables that have a significant impact on that knowledge. MATERIAL AND METHODS: The analysis is based on the results of the National Multicenter Health Survey - WOBASZ II. The number of subjects surveyed was 6170, including 2760 men and 3410 women, aged 20-74 years. Data on socio-demographic variables, lifestyle and subjective health assessment were collected using the face-to-face technique. RESULTS: The results obtained in the WOBASZ II project showed that >85% of the respondents had an unsatisfactory level of knowledge about diabetes prevention methods and approximately to 85% of the respondents - about the consequences of untreated diabetes. Moreover, one-fourth of the respondents were unable to identify a single way of preventing diabetes, and more than one-third could not identify a single disease caused by diabetes. The risk of a lack of knowledge about diabetes prevention and the consequences of untreated diabetes is more common for men, people with a low level of education, not married, non-diabetic, and without diagnosed diabetes in the family. CONCLUSIONS: The presented results indicate that there is an prevailing lack of knowledge about diabetes prevention and the consequences of untreated diabetes in the Polish society. It is associated with several variables like: sex, level of education, age, marital status, subjective health assessment and diabetes diagnosed in the respondent and/or in the respondent's family. Int J Occup Med Environ Health. 2021;34(5):667-78.

Knowledge, Beliefs and Attitudes towards the Influenza Vaccine among Future Healthcare Workers in Poland.

The flu vaccine is the best treatment for avoiding the flu and its complications. The aim of the study was to evaluate the knowledge of the flu vaccine and attitude towards the influenza vaccine among medical students in four majors of study (Nursing, Midwifery, Pharmacy, and Public health) in all years of study. A total number of 1137 subjects took part in the study. Most of the vaccinated students assessed the flu vaccine positively (78.5%, 73.7%, 60.7%, and 65.1%, according to their respective majors) and reported that they did not get the flu during the period of vaccination (90.4%, 92.1%, 87.4%, and 97.7%, respectively). Therefore, 65% of the students of Pharmacy, 78% of Midwifery, and 83% of Nursing who were vaccinated once in the last three years recommended the influenza vaccination, and 100% of all students received a regular vaccination every year. The univariate and multivariate logistic regressions showed that a maximum of four factors had a significant impact on the students' knowledge of the influenza vaccine. Knowledge about the flu vaccine was the highest among Pharmacy students and lowest among Public health students. Final-year students answered the questions better than the younger ones (p < 0.05). Their place of residence and flu vaccination status also appeared to influence their answers. Although all students demonstrated good knowledge of the flu vaccine and demonstrated positive attitudes towards the vaccine, their rate of immunization was low. Therefore, health promotion programs are needed to improve immunization coverage among medical students who are future healthcare workers.

The Influence of Hippotherapy on the Body Posture in a Sitting Position among Children with Cerebral Palsy.

The purpose of this study was to assess the influence of hippotherapy (therapy with horses) on posture and body function among children with cerebral palsy. A case-control study included forty-five children aged 6-12 years, classified as Gross Motor Function Classification System (GMFCS) level I or II, with spastic diplegia or hemiplegia. The participants were randomly divided into three groups: study I (n = 15), study II (n = 15) and control (n = 15). The children from the study groups attended 30min hippotherapy sessions for 12 consecutive weeks, twice (study group I) or once (study group II) a week. The Sitting Assessment Scale (SAS) was used. A comparison of SAS showed an improvement in almost all the assessed categories among the children who participated in hippotherapy. In study group I, statistically significant differences were noted in the assessment of head position control, arm function (in both cases, p = 0.012) and trunk control (p = 0.005) and in study group II in the assessment of trunk control (p = 0.028). Hippotherapy has a positive influence on the body posture and function of individual body parts in a sitting position among children with cerebral palsy.

A Comparison of the Attitudes to Influenza Vaccination Held by Nursing, Midwifery, Pharmacy, and Public Health Students and Their Knowledge of Viral Infections.

