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The steep rise in the incidence of tick-borne encephalitis (TBE) in the 1990s and its subsequent high level in the Czech Republic are not even over the whole territory. It is manifested markedly in the Czech-Moravian Highland region. In the decades of 1971 through 1992, TBE incidence in the Highland Region did not reach the countrywide average. The rise has been noted only since 1997; in the year 2006 TBE incidence in that administrative region was more than double the countrywide average. Analysis of the situation have not found any socio-economic shifts or land-use changes, or in the numbers of game animals, that could have had an effect on TBE incidence. The rise of infections in localities 500 m above sea level (a.s.l.) and more was markedly steeper than that below that altitudinal limit. At those altitudes there has been found an increase in average monthly temperatures exceeding countrywide averages namely in the period of maximum Ixodes ricinus activity (May-August). Detailed analysis of meteorological conditions and comparison with a long-term study of the influence of modifications of the mountain climate in the Krkonoše Mts. on I. ricinus tick distribution and the pathogens transmitted by them, have led to the conclusion that likewise in the Czech-Moravian Highland a marked warming had influenced the local population of the vector I. ricinus, caused an activation of foci of TBE, increased contacts of humans with the vector, consequently giving rise to an apparent increase in the incidence of human cases of TBE.

The article will briefly explain the processes of organized screening in the NHS Cervical Screening Programme (NHSCP). Quality control is well established and monitored by regional quality assurance reference centres. The final outcome of screening is also monitored by national cervical cancer mortality and incidence rates: data will be presented for rates of in situ and invasive cervical carcinoma before and after the introduction of organized screening. The NHSCSP is using the introduction of liquid-based cytology as a platform for modernization, which is planned to include high-risk human papillomavirus (HR HPV) testing for low-grade cytology triage as well as a test of cure after treatment. Trials of computer-assisted screening are also in progress. High standards of quality control will be needed in the era of vaccination, when prevalence of preinvasive and invasive cervical cancer will decline. The NHSCSP is well placed to take on these challenges, if necessary by introducing primary HR HPV testing so that cytology screening can be concentrated on women who are genuinely at risk.

Objectives: The aim of this study was to explore the influence of sick leave frequency determinants on in terms of age and profession homogeneous groups in two socio-economically comparable, but socio-culturally different regions in the Netherlands, i.e. Utrecht (mean frequency 1.10 spells) and South Limburg (mean frequency 1.92 spells). In addition, to get an idea of the study's topical interest, a literature review on sick leave frequency determinants covering the past few decades was performed.
Material and methods: 184 participants in the Utrecht and South Limburg regions were interviewed on work, individual and health characteristics. Sick leave frequency data were obtained from a social fund. For the literature review (inter)national scientific journals, academic theses and Medline were consulted.
Results: A comparison of sick leave frequency in the two regions showed that, in South Limburg, the determinants called 'opinion on socialmedical support during sick leave', 'type of appointment' and 'annual number of visits (family doctor)' were associated with sick leave frequency whereas this was not the case in Utrecht. The literature review presented a highly consistent picture of determinants of sick leave frequency over the last few decades.
Conclusions: In the two regions studied, different determinants appeared to be associated with sick leave frequency. This phenomenon is attributed to the different socio-cultural characters of the regions. As per region different determinants appeared to be associated with sick leave frequency, nationwide interventions to reduce sick leave frequency should take into account the potential influence of regional differences in determinants that predict sick leave frequency. Sick leave frequency determinants have not changed in the past few decades. Although the study was performed in the nineties, its results are still relevant.

