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Background and Aims: Polycyclic aromatic hydrocarbons (PAH) are a group of compounds, comprising two or more fused aromatic rings, that are formed as a result of incomplete combustion of organic ma...

Environmental tobacco smoke exposure (ETS) is a significant risk factor for the development of many diseases, including lung cancer, lower respiratory tract infections, asthma and eye, throat and nasal irritations. Hospitality workers form an occupational group with high exposure to ETS in their workplace. Taking into account the health consequences of ETS exposure and high prevalence of exposure in public places, including workplaces, many countries have implemented the smoking ban that prohibits or restricts smoking in workplaces, including restaurants and bars. The epidemiological studies have indicated a significant reduction in the exposure level after implementation of the smoking ban. Most studies have also indicated a significant reduction in respiratory and sensory symptoms. The impact of the smoking ban on the lung function measurements is still not clear.

Environmental tobacco smoke (ETS) exposure induces serious negative health consequences, of which the increased risk of cardiovascular diseases, cancer, respiratory symptoms and poor pregnancy outcomes appear to be most important. Taking into account those health consequences of ETS exposure most countries have introduced legislation to ban or restrict smoking in public places. In this paper the effectiveness of the introduced legislation was analyzed with regard to the protection of hospitality workers from ETS exposure in the workplace. The analysis of 12 papers published after 2000 covered the year of publication, type of legislation, study population, hospitality venue (pub, bar, restaurant, disco) and type of markers or self-reported perception of exposure to ETS. The analysis indicates that the legislation to ban smoking in hospitality venues protects workers from ETS exposure when the venues are 100% tobacco smoke free. The reduction of the cotinine level in biological samples after the implementation of smoke free law was 57-89%, comparing to the biomarker level in the samples taken before the new law was introduced. About 90% of reduction in nicotine and PM levels was also noted. In addition, the positive self perception reported by workers proved the effectiveness of new legislation protecting them from ETS exposure.

The aim of the study was to analyze the association between prenatal environmental tobacco smoke exposure (ETS) and child anthropometric parameters at birth such birth weight, length, head and chest circumference. The study population consisted of 107 pregnant women from Lodz district as the part of Polish Mother and Child Cohort study. The child prenatal ETS exposure was assessed based on questionnaire with mothers and cotinine level in saliva collected three times in pregnancy. The level of cotinine in biological samples was analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS ESI+). About 35% of the children were prenatally exposed to ETS. The birth weight of the children prenatally exposed to ETS was 335 g lower than the birth weight of non-exposed newborns p0.001 after adjustment for: maternal educational level, marital status, prepregnancy weight, child gender, and gestational age. The same refers to child length and chest circumference (coef. -1.1 cm; p = 0.03 and coef. -1.3 cm; p = 0.002 respectively). Taking into account the negative effect of prenatal exposure to ETS, more efforts need to be taken to eliminate child ETS exposure.

The aim of the study was to evaluate smoking prevalence and exposure to environmental tobacco smoke among school administrators. The study population consisted of 320 administrative workers in schools from Lodz district. Among the study participants self-administrative questionnaire was conducted. The questionnaire focused on socio-demographic characteristics, detail information about active smoking and environmental tobacco smoke exposure. Current tobacco smoking was indicated by 19% of women and 28% of men (p = 0.06). Only 35% of the study subjects declared willingness to give up the habit. Significantly less men than women felt that they should quit smoking (36% vs. 11.4%, p0.05). Only small part of the study population expected the help in quitting smoking from specialists, physicians or school. It is crucial to increase awareness among the school administrators about negative effects of smoking and to motivate them to give up the habit. About 7% of study subjects (5% of women and 11% of men, p0.05) declared that smoking is allowed in school building and 13% of them indicated that there are no regulations on it or did not know such regulations.

The aim of the study was to analyze the opinion of administrative personnel in school on smoke-free regulations. The study population consisted of 320 subjects. Among the study population questionnaire was conducted including socio-demographic characteristic, smoking and SHS profile. Detail information was collected about opinion on smoke-free public places such as offices, other workplaces, health and educational buildings, restaurants and bars. About 22% of study population declared current tobacco smoking. More current everyday smoking was observed among men comparing to women (17.8% vs. 9.1%; p0.05). The study indicated that high percentage support total ban of smoking in public offices (84%), health care buildings (89%), and educational buildings (86%). 60% of the study subject were in favor of smoke-fee restaurants and 38% sypport smoke-free burs, pubs and clubs. The strong approval for ban on tobacco product advertising was indicated by 41% of respondents and 38% of them expect pictorial warnings on tobacco packs.

