Wyniki wyszukiwania - Biblioteka Nauki

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Work safety among Polish health care workers in respect of exposure to bloodborne pathogens

100%

Rybacki M. , Piekarska A. , Wiszniewska M. , Walusiak-Skorupa J.

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tom 64

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nr 1

1-10

PL

Wstęp: Wirusowe zapalenie wątroby jest drugą najczęściej stwierdzaną zakaźną chorobą zawodową i rozpoznawaną głównie u pracowników ochrony zdrowia. Ta grupa zawodowa jest najbardziej narażona w miejscu pracy na ryzyko ekspozycji na patogeny krwiopochodne, w tym wirusy HBV i HCV. Celem badania była ocena skuteczności działań ukierunkowanych na bezpieczeństwo pracy w placówkach ochrony zdrowia, częstości incydentów ekspozycji na materiał biologiczny w ostatnich 12 miesiącach poprzedzających badanie oraz ich zgłaszalności. Materiał i metody: Do analizy użyto badania kwestionariuszowego przeprowadzonego w latach 2009-2010 wśród 1138 pracowników ochrony zdrowia. Wyniki: Ekspozycja na materiał biologiczny miała miejsce u 242 pracowników (21% całej grupy). Tylko 146 osób zgłosiło te zdarzenia odpowiednim służbom. Przypadkowe przerwanie ciągłości tkanek miało związek z postrzeganiem pracy jako obarczonej wysokim stopniem narażenia (OR = 3,69, p = 0,0027), zatrudnieniem w ambulatoryjnych (w porównaniu ze stacjonarnymi) placówkach ochrony zdrowia (OR = 1,71, p = 0,0089), przekonaniem o niewystarczającym poziomie przekazywanych przez zakład pracy informacji na temat zakażeń krwiopochodnych oraz brakiem procedur i wiedzy dotyczących raportowania ekspozycji. Wnioski: Mimo prezentowania w różnych publikacjach wytycznych dotyczących postępowania poekspozycyjnego, szczególnie w placówkach nieświadczących usług całodobowych, procedury te są nieznane bądź nieprzestrzegane. Powinien być kładziony większy nacisk na szkolenie pracowników, szczególnie w zakresie ryzyka transmisji zakażeń oraz korzyści płynących z przestrzegania procedur poekspozycyjnych i zgłaszania przypadków ekspozycji. Med. Pr. 2013;64(1):1-10

EN

Objectives: Viral hepatitis is the second most often identified infectious illness acquired at work and it is mostly registered among health care personnel. This group of workers is at greater risk of exposure to blood and bloodborne pathogens, including hepatitis B and C viruses. The aims of this study were to evaluate the efficacy of methods promoting work safety in healthcare settings, to assess the frequency of exposures in the last 12 months prior to the study and to determine a rate of reporting them to appropriate authorities. Methods: A total of 1138 Polish healthcare workers were interviewed during the study period (between 2009 and 2010). Results: Sustaining accidental occupational percutaneous exposure during last 12 months was declared by 242 workers (21% of the whole group). Only in 146 cases these incidents were reported to authorities. Exposure incidents were associated with self-perception of high risk of exposure (OR = 3.69, p = 0.0027), employment in out-patient (vs. hospital-based) healthcare setting (OR = 1.71, p = 0.0089), conviction that the level of information about bloodborne infections conveyed at work was insufficient, lack of both exposure reporting system and knowledge about the ways of reporting. Conclusions: Despite the different established proposals of the post-exposure procedures, it turns out that particularly in small, not providing 24 hours service healthcare settings these procedures are not known or are not respected. More attention should be given to education, especially in regard to the risk of infection, advantages of post-exposure prophylaxis and reporting exposure incidents. Med Pr 2013;64(1):1–10

2

Czy eozynofilowe zapalenie oskrzeli można zakwalifikować do grupy chorób zawodowych? Aspekty orzecznictwa lekarskiego

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Kleniewska A. , Wiszniewska M. , Walusiak-Skorupa J.

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tom 64

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nr 4

569-578

EN

Eosinophilic bronchitis (EB) is a condition which can be associated with occupational exposure to low, as well as to high molecular weight allergens. The prevalence of occupational eosinophilic bronchitis is unknown and the data concerning its work-related etiology are available only from the case reports. However, there is a need to establish the principles, especially in the context of medical certification among workers occupationally exposed to allergens. This paper reviews current knowledge on the etiology, clinical features, and diagnostic procedures in the eosinophilic bronchitis. The importance of EB, especially in view of the problems emerging in the prophylactic care taken by occupational health services and the principles of medical certification when occupational etiology is suspected are also presented. Med Pr 2013;64(4):569–578

PL

Eozynofilowe zapalenie oskrzeli (EZO) jest schorzeniem, które może być związane z zawodowym narażeniem na alergeny zarówno o dużej, jak i małej masie cząsteczkowej. Nie ma danych epidemiologicznych na temat częstości występowania EZO spowodowanego ekspozycją zawodową, a dostępne informacje o zawodowej etiologii choroby pochodzą z opisów przypadków klinicznych. Istnieje jednak konieczność opracowania zasad dotyczących orzecznictwa i profilaktyki EZO wśród pracowników zawodowo narażonych na czynniki o działaniu alergizującym. W pracy przedstawiono etiologię, obraz kliniczny oraz metody diagnostyczne eozynofilowego zapalenia oskrzeli. Omówiono również znaczenie tego schorzenia w medycynie pracy, szczególnie w aspekcie opieki profilaktycznej nad pracownikiem, oraz zasady orzecznictwa w przypadku podejrzenia zawodowej etiologii schorzenia. Med. Pr. 2013;64(4):569–578

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Identification of cross-reactive carbohydrate determinants in subjects reporting work-related respiratory symptoms

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Wiszniewska M. , Zgorzelska-Kowalik J. , Nowakowska-Świrta E. , Walusiak-Skorupa J.

International Journal of Occupational Medicine and Environmental Health

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2015

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tom 28

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nr 1

90-101

EN

Introduction: The role of cross-reactive carbohydrate determinants (CCDs) in diagnostics of occupational allergy remains unclarified and its clinical relevance is still questioned. The aim of the study was to assess the frequency of positive response to CCDs in the subjects with suspected occupational allergy and the relationship between other diagnostic test results and final diagnosis. Material and methods: The study group included 201 patients. They underwent clinical examination, skin prick test (SPT) to common and occupational allergens, specific serum immunoglobulin (sIgE) determinations, spirometry and specific inhalation challenge test. Moreover, sIgE to CCDs from bromelain was assessed in all subjects. Results: Occupational respiratory allergy was recognized in 64.3% of CCD-positive and 52.4% of CCD-negative patients. Positive SPT results to common and occupational allergens were found in 64.3% and 35.7% of CCD-positive subjects, respectively. In all subjects with CCDs, the sIgE to grass pollens as well as to occupational allergens were detected. The total IgE level > 100 kU/l was significantly associated with the presence of sIgE to CCDs. Conclusions: sIgE to CCDs were found in 7% of subjects suspected to suffer from occupational respiratory allergy. The presence of CCDs is not significantly associated with occupational respiratory allergy. It is also not more frequent in subjects reporting work-related respiratory symptoms in whom occupational allergy was not confirmed. The elevated total IgE level was related with CCD positivity. In patients with suspected occupational allergy, the presence of sIgE to CCDs in serum did not indicate the irrelevance of positive sIgE to occupational allergens.

4

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

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Nowakowska-Świrta E. , Wiszniewska M. , Lipińska-Ojrzanowska A. , Walusiak-Skorupa J.

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nr 2

235-239

EN

ObjectivesVarious 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 MethodsFour 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.ResultsPositive 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.ConclusionsThe 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.

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Dobra praktyka w opiece profilaktycznej: opieka profilaktyczna i aktywizacja zawodowa osób niepełnosprawnych z chorobami układu oddechowego

88%

Wiszniewska M. , Tymoszuk D. , Lipińska-Ojrzanowska A. , Wągrowska-Koski E. , Walusiak-Skorupa J.

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tom 64

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nr 3

427-438

EN

Respiratory diseases are a cause of long-term sickness absence, and even of partial or complete inability to work. This paper presents the first in Poland description of principles of good practice in occupational health service provided for people with respiratory diseases. The issues concerning the certification of the ability to work in this group of patients are discussed. The key-principles of preventive care of workers with obstructive and interstitial lung diseases with particular attention paid to the control of major risk factors are also presented. The importance of possible contraindications for job performance by workers affected by these diseases, as well as the responsibilities of occupational health physicians were highlighted. Med Pr 2013;64(3):427–438

PL

Choroby układu oddechowego są istotną przyczyną długotrwałej absencji chorobowej, a nawet częściowej lub całkowitej niezdolności do pracy zawodowej. Artykuł jest pierwszym w Polsce opracowaniem zasad dobrych praktyk w opiece profilaktycznej nad osobami z chorobami układu oddechowego. Omówiono w nim zagadnienia związane z orzekaniem o zdolności do pracy u tych osób oraz przedstawiono kluczowe elementy opieki profilaktycznej nad pracownikiem z obturacyjnymi i śródmiąższowymi chorobami układu oddechowego, ze szczególnym uwzględnieniem kontroli czynników ryzyka. Zwrócono również uwagę na możliwe przeciwwskazania do wykonywania pracy w przypadku tych schorzeń oraz zadań lekarza sprawującego opiekę profilaktyczną. Med. Pr. 2013;64(3):427–438

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Spirometric and hygienic criteria in recognition of occupational COPD in Poland – A retrospective analysis of medical records

88%

Kleniewska A. , Walusiak-Skorupa J. , Lipińska-Ojrzanowska A. , Szcześniak K. , Wiszniewska M.

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nr 2

139-150

EN

Objectives: Chronic obstructive pulmonary disease (COPD) may be work-related. It has been estimated that 15% of the population burden of COPD is attributable to occupational exposure. However, in Poland COPD is rarely recognized as an occupational disease. The aim of the study has been to analyze the causes of the low prevalence of work-related COPD in the context of the existing criteria as well as to analyze which part of the assessment – clinical or hygienic one – is responsible for such a low rate of occupational COPD recognitions. Material and Methods: The study group included 150 patients hospitalized with a suspicion of occupational COPD. Each patient underwent a clinical examination, spirometry and reversibility test using bronchodilator. Moreover, hygienic evaluation of work conditions was performed in all the considered cases. Results: In the case of the patients who fulfilled the criteria for COPD diagnosis in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) occupational origins of the disease, the disease was not recognized because 24.1% of the individuals did not meet spirometric criteria included in a definition of COPD in the Polish list of occupational diseases, while 27.8% of the individuals did not fulfill the criterion of a documented exposure to dusts and irritant gases. None of these criteria was fulfilled by 42.6% of the patients. Conclusions: In our country, both clinical and hygienic criteria result in limitations in recognition of occupational COPD. There is the need to establish new guidelines for the recognition of COPD as a compensable disease in Poland. Int J Occup Med Environ Health 2018;31(2):139–150

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The role of occupational health services in cancer prevention – which factors determine the implementation of preventive measures?

88%

Wiszniewska M. , Marcinkiewicz A. , Lipińska-Ojrzanowska A. , Kalska-Sochacka K. , Walusiak Skorupa J.

International Journal of Occupational Medicine and Environmental Health

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2021

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tom 34

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nr 6

723-736

EN

ObjectivesEpidemiological 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 MethodsThe study was conducted among 362 OMPs. The interviews were carried out by the computer assisted telephone interview (CATI) method.ResultsOver 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).ConclusionsIn 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.

8

Contact blepharoconjunctivitis due to black henna - A case report

75%

Pas-Wyroślak A. , Wiszniewska M. , Kręcisz B. , Świerczyńska-Machura D. , Pałczyński C. , Walusiak-Skorupa J.

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nr 2

196-199

EN

Para-phenylenediamine (PPD) can induce immediate or – more often – delayed hypersensitivity. We report the case of 48-year old female admitted to the out-patient allergy clinic a day after her visit in a beauty parlour, where she had her eyelashes and eyebrows dyed with henna. Physical examination revealed prominent edema of the upper part of the face including forehead, cheeks and eyes causing severe narrowing of the palpebral chink. Skin prick tests (SPT) with common allergens were positive for Dermatophagoides pteronyssinus, Dermatophagoides farinae and moulds, while the SPT with PPD was negative. Patch test to PPD was positive. Further investigations revealed eosinophilia in the tear fluid. To our knowledge, this is the first case of PPD-induced contact blepharoconjunctivitis (CB) with concomitant increased eosinophilia in the tear fluid.

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Evaluation of selected risk factors for cardiovascular diseases and diabetes as a background for the prevention program in occupational healthcare

75%

Lipińska-Ojrzanowska A. , Walusiak-Skorupa J. , Ojrzanowski M. , Marcinkiewicz A. , Plewka M. , Wiszniewska M.

International Journal of Occupational Medicine and Environmental Health

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2021

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tom 34

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nr 3

403-413

EN

ObjectivesCardiovascular 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 MethodsOverall, 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.ResultsWomen 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.ConclusionsCivilization 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.