Objectives: The main objective of ERFORT Study is to investigate cardiovascular risk factors, life-style related factors and psychosocial factors with regard to total and cause-specific mortality and morbidity. This paper describes the study design, frequency data on cardiovascular and psychosocial factors at baseline survey, and findings of three 5 year follow-up medical examinations. Life status was followed for 30 years. Methods: The Erfurt Male Cohort Study (ERFORT Study) is a population-based prospective cohort study and has its origin in the WHO initiated feasibility study to acquire experience in multi-factorial intervention programs. The baseline survey in 1973-75 examined a random populationbased sample of 1,160 males aged 35-61 years (brutto response rate 74.6 %) from the city of Erfurt, East Germany.
Results: Standardized and mostly validated methods were applied for a collection of data on cardiovascular risk factors, lifestyle-related and psychosocial factors, blood tests and ECG. Three consecutive follow-up examinations yielded datasets of 907, 740 and 609 subjects' re-examination in 1978-79, 1983-85 and 1988-90. Cardiovascular diseases such as myocardial infarction, angina pectoris, and claudication intermittent approximately doubled within a 15-year follow-up. Prevalence of diabetes strongly increases from 2.8 % at baseline to 12.0 % at the 15-years follow up. High blood pressure (≥160/95 mm Hg) only slightly increased, whereas the antihypertensive treatment increased from 8.7% to 33.6%. Conclusions: This data set of a German cohort followed for several decades is an outstanding database to answer questions about long-term associations between biological and psychosocial factors and mortality in men.

The authors present a retrospective analysis of community-acquired and hospital-acquired rotaviral gastroenteritis (RVGE) cases in a 5 years period 2001-2005 and prospective analysis in 2006 in the referral area in a population of 7,000 children under 5 years of age.
Out of 228 patients with RVGE, nosocomial RVGE accounted for 27.75% of the cases. Children with nosocomial RVGE were in average 9.8 months younger compared to patients with community-acquired RVGE. Nosocomial cases were also characterised by the need for longer stay in intensive care, overall longer hospital stay, longer duration of the illness and by lower age of the patients.
The wider implementation of vaccination in the youngest members of the population would be likely to have a significant influence on the occurrence of not only community-acquired but also hospital-acquired RVGE.

Carcinoma of the cervix (CaCer) is the second most frequent malignancy in women on a global scale. Epidemiological studies carried out at the beginning of the second half of the 20th century showed that CaCer was of infectious nature and that its agent was transmitted by sexual intercourse. For some 15 years, herpes simplex virus type 2 (HSV2), the genital herpes virus, was suspected to be the etiological agent. This hypothesis was disproved just in the time when the first convincing evidence that the agents of the disease were human papillomaviruses (HPVs) was produced. Copious new findings obtained during the 1980's and 1990's unequivocally confirmed that HPVs were the causative agents. The most dangerous among the over 100 HPV types are types 16 and 18, which together account for over 70% of CaCer cases and very likely also for most of the other malignancies of the anogenital region and the oropharynx. Extensive research of the HPV biology and immunology enabled the development of vaccines based on the s.c. virus-like particles (VLP) prepared by genetic engineering. At present, there is one HPV vaccine on the market; it contains, besides types 16 and 18, also types 6 and 11, the causative agents of certain benign tumours of the genital area and of the larynx. A new vaccine, comprising types 16 and 18 only, the product of another firm, is to appear on the market soon. Both vaccines have already been tested in extensive clinical trials. They are nearly 100% effective, only very weakly reactogenic and they undoubtedly belong among the most perfect vaccines ever produced. The darker side of the anti-HPV vaccines is their high price, the fact that the highest benefits they bring will only become evident in 20 or 30 years, and that they do not afford protection against all oncogenic HPVs. It is therefore imperative that organized cytological screening be continued: it is destined to remain the main instrument of CaCer prevention for several decades. With all probability also other types of vaccine are under development, viz. VLP-based vaccines, whose range of applicability will be wider than that of the present preventive vaccines, as well as vaccines that will, hopefully, be able to inhibit already progressing infection or will be utilizable in CaCer immunotherapy.

The situation in early childhood is supposed to be a risk factor for later development of allergic diseases. The birth cohort from the LISA (Lifestyle - Immune System - Allergy) study gave us the opportunity to investigate the relationship between early childhood situation and the development of allergic diseases.
This paper describes our findings regarding to the relationship between entry age into day care and obstructive bronchitis as well as allergic rhinitis and atopic eczema.
Study was designed as a longitudinal birth cohort study. Children were examined by a physician at birth, 1/2 year, 1 year, 1 1/2 year, 2 years, 3 years and 4 years. Further information was collected using a structured questionnaire which was answered by the parents.
Outcomes under investigation were atopic eczema, allergic rhinitis, wheezing (with and without cold), obstructive bronchitis and asthma (after 2nd year of life).
Logistic regression analysis adjusted for infectious diseases of the mother during pregnancy, vaccination of the mother during pregnancy, antibiotics, prenatal smoking of the mother or other persons in the apartment and vaccination state showed an significant promoting effect of entry age into day care against obstructive bronchitis over the first three years of life (OR 1/2 year: 8.55; 95%CI: 2.93…24.97; OR 1st year: 4.96; 95% CI: 1.73…14.24; OR 2nd year: 3.06 95% CI: 1…9.37). A further significant effect was found for crowding against asthma in the fourth year of life (OR 25.7; 95%CI: 1.65…400.17).
No significant effects were found between the other periods under investigation (1st year until 4th year of life).
On the base of our findings we recommend an entry age into day care of more than six months to prevent effects shown.

