Medycyna pracy最新文献

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.

This article discusses the classification of micro- and nanoplastics (MNP), the routes of their exposure and the effects of MNP on the reproductive, respiratory, digestive and immune systems based on in vitro and in vivo studies, as well as available epidemiological data. The MNP can enter our body through inhalation, food or skin. The presence of microplastics (MP) in tap, bottled and deep sea water, as well as in sea salt, fruit and vegetables has been demonstrated. Due to their small size, MNP can be absorbed and easily distributed through the blood and lymphatic vessel system to tissues and organs. Recent studies have provided evidence of the accumulation of MNP in human lungs and even in the placenta. The accumulation of MNP in the body may have long-term effects and lead to health problems in humans, such as bronchitis, development of asthma, pulmonary fibrosis, inflammation and cancer. The information included in the article gives partial insight into how MNP may affect the human body. However, to fully assess the toxicity of MNP, comprehensive research is necessary, including standardization of MNP detection techniques and determination of the MNP content in food and water. It is also advisable to assess toxicokinetic parameters, as well as to determine the daily dose of exposure and interaction of MNP with various cells. Insufficient data on direct exposure to MNP in the work environment, as well as in other public places, constitutes a factor hindering the establishment of appropriate legal standards. In 2024, work on establishing the first act of EU law enabling the monitoring of MP in drinking water should be completed, which raises great hopes that in the future limit values for MNP in water and food and in workplaces will also be established. Med Pr Work Health Saf. 2024;75(1):81-96.

Healthcare workers are representatives of occupations that are most exposed to high levels of stress in the work environment. These characteristics of work increase the probability of suffering from mental disorders. One aspect of mental disorder prevention in the workplace is the role of healthcare managers as those people who are responsible for minimizing the negative impact of work-related stress factors. Their role can be performed by creating effective initiatives supporting workers' mental health. The need to support the implementation of such initiatives has been highlighted by the COVID-19 pandemic. The aim of the review is to summarize available types of managerial interventions in the field of mental health protection of medical staff, considering the assessment of their prevalence, determinants of effectiveness, and limitations from the perspective of healthcare managers. The article was prepared based on the literature review method and covered publications from original research in English and Polish, published until June 2023 in the following databases: PubMed, Google Scholar, and PsycINFO. In addition to the original research, the review also includes documents developed by international health organizations. The determinants of effective managerial interventions that can be used for the needs of managers and decision-makers in the field of mental health management in the workplace have been presented. The greatest widespread of mental health initiatives concerned the pandemic period, but now the key systemic task should be to maintain the frequency of impacts outside the pandemic period, due to the constant nature of stressors. The determinants of their effectiveness include, among others: incorporating elements of psychological knowledge into the process of educating managers, involving healthcare specialists in the development of programs, and examining the needs of the staff each time at the stage preceding interventions. Med Pr Work Health Saf. 2024;75(1):57-67.

Background: To evaluate incidence and search for possible predictors of brain fog and quality of life at work (QoL-W) among low-to-moderate risk subjects previously hospitalized due to COVID-19.

Material and methods: Participants aged ≥18 retrospectively reported 8 brain fog symptoms pre-COVID-19, at 0-4, 4-12 and >12 weeks post-infection via validated clinical questionnaire. The QoL-W was assessed with a 4-point Likert scale where 0, 1, 2, and 3 meant no, mild, moderate, and severe impairment in performing activities at work, respectively. Data on age, sex, comorbidities, and laboratory results (including first in-hospital high-sensitivity cardiac troponin I [hs-cTnI] measurement) were gathered.

Results: The study included 181 hospitalized subjects (age Me = 57 years), 37.02% women. Most had low disease severity (Modified Early Warning Score = 1, 77.90%) and low comorbidity (Charlson Comorbidity Index 0: 28.72%, 1-2: 34.09%), with no intensive care unit treatment needed. COVID-19 led to almost 3-fold increased brain fog symptoms, with incidence of 58.56%, 53.59%, and 49.17% within 4, 4-12, and >12 weeks, respectively (p < 0.001). First in-hospital hs-cTnI levels were 47.3% higher in participants who later presented with brain fog at median follow-up of 26.7 weeks since the diagnosis of the SARS-CoV-2 infection. Individuals who experienced at least one brain fog symptom at follow-up, had elevated hs-cTnI, less often presented with atrial fibrillation, and used anticoagulants during initial hospitalization due to COVID-19. The Hs-cTnI >11.90 ng/l predicted brain fog symptoms in multivariable model. COVID-19 was associated with 3.6‑fold, 3.0‑fold, and 2.4-fold QoL-W deterioration within 4, 4-12, and >12 weeks post-infection (p < 0.05). Subjects with QoL-W decline >12 weeks were younger, mostly women, had more brain fog symptoms, and higher platelet counts. Multivariable models with self-reported brain fog symptoms (responding coherently and recalling recent information), age, and sex exhibited good discriminatory power for QoL-W impairment (area under the receiver operating characteristic curve 0.846, 95% CI: 0.780-0.912).