A prospective cohort study design gives the opportunity for identification, update of different exposures and their verification by biomarker measurements. The aim of The Polish Mother and Child Cohort Study (REPRO_PL) is to evaluate the impact of exposure to different environmental factors during pregnancy and, after birth, on the pregnancy outcome, children's health and neurodevelopment.REPRO_PL cohort was established in 2007. From the cohort of 1300 mother-child pairs, 300 children are followed-up until they are two years old to asses the exposure, health status and neurodevelopment. Children are examined twice: at one and two years of age by a pediatrician and a psychologist/child development specialist. During each visit, detailed questionnaire is conducted with the mothers and supplemented with the information from the medical charts to have appropriate recognition of the child's health and development. Additionally, the current health status of the child is checked and his/her biometry is performed. A urine sample is collected from each child for the verification of environmental tobacco smoke (ETS) and polycyclic aromatic hydrocarbons (PAH) exposure. Some children have a blood sample collected for the assessment of the lead and cadmium levels. Child's neurodevelopment is assessed based on Bayley Scales for Infant and Toddler Development (Bayley-III).The results of the study will become available within the next few years and will help to determine the impact of the environmental exposures on children's health and neurodevelopment. REPRO_PL cohort is a middle-sized cohort, very much focused on specific research questions with the potential for future extension and cooperation.

The aim of the study was to characterize the PAH exposure level based on 1-hydroxypyrene (1-HP) in urine of Polish pregnant women and to assess the relationship between PAH and factors such as smoking, environmental tobacco smoke exposure, place of residence, heating and cooking method.The study population included in this analysis consisted of 449 pregnant women who had been the subjects of the prospective Polish Mother and Child Cohort study performed in 8 regions of Poland. The women were interviewed three times during pregnancy (once in each trimester). 1-HP concentration in urine was chosen as the biomarker of exposure to PAH. The urine sample was analysed using high performance liquid chromatography (HPLC). The active and passive smoking exposure was verified by saliva cotinine, analysed by high performance liquid chromatography coupled with tandem mass spectrometry (LC-MSMS) and isotope dilution method.1-HP concentration in urine ranged from 0.02 to 10.2 μg/g creatinine with the geometric mean (GM) 0.4 μg/g creatinine. The significantly higher concentration of urinary 1-HP in pregnant women was observed for summer collection (GM ratio: 1.1; p = 0.01), among smokers (GM ratio: 1.7; p0.001) and for the women living in big cities (GM ratio: 1.3; p = 0.001).The significantly higher concentration of urinary 1-HP in pregnant women was observed for summer collection, among smokers and those living in big cities.

The aim of the study was to evaluate the prenatal and postnatal child exposure to environmental tobacco smoke. The study population consisted of 83 women from Lodz, Poland among which detail questionnaire was conducted three times during pregnancy period. From all women included into the study the saliva sample was collected to verify smoking status in pregnancy. One year after delivery the second questionnaire was performed and urine sample from all children was collected. The cotinine level in saliva and urine was analyzed using Liquid Chromatography with Tandem Mass Spectrometry (LC-MS/MS ESI+). About 22% of the children were expose to ETS during prenatal and 46% in postnatal period. Cotinine level in children's urine statistically differentiated children from smoking mothers (Geometric Mean (GM) 11.4 ng/ml; 95% CI 7.1-18.3) and exposed homes (GM 7.3 ng/ml; 95% CI 3.6-15.0) compared with non-exposed homes (GM 1.3 ng/ml; 95% CI 0.9-1.7) (p0.001). Children should be more protected from ETS exposure in prenatal and postnatal period.

The aim of the study was to evaluate the nurses' knowledge about health effects of active and passive smoking and their attitude towards providing smoking cessation activities. The study population consisted of 299 nurses. About 57% of the women thought that some kind of cigarettes can be less dangerous than other. Almost all of the nurses indicated that tobacco smoking may lead to addiction. Unfortunately only 67% of study population thought that sidestream smoke contains substances dangerous for health. All nurses indicated that tobacco smoking causes lung cancer and 77% of them that it can cause cardio-vascular diseases and only 26% that it increases the risk of bladder cancer. Almost all women indicated that environmental tobacco smoke exposure is dangerous for pregnant women and the faetus. The nurses were educated about health effects of active and passive smoking but they have limited knowledge about the methods used in antismoking counseling.

The aim of the study was to analyze the nurse attitudes towards smoke-free regulations in public places. The study population consisted of 299 nurses. Among the study population questionnaire was conducted including socio-demographic characteristic, smoking and ETS profile, knowledge about health effects of smoking and abilities for conduction of antismoking counseling. Detail information was collected about nurse opinion on smoke-free public places such as offices, other workplaces, health and educational buildings, restaurants and bars. About 18% of study participants declared current tobacco smoking and 25% were former smokers. Almost all participating in the study women (85%-98%) are in favor of smoking ban in offices, health and educational buildings. 75% supported smoking ban in workplaces but 15% of them were somewhat opposed. Most of the nurses were in favor of smoke-free restaurants (64%) but they were less likely to support smoke-free bars, pubs and clubs (45%). Unfortunately 63% of interview women do not accept smoking ban in private cars. The percentage of women who support total ban of smoking in the presence of pregnant women was 93% and in the presence of children 79%. It is important to conduct educational and informational activities to increase public awareness on health consequences of active and passive smoking and the ways of elimination of such exposures.

The aim of the study was to evaluate the nurses' exposure to active and passive smoking. The study population consisted of 299 nurses. Among the study population detailed questionnaire was conducted incusing sociodemographic characteristic, smoking profile and environmental tobacco smoke exposure. About 18% of nurses indicated current tobacco smoking and 25% smoking in the past. Only 13% of the study population declared complete ban of tobacco smoking in their homes and 20% indicated exposure to tobacco smoke in the workplaces. The women were most frequently exposed to inhaling tobacco smoke in bars and pubs (97%), restaurants (65%) and in private cars (64%).