Influenza is a viral vaccine-preventable disease. The present study aims to explore the attitude to influenza immunization and the knowledge of influenza among students in Poland. A cross-sectional survey was conducted at the end of 2019 and the beginning of 2020 among students of Nursing, Midwifery, Pharmacy, and Public health in all years of study. Data was obtained from 1137 students (90.7% female, 9.3% male), mean age 21.3 ± 1.62 years. The urban students were more likely to be vaccinated against seasonal influenza than rural students (OR: 1.52; 95% CI [1.10-2.10], p = 0.010362). The students of Public health were more likely to be vaccinated against influenza (48.9%, regularly annually 1.1%) than Pharmacy (31%, regularly annually 2.5%), Nursing (30.7%, regularly annually 1.3%) or Midwifery (25.1%, regularly annually 2.4%). First-year and second-year students were vaccinated more often (OR: 2.75; 95% CI [1.99-3.82], p = 0.00000; OR: 1.84; 95% CI [1.32-2.59], p = 0.0004, respectively) than later-year students. All students reported the main reasons for vaccination to be their own protection and parental decision. Concluded, present findings demonstrate a low prevalence of flu vaccination among medical students. Therefore, strategies are needed to increase the uptake of influenza vaccine in students, especially considering the future contact between this group of future health care workers and higher risk groups.

Vitamin D - dietary intake, supplementation and metabolic status of Polish adults

OBJECTIVES: Contrary to popular opinion on the preventive properties of vitamin D, results of previous studies have been inconclusive. The aim of this research was to evaluate the associations between the intake of vitamin D and metabolic abnormalities in a representative sample of Polish adults. MATERIAL AND METHODS: Within the framework of the Multi-Center National Population Health Examination Survey (referred to as WOBASZ), a random sample of 2381 adult residents of Poland (53.8% of whom were women) was examined. All the study subjects were extensively reviewed, including 24-h dietary recall. The intake of vitamin D was assessed on the basis of dietary and supplements reviews. Metabolic abnormalities were evaluated using measurements of waist circumference (WC), blood pressure (BP), serum triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and fasting glycemia. Metabolic syndrome was defined according to the International Diabetes Federation. RESULTS: Of all the study participants, about 4.4 % of women and 2.6% of men declared a regular supplementation of vitamin D. Among women, a significant inverse correlation between vitamin D supplementation and the mean systolic BP was found (p < 0.01). A more substantial relationship was noted after dividing the study subjects according to their body mass. Among obese men, there was a significant inverse relationship between vitamin D intake and the mean systolic BP (p < 0.01) and diastolic BP (p < 0.05), as well as a positive correlation with HDL-C (p < 0.05). Among obese women, a negative correlation was found between vitamin D supplementation and the mean systolic BP (p < 0.01) and diastolic BP (p < 0.05), and a positive correlation with TG (p < 0.05). Among non-obese male subjects, a negative correlation between vitamin D intake and WC was observed. CONCLUSIONS: The obtained findings suggest that the correlation between vitamin D intake and metabolic abnormalities may depend on the obesity status. A higher vitamin D intake may reduce BP and increase HDL-C in obese subjects. The positive relationship between vitamin D intake and TG concentration in women needs further investigation. Int J Occup Med Environ Health. 2020;33(1):107-18.

Years of life lost as a measure of premature death among dual­chamber pacemaker recipients from Malopolska Province.