Conclusions: This study highlighted that in non-high-risk subjects hospitalized during the first 2 pandemic's waves: 1) brain fog was common, affecting nearly half of individuals, and impacting QoL-W >12 weeks after initial infection, 2) after 3 months of COVID-19 onset, the decline in QoL-W was primarily attributed to brain fog symptoms rather than demographic factors, health conditions, admission status, and laboratory findings, 3) components of brain fog, such as answering in an understandable way or recalling new information increased the likelihood of significantly lower QoL-W up to tenfold, 4) biochemical indicators, such as the first hs-cTnI level, might predict the risk of experiencing brain fog symptoms and indirectly decrease

Background: Nurses constitute a crucial professional group within the healthcare system. Job satisfaction and opportunities for professional development directly impact the quality of medical services provided and help prevent burnout. The study aimed to assess the preferred career model, the level of job satisfaction, and determine the type of work-related behavior presented by Polish nurses.

Material and methods: A cross-sectional survey was conducted among 795 nurses after the COVID-19 pandemic. Three standardized scales were used: My Career questionnaire to access the preferred career model, the Job Satisfaction Scale, and Work‑Related Behavior and Experience Patterns (Arbeitsbesorgenes Verhaltens und Erlebenmuster - AVEM) questionnaire assessing types of work-related behavior. Descriptive statistics, Spearman's correlation coefficient, and multiple linear regression were used for analysis of data.

Results: The results concerning the relationship between the types of work-related behavior, job satisfaction, and the preferred career model revealed that type G (healthy) was significantly and positively correlated (p < 0.05, r > 0) with the Challenge subscale of the career model (r = 0.095, p = 0.007) and job satisfaction (r = 0.136, p < 0.001). The higher the score on the Challenge subscale and greater job satisfaction, the more pronounced type G personality. The multiple linear regression models explained only 2.5 to 5% of the variability of studied questionnaire outcomes but indicated that significant, independent predictors for the My Career questionnaire subscales and AVEM raw scales for each type were additional qualifications, level of education, work experience, and place of work. Significant predictors of the job satisfaction scale were employment in private healthcare facilities and a master's degree.

Conclusions: Nurses experience job satisfaction, but the workload, demanding daily tasks, and the sense of responsibility can lead them to feel fatigued and burnt out. The preferred career model involves Security and Stability, as well as Service and Commitment to other domains. Only a small percentage of the variability in the results of the analyzed dependent variables was explained by the explanatory variables included in the model. Med Pr Work Health Saf. 2024;75(1):19-30.

Background: The work of a paramedic, is characterised by a high risk of injury. Ergonomic, psychological, and biomechanical factors are considered risk factors in the profession of emergency medical technicians. Ensuring ergonomic working conditions for emergency medical technicians is a priority and requires a thorough assessment both in the design process and during the operation of the ambulance, to provide a diagnosis of the current state and present necessary recommendations for modernization. Identifying stressors will enable the design of an ergonomic interior for the ambulance, ensuring comfort and reliability for members of the emergency medical team, thereby reducing the risk of injuries.

Material and methods: The authors of this article developed a comprehensive methodology for assessing the nuisances occurring during the paramedic's work, which required specialised preliminary research. The research included the measurement and analysis of the paramedic's movement kinematics during typical medical procedures, both at a standstill and while driving the ambulance. For the analysis of motion kinematics, a non-invasive method called myoMotion was employed, and the study was conducted in a Mercedes ambulance.

Results: This article contains preliminary results on the evaluation of movement kinematics. These demonstrated the necessity for the paramedic to adopt forced positions when performing medical procedures. The ranges of movement of the individual body parts of the paramedic deviated from accepted norms, resulting in musculoskeletal overload.

Conclusions: The acquired knowledge forms the basis for a detailed analysis of tasks performed within each procedure from the perspective of the spatial structure of the ambulance, the arrangement of equipment and medical supplies, their accessibility during work, and the organization of work within the ambulance. Additional identification of musculoskeletal system stress, its sources, and the formulation of modification recommendations for the ambulance interior will enable ensuring the comfort and reliability of the work for emergency medical teams, thereby reducing the risk of injuries in the workplace. Med Pr Work Health Saf. 2024;75(1):31-44.