Objective: To review strategies of transnational tobacco companies (TTCs) at creating a favourable advertising environment for their products in Hungary, with special regard to efforts resulting in the liberalisation of tobacco advertising in 1997.
Method: Analysis of internal tobacco industry documents relevant to Hungary available on the World Wide Web. Transcripts of speeches of members of the Parliament during the debate of the 1997 advertising act were also reviewed.
Conclusions: The tobacco companies not only entered the Hungarian market by early participation in the privatisation of the former state tobacco monopoly, but also imported their sophisticated marketing experiences. Evasion and violation of rules in force, creation of new partnerships, establishment and use of front groups, finding effective ways for influencing decision makers were all parts of a well orchestrated industry effort to avoid a strict marketing regulation for tobacco products.

The official reporting system in the Province of Vojvodina (PV) indicates that cases of human salmonellosis were partly covered by complete epidemiological investigation including laboratory analysis of the suspected food. Intestinal campylobacteriosis and yersiniosis and four cases of septicemias caused by Listeria monocytogenes were not fully epidemiologically investigated. Actual country legislation on food safety does not include provisions for a routine control of the above mentioned pathogens except for Salmonella. In the PV, there are no other sources of data that contribute to risk assessment of the above food-borne diseases.
A pilot investigation, performed in Novi Sad, indicated that 8.17% out of the total number of 257 retail food samples (90 of fresh meat and 167 of ready-to-eat food) had been contaminated with one of the tested bacteria Campylobacter or Salmonella or Listeria monocytogenes. Yersinia enterocolitica was not detected in any of the tested samples. Fresh poultry meat and other fresh meats were the dominant sources of the detected pathogens compared to samples of ready-to-eat food (p< 0.05). Campylobacter was detected in 18.8% and 10.0% samples of fresh poultry and other fresh meat respectively, which was not statistically significant (p>0.05). Salmonella was detected in 3.3% samples of fresh poultry meat. Listeria monocytogenes was detected in 5.0% samples of fresh poultry and in 3.3% samples of other fresh meat, the difference was not statistically significant (p>0.05). One sample (0.6%) of ready to eat food was contaminated with Campylobacter and one (0.6%) with Salmonella.

This paper presents reference frameworks which order effective and feasible policies and interventions for the health management of measles, breast cancer and diabetes (type II). These reference frameworks can be used to rapidly appraise regional health policy documents and existing health management systems. Furthermore, the reference frameworks can serve health policy makers for the planning of health management measures.

Introduction: Aim of the study was to determine risk behaviour and HIV prevalence among commercial sex workers (CSWs) and intravenous drug users (IDUs) in streets of Bratislava and B. Bystrica, SR.
Methods: HIV antibodies were tested from saliva using ELISA test. Anonymous questionnaire was completed.
Results: 121 persons (61 men and 60 women) were involved in the sociological study. Mean age of the participants was 21.9 years. 185.1% of subjects were from Bratislava. 108 participants were tested for the presence of HIV-antibodies, one was confirmed HIV-positive (0.82%). In the past 47.9% of participants and 22.3% of their partners were tested for the presence of HIV-antibodies. 10.8% of subjects proclaimed that they suffered from other sexually transmitted infection (STI) in the past. HIV testing of participants significantly correlated with the testing for other STI (p<0.002) as well as with HBV/HCV (p<0.001). 58 participants were using tattooing (47.9%). 46.3% of all participants never used condoms with partners. 31.4% of respondents proclaimed disruption of condom during sexual intercourse. Significant correlation was found between testing of participants for other STI and usage of condoms with their partners (p<0.013). Women used condoms more often by sexual contacts with partners than men used condoms (p<0.094). They were also significantly more tested for other STI in the past (p<0.021) and they suffered from other STI more often than men (p<0.033). 26.5% of person - only women - were involved in commercial sex work. 93.5% of them were taking drugs as well, 21.8% suffered for other STI in the past. They were working in sex business on average for 26 months. The average number of their clients per week was 12.3. CSWs used condoms more often with clients than with partners. 98.2% of all participants were taking drugs, 93% of them intravenously. 24.6% of IDUs always used new or their own needles and syringes, while 69.4% shared equipments with the other users. IDUs drug users used condoms significantly less often with their partners than did CSWs (p<0.006). CSWs were significantly more often tested for other STI (p<0.001) and they also more often suffered for other STI than IDUs (p<0.045).
Conclusion: More effort should be done to decrease risk behaviour revealed in the groups of CSWs and drug users.

