A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis

BACKGROUND

Maternal smoking during pregnancy is linked to reduced birth weight but the gestation at onset of this relationship is not certain. We present a systematic review of the literature describing associations between maternal smoking during pregnancy and ultrasound measurements of fetal size, together with an accompanying meta-analysis.

METHODS

Studies were selected from electronic databases (OVID, EMBASE and Google Scholar) that examined associations between maternal smoking or smoke exposure and antenatal fetal ultrasound measurements. Outcome measures were first, second or third trimester fetal measurements.

RESULTS

There were 284 abstracts identified, 16 papers were included in the review and the meta-analysis included data from eight populations. Maternal smoking was associated with reduced second trimester head size (mean reduction 0.09 standard deviation (SD) [95% CI 0.01, 0.16]) and femur length (0.06 [0.01, 0.10]) and reduced third trimester head size (0.18 SD [0.13, 0.23]), femur length (0.27 SD [0.21, 0.32]) and estimated fetal weight (0.18 SD [0.11, 0.24]). Higher maternal cigarette consumption was associated with a lower z score for head size in the second (mean difference 0.09 SD [0, 0.19]) and third (0.15 SD [0.03, 0.26]) trimesters compared to lower consumption. Fetal measurements were not reduced for those whose mothers quit before or after becoming pregnant compared to mothers who had never smoked.

CONCLUSIONS

Maternal smoking during pregnancy is associated with reduced fetal measurements after the first trimester, particularly reduced head size and femur length. These effects may be attenuated if mothers quit or reduce cigarette consumption during pregnancy.

Endotoxin exposure and changes in short-term pulmonary function among sewage workers

OBJECTIVES

The inhaled endotoxin is considered as a causative factor in the process of acute bronchial obstruction, which can be measured by a decrease in forced expiratory volume in 1 s (FEV1). The aim of this study was to assess endotoxin exposure among sewage treatment plant workers (STPW) and its effect on across-shift changes in respiratory airflow.

MATERIAL AND METHODS

A group of 78 STPW from a large sewage treatment plant was studied. Inhalable dust for endotoxin assessment was collected using personal aerosol samplers. Endotoxin was assayed with the kinetic, chromogenic Limulus amebocyte lysate test. Across-shift spirometric measurements were performed on Mondays, after 2-days absence from work, with the use of portable spirometer. The forced vital capacity (FVC), and FEV1 parameters were analyzed. Multifactor regression modeling was performed to determine parameters significantly associated with endotoxin exposure.

RESULTS

The concentration of inhalable dust and endotoxin ranged from 0.01-1.38 mg/m3 and 0.68-214 endotoxin units per cubic meter of air (EU/m3), respectively. Endotoxins were characterized with the skewed distribution (arithmetic mean (AM) = 38.8 EU/m3, geometric mean (GM) = 15.4 EU/m3, geometric standard deviation (GSD) = 4.21). Through the use of multifactor analysis, which excluded the main confounders (inhalable dust and smoking habit) it was found that, despite low levels of endotoxin, it had significant impact on the observed across-shift decline in FEV1 (p = 0.044). For this parameter, the regression slope was additionally calculated (r = -0.017, p = 0.071).

CONCLUSIONS

Relatively low levels of endotoxin among sewage treatment plant workers may cause small, but significant across-shift declines in FEV1. The observed relationship was independent of organic dust concentrations and smoking habit. The respiratory protection should be provided for STPW.

Predictors of short- and long-term sickness absence in female post office workers in Poland

BACKGROUND

The aim of this study was to highlight major predictors of the frequency of sickness absence in a group of workers directly involved in customer service.

MATERIAL AND METHODS

The study was carried out on a random sample of 229 women employed as assistants and clerks in post offices. The survey was based on the Subjective Work, Health Status and Life Style Characteristics Questionnaire, and sickness absence data for the years 2004-2006.

RESULTS

The negative binominal regression model of sickness absence risk revealed the following significant predictors of short-term absence spells (1-29 days): 1) marital status, sickness absence risk for single women was (rate ratio (RR)) = 1.56 (95% confidence interval (CI): 1.01-2.39) vs. married women; 2) post offices employing 7 workers had a rate ratio of sickness absence of 1.6 (95% CI: 1.04-2.42); 13-25 workers - RR = 2.03 (95% CI: 1.41-2.93); > 25 workers - RR = 1.82 (95% CI: 1.15-2.88) compared with an average number of 8-12 workers; 3) shift work, RR = 1.57 (95% CI: 1.14-2.14); 4) breaks from work - the risk of absence in the case of any breaks amounted to RR = 1.5 (95% CI: 1.07-2.07) in comparison with the statutory breaks; 5) self-rated health reported as moderate relative to good health, RR = 1.71 (95% CI: 1.26-2.32); and 6) occurrence of respiratory diseases resulted in the risk of RR = 1.51 (95% CI: 1.08-2.08). The Poisson regression model of long-term sickness absence spells (≥ 30 days) revealed the following significant predictors: 1) number of clients per shift: 51-100 clients, RR = 3.62 (95% CI: 1.07-22.6) compared with a lower number of clients; 2) self-rated health, assessed as moderate, RR = 1.97 (95% CI: 1.06-3.78) and 3) household chores performed for at least 4 h a day, RR = 0.4 (95% CI: 0.18-0.79).

CONCLUSIONS

Association between sickness absence and workload as well as work organization indicates directions of corrective actions, which could reduce the scale of the problem.

Exposure to widespread environmental endocrine disrupting chemicals and human sperm sex ratio

In recent years, a trend toward a declining proportion of male births has been noted in several, but not all, industrialized countries. The underlying reason for the drop in the sex ratio is unclear, but one theory states that widespread environmental endocrine disrupting chemicals affecting the male reproductive system in a negative manner could be part of the explanation. The present study was designed to investigate whether the urinary phthalate, pyrethroids and polycyclic aromatic hydrocarbons metabolites concentrations were associated with sperm Y:X ratio. The study population consisted of 194 men aged under 45 years of age who attended infertility clinic in Lodz, Poland for diagnostic purposes with normal semen concentration of 20-300 mln/ml or with slight oligozoospermia (semen concentration of 15-20 mln/ml) (WHO, 1999). The Y:X ratio was assessed by fluorescent in situ hybridization. Urinary concentrations of 1-hydroxypyrene were measured by high performance liquid chromatography, phthalate metabolites were analyzed using a procedure based on the LC-MS/MS methods and metabolites of synthetic pyrethroids were assessed by gas chromatography ion-tap mass spectrometry method. After adjustment for potential confounders (past diseases, age, abstinence, smoking, alcohol consumption, sperm concentration, motility, morphology) 5OH MEHP, CDCCA to TDCCA and 1-OHP was negatively related to Y:X sperm chromosome ratio (p = 0.033, p < 0.001, p = 0.047 respectively). As this is the first study to elucidate the association between the level of metabolites of widespread environmental endocrine disrupting chemicals (phthalates, synthetic pyrethroids, polycyclic aromatic hydrocarbons) on sex chromosome ratio in sperm therefore, these findings require further replication in other populations.

