[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.

[Non-occupational but work-related diseases - Legislation, judicature and potential implications to employers and employees in Poland]. / Choroby niezawodowe zwiazane z praca ­ uregulowania prawne, orzecznictwo oraz potencjalne konsekwencje dla pracodawców i pracowników w Polsce.

BACKGROUND: Non-occupational work-related diseases refer to health problems of multifactorial etiology, the occurrence, development and prognosis of which may be affected by work environment or by the way the work is performed but are not treated as occupational diseases under the applicable law. When analyzing their impact on labor market, it is necessary to also consider the employees' right to put in a claim for compensation due to the consequences of the occurrence of such diseases. MATERIAL AND METHODS: Legal regulations as well as judicial decisions on the possibilities and methods of pursuing claims for compensation from an employer due to the occurrence of non-occupational work-related disease were analyzed. RESULTS: The analyzed legal regulations and judicial decisions referred to the regulations of the Labour Code, Civil Code and Resolution of the Supreme Court of 4 December 1987. The paper presents examples of non-occupational diseases considered to be work-related and conditions necessary to assert a claim by the employee at the court. CONCLUSIONS: Despite the lack of precise legal regulations in Poland, non-occupational work-related diseases may impact the legal situation of employees as well as employers. Employees are granted the right to claim for compensation from their employers in accordance with the Civil Code. Depending on the employer's legal responsibility, it is necessary to prove the meeting of the appropriate essential conditions to put in a claim for damage. Raising the employers' awareness of the legal and financial consequences shall support the occupational medicine services in intensifying their activity aimed at preventing all work-related diseases. Med Pr 2018;69(5):539-546.

[Can diabetes be treated as an indirectly work-related disease?] / Czy cukrzyce mozna traktowac jako chorobe posrednio zwiazana z praca?

In this article the authors attempted to analyze the arguments for considering diabetes as a work-related disease. An overview of literature has been done out of articles published in the years 1980-2016, with the use of combination of key words referring to employment, workplace, and diabetes. The PubMed database was the source of data. The authors indicate that the following arguments are in favor of diabetes being recognized as a work-related disease: diabetes is not an occupational disease, it is not directly related to the work environment or the way the work is performed, but there are observed adverse effects of occupational work-related nuisances, such as night shift work, long work hours, job strain or workplace standing time, which influence its development and course. The number of publications on diabetes, including the problem of occupational work is comparable to the number of analogous publications concerning work-related diseases such as hypertension or ischemic heart disease. Moreover, some aspects of professional activity and diabetes were also included in clinical recommendations for the workplace, which is uncommon in the case of other diseases, even those generally recognized as work-related. Data from medical references, indicating the effectiveness of workplace interventions aimed at preventing diabetes development and/or worsening of its course should be considered as an argument for the inclusion of diabetes into the group of work-related diseases. This should also support the need for further research and practical actions aimed at preventing diabetes at the workplace. Med Pr 2017;68(5):667-675.

[Analysis of tasks of occupational health services accomplished in Poland, 1997-2014. Do we exploit the full potential of prophylactic examinations of workers?] / Analiza zadan sluzby medycyny pracy realizowanych w Polsce w latach 1997­2014. Czy w pelni wykorzystujemy potencjal badan profilaktycznych?

BACKGROUND: Mandatory medical reports can be used to evaluate the scope of activity of occupational health services (OHS), including the number and kind of services. MATERIAL AND METHODS: The analysis comprised data for the period 1997-2014, derived from mandatory reports MZ-35A submitted by OHS units. RESULTS: During the analyzed period the number of occupational medicine physicians decreased from 8507 to 6741, while the number of OHS units - responsible for prophylactic care - increased from 4967 to 6261. In the years under report 3,961 million mandatory health check-ups were performed, of which 99.3% resulted in issuing fitness for work certificates. Pre-employment examinations made 38.8%, while periodical ones - 52.8% and control ones - 6.7% of all check-ups. Moreover, 336 700 examinations of apprentices, students, vocational courses attendants and Ph.D. students were performed to evaluate any contradictions for vocational training. In 2014, there were 1871 workers provided with preventive care per 1 occupational physician. It was estimated that despite legal obligation, only 22.2% of employers had signed agreements with OHS units. CONCLUSIONS: The analysis of the number and kind of services provided by OHS units revealed high but not fully exploited potential for efficient prophylaxis of both directly occupational work-related and indirectly work-exacerbated diseases. Med Pr 2017;68(1):105-119.

