Medycyna pracy最新文献

{"title":"Epidemiological surveillance of infectious diseases among the elderly in Lower Silesia.","authors":"Ireneusz Skawina, Michal Wróbel, Dariusz Szarek, Vitaly Belik, Andrzej Jarynowski","doi":"10.13075/mp.5893.01721","DOIUrl":"https://doi.org/10.13075/mp.5893.01721","url":null,"abstract":"<p><strong>Background: </strong>The elderly population in Lower Silesia, Poland, faces increased vulnerability to infectious diseases due to population ageing. A comprehensive epidemiological surveillance program among seniors is crucial for effective public health planning and intervention strategies. This study aims to characterise infectious‑disease trends among individuals aged ≥65 years, emphasising the importance of tailored preventive measures.</p><p><strong>Material and methods: </strong>This retrospective study analysed infection registries maintained by the State Sanitary Inspection 2020-2023 for people aged ≥65 years. Included registries encompassed notifiable infectious diseases (12 811 doctors' reports and 1499 laboratory reports), hospital‑acquired infections and outbreaks, tuberculosis notifications (230 cases), influenza‑like illnesses (ILI) (104 487 suspected cases), and gastrointestinal outbreaks (46 outbreaks in facilities with seniors). Spatial and temporal variations in incidence were examined in relation to demographic changes and disease types.</p><p><strong>Results: </strong>There was a notable increase in bacterial gastrointestinal infections and ILI among the elderly, with reporting rising markedly after lockdowns. Incidence rates shifted toward older age groups. Bacterial intestinal infections, primarily caused by<i> Clostridioides difficile</i>, increased by approx. 54%/year. Hepatitis B and C incidence was elevated, especially in long‑term care facilities. Gastric outbreak numbers were stable, despite more notifications overall. Spa districts recorded higher infection rates than the rest of the region (1186.6 vs. 630.0/100 000 adults aged ≥65 years, p = 0.014). Notifications of sexually transmitted infections (STIs) were very rare.</p><p><strong>Conclusions: </strong>The findings highlight increased vulnerability of seniors, driven by diminished immunity and comorbidities, and underscore the need for targeted vaccination, systematic screening for STIs and other infections, and capacity building to meet rising demand for care among older patients. Spatial analyses point to higher risks in spa districts and call for more accurate surveillance of visitors. Improved digital integration of health surveillance systems will be critical for monitoring and responding to infectious threats in the elderly population. Med Pr Work Health Saf. 2026;77(4).</p>","PeriodicalId":101460,"journal":{"name":"Medycyna pracy","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety determinants of cardiovascular diseases.","authors":"Jelena Dinić, Olivera Đokić, Slobodan Tomić","doi":"10.13075/mp.5893.01717","DOIUrl":"10.13075/mp.5893.01717","url":null,"abstract":"<p><strong>Background: </strong>Researchers from the fields of safety studies and internal medicine (cardiology) conducted a cross-sectional interdisciplinary study aimed at determining the impact of patients' experiences with various forms of violence, psychological, physical, and digital as well as hazards such as floods, fires, earthquakes, traffic accidents, crime (theft and fraud), and political violence (war) on the onset and progression of cardiovascular diseases.</p><p><strong>Material and methods: </strong>To assess the relationships between the variables, a quantitative research design was employed. The questionnaire was administered to 302 patients in a pre-operative department. The results of this exploratory study were presented using descriptive statistics, non-parametric analysis (Mann-Whitney U test) and simple linear regression models.</p><p><strong>Results: </strong>The key results highlight a consistent link between all assessed threats to personal safety and adverse cardiovascular outcomes. Statistical analysis, conducted through the combined lens of safety studies and cardiology, underscores the need for further research, particularly into the effects of digital violence, theft, fraud, and traffic accidents on the cardiovascular health of the broader population.</p><p><strong>Conclusions: </strong>Given that a substantial proportion of participants had been involved in traffic accidents and that this experience was statistically linked to cardiovascular conditions, the study highlights an urgent need for further research in this area. Med Pr Work Health Saf. 2026;77(3):205-215.</p>","PeriodicalId":101460,"journal":{"name":"Medycyna pracy","volume":" ","pages":"205-215"},"PeriodicalIF":0.