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Objectives: Chronic obstructive pulmonary disease (COPD) may be work-related. It has been estimated that 15% of the population burden of COPD is attributable to occupational exposure. However, in Poland COPD is rarely recognized as an occupational disease. The aim of the study has been to analyze the causes of the low prevalence of work-related COPD in the context of the existing criteria as well as to analyze which part of the assessment - clinical or hygienic one - is responsible for such a low rate of occupational COPD recognitions.Material and Methods: The study group included 150 patients hospitalized with a suspicion of occupational COPD. Each patient underwent a clinical examination, spirometry and reversibility test using bronchodilator. Moreover, hygienic evaluation of work conditions was performed in all the considered cases.Results: In the case of the patients who fulfilled the criteria for COPD diagnosis in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) occupational origins of the disease, the disease was not recognized because 24.1% of the individuals did not meet spirometric criteria included in a definition of COPD in the Polish list of occupational diseases, while 27.8% of the individuals did not fulfill the criterion of a documented exposure to dusts and irritant gases. None of these criteria was fulfilled by 42.6% of the patients.Conclusions: In our country, both clinical and hygienic criteria result in limitations in recognition of occupational COPD. There is the need to establish new guidelines for the recognition of COPD as a compensable disease in Poland. Int J Occup Med Environ Health 2018;31(2):139-150. [ABSTRACT FROM AUTHOR]

The etiology of cancer is multifactorial. Malignant tumors caused by factors occurring in the work environment, classified as carcinogenic in humans, can be recognized as an occupational disease. Analysis of epidemiological data indicates a significant underestimation of occupational cancer, mainly due to long latency period of these diseases. This publication provides guidance to certify occupational etiology of malignant tumors, based on the reviews of existing legislation and medical literature, as well as on the experience of their authors. The publication presents the epidemiology of cancers, including occupational cancers, risk factors, occupational carcinogens and presents the principles of occupational cancer certification. Med Pr 2018;69(1):93-108., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Multiple sclerosis (sclerosis multiplex-SM) is a chronic inflammatory disease, characterized by disseminated damage of the nervous system. It is most commonly diagnosed between the ages of 20 and 40, which puts it at the top of the lits of disabling neurological diseases in young and middle-aged adults. The third and fourth decade of life is the period of high activity, thus the progressive impairment of many functions of the nervous system is not only a medical problem, but also social and economic issues. Educational actions addressed to occupational health services physicians are needed because only adequate knowledge of the disease can prevent wrong decisions in certifying the ability to work.

Cardiovascular diseases (CVD) are a very important issue for the health care system. They are usually chronic diseases widespread in the society that require costly treatment and cause long-term sick absenteeism and partial or total incapacity for work. CVD are one of the most common cause of disability in Poland, therefore they constitute a medical, social and economic problem. Low occupational activity of people with CVD at working age requires special effort to develop and implement methods of their professional activation. A key role in this process should be played by physicians of occupational health services (OHS). In the case of disabled workers with cardiovascular disease, the decision about avoiding professional activity is often medically unjustified. It arises from a lack of sufficient knowledge ofjurisprudence and the fear of both the physician and the employee ofpatient's health deteriorations. Therefore, educational actions addressed to OHS physicians and to the patients are needed to enable the patients with CVD to remain at or to return to work.