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1,1'-azodi(formamide) (azodicarbonamide - ADCA) is widely used as a blowing agent, a chemical substance designed to induce foaming processes. In Poland, ADCA is manufactured by a company specializing in the production of polyethylene foam bags and laminates used in various industries including home appliances, electronics, construction, furniture, automotive, and sports and leisure. The mechanism of action of ADCA involves thermal decomposition, resulting in nitrogen, carbon monoxide, as well as ammonia and carbon dioxide as the main gaseous decomposition products. These penetrate the polymer matrix, contributing to expansion and foaming properties. Most studies evaluating the relationship between occupational exposure and the development of allergic respiratory diseases focus on workers involved in ADCA production or its use as a blowing agent in plastics. The objective is to assess the respiratory sensitizing effects of ADCA in humans due to occupational exposure, based on literature data. The presented data confirm that long-term occupational exposure to ADCA can lead to persistent bronchial hyperreactivity symptoms in workers. 1,1'-azodi(formamide) can induce occupational asthma, with initial symptoms including nasal congestion, conjunctivitis, wheezing, and cough. Subsequently, symptoms such as chest tightness, dyspnea, and nocturnal cough attacks may appear, with a latency period of several years observed before symptom onset. In some cases, symptom progression was noted with continued ADCA exposure, while in others, exposure was discontinued after initial symptoms, preventing observation of symptom exacerbation. Prior exposure to allergens, such as working in bakeries, appears to accelerate symptom onset. Improvement in allergy symptoms has been noted during weekend breaks from work. There is no safe concentration identified for ADCA that would not result in adverse health effects for workers. A concentration of 0.036 mg/m 3 is considered the lowest observed adverse effect concentration, causing critical reduction in lung spirometric parameters. Med Pr Work Health Saf. 2024;75(5):455-473., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Background: Occupational exposure to chemicals occurs mainly through inhalation and the skin. The inhalation exposure assessment is regulated by law, while in Poland the method of conducting measurements for dermal exposure has not been indicated in the law. However, due to the restrictions 71 and 76 from Annex XVII of REACH for 1-methyl-2-pyrrolidone (NMP) and N,N -dimethylformamide (DMF), exposure assessment by the dermal route is necessary. These restrictions require to ensure that exposure of workers is below the derived no-effect levels (DNELs) for dermal exposure. The aim of the work was assessment of suitability of selected non-measurement forecasting models for the estimation of dermal occupational exposure to chemicals for the purposes of assessing compliance of working conditions with the restrictions 71 and 76 of the REACH regulation., Material and Methods: Three tools estimating dermal exposure, recommended by European Chemical Agency (ECHA), were selected: ECETOC TRA, RISKOFDERM and IH SkinPerm, which were used to estimate 2 exemplary workplaces., Results: Results of the estimations of dermal exposure showed that non-measuring models are useful for fulfilling the obligations under restrictions 71 and 76 of Annex XVII of REACH. The type of exposure scenario and amount of data available for the workplace are crucial for the selection of the model. The ECETOC TRA was considered the best model for this type of analysis, whose main advantages are direct comparison of the output data in mg/kg/day with the DNEL value and use of standardized descriptors system., Conclusions: Exposure modeling is a good and cheap way to determine the dermal exposure magnitude at workplaces, also to comply with the requirements of restrictions 71 and 76 of Annex XVII of REACH. The application of modeling in the case of occupational exposure by the dermal route is one of the solutions when it is necessary to comply with the DNEL for dermal exposure. Med Pr Work Health Saf. 2023;74(6):487-500., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Background: Central register of data on exposure to carcinogenic or mutagenic chemical substances, their mixtures, agents or technological processes (CRCR) conducted by Nofer Institute of Occupational Medicine (NIOM) enables monitoring of such agents occurrence in working environment in Poland. The NIOM conducts CRCR based on the provisions of the Regulation of the Minister of Health of 24 July 2012 on chemical substances, their mixtures, agents or technological processes with carcinogenic or mutagenic effects in the work environment. The work summarizes the information reported to CRCR in 2018-2021., Material and Methods: The data were extracted from CRCR, to which it was transferred by sanitary inspections. The data were extracted from CRCR. Data in this register is gathered based on employers' notifications to sanitary inspection. The study includes the number of reported agents (chemical substances and technological processes), the number of enterprises and the number of persons exposed to particular groups of agents (chemical substances, technological processes, ionizing radiation)., Results: The number of substances notified to the CRCR increases, from 382 reported substances in 2018 to 444 in 2021. Significant increase in the number of enterprises reporting technological processes (from 981 in 2018 to 5422 in 2021) and the number of exposed persons results from the law amendments extending the list of carcinogenic or mutagenic processes., Conclusions: The CRCR is a unique database on the occurrence and exposure to occupational carcinogens and mutagens, in which data from over 20 years has been collected. The increase in the number of reports to the register was mainly influenced by legislative changes regarding carcinogenic or mutagenic agents. Due to amount and complexity of data, they can be used for analysis in projects and programs aimed at raising awareness and reducing risk of occupational exposure to carcinogens and also during legislative works in Poland and in the EU. Med Pr Work Health Saf. 2023;74(5):399-407., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Background: In Poland conditions related to or aggravated by the pregnancy, childbirth or the puerperium are one of the common causes of sickness absence. The aim of the study was to analyze the occupational activity pattern during pregnancy and to evaluate the determinants of pregnancy-related temporary work disability confirmed by medical certificate., Material and Methods: The presented analysis is based on data collected under the Polish Mother and Child Cohort Study. The study population consisted of 954 women who reported occupational activity during pregnancy. All women participating in the study were interviewed 3 times during pregnancy. Detail information on occupational activity during pregnancy and occupational stress, based on the Subjective Work Characteristics Questionnaire, was collected from all women., Results: The pregnant women had been issued medical certificate of temporary work disability because of conditions related to or aggravated by the pregnancy, childbirth or by the puerperium at 16 week of gestation on average and did not continue their activities until the end of pregnancy. The statistically significant determinants of receiving such medical certificate in the first trimester of pregnancy (< or = 12 weeks of pregnancy) comprised poor health condition and complications during pregnancy (OR = 1.4; p = 0.01), lower education (OR = 2.4; p <0.001), socio-economic status (OR = 9.6; p = 0.03), use of public transport to commute to work (OR = 2.7; p <0.001), a longer work commute (OR = 1.4; p = 0.008) and a higher level of occupational stress (OR = 3.0; p < 0.01). Waitresses, nurses and saleswomen received medical certificate of temporary work disability in the first trimester of pregnancy more frequently than office workers (OR = 4.2; p = 0.005; OR = 3.3; p = 0.02; OR = 2.3; p < 0.001 respectively)., Conclusions: It is crucial to develop the model of cooperation between occupational medicine physicians and gynecologists and a greater involvement of the former in the prophylactic care of occupationally active pregnant women. It is also important to increase the employers' awareness of potential risks and arduousness at work to assure working conditions safe for the pregnancy outcome and health of both women and their babies.