The health effects in teachers of a mold-damaged school before and during an extensive remediation process were assessed. Health data were collected with self-administered questionnaires from teachers (n=31) working in a moisture and mold damaged school and from the reference group of teachers (n=13) working in a non-damaged school. The questionnaire study was repeated three times. Spirometry was measured in 33 individuals in the spring 1997 and repeated in the spring 1999 and 2000.
In the damaged school, a cluster of eight asthma cases was identified, the prevalence of asthma being 26%. Before the remediation, the number of sinusitis episodes was higher (p=0.040) and the mean duration of sick leaves longer (p=0.015) among the study group than in the reference group. A higher prevalence of hoarseness and perceived poor quality of indoor air were reported. During the follow-up, no new asthma cases appeared. After the remediation, bronchitis, conjunctivitis, symptoms of allergic rhinitis and the sum of respiratory infection episodes decreased significantly. Some of the asthmatics had low values in the spirometry, but no changes in the lung function were observed at the group level.
The remediation of the mold damage had beneficial effects on teachers' health.

The Czech Republic Global Youth Tobacco Survey (GYTS) is a school-based survey of students in grades 7-9, conducted in 2002. A two-stage cluster sample design was used to produce representative data for all of the Czech Republic.
On a large sample of students (N=4,149) from 7 - 9th grade it reveals that smoking among children has been continually growing. According to the results of this study, over 34% of the respondents smoke.
Results of the study help us to understand social and attitudinal factors that affect adolescent smoking habits. Social factors include particularly the convenient availability of cigarettes and the lack of the legal regulation of the retail of cigarettes: over one half of all smokers under 15 years of age regularly purchase cigarettes in regular retail outlets; 72% of them reported never having been restricted in their purchases because of their age. Advertising and media coverage appears to be another important factor that affects smoking in this age group. Over 80% of children under 15 years of age reported that they have been exposed to the tobacco advertising.
The study also allows an interesting analysis of the exposure to the environmental tobacco smoke. Compared to non-smokers, this exposure has been significantly higher in the case of smokers - both in their homes and at other locations (58% vs. 25%, and 90% vs. 57% respectively). The analysis of the data also revealed a strong misconception about the health risks related to passive smoking among smokers.
The study provides three key findings for health promotion: (1) it is necessary to exert a continuous pressure on the political representation to strictly enforce the regulations of tobacco distribution and availability to minors; (2) school health education as well as community oriented prevention programs need to explicitly communicate non-smoking as a standard; and (3) it is important to increase the attractiveness and availability of smoking cessation programs.

