Medycyna pracy最新文献

Background: The aim of the study is to present information on the occurrence of carcinogenic or mutagenic agents in Polish enterprises in 2022-2023, based on information from the Central Register of Data on Exposure to Carcinogenic, Mutagenic or Reprotoxic Chemical Substances, Their Mixtures, Agents or Technological Processes (Centralny rejestr danych o narażeniu na substancje chemiczne, ich mieszaniny, czynniki lub procesy technologiczne o działaniu rakotwórczym, mutagennym lub reprotoksycznym - CRCR) maintained at the Nofer Institute of Occupational Medicine.

Material and methods: Employers who employ workers with carcinogenic, mutagenic, and, from 2024, also reprotoxic agents, are legally obliged to register such works. Information from voivodeships is submitted annually to the sanitary and labor inspection, and nationwide data are collected in the CRCR. The study used data for 2022-2023, collected and verified by the CRCR staff in 2023-2024. Data for groups of agents - chemical substances, physical factor - ionizing radiation, and technological processes - were also analyzed. Previous data (2005-2021) were used for comparison.

Results: In 2022-2023 data were collected from 14 500 and 17 100 enterprises. An increase also occurred for specific groups of agents - chemical substances, technological processes, and the only physical agent legally recognized as carcinogen and mutagen - ionizing radiation. The largest increase concerned technological processes - >26% (7653 and 9685 during the analyzed years). The most frequently reported were 2 technological processes - work involving exposure to wood dust and the respirable fraction of crystalline silica - followed by ionizing radiation and 2 chemical substances: unspecified low-boiling-point gasoline and formaldehyde.

Conclusions: The increase in the number of reports is due not only to economic and technological developments, but also to legal changes that have expanded the list of carcinogenic or mutagenic agents. The further extending the list of substances subject to the obligation to register in workplaces to include reprotoxic substances will result in a sharp increase in the number of notifications for 2024. Med Pr Work Health Saf. 2026;77(1):49-59.

The case report concerns a patient who, during a medical examination conducted to asses medical fitness to drive motor vehicles, concealed the truth about his health condition. Particular attention was paid to the discussion of the patient's responsibility for the content of information provided in the interview. The article discusses criminal liability for making a false statement, for obtaining false certification by fraud and for using a document obtained by fraud. Attention was also drawn to the social obligation to denounce, which may also apply to physicians involved in medical certification. In case of medical examinations of drivers, every patient has a legal and moral obligation to provide the physician with truthful and complete information about his/her health, medications, past illnesses, and lifestyle. Providing false information or concealing important information can lead to an incorrect final diagnosis and, consequently, an incorrect decision, which can endanger the health and life of not only the driver but also other road users. Med Pr Work Health Saf. 2026;77(1):71-80.

Background: Occupational injuries among firefighters significantly impact their job performance. To reduce these injuries and enhance their professional capabilities, this study investigates and comprehensively evaluates the factors contributing to occupational injuries among frontline firefighters in China. It analyzes the underlying mechanisms of these injuries and proposes preventive strategies.

Material and methods: This study employed questionnaire surveys and factor analysis methods to conduct a comprehensive investigation and comprehensive assessment of occupational injuries and their influencing factors among 200 firefighters in China. The research subjects were randomly selected from the grassroots firefighters in cities of FuJian Province. Among them, 179 firefighters successfully completed the questionnaire survey. Through exploratory factor analysis, the key factors influencing firefighters' injuries were identified.

Results: The injury rate among the participating firefighters in 2023 was 40.78%. The highest injury rate was observed during daily training (58.52%). Notably, the injury rate tends to decrease with increasing age. The most common types of injuries were sprains and strains (57.10%), with the knee joint exhibiting the highest incidence of injury among all body parts (47.00%). The primary factors influencing occupational injuries among firefighters include training factors, support factors, educational factors, and mental health factors, which collectively account for a variance contribution rate of 79.56%.

Conclusions: Training, support, educational, and mental health factors are the 4 primary influences on firefighters' occupational injuries. The administrative department should strengthen the study and practice of physical fitness theory for firefighters, prioritize the prevention of occupational training injuries, enhance the scientific rigor of training programs, and promote the occupational health of firefighters. Med Pr Work Health Saf. 2026;77(1):1-10.

