Correction: Paciej-Gołębiowska et al. Twenty-Year Mortality Trends in Patients with Kidney Disease in Poland with the Use of the Years of Life Lost Measure, 2000-2019. Int. J. Environ. Res. Public Health 2022, 19, 2649

Ilona Kurnatowska and Irena Maniecka-Bryła were not included as authors in the original publication [...].

Mortality Trends Due to Skin Melanoma in Poland in the Years 2000-2020

The aim of this article is to assess mortality trends due to skin melanoma in Poland between the years 2000 and 2020, taking into account gender and place of residence (urban, rural). The subject of the analyses was data on 25,061 deaths that occurred between 2000 and 2020 due to skin melanoma (C43 according to ICD-10). Mortality rates due to this cancer, both crude (CDR) and standardised (SDR), were calculated. Trends on the calculated rates were analysed using the annual percentage change (APC) and average annual percentage change (AAPC), obtained from joinpoint regression models. Over the study period, the standardised death rate (SDR) due to skin melanoma in Poland increased from 3.60 to 4.03 per 100,000 population (AAPC = 1.1; p < 0.05), for urban residents it increased from 3.56 to 3.91 (APC = 1.2; p < 0.05) and for rural residents it increased from 3.00 to 4.24 (APC = 2.2; p < 0.05). A higher growth rate in terms of the SDR value between the years 2000 and 2020 was recorded in men compared to women and in rural when compared to urban residents. In Poland, mortality due to skin melanoma is on the rise. The early diagnosis of this cancer should become common practice in the Polish population.

Years of life lost due to alcohol-related mortality: A nationwide population study in Poland, 1999-2017

BACKGROUND

The aim of this study was to assess alcohol-related mortality and years of life lost (YLL) in Poland between 1999 and 2017.

METHODS

A database of 7,168,765 death certificates of Polish residents who died in 1999-2017 was reviewed. This number included 112,512 people who had died due to alcohol consumption. YLL was calculated with the use of the Standard Expected Years of Life Lost (SEYLL) measure; its value was related to the size of the study population and calculated per 100,000 people (SEYLLp). Time trends were determined by joinpoint regression analysis.

RESULTS

In 1999, the SEYLLp value was 653.99 years among males and 71.20 years among females; in 2017, these numbers rose to 1,263.76 and 293.10 years, respectively. Time trend analysis revealed that SEYLLp increased more quickly in females (by 8.69 % per year) than in males (by 3.68 %). The ratio of male to female SEYLLp values decreased from 9.18 to 4.31 over the study period.

CONCLUSIONS

In Poland, both males and females are experiencing adverse changes in the number of alcohol-induced YLLs. However, the disparity in YLLs between males and females is gradually decreasing, primarily due to the value increasing more quickly in females.

Years of life lost due to viral hepatitis in Poland, 2000-2014

INTRODUCTION

Viral hepatitis often affects young people; it therefore seems reasonable to analyze the phenomenon of premature mortality due to this reason, using Years of Life Lost (YLLs) measurement.

OBJECTIVE

The aim of the study was to analyze YLLs due to viral hepatitis in Poland in 2000-2014. For the years 2002 and 2011, socio-economic variables (marital status, level of education, working status, place of residence) were included.

MATERIAL AND METHODS

The research material was a database containing information from 5,601,568 death certificates of Polish citizens from 2000-2014. The data on deaths caused by viral hepatitis, i.e. coded as B15-B19 according to the ICD-10, was used for the analysis. The Standard Expected Years of Life Lost measure was used to calculate YLLs. Analysis of time trends was performed with the linear regression method using the joinpoint model.

RESULTS

In the studied period, 3.628 deaths of Polish citizens were caused by viral hepatitis (0.06% of all deaths), which translated to 92,845.70 YLLs (16.17 years per 100,000 inhabitants). The number of YLLs increased over time (p<0.05), reaching its highest value in the last analyzed year - 22.14 years per 100,000. The YLLs average per one death was 25.59 years. Among the risk group there were individuals living in urban areas, divorced/separated, with lower than secondary education, and economically inactive.

CONCLUSIONS

Despite the fact that Poland belongs to a group of countries with low mortality due to viral hepatitis, this disease is a serious social problem as measured with YLLs. The study provides the basis for policymakers to implement more effective methods to prevent premature deaths caused by this disease.

Years of life lost due to malignant neoplasms of the digestive system in Poland during 10 years of socioeconomic transformation

The aim of the study was to analyse years of life lost due to selected malignant neoplasms of the digestive system (colorectum, stomach, and pancreas) in Poland, a post-communist country in Central Europe, according to socioeconomic variables: sex, age, level of education, marital status, working status, and place of residence. The study included a dataset comprising death certificates of Polish citizens from 2002 (N = 359 486) and 2011 (N = 375 501). The data on deaths caused by malignant neoplasms of the digestive system, that is, coded as C15-C26 according to International Statistical Classification of Diseases and Related Health Problems, 10th Revision, was analyzed. The standard expected years of life lost meter was used to calculate years of life lost. In 2002, malignant neoplasms of the digestive system caused 25 024 deaths among Polish citizens (7.0% of all deaths), which translated into a premature loss of 494 442.1 years of life (129.4 years per 10 000 people). In 2011, the number of deaths increased to 26 537 (7.1% of all deaths) and the number of years of life lost rose to 499 804.0 (129.7 years per 10 000). The most important causes of mortality and years of life lost were colorectal, stomach, and pancreatic cancers. In both studied years, the socioeconomic features with an adverse effect on years of life lost due to each considered malignant neoplasm of the digestive system included male gender, lower than secondary education, widowed marital status, economic inactivity, living in urban areas. Years of life lost analysis constitutes a valuable part of epidemiological assessment of health inequalities in society. It appears that the observed inequalities may have many causes; however, further research is needed to better understand their full extent.

Changes in mortality and years of life lost due to lung cancer in Poland, 2000-2016

BACKGROUND

The aim of the study was to evaluate trends of mortality and the number of years of life lost due to lung cancer in Poland, in the period 2000-2016.

METHODS

The study material was 375,151 death certificates of all inhabitants of Poland who died in the period 2000-2016 due to lung cancer. In order to calculate the number of years of life lost, the authors used indices: SEYLL_p (Standard Expected Years of Life Lost per living person), SEYLL_d (per deaths), APC (Annual Percentage Change) and AAPC (Average Annual Percentage Change).

RESULTS

The standardized death rate (SDR) due to lung cancer decreased in the analyzed period from 74.5 to 68.3 per 100,000 population (AAPC = -0.6%). The most rapid decrease was noted in the years 2008-2011 (APC = -2.2%). With regards to males, SDR decreased from 148.8 to 114.5 (AAPC = -1.7%), whereas in females, it increased from 25.7 to 37.6 (AAPC = 2.3%). The SEYLL_p index, calculated per 100,000 inhabitants, increased from 1189.9 in the year 2000 to 1250.5 in the year 2016. The trend and pace of changes fluctuated. In 2000-2008, the SEYLL_p index was increasing at a pace of 0.7%. This growth was followed by a decrease at a pace of -1.2%, noted in 2008-2011. After the year 2011, the indices started to grow at an annual pace of 0.4%. AAPC in the whole study period was 0.3%. Increased mortality in females was responsible for the increase in the number of lost years of life. SEYLL_p values in this sex group increased from 464.8 in the year 2000 to 774.7 in the year 2016 (APC = 3.3%).With regards to males, SEYLL_p values, calculated for 100,000 male population, decreased in the analyzed period from 1961.1 to 1758.3.

CONCLUSIONS

Lung cancer still poses a serious epidemiological problem in Poland and the number of years of life lost due to this cause reflects social and economic implications of premature lung cancer-related mortality. There is a great need to educate, particularly women, and show effective ways of quitting smoking.

Trends of mortality due to breast cancer in Poland, 2000-2016

Background

The aim of the study was to assess trends in mortality and the number of lost years of life due to breast cancer in the female population in the years 2000–2016, with consideration given to differences regarding the level of education and place of residence.

Methods

The analysis was based on a database of the Central Statistical Office of Poland, containing information gathered from 92,154 death certificates of all Polish female inhabitants who died in the period 2000–2016 due to breast cancer. The SEYLL_p (Standard Expected Years of Life Lost per living person), the SEYLL_d (per deaths), the APC (Annual Percentage Change), the AAPC (Average Annual Percentage Change) were calculated to determine years of life lost.

Results

The mean age of women who died from breast cancer increased in the study period from 64.7 years to 69.7. The SEYLL_p index (per 100,000) increased to 776.8 years in 2016 (AAPC = 0.5%). The most unfavorable changes were observed in the group of women with secondary education. In 2004, the SEYLL_p values started to grow at a rate of 2.3% and since 2011, they have been higher than amongst women with elementary education. In the years 2000–2016, the authors observed that SEYLL_p was steadily declining (APC = -1.0%) in the group of inhabitants of rural areas, whereas with regards to city dwellers, the SEYLL_p index has been increasing since 2004 (APC = 0.5%), which has resulted in increased disproportions regarding the place of residence.

Conclusions

The results of this study showed that breast cancer is becoming a serious epidemiological problem in Poland. There is the need to intensify activities among women at highest risk group and it should be the starting point for making key decision in combating breast cancer.

Standard Expected Years of Life Lost Due to Malignant Neoplasms in Poland, 2000-2014

The aim of the study was an analysis of mortality trends due to malignant neoplasms in Poland. The study material was a database, consisting of 1,367,364 death certificates of inhabitants of Poland who died during the period 2000-2014 due to malignant cancer. To calculate years of life lost, the SEYLLp index (Standard Expected Years of Life Lost per living person) was applied. We also calculated AAPC (Average Annual Percentage Change). The SEYLLp index (per 10,000 population) due to malignant neoplasms in Poland in males decreased from 586.3 in 2000 to 575.5 in 2014, whereas in females it increased from 398.6 in 2000 to 418.3 in 2014. The greatest number of lost years of life in 2014 was attributed to lung cancer (174.7 per 10,000 males and 77.3 per 10,000 females), breast cancer in females (64.5) and colorectal cancer in males (39.0). The most negative trends were observed for lung cancer in females (AAPC = 3.5%) and for colorectal cancer (AAPC = 1.8%) and prostate cancer (AAPC = 1.6%) in males. Many lost years could have been prevented by including a greater number of Polish inhabitants in screening examinations, mostly targeted at malignant neoplasm, whose incidence is closely connected with modifiable risk factors.

Years of life lost due to diseases of the digestive system in Poland according to socioeconomic factors: a cross-sectional study

OBJECTIVES

To analyse years of life lost (YLLs) due to digestive diseases in Poland according to: marital status, education, working status and place of residence.

DESIGN

A cross-sectional study.

SETTING

The study was based on a dataset containing information from death certificates of Poles who died in 2002 and in 2011.

PARTICIPANTS

The analysis covered records with codes K00-K93 according to the International Classification of Diseases and Related Health Problems, 10th Revision.

OUTCOME MEASURES

YLL values were calculated using the Standard Expected Years of Life Lost measure. For each socioeconomic variable, the rate ratio (RR) was calculated as the quotient of YLLs in the less privileged group to the more privileged group.

RESULTS

Among the categories of marital status, the smallest YLL values (per 10 000) were recorded among singles (men: 100.63 years in 2002, 121.10 years in 2011; women: 26.99, 33.33, respectively), and the most among divorced men (657.87, 689.32) and widowed women (173.97, 169.46). YLL analysis according to education level revealed the lowest values in people with higher education (men: 54.20, 57.66; women: 17.31, 18.31) and the highest in people with lower than secondary education (men: 178.85, 198.32; women: 104.95, 125.76). Being economically active was associated with a smaller YLL score (men: 39.93, 59.51; women: 10.31, 14.96) than being inactive (men: 340.54, 219.93; women: 126.86, 96.80). Urban residents had higher YLL score (men: 159.46, 174.18, women: 73.03, 78.12) than rural ones (men: 126.83, 137.11, women: 57.32, 57.56).In both sexes, RR according to education level and place of residence increased, and those according to marital status and working status decreased with time.

CONCLUSIONS

Activities aimed at reducing health inequalities in terms of YLL due to digestive diseases should be primarily addressed to inhabitants with lower than secondary education, divorced and widowed people, urban residents and those who are economically inactive.

Epidemiology of Mortality Due to Prostate Cancer in Poland, 2000-2015

The aim of the study was to assess trends in mortality and years of life lost due to prostate cancer (PCa) in Poland in 2000–2015. The crude death rates (CDR), standardised death rates (SDR), standard expected years of life lost per living person (SEYLL_p) and per death (SEYLL_d) values were calculated. Joinpoint models were used to analyse time trends. In the study period, 61,928 men died of PCa. The values of mortality rates in 2000 (per 100,000) were: CDR = 16.97, SDR = 16.17, SEYLL_p = 332.1. In 2015, the values of all rates increased: CDR = 26.22, SDR = 16.69, SEYLL_p = 429.5. However, the SEYLL_d value decreased from 15.62 to one man who died due to PCa in 2000 to 13.78 in 2015. The highest SEYLL_p values occurred in the group of men with primary education (619.5 in 2000 and 700.7 in 2015). They were respectively 2.24 and 2.96 times higher than in men with higher education (275.7 and 237.1). SEYLL_p values increased in urban areas (from 295.7 to 449.4), slightly changed in the rural areas (from 391.5 to 400.2). Unfavorable trends in mortality due to PCa in Poland require explanation of the causes and implementation of appropriate actions aimed at mortality reducing.

Years of Life Lost due to Diseases of the Digestive System in Poland in 2000-2014

BACKGROUND AND AIMS

Diseases of the digestive system substantially contribute to premature mortality of the Polish population. Years of Life Lost (YLLs) are more and more commonly used in order to evaluate social and economic aspects of these deaths. The aim of the study was to analyse YLLs due to diseases of the digestive system in Poland between 2000-2014.

METHODS

The study material included a database which contained information gathered from 5,601,568 death certificates of Poles who died between 2000-2014. Data on deaths due to diseases of the digestive system were used for the analysis (i.e. coded as K00-K93 according to International Statistical Classification of Diseases and Related Health Problems, 10th Revision). Standard Expected Years of Life Lost (SEYLL) was used to calculate YLLs.

RESULTS

In 2000-2014 diseases of the digestive system contributed to 239,176 deaths of Poles (4.3% of all deaths), which corresponded to 5,470,096.8 YLLs (95.2 years per 10,000 population). Each death due to the above cause was responsible for the average loss of 22.9 years. Diseases of the liver, including alcoholic liver disease and fibrosis and cirrhosis of the liver, contributed to the highest number of YLLs (54.1%).

CONCLUSIONS

Of all digestive diseases, the dominant causes of YLLs are alcohol-related liver diseases. In order to minimize this phenomenon, it is important to intensify public health activities, aimed at combating alcohol addiction in Poland.

Years of life lost due to malignant neoplasms of the digestive system in Poland in the years 2000-2014

Background

Every fourth death that occurs in Poland is caused by a malignant neoplasm. A particularly negative epidemiological situation relates to colorectal cancers; in 2015 they constituted the fifth most important cause of years of life lost (YLL) in Poland.

Objective

We aimed to analyse YLL due to malignant neoplasms of the digestive system in Poland in between 2000 and 2014.

Methods

The study material included a database containing information gathered from 5,601,568 death certificates of Poles who died in 2000-2014. YLLs were calculated with the use of the standard expected years of life lost index (SEYLL).

Results

In the 15-year study period, malignant neoplasms of the digestive system contributed to 213,041 deaths in males and 177,644 deaths in females, which corresponded to a loss of 158.6 years per 10,000 men and 105.3 years per 10,000 women. Neoplasms of the large intestine (23.6%), stomach (22.0%) and pancreas (17.4%) contributed the most. A time trend analysis revealed (p < 0.05) a growing tendency of YLLs due to neoplasms of the large intestine and pancreas, and a decreasing trend due to neoplasms of the stomach.

Conclusion

Malignant neoplasms of the digestive system, especially of the large intestine, are becoming a more common cause of premature mortality in Poland.

Lost life years due to premature mortality caused by diseases of the respiratory system

BACKGROUND

In Poland, as in most other European countries, diseases of the respiratory system are the 4th leading cause of mortality; they are responsible for about 8% of all deaths in the European Union (EU) annually. To assess the socio-economic aspects of mortality, it has become increasingly common to apply potential measures rather than conventionally used ratios.

OBJECTIVES

The aim of this study was to analyze years of life lost due to premature deaths caused by diseases of the respiratory system in Poland from 1999 to 2013.