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational burnout and its association with physical activity and cardiorespiratory fitness among nurses: a narrative review.","authors":"Arnengsih Nazir, Yulia Sofiatin, Deni K Sunjaya","doi":"10.13075/mp.5893.01724","DOIUrl":"10.13075/mp.5893.01724","url":null,"abstract":"<p><p>Burnout is a multidimensional occupational syndrome characterized by emotional exhaustion (EE), depersonalization, and low personal accomplishment. Nurses are particularly vulnerable due to sustained physical, emotional, and organizational stressors. Physical activity (PA) and cardiorespiratory fitness (CRF) have been proposed as protective factors; however, evidence remains inconsistent, and burnout is often analyzed as a single global construct. This review aimed to synthesize evidence on the association between burnout and PA or CRF in nurses, with emphasis on burnout dimensions, underlying mechanisms, epidemiological findings, measurement considerations, and occupational health implications. A literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for English-language studies published up to 2025. Observational and interventional studies, as well as systematic reviews, examining burnout in relation to PA or CRF were included. Evidence was synthesized narratively without quantitative meta-analysis. Burnout prevalence among nurses is high, particularly for EE. Most studies demonstrate an inverse association between PA and burnout, with some evidence of dose-response relationships. However, PA is predominantly self-reported, and objective CRF assessment in nurses is scarce. Burnout dimensions are inconsistently analyzed, with many studies relying on total scores rather than dimension-specific evaluation. Mechanistically, PA and CRF may reduce burnout risk through improved stress regulation, autonomic balance, recovery processes, and enhanced functional work capacity. To conclude, PA appears protective against burnout in nurses, whereas the role of objectively measured CRF remains underexplored. Future longitudinal research incorporating dimension-specific burnout analysis and objective CRF assessment is needed to inform targeted occupational health interventions. Med Pr Work Health Saf. 2026;77(3):255-269.</p>","PeriodicalId":101460,"journal":{"name":"Medycyna pracy","volume":" ","pages":"255-269"},"PeriodicalIF":0.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of occupational health and safety training on students' knowledge level and safety culture: a quasi-experimental study.","authors":"Elif Işik Demirarslan","doi":"10.13075/mp.5893.01720","DOIUrl":"10.13075/mp.5893.01720","url":null,"abstract":"<p><strong>Background: </strong>This study investigates university students' occupational health and safety (OHS) knowledge levels and their perceptions of safety culture, with a particular emphasis on evaluating the effectiveness of structured OHS training.</p><p><strong>Material and methods: </strong>The research was conducted with 1291 students at Artvin Çoruh University Artvin, Türkiye, using a quasi-experimental pre-test/post-test design. Data were analyzed through descriptive statistics, correlation analysis, independent samples Student's t-tests, and analysis of variance.</p><p><strong>Results: </strong>Students demonstrated high safety culture perceptions (mean±standard deviation [M±SD] 4.38±0.67 on a 5-point Likert scale) but moderate OHS knowledge levels (M±SD 2.38±0.48 on a 3-point Likert scale). A positive and statistically significant correlation was found between OHS knowledge and safety culture (r = 0.330, p < 0.01). Following the training, knowledge scores increased significantly from pre-training (M±SD 24.15±5.06 pts) to post-training (M±SD 29.22±4.20 pts) with a large effect size (Cohen's d = 1.07, p < 0.001). Female students reported significantly higher safety culture perceptions than male students (p < 0.001). Engineering students achieved the highest safety culture scores, significantly surpassing several health-related programs (p < 0.05).</p><p><strong>Conclusions: </strong>Occupational health and safety training significantly enhances students' knowledge levels, demonstrating a strong intervention effect. Safety culture perceptions are positively associated with knowledge and vary according to gender and academic discipline. Med Pr Work Health Saf. 2026;77(3):185-193.</p>","PeriodicalId":101460,"journal":{"name":"Medycyna pracy","volume":" ","pages":"185-193"},"PeriodicalIF":0.