THE IMPORTANCE OF SIGHT FOR DRIVERS

Sight is the basic sense for drivers. Condition of the eye determines correct, comfortable and safe performance of the work as drivers. This article presents various factors influencing the sight condition. There are two groups of factors, external (environment, the kind and time of work, stress caused by work) and internal (systemic and local disorders). All these factors can reduce significantly visual functions, such as visual acuity, field of vision, color vision, strereoscopic vision, twilight vision and glare sensitivity. There are also presented actual requirements for drivers and causes of the car accidents in various age groups. Impairments in vision functions can be dangerous for both the driver and other road users. Med Pr 2013;64(3):419–42

Can alveolar hypoventilation due to kyphoscoliosis be a contraindication to driving?

Road accidents are among the main fatalities worldwide and drowsy driving is a significant cause of road deaths where drivers are at fault. There are well known diseases which impair sensory and cognitive functions and can cause sleepiness during driving. Such diseases can be an important contraindication to driving because they may have an adverse effect on its safety. Thus, medical examinations for drivers should also be directed at identifying any possible conditions posing risks for driving safety. Occupational medicine specialists should look for symptoms of locomotor and sleep-related breathing disorders as these are medical conditions which could preclude a person from driving. In this case report, the authors describe a professional driver with chest deformity and present a pioneering attempt at assessing his medical fitness to drive. It is also explained why scoliosis can impair driving ability and how it should be diagnosed and treated. Finally, the authors describe how they used driving simulator tests as part of their diagnosis and suggest a relevant treatment regimen

Results of conservative, surgical treatment and rehabilitation of entrapment neuropathies in elderly patients in geriatric practice

Entrapment neuropahies of upper limbs can cause mainly nocturnal neuropathic pain and impaired manual dexterity. The most common entrapment neuropathy is carpal tunnel syndrome and ulnar groove syndrome - ulnar nerve entrapment at the elbow. Treatment of entrapment neuropathies is both analgetic therapy and physiotherapy. In the cases of conservative treatment inefficiencies surgical decompression of nerves is performed. Authors of this oublication present results of both conservative  and surgical of entrapment neuropathies in patients over 65 years old. Among the 17 patients with entraoment neuropathies 12 of them underwent surgical treatment. Achieved partial improvement in pain, mostly nocturnal and improving the quality of life and dexterity. In comparison, however, a group of younger patients who underwent surgery for the improvement was less spectacular, which may testify advancement and irreversibility of changes in older patients

Assessment of the prevalence of nootropic drugs by elderly patients in geriatric practice

So-called nootropics include a diverse group of drugs whose idea is to improve brain function. They are quite commonly accepted among the elderly. Although currently available data from the literature do not show unequivocally the efficacy of these drugs, in practice a large number of patients are in practice. These drugs are prescribed to patients fairly commonly and the range of indications for their use is wide and non-specific. This publication presents the mechanism of action of these nootropic drugs, historical outline of their use and epidemiological data on their use in elderly patients on the basis of patients treated in the Department of Geriatrics of Medical University in Bydgoszcz

Prevention of cardiovascular diseases – Prophylactic program in a selected enterprise

Background: In Poland cardiovascular diseases (CVD), classified as work-related diseases, are responsible for 25% of disability and cause 50% of all deaths, including 26.9% of deaths in people aged under 65 years. The aim of the study was to analyze employee expectations regarding CVD- oriented prophylactic activities in the selected enterprise. Material and Methods: A questionnaire, developed for this study, consists of: socio-demographic data, job characteristics, occupational factors, and questions about the respondents’ expectations concerning the prevention program. The study group comprised 407 multi-profile company employees aged (mean) 46.7 years (standard deviation (SD) = 9.1), including 330 men (81.1%), mean age = 46.9 (SD = 9.2) and 77 women (18.9%), mean age = 45.9 (SD = 8.2) The study was performed using the method of auditorium survey. Results: Employees declared the need for actions related to physical activity: use of gym, swimming pool, tennis (56.5%), smoking habits – education sessions on quitting smoking (24.6%). A few people were interested in activities related to healthy diet. According to the majority of the study group, the scope of preventive examinations should be expanded. Based on our own findings and literature data CVD- oriented preventive program, addressed to the analyzed enterprise was prepared. The program will be presented in another paper. Conclusions: The results showed significant quantitative and qualitative differences in the classic and occupational CVD risk factors between men and women, as well as in preferences for participation in prevention programs. Therefore, gender differences should be taken into account when planning prevention programs. Med Pr 2017;68(6):757–76

Impedance cardiography – Old method, new opportunities. Part I. Clinical applications

