Cardiac and vascular disorders as para-occupational diseases – a Polish perspective
More details
Hide details
Medical University, Wrocław, Poland
Paweł Gać   

Uniwersytet Medyczny we Wrocławiu, Poland
The study presents the difference between occupational and para-occupational diseases in terms of Polish law, and indicates the fact that cardiovascular diseases (CVDs) are considered to be work-related, and describes the latest reports on the prevalence of cardiovascular risk factors in workplaces.

The aim of this study is to present the difference between occupational and para-occupational diseases in terms of Polish law. Also indicated is the fact that cardiovascular diseases (CVDs) are considered to be work-related and the latest reports on the prevalence of cardiovascular risk factors in workplaces are described.

Brief description of the state of knowledge:
Polish law distinguishes two groups of diseases that may arise in connection with work: occupational diseases and work-related diseases (so-called para-occupational diseases). Despite the fact that both groups are connected with the work environment they are not equivalent in legal terms. CVDs are one of the greatest threat to human life. The pathogenesis of these diseases is highly dependent on the compilation of adverse risk factors, which are typically divided into modifiable and non-modifiable. To-date, modifiable factors, i.a. excess weight and high blood pressure, were mainly associated with an unhealthy lifestyle. However, a shift in perspective has taken place and currently researchers focus more on the work environment as a possible factor affecting people’s health. It is emphasized that an unhealthy work environment increases the risk of CVD. Research shows that workplaces are rich in risk factors specifically related to work, including psychosocial, physical and chemical factors.

Legal principles covering para-occupational diseases in Poland seem incomplete. It is suggested that providing detailed legal authorization and defining the bodies that will objectively and reliably engage in the diagnostic process of para-occupational diseases may be beneficial to employees.

