Showing papers in "Medycyna Pracy in 1998"

[The role of free radicals in mechanisms of biological function exposed to weak, constant and net magnetic fields].

Abstract: For many years biological effect of magnetic fields has been the subject of great interest. Based on the current body of knowledge, many specialists suggest that it may play some role in the process of embryogenesis and teratogenesis; disturb the functioning of the central nervous and immunological systems; and effect cellular growth and differentiation, particularly in terms of carcinogenesis. However, sufficient evidence collaborating the assumption of health hazard arising from general exposure to magnetic field has not as yet been provided. At present, very intensive studies have been carried out in order to elucidate the mechanism of the effect of magnetic fields both in terms of physical and biological aspects. The authors present the most recognised hypotheses among those suggested in this area. They devote more attention to the hypothesis on a possible effect of weak magnetic fields, namely those observed in the occupational and commmunal environments, on free radicals which play a key role in a number of processes occurring in live organisms. The results of in vitro studies which confirm that such a mechanism does exist in simple biological systems are also discussed. The effect of this mechanism on the whole organism is still unknown. The future experimental, particularly in vivo, studies should provide a final answer to the question whether the effects observed are only transient ones or whether they play a decisive role in the mechanism of magnetic fields affecting human organism.

Usefulness of determining urinary markers of early renal damage for monitoring nephrotoxicity during occupational exposure to mercury vapors

Abstract: Using nephelometry, concentration of albumin, IgG, transferrin, retinol binding protein (RBP) alpha 1-microglobulin were determined in urine of 83 males with history of occupational exposure to metallic mercury vapours from 0.6 to 37 years, and in 30 non-exposed males. The weighted average of mercury air concentrations was 0.028 mg/m3. Duration of occupational exposure to mercury vapours did not elevate urine excretion of proteins. The urine concentration of proteins in question were higher (especially beta 2-m) in workers with urine mercury concentration between 51 and 150 microliter-1 and highest in workers with urine mercury concentrations above 150 micrograms l-1 and the differences were significant. In addition, a positive correlations between urine mercury concentrations and alpha 1-m (r = 0.33) as well as between urine mercury concentration and albumin (r = 0.31) were observed. In conclusion, the determination of proteins in urine as markers of early renal damage may be useful for monitoring occupational exposure to mercury vapours, especially in the group of workers with elevated values of urine mercury concentrations.

[Levels of immunoglobulin and subpopulations of T lymphocytes and NK cells in men occupationally exposed to microwave radiation in frequencies of 6-12 GHz]

Abstract: Immunoglobulin concentrations and T-lymphocyte subsets in workers of TV re-transmission and satellite communication centres were assessed. An increase in IgG and IgA concentrations, an increased count of lymphocytes and T8 lymphocytes, an decreased count of NK cells and a lower value of T-helper/T-suppressor ratio were found. Neither disorders in immunoglobulin concentrations nor in the count of T8 and NK cells had any clinical implications.

Urinary cotinine as a biomarker of exposure to tobacco smoke

Abstract: Several markers are used to monitor active or passive exposure to tobacco smoke. They include measurements of carboxyhaemoglobin in the blood, carbon dioxide in the expired air, thiocyanates and nicotine in the saliva, plasma (serum) or urine. The determination of cotinine, the main nicotine metabolite, in biological fluids is a biomarker which finds still wider application. This metabolite can be determined in the urine and saliva and plasma. Cotinine, as a biomarker of exposure to tobacco smoke, is used in epidemiological studies aimed to find out to what extent the exposure to occupational harmful factors affects the workers' health. The application of this biomarker helped to classify workers more effectively into smokers and non-smokers, and to provide better conditions for finding out whether other non-occupational factors such as smoking do not confound the evaluation of health threats induced by work-related hazards.