The aim of the study was to identify moderate liver impairment in a group of hyperbilirubinaemic adolescents. Using gas chromatography we assessed both total bile acid and primary bile acid levels in 50 adolescents with juvenile hyperbilirubinaemia. At the same time we performed hepatologic examinations and subsequent follow-up assessment of these patients for a period of at least 2 years. As a control group we examined 30 adolescents without any impairment of both the liver and gastrointestinal tract, and 18 patients with low grade (moderately) active chronic hepatitis. In both groups we assessed total and primary bile acids levels as well as conventional liver tests (bilirubin, ALT, AST). On the basis of the clinical course and laboratory findings we divided our patients with juvenile hyperbilirubinaemia into two groups: a group of individuals with Gilbert's syndrome (30 patients) and a group of individuals with probable moderate liver impairment (20 patients). The latter group consisted of the adolescents who exhibited bilirubinaemia over 90 µmol/l and/or exhibited hepatomegaly or splenomegaly proved by the ultrasound examination and/or exhibited intermittent elevation of the liver aminotransferases serum levels.
In the group of individuals with moderate liver impairment serum total bile acid levels were significantly elevated in 26% of patients, and the serum cholic acid level was significantly elevated in 25% of patients. These two parameters mutually correlated at a high level of significance. Juvenile hyperbilirubinaemia is one of the common conditions of adolescent age. Its etiology is diverse; it includes both benign conditions like Gilbert's syndrome and post-hepatitic and toxic conditions that require a long-term regimen and follow-up examinations.
The number of people suffering from juvenile hyperbilirubinaemia has been growing in the population. Currently 4-6% of the adolescent population suffers from this disease. This growing number is probably caused by external factors of our environment (infection, toxic effects). The determination of mild liver disease in hyperbilirubinaemic patients and the provision of an adequate regimen of exercise and adequate nutritional measures is of great importance for the health of the adolescent population.

The international pattern of obesity is only partly understood. While in developed countries the association between education and obesity is inverse, in the developing world social distribution of obesity is less predictable. We examined obesity patterns in three countries of Central and Eastern Europe (CEE): Russia, Poland and the Czech Republic, middle-income post-communist countries undergoing social and economic transition. The prevalence of obesity was inversely associated with education of individuals in our three samples of Central and Eastern European populations. In agreement with previous findings, the inverse socioeconomic gradient was more pronounced in the Czech Republic and Poland, countries with higher Gross National Product (GNP) than Russia. In addition, obesity was more common in Russian women than in Czech or Polish women while Russian men were less obese than Czech or Polish men. These findings are consistent with the hypothesis that the social gradient in obesity differs between populations - it is more likely to find a reverse association between socioeconomic position and prevalence of obesity in the more westernized countries with higher population income.

The growth charts of basic body measurements are an important aid for the daily routine practice of paediatricians. Charts for children from birth to 2 years of age form an integral component of a set of such tools for the age spectrum from birth to 18 years of age. The interpretation of growth charts is highly dependent on the data on basis of which the charts were constructed.
In the Czech Republic, the growth reference data have been regularly updated since 1951, in 10-year intervals. These updates are based on data from nation-wide anthropological surveys of children and adolescents. Countries, which do not have their own reference data, have been using for growth assessment the 1977 World Health Organization (WHO) and the National Center for Health Statistics (NCHS) international reference growth charts. These charts, developed for height for age, weight for age, and weight for height, were based for children younger than 2 years on a longitudinal study of North American children.
Over the years, use in practice showed that because of the original criteria used to select the child population studied, these reference growth charts were not suitable for assessing growth of breastfed children. The 1977 reference is based on predominantly artificially, that is formula-fed, child population. The evidence shows that breastfed and artificially fed infants grow differently and that the growth pattern of breastfed children most likely better reflects physiological growth. In 1994, based on the accumulated evidence, the WHO started working on new international standards which would be based on a sample of healthy breastfed children.
The project, the WHO Multicentre Growth Reference Study (MGRS), was carried out from 1997-2003. It focused on collection of growth and development data of 8440 children from different ethnic and cultural groups. The underlying assumption of the project was that in favourable socio-economic conditions and with a recommended level of nutrition and lack of maternal smoking, children's growth is very similar, regardless of their ethnic origin and geographic location. The new growth standard for children 0-5 years of age will be available early in 2006. In the Czech Republic, we plan to analyse our national reference against this standard. If considered necessary, a process will be put in place for replacing the Czech reference with the WHO standard.
The objective of this article is to alert health professionals that growth charts currently used in their country may not represent an optimal tool, especially with regard to the assessment of nutritional status for 0 to 2-year-old children, unless already based on data of breastfed children. Generally, the lack of awareness of the difference between the two growth patterns - the breastfed versus artificially fed child - poses a serious problem since a strict interpretation of the growth charts may lead to early supplementation of breastmilk with infant formula and/or premature introduction of complementary foods. Both of these practices tend to lead to premature cessation of breastfeeding, one of the key strategies to improve child health and development.