BACKGROUND: Pacemakers have become the standard of care in patients with severe bradycardia and conduction abnormalities. The survival and premature mortality can be assessed using the years of life lost (YLLs). AIMS: The aim of the study was to analyze mortality trends over the period from 1999 to 2015 among patients implanted with a dual­chamber (DDD) pacemaker who were inhabitants of Malopolska Province. METHODS: This was a retrospective study of records collected from consecutive patients who underwent de novo DDD pacemaker implantation at a single center between 1984 and 2014. Inclusion criteria were residence status in Malopolska Province at the latest follow­up visit and death between 1999 and 2015. The standard expected years of life lost per death was used to calculate YLLs. Time trends were evaluated with joinpoint models and presented as an average annual percentage change (AAPC). RESULTS: Among a total of 3932 consecutive patients implanted with a DDD pacemaker, 1211 patients met the inclusion criteria. We noted an increase in the mean age at implant from 70 years in 1999 to 75.5 years in 2015 (AAPC, 0.6%; P <0.05), the number of years lived after DDD pacemaker implantation from 2.6 years to 8.2 years (AAPC, 7.4%; P <0.05), and the mean age at death from 72.6 years to 83.8 years (AAPC, 0.89%; P <0.05). Finally, we observed a reduction of the YLLs per death from 17.4 years in 1999 to 9 years in 2015 (AAPC, -4%; P <0.05). All trends were significant for both men and women. CONCLUSIONS: In the 17­year follow­up, we showed significant changes in analyzed trends, in particular a reduction in the YLLs per death.

Standard expected years of life lost (SEYLL) due to chronic obstructive pulmonary disease (COPD) in Poland from 1999 to 2014.

PURPOSE: The aim of the study is to analyze the standard expected years of life lost (SEYLL) due to chronic obstructive pulmonary disease (COPD) in Poland from 1999 to 2014 by sex and place of residence. METHODS: The number of deaths due to chronic obstructive pulmonary disease (J40 -J44 and J47 according to ICD-10) over the period 1999 to 2014 was analyzed based on data obtained from the Central Statistical Office in Poland. Standard expected years of life lost due to chronic obstructive pulmonary disease were calculated by sex and place of residence according to the living population (SEYLLp) and the number of deaths caused by the disease (SEYLLd). Changes in the calculated measures were evaluated using joinpoint models. The annual percentage change (APC) and the average annual percentage change (AAPC) were also calculated. RESULTS: The study revealed that COPD contributed to 1.8% of the total number of deaths which occurred between 1999 and 2014. The greatest decrease in the analyzed measures was observed among males from rural areas (p<0.05) (SEYLL: AAPC = -1.6; 95%CI: -3.0;-0.2; SEYLLp: AAPC = -2.0; 95%CI: -3.4;-0.6; SEYLLd: AAPC = -1.1; 95%CI: -1.2;-0.9). A statistically significant increase in the SEYLL and SEYLLp indices was observed among female city dwellers (SEYLL: AAPC = 2.4; 95%CI:0.7;4.0 and SEYLLp: AAPC = 2.4; 95%CI: 0.8;4.1). CONCLUSIONS: All studied measures were higher in the male group than in the female group, regardless of the place of residence. A male who died of COPD in Poland in 2014 potentially lost 14.9 years of life, whereas a female lost 14.2 years.

Lost life years due to premature mortality caused by diseases of the respiratory system.

BACKGROUND: In Poland, as in most other European countries, diseases of the respiratory system are the 4th leading cause of mortality; they are responsible for about 8% of all deaths in the European Union (EU) annually. To assess the socio-economic aspects of mortality, it has become increasingly common to apply potential measures rather than conventionally used ratios. OBJECTIVES: The aim of this study was to analyze years of life lost due to premature deaths caused by diseases of the respiratory system in Poland from 1999 to 2013. MATERIAL AND METHODS: The study was based on a dataset of 5,606,516 records, obtained from the death certificates of Polish residents who died between 1999 and 2013. The information on deaths caused by diseases of the respiratory system, i.e., coded as J00-J99 according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), was analyzed. The Standard Expected Years of Life Lost (SEYLL) indicator was used in the study. RESULTS: In the years 1999-2013, the Polish population suffered 280,519 deaths caused by diseases of the respiratory system (4.69% of all deaths). In the period analyzed, a gradual decrease in the standardized death rate was observed - from 46.31 per 100,000 inhabitants in 1999 to 41.02 in 2013. The dominant causes of death were influenza and pneumonia (J09-J18) and chronic lower respiratory diseases (J40-J47). Diseases of the respiratory system were the cause of 4,474,548.92 lost life years. The Standard Expected Years of Life Lost per person (SEYLLp) was 104.72 per 10,000 males and 52.85 per 10,000 females. The Standard Expected Years of Life Lost per death (SEYLLd) for people who died due to diseases of the respiratory system was 17.54 years of life on average for men and 13.65 years on average for women. CONCLUSIONS: The use of the SEYLL indicator provided significant information on premature mortality due to diseases of the respiratory system, indicating the fact that they play a large role in the health status of the Polish population.

