Medycyna pracy最新文献

Background: Building law regulations determine designing the built environment recognising the needs of users of different ages and psychophysical abilities. Seniors and their spatial needs are covered there to a limited extent. The benchmark for design are wheelchair users. Their spatial requirements are greater in relation to independent walkers, including most older people. This makes it difficult to adapt the whole built environment to the needs of people with less mobility dysfunction. This can be considered in terms of spatial design and investment costs.

Material and methods: The paper analyses the building regulations of 3 countries in terms of legal conditions to shape the architectural movement space of older people and disabled people. Analytical and comparative methods are used. Such research is becoming relevant and necessary. The analyses are conducted in the context of ageing populations. They are justified by statistical data on the age groups of Polish society. This is followed by design analyses of the legal requirements in the wheelchair movement space and proposals for alternatives, e.g., people walking with canes (case study). Their aim is to indicate methods to limit excessive communication spaces in buildings while maintaining functional values for all users.

Results: Research may show the possibility of greater diversification of regulations and alternatives to current laws. They are dedicated to participants in investment processes to shape accessible buildings. They can also be used in legislative work on amendments to the construction law.

Conclusions: Changes in building regulations and a detailed approach to the mobility needs of older and disabled people (walking independently) are proposed. These decisions can provide benefits (spatial and economic savings). They fall into the "design for all" trend and sustainability of the built environment. These demands are based on no longer valid normative regulations. Med Pr Work Health Saf. 2024;75(3):189-197.

Background: Non-alcoholic fatty liver disease (NAFLD) is currently the most common liver disorder affecting about 25% of the global population. The causes of its development include poor diet, low physical activity, overweight, obesity, older age, diabetes, and lipid disorders. Non-alcoholic fatty liver disease is identified by some researchers as a hepatic manifestation of metabolic syndrome. It has been observed that patients with NAFLD have an increased risk of cardiovascular events, as well as a higher number of deaths from myocardial infarction compared to the general population.

Material and methods: A retrospective analysis was conducted on the data of 237 patients diagnosed with hepatic steatosis, treated in the Department of Geriatrics at the University Clinical Hospital in Wrocław from 2019 to 2022, focusing on coexisting overweight, obesity, and concomitant diseases. Laboratory results and the degree of left ventricular muscle hypertrophy were analyzed. Parameters assessed by echocardiography, including interventricular septal thickness in diastole (IVSd), left ventricular posterior wall thickness in diastole (LVPWd), and IVSd + LVPWd/2, were used to evaluate left ventricular hypertrophy.

Results: Data from 237 patients were analyzed: 79 men (age: 77.2±7.1 years) and 158 women (age: 78.4±7.7 years). Body mass index (BMI) values for men and women were 30.5±5.0 kg/m² and 31.9±5.6 kg/m², respectively. There was a positive correlation between BMI and the degree of left ventricular hypertrophy for the parameters IVSd (ρ = 0.36, p < 0.001), LVPWd (ρ = 0.36, p < 0.001), and IVSd + LVPWd/2 (ρ = 0.38, p < 0.001).

Conclusions: The study demonstrated a moderate positive correlation between BMI and the degree of left ventricular hypertrophy in patients diagnosed with hepatic steatosis. These findings indicate the necessity of actively searching for cardiovascular risk factors, including the evaluation of echocardiographic parameters in patients with NAFLD. Med Pr Work Health Saf. 2024;75(3):223-231.

Cardiovascular diseases (CVDs) are one of the main causes of morbidity and disability worldwide. Due to modern methods of diagnosis and treatment, it is possible to protect patients with acute coronary syndromes from myocardial infarction as well from its early complications. However, the challenge remains to improve the long-term prognosis of CVDs. Analysis of body composition using the bioelectrical impedance (BIA) appears to be a good method for assessing changes in patients' organisms following various cardiac incidents, as well as those participating in rehabilitation programmes. This study aims to provide a complementary analysis of the scientific literature and a critical review of the data from the use of BIA to assess phase angle in people with a history of cardiac diseases. This critical literature review was prepared based on the Scale for the Assessment of Narrative Review Articles recommendations. Inclusion criteria included 1) original publications of a research nature, 2) papers indexed in PubMed, Scopus, Embase databases, 3) full-text articles in English, 4) recent papers published between 2013-2023, 5) papers on the use of BIA with phase angle assessment as a prognostic factor in multiple aspects of health and disease, 6) papers showing changes in body composition in the process of cardiac rehabilitation. Based on a review of PubMed, Scopus and Embase databases, 36, 31 and 114 publications were found, respectively, chosen on the basis of precisely selected keywords and included for further full-text analysis. Exploring the role of the BIA holds lots of hope as a non-invasive method that can be used as a predictive marker for changes in the state of health in various fields of medicine. In young, healthy adults, BIA parameters may be important in identifying risk factors for the development of particular diseases, in predicting the rapid development of disease symptoms and in promoting motivation to lifestyle changes. Med Pr Work Health Saf. 2024;75(3):243-254.

Background: The aim of this article is to attempt to answer the question of how to enhance the fulfillment of needs for senior citizens residing in riverside cities. To achieve this, an attempt was made to develop the principles of a cohesive system that enables the activation of waterfront areas located in urbanized regions, often affected by a deficit of green spaces. The concept presented in this article is based on a consistent focus on architectural and urban design solutions that provide opportunities for functional enrichment of underutilized riverside areas for recreational purposes.

Material and methods: Based on literature studies, field research, and design analysis, this article demonstrates the possibility of taking a structural approach to implementing changes in the utilization of green spaces located by the water in contemporary cities. Using the results of the analysis, an original system called the mobile architectural-urban elements (mobilne elementy architektoniczno-urbanistyczne - MEAU) was developed to activate the untapped potential of waterfront areas to meet the specific needs of senior citizens.

Results: The research objective outlined in the introduction led to the development of a solution based on the utilization of floating architecture for the establishment of services and amenities that enable comfortable and diverse leisure activities for the elderly. Additionally, it was demonstrated that the described approach aligns with the multidimensional vision of improving the well-being of users, as defined by the European Commission in the New European Bauhaus (NEB) program.

Conclusions: The analysis conducted in this article allows for preliminary confirmation of the hypothesis that the specific needs of senior citizens can be fulfilled through the activation of waterfront areas using MEAU located on the water. Such actions not only activate existing resources but also align with the guidelines of the NEB idea, providing a coherent and applicable model with significant implementation potential for most waterfront cities. Med Pr Work Health Saf. 2024;75(3):211-222.

Background: Analysis of demographic trends indicates that there is an increasing proportion of people who can be described as elderly. In Poland, the population aged >60 years is expected to increase to 10.8 million in 2030 and to 13.7 million in 2050, i.e., around 40% of total population. In line with the general trend, the issue of the aging of the professionally active population is becoming more relevant.

Material and methods: The average age of the world's working population is steadily increasing. In the European Union, workers aged 55-64 years accounted for 50% of the total workforce in 2013, and already 59% in 2018. In Poland, in 2018, people aged 55-64 years accounted for 49% of the employed population. The low percentage of people working at this age is due, among other things, to employers' attitudes towards employing older people, perceiving them as employees who are more difficult to manage and have health problems. Moreover, working conditions of seniors are not adapted to their age capabilities.

Results: It is necessary to reduce the burden of physical work, especially in awkward positions, carrying loads, monotonous work and piecework. It is important to create work organization in which it is possible to refer to the experience of older people, who should have freedom of action, without time pressure and the need to perform many tasks at the same time. The ever-increasing social dependence on information technology tools creates new problems for seniors. Taking into account age-related difficulties in acquiring new knowledge, it is important to provide them with simplified tools that are easier to use.

Conclusions: The scope of necessary actions to enable the aging population to work is very wide, ranging from legislative, technological and organizational changes, ending with education addressed both to people responsible for employee safety (including occupational health services) and to current and potential employees. Med Pr Work Health Saf. 2024;75(3).

Background: Taking into account the multi-directional beneficial effects of vitamin D₃ and its widespread deficiency, regular supplementation is recommended. However, more and more attention is being paid to the risk of overdose with supplemented vitamin D₃ and the associated serious health consequences.

Material and methods: The concentration of 25-hydroxyvitamin D (25(OH)D) is a routine test recommended upon admission to the Geriatrics Clinic of Wroclaw Medical University. The aim of the study was to analyze the results from January 2018 to June 2023. Additionally, information on the reported symptoms, gender and age of people with an increased level of vitamin D₃ was collected.

Results: Analyzing a group of 1400 patients, it was noted that within 5 years, vitamin D₃ concentrations exceeding the recommended level were recorded in 7 patients, including 3 with toxic levels. All abnormal results occurred in women. The most frequently reported symptoms included general weakness, lower limbs and joint pain, sleep disorders, low mood. People with toxic concentrations reported dizziness. In seniors there is a gradual increase in vitamin D concentration and its deficiency is less common. Higher concentrations were recorded in the group of older seniors, and concentrations considered toxic occur in the population >74 years of age. Supplements and drugs with vitamin D are most often used without consulting a doctor, without determining the appropriate dose, or without assessing the concentration of 25(OH)D in the serum.

Conclusions: To prevent vitamin D deficiency in seniors, doses >4000 IU daily are not recommended. It is advisable to check all medications and supplements taken at each doctor's visit in terms of duplicating treatment with vitamin D. It is advisable to assess the status of vitamin D supply the concentration of 25(OH)D in order to select the appropriate dose. Assessment of 1,25-dihydroxyvitamin D concentration is recommended in cases of vitamin D toxicity. Med Pr Work Health Saf. 2024;75(3).

This paper discusses the potential of additive printing, the risks it poses to users' health (including 3D printer operators) and the effects of chemical substances released during the printing based on the available in vitro and in vivo studies. It was shown that substances emitted during printing with the commonly used acrylonitrile butadiene styrene filament in additive manufacturing might have carcinogenic, hepatotoxic and teratogenic effects, as well as toxic effect on the respiratory system. The latest research on the mechanism of formation of particles and volatile organic compounds during 3D printing, the parameters affecting their potential emission, and trends in reducing these hazards are indicated. The need for the design of more environmentally friendly and less emissive printing materials, as well as strategies for prevention and individual and collective protection measures are emphasized. Users of 3D printers should be familiar with all possible aspects of the threats associated with the printing process. Insufficient data on direct exposure to chemicals and particles released during the use of filaments makes it difficult to build awareness of safe working practices. Of particular concern is the health impact of emitted chemicals and particles from thermally treated materials in one of the most popular technologies for 3D printing, i.e., fused deposition modelling. Exposure of the users to, e.g., plasticizers added to filaments occurs through a variety of routes, by absorption through the skin, by inhalation or ingestion. Available epidemiological data, as well as current experimental works, indicate that such exposure is a high risk of cardiovascular diseases, atherosclerosis in adults, and cardiac problems and metabolic disorders in children. This review, by identifying potential risk factors, may contribute to reducing the health loss of printer users and improving working conditions and safety, especially in enterprises where additive manufacturing technology is used. Med Pr Work Health Saf. 2024;75(2):159-171.

Background: The study aimed to investigate the influence of extremely low-frequency electromagnetic fields (ELF-EMF) on clear cell renal cell carcinoma (ccRCC) by assessing alterations in gene expression and the secretion of cytokines and chemokines.

Material and methods: Three ccRCC cell lines (786-O, 769-P, and CAKI-1) and a healthy HEK293 cell line were subjected to ELF-EMF exposure (frequency 50 Hz, magnetic field strength 4.5 mT) for 30 min daily for 5 days. The study examined the expression of ADAM28, NCAM1, and VEGFC genes, along with the secretion of 30 cytokines and chemokines.

