International journal of occupational medicine and environmental health最新文献

Objectives: To investigate the effect of CO₂ during sleep on next-morning cognitive performance in young schoolchildren, the authors performed a double-blind fully balanced crossover placebo-controlled study.

Material and methods: The authors included 36 children aged 10-12 years in the climate chamber. The children slept at 21°C in 6 groups each at 3 different conditions separated by 7 days in a random order. Conditions were as follows: high ventilation with CO₂ at 700 ppm, high ventilation with added pure CO₂ at 2000-3000 ppm, and reduced ventilation with CO₂ at 2-3000 ppm and bioeffluents. Children were subjected to a digital cognitive test battery (CANTAB) in the evening prior to sleep and on the next morning after breakfast. Sleep quality was monitored with wrist actigraphs.

Results: There were no significant exposure effects on cognitive performance. Sleep efficiency was significantly lower at high ventilation with CO₂ at 700 ppm which is considered to be a chance effect. No other effects were seen, and no relation between air quality during sleep and next-morning cognitive performance was observed in the children emitting an estimated 10 l_CO2/h per child.

Conclusions: No effect of CO₂ during sleep was found on next day cognition. The children were awakened in the morning, and spent from 45-70 min in well-ventilated rooms before they were tested. Hence, it cannot be precluded that the children have benefitted from the good indoor air quality conditions before and during the testing period. The slightly better sleep efficiency during high CO₂ concentrations might be a chance finding. Hence, replication is needed in actual bedrooms controlling for other external factors before any generalizations can be made. Int J Occup Med Environ Health. 2023;36(2):177-91.

Objectives: A significant proportion of healthcare workers (HCWs) had been infected with SARS-CoV-2, which complicated the organization of patient care during the COVID-19 pandemic. However, the exact scale of infection prevalence among the group of HCWs is not known, therefore this study aimed to assess the prevalence of SARS-CoV-2 infection among HCWs in the Silesian voivodeship, Poland, and to define its determinants.

Material and methods: The cross-sectional study was conducted in 2 multidisciplinary hospitals in the Silesian voivodeship during the period October 2021-February 2022. The standardized WHO questionnaire Surveillance protocol for SARS-CoV-2 infection among health workers was completed by 242 HCWs. To assess the prevalence of SARS-CoV-2 infection and its determinants, such as personal, occupational, and work environment-related conditions and preventive behaviors, the collected data were subjected to statistical analysis. For this purpose, descriptive and analytical statistics (significance of differences in χ² test) were used.

Results: Almost half (42.6%) of subjects were infected with coronavirus, most frequently care assistants (57.1%) and paramedics (50%). People suffering from chronic diseases were infected significantly more often (p < 0.001). The majority of the infected HCWs declared previous contact with COVID-19 patients (56.3%). Unfortunately, 10.3% of respondents refused to be vaccinated against COVID-19, most often care assistants (38.1%) and nurses (10.6%). The determinants such as sex, age, occupation, place of work (ward), participation in occupational safety and health training, use of personal protective equipment (PPE), or preventive behaviors did not significantly affect the risk of infection (p > 0.05).

Conclusions: Even though the PPE was used and the percentage of fully vaccinated HCWs against COVID-19 was high (89.7%), the frequency of SARS-CoV-2 infected HCWs remains high at 42.6% (95% CI: 40.7-44.5%). The main determinants of SARS-CoV-2 infection risk among HCWs were previous contact with infected individuals and the presence of chronic disease. Int J Occup Med Environ Health. 2023;36(2):201-13.

Objectives: The policy of the standardized workload has been implemented among primary and secondary schoolteachers in Shanxi Province. The aim of this cross-sectional cohort study is to assess teacher stress among primary and secondary schoolteachers in Datong, a city of Shanxi Province and the association between teacher stress and the quantified workload.

Material and methods: Three hundred and fifty schoolteachers in 10 public primary schools, 187 schoolteachers in 6 secondary schools and 268 non-teachers in 21 education institutes were recruited. A single-item rating assessment of work-related stress was completed by using the Exposure to Job Stress measure with modification. The quantified workload included class size, teaching hours, and subjects. Descriptive and logistic regression analyses were carried out.

Results: In 805 participants, the pro- portion of primary and secondary schoolteachers with moderate stress was significantly greater. The results of Spearman's correlation and logistic regression analyses showed that the occupations of the primary and secondary schoolteachers had higher stress risk. Further, the stratified results showed that among the primary schoolteachers, the independent stress risk factor was larger class size; while among the secondary schoolteachers, the stress associated factor was more weekly teaching hours.

Conclusions: After standardization of the workload, there remain higher levels of work stress among primary and secondary schoolteachers. Notwithstanding, the stress state in teachers is manageable and they may be faced with controllable stressors. Int J Occup Med Environ Health. 2023;36(2):161-76.

Objectives: The objective of this study was to develop a numerical model of the eyeball and orbit to simulate a blunt injury to the eyeball leading to its rupture, as well as to conduct a comparative analysis of the results obtained using the finite element method against the clinical material concerning patients who had suffered an eyeball rupture due to a blunt force trauma.

Material and methods: Using available sclera biometric and strength data, a numerical model of the eyeball, the orbital contents, and the bony walls were developed from the ground up. Then, 8 different blunt force injury scenarios were simulated. The results of numerical analyses made it possible to identify possible locations and configurations of scleral rupture. The obtained results were compared against the clinical picture of patients hospitalized at the Department of Ophtalmology, Medical University of Gdańsk in 2010-2016 due to isolated blunt force trauma to the eyeball.

Results: It has been demonstrated that the extent of damage observed on the numerical model that indicated a possible location of eyeball rupture did not differ from the clinically observed configurations of the scleral injuries. It has been found that the direction of the impact applied determines the location of eyeball rupture. Most often the rupture occurs at the point opposite to the clock-hour/positions of the impact application. The eyeball rupture occurs in the first 7-8 ms after the contact with the striking rigid object. It has been established that the injuries most often affected the upper sectors of the eyeball. Men are definitely more likely to sustain such injuries. Eyeball ruptures lead to significant impairment of visual acuity.

Conclusions: This study may contribute to a better understanding of injury mechanisms and better treatment planning. It may also contribute to the development of eyeball protection methods for employees exposed to ocular injuries. Int J Occup Med Environ Health. 2023;36(2):263-73.

Objectives: It has been shown that monitoring temporary threshold shift (TTS) after exposure to noise may have a predictive value for susceptibility of developing permanent noise-induced hearing loss. The aim of this study is to present the assumptions of the TTS predictive model after its verification in normal hearing subjects along with demonstrating the usage of this model for the purposes of public health policy.

Material and methods: The existing computational predictive TTS models were adapted and validated in a group of 18 bartenders exposed to noise at the workplace. The performance of adapted TTS predictive model was assessed by receiver operating characteristic (ROC) analysis. The demonstration example of the usage of this model for estimating the risk of TTS in general unscreened population after exposure to loud music in discotheque bars or music clubs is provided.

Results: The adapted TTS predictive model shows a satisfactory agreement in distributions of actual and predicted TTS values and good correlations between these values in examined bartenders measured at 4 kHz, and as a mean at speech frequencies (0.5-4 kHz). An optimal cut-off level for recognizing the TTS events, ca. 75% of young people (aged ca. 35 years) may experience TTS >5 dB, while <10% may exhibit TTS of 15-18 dB.

Conclusions: The final TTS predictive model proposed in this study needs to be validated in larger groups of subjects exposed to noise. Actual prediction of TTS episodes in general populations may become a helpful tool in creating the hearing protection public health policy. Int J Occup Med Environ Health. 2023;36(1):125-38.

Objectives: Hypothermia is an established method of treating severe forms of perinatal hypoxia in newborns. Some of them develop neonatal encephalopathy, which is associated with high morbidity and mortality. Therefore, prophylaxis of this pathology is important as well as determining environmental factors in mothers of newborns affected by this pathology. The aim of the study was to assess of selected environmental factors in mothers of newborns qualified for hypothermia.

Material and methods: The material consisted of 102 subjects, including 51 mothers of newborns with hypoxic-ischemic encephalopathy referred for hypothermia treatment (group I) and 51 mothers of newborns without signs of hypoxia (group II). The case-control study was carried out in the third level reference centre. It is 1 of 20 centers of therapeutic hypothermia for newborn in Poland. Data was collected based on a data collection sheet. Study groups were compared in terms of demographic and environmental data. The odds ratio (OR) was determined and the logistic regression analysis of univariate and multivariate regression was used to determine the probability of the need for hypothermia in the study group.

Results: The groups did not differ in terms of age, BMI and place of living. The need to use hypothermia increased in pregnant women living together with their parents (OR = 6.8, 95% CI: 2.4-19.6) also in case of exposure to factors at the workplace, i.e., noise (OR = 4.1, 95% CI: 1.1-15.5).

Conclusions: Based on the results of our case-control study we postulate to pay attention during preconception care to proper preparation for pregnancy especially in younger women exposed to nuisance in the work environment and at home. In this area postulated activities should include education programs, in close cooperation occupational medicine practitioners and obstetricians even before the conception as a part of pre-conception counseling. Int J Occup Med Environ Health. 2023;36(1):59-68.

Objectives: The development of allergic conditions is largely dependent on the interactions between genetic (individual genetic predisposition) and environmental factors (exposure to risk factors). The aim of this study was an attempt to assess the influence of selected elements of the hygiene theory in the development of allergic diseases such as allergic rhinitis and asthma.

Material and methods: The study group consisted of 5518 women and 3868 men. The method that was used was the European Community Respiratory Health Survey II and International Study of Asthma and Allergies in Childhood questionnaire validated and adapted to Central and Eastern European conditions. The project was conducted in 8 urban areas (Gdańsk, Wrocław, Poznań, Katowice, Kraków, Lublin, Białystok, Warsaw) and 1 rural area (Krasnystaw county). This study had 2 stages; the first stage involved grouping the 22 500 respondents based on their questionnaire responses with the use of a Personal Digital Assistant (PDA); the second stage involved 7000 subjects, who underwent additional assessments: skin prick tests (birch, grasses/cereals, Dermatophagoides pteronyssinus and Dermatophagoides farinae, molds [set I: Botrytis cinerea, Cladosporium herbarum, Alternaria tenuis, Curvularia lunata, Fusarium moniliforme, Helminthosporium], molds [set II: Aspergillus fumigatus, Mucor mucedo, Penicillium notatum, Pullularia pullulans, Rhizopus nigricans, Serpula lacrymans], cat, dog, molds Cladosporium herbarum, Alternaria tenuis) and spirometry tests.

Results: The age at which children attend the nursery school is critical to the development of allergic diseases; in allergic rhinitis, the risk of an IgE-dependent reaction is 2 times higher in the second than in the first year of life (p = 0.00147, p < 0.05), while in asthma, having a large number of siblings increases the risk of developing obstructive disease by almost 6 times (p = 0.00316, p < 0.05).The age at which children attend the nursery school is critical to the development of allergic diseases; in allergic rhinitis, the risk of an IgE-dependent reaction is 2 times higher in the second than in the first year of life (p = 0.00147, p < 0.05), while in asthma, having a large number of siblings increases the risk of developing obstructive disease by almost 6 times (p = 0.00316, p < 0.05).

Conclusions: The hygiene theory is particularly applicable and can explain the relationship of selected habits in the development of allergic diseases. Int J Occup Med Environ Health. 2023;36(1):69-83.

Objectives: The COVID-19 pandemic has globally affected healthcare workers' (HCWs) health and wellbeing. Most studies on COVID-19 have focused on tertiary healthcare. The aim of this study was to increase the knowledge on the effects of the pandemic on working conditions in tertiary and primary healthcare.

Material and methods: The comparative cross-sectional study consisted of an online questionnaire sent to HCWs of the City of Helsinki (primary healthcare) and Helsinki University Hospital (tertiary healthcare). Altogether 1580 HCWs with direct patient contact participated in the study: 895 from tertiary and 685 from primary healthcare. Statistical analysis used SPSS 25 from IBM. The tests used were the χ2 test, Fisher's exact test, and binary logistic regression analysis.

