International journal of occupational medicine and environmental health最新文献

The iodine-131 (I-131) content in the thyroid of staff members working with this radionuclides has been measured with about 500 employees in about 25 hospital's departments of nuclear medicine performing therapy and diagnosis of thyroid disease in Poland. The measurements were performed with portable detection unit for in situ measurements of radioiodine. This is consist with scintillation detector sodium iodine activated by thallium (NaI(Tl)) - battery-powered and portable tube base Multichannel Analyzer Canberra UniSPEC. Based on direct measurements of the iodine content, the effective dose equivalent for workers due to inhalation of I-131 was estimated. All individuals actively working with iodine show measurable amounts of this isotopes in their thyroids. The average measured activity in the thyroid of the nuclear medicine staff was found to be equal at average 550 Bq within the range 70 Bq-2.5 kBq. There is no apparent correlation between the measured I-131 levels and risk categories. Nevertheless the technical and nuclear medicine staff show higher I-131 thyroid level comparing to hospital services staff. Calculated maximum committed effective dose for particular exposed person is <10% of 20 mSv/year. Int J Occup Med Environ Health. 2023;36(5):587-95.

Objectives: Hearing loss is a major worldwide health issue affecting an estimated 1.5 billion people. Causes of hearing loss include genetics, chemicals, medications, lifestyle habits such as smoking, and noise. Noise is probably the largest contributing factor for hearing loss. Noise arises from the workplace, ambient environment, and leisure activities. The easiest noise sources to control are workplace and environmental. Workplace noise is unique in that the employer is responsible for the noise and the worker. Also, workers may be exposed to much higher levels of noise than they would accept elsewhere. Employers follow the traditional hierarchy of controls (substitution/engineering, administrative, personal protective equipment [PPE]). Substituting or engineering a lower noise level actually reduces the hazard present to the worker but demand more capital investment. Administrative and PPE controls can be effective, but enforcement and motivation are essential to reducing risk and there is still some hearing loss for a portion of the workers. The challenge is to estimate the costs more clearly for managers. A systems engineering approach can help visualize factors affecting hearing health.

Material and methods: In this study, a systems engineering causal loop diagram (CLD) was developed to aid in understanding factors and their interrelationships. The CLD was then modeled in VenSim. The model was informed from the authors' expertise in hearing health and exposure science. Also, a case study was used to test the model. The model can be used to inform decision-makers of holistic costs for noise control options, with potentially better hearing health outcomes for workers.

Results: The CLD and cost model demonstrated a 4.3 year payback period for the engineered noise control in the case study.

Conclusions: Systems thinking using a CLD and cost model for occupational hearing health controls can aid organizational managers in applying resources to control risk. Int J Occup Med Environ Health. 2023;36(5):672-84.

Objectives: Employees of uniformed services (EoUS) were screened for cardiovascular risk factors.

Material and methods: A total of 1138 EoUS (age M±SD 49.9±6.0 years) and 263 controls (age M±SD 54.4±9.7 years) under the care of the cardiology clinic in Gdańsk, Poland, were included in the study. Medical history and blood samples were collected, and a physical examination was performed. Ten-year cardiovascular risk of death was calculated using the systematic coronary risk evaluation (SCORE) risk algorithm for high-risk countries.

Results: Significantly higher values of mean systolic and mean diastolic blood pressure, mean total cholesterol level and mean BMI were recorded among the EoUS compared to controls (M±SD 141.7±11.6 mm Hg vs. 135.5±11.0 mm Hg, p < 0.001; 90.1±5.9 mm Hg vs. 84.5±6.8 mm Hg, p < 0.001; 6.01±0.76 mmol vs. 5.44±0.87 mmol, p < 0.001; 29.3±4.7 vs. 29.0±4.1, p < 0.001, respectively). Smoking cigarettes was most frequently reported by the youngest group (20-39 years old) - 47.7% and it was significantly higher in the entire EoUS group compared to control group (35.5% vs. 16.7%, p = 0.001). The occurrence of observed risk factors (blood pressure ≥140/90 mm Hg, total cholesterol concentration >5 mmol, smoking,) was significantly higher among EoUS compared to controls (92.1% vs. 57.8%, p < 0.001; 89.0% vs. 66.9%, p < 0.001; 35.5% vs. 16.7%, p < 0.001, respectively). In the male group, the mean calculated ten-year risk of fatal cardiovascular events, the percentage of high calculated risk, and very high risk were higher in the EoUS group compared to controls (M±SD 4.44±3.49 vs. 4.23±3.86, p = 0.001; 23.7% vs. 20.2%, p = 0.007; 7.4% vs. 6.5%, p = 0.03, respectively).

Conclusions: The prevalence of all identified risk factors was found to be higher among employees of uniformed services when compared to the control group. The presence of these risk factors within the population of uniformed service employees results in a greater risk of mortality from cardiovascular diseases. Int J Occup Med Environ Health. 2023;36(5):656-71.

