Wilczyńska U

Cancer mortality and occupational exposure to aromatic amines and inhalable aerosols in rubber tire manufacturing in Poland

AIM Most data on carcinogenic risk in the rubber industry are based on data from Western countries. This study assessed cancer risks in a retrospective cohort in a Polish tire manufacturing plant, relying on quantified exposure to inhalable aerosols and aromatic amines instead of job titles or external comparisons. METHODS Cumulative exposure for all exposures was assigned to cohort members based on estimates from a company-specific JEM. Cancer risks associated with cumulative exposure adjusted for co-exposures, gender and year of birth were calculated. RESULTS Exposure levels were higher for women than for men. Aromatic amine exposure was significantly associated with increased urinary bladder cancer risk (RR=7.32-8.27), depending on exposure level, and prostate cancer at low levels only (RR=5.86). In women, increased risks were found for all cancers (RR=2.50) and of the digestive organs and peritoneum (RR=4.54) at low level only, while an exposure-response association with breast cancer risk was found. Inhalable aerosol exposure was associated with cancers of the liver and intrahepatic bile ducts in a dose-dependent manner, while dose-dependent reduced risks were found for respiratory cancers (most notably the larynx) and cancer of the colon. CONCLUSIONS Increased risks for specific cancer sites in this rubber plant were similar to Western Europe and the US. However, several cancer risks were gender-specific which could relate to higher exposure levels in women or to differences in exposures to chemicals not assessed in this study.

Asbestos in Poland: occupational health problems.

The presentation addresses current problems of health risk and health effects associated with exposure to asbestos, including data on historical exposure and on currently valid occupational exposure limits. The quantity and types of the raw material used for the production of various asbestos products have also been discussed in relation to the particular types of asbestos-induced occupational diseases. The authors describe the medical care system for former asbestos workers and those currently exposed during removal of asbestos-containing products. The national system for medical certification of occupational asbestos-related diseases and the compensation procedure have been outlined as well. According to the parliamentary Act of 1997, importing, manufacture and sale of asbestos and asbestos-containing materials are prohibited in Poland. Thus, the assessment of asbestos exposure and the monitoring of health conditions of workers at asbestos-processing plants have become irrelevant. However, the delayed health effects attributable to past exposure continue to be the matter of concern for public health. Likewise, the environmental pollution from asbestos waste landfills in the vicinity of asbestos-processing plants (where high levels of asbestos fibre in ambient air have been recorded) will continue to be a serious public health problem. Presently, two programmes aimed at minimising the adverse effects of asbestos on population health are underway. One of them is the governmental programme for “Elimination of asbestos and asbestos-containing products used in Poland, 2002–2032”. The programme was updated in 2009 to cover the workers contracted to perform demolition works and provide protective covers to asbestos waste landfills. This will be the exposed group who need prophylactic health care. The other is a programme of prophylactic examinations for former asbestos workers and is referred to as the AMIANTUS programme. Both programmes have been briefly described.

Environmental asbestos pollution — Situation in Poland

ObjectivesEnvironmental exposure of the general population to asbestos in Poland is mainly due to degradation of very popular asbestos-cement products and the resultant release of the elementary asbestos fibres into the ambient air. Assessments of environmental pollution by asbestos were based on the volume of the raw material used, amount of manufactured asbestos products, and measuring the concentration of fibres in the air.Material and MethodsUnder the governmental program intended to remove asbestos, measurements of the concentration of asbestos fibres were performed in 2004–2010 in all provinces of Poland. Considering that potential sources of asbestos dust emissions were present in residential areas, 1634 sampling sites were designated. From 2 to 4 air samples were collected at each sampling site. A total of 5962 samples were collected during seven years. A single dose of air collected by 25 mm 0.8 μm pore Sartorius filter was 1,300 litres. The fibres were counted using optical microscopy with phase contrast (PCM) on a polarizing microscope (PLM) at a total magnification of 600×.; method was adapted to determine the concentration of asbestos fibres in non-occupational environment.ResultsMean concentration of asbestos fibres was 492 f/m3 (95% CI: 467–518). In 82% of the sampling sites, the mean concentrations did not exceed 800 f/m3. As much as 25.8% of the samples were found to be below the detection limit of the method. Estimated mean concentrations of fibres in different provinces ranged from 146 (95% CI: 106–203) to 709 f/m3 (95% CI: 591–851). In the areas affected by former asbestos-processing plants, mean concentration was 732 f/m3 (95% CI: 527–1016) and was significantly higher than levels recorded in other areas of Poland.ConclusionAsbestos consumption per capita and the recorded moderate levels of asbestos fibres concentration in atmospheric air point to a relatively low level of environmental asbestos pollution in Poland.