Objectives Exposures during prenatal period have implications for pregnancy outcome as well as for children's health, morbidity and mortality. Prospective cohort study design allows for the identification of exposures that may influence pregnancy outcome and children's health, verification of such exposures by biomarker measurements and notification of any changes in exposure level. Materials and methods Polish Mother and Child Cohort Study (REPRO_PL) is multicenter prospective cohort study conducted in 8 different regions of Poland. The final cohort is intended to comprise 1300 mother-child pairs to be recruited within 4-year period (2007-2011). The recruitment and all scheduled visits are conducted in maternity units or clinics in the districts included in the study. The women are followed-up 3 times in pregnancy (once in each trimester) and after delivery for the notification of pregnancy outcome. During each visit, detailed questionnaire and biological samples are collected including saliva, urine, hair, maternal blood and cord blood. About 6 weeks postpartum, breast milk from part of the women is collected. The study concentrates on the identification and evaluation of the effects of prenatal environmental exposure on pregnancy outcome and children's health. Specific research hypotheses refer to the role of heavy metals, exposure to polycyclic aromatic hydrocarbons (PAHs) and environmental tobacco smoke (ETS) in the aetiology of small-for-gestational-age (SGA) and preterm delivery (PD). The role of oxidative stress putative mechanism and pregnant women nutritional status will be investigated. Based on questionnaire data, the impact of occupational exposures and stressful situations will be evaluated. Results The results of the study will become available within the next few years and will help to determine levels of child prenatal exposure in several areas of Poland and its impact on course and outcome of pregnancy.

Objectives: The aim of the study was to examine the impact of polycyclic aromatic hydrocarbons (PAH) on foetal growth. Materials and Methods: The prospective Polish Mother and Child Cohort study was performed in 8 regions of Poland. The study population consisted of 449 mother-child pairs All women were interviewed three times during pregnancy (once in each trimester). 1-hydroxypyrene (1-HP) concentration in urine was chosen as the biomarker of exposure to PAH. The urine sample collected from the participant women between 20-24 weeks of pregnancy was analysed using high per- formance liquid chromatography (HPLC). The active and passive smoking exposure was verified by determination of saliva cotinine level using high performance liquid chromatography coupled with tandem mass spectrometry/positive electro- spray ionisation (LC-ESI + MS/MS) and isotope dilution method. Results: The exposure to PAH measured by 1-HP level in urine of pregnant women was significantly associated with child birth weight (β = -158.3; p = 0.01), chest circumference (β = -0.7; p = 0.02) and cephalisation index (β = 4.2; p = 0.01) after adjustment for gestational age, child gender, pregnant woman marital status, educational level, season of last menstruation period (LMP), prepregnancy body mass index (BMI), and weight gain in pregnancy. After inclusion salivary cotinine levels into the analysis, the results were not statistically significant. Conclusions: Prenatal exposures to PAH adversely influence foetal development including child weight, length, head and chest circumference. Tobacco smoking is the important source of PAH. After controlling for active and passive smoking, the observed associations were not statistically significant.

Tobacco is the single greatest preventable cause of death in the world today, killing approximately half of the people who use it. Several strategies have been proved to reduce tobacco use. However, more than 50 years after the health effects of smoking were scientifically proven, and more than 20 years after evidence confirmed the hazards from exposure to second-hand smoke, few countries have implemented effective and recognized strategies to control the tobacco epidemic. This paper summarizes the World Health Organization recommendations for effective protection from exposure to environmental tobacco smoke along with the existing tobacco control programs and legislation in force in Poland.

Polycyclic aromatic hydrocarbons (PAHs) are compounds that are formed as a result of incomplete combustion of organic matter. The most common sources of PAHs are cigarette smoke, coal-fired utilities, steel plants, coke-oven plants, graphite electrode manufacturing plant, Söderberg aluminum electrolysis plant, vehicle exhaust, wood-burning ovens and fireplaces, and charcoal-grilled and smoked food. The aim of the study was to assess the exposure of smoking pregnant women to PAHs.The study population consisted of 189 pregnant women from the Lódź voivodeship (province). Smoking status was assessed based on saliva cotinine level analyzed by liquid chromatography with tandem mass spectrometry (LC-MS/MS). The cutoff point 10 ng/ml was adopted for saliva cotinine level. 1-hydroxypyrene (1-HP) concentration in urine sample was chosen as the biomarker of exposure to PAHs.The mean concentration of 1-HP in urine of nonsmoking woman was 0.60 microg/g creatinine, whereas in smoking one 1.35 microg/g creatinine. Among the women with saliva cotinine level higher than 10 ng/ml, the mean concentration of 1-HP in urine was over twofold higher than that in women with cotinine level lower than 10 ng/ml after adjustment for the day of urine ample collection (ratio of geometric mean 2.3; 95% CI 1.7-3.0). The study confirmed a higher risk of exposure to PAHs in the group of women who smoke cigarettes during pregnancy as compared to nonsmoking women. It should be stressed that cigarette smoking is not the only source of exposure to PAHs.

