Medycyna pracy最新文献

Background: The aim of the study was to assess the correct insertion of earplugs in the ear canal by people with different knowledge regarding this matter. The use of hearing protectors leads to a reduction in the risk of hearing loss, which is part of environmental engineering.

Material and methods: Measurements of sound attenuation by earplugs were carried out with the participation of 21 people with no experience in the use of earplugs. The measurements were repeated until the subjects had read the instructions for the use of earplugs, and then after the subjects had been trained in the correct insertion of earplugs in the ear canal. The tests were carried out using a newly developed portable device for quick measurements of sound attenuation.

Results: Familiarizing the subjects with the instructions for use resulted in a sound attenuation value being 6.7 and 3.3 dB higher, at 250 and 4000 Hz, respectively, compared to the measurement when the subjects inserted earplugs in the ear canal without any guidance. An even greater increase in attenuation was observed when the subjects were trained to insert earplugs, at 9.2 dB (250 Hz) and 5.4 dB (4000 Hz), respectively. In most cases, the changes in attenuation as a result of providing guidance were statistically significant.

Conclusions: Persons who have no experience in using earplugs have significant problems with their correct insertion. Reading the instructions for use does not guarantee that earplugs will be inserted correctly. Only the training showing how to insert the earplugs correctly results in people being able to do it correctly in most cases. Med Pr. 2021;72(5):521-8.

Work-related diseases that are not included in the occupational diseases lists have become a significant social phenomenon, generating increasing costs for the EU member states and for European employers. The impact they have on workers' health and claims results in a need to implement changes in the legislation, which in Poland is currently limited to providing protection and prevention of already established occupational diseases. In the review, a formal-dogmatic approach was used, in a manner of analyzing the current state of Polish legislation and court rulings based upon it. The Polish legal framework was compared to that of the 3 EU member states selected on the basis of their regulations concerning occupational and work-related diseases (Germany, Finland and Ireland). The presented arguments indicate the purpose of the need for a change in the Polish legal framework of occupational and work-related diseases in the direction of either the Finnish or German model. The current Polish law forces people suffering from those work-related diseases which are not recognized as occupational diseases to seek legal remedies under general provisions of civil law, which demands proving not only an adequate causal link between the type of work and the disease but also the employer's culpability, which puts the affected employee in a worse legal situation than those suffering from an established occupational disease. The provisions of the statutory law implemented in the Federal Republic of Germany provides a solution for a fraction of the abovementioned problems deriving from the referred differences in occupational and work-related diseases regulation, while the Finnish model, based on causality, instead of the legal definition of occupational disease as such, practically allows for a complete elimination of the problem. Med Pr. 2021;72(5):549-60.

Haff disease is a group of symptoms caused by rhabdomyolysis following ingestion of some species of fish and crayfish. Pathophysiology remains unknown. Outbreaks of the Haff disease have been reported in many regions of the world. In this article we present the case of a 38-years-old patient, professional fisherman, suspected of suffering from Haff disease. He developed symptoms of diffuse myalgia, headache, chest pressure, brown-colored urine and elevated blood pressure. Predominant laboratory abnormalities were elevated serum creatine kinase and creatinine concentrations. During hospitalization the patient required the renal replacement therapy. As a result of applied procedures, clinical and laboratory improvement was achieved. The patient was discharged home in good general condition. The Haff disease should be included in the differential diagnosis of rhabdomyolysis. Detailed medical interview, especially questions about recently consumed food and occupational exposure, is crucial in making a proper diagnosis. Med Pr. 2021;72(5):605-10.

Background: The purpose of this research was to examine the relationships between selected personality dimensions and occupational burnout among professional and volunteer firefighters. Difficult conditions are the cause of loss of not only health but also life. Such working conditions may cause occupational burnout consisting of employee's exhaustion.

Material and methods: The group under examination consisted of 164 firefighters, including 76 volunteers aged 19-61 years (M = 32.49, SD = 9.21) and 88 professional firefighters aged 20-49 years (M = 33.85, SD = 10.05). This research employed the Maslach Burnout Inventory and Gough and Heilburn's Adjective Check List along with the Personality and Axiological Model (MOA) (competences, relations, autonomy).

