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Background: There are several techniques to diagnose post-traumatic stress disorder (PTSD) symptoms that correspond to the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification of mental disorders. This study aimed at testing the reliability and construct validity of the Polish version of the PTSD-8. The results obtained in four professional groups of healthcare workers (physicians, nurses, paramedics, other occupations) were compared.

Material and methods: The PTSD-8 questionnaire includes questions on stress reactions manifested by intrusion (4 items), avoidance (2 items), or hypervigilance (2 items). Respondents were asked about their reactions to the traumatic work-related experiences occurring during the COVID-19 pandemic. The nationwide survey conducted in 2022 included 2303 employees, among whom 746 had such an experience and completed the PTSD-8 questionnaire.

Results: Based on confirmatory factor analysis (CFA) results, it was shown that a single-factor model is acceptable, but under the condition of modification by correlation of random errors at selected observable variables. The reliability of this scale is very good (McDonald's Ω = 0.890), and the goodness-of-fit of the overall CFA model is confirmed by: CMIN/DF = 3.969, NFI = 0.982, RFI = 0.964, IFI = 0.986, TLI = 0.983, RMSEA = 0.063. The model estimated for female nurses has the best psychometric properties. In the study group of 2303 respondents, 16.76% met the criteria for PTSD, accounting for 52.74% of those who were traumatized by a work-related event. The PTSD-8 index is M±SD 20.01±5.55 pts (range: 8-32 pts). The PTSD-8 index is significantly higher in women than in men, and higher in nurses compared to other professions. However, the differences between professional groups are significant only for women, and the largest when comparing female physicians and nurses.

Conclusions: The analyses confirmed the rationale of further implementation of the PTSD-8 questionnaire in Poland, both as a tool for identifying PTSD and for studying the severity of the syndrome, its determinants and health effects. Med Pr Work Health Saf. 2024;75(1):45-56.

The paper presents the current radiation protection standards, in line with the recommendations of the International Commission on Radiological Protection (ICRP), and their evolution over the years based on new knowledge about the biological effects of ionizing radiation and the changing attitude of people to the accepted risk. The work takes into account in particular the role of the dose limit principle and individual dose measurements in activities aimed at health prevention of individual people occupationally exposed to ionizing radiation. Med Pr Work Health Saf. 2023;74(6):527-39.

Background: The work presents the intentional use of harmful biological agents based on National Register of Biological Agents (Krajowego Rejestru Czynników Biologicznych - KRCB) collected by June 2023.

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

Results: with the regulation of the Minister of Health of December 11, 2020 amending the regulation regarding biological agents. Results: Notifications were sent by 712 enterprises for: diagnostic - 62%, research - 31% and industrial purposes - 7%. Notifications were most often sent by hospital and non-hospital clinical and diagnostic laboratories (33% each group) and higher education and research units - 16%. In total, 7352 workers (88% women, 12% men) were exposed to biological agents intentionally used at work. Biological agents from 2 and 3 group risk were used by 98% and 16% enterprises, respectively. The most frequently were used bacteria Escherichia coli (with the exception of non-pathogenic strains) - 5972 (81%) exposed workers, Staphylococcus aureus - respectively 5760 (78%) and Pseudomonas aeruginosa - 5155 (70%). Among the total workers, nearly 25% were exposed to at least 1 biological agent carcinogenic to humans, including viruses (hepatitis B virus [HBV] - 1800 workers, 24%; hepatitis C virus [HCV] - respectively, 1767, 24%; human immunodeficiency virus-1 [HIV-1] - 1557, 21%; human gammaherpesvirus type 4 (Epstein-Barr virus) - 199, 3%; Papillomaviridae - 52, <1%; human gammaherpesvirus type 8 [HHV-8] - 16, <1%; human T-lymphotropic virus type 1 [HTLV- 1] - 38, <1%; bacteria Helicobacter pylori - 299, 4%; parasites Schistosoma haematobium - 9, <1%).

Conclusions: Intentionally used biological agents most often pose a threat to workers of hospital and non-hospital clinical and diagnostic laboratories, but a higher health risk concerns workers of and higher education and research units. Med Pr Work Health Saf. 2023;74(6):501-11.

Background: The unexpected outbreak of the COVID-19 pandemic has led huge impact on health and safety of employees. Although now the epidemiological situation has improved, but it remains a challenge, especially in light of the emergence of new threats. The aim of the work is to present an epidemiological analysis of data on COVID-19 as an occupational disease in Poland.

Material and methods: The analysis covered all cases of occupational diseases sent by state sanitary inspectors to the Central Register of Occupational Diseases. The years 2020-2022 and such available data as: age, gender, activities and territorial differentiation were analyzed. The data were presented as absolute numbers and incidence rates per 100 000 employed persons and for healthcare workers also per 100 000 persons authorized to practice.