[Physicians' knowledge on the work-related chronic obstructive pulmonary disease]. / Ocena wiedzy lekarzy na temat przewleklej obturacyjnej choroby pluc pochodzenia zawodowego.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) may be induced by the work environment conditions. According to the estimates, 10-20% of all COPD cases are associated with occupational exposure to dusts and irritant gases. However, in 2014, only 11 cases of work-related COPD were recognized in Poland. The aim of the study was to analyze the reasons for the low incidence of work-related COPD in the context of pulmonologists' knowledge about occupational risk factors and procedures on reporting suspected occupational diseases. MATERIAL AND METHODS: A survey included 94 pulmonologists randomly selected out of 225 specialists registered at the Local Physicians Chamber in Lódz. The study was performed anonymously with the use of original questionnaire. RESULTS: More than a half of the surveyed pulmonologists identified environmental risk factors for COPD correctly, while only 23.4% properly identified the main occupational risk factors as the cause of COPD. Only 58.5% of the pulmonologists always asked their patients suffering from COPD about their job/profession and 60.6% of them did not have any knowledge about procedures on reporting suspected occupational diseases. CONCLUSIONS: The physicians rarely ask patients suffering from COPD about their job/profession and the relationship between their ailments and occupational exposure. What is more, they do not know legal regulations on proper referral of a patient with a suspected case of occupational disease. The results of the study clearly indicate that there is an urgent need for increasing pulmonologists' knowledge on work-related COPD. Med Pr 2016;67(3):375-384.

[Challenges to occupational medicine in view of the problem of work-related diseases and the aging of workforce. Directions for further development and intentional changes in preventive care of employees in Poland]. / Wyzwania medycyny pracy wobec problemu chorób zwiazanych z praca oraz starzenia sie populacji osób pracujacych. Dalszy kierunek rozwoju i celowe zmiany w opiece profilaktycznej nad pracujacymi w Polsce.

The system of occupational health care in Poland, based on occupational medicine service, takes care of almost 12.5 million employees subjected to over 4.5 million obligatory periodic medical check ups. This form of providing prophylactic care comes down to examinations dictated by legal regulations, whose scope is not oriented towards a comprehensive workers' health assessment, but to the examination of the systems and organs critical to work-related dangers. Simultaneously, epidemiological data indicate a large number of chronic diseases, which may influence the professional activity, like hypertension or diabetes and a high percentage of patients not aware of their illness. Since patients participating in obligatory examinations usually feel healthy and do not use health care services on a daily basis, an occupational medicine physician has a unique opportunity to detect health disorders at an early stage, which can prevent the development of health complications affecting the condition of the patient, limiting their professional activity, but also causing additional costs of the health care system. The authors have proven the need to involve occupational medicine services in the prevention of chronic diseases and the need to introduce additional sources of financing for procedures enabling early detection of diseases the patient may not be aware of or control of the effectiveness of already diagnosed illnesses. They addressed the need to change the current legal form of establishing and announcing the range of examinations and directives for certifying the lack or presence of health contraindications to work to the specified and updated standards prepared by scientific research institutes and occupational medicine societies. Med Pr 2016;67(5):691-700.

[Good practice in occupational health services--Certification of stroke as an accident at work. Need for secondary prevention in people returning to work after acute cerebrovascular events]. / Dobre praktyki w opiece profilaktycznej nad pracujacymi--kwalifikacja udaru mózgu jako wypadku przy pracy. Potrzeba prowadzenia prewencji wtórnej u osób powracajacych do pracy po ostrych incydentach mózgowo-naczyniowych.

