[Dance as a risk factor for injuries and development of occupational diseases]. / Ples kao cimbenik rizika za ozljede i razvoj profesionalnih bolesti.

Injuries and diseases can significantly affect the creativity and artistic performance. The link between working conditions and artistic performance had been recognised as early as the medieval age. Physically demanding performance arts such as dance can sometimes result in injuries, illnesses, inability to perform, and even end artist's career. Dancers are exposed to specific risks and in need of specific medical care. Many dancers often stretch their physical capabilities and endurance and neglect their physical limitations. Their health problems include a number of work-related illnesses that range from stress and stage fright to metabolic and nutritional disorders. They also include musculoskeletal injuries due to overload training that are often the beginning of chronic health problems.

Five-year cumulative incidence of unhealthy diet in adult Croatian population: the CroHort study.

This study investigated 5-year cumulative incidence of unhealthy dietary habits across various gender and age groups within the CroHort study, a repeated cross-sectional survey of Croatian adults. The results monitoring the frequency of certain foodstuffs consumption indicate that 10.6% of examinees (10.9% of men, and 9.1% of women) reported worsening of their dietary habits in 2008 as compared to 2003. The cumulative incidence of unhealthy diet was higher in men than in women, and was highest in younger age-groups (18-34 years), both in men and women. The public health programmes should be strengthened in a way which would put a special emphasis on education of younger adults, especially males, on nutrition health impact and healthy diet principles.

[Obesity--a public health problem and challenge]. / Pretilost--javnozdravstveni problem i izazov.

Obesity is a major health problem today that grows into a global epidemic. According to the World Health Organization report, 1.5 billion adults were overweight, over 500 million of them were obese, and the prevalence of obesity is expected to rise in the years to come. A similar situation is recorded in Croatia, where there are 25.3% of obese men and 34.1% of obese women. There are multiple factors that cause obesity. Accelerated lifestyle, fast food, unhealthy eating habits and sedentary lifestyle are considered as the major risk factors of overweight and obesity development. Accumulation of fat tissue, especially visceral fat tissue has been demonstrated to be associated with some chronic changes and diseases of different organ systems. Some anthropometric measurements, especially body mass index, waist circumference and waist-to-hip ratio, have been used to diagnose obesity and estimate the health risk. Developing well-structured prevention programs that would encourage people to become aware of obesity as a disease and that imbalanced dietary habits and physical activity are important for obesity prevention and health, is a major public health challenge.

Known symptoms and diseases of a number of classical European composers during 17th and 20th century in relation with their artistic musical expressions.

Medical history and relationship to the medical conditions as well as to the music creativity and productivity of some of the classical European composers have been described. In this review article we analyzed their illnesses as well as association between physical or mental diseases and their creativity and adaptability to disease. Some classical composers suffered from organic diseases, while others complained of mental disturbances. However, in spite of their disorders, the intensity of their creativity mostly remained unchanged.

[Using of household budget survey data for public health monitoring of dietary habits in Croatia--DAFNE initiative]. / Javnozdravstveni aspekt pracenja prehrambenih navika temeljem istrazivanja potrosnje u kucanstvima--inicijativa DAFNE.

AIM: The aim of the study was to determine mean food availability based on the data of national Household Budget Surveys (HBS) provided for the years 1999 and 2004, and also to identify the trends in dietary patterns of the Croatian population according to the Data Food Networking (DAFNE) procedure. SUBJECTS AND METHODS: The Croatian National Statistics Bureau conducted the first HBS survey in 1999 on the sample of 2937 households and the second in 2004 on 2847 households, respectively. Those two raw data sets together with the data on relevant socio-demographic characteristics: household locality, number of household members, education and occupation of the household head were sent to the DAFNE coordinating centre in Athens. A post-harmonisation of the raw data was performed according to DAFNE procedure. Further, data were statistically analysed and integrated into the DAFNE databank (DafneSoft). RESULTS: Average daily food availability per person/day for both surveyed years seems to be satisfying. However, a dietary pattern showed discrepancies between proposed dietary guidelines and consumption of some food items. In comparison with proposed daily intake of 400 grams or more of fruits and vegetables, an average availability is lower and accounts 343 grams in 1999 and 314 grams in 2004. Availability of fish and seafood is low (23-27 g) but in the same time daily availability of meat and meat products is high (181-186 g), especially regarding red meat. During the five year period a decreasing trend is evident for availability of most food items, including lipids and sugar products. The availability has increased only for nuts, fruit and vegetable juices. The differences in availability of certain food groups are evident amongst some socio-economic categories of households. In urban households the availability of milk products, fish, vegetables, fruit and fruit juices is higher than in rural households, as it is in households with higher educated in comparison to low educated household heads. The highest food availability is registered in households with one person. However, there is a general trend that the food quantities are lowering in households with a growing number of persons. CONCLUSION: The data of HBS harmonised and statistically analysed according to DAFNE methodology offers the possibility to monitor and compare dietary habits and trends in food availability on national level as well as across European countries. If the HBS data are properly expanded and exploited they could become valuable tool for planning national food and nutrition policy, development of national dietary guidelines, promotion of healthy eating, planning and implementation of public health interventions, and for many other positive features.