World Health Organization. Fact sheet: the top 10 causes of death. Available from: [Accessed 5th April 2020].
Art. 235 1 k.p. oraz Rozporządzenie Rady Ministrów z dnia 30 czerwca 2009 r. w sprawie chorób zawodowych, Dz.U. z 2013 r. poz. 1367.
Świątkowska B, Hanke W, Szeszenia-Dąbrowska N. Choroby zawodowe w Polsce w 2018 r. Łódź: Instytut Medycyny Pracy im. prof. J. Nofera, 2019.
Ustawa z dnia 26 czerwca 1974 r. — Kodeks pracy, Dz.U. z 2018 r. poz. 917.
World Health Organization, Regional Office for the Eastern Mediterranean. 2002. Occupational health: a manual for primary health care workers. Avaible from: [Accessed 5th April 2020].
WHO Expert Committee on Identification and Control of Work-Related Diseases & World Health. Identification and control of work-related diseases: report of a WHO expert committee. Geneva: World Health Organization, 1985.
Por. uzasadnienie do wyroku SN: z dnia 19 marca 2008 r. I PK 256/07 OSNP 2010, nr 7–8, poz. 85; z dnia 2 października 2008 r., I PK 57/08; z dnia 10 października 2012 r., III BP 4/11, LEX nr 1351626.
European Agency for Safety and Health at Work (EU-OSHA). The economics of occupational safety and health – the value of OSH to society. https://visualisation.osha.eur... (access: 2020.01.11).
Takala J. Global Estimates of the Burden of Injury and Illness at Work in 2012. J Occup Environ Hyg. 2014; 11(5): 326–37. doi: 10.1080/15459624.2013.863131.
EU-OSHA. Cost to society of work-related injury and illness. https://visualisation.osha.eur... (access: 2020.01.11).
Główny Urząd Statystyczny (GUS). Rocznik Demograficzny. Warszawa: Zakład Wydawnictw Statystycznych. 2019.
Ward A, Zinni M, Marianna P. International productivity gaps: Are labour input measures comparable?. Paris: OECD Statistics Working Papers. 2018.
Yusuf S, et al. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): A prospective cohort study. The Lancet 2019; [e-pub]. doi: 10.1016/S0140-6736(19)32008-2.
World Health Organization. World Health Statistics 2016: Monitoring Health for the SDGs Sustainable Development Goals. Geneva: World Health Organization. 2016.
Małyszko J, et al. Do we know more about hypertension in Poland after the May Measurement Month 2017? Europe. Eur Heart J. 2019; 2019 Apr; 21(Suppl D): D97–D100. doi: 10.1093/eurheartj/suz067.
Public Kantar. Raport z ogólnopolskiego badania ankietowego na temat postaw wobec palenia tytoniu. Główny Inspektorat Sanitarny. 2017.
Wojtyniak B, Goryński P. Sytuacja zdrowotna ludności polski i jej uwarunkowania. Warszawa: Narodowy Instytut Zdrowia Publicznego i Państwowy Zakład Higieny. 2018.
Chrousos G. Stress and disorders of the stress system. Nat Rev Endocrinol. 2009 Jul; 5(7): 374–81. doi: 10.1038/nrendo.2009.106.
Strahler J, et al. Dysregulated stress signal sensitivity and inflammatory disinhibition as a pathophysiological mechanism of stress-related chronic fatigue. Neurosci Biobehav Rev. 2016 Sep; 68: 298–318. doi: 10.1016/j.neubiorev.2016.05.008.
Tom C, Amanda G, Stavroula L. Work organization and work-related stress. Occupational hygiene. Oxford: Blackwell Publishing. 2005; 421–433.
Karasek R, Job Demands. Job Decision Latitude, Mental Strain: Implications for Job Redesign. Adm Sci Q. 1979; 24: 285–307. doi: 10.2307/2392498.
Harter J, Schmidt F, Theodore H. Business-unit-level relationship between employee satisfaction, employee engagement, and business outcomes: a meta-analysis. J Appl Psychol. 2002 Apr; 87(2): 268–79. doi: 10.1037/0021-9010.87.2.268.
Mościcka-Teske A, Potocka A. Zagrożenia psychospołeczne w miejscu pracy. Zeszyty Naukowe Politechniki Poznańskiej. Organizacja i Zarządzanie. 2016; 139–153.
Liu MY, Li N, Li WA, Khan H. Association between psychosocial stress and hypertension: a systematic review and meta-analysis. Neurol Res. 2017 Jun; 39(6): 573–580. doi: 10.1080/01616412.2017.1317904.
Lambert E, Lambert G. Stress and Its Role in Sympathetic Nervous System Activation in Hypertension and the Metabolic Syndrome. Curr Hypertens Rep. 2011; 13(3): 244–8. doi: 10.1007/s11906-011-0186-y.
Groeschel M, Braam B. Connecting chronic and recurrent stress to vascular dysfunction: no relaxed role for the renin-angiotensin system. Am J Physiol Renal Physiol. 2011 Jan; 300(1): F1–10. doi: 10.1152/ajprenal.00208.2010.
Didion S. Cellular and Oxidative Mechanisms Associated with Interleukin-6 Signaling in the Vasculature. Int J Mol Sci. 2017 Dec; 18(12): 2563. doi: 10.3390/ijms18122563.
Departament Rynku Pracy. Badanie organizacji i rozkładu czasu pracy w drugim pracy w drugim kwartale 2019r. (na podstawie wstępnych wyników badania modułowego BAEL). Główny Urząd Statystyczny. 2019.
