[Ability to work--new approach to evaluation methods]. / Zdolnosc do pracy--nowe podejscie do sposobu oceny.

In Poland, the assessment of work ability has thus far been almost entirely objective, which means that it was based on the evaluation of the individual's health state. That is why a subjective method of work ability assessment with work ability index (WAI), developed by the Occupational Health Institute in Helsinki, was used in our present study. This method allows to indicate other possible factors which modify work ability. The study covered 189 men employed in five metallurgical plants, located in the region of Lódz. In the study population, WAI and work load on the basis of the expenditure of energy were measured, the health condition was evaluated, and information on life styles and non-occupational responsibilities was gathered. It was found that WAI values were inversely proportional to age and work load. They were also modified by individual characteristics, such as life style, body mass, and activities at leisure. It was found that the correlation between the general index of work ability and the objective health indicators was low with the concomitant considerably higher correlation with the values of the components which reflect subjective work abilities. In view of the results obtained, WAI can be recommended as a tool for assessing work ability. Due to this method it is possible to present conclusively all elements of individual characteristics and to identify at the same time links with working conditions.

Can nurses be employed in 12-hour shift systems?

Nurses are often obliged to work in a 12-hr shift work system. We have decided to check whether such a working system constitutes an excessive load for nurses. On the basis of a questionnaire survey among nurses working in an 8-hr daytime shift system (169 nurses) and in a 12-hr shift (536 nurses), the amount of physical workload, work stress, and after-work activities were compared. Data analysis has shown that a 12-hr shift system is characterized by less significant physical workload but greater mental load. The nurses working in a 2-shift system were more tired after work, but they could spend more time on leisure activities and do housework. The data suggest that there are no significant contraindications for nurses to work in a 2-shift system.

[Risk factors for preterm birth in a group of unemployed women. II. Analysis of independent variables]. / Czynniki ryzyka porodu przedwczesnego w grupie kobiet niepracujacych zawodowo. II. Analiza niezaleznego wplywu badanych zmiennych.

The incidence of preterm birth is conditioned by a number of factors. The identification of these factors in individual groups of women helps to adopt well-oriented preventive measures. The analysis of logistic regression allows to identify significant and independent factors responsible for preterm birth. This paper describes the results of the analysis carried out in the group of non-employed women. The results revealed two following independent factors of risk for preterm birth in the study group of women: the state of health and the burden of considerable physical strain resulting from difficult economic situation of women.

The assessment of Big Five Personality Factors and Temperament Domains as modifiers of cardiovascular response to occupational stress.

The aim of the study was to explore the role of Big Five Personality Factors and Temperament Domains as the factors influencing cardiovascular response to work, and their moderating effect on the relationship between occupational stress and cardiovascular reactivity. The self-reported data on occupational stress and filled in NEO-Five Factor Inventory by Costa, and McCrae and Pavlovian Temperament Survey by Strelau et al. were collected from 97 bank clerks employed in large bank branches. The subjects also responded to the questionnaire on personal and professional background factors. A 24 hour monitoring of cardiovascular reactivity (heart rate and blood pressure) was also provided. Conscientiousness was found to be the only modifier of cardiovascular response to occupational stress reflected by systolic blood pressure. Several main, independent of stress effects of personality and temperament domains were also found. The ratio of heart rate at work to heart rate during sleep was associated with the strength of excitatory process, the percentage of maximum heart rate index with Conscientiousness, and systolic blood pressure at work was influenced by the strength of inhibitory process. However, generally speaking, physiological indicators of the cardiovascular system functioning were not very sensitive to changes in values of personality and temperament variables at the level of occupational stress reported by the bank clerks who participated in the study.

[The evaluation of the exposure of seamstresses to electromagnetic fields, emitted by sewing machines]. / Ocena narazenia szwaczek na pola elektromagnetyczne emitowane przez maszyny szwalnicze.