Objectives: The present study examined the relationship between medical student fatigue with psychological variables: emotional intelligence (EI), sense of coherence (SoC) (comprehensibility, manageability, and meaningfulness), quality of life (QoL), stress, and satisfaction with studying medicine.

Material and methods: The sample consisted of 566 medical students from the Medical University of Gdańsk, Poland. The instruments used were the Chalder Fatigue Scale, Schutte Self Report Emotional Intelligence Test, Sense of Coherence Questionnaire, and a questionnaire designed by the authors, comprised questions relating to the quality of life, stress levels, and satisfaction with studying medicine.

Results: The results show that fatigue was negatively related to the ability to use emotions effectively in the management of one's activities (EI), 1 aspect of SoC - a level of comprehensibility, QoL, and satisfaction with studying medicine. Fatigue is positively related to the ability to recognize, understand, and control emotions (EI) and stress connected with studying medicine.

Conclusions: The outcomes of the study afford a better understanding of the relation- ship between selected variables in the field of individual differences in the context of fatigue in the medical student population. It may help medical educators and authorities to have a better understanding of the phenomenon of building resilience and increasing abilities to cope with the negative effects of chronic stress such as fatigue in the population of medical students. Early recognition of specific psychological features in medical stu- dents, such as misunderstanding emotions and their perception of environments as unstructured, would make it possible to prepare early support and development programmes. Int J Occup Med Environ Health. 2023;36(4):517-25.

Objectives: Non-adherence and non-compliance to pharmaceutical treatment is one of the most common causes of not effective management of patients suffering from ischemic heart disease (IHD). It is crucial to understand the reasons behind it but studies on this subject performed in the Polish population are still lacking.

Material and methods: The 329 patients (160 male and 169 female) diagnosed with IHD who reported for follow-up appointments are examined. The following standardized questionnaires were used: Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) and Adherence to Refills and Medication Scale (ARMS), which evaluates the patient's compliance and adherence level, respectively.

Results: Patients with IHD showed moderate compliance with pharmacological recommendations and average satisfaction with treatment. Anemia, drugs side effects, and SATMED-Q total score were significant predictors of the overall ARMS score in the univariate analysis, whereas the male gender and satisfaction with treatment improves this results. In multivariate analysis, significant predictors of lower adherence included family history of IHD, anemia and drugs side effects, while higher education and SATMED-Q overall score increased adherence.

Conclusions: Treatment satisfaction is a significant predictor of increased overall treatment adherence as well as adherence in terms of drug intake and drug and prescription refills. Raising patient awareness should be an important goal of future educational activities. Int J Occup Med Environ Health. 2023;36(4):465-76.

Objectives: Adapting to stress over time is a process involving various cognitive and emotional assessments; it also depends on the objective situation related to working conditions, as well as on individual factors. The aim of this paper is to outline the dynamic nature of stress experienced by workers employed on oil rigs over a period of 20 years. The presented research is part of a larger project and concerns subjective stress.

Material and methods: Longitudinal studies included the analysis of data regarding the period of 1993-2014. They concerned 167 Polish oil rig workers, all men; the average age at the beginning of the study was 29 years. Each employee was surveyed at least 4 times over a period of 20 years at intervals of 4-6 years in the workplace. The subjective level of stress at work (based on the Subjective Job Evaluation Questionnaire) and the level of declared stress (based on the Stress Survey) were examined.

Results: Oil rig workers show different adaptations to stress over a long term, depending on their subjective perception of stress. Baseline stress levels can vary from person to person over the years. The first group was characterized by high initial stress, but the stress decreased systematically over 20 years ("stress resisting"). Employees from the second group were characterized by low initial stress, but declared a systematic increase in stress in the same period ("stress sensitizing"). Finally, employees from the third group adapted to stress in a flexible way, with subjective stress being most strongly associated with objective stress ("flexible group").

Conclusions: The presented prospective study showed differences between the subjective levels of stress depending on the distinguished groups over 20 years, i.e., between-group and intra-group variability. The method of prospective research shows that the perception of stress at work is a dynamic process and it changes over time. Int J Occup Med Environ Health. 2023;36(4):477-92.

Objectives: The COVID-19 outbreak is an example of a crisis that triggered an increase in generalized anxiety disorder. The study aims to validate the Polish version of the Generalized Anxiety Disorder 7-item scale (GAD-7) by Spitzer et al. among a non-clinical sample of employees and examine the invariance depending on the gender and age of working adults.

Material and methods: For assessing factor structure of the Polish version of the GAD-7, the data were collected from a sample of 821 adults employed in 4 economic sectors (health care, education, IT, public administration) during the initial phase of the COVID-19 pandemic in Poland (April 10-May 24, 2020). Due to differences in the severity of GAD symptoms across gender and age groups, the measurement invariance in these groups was tested.