Tobacco smoking, lack of recreational physical activity, unbalanced diet, overweight and obesity are the major modifiable risk factors for chronic diseases. The aim of the study was to evaluate the prevalence of smoking and the other lifestyle behaviors among economically active adults.The study population consisted of 442 randomly selected economically active adults from the Lódź and Lublin districts, Poland. The prevalence and different possible combination of four major risk factors for chronic diseases was determined.About 40% of men and 28% of women smoke at least one cigarette per day. Only 3.5% of men and 1.9% of women meet the recommended guidelines for four common health life style factors. Only about 2% of smokers obey the rules relating to other healthy behaviors. In women smoking cigarettes, the risk for not being physically active is twice as high as that in nonsmokers.The prophylactic programs for healthy lifestyle behaviors should be addressed to all economically active individuals, taking into account their level of education, the type of work performed and income.

In Poland, prenatal exposure to tobacco smoke is observed in about 30 percent of children and postnatal in over 50 percent of children. This exposure has serious health consequences, including the negative effect on child neurodevelopment. The aim of the study was to assess the effect of environmental tobacco smoke (ETS) exposure on child psychomotor development.The study population consisted of 63 children with well assessed prenatal ETS exposure (a threefold analysis of cotinine level in saliva of pregnant women). To assess ETS exposure in infants within one year after birth a questionnaire-based interview was conducted with mothers. The Bayley Scale for Infant and Toddler Development (BESID-III) was used for the evaluation of child neurodevelopment.Multivariate analysis (including gender, birth order of the child and parental educational status) indicated the statistically significant association between prenatal exposure to ETS and cognitive child development (b = -4.0; p = 0.04). ETS exposure has also a negative impact on motor (b = -2.7; p = 0.2) and language (b = -3.4; p = 0.08) abilities of the child although the results were not statistically significant.Maternal smoking was found to be related to a decrease in child neurodevelopment, however, it was impossible to separate the prenatal from postnatal exposure. A lot of effort should be made to eliminate ETS exposure of children.

The aim of the study was to evaluate the effectiveness of antismoking counseling for postpartum women. The study was conducted between 2004-2006 in Lodz district. The study population consisted of 199 women and among them 100 were included into the intervention group and 99 to control one. Antismoking intervention and control activities were conducted among the women who quit smoking during pregnancy and maintained smoking abstinence after delivery. There were no statistically significant differences regarding the socio-demographic characteristic between intervention and control group. The women who received antismoking advice relapsed into the smoking less frequently than the women from the control group (26% vs. 56%; OR = 0.25; 95% CI 0.15-0.51). The antismoking counseling for postpartum women is the effective tool to help them to maintain smoking abstinence.

Smoking plays an important role in no communicable diseases including cardiovascular diseases etiology. In recent years more attention has been paid to the role of physicians in smoking prevention and treatment. The aim of this study was to analyze the presence of antismoking counselling given by physicians among the patients with the risk factors for cardiovascular diseases. The study was performed in the randomly selected group of 1267 men and women aged 18-65 years from Lodz and Lublin district. Each surveyed person had medical examination, blood pressure measured, anthropometry, biochemical tests included a full lipidogram and glucose concentration. Moreover detailed questionnaire surveys were conducted. Logistic regression models were applied to assess role of factors influencing undertaken of antismoking counseling among the patients with risk factors of cardiovascular diseases. The study revealed that smoking addiction affected 44% males and 23 % females. Abdominal obesity frequency in males was 24% and in females 35%. Hypertension was diagnosed in 30% of males and 21% of females, hyperlipidemia was diagnosed in 29% men and 19% women. High glucose concentration was identified in 7% of men and 5% of women. Only half of the smoking population received anti-smoking counselling given by physician. More frequently antismoking advice was given to the patients with abdominal obesity, (68%), and hypertension (67%). Only 36% of people with high glucose concentration received antismoking advice. This study results revealed, that anti smoking treatment among adults should be consider as an important part of preventing strategies. More effort should be given to increase awareness of physicians relating to the smoking habit of their patients.

Nowadays, tobacco smoking is the single most preventable cause of death all over the word. Now it kills annually more than five million people and this number will increase to over 8 million by 2030. The aim of this study was to assess the prevalence of smoking and risk factors for smoking in the adult population of the Lódź district.We included into the study a representative group of the adult population (1037 people) living in this district. The sampling and all study procedures were based on the methods for Multi-Center Representative Nationwide Study--WOBASZ. A questionnaire was employed to determine the smoking status. Logistic regression models were applied to assess the factors related to the smoking habit.In the study population, 40.8% of men and 19.5% of women were active smokers. The following factors were associated with the smoking status: lower educational level (OR = 3.1; 95% CI: 1.4-6.8) and lower level of income (OR = 2.4; 95% CI: 1.2-4.9) in men, and marital status--widow (OR = 3.3, 95% CI: 1.4-7.5) in women. People living in small districts showed a higher risk for smoking than those living in larger urban areas (men, OR = 2.1; 95% CI: 1.3-3.6; women, OR = 2.8, 95% CI: 1.5-5.2) Older persons smoke less frequently than younger ones (men, OR = 0.3; 95% CI: 0.1-0.8; women, OR = 0.1; 95% CI: 0.02-0.5).The lower levels of education and income, as well as living in small districts are the risk factors for cigarette smoking.

