| 1. |
- Bröms, Kristina, 1954-
(författare)
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A Nationwide Study of Asthma and Allergy in Swedish Preschool Children : with Special Reference to Environment, Daycare, Prevalence, Co-ocurrence and Incidence
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim of this project was to study the age and sex specific occurrence of atopic and non-atopic asthma and other atopic manifestations in a nationwide sample of Swedish pre-school children. Methods: All 70 allergen avoidance day-care centres (AADC) with 84 sections and 140 matched ordinary day-care centres with 440 sections in 62 municipalities across Sweden were sampled. In 2000 the staff at each section responded to a questionnaire on indoor and outdoor environment at the section. In 2002 parents of 5,886 children attending the AADCs and ODCs responded to a postal questionnaire regarding symptoms indicating prevalent asthma, allergic rhinitis, eczema, and food, furred pet and pollen allergy and other data in their children. In 2007, parents of 4255 children responded to an almost identical follow-up questionnaire. Results: The AADCs had far more strict rules than ODCs on furred pets and smoking at home and on perfume use, and the indoor environment was better, owing to better cleaning. The age specific asthma prevalence was curvