[Chronic kidney disease - The relevant information for an occupational physician]. / Przewlekla choroba nerek ­ istotne informacje dla lekarza medycyny pracy.

For a number of years chronic kidney disease (CKD) has been listed in the group of lifestyle diseases, such as obesity, diabetes, cardiovascular disease and hypertension. It is estimated that in Poland more than 4 million people may suffer from various stages of CKD. Chronic kidney disease may also be a consequence of all the other civilization diseases. At the same time it is worth noting that nephrological problems are increasingly being taken into account in modern medical certification. The aim of this work is, among other things, to improve safe access to the labor for patients with kidney diseases. In the legislation existing in our country since 2014 it is stated that chronic renal failure is a potential health contraindication to driving. Also in the annex to the Regulation of the Minister of Health dated 9 December 2015 on health conditions required for seafarers to work on a seagoing ship, it is said that ICD-10 codes (International Classification of Diseases) corresponding to acute and chronic renal failure (N17-N19) should be taken into account when qualifying employees to work at sea. Med Pr 2018;69(1):67-75.

[Age and duration of employment of health care workers with occupational viral hepatitis B and C]. / Wiek i staz zawodowy pracowników ochrony zdrowia z zawodowym wirusowym zapaleniem watroby typu B i C.

BACKGROUND: In this paper we present the study of the incidence of hepatitis B and C among health care workers in the Pomorskie voivodeship in the years 1999-2009. The aim of the study was to analyze the relationship between the certified occupational HCV and HBV infections and the age and duration of employment of infected health care workers. MATERIAL AND METHODS: To analyze the epidemiological situation of occupational hepatitis among health care workers in the Pomorskie voivodeship, the data 338 occupational disease certificates were obtained. RESULTS: Of the 338 certified cases of occupational viral hepatitis during this period 222 (65.7%) cases were diagnosed with hepatitis B, and 116 (34.3%) with hepatitis C. The total number of health care workers included 301 (89%) women, and 37 (11%) men. The majority of occupational hepatitis cases occurred in the following age groups 45-49, 40-44, 50-54 and 35-39 years. The mean age for the whole population was 46.20 years. The average duration of employment was 18.34 years, and it was lower for women than for men by 1.71 years (18.15 vs. 19.86). The cases of hepatitis mostly occurred during the periods of 15-19, 20-24 and 25-29 years of employment (50% of cases). CONCLUSIONS: These data suggest that the employees used to postpone the procedure of occupational disease certification. Short work experience confirms a higher risk of infection among employees of analytical laboratories and dental offices. The relationship between a higher risk of infection in workers and a shorter duration of employment (little work experience) was evidenced.

[Occupational HBV and HCV infections among health care workers]. / Zawodowe zakazenia wirusami HBV i HCV wsród pracowników ochrony zdrowia.

BACKGROUND: Analysis of the number of reported occupational hepatitis cases in the years 1971-2009 reveals a clear upward trend in the late 1980's, followed by a downward trend that has continued to the present. The aim of this study was to determine the number of recorded occupational hepatitis B and C in the Pomorskie voivodeship in the years 1999-2009 by the type and location of health care institutions and workpost category. MATERIALS AND METHODS: To analyze the epidemiological situation of occupational hepatitis among health care workers in the Pomorskie voivodeship, the data from 338 occupational disease certificates were obtained. RESULTS: In the period under study 341 cases of occupational hepatitis B and C (hepatitis B, 229; hepatitis C 112) were recorded in the province of Pomerania. The number of occupational hepatitis B decreased by 96.6% in the years 1999-2009, and hepatitis C by 90.5% in the years 2000-2009. The majority of infections occurred in large cities (Gdansk, Gdynia and Slupsk). The total number of cases included 301 (89%) women and 37 (11%) men. The largest number of infections was observed among nurses and midwives (155 and 10 cases, respectively). Definitely the highest incidence was observed in hospitals (230 cases), analytical laboratories (42 cases), medical and dental clinics (20 cases). CONCLUSIONS: The obtained data show a significant decrease in the incidence of occupational hepatitis during the discussed period. The highest number of infections was found among employees of hospitals and laboratories. A high number of cases in a small occupational group, employees of analytical laboratories, attracted our attention.