Dietary Patterns and Their Relationship With Semen Quality

Diet is a complex exposure variable, which calls for multiple approaches to examine the relationship between diet and disease risk. To address these issues, several authors have recently proposed studying overall dietary patterns by considering how foods and nutrients are consumed in combinations. The aim of the study was to investigate the associations between dietary patterns, semen quality parameters, and the level of reproductive hormones. The study population consisted of 336 men who attended the infertility clinic for diagnostic purposes and who had normal semen concentration of 20 to 300 mln/ml or slight oligozoospermia (semen concentration of 15-20 mln/ml). Participants were interviewed, and a semen sample was provided by them. Diet was assessed via food frequency questionnaire, and dietary patterns were identified by factor analysis. Men were classified into three groups according to scores of each dietary pattern: Western, Mixed, or Prudent. A positive association was observed between sperm concentration and Prudent dietary pattern, and level of testosterone and Prudent dietary pattern ( p = .05, p = .03, respectively). Additionally, Prudent dietary pattern was identified to decrease the DNA fragmentation index ( p = .05). The results were adjusted for sexual abstinence, age, smoking, past diseases, and alcohol consumption. Higher consumption of a Prudent dietary pattern was associated with higher sperm concentration and higher level of testosterone. Sperm chromatin structure was inversely related to higher consumption of a Prudent dietary pattern. Further research is needed to confirm these findings and extend these results to other populations.

Exposure to ambient air pollution--does it affect semen quality and the level of reproductive hormones?

BACKGROUND

Ambient air pollution has been associated with a variety of reproductive disorders. However, a limited amount of research has been conducted to examine the association between air pollution and male reproductive outcomes, specifically semen quality.

AIM

The present study was designed to address the hypothesis that exposure to fluctuating levels of specific air pollutants adversely affects sperm parameters and the level of reproductive hormones.

SUBJECTS AND METHODS

The study population consisted of 327 men who were attending an infertility clinic in Łodź, Poland for diagnostic purposes and who had normal semen concentration of 15-300 mln/ml. All participants were interviewed and provided a semen sample. Air quality data were obtained from AirBase database.

RESULTS

The statistically significant association was observed between abnormalities in sperm morphology and exposure to all examined air pollutants (PM10, PM2.5, SO2, NOX, CO). Exposure to air pollutants (PM10, PM2.5, CO, NOx) was also negatively associated with the level of testosterone. Additional exposure to PM2.5, PM10 increase the percentage of cells with immature chromatin (HDS).

CONCLUSIONS

The present study provides suggestive evidence of an association between ambient air pollution and sperm quality. Further research is needed to explore this association in more detail. Individual precise exposure assessment would be needed for more detailed risk characterization.

Association of Rotating Night Shift Work with BMI and Abdominal Obesity among Nurses and Midwives

BACKGROUND

Mounting epidemiological evidence suggests that night shift work may contribute to the etiology of increased body weight. The present study aimed to examine association between rotating night shift work and body mass index (BMI), and abdominal adiposity respectively among nurses and midwives.

METHODS

A cross-sectional study was conducted among 724 female nurses and midwives, aged 40-60 years (354 rotating night shift and 370 daytime workers) in Łódź, Poland, between 2008 and 2011. Information about occupational history and potential confounders was collected during personal interviews. Anthropometric measurements of body weight, height, waist (WC) and hip (HC) circumference were made, and body mass index (BMI), waist to hip ratio (WHR) and waist to height ratio (WHtR) were calculated. GLM regression models and multinomial logit regression models were fitted to explore the association between night shift work and anthropometric parameters, with adjustment for age, body silhouette at age 20, current smoking status, packyears, marital status, and menopausal hormone therapy use.

RESULTS

Cumulative night shift work showed significant associations with BMI, WC, HC and WHtR, with BMI increasing by 0.477 kg/m2 per 1000 night duties and by 0.432 kg/m2 per 10000 night shift hours, WC increasing respectively by 1.089 cm and 0.99 cm, and HC by 0.72 cm and WHtR by 0.007 cm for both metrics. Both current and cumulative night work was associated with obesity (BMI≥30kg/m2), with OR=3.9 (95%CI:1.5-9.9), in women reporting eight or more night shifts per month.

CONCLUSION

The results of the study support the previously reported relations between night shift work and development of obesity.

The association between environmental exposure to pyrethroids and sperm aneuploidy

The aim of the present study is to determine whether the environmental exposure to pyrethroids was associated with males sperm chromosome disomy. The study population consisted of 195 men who attended the infertility clinic for diagnostic purposes and who had normal semen concentration of 20-300×10(6) mL(-1) or slight oligozoospermia (semen concentration of 15-20×10(6) mL(-1)) (WHO, 1999). Participants were interviewed and provided a semen sample. The pyrethroids metabolites: 3-phenoxybenzoic acid (3PBA), cis-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (CDCCA), trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (TDCCA) and cis-2,2-dibromovinyl-2,2-dimethylcyclopropane-1-carboxylic acid (DBCA) were analysed in the urine using a validated gas chromatography ion-tap mass spectrometry method. Sperm aneuploidy was assessed using multicolor FISH (DNA probes specific for chromosomes X, Y, 18, 13, 21). Our results showed that CDCCA >50th percentile was associated with disomy of chromosome 18 (p=0.05) whereas the level of TDCCA in urine >50th percentile was related to XY disomy (p=0.04) and disomy of chromosome 21 (p=0.05). Urinary 3PBA level ⩽50 and >50 percentile was related to disomy of sex chromosomes: XY disomy (p=0.05 and p=0.02 respectively), Y disomy (p=0.04 and 0.02 respectively), disomy of chromosome 21 (p=0.04 and p=0.04 respectively) and total disomy (p=0.03 and p=0.04 respectively). Additionally disomy of chromosome 18 was positively associated with urinary level of 3PBA >50 percentile (p=0.03). The results reported here are found that pyrethroids may be a sperm aneugens. These findings may be of concern due to increased pyrethroid use and prevalent human exposure.

Maternal lifestyle during pregnancy and child psychomotor development - Polish Mother and Child Cohort study

BACKGROUND

Nowadays special attention is paid to prenatal exposures to maternal lifestyle factors and their impact on a child development.

AIM

The objective of this study was to evaluate the impact of modifiable maternal lifestyle factors on child neurodevelopment based on the Polish Mother and Child Cohort study.