MATERIAL AND METHODS

The study was based on a dataset of 5,606,516 records, obtained from the death certificates of Polish residents who died between 1999 and 2013. The information on deaths caused by diseases of the respiratory system, i.e., coded as J00-J99 according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), was analyzed. The Standard Expected Years of Life Lost (SEYLL) indicator was used in the study.

RESULTS

In the years 1999-2013, the Polish population suffered 280,519 deaths caused by diseases of the respiratory system (4.69% of all deaths). In the period analyzed, a gradual decrease in the standardized death rate was observed - from 46.31 per 100,000 inhabitants in 1999 to 41.02 in 2013. The dominant causes of death were influenza and pneumonia (J09-J18) and chronic lower respiratory diseases (J40-J47). Diseases of the respiratory system were the cause of 4,474,548.92 lost life years. The Standard Expected Years of Life Lost per person (SEYLLp) was 104.72 per 10,000 males and 52.85 per 10,000 females. The Standard Expected Years of Life Lost per death (SEYLLd) for people who died due to diseases of the respiratory system was 17.54 years of life on average for men and 13.65 years on average for women.

CONCLUSIONS

The use of the SEYLL indicator provided significant information on premature mortality due to diseases of the respiratory system, indicating the fact that they play a large role in the health status of the Polish population.

Standard expected years of life lost due to tuberculosis in Poland

SETTING

Central European countries such as Poland have higher tuberculosis (TB) morbidity and mortality than Western European Union countries.

OBJECTIVE

To evaluate changes in mortality due to TB during the period 1999-2012 in Poland and years of life lost due to the disease.

DESIGN

Information obtained from 5 219 205 death certificates in Poland during the period 1999-2012 was used for the study. Crude (CDRs) and standardised (SDRs) death rates due to TB were analysed. Standard expected years of life lost per living person (SEYLLp) was also calculated.

RESULTS

In Poland, TB and related complications contributed 0.23% of total deaths from 1999 to 2012. The SEYLLp was 3.46 per 10 000 population in 1999 and 1.88 in 2012. It was respectively 5.75 and 3.12 for males, and 1.31 and 0.72 for females. The SEYLLp index decreased over the period (annual per cent change [APC] -4.27%, P < 0.05); the decrease was greater in females than in males (APC -4.75%, P < 0.05 vs. APC -4.15%, P < 0.05).

CONCLUSION

Despite an improvement in the epidemiological situation, TB remains the most common single cause of death due to an infectious agent in Poland.

[Socioeconomic inequalities in mortality due to all causes in the working age population of Poland in 2002 and 2011]

BACKGROUND

The aim of the study was to evaluate the influence of education, marital status, employment status and place of residence on mortality in the working age population of Poland in 2002 and 2011.

MATERIAL AND METHODS

All deaths of Poland's inhabitants aged 25-64, in 2002 (N = 97 004) and 2011 (N = 104 598) were analyzed. For individual socio-economic groups standardized mortality rates (SDR) per 100 000 and rate ratio (RR) were calculated.

RESULTS

In the group of economically inactive men SDR decreased from 2244.3 in 2002 to 1781.9 in 2011, while in the group of economically active population increased from 253.8 to 298.9 (RR drop from 8.8 to 6). In the group of economically inactive women SDR decreased from 579.5 to 495.2, and among the economically active women population it increased from 78.8 to 90.9 (RR drop from 7.4 to 5.4). In the group of men with higher education SDR decreased from 285.7 to 246, while among men with primary education it increased from 1141 to 1183 (RR increase from 4 to 4.8). In the group of women with higher education SDR decreased from 127.2 to 115.6 and among women with primary education it increased from 375.8 to 423.1 (RR increase from 3 to 3.7). In the group of divorced/separated SDR also increased - from 1521.4 to 1729.8 among men and from 365.5 to 410.8 among women.

CONCLUSIONS

Future prevention and educational programs should be addressed primarily to the population economically inactive, with primary education and those divorced/separated. Med Pr 2017;68(6):771-778.

Years of life lost due to bronchial asthma in Poland between 1999 and 2013

OBJECTIVE

The aim of this study was to analyze the years of life lost due to asthma in Poland between 1999 and 2013, with the use of the SEYLL measure (Standard Expected Years of Life Lost).

METHODS

The study was based on a dataset of 5,606,516 records gathered from death certificates of Polish residents from 1999 to 2013. The data on the deaths due to bronchial asthma and status asthmaticus (J45 and J46 according to ICD-10) were used for the analysis. The SEYLL, SEYLL_p (SEYLL per person) and SEYLL_d (SEYLL per death) were implemented to assess lost life years. The analysis of time trends was performed with the use of the join point model.

RESULTS

In 1999-2013, asthma and status asthmaticus were the cause of 11,380 deaths of Poles (0.20% of all deaths), resulting in 4.23 prematurely lost life years per 10,000 males and 3.22 years per 10,000 females. Over the analyzed years, the value of SEYLL decreased both for men and women. Every man who died due to bronchial asthma in Poland in the studied period, lost on average 19.12 years of life, and every woman 18.20 years.

CONCLUSIONS

The analysis of SEYLL indicated that premature mortality due to asthma is still a meaningful problem in the Polish population and a constant challenge for public health activities.

Fifteen-year mortality trends due to cardiovascular diseases in Poland using standard expected years of life lost, 2000-2014

BACKGROUND

Measures presenting the number of years of lost life point out social and economic aspects of premature mortality.

AIM

The aim of the study was to determine trends and pace of changes in years of life lost, in inhabitants of Poland, in 2000-2014, due to cardiovascular diseases (CVD).

METHODS

The study material was a database including 2,587,141 death certificates of Polish inhabitants who died of CVD in 2000-2014. We applied the standard expected years of life lost (SEYLL) indicators per living person (SEYLLp) and per death (SEYLLd) to calculate life years lost. We also estimated annual percentage changes (APC) and average annual percentage changes (AAPC) in the SEYLL indicators.

RESULTS

In 2000 the SEYLLp index due to CVD was 860.3 years per 10,000 males and 586.9 years per 10,000 females. In 2000-2004 the indices were decreasing and the average annual rate was -0.8% in the male group and -1.2% in the female group. Eventually, in 2014 its values were 721.4 years per 10,000 males and 475.6 years per 10,000 females. The respondents were losing years of life due to ischaemic heart disease (IHD) most rapidly (AAPC = -3.3% in the male group and -3.2% in the female group) and due to cerebrovascular diseases (AAPC = -2.5% in the male group and AAPC = -3.3% in the female group). On the other hand, there was an increase in the number of years of life lost due to heart failure (HF) (AAPC = 5.7% in the male group and AAPC = 4.4% in the female group). In 2014 SEYLLp due to IHD were 207.3 per 10,000 males and 99.1 per 10,000 females, due to cerebrovascular diseases - 124.3 and 102.2, and due to HF - 155.3 and 104.9. Each male who died of CVD lost on average 19.1 years in the year 2000 and 17.0 years in the year 2014 (AAPC = -0.5%). Regarding women, SEYLLd values were 12.6 years in 2000 and 10.4 years in 2014 (AAPC = -1.4%). A decrease in the SEYLLd value was observed in all analysed causes of mortality, in both males and females.

CONCLUSIONS

Among CVDs, IHD and cerebrovascular diseases contribute to the highest number of years of life lost in inhabitants of Poland. The constant decline in the average number of years of life lost by each person who died of CVD might result from implementation of more effective prophylaxis and more effective treatment, which extend lifespan.

ears of life lost due to bladder cancer among the inhabitants of Poland in the years 2000 to 2014

Introduction

The aim of the study is to evaluate the number of years of life lost in inhabitants of Poland due to bladder cancer (BC), identify trends of the mortality and calculate the pace of change which has happened over the period of the first fifteen years of the 21^st century.

Material and methods

The study material was a database including 44,283 death certificates of Polish inhabitants who died due to bladder cancer in the period 2000–2014. The number of years of life lost were calculated using the SEYLL indices: SEYLLp (Standard Expected Years of Life Lost per living person) and SEYLLd (Standard Expected Years of Life Lost per death).

Results

The crude death rates (CDR) index increased from 10.79 per 100,000 males in 2000 to 14.30 in 2014 (Annual Percentage Change [APC] = 2.1%, p <0.05). In women, the group value of the CDR index increased from 2.50 in 2000 to 3.83 in 2014 (APC = 2.9%, p <0.05). The standardized death rates (SDR) index fell from 23.27 in 2000 to 22.48 in 2014 (APC = -0.1%, p >0.05) in men, but rose from 3.54 in 2000 to 3.83 in 2014 (APC = 0.4%, p <0.05) in women.

The SEYLLp index (per 100,000 population) due to bladder cancer in Poland increased from 202.9 in 2000 to 243.4 in 2014 (APC = 1.3%, p <0.05) in men, and from 40.4 in 2000 to 60.1 in 2014 (APC = 2.7%, p <0.05) in women.

Conclusions

Despite the prolongation of patient life, as shown by the SEYLLd factor, Polish patients still lose too many years of life due to BC than compared to United States patients.

Territorial differences in years of life lost due to premature mortality in inhabitants of Poland

INTRODUCTION

Reduction of social and territorial differences with regards to health of a population is one of the most crucial global problems of public health. An analysis of years of life lost focuses on social and economic aspects of premature mortality.

AIM

The aim of the study is to analyze territorial differences in years of life lost due to premature mortality in inhabitants of various regions of Polan d, according to the most important causes of death, with consideration given to classification categories of ICD-10.

METHODS

The study material included a database which contained information gathered from 387,312 death certificates of inhabitants of Poland in 2013. The SEYLLp index (Standard Expected Years of Life Lost per living person) was used to calculate standard expected years of life lost.

RESULTS

The absolute number of years of life lost in inhabitants of Poland for the year 2013 was 4,168,256 in males and 2,536,447 in females, which corresponded to 2,237 years per 10,000 males and 1,277 per 10,000 females. Inhabitants of the Lodz Province are characterized with the highest number of years of life lost (2,858 years per 10,000 males and 1,544 per 10,000 females), whereas inhabitants of the Subcarpathian Province are characterized with the lowest number of years of life lost (1,833 years per 10,000 males and 1,039 per 10,000 females). In the male group, the highest SEYLLp values were contributed by: ischemic heart disease (217 years), malignant neoplasms of the trachea, bronchi and lungs (175 years) and cardiac insufficiency (156 years), whereas in the female group, the causes included: cerebral diseases (106 years), cardiac insufficiency (105 years) and ischemic heart disease (103 years)

CONCLUSIONS

There are huge territorial differences in Poland with regards to a number of years of life lost. Thus, there is a need to continue studies in order to find an explanation for these differences and gradually eliminate them.

Years of life lost of inhabitants of rural areas in Poland due to premature mortality caused by external reasons of death 1999-2012

INTRODUCTION

External causes of death are the third most common causes of death, after cardiovascular diseases and malignant neoplasms, in inhabitants of Poland. External causes of death pose the greatest threat to people aged 5-44, which results in a great number of years of life lost.

OBJECTIVE

The aim of the study is the analysis of years of life lost due to external causes of death among rural inhabitants in Poland, particularly due to traffic accidents and suicides.

MATERIAL AND METHODS

The study material included a database created on the basis of 2,100,785 certificates of rural inhabitants in Poland in the period 1999-2012. The SEYLL_p (Standard Expected Years of Life Lost per living person) and the SEYLL_d (per death) indices were used to determine years of life lost due to external causes of death. Joinpoint models were used to analyze time trends.

RESULTS

In the period 1999-2012, 151,037 rural inhabitants died due to external causes, including 27.2% due to traffic accidents and 25.2% due to suicides. In 2012, the SEYLL_p was 1,817 per 100,000 males and 298 per 100,000 females. Among males, suicides (SEYLL_p = 633 years per 100,000) and traffic accidents (SEYLL_p = 473 years per 100,000) contributed to the largest number of years of life lost. Among females, SEYLLp values were: 109 years due to traffic accidents and 69 years due to suicides (per 100,000). Among males, SEYLL_p values started to decrease in 2008 at the average annual rate of 3.2%. In the group of females in the period 1999-2012, SEYLL_p values were decreasing by 2.4% per year.

CONCLUSIONS

The decreasing trend of the number of lost years of life due to external causes among rural inhabitants does not apply to suicides among men. The SEYLL_p due to this group of causes has been steadily increasing since 1999. Analysis of the years of life lost focuses on the social and economic aspects of premature mortality due to external causes.

Educational inequalities in premature mortality in Poland, 2002-2011: a population-based cross-sectional study

BACKGROUND

The aim of the study is to evaluate the differences in premature mortality between educational groups of Polish inhabitants in 2002 and 2011.

METHODS

The analysis included all deaths among inhabitants of Poland, aged 25-64 years, which occurred in 2002 (N=97 004) and 2011 (N=104 598). We calculated age-standardised death rates (SDRs) and summary measures on inequalities. The relative index of inequality (RII) was calculated with Poisson regression.

RESULTS

The SDR for Poland decreased from 285.7 per 100 000 in 2002 to 246.0 in 2011 among males with higher education and increased from 1141.0 in 2002 to 1183.0 in 2011 among males with lower secondary or less education (the rate ratio increased from 4.0 to 4.8). With regard to females with higher education, the SDR decreased from 127.2 per 100 000 in 2002 to 115.6 in 2011. Among females with lower secondary or less education, the SDR increased from 375.8 per 100 000 in 2002 to 423.1 in 2011 (the rate ratio increased from 3.0 to 3.7). The RII increased from 5.8 to 9.7 in the male group and from 4.4 to 8.3 in the female group. The greatest educational inequalities in 2011 were observed in females who died of cardiovascular diseases (RII=14.9) and lung cancer (RII=6.6) and in males who died of suicides (RII=19.3) and lung cancer (RII=11.9).

CONCLUSIONS

Educational inequalities in premature mortality in Poland are growing. There is a need to implement health education programmes targeted at groups of the most poorly educated Polish inhabitants, especially for diseases resulting from smoking and excessive alcohol consumption.

Years of Life Lost due to Premature Mortality in a Province with the Shortest Life Expectancy in Poland

AIM

The aim of the study was to evaluate years of life lost for citizens of the Lodz Province, which is characterized by the lowest life expectancy in Poland, and to identify current trends in this area according to the most common causes of death.

METHODS

The study material included a database containing information gathered from 470,000 death certificates of Lodz Province inhabitants, who died between 1999 and 2011. In order to calculate years of life lost, the authors applied the SEYLLp (Standard Expected Years of Life Lost per living person) and SEYLLd (per death) indices. The analysis of time trends was carried out with the application of joinpoint models.

RESULTS

The SEYLLp measure was 2,300 years per 10,000 males and 1,500 years per 10,000 females in 2011. Cardiovascular diseases contributed to the highest number of years of life lost (SEYLLp=682 years per 10,000 males and 559 years per 10,000 females). Next were malignant neoplasms (SEYLLp=505 years per 10,000 males and 437 years per 10,000 females), external causes of death (SEYLLp=361 years per 10,000 males and 83 years per 10,000 females). The number of years of life lost due to acute myocardial infarction decreased most rapidly, the Annual Percent Change (APC) was -10.1% in males and -3.7% in females. However, heart failure contributed to the highest increase in the number of years of life lost (APC=10.8% in males and 10.9% in females).

CONCLUSIONS

A further decrease in the mortality rate due to cardiovascular diseases might contribute to the highest reduction of years of life lost. The most effective preventive activities are those aimed at reducing productive years of life lost due to a particular cause of death, i.e. road traffic accidents, suicides, cirrhosis of the liver, alcoholic liver disease, and malignant neoplasms of the trachea, bronchi and lungs.

Lost life years due to premature deaths caused by diseases of the digestive system in Poland in 2013

BACKGROUND

In order to evaluate the health status of a population, besides indicators measuring the incidence of diseases and deaths, potential measures are becoming more frequently used, ie. measures that take into account life-time potential of the individuals in the population. They can particularly by applied to analyse the problem of premature mortality, which is measured by lost life years.

AIM

The aim of the study was to evaluate life years lost due to diseases of digestive system in Polish population in 2013.

MATERIALS AND METHODS

The study was based on a dataset containing 387,312 death certificates of Poles who died in 2013, provided by the Central Statistical Office in Poland. Data on deaths caused by diseases of digestive system (K00-K93 by ICD-10) were used in the study – that were 16,543 records (4.3% of all the deaths). Lost life years were assessed with the measures: SEYLL (Standard Expected Years of Life Lost), SEYLLp (Standard Expected Years of Life Lost per living person), SEYLLd (Standard Expected Years of Life Lost per death).