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.

Background: Stress is one of the most important health and social problems. Psychological stress has long been suspected of having an important impact on infertility. Studies on the effects of psychological stress on male fertility, especially the semen quality, have so far yielded equivocal findings., Materials and Methods: The study population consisted of 179 men who had reported to the infertility clinic for diagnostic purposes, some of them with normal fertility (semen total concentration of 15-300 mln/ml) or with slight oligozoospermia (semen total concentration of 10-15 mln/ml). The semen samples were analyzed in one laboratory according to the WHO manual on basic semen analysis. The main semen parameters were assessed: volume, motility, percent of atypical and progressive spermatozoa. To assess the occupational stress the Subjective Work Characteristics Questionnaire was used. Assessing the level of stress we concentrated on the sum of points obtained by each man taking part in the study and the number of psychosocial factors present at work reported by the subjects., Results: Measuring the level of stress by the Subjective Work Characteristics Questionnaire, we revealed negative effects of a number of stressful situations at work, which affect semen volume and percent of progressive spermatozoa, taking account of confounding factors that can have impact on the semen quality and thus affect fertility, such as duration of the couple's infertility, past sexual abstinence and diseases., Conclusion: The study confirm that the occupational stress can affect the male semen quality, however, due to the limited data on this issue, the obtained results must be confirmed by more extensive, longitudinal studies.

Background: There are two major potential hazards typical of work in greenhouses: hard physical work or exposure to pesticides. The aim of the study was to investigate whether the work in greenhouse during pregnancy have an adverse effect on its outcome (preterm delivery, spontaneous abortion and birth defects)., Materials and Methods: The study was performed in a group of 460 women employed in 14 greenhouses involved in growing vegetables and flowers., Results: The rate of spontaneous abortions was much elbeit insignificantly higher in the women working in greenhouses during pregnancy than in those employed out of them; that applied mostly to the women performing light jobs in greenhouses. An increased risk of preterm delivery and spontaneous abortion was also observed in women performing greenhouse light jobs. No significantly increased risk of birth defects was observed in children born to women working in greenhouses. Neither was there any relationship between exposure to RD or ED pesticides exposure--and the occurrence of preterm delivery, spontaneous abortion and birth defects., Conclusions: No higher risk of pathological pregnancy that could be associated with hard physical work and pesticide exposure was observed. This may result from the fact that women themselves select an appropriate kind of job during pregnancy and a possible removal of women with pathological pregnancy from jobs involving pesticide exposure, as well as from the promotion of biological protection. The greenhouse workers should be aware of the two typical hazards found in greenhouses (hard work and exposure to pesticides) and their potential negative effects on the reproduction. The results of this study warrant the need for further study of the effect of pesticide exposure and work load on the pregnancy outcome.

