Objectives: To investigate the risk factors for the development of airway diseases from occupational exposure to birds' allergens among Polish zoo garden keepers caring for birds. Methods: Two hundred workers responded to the questionnaire including the history of work-related symptoms, job characteristics, description of occupational exposure, information on smoking habit, contact with birds and animals at home and family history of allergic diseases. Results: General work-related symptoms were reported by 58 subjects (29%), whereas work-related respiratory symptoms were found in 40 workers (20%). The multivariate logistic regression analysis confirmed the significant role of positive family history of atopy and occupational contact with parrots either in the development of work-related symptoms or work-related respiratory allergic symptoms. Conclusions: The findings may confirm that work-related respiratory symptoms are an important health problem among zoo bird keepers in Poland.

Objectives: To evaluate the risk factors for the development of occupational allergy to birds among Polish zoo garden keepers. Methods: A total of 200 bird zookeepers employed in the Polish zoo gardens in Łódź, Warsaw, Gdańsk, Chorzów and Płock and exposed occupationally to bird allergens were examined using a questionnaire, skin prick tests (SPTs) to common allergens and bird allergens, spirometry and cytograms of nasal swab. The level of total IgE in serum and serum-specific IgE to parrot, canary, pigeon feathers and serum were also evaluated. Results: Eight percent of bird zookeepers were sensitized to at least one of the bird allergens. The most frequent allergens yielding positive SPT results were D. farinae -32 cases (16%), D. pteronyssinus -30 cases (15%) and grass pollens (16.5%). In the studied group, allergen-specific IgE against bird allergens occurred with the following frequency: 87 (43.5%) against canary feathers and/or serum, 80 (40%) against parrot feathers and/or serum and 82 (41%) against pigeon feathers and/or serum. Occupational allergy was diagnosed in 39 (26.5%) cases, occupational rhinitis was present in 22 (15%) cases, occupational asthma in 20 (13.6%) subjects, occupational conjunctivitis in 18 (12.2%) cases, whereas occupational skin diseases in 11 (7.5%) cases. More eosinophils were found in nose swab cytograms among bird zookeepers with occupational airway allergy. Conclusions: The findings indicate that occupational allergy to birds is an important health problem among zoo bird keepers in Poland.

StreszczenieWstęp: W dniu 3 lipca 2009 r. weszły w życie nowe przepisy prawne dotyczące orzecznictwa w zakresie chorób zawodowych. W artykule przedstawiono opinie przedstawicieli jednostek orzeczniczych I stopnia i inspekcji sanitarnej na temat funkcjonowania tych podmiotów oraz problemów, które mogą być przyczyną trudności i/lub błędów diagnostyczno-orzeczniczych. Materiał i metody: Badaniem ankietowym objęto przedstawicieli 20 wojewódzkich ośrodków medycyny pracy i 40 państwowych powiatowych inspektorów sanitarnych. Analizie poddano 57 otrzymanych ankiet. Wyniki: Pozytywnie zostały ocenione: zmiana procedury zgłaszania podejrzenia choroby zawodowej (50%), utrzymanie terminów ograniczających możliwość rozpoznania choroby zawodowej (89,2%) i zmiany dotyczące jednostek orzeczniczych w zakresie chorób zakaźnych (92,9%). Za przeprowadzaniem oceny narażenia zawodowego wspólnie przez lekarza i służbę bhp pracodawcy i/lub inspekcji sanitarnej opowiada się 66,7% ankietowanych. W opinii 1/3 respondentów zmiany w wykazie chorób zawodowych nie mają wpływu na postępowanie orzecznicze. Wnioski: Wprowadzenie nowych regulacji prawnych przyczyniło się do usprawnienia postępowania orzeczniczego dotyczącego chorób zawodowych. Konieczne jest natomiast opracowanie szczegółowych wytycznych diagnostycznych i kryteriów rozpoznawania chorób zawodowych oraz powołanie przez Ministra Zdrowia zespołu ekspertów zajmującego się analizowaniem najnowszych osiągnięć wiedzy medycznej i uaktualnianiem wykazu chorób zawodowych. Standardem powinno być przeprowadzenie oceny narażenia zawodowego przez zespół składający się z lekarza sprawującego profilaktyczną opiekę zdrowotną, przedstawiciela służby bhp oraz inspekcji sanitarnej. Med. Pr. 2014;65(4):473-483 Słowa kluczowe: choroby zawodowe, orzecznictwo, ocena narażenia, jednostki orzekające Abstract Background: On 3 July 2009, new law pertaining to occupational diseases (ODs) became effective in Poland. The article presents opinions of the representatives of the 1st degree ODs certification entities and sanitary inspectorates on the changes in OD law and the problems that may cause difficulties and/or certification errors. Material and Methods: A questionnaire study was performed covering representatives of 20 voivodeship occupational medicine centers and 40 national district sanitary inspectorates. We received 57 completed questionnaires which were analyzed. Results: Positive opinions were expressed on changes in procedures on reporting suspected occupational diseases (50%), keeping time limits for diagnosing ODs (89.2%), and changes pertaining to entities responsible for certifying infectious ODs (92.9%). A large group of respondents (66.7%) was in favor of conducting jointly an occupational exposure risk analysis by occupational medicine physicians and occupational health and safety practitioners and/or sanitary inspectors. One-third of the respondents declared that changes in the list of ODs had no influence on the certification procedure. Conclusions: New law has improved the existing procedu...

Introduction: Fire smoke inhalation is a well-recognized aetiological factor of airway injuries. The objective of this study was evaluation of Clara cell protein (CC16) and myeloperoxidase (MPO) concentrations in serum of patients after exposure to uncontrolled fire smoke. Methods: The study group consisted of 40 consecutive patients admitted to the Toxicology Unit after exposure to fire smoke. CC16 and MPO concentrations in their serum samples was measured on the day of admission to hospital and rechecked at the 2nd day and on the day of discharge. Patients also underwent routine toxicological diagnostic procedures applied in case of exposures, such as carboxyhaemoglobin (COHb) levels and blood lactate and urinary thiocyanate concentrations. The same diagnostic tests were performed in the control group consisting of 10 healthy subjects not exposed to fire smoke. Results: The average concentration of CC16 in the serum of subjects exposed to toxic factors was significantly higher at the day of admission in comparison with the respective values recorded on the 2nd day and on the day of discharge. The mean level of CC16 in the serum of the exposed group was also significantly higher than that in the control group. Tests for MPO concentrations in the serum did not reveal any significant changes in patients exposed to fire smoke. Conclusions: As indicated, acute exposure to smoke induces injury at the alveolar level, which results in a transient increase of CC16 in serum of exposed subjects.