RESULTS

In the analysed year among men there were 9,275 deaths caused by diseases of digestive system and in women 7,268 deaths. SEYLL in the group of men amounted to 102 230.7 and in the group of women it was 53,475.5. The number of lost life years calculated per 10 000 male inhabitants was 54.9, and for 10,000 females it was 26.9. The highest share in lost life years had alcoholic liver disease (SEYLLp for men – 20.87, for women – 6.1), fibrosis and cirrhosis of the liver (SEYLLp for men- 9.7, for women- 5.6) and acute pancreatitis (SEYLLp for men – 5.3, for women – 2.1).

CONCLUSIONS

The results of the study indicate that diseases of digestive system have an important contribution to the loss of life-time potential in Polish population (6.6% of all SEYLL in 2013). The dominant role in this class of diseases played alcoholic liver disease – K70, fibrosis and cirrhosis of the liver – K74 and acute pancreatitis – K85.

Pregnancy and Delivery in Women with Uterine Malformations

BACKGROUND

Uterine defects are the most common malformations of the female reproductive system. They can lead to many obstetric complications, e.g. preterm delivery, intrauterine growth restriction, oligohydramnios and operational delivery.

OBJECTIVES

Our aim was to analyze the impact of different types of uterine defects on pregnancy outcomes.

MATERIAL AND METHODS

The study involved 94 pregnant women with different types of uterine defects hospitalized at the Department of Fetal--Maternal Medicine and Gynecology, RIPMMH in Łódź, between 1994 and 2012. The patients were divided into 5 groups on the basis of diagnosed defects: arcuate (n=6), bicornuate (n=50), duplex (n=29), septate (n=5) and unicornuate uterus (n=4). In order to avoid correlated data in statistical analysis, our research did not consider the total number of pregnancies and births but the number of patients. The first pregnancy of each patient, if completed after 22-week gestation, was studied and analyzed.

RESULTS

Preterm delivery was the most common complication in pregnancy (55 women, 58.5%). The caesarean section was performed in 73 (78%) women. IUGR was diagnosed in 16% of cases. Placental abruption occurred in 13 (14%) and cervical insufficiency in 10 cases (11%), respectively. Prenatal diagnostic showed abnormalities in 12 fetuses (13%). The Apgar score from 0 to 4 points was assigned to 9 newborns (9.6%), 5-7 to 20 children (21.3%) and 8-10 points to 75 cases (69.1%). Normal birth weight (>2500 g) was determined in 51 newborns (54.3%).

CONCLUSIONS

Women with uterine defects are subject to an increased risk of complications in pregnancy and delivery, including premature births, low birth weights, births by cesarean section.

The burden of premature mortality in Poland analysed with the use of standard expected years of life lost

Background

Despite positive changes in the health of the population of Poland, compared to the EU average, the average life expectancy in 2011 was 5 years shorter for males and 2.2 years shorter for females. The immediate cause is the great number of premature deaths, which results in years of life lost in the population. The aim of the study was to identify the major causes of years of life lost in Poland.

Methods

The analysis was based on a database of the Central Statistical Office of Poland, containing information gathered from 375,501 death certificates of inhabitants of Poland who died in 2011. The SEYLL_p (Standard Expected Years of Life Lost per living person) and the SEYLL_d (SEYLL per death) measures were calculated to determine years of life lost.

Results

In 2011, the total number of years of life lost by in Polish residents due to premature mortality was 2,249,213 (1,415,672 for males and 833,541 for females). The greatest number of years of life lost in males were due to ischemic heart disease (7.8 per 1,000), lung cancer (6.0), suicides (6.6), cerebrovascular disease (4.6) and road traffic accidents (5.4). In females, the factors contributing to the greatest number of deaths were cerebrovascular disease (3.8 per 1,000), ischemic heart disease (3.7), heart failure (2.7), lung cancer (2.5) and breast cancer (2.3). Regarding the individual scores per person in both males and females, the greatest death factors were road traffic accidents (20.2 years in males and 17.1 in females), suicides (17.4 years in males and 15.4 in females) and liver cirrhosis (12.1 years in males and 11.3 in females).

Conclusions

It would be most beneficial to further reduce the number of deaths due to cardiovascular diseases, because they contribute to the greatest number of years of life lost. Moreover, from the economic point of view, the most effective preventative activities are those which target causes which result in a large number of years of life lost at productive age for each death due to a particular reason, i.e. road traffic accidents, suicides and liver cirrhosis.

Determinants of self-rated health of a working population

BACKGROUND

Self-rated health relates to the use of medical help and, as a consequence, determines sick leave in the population of employees. The aim of the study was to analyze the relationship between socioeconomic variables, selected forms of positive health behaviour and subjective evaluation of health in employees.

MATERIAL AND METHODS

Five hundred and 99 subjects were included in the study - 331 females and 268 males, aged 18-67, working in the area of the Świętokrzyskie province. The authors' survey questionnaire on the selected elements of the state of health and positive health behavior in life style has been used in the study. Anthropometric measures were carried out. A Chi2 test for independence was used in'the statistical analysis. In order to evaluate the effect of the selected factors on the self-rated health of the studied subjects theresearchers have applied single- and multiple-factor logistic regression.

RESULTS

In the multiple-factor logistic regression the features contributing to good or excellent self-rated health were the following: age up to 39 (odds ratio - OR = 4.17; 95% confidence interval - Cl: 1.72-10.10; p < 0.002), higher education (OR = 3.01; 95% CI: 1.04-8.70; p < 0.05) and care for health (OR= 4.77; 95% CI: 2.81-8.09; p < 0.001).

CONCLUSIONS

Working people with higher education are characterized by a better control over their own health and, consequently, by a better perception of it. Monitoring self-rated health in a working population is an invaluable indicator in the evaluation of health in employees and the need for medical care.

Life years lost due to cardiovascular diseases

BACKGROUND

When evaluating the health status of a population, an increasingly important role is played by measures aiming to access premature mortality in lost lifetime units. There is a considerable number of life years 'to be recovered' provided cardiovascular disease (CVD) mortality is reduced, as CVD cause the highest absolute number of years lost.

AIM

To access life years lost by the inhabitants of the Lodz region due to CVD and to determine the rank of each disorder within this ICD-10 class, which causes most life years lost, as well as to identify trends in this regard.

METHODS

Our research was based on a dataset consisting of 313,144 death certificates, including 146,852 due to CVD, of the inhabitants of the Lodz region from 1999 to 2008. We applied the standard expected years of life lost (SEYLL) indicators per living person (SEYLLp) and per death (SEYLLd) to calculate life years lost. Joinpoint models were used to analyse changes in time. We also estimated average annual percentage changes in the SEYLL indicators.

RESULTS

In 2008, the number of life years lost amounted to 754 per 10,000 males and 595 per 10,000 females. The most important contribution to life years lost among males was from ischaemic heart disease (IHD) (SEYLLp = 200), particularly acute myocardial infarction (AMI) (SEYLLp = 128). Nearly the same number of years lost was due to other heart disease (SEYLLp = 199), especially heart failure (SEYLLp = 121). Cerebrovascular disease caused 191 life years lost per 10,000 males, while diseases of arteries, arterioles and capillaries caused the loss of 98 life years per 10,000 males. In women, the highest number of life years lost was attributed to cerebrovascular disease (SEYLLp = 176) and other heart disease (SEYLLp = 152), especially heart failure (SEYLLp = 95). IHD contributed to the loss of 113 life years per 10,000 females (including AMI: SEYLLp = 62), while diseases of arteries, arterioles and capillaries led to 112 life years lost per 10,000 females.

CONCLUSIONS

The highest number of life years lost resulted from IHD among males and cerebrovascular disease among females. A growing trend in the number of life years lost due to CVD was noted since 2002 for males and since 2003 for females. These unfavourable trends decelerated considerably after 2006. The highest decrease in life years lost for both sexes in 1999-2008 was noted for IHD.

[The impact of smoking tobacco and drinking alcohol on mortality risk in people of working age -results of an 8-year study in a large urban center]

BACKGROUND

The aim of the study was to assess the effects of smoking and drinking alcohol on death rates in working-age urban inhabitants in Poland.

MATERIAL AND METHODS

In 2001 randomly selected inhabitants of Łódź, aged 18-64 years, were included in the WHO Program Countrywide Integrated Noncommunicable Diseases Intervention (CINDI). the study sample comprised 1828 people (1002 men, 826 women). In 2009 for all participants of the 2001 study, information was obtained whether they were living or deceased, or moved out of Łódź. The Cox proportional hazard model was used for the evaluation of hazard ratios (HR).