Results: In the period 2020-2022 in Poland 7030 diseases recognized as occupational diseases were recorded, of which almost half were infectious diseases (47%). Among infectious diseases, dominated COVID-19 in number of 2059 cases. In this period 98.6% of all cases of COVID-19 were concentrated in the health care and social activities. According to workplaces, most diseases were caused by working in hospitals - 1825 cases (88.6% of all COVID-19 cases in the healthcare workers). Most cases concerned nurses - 1355 cases (65,8%) and doctors - 212 cases (10,3%). The incidence of COVID-19 in the group of physicians per 10 000 persons entitled to practice ranged from 2.6 in 2020 to 68.3 in 2022, while among nurses and midwives the rates were 7.9 and 194.9, respectively.

Conclusions: The COVID-19 pandemic changed the picture of occupational diseases in Poland. Therefore, it is very important to understand the key contributions of people working in environments where workers are at increased risk of contracting COVID-19 due to the nature of their work, and to promote the recognition of COVID-19 as an occupational disease. Med Pr Work Health Saf. 2023;74(6):479-86.

Accusations of medical malpractice, increasingly common among healthcare professionals, are a massive source of stress which can lead to the development of medical malpractice stress syndrome (MMSS). The symptoms of this syndrome are often compared to those in post-traumatic stress syndrome (PTSD), and the doctors are referred to as "second victims" of medical mistakes. The aim of the publication is to highlight MMSS, its symptoms, its similarity to PTSD, its consequences, and methods of prevention and management. In addition, attention was paid to the number of medical malpractice lawsuits among medical specialties mostly affected by this problem to illustrate the scale of the phenomenon. The publication is a narrative review. Medical databases (PubMed, ResearchGate, Biblioteka Nauki), termedia and Jurnals.viamedica service from the years 1988-2023 were reviewed. The MMSS manifests itself with symptoms such as anger, frustration, anxiety, guilt, sleeping disorders, loss of self-confidence, and depression. Later, somatic symptoms, such as cardiovascular, also appear. The MMSS may lead to unnecessary ordered examinations, delayed therapeutic processes, or premature retirement from the profession. Recently, patients have become more aware of their rights, resulting in an increase in malpractice lawsuits, particularly in specialties such as gynecology and obstetrics, neurosurgery, and radiology. Concerns about the legal consequences of medical errors may affect future specialization choices. Graduates tend to avoid specialties with a high risk of medical malpractice. Coping with MMSS requires social support and cooperation between doctors and lawyers or psychiatrists. Prevention of MMSS includes awareness of stress reactions and procedures decreasing the risk of committing medical malpractice. The prevalence of MMSS among physicians and the impact of the risk of medical malpractice lawsuits on the choice of medical specialty in Poland require further examinations. Med Pr Work Health Saf. 2023;74(6):513-26.

A major challenge over the pandemic period was to establish the criteria for recognizing COVID-19 as an occupational disease. The European Center for Disease Prevention and Control has attempted to estimate the incidence of COVID-19 in individual occupational groups and economy sectors in the European Union and the United Kingdom, and to identify possible factors increasing the transmission of the virus at workplaces. Legal regulations of various countries in the world allow COVID-19 to be recognized as an accident at work and/or an occupational disease. In Poland, an occupational disease is defined as a disease caused by harmful factors occurring in the work environment or connected with performing a given job, included in the official list of occupational diseases. When assessing occupational exposure in the healthcare sector, it should be considered that healthcare workers include all persons in contact with patients or their biological material, as well as employees who are not medical professionals but who share a common space with patients due to the nature of their work. The latter group includes administrative and technical employees, control and rescue service workers, people supporting medical staff, and employees of nursing homes. In the case of non-medical occupations, the decision to recognize COVID-19 as an occupational disease should be made on an individual basis, after confirming a significant risk of contracting a SARS-CoV-2 virus infection at the workplace and in the absence of evidence of a non-occupational source of infection. An assessment of occupational exposure should always include evaluating the possibility of SARS-CoV-2 transmission. Med Pr Work Health Saf. 2023;74(5):435-42.

Occupational medical research involves the collection and analysis of data to draw conclusions about the causes and prevention of workplace injuries and diseases. However, there has been criticism that some studies lack rigour in determining causation. This article examines the similarities and differences between occupational medical research and particle physics in terms of their approach to hypothesis testing, statistical methods, and confounder control. The article also explores the use of criteria such as the Bradford Hill criteria to determine causation in occupational medical research. While particle physics is often viewed as a highly rigorous science, occupational medical research also employs rigorous scientific methods to ensure findings are accurate and reliable. However, there is room for improvement in determining causation in occupational medical research, particularly in the use of criteria such as the Bradford Hill criteria to guide the development of more robust studies. It is essential for occupational medical research to adhere to rigorous scientific methods to deliver findings that can help reduce workplace injuries and diseases. The use of criteria such as the Bradford Hill criteria can ensure that the conclusions drawn. Med Pr Work Health Saf. 2023;74(4):333-9.