ADAMTS13 deficiency and immunological abnormalities in patients with systemic sclerosis.

INTRODUCTION: Systemic sclerosis (SSc) is a chronic autoimmune connective tissue disorder characterized by immunological deviations and generalized microvascular damage. AIM: To determine the serum level of the von Willebrand factor cleaving protease (ADAMTS13) in 39 SSc patients and healthy controls. MATERIAL AND METHODS: ADAMTS13 serum level was determined in 39 SSc patients and 11 healthy controls. Complete history of the patients was recorded and thorough clinical, rheumatological, and dermatological examinations were performed. RESULTS: The serum levels of ADAMTS13 were significantly lower in SSc than in normal controls (455.47 ±128 vs. 702.01 ±142 ng/ml, p < 0.00001). However significant correlations among serum ADAMTS 13 levels and organ changes were not found in SSc patients. CONCLUSIONS: We demonstrate a decreased serum level of ADAMTS13 in SSc patients, which may contribute to the vessel microangiopathy observed in systemic sclerosis.

Years of life lost due to bronchial asthma in Poland between 1999 and 2013.

OBJECTIVE: The aim of this study was to analyze the years of life lost due to asthma in Poland between 1999 and 2013, with the use of the SEYLL measure (Standard Expected Years of Life Lost). METHODS: The study was based on a dataset of 5,606,516 records gathered from death certificates of Polish residents from 1999 to 2013. The data on the deaths due to bronchial asthma and status asthmaticus (J45 and J46 according to ICD-10) were used for the analysis. The SEYLL, SEYLLp (SEYLL per person) and SEYLLd (SEYLL per death) were implemented to assess lost life years. The analysis of time trends was performed with the use of the join point model. RESULTS: In 1999-2013, asthma and status asthmaticus were the cause of 11,380 deaths of Poles (0.20% of all deaths), resulting in 4.23 prematurely lost life years per 10,000 males and 3.22 years per 10,000 females. Over the analyzed years, the value of SEYLL decreased both for men and women. Every man who died due to bronchial asthma in Poland in the studied period, lost on average 19.12 years of life, and every woman 18.20 years. CONCLUSIONS: The analysis of SEYLL indicated that premature mortality due to asthma is still a meaningful problem in the Polish population and a constant challenge for public health activities.

Years of life lost due to infectious diseases in Poland.

PURPOSE: An evaluation of mortality due to infectious diseases in Poland in 1999-2012 and an analysis of standard expected years of life lost due to the above diseases. METHODS: The study material included a database created on the basis of 5,219,205 death certificates of Polish inhabitants, gathered between 1999 and 2012 and provided by the Central Statistical Office. Crude Death Rates (CDR), Standardized Death Rates (SDR) and Standard Expected Years of Life Lost (SEYLL) due to infectious and parasitic diseases were also evaluated in the study period as well as Standard Expected Years of Life Lost per living person (SEYLLp) and Standard Expected Years of Life Lost per dead person (SEYLLd). Time trends were evaluated with the application of joinpoint models and an annual percentage change in their values. RESULTS: Death certificates report that 38,261 people died due to infectious diseases in Poland in the period 1999-2012, which made up 0.73% of the total number of deaths. SDR caused by these diseases decreased, particularly in the male group: Annual Percentage Change (APC = -1.05; 95% CI:-2.0 to -0.2; p<0.05). The most positive trends were observed in mortality caused by tuberculosis (A15-A19) (APC = -5.40; 95% CI:-6.3 to -4.5; p<0.05) and also meningitis, encephalitis, myelitis and encephalomyelitis (G03-G04) (APC = -3.42; 95% CI:-4.7 to -2.1; p<0.05). The most negative mortality trends were observed for intestinal infectious diseases (A00-A09) Annual Average Percentage Change (AAPC = 7.3; 95% CI:3.1 to 11.7; p<0.05). SDR substantially decreased in the first half of the study period, but then significantly increased in the second half. Infectious and parasitic diseases contributed to a loss of around 37,000 standard expected years of life in 1999 and more than 28,000 in 2012. During the study period, the SEYLLp index decreased from 9.59 to 7.39 per 10,000 population and the SEYLLd index decreased from 14.26 to 10.34 years (AAPC = 2.3; 95% CI:-2,9 to -1.7; p<0.05). CONCLUSIONS: Despite smaller numbers of deaths reported from infectious causes these diseases still represent a serious problem for Poland compared to countries in Western Europe.

Circulating angiostatin serum level in patients with systemic sclerosis.

INTRODUCTION: Systemic sclerosis (SSc) is achronic connective tissue disease characterized by microangiopathy with inadequate angiogenesis. Angiostatin (AS) is a potent antiangiogenic factor specifically inhibiting proliferation and inducing apoptosis of vascular endothelial cells. AIM: To evaluate the level of angiostatin in the serum of patients with SSc. MATERIAL AND METHODS: Serum levels of AS were measured in 20 SSc patients and 12 healthy controls. RESULTS: A statistically significant difference in the serum levels of AS in SSc patients was observed compared to the control group (636.51 vs. 869.20 ng/ml; p = 0.012). Significant correlations between limited and disseminated SSc (lSSc/dSSc) were not found, however, a difference between lSSc and the control group was demonstrated (620.00 vs. 869.20 ng/ml; p = 0.011). The serum level of AS was not associated positively with organ changes caused by SSc. However, a statistically significant lower serum level of AS was observed in patients with SSc and no esophageal (p = 0.008) or pulmonary changes (p = 0.007) compared to the control group. CONCLUSIONS: Our results reveal significant differences in AS level in SSc patients compared to the healthy controls, and suggest that a low level of AS may occur as a result of impaired angiogenesis.

Ten-Year Changes in the Prevalence and Socio-Demographic Determinants of Physical Activity among Polish Adults Aged 20 to 74 Years. Results of the National Multicenter Health Surveys WOBASZ (2003-2005) and WOBASZ II (2013-2014).

INTRODUCTION: The aim of the study was to estimate ten-year changes in physical activity (PA) patterns and sociodemographic determinants among adult residents of Poland. METHODS: The study comprised two independent samples of randomly selected adults aged 20-74 years participating in the National Multicentre Health Survey WOBASZ (2003-2005; n = 14572) and WOBASZ II (2013-2014; n = 5694). In both surveys the measurements were performed by six academic centers in all 16 voivodships of Poland (108 measurement points in each survey). Sociodemographic data were collected by an interviewer-administered questionnaire in both surveys. Physical activity was assessed in three domains: leisure-time, occupational and commuting physical activity. RESULTS: Leisure-time PA changed substantially between the surveys (p<0.001). The prevalence of subjects being active on most days of week fell in both genders in the years 2003-2014 (37.4% vs 27.3% in men); 32.7% vs 28.3% in women. None or occasional activity increased from 49.6% to 56.8% in men, while remained stable in women (55.2% vs 54.9%). In both WOBASZ surveys the likelihood of physical inactivity was higher in less educated individuals, smokers and those living in large agglomerations (p<0.01). No significant changes were observed in occupational activity in men between the surveys, while in women percentage of sedentary work increased from 43.4% to % 49.4% (p<0.01). Commuting PA decreased significantly in both genders (p<0.001). About 79.3% of men and 71.3% of women reported no active commuting in the WOBASZ II survey. CONCLUSIONS: The observed unfavourable changes in PA emphasize the need for novel intervention concepts in order to reverse this direction. Further detailed monitoring of PA patterns in Poland is of particular importance.