MATERIAL AND METHODS

The current analysis included 538 mother-child pairs. The following factors related to maternal lifestyle were considered: smoking and environmental tobacco smoke (ETS) exposure (based on the cotinine level in maternal saliva measured using LC-ESI+MS/MS method), alcohol consumption and leisure-time physical activity (LTPA) in pregnancy, pre-pregnancy BMI, and folic acid supplementations before and during pregnancy based on questionnaire data. Psychomotor development was assessed in children at the ages of one and two by the Bayley Scales of Infant and Toddler Development.

RESULTS

Significant association was observed between prenatal exposure to tobacco constituents and a decreased child motor development in assessments performed at both ages (β=-0.8, p=0.01; β=-1.4, p<0.001). Maternal pre-pregnancy underweight was associated with decreased language abilities at 12 months of age (β=-5.2, p=0.01) and cognitive and motor development at 24 months of age, for which the associations were of borderline significance (p=0.06). The recommended level of LTPA during pregnancy was beneficial for child language development at two years of age (β=4.8, p=0.02). For alcohol and folic acid consumption there were no significant associations with any of the analyzed domains of child neurodevelopment.

CONCLUSIONS

Children prenatally exposed to tobacco compounds and those of underweight mothers had a decreased psychomotor development. The recommended level of LTPA during pregnancy had positive impact on child development. These results underscore the importance of policies and public health interventions promoting healthy lifestyle among women in reproductive age and during pregnancy.

Human sperm aneuploidy after exposure to polycyclic aromatic hydrocarbons

The purpose of this cross-sectional study was to investigate whether environmental exposure to polycyclic aromatic hydrocarbons (PAHs) was associated with sperm aneuploidy. A sample of 181 men who attended an infertility clinic for diagnostic purposes and who had a normal semen concentration of 20-300×106 spermatozoa mL-1 or slight oligozoospermia (semen concentration of 15-20×106 spermatozoa mL-1; Collapse

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[Occupational diseases in Poland in 2013 and their causative agents]

BACKGROUND

The paper presents the incidence of occupational diseases in Poland (2013).

MATERIAL AND METHODS

Occupational disease reporting forms, supplied to the Central Register of Occupational Diseases, were used as the study material. The incidence was specified in terms of rates per 100 000 employed people.

RESULTS

The number of new cases was 2214 with the incidence rate of 15.6. The downward trend recorded over several years continues; compared to 2012, the number of new cases decreased by 7.8%. Exposure to dusts (35% cases), mostly inorganic (carbon, asbestos, and industrial dusts containing free crystalline silica) was the most common cause of occupational diseases. Among the organic dusts allergenic effects of flour and vegetable dusts predominated. Every 3rd case of occupational disease was attributable to physical agents, mainly the way the work is done, excessive vocal effort and noise. The sections of national economy with the highest incidence comprised mining and quarrying (271.1), manufacturing (24.3), education (22.4), agriculture, forestry, hunting and fishing (21.0), human health and social assistance (20.5).

CONCLUSIONS

The decreased incidence of 'traditional' diseases observed over the recent 15 years and the analysis of the 2013 incidence indicate a need to revise the Polish list of occupational diseases by exposures found in the modern work environment. Particular attention should be paid to conditions prevailing in workplaces with high exposures to industrial dusts containing free crystalline silica. A considerable variation in the incidence of voice disorders in teachers between individual voivodeships (provinces) points to the need for harmonization of the standards of preventive, diagnostic and certification procedures.

The relationship between exposure to air pollution and sperm disomy

The causes of the chromosome abnormalities have been studied for decades. It has been suggested that exposure to various environmental agents can induce chromosomal abnormalities in germ cells. This study was designed to address the hypothesis that exposure to specific air pollutants increases sperm disomy. The study population consisted of 212 men who were attending an infertility clinic for diagnostic purposes. They represented a subset of men in a multicenter parent study conducted in Poland to evaluate environmental factors and male fertility. Sperm aneuploidy for chromosomes 13, 18, 21, X, and Y was assessed using multicolor fluorescence in situ hybridization. Air quality data were obtained from the AirBase database. After adjusting for age, smoking, alcohol consumption, temperature (90 days), season, past diseases, abstinence interval, distance from the monitoring station, concentration, motility and morphology, positive associations were observed between exposure to PM2.5 and disomy Y (P = 0.001), sex chromosome disomy (P = 0.05) and disomy 21 (P = 0.03). Exposure to PM10 was associated with disomy 21 (P = 0.02). Conversely, exposure to ozone, CO, SO2, and NOx did not affect sperm aneuploidy. A separate analysis conducted among men who were nonsmokers (n = 117) showed that the relationship between PM2.5 and disomy Y and disomy 21 remained significant (P = 0.01, P = 0.05, respectively). The present findings indicate that exposure to air pollution induces sperm aneuploidy.

Asbestos related diseases among workers of asbestos processing plants in relation to type of production and asbestos use

BACKGROUND

Asbestos dust is one of the most dangerous pneumoconiotic and carcinogenic agents. The aim of this study was to assess the occurrence of asbestosis and pleural mesothelioma, depending on asbestos consumption and the type of manufactured products, among former asbestos workers in Poland.

MATERIAL AND METHODS

The study subjects included employees of 18 large state-owned asbestos processing enterprises operating in the Polish market in 1945-1998. The study is based on data obtained from asbestos company records and the Central Register of Occupational Diseases data on the cases of asbestosis and mesothelioma for the period from 1970 till 2012 as well as data from Amiantus Programme. The analysis was performed for 5 sectors comprising plants classified according to the products manufactured and applied production technology.

RESULTS

In the study period, 2160 cases of asbestosis and 138 cases of mesothelioma were reported. The plants processed a total of about 2 million tons of asbestos, including about 7.5% of crocidolite. Total asbestosis consumption was a strong predictor of the rate of asbestosis incidence (R2 = 0.68, p = 0.055). The highest risk occurrence of asbestosis was observed in the production of textiles and sealing products. Mesothelioma occurred only in plants where crocidolite had been ever processed.

CONCLUSIONS

Total asbestos consumption was a strong predictor of the rate of asbestosis incidence. The observation confirms the relationship between exposure to crocidolite and the occurrence of mesothelioma, regardless of the manufactured products, and suggests the absence of such a link for the total volume of asbestos consumption.

The effect of environmental exposure to pyrethroids and DNA damage in human sperm

The present study was designed to investigate whether environmental exposure to pyrethroids was associated with sperm DNA damage. Between January 2008 and April 2011 286 men under 45 years of age with a normal sperm concentration of 15-300 10(6)/ml [WHO 2010] were recruited from an infertility clinic in Lodz, Poland. Participants were interviewed and provided urine, saliva, and semen samples. The pyrethroids metabolites: 3-phenoxybenzoic acid (3PBA), cis-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (CDCCA), trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (TDCCA), and cis-2,2-dibromovinyl-2,2-dimethylcyclopropane-carboxylic acid (DBCA) were analyzed in the urine using a validated gas chromatography ion-tap mass spectrometry method. Sperm DNA damage was assessed using a flow cytometry based on sperm chromatin structure assay (SCSA). A positive association was observed between CDCCA >50th percentile and the percentage of medium DNA fragmentation index (M DFI) and percentage of immature sperms (HDS) (p = 0.04, p = 0.04 respectively). The level of 3PBA >50th percentile in urine was positively related to the percentage of high DNA fragmentation index (H DFI) (p = 0.03). The TDCCA, DBCA levels, and the sum of pyrethroid metabolites were not associated with any sperm DNA damage measures. Our results suggest that environmental pyrethroid exposure may affect sperm DNA damage measures index indicated the reproductive effects of pyrethroid exposure on adult men. In view of the importance of human reproductive health and the widespread usage of pyrethroids, it is important to further investigate these correlations.