Results: The results of the conducted research indicate differences between the examined groups of firefighters in personality dimensions (Ord: t = -2.739, p = 0.006; Mls: t = -2.159, p = 0.032; competences t = -2.390, p = 0.017). The research also enabled assessing the correlations with occupational burnout. The greatest relationship with occupational burnout in the group of volunteer firefighters concerns succorance (Suc) and total occupational burnout, and the greatest relationship with occupational burnout in the group of professional firefighters pertains to the competence dimension from the MOA model.

Conclusions: The results of the conducted research should be related to the cognitive aspect (the application of the new MOA model in this professional group) and attention should be paid to the personality differences between the groups of volunteer and professional firefighters. The application value for more effective work of psychologists with this professional group is also important in terms of the results obtained. Med Pr. 2021;72(5):509-19.

Background: Employees in the aviation sector constitute an especially interesting professional group due to a lack of empirical data on their psychological functioning, and the fact that this industry is currently experiencing a phase of dynamic development. However, taking into consideration the automation and specific qualities of the sector, human resources should be given much more attention as they are constantly challenged and face diverse difficulties at work while cooperating in various organic and non-organic teams.

Material and methods: The study included 326 employees of Pyrzowice (Poland), Szymany (Poland), and Košice (Slovakia) airports (however, people employed at the Polish airports were predominant, N = 250). The average age of the participants was 39.3 years, and the sample was predominantly male (N = 278, 85.3%). During the research procedure, the following questionnaires were used: the Feeling of Threat in the Workplace Questionnaire, the Feeling of Stress Questionnaire, the 10-Item Personality Inventory, and the Mini-COPE Stress Inventory.

Results: The regression analysis indicated that personality variables did not allow for predicting the level of stress. However, the helplessness-oriented style (β = 0.191, p = 0.004), avoidant behaviors (β = 0.244, p < 0.001), and the feeling of threat (β = 0.147, p = 0.009) were significant predictors of the feeling of stress, and their high level corresponded with a higher level of stress. The final model explained 23% of the total variance in the feeling of stress.

Conclusions: Based on the results, practical recommendations should concern developing employees' skills related to monitoring stressors and strengthening proactivity in difficult or threatening situations. Such proactive strategies may decrease the tendency to use avoidant and helplessness-oriented behaviors that may cause a higher level of stress perceived by employees. Also, the authors recommend providing training and support using some cognitive behavioral techniques because it seems that the regular application of those methods supports the development of agency and control while facing challenging situations. Med Pr. 2021;72(5):467-77.

Following the outbreak of the COVID-19 pandemic, the objectives of the health care system had to be adapted to the changing circumstances, in order to meet the health needs of patients, but also the expectations of medical workers related to ensuring safe working conditions in the crisis situation. The activities of medical staff are greatly affected by organizational and financial changes in health care systems, which affect both the health care systems all over the world and the functioning of all forms of health care. The article examines the organizational and financial changes resulting from the introduction of regulations affecting the conditions of primary health care (PHC) workers in Poland from the beginning of the COVID-19 pandemic to May 8, 2021. The findings regarding measures taken to ensure the stability of PHC functioning during the pandemic highlight that the public health emergency exposed a significant need to introduce organizational and financial changes in PHC. The changes arising from legislation and good practices of medical, organizational and financial character resulted in health care system modernizations in Poland. It is worth stressing, however, that there is a great need to maintain coherence when implementing organizational and financial changes affecting the fluidity and effectiveness of the actions taken by PHC personnel, and thus their working conditions, when implementing future responses to public health emergencies. Such changes should be based on an analysis of the solutions introduced since the beginning of the pandemic in Poland: these include organizational changes such as housing conditions, organization of work and workplaces, flow of information and way of supplying the patient, and financial changes involving mobilization of additional financial resources. The article presents a list of future research questions that merit consideration when setting problems and priorities: these can be used to guide the introduction of permanent modifications to the functioning of PHC in Poland and to facilitate possible future adaptation in times of emergency. Med Pr. 2021;72(5):591-604.

Background: The article addresses the issue of attitudes towards safety at work in the context of subjective variables such as psychological stress and the subjective self-efficacy of workers in the aviation sector. The research was exploratory in nature. It focused on capturing the individual experiences of ground handling staff at Polish and Slovak airports. Among the 326 people surveyed were engineers, firefighters, mechanics and electricians - a crew that works in difficult and threatening working conditions on a daily basis, often experiencing unexpected accidents and breakdowns. The psychosocial factors in industry 4.0 and this branch of industry itself are - according to the authors - verified empirically quite poorly. Taking care of safety at work and strengthening a positive attitude towards safety seems to be a key aspect of management in such units.