Background: The work is a report on the intentional use of harmful biological agents in workplaces in Poland based on National Register of Biological Agents (Krajowy Rejestr Czynników Biologicznych - KRCB) as of June 2025.

Material and methods: The KRCB is a central database gathering notifications of the intentional use of biological agents in risk groups 2-4 in work processes in accordance with the Regulation of the Minister of Health of December 11, 2020, amending the regulation regarding biological agents.

Results: Notifications were sent by 749 enterprises for: diagnostic - 59.3%, research - 32.4% and industrial purposes - 8.1%. Notifications were most often sent by microbial laboratories (N = 438, 58.5%), scientific-research institutions (N = 229, 30.6%) and industrial enterprises (N = 82, 11.0%). In total, 7795 workers (87.6% women, 12.4% men) were exposed to biological agents intentionally used at work. Biological agents from risk groups 2 and 3 were used by 97.6% and 15.9% enterprises, respectively. The most frequently were used bacteria Escherichia coli (with the exception of non-pathogenic strains) - 4823 exposed workers (61.9%), Staphylococcus aureus - respectively 4655 (59.7%) and Pseudomonas aeruginosa - 4188 (53.7%). National Register of Biological Agents gathered 9 notifications of intentionally using of the biological agent carcinogenic to humans, including viruses (hepatitis B virus [N = 2015 workers, 25.8%], hepatitis C virus [N = 1982, 25.4%], human immunodeficiency virus type 1 [N = 1796, 22.7%], Epstein-Barr virus [N = 196, 2.5%], human papilloma virus [N = 60, 0.8%], human herpes virus type 8 [N = 16, 0.2%], human T-lymphotropic virus type 1 [N = 38, 0.5%]), bacteria (Helicobacter pylori [N = 327, 4.2%]), parasite (Schistosoma haematobium [N = 9, 0.1%]).

Conclusions: Intentionally used biological agents most often pose a threat to workers of microbial laboratories, but a higher health risk concerns workers of scientific-research institutions. Med Pr Work Health Saf. 2026;77(1):11-26.

Occupational exposure to wood dust is a major public health and occupational safety concern, particularly in woodworking, furniture production, and the wood-based materials industry. Its carcinogenic, allergenic, and toxic potential depends on wood species, physicochemical properties, processing methods, and applied chemical treatments. The aim of this review was to analyze occupational exposure to wood dust by synthesizing current evidence on worker health risks, measurement methods, legal regulations, and preventive strategies, in order to evaluate the adequacy of existing solutions and identify areas requiring further improvement. The review is based on 61 literature sources: publications, legal acts, official guidelines from international and national institutions (International Agency for Research on Cancer, National Institute for Occupational Safety and Health, Occupational Safety and Health Administration, American Conference of Governmental Industrial Hygienists, European Agency for Safety and Health at Work, Statistics Poland, Nofer Institute of Occupational Medicine, Polish Ministry of Health). Sources published 2010-2024 were analyzed with particular focus on dust characteristics, exposure limits, measurement methods, preventive measures, and regulatory frameworks. Exposure to wood dust contributes to both acute and chronic respiratory conditions, skin and eye irritation, and a higher incidence of upper respiratory tract cancers. Recent regulatory changes have expanded the classification of wood dust as a carcinogen to include all species. Despite existing occupational exposure limits (OELs), exceedances remain common in woodworking industries. Conventional monitoring methods may underestimate respirable and ultrafine particles (UFP <100 nm), which pose substantial health risks. Preventive strategies - including technical controls, ventilation, personal protective equipment, and medical surveillance - significantly reduce airborne dust concentrations and worker exposure. Findings indicate a need to update OELs and harmonize regulations with current scientific evidence. Effective prevention requires integrating legal requirements, engineering controls, process automation, and medical and educational interventions. Strengthening national standards within the European Union regulatory framework and improving measurement methods - especially for inhalable and ultrafine fractions - are essential to ensuring adequate worker protection. Med Pr Work Health Saf. 2026;77(1):61-70.