The prevalence of child obesity in the Czech Republic has increased in the last several years, especially among school-aged children. While obesity trends are closely monitored in the Czech Republic, very little is known about the dietary habits and exercise behaviors of Czech children. The purpose of this study was to evaluate nutrient intakes and physical activity, as well as identify predictors of BMI-for-age in a sample of Czech school-aged children. Ninety-seven fourth, fifth and sixth graders and their parents from two large Czech cities participated in the study. Two 24-hour recalls provided total amount of energy, fat, percentage of energy derived from fat, dietary fiber, and servings of fruits and vegetables. Physical activity was measured by the Self-administered Physical Activity Checklist (SAPAC). Children consumed less energy and dietary fiber than suggested by Czech dietary recommendations. The proportion of energy that children consumed from fat was 28.5%. Children consumed 1.4 cups of fruit and 1.2 cups of vegetables. Children's physical activity levels fell within the current recommendations. Age was the only significant predictor of higher BMI-for-age. Poor dietary quality may be responsible for increasing rates of child obesity in the Czech Republic. Nutritional professionals in the Czech Republic should focus on increasing consumption of fruits, vegetables, and other high-fiber foods in order to reduce the risk for overweight among Czech children.

Aim: We designed this study to assess the effect of breastfeeding and its duration on acute otitis media (AOM) in children of our geographical region. Our main aim was to determine the period of breastfeeding, necessary to achieve optimal preventive results against AOM. Methods: The children that, according to the questionnaire, had suffered AOM infections in the past were used as the study group with the rest of the children used as control. The duration of breastfeeding was divided into months and the odds ratios for the occurrence of AOM were calculated for the children breastfed for more than or equal to a certain period, compared to the children breastfed for less than that period. This was repeated for each month separately and the results plotted on a graph of the confidence interval (CI) for the odds ratio values, against months of breastfeeding.
Results: The results of our study show that breastfeeding for a period of up to 11 months can play a significant preventive role against AOM (odds ratio and lower 90% CI >1). Breastfeeding for longer periods of time is also beneficial, with breastfeeding up to 18 months being associated with some preventive effect against the disease (odds ratio >1), but the reduction in the incidence of AOM is not statistically significant after the 11th month. Furthermore, there are marked differences in the importance of breastfeeding during the first 11 months, with a vital protective effect during the first 4 months of life which, however, drops by the 5th month and then rises again from the beginning of the 6th to the end of the 8th month. The protective effect then drops once more, although it remains positive and statistically significant until the 11th month of life and positive, but not statistically significant, until the 18th.
Conclusion: Our study has revealed that for an optimal preventive effect to be achieved, the child should be breastfed for at least the first 11 months of its life. Continuing after this for up to the 18th month shows some preventive effect, which however is not statistically significant. Our results support the hypothesis that the importance of breastfeeding varies with the development of the child, its changing environment and to the new immunological challenges this brings.

Skin tumors are the most frequent malignancies in the white population worldwide and have reached the proportion of an epidemic disease. Since non-melanocytic skin cancers can be cured when timely detected, given that still malignant melanoma may have good prognosis if early diagnosed, and considering the key role of primary care in cancer screening advising and implementation, the international PACMeR study group (trial_01.3) adjourned SESy_Europe database in a version comprehensive of skin-malignancies screening indexing. The novel database provides standardized pre-codified translations of 2,331 parameters in eight languages (English, French, German, Greek, Italian, Romanian, Spanish and Turkish) and records the time elapsed from last skin examination, cause and frequency of skins examinations and stratifies skin cancer risk patterns by a systematic registering of risk factors.
A comprehensive indexing of skin cancer screening practices among European countries may in fact turn helpful in programming future health policy and tailoring interventions.

