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Objectives The aim of the study was to establish whether the driver's visual strategy may influence a driver's behavior to avoid a crash in a high-risk situation. Any published papers on drivers' visual strategies just before a crash were not found. Material and methods Tests were performed using a high-tech driving bus simulator. Participants comprised 45 men drivers, aged 43.5±7.9 years old, seniority as a bus driver of 13.3±8.6 years. The tests were preceded by medical examinations: general, neurological and ophthalmological. Each participant drove the same city route for approximately 40 min (entire route - ER). In the final phase, a collision situation was simulated (a phantom car blocked the participant's right of way). Driver's visual strategy was analyzed using the FaceLab device with 2 cameras during ER and just before collision. The field-of-view covered by camera 1 was divided into 8 regions, by camera 2 into 10 regions. The distribution of gazes in regions was a criterion of visual strategy. Results Thirty-five drivers completed the simulated driving test, 14 escaped the collision, 21 crashed. These groups differed only in resting systolic blood pressure before the test. The analysis of covariance, after adjusting to this factor, indicated that during the ER visual strategy recorded by camera 1 did not differ between groups, in camera 2 the drivers in the crash group fixed their gaze more frequently (p = 0.049) in region 3 (close part of the road in front of the windshield). Just before the collision drivers who escaped the collision fixed their gaze significantly more often in region 6 (left side of the road) in camera 1 and in region 6 (in front of the windshield,) and region 10 (right side) in camera 2. Conclusions The visual strategy has an impact on the road safety. The analysis of visual strategies may be a useful tool for the training of drivers. Int J Occup Med Environ Health. 2019;32(2):161-74.

Workers' medical prophylactic examinations referred to in the Labor Code are one of the tasks of the occupational medicine services. They are regulated by law which has been in force for more than 20 years in unchanged form. During this period, new harmful, burdensome or dangerous to health factors appeared in the workplaces, for which no preventive health check-up standard was defined. In the meantime, the health criteria for drivers and persons applying for driving licenses have also been significantly liberalized. The above changes, the authors' own experience, comments and problems reported by physicians who provide workers' prophylactic health care and employers as well as analysis of literature related to workers' health care in other countries have created the need to harmonize and update guidelines on health requirements for selected types of work. In addition the scope and frequency of prophylactic examinations for exposures, which are not included in applicable legal acts, has been developed. Med Pr. 2019;70(1):125-37. Badania profilaktyczne pracowników, o których mowa w Kodeksie pracy, to jedno z zadań służby medycyny pracy. Są one regulowane przepisami prawa obowiązującymi w niezmienionej formie już od ponad 20 lat. W tym okresie na wielu stanowiskach pracy pojawiły się nowe czynniki szkodliwe, uciążliwe lub niebezpieczne dla zdrowia, dla których nie określono standardu badania profilaktycznego. Znacznie zliberalizowano także kryteria zdrowotne dla kierowców i osób ubiegających się o uprawnienia do prowadzenia pojazdów silnikowych. Powyższe zmiany, doświadczenia własne autorów, uwagi i problemy zgłaszane przez lekarzy sprawujących opiekę profilaktyczną i pracodawców oraz analiza piśmiennictwa związanego z ochroną zdrowia pracujących w innych krajach stworzyły konieczność ujednolicenia i uaktualnienia wytycznych dotyczących wymagań zdrowotnych dla wybranych rodzajów prac. Ponadto opracowano zakres i częstotliwość badań profilaktycznych dla narażeń, które nie są ujęte w obowiązujących aktach prawnych. Med. Pr. 2019;70(1):125–137.

Background The most important occupational allergens in baking include flour and enzymes, especially α-amylase. Although xylanolytic enzymes have previously been described as sensitizers, they may be overlooked during assessment of bakery workers with work-related symptoms. Aims To report a case of a baker who suffered from work-related respiratory, ocular and skin symptoms as a consequence of sensitization to xylanolytic enzymes. Methods Physical examination, chest X-ray, routine laboratory tests, skin prick tests (SPTs) with common and occupational allergens (wheat, pearl, rye, corn and oat flours, α-amylase, bakery adjuvants) and spirometric measurements, as well as assessments by a laryngologist, dermatologist and ophthalmologist were performed. Specific IgE (sIgE) to occupational agents were evaluated for flours, α-amylase, xylanase, cellulose and glucoamylase. Specific inhalation challenges (SICs) with flours and bakery adjuvants were carried out. Results Hypersensitivity to Aspergillus moulds, flours and α-amylase was confirmed in SPTs; however, SIC with those agents gave a negative result. Further investigation revealed the presence of sIgE to xylanolytic enzymes. During SIC with bakery adjuvants, allergic skin, ocular and respiratory symptoms occurred and were confirmed by objective assessment. Conclusions In the assessment of work-related allergic symptoms in bakers, sensitization to xylanolytic enzymes should be considered. Completion of diagnostic procedures having excluded asthma and rhino-conjunctivitis related to flour hypersensitivity might result in a false-negative assessment.

