ETIOLOGICAL FACTORS OF CARPAL TUNNEL SYNDROME IN SUBJECTS OCCUPATIONALLY EXPOSED TO MONOTYPE WRIST MOVEMENTS

Background: Carpal tunnel syndrome (CTS) is the most common neuropathy of upper limbs and a leading cause of upper extremity musculoskeletal disorders, in terms of work exposure, repetitive and forceful exertions of the hand and use of vibrating hand tools. The aim of the study was to evaluate etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype movements in wrist. Material and Methods: We conducted the retrospective analysis of 300 patients (261 women, 39 men), mean age 52 years (standard deviation: ±6.93) hospitalized with the suspicion of occupational CTS. Results: The study revealed high percentage (68.7%) of diseases and systemic factors involved in the pathogenesis of CTS in the analyzed population, especially obesity (32%), thyroid diseases (28.7%), hormone replacement therapy and/or oophorectomy (16.3%) and diabetes mellitus (12%). In 111 patients the coexistence of at least a couple of potential etiological factors of the neuropathy was recognized. Clinical analysis and occupational exposure allowed to diagnose occupational carpal tunnel syndrome in 18 (6%) patients only. The undeniable long-term (20.2±9.3 years) occupational exposure to repetitive, forceful movements in the wrist was observed in this group. Conclusion: The results of our study indicated that non-occupational etiological factors of CTS predominated and in 37% of patients at least several factors were found. The analysis showed the high prevalence of CTS in workers employed in various sectors of industry, including so called "blue collar" workers. Our study confirmed the multifactorial etiology of carpal tunnel syndrome, however, occupational agents contributed to only 6% of cases. Med Pr 2014;65(2):261–27

PULMONARY TUBERCULOSIS OF OCCUPATIONAL ORIGIN IN A FUNERAL DIRECTOR: A CASE REPORT

In Poland the incidence rate of tuberculosis is higher than the average for countries of the European Union, Norway or Iceland. On the other hand, occupational tuberculosis is still rarely recognized in our country. In this paper we present the first in Poland- to our best knowledge - case of pulmonary manifestation of this disease acquired at work in a funeral director. The recognition of the occupational etiology of the discussed illness gave rise to an array of diagnostic problems and became feasible after a thorough analysis of the patient's history and literature data, which allowed finding the relationship between infection and performed job. We speculated that the transfer of the dead body and handling of cadavers may expel residual air from the lungs of the deceased. Although tuberculosis occurs frequently in the general population, the recognition of work-related cases of this disease is still rare, especially among funeral directors. Med Pr 2014;65(3):429–43

Late effects of mass acute phosphine poisoning – Case report

This paper reports the case of collective acute phosphide (PH 3 ) intoxication among the crew aboard a merchant ship. All the intoxicated individuals were hospitalized 3 months after the accident. The aim of examinations was to identify late health effects of the accident. Laboratory tests and consultations were performed during their stay in the hospital. There were 5 cases of toxic liver damage. other 5 patients were diagnosed with posttraumatic stress disorder and adjustment disorders. The results of the study suggest that in cases of acute phosphide intoxication, the assessment of patients’ psychological functioning should be an indispensable part of diagnostic procedure. Med Pr 2018;69(3):337–34

Analysis of tasks of occupational health services accomplished in Poland, 1997–2014. Do we exploit the full potential of prophylactic examinations of workers?