Monitoring of cardiovascular hemodynamic changes requires a very expensive and highly specialized equipment and skilled medical personnel. Up to the present time, an inexpensive, non-invasive and easy-to-use method which, like Doppler echocardiography, magnetic resonance angiography or radionuclide imaging, would assess hemodynamics of the cardiovascular system was not available. A method known as impedance cardiography (ICG) or thoracic electrical bioimpedance cardiography (TEBC) meets those criteria. It is non-invasive, which is of a particular advantage over the conventional methods that require catheterization. As a result, the patient is not at risk of possible complications and the procedure is less expensive and easier. Impedance cardiography, despite its non-invasive character, has not been so far extensively used for monitoring of hemodynamic parameters in hospitalized patients. Various authors report that attempts have been continued to compare the results from ICG and those obtained by other diagnostic methods. This paper presents the use of impedance cardiography in diagnosis of hypertension, cardiac insufficiency, differentiating the causes of acute dyspnea, as well as in assessing the effects of cardiac rehabilitation in patients with heart failure

Impedance cardiography – Old method, new opportunities. Part II. Testing of cardiovascular response to various factors of work environment

Impedance cardiography seems to be a very good, although underappreciated diagnostic method. What may distinguish it from among the many research methods is the fact that it enables non-invasive monitoring of cardiac output, stroke volume and systemic vascular resistance. Holter recording of the hemodynamic parameters makes it possible to study them not only in stationary (hospital, outpatient clinic) conditions, but also during household or professional activities, e.g., during road vehicle driving. Assessment of the trends of changes in the circulatory system of the employee at work makes it possible to judge whether the type of work performed by the worker is well tolerated – whether it is not too hard or too stressful. This is important, therefore, impedance cardiography can be extensively used in occupational medicine. Provision of preventive care to workers according to current standards requires, on the one hand, the use of the latest diagnostic methods while, on the other hand, the methods must be inexpensive, because otherwise the employer would not be able or willing to pay the associated costs. Impedance cardiography meets those criteria; however, few data is available in literature worldwide on the use of this method in the research on the impact of occupational work on cardiovascular responses of the employees. This work reports the use of impedance cardiography in studies on the various aspects of work environment

Family, school and neighborhood factors moderating the relationship between physical activity and some aspects of mental health in adolescents

The impact of physical activity on mental health is widely described in literature. Less attention is given to factors which may modify this correlation, except for gender. The aim of this study was to conduct a qualitative assessment of such papers relating to children and young people. Selected papers were evaluated with regard to additional factors related to family, school and neighborhood. Attention was drawn to the definitions of these variables, the methods of analysis, and the content of the discussion. The starting point for this study included 7 systematic reviews published in 2006–2018. A total of 161 full articles described in detail in those reviews, and representing different research patterns, were selected for qualitative analysis. They met the criteria for the type of publication, mental health outcome, the direction of association, and the age group. A supplementary section of this paper contains a review of Polish literature from the Polish Medical Bibliography, and an analysis of national studies and some more recent papers not included in the analyzed reviews. It was demonstrated that 33 papers analyzed environmental variables to a greater degree than the characteristics of the sample. Twenty-three papers containing the results of statistical analyses were considered to be of particular interest. Almost 50% of these included both the socio-economic position of the family and the characteristics of the neighborhood. However, only 1 featured stratification of the sample with regard to contextual environmental variables. The obtained results are of great practical importance. Firstly, development of the research into environmental moderators should be advocated. Secondly, the social context in which adolescents grow up should be taken into account when designing intervention programs. Int J Occup Med Environ Health. 2019;32(4):423–3

Impedance cardiography – Old method, new opportunities. Part II. Testing of cardiovascular response to various factors of work environment

Impedance cardiography seems to be a very good, although underappreciated diagnostic method. What may distinguish it from among the many research methods is the fact that it enables non-invasive monitoring of cardiac output, stroke volume and systemic vascular resistance. Holter recording of the hemodynamic parameters makes it possible to study them not only in stationary (hospital, outpatient clinic) conditions, but also during household or professional activities, e.g., during road vehicle driving. Assessment of the trends of changes in the circulatory system of the employee at work makes it possible to judge whether the type of work performed by the worker is well tolerated – whether it is not too hard or too stressful. This is important, therefore, impedance cardiography can be extensively used in occupational medicine. Provision of preventive care to workers according to current standards requires, on the one hand, the use of the latest diagnostic methods while, on the other hand, the methods must be inexpensive, because otherwise the employer would not be able or willing to pay the associated costs. Impedance cardiography meets those criteria; however, few data is available in literature worldwide on the use of this method in the research on the impact of occupational work on cardiovascular responses of the employees. This work reports the use of impedance cardiography in studies on the various aspects of work environment