[Resources and activities of voivodeship occupational medicine centers in Poland during the COVID-19 pandemic]. / Zasoby i dzialalnosc wojewódzkich osrodków medycyny pracy w Polsce w okresie pandemii COVID-19.

BACKGROUND: Voivodeship Occupational Medicine Centres (VOMC), being higher-level units towards basic units providing preventive care for employees in Poland, play a consultative, appeal, supervisory and registration role towards them. Additionally, they perform many other tasks specified in the Occupational Medicine Service Act, including conducting diagnostic and jurisprudential activities related to occupational diseases and postgraduate education in occupational medicine. MATERIAL AND METHODS: The analysis covers data from 2017-2022 on VOMCs activities, derived from mandatory MZ-35 reporting. RESULTS: Over 6 years, the number of employed physicians at VOMCs decreased from 830 in 2017 to 820 in 2022, with >20% of employment contracts transitioning to other forms of cooperation. The number of employed nurses decreased from 375 to 342, and the number of psychologists from 86 to 82. During the 3 years of the pandemic (2020-2022), compared to 2017-2019, the consultative activity of VOMCs for basic units of occupational health service decreased by nearly 30%, while appeal and supervisory activities decreased by 15.2% and 15.8%, respectively. The number of individuals receiving outpatient medical rehabilitation for occupational pathology decreased by >32%, and the number of services provided for established occupational pathology decreased by >14%. The number of certifications for occupational diseases decreased from 3963 in 2019 to 3518 in the first year of the pandemic, then increased to 4145 in 2021 and 3990 in 2022. CONCLUSIONS: The COVID-19 pandemic had a significant impact on the functioning of VOMCs. Changes in specific areas of their judicial, consultative, appeal, supervisory, training and rehabilitation activities corresponded with the socio-legal changes observed between 2020-2022. The structure of employment at VOMCs and the scope of their tasks remained stable during the pandemic. The observed changes in employment of medical staff were in line with general trends in healthcare institutions and regional conditions. Med Pr Work Health Saf. 2024;75(4).

Night shift work and modifiable lifestyle factors.

OBJECTIVES: Night shift work has been linked to some chronic diseases. Modification of lifestyle by night work may partially contribute to the development of these diseases, nevertheless, so far epidemiological evidence is limited. The aim of the study was to explore association between night shift work and lifestyle factors using data from a cross-sectional study among blue-collar workers employed in industrial plants in Lódz, Poland. MATERIAL AND METHODS: The anonymous questionnaire was self-administered among 605 employees (236 women and 369 men, aged 35 or more) - 434 individuals currently working night shifts. Distribution of the selected lifestyle related factors such as smoking, alcohol drinking, physical activity, body mass index (BMI), number of main meals and the hour of the last meal was compared between current, former, and never night shift workers. Adjusted ORs or predicted means were calculated, as a measure of the associations between night shift work and lifestyle factors, with age, marital status and education included in the models as covariates. RESULTS: Recreational inactivity (defined here as less than one hour per week of recreational physical activity) was associated with current night shift work when compared to never night shift workers (OR = 2.43, 95% CI: 1.13-5.22) among men. Alcohol abstinence and later time of the last meal was associated with night shift work among women. Statistically significant positive relationship between night shift work duration and BMI was observed among men (p = 0.029). CONCLUSIONS: This study confirms previous studies reporting lower exercising among night shift workers and tendency to increase body weight. This finding provides important public health implication for the prevention of chronic diseases among night shift workers. Initiatives promoting physical activity addressed in particular to the night shift workers are recommended.

[Night work and health of nurses and midviwes--a review]. / Praca w nocy a zdrowie pielegniarek i poloznych-- przeglad literatury.