Objective: The article analyses changes in tobacco use in medical students in Slovakia in 1995, 1999 and 2004.
Methods: Questionnaire survey in 448 students of the Jessenius Faculty of Medicine, Comenius University in Martin, Slovakia, was carried out in October and November 2004. Data were compared with similar surveys carried out in 1995 and 1999.
Results: Prevalence of daily smoking in men increased from 11.1 in 1995 to 21.8% in 2004. In women, within 1995-2004, daily smoking increased from 5.2% to 12.3%, occasional smoking from 11.6% to 19.8%. Also proportion of women initiating smoking during their university study increased. In both genders the proportion of never smokers dramatically dropped between 1995 and 1999 (in men from 43.2% to 23.2%; in women from 61.9 to 18.2).
Conclusion: Upward trend in tobacco use, particularly in women, is a reason for concern. In medical faculties, principles of prevention should be more emphasized and the students motivated for healthy life-style and to fulfill their future role in public health. The situation noted among medical students indicates that a community in Slovakia is still not satisfactory inclined towards non-smoking and a dramatic decrease of tobacco use can hardly be expected either in the near future.

Sunlight exposure is considered to be the most important cause of "natural disinfection" in surface water environments. The UV-B portion of the solar spectrum is the most bactericidal, causing direct (photo-biological) DNA damage.
In the present experimental study, the effect of solar radiation on the elimination of bacteria in water, especially in surface water, was studied. The influence of depth and UV-B transmittance of water was determined. Comparing Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa and Staphylococcus aureus, Enterococcus faecalis proved to be the most resistant organism.
Pseudomonas aeruginosa was shown to be the most sensitive indicator bacterium among the tested microorganisms.
Results show a significant correlation between radiation intensity and reduction rates. Best elimination of microorganisms occurs on the water surface; with increasing water depth, there is less UV radiation to inactivate bacteria. High turbidity substantially reduces UV-B transmittance in water causing decreased elimination efficiency.
The results of the present study show that sunlight, given an appropriate intensity and good water transparency is suitable to inactivate fecal indicator bacteria within a few hours in surface waters and therefore also in bathing waters.

Objective: To prove that higher cigarette taxes eventually decrease smoking and do also increase state incomes from tobacco taxes by using Hungarian figures.
Method: Collection and analysis of available data on tobacco use, levels of excise and value added taxes on tobacco products and state incomes originating from the tobacco sector.
Conclusions: In Hungary, regular tobacco tax increases resulted in decreased cigarette consumption and its lower prevalence figures in some population groups. State incomes have increased in spite of regular cigarette tax raises. Therefore, there is on conflict of interest between the health and finance portfolios in supporting further tobacco tax increases. Hungary should use regular, above the inflation tobacco tax raises as means for improving population health. Tobacco control advocates should prevent tobacco companies' attempts aimed at deterring decision makers from supporting such tax policies.

The short-term effects of air pollution on cardiovascular mortality in elderly were investigated in Niš, during the 2001-2005. Daily measurements of black smoke (BS) and sulphur dioxide (SO2), as well as the daily number of cardiovascular death among person ≥ 65 yrs of age, were collected. Generalized linear model extending Poisson regression was applied. The effects of time trend, seasonal variations, day of week, temperature, relative humidity and barometric pressure were analysed. The results did not support findings from previous studies that had shown an increase in the number of cardiovascular death in elderly in association with air pollution.

The health risks among children in "new" and "old" members of the European Union seem to be different. Farms are the most frequent place of injuries among children living in rural areas in Poland. Our aim is to present data on the farm-related injuries conditions among children aged 6-15 in one large region in Poland. The analysis has been made on the basis of information collected from the Farmers' Insurance Fund in Włocławek, which registers all farm-related injuries reported within the Włocławek Province. Over the 10-year study period 449 injuries were recorded (1.29 injuries per 1000 person-years). Among all victims there were 132 girls (29.4% of the total) and 317 boys. 14-year-old children fell victims of injuries most frequently (20.0% of all injuries). The highest number of injuries was recorded during the summer season. The injuries resulted mainly from falls or slips (47.2%) and falling from high altitudes (22.9% of all injuries). Individual and unattended works accounted for 37.5% of cases while 30.4% of all injuries happened while children were assisting in the work performed by adults. The sites were farm facilities (29.0%), farmyard (23.8%), around farm facilities (13.1%), pastures and meadows (11.1%), fields (9.1%), roads leading to houses or farm facilities (7.6%) and home (6.2%). We conclude that 13-15-year-old boys falling during an individual unattended work or while assisting in the work performed by adults, inside and around farm facilities, and during summer months, were the most frequent victims of injuries on farms. Information obtained in this study may be helpful in developing and implementing injury prevention strategies tailored to the Central-Eastern European agricultural realities.

