International journal of occupational medicine and environmental health最新文献

Objectives: Cognitive dysfunction is part of the clinical picture of stroke. Most of the executive dysfunctions are diagnosed in the early stage of rehabilitation, a few weeks after the vascular incident. Coexistence of executive dysfunctions with other disorders in stroke patients may hinder patient's functions, slow down the rehabilitation process, and disrupt self-awareness, interpersonal communication, and professional activity in everyday life.

Material and methods: Ninety patients after ischemic stroke were examined (right hemisphere stroke: N = 33, left hemisphere stroke: N = 57). The study group (N = 45) consisted of patients rehabilitated in the Department of Rehabilitation and Physical Medicine of the University Teaching Hospital of the Military Medical Academy in Lodz, Łódź, Poland, in whom a comprehensive neurorehabilitation program was implemented, consisting of motor and neuropsychological rehabilitation. The control group (N = 45) consisted of patients awaiting admission to the department, who were covered by comprehensive environmental rehabilitation including exercise therapy and neuropsychological therapy. Executive function was measured with 3 popular diagnostic tools: the Wisconsin Card Sorting Test (WCST), the Trail Making Test (TMT part A, TMT part B), and the letter test and category test with the Verbal Fluency Test (VFT). The tests were carried out twice: the first time before the start of rehabilitation and 5 weeks later after its completion.

Results: Although patients with right-hemispheric stroke showed better improvement in executive functions, stroke location did not prove to have significant impact on how effective the rehabilitation was.

Conclusions: Right hemisphere stroke patients showed greater improvement in restoring executive functions after rehabilitation compared to left hemisphere stroke patients. The location of the stroke did not significantly correlate with the efficiency of the rehabilitation setting. Int J Occup Med Environ Health. 2024;37(4):452-67.

Objectives: Team or group cohesion is a multifaceted construct with a variety of definitions and measurement instruments. However, most of these measures are context and group-specific and/or time-consuming. There is no adaptable and economic measure of group cohesion in Germany. Therefore, the aim of this study was to validate the German version of the 6-item Perceived Cohesion Scale (PCS) in a sample of adult nurses in a German University Hospital.

Material and methods: The German version of the PCS was generated according to existing guidelines. Confirmatory factor analysis was conducted to assess factor structure. Reliability was tested via internal consistency. To assess convergent and divergent validity, the authors applied the Copenhagen Psychosocial Questionnaire (COPSOQ), the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Social Support Inventory (ESSI), the Effort-Reward Imbalance (ERI) scale and the Patient Health Questionnaire (PHQ-4).

Results: The confirmatory factor analysis confirmed a 2-factor structure. Psychometric properties of the German PCS prove satisfactory. Internal consistency was excellent for the whole scale (α = 0.95), as well as for both subscales: sense of belonging (SOB) (α = 0.94) and morale (MOR) (α = 0.93). Moderate to strong correlations with the subscales of COPSOQ (Kendall's Tau (τ) = 0.239 - 0.471) indicated very good convergent validity. Regarding divergent validity, the correlations of the PCS subscales and the PHQ-4 were low (τ = -0.109-[-0.143]), as were the correlations with ESSI (τ = 0.045-0.136). Correlations with ERI were low to moderate (τ = -0.181-0.283).

Conclusions: The German version of the PCS showed good psychometric properties. Due to its economic and universal deployment, group cohesion can be measured in a variety of contexts and settings. Int J Occup Med Environ Health. 2024;37(4):421-32.

Exposure to pyrethroids, a widely used agricultural, forestry, and household insecticide, is a major public health concern due to its potential health effects on children. The aim of this review was to summarize the current knowledge of the effects of prenatal exposure to pyrethroids on the course and outcome of pregnancy, health status, and neurobehavioural development of children. A systematic and comprehensive search of the PubMed, Web of Science, and Scopus databases was conducted during January-February 2024. The review included original articles published in peerreviewed English-language journals since 2015. Based on keywords, 198 studies were identified and screened for eligibility. Ultimately, the review analyzed 25 articles including 16 that assessed the effects of prenatal exposure to pyrethroids on children's neurobehavioural development, 3 studies that assessed the effects on the course and outcome of pregnancy, and further 3 focused on respiratory disease. In addition, 1 study analyzed the development of obesity and 2 studies examined the effects on children's growth, weight and body composition in early childhood. In conclusion, there is considerable uncertainty about the adverse effects of prenatal exposure to pyrethroids on children's health. The strongest evidence has been reported for neurobehavioural development although results are also inconsistent. Further research is needed to understand the mechanisms of action and health effects of pyrethroids in susceptible populations. Int J Occup Med Environ Health. 2024;37(4):381-402.

Objectives: Vascular and interventional radiology procedures are characterized by high exposure of personnel to ionizing radiation. This study assessed the exposure of medical personnel to ionizing radiation during vascular radiology and mechanical thrombectomy procedures.

Material and methods: During vascular radiology procedures, the exposure of 4 groups of workers participating in the procedures was analyzed, i.e., the main operating physician, an assistant physician, a sterile nurse, and a nurse. Measurements of exposure to ionizing radiation were performed using thermoluminescent dosimetry.

Results: The registered effective dose during 1 treatment in individual groups is, respectively: mean (M) ± standard deviation (SD) 75±15 μSv, 24±5 μSv, 13±3 μSv, and 8±2 μSv. During mechanical thrombectomy, the operating physician receives an effective dose of M±SD 9±2 μSv. The equivalent doses for the lenses for the operating physician and the doctor assisting during vascular radiology procedures are M±SD 1419±285 μSv and 987±198 μSv, respectively, and for the hands, including the left and right hands, M±SD 4605±930 μSv, 1420±284 μSv, 1898±380 μSv, 1371±274 μSv.

Conclusions: If the principles of optimizing radiological protection are not applied during vascular radiology procedures, the permissible dose limits and operational limits equivalent to doses to lenses and hands may be exceeded. Exposure during vascular radiology procedures is comparable to exposure during nuclear medicine procedures in terms of the use of glucose labeled with radioactive fluorine. Int J Occup Med Environ Health. 2024;37(4):403-10.

Objectives: The aim of the study was to examine the relationship between work engagement, burnout and coworker support, social climate at work, work-language proficiency and post-migration job skill change, among international migrant workers.

Material and methods: Polish versions of Utrecht Work Engagement Scale, Burnout Assessment Tool, and the second Copenhagen Psychosocial Questionnaire were used for the measurement of the studied variables. All participants were recruited using announcements at Polish diaspora online forums and snowball sampling. The questionnaire was submitted to them in a form of an anonymous online survey.

Results: From 420 questionnaires filled in by the respondents, 411 were qualified for analysis. The results of a multiple regression analysis indicate that a positive perception of the social climate at work increases the scores of general work engagement (β = -0.22, p = 0.001), as well as all its subscales: dedication (β = -0.14, p = 0.002), vigor (β = -0.20, p = 0.001) and absorption (β = -0.22, p = 0.001). Support received from coworkers has a positive influence on the vigor dimension (β = -0.14, p = 0.002). Furthermore, work-language proficiency can be associated with more engagement F(1, 409) = 37.66, p = 0.000 and less burnout F(1, 409) = 11.68, p = 0.000 than limited work-language knowledge. In a similar manner, increased or similar job skill level compared to one's last employment in the sending country may be associated with better engagement F(2, 408) = 33.88, p = 0.000 and fewer symptoms of burnout F(1, 409) = 7.96, p = 0.005 than post-migration decrease of job skill.

Conclusions: The perception of social climate at work and coworker support have shown to be positive predictors for particular dimensions of work engagement. Moreover, work language proficiency and job skill have been shown to associate with work engagement and burnout. Int J Occup Med Environ Health. 2024;37(4):433-51.

Objectives: The COVID-19 pandemic has led to significant changes in daily life, including changes in physical activity levels. This study aims to examine the impact of the pandemic on sport participation and walking among Polish adults.

Material and methods: The data was collected using the National Test for Poles' Health, a large-scale online survey. The survey was conducted before and 1 year after the pandemic onset in Poland (March 2020 and March 2021), with >300 000 participants in each year.

Results: The results revealed that the percentage of respondents engaging in at least 2 h/week of sport increased by 2.3% (from 24.6% to 26.9%) (p < 0.0001) and percentage of respondents not engaging in any sport decreased by 2.5% (from 48.0% to 45.5%) (p < 0.0001). These trends were observed across different age, sex, dwelling-place, education level, and employment groups. Percentage of respondents declaring they spend >2 h/day on walking also increased, from 5.6% to 6.6% (p < 0.0001). Furthermore, a positive association was found between sport participation and walking time (p < 0.0001).

Conclusions: The findings suggest a slight improvement in physical activity levels among Polish adults during the pandemic, which may be attributed to factors such as increased time available due to remote work and the prioritization of health during the crisis. Further research is needed to explore the long-term consequences of the pandemic on physical activity and public health. Int J Occup Med Environ Health. 2024;37(4):468-81.

Objectives: Research investigating the association between reproductive health and diet has predominantly focused on the antenatal and prenatal periods, as well as childbirth in women, and semen quality in men. There is a limited amount of research addressing female fertility assessed as ovarian reserve in relation to diet. The main aim of this study was to evaluate the association between dietary patterns and the parameters of ovarian reserve, such as antral follicle count (AFC), anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol (E2) - predictors of reproductive health in women of childbearing age.

Material and methods: Women aged 24-39 years (N = 511) were enrolled from fertility clinic in central Poland. The count of antral follicles was determined using ultrasonography (USG), FSH and E2 levels were measured using a chemilumi- nescence method and for determination of AMH level, an enzyme-linked immunosorbent assay method was employed. Diet was assessed according to food frequency questionnaire and dietary patterns were identified by factor analysis. Women were classified into 3 groups according to scores of each dietary pattern: Western, mixed, prudent.

Results: Higher adherence to the prudent dietary pattern in obese women was associated with significantly higher AFC (p = 0.03) and AMH (p = 0.05) as compared to participants with the Western dietary pattern. The results were adjusted for age, BMI, smoking and duration of fertility. Increased consumption of mixed dietary pattern was not statistically significant associated with any of examined ovarian reserve parameters.

Conclusions: The prudent dietary pattern is positively associated with ovarian reserve in a cohort of women seeking fertility care. Continued research in this area will provide nutritional guidance for clinicians and their patients and provide novel insight on potential modifiable lifestyle factors which can be associated with ovarian reserve. Int J Occup Med Environ Health. 2024;37(4):411-20.

Objectives: The study aimed to assess the mental health and well-being of Lithuanian healthcare workers by gathering demographic information, identifying common stressors affecting the work environment, evaluating mental health, and exploring directions for psychosocial care. Additionally, the research explored the prevalence of considering a career change among respondents.

Material and methods: The study included 1618 responders who completed an online survey in December 2021 - January 2022. Participants included in this study: physicians, nurses, residents and other healthcare workers. It evaluated their demographics, most common stressors affecting their work environment and mental health on the Depression, Anxiety and Stress Scale - 21 (DASS-21) scale. Lastly, all responders asked if they had considered changing their occupation to a non-medical job. Univariate analysis was performed using χ2 and Student's t test, and binary logistic regression evaluated career change predictors.

Results: Career change was considered by 1081 (66.8%) responders. The main career change predictors were poor working conditions (OR 1.91, p < 0.001), direct contact with patients (OR 1.84, p < 0.001), lack of career perspectives (OR 1.95, p < 0.001), mobbing (OR 1.67, p = 0.001) and exhaustion (OR 1.51, p = 0.005). After evaluating DASS-21 scores, it was found that 23% of respondents had severe and extremely severe depression symptoms, 27.4% severe and extremely severe anxiety, and 21.4% had severe and extremely severe stress levels.

Conclusions: Lithuanian healthcare workers are in high distress and have poor mental health. They are in need psychosocial assistance to avoid burnout and staff loss. Int J Occup Med Environ Health. 2024;37(3):287-99.

Objectives: This study aims to define and assess communal and agentic workplace climates (AWC), 2 pivotal dimensions perceived by employees within organizational contexts. Communal workplace climate highlights employees' well-being, while AWC emphasizes productivity-related aspects.

Material and methods: To enhance comprehension, the Communal and Agentic Workplace Climate Scale (CAWCS) was created and validated through a series of studies. The research involved 4008 employees from diverse positions and organizations across Poland. Initially, a pool of 20 items was designed to reflect these dimensions, with exploratory factor analysis identifying a robust set of 12 items.

Results: Confirmatory factor analysis substantiated the 2-factor structure of CAWCS. Reliability analyses indicated good internal consistency, supported by correlation analyses linking scale scores with diverse attitudinal and behavioral constructs.

Conclusions: This validation confirms the validity of CAWCS and highlights the significant associations between employees' perceptions of these dimensions and their workplace experiences and behaviors. Int J Occup Med Environ Health. 2024;37(3):311-25.

Objectives: To find possible relationship between asthma exacerbation and metabolomic profile of airways, assessed by non-invasive method - free volatile organic compounds (VOCs) in exhaled air in children.

Material and methods: The study included 80 children aged 4-18 years with asthma: 42 children with a min. 3 asthma exacerbations in the past 12 months, and 38 children without a history of exacerbations in the past year. During the study visit, each patient was examined, medical history (including information regarding atopy and eosinophil blood count) was taken, spirometry and fractional exhaled nitric oxide (FeNO) were tested, an exhaled air sample was taken to test for the presence of VOCs, and the patient also completed standardized form - Asthma Control Questionnaire. Volatile organic compounds were measured by combined gas chromatography coupled to mass spectrometry.

Results: The obtained results of VOCs were correlated with the history of the disease. The 2 gas profiles were defined and they formed 2 clinically distinct clusters (p = 0.085). Cluster 2 was characterized for children with a higher number of bronchial asthma exacerbations and worse lung function parameters (predicted percentage forced expiratory volume in 1 s [FEV₁] [p = 0.023], FEV₁/ forced vital capacity ratio [FVC] [p = 0.0219]). The results were independent of the age, sex, BMI, atopy (house dust mite allergy) and eosinophil blood count.

Conclusions: The study findings suggest that a relative group of gases may be a useful predictor of having asthma exacerbations in children. Additionally, a single FeNO value was unlikely to be clinically useful in predicting asthma exacerbations in children. The VOCs profile reflecting the metabolism of the airway epithelium and local microbiota was associated with the course of asthma, which strongly justifies further prospective validation studies. Int J Occup Med Environ Health. 2024;37(3):351-59.