Background: Mandatory medical reports can be used to evaluate the scope of activity of occupational health services (OHS), including the number and kind of services. Material and Methods: The analysis comprised data for the period 1997–2014, derived from mandatory reports MZ-35A submitted by OHS units. Results: During the analyzed period the number of occupational medicine physicians decreased from 8507 to 6741, while the number of OHS units – responsible for prophylactic care – increased from 4967 to 6261. In the years under report 3,961 million mandatory health check-ups were performed, of which 99.3% resulted in issuing fitness for work certificates. Pre-employment examinations made 38.8%, while periodical ones – 52.8% and control ones – 6.7% of all check-ups. Moreover, 336 700 examinations of apprentices, students, vocational courses attendants and Ph.D. students were performed to evaluate any contradictions for vocational training. In 2014, there were 1871 workers provided with preventive care per 1 occupational physician. It was estimated that despite legal obligation, only 22.2% of employers had signed agreements with OHS units. Conclusions: The analysis of the number and kind of services provided by OHS units revealed high but not fully exploited potential for efficient prophylaxis of both directly occupational work-related and indirectly work-exacerbated diseases. Med Pr 2017;68(1):105–11

Work-related dysphonia in subjects with occupational asthma is associated with neutrophilic airway inflammation

Dysphonia; Neutrophilic inflammation; Occupational asthmaDisfonía; Inflamación neutrofílica; Asma ocupacionalDisfonia; Inflamació neutròfila; Asma ocupaciona

Work Ability Index (WAI) values in a sample of the working population in Poland

Introduction: Ability to work is most often defined as a relationship between a person’s resources and requirements specific to a particular type of work. It is the result of interaction between job requirements in terms of physical and mental strain, capabilities and skills of the employee, as well as his/her health condition and own evaluation of functioning in a given organizational and social situation. Objective: The primary objective of the study was to evaluate the current value of the Work Ability Index (WAI) in a sample of employees in Poland. Material and methods: The study sample was selected purposefully from 422,000 employees covered by the largest occupational health provider in Poland. The standard WAI questionnaire provided by CAWI (Computer-Assisted Web Interview) methodology was voluntary and completed anonymously by 688 employees within 12 months (0.16% response rate). The results were statistically analyzed using the Pearson’s chi-squared test and correlation coefficient, independent-sample T test and one-way analysis of variance (p<0.05). Results: It was found that the average value of WAI was 37.5 ± 7.7, and 37% of the participants represented low to moderate ability to work. The results showed no significant correlation between the WAI value and its 7 compounds and demographic variables. Nonetheless, a dependency between WAI level and industrial branch was observed. Conclusions: Subjects with moderate and low WAI (1/3 of the study population) had particular indications to implement prophylactic actions, especially for the health care employees and civil servants, whose ability to work may be subject to accelerated deterioration

COVID-19 pandemic and allergen immunotherapy-an EAACI survey

Background As in many fields of medical care, the coronavirus disease 2019 (COVID-19) resulted in an increased uncertainty regarding the safety of allergen immunotherapy (AIT). Therefore, the European Academy of Allergy and Clinical Immunology (EAACI) aimed to analyze the situation in different countries and to systematically collect all information available regarding tolerability and possible amendments in daily practice of sublingual AIT (SLIT), subcutaneous AIT (SCIT) for inhalant allergies and venom AIT. Methods Under the framework of the EAACI, a panel of experts in the field of AIT coordinated by the Immunotherapy Interest Group set-up a web-based retrospective survey (SurveyMonkey(R)) including 27 standardized questions on practical and safety aspects on AIT in worldwide clinical routine. Results 417 respondents providing AIT to their patients in daily routine answered the survey. For patients (without any current symptoms to suspect COVID-19), 60% of the respondents informed of not having initiated SCIT (40% venom AIT, 35% SLIT) whereas for the maintenance phase of AIT, SCIT was performed by 75% of the respondents (74% venom AIT, 89% SLIT). No tolerability concern arises from this preliminary analysis. 16 physicians reported having performed AIT despite (early) symptoms of COVID-19 and/or a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Conclusions This first international retrospective survey in atopic diseases investigated practical aspects and tolerability of AIT during the COVID-19 pandemic and gave no concerns regarding reduced tolerability under real-life circumstances. However, the data indicate an undertreatment of AIT, which may be temporary, but could have a long-lasting negative impact on the clinical care of allergic patients.Peer reviewe