Background: Violin playing involves prolonged upper limb exertion and asymmetrical posture, potentially leading to pain and postural defects. Despite the known prevalence of playing-related musculoskeletal disorders, data on young adult violinists compared to a control group remains insufficient. The aim of this study was to assess pain and postural problems among young adult violin players, and to compare them with those of non-violin players. Additionally, an attempt was made to identify the causes of these problems in violinists and to indicate directions that should be developed in further research.

Material and methods: The study included 50 participants (25 violinists and 25 individuals in the control group). A custom questionnaire was used to assess pain (Numerical Pain Rating Scale - NPRS), along with postural assessment based on the Kasperczyk method. Statistical analysis was conducted using the Mann-Whitney U test, chi-squared test, and Spearman's correlation coefficient.

Results: In the group of violinists, pain occurred significantly more frequently in the trapezius muscle (left: 68%, p = 0.0006; right: 52%, p = 0.0169) and the left shoulder (36%, p = 0.0405). The average pain intensity (NPRS) was significantl higher in the study group than in the control group (6.6 pts vs. 4.7 pts, p = 0.0085). In terms of posture, violinists scored significantly higher on the Kasperczyk assessment (M = 9.8 pts vs. M = 6.1 pts, p = 0.0002), indicating more postural abnormalities. The most common defects in this group included forward head posture, shoulder asymmetry, and foot flattening/valgus. Additionally, 88% of violinists reported that pain interfered with their ability to play in the past week.

Conclusions: Playing the violin is associated with an increased risk of musculoskeletal pain and postural abnormalities, particularly in the upper body. The results highlight the need for preventive strategies among musicians. The collected data may serve as a foundation for implementing preventive programs in music education, which should be continued into the violinist's later professional career. The data serve as a starting point for further research. Med Pr Work Health Saf. 2026;77(1):27-48.

Pneumoconioses are among the most frequently diagnosed occupational diseases in Poland, with collagenous pneumoconiosis forming a significant subgroup. These diseases develop as a result of exposure to fibrogenic dusts. One of the rare forms of such conditions is Caplan's syndrome - a rheumatoid type of pneumoconiosis characterized by the coexistence of pulmonary nodular lesions and rheumatoid arthritis. This condition is rarely diagnosed, most commonly among individuals occupationally exposed to silicate dust, such as coal miners. This article presents a case of a men with Caplan's syndrome qualified as occupational background just in the second instance of medical certification. A thorough re-evaluation of the patient's occupational and medical history confirmed a causal relationship between the development of the disease and exposure to silicate dust in his profession as a dental technician. This case highlights the diagnostic challenges resulting from the common misconception that Caplan's syndrome occurs exclusively in coal miners, whereas the risk extends to various occupational groups exposed to silicate dust. The described case underscores the importance of a comprehensive approach to clinical and occupational assessment in the diagnosis of pneumoconioses, particularly in the context of rare disease entities. Med Pr Work Health Saf. 2026;77(1):81-88.

Background: This study aimed to identify distinct employee and organizational profiles influencing workplace safety behaviors (compliance and participation) using latent profile analysis (LPA), focusing on psychological need satisfaction, work performance, and organizational safety culture.

Material and methods: A cross-sectional survey of 1293 Polish employees across diverse sectors (industry, transportation, construction, agriculture) assessed individual factors (personal safety culture, basic psychological needs, task/contextual performance, counterproductive behaviors) and organizational factors (safety values, leadership commitment, training quality, psychosocial climate). Validated scales, including the Basic Psychological Need Satisfaction and Frustration Scale at Work, Individual Work Performance Questionnaire, individual safety culture questionnaire (Kultura bezpieczeństwa jednostki), and organizational safety culture questionnaire (Kultura bezpieczeństwa zakładu), were administered via computer-assisted web interview. Separate LPAs identified employee and organizational profiles; non-parametric tests compared safety outcomes across profiles.