Introduction One of the most important parameters of interest in the study of drivers on the driving simulator is the oculometric data obtained during driving. Using this method we have a direct view of the driver’s eye path and ability to analyse it. The purpose of the study was to trace the places where the driver’s eyes focus when driving on a bus simulator. Materials and methods The study was conducted in a group of randomly selected 45 city bus drivers. Thanks to the use of appropriate infrared cameras, scene cameras and specialised software, data has been obtained and selected using special programs and statistical analysis. By collecting this data we are able to analyse the driver’s eye-path in different situations on the road (urban driving, off-road driving, and stress-based driving). Methods FaceLab was used to track the visual path with infrared cameras. We also use scene cameras and Eyeworks (Record, Analyse) and Captive programs. These programs enabled the visual path to be taken in the form of saccades and fixations applied to a video file with recorded driving data and data from the simulator. Then the image from the scene camera (what the driver saw) was divided into regions (areas in front of the driver’s eye or side mirror surfaces) so it was possible to analyse the individual regions of all the drivers taking part in the experiment. Results The driver during 28.77% of the driving time on the simulator focused on the area of the road directly in front of the vehicle and on the right-hand mirror it was 2.27% of the driving time. Discussions The obtained data confirm that the driver is most likely to look at the road ahead and the area surrounding the right mirror (which is affected by stops at the bus stops).

Occupational allergy from exposure to squid has been rarely described, mainly as contact dermatitis or urticaria. Our report presents the first case of occupational asthma, rhinitis, conjunctivitis and contact urticaria to squid in a 33-year-old seafood production worker, with documented increased eosinophilia in the nasal and tear fluids after specific inhalation challenge test (SICT) with squid. IgE-mediated sensitization to squid was confirmed by positive skin prick test and opened skin test with squid extract. SICT demonstrated a direct and significant link between the exposure to squid and the allergic response from the respiratory system and conjunctiva.

Para-phenylenediamine (PPD) can induce immediate or — more often — delayed hypersensitivity. We report the case of 48-year old female admitted to the out-patient allergy clinic a day after her visit in a beauty parlour, where she had her eyelashes and eyebrows dyed with henna. Physical examination revealed prominent edema of the upper part of the face including forehead, cheeks and eyes causing severe narrowing of the palpebral chink. Skin prick tests (SPT) with common allergens were positive for Dermatophagoides pteronyssinus, Dermatophagoides farinae and moulds, while the SPT with PPD was negative. Patch test to PPD was positive. Further investigations revealed eosinophilia in the tear fluid. To our knowledge, this is the first case of PPD-induced contact blepharoconjunctivitis (CB) with concomitant increased eosinophilia in the tear fluid.

The aim of this study was to assess the impact of the visual work with display monitors on the eye surface temperature, intraocular pressure and on the eye moisturizing condition.The study was conducted among 50 people working with display monitors (CRT, LCD) and without monitor. The temperature of the eye surface via thermo camera and intraocular pressure were measured, as well as Schirmer's test was performed before and after 4 h of visual work. Thermography was also performed after 1 h.The studies revealed no significant effect of all visual works in patients with normal tear secretion. Only among those with dry eye syndrome, statistically significant increase in the eye surface temperature was found and averaged 0.5 degrees C after 4 h of all visual works.The studies revealed that intensive visual work with CRT and LCD display monitors and without monitor causes changes in the eye surface temperature, especially after the first hour of visual work and in patients with dry eye syndrome. The results of tonometry showed that all visual works at a short distance lead to the decreased intraocular pressure, resulting from the improved aqueous humor outflow. Finally, no negative effects of the visual work with the display monitor on the eye was found. However, the appropriate duration of work and application of tear substitutes play an important role in people with the symptoms of dry eye syndrome.

The aim of this study was to assess the impact of the visual work on the tear film and the degree of eye strain.The survey was conducted among 50 people working 4 h with different types of monitors (CRT, LCD) and without a monitor. Schirmer's test and evaluation of the degree of eye strain were performed in all subjects before and after work.The studies revealed no significant change in Schirmer's test. Most people reported eye fatigue after every kind of visual work. The highest degree of eye strain was noted after work with the CRT display screen, especially among people with dry eye syndrome.The studies revealed no significant impact of various visual works on the tear film. However, they showed that any kind of intense eye work may cause eye irritation and strain, particularly in the people affected by dry eye syndrome.