Regular physical activity and cardiovascular biomarkers in prevention of atherosclerosis in men: a 25-year prospective cohort study.

BACKGROUND: The purpose of the study was to examine the association between leisure-time physical activity (LTPA), cardiovascular biomarkers and atherosclerosis among asymptomatic men with stable LTPA level throughout the 25-year prospective observation. METHODS: Out of 101 asymptomatic men prospectively observed for their lifestyle and cardiovascular risk factors, the cohort of 62 individuals (mean age 59.9 years) maintained a stable LTPA level during the 25-year observation. Regular check-ups with the assessment of traditional risk factors, detailed measurements of LTPA level and aerobic capacity were performed since baseline. At the latest follow-up (2011/12) a set of cardiovascular biomarkers was measured using enzyme-linked immunosorbent assay. Subclinical atherosclerosis was assessed by means of coronary artery calcification score and intima-media thickness (IMT). Endothelial function was evaluated by means of the reactive hyperemia index. The studied biomarkers and indices were analyzed in the three cohorts representing stable low-tomoderate (<2050 kcal/week), high (2050-3840 kcal/week) and very high LTPA (>3840 kcal/week). RESULTS: At baseline the three cohorts were comparable in terms of age and clinical characteristics. At follow-up, the cohort with stable high LTPA (2050-3840 kcal/week) had significantly lower concentrations of hs-CRP (2.20 ± 1.0 mg/L), oxidized-LDL (68.35 ± 67.7 ng/mL), leptin (4.71 ± 3.07 ng/mL) and irisin (0.47 ± 0.13 µmol/L), and the most favorable indices of atherosclerosis and endothelial function as compared with other groups (p < 0.05). Regular marathon runners had increased concentrations of hsCRP (3.12 ± 1.4 mg/L), oxidized-LDL (249.8 ± 129 ng/ml), Interleukine-6 (3.74 ± 2.4 pg/ml). A positive correlation was observed between hsCRP and IMT (r = 0.301; p < 0.01), and irisin and IMT (r = 0.223; p < 0.05). CONCLUSIONS: The data suggest that stable high LTPA (2050-3840 kcal/week) is associated with the most favorable profile of key cardiovascular biomarkers and indices of atherosclerosis. Lifetime very high LTPA is associated with increased lowgrade inflammation and may, therefore, exert an atherogenic effect.

Heaviness of smoking among employed men and women in Poland.

OBJECTIVES: At least 50% of smokers die prematurely. Those who smoke heavily are at an increased health risk. The purpose of the current report was to evaluate socio-demographic correlates of heavy smoking among employed men and women. MATERIAL AND METHODS: Data derive from the representative, household study - the Global Adult Tobacco Survey conducted in Poland over the years 2008-2010. RESULTS: Of 14 000 households selected for the survey, 7840 sampled individuals completed the interviews. Among 1189 daily smokers, the rate of heavy smokers was 63.5% in males and 43% in employed females (p < 0.001). The study showed that age and age at the smoking onset were significantly associated with heavy smoking among both genders. Among males and females the heavy smoking rate was the highest in the subjects that started smoking at the age between 14-17 years compared to those who started smoking at the age ≥ 21 years (odds ratio (OR) = 3.3, 95% confidence interval (CI): 2-5.5, p < 0.001 and OR = 2.7, 95% CI: 1.4-5.3, p < 0.0001, respectively). The men with house rules that prohibited smoking with some exceptions were 2.4 times more likely to be heavy smokers in comparison with those having rules which completely prohibited it (p < 0.01). The men working in workplaces where smoking was prohibited in all indoor areas were at lower odds of heavy smoking relative to those working in areas where smoking was allowed everywhere (OR = 0.5, 95% CI: 0.3-0.9, p < 0.05). Among the men, there was also an association between job features and heavy smoking, which was not observed among the women. CONCLUSIONS: These findings should be taken into account while developing tobacco control measures addressed to economically active population.