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Key competencies required of managers of medical facilities in Poland in times of crisis: conclusions from questionnaire studies].","authors":"Katarzyna Badora-Musiał, Maja Mydel, Maciej Polak, Małgorzata Gałązka-Sobotka, Jakub Dulniak, Magdalena Łoś, Iwona Kowalska-Bobko","doi":"10.13075/mp.5893.01657","DOIUrl":"10.13075/mp.5893.01657","url":null,"abstract":"<p><strong>Background: </strong>Contemporary healthcare facility management operates under conditions of increasing instability, requiring high leadership competencies from executives. Crises, such as the COVID-19 pandemic, have underscored the key importance of skills in coping with pressure and stress, as well as efficient work reorganization (adaptive capabilities). The study utilized the Healthcare Leadership Alliance (HLA) model to assess these competencies.</p><p><strong>Material and methods: </strong>A computer-assisted web interview survey was conducted among 71 representatives of healthcare management staff in Poland. An original questionnaire based on the 5 domains of the HLA model was used. Statistical analyses were performed using Fisher's exact test and Spearman's rank correlation.</p><p><strong>Results: </strong>In the self-assessment according to the Dreyfus model, the competent level prevailed (nearly 50%), and team management was the highest-rated area. Significant deficits were identified regarding the reorganization of one's own and the team's work (difficulties reported by 1/3 of respondents) and the identification of stress in employees (deficiencies perceived by 25% of managers). Women more frequently indicated the mobilizing effect of stress (p = 0.048), while men rated their active listening skills higher (p = 0.02). Higher self-assessment correlated with better internal communication (p = 0.006) and operational continuity planning (p = 0.002). Contract-based managers were significantly more capable of planning business continuity (p = 0.009). Data-driven management is significantly more frequent in inpatient care than in outpatient care (p = 0.03).</p><p><strong>Conclusions: </strong>The identified deficits in the ability to cope with stress and data analytics limit managers; ability to adapt effectively to the volatile and unpredictable environment described by the volatility, uncertainty, complexity, ambiguity - VUCA and brittle, anxious, non-linear, incomprehensible - BANI concepts. It is necessary to modify management training programs by integrating psychological knowledge (coping with pressure) with the practical application of data in management, which will enable the building of sustainable organizational resilience in healthcare facilities. Med Pr Work Health Saf. 2026;77(3):217-238.</p>","PeriodicalId":101460,"journal":{"name":"Medycyna pracy","volume":" ","pages":"217-238"},"PeriodicalIF":0.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific body composition changes after a pilot multidisciplinary lifestyle intervention in active-duty Hungarian Defence Forces personnel.","authors":"Attila Novák, Tímea Téglás, Tibor Zoltán Lantos","doi":"10.13075/mp.5893.01743","DOIUrl":"10.13075/mp.5893.01743","url":null,"abstract":"<p><strong>Background: </strong>To compare sex-specific body composition changes after a structured lifestyle intervention in Hungarian Defence Forces (HDF) personnel and to describe baseline dietary, behavioral, and psychological profiles.</p><p><strong>Material and methods: </strong>This quasi-experimental pilot study included 40 active-duty participants (21 men, 19 women), aged 24-55 years, enrolled in an ongoing HDF lifestyle program. The 6-month intervention integrated individualized dietary counselling, supervised physical training 3 times weekly, and weekly cognitive-behavioral group sessions. Body composition was assessed at baseline (D0) and after 6 months (D1). Psychological, behavioral, and physical activity variables were assessed at baseline only as profile measures.</p><p><strong>Results: </strong>At baseline, age and body mass index (BMI) did not differ significantly between sexes. Men had higher body weight, skeletal muscle mass, visceral fat, and phase angle, whereas women had higher body fat percentage. In both sexes, body weight, BMI, and body fat percentage decreased significantly over 6 months. In men, body weight decreased by mean±standard deviation (M±SD) 9.25±11.68 kg (p = 0.001), BMI by M±SD 2.73±2.97 kg/m² (p = 0.007), body fat percentage by M±SD 3.77±4.94 percentage points (pp) (p = 0.011), and skeletal muscle mass increased by M±SD 1.70±3.58 kg (p = 0.029). In women, body weight decreased by M±SD 5.79±5.88 kg (p = 0.005), BMI by M±SD 2.27±2.47 kg/m² (p = 0.024), and body fat percentage by M±SD 2.66±3.53 pp (p = 0.030), whereas skeletal muscle mass increased non-significantly by M±SD 1.13±1.76 kg (p = 0.063). Baseline profiles were otherwise similar, except for higher energy intake in men and higher eating behavior scores in women.</p><p><strong>Conclusions: </strong>In this pilot sample, participation in a structured multidisciplinary lifestyle intervention was associated with meaningful body composition improvements in both sexes, although response patterns differed. These findings support further evaluation of tailored multidisciplinary lifestyle interventions in military occupational health practice. Med Pr Work Health Saf. 2026;77(3):195-203.</p>","PeriodicalId":101460,"journal":{"name":"Medycyna pracy","volume":" ","pages":"195-203"},"PeriodicalIF":0.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic respiratory risks in coffee processing: a systematic review of alpha-diketone, carbon monoxide, and dust co-exposure.","authors":"Giacomo Beretta, Giovanni Cappelli, Giuseppe La Torre, Ilaria Rapi, Niccolò Fanfani, Sara Pierattini, Nuriiar Safarov, Laura Tuulikki Beretta, Antonio Baldassarre, Nicola Mucci, Stefano Dugheri","doi":"10.13075/mp.5893.01716","DOIUrl":"10.13075/mp.5893.01716","url":null,"abstract":"<p><p>Modern coffee processing generates a complex, co-localized mixture of respiratory hazards, such as carbon monoxide (CO), volatile α-diketones (principally diacetyl and 2,3-pentanedione), and bio-reactive coffee dust, that challenge single-agent risk paradigms. This systematic review synthesizes quantitative exposure data, exposure-response relationships, mechanistic plausibility, and control efficacy to characterize the occupational respiratory burden associated with simultaneous exposure to these agents. A systematic search of literature (in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA 2020) was conducted choosing eligible studies reported quantitative exposure metrics (CO in ppm, α-diketones in ppb, particulate matter in mg/m³) and respiratory health outcomes among coffee industry workers. Task-based monitoring identified grinding, flavoring, and packaging as peak emission events. Epidemiological findings included sentinel clusters of obliterative bronchiolitis, increased prevalence of obstructive spirometric abnormalities, and measurable forced expiratory volume (FEV₁) declines associated with cumulative α-diketone exposure; organic dust exposure correlated with chronic cough, dyspnea, and reduced FEV₁/forced vital capacity. Co-exposure to CO, α-diketones, and coffee dust in roasting, grinding, and packaging operations produces a substantive occupational respiratory risk profile, including both acute systemic hazards and chronic small-airway injury. Preventing occupational risk requires prioritizing engineering controls, task-specific ventilation design for peak emissions, and longitudinal exposure and health surveillance to define dose-response relationships for complex mixtures and to inform evidence-based occupational exposure limits.</p>","PeriodicalId":101460,"journal":{"name":"Medycyna pracy","volume":" ","pages":"239-254"},"PeriodicalIF":0.9,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Elderly patients in hospital environment].","authors":"Michał Wróbel, Ewa Wróbel, Berenika Dyczek, Maciej Wołkowiecki, Katarzyna Kapuścińska, Zenona Jabłońska","doi":"10.13075/mp.5893.01719","DOIUrl":"https://doi.org/10.13075/mp.5893.01719","url":null,"abstract":"<p><p>During hospitalization, older patients are exposed to an environment that differs from their home environment, which is particularly difficult for them. This article is a descriptive review of articles concerning the identification of factors relevant to the well-being of older people requiring hospitalization, covering data from the PubMed database 2015-2025. These factors included aspects of the hospital environment (such as interior design, furniture, lighting, music, the presence of friends or family), leisure activities, physical activity, adequate sleeping conditions and a sense of security. New technologies, such as smartphones and wearable devices, can help to achieve these goals. Elderly-friendly hospitals should recognise the specific needs of older people and provide them with security, well-being and privacy. Ultimately, improving the comfort of elderly patients in hospital leads to better treatment outcomes. Med Pr Work Health Saf. 2026;77(4).</p>","PeriodicalId":101460,"journal":{"name":"Medycyna pracy","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The use of artificial intelligence tools in the perception of electroradiologists].","authors":"Bartłomiej Nowak, Kornelia Koszczyk, Elżbieta Łuczyńska","doi":"10.13075/mp.5893.01688","DOIUrl":"10.13075/mp.5893.01688","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is playing an increasingly important role in diagnostic imaging, helping specialists improve the quality and speed of medical services. Despite the potential of AI, electroradiologists express concerns about algorithm errors, overreliance on technology, and ethical issues. Further training of medical personnel is necessary to ensure the safe and informed implementation of AI in diagnostics. This study examines the use of AI tools as perceived by radiographers, focusing on their impact on work organization.