The authors present the results of the first phase of the studies on the risk of pregnancy complications in semesters and on their work environment with special reference to electromagnetic fields (EMF) emitted by various types of industrial sewing machines. EMF measurements were taken in the surrounding of 464 sewing machines used in five sewing works in the region of Lodz. The results obtained provided evidence that semesters++ working with industrial sewing machines were exposed to EMF of 60 Hz. Thirteen types of machines were identified. Having based on the statistical analysis (analysis of variance) it was found that individual types of sewing machines emit substantially different EMFs. Depending on the level of EMF emitted at a given workpost, all the machines were classified into three groups: those with weak (O A/m-1.5 A/m); medium (2 A/m-4 A/m); and strong (9 A/m-16 A/m) emissions.

[Health-related absenteeism among workers employed in various work environments]. / Zdrowotne przyczyny absencji chorobowej pracowników zatrudnionych w róznych warunkach srodowiska pracy.

The state of health in working people is determined by a number of factors among which working conditions and the kind of job performed play undoubtedly a crucial role. The observation and analysis of trends in sick absenteeism may provide indirect information on health problems of the occupationally active population. The aim of the analysis presented was to define the magnitude and the causes of temporary work disability among workers employed in individual branches of the national economy, and finally to identify high risk groups of workers because of their employment in specific working conditions. The statistical material used as the basis for the calculation of absenteeism indicators embraced the data on the number of work disability days, derived from a 15 representative sample of punched cards, concerning certificates of temporary work disability. In order to accomplish the objectives of the analysis, the trends in sick absenteeism observed before 1989, the period preceding the structural changes and the transformation of Polish economy were taken into consideration. The analysis indicates that the level of sick absenteeism in the branches of the national economy (forestry, building construction, transport, industry) and the proportion of chronic diseases in its structure prove the effect of working conditions on the workers' health. Considering individual branches of industry, the highest levels of sick absenteeism are observed in the following branches: mining for men (5.61), non-ferrous metals for women (10.04) and men (4.95), ferrous metallurgy for women (9.99) and men (4.93), and petroleum products for women (11.76). The analysis of sick absenteeism in the branches selected in view of hazardous working conditions shows that: (1) in many branches chemical hazards in the work environment are responsible for an increased sick absenteeism due to diseases of the circulatory system, particularly among men, mental disorders and neoplasms, both among men and women, and complications of pregnancy among women; (2) physical work overload increases sick absenteeism mainly due to diseases of the musculoskeletal and peripheral nervous systems, as well as due to cardiac disease and arterial hypertension; and (3) hot microclimate contributes to sick absenteeism because of diseases of the circulatory system, including cardiac disease and arterial hypertension, particularly among men, as well as acute and chronic respiratory diseases.

Heavy physical work during pregnancy--a risk factor for small-for-gestational-age babies in Poland.

BACKGROUND: Heavy physical work is still considered one of the most prevalent risk factors of negative pregnancy outcome. The present study was undertaken to evaluate the impact of heavy physical work during pregnancy, based on subjective assessment of workload, on the risk of delivering a small-for-gestational-age (SGA) baby. METHODS: Job characteristics were compiled for 1,064 working women from the Lódz region (8% population sample) based on questionnaire responses. Energy expenditure during daily work was estimated. SGA was diagnosed when the birth weight was below the 10th percentile of the standard curves for central Poland. The SGA group comprised 78 women who delivered SGA babies, while the non-SGA group consisted of 986 women with eutrophic newborns. RESULTS: An excessive risk of SGA was found in the group reporting heavy physical effort at work. The physical effort perceived as heavy by pregnant women appeared to be a better predictor of SGA manifestation than the estimated energy expenditure at work. CONCLUSIONS: The information obtained from a pregnant worker should constitute an essential decisive factor for determining the time of work cessation during pregnancy.

Comparison of cardiac response to managerial workload between men and women.