[Biological effects of non-ionizing electromagnetic radiation]

Abstract: Since the mid 1970's, when Adey discovered that extremely-low-frequency electromagnetic field (ELF EMF) may affect the calcium ions efflux from various cells, bioeffects of non-ionizing radiation (NIR) have become the subject of growing interest and numerous research projects. At present, the fact that NIR exerts both stimulatory and inhibitory effects on different physiological cellular parameters is rather unquestionable. At the same time, some epidemiological studies suggest that exposure to EMF is potentially harmful even if its intensity is very low. It has been proved that thermal factors are not responsible for these effects, therefore nowadays, they are called 'non-thermal effects'. Our paper deals with three different aspects of biological effects of non-ionizing radiation, bioelectromagnetism, electromagnetobiology and electromagnetic bioinformation. Firstly, we describe how EMF and photons can be produced within a living cell, how biological cycles are controlled, and what are the features of endogenous electromagnetic radiation. Secondly, we discuss various facets of external EMF interactions with living matter, focusing on extremely-low-frequencies, radio- and microwaves. Possible mechanisms of these interactions are also mentioned. Finally, we present a short overview of current theories which explain how electromagnetic couplings may control an open and dissipative structure, namely the living organism. The theory of electromagnetic bioinformation seems to explain how different physiological processes are triggered and controlled, as well as how long-range interactions may possibly occur within the complex biological system. The review points out that the presented research data must be assessed very carefully since its evaluation is crucial to set the proper limits of EMF exposure, both occupational and environmental. The study of biological effects of non-ioinizing radiation may also contribute to the development of new diagnostic and therapeutic methods.

[Skin reactivity in subjects sensitive to different concentrations of nickel, chromium and cobalt].

Abstract: Patch tests with serial dilutions of nickel sulphate, potassium dichromate and cobalt chloride in petrolatum were performed on 124 nickel-sensitive, 64 chromium-sensitive, and 72 cobalt-sensitive subjects. The lowest eliciting patch test concentrations were as follows: nickel sulphate--0.005, potassium dichromate--0.0025, and cobalt chloride--0.005.

Evaluation of reproductive disorders in men occupational exposed to lead

Abstract: The objective of the study was to define the prevalence of reproductive disorders in men occupationally exposed to lead in concentrations occurring usually in the work environment. The period of time preceding the conception in couples in which men were occupationally exposed to lead was adopted as the measure of the disorder. A cross-section survey was performed. Men of selected plants of Upper Silesia and Glogow responded to questions included in the questionnaire regarding age, education, occupation, occupational exposure, health condition, addictions, the situation in the family as well as questions concerning the respondent's spouse (age, education, occupation, addictions, health condition). The blood lead concentrations in persons exposed to this metal in the period preceding the conception were defined on the basis of medical data stored by the plant occupational outpatient clinics. The control group consisted of workers of the metallurgic industry, living in Lodź or its vicinity, and non-occupationally exposed men living in Silesia. In total 341 exposed men and 510 non-exposed controls participated in the study. The investigated groups were rather homogeneous as to the age of those under study and their spouses, education, addictions and the number of children. The analysis of the survey results indicated that in 5% of couples in the control group the time before conception exceeded one year. A similar occurrence of reproductive disorders was found in couples in which man was occupationally exposed to lead. The proportion of couples with reproductive disorders in this group (regardless of the size of Pb exposure) was 6%. The stratification of the Pb-exposed groups, taking into account the exposure size in accordance with the WHO criteria (group 1-220 micrograms/l, that is below the accepted value above which the ZnPP level increases; group II-PbB 200-400 micrograms/l that is up to the level recommended as the highest level for the population occupationally exposed to lead; and group III-PbB above 400 micrograms/l) allowed the analysis of the frequency of reproductive disorders depending on the size of the exposure. The percentage of couples with delayed conception accounted for 4.5% in group I; 8.7% in group II, and in group III did not differ significantly from that in the control group. These results show that men's occupational exposure to lead below allowable concentration in the biological material (500 micrograms/Pb/l blood in Poland or 400 micrograms/Pbl recommended by WHO) does not pose the risk for prolonged period preceding the conception in their partners.