[Regional features of Croatian nutrition]. / Regionalne karakteristike prehrane u Hrvatskoj.

AIM: To investigate dietary habits and assess pertinent regional differences observed in different parts of the Republic of Croatia. Based on these results, to identify the geographical regions where inhabitants are at the highest risk of developing hypertension. SUBJECTS AND METHODS: The study was carried out in 2003, using a modified food consumption questionnaire (Croatian Health Survey, CHS 2003), and included a total of 9070 adults aged > or =18. The following six regions were investigated: mountainous, eastern, littoral, northern and central Croatia, and the City of Zagreb. The criterion used to establish diet-associated risk was the presence of at least one of the following variables: salting the food without tasting it first, regular consumption of dried meat products, and significant bread consumption ( > or =4 slices). The results pertinent to qualitative variables were expressed as frequencies. RESULTS: The analysis of dietary habits of the Croatian population revealed differences in the nutrition patterns customary for the investigated regions. The greatest number of subjects (>12.3%) adding salt to food without tasting it first were recorded in the mountainous and eastern regions, followed by the City of Zagreb (10.3%), while the lowest number of subjects with such a dietary pattern were found in northern region. The highest incidence of smoked meat product consumption was recorded in the mountainous (30.7%) and eastern (26.5%) regions, and lowest in the northern region (15.6%). The most common type of bread was wheat bread with the frequency of consumption ranging from 65% (City of Zagreb) to 90.5% (mountainous region). The highest daily consumption of bread (4 slices) was recorded in the littoral (58.7% of men and 28.3% of women). All major foodstuffs contain a substantial amount of salt, i.e., sodium, thus posing a risk for hypertension. Grouping of these foodstuffs according to the respective cardiovascular risk level revealed the population in east Croatia to be at the highest risk of developing hypertension, followed by the mountainous region population, whereas the population of northern Croatia and the City of Zagreb were at the lowest risk of hypertension. In addition, the subjects from the mountainous region and in particular those from the eastern region reported other unhealthy dietary patterns in terms of more common animal fat consumption, rare or only sporadic vegetable and fruit intake, more common use of cakes and sweets, and considerably greater coffee intake as compared with other study areas. CONCLUSION: Substantial consumption of salt and sodium-rich foodstuffs, typical of the nutrition traditionally used by the Croatian population, calls for continuous promotion of healthy diet, healthy lifestyle and respective education of the population at large.

[Reason for dietary salt reduction and potential effect on population health--WHO recommendation]. / Razlozi za smanjenje soli u prehrani i potencijalni ucinak na zdravlje populacije--preporuke Svjetske zdravstvene organizacije.

It is well known that reduction of salt results in lowering blood pressure and cardiovascular incidents. Daily salt is double the recommended daily quantity and mainly comes from processed food. The assessment of daily salt intake for Croatia is 12 g/day (WHO recommendation is <5 g/day). The main source of sodium is processed food and food prepared in restaurants (77%), natural content of sodium in food (12%), added salt at table (6%) and prepared meals at home (5%). Reduction of salt by 50% would save nearly 180,000 lives per year in Europe. It is necessary to establish better collaboration with food manufacturers in order to reduce the content of salt in processed food and to achieve appropriate salt intake per day in accordance with the WHO recommendation. Further, it is necessary to encourage food manufacturers to produce food and meals with low or reduced salt content (shops, catering, changes in recipes, offer salt substitutions). This kind of collaboration is based on bilateral interests that can result in positive health effects. One of the most important public health tasks is to educate consumers and to give them choice when buying food. This can be achieved by effective campaigns and social marketing, by ensuring a declaration of salt content on the product, or specially designed signs for food products with low or reduced salt content.

