Małgorzata Pikala

Epidemiology of physical inactivity in Poland: prevalence and determinants in a former communist country in socioeconomic transition.

OBJECTIVES The aim of this study was to identify physical activity patterns and determinants of physical inactivity in a representative sample of Polish adults. STUDY DESIGN A cross-sectional analysis of 14 769 randomly selected individuals (52.7% women and 47.3% men) aged 20-74 years participating in the National Polish Health Survey, WOBASZ (2002-2005). METHODS Sociodemographic and lifestyle details were collected. Assessment of physical activity was based on selected questions from the CINDI Health Monitor Questionnaire. RESULTS Approximately 35% of Polish adults are not physically active in leisure time, whilst 39.5% declare sufficient level of leisure-time physical activity. Leisure-time inactivity is significantly less likely in persons aged <35 years, those with university education and those living in rural areas. Almost 48% of men and 28.4% of women employed full- or part-time report highly active work, whilst sedentary work is reported by 42.7% of women and 30.2% of men. Low occupational activity is more prevalent in young adults, persons with university education and those living in large urban areas. Nearly 67% of the entire working population report no active commuting. CONCLUSIONS There is a need to promote various forms of physical activity, with special attention on active commuting and leisure-time activities across both genders and all age groups. Public health policies and programmes should focus on substantial differences between various sociodemographic groups.

Socio-demographic and lifestyle correlates of commuting activity in Poland.

OBJECTIVES The aim of this study is to analyse the epidemiology of active transportation and to investigate the relationship between commuting physical activity (PA) and socio-demographic and lifestyle characteristics in Poland. METHODS A cross sectional analysis was conducted among 7280 randomly selected individuals (3747 men and 3533 women) aged 20-74 years participating in the National Multicentre Health Survey WOBASZ (2002-2005). Socio-demographic, smoking and physical activity details were assessed by an interviewer-administered questionnaire. RESULTS Only 36% of the participants (30% men and 42% of women) are active commuters. Moreover, 55.4% of them spend less than 15 min/day on walking or cycling. The highest risk of commuting inactivity was noticed among residents of large urban settings, with university education, the highest income and low occupational PA in both genders. Smoking and leisure-time PA were not significantly associated with commuting activity. CONCLUSIONS Active commuting is not common in Poland. There are several differences in commuting patterns as compared with the US or Western European populations. Due to important differences between various socio-demographic groups, future interventions should be specific for the targeted subpopulations.

Commuting physical activity and prevalence of metabolic disorders in Poland

OBJECTIVES The aim of this study was to examine the relationship between walking or cycling to work and prevalence of metabolic syndrome (MetS) and its components. METHODS Cross-sectional analysis of 6401 randomly selected individuals (3297 men and 3104 women) aged 20-74 years, who participated in the National Multicentre Health Survey WOBASZ, Poland (2002-2005). Commuting physical activity (PA) was assessed by asking about type and time spent on transportation to/from work using an interviewer-administered questionnaire. Weight, height, waist circumference (WC), blood pressure (BP), fasting plasma glucose (FPG), triglycerides (TG) and high-density cholesterol, (HDL-C) were measured by standard methods. MetS was defined according to the NCEP-ATP III and IDF criteria. RESULTS Active commuting was associated with decreased likelihood of abdominal obesity (WC≥94 cm), lower HDL-C and elevated TG in men and abdominal obesity (WC≥80 cm) in women. In a subgroup of postmenopausal women (n=317) active commuting was favourably associated with abdominal obesity, low HDL-C and elevated FPG. Prevalence of MetS was significantly lower among those who spent above 30 min/day daily on walking/cycling to work than among other gender subgroups. CONCLUSION Increasing of commuting PA level may have an important influence on reducing the prevalence of metabolic disorders.

Smoking status, the menopausal transition, and metabolic syndrome in women.

ObjectiveData on the relationship between tobacco use and metabolic risk among women with regard to their menopause status are scarce. This study assessed the prevalence of metabolic disorders in relation to smoking status in premenopausal and postmenopausal women. MethodsA cross-sectional analysis of 7,462 randomly selected women aged 20 to 74 years who are participating in the WOBASZ (Polish National Multicentre Health Survey) was carried out. Lifestyle and menopause status details were collected via an interviewer-administered questionnaire. Weight, height, waist circumference, blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol (HDL-C) levels were measured by standard methods. Metabolic syndrome (MetS) was defined according to the International Diabetes Federation criteria. ResultsThe prevalence of MetS was 3.3-fold higher among postmenopausal than premenopausal women. Regardless of menopause status, the prevalence of central obesity was significantly higher among never and past smokers versus current smokers (P < 0.001). Past smoking was associated with a significantly higher probability of elevated blood pressure, fasting plasma glucose, and MetS (P < 0.05). However, premenopausal never and past smokers had a substantially lower prevalence of decreased HDL-C than did current smokers. Among postmenopausal nonsmoking women, high levels of leisure time and commuting physical activity were associated with a reduced likelihood of MetS (P < 0.01). Making an additional adjustment for calorie consumption did not substantially influence the results. ConclusionsExcept for HDL-C level, not smoking is associated with an unfavorable metabolic profile in women, regardless of menopause status. High level of physical activity may reduce the prevalence of MetS among never and past smokers after the menopausal transition.