Results: Notably, primary tumor-derived cell lines, but not those from metastatic sites, exhibited ADAM28 gene expression, which increased following ELF-EMF exposure. A statistically significant reduction in VEGFC gene expression was observed in 769-P cells after ELF-EMF exposure. Additionally, NCAM1 gene expression was upregulated in HEK293, 769-P, and 786-O cells, representing normal embryonic kidney cells and primary tumor cells, but not in CAKI-1 cells, which model metastatic sites. After EMF exposure, there was a statistically significant decrease in transforming growth factor β1 (TGF-β1) concentration in the cell culture supernatants of HEK293 and CAKI-1 cell lines, with no other significant changes in the secretion of tested cytokines.

Conclusions: Given the study's findings and available research, caution is warranted when drawing conclusions about the potential inhibitory effect of ELF-EMF on ccRCC progression. Standardization of experimental models is imperative when assessing the effects of EMF in a human context. Med Pr Work Health Saf. 2024;75(2):133-141.

Background: Workers who do monotonous and repetitive work in a static position often complain about fatigue and decreased work efficiency. Some studies indicate that to improve muscle fatigue, resistance strength training can be used.

Material and methods: To investigate the effect of 4-week inertial training on shoulder muscles' strength and muscles' fatigue resistance 44 female workers with disabilities were examined. The participants were randomized into the training group (T) (N = 32) and the control group (C) (N = 12). Before the training and after that shoulder muscles' strength were tested at the start and at the end of the workday (Monday and Friday). The participants were asked to complete questionnaire concerning their fatigue at work (T and C), inertial training and work efficiency (T).

Results: The work performed during the last day of the workweek, i.e., Friday (before training) resulted in a significant decrease in shoulder muscles' strength in T and C. Muscle strength achieved at the end of the workweek (Friday afternoon) was significantly lower than achieved at the start of the workweek (Monday morning) in both tested groups (before training). Moreover, inertial training resulted in a significant increase in shoulder muscles' strength in T; 34-74% for different muscles. No changes in muscles' strength were noted in C. Increased muscle strength in T following inertial training effectively prevented muscle fatigue. After training the differences in shoulder muscles' strength noted in T during different times of the workday and workweek were insignificant. Moreover, 4-week inertial training increased significantly the work efficiency of women from T by 4%; no changes were noted in C. Inertial training was well tolerated by the participants.

Conclusions: Using inertial training in women with disabilities to prevent shoulder muscles' fatigue during the workday and workweek is recommended. Med Pr Work Health Saf. 2024;75(2):113-122.

Background: The aim of the study was to better understand the process through which recovery leads to teachers' exhaustion and performance. The direct and the indirect, i.e., mediated by teacher' work-related self-efficacy, effects of recovery on exhaustion and job performance were measured. To assessment of recovery, the Polish version of the Work-Related Rumination Scale (W-RRS) was developed. It measures detachment, affective rumination and problem-solving pondering. The psychometric properties of this tool constitute an additional contribution to the article.

Material and methods: The study was conducted among a group of primary and secondary school teachers (N = 503). The factor structure of the W-RRS scale was checked using confirmatory factor analysis (CFA), its reliability by using of Cronbach's α measure, and its theoretical validity by means of correlation of main variables with criterion variables. Hypotheses related to direct and mediation effects were verified using structural equation modeling (SEM).

Results: The obtained results confirmed the criterion and construct validity and reliability of the W-RRS. It has been also shown that detachment is directly negatively associated with exhaustion (but not with performance), affective rumination is a predictor of higher exhaustion and lower job performance, and problem-solving pondering is related to job performance (but not to exhaustion). Self-efficacy mediates the effect of 2 (out of the 3) types of recovery on exhaustion and job performance, such that high levels of problem-solving pondering and low levels of affective rumination translate into high self-efficacy, which in turn leads to lower exhaustion and higher job performance.

Conclusions: The recovery methods have various implications for functioning of teachers. While detachment and problem-solving pondering seem to promote it, affective rumination intensifies exhaustion and reduces performance. The mediator of the recovery-psychological well-being relationship is self-efficacy. The W-RRS questionnaire can be used to assessment of rumination among teachers.