Differences in eating and lifestyle habits between first- and sixth-year medical students from Zagreb.

Eating and lifestyle habits of first (n=169) and sixth (n=272) year students, aged 18 to 26 years, attending a Medical School in Zagreb, were compared related to the years of study. A self-administered questionnaire created for this study incorporated a food frequency questionnaire. Both year students reported similar number of meals per day, irregular consumption of meals, skipping breakfast, frequency of vegetables, fruits, cereals, sweets, milk and dairy products consumption, body mass index (BMI) calculated from self-reported weight and height and alcohol consumption. Significant differences between groups were observed in consuming supper (p = 0.001), being on diet (p = 0.032), intake of supplements (p = 0.041), meat (p < 0.001), dried meat (p = 0.027), coffee and tea consumption (p = 0.016), physical activity (p = 0.041; p = 0.016), and smoking (p = 0.029). This study showed non-healthy eating arid lifestyle behavior among Medical School students. We observed association between the year of study, and some of the eating habits and lifestyle factors.

[Human lifespan: to live and outlive 100 years?]. / Ljudski vijek: dozivjeti i nadzivjeti 100 godina?

Aged population dominates in developed countries. Centenarians are a select group, and only one in 7,000 to 10,000 reach that age. Factors of longevity are numerous and include genetic predisposition (a locus on chromosome 4), environment, healthy lifestyle (hypocaloric diet, regular physical and mental exercise), accessible health services, and efficient health protection at old age. Centenarians are well adapted to the new life and compensate for the loss of functions with age. The limits of human life are extended, so that nowadays the oldest person has reached the age of 128. Some geographic areas are characterised by higher numbers of centenarians. This article mentions a few individuals who outlived 100 years in the world, Croatia, and neighbouring countries. Although some argue that the limits of human life cannot be extended over the age of 120 years, for now we cannot predict the actual limits of human life.

Regional differences in dietary habits of adult Croatian population.

The aim of this study was to investigate the dietary habits of the adult Croatian population according to geographical regions and gender. Date was obtained from the Croatian Adult Health Survey questionnaire, carried out in six regions of Republic of Croatia (Eastern, Northern, Central, City of Zagreb, Mountainous and Coastal), with a total of 9,070 responses. Results have shown that the highest prevalence of unhealthy dietary habits was recorded in Eastern and Central regions, while Coastal region and city of Zagreb had significantly lower prevalence of unhealthy dietary habits (P < 0.05). Prevalence of unhealthy dietary habits was higher in men in all regions. Women had healthier dietary habits, what was strongly expressed in Coastal and Mountainous region. This study has shown that the unhealthy dietary habits were practiced by approximately one quarter of the adult population, regardless on the region in which they resided. Regional differences in dietary habits should be taken into account in any new public health studies and interventions.

Respiratory function in wind instrument players.

BACKGROUND: The playing of wind instruments has been associated with changes in respiratory function. STUDY OBJECTIVES: To investigate the effect of playing wind instruments on lung function and respiratory symptoms. METHODS: The present study included 99 wind instrument players and a group of 41 string instrument players as a control from 3 major orchestras in Zagreb, Croatia. Data on chronic respiratory symptoms were recorded in all studied subjects. Lung function was measured in wind instrument players by recording maximum expiratory flow-volume curves. RESULTS: Wind instrument players demonstrated significantly higher prevalences of sinusitis, nasal catarrh and hoarseness compared to control musicians. One wind instrument player developed asthma associated with his work. Odds ratios for wind instrument players were significant for chronic cough, chronic phlegm and chronic bronchitis by smoking habit (p<0.05 or p<0.01) but not for length of employment. Ventilatory capacity data indicate that wind instrument players had significantly greater FEV1 (smokers and nonsmokers) as well as FEF50 (nonsmokers) (p<0.05) compared to predicted values. Regression analysis of pulmonary function tests in wind instrument players demonstrate a significant link between FEV1 and FEF50 and length of employment. Those wind instrument players with longer employment had the greatest increases in lung function. CONCLUSIONS: Our data suggest that musicians playing wind instruments may be susceptible to chronic upper airway symptoms. Interestingly wind instrument playing may be associated with higher than expected lung function parameters.