Elaboration of a quantitative job‐exposure matrix for historical exposure to airborne exposures in the Polish rubber industry

BACKGROUND A job-exposure matrix (JEM) for inhalable aerosols, aromatic amines, and cyclohexane soluble matter (CSM) was elaborated based on measurements collected routinely between 1981 and 1996. METHODS The data were grouped based on similarities in exposure levels and time trends in different departments, and were analyzed using smoothing splines and mixed effects models. RESULTS Although higher than in western European countries, inhalable aerosol exposure decreased after changes in production volume and implementation of exposure reduction measures in mid-1980s. Aromatic amines concentrations first increased following the factorys production volume, but subsequently decreased in more recent years. CSM concentrations were uniformly distributed between departments. CONCLUSIONS This JEM provides an overview of historical exposure levels in a large Polish rubber factory and will enable estimation of lifetime exposure for individual workers in a Polish rubber workers cohort and further investigation of the associations between specific exposures and cancer risk.

Medical monitoring of asbestos-exposed workers: experience from Poland.

Abstract In Poland, the use of asbestos was banned in 1997 and asbestos plants have been closed since then. Despite their closure, cases of asbestos-related occupational diseases among former asbestos workers are still being recorded in the Central Register of Occupational Diseases. Between 2001 and 2014, there were 2726 asbestos-related illnesses, classified and reported as diseases associated with occupational exposure to asbestos. In 2000, Poland introduced a programme called Amiantus, targeted at former asbestos-processing plant workers. The programme provided periodic medical examinations to workers and free access to medications for treatment of asbestos-related illnesses. Introduction of the programme provided additional data to generate a reliable estimation of the number of asbestos-related occupational diseases, including cancer. The average latency period for asbestosis, lung cancer and mesothelioma is about 40 years so there may still be some health impact to former workers necessitating follow-up. We present the Polish experience of implementing a medical examination programme for asbestos-exposed workers and provide a list of activities to consider when planning for such a programme.

Occupational diseases in Poland — An overview of current trends

IntroductionThe number of occupational diseases (OD) recorded in Poland in the 1990’s rapidly increased, and the number of recognized cases has steadily decreased until now. Hence, it was decided to demonstrate the trends of selected pathologies which in Poland are “underestimated” in comparison to other countries. The presented data may constitute a basis for further research into the dependence of OD on socio-economic factors.Materials and MethodsOccupational Disease Reporting Forms, completed and sent obligatorily by the state health inspectors to the Central Register of Occupational Diseases were used as source documents for analysis. This work analyzes changes in the incidence of chronic poisonings, asbestosis, voice organ diseases, cancers, viral hepatitis, asthma and the musculoskeletal disorders over the years 1998–2011.ResultsIn 1998, the total number of registered diseases reached the maximum — 12,017 cases, which fell in the subsequent years to 2,562 cases in 2011. During that period, the incidence rate decreased by 6 cases per year per 100,000 employees. A considerable decrease, exceeding 90% of cases, was observed in voice organ disorders, hearing loss, chronic poisonings and viral hepatitis. The abovementioned changes, as well as improved detection of asbestos-related diseases through implementing a medical examination program of former asbestos processing plant workers, are advantages of the current situation in the epidemiology of OD. However, the disadvantages include underestimation, in comparison to other countries, of asthma, cancer and pathologies of the musculoskeletal system.ConclusionThe reported data indicates the need to assess the occupational fraction of the underestimated pathologies present in the work environment in Poland, as well as the need for studies aimed at clarifying the effect of systemic factors on identifying their occupational background.

Occupational diseases among farmers in Poland

BACKGROUND The studys objective is to present epidemiological situation concerning the incidence of occupational diseases among farmers in Poland. MATERIAL AND METHODS All 3438 cases of occupational diseases diagnosed among farmers and obligatorily reported to the Central Register of Occupational Diseases (covering all the national territory and all the cases of occupational diseases diagnosed in Poland after 1970) over the years 2000-2014 were subjected to analysis. RESULTS The annual incidence in the analyzed period ranged 5-14 per 100 000 farmers. The analysis showed that about 90% of pathologies were induced by the biological agents. Almost every third pathology due to biological agents had allergic origin. Infectious and parasitic diseases accounted for 62% of the cases. Among them the diseases carried by ticks (93%) - borreliosis (85.8%) and tick-borne encephalitis (7.2%) were the most frequent ones. The age of farmers, in the case of whom bronchial asthma and allergic rhinitis were diagnosed, was significantly higher than the age of remaining employees of the national economy, in which these occupational diseases were recognized. CONCLUSIONS The study indicates the necessity to introduce periodic health examinations programs focusing on agricultural workers to monitor health and well-being and improve working conditions and the working environment. Med Pr 2016;67(2):163-171.