Objectives: The study objective was to evaluate an association between selected work-related and socio-economic factors and tobacco smoking among economically active individuals. Materials and Methods: The study was conducted among randomly selected residents of the city of Łodź (n = 598) aged 25–64 years. The smoking status was determined based on questionnaire data. Logistic regression models were applied to assess the factors related to the smoking habit. Results: Multifactorial logistic regression analysis indicated that low level of education, lack of recreational physical activity and medium/heavy physical work were significant determinants of smoking. Conclusions : Prevention programs aimed at im-proving health-related habits and behaviors should be addressed to all economically active individuals, particularly to those who perform medium and heavy physical work. An antismoking intervention should be tailored to individual needs, taking into account the educational level.

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.

Most of women who quit smoking during pregnancy return to smoking within 12 months after delivery. Since smoking cessation is more likely during pregnancy than at other times, interventions to maintain quitting postpartum may give the best opportunity for a long-time abstinence. It is still not clear what kind of advice or counseling should be given to help prevent the post-delivery relapse. To find an answer to that question, we need to know which factors predispose the women for and which protect from restarting smoking after delivery. The profile of women who relapse to smoking can be described as living with smokers. Breastfeeding and positive experience related to the quitting of smoking protect the women from returning to smoking after delivery. Those factors should be taken into account while creating antismoking intervention.

The aim of the study was to evaluate the reliability of self-reported smoking status and environmental tobacco smoke exposure (ETS) during pregnancy, assessing serum cotinine level.The prospective cohort study was conducted in 2 antenatal care units in Lodz, Poland. Study population consisted of 183 pregnant women between 20-24 weeks of pregnancy. All of the women who agreed to participate in the study were interviewed to investigate certain socio-demographic, lifestyles, behavioural characteristics and obstetric background. Self-reported smoking status and ETS exposure were verified with the help of serum cotinine level. Cotinine level was analyzed by means of gas chromatography with mass spectroscopy (GC-MS). We choose more than 15 ng/ml as serum cotinine level for smokers, 2-15 ng/ml for ETS exposure and less than 2 ng/ml for non-smokers not exposed to ETS.Among non-smoking and not ETS-exposed women, 17% had cotinine level indicating active smoking and 74% ETS exposure. About 4% of the women who indicated ETS exposure during pregnancy had serum cotinine level higher than 15 ng/ml indicating active smoking.The information about active and passive smoking during pregnancy obtained from mothers and based on the questionnaire does not indicate objective maternal exposure to tobacco smoke.

Among available methods to estimate the exposure to tobacco smoke, cotinine, a major metabolite of nicotine is considered the most accurate marker. The aim of this study was to evaluate environmental tobacco smoke exposure in pregnancy and postpartum period. The cohort study was conducted in 2004 and 2006 in public maternity units in Lodz, Poland. The study population consisted of women between 32-36 weeks of pregnancy who have quit smoking within 2 months before pregnancy or no later than three months prior to participation in the study. Women were interviewed twice: during pregnancy and three months after delivery. Self-reported non-smoking status was verified using saliva cotinine level. Cotinine level in saliva sample was analyzed using Liquid Chromatography with Tandem Mass Spectrometry. We included into the analysis 62 women who, based on self-reported smoking status and saliva cotinine level were classified as non-smokers. There were no statistically significant differences in mean saliva cotinine level measured in pregnancy and postpartum period. Pregnant women who smoked more cigarettes per day before quitting smoking had significantly higher cotinine level comparing to women who smokedor = 10 cigarettes per day (p = 0.03). Saliva cotinine level was significantly higher among women exposed to environmental tobacco smoke at home compared to non-exposed (p = 0.02).

The aim of the paper was to evaluate the association between preconceptional and prenatal exposure to tobacco smoke and the risk of all cancers combined and separately, for brain tumors, leukemias, lymphomas and other childhood cancers. We conducted systematic search of the literature using PUBMED, MEDLINE and EBSCO database to identify all publications dealing with environmental tobacco smoke exposure and childhood cancer.

OBJECTIVES The aim of the studywas to work out a program that would help develop the most effective methods for protecting the safety and health of young workers. MATERIALS AND METHODS The program was designed by a multidisciplinary team of experts in occupational and public health, occupational hygiene, health promotion, sociology, and regulatory and control activities. RESULTS The program points out the major aspects to be considered while implementing the existing legislation. The employers should have a proper recognition of health hazards related to working conditions at their enterprises. These should be considered while assessing work capability of adolescents during the pre-placement and periodic medical examinations. Prophylactic examinations for adolescent workers should be oriented towards the potential or existing health hazards and strenuous conditions of in-plant vocational training. It is essential to inform them about work-related health hazards and the preventive methods to be applied by both the workers themselves and the occupational health services. If a health problem or ailment is detected by an occupational physician, the adolescent worker should be referred to primary health care unit for further diagnostics. CONCLUSIONS The most effective ways to protect the safety and health of young workers include a more accurate assessment of working conditions, contracting prophylactic examinations with only one occupational health service unit, providing appropriate risk information to adolescent workers/students, and a closer collaboration between school administration, employers and occupational health services..