RESULTS

The analysis revealed the increased risk of death among Łódź inhabitants of working age. An 8-year follow-up yielded the following values: for active smokers compared with people slightly addicted to nicotine, HR= 2.582 (95% CI: 1.381-4.825, p < 0.003); for people heavily addicted to nicotine, HR = 3.656 (95% CI: 1.544-8.654, p <0.004); and for passive smokers (risk for persons staying in smoky rooms up to 5 h a day, compared to those not living in smoke-filled rooms), HR = 2.021 (95% CI: 1.111-3.672, p < 0.03). The variable that had a protective effect on the mortality risk of working-age population turned out to be a "reasonable" use of alcohol (HR = 0.411, 95% Cl: 0.227-0.744, p < 0.004), compared to non-drinking alcohol at all.

CONCLUSIONS

Addiction to smoking significantly increases the risk of premature death, and therefore appropriate prevention programs aimed at the reduction of smoking can contribute to closing the gap in the population health status.

Self-rated quality of life of city-dwelling elderly people benefitting from social help: results of a cross-sectional study

Background

The percentage of people aged 65 or older living in Poland is 13.6%, but 17.2% in Łódź. The aim of the study was to identify factors correlating with the self-rated quality of life of elderly inhabitants of cities applying for social help, on the basis of a cross-sectional study.

Methods

The study was conducted in Łódź, a large Polish city, between September 2011 and February 2012 in a group of people applying for help in the Municipal Social Welfare Centre. Four hundred and sixty-six respondents aged 65 or older were included in the study. The tool used in the study was an interview questionnaire. The respondents answered questions on their demographic situation, living conditions, financial, health and social situation. The authors also applied the WHOQOL-BREF Questionnaire, the Activities of Daily Living Scale (ADL) and the Geriatric Depression Scale (GSOD). For statistical purposes, the authors used single- and multiple-factor regression and the Statistica 9.0 Program. The results were presented as an odds ratio (OR) with a 95% confidence interval (CI); the adopted significance level was p < 0.05. The authors applied the Pearson’s x² test in order to evaluate the structure of the studied group and the subpopulation, who were aged 65 or older and using social help, throughout the city.

Results

Logistic regression confirmed that a high quality of life depends on the following variables: university education (OR = 2.31; p < 0.05), an income which is sufficient to live (OR = 1.63; p < 0.05), no heart palpitations (OR = 2.32; p < 0.05), stable blood pressure (OR = 2.32; p < 0.05), no headaches (OR = 1.55; p < 0.05), no pain in the chest (OR = 1.51; p < 0.01), no shortness of breath (OR = 1.51; p < 0.01), no tiredness (OR = 2.08; p < 0.05), a score on the Geriatric Depression Scale pointing to a lack of suspected depression (OR = 9.88; p < 0.001 if the person does not suffer from depression and OR = 6.33; p < 0.001 if there is uncertain depression) as well as not using nursing services, a score on the ADL Scale confirming the person’s fitness and participation in family gatherings.

Conclusions

A subjective evaluation of the quality of life of the elderly depends on many factors. An identification of these factors might be helpful in implementing steps aimed at improving the quality of life of elderly people who, as a consequence, will need less social help: particularly nursing services.

Factors associated with self-rated health (SRH) of a University of the Third Age (U3A) class participants

INTRODUCTION

A U3A is a way of making elderly people active. Our study aims to investigate the association between socioeconomic variables, selected symptoms, disorders and the SRH of participants of classes at the U3A.

MATERIALS AND METHODS

The study was conducted in 2011 in a group of participants of classes at the U3A in Plock, Poland. The authors examined 250 people aged 60 or older. A survey questionnaire was the study tool. Statistica 9.0. was used for statistical analysis, including ordinal regression models.

RESULTS

Being younger (65-69) increases the chance of returning a good SRH score to over five times compared to being 75 and over (odds ratio (OR)=5.30, confidence interval (CI)=1.76-15.97), p<0.01). The chance of a good SRH score is almost four times more likely in subjects with a disposable income which satisfies basic needs compared to that which does not (OR=3.97, CI=1.12-14.04, p<0.05). Furthermore, lack of symptoms and disorders have a strong influence on good SRH (no leg edema - OR=4.06, CI=1.63-10.12, p<0.01; no headache - OR=2.75, CI=1.34-5.62, p<0.01; no toothache - OR=4.32, CI=1.12-16.68, p<0.05; no hypertension - OR=1.78, CI=1.02-3.14, p<0.05; no degenerative disease - OR=1.88, CI=1.08-3.27, p<0.05). Feeling happy raised the chance of reporting good SRH by almost three times (OR=2.91, CI=1.35-6.27, p<0.01).

CONCLUSIONS

A subjective evaluation of health by the elderly constitutes an important indicator of their health and quality of life. It can become a basis for implementing activities of gerontological prophylaxis and leveling out health inequalities.

An assessment of health effects of a cardiological prophylaxis programme in a local community with the use of the SCORE algorithm

INTRODUCTION

In 2009, the SDR due to cardiovascular diseases was 356.3 per 100,000 people in Poland. The Prophylaxis and Early Detection of Cardiovascular Diseases Programme (PEDCCP) aimed at decreasing mortality caused by cardiovascular diseases (CVD) in Poland by 25%. The global risk of SCORE (European Systematic Coronary Risk Evaluation) has become a reason for implementing pro-health recommendations in order to eliminate risk factors in CVD.

METHODS

The presented observation study encompassed 458 participants of the PEDCCP from 2009-2011. The subjects received two arterial blood pressure tests as well as anthropometric measurements. Also, TC, LDL, HDL and TG levels were measured in laboratory tests. Statistical analysis included elements of descriptive and analytical statistics, with bivariate and multivariate logistic regression (odds ratios with 95% CIs).

RESULTS

A positive change in SCORE was observed in 13.3% of the subjects. It was higher in almost every third subject of the authors' own study (29.5%). Mostly gender and age contributed to the change in SCORE, but regular glucose levels and no tendency to compete were also relevant.

CONCLUSIONS

There is a need to continue such prophylaxis programmes in primary health care to better estimate the risk of mortality due to CVD in local communities.

Cross-cultural adaptation and translation of a quality of life tool for new mothers: a methodological and experiential account from six countries

AIM

To examine the challenges and solutions encountered in the translation and cross-cultural adaptation of an English language quality of life tool in India, China, Iran, Portugal, Brazil, and Poland.

BACKGROUND

Those embarking on research involving translation and cross-cultural adaptation must address certain practical and conceptual issues. These include instrument choice, linguistic factors, and cultural or philosophical differences, which may render an instrument inappropriate, even when expertly translated. Publication bias arises when studies encountering difficulties do not admit to these, or are not published at all. As an educative guide to the potential pitfalls involved in the cross-cultural adaptation process, this article reports the conceptual, linguistic, and methodological experiences of researchers in six countries, who translated and adapted the Mother-Generated Index, a quality of life tool originally developed in English.

DATA SOURCES

Principal investigator experience from six stand-alone studies (two published) ranging from postgraduate research to citywide surveys. DISCUSSION/IMPLICATIONS FOR NURSING: This analysis of a series of stand-alone cross-cultural studies provides lessons about how conceptual issues, such as the uniqueness of perceived quality of life and the experience of new motherhood, can be addressed. This original international approach highlights practical lessons relating to instrument choice, and the resources available to researchers with different levels of experience. Although researchers may be confident of effective translation, conceptual and practical difficulties may be more problematic.

CONCLUSION

Instrument choice is crucial. Researchers must negotiate adequate resources for cross-cultural research, including time, translation facilities, and expert advice about conceptual issues.

Health inequalities among rural and urban inhabitants of Łódź Province, Poland

INTRODUCTION AND OBJECTIVE

The aim of the study was to compare the state of health of the inhabitants of the countryside and city dwellers in the Łódź province, measured with the real and standardized death rate and years of life lost, as well as the analysis of causes of deaths distinguishing these two populations.

MATERIALS AND METHODS

The study material included a database containing information gathered from 313,144 death certificates of the inhabitants of Łódź province who died between 1999-2008. Real and standardized death rates were determined. The standardization was carried out by a direct method. The Standard Expected Years of Life Lost (SEYLL method) was used to compute years of life lost. Analysis of time trends of death rates and life span in the Łódź province was conducted with jointpoint models. The intensity of mortality computed with standardized death rates in the province was higher in the countryside than in the city.