The effects of occupational exposure to nitrogen dioxide (NO2) on the immunological parameters in workers

Abstract: The study of T-cell subpopulation: T CD3+, T CD4+, T CD8+; NK CD16+ and B CD19+ cells as well as of serum concentrations of immunoglobulins G, A, M, E, complement components C3c and C4, total circulating immune complexes (CIC), CRP, haptoglobin, ceruloplasmin and transferin, was carried out in 16 males, smokers and non-smokers. The control group of smokers and non-smokers comprised 36 males not exposed to any chemical compound. The study was performed also in two groups of non-smokers: 5 workers occupationally exposed and 7 non-exposed controls. For the determination of T-cells, NK- and B CD19+ cells populations monoclonal antibodies were used in indirect immunofluorescence tests. Passive sampling spectrophotometric method was employed to determine NO2 and NO concentrations in the work environment air. Their mean values were 0.0867 +/- 0,0585 mg x m-3 (from 0.0165 to 0.1960) and 0.0614 +/- 0.0263 mg x m-3 (from 0.0220 to 0.1090), respectively. The number of total leucocytes and lymphocytes in the group of 16 smokers and non-smokers exposed to NO2 and NO was increased. Stimulation T-cells line in the men exposed to NO2 and NO was evidenced by an increased number of T CD3+ cells, about two-fold increase in absolute number of T CD4+ cells (p < 0.001), an increased number of T CD8+ cells (p < 0.001) and by an enhanced value (by 24.7%) of the T CD4+/T CD8+ ratio. In the group of 16 persons exposed to NO2 and NO serum IgG concentration was elevated (p < 0.01), C3c C4 decreased (p < 0.001), and serum CIC enhanced by about two times (p < 0.001). Stimulation T-cells line in the groups of 5 non-smoking workers exposed to NO2 and NO was evidenced by an increased number of T CD3+ (p < 0.05), T CD4+ (p < 0.05) and T CD8+ cells but without any change in the value of the T CD4+/T CD8+ ratio. In addition, decreased serum C3c and C4 levels together with serum CIC elevated by 76.7% (p < 0.05) were evidenced in this group on non-smokers. Moreover, significant positive correlations between NO2 concentrations in the air and the numbers of total lymphocytes, T CD3+, TCD4+, T CD8+ cells or IgG: (magnitude of r in the range between 0.31 and 0.71), as well as significant negative correlations between NO2 concentrations in the air and C3c (r = 0.44) in the group of 16 smoking and non-smoking workers were calculated. In this group significant positive correlation between NO concentrations in the air of the workplace and counts of T CD3+, T CD8+, B CD19+ (magnitude of r in the range between 0.51 and 0.63), haptoglobin and ceruloplasmin (magnitude of r from 0.37 to 0.58), as well as significant negative correlation between NO concentrations in the air and serum levels of IgG, IgA and IgM (magnitude of r from -0.67 to -0.47) and CIC (magnitude of r = -0.39) were also observed. In the group of 5 exposed non-smoking workers, the values of correlation coefficients magnitude of r between NO2 and NO concentrations in the work environment air and immunological parameters were similar to those in the whole group. The results obtained suggest that during occupational exposure NO2 may play a more important role mainly in the process of inflammation but exogenous NO seems to act as modulating factor of this proinflammatory NO2 effect through a greater and exposure-dependent influence mainly on B CD19+ cells and other parameters of humoral immunity.

[The effect of heavy metals (lead, cadmium, and manganese) on the function of the visual system].

Abstract: The effect of the eyesight intoxication by heavy metals (lead, cadmium and manganese) is presented. The most common and dangerous forms of the eye intoxication are caused by lead additionally reinforced by cadmium. In various cases some changes in the eye may be also induced by manganese. Young organisms, as well as human embryos and fetuses are particularly vulnerable to the effect of heavy metals. Adults in general, and workers in particular, seem to develop their own system of adaptation. Nevertheless, despite the absence of clinical symptoms they should also be given regular check-ups.

