Showing papers in "Medycyna Pracy in 1999"

[Health-related absenteeism among workers employed in various work environments].

Abstract: The state of health in working people is determined by a number of factors among which working conditions and the kind of job performed play undoubtedly a crucial role The observation and analysis of trends in sick absenteeism may provide indirect information on health problems of the occupationally active population The aim of the analysis presented was to define the magnitude and the causes of temporary work disability among workers employed in individual branches of the national economy, and finally to identify high risk groups of workers because of their employment in specific working conditions The statistical material used as the basis for the calculation of absenteeism indicators embraced the data on the number of work disability days, derived from a 15 representative sample of punched cards, concerning certificates of temporary work disability In order to accomplish the objectives of the analysis, the trends in sick absenteeism observed before 1989, the period preceding the structural changes and the transformation of Polish economy were taken into consideration The analysis indicates that the level of sick absenteeism in the branches of the national economy (forestry, building construction, transport, industry) and the proportion of chronic diseases in its structure prove the effect of working conditions on the workers' health Considering individual branches of industry, the highest levels of sick absenteeism are observed in the following branches: mining for men (561), non-ferrous metals for women (1004) and men (495), ferrous metallurgy for women (999) and men (493), and petroleum products for women (1176) The analysis of sick absenteeism in the branches selected in view of hazardous working conditions shows that: (1) in many branches chemical hazards in the work environment are responsible for an increased sick absenteeism due to diseases of the circulatory system, particularly among men, mental disorders and neoplasms, both among men and women, and complications of pregnancy among women; (2) physical work overload increases sick absenteeism mainly due to diseases of the musculoskeletal and peripheral nervous systems, as well as due to cardiac disease and arterial hypertension; and (3) hot microclimate contributes to sick absenteeism because of diseases of the circulatory system, including cardiac disease and arterial hypertension, particularly among men, as well as acute and chronic respiratory diseases

[Occupational N-hexane neuropathy: clinical and neurophysiological investigation].

Abstract: A group of 37 patients (26 men and 11 women), aged 18-49 (mean: 29.7) with subacute toxic polyneuropathy was investigated clinically and electrophysiologically. In all cases the disease was induced by occupational exposure to n-hexane in a small enterprise of purse makers. Toxicological investigations revealed a highly increased concentration of n-hexane in glue used in the manufacture process. The clinical course, including delayed worsening of symptoms after cessation of exposure, was typical when compared with previously reported cases of n-hexan-induced neuropathy after glue sniffing and industrial exposure. Electroneurographic (ENeG) studies showed a predominately decreased motor nerve conduction velocity (MNCV) with focal conduction block followed by dramatically diminished CMAPs. Recovery of EneG abnormalities paralled the clinical improvement.

[Malonyl dialdehyde concentration in red blood cells of workers engaged in the production of iron-manganese alloys].

Abstract: The increased concentration of malonyl dialdehyde (MDA) in peripheral blood red cells of workers engaged in the production of iron-manganese alloyes was found. That provide evidence that increased peroxidation of red blood cell lipids induced by the production of free radicals is due to factors present in the occupational environment.

[Types of hearing disorders in drug addicts and individuals drinking non-consumable alcohols].

Abstract: All over the world an increase in the number of subjects addicted to various chemical substances has been observed. The studies of their toxic effect on the hearing have been so far most frequently limited to acute intoxication or direct effect: there are no data concerning distant and persistent effects. The aim of the study was to determine the type of hearing loss in drug addicts and individuals drinking non-consumable alcohols, examined during the period of abstinence. A group of 210 subjects addicted to various substances was examined using acumetry test and tuning forks, as well as threshold, suprathreshold and speech audiometry. Taking into consideration the threshold results for particular subjects, the percentage of hearing loss for both ears was calculated using CPT index. Most frequent complaints connected with the organ of hearing, such as tinnitus and hearing impairment were reported by alcoholics and opioid addicts. In the age adjusted threshold audiometry, perceptive hearing loss was diagnosed in nearly 50% of the subjects. The percentage of hearing loss calculated for both ears, using CPT index, demonstrated the highest values in the group of subjects drinking non-consumable alcohols and addicted to volatile organic substances.

The toxic effect of mercury in occupational exposure

Abstract: The paper addresses the problems of environmental and occupational exposures to mercury compounds. Mercury and its compounds are very toxic. Occupational exposure and environmental pollution are the major sources of hazard to human health. Metallic mercury evaporates at room temperature producing inorganic and organic compounds, and forms amalgams with many metals. In more than 50 professions, workers may be exposed to mercury, particularly in the mining and chemical industries and in agriculture. Occupational poisoning is rarely acute but it is usually chronic. The symptoms result from the damage to the central nervous system, and the kidney, as well as from the impairment of erythrocyte metabolism, coagulation and immune response. Mercury may also induce allergic reactions. Chronic mercury poisoning is diagnosed on the basis of the clinical picture in the presence of the occupational exposure. Inorganic mercury poisoning is treated specifically with chelating agents.