Implementation of smoke-free homes in Poland.

OBJECTIVES: Exposure to environmental tobacco smoke (ETS) constitutes a threat to the health of many people. In order to diminish ETS exposure, countries (including Poland) implemented legal restrictions of smoking in public places and worksites. Currently more attention is also paid to reduce overall and residential ETS exposure by voluntary smoke-free home policy adoption. The aim of current analysis was to evaluate the prevalence and determinants of implementing smoking bans at place of residence among economically active males and females in Poland. MATERIAL AND METHODS: Data from cross-sectional, household study - Global Adult Tobacco Survey (GATS 2009-2010) were analyzed. The logistic regression model was applied for appropriate calculations. RESULTS: Out of 3696 studied subjects only 37.1% adopted total smoking ban within the home. Decreased likelihood of adopting total smoking bans was associated with current smoker status, low education attainment, lack of awareness on adverse health consequences of ETS, low level of support for tobacco control policies, and cohabitation with a smoker in both genders. Having smoke-free homes was also linked with age in women, place of residence and work smoking policy in indoor areas in men. CONCLUSIONS: Targeted activities to encourage adopting voluntary smoke-free rules among groups least likely to implement 100% smoking bans in the home and activities to decrease social acceptance of smoking in the presence of nonsmokers, children, pregnant woman are urgently needed.

The impact of long-term changes in metabolic status on cardiovascular biomarkers and microvascular endothelial function in middle-aged men: a 25-year prospective study.

BACKGROUND: The aim of this analysis was to examine long-term effects of changes in metabolic status on microvascular endothelial function and cardiovascular diseases (CVD) biomarkers among physically active middle-aged men. METHODS: Metabolically healthy men (n = 101, mean age 59.7 years), free of symptoms and treatment, have been prospectively observed for their lifestyle and CVD risk factors (observation period 24.7 years). At the latest follow-up (2011/2012) a set of CVD biomarkers was measured using enzyme-linked immunosorbent assay. Microvascular endothelial function was evaluated by means of the reactive hyperemia index (RHI) using Endo-PAT2000 system. At follow-up the participants were divided into metabolically healthy (0-1 metabolic parameters) and metabolically unhealthy (≥2 metabolic parameters) groups. Metabolic syndrome was defined according to the NCEP ATP III definition. RESULTS: Traditional metabolic risk factors were significantly associated with hsCRP, ox-LDL, Il-6, leptin and adiponectin/leptin ratio. Reactive hyperemia index was negatively related to body mass (p < 0.01), waist circumference (p < 0.05), triglycerides (p < 0.01), TG/HDL ratio (p < 0.01), uric acid (p < 0.05), sICAM-1 (p < 0.05) and Il-6 (p < 0.05), and positively to HDL-C (p < 0.01) and leisure-time physical activity (p < 0.01). Men who maintained metabolically healthy status (n = 47) through the observation had significantly lower hsCRP and uric acid (p < 0.05), higher adiponectin/leptin ratio (p < 0.05), higher mean RHI and lower prevalence of endothelial dysfunction (p < 0.05) as compared to the metabolically unhealthy group (n = 54). Regular physical activity level was significantly higher among metabolically healthy individuals during the whole observation. CONCLUSIONS: Even subtle changes in metabolic profile influence inflammatory biomarkers and microvascular endothelial function. Leptin, adiponectin/leptin ratio and hsCRP are significant predictors of metabolic profile. Interleukine-6 and sICAM-1 may be used as indicators of early endothelial dysfunction in asymptomatic men. High leisure-time physical activity level is an important contributor of metabolically healthy profile through middle adulthood.