Medycyna Pracy (Occupational Medicine) 2021/03

  • Occupational exposure to nanoparticles originating from welding – case studies from the Czech Republic
    Nanomaterials are virtually ubiquitous as they are created by both natural processes and human activities. The amount of occupational exposure to unintentionally released nanoparticles can, therefore, be substantial. The aim of the study was to determine the concentrations of incidental nanoparticles that workers can be exposed to during welding operations and to assess related health risks. The specific focus on welding operations was determined based on the fact that other case studies on the manufacturing industry confirm significant exposure to incidental nanoparticles during welding. In the Czech Republic, 92% of all industrial workers are employed in the manufacturing industry, where welding operations are amply representedBased on the conducted measurements, it was confirmed that there is a significant number of incidental nanoparticles released during welding operations in the manufacturing industry as a part of production and processing of metal products. The recommended occupational exposure limits for nanoparticle number concentrations were exceeded approximately 4–8 times for all assessed welding operations. The use of local exhaust ventilation in conjunction with personal protective equipment, including FFP2 or FFP3 particle filters, for welding is, therefore, recommended.
  • The relationship between nurse’s job satisfaction and missed nursing care
    The main aims of the study were to explore the frequency of missed nursing care (MNC) among Czech hospital nurses, and to find the relationship between nurse’s job satisfaction and MNC. Nurse’s job satisfaction is associated with the level of nursing care provided; more missed care means more dissatisfaction among nurses.
  • A study of oxidative stress and pulmonary damage after silica instillation in rats and the effect of curcumin administration
    The authors’ aim was to study the dynamics of oxidative stress in experimental exposure to silica dust, to evaluate the histopathological findings in the phase preceding the formation of fibrous/fibrohyaline pulmonary nodules, and to assess the effects of curcumin administrationThe study confirms the early onset of oxidative stress in experimental silicosis. It also simultaneously and dynamically researches markers of oxidative stress in blood and the lung tissue. Curcumin proved beneficial on oxidative stress and lesions in the alveolar epithelia, but ineffective in preventing vascular and airway remodeling.
  • An assessment of PM1 levels based on indicative PM1 measurements and relationships with PM10 and PM2.5 concentrations, for the analysis of hospital admissions and mortality in the Moravian region
    Particulate matter (PM) air pollution is a serious concern in the city of Ostrava. Thus, in 2018, a project entitled “Validation of the relationships between PM10, PM2.5 and PM1 concentrations, and morbidity and mortality, in the heavily polluted region in the Czech Republic,” was launched. The relationship between hospital admissions and mortality in the said region is based primarily on short-term PM10 and PM2.5 concentrations and indicative PM1 measurement. The analysis of spatiotemporal variations and the relationship between PM10, PM2.5 and PM1 data from 3 measurement sites within the city of Ostrava is presented.  The correlations found will be used for indicative PM1 measurements in other areas of the region. Seasonal variability should be taken into account as well.
  • Mental health of people diagnosed with neuroborreliosis
    In recent years, the number of recorded cases of Borrelia burgdorfe-ri infections causing Lyme disease (Lyme disease) in Poland has been steadily increasing. A wide spectrum of disorders in the peripheral and central nervous system is observed in the course of infection. Non-specific symptoms occurring in LB are reported by about 10–25% of infected B. burgdorferi. They can relate to both the somatic and mental spheres, and consequently significantly hinder the daily functioning of patients. The main aim of the research was to compare the mental health of people diagnosed with Lyme disease with the mental state of healthy people. An answer was also obtained to the question of whether people suffering from neuroborreliosis experience difficulties in functioning in the following areas: family, social, professional and educational. The results of the study indicate significant differences in the mental health of people diagnosed with neuroborreliosis and healthy people. The patients obtained significantly higher results in GHQ-28 than the healthy ones, which proves their poor mental health. It has also been confirmed that people diagnosed with LNB experience difficulties in functioning in social, professional and educational areas. Therefore, it becomes crucial to deepen research taking into account mental health in tick-borne diseases, including neuroborreliosis, and to adapt and implement appropriate preventive and therapeutic measures.
  • Determination of nickel and its compounds in the work environment
    Nickel and its compounds have been classified as carcinogenic in a regulation of the European Parliament called the CLP Regulation (Classification, Labeling and Packaging). These substances are found in industry in the production of steel and alloys and in the production of protective coatings. In Poland, the value of the highest permissible concentration (NDS) for nickel and its compounds, amounting to 0.25 mg / m3, will decrease to 0.1 mg / m3. The aim of this work was to develop a selective method for the determination of nickel and its compounds in the air at workplaces, used to assess occupational exposure, in accordance with the requirements for the procedures for determining chemical agents in the work environment. The developed method for the determination of nickel and its compounds allows for selective determination of these substances in the air at workplaces in the concentration range of 0.014–0.56 mg / m3 and 0.007–0.28 mg / m3 for an air sample with a volume of 720 l and for the determination of of this substance both from 1/10 to 2 of the TLV value for the current value of 0.25 mg / m3, and for 2.5 times lower hygienic standard proposed by 2025 as a binding limit value in the EU. The method meets the requirements of the PN-EN 482 standard.