Gender and respiratory findings in workers occupationally exposed to organic aerosols: a meta analysis of 12 cross-sectional studies.

BACKGROUND: Gender related differences in respiratory disease have been documented. The aim of this study was to investigate gender related differences in respiratory findings by occupation. We analyzed data from 12 of our previously published studies. METHODS: Three thousand and eleven (3011) workers employed in "organic dust" industries (1379 female and 1632 male) were studied. A control group of 806 workers not exposed to any kind of dust were also investigated (male = 419, female = 387). Acute and chronic respiratory symptoms and lung function were measured. The weighted average method and the Mantel-Haentszel method were used to calculate the odds ratios of symptoms. Hedge's unbiased estimations were used to measure lung function differences between men and women. RESULTS: There were high prevalences of acute and chronic respiratory symptoms in all the "dusty" studied groups compared to controls. Significantly less chronic cough, chronic phlegm as well as chronic bronchitis were found among women than among men after the adjustments for smoking, age and duration of employment. Upper respiratory tract symptoms by contrast were more frequent in women than in men in these groups. Significant gender related lung function differences occurred in the textile industry but not in the food processing industry or among farmers. CONCLUSION: The results of this study suggest that in industries processing organic compounds there are gender differences in respiratory symptoms and lung function in exposed workers. Whether these findings represent true physiologic gender differences, gender specific workplace exposures or other undefined gender variables not defined in this study cannot be determined. These data do not suggest that special limitations for women are warranted for respiratory health reasons in these industries, but the issue of upper respiratory irritation and disease warrants further study.

Women in medicine through the ages.

BACKGROUND: Female practitioners of the medical arts have been active since the ancient world The role of women in science, and particularly in medicine, has changed significantly over time. METHODS: We provide a chronological review of the growing knowledge in medicine related to women's activities through the ages with particular attention to occupational medicine. Throughout history hazards have been shaped by the forces that shape work itself social evolution, shifting economic powers and demographic changes. RESULTS: Mythical Greece, Egypt and ancient Rome were the cradle of ancient medicine. In the past century, women were allowed to enter the medical profession with increasing acceptance. Some of the most important women in ancient and modern medicine are recalled, such as Mother Peseshet in ancient Egypt, Artemisia of Caria and Phanostrate and Philista in the Greek period, Hildegard of Bingen, Marie Marguerite Biheron in England, Elisabeth Blackwell, Emily Jennings, Maude E. Abbott and others. Women in occupational medicine are described separately, such as Alice Hamilton, Harriet L. Hardy, Molly Newhouse and Olga Macek. CONCLUSIONS: Certainly, the first few women who iluminated the way for the generations that followed them into medicine, the women who made outstanding contributions to medicine, and the women who are currently finding success in medicine deserve our respect and admiration.

[Causes of climatic changes and their consequences on human health]. / Uzroci klimatskih promjena i njihove posljedice za zdravlje covjeka.

Environmental disasters are common phenomena caused by human factors. Disaster episodes may be the result of climatic changes such as global warming, which can lead to floods or drought. Greenhouse gases, and especially the ozone, represent a special problem. Atmospheric pollutions are the result of fire, storm dusts, winds, acid rain, etc. Underwater earthquakes very often end in tsunami with waves of up to 30 meters. Disasters described in the territory of Croatia include atmospheric pollutions, fires, floods, and droughts. All disasters affect the health of the population, particularly of the elderly. This most often includes the cardiovascular and respiratory systems, allergic reactions, and carcinogenic effects, resulting in increased mortality.

Ancient medicine--a review.