Background: Drug-resistant bacteria are one of the main reasons of deaths worldwide. A significant group of these bacteria are carbapenemase producing Enterobacteriaceae (CPE). The goal of this study was to develop a diagnostic and therapeutic model targeted at asymptomatic carriers of CPE.

Material and methods: A team of experts from different branches connected to health care, discussing the topic based on the data collected from previous research. Working sessions were dispersed between June and December 2022. The consensus has been reached via repeated discussion and literature search.

Results: The facility where CPE are detected is required to create an alert pathogen note and to notify sanitary-epidemiological station and National Reference Centre for Antimicrobial Susceptibility of Microorganisms - neither these institutions, nor the patient are required to notify the primary care physician. In primary care clinics, it is possible to work towards breaking the transmission of CPE by educating patients with CPE and persons who were in contact with them, and to undertake actions in order to look for patients with risk factors for CPE colonisation. In order to improve communication between individual levels of the health care system, standardised information could be introduced to the discharge note about a case of CPE, which will be electronically transmitted to the primary care facility. It might contribute to effective combating of the spread of CPE, by serving as a source of knowledge and education for patients and by checking the patient's risk factors, which will improve the performance of tests for CPE colonisation.

Conclusions: The established model of good practice requires a change of legal regulations and its implementation, which will reduce the spread of CPE in health care facilities and will enable its future improvement. Med Pr Work Health Saf. 2023;74(4):263-70.

In the paper authors present general assumptions of health surveillance programme concept for workers employed in respirable crystalline silica (RCS) exposure at present and in the past. There is no effective treatment for silicosis thus disease prevention is of paramount significance. For decades efforts of World Health Organization (WHO) and International Work Organization (ILO) have been focused on eliminating silicosis globally. Unfortunately silicosis is still one of the most lethal occupational diseases and the preventative programmes have not yet been successful. The authors identify main steps to complete an overview of RCS exposure and suggest lines of actions to be taken before launching the health surveillance programme. Introduction of the health surveillance programme would increase awareness of harmful health effects of the RCS exposure, emphasize the significance of preventive medical check-ups and early diagnostics of occupational diseases as well as the importance of using appropriate protective equipment. The programme development on a national level might be carried out with the cooperation of multiple backgrounds and institutions. This would allow for detailed planning, implementation, monitoring and effective evaluation of its results. Having a better and updated knowledge of silicosis epidemiology, early diagnostics, the possible sources of RCS occupational exposure and evaluation of undertaken preventive actions are crucial factors in disease prevention. The programme introduction would be of educational significance for all the stakeholders and the groups engaged in the project implementation, which would contribute to high effectiveness of the preventive activities and their improvement in the future. Med Pr Work Health Saf. 2023;74(4):341-6.

Background: The authors aimed to explore carpal tunnel syndrome (CTS) among electronic sports (esports) athletes, to compare hand symptoms and their severity between esports athletes and the control group and within the esports athletes, and to study the relationship between esports athletes' variables.

Material and methods: A cross-sectional survey study via telephone with systematic randomized approach was used for esport athletes sampling. Control group were non-esports athletes who do not use computer for prolonged duration. The survey consisted of sports athletes' characteristics, hand symptoms and functions, and the Boston Carpal Tunnel Questionnaire (BCTQ). The unpaired student's t-test, Mann-Whitney U test, and χ² test were utilised for statistical comparison, with p < 0.05. Pearson's and Spearman's correlation coefficient tests were used for relationship analyses.

Results: Eligible participants were 198 out of 229. Compared to control group, esport athletes reported more CTS (p = 0.01), and radiated pain and numbness in their hands (p = 0.05). Males complained of hand symptoms (p < 0.01) and its radiation (p < 0.01) more than females among esports athletes. Higher BCTQ Symptom Severity Scale (BCTQ-SSS) scores were reported for esports athletes who had been playing esports for prolonged periods compared to those who had playing recently (p = 0.003), with a moderate positive correlation (+0.59, p = 0.004). A significant moderate positive correlation was reported for BCTQ Functional Severity Symptoms (BCTQ-FSS) scores in terms of hours of playing (+0.44, p = 0.04). Esports athletes who used armrests and a PC with a controller for gaming reported less hand symptoms and had milder BCTQ scores than those who used a PC with a keyboard/mouse. Generally, esports athletes spend 5-10 h/day on gaming.

Conclusions: Esports athletes might be at risk of developing upper-extremity nerve compression and CTS. Prolonged playing, hours of playing, type of esports device, and using armrests are possible risk factors. Med Pr Work Health Saf. 2023;74(4):279-87.