  • Aggravating factors in teachers' work and fatigue
    Teachers are a professional group in which, due to the type of work and the specificity of the workload, we can expect the occurrence of increased fatigue. However, there is little research into this problem. The aim of these studies was to assess the level of post-work fatigue and chronic fatigue in teachers and to determine whether and to what extent they are dependent on occupational and non-occupational loads. The conducted study allowed to determine the profile and frequency of occupational and non-professional factors that shape the level of fatigue in teachers. Med. Pr. 2021; 72 (3): 283-303
  • Influenza vaccinations of medical workers - vaccination level, determinants, possibilities of intervention
    Influenza vaccinations are recommended every year to all healthcare professionals as a key part of efforts to, inter alia, preventing flu transmission in healthcare settings. Given this recommendation and the importance of such vaccinations, an unsystematic literature review was carried out to assess vaccination rates, stated motives and vaccination barriers, as well as interventions aimed at increasing vaccination rates in this occupational group. Data from available publications indicate that the rate of implementation of influenza vaccinations among medical workers is generally low and varies over time, locally, as well as among particular medical professions. The main reason to get flu vaccine is to protect yourself and your family. Among the numerous barriers, the most common are misconceptions about the safety and effectiveness of vaccinations, and organizational barriers. It is indicated that there is a great need for educational and promotional activities as key elements of increasing the vaccination rate in a voluntary vaccination strategy.
  • Can SARS-CoV-2 virus damage hearing and balance?
    In 2019, the disease caused by SARS-CoV-2 - COVID-19 - sparked an ongoing pandemic. The most common clinical symptoms of SARS-CoV-2 infection include fever, dry cough, fatigue, muscle aches, breathing problems, loss of smell and / or taste. Other symptoms, including those related to the hearing and balance organs, such as hearing loss, tinnitus or dizziness, are reported less frequently by patients. The first symptoms of this infection are occasionally indicated. To answer the question whether SARS-CoV-2 may cause hearing and balance damage, the authors of the 2019-2020 literature review at EMBASE and PubMed databases, entering the following keywords: "hearing loss", "COVID-19 "," Corona virus "," sensorineural hearing loss "," vertigo "," dizziness ". Nine papers on the potential relationship of hearing loss with SARS-CoV-2 and four papers discussing possible imbalances resulting from SARS-CoV-2 infection were qualified for the study. The results of the analysis indicate a possible relationship between COVID-19 and hearing loss, while there is no evidence of a similar relationship between the history of infection with this virus and the equilibrium system. This possible dependence - especially the possibility of sudden sensorineural hearing loss as the first symptom of COVID-19 - should be especially remembered by hospital emergency room doctors, otolaryngologists and audiologists. This also applies to doctors of other specialties. The authors indicate the need for further, intensive, multifaceted research on this issue.
  • A patient in an otolaryngology office in the time of the COVID-19 pandemic in the light of current guidelines, legal regulations and own experience
    COVID-19 is an acute infectious disease caused by the SARS CoV-2 virus. The most common human-to-human transmission occurs as a result of contact with infectious secretions from the respiratory tract. Clinical symptoms vary from mild, non-specific ailments to life-threatening conditions. The announcement by the World Health Organization in March 2020 of the COVID-19 pandemic affected many medical, legal, social and economic aspects of life in countries around the world. This paper summarizes the recommendations for outpatient care for an ENT patient and the legal basis regarding the risk of infection in a patient in a doctor's office. In the selection of works, English and Polish-language medical portals were used, by entering into the search engine the following terms: SARS CoV-2, COVID-19, otolaryngology, endoscopy, personal protective equipment and legal liability of the doctor. The mucosa of the upper respiratory tract is a potential site of virus replication. The specificity of ENT examination and direct patient-doctor contact favor transmission of the infection. The elements of self-protection of medical personnel were discussed in detail and legal aspects resulting from the risk of infection of the patient in the office were indicated. In case of direct contact with a patient, personal protective equipment is required: a cap, mask with FFP-2 filter, goggles, apron and gloves. If, during the visit, exposure to secretions and aerosol from the respiratory tract is expected, you should additionally wear a visor and a waterproof apron. The patient's visit to the clinic should be preceded by teleportation. Patients should be screened prior to direct contact with a physician by means of a short patient questionnaire. The questionnaire may consist of simple questions about the characteristic symptoms of SARS CoV-2 infection and exposure to the patient in the last 14 days. The question of staying in high-risk areas of infection, in view of including all of Poland in this area, is of little importance. Due to the spread of the SARS CoV-2 virus, new procedures for providing medical services have been introduced. In the case of claims on the part of a patient, the only protection of the doctor or facility is confirmation of scrupulous observance of medical procedures.

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