Industrial wastes and health hazards

Abstract: Uncontrolled industrial waste sites are potential sources of unplanned release of hazardous substances into the environment. According to the reports of the State Inspectorate for Environment Protection (PIOS), 60% of hazardous waste sites registered in Poland create potential or real threat to public health and the environment. hazardous substances migrating off the site can spread and affect the environmental media: ground water, surface water, air, soil, biota. They can also enter the human body. As a result of research studies aimed at identifying the hazard and assessing health effects posed by hazardous waste sites in the United States, the Agency for Toxic Substances and Disease Registry (ATSDR) has identified seven groups of health effects most common among populations living in the vicinity of waste sites. These are: birth defects, cancer, immune function disorders, kidney and liver dysfunction, lung and respiratory diseases and neurotoxic disorders. However, the evidence based on exposure-effect relationship is not generally very strong. Most of the studies lack sufficiently accurate exposure assessment.

[Unemployment during pregnancy: direct or indirect risk factor of prematurity and fetus hypotrophy?].

Abstract: The question as to whether in a transitional phase in the political and socio-economic development in Poland, an increased threat of unemployment may also produce health effects manifested by an elevated risk for prematurity and fetus hypotrophy is one of important challenges. If the answer is positive then this issue should have much stronger impact on political and economic decisions. The data obtained from numerous studies carried out in countries of western Europe and the United States shows that the job performance during pregnancy under conditions free from occupational exposure and arduousness does not directly augment the risk of detrimental effect to the health of pregnant woman or her fetus. Just on the contrary, it was found that job performance during pregnancy, and strictly speaking steady employment during this period may somewhat become a 'protective factor'. In Poland, the highest rate of unemployment is observed among women in the 18-24 age group, that is at the age most suitable for procreation. Nowadays it is common that the decision on child-bearing is postponed until the economic status of the woman or her family comes to be more stable. On the other hand, in the population of women looking for a job but determined to set up a family prematurity is quite common that results only in part from an excessive effect of risk factors for this pathology very typical of this social group, like smoking, single parenthood, early or late child-bearing age. After adjusting these factors, the risk of prematurity decreased considerably but it was still high. It is thought that stress and the sense of threat and uncertainty is mostly responsible for this phenomenon. An increased risk of fetus hypotrophy among unemployed women after considering all confounding factors, was not observed.

Some occupational determinants of work disability

Abstract: Occupational determinants play a significant role in the studies of the causes of work disability. The duration of employment is that particular variable, frequently analysed, which reflects indirectly the effect of work conditions on the worker's health state and also on his her disease-related work disability. Therefore, the aim of this work was to show the difference in sick absenteeism between various occupational groups, depending on the duration of employment. The empirical material embraced data on work disability, among workers employed in the automative industry plant during the years 1989-94. Out of 8,599 persons covered with the study, 77% left the job, including 7% of those who left the job because of health problems. An analysis of the impact of occupational determinants on the sick absenteeism was carried out on the basis of the absenteeism rate adjusted by age, sex and occupational activity in groups of the production, auxilliary and administrative workers, as well as in occupational groups exposed to possibly similar harmful factors. The duration of worker's employment in the plant showed a positive influence on sick absenteeism, since together with extended period of employment the decrease in the rate of general sick absenteeism was observed. However, in a number of disease categories an increase in absenteeism together with extended duration of employment, and a high level of absenteeism among workers involved directly in the production, were noted. This proves an adverse effect of work conditions on work disability among workers. The effect of harmful factors present at workposts is also confirmed by the increasing sick absenteeism together with the prolonged duration of employment in various occupational groups. In the group of welders the highest level of sick absenteeism was observed among persons with duration of employment ranging from 11 to 20 years (rate: 10.52), and it was related to diseases of the respiratory (3.10) and circulatory (2.09) systems. In this group the increase in absenteeism together with prolonged duration of employment was related to diseases of the genitourinary system (about fourfold), musculoskeletal system (about threefold) and nervous system and sense organs (about 20%). It may be concluded that in selected high risk occupational groups, the duration of employment may reflect the effect of work conditions on workers' sick absenteeism, and the analysis of work disability caused by individual diseases provides an image of health effects due to hazards to which those groups are exposed.

