[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).

[Epidemiology, diagnosis, and prevention of tick-borne encephalitis in Poland and selected European countries - a position statement of the Polish group of experts]. / Epidemiologia, diagnostyka i profilaktyka kleszczowego zapalenia mózgu w Polsce i wybranych krajach europejskich ­ stanowisko polskiej grupy ekspertów.

Tick-borne encephalitis (TBE) is one of the most common viral neuroinfections in Poland. Detection of specific IgM and IgG anti- TBE antibodies in the serum or cerebrospinal fluid with enzyme-linked immunosorbent assay (ELISA) is a method of choice in TBE diagnostics. No effective antiviral treatment is available for TBE. Increased intracranial pressure, epileptic seizures, and other neurological symptoms in the course of TBE are managed with standard procedures. A routine use of corticosteroids is not recommended. Adults with TBE-related neurological sequelae should undergo physical mobilization and periodic neurological assessments. All patients ought to control their psychological condition and visit a physician in case of worrisome symptoms. Additionally, children need to undergo regular psychological and otolaryngologic consultations. Notably, TBE cases are reported across Poland; therefore, the entire country must be considered as a TBE risk region. The degree of endemicity can be variable in particular parts of the country. Immunization against TBE containing a European subtype of the virus is the most effective prophylactic method. In areas where the disease is highly endemic (according to the WHO definition of ≥5 cases/100 000 population/year), immunization needs to be offered to all ages. Vaccination is recommended in the communities living in areas of moderate TBE endemicity (1-5 cases/100 000/ year), in particular for individuals at high risk of a TBE infection as well as children and the elderly. Vaccination should also be offered to subjects living in areas where TBE occurrence is rare (<1 case/100 000/year) but who are at high risk of infection. A TBE vaccine is recommended to the following populations at high risk of TBE: a) individuals undertaking outdoor leisure activities, b) all professionals working outdoors, particularly in green areas, and c) individuals traveling to endemic areas, if activities during their visit may pose a risk of a tick bite. Post-exposure immunization is not recommended. Med Pr. 2021;72(2):193-210.

[Health criteria and scope of workers' periodic health check-ups for selected types of work and exposure factors - Nofer Institute of Occupational Medicine guidelines]. / Kryteria zdrowotne i zakres badan profilaktycznych dla wybranych rodzajów prac i czynników narazenia ­ wytyczne Instytutu Medycyny Pracy w Lodzi.

Workers' medical prophylactic examinations referred to in the Labor Code are one of the tasks of the occupational medicine services. They are regulated by law which has been in force for more than 20 years in unchanged form. During this period, new harmful, burdensome or dangerous to health factors appeared in the workplaces, for which no preventive health check-up standard was defined. In the meantime, the health criteria for drivers and persons applying for driving licenses have also been significantly liberalized. The above changes, the authors' own experience, comments and problems reported by physicians who provide workers' prophylactic health care and employers as well as analysis of literature related to workers' health care in other countries have created the need to harmonize and update guidelines on health requirements for selected types of work. In addition the scope and frequency of prophylactic examinations for exposures, which are not included in applicable legal acts, has been developed. Med Pr. 2019;70(1):125-37.

[Experts' opinion on criteria for certification of primary occupational medicine service units]. / Kryteria certyfikacji jednostek podstawowych sluzby medycyny pracy w opiniach ekspertów.

BACKGROUND: The article shows the results of a survey of the experts' opinions on the criteria for certification of primary occupational medicine service units. MATERIALS AND METHODS: The group of experts surveyed comprised: the national consultant and regional consultants in occupational medicine, directors of regional occupational medicine centres, heads of organisation and supervision departments of those centres and chairmen of chapters of the Polish Association of Occupational Medicine. A questionnaire employed in the survey of the experts' opinions on the quality assessment criteria and indicators used in primary occupational medicine service units certification system were based on variables typical for management and quality assurance systems applied in health care. Of the 68 questionnaires sent, 45 of them were completed and returned. RESULTS AND CONCLUSIONS: Among criteria for certification of primary occupational medicine service units, verified by experts, there were criteria common for management and quality assurance systems used in health care, e.g., client orientation; improvement of qualifications; using standards and medical procedures, quality book and medical documentation of self-control procedures; obligation to implement quality goals; information management, i.e. performance of cumulative analysis of documentation. Criteria used in quality management systems concerning organisation management, internal audits and human resources management do not apply to primary occupational medicine service units, because the majority of them are one-person enterprises acting as individual medical practices or physicians authorised to perform prophylactic examinations and acting as a primary occupational medicine service unit in the structure of public or non-public health care units. The survey revealed the presence of common criteria and indicators for services quality assessment in primary occupational medicine service units and other systems of management and health services quality assurance. Among them the following may be indicated: client-patient orientation (learning about his/her needs, regular assessment of satisfaction with services), improvement of personnel qualifications, information management, or constant improvement of services.

[Criteria used in the health care quality assurance systems]. / Kryteria stosowane w systemach zapewnienia jakosci wykorzystywanych w opiece zdrowotnej.

The author presents the criteria used in the health care quality assurance systems with special attention paid to the following issues: Quality management system ISO 9000:2000. European Foundation Quality Management. Hospital accreditation. Quality assurance system in occupational health services in Norway "Good OHS". Quality management criteria are regarded as guidelines for functioning of organizations. All presented evaluation systems are based on a common set of criteria, which include: client-patient orientation; advancement of stuff skills; information management; services and management improvement.