RESULTS

In 2008, the standardized death rate in the countryside was 904.5 per 100,000 inhabitants, and in the city - 903.4 per 100,000 inhabitants. Inhabitants of the countryside more often died of cardiovascular diseases (SDR=418.7 vs. 367.9) and from external causes (SDR=90.2 vs. 63); those from the city and towns died from malignant neoplasms (SDR=204.5 vs. 195.6) and diseases of the alimentary tract (SDR=55.6 vs. 34.6). In 2008, SEYLL calculation for 1,000 people was 204 years for the inhabitants of the city and towns and 190 years for the inhabitants of the countryside.

CONCLUSION

It is necessary to introduce more effective prophylactic and health promoting activities in order to lessen the differences in the state of health state in the Łódź province and the rest of the country.

[The role of prophylaxis and early detection of cardiovascular disease programme in shaping health behaviours related to smoking]

Smoking is one of the major risk factors for cardiovascular disease. In Poland, 25% of women and 42% of men smoke cigarette regularly. The risk of myocardial infarction decreased significantly after cessation of smoking. Tobacco prevention is an integral part of health policies implemented in our country. Smoking is an indispensable element in the assessment of risk of death from cardiovascular using SCORE algorithm used by the Program for Prevention and Early Detection of Cardiovascular Diseases, conducted by the National Health Fund.

MATERIALS AND METHODS

The study was conducted in 2009-2011 in Zgierz (lodzkie voivodship). Study group consisted of former participants of the Programme of Prevention and Early Detection of Cardiovascular Diseases in the years 2006-2008. Tool for the study was a questionnaire survey extended with the study card, where laboratory results were applied. SCORE risk assessment used charts for countries with high risk. In all patients, laboratory tests assessing total cholesterol, LDL cholesterol, HDL cholesterol and fasting glucose were made. Respondents were also performed two-measurement of blood pressure. For the calculations, the methods of descriptive statistics and analysis using the package Statistica 9.0 PL.

RESULTS

The study sample consisted of 458 persons. Among the respondents, 27.4% women and 38.2% of men smoked cigarettes. For regular smokers were 144 people, including 26 claimed that smokes occasionally. 74 people have decided to stop smoking after participating in the preventive program. We observed a strong correlation between smoking and arterial hypertension and glucose intolerance.

CONCLUSIONS

Should be stepped up preventive measures aimed at combating the prevalence of tobacco consumption in local communities.

[Relation between occupation and health related quality of life of pregnant women]

BACKGROUND

The aim of this study was to find out the relationship between occupation and health-related quality of life.

MATERIAL AND METHODS

The study included 504 pregnant women. Two questionnaires, SF-36v2 and EQ-5D, were used to estimate health-related quality of life. The information on socio-economic status were gathered by performing the third survey.

RESULTS

The study evidenced that the health-related quality of life of working women was significantly better than that of those who were on sick leave or unemployed. In the study group, white collar workers had significantly more childbirths in the past than blue collar workers (p = 0.0055). The mean age ofprimiparas employed as white collar workers was 28 while the mean age of blue-collar primiparas was 26, and the difference was significant (p = 0.0000).

CONCLUSIONS

The occupation is important not only because it decides about the economic status, but it also influences the health-related quality of life of pregnant women.

[Evaluation of antenatal quality of life of hospitalized women with the use of Mother-Generated Index--pilot study]

OBJECTIVES

The objectives of this study included: (1) evaluation of the Polish version of Mother Generated-Index (MGI) as a tool for measuring antenatal Health Related Quality of Life (HRQL) of hospitalized women; (2) identification of factors influencing antenatal quality of life of hospitalized women; (3) assessment of correlations between MGI and SF-36v2, and between MGI and EQ-5D.

MATERIAL AND METHODS

MGI is a three-step questionnaire. Respondents were asked to name important areas of life that had been affected by their pregnancy (step 1) and then to assess, on the scale from 0 to 10, their positive or negative value (step 2). In Step 3, the women ranked the importance of the areas by allocating a total of 20 'spending points' among them. The sub-index MGI1 is defined as the mean of the Step 2 scores, the sub-index MGI2 is defined as the weighted mean of Step 2 scores with weights given in Step 3. Using SF-36v2, EQ-5D, MGI questionnaires and socioeconomic survey we studied the HRQL of 99 pregnant women hospitalized in ICZMP in Łódź.

RESULTS

Sub-index MGI1 was included between 1.83 and 10 with mean 5.86 (SD 1.71). Sub-index MGI2 was between 0 and 10, with mean 6.70 (SD 2.34). Sub-indexes of MGI were significantly (p < 0.05) positively correlated with EQ-5D and with sub-indexes of SF-36v2. The correlations are weak or moderate (between 0.2 and 0.4). The mean of the score given in the second part of MGI was 8.58 (SD 1.13) for positive comments, 2.63 (SD 1.22) for negative comments, and 5.02 (SD 1.55) for neutral comments. Differences between positive, negative and neutral comments were statistically significant (ANOVA, p = 0.00). Among factors which influence antenatal quality of life, the respondents named relationship with partner and family attitudes towards pregnancy delivery and baby work and personal finances.

CONCLUSIONS

(1) MGI should be treated as an additional tool for HRQL measurement, since it reflects the differences between expectations towards pregnancy and reality Multicultural factors can influence MGI. (2) MGI allows to identify factors which influence the antenatal quality of life, taking into account their importance. (3) There are statistically significant positive correlations between sub-indexes of MGI and sub-indexes of SF-36v2, and between sub-indexes of MGI and EQ-5D.

[Mother Generated-Index--a new indicator of antenatal and postnatal quality of life]

OBJECTIVES

The objective of this study was 1. description of an antenatal and postnatal quality of life measure, namely Mother Generated-Index (MGI), and its applications in the scientific studies. 2. critical analysis of MGI survey. 3. suggestion of further studies on MGI survey.

FINDINGS

The MGI is a three-step questionnaire. Women were asked to specify the important areas of their life that had been affected by their pregnancy (Step 1). Having specified up to eight such areas, the women scored each of them from 0 to 10 (Step 2). The women allocated 20 'spending points' between areas, with more points given to those aspects that their felt were more important (Step 3). The sub-index MGI 1 is defined as the mean of the Step 2 scores, and the subindex MGI 2 is defined as the weighted mean of Step 2 scores with weights given in Step 3. MGI was used in several studies to evaluate postnatal and antenatal quality-of-life. It was used to study HRQL of different populations, namely women in Scotland and in India, and it was used together with number of psychometric tools for measuring HRQL (generic and specific), such as EPDS, SF-12, PNMI, MAMA, GHQ-30, SF-36v2, EQ-SD.

KEY CONCLUSIONS

1. Three step questionnaire MGI was used in several studies on postnatal and antenatal quality-of-life. The authors are planning further study on antenatal HRQL with MGI 2. MGI should be still treated as a methodological experiment. It is not clear what mean MGI scores, how surveying, description of query, multi-culture and socio-economical factors can affect the results. However, MGI can be easily translated to Polish, since it does not require linguistic validation, which is important because of lack of Polish versions of postnatal and antenatal HRQL tools. 3. Further studies on MGI are needed. In particular, test-retest study should be perform to verify reliability of MGI.

[Tobacco smoking and job characteristics--study of the working population from the Swietokrzyskie voivodeship]

BACKGROUND

Tobacco smoking is the most important modifiable risk factor of Non-Communicable Diseases (NCDs). According to WHO tobacco-related disorders every year kills 5,4 million people worldwide. In Poland tobacco smoking was the cause of approximately 69 000 deaths (57 000 among man and 12 000 among women). Tobacco smoking is also the important factor of economic consequences caused by work absences, low work productivity and tobacco-related disorders treatment.

AIM

The aim of the study was to investigate the prevalence of tobacco smoking and its determinants in working population from the Swietokrzyskie voivodeship.

MATERIAL AND METHODS

The study population consisted of randomly selected working adults living in the Swietokrzyskie voivodeship. The research tools included a questionnaire inquiring about data concerning healthy habits. In the statistic analysis the Chi2 test was used and the relationship between variables was estimated at p < 0.05.

