Medycyna pracy最新文献

Gender equality in the workplace and the good health of both women and men are key goals outlined in agendas promoting social justice and sustainable development. The Constitution of the Republic of Poland guarantees equal employment rights for women and men, and the Labor Code prohibits discrimination in establishing and terminating employment relationships, including on the basis of gender. On the one hand, an employer cannot allow an employee to work without a current medical certificate confirming the absence of contraindications for the specific job position, and is obliged to assess occupational risk related to manual handling tasks, taking into account, among other factors, the individual capabilities of the employee. On the other hand, the legislator sets different standards for women and men in terms of manual handling of objects by a single employee or during team-based work. Therefore, when a job candidate or employee is a transgender person - especially one undergoing medical procedures aimed at aligning their physical characteristics with their gender identity - difficulties arise in interpreting existing legal regulations. This article discusses the legal uncertainties in Poland related to weight-lifting criteria, the issue of disclosing an employee's gender in order to tailor working conditions to their needs, and the principles that should guide the physician responsible for occupational health care during and after gender transition. Med Pr Work Health Saf. 2025;76(2):149-157.

Background: Lifestyle is considered one of the most important determinants of health, which most of us have an influence on and can modify. However, it is necessary to raise health awareness among people so that they know how to do it effectively. The purpose of the study was to assess women's health behaviors and determine the factors that determine them in a group of professionally active women.

Material and methods: Anonymous questionnaire surveys were conducted among 927 women aged 18-65 using the computer-assisted web interview method, using a survey developed for the project, containing selected standard tools and a personal questionnaire covering personal data and questions regarding, among others, self-assessment of health status and care for it, understanding the concepts of "health" and "care for health," sources of information about health. The Positive Health Behaviors Scale for women was used to assess health behaviors, with a set of questions regarding anti-health behaviors (including smoking, alcohol use), including a set of 34 statements grouped into 5 subscales: Nutrition, Body Care, Safety, Sleep, Rest and Mental health, and Physical Activity. The scale is used to assess individual health care, and its results are given in the form of points.

Results: Studies conducted among 927 women showed that they assess their health well and declare that they take care of it. The results regarding the undertaken pro-health behaviors do not confirm this, as evidenced by the relatively low average score obtained in the Positive Health Behaviors Scale (60.3 pts out of 102 possible to obtain). Self-efficacy turned out to be the strongest predictor of positive health behaviors among women, women's care for their health increased with age, and was also higher among those women performing mental work compared to those performing physical work.

Conclusions: Due to the discrepancies between women's self-assessment of health care and their actual health-related behaviours, there is a need to continuously increase the awareness of women of all ages about the need for individual care for their health, taking into account both professional and non-professional factors. Med Pr Work Health Saf. 2025;76(2):123-135.

Background: Spiritual care refers to the provision of support that recognizes and responds to the spiritual needs of patients, particularly in times of illness, distress, or crisis. It encompasses addressing questions of meaning, purpose, connection, and transcendence, as well as supporting religious and existential concerns. Working in palliative care requires exceptional interpersonal skills, as hospice workers often develop close relationships with patients and their families during critical moments in their lives. While much research highlights the significance of spiritual care for the well-being of patients and their loved ones, growing attention is being given to its role in the functioning of palliative care workers.

Material and methods: This study examined a mediation model in which spiritual care mediated the relationship between the light and dark triads and life and work satisfaction among hospice workers. A cross-sectional study was conducted with 261 hospice workers in Poland.

Results: Results indicated that, among palliative care workers, the light triad was positively associated with spiritual care, life satisfaction, and work satisfaction, while the dark triad was negatively associated only with spiritual care. Additionally, spiritual care was positively linked to both life and work satisfaction. Mediation analysis revealed that spiritual care mediated the relationship between the light triad and life satisfaction, as well as the relationship between the dark triad and both life and work satisfaction among palliative care workers.

Conclusions: These findings from a cross-sectional study highlight the crucial role of spiritual care in enhancing the life and work satisfaction of hospice workers. Given its significance, integrating spiritual care training and support systems into palliative care settings could foster both personal well-being and professional fulfilment among hospice workers. Future research should explore interventions aimed at strengthening spiritual care competencies and examine their long-term effects on healthcare professionals' resilience and job satisfaction. Med Pr Work Health Saf. 2025;76(2):77-86.

Background: The work environment of nurses is characterized by high levels of stress and emotional tension. Nurses frequently experience aggression, considered one of the main occupational hazards in healthcare. The study aimed to identify causes, motivations, and factors influencing aggression towards young nurses.

Material and methods: The study involved 105 nurses from hospitals in the Silesian region of Poland, recruited via social media, with ≤5 years of professional experience. Conducted from January 18 to May 30, 2023, it used a proprietary questionnaire of 21 questions about the frequency, types, and causes of aggression experienced at work.