Background: The work in greenhouses might involve indirect exposure to pesticides, resulting from the contact with previously pesticide-treated flowers and vegetables. The objective of the study was to assess the exposure to selected pesticides of workers tending and harvesting greenhouse cultivations after the restricted-entry intervals expired using cotton patches., Material and Methods: Pesticide exposure was assessed among women (n=19) tending and harvesting vegetables in one of the vegetable production greenhouse in Poland. The exposure assessment methods were used to estimate workers' exposure to selected pesticides (hexythiazoks, azoksystrobin, imazalil) after the restricted-entry intervals expired. Cotton gloves and patches on chest and arms were used during the whole workshift in the greenhouse., Results: All the three kinds of pesticides were found on cotton patches and gloves. The concentration of the examined active ingredients was higher on gloves than on patches. Their concentration on patches and gloves between sprayings was proportional to the concentration of active ingredients used during sprayings., Conclusion: Dermal exposure of women to pesticides during work in a greenhouse takes place even when employees are not directly engaged in the process of spraying. Therefore, it is nececarry to ensure that this occupational group is provided with the efficient personal protective equipment.

This study reviews the evidence on the association between work in greenhouses and reproductive disorders. The analysis indicate that employment in greenhouses may increase the risk of birth defects, preterm delivery and spontaneous abortion, and also may affect birth weight. The obtained results showed that employment in the agriculture production sector (greenhouses) of more than 10 years decreased the median sperm concentration in men. The data on the effect of employment in greenhouses on the time to pregnancy are unequivocal, but most of them suggest that there is a relationship between the decreased fecundity ratio and greenhouse work, mostly due to exposure to pesticides. The literature review indicates a great need to increase awareness among greenhouse workers occupationally exposed to pesticides about potential negative effects of these chemicals on their health.

The aim of the study was to analyze the active smoking by pregnant women in different weeks of pregnancy. The study population consisted of 136 women before 22 weeks of pregnancy. The women were interviewed three times during pregnancy. From all women included into the study the saliva sample was collected three times to verified smoking status in pregnancy. Cotinine level in saliva was analyzes using Liquid Chromatography with Tandem Mass Spectrometry. Based on interview about 25-30% of pregnant women smoked cigarettes during pregnancy. This percentage was higher when the smoking status was verified using cotinine level in saliva (33-41%). In the group of pregnant women who smoked cigarettes there was no decreasing trend in cotinine level during pregnancy whereas in nonsmokers the decreasing trend was observed. Unmarried women, those with lover educational level, and unemployed had the highest risk of smoking during pregnancy.

Objectives: Maternal work during pregnancy, especially with high work-related physical exertion, is still considered one of the most prevalent risk factors of negative pregnancy outcome., Materials and Methods: Nofer Institute of Occupational Medicine has recently completed a study of women working in polish greenhouses. The greenhouse is a very good environment to measure the energy expenditure during work. That's why the women working for a period of at least 2 years in greenhouses in Poland were asked to participate in the project. We classified pregnancies of women on the basis of energy expenditure during mother's work into three groups: light work (200-700 kcal/shift); moderate work (701-1000 kcal/shift); and heavy work (1001-1200 kcal/shift)., Results: The study among women working in greenhouse revealed that the mean birth weight of infants whose mothers worked in greenhouse with heavy wok (work expenditure >1000 kcal/shift) during pregnancy was 177 g. lower, than that of those whose mothers worked out of greenhouse with light work (light work <700 kcal/shift) (p=0.05)., Conclusions: The results suggest the necessity to inform pregnant women about the potential negative influence of heavy work on pregnancy outcome.

Background: Pesticides have been used since the early days of modern agriculture. They are biologically active compounds that may pose a grave risk to health during or after their use. The available data, documenting pesticide exposures and related health effects in farmers, especially in pregnant women, are limited., Materials and Methods: Women were informed that the purpose of the research was to gather information about the exposure to pesticides during pregnancy. They were asked to provide information about their work in the field, spraying or preparatory work (washing clothes after spraying, cleaning, spraying equipment, preparing mixture for spraying). We received information about all spraying in household during woman's pregnancy, trade names of pesticides, names of active ingredients, type of cultivation and its area., Results: The survey of pregnant women working in agriculture provided us with knowledge of potential hazards resulting from their work during pregnancy, especially from their involvement in spraying or preparatory work and working in the field after spraying. Other data obtained informed us what kind of pesticides were used in agriculture., Conclusions: The results indicate the necessity for increasing awareness of potential exposure to pesticides and their harmful effect among workers, especially among pregnant women. There is also a need to estimate real exposure via biological monitoring.

Among numerous factors typical of occupations in agriculture, pesticides occupy a specific place. Their hazardous effects may be manifested among others by reproductive disorders. Therefore, it is very important to know what kind of pesticides is used in both agriculture and greenhouses. The aim of the study was to review the kinds and amounts of pesticides used in agriculture and greenhouses. The review was performed in the Kujawsko-pomorskie voivoship and on 14 horticulture farms. Their selection was based on the register of the Polish Horticulture Chamber. The pesticides were classified into two groups: those containing reproductive and/or developmental toxins (RD) and those acting as endocrine disrupters (ED). The majority of pesticides used in agriculture and horticulture belong to one of those groups. The results of the review suggest that the awareness of potential adverse effects of pesticides on fertility and pregnancy outcome should be increased among workers occupationally exposed to pesticides.