The aim of the study, was to estimate the reaction of selected circulatory system parameters to psychic workload in industrial managers and to answer the question whether may affect this reaction. The study was performed in 23 men (mean 46 +/- 6 years of age) and 16 women (mean 42 +/- 6 years of age), employed as executives in a large industrial plant. The subjects had their 24-h ECG recorded using Medilog 3000 (Oxford). The ECG recordings were classified as pathological according to the standards of Bjerregaard. Heart rate was calculated for working time, leisure time and sleep. The subjects were also asked to estimate the perceived psychic load according to a method involving subjective estimation of work-demands and of an ability to cope with them. Generally, the subjects reported high work demands, but coping abilities were higher than work demands. Both in the men and women, a relationship was found between the intensity of subjective estimation of psychic load and heart rate response. However, the reaction of the circulatory system to the psychic workload in men was long-lasting (its effects continued until late at night); in women it was more direct (only during work). The frequency of abnormalities in 24-h Holter ECG recordings for both test groups was not very high, a little higher in men (30%) than in women (25%), and was comparable with the frequencies in selected general population groups. Our results may indicate that mental workload of the managerial staff, does not cause increased frequency of ECG abnormalities. However, in view of the fact that cardiovascular diseases are more frequent among men than among women, different reaction of the circulatory system to workload should also be accounted for in an attempt to explain the sources of that phenomenon.

[Risk factors for premature birth. I. Analysis of selected factors in a group of non-working women]. / Czynniki ryzyka porodu przedwczesnego. I. Analiza wybranych czynników w grupie kobiet niepracujacych zawodowo.

Selected risk factors responsible for premature birth in a group of women non-employed professionally were discussed. The analysis included demographic (age, education, marital status, maternal body weight, the number of previous pregnancies, as well as spontaneous and artificial abortions reported in interview), social (smoking, exposure to tobacco smoke, family economic status, standard of living conditions, and facilities used in running the household), and medical (maternal health status before and during pregnancy, and perinatal care) factors, as well as work load at home. The authors found low maternal body weight, genital bleeding during pregnancy and work overload at home to be the most significant risk factors.

[The influence of chemical and physical factors in the work environment on the amount of risk for abnormal pregnancy outcome]. / Ocena wplywu chemicznych i fizycznych czynników wystepujacych w srodowisku pracy na wielkosc ryzyka niekorzystnego wyniku ciazy.

The authors present a review of the literature on adverse effects of chemical and physical factors in the work environment on the course and outcome of pregnancy together with the results of their own study. The objective of the study was to identify the magnitude and frequency of exposures to chemical and physical factors at workposts where pregnant women were employed and to asses to what extent the existing exposure increased the risk for complications in pregnancy outcome The study involved the collection of information on factors with potential adverse effect on the course and outcome of pregnancy in employed women who were hospitalised in the Polish Mother Memorial Hospital in Lódz during the years 1992-94. The study was carried out in the group of 526 women with abnormal pregnancy outcome (N), including preterm birth (PB)--256; low birth weight < 2500 g (LBW)--232; small for gestational age (SGA)--196; asphyxia (APG)--116; and congenital malformations (M)--71. The control group (C) was composed of 683 women. As the reports on the work environment indicated working conditions in the group of women with abnormal pregnancy outcome were worse than in the control group; the presence of potentially harmful factors in the work environment were reported 57% of women in group N and 51.2% of women in group C. The increase in the risk of abnormal pregnancy outcome was relatively law (OR = 1.26). Taken into account the duration of exposure to these factors (period of employment under conditions of exposure to physical and/or chemical factors) it was revealed that pregnancy is at risk if women continue to work under such work conditions by the end of the second trimester. In this group of women odd ratio for abnormal pregnancy outcome accounted for 1.80 and it was statistically significant. The employment in the period preceding pregnancy and during the first trimester enhanced the risk insignificantly. A similar situation was observed if the risk of abnormal pregnancy outcome was assessed separately for exposure to chemical factors and to physical factors. A conclusion of great practical importance can be then drawn: expecting mothers should be prevented from working under harmful work conditions after the first trimester of gestation. Therefore, doctors attending occupationally working pregnant women should be obliged to make very careful inquiries about their working conditions. Logistic regression analysis helped to reveal and adverse effect of physical factors only in regard to newborns' body weight, but if failed to show negative effect of chemical factors on pregnancy outcome. On the other hand, the analysis highlighted a significant influence on certain social situations, lifestyles and mothers' health status on pregnancy outcome; a positive effect of higher education in the case of preterm birth and asphyxia; and a negative effect of mother's single status, smoking during pregnancy and the poor health condition during pregnancy on the incidence of congenital malformations.