Results: Five latent profiles emerged for both employees and organizations. Employees with high basic need satisfaction, strong personal safety values, and high performance exhibited the highest safety compliance and participation. Conversely, those with unmet needs despite strong safety values showed the lowest level of safety behaviors. Organizations with holistic safety cultures (leadership commitment, tailored training, psychosocial support) achieved superior safety outcomes, while those neglecting systemic safety investments performed the poorest.

Conclusions: Workplace safety behaviors are shaped by interactions between various individual and organizational variables. The study highlighted the importance of both organizational factors, such as safety climate, and individual factors, including need satisfaction, performance, and counterproductive behaviors. Med Pr Work Health Saf. 2025;76(6):435-447.

This article, aimed at assessing potential health risks to medical personnel, presents a literature review on paclitaxel (PTX), a natural taxane alkaloid widely used in cancer chemotherapy. The review analyzes the toxic properties of PTX, occupational exposure routes and sources, as well as findings from environmental and biological monitoring studies and potential health effects. The methodology included a review of literature from reputable databases, institutional reports on hazardous medicinal products, and data from national registries. The results confirm that, despite its effectiveness in cancer treatment, PTX is a highly toxic substance associated with significant occupational risk. Due to its high molecular weight and relatively high vapor pressure, exposure may occur via inhalation and dermal contact during various stages of drug handling - from preparation to contact with patients' excreta. Biological monitoring has detected PTX in the urine and plasma of healthcare workers, while environmental monitoring has confirmed widespread surface contamination in medical facilities. The potential health effects of PTX primarily include mutagenic and genotoxic actions (aneugenicity, clastogenicity, DNA damage, chromosomal aberrations, and micronuclei formation), as well as neurotoxicity, myelosuppression, hepatotoxicity, and adverse effects on reproduction (embryotoxicity, fetotoxicity, and impaired fertility). To identify irregularities early and effectively reduce health risks associated with PTX exposure, a comprehensive occupational exposure assessment should become standard practice. This assessment should incorporate 3 complementary components: biological monitoring of workers, air concentration measurements, and surface contamination testing using wipe sampling. The inclusion of surface contamination measurements as a routine exposure surveillance method should be recognized as a best practice in healthcare settings where cytotoxic substances are used. A reference value of 0.1 ng/cm² for surface contamination is recommended. The implementation of effective preventive measures, appropriate personal protective equipment, regular decontamination, and staff training is essential for protecting the health of medical personnel. Med Pr Work Health Saf. 2025;76(6):469-486.

Background: Malignant cancers are one of the most significant public health challenges, both in Poland and globally. In the context of increasing incidence, particular attention should be given to cancers with occupational etiology. Despite awareness of these risks, in Poland, this issue remains insufficiently recognized and registered within the occupational disease system. The aim of this study was to assess the occurrence occupational cancers in Poland 2015-2024, focusing on high-risk industries and the most common causes of occupational carcinogens.

Material and methods: The analysis included data on reported cases of confirmed occupational diseases 2015-2024, which were submitted by sanitary-epidemiological stations to the Central Register of Occupational Diseases at the Nofer Institute of Occupational Medicine in Łódź.

Results: In the analyzed period, 601 cases of occupational cancers were reported, including 512 in men and 89 in women. The most frequently diagnosed cancers were lung cancer (50.1%), pleural mesothelioma (36.6%), hematopoietic system cancers (3.3%), and laryngeal cancer (2.8%). The average duration of exposure was about 20 years. The highest number of cases was associated with industrial processing, mining, and construction, with dominant risk factors such as asbestos, benzene, and ionizing radiation. Asbestos exposure was responsible for all cases of pleural and peritoneal mesothelioma, >56% of lung cancers, and nearly 47% of laryngeal cancers.

Conclusions: The analysis revealed that occupational cancers account for only 2.7% of all reported occupational diseases indicating a significant underestimation. Further actions are needed to strengthen the detection, diagnosis, and prevention systems for these carcinogens. It is essential to introduce tools to monitor exposure to carcinogenic factors and to promote cooperation between employers, occupational health and safety services, doctors, and public health protection institutions. Med Pr Work Health Saf. 2025;76(6):449-456.