Results: The results of a series of confirmatory factor analyses confirmed the unidimensionality of the GAD-7. The values of the composite reliability index and Cronbach's α showed that it is a reliable tool. The GAD levels demonstrated strong relationships with professional burnout, psychological distress, and psychological complaints. These relationships were stronger than the relationships between these factors and job satisfaction. Construct, metric and scalar invariance across gender and age groups were documented. Women experienced more severe symptoms of generalized anxiety disorder than men. Generalized anxiety disorder affected 28% of respondents.

Conclusions: This study contributes evidence of the validation of the GAD among employees and also confirms the invariance depending on gender and age. The Polish version of the GAD-7 has good psychometric properties in a group of professionals and can be recommended for research and to be used in an occupational medicine practice, especially during crisis periods associated with the risk of developing a generalized anxiety disorder. Int J Occup Med Environ Health. 2023;36(4):493-504.

Objectives: The aim of this article is to assess the health behaviors of Polish Army soldiers participating in the National Health Programme 2016-2020 in relation to types of armed forces, BMI and selected demographic factors.

Material and methods: Anthropometric and questionnaire data were obtained in a group of 1229 soldiers of the Polish Armed Forces (PAF) from military units from all over Poland. Health behaviors patterns were assessed using the Health Behavior Inventory (HBI), developed by Juczyński.

Results: The HBI of PAF soldiers was 79.9±12.68, indicating an aver- age score. Statistically significant differences were found in the HBI values and in the individual categories of health behaviors according to the type of armed forces. The highest scores in each category of health behaviors were obtained by the Air Force (AF) soldiers. The lowest HBI score was obtained by the Land Forces and Territorial Defence Forces soldiers. Soldiers with higher education obtained significantly higher scores in such health categories as proper eating habits, preventive behaviors and health practices, compared to respondents with secondary education. Soldiers residing in cities had statistically significantly higher health behaviors intensities in all categories, compared to village residents. A significantly higher score in all health categories was noted in soldiers with normal body weight compared to those with diagnosed obesity. There was no significant relationship between the age of the respondents and health behaviors.

Conclusions: The study found that factors such as type of armed forces, BMI, place of residence and education level were significant for the adoption of health behaviors by PAF. The level of health practices was significant- ly higher among AF soldiers compared to other types of armed forces. It seems necessary to further disseminate education on pro-health behaviors, especially among soldiers with obesity through participation in organized training and psychodietetic consultations as part of the National Health Programme. Int J Occup Med Environ Health. 2023;36(4):437-49.

Objectives: Objective was to find personality traits in singers performing various music styles and with different singing status.

Material and methods: The study consisted of 87 singers (66 females, 21 males; age: M±SD 25.5±8.2 years; 40 students, 22 professionals and 25 amateurs; 38 classical singers, 42 contemporary commercial music [CCM] singers; 55 solo singers and 22 choral singers). Participants filled in the NEO Five-Factor Inventory questionnaire and demographic information form.

Results: Median values compared to the Polish general population, suggest that solo, CCM, student and professional singers have a high level of conscientiousness. Those who sing in a choir, classical music, amateurs and students have relatively high level of agreeableness. High level of extraversion is observed among CCM singers and students. Students score higher on extraversion then professionals (p < 0.001). Professionals score higher on extraversion then amateurs (p < 0.01). Professionals less frequently than amateurs and students score high on agreeableness (p < 0.001). High scores on conscientiousness are significantly higher among professionals and students compared to amateurs (p < 0.001 in both cases). Solo singers have higher level of conscientiousness (p < 0.001) and openness (p < 0.001) and lower neuroticism (p < 0.01) than choral singers. Classical singers more often than CCM singers score low on openness (p < 0.01) and high on agreeableness (p < 0.01).

Conclusions: Classical singers have lower level of openness and higher level of agreeableness than CCM singers. Neuroticism is higher among choir than solo singers and conscientiousness is higher among solo than choir singers. Amateurs had the highest level of neuroticism and the lowest level of conscientiousness as compared with professional singers and students. Int J Occup Med Environ Health. 2023;36(4):541-50.

Objectives: Religiosity may serve as a personal source of support when people face a life-threatening illness, but it can also elicit stress. The main aim of this study is to show how various religious dimensions interplay in predicting death anxiety in patients diagnosed as having cancer.

Material and methods: In the cross-sectional, descriptive-analytical research, 141 Polish patients who were hospitalized due to cancer were selected using sequential convenience sampling. Data were collected using the Centrality of Religiosity Scale, Religious Comfort and Strain Scale, and the Death Anxiety and Dying Distress Scale.

Results: The authors' results show that the effect of the centrality of religiosity on death anxiety is non-linear. We can also confirm the mediating role of religious comfort and struggles in the relationship between the centrality of religiosity and death anxiety.

Conclusions: Thus, religious struggles appear to weaken the effect of religion on death anxiety, whereas religious comfort (contrary to expectation) does not enhance it. Int J Occup Med Environ Health. 2023;36(4):450-64.