Results: Primary HCWs were less likely to treat COVID-19 patients (OR = 0.45, 95% CI: 0.37-0.56). However, both groups reported a similar number of COVID-19 infections, primary HCWs 4.9% and tertiary HCWs 5.0%, and workrelated quarantine was significantly more prevalent (OR = 1.96, 95% CI: 1.38-2.79) among primary HCWs. In addition, work-related wellbeing was poorer among primary HCWs than tertiary HCWs in terms of feeling more stressed at work (OR = 3.20, 95% CI: 2.55-4.02), not recovering from work (OR = 0.49, 95% CI: 0.39-0.62), reported mental wellbeing below normal levels (OR: 1.59, 95% CI: 1.26-2.00), and increased working hours (OR = 1.63, 95% CI: 1.25-2.12).

Conclusions: The study demonstrates how the pandemic has affected the wellbeing and working conditions of not only tertiary but also less studied primary HCWs. The authors' findings suggest that the challenges identified during the COVID-19 pandemic in the health and wellbeing of healthcare workers are even greater in primary care than in tertiary care. Int J Occup Med Environ Health. 2023;36(1):139-50.

Objectives: COVID-19 has become a major source of stress for people around the world. Stressful life events play a role in the pathogenesis of sleep disorders such as insomnia which is considered a risk factor for anxiety and depression. Emotion regulation is an important factor linked with sleep and mental health problems. Therefore, the main goal of the present study was to examine whether insomnia could constitute a mediation mechanism that explains the relationship between emotion regulation strategies (rumination, reappraisal, suppression) and stress-induced mental health outcomes during the COVID-19 pandemic.

Material and methods: The cross-sectional study was conducted among young (M±SD 24.8±2.24) individuals (N = 281, 85.4% women) during the time of the third wave of infections in Poland. Data were collected by means of selfreport questionnaires, including the Emotion Regulation Questionnaire; Cognitive Emotion Regulation Questionnaire; Athens Insomnia Scale; Depression, Anxiety and Stress Scale. The direct and indirect effects of emotion regulation strategies on depression, anxiety, and stress were calculated using a bootstrap estimation technique.

Results: All analyzed indirect effects were significant. The results show that insomnia mediates the relationships between all 3 emotion regulation strategies and stress, anxiety and depression.

Conclusions: The presented results shed the light on the role of insomnia on the relationships between emotion regulation strategies and emotional states experienced during the COVID-19 pandemic. Additionally, the present study suggests that educational and therapeutic interventions aimed at improving emotion regulation might be useful for improving symptoms of insomnia and, through it, symptoms of affective disorders. Int J Occup Med Environ Health. 2023;36(1):151-59.

Objectives: Secondhand smoke exposure causes serious health problems. Banning smoking in public venues decreases exposure to secondhand smoke. However, the implementation of smoke-free rules in a private setting (including homes) is largely voluntary. This study aimed to assess the prevalence and characteristics of voluntary smoke-free home rules in Poland during the COVID-19 pandemic as well as to identify factors associated with the voluntary implementation of smoking bans at home.

Material and methods: This cross-sectional survey was conducted in March 2022 with a nationally representative sample of 1090 individuals aged ≥18 years in Poland. Data were collected using a computerassisted web interviewing (CAWI) technique. The research tool was an original questionnaire developed for the purpose of this study.

Results: Nationally, 60.6% of individuals had total ban on smoking in home (100% smoke-free home rules), 34.0% had implemented a partial smokefree home rule and 5.4% had not implemented any smoke-free home rules. Over three-quarters of non-smokers (76.8%) and only one-fifth of smokers (20.7%) had adopted a full smoke-free home rule. In multivariate logistic regression analysis, males (OR = 1.65, 95% CI: 1.22-2.22, p < 0.01), non-smokers (OR = 13.78, 95% CI: 9.80-19.38, p < 0.001), respondents who had higher education (OR = 1.57, 95% CI: 1.15-2.14, p < 0.01) as well as those who lived alone (OR = 2.44, 95% CI: 1.52-3.90, p < 0.001) had higher odds of having a 100% smoke-free home rule.

Conclusions: This study demonstrated the negative impact of the COVID-19 pandemic on the implementation of smoke-free home rules in Poland. Less than two-thirds of the Polish population has adopted a total smoke-free home rule, with significant gaps between smokers and nonsmokers. Information on current voluntary smoke-free rules will be useful for further implementation of the smoke-free law in Poland. Int J Occup Med Environ Health. 2023;36(1):84-95.