</p><p><strong>Material and methods: </strong>The work was carried out using a diagnostic survey method in the form of questionnaires. The survey was conducted in the second quarter of 2025. The analysis used both descriptive statistics and statistical tests to assess the significance of differences and relationships between variables. Descriptive statistics analyzed quantitative variables. Statistical calculations were based on the χ² test. A significance level of p < 0.05 was adopted. In analyses considering respondents' age, age groups were categorized accordingly.</p><p><strong>Results: </strong>The study involved 202 professionally active electroradiologists (working in diagnostic imaging and interventional radiology) - 166 women (82.18%) and 36 men (17.82%), with an average age of 31.75 years. Analyses showed no statistical correlation between education, age, work experience, and level of knowledge about AI. However, correlations appeared in the implementation of these tools across medical facilities and their use in radiographers' work. In-depth analyses revealed a positive attitude toward AI tools but also highlighted insufficient education and the need for training.</p><p><strong>Conclusions: </strong>Most electroradiologists are familiar with the general concept of AI, but lack detailed knowledge, indicating a need for targeted education. Despite a positive attitude towards AI, a lack of training limits readiness for its implementation. Age and workplace influence the perception of AI, while education, gender, and seniority remain insignificant. The key barriers are competency- and organization-related, highlighting the need for consistent educational programs. Med Pr Work Health Saf. 2026;77(2):147-161.</p>","PeriodicalId":101460,"journal":{"name":"Medycyna pracy","volume":" ","pages":"147-161"},"PeriodicalIF":0.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A dynamic approach to FMEA-RPN risk classification: comparing with the classical FMEA method.","authors":"Mufide Narli","doi":"10.13075/mp.5893.01678","DOIUrl":"10.13075/mp.5893.01678","url":null,"abstract":"<p><strong>Background: </strong>Failure mode and effects analysis (FMEA) uses risk priority numbers (RPNs) based on 3 parameters to classify risks. Risk analysis methods use thresholds to determine risk. These class intervals do not account for contextual and system dynamics in high-risk environments such as neonatal intensive care units (NICUs). This study proposes a dynamic classification model that prioritizes risk by integrating contribution percentages and percentile ranks through a decision matrix.</p><p><strong>Material and methods: </strong>This study identified 21 ergonomic failure modes through field observations at a hospital's NICU, interviews with nurses, and a literature review, evaluated a dynamic classification model. The RPN for each failure mode was calculated, and the risks were classified using classical fixed-threshold FMEA. Then, each failure mode was classified using a dynamic model based on a decision matrix that balances risk intensity by its impact contribution percentage and relative importance percentile rank. Model robustness was assessed via a one-at-a-time sensitivity analysis (±1 perturbations in occurrence [O], severity [S], and detection [D]), and agreement was evaluated using weighted agreement measures.</p><p><strong>Results: </strong>According to FMEA, risk factors such as \"long shift hours\" and \"constant exposure to alarm sounds\" were classified as medium risk. Yet, in the dynamic model, they were classified as very high risk. The model's sensitivity was tested by measuring the effect of a change in the FMEA input ratings (O/S/D) on the results. The model was determined to provide high agreement with practitioners' classifications, with a 93.7% weighted agreement across 63 comparisons between nurse assessments and model results.</p><p><strong>Conclusions: </strong>The proposed dynamic framework provides context-sensitive prioritization by integrating each failure mode's contribution to total risk with its position in the unit-specific RPN distribution. When applied to NICU ergonomic failure modes, it produced a different prioritization than classical fixed-threshold FMEA and offers a transparent, reproducible basis for risk-focused improvement planning in high-risk care settings. Med Pr Work Health Saf. 2026;77(2):89-99.</p>","PeriodicalId":101460,"journal":{"name":"Medycyna pracy","volume":" ","pages":"89-99"},"PeriodicalIF":0.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}