Lacrimation disorders in workers chronically exposed to petroleum derivatives

Abstract: Lacrimal fluid plays a very significant role in maintaining proper functions of conjuctivas, cornea and eyelids. The fluid is secreted by the main lacrimal gland and additional glands. It produces the so called preocular lacrimal film. A number of clinical tests, such as Chirmer's tests I and II, break-up-time (BUT), lysozyme, and flow tests are used in quantitative and qualitative analyses, as well as in the determination of the lacrimal film stability. The aim of work was to utilize these in assessing the lacrimal secretion and the lacrimal film stability in workers chronically exposed to petroleum derivatives. Fifty three workers from departments of acetobenzene, benzene and butadiene, phenol and acetone, sewage waters, asphalt oxidas, polyethylene and polypropylene, were eligible for the study (group I). During previous examinations, acquired disorders in colour perception were diagnosed in all the subjects by means of the Mansuella-Fansworth 100-Hue test. The age range was 25 to 56 years, with a mediane of 44.1 years +/- 6.5. Mean duration of employment was 22 years (SD +/- 8.25). The control group (group II) was composed of 28 men aged between 24 and 60 years with a median of 42.7 years +/- 6.3, never employed under conditions of exposure to toxic chemicals. On the right eye of each subject Schirmer's test was performed after instilling into the conjunctival sac 1-2 drops of Alcain solution according to Whitcher. Five min following anesthesia of the conjunctival sac, a standardised belt of blotting-paper with colour dampness markers Vidisic (Dr Mann Pharma GMBH, Germany) was placed in the vicinity of the external angle of the eye. After 5 min the degree of the belt dampness was measured in millimetres. After 30 min the break-up-time test was performed on the left eye. Fluorescein was released to conjunctival sac from a sterile belt of blotting-paper (Haag-Strait Co.). A slit lamp with cobalt filter was used to calculate time (in sec) that elapsed between opening of the lid slit and the first symptom of breaking-up the lacrimal film. The results obtained were presented in the form of arithmetic means and standard deviation values +/- SD. Schirmer's test was 13.40 +/- 7.43 mm in group 1, and 22.54 +/- 8.25 mm in the control group, mean values differed significantly, p < 0.01. Lacrimal film break-up-time was 16.30 +/- 6.19 sec in group 1, and 31.48 +/- 7.96 sec in the control group, mean values differed significantly, p < 0.01. In persons chronically exposed to petroleum derivatives, statistically significant decrease in lacrimal secretion, as well as shortening of lacrimal film break-up-time were found when compared with the control group.

Incidence of occupational diseases in Poland

Abstract: The paper is aimed at presenting the incidence of occupational diseases in Poland. The analysis was performed on the basis of the information included in 'occupational disease certificates'. All sanitary and epidemiological stations throughout the country are committed to send these certificates to the Central Register of Occupational Medicine in The Nofer Institute of Occupational Medicine in Lodź. The incidence of occupational diseases during the three recent years (1996-97-98) was the subject of a thorough analysis. In all, 11,318, 11,685 and 12,017 cases of occupational diseases, respectively were registered over those three years. The corresponding rates were 116.0, 116.9 and 117.3, respectively per 100,000 people employed. In 1998, diseases of the voice organ predominated (30.4%) of all occupational diseases) and they were followed by hearing impairment (28.2%), infectious and parasitic diseases (9.9%), pneumoconioses (8.2%), dermatoses (6.4%), vibratory syndrome (2.9%) and poisoning (2.5%). These disease categories constituted over 88% of all occupational diseases registered in that year. Diseases of the voice organ which showed the greatest growth dynamic were mainly diagnosed among teachers. Neither in the United States nor in the member states of the European Union, this pathology is included into the list of occupational diseases. In view of high rates of its incidence in our country it has become one of essential problems of occupational medicine. In Poland, particular attention is paid to infectious and parasitic diseases among which hepatitis occupies the first place (65%), mostly among health service workers. The decrease in hepatitis incidence observed in the 1990s has been due to an intensive vaccination programme in this group of workers. The incidence of occupational hepatitis became rather stable and accounted for 940 cases per year, however the incidence of hepatitic C increased at the same time. Lower rates of incidence of 'classic' occupational diseases, such as poisoning, pneumoconioses or vibratory syndrome are a positive observation. It is also interesting to note that the rate of occupational diseases diagnosed in advanced stage has also diminished. When analyzing occupational diseases one should bear in mind that the majority of pathologies already diagnosed result from long-term effect of exposure to harmful factors. In all, 93% of cases of occupational diseases emerged after a ten-year exposure. The highest rates, taking account of sections of activity, were found in mining and quarrying, health service, agriculture, hunting and forestry.

Epidemiology of Lyme borreliosis

Abstract: In this paper basic issues concerning epidemiology of Lyme disease were presented. The role of ticks and small mammals was emphasised. An increasing prevalence of Lyme disease especially among people working in forests was pointed out.

[Problems in the evaluation of miners' exposure to radon in Poland in view of international organizations recommendations and European Union directives].