Item does not contain fulltext Almost half of the child population is involuntarily exposed to environmental tobacco smoke (ETS). The ETS exposure gives rise to an excessive risk of several diseases in infancy and childhood, including sudden infant death syndrome, upper and lower respiratory infections, asthma and middle ear diseases. It is also linked to cancer, and behavioural problems and neurocognitive deficits in children.Conclusions: Protecting children from ETS exposure is a complex and important issue. The best improvement in children's health is to be gained when parents stop smoking or, when that is not possible, they stop smoking in their children's environment. Paediatricians, because of their authority, and their frequent and regular contact with parents, play a leading role in protecting children from ETS exposure. An ideal approach to help parents to stop smoking seems to be initial minimal-contact advice provided by their paediatrician with feedback and supplemental printed materials, leading to greater intensity and duration of follow-up home visits.

The aim of the study was to evaluate the effectiveness of smoking cessation interventions for pregnant women.The study including meta-analyses of randomized trials and description of the study performed in Poland.The anti-smoking counseling for pregnant women was performed in the maternity centers in Lódź. This study consisted of two stages. At the first stage which was performed between 1 December 2000 and 31 December 2001, 149 current smokers and 56 spontaneous quitters were randomized into the smoking cessation intervention and 144 current smokers and 37 spontaneous quitters were included into the control group. The intervention program included four midwife visits during pregnancy and one after delivery. The control units received standard written information about the health risk from maternal smoking to the fetus. The second stage of the study included collection of data on smoking relapse one year postpartum.The chance of quitting smoking by the women who agree to participate in the program was significantly higher in the intervention group than in the control group (OR=5.8; p0.001). The chance to maintain smoking abstinence one year after delivery was four times higher in intervention than control group (3.7, p=0.03).The midwife-assisted smoking cessation intervention preformed in Lodz region seems to be an effective tool to help pregnant smoker make a decision to quit smoking and maintain smoking abstinence after delivery.

The aim of the study was to characterize the smoking habit among pregnant women and evaluate the effectiveness of antismoking intervention based on the results of the test "Why am I smoker?". A randomized trial was conducted between December 1, 2000, and December 31, 2001, in public maternity centers in Lódź, Poland. We included into the study all women below 36 weeks of pregnancy who smoke at least one cigarette per day (intervention group - 149 smokers, control group- 144 smokers). The intervention consisted of five visits of the midwife to the home of the smoking pregnant woman. The intervention was based on the results of the test "Why am I smoker?". The results of the test "Why am I smoker?" give the good characteristics of the smoking habit among pregnant women. The intervention based on the results of this test seems to be an effective tool to help them quit smoking.

The aim of the randomized trial was to evaluate the risk of smoking relapse one year after delivery among the women who quit smoking during pregnancy.The study was carried out in 2002 and 2003 and included the collection of data on smoking relapse within one year after delivery among 175 women who participated in the randomized smoking cessation trial and quit smoking during pregnancy.About 50% of women who quit smoking during pregnancy relapsed into that habit within 12 months postpartum. The analysis of women who quit smoking before 14 weeks of pregnancy revealed a significantly higher risk of smoking relapse after delivery for women with the higher level of smoking addiction indicated by the Fagerström test (OR = 5.0; 95% CI: 1.5-16.2). Compared to the control group, spontaneous quitters who participated in intervention activities during pregnancy showed lower risk of smoking relapse within one year after giving birth (OR = 0.3; 95% CI: 0.1-0.9). In the group of women who quit smoking after 14 weeks of gestation, the risk of smoking relapse postpartum was significantly higher for those with the higher Fagerström test score (OR = 4.8; 95% CI: 1.6-14.1). The risk of smoking relapse 12 months after delivery was lower for spontaneous quitters who participated in the intervention during pregnancy and for women who quit smoking after participation in the intervention activities than for controls (OR = 0.03; 95% CI: 0.01-0.2, OR = 0.1; 95% CI: 0.03-0.6).Women who had higher score in the Fagerström test before quitting smoking had significantly higher risk of smoking relapse within 12 months after delivery. Anti-smoking intervention during pregnancy helps women to maintain smoking abstinence after delivery.

The association between maternal smoking and retarded maternal condition and birth outcome is well know. Smoking during pregnancy increases risk of spontaneous abortion, placenta previa, abruptio placenta, preterm premature rupture of membranes, stillbirth, preterm delivery and sudden infant death syndrome. The recently conducted studies also indicate that prenatal exposure to tobacco smoke is a risk factor for respiratory infections, asthma, allergy, childhood cancer, and it has neurobehavioral consequences regarding children's health. The risk for most of these conditions has been found to increase with the number of cigarettes smoked. On the other hand women who stopped smoking during pregnancy are at lower risk for most of those pathologies.

The association between maternal smoking and retarded fetal grow was first time described in 1957, and now is well know. In addition smoking during pregnancy increases risk of spontaneous abortion, placenta previa, abruptio placenta, preterm premature rupture of membranes, stillbirth, preterm delivery and congenital malformations. The risk for most of these conditions has been found to increase with the number of cigarettes smoked and on the other hand women who stopped smoking during pregnancy are at the lower risk for most of those pathologies.