Years of life lost due to malignant neoplasms characterized by the highest mortality rate.

Introduction The analysis of premature deaths measured with years of life lost between the studied and referential populations helps to emphasize the social and economic aspect of a loss caused by deaths due to malignant neoplasms. The aim of the study was to analyze years of life lost by inhabitants of the Lodz province due to malignant neoplasms. Material and methods The study material included a database which contained information gathered from 313,144 death certificates (including 66,899 people who died of malignant neoplasms) of inhabitants of the Lodz province who died between 1999 and 2008. The SEYLLp (Standard Expected Years of Life Lost per living person) method was used to determine years of life lost. Jointpoint models were used to analyze time trends. Results In males the diseases which mostly contributed to death were tracheal, bronchial and lung malignant neoplasms (SEYLLp = 170.7) and cancer of the large intestine, rectum and anus (SEYLLp = 47.5). In females the principal diseases were tracheal, bronchial and lung malignant neoplasms (SEYLLp = 61.6), breast cancer (SEYLLp = 60.4) and cancer of the large intestine, rectum and anus (SEYLLp = 42.3). The years of life lost were growing in the period under study. Conclusions The number of years lost due to malignant neoplasms in the Lodz province between 1999 and 2008 was growing. The main reasons for deaths in females were tracheal, bronchial and lung malignant neoplasms as well as breast cancer and in males – cancer of the large intestine, rectum and anus as well as prostate cancer.

The burden of premature mortality in Poland analysed with the use of standard expected years of life lost.

BackgroundDespite positive changes in the health of the population of Poland, compared to the EU average, the average life expectancy in 2011 was 5 years shorter for males and 2.2 years shorter for females. The immediate cause is the great number of premature deaths, which results in years of life lost in the population. The aim of the study was to identify the major causes of years of life lost in Poland.MethodsThe analysis was based on a database of the Central Statistical Office of Poland, containing information gathered from 375,501 death certificates of inhabitants of Poland who died in 2011. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (SEYLL per death) measures were calculated to determine years of life lost.ResultsIn 2011, the total number of years of life lost by in Polish residents due to premature mortality was 2,249,213 (1,415,672 for males and 833,541 for females). The greatest number of years of life lost in males were due to ischemic heart disease (7.8 per 1,000), lung cancer (6.0), suicides (6.6), cerebrovascular disease (4.6) and road traffic accidents (5.4). In females, the factors contributing to the greatest number of deaths were cerebrovascular disease (3.8 per 1,000), ischemic heart disease (3.7), heart failure (2.7), lung cancer (2.5) and breast cancer (2.3). Regarding the individual scores per person in both males and females, the greatest death factors were road traffic accidents (20.2 years in males and 17.1 in females), suicides (17.4 years in males and 15.4 in females) and liver cirrhosis (12.1 years in males and 11.3 in females).ConclusionsIt would be most beneficial to further reduce the number of deaths due to cardiovascular diseases, because they contribute to the greatest number of years of life lost. Moreover, from the economic point of view, the most effective preventative activities are those which target causes which result in a large number of years of life lost at productive age for each death due to a particular reason, i.e. road traffic accidents, suicides and liver cirrhosis.

Years of life lost due to external causes of death in the lodz province, Poland

Background The aim of the study is the analysis of years of life lost due to external causes of death, particularly due to traffic accidents and suicides. Materials and Methods The study material includes a database containing information gathered from 376,281 death certificates of inhabitants of the Lodz province who died between 1999 and 2010. The Lodz province is characterized by the highest mortality rates in Poland. The SEYLLp (Standard Expected Years of Life Lost per living person) and the SEYLLd (per death) indices were used to determine years of life lost. Joinpoint models were used to analyze time trends. Results In 2010, deaths due to external causes constituted 6.0% of the total number of deaths. The standardized death rate (SDR) due to external causes was 110.0 per 100,000 males and was five times higher than for females (22.0 per 100,000 females). In 2010, the SEYLLp due to external causes was 3746 per 100,000 males and 721 per 100,000 females. Among males, suicides and traffic accidents were the most common causes of death (the values of the SEYLLp were: 1098 years and 887 years per 100,000 people, respectively). Among females, the SEYLLp values were 183 years due to traffic accidents and 143 years due to suicides (per 100,000 people). Conclusions A decrease in the number of years of life lost due to external causes is much higher among females. The authors observe that a growing number of suicides contribute to an increase in the value of the SEYLLp index. This directly contributes to over-mortality of males due to external causes. The analysis of the years of life lost focuses on the social and economic aspects of premature mortality due to external causes.