Rotating night shift work, sleep quality, selected lifestyle factors and prolactin concentration in nurses and midwives

The pattern of secretion of many hormones, including prolactin, is dependent on the circadian rhythm. Night shift work involves exposure to artificial light at night and sleep deficiency, which in turn can affect prolactin synthesis. The aim of this study was to evaluate a possible association between night shift work characteristics, sleep quality, lifestyle factors and prolactin concentration, using data from a cross-sectional study of nurses and midwives. A cross-sectional study was conducted among 327 nurses and midwives currently working on rotating night shifts, and 330 nurses and midwives working during the day (aged 40-60 years) (388 premenopausal and 269 postmenopausal). Information about night shift work characteristics, lifestyle, reproductive factors, sleep pattern and other covariates was collected through a face-to-face interview, and from a one-week work and sleep diary completed by the subjects. Weight and height were measured. Prolactin concentration was measured in the morning blood sample using the electrochemiluminesence immunoassay method. Associations were analyzed using linear regression models adjusted for important confounders. Analyses were carried out separately in pre- and postmenopausal women. None of the night shift work or sleep characteristics was significantly associated with prolactin concentration. Prolactin concentration was significantly (p < 0.05) inversely associated with smoking and time of blood sample collection. These results were consistent among both pre- and postmenopausal women. Nulliparity was significantly positively associated with prolactin among premenopausal women, but inversely among postmenopausal. Age was related to prolactin among postmenopausal women only. Our study indicates that rotating night shift work is not associated with prolactin concentration. Smoking, parity, time of blood collection and age among postmenopausal women were significant determinants of prolactin.

Rotating night shift work and physical activity of nurses and midwives in the cross-sectional study in Łódź, Poland

Shift work have been thought to restrict participation in leisure time activities, but the knowledge about physical activity in rotating night shift nurses has been limited so far. We investigated the associations between the rotating night shift work and physical activity using data from a cross-sectional study among nurses and midwives. This study included 354 nurses and midwives (aged 40-60) currently working rotating night shifts and 371 ones working days only. The information on the work characteristics and potential covariates was collected via a personal interview. Weight and height were measured and BMI was calculated. Physical activity was assessed according to the international questionnaire on physical activity - IPAQ, and four domains: leisure time, occupational, transport related and household were analyzed. Women who reported none leisure time activity were defined as recreationally "inactive". The associations were examined with multiple linear or logistic regression models adjusted for age, season of the year, number of full term births, marital status and BMI. Total and occupational physical activity was significantly higher among nurses working rotating night shifts. However, leisure time activity was significantly affected among rotating night shift nurses and midwives, compared to women working during the days only, with increased odds ratio for recreational "inactivity" (OR = 1.57, 95% CI: 1.11-2.20). Rotating night shift work among nurses and midwives is associated with higher occupational physical activity but lower leisure time activity. Initiatives supporting exercising among night shift workers are recommended.

Risk factors for the development of atopic dermatitis and early wheeze

A global assessment of allergic diseases and prenatal and postnatal exposure to various environmental risk factors is needed to enable early prevention of allergic diseases. This study was designed to evaluate an inner-city urban birth cohort to identify early environmental factors associated with atopic dermatitis and food allergy, as well as the incidence of wheezing during the 1st year of life. We evaluated 501 children from the Polish Mother and Child Cohort Study (2007-2011). The children's health, socioeconomic status, and housing conditions were assessed using a questionnaire. Exposure to tobacco was assessed based on questionnaire data and cotinine measurements. Multiple regression analysis showed that parental atopy, higher paternal education, and more frequent house cleaning significantly predicted atopic dermatitis in the 1st year of life; odds ratio (OR) for the variables was 2.7 (95% CI, 1.3-1.57), 2.8 (95% CI, 1.5-5.0), and 1.8 (95% CI, 1.1-2.9), respectively. Keeping a pet at home during pregnancy increased the risk of food allergy (OR, 1.48; 95% CI, 1.02-2.16). Longer breast-feeding decreased the risk of both food allergy (OR, 0.88; 95% CI, 0.82-0.95) and atopic dermatitis (OR, 0.9; 95% CI, 0.8-0.95) in the 1st year of life. Positive association between maternal exposure to increased concentrations of particulate matter 10 and atopic dermatitis in univariate analyses was found. Atopic dermatitis/food allergy and wheezing/inhaled corticosteroid use had distinct risk factors. The risk factor profile of atopic dermatitis/food allergy in early childhood that is defined in this study support the following recommendations: (i) longer breast-feeding, (ii) avoid pets during gestation, (iii) avoid too frequent house cleaning, and (iv) living in an area with decreased traffic density. This study was a part of the clinical trial NCT01861548 registered in www.clinicaltrials.gov.

Effect of prenatal polycyclic aromatic hydrocarbons exposure on birth outcomes: the Polish mother and child cohort study

The aim of this study was to assess the impact of PAH exposure on various anthropometric measures of birth outcomes. The study population consisted of 210 nonsmoking pregnant women. Urine samples collected between 20th and 24th week of pregnancy were used for analysis of the following PAH metabolites: 1-, 2-, 3-, 4-, and 9-hydroxyphenanthrene (1-, 2-, 3-, 4-, and 9-OH-PHE), 1-hydroxypyrene (1-OH-PYR), 1,6 + 1,8-dihydroxypyrene (DI-OH-PYR), phenanthrene trans-1,2-dihydrodiol (PHE-1,2-diol), and phenanthrene trans-9,10-dihydrodiol (PHE-9,10-diol) by gas chromatography-mass spectrometry. Environmental tobacco smoke exposure (ETS) was assessed by cotinine level in saliva using a stable isotope dilution LC-ESI-MS/MS method. The mean PAH metabolite concentrations were in the range of 0.15 µg/g creatinine for 9-OH-PHE to 5.9 µg/g creatinine for PHE-9,10-diol. It was shown that none of the individual PAH exposure markers demonstrate a statistically significant influence on birth outcomes. Interestingly a statistically significant association was found between the sum of OH-PHE along with cotinine level and the cephalization index after adjusting for potential confounders (P = 0.04). This study provides evidence that combined exposure of pregnant women to common environmental pollutants such as PAH and ETS might adversely affect fetal development. Thus, reduction of human exposure to these mixtures of hazardous compounds would in particular result in substantial health benefits for newborns.