Night shift work has been thought to play a role in the etiology of chronic diseases through a disruption of the circadian rhythm, decreased synthesis of melatonin and sleep deprivation. Our aim was to review the epidemiological studies on the association between night shift work and some pathologies in nurses and midwives. We reviewed publications available in the MEDLINE database and published before June 2012, describing the cross-sectional (almost two thirds of all papers) and cohort studies. In total, we identified 26 original papers, including 5 epidemiological studies addressing diseases or disorders of the digestive system, 3--metabolic syndrome, 2--type 2 diabetes, 9--cardiovascular diseases and (CVD risk factors, 5--obesity/overweight, 2--menstrual disorders and 3--poor pregnancy outcomes. The analysis of the literature indicates that night shift work of nurses and midwives is most strongly associated with a higher risk ofobesity/overweight. In each of the five studies, which we identified this association was observed (confirmed by the statistical significance of the results), also after adjustment for confounders. The results for type 2 diabetes and disorders of the menstrual cycle are also suggestive. Epidemiological data on the other disorders or pathologies discussed in this article seem to be less certain - their results are inconsistent or their number is too small to draw definite conclusions. Further epidemiological studies of nurses and midwives working on night shifts and prospective observations in particular are recommended to find out whether potential association between the night work and discussed health issues is causal.

Night shift work characteristics and occupational co-exposures in industrial plants in Lódz, Poland.

OBJECTIVES: Night shift work involving circadian rhythm disruption has been classified by IARC as a probably carcinogenic to humans (Group 2A). Little is known about co-exposures of the night shift work in occupational settings. The aim of our study was to characterize night shift work systems and industrial exposures occurring in the manufacturing plants in Lódz, Poland, where night shift work system operates, with particular focus on potential carcinogens. MATERIAL AND METHODS: Data on the night shift work systems and hazardous agents were collected through survey performed in 44 enterprises. The identified hazardous agents were checked using the IARC carcinogen list, and the harmonized EU classification of chemical substances. We also examined databases of the Central Register of Data on exposure to substances, preparations, agents and technological processes showing carcinogenic or mutagenic properties in Poland. RESULTS: The most common system of work among studied enterprises employed 3 (8-hour) shifts within a 5-day cycle. We identified as many as 153 hazards occurring in the environment of the plants, with noise, carbon monoxide and formaldehyde recorded as the most common ones. Out of these hazards, 11 agents have been classified by IARC to group 1 - carcinogenic to humans, whereas 10 agents have been classified as carcinogens by the regulation of European Classification of carcinogens. Analysis of the data from the Central Register revealed that 6 plants reported presence of carcinogens in the environment of work. CONCLUSIONS: In our study we observed that in none of the workplaces the night shift work was a single exposure. Further epidemiological studies focusing on investigation of health effects of the night shift work should identify occupational co-exposures and examine them as potential confounders.

Night work and health status of nurses and midwives. cross-sectional study.

BACKGROUND: The aim of this study was to assess the association between night shift work and the prevalence of diseases and conditions among nurses and midwives. MATERIAL AND METHODS: The study included 725 subjects (354 working on night shifts and 371 working only during the day). The data were collected via an interview based on the "Standard Shiftwork Index". We analyzed the frequency of diseases and conditions and the relative risk expressed as the odds ratio (adjusted for important confounding factors). RESULTS: The most common diseases in the study population were chronic back pain (47.2%), hypertension (24.5%) and thyroid diseases (21.2%). We found no statistically significant increased relative risk of any diseases and conditions among the night shift nurses, compared to the day shift ones. The duration of the work performed on night shifts was significantly associated with the relative risk of thyroid diseases--increased almost two times in the women working for 15 or more years in such system (p for trend: 0.031). The analysis showed the significantly increased (more than eight times higher) relative risk of feet swelling in the women with 8 or more night duties per month, compared to the women having fewer night shifts. CONCLUSIONS: We did not observe a higher frequency of diseases in the night shift nurses, compared to the day shift nurses. These results may be related to the so-called "Healthy Worker Effect". There is a need for further long-term observational studies in the populations of nurses.