Abstract: Exposure of miners to natural radiation in which radon-222 plays the major role has been studied in Poland since the end of the nineteen sixties. The work environment measurements and personal monitoring methods have been developed for monitoring the exposure. A quite wide range of doses resulting from big differences in radon concentrations in mines is characteristic of miners' exposure. It was estimated that about 16% of miners received doses above 5 mSv per year. This group of miners should be provided with individual dosymentry. In this paper methodological and legal aspects of the situation in mines are analysed. A large number of Polish recommendations and legal regulations must be changed in order to harmonise them with the directives of the European Union.

[The evaluation of the exposure of seamstresses to electromagnetic fields, emitted by sewing machines].

Abstract: The authors present the results of the first phase of the studies on the risk of pregnancy complications in semesters and on their work environment with special reference to electromagnetic fields (EMF) emitted by various types of industrial sewing machines. EMF measurements were taken in the surrounding of 464 sewing machines used in five sewing works in the region of Lodź. The results obtained provided evidence that semesters++ working with industrial sewing machines were exposed to EMF of 60 Hz. Thirteen types of machines were identified. Having based on the statistical analysis (analysis of variance) it was found that individual types of sewing machines emit substantially different EMFs. Depending on the level of EMF emitted at a given workpost, all the machines were classified into three groups: those with weak (O A/m-1.5 A/m); medium (2 A/m-4 A/m); and strong (9 A/m-16 A/m) emissions.

[Natural radioactivity of underground waters: surveying of alpha and beta global activity].

Abstract: Two sets of measurements used in surveying of the alpha and beta global activity of drinking water drawn from 44 abyssal wells located in the Lodź cretaceous basin are discussed. The measurement method used involved the comparison between the activities of a model source and a prepared sample of water. Radioactive isotopes Am-241 were employed in alpha and K-40 in beta measurements. In order to detect radiation, a semiconducting radiation detector Si of high purity for registration of alpha molecules and a set of two G-M counters operating in the anticoincidence circuit for registration of beta radiation were used.

Sources of finance for provincial occupational health services. Theory and practice

Abstract: The financing of occupational health services (OHS) at the provincial level is an important issue in view of the transformation process going on not only in OHS but also in the overall health care system in Poland. New principles of financing must be now based on the cost and effects analyses. Thus, the question arises on how to provide financial means adequate to needs of health care institutions resulting from their tasks and responsibilities. The gaps existing in the information system have encouraged us to examine the situation in regard to the structure of financing and internal allocation of financial means. The objectives were formulated as follows: to characterise the sources of financial means received by provincial OHS centres; to analyse the structure of financial means derived from various sources, taking into account forms of financial administration, using the data provided by selected centres; to define the relation between the financial means being at the disposal of OHS centres and the scope of their activities; The information on the financing system was collected using a questionnaire mailed to directors of selected OHS centres. The information collected proved to be a valuable source of knowledge on the above mentioned issues as well as on how far the new system of financing associated with a new form of financial administration--an independent public health institution--has already been implemented. The studies indicated that at the present stage of the OHS system transformation it is very difficult to formulate conclusions on the financing administration in provincial OHS centres.

The labor potential in occupational health services at the provincial level before the occupational health services act came into effect

Abstract: The author evaluates how far the personnel of occupational health services (OHS) at the provincial level is ready to undertake and implement the tasks provided by the Occupational Health Services Act at the eve of its coming into force. Personnel resources of OHS differ depending on the region. This applies to all groups of workers and is generally related to the provincial regulations and employment policy. Specialists-consultants constituted 12% of provincial OHS workers and the majority of them (60%) were employed on a full-time basis. Specialists in laryngology, ophthalmology and neurology were employed most frequently. Physicians with additional qualifications necessary for performing preventive examinations accounted for 16% of the total number of OHS workers; and those with acknowledged competence due to long experience--40%. Thus, 60% (400) of physicians should be trained in research institutions. As to qualifications of nurses, the situation is even worse. Only 6% of nurses were specialised in occupational health, and 35% of nurses employed at the provincial level completed relevant qualification courses. The qualifications of over 60% of nurses are insufficient for implementing tasks provided by the new OHS Act.

Prevention of detrimental effect of traumatic effect in the workplace

Abstract: The workplace may be the source of chronic and traumatic stresses. The latter may lead to the occurrence of disorders which have been listed in the Diagnostic and Statistic Manual (DSM) since 1990. In order to avoid this kind of disorders occupational health service workers should promote preventive activities in the workplace. Depending on the prevalence of traumatic episodes in a given workplace the activities should be carried out according to two models. The first model known as 'debriefing' is adjusted to preventing effects of traumatic stress in special services like the police, fire brigades or emergency services. In workplaces where the risk of traumatic episodes is not so high, the prevention should follow the model of crisis prevention developed by M. Braverman. Both models for preventing stress disorders in the workplace are discussed in this paper.