Biomedical subjects

Wojciech Hanke

Publications and source records attributed to Wojciech Hanke.

At least 19 recordsLinked to original sources

PubMed2006

Adverse health effects of children's exposure to pesticides: what do we really know and what can be done about it.

UNLABELLED: Children may be exposed to pesticides in several ways, such as by transplacental transfer during foetal life, by intake of contaminated breast milk and other nutrients, or by contact with contaminated subjects and areas in the environment such as pets treated with insecticides, house dust, carpets and chemically treated lawns and gardens. Exposure early in life, and particularly during periods of rapid development, such as during foetal life and infancy, may have severe effects on child health and development by elevating the risk of congenital malformations, cancer, malabsorption, immunological dysfunction, endocrine disease, and neurobehavioural deficiencies. As pesticides can also interfere with parental reproductive health, exposure of parents may have consequences for the offspring leading to reduced chance of male birth and increased risk of childhood cancer. CONCLUSIONS: Current knowledge about tolerable levels and consequences of toxic exposure to pesticides during human development is rather scarce. Owing to the high risk of exposure to pesticides, particularly in less developed countries, further elucidation by well-controlled epidemiological studies in this field it is urgently needed. The Policy Interpretation Network on Children's Health and Environment (PINCHE), which is financed by the EU DG research has suggested actions against pesticide exposure. They have been presented and discussed in this paper. Several suggestions of PINCHE concerning action needed regarding pesticides were presented in the paper.

Child↗

PubMed2006

Environmental tobacco smoke exposure and children's health.

UNLABELLED: 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.

Asthma↗

PubMed2006

Reducing health risks arising from child and adolescent labor.

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..

Adolescent↗

PubMed2006

[Costs of intensive care of premature infants].

UNLABELLED: It is often pointed that hospitalizations of premature infants generate high costs. It is particularly bothering with reference to neonatal intensive care units (NICU). OBJECTIVE: Since there is lack of desirable data in Poland, a study was launched in the city of Lódź in order to estimate exact costs of intensive care of premature infants. METHODS: The study consisted in collecting data cocerning all resources (drugs, materials, medical equipment etc.) used during the hospitalizations of the neonates. It was constructed in a retrospective way, which means that data was collected from the first day of each patient's hospitalization till his or her discharge. The study lasted from 03.10.2004 to 06.04.2005. The study population were neonates borned before 37 week of gestation, who were treated in the Intensive Care Unit of Paediatric University Hospital, Medical University of Lodz. The population consisted of 30 patients borned between 23-36 week of gestation and birthweight between 600g and 3300g. RESULTS: The structure of costs shows that the most expensive was medical care which constituted 51% of total costs. 90% of neonates costed no more than 30,000 zł and the average cost was 17,633,76 PLN. CONCLUSIONS: Total cost of hospitalization depends mainly on the length of stay. Among recovered patients hospitalizations lasted from 6 to 125 days. The longest stay costed 90,780 PLN. Detailed analysis is needed to consider if there is feasible possibility to limit time of hospitalizations in order to decrease costs.

Costs and Cost Analysis↗

PubMed2006

[Occupational respiratory diseases surveillance programs].

The authors discus selected aspects of occupational health surveillance based on the activities carried out by the US National Institute of Occupational Safety and Health (NIOSH). Several surveillance programs concerning occupational and work-related respiratory diseases in different countries are presented. A special emphasis is put on the possibility of using the existing data in assessing the prevalence of these diseases in populations, monitoring of changing trends, and assuring proper orientation of activities aimed at improving safety and health of the working population.

Global Health↗

PubMed2006

[Effectiveness of smoking cessation interventions for pregnant women--meta-analyses of randomized trials and description of the study performed in Poland].