[Detection of antibodies to Borrelia burgdorferi among forestry workers in North-Eastern Poland].

Abstract: The purpose of the study was to assess the incidence of Borrelia burgdorferi antibodies and clinical forms of Lyme borreliosis among forestry workers in north-eastern Poland. The group studied consisted of 1,466 persons (297 women and 1,169 men), aged 20-70 years. In 439 (23.81%) persons the presence of B. burgdorferi antibodies was detected in serum, in 271 (18.49%) persons active Lyme borreliosis was diagnosed and 78 (5.32%) persons were carriers of B. burgdorferi antibodies. Arthritis (43.84%) and neuroborreliosis (32.95%) were found to be the most common forms of borreliosis.

The role of formaldehyde in the occurrence of contact allergy

Abstract: The authors present the major sources of formaldehyde, and discuss the incidence of contact allergy to this compound in Poland and throughout the world. The attention was turned to an increasing trend in the incidence of allergy in question, as well as to the problem of cross-sensitization to other chemical compounds of the aldehyde group (glyoxal, glutaraldehyde, succinaldehyde and cinnamic aldehyde).

Mortality of men with occupational lead poisoning in Poland

Abstract: The cohort method was used in the study. A retrospective observation covered 4.556 males with occupational disease, manifested by lead poisoning, diagnosed during the years 1970-1992. Mortality risk analysis by causes was based on standardized mortality ratios (SMRs) calculated by person-years method. Their statistical significance was assessed by means of the test based on Poisson distribution. The general adult male population was adopted as the reference population. The state of the cohort as of 31 December 1992 was considered. The cohort accessibility was 95.6%. The study revealed increased total mortality among lead poisoned males (670 deaths; SMR = 108; 95% CI: 100-116). Significant excess mortality was observed in diseases of the digestive system (37 deaths; SMR = 148; 95% CI: 104-204), including chronic hepatitis and cirrhosis (19 deaths; SMR = 173; 95% CI: 104-270); malignant neoplasms of respiratory and intrathoracic organs (82 deaths; SMR = 135; 95% CI: 107-168), including malignant neoplasm of larynx (13 deaths; SMR = 213; 95% CI: 113-364). In the subcohort with high exposure, death risk was significantly enhanced in comparison to the general population (153 deaths; SMR = 129; 95% CI: 109-151). In addition, significant excess of malignant neoplasms was observed (43 deaths; SMR = 151; 95% CI: 109-203) including liver (4 deaths; SMR = 419; 95% CI: 114-1073) and respiratory and intrathoracic organs tumors (21 deaths; SMR = 175; 95% CI: 108-268). Language: pl

Exposure to electromagnetic fields with frequencies of 50 Hz and changes in the circulatory system in workers at electrical power stations

Abstract: Bearing in mind a great diffusion of electromagnetic fields (EMF) with power-line frequency (in Poland-50 Hz) both in the occupational and communal environments, it is not surprising that possible health effects related to this exposure evoke much interest. Electromagnetic fields may affect the circulatory and nervous systems because of theoretical probability that electric impulses, generated by external electric and magnetic fields, may disturb their functions. For this reason we have decided to evaluate the functioning of the circulatory system in persons occupationally exposed to power-line frequency electromagnetic fields by employing the most up-to-date methods facilitating the in-depth diagnosis of the circulatory system and neurovegetative mechanisms. The work presented focused on the evaluation of electrocardiographic changes. The study covered 63 workers of the transforming and distributing stations, aged 22-67 years (median 39 +/- 10), employed under exposure for 2-43 years (median 15 +/- 10). The control group consisted of 42 workers of radio link stations, aged 23-65 years (median 30 +/- 14), employed in the similar system but not exposed to EMF, with employment duration of 1-42 years (median 13 +/- 4). All persons were subject to general medical examinations, resting ECG, and 24 h Holter monitoring. In addition, the level of exposure in individual workplaces was estimated following the measurements of the intensity of electric and magnetic fields. In workers of electromagnetic stations an increased risk for electrocardiographic disturbances was revealed. Under conditions of exposure to electric fields, observed in stations where workers were employed, the risk was increased by 10%.