Material and methods: The Polish Questionnaire of Attitude towards Safety by M. Znajmiecka-Sikora, the Generalized Self-Efficacy Scale and the Plopa and Makarowski Stress Feeling Questionnaire were used in the research.

Results: The statistical analyses carried out, including regression analyses and a model of analysis of mediation between variables, have indicated that this sense of effectiveness is a key positive predictor of every aspect related to strengthening attitudes towards safety (a cognitive aspect [β = 0.21, p < 0.001], an affective aspect [β = 0.15, p = 0.001] and a behavioral aspect [β = 0.15, p = 0.002]), as well as the overall level of attitude towards safety (β = 0.19, p < 0.001).

Conclusions: The sense of effectiveness is an important mediator between the level of perceived stress and attitudes towards safety, which means that as the subjectively perceived sense of self-efficacy increases, the level of experienced stress decreases and thus the positive attitude towards safe actions and behaviors in the workplace is strengthened. Med Pr. 2021;72(5):479-87.

Background: The aim of the study was to analyze data on the exposure of military personnel to carcinogenic chemical substances, ionizing radiation and technological processes.

Material and methods: Reports collected from the Military Centers of Preventive Medicine on carcinogens and exposure of workers in military units and institutions were subjected to a detailed analysis.

Results: The number of workers exposed to carcinogenic factors increased in the period under analysis. In 2019, the total number of people exposed in the workplace to chemical carcinogens or mutagens was 4058, to ionizing radiation - 1015, and to technological processes with carcinogenic or mutagenic effects - 12, compared to 3224, 1289 and 8 people, respectively, in 2018. The most common chemical agents in military units which caused exposure, from the point of view of occupational health and safety, were mixtures of liquid hydrocarbons used as fuel for driving vehicles and devices with internal combustion engines. In military units dedicated to the provision of medical services, exposure to X-ray radiation (diagnostics imaging) and formaldehyde (pathomorphology) was the most common.

Conclusions: The collected data presents different approaches of individuals in terms of reporting and assessing occupational exposure. Understanding the long-term health effects requires more thorough research. Med Pr. 2021;72(5):501-8.

Background: Exposure to fine and ultrafine particles from transport processes is a main consequence of emissions from engines, especially those with self-ignition. The particles released in these processes are a source of occupational and environmental particles exposure. The aim of this study was to assess the fine and nano-sized particles emission degree during work connected with transport and vehicle servicing.

Material and methods: The tests were carried out at 3 workplaces of vehicles service and maintenance (a car repair workshop, a truck service hall, and a bus depot) during 1 work day in each of them. Measurements were performed using the following devices: DISCmini meters, GRIMM 1.109 optical counter and the DustTrak monitor. The number, surface area and mass concentration, and the number size distribution were analyzed.

Results: The mean number concentration (DISCmini) increased during the analyzed processes, ranging from 4×104 p/cm³ to 8×104 p/cm³, and the highest concentration was found in the car repair workshop. The particles mean diameters during the processes ranged 31-47 nm, depending on the process. An increase in the surface area concentration value was observed in correlation with the particles number, and its highest concentration (198 m²/cm³) was found during work in the car repair workshop. The number size distribution analysis (GRIMM 1.109) showed the maximum value of the number concentration for particles sized 60 nm. The mean mass concentrations increased during the tested processes by approx. 40-70%, as compared to the background.

Conclusions: According to the measurement results, all the workplaces under study constituted a source of an increase in all analyzed parameters characterizing emissions of nano-sized particles. Such working environment conditions can be harmful to the exposed workers; therefore, at such workplaces solutions for minimizing workers' exposure, such as fume hoods or respiratory protection, should be used. Med Pr. 2021;72(5):489-500.

In recent years, there has been a clear increase in the interest in positive phenomena in work psychology. One of such issues is employee-initiated behavior aimed at transforming working conditions in order to increase job satisfaction and match it to one's needs and abilities. These behaviors are referred to as job crafting. With the development of research on this issue, different theoretical concepts and definitions of job crafting were created and then evolved. The aim of the work is to systematize them and perform a critical analysis. The article analyzes 5 theoretical models of job crafting: Wrzesniewski and Dutton's model, Tims and Bakker's model, Zhang and Parker's model, Bindl et al.'s model, and Kooij et al.'s model The publication presents the differences between these models, and strengths and critical points of each of them. Med Pr. 2021;72(4):423-36.