The determination of polycyclic aromatic hydrocarbons in the urine of non-smoking Polish pregnant women

The aim of this study was to characterize the PAH exposure level among the non-smoking Polish pregnant women and to identify the minimal set of PAH metabolites that specifically reflect environmental PAH exposure. The study population consisted of 210 non-smoking pregnant women. The urine sample was used for analysis of the following PAH metabolites: 1-, 2-, 3-, 4-, 9-hydroxyphenanthrene (1-, 2-, 3-, 4-, 9-OH-PHE), 1-hydroxypyrene (1-OH-PYR), 1,6+1,8-dihydroxypyrene (DI-OH-PYR), phenanthrene trans-1,2-dihydrodiol (PHE-1,2-diol) and phenanthrene trans-9,10-dihydrodiol (PHE-9,10-diol). The analysis of all the biomarkers was performed by gas chromatography-mass spectrometry after their derivatization. The mean PAH metabolite concentrations were in the range of 0.15 (± 0.2) μg/g creatinine for 9-OH-PHE to 5.9 (± 10.6) μg/g creatinine for PHE-9,10-diol. Women living in the city center had higher concentrations of 1-OH-PHE (β=0.6; p=0.04), 3-OH-PHE (β=0.8; p=0.02), 9-OH-PHE (β=0.9; p=0.02), and DI-OH-PYR (β=1.0; p=0.006) than those living outside the city center. The usage of coal for residential heating was a significant predictor of all PAH metabolites except for 9-OH-PHE (p=0.1) and PHE-9,10-diol (p=0.08). With the increasing cotinine levels we observed a significant increase in the concentrations of the following PAH metabolites: 3-OH-PHE (β=0.2; p=0.007), 4-OH-PHE (β=0.3; p=0.002), PHE-1,2-diol (β=0.3; p<0.001), 1-OH-PYR (β=0.2; p=0.01). High-density housing, usage of coal for residential heating, cotinine level in saliva, season of urine collection and distance from the place of residence to the main road explained 26% of the variance of 3-OH-PHE and 21% of the variance of 1-OH-PHE. 2-OH-PHE, 3-OH-PHE, 9-OH-PHE and PHE-9,10-diol are sufficient to predict environmental PAH exposure. The urinary PAH biomarker levels found in this study indicate that non-smoking Polish pregnant women suffer from a higher PAH exposure than those in other western countries. This higher PAH exposure level probably poses a significant health risk for the newborns and young children and will require further attention in the future.

Impact of socioeconomic risk factors on the seroprevalence of cytomegalovirus infections in a cohort of pregnant Polish women between 2010 and 2011

The purpose of this investigation was to perform an evaluation of the prevalence and socioeconomic risk factors for human cytomegalovirus (HCMV) infections in a cohort of Polish pregnant women between 2010 and 2011. HCMV-specific IgG and IgM antibody levels were assayed with enzyme-linked immunosorbent assay (ELISA) tests in serum samples collected from 1,250 pregnant women attending outpatient obstetric clinics and hospitalized at two hospitals in Lodz. The seroprevalence of anti-HCMV IgG and IgM antibodies was 62.4 and 2.2 %, respectively, and differed significantly between age-stratified groups (p ≤ 0.05). The highest IgG prevalence was observed in women above 36 years of age (76.2 %) and IgM in adolescent women aged 16–20 years (6.0 %). Of the various socioeconomic factors, age above 36 years, basic and professional education, and offspring were significantly associated with HCMV IgG prevalence rates (PRs; 1.89, 1.80, and 1.56, respectively). Financial status, occupational risk related to contact with children, and transfusions were not related to the prevalence of IgG antibodies. The IgM prevalence was not associated with any of the analyzed risk factors. A slightly higher prevalence was observed in women who were transfused in the past, but the relationship was not significant. The current data have revealed a decrease in HCMV IgG seroprevalence in our region during recent years (62.4 vs. 76.7 %). Basic and professional education, as well as bringing up offspring, were determined as significant risk factors for HCMV infections in Polish pregnant women [risk ratio (RR) 1.20 and 1.17, respectively], suggesting that the primary and secondary prophylaxis of cytomegaly is necessary during pregnancy, even if screening is not mandatory.

The role of zinc, copper, plasma glutathione peroxidase enzyme, and vitamins in the development of allergic diseases in early childhood: The Polish mother and child cohort study

It has been hypothesized that the increase in allergic disorders may, in part, be a consequence of changing diet. The primary aim of this study was to assess the associations between occurrence of atopic dermatitis; food allergy; the incidence of wheeze inhaled glucocorticosteroid use in children during the 1st year of life; and cord blood concentrations of copper, zinc, vitamins (A and E), and glutathione peroxidase activity. We evaluated 240 1-year-old children from the Polish Mother and Child Cohort Study. Women were interviewed during pregnancy to collect demographic and socioeconomic data and medical and reproductive history. Exposure to tobacco constituents was assessed based on questionnaire data. At delivery, umbilical cord blood plasma was sampled. One year after the birth, the child's exposure and health status were examined. In the analyses a multivariable model was used. Higher zinc and copper concentrations in cord blood were associated with increased likelihood of wheezing in 1-year-old children. This effect was seen only among children exposed to tobacco smoke at home. We also showed significantly lower activity of glutathione peroxidase enzyme 3 in umbilical cord blood plasma of children with atopic dermatitis during the 1st year of life. There were no significant associations between vitamin A and E concentrations in plasma and children's health. We showed imbalance in the antioxidant defense system in cord blood, which may lead to development of atopic dermatitis or wheezing in infancy. The association between maternal nutrient status during pregnancy and child's health is complex and interacts with other environmental factors such as tobacco exposure. This study was a part of the clinical trial NCT01861548 registered at ClinicalTrials.gov.

Predictors of environmental lead exposure among pregnant women - a prospective cohort study in Poland

Blood lead levels (BLL) in women of child-bearing age have been decreasing in recent decades, but still remains a concern for long-term effects of child psychomotor development. The aim of the study was to characterize lead exposure among Polish pregnant women and assess the relationship between BLL and selected socio-demographic, economic and lifestyle factors. The study population consisted of 594 pregnant women who had been the subjects of the prospective Polish Mother and Child Cohort Study (REPRO_PL). The women were interviewed three times during pregnancy (once in each trimester. Lead concentration in the blood collected during the second trimester of pregnancy was analyzed using graphite furnace atomic absorption spectrometry (GF-AAS), or inductively coupled plasma mass spectrometry (ICP-MS). Active and passive smoking was analyzed by the cotinine level in saliva using liquid chromatography with tandem mass spectrometry (LC-MS/MS). The lead level in the blood ranged from 0.3 - 5.7 μg/dL, with a geometric mean (GM) of 1.1 μg/dL (GSD ±0.2 μg/dL). Statistically significant associations were found between BLL and factors such as maternal age (β=0.01; p=0.02), education (β=0.08; p=0.04) and prepregnancy BMI (β=0.1; p=0.001). Additionally, BLL increased with increasing cotinine level in saliva (β=0.02; p=0.06) and decreased with the increasing distance from the copper smelter (β=-0.1; p=0.009). Public health interventions, especially in regions with a higher level of exposure to lead, among women with lower SES and among smokers, are still reasonable.