Objectives: The main objective of this work is to quantify the number of hospitalizations caused by smoking, estimate the costs of hospital treatment and to estimate contribution of smoking to mortality in the Czech Republic (CR) in 2002.
Methods: The estimate of the proportion by which smoking contributed to hospitalizations and to mortality in the CR was computed using the method of smoking-attributable fractions (SAF). The SAF was computed from relative risks established in the American study Cancer Prevention Study II and from estimates of the prevalence of smoking in the CR from a nationwide study conducted in 2002.
Results: In 2002, based on data provided by the General Health Insurance Company, there were 145,336 hospitalizations, and the total cost of hospital treatment was estimated as 4.727,612 (in thousands) CZK. The total number of deaths caused by smoking was 20,550 (95% CI: 18,851-22,262), 14,525 in men and 6,025 in women. Deaths caused by smoking represented 19% of the total nationwide mortality for 2002. Earlier estimates were published by Peto and Lopez for 1995 (22,300 deaths caused by smoking) and 2000 (17,746 deaths). The estimate arrived by authors using the SAF method for 2002 corresponds quite well with that by Peto and Lopez for 2000.
Conclusions: The high morbidity and mortality rate related to smoking is directly connected to high prevalence of smoking in the Czech Republic. An effective tobacco control policy, including restrictive measures on availability of tobacco products combined with preventive programmes and smoking cessation programmes, could contribute to the reduction of smoking and save lives and treatment costs caused by smoking.

Aim of the study was to investigate serological markers of selected sexually and blood transmitted infections (HBV, HCV, CMV, and Treponema pallidum) in the group of pregnant women and in newborns of HIV-positive mothers in Slovakia.
IgG antibodies to CMV were found in 78 of 97 women, from them in 6 of 7 HIV-positive and in 72 of 90 HIV-negative persons. Occurrence of HbsAg and HCV was significantly higher in the group of HIV-positive women (1/7 and 2/7) comparing to the HIV-negative one (4/90 and 0/92, respectively). Antibodies to T.pallidum were found only in one HIV-negative woman from 92 women tested.
Five of seven children born to HIV-1 infected mothers were found HIV-1 negative, two children are still under control. Four of 7 newborns were found anti-CMV IgG positive. Although one woman, IDU, was confirmed HbsAg and anti-HCV positive, vertical transmission of HBV and HCV to her newborn was not observed by molecular-biological methods. Similarly, HCV antibodies were found in one more women and neither in her child HCV infection was confirmed. In no one of mother - child pair's antibodies to T.pallidum were observed.
Due to these findings strong attention should be paid to health education and prophylaxis of mother to child HIV and other STIs transmission in Slovakia.

Objectives: To compare M. tuberculosis complex genotypes from representative regions of the Czech Republic in order to estimate changes in strain prevalence and in the extent of imported drug-resistant tuberculosis.
Methods: Primary M. tuberculosis complex isolates (n = 155) and follow-up isolates (n = 15) from 155 patients from the first half of 2004 (98 from Prague, 37 from South Moravia and 35 from the Moravian-Silesian region) were genotyped by IS6110-RFLP, spoligotyping, and partly by VNTR-genotyping.
Results: Based on IS6110-RFLP, 110 of 155 (71%) primary isolates were unique. Forty-five isolates (29 %) were found in 15 clusters comprising two to six patients and all but one cluster were also discriminated by MIRU-VNTR-genotyping. Four clusters comprised patients from different regions, and six were ongoing for several years. An indication of MDR-strain transmission was found in one instance. All four Beijing-type isolates with any resistance were associated with immigration from Eastern Europe.
Conclusions: The molecular epidemiological data of this period-prevalence, population based study and its comparison to earlier investigations point to a low extent of clustering between M. tuberculosis complex isolates in representative regions of the Czech Republic. Few clusters extending geographically and/or over several years were identified, providing a means for an in-depth analysis of risk factors of transmission. Beijing genotype isolates were shown to increase in prevalence to reach 6.5%. Drug resistant isolates of this genotype were associated with immigration of from Eastern Europe, although direct transmission of a resistant isolate was probable only in one of eleven cases.