Different aspects of medicine and/or healing in several societies are presented. In the ancient times as well as today medicine has been closely related to magic, science and religion. Various ancient societies and cultures had developed different views of medicine. It was believed that a human being has two bodies: a visible body that belongs to the earth and an invisible body of heaven. In the earliest prehistoric days, a different kind of medicine was practiced in countries such as Egypt, Greece, Rome, Mesopotamia, India, Tibet, China, and others. In those countries, "medicine people" practiced medicine from the magic to modern physical practices. Medicine was magical and mythological, and diseases were attributed mostly to the supernatural forces. The foundation of modern medicine can be traced back to ancient Greeks. Tibetan culture, for instance, even today, combines spiritual and practical medicine. Chinese medicine developed as a concept of yin and yang, acupuncture and acupressure, and it has even been used in the modern medicine. During medieval Europe, major universities and medical schools were established. In the ancient time, before hospitals had developed, patients were treated mostly in temples.

[Effects of volcanic eruptions on environment and health]. / Ucinci vulkanskih erupcija na okolis i zdravlje.

Volcanoes pose a threat to almost half a billion people; today there are approximately 500 active volcanoes on Earth, and every year there are 10 to 40 volcanic eruptions. Volcanic eruptions produce hazardous effects for the environment, climate, and the health of the exposed persons, and are associated with the deterioration of social and economic conditions. Along with magma and steam (H2O), the following gases surface in the environment: carbon dioxide (CO2) and sulphur dioxide (SO2), carbon monoxide (CO), hydrogen sulphide (H2S), carbon sulphide (CS), carbon disulfide (CS2), hydrogen chloride (HCl), hydrogen (H2), methane (CH4), hydrogen fluoride (HF), hydrogen bromide (HBr) and various organic compounds, as well as heavy metals (mercury, lead, gold).Their unfavourable effects depend on the distance from a volcano, on magma viscosity, and on gas concentrations. The hazards closer to the volcano include pyroclastic flows, flows of mud, gases and steam, earthquakes, blasts of air, and tsunamis. Among the hazards in distant areas are the effects of toxic volcanic ashes and problems of the respiratory system, eyes and skin, as well as psychological effects, injuries, transport and communication problems, waste disposal and water supplies issues, collapse of buildings and power outage. Further effects are the deterioration of water quality, fewer periods of rain, crop damages, and the destruction of vegetation. During volcanic eruptions and their immediate aftermath, increased respiratory system morbidity has been observed as well as mortality among those affected by volcanic eruptions. Unfavourable health effects could partly be prevented by timely application of safety measures.

Occupational health hazards of artists.

Artists may be exposed to a variety of potentially noxious materials. The modern techniques they use imply exposure to environmental hazards. Occupational health was evaluated in individuals engaged in different arts such as sculpture, painting, printmaking, restoration photography, glass-work and ceramics, because of exposure to toxic chemicals in art materials, tools and methods used in their work. This evaluation demonstrated that artists sustain extensive exposure to toxic substances similar to occupational exposure of workers in different industrial settings. Hazards for artists are numerous and therefore it is important to identify the noxious materials and techniques used. Preventive measures should include basic safety, precautions, education and preventive medical surveillance.

[Dietary habits: Croatian health survey]. / Prehrambene navike--hrvatska zdravstvena anketa.

OBJECTIVE: To examine dietary habits and to determine the presence of possible regional differences in Croatia. SUBJECTS AND METHODS: Survey was performed during 2003 by means of modified food frequency questionnaire. Survey included randomly selected 9070 adult examinees at the age of 18 and above in the whole Croatia. The SPSS program using weighted database was used for statistical analysis. RESULTS: Obtained data indicate existing significant differences in dietary habits at county and regional level in nutrition of the Croatian population. There is a tendency toward grouping as much unhealthy dietary habits as healthy by certain counties, respectively regions. Population of the Eastern and Northern regions (except of the Medjimurska County) living in the counties of Vukovarsko-srijemska, Koprivnicko-krizevacka, Pozesko-slavonska and Viroviticko-podravska in comparison to population of other counties, respectively regions, significantly more often use animal fats, add salt to foods, consume less fruit and vegetables, eat more cakes, sweets and cured meat products. The observed characteristics are considered risk factors for development of cardiovascular diseases and other chronic non-communicable diseases. Population of the Southern and Western regions, in the counties of Primorsko-goranska, Istarska, Zadarska, Dubrovacko-neretvanska, but also in Medjimurska County, significantly more often use vegetable oils; they also on daily basis consume more often fruit and vegetables, less frequent or rarely add salt and consume sweets and cakes. Differences are also observed in dietary habits between genders, but also within the same sex in certain counties. CONCLUSIONS: Indicators of the present nutrition of the population show regional dietary differences. It is important to point out a need for broader education of general public regarding the impact of diet on health, principles of healthy nutrition, and promotion of comparative advantages of the Mediterranean diet as a prototype of healthy nutrition.