Occupational, life stress and family functioning: does it affect semen quality?

BACKGROUND AND AIMS

Although psychological stress has been implicated as a cause of idiopathic infertility in both men and women, it has received little scientific attention among males as compared to females. The aim of the study was to examine the association between occupational, life stress, family functioning and semen quality.

METHODS AND RESULTS

The study population consisted of 327 men who were attending an infertility clinic for diagnostic purposes. Psychological stress was assessed based on two questionnaires: The Subjective Work Characteristics Questionnaire and the Perceived Stress Scale. The level of satisfaction with family functioning and support was evaluated by means of the APGAR Family Scale. The findings suggest that, on the one hand, exposure to occupational stressors can be negatively associated with semen quality (there was a positive association between stress and the percentage of sperm with DNA damage (p = 0.03) and atypical sperm (p = 0.05)); on the other hand, there was no correlation between the level of life stress and semen quality indicators. Negative associations were found between satisfaction with family functioning and the percentage of motile sperm cells (p = 0.02), VAP (p = 0.05), VSL (p = 0.05) and VCL (p = 0.04).

CONCLUSION

The study indicates that occupational stress can affect male semen quality; however, due to limited data on this issue, the obtained results should be confirmed in longitudinal studies.

[Evaluation of osteoporotic fractures in the group of woman over 50 years of age--comparison of tools FRAX BMD versus FRAX BMI]

BACKGROUND

The aim of the project is to identify the risk of osteoporotic fractures in women aged over 50, the of FRAX BMD and FRAX BMI in women with and without osteoporotic fractures and the proposal of therapeutic starting points for treatment of osteoporosis.

MATERIAL AND METHODS

A group of 1014 women aged 50-89, living in the Kujawsko-Pomorskie province, was investigated. The analysis was based on the WHO definition of osteoporosis. Calculations of 10-year absolute risk of major osteoporotic fractures (AR-10 MOF Fx) and femoral neck fractures (AR-10 FN Fx) were done using Polish 3.3 version of FRAX tool. The analysis of fracture risk employed the logistic regression method.

RESULTS

A statistically significant relationship was found between the risk of osteoporotic fractures and age, femoral neck BMD, a history of previous osteoporotic fractures, estimated calcaneal BMD and vertebral column BMD. The differences between 10-year absolute risk of major osteoporotic fractures BMD and BMI was small, which means that FRAX BMI might be a useful tool for GPs and occupational medicine specialists.

CONCLUSIONS

A high usefulness of the FRAX BMI tool for evaluating the risk of major osteoporotic fractures provide a new possibility of identifying women at risk of such events. The mean value of 10-year absolute risk of major osteoporotic fractures for FRAX BMD and BMI was identified as 10% and 12%, respectively and these values were proposed as therapeutic starting points for treatment of osteoporosis in women living in the Kujawsko-Pomorskie province.

[Occupational diseases in Poland, 2012]

BACKGROUND

The aim of the paper was to present basic statistical data on occupational diseases diagnosed in 2012.

MATERIAL AND METHODS

The work was based on the data from "Occupational Disease Reporting Forms" received by the Central Register of Occupational Diseases in 2012. The data comprised information on nosologic units, gender and age of patients, duration of occupational exposure, sections of the national economy and voivodeships. The incidence was specified in terms of the number of cases in relation to paid employees or to employed people.

RESULTS

The number of occupational diseases accounted for 2402 cases. The incidence rate was 23 cases per 100 000 paid employees. In spite of the general decline in the number of cases, the incidence of infectious and parasitic diseases increased by 8.6%. The highest incidence was noted for infectious and parasitic diseases (6.8/100,000), pneumoconioses (5.5/100,000), hearing loss (2.1/100,000), diseases of: the peripheral nervous system (2/100,000), voice disorders (1.9/100,000) and the musculoskeletal system pathologies (1.1/100,000). The pathologies specified above accounted in total for 84% of all occupational diseases. The industrial sectors of the national economy characterized by the highest incidence included mining and quarrying (288.3/100,000) and manufacturing (27.8/100,000). The highest incidence was recorded in the Silesian (46.2/100,000) and the lowest in the Opolskie (4.2/100,000) voivodeships.

CONCLUSIONS

The downward trend in the incidence of occupational diseases continues. Different incidence of voice disorders among teachers in individual provinces suggests that uniform preventive, diagnostic and certification standards are missing.

Relationship between intensity of night shift work and antioxidant status in blood of nurses

Purpose

Light-at-night exposure can disrupt the human circadian rhythm via clock gene expressions. The circadian rhythm influences antioxidant enzymes’ activity and cellular mRNA levels of these enzymes. The employees working based on a shift system adjust to the changes occurring both on the cell level and on the level of the whole organism. Therefore, a question should be answered whether shift work disturbs oxidant–antioxidant balance and/or generates oxidative stress.

Methods

A cross-sectional study was conducted among nurses selected from the Local Registry of the Chamber of Nurses and Midwives in Lodz: 359 nurses worked daily only and 349 working rotating night shifts. These two groups differed significantly in respect of age (p < 0.0001), menopausal status (p < 0.0001), and current smoking habit (p = 0.02). The average total work duration was significantly shorter (12.4 years) in nurses working currently rotating night shifts who worked significantly longer on night shifts than day-workers (26.6 years).

Results

We found statistically significant higher red blood cell glutathione peroxidase in nurses working on night shifts (21.0 ± 4.6 vs. 20.0 ± 5.0 U/g Hb, p < 0.009) after adjusting for age, oral contraceptive hormone use, smoking, and drinking alcohol during last 24 h. Statistically significant lower vitamin A and E levels were found in the premenopausal women working in rotating system (0.690 ± 0.238 vs. 0.786 ± 0.262 μg/ml, p < 0.0001 for vitamin A and 10.93 ± 4.15 vs. 12.78 ± 4.75 μg/ml, p < 0.0001 for vitamin E). The marker of lipid peroxidation (TBARS concentration) was significantly lower in the premenopausal nurses than postmenopausal ones working day shifts only (2.06 ± 0.76 vs. 2.21 ± 0.80 nmol/ml, p < 0.038). We observed that erythrocyte GSH-Px activity rose statistically significant in nurses working more night shifts per month (p < 0.01).