[The effect of mothers' occupation on body mass of newborns born at term]. / Wplyw pracy zawodowej matek na mase ciala noworodków urodzonych o czasie.

The body mass is one of the major indicators which determine the clinical condition of newborns, influence the rate of neonatal mortality and further development of newborns. In order to prevent malformations it is necessary to identify factors which impair the fetus development and cause fetal hypotrophy. The main objective of the study was to find out whether mothers' occupational work affected the body mass of infants born at term. The study covered a group of 1015 women randomly sampled among those who had delivered their babies in the Polish Mother Memorial Hospital in Lódz, during the years 1992-94. In this group the percentage of working women accounted for 69%. The comparison of the body mass in infants born to women employed and not employed during pregnancy did not indicate differences. However, it was found that male infants born to employed mothers showed a lower body mass than those born to not employed mothers. The effect of some factors modifying infants' body mass was different in the case of not employed women than in those employed. In the group of not employed women a significantly lower body mass in infants was observed in the following subgroups: mothers under 24 years of age, spontaneous abortion of one of previous pregnancies, consumption of large quantity of caffeine (equivalent of > two cups of coffee), and poor economic status. Smoking during pregnancy decreased the body mass of infants in both groups of women. In the group of working women, chronic diseases before pregnancy and diseases involving fever during pregnancy proved to be factors affecting the body mass of infants. The indicators of perinatal medical care (the beginning of medical care and the number of visits during pregnancy) in working women were better than in those not working. None of factors characterizing occupational work affected significantly the body mass of infants. Slightly lower infants' body mass was observed only in those born to mothers working overtime (> 9 hrs daily), involved in hard physical work or working in the environment with harmful chemical and physical factors. According to the data obtained, a negative effect of occupational work on the fetus development should not be overestimated. Nevertheless, the performance of occupational work may aggravate a negative effect of woman's bad health condition on the fetus development.

[Psycho-social work conditions as risk factors for premature birth and newborn hypotrophy]. / Psychospoleczne warunki pracy jako czynniki ryzyka wystepowania porodu przedwczesnego i hipotrofii noworodka.

On the basis of the studies carried out the authors verified a hypothesis that psychosocial work conditions and occupational stress are risk factors for premature birth and newborn hypotrophy. The following aspects were considered in the evaluation of psycho-social work conditions: (a) work-related psychological demands; (b) the extent to what an employee is able to control the situation at work; (c) occupational stress arising from the discrepancy between work-related demands and the extent of control over the work situation; and (d) interpersonal relations at work. The analysis covered 219 cases of premature births and 159 cases of newborn hypotrophy. The control group comprised 586 women sampled randomly who gave birth at term to a healthy baby with correct birth weight. The authors found that ill interpersonal relations and a low level of control over the situation at work elevate the risk of giving birth to a baby with hypotrophy, while good interpersonal relations and a high level of control over the situation at work play a protective role. The effect of these psycho-social factors applied only to hypotrophy of a newborn and it was related neither to other features of occupational work nor to biomedical factors. It seems that this kind of factors may have generally less pronounced impact on premature birth.

[Electromagnetic poles and reproduction]. / Pola elektromagnetyczne a reprodukcja.

The authors review epidemiological data concerning the relationship between reproduction disorders and the exposure to electromagnetic fields (EMF) emitted by power lines, industrial power-charged devices, diagnostic and therapeutical appliances, video display terminals (VDTs) and electric household devices. The studies involved the analysis of the EMF effect on female and male reproduction, including the risk of spontaneous abortion, still birth and premature birth, low birth weight and congenital malformations as well as on the progeny gender proportion, among persons employed under the condition of EMF exposure. It was observed that the findings were frequently inconsistent, i.e. under the same conditions of EMF exposure some date indicated its negative effect on the reproduction process and some did not. No data confirming an acute effect of occupational exposure to EMF on the risk of spontaneous abortion, low birth weight, congenital malformations or other reproduction disorders were obtained, however, the negative effect of EMF cannot be explicitly excluded.

