title: [Realities of the prophylactic health care of workers in Poland].
abstract: BACKGROUND
  The Polish occupational health system (OHS), existing over the past 17 years, has recently been contested as never before. Critical voices pertain to both legislative and executive aspects of the system, in which key roles are played by employers and occupational medicine service. There are some reasons for making a hypothesis that relevant norms are not always respected by the main actors.
  
  
  METHODS
  The data on the observance of norms by entities responsible for providing workers with prophylactic health care were analyzed. They were obtained from the existing external resources and materials collected during the implementation of tasks assigned by the Ministry of Health.
  
  
  RESULTS
  Legal norms, which constitute OHS in Poland are generally neither respected by the employers, nor by the representatives of occupational medicine service. Nearly half (45-47%) of employers infringe provisions relating to medical examinations of workers. Such a degree of non-observance of respective laws would have not been the case if it was not for the attitudes and "silent approval" of many (but not all) occupational physicians. Laws defining the responsibilities of occupational medicine service units on one hand, and of employers on the other, are for many reasons infringed by both groups.
  
  
  CONCLUSIONS
  The data analyses indicate that the Polish OHS is, to a large extent, not acceptable and should be replaced with another one founded on other assumptions and responsive to contemporary occupational health challenges. New provisions should be formulated on the basis of merit and guided by socially accepted norms.
authors.affiliation: Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Zakład Polityki Zdrowotnej / Health Policy Department).
authors.forename: Jerzy A
authors.initials: JA
authors.lastname: Kopias
mesh_terms: D000328:Adult; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control*; D016272:Occupational Health / Q000706:statistics & numerical data*; D009786:Occupational Health Services / Q000592:standards*; D009787:Occupational Medicine / Q000592:standards; D011044:Poland; D011314:Preventive Health Services / Q000592:standards*; D011785:Quality Assurance, Health Care
keywords: health care organization; health care system; health policy; occupational health care; occupational medicine service; prophylactic medical check-ups of employees