Conclusions

The results quoted above seem to support the existence of an association between light-at-night exposure and blood glutathione peroxidase activity in female shift workers. Nevertheless, in order to explain the mechanisms of this association, we need more studies.

Circadian gene expression in peripheral blood leukocytes of rotating night shift nurses

OBJECTIVE

It has been hypothesized that the underlying mechanism of elevated breast cancer risk among long-term, night-working women involves circadian genes expression alteration caused by exposure to light at night and/or irregular work hours. The aim of the present study was to determine the effect of rotating night shift work on expression of selected core circadian genes.

METHODS

The cross-sectional study was conducted on 184 matched nurses and midwives, who currently work either day or rotating night shifts, to determine the effect of irregular work at night on circadian gene expression in peripheral blood leukocytes. Transcript levels of BMAL1, CLOCK, CRY1, CRY2, PER1, PER2, and PER3 were determined by means of quantitative real-time polymerase chain reaction (PCR).

RESULTS

After adjusting for hour of blood collection, there were no statistically significant changes of investigated circadian genes among nurses and midwives currently working rotating night shifts compared to nurses working day shifts. The highest expression of PER1 messenger ribonucleic acid (mRNA) was observed for women currently working shifts who had worked >15 years in rotating night shift work. PER1 gene expression was associated with the lifetime duration of rotating night shift work among women currently working night shifts (P=0.04). PER1 and PER3 transcript levels in blood leukocytes were significantly down-regulated in the later versus early hours of the morning between 06.00-10.00 hours (β-coefficient -0.226, P=0.001 and β-coefficient -0.181, P<0.0001, respectively).

CONCLUSIONS

These results suggest that current rotating night shift work does not affect circadian gene expression in human circulating leukocytes. In analysis of the peripheral clock in human studies, the hour of blood collection should be precisely specified.

Rotating night shift work and mammographic density

BACKGROUND

An increased risk of breast cancer has been observed in night shift workers. Exposure to artificial light at night and disruption of the endogenous circadian rhythm with suppression of the melatonin synthesis have been suggested mechanisms. We investigated the hypothesis that rotating night shift work is associated with mammographic density.

METHODS

We conducted a cross-sectional study on the association between rotating night shift work characteristics, 6-sulfatoxymelatonin (MT6s) creatinine adjusted in a spot morning urine sample, and a computer-assisted measure of mammographic density in 640 nurses and midwives ages 40 to 60 years. The associations were evaluated using regression models adjusted for age, body mass index, menopausal status, age at menopause, age at menarche, smoking, and the calendar season of the year when mammography was conducted.

RESULTS

The adjusted means of percentage of mammographic density and absolute density were slightly higher among women working rotating night shifts but not statistically significant [percentage of mammographic density = 23.6%, 95% confidence interval (CI), 21.9%-25.4% vs. 22.5%, 95% CI, 20.8%-24.3%; absolute density = 23.9 cm(2), 95% CI, 21.4-26.4 cm(2) vs. 21.8 cm(2), 95% CI, 19.4-24.3 cm(2) in rotating night shift and day shift nurses, respectively). There were no significant associations between the current or cumulative rotating night shift work exposure metrics and mammographic density. No association was observed between morning MT6s and mammographic density.

CONCLUSIONS

The hypothesis on the link between rotating night shift work, melatonin synthesis disruption, and mammographic density is not supported by the results of the present study.

IMPACT

It is unlikely that the development of breast cancer in nurses working rotating night shifts is mediated by an increase in mammographic density.

Rotating night shift work and polymorphism of genes important for the regulation of circadian rhythm

OBJECTIVE

People living in industrialized societies have developed specific working schedules during the day and at night, including permanent night shifts and rotating night shifts. The aim of this study was to examine the association between circadian polymorphisms and rotating night shift work.

METHODS

This cross-sectional study comprised 709 nurses and midwives (348 current rotating and 361 current day workers). Genetic polymorphism of selected clock genes BMAL1 (rs2279287), CLOCK (rs1801260), PER1 (rs2735611), PER2 (rs2304672), PER3 (rs10462020), CRY1 (rs8192440), CRY2 (rs10838527, rs10838527) was determined using real-time polymerase chain reaction (PCR) assays.

RESULTS

There were no differences in BMAL1, CLOCK, CRY2, PER1, PER2, and PER3 genotypes among nurses and midwives working rotating night and day shifts. The frequency of women with rare CRY1 TT genotype was higher in the group of rotating night shift than day workers (17.0% versus 13.9%, P=0.06). Moreover, CRY1 TT genotype was associated with the total rotating shift-work duration, compared to women rarely working night shifts.

CONCLUSIONS

These results suggest that CRY1 (rs8192440) polymorphism may influence the adaptation to the rotating night shift work among nurses and midwives.

Exposure to phenoxyacetic acid herbicides and predictors of exposure among spouses of farmers

The purpose of the study was to assess the environmental exposure to 2 commonly used pesticides: 2-methyl-4- chlorophenoxyacetic acid (MCPA) and 2,4-dichlorophenoxyacetic acid (2,4-D) among spouses of farmers, not directly involved in the process of spraying. Exposure to 63 sprayings 24 women in households from the rural area of the Łódż Voivodeship in Poland was assessed. The women were asked to collect 3 biological urine samples: in the morning before spraying (sample A), in the evening after spraying (sample B), and on the morning of the next day (sample C). The determination of pesticides in urine was performed by high performance liquid chromatography, coupled with tandem mass spectrometry and negative electrospray (LC-MS/MS-ESI-). In the case of both active ingredient, the number of urine samples with the level of pesticides above limit of detection (LOD) increased from 30% in samples A to 45% in samples B and C. The average levels of herbicides increased from sample A (2.8 ng/g creatinine) to sample B (6.0 ng/g creatinine). The mean value of the C sample was 4.0 ng/g creatinine. Similar results were obtained when the average was calculated for all measurements, including those below LOD. The outdoor activity of the women during spraying was statistically significant (p=0.023), a predictor of exposure in multivariate analyses. The presented study indicates that farmers' spouses might be exposed to pesticides, even if they do not take part in the spraying.

[Occupational diseases in Poland, 2010]

BACKGROUND

The aim of the paper was to present basic statistical data on occupational diseases diagnosed in 2010.

MATERIAL AND METHODS

The work was based on the data compiled from "Occupational Disease Reporting Forms" received by the Central Register of Occupational Diseases in 2010. The data comprised information on nosologic units, gender and age of patients, and duration of occupational exposure to harmful agents responsible for the development of specified pathologies. These data were further classified by sectors of the national economy and voivodeships. The incidence was specified in terms of the number of cases in relation to paid employees or to employed persons.