Results: All nurses (100%) reported experiencing aggression in the workplace, mainly from colleagues (41.90%) and patients (34.29%). The most common forms were shouting (33.33%) and verbal abuse (31.43%). Adultism, defined as discrimination based on age or short tenure, was reported by 72.38% of nurses. Those experiencing adultism were more likely to report aggression from senior nurses (57.58% vs. 15.38%), but less likely to report aggression from patients (25.76% vs. 48.72%, p = 0.004). Although the association between unit type and level of adultism did not reach statistical significance (χ² = 5.555, p = 0.063), the data suggest a trend toward higher levels of adultism in certain units, particularly intensive care units which warrants further investigation. Nurses experiencing adultism reported lower job satisfaction (51.52% vs. 82.05%, p = 0.004) and were more likely to consider changing jobs (71.43%) highlighting the impact of adultism on professional relationships, job satisfaction, and overall well-being.

Conclusions: Early-career nurses frequently encounter workplace aggression, primarily in the form of horizontal aggression associated with adultism and stress, which significantly reduces their job satisfaction. The most commonly reported forms of aggression include workplace obstruction, lack of support, insults, and shouting. Implementing conflict management training, psychological support programs, and mentoring initiatives can substantially improve working conditions and reduce staff turnover. Med Pr Work Health Saf. 2025;76(2):87-99.

Background: In the face of increasing problems related to lifestyle related diseases, attention is increasingly drawn to the untapped potential of the occupational health service (OHS) in undertaking preventive actions. The aim of the study was to assess the scope of activities and the perception by the surveyed employees of the quality of preventive care provided in basic OHS units in Poland.

Material and methods: The research tool was the author's anonymous online questionnaire. It contained questions about the details of the last visit to an occupational medicine doctor. Only those who had ever undergone such a medical examination (267 respondents) were included in the analysis. To compare the frequency of occurrence of specific categories of quantitative traits in the analyzed groups, the χ² test of independence was utilized with Yates' correction for small sample sizes.

Results: More than 50% of the respondents rated the quality of preventive care for employees in Poland as either good or very good, one-third of the respondents received recommendations from an occupational medicine physician on preventing workplace hazards, 60% of respondents believe that preventive examinations should include a comprehensive health status assessment, 39% expect to have the option to choose their occupational medicine physician or influence the selection of the facility providing preventive care. The last visit to an occupational medicine physician typically lasted 6-15 min.

Conclusions: A good or very good evaluation of the quality of preventive care by >50% of the surveyed employees requires constant improvement of the quality of the preventive examination. The potential of the healthcare system for working individuals in Poland remains underutilized in terms of activities related to the prevention of lifestyle diseases and health promotion. Occupational health physicians, who play a special role in the health prevention of workers and have a significant impact on increasing health awareness, should perform their duties in a holistic manner. Med Pr Work Health Saf. 2025;76(2):137-147.

Background: The impact of lead on the peripheral nervous system (PNS) remains inadequately explored. Despite the absence of classic lead neuropathy resulting from uncontrolled exposure to high metal doses in workers under biomonitoring, the focus shifts to chronic exposure at lower doses. This study aims to evaluate the influence of occupational lead exposure on peripheral nerve conduction in chronically exposed individuals.

Material and methods: The study comprised 58 workers, divided based on an 8-year mean serum lead concentration into lower exposure (blood lead [PbB] level ≤40 μg/dl) and higher exposure (PbB level >40 μg/dl) subgroups. Conduction tests and laboratory assessments, including oxidative stress parameters, were conducted.

Results: In the higher lead exposure group, average amplitudes of motor fiber-evoked potentials and sensory fiber conduction velocity were 8% and 3% lower, respectively, compared to the lower exposure group. Correlation analysis revealed positive correlations between sensory fiber-evoked potential amplitudes and blood serum sulfhydryl groups, and catalase activity. Motor fiber-evoked potential amplitudes negatively correlated with lipofuscin concentration. Lipofuscin concentration also negatively correlated with sensory fiber-evoked potential amplitudes. Zinc protoporphyrin concentration negatively correlated with sensory fiber-evoked potential amplitudes and conduction velocity.

Conclusions: Chronic lead exposure disrupts peripheral nerve conduction, evident in reduced motor fiber-evoked potential amplitudes and slower sensory fiber conduction velocity. The toxic impact on the PNS may be attributed to oxidative stress and heme biosynthesis disorders. Med Pr Work Health Saf. 2025;76(2):67-75.

Background: Due to the increase in mental health problems in the population, the demand for psychological services is increasing. Not only the availability of mental health specialists is important, but also the social perception of these professions and the services they provide. The undertaken research concerned the image of the psychologist's profession.

Material and methods: The study group consisted of 191 people, including 135 (71%) women and 56 (29%) men, aged 18-101 years (M±SD 44.95±20.04). Most respondents had not previously used psychological or psychiatric counselling (71% and 83%, respectively). The study used 2 scales: the Image of a Psychologist and the Using Psychological Help (both with good psychometric properties) and a sociodemographic form. Data were collected mainly online, using a Google Forms.