[Occurrence of occupational diseases in Poland, 2014].

BACKGROUND The aim of the annual analysis of the incidence of occupational diseases in Poland is to evaluate the extent of the incidence and to identify its causes as well as activities involving factors that are harmful or annoying to such an extent that they result in occupational diseases. MATERIAL AND METHODS Occupational diseases reporting forms supplied to the Central Register of Occupational Diseases were used as the study material. RESULTS In 2014, there were 2351 cases of occupational diseases recorded, i.e., 16.5 cases per 100 thousand of employees. The most numerous categories comprised infectious or parasitic diseases (borreliosis), pneumoconiosis, voice disorders and hearing loss (in total 79.7% of cases). The main causative factors of occupational diseases were as follows: industrial dust containing free silica, tick-transmitted Borrelia spirochete, and the way the work is done, including excessive vocal effort, and noise. The highest incidence per 100 thousand workers were recorded in mining and quarrying (296), manufacturing (24.9), education (24.6), agriculture and forestry (24.2) sectors. CONCLUSIONS Compared with the previous year, there was a slight increase in the number of cases of certified occupational diseases (6.2%), primarily due to the increased incidence of Lyme disease. The incidence of voice disorders among teachers continues to vary considerably in individual provinces (0-11.3/10 000), reflecting the use of non-uniform diagnostic and certification methods. Med Pr 2016;67(3):327-335.

Choroby zawodowe w Polsce w 2014 r.

BACKGROUND The aim of the annual analysis of the incidence of occupational diseases in Poland is to evaluate the extent of the incidence and to identify its causes as well as activities involving factors that are harmful or annoying to such an extent that they result in occupational diseases. MATERIAL AND METHODS Occupational diseases reporting forms supplied to the Central Register of Occupational Diseases were used as the study material. RESULTS In 2014, there were 2351 cases of occupational diseases recorded, i.e., 16.5 cases per 100 thousand of employees. The most numerous categories comprised infectious or parasitic diseases (borreliosis), pneumoconiosis, voice disorders and hearing loss (in total 79.7% of cases). The main causative factors of occupational diseases were as follows: industrial dust containing free silica, tick-transmitted Borrelia spirochete, and the way the work is done, including excessive vocal effort, and noise. The highest incidence per 100 thousand workers were recorded in mining and quarrying (296), manufacturing (24.9), education (24.6), agriculture and forestry (24.2) sectors. CONCLUSIONS Compared with the previous year, there was a slight increase in the number of cases of certified occupational diseases (6.2%), primarily due to the increased incidence of Lyme disease. The incidence of voice disorders among teachers continues to vary considerably in individual provinces (0-11.3/10 000), reflecting the use of non-uniform diagnostic and certification methods. Med Pr 2016;67(3):327-335.

Occupational diseases in Poland, 2014

BACKGROUND The aim of the annual analysis of the incidence of occupational diseases in Poland is to evaluate the extent of the incidence and to identify its causes as well as activities involving factors that are harmful or annoying to such an extent that they result in occupational diseases. MATERIAL AND METHODS Occupational diseases reporting forms supplied to the Central Register of Occupational Diseases were used as the study material. RESULTS In 2014, there were 2351 cases of occupational diseases recorded, i.e., 16.5 cases per 100 thousand of employees. The most numerous categories comprised infectious or parasitic diseases (borreliosis), pneumoconiosis, voice disorders and hearing loss (in total 79.7% of cases). The main causative factors of occupational diseases were as follows: industrial dust containing free silica, tick-transmitted Borrelia spirochete, and the way the work is done, including excessive vocal effort, and noise. The highest incidence per 100 thousand workers were recorded in mining and quarrying (296), manufacturing (24.9), education (24.6), agriculture and forestry (24.2) sectors. CONCLUSIONS Compared with the previous year, there was a slight increase in the number of cases of certified occupational diseases (6.2%), primarily due to the increased incidence of Lyme disease. The incidence of voice disorders among teachers continues to vary considerably in individual provinces (0-11.3/10 000), reflecting the use of non-uniform diagnostic and certification methods. Med Pr 2016;67(3):327-335.