Narodowy Fundusz Zdrowia (NFZ) – Departament Analiz i Strategii. NFZ o zdrowiu. Nadciśnienie tętnicze. Warszawa: Narodowy Fundusz Zdrowia. 2019.
Kivimäki M, Nyberg S. Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. The Lancet. 2012 Oct 27; 380(9852): 1491–7. doi: 10.1016/S0140-6736(12)60994-5.
Selander J, Bluhm G, Nilsson M, Hallqvist J, Theorell T, Willix P, et al. Joint effects of job strain and road-traffic and occupational noise on myocardial infarction. Scand J Work Environ Health. 2013 Mar 1; 39(2): 195–203. doi: 10.5271/sjweh.3324.
Virtanen M, Heikkilä K, Jokela M, Ferrie J, Batty D, Vahtera J, et al. Long Working Hours and Coronary Heart Disease: A Systematic Review and Meta-Analysis. Am J Epidemiol. 2012 Oct 1; 176(7): 586–96. doi: 10.1093/aje/kws139.
Yao B, Meng L, Meng-lei H. Chronic stress: a critical risk factor for atherosclerosis. J Int Med Res. 2019 Apr; 47(4): 1429–1440. doi: 10.1177/0300060519826820.
Siegrist J, Peter R, Junge A, Cremer P, Seidel D. Low status control, high effort at work and ischemic heart disease: Prospective evidence from blue-collar men. Soc Sci Med. 1990; 31(10): 1127–34.
Münzel T, Gori T, Babisch W, Basner M. Cardiovascular effects of environmental noise exposure. Eur Heart J. 2014 Apr 1; 35(13): 829–836.
Münzel T, Sørensen M, Gori T, Schmidt F, Rao X, Brook F, et al. Environmental stressors and cardio-metabolic disease: part I-epidemiologic evidence supporting a role for noise and air pollution and effects of mitigation strategies. Eur Heart J. 2017 Feb 21; 38(8): 550–556. doi: 10.1093/eurheartj/ehw269.
Ljungman P, Andersson N, Stockfelt L, Andersson E, Sommar J, Eneroth K, et al. Long-Term Exposure to Particulate Air Pollution, Black Carbon, and Their Source Components in Relation to Ischemic Heart Disease and Stroke. Environ Health Perspect. 2019 Oct; 127(10): 107012. doi: 10.1289/EHP4757.
WHO Regional Office for Europe. Burden of disease from environmental noise Environmental Noise – Quantification of Healthy Life Years Lost in Europe. Copenhagen: WHO Regional Office for Euro. 2011.
Münzel T, Daiber A, Steven S, Tran L, Ullmann E, Kossmann S, et al. Effects of noise on vascular function, oxidative stress, and inflammation: mechanistic insight from studies in mice. Eur Heart J. 2017 Oct 1; 38(37): 2838–2849. doi: 10.1093/eurheartj/ehx081.
Pomorski Ośrodek Badań Regionalnych. Warunki pracy w 2018 r. Gdańsk: Urząd Statystyczny w Gdańsku. 2019.
Golmohammadi R, Aliabadi M, Nezami T. An Experimental Study of Acoustic Comfort in Open Space Banks Based on Speech Intelligibility and Noise Annoyance Measures. Arch Acoust. 2018; 42(2): 333–347. doi: 10.1515/aoa-2017-0035.
Akerman A, Cotter J, Kjellstrom T. Occupational heat exposure and cardiovascular health risks related to climate change in pacific countries. Occup Environ Med. 2019 Apr;76(1). doi: 10.1136/OEM-2019-EPI.196.
Ma R, Zhong S, Morabito M, Hajat S, Xu Z, He Y, et al. Estimation of work-related injury and economic burden attributable to heat stress in Guangzhou, China. Sci Total Environ. 2019 May 20; 666: 147–154. doi: 10.1016/j.scitotenv.2019.02.201.
Copernicus Climate Change Service, Record-breaking temperatures for June 2019. (access: 2020.01.11).
Flouris A, McGinn R, Poirier M, Louie J, Ioannou L, Tsoutsoubi L, et al. Screening criteria for increased susceptibility to heat stress during work or leisure in hot environments in healthy individuals aged 31–70 years. Temp. 2017 Dec 18; 5(1): 86–99. doi: 10.1080/23328940.2017.1381800.
Pradhan B, Kjellström T, Atar D, Sharma P, Kayastha B, Bhandari G. Heat Stress Impacts on Cardiac Mortality in Nepali Migrant Workers in Qatar. Cardiol. 2019; 143(1): 37–48. doi: 10.1159/000500853.
Du Y, Xu X, Chu M, Guo Y, Wang JH. Air particulate matter and cardiovascular disease: The epidemiological, biomedical and clinical evidence. J Thorac Dis. 2016 Jan;8(1):E8-E19. doi: 10.3978/j.issn.2072-1439.2015.11.37.
Viitanen AK, Uuksulainen S, Koivisto A, Hämeri K, Kauppinen T. Workplace Measurements of Ultrafine Particles—A Literature Review. Ann Work Expo Health. 2017 Aug 1; 61(7): 749–758. doi: 10.1093/annweh/wxx049.
DiGiacomo S, Jazayeri MA, Barua R, Ambrose J. Environmental Tobacco Smoke and Cardiovascular Disease. Int J Environ Res Public Health. 2019 Jan; 16(1): 96. doi: 10.3390/ijerph16010096.
Ustawa z dnia 8 kwietnia 2010 r. o zmianie ustawy o ochronie zdrowia przed następstwami używania tytoniu i wyrobów tytoniowych oraz ustawy o Państwowej Inspekcji Sanitarnej. Dz.U. 2010 nr 81 poz. 529.