Results: The youngest people, those with higher education, living in large agglomerations, professionally active, and having previous contact with a psychologist had a more positive image of a psychologist and were more likely to perceive the use of psychologist's help as a manifestation of care for health and less often as a manifestation of disorders and inability to cope. The perception of using psychological help as an ineffective whim was stronger among men, the oldest people, and those with lower education. The perception of using psychological help as a reason for fear and shame was more intense in younger people and those with higher education.

Conclusions: The image of a psychologist was rather positive in this study. This profession was associated more with intellectual and cognitive attributes than with emotional ones. People with negative attitudes toward psychological help were people who may be at increased risk of experiencing difficulties or psychological crises. In these groups, additional educational activities and dissemination of an appropriate image of a psychologist are recommended. Med Pr Work Health Saf. 2025;76(1):13-24.

Background: To determine the difference in the radiation exposure of patients undergoing conventional single-energy computed tomography pulmonary angiography (SECTPA) and dual-energy CT pulmonary angiography (DECTPA) and determination of the benefits of both methods in the diagnosis of pulmonary embolism (PE).

Material and methods: In this single-center retrospective study, 105 consecutive CTPA examinations performed on dual-source dual-energy CT scanner November 2018-December 2020 at St. Michael's University Hospital Radiodiagnostic Clinic, Bratislava, Slovakia were reviewed for detection of acute PE and dose-length product (DLP) in each examination was noted and compared in SECTPA and DECTPA. The 105 examinations included 95 patients (mean [M] = 60.5 years, range 20-88 years).

Results: Of the 95 examined patients, 92 had an initial examination, of whom 22 had confirmed acute PE (23.9% of initially examined patients, 11 by SECTPA, and 11 by DECTPA), in 70 patients (i.e., 76.1%) PE was not present. The DLP in DECTPA was M = 344.4 mGy × cm, and in SECTPA M = 176.7 mGy × cm.

Conclusions: Mean DLP in DECTPA was almost 2-times higher than in SECTPA (with a statistically significant difference, p < 0.001), while in three-quarters of patients, acute PE was not confirmed, which is in the era of CTPA overuse unnecessary radiation exposure. However, DECTPA with iodine perfusion maps is superb in the follow-up of patients with confirmed PE by detecting small chronic subsegmental PE and thus preventing chronic complications in the form of chronic thromboembolic pulmonary hypertension, which, if untreated, is fatal. Med Pr Work Health Saf. 2025;76(1):25-30.

Background: The aim of the analysis was to evaluate the concentrations of radioactive radon in the air in workplaces located in various regions of Poland and to identify areas at risk of elevated radon levels. The study analyzed the number of instances where the reference level of 300 Bq/m^³ (becquerel - Bq) was exceeded, as well as the observed differences in radon concentrations across different buildings.

Material and methods: The analysis was based on the results of commercial measurements carried out by the Institute of Occupational Medicine in Łódź in 2022-2023. Measurements were taken in 6 provinces, across workplaces associated with various types of activities. The measurements were conducted during the heating season October-March. Track detectors were placed in dosimetric cassettes and sent to the clients with instructions for use. The returned dosimeters were subjected to chemical processing, followed by reading the track density using an automated image analysis system, in accordance with the accredited procedure.

Results: The majority of measurements were conducted in the Świętokrzyskie and Dolnośląskie voivodeships. The highest average radon concentrations were found in buildings located in spa areas, while the lowest levels were recorded in production halls.

Conclusions: The results confirm the need for ongoing monitoring of radon concentrations in Poland and highlight the importance of further studies on the factors influencing its levels. The study also proposes preventive strategies for areas with the highest radon exposure. Med Pr Work Health Saf. 2025;76(1):31-40.

Background: To protect employees against the hazards they may be exposed to during work, employers must provide preventive occupational safety and health (OSH) in international and national legislation. Employers can provide these services by their firm or by third parties. Structures created outside the workplace, within the scope of the private sector, are called joint health and safety units (JHSUs). The number of studies examining the effectiveness and adequacy of JHSUs is limited.

Material and methods: This study experimentally and hypothetically reveals the effectiveness level of JHSUs in providing OSH by conducting an extensive field study with a survey of 381 health and safety professionals and developing an Occupational Safety and Health Services Effectiveness Scale. Moreover, it compares those who receive the service from JHSUs and those who receive the service from the workplace, and the effectiveness level of JHSUs is evaluated.

Results: The fit index as a result of confirmatory factor analysis with the scale is at an acceptable level with χ^²/df = 3.18, RMSEA = 0.076, TLI = 0.89, and CFI = 0.91. Cronbach's α values of the factors are at a high level of reliability with PMCE = 0.949, OSHA = 0.927, OSHCM = 0.875, OSHEC = 0.869, OSHSQ = 0.877, OSHSE = 0.852.

Conclusions: The effectiveness of JHSUs in OSH services differs from the effectiveness achieved by internally assigning an occupational safety expert. The Student's t-test accepts all hypotheses H1-H6 regarding the developed scale and that there is a significant difference between the external and internal groups in all factors. Med Pr Work Health Saf. 2025;76(1):3-11.