RESULTS

The number of occupational diseases diagnosed in 2010 accounted for 2933 cases. The incidence rate was 28.3 cases per 100 000 paid employees. The highest incidence rates were noted for pneumoconioses (7.6/100,000), infectious and parasitic diseases (7/100 000), hearing loss (3.2/100,000) and chronic voice disorders (3.1/100,000). As many as 77% of patients affected by occupational diseases had been exposed to harmful agents for longer than 20 years. In industrial sectors of the national economy, the highest incidence rate was noted in mining and quarrying (368.2/100,000). Taking into account geographic distribution of occupational diseases, the highest incidence was recorded in the Silesian and the lowest in the Mazovian voivodeships (79.7 and 9.7 cases per 100 000 employed persons, respectively).

CONCLUSIONS

A decrease of 213 (6.8%) cases of occupational diseases and a decrease of 5.4% in their incidence rate over previous year were noted. The greatest drop in the number of cases was noted in chronic voice disorders (of 302 cases--48.5%) and the greatest rise in pneumonioses (of 156 cases--24.6%).

[The assessment of changes in radiological parameters of acetabulum of the hip joint according to position of the pelvis]

The aim of the study was to analyze the repeatability of selected radiological parameters in the assessment of mild forms of developmental dysplasia of the hip and to evaluate the changes of the parameters according the position of the pelvis. Retrospective review of radiographs of 98 hips (49 children) was done in antero-posterior and Lauenstein position. Among them 59 hips were treated for type II hip dysplasia according to Graf. At the latest follow-upthe mean age was 9.1 years (range from 4 to 15 years). On radiographs in antero-posterior position of the hips mean rotation index (Tönnis-Brunken index) was 1.0, and on radiographs in Lange position was 0.98 and had no influence on measured parameters. On radiographs in antero-posterior position pelvis was more in forward rotation than in Lange position. With the pelvis in more forward rotation (measured using Ball-Kommend index) the value of Lequesne and Ullmanna-Sharp angles were decreased and Wiberg angle was increased. The angles had good repeatability. The other parameters: acetabular index, decentration distance and Idelberg-Frank angle were not statistically related to Ball-Kommend index. Idelberg-Frank angle had satisfactory repeatability but acetabular index and decentration distance had poor repeatability. Considering above mentioned characteristics of Idelberg-Frank angle, this parameter may be a useful tool for assessment of the hip.

[Occupational exposure to pesticides among farmers of the Łódź' voivodeship agricultural area]

BACKGROUND

Pesticides are widely used in agriculture for the crop protection. Despite advanced mechanization of the agricultural production, the population's exposure to these chemicals is still significant. The objective of the study was to evaluate farmers' occupational exposure to two most frequently used pesticides: MCPA and 2,4-D.

MATERIAL AND METHODS

Pesticide exposure was assessed in 24 farmers, living in the Łódź voivodeship agriculture area, for 71 sprayings performed on their arable areas. The exposure assessment methods were used to estimate workers' exposure to selected pesticides (MCPA and 2,4-D). The analysis covered the biological material (urine) collected on the day of pesticides spraying: in the morning before spraying (Sample A), in the evening after spraying (Sample B) and on the next day (Sample C).

RESULTS

The level of pesticides found in farmers' urine was growing from sample A to sample C. The highest level of pesticides was found in sample C and the lowest in sample A. The predictors of the pesticide level were: sample collection time (urine concentration of pesticides in sample C compared with sample B) (p = 0.002), concentration of pesticides in sample A (p = 0.012) and the amount of products used during spraying (p = 0.021). 'The use of protective equipment was at the border of statistical significance (p = 0.059). The differences in exposure between farmers can be only partly explained by the analyzed exposure predictors.

CONCLUSIONS

The study not only confirmed the presence of occupational exposure but also showed the level of exposure among farmers under study. This is very important because in Poland the level of exposure among farmers is unknown and studies using the biological monitoring are very rare.

[Implementation of the Amiantus project involving prophylactic medical examinations of the former employees of asbestos processing plants]

BACKGROUND

Based on a 11-year implementation of the Amiantus Project, this paper reports the results of prophylactic medical examinations of the former workers of asbestos processing plants. The Project involving employees of 28 former asbestos plants was started by the Ministry of Health in 2000 under the Act on the ban of all products containing asbestos.

MATERIAL AND METHODS

Preventive examinations, continued in 13 centers of occupational medicine throughout the whole territory of Poland, have been coordinated by the Nofer Institute of Occupational Medicine in Lodz (NIOM). During the examinations, a specific Examination Form is filled-in by a physician. The Form is then sent to NIOM for monitoring health effects in the population covered by the Project. The results obtained by analyzing the lung radiological images are recorded in the Examination Form according to the ILO 1980 classification of pneumoconiosis. The diagnosis of the asbestos-related pathologies is based on the Helsinki criteria.

RESULTS

During the years 2000-2010, altogether 6,853 people were involved in the Project, and they were subjected to a total of 18,955 preventive examinations. Asbestosis was diagnosed in 1475 people, representing 21% of all respondents, lung cancer in 68 and mesothelioma in 40 people. Pleural radiographic changes were observed in 3027 (44%) patients, pulmonary parenchymal opacities in 4086 (60%) patients. The analysis showed that the asbestos-related pathologies were most frequent in the group of former employees of asbestos-cement plants. This group was also characterized by an age-, tenure-, and latency-related increasing trend in the prevalence of silicosis and the frequency of radiographic lesions in the lungs of those subjects.

CONCLUSIONS

The continuation of the examinations of former workers of asbestos processing industry has improved the detection of pathologies associated with exposure to asbestos and enabled undertaking an appropriate preventive action. The growing percentage of poorer radiography results reflects the progressive development of pathological processes in the respiratory system of people occupationally exposed to asbestos dust in the past.

Coagulation abnormalities and severe intraventricular hemorrhage in extremely low birth weight infants

BACKGROUND

The association between intraventricular hemorrhage (IVH) and coagulation in infants has been a subject of controversy. Only few publications assessing risk factors for development of IVH reported results of coagulation studies.

OBJECTIVES

To evaluate the levels of coagulation and fibrinolysis systems in ELBW infants and determine their influence on IVH.

PATIENTS AND METHODS

Following IRB approval coagulation status of 38 ELBW infants was evaluated on first and second day of life. Severity of IVH assessed by cerebral ultrasonography was graded according to Papile classification. Newborns were assigned to either Group A--Grade III or IV, or Group B--Grade I-II, or no IVH.

RESULTS

Neonates with Grade III/IV IVH had significantly lower plasma Factor VII (FVII) level on first day of life and FVII differed significantly between Groups A and B with sensitivity of 100%, specificity 41% for a cut-off value of< 7%. In Group A there was no improvement of prothrombin and activated partial thromboplastin times on Day 2. A significant decline of platelet count was also observed.

CONCLUSIONS

High-grade IVH coincides with severe derangement of coagulation in ELBW infants with FVII level being the most sensitive, it is not clear what the reason for such low FVII concentration is. Further studies are indicated.