[Objective evaluation of physical exertion in pregnant women based on long-term recording of heart action. Results of a pilot study]. / Obiektywna ocena obciazenia wysilkiem fizycznym kobiety w ciazy na podstawie dlugookresowej rejestracji akcji serca. Wyniki badania pilotowego.

The heart rate during whole day, periods of activity and sleep as well as repeatable daily activities were identified in a group of 22 women, aged 19-40, and pregnant for 12-36 weeks, following a 24-hour recording of the heart work. In four women only, mean circadian heart rate was under 87/min, a value considered as normal in moderate active persons. That indicates a significant pregnancy-related increase of heart rate. A considerable great variation of heart rates was observed during a day. The highest heart rate (97-140/min) was caused by mounting the stairs; it was also noted during performing minor household jobs and/or preparing meals. While using transportation means, heart rate ranged from 78 to 130/min, and at leisure form 89 to 108/min. It was found that the level of an acceptable load for women (100 heart beats/min) was already higher than the mean value for the whole period of activity. An analysis of the relationship between heart rate in certain situations and the age of women under study, and the pregnancy advancement, shows that heart rate was, in each period of recording, positively correlated with the women's age. That means an increasing, with age pregnancy-related load. Heart rate during a 24-hour period, periods of activity and sleep, during the use of transportation means, watching television and resting in a sitting position, was positively correlated with the duration of pregnancy. Negative correlation between heart rate and the duration of pregnancy was observed while mounting the stairs, preparing meals and performing other household jobs. The negative correlation indicates that the pace of activities performed can be easily regulated, and thus, the load magnitude adjusted to physical abilities, whereas the positive correlation indicates that such a possibility does not exist in regard to the expenditure of energy (work pace). To sum up, the data presented shows that the use of transportation means increased the women's load but they could easily perform minor household jobs. However, there were no occupationally working women in the study group, it can be concluded that this kind od analysis, and conclusions drawn, can be used in identifying types of work and workplaces which pose too much load to pregnant women.

[Physical exertion at work and the course and outcome of pregnancy]. / Wysilek fizyczny w pracy zawodowej a przebieg i wynik ciazy.

The authors present the latest data on the effect of physical load on pregnancy course and outcome, and they indicate that such as load may become a risk factor for preterm birth and low birth weight. The probability of pregnancy complications induced by great physical load is related to physiological changes occurring in the female body during pregnancy. Observations made in regard to physical load related with sport or recreation activities confirm such a likelihood. In the literature on the effect of occupation-related physical load on pregnancy course and outcome, the following factors are emphasised: intensity of physical activity (work), work pace, handling heavy objects, body position during work performance, time spent in standing position, and daily or weekly distribution of working time. The study results indicate evidently negative effect of occupation-related physical load only in the case low living standards experienced by pregnant women. The results of the studies carried out in Poland showed that high occupation burden is an independent risk factor or preterm birth and hypotrophia. Therefore, according to current regulations concerning job restrictions for pregnant women only light work and standing position limited to three hours during shift are permissible, whereas forced body position and forced work pace (e.g. at production belt) are forbidden. In the discussion, the authors compare the legal regulations binding in our country with the European Union's legislation on the protection of pregnant women against harmful factors occurring in the work environment. Attention is also turned to the need for bringing our legal regulations closer to solutions adopted by the European Union, especially in the case of lack of jobs in a given enterprise which could be performed by pregnant women.

[Professional work of woman as a risk factor for circulation disorders]. / Praca zawodowa kobiet jako czynnik ryzyka chorób ukladu krazenia.