[Low back pain syndrome in coal miners: preliminary results of an epidemiological study].

Abstract: The objective of the study was to determine the occurrence of low-back-pain syndrome in coal-miners and to compare the results obtained in the study and control groups. In two groups of subjects (624 employees of the 'Staszic' and 598 employees of the 'Sośnica' mines) the survey and medical assessment were performed and available medical records reviewed. Two groups were similar in terms of age and employment duration, however, working conditions in the 'Sośnica' mine were more difficult, and associated with a larger physical burden. All workers were divided into three groups according to the workload: workers with 'heavy workload' (35.9%), 'medium workload' (37.6%), and 'light workload'. The control group consisted of 449 policemen matched by age and the number of years preceding their retirement. The study revealed that low-back-pain syndrome occurred in 66.4% and 62.2% of the 'Sośnica' and 'Staszic' miners, respectively, while in policemen this figure accounted for only 7.5%. Among miners and policemen, a group with the employment ranging from 10 to 20 years was identified. The group comprised 730 miners, including 179 persons with light workload, and 142 policemen. Law-back-pain occurred in 61.6% of miners and in 14.1% of policemen. In miners the syndrome was associated mainly with lifting heavy objects or with an inappropriate forced position of the body at work. The preliminary results of the epidemiological study indicated that low-back-pain syndrome occurred more frequently in coal-miners than in policemen.

[Multiple chemical sensitivity: a new type of toxicity?].

Abstract: Multiplechemical sensitivity (MCS) is a chronic condition manifested by the appearance of variable symptoms, involving many systems and organs, after exposure to extremely low levels of chemicals, mainly pesticides and solvents. The paper discusses briefly the main hypotheses concerning causes and mechanisms of MCS development. It was emphasized that during neurotoxicity assessment is necessary to pay more attention to these aspects of toxic effects of chemicals likely to generate MSc.

[Risk factors for premature birth. I. Analysis of selected factors in a group of non-working women]

Abstract: Selected risk factors responsible for premature birth in a group of women non-employed professionally were discussed. The analysis included demographic (age, education, marital status, maternal body weight, the number of previous pregnancies, as well as spontaneous and artificial abortions reported in interview), social (smoking, exposure to tobacco smoke, family economic status, standard of living conditions, and facilities used in running the household), and medical (maternal health status before and during pregnancy, and perinatal care) factors, as well as work load at home. The authors found low maternal body weight, genital bleeding during pregnancy and work overload at home to be the most significant risk factors.

[The effect of systemic changes on sick-day absenteeism in the workplace. II. Causes of work disability among persons under termination of employment].

Abstract: During the period of transformations and restructuring of workplaces in Poland, the reduction of employment becomes quite common, what seems to make a considerable impact on sick absenteeism. The analysis presented aimed at defining how far the risk of sick absenteeism increases among workers under termination of employment because of different reasons, and indicating morbidity causes in case of which sick absenteeism is most extensive. The study was carried out in one of the largest plants of the motor car industry (before the process of restructuring), and it covered a cohort of 5,373 men and 3,215 women employed during the years 1989-94. The workers who terminated their employment during those years made 77% of the whole cohort under study. The case index, calculated as the ratio of the number of cases to the number of man-days under observation, was taken as an analysis parameter. Poisson regression model involving a number of variables (age, departments, current workers, workers discharged according to particular reasons, and the period preceding the termination of employment) was used in the statistical analysis. The study indicated an increased risk of sick absenteeism in the group of workers approaching the termination of employment in comparison with that among current workers. The highest risk of work disability, both among men and women, was observed in persons leaving their jobs because of long-lasting illness or disability pension. The highest risk indices were noted in men whose sick absenteeism was caused by neoplasms (RR = 14.42); endocrine secretion disorders (RR = 4.83); cardiovascular disorders (RR = 3.60); mental disorders (RR = 3.04); and diseases of the musculoskeletal system (RR = 2.95); and in women with neoplasms (R = 6.42); diseases of the musculoskeletal system (RR = 4.01); and cardiovascular diseases (RR = 3.99). Risk of sick absenteeism was over 50% higher among retiring workers than among current workers (RR = 1.50 for men; and RR = 1.53 for women). Among workers discharged because of economic reasons, statistically significant risk of sick absenteeism was also observed (RR = 1.51 for men; and RR = 1.37 for women). In the group of workers leaving their jobs, following the agreement of the parties, an increased risk of sick absenteeism was noted in men (RR = 1.45). The economy transformation processes make a considerable impact on the occurrence of sick absenteeism in workplaces. Workers leaving their jobs because of health problems or of their own accord, as well as those discharged because of economic reasons belong to the highest risk groups.

[Compartment simulation models and physiologic use in pharmaco- and toxicokinetics].

Abstract: The pharmaco- and toxicokinetic studies describe the process of absorption, distribution, metabolism and elimination of drugs or chemical compounds in animals and humans. In simple compartmental models, the body is divided into basic compartments, central and peripheral. The central compartment is an equilibrium of arterial and venous blood flows, and the peripheral one is connected to the central compartment through a series of flow rate constants that describe the flow of chemicals in both directions. For instance, we can use the PH/EDSIM software for calculating the constants. The flow of the material from one to the other reflected by vectorial connections of two types of kinetics: linear and Michaelis-Menten (nonlinear). At present, the PB-PK models (physiologically-based pharmacokinetic models), which rely on actual physiological (breath rates, blood flow rates and tissue volumes), biochemical and metabolic parameters, tend to be more commonly used. Tissue groups or compartments that are frequently applied in PB-TK model include organs, muscle, fat tissue and the liver. Tissue compartments are connected by arterial and venous blood flows, and each compartment is characterised by a unique set of differential equations. The flow rate constants that describe that flow of materials from and to the compartments, and the rate of change in the amount of chemical in each compartments are directly proportional to the blood flow rate, tissue solubility and organ value.

The evaluation of mean indoor concentration of radon based on the measurement of 210Pb concentration in glass

Abstract: An average dose received by an inhabitant of the terrestrial globe from all natural sources of ionizing radiation occurring in the nature accounts for 2.6 mSv annually. Nearly 50 of this dose comes from radon and products of its decomposition which accumulate in our dwellings. Bearing in mind changes in radon concentrations over the time it would be advisable to develop a method for the evaluation of mean long-term concentrations of radon. Such an evaluation can be carried out by measuring the amount of 210Pb implanted in glass. These measurements are most frequently performed by means of ionization chambers or trace detectors which record the number of alpha particles produced by 210Pb decomposition.

Acute poisoning by carbon monoxide affecting the extrapyramidal system

Abstract: A case record of a 19-year old women acutely poisoned by carbon monoxide is presented. The state of the patient was very serious with loss of consciousness, cerebral oedema and acute circulatory failure, manifested by pulmonary oedema. The presence of carboxyhemoglobin in concentration of 45% was found in the blood. During the second week after the incident, extrapyramidal symptoms, manifested by hyperkinetic-hypokinetic syndrome with predominant involuntary movement, was observed. The diagnostic examinations of the central nervous system showed necrosis of globus pallidus, external capsule and a part of internal capsule. Language: pl

Contact allergy to nickel

Abstract: The authors present data on allergy to nickel. They highlight the necessity to evaluate the incidence of allergy in young people who begin vocational training that entails their contact with metal lead-containing objects.

Vibration syndrome and occupational exposure in Poland

Abstract: The objective of the study was to analyse the data on the exposure to vibration, and the incidence of vibration syndrome in individual branches of the national economy and voivodships. The data were obtained from the records of The Nofer Institute of Occupational Medicine in Lodź, containing reports submitted to the Institute every three years, and the literature on fragmentary analyses of this kind of exposure. Although, the number of persons exposed to vibration, and the incidence of occupational diseases induced by vibration have decreased, the material collected provide evidence that vibration syndrome still plays an essential role in occupational pathology. The decrease in the vibration syndrome incidence observed during the years 1982-97 was lower than the decline in the number of persons exposed to vibration, but the ratio of the number of cases to the number of those exposed remained unchanged (2.1). In 1994-97, forestry workers constituted the largest working population exposed to vibration, and the number of persons with diagnosed vibration syndrome significantly increased, however, exposure to vibration in this branch of economy considerably declined. In the mining industry, a significant decrease in the number of persons exposed to vibration, as well as in the incidence of vibration syndrome was observed at that time. The worse situation in forestry might result from the past negligence of hygiene norms or less effective diagnosis in early stages of the disease development. The lack of measuring and monitoring of vibration intensity in the working environment is an alarming observation in view of the fact that both the number of persons exposed, and the incidence of occupational diseases caused by this kind of exposure are still high.

Attitudes of Polish occupational medicine physicians towards a proposal of requirements for occupational medicine training in Europe

Abstract: In order to determine key competences required of occupational medicine specialists, common throughout Europe, a questionnaire has been developed and distributed among several European countries. The questionnaire contained 115 subjects related to 8 fields of activities carried out by occupational medicine physicians (occupational hazards to health, assessment of disability and fitness for work, communications, research methods, management, environmental medicine, occupational health law and ethics, and health promotion). In each of these fields, competences were classified into three following categories: knowledge, experience and skills. Respondents were asked to allocate a score from 0 to 5 for each subject, where 0 = not necessary; 1 = of minimum importance, and 5 = most important or essential. In Poland the questionnaire was distributed among two groups of specialists: group I--experienced specialists in occupational medicine (leading representatives of occupational health care management), and group II--relatively younger and less experienced occupational medicine physicians, participating in the specialist training, organised by The Nofer Institute of Occupational Medicine. A comprehensive analysis of the completed questionnaires was carried out in two dimensions: substantive (the importance of individual competences as perceived by Polish specialists in occupational medicine), and comparative (evaluation and interpretation of similarities and differences between two groups of respondents). A hierarchy of requirements, occupational medicine training in Poland is to satisfy, was reconstructed with two sets of competences, one recognised by respondents as needless and the other recognised as useful with different grades of importance. Some characteristic differences in opinions between two groups studies were highlighted.

[The influence and sources of infrasound: review of literature].

Abstract: This paper presents a short review of infrasound sources and effects on humans.

[Coefficient of linear correlation between levels of fibrinogen, antithrombin III, thrombin-antithrombin complex and lipid fractions in women exposed chronically to carbon disulfide].

Abstract: The authors examined 65 women, aged 22-58 years. They were derived from two industrial populations of different production profiles, and divided into three groups. Group I--the control group--was composed of 20 women, mean age 44.5 +/- 12.02 years, employed in the DANA Enterprise, Szczecin, not exposed to carbon disulfide; Group II--the group studied--comprised 22 women, mean age 42.5 +/- 4.95 years, employed in the WISKORD Enterprise, Szczecin, chronically exposed to carbon disulfide at the concentration of 9.36-23.4 mg/m2; and Group III--included 23 women, mean age 46.7 +/- 8.81 years, suffering from diabetes mellitus II. The study reveals that carbon disulfide exerts significant adverse effect on plasma lipid fractions, and induces changes in the coagulation system, creating the risk of ischaemic diseases.

The evaluation of the balance organ in workers occupationally exposed to organic solvents and tinctorial dusts

Abstract: The aim of the study was to evaluate the balance organ in persons occupationally exposed to organic solvent vapours. The study was performed in a group of 35 workers employed for eight years on average in two departments of the Polifarb S.A. factory of patients and lacquers, Wroclaw. The control group consisted of 53 healthy persons. Static and dynamic posturography was used to assess the condition of the balance organ. In the persons exposed static posturography tests revealed statistically significant increase in the field of spread area and extent of sways, and dynamic posturography tests indicated an increased radius. It was shown that posturography ensure an objective assessment of balance disorders and can be applied in the screening of persons exposed to toxic substances. It is also useful in recording functional condition of the balance organ.

[Evaluation of the circulatory system in workers in the cellulose-paper industry].

Abstract: The effect of occupational exposure on the circulatory system disorders was evaluated in 802 workers (675 men and 127 women). Occupational histories were analysed, as well as physical and X-ray examinations, laboratory tests (fasting blood cholesterol, triglycerides and glucose) and ECGs were performed. In doubtful cases echocardiography and stress tests on an ergonometer were carried out. Ischaemic heart disease was diagnosed in 1.37% and symptoms suggesting this disease in 6.48% of workers. The incidence of hypertension, anginal pain and dysrhythmias reported were significantly related to workers' age and duration of employment. Smoking, obesity, hypercholesterolaemia and positive family history were found to be most frequent risk factors. Arterial hypertension was diagnosed in 9.48% of workers. Non-occupational factors seem to be mainly responsible for the circulatory system disorders, however, the effects of occupational factors occurring in the cellulose and paper industry which may accelerate the development of ischaemic heart disease, arterial hypertension and dysrhythmias cannot be excluded.

[New principles of reporting in occupational health services--bureaucracy or an effective marker instruments?].

Abstract: A several-year process of transformation in occupational health services (OHS) was concluded with the Occupational Health Services Act adopted by Polish Parliament on 27 June 1997. By the time the Act came into effect, a whole series of executive regulations had been lain down. The Act like its executive regulations came into force on 1 January 1998. In view of the new Act, the system of reporting on the OHS activities and resources became inadequate and did not correspond with the reality. To this end, there was a great need to develop new principles of the reporting system as well as new reporting forms which could replace those binding thus far, and satisfy new requirements arising from modified organizational schemes and responsibilities. The work began in the Nofer Institute of Occupational Medicine in 1995. Then the first drafted forms for annual reports on prevention carried out by occupational doctors and voivodship OHS centres were presented. In the new system, occupational doctors responsible for prevention, and not health care centres, are committed to present reports. So that, together with the competence the reporting responsibility is placed on a given person and not on an institution. A practising occupational doctor can be a primary OHS units, and at the same time he/she can practice in occupational health centre providing preventive care of workers, according to the provisions of the Act, within his/her responsibilities. Both report forms, part one and part two, are supplied with detailed instructions how they should be completed. The pattern and context of the forms as well as instructions have been agreed upon with the executives, specialistic supervision and the National Center for Health System Management in Warsaw.

[The effect of occupational exposure to noise among tractor drivers: assessment based on 'noise threshold'].

Abstract: The effects of occupational exposure to noise was analysed among operators of agricultural tractors (n = 172). The assessment was based on a parameter called 'noise immission level' (dose connected with the period of employment). The study showed that the correlation between hearing loss and noise immission dose was stronger than that between hearing loss and the period of employment. Equations of simple regression presented in this paper allow us to make a prognosis concerning the risk of occupational deafness and to develop the system of the prevention interventions. The results obtained indicated that the parameter of hygiene evaluation of exposure to noise, called 'noise immission level' should be used more frequently for the noise measurement, especially in the prevention of occupational diseases. Language: pl