[Relationship of regional alcohol drinking habit and cardiovascular risk factors in Croatia]. / Usporedba regionalne potrosnje alkoholnih pica i kardiovaskularnih cimbenika rizika u Hrvatskoj.

AIM: The aim was to investigate regional distribution of drinking habit and its relation to the prevalence of cardiovascular risk factors. SUBJECTS AND METHODS: Nine thousand and seventy participants older than 18 questioned during THE 2003 Croatian health Survey were analyzed and weighted data extrapolated to the adult Croatian population. Study group included subjects reporting regular intake of any type of alcohol drink (liquor, wine or beer) during the past year. Alcohol abstainers surved as a control group. RESULTS: The highest prevalence of alcohol drinking was recorded in south Croatia (32.3%, n= 215529). Alcohol drinkers were mostly men (72%). In all Croatian regions there was a rather uniform distribution of liquor drinking (6-7 glasses, 0.033 L per day). Subjects from west Croatia and the City of Zagreb mostly reported drinking wine (4-5 glasses, 0.2 L per day). A mixture of wine and water predominated in south and north Croatia (7 glasses, 0.2 L per day), whereas subjects that mainly took beer were from east and central Croatia (10 bottles, 0.33 L per day). The highest prevalence of arterial hypertension (56.6%) was found in regular alcohol drinkers from west Croatia. The highest prevalence of acute myocardial infarction (6.7-7.0%) and angina pectoris (8.2-8.6%) was observed in subjects from northn Croatia and the City of Zagreb. However, the occurrence of acute myocardial infarction was more common in regular alcohol drinkers, and of angina in abstainers. The lowest prevalence of acute myocardial infarction was recorded in regular drinkers from central Croatia (1.4%). The prevalence of stroke was generally lower in regular drinkers, with lowest prevalence in west Croatia (0.9%). CONCLUSION: Drinking habit varies among regions of the Republic of Croatia, according to the prevalence, quantity and type of alcohol beverage, and so does the distribution of cardiovascular risk factors. On comparing regional distribution of cardiovascular risk factors between regular consumers and abstainers we observed a divergent influence of alcohol consumption, especially on the occurrence of arterial hypertension and stroke.

Body mass index and nutrition as determinants of health and disease in population of Croatian Adriatic islands.

AIM: To investigate the relationships between body mass index (BMI), dietary habits, and cardiovascular risk factors in isolated Adriatic island populations of Croatia. METHODS: Random sample of subjects (n=1001) was interviewed, using a validated questionnaire developed for this research program. Dietary habits were assessed on the basis of applied Food Frequency Questionnaire (FFQ). Biochemical analyses of total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, and blood glucose were performed. Blood pressure (mm Hg), height (m), and weight (kg) were measured following standard procedures. RESULTS: Out of 1001 study participants, 507 (50.7%) were overweight (247 [48.7%] men and 260 [51.3%] women), whereas 268 (26.8%) were obese (122 [45.5%] men and 146 [54.5%] women). In both genders, there was a positive correlation between body mass index (BMI) and levels of triglycerides (P<0.001), glucose (P<0.001), diastolic blood pressure (P<0.001), and systolic blood pressure (male: P=0.002, female: P<0.001). Logistic regression showed that female gender (OR, 2.31; 95% CI, 1.61-3.31), overweight (OR, 1.97; 95% CI, 1.34-2.88), obesity (OR, 1.90; 95% CI, 1.22-2.96), more frequent consumption of meat (OR 1.17; 95% CI, 1.06-1.30) and beer (OR 1.14; 95% CI, 1.03-1.27), and less frequent consumption of potatoes (OR 0.91; 95% CI, 0.83-0.99) were predictive for the presence of cardiovascular risk factors. CONCLUSION: Prevalence of obesity and related health outcomes was surprisingly high for the studied population. We found a correlation between BMI, dietary habits, and cardiovascular risk factors.