The author presents an up-dated review of the literature on the effects of professional work on the incidence of diseases of the circulatory system in women, and the incidence of ischaemic heart disease and arterial hypertension in particular. An analysis of health effects of professional work revealed that a limited influence on the final effect of own work (a limited control of own situation at work) and subordination to superiors, belong to these factors which exert the most detrimental effect on the circulatory system. A negative effect frequently manifested by the level of blood pressure is also related with heavy physical burden. The literature data also reveal that the professional work, itself, does not contribute to an increased incidence of diseases of the circulatory system or to the profile of risk factors. A possible reason for this observation lies in similar responsibilities faced by women acting only as housewives and those faced in occupational work. The review presented also stresses the role of endogenic risk factors in women related with the number of pregnancies/deliveries as well as with menopause.

[Is heavy physical work a risk factor for ischemic heart disease?]. / Czy ciezka praca fizyczna jest czynnikiem ryzyka choroby niedokrwiennej serca?

The authors presents current data on the relationship between the level of physical activity and the incidence of ischaemic heart disease. It was stressed that occupational and non-occupational physical activity should be considered differently in view of the fact that the most common physical effort at work applies to a limited group of muscles with a high component of static effort. Therefore it is not optimal from the training point of view, and affects negatively the circulatory system. Attention is also turned to the health consequences of a psycho-social load related to work, education and social status. In conclusion it is stated that blue collar workers become a group of an increased risk of ischaemic heart disease because of accumulation of all negative factors: heavy work, static effort, insufficient physical activity outside the work and limited health conductive life style, inadequate and rapidly lowering physical fitness, usually work at high speed and difficulties in controlling own situation. Therefore, special preventive programs indicating how to eliminate unhealthy behaviour and promote life style which reduces the risk of ischaemic heart disease should be developed.

Cardiac arrhythmia in women performing heavy physical work.

The objective of this work was to determine the response of the circulatory system to heavy physical work (the average energy expenditure was about 5000 kJ/shift). The tests were performed on a group of 35 women aged between 24 and 50 years, employed at a printing office as printing machine operators. The average length of employment for the group was 17 years (3-28 years). A 24-hour Holter ECG recording was taken on these women with the aid of an Oxford Medilog 3000 system. Before and after each recording, the arterial blood pressure was measured. Based on the ECG recordings, the heart rates during work, leisure time and sleep were calculated and the morphologies of the recordings were evaluated. In the group investigated, the abnormality in 24-hour ECG recordings classified as pathology, were found in 9 women within this group. Frequent ventricular premature beats (ExV) occurred in 3 women, ventricular bigeminy in 1 women, and single R/T excitations in 1 women. Frequent premature supraventricular extrasystols (ExSV) were found in 4 women, and within this number, in 1 woman both those heart rhythm disturbances were found. The heart rhythm disturbances occurred in connection with the performed physical task. Sinusal pauses were found in 2 women and A-V Mobitz II block was found in 1 women within the group investigated. Those changes occurred at night. No resting ECG changes were observed. The high frequency of occurrence of pathological changes in the group investigated indicates that the careful control of the state of the circulatory system in people performing heavy physical work is required.

Stress and strain during work among women performing different work tasks.

This study measured the association between the severity of work in occupations performed most frequently by women, workload (as relative aerobic strain and heart rate during work) and the reaction to work measured on the basis of changes after work in the subjective fatigue rating and working ability. The results indicate that there is no rational selection to individual work posts from the point of view severity of work and the level of physical working capacity. Nevertheless, it has been found that the heart rate during work was dependent on the severity of work and not the level of physical working capacity. A decrease of working ability after work was more frequent than an increased level of fatigue, but the work performed, the level of physical working capacity and the relative aerobic strain did not produce any significant differences in these parameters. Thus, the data presented above does not confirm the suggestion that people with a higher level of physical working capacity can engage a higher percentage of VO2max during working time. On the other hand, changes in the reaction to work, especially working ability changes, were significantly statistically dependent on the heart rate during work. Working ability was unquestionably worse when the heart rate during work exceeded 100 beats/min, 50% maximal heart rate or 30% heart rate reserve.