OBJECTIVES: The aim of the study was to evaluate the effectiveness of smoking cessation interventions for pregnant women. DESIGN: The study including meta-analyses of randomized trials and description of the study performed in Poland. MATERIALS AND METHODS: 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. RESULTS: 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; p<0.001). The chance to maintain smoking abstinence one year after delivery was four times higher in intervention than control group (3.7, p=0.03). CONCLUSIONS: 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.

Adult↗

PubMed2006

[Heaviness of the work measured by energy expenditure during pregnancy and its effect on birth weight].

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.

Adult↗

PubMed2006

[The effect of occupational and non-occupational psychosocial stress on the course of pregnancy and its outcome].

The effect of stressful professional work on the course of pregnancy and its outcome is for various reasons an important issue. The aim of this work was to compare and evaluate studies carried out in different countries all over the world on the risk of preterm delivery (PTD) and fetal hypotrophia in infants whose mothers were occupationally exposed to psychosocial stress during gestation. An analysis of available literature confirms a significantly higher PTD odds ratio among pregnant women working in adverse psychosocial conditions. Low birth weight (LBW) in newborns of this group of mothers occurs more frequently than in the general population.

Burnout, Professional↗

PubMed2006

[Preconceptional and prenatal exposure to tobacco smoke and risk of childhood cancer].

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.

Brain Neoplasms↗

PubMed2005

Exposure to pesticides and heavy work in greenhouses during pregnancy: does it effect birth weight?

OBJECTIVES: Work in greenhouses is performed in warm microclimate during the most time of the year, involves usually moderately intense or heavy work. The working conditions in greenhouses might involve also indirect exposure to pesticides resulting from contact with pesticide-treated flowers and vegetables. The aim of the study was to investigate whether the work in greenhouse during pregnancy adversely influenced infant birth weight and, if so, which of the two main potential hazards typical for such environment (heavy physical work or exposure to pesticides) played the major role in this process. METHODS: The list of 14 major greenhouses (each above 5 ha) growing vegetables (cucumbers and tomatoes) was obtained from the Polish Chamber of Horticulture. Between January 2001 and December 2003, 460 women at the age below 45 years, married or who lived with a partner and who had been 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 working in, and out of, greenhouses on the basis of energy expenditure during mother's work into three groups: A (200-700 kcal/shift); B (701-1000 kcal/shift); and C (1001-1200 kcal/shift). Information about application of pesticides in 1997-2001 was received from persons responsible for chemical protection in each examined greenhouse. Trade names of pesticides, names and amounts of the active ingredients, type of cultivation and its area were abstracted from pesticide application registers run by each greenhouse operator. Pesticides were classified as reproductive and developmental (RD) toxins according to Pan American Pesticide Database classification. RESULTS: The mean birth weight of infants whose mothers worked in greenhouse during pregnancy (work expenditure >1000 kcal/shift) was 177 g lower than that of those whose mothers worked out of greenhouse (light work <700 kcal/shift) (p = 0.05). Mothers who during work in greenhouse were potentially exposed to RD pesticides, delivered infants with birth weight lower by about 70 g. than infants' mothers not working at places where pesticides RD were applied, but these findings were not statistically significant. CONCLUSION: Our results indicate that infants of mothers performing heavy work inside greenhouse during pregnancy had lower mean birth weight than infants of mothers working out of greenhouse. No similar effects of current exposure to pesticides was observed.

Adult↗

PubMed2005

Impact of prenatal tobacco smoke exposure, as measured by midgestation serum cotinine levels, on fetal biometry and umbilical flow velocity waveforms.

The aim of this prospective cohort study was to evaluate the impact of tobacco smoke exposure, measured by maternal serum concentration of cotinine, on fetal midgestation biometric parameters and umbilical artery (UA) qualitative blood flow indices. The study population consisted of 114 healthy women in 20 to 24 weeks gestation who were recruited from the patients of two antenatal care units in Lodz, Poland. Significant negative correlation was found between fetal biparietal diameter (BPD) and serum cotinine concentration. Serum cotinine positively correlated with all blood flow indices under study (systolic/diastolic index [S/D], resistance index, and pulsatility index) after controlling for gestational age, gender, and femur length. The midgestation UA S/D ratio > 3 was found to be a significant risk factor for decreased birthweight. Tobacco smoke exposure is a significant factor inducing increased resistance of umbilical blood flow as measured in 20 to 24 weeks gestation. This could be one of the main mechanisms leading to decreased birthweight observed among infants with prenatal exposure to tobacco smoke.