Ten-Year Changes in the Prevalence and Socio-Demographic Determinants of Physical Activity among Polish Adults Aged 20 to 74 Years. Results of the National Multicenter Health Surveys WOBASZ (2003-2005) and WOBASZ II (2013-2014).

Introduction The aim of the study was to estimate ten-year changes in physical activity (PA) patterns and sociodemographic determinants among adult residents of Poland. Methods The study comprised two independent samples of randomly selected adults aged 20–74 years participating in the National Multicentre Health Survey WOBASZ (2003–2005; n = 14572) and WOBASZ II (2013–2014; n = 5694). In both surveys the measurements were performed by six academic centers in all 16 voivodships of Poland (108 measurement points in each survey). Sociodemographic data were collected by an interviewer-administered questionnaire in both surveys. Physical activity was assessed in three domains: leisure-time, occupational and commuting physical activity. Results Leisure-time PA changed substantially between the surveys (p<0.001). The prevalence of subjects being active on most days of week fell in both genders in the years 2003–2014 (37.4% vs 27.3% in men); 32.7% vs 28.3% in women. None or occasional activity increased from 49.6% to 56.8% in men, while remained stable in women (55.2% vs 54.9%). In both WOBASZ surveys the likelihood of physical inactivity was higher in less educated individuals, smokers and those living in large agglomerations (p<0.01). No significant changes were observed in occupational activity in men between the surveys, while in women percentage of sedentary work increased from 43.4% to % 49.4% (p<0.01). Commuting PA decreased significantly in both genders (p<0.001). About 79.3% of men and 71.3% of women reported no active commuting in the WOBASZ II survey. Conclusions The observed unfavourable changes in PA emphasize the need for novel intervention concepts in order to reverse this direction. Further detailed monitoring of PA patterns in Poland is of particular importance.

Fifteen-year mortality trends in Poland analysed with the use of standard expected years of life lost, 2000–2014

The aim of the study is an evaluation of years of life lost by inhabitants of Poland according to the most important causes of mortality and identification of trends in the period 2000–2014. The study material included a database which contained information gathered from 5,601,568 death certificates of inhabitants of Poland. In order to calculate years of life lost, the SEYLLp index (Standard Expected Years of Life Lost per living person) was applied. We also calculated AAPC (Average Annual Percentage Change). The SEYLLp index (per 10,000 population) in Poland decreased from 2503.4 in 2000 to 2193.2 in 2014 among males (AAPC = −0.8%, p < 0.05) and from 1430.2 in 2000 to 1269.4 in 2014 among females (AAPC = −0.6%, p < 0.05). In 2014, the top 5 causes of years of life lost were: cardiovascular diseases (721.4 per 10,000 males and 475.6 per 10,000 females), malignant tumours (575.5 and 418.3), unintentional injuries (202.2 and 46.8), intentional injuries (114.6 and 16.3) and digestive diseases (120.2 and 58.3). Due to negative trends, there is a need to implement preventative measures, aimed at reducing mortality caused by respiratory infections in both males and females, malignant tumours in females and diabetes mellitus and intentional injuries in males.

Years of Life Lost Due to Premature Mortality in a Province with the Shortest Life Expectancy in Poland

AIM The aim of the study was to evaluate years of life lost for citizens of the Lodz Province, which is characterized by the lowest life expectancy in Poland, and to identify current trends in this area according to the most common causes of death. METHODS The study material included a database containing information gathered from 470,000 death certificates of Lodz Province inhabitants, who died between 1999 and 2011. In order to calculate years of life lost, the authors applied the SEYLLp (Standard Expected Years of Life Lost per living person) and SEYLLd (per death) indices. The analysis of time trends was carried out with the application of joinpoint models. RESULTS The SEYLLp measure was 2,300 years per 10,000 males and 1,500 years per 10,000 females in 2011. Cardiovascular diseases contributed to the highest number of years of life lost (SEYLLp=682 years per 10,000 males and 559 years per 10,000 females). Next were malignant neoplasms (SEYLLp=505 years per 10,000 males and 437 years per 10,000 females), external causes of death (SEYLLp=361 years per 10,000 males and 83 years per 10,000 females). The number of years of life lost due to acute myocardial infarction decreased most rapidly, the Annual Percent Change (APC) was -10.1% in males and -3.7% in females. However, heart failure contributed to the highest increase in the number of years of life lost (APC=10.8% in males and 10.9% in females). CONCLUSIONS A further decrease in the mortality rate due to cardiovascular diseases might contribute to the highest reduction of years of life lost. The most effective preventive activities are those aimed at reducing productive years of life lost due to a particular cause of death, i.e. road traffic accidents, suicides, cirrhosis of the liver, alcoholic liver disease, and malignant neoplasms of the trachea, bronchi and lungs.