RESULTS

The study group consisted of 599 people (55.3% females and 44.7% males) aged 18-67. The research found out that 25% of respondents (21.1% of women and 29.9% of men) smoked cigarettes. A statistically significant correlation between men and women was revealed in terms of intensity of smoking (p < 0.01). The ratio of smoking among individuals with the primary/secondary level of education and inhabitants of cities with fifty to one hundred thousand people was higher (p < 0.05; p < 0.01). The study results showed also that the smoking rate was higher among physical workers and working in shifts (p < 0.01). Age, economic status, trade and occupational position were not connected with the fact of smoking in the study group.

CONCLUSIONS

The data presented in the review confirm the correlation between the frequency of tobacco smoking and education level, place of living and job characteristics. Frequency of tobacco smoking in working population from Swietokrzyskie voivodeship indicate that special prophylactic programs should be addressed to professionally active.

[Knowledge of toxoplasmosis among pregnant women, midwifes, medical students and obstetricians]

BACKGROUND

Knowledge of toxoplasmosis has been assessed among obstetricians, medical students, midwifes and pregnant women. The aims of the study were as follows: 1) evaluation of intra- and inter-group variation in correct answers to the questions included in the questionnaire used as a study tool; 2) evaluation of inter-group variation in answers to specialist and non-specialist questions; and 3) intra-group evaluation of self-assessed difficulty in completing the questionnaire.

MATERIALS AND METHODS

In the prospective study, 310 participants were included: 109 pregnant women, 116 midwifes 85 physicians (including 69 specialists in OB/GYN) and 16 medical students. The anonymous questionnaire consisted of 26 questions, with four answers proposed for each question of which one was correct.

RESULTS

There was no difference between correct answers among midwifes, physicians and medical students (p = 0.20), but the difference was found between the group of physicians and medical students and pregnant women as well as between midwifes and pregnant women (p < 0.001). Physicians, medical students and midwifes gave best answers to the non-specialist questions (p < 0.001), and midwifes obtained higher scores than pregnant women (p < 0.001). The mean percentage of correct answers to the specialist questions was among pregnant women (29%) showing a high level of randomness. The best answers to the non-specialist questions were found for physicians and midwifes (p = 0.93). However, there was a difference between the group of physicians and medical students and pregnant women and between midwifes and pregnant women in self-assessment of difficulty in completing the questionnaire (p < 0.001).

CONCLUSIONS

Pregnant women assessed their knowledge of toxoplasmosis as least adequate, whereas midwifes, as most adequate. Pregnant women's knowledge about toxoplasmosis is poor. The group of physicians and medical students yielded evidently better score than pregnant women. There is a need for the improvement among prenatal care providers in both patient education and self-education.

[Determinants of smoking cessation during pregnancy]

The numerous researches confirmed that cigarette smoking during pregnancy negatively affects unborn fetus. A survey of 330 pregnant women hospitalized in ICZMP in Łódź was performed; 257 women agreed to participate in the study. Smoking prevalence was 9.2% and 73% women quit successfully smoking while pregnant or near to pregnancy. Smoking cessation is higher among older, wealthier and better educated women. According to the Mental Health factor of SF36v2 health related quality of life (HRQL) survey, women who quit smoking successfully have better psychological well-being, than that who smoked during pregnancy.

[Prevalence of tobacco smoking among participants of the Cardiovascular Prophylactic Program]

BACKGROUND

Cigarette smoking contributes to nearly 40 percent of premature deaths all over the world. In Poland, approximately 10 million people are addicted to smoking. Smoking prevalence depends on the socioeconomic status. The frequency of smoking is higher among people with low levels of education.

MATERIAL AND METHODS

The study was conducted among the participants of Cardiovascular Prophylactic Program. Patients with diagnosed cardiovascular system disorders or/and diabetes were excluded from the Programme. Patient's Prophylactic Card with collected data concerning risk factors for cardiovascular diseases, blood pressure measurements, body mass and height, levels of glucose and total cholesterol, including HDL and LDL fractions, was the study instrument. In the statistical analysis, the Chi2 test was used. The relationship between variables was assessed at p < 0.05. The strength of the correlations was estimated with C-Pearson's coefficient.

RESULTS

202 people, aged 35, 40, 45, 50 and 55, including 83 males (41.1%) and 119 females (58.9%), were surveyed. The study revealed that 33.7% of our respondents (32.5% of females and 35% of males) smoked cigarettes. Cigarette smoking was more intensive among people with a low level of education and blue-collar workers (p < 0.05). Hypertension, diabetes and hypercholesterolemia were more common among smokers.

CONCLUSIONS

The results of the conducted study confirm a strong need to promote educational programs in local comunities to increase public awareness of health effects of tobacco smoking, taking into account socioeconomic disparities in tobacco use.

[Frequency and location of inhaling tobacco smoke by the still smoking participants of the 'Quit and Win' competition who live in cities]

Mount of toxic chemical substances supplied to the human organism is directly proportional to the number of smoked cigarettes. Passive smoking is harmful not only for the non-smokers but also for the smokers themselves. The aim of the work is to establish the number of smoked cigarettes and location where tobacco smoke is inhaled at home, together with checking the differences in behaviour concerning smoking tobacco among the still smoking participants of the 'Quit and Win' competition who live in cities. Leading long-term researches, in August 2006, another questionnaire was sent by post to 1700 participants of the 'Quit and Win' competition organized in 1996 in Poland at the end of the 2nd International Antinicotine Campaign. Answers were sent back in by 648 people 550 of whom (which is 84.9%) lived in cities. Ten years after joining the 'Quit and Win' competition, from among 550 respondents living in cities, 126 (22.9%) said they still smoke. 52.4% (66 people) of those still inhaling tobacco smoke lived in big cities, which is basically Lodz, 23.8% (30 people) lived in cities with fifty to two hundred thousand people and also 23.8% (30 people) lived in cities below fifty thousand inhabitants. The ratio of smoking respondents living in big cities was 27.0% (66 people), in cities with fifty to two hundred thousand people - 19.6% (30 people) and among respondents living in cities below fifty thousand inhabitants, also 19.6% (30 people). People smoking a large number of cigarettes, that is from 11 to 40 cigarettes a day made up for the majority of the respondents living in big cities (44 people, f = 0.67), whereas the lowest number (11 people, f = 0.37) was among the respondents from cities between fifty to two hundred thousand inhabitants. People who could not quit smoking throughout the ten-year period (126 people) were asked in which part of the house they smoke most often after work. The analysis of the answers allowed to draw a conclusion that 72 people (57.2%) smoked mostly in the house, in the room (51 people = 40.5%) or in the bathroom, or the kitchen (21 people = 16.7%), whereas 54 respondents (42.8%) concluded that in order to smoke they usually go out to the hall or to the balcony. Those who smoked at home but outside the flat, were primarily from the cities of below fifty thousand inhabitants (17 people, f = 0.57), whereas the smallest part was made up of respondents living in big cities (24 people, f = 0.36). The obtained results proved that frequency and location of the inhaled tobacco smoke by the still smoking participants of the 'Quit and Win' competition living in cities differed significantly and depended on the size of the city.

[Tobacco smoking in a sample of middle-size city inhabitants aged 35-55]

Tobacco smoking constitutes a common risk factor for the majority of civilization diseases, such as cardiovascular system diseases, malignant neoplasms and digestion and respiratory system disorders as well. Tobacco-related disorders relate to exacerbation of chronic diseases, for example diabetes and multiple sclerosis. Poland is one of those countries, where the prevalence of smoking is especially widespread. In Poland 42% of men and 25% of women smoke cigarettes and the amount of addicted people amounts to approximately 10 million. The latest data from the year 2003 show that the amount of cigarettes smoked by a particular citizen in Poland has risen fourfold since the beginning of 21st century. This paper presents an analysis of prevalence of tobacco smoking among inhabitants of a middle-size city in the Lodz province aged 35-55 years. The study sample comprised 124 people, including 75 females and 49 males. The tool of the research was a questionnaire survey containing questions concerning cigarette smoking. The study found out that 39.5% of respondents (41.3% of females and 36.7% of males) smoked cigarettes. The percentage of former smokers amounted to 15.3% and the percentage of non-smokers was higher than regular smokers and amounted to 44.8%. The study results showed that the majority of smokers were in the age interval of 45 to 49. Cigarette smoking influenced on smokers' health. The blood pressure and lipid balance was higher among smokers than among people who did not smoke cigarettes. The results of the conducted study confirm that there is a strong need of implementation of programmes towards limiting tobacco smoking, which may contribute to lowering the risk of tobacco-related diseases.