Adult↗

PubMed2005

[Influence of smoking during pregnancy on children's health--overview of epidemiologic studies].

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.

Adult↗

PubMed2005

Smoking relapse one year after delivery among women who quit smoking during pregnancy.

OBJECTIVES: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.

Adolescent↗

PubMed2005

[Exposure to pesticides among pregnant women working in agriculture].

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.

Adult↗

PubMed2005

[Calculating costs of premature infants' intensive care in the United States of America, Canada and Australia].

Although advanced neonatal care technology has contributed to significant decline in mortality of premature infants, it has also resulted in rising costs of hospitalization. Premature infants constitute 4% to 6% of all newborns treated annually in Neonatal Intensive Care Units (NICUs) and that is why the cost of prematurity determines considerable financial burden on health care in each country. In Poland research concerning costs of neonatal intensive care have not been conducted so far. The object of this paper is to review world-wide literature on that subject, particularly taking into consideration methods of estimating costs and economic analysis, such as cost-benefit analysis, cost-effect analysis and cost-utility analysis. The results of studies undertaken in the United States of America, Canada and Australia have been presented. Results of review indicate the strong relationship between high costs and small gestational age or low birth-weight of newborns. As no research in this area has been conducted in Poland so far, it seems to be crucial to estimate costs of neonatal intensive care of premature infants in Poland. Precise analysis of main factors determining high costs may be helpful in searching for significant savings. It would be a useful decision-making tool both for the NICU and the hospital managers.

Australia↗

PubMed2005

[Characteristic of the smoking habit among pregnant women on the base of the test "Why am I smoker?"].

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.

Adult↗

PubMed2004

The risk of adverse reproductive and developmental disorders due to occupational pesticide exposure: an overview of current epidemiological evidence.

The epidemiological studies presented in this paper refer to the association between agricultural occupation of parents and the incidence of infertility, congenital malformations, miscarriage, low birthweight, small-for-gestational-age (SGA) birth, preterm delivery and stillbirth. The results of the analyses showed that employment in agriculture increases the risk of specific morphological abnormalities in sperm, including the decreased sperm count per ejaculate and declined percentage of viable sperm. In general, no effect of exposure to pesticides on sexual hormones was observed. The data on the effect of employment in agriculture on the time to pregnancy are unequivocal, but most of them suggest that there is a relationship between the decreased fecundability ratio and pesticide exposure. Nor does the research on the sex ratio of offspring provide explicit results. The analyses indicate that parental employment in agriculture could increase the risk of congenital malformations in the offsprings, particularly such as orofacial cleft, birthmarks in the form of hemangioma as well as musculoskeletal and nervous system defects. The data on the effect of occupational exposure to pesticides on birthweight are inconsistent. Although most of epidemiological studies do not reveal a significantly increased risk of SGA, a slower pace of fetal development corresponding to SGA in the population of women exposed to pyrethroids has been recently reported. There are also some indications that exposure to pesticides may contribute to stillbirth and female infertility. The literature review suggests a great need to increase awareness of workers who are occupationally exposed to pesticides about their potential negative influence on fertility and pregnancy outcome. In the light of existing although still limited evidence of adverse effects of pesticide exposure on fertility during the preconceptual period, it is necessary to reduce the exposure to pesticides.

Agricultural Workers' Diseases↗

PubMed2004

[Current use of pesticides in Poland and the risk of reproductive disorders].

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.

Agricultural Workers' Diseases↗