[Evaluation of occupational medicine service tasks in the context of the Occupational Medicine Service Act, article 12, on the basis of statistical indicators in the Pomorskie voivodship]. / Ocena realizacji zadan sluzby medycyny pracy w kontekscie art. 12 ustawy o sluzbie medycyny pracy na podstawie wybranych wskazników statystycznych w województwie pomorskim.

BACKGROUND: Occupational health service is based on legal regulations. We have made an attempt to estimate the implementation of the tasks resulting from article 12 of the Occupational Medicine Service Act introduced in 1998. MATERIALS AND METHODS: In this paper we analyzed statistical data concerning the number of prophylactic health contracts, economic entities and health insurance payers. The data come from the Nofer Institute of Occupational Medicine, Central Statistical Office and Social Insurance Institution. RESULTS: Contract Coverage Rate (CCR) has been introduced for the purpose of this research. The data show that in 2007, the Contract Coverage Rate (CCR) for the Pomorskie voivodeship (province) accounted for 45.7%, with the median value of 14.4% for all voivodeships in Poland. CONCLUSIONS: According to the gathered statistical data, it should be concluded that the implementation of article 12 is insufficient. The amendment to the Act introducing the provision on written contracts is an opportunity to provide an effective mechanism, by which the present situation can be improved and the rates raised to a satisfactory level.

[Prevalence and risk factors of chronic hepatitis C virus infection among health-care workers in Pomeranian voivodeship]. / Czestosc wystepowania i czynniki ryzyka zakazenia HCV wsród pracowników ochrony zdrowia w województwie pomorskim.

OBJECTIVE: Since many people with chronic hepatitis C virus (HCV) infection are asymptomatic, the occurrence of HCV infection and the role of risk factors among the health-care workers in Poland is unknown and not yet investigated. METHODS: In order to determine the risk of HCV infection with regard to different occupational exposures and medical history, we carried out a cross-sectional study of a cohort of 4248 health-care workers in pomeranian voivodship, Northern Poland. MAIN OBSERVATIONS: The prevalence of positive anti-HCV antibodies was 1.3% (56/4248) among health-care workers. The independent predictors of positive result was the history of dialysis odds ratio (OR) 12.05 95% confidence interval (CI)1.37-105.68, history of surgery OR 1.9 95% CI 1.11-3.27 and work with direct contact with the patient OR 0.48 95% CI 0.26-0.9. We did not find any significant difference between differentjob groups. However the highest risk was related to "untrained staff" group: OR 1.87 95% CI 0.61-5.75 (doctors were the reference category because of the lowest prevalence). CONCLUSIONS: No excessive risk was found among the health-care workers as a whole or among the different categories of personnel, confirming the role of surgery and dialysis as risk factors and the beneficial role of preventative measures when working with direct contact with patients.

[A quality assessment of prophylactic examinations carried out by physicians of various specializations and qualifications among employees in the Pomorskie Voivodeship in the years 2005-2008]. / Ocena jakosci badan profilaktycznych pracowników wykonywanych przez lekarzy o róznych specjalizacjach i kwalifikacjach w województwie Pomorskim w latach 2005-2008.

BACKGROUND: The quality assessment of the prophylactic examinations of employees in the context of professional qualifications of physicians, presented by the authors, distinguished four groups of physicians legally entitled to conduct these examinations: physicians specialized in occupational medicine or with equivalent specializations, general practitioners and those with a six-year experience in industrial health service. The aim of the study was to compare the quality of prophylactic examinations and procedural errors made by these four groups of physicians. MATERIALS AND METHODS: The protocols of inspections carried out by occupational medicine center in Gdansk in the years 2005-2008 were used for analysis. The criteria have been singled out on the basis of occupational health legal regulations. RESULTS: Significant differences were noted in the quality of the conducted prophylactic examinations. CONCLUSIONS: Occupational medicine specialists were found to be the only group of physicians sufficiently qualified to conduct prophylactic examinations. In view of the study results it seems necessary to modify the training system as well as to revise professional knowledge and qualifications especially among physicians without occupational medicine specialization or to verify the range of competences assigned to them in the field ofprophylactic examinations.