The aim of randomized trial was to evaluate the effectiveness of anti-smoking counseling in the population of pregnant women from the maternity centers in Lódź, central Poland.One hundred and forty nine current smokers and 56 spontaneous quitters were randomized into the smoking cessation intervention and 144 current smokers and 37 spontaneous quitters were included in the control group. The intervention program covered four midwife visits during pregnancy and one after delivery. The control units received standard written information about the health risk from maternal smoking to the fetus.The chance of quitting smoking by the women was significantly higher in the intervention group than in the control group (OR = 2.5; 95% CI 1.8-3.7). The difference in the mean infant birthweight between the quitters and non-quitters was 203.8 g (p = 0.01) in the intervention group and 198.2 g in the control group (p = 0.08). After controlling for socio-demographic characteristics that could affect the birthweight, the differences remained significant in the intervention group - 182.8 g (p = 0.02), whereas in the control group it was 92.4 g (p = 0.4).The midwife-assisted smoking cessation intervention seems to be an effective tool to help pregnant smokers make a decision to quit smoking.

Our purpose was to assess the effect of prenatal smoking interventions on rates of smoking cessation. A total of 37 trials, conducted between 1976 and 2002 and comprising over 14000 women were identified and included in the meta-analyses. There was a significant increasing in the odds of women who quit smoking in late pregnancy in the intervention group (OR = 1.6; 95% CI 1.4-1.8). The effectiveness of the intervention was significantly higher in the studies that smoking cessation intervention included written materials for pregnant women then in the studies without those materials. The percentage of pregnant women who quit smoking was higher among American women than among women from the European Countries.

The aim of this study was to evaluate the influence of maternal exposure to pesticides in the 1st and 2nd trimesters of pregnancy on infant birthweight in a population of Polish farmers. The subjects were women who delivered in 25 maternity hospitals in the region of Lódź (Central Poland), including 117 women who delivered infants with low birthweight (LBW) and 377 infants with birthweightor = 2500 g delivered on randomly selected 70 days between 31 January 1998 and 30 June 2001. A questionnaire on maternal demographic and anthropometric characteristics as well as the occurrence of several occupational hazards, including pesticide use and involvement in heavy physical work on the farm in each of pregnancy trimesters, was administered by a physician 1-2 days after delivery. The pesticides used most frequently included: phenoxyacetic acid derivatives, organophosphates, ureas, triazines, synthetic pyrethroids and N-phenylamides (anilides). Infants born to women exposed to pesticides in 1st or 2nd trimester had birthweight lower by 189 g than that of infants of the non-exposed women. When adjusted for pregnancy duration, the women exposed to pesticides were found to deliver infants with birthweight lower by about 100 g (p = 0.067) than that of infants of the non-exposed women. After adjusting for the variables that may have impact on pregnancy duration, we noted that mothers exposed to pesticides, on average delivered half a week earlier than those non-exposed. Our results indicate that maternal exposure to pesticides may contribute to a slight reduction in the duration of pregnancy. A slower pace of fetal development, corresponding to the small-for-gestational-age effect, was observed, but the increment in the risk was of borderline significance.

Background: Environmental tobacco smoke exposure (ETS) is associated with poor pregnancy outcome including increases risk of spontaneous abortion, stilbirth, low birth weight, preterm delivery and sudden infant death syndrome. ETS exposure after birth can increase the risk of sudden infant death syndrome, respiratory infections, asthma, middle ear diseases or even cancer and it can cause neurodevelopmental and behavioural problems in children. The aim of the study was to evaluate the prenatal and postnatal child exposure to environmental tobacco smoke. Material and Methods: The study population consisted of 150 women from Lodz, Poland among which detail questionnaires were conducted three times during pregnancy period. From all women included into the study the saliva sample was collected to verify smoking status in pregnancy. One and two years after delivery additional questionnaires were performed and urine sample from all children was collected. The cotinine level in saliva and urine was analyzed using Liquid Chromatography with Tandem Mass Spectrometry (LC-MS/MS ESI+). Results: About 22% of the children were expose to ETS during prenatal and 46% in postnatal period. Cotinine level in children's urine statistically differentiated children from smoking mothers (geometric mean (GM) 11.4 ng/ml; 95% CI 7.1-18.3) and in exposed homes (GM 7.3 ng/ml; 95% CI 3.6- 15.0) compared with non-exposed homes (GM 1.3 ng/ml; 95% CI 0.9-1.7) (p< 0.001). Conclusions: Children should be more protected from ETS exposure in prenatal and postnatal period.