The classification of an acute vascular episode, both heart infarct and stroke, as an accident at work poses difficulties not only for post accidental teams, but also to occupational health professionals, experts and judges at labor and social insurance courts. This article presents the case of a 41-year-old office worker, whose job involved client services. While attending a very aggressive customer she developed solid stress that resulted in symptoms of the central nervous system (headache, speech disturbances). During her hospitalisation at the neurological unit ischemic stroke with transient mixed type aphasia was diagnosed. Magnetic resonance imaging (MRI) scan of the head revealed subacute ischemia. After an analysis of the accident circumstances, the employer's post accidental team decided that ischemic stroke had been an accident at work, because it was a sudden incident due to an external cause inducing work-related traumatic stroke. As a primary cause tough stress and emotional strain due to the situation developed while attending the customer were acknowledged. During control medical check up after 5 months the patient was found to be fit for work, so she could return to work. However, it should be noted that such a check up examination of subjects returning to work after stroke must be holistic, including the evaluation of job predispositions and health education aimed at secondary prevention of heart and vascular diseases with special reference to their risk factors.

[Employees with mental illness - possibilities and barriers in professional activity]. / Pracownik z choroba psychiczna - mozliwosci i bariery w pracy zawodowej.

In Poland patients with psychiatric problems form a large group; in 2010 there were almost 1.5 million people for whom outpatient psychiatric care was provided, whereas approximately 200 thousand ill individuals were treated in 24-h psychiatric wards. Only 17% of the mentally disabled are professionally active. The results of many researches show that despite the detrimental influence of mental disorders on the employment (e.g., lower productivity, absenteeism, presenteism, increased risk of accidents at the workplace), professional activity can play a key role in the7stabilization of the mental state, it can also help in disease recovery. People with mental disorders are a social group that is at the higher risk of exclusion from the job market. The opinion prevailing among employers is that mentally ill individuals have decreased ability to conduct professional activity, and social attitudes towards them tend to be based on marking and stigmatizing. This review tackles the advantages of working during the illness, barriers which people with mental disorders face on the job market when they want to either start or continue work, and professional functioning of people with diagnosed depression (e.g., affective disorders) and schizophrenia (representing psychotic disorders). The analysis of existing data show that to improve the situation of mentally ill people present on the job market close cooperation between the representatives of various medical specializations is necessary, as well as their active participation in the process of social and professional rehabilitation of people affected by mental disorders.

[Good practice in occupational health services - The influence of hazardous conditions and nuisance coexisting in the work environment and at home on the course and outcome of pregnancy]. / Dobre praktyki w opiece profilaktycznej nad kobieta ciezarna w miejscu pracy - wplyw czynników szkodliwych i uciazliwosci wystepujacych w srodowisku pracy i domowym na przebieg oraz wynik ciazy.

The key activity in good practice of occupational medicine is to control, on a regular basis, the workers' health and how it is affected by the work environment and - consequently - to provide the employers and employees with advice regarding the organization, ergonomics, physiology and psychology of work. Occupational medicine practitioners should remember that certain duties are performed both at work and at home. This issue is particularly important in preventive healthcare of pregnant working women. Taking the above into consideration, we reviewed the literature with respect to nuisance and occupational risk factors, which might be associated with professional and household duties. The research indicates the need to reduce activities that require frequent bending or lifting, put a women at risk of falling or cause excess occupational stress for pregnant women. We would like to draw the doctors' attention to the possibility of exceeding a 4-hour limit of work at video display terminals and negative effects of low physical exercise and sitting for a long time both at work and at home. Since long working hours (over 40 h/week) affect the course of pregnancy negatively, total working time at work (including any additional jobs) and at home must be taken into account in the occupational risk assessment. To sum up, we emphasize that preventive healthcare of pregnant working women should mainly include education programmes. Women need to know how to perform their work safely and pay attention to the scope and frequency of household tasks (duties).

[Occupational activity during pregnancy based on the Polish mother and child cohort study]. / Aktywnosc zawodowa w czasie ciazy na podstawie badania "Polska kohorta matka-dziecko".