Background: Outdoor secondhand smoke (SHS) concentrations are usually lower than indoor concentrations, yet some studies have shown that outdoor SHS levels could be comparable to indoor levels under specific conditions. The main objectives of this study were to assess levels of SHS exposure in terraces and other outdoor areas of hospitality venues and to evaluate their potential displacement to adjacent indoor areas. Methods: Nicotine and respirable particles (PM2.5) were measured in outdoor and indoor areas of hospitality venues of 8 European countries. Hospitality venues of the study included night bars, restaurants and bars. The fieldwork was carried out between March 2009 and March 2011. Results: We gathered 170 nicotine and 142 PM2.5 measurements during the study. The median indoor SHS concentration was significantly higher in venues where smoking was allowed (nicotine 3.69 mg/m3, PM2.5: 120.51 mg/m3) than in those where smoking was banned (nicotine: 0.48 mg/m3, PM2.5: 36.90 mg/m3). The median outdoor nicotine concentration was higher in places where indoor smoking was banned (1.56 mg/m3) than in venues where smoking was allowed (0.31 mg/m3). Among the different types of outdoor areas, the highest median outdoor SHS levels (nicotine: 4.23 mg/m3, PM2.5: 43.64 mg/ m3) were found in the semi-closed outdoor areas of venues where indoor smoking was banned. Conclusions: Banning indoor smoking seems to displace SHS exposure to adjacent outdoor areas. Furthermore, indoor settings where smoking is banned but which have a semi-closed outdoor area have higher levels of SHS than those with open outdoor areas, possibly indicating that SHS also drifts from outdoors to indoors. Current legislation restricting indoor SHS levels seems to be insufficient to protect hospitality workers – and patrons – from SHS exposure. Tobacco-free legislation should take these results into account and consider restrictions in the terraces of some hospitality venues to ensure effective protection, This work was supported by the Executive Agency for Health and Consumers, DG SANCO, European Commission, grant number 2007313. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Aim: The aim of the study was to analyze the influence of environmental tobacco smoke exposure on pregnancy outcome and children's health. Material and Methods: The study population consisted of pregnant women and their children followed up to two years of life. Pregnant women were interviewed three times during pregnancy. From all women included into the study the saliva sample was collected. Assessment of child ETS exposure within two years after birth was based on questionnaires, confirmed by biochemical verification of cotinine level in child urine. Cotinine level in biological samples was analyzed using Liquid Chromatography with Tandem Mass Spectrometry. Pregnancy outcomes were noticed by neonatologist. The children's health focused on anthropometry indicators and the incidences of respiratory infections and allergy was performed by pediatricians during the first and second year of life. Results: For the lower cotinine levels in saliva (up to 10 ng/ml) we observed increasing trend in birth weight, head and chest circumference with the increasing level of cotinine (p trend < 0.05). For the cotinine level higher than 10 ng/ml we noticed decreasing trend for birthweight, head and chest circumference as the level of this biomarker increased. The newborn length decreased with the increasing cotinine level in saliva (p trend < 0.001). There were no statistically significant associations between ETS exposure and anthropometric measurements within first two years of life. Such exposure increases the risk of pneumonia but the results were not statistically significant. Conclusions: All effort should be taken to eliminate the child ETS exposure.

Background: In Poland about 30% of children is exposed to environmental tobacco smoke during prenatal period and more than 50% in postnatal one. Such exposure has serious health consequences including negative effect on child neurodevelopment. The aim of the study was to assess the effect of environmental tobacco smoke (ETS) exposure on child psychomotor development. Material and Methods: The study population consisted of children with well assessed prenatal exposure to environmental tobacco smoke (three times analysis of cotinine level in saliva of pregnant women). Assessment of child ETS exposure within two years after birth was based on questionnaires conducted with mothers, confirmed by biochemical verification of cotinine level in child urine. The cotinine level in biological samples was analyzed using Liquid Chromatography (HPLC) with Tandem Mass Spectrometry (MSMS). The Bayley Scale for Infant and Toddler Development (BESID-III) was used for the evaluation of child neurodevelopment. Results: Multivariative analysis (including gender, birth order of the child and parental educational status) indicated the statistically significant association between child ETS exposure and cognitive development (b=-4,0; p=0,04). ETS exposure has also negative impact on motor (b=- 2.7; p=0.2) and language (b=-3.4; p=0.08) abilities of the child although the results were not statistically significant. Conclusions: Maternal smoking was found to be related to a decrease child neurodevelopment although it impossible to separate the prenatal from postnatal exposure. All effort should be taken to eliminate the child ETS exposure.

Approximately 30?40% of pregnant women, who smoke prior to pregnancy, tend to quit smoking by the first prenatal visit but more than half of them relapse to smoking after delivery. Interventions to maintain quitting smoking after delivery were so far rarely performed and their effectiveness is not well documented. The aim of this study was to evaluate the effectiveness of the smoking relapse prevention intervention for postpartum women. The study included 199 postpartum women (100 in the intervention group and 99 in a control group) who had quit smoking in the recent pregnancy and maintained smoking abstinence within 2 weeks after delivery (confirmed by biochemical verification). The intervention consisted of three visits conducted by midwives trained in anti-smoking intervention techniques. Women from the control group received a standard anti-smoking message. The smoking status of the study subjects was updated 6 and 12 months after delivery. The distribution of the socio-demographic characteristic of the women from the two groups did not show statistically significant differences. The women from the intervention group relapsed to smoking 12 months after delivery significantly less frequently than the women from the control group (26% vs. 56%; odds ratio = 0.28; 95% CI 0.15?0.51). The women who returned to smoking, did this later and smoked fewer cigarettes per day when they had participated in the programme.