BACKGROUND: In Poland conditions related to or aggravated by the pregnancy, childbirth or the puerperium are one of the common causes of sickness absence. The aim of the study was to analyze the occupational activity pattern during pregnancy and to evaluate the determinants of pregnancy-related temporary work disability confirmed by medical certificate. MATERIAL AND METHODS: The presented analysis is based on data collected under the Polish Mother and Child Cohort Study. The study population consisted of 954 women who reported occupational activity during pregnancy. All women participating in the study were interviewed 3 times during pregnancy. Detail information on occupational activity during pregnancy and occupational stress, based on the Subjective Work Characteristics Questionnaire, was collected from all women. RESULTS: The pregnant women had been issued medical certificate of temporary work disability because of conditions related to or aggravated by the pregnancy, childbirth or by the puerperium at 16 week of gestation on average and did not continue their activities until the end of pregnancy. The statistically significant determinants of receiving such medical certificate in the first trimester of pregnancy (< or = 12 weeks of pregnancy) comprised poor health condition and complications during pregnancy (OR = 1.4; p = 0.01), lower education (OR = 2.4; p <0.001), socio-economic status (OR = 9.6; p = 0.03), use of public transport to commute to work (OR = 2.7; p <0.001), a longer work commute (OR = 1.4; p = 0.008) and a higher level of occupational stress (OR = 3.0; p < 0.01). Waitresses, nurses and saleswomen received medical certificate of temporary work disability in the first trimester of pregnancy more frequently than office workers (OR = 4.2; p = 0.005; OR = 3.3; p = 0.02; OR = 2.3; p < 0.001 respectively). CONCLUSIONS: It is crucial to develop the model of cooperation between occupational medicine physicians and gynecologists and a greater involvement of the former in the prophylactic care of occupationally active pregnant women. It is also important to increase the employers' awareness of potential risks and arduousness at work to assure working conditions safe for the pregnancy outcome and health of both women and their babies.

[Good practice in occupational health services: recommendations for prophylactic examinations and medical certifications in persons with diabetes mellitus]. / Dobre praktyki w opiece profilaktycznej nad pracujacymi-zalecenia do badan profilaktycznych oraz postepowania orzeczniczego u osób z cukrzyca.

The prevalence of diabetes and a significant proportion of unawareness of its risk among the patients indicate the need to include into general prophylactic examinations the standards of medical certification, which would prevent discrimination and ensure public safety. In certifying medical predispositions to work in a person with diabetes mellitus the key issue is to distinguish 2 categories of medical requirements: the higher - related to qualifying workers for jobs demanding psychophysical abilities, which affect the safety of the workers and their environment and the lower - related to qualifying workers for jobs characterized by harmful factors and nuisances, which might have a negative effect on the course of diabetes. The very fact of having diabetes cannot be the reason for the patient being disqualified and the decision on certifying the capacity to perform a particular job should always be based on an individual health assessment of the patient, taking into account the risk of hypoglycemia, metabolic control, the progression and dynamics of chronic complications, as well as the level of health awareness in patients. The objective assessment of the health status of the patient with diabetes involves the judgment of an attending physician, additionally supported by the consultation of a diabetes specialist to ensure that the patient is able to perform properly the job, requiring psychomotor abilities.

[Resources and activities of voivodeship occupational medicine centers in Poland during the COVID-19 pandemic]. / Zasoby i dzialalnosc wojewódzkich osrodków medycyny pracy w Polsce w okresie pandemii COVID-19.

BACKGROUND: Voivodeship Occupational Medicine Centres (VOMC), being higher-level units towards basic units providing preventive care for employees in Poland, play a consultative, appeal, supervisory and registration role towards them. Additionally, they perform many other tasks specified in the Occupational Medicine Service Act, including conducting diagnostic and jurisprudential activities related to occupational diseases and postgraduate education in occupational medicine. MATERIAL AND METHODS: The analysis covers data from 2017-2022 on VOMCs activities, derived from mandatory MZ-35 reporting. RESULTS: Over 6 years, the number of employed physicians at VOMCs decreased from 830 in 2017 to 820 in 2022, with >20% of employment contracts transitioning to other forms of cooperation. The number of employed nurses decreased from 375 to 342, and the number of psychologists from 86 to 82. During the 3 years of the pandemic (2020-2022), compared to 2017-2019, the consultative activity of VOMCs for basic units of occupational health service decreased by nearly 30%, while appeal and supervisory activities decreased by 15.2% and 15.8%, respectively. The number of individuals receiving outpatient medical rehabilitation for occupational pathology decreased by >32%, and the number of services provided for established occupational pathology decreased by >14%. The number of certifications for occupational diseases decreased from 3963 in 2019 to 3518 in the first year of the pandemic, then increased to 4145 in 2021 and 3990 in 2022. CONCLUSIONS: The COVID-19 pandemic had a significant impact on the functioning of VOMCs. Changes in specific areas of their judicial, consultative, appeal, supervisory, training and rehabilitation activities corresponded with the socio-legal changes observed between 2020-2022. The structure of employment at VOMCs and the scope of their tasks remained stable during the pandemic. The observed changes in employment of medical staff were in line with general trends in healthcare institutions and regional conditions. Med Pr Work Health Saf. 2024;75(4).

Attitudes regarding vaccination on the example of COVID-19 prevention.

BACKGROUND: COVID-19 vaccines for public use were approved at the turn of 2020 and 2021. The level of vaccination coverage against COVID-19 in Poland is one of the lowest in Europe. Despite scientific studies there are people who are afraid of vaccinations and spread false information about them. Vaccinations against COVID-19 allowed to learn about the attitudes of people who decided to be vaccinated, which can be used to improve the effectiveness of the infectious diseases prevention in the work and public environment. The aim of the study was to analyze the main reasons determining a decision to get vaccinated against COVID-19. MATERIAL AND METHODS: The study was carried on among all the people who decided to be vaccinated against COVID-19 in Nofer Institute of Occupational Medicine in Lódz. All vaccinated people completed an anonymous survey containing questions related to the most important factors, which encouraged them to undergo this vaccination. RESULTS: The study involved 945 people vaccinated against COVID-19. Statistical significance was revealed between 3 different reasons (one's own health, stress-free work, safe travelling and easier access to entertainment) for getting vaccinated and age, gender and a form of employment. The authors also found statistical significance of the correlation between the age, gender, education and form of employment of the respondents and the reason for choosing the specific vaccine product. CONCLUSIONS: Despite evidence presented by scientists about the effectiveness and safety of vaccinations, many people refused and still refuse to receive the vaccine. In order to increase the readiness of the population for vaccinations against COVID-19 and subsequent ones, if there is a need to limit new epidemics, the following should be done: introduce activities to raise health awareness, intensify strategies and campaigns aimed at increasing public trust in available vaccines against COVID-19, devolop individualized messages that contribute to vaccine hesitancy. Med Pr Work Health Saf. 2024;75(2):123-131.

[Preventive care of pregnant employees. Is there a need to set rules of cooperation between occupational and gynecologist-obstetricians?]. / Opieka profilaktyczna nad pracujaca ciezarna--czy istnieje potrzeba okreslenia zasad wspólpracy miedzy lekarzem medycyny pracy a ginekologiem-poloznikiem?

BACKGROUND: From 2008 the obstetric care for pregnancy-related conditions has been the most common cause of sickness absence. One of the postulated causes of frequent use of sick leaves by gravids is the fear of potential harmful and arduous factors in the workplace. An insufficient involvement of occupational health services in the implementation of actions aimed at protecting pregnant employees from risks to their health and safety in the work environment, imposed by Polish law, is also suggested. MATERIALS AND METHODS: A survey on the current state of preventive care of pregnant employees was conducted among gynecologists-obstetricians working in the Lodz hospitals. They were asked to present their opinions in this regard. RESULTS: In the opinion of the surveyed gynecologists occupational physicians do not implement their tasks involving preventive care of pregnant employees, and the main burden of care lies with their gynecologists. They admitted that the decision to certify that a pregnant employee is temporarily unable to work is determined not only by the health assessment of a pregnant employee, but also by exposures and loads occurring in her workplace. They emphasized the lack of direct contacts between gynecologists and occupational physicians who should share the information on the potential impact of working conditions on the pregnant employee's health. CONCLUSION: The survey confirmed the need, noticed also by gynecologists to elaborate standards of specific preventive care addressed to pregnant employees and to set the rules of cooperation between occupational physicians and gynecologist-obstetricians.

[Active physician attitude vs. patient inertia: detection of chronic myeloid leukemia during periodic examinations]. / Aktywna postawa lekarza versus inercja pacjenta: wykrycie przewleklej bialaczki szpikowej podczas badan okresowych.

The case report concerns the prophylactic and medical certification procedure initiated during periodic examinations, which led to the early detection of chronic myeloid leukemia. Particular attention was paid to the shortening of the period of validity of the periodic examination, justified by an abnormal health condition that is not directly related to the working conditions, as well as the method of communication and influencing the employee to comply with medical recommendations. The conclusions stated that, although obligatory and periodic preventive examinations for the purposes of the Labor Code create the possibility of early detection of unawereness of disease, thus giving a chance to improve health, but at the same time they can be treated as an interference with the individual's right to self-determination about his life and health. It was noted that the key factor in assessing the situation would be the attitude of the occupational medicine physician and the manner of his communication with the employee, who would not be forced, but convinced - for his benefit, to undertake diagnostics or health interventions. Med Pr. 2022;73(6):485-90.

[The impact of the COVID-19 pandemic on the resources and activities of basic occupational health services in Poland]. / Wplyw pandemii COVID-19 na zasoby i dzialalnosc jednostek podstawowych sluzby medycyny pracy w Polsce.

BACKGROUND: In 2020, the first year of the COVID-19 pandemic, there were a number of factors affecting employees, employers, and consequently, both directly and indirectly, the occupational health service (OHS). The purpose of this publication is to analyze the activity of physicians and OHS units in this period in Poland. MATERIAL AND METHODS: The analysis of the number of physicians, OHS units and their activities was performed on the basis of the MZ-35 and MZ-35A statistical forms, which represent obligatory medical reporting. RESULTS: There were 6349 occupational medicine physicians in Poland, who are entitled to conduct prophylactic examinations of employees and provide preventive health care, necessary due to working conditions (less by 248 [3.8%] compared to 2019). At the same time, the number of OHS basic units decreased to 5784 (by 3.2%). In 2020, occupational health physicians reported 4 314 520 prophylactic examinations of employees and job applicants, what is over 1 million 231 thousand (22.2%) less than in the year preceding the pandemic. In addition, they reported the performance of 255 887 prophylactic examinations related to the practical vocational training of pupils, students, participants in qualification vocational training and Ph.D. candidates (less by 157 220 [38.1%]). In 2020, they performed 1 933 355 preliminary examinations (23.9% less), 1 924 929 periodic examinations (25.1% less) and 456 236 follow-up examinations (5.1% more). In 2020, there was also a significant decrease in the number of visits to entire workplaces (from 6437 to 3625) and individual positions (from 46 197 to 26 389) carried out by OHS units. Also in 2020, an almost threefold increase (to 2183) in the number of suspected occupational diseases was reported by OHS physicians. In 2019, the duty to submit an annual report regarding prophylactic activities on the MZ-35A form has been obeyed by only 3607 (56.8%) obliged physicians. CONCLUSIONS: The COVID-19 pandemic has significantly affected preventive activities carried out by occupational physicians. Med Pr. 2022;73(1):19-24.

[Is dental prophylaxis justified in activities of occupational medicine?] / Czy profilaktyka stomatologiczna ma uzasadnienie w dzialaniach z zakresu medycyny pracy?

BACKGROUND: The growing incidence of caries at all ages groups, justifies the need of constant search for effective methods of preventing, also in the context of the assessment of the impact of occupational agent. The research hypothesis assumed that due to the specificity of the profession, students of the gastronomic school have forced, additional contact with food. Thus it might be difficult for them students to maintain proper oral hygiene and, consequently, increase the incidence of tooth decay. MATERIAL AND METHODS: The study group comprised 109 men: 55 students of a gastronomic technical school (GA) and for comparison 54 students of an electrical and IT technical school (E-I), whose vocational education was completely unrelated to food processing. The study was performed at 2 stages (at the beginning and after 3 years of practical vocational training) and comprised of 2 parts: a dental examination and a questionnaire examination (assessment of individual oral hygiene, preferred food products and sources of knowledge about nutrition). RESULTS: After 3 years of observation, a higher, statistically significant, increase in the number of people with caries (P > 0) was observed in the group of students from the E-I school. The analysis of the sources of knowledge on healthy eating and oral hygiene showed that after 3 years of practical vocational training, the main source of knowledge for GA students was school and the Internet, for E-I students the internet and the family. CONCLUSIONS: The smaller increase in the incidence of tooth decay in the group of GA might probably be associated with the theoretical and practical teaching of food and nutrition in the school. Therefore, the methods of conducting pro-health education on oral hygiene in vocational schools should be improved and the standards of medical conduct during obligatory preventive examinations in every student starting their practical vocational training should be extended. Med Pr. 2022;73(3):219-27.

Nutritional Education and the State of Oral Health in Adolescents.

Background. Health promotion of adolescents is a high priority in Poland. Epidemiological data still indicates the low effectiveness of the health care system in this area. The relationship between the state of oral health and the vocational education of adolescents seems to be justified. The objective is to evaluate changes in the oral health status, eating habits, and the relationship between oral health and lifestyle related to vocational education among students from a secondary technical school of gastronomy and electro-engineering and information technology. Methods. The study consisted of two stages (at the beginning and end of education) and two parts: a questionnaire and a dental examination. The study group initially included 55 male students from the secondary technical school of gastronomy and 54 in electro-engineering and information technology school. In the second stage of the study, it was 42 and 51, respectively. Results. After three years, in the engineering and information technology group, compared to gastronomy one, a statistically significant increase in caries prevalence and the number of students eating between meals was observed. Conclusions. Professional education on proper nutrition conducted in the gastronomic school could have a decisive impact on the better oral health status of students.

[New medical standards for evaluation of driving predispositions of people suffering from diabetes mellitus]. / Nowe zasady orzecznictwa lekarskiego w zakresie oceny predyspozycji zdrowotnych do kierowania pojazdami u osoby chorej na cukrzyce.

As a result of the changed Ordinance of January 7, 2004, issued by the Ministry of Health, new medical standards for assessing people suffering from diabetes mellitus, in terms of their health contraindications for driving, came into force on June 29, 2011. Thus the medical standards for diabetes and driving have been harmonized with EU regulations. New standards for diabetes and driving define the key terms such as severe and recurrent hypoglycemia, and hypoglycemia awareness. In addition, health contraindications for Group 1 and Group 2 driving license, deadline for subsequent medical check-ups and indications for diabetologic consultation are defined. The regulations also introduce a new tool in the form ofa consultation file produced by the diabetologist. The structure of the consultation file imposes on the diabetologist an obligation to provide the physician, certifying the ability or disability to drive, the key diabetologic information. This guarantees an objective medical opinion based on an individual approach appropriate for each case.

[Occupational and work-related diseases in community law and in the legislature of selected EU member states - a comparative perspective]. / Choroby zawodowe oraz choroby niezawodowe zwiazane z praca w prawie wspólnotowym i wybranych krajach Unii Europejskiej ­ ujecie porównawcze.

Work-related diseases that are not included in the occupational diseases lists have become a significant social phenomenon, generating increasing costs for the EU member states and for European employers. The impact they have on workers' health and claims results in a need to implement changes in the legislation, which in Poland is currently limited to providing protection and prevention of already established occupational diseases. In the review, a formal-dogmatic approach was used, in a manner of analyzing the current state of Polish legislation and court rulings based upon it. The Polish legal framework was compared to that of the 3 EU member states selected on the basis of their regulations concerning occupational and work-related diseases (Germany, Finland and Ireland). The presented arguments indicate the purpose of the need for a change in the Polish legal framework of occupational and work-related diseases in the direction of either the Finnish or German model. The current Polish law forces people suffering from those work-related diseases which are not recognized as occupational diseases to seek legal remedies under general provisions of civil law, which demands proving not only an adequate causal link between the type of work and the disease but also the employer's culpability, which puts the affected employee in a worse legal situation than those suffering from an established occupational disease. The provisions of the statutory law implemented in the Federal Republic of Germany provides a solution for a fraction of the abovementioned problems deriving from the referred differences in occupational and work-related diseases regulation, while the Finnish model, based on causality, instead of the legal definition of occupational disease as such, practically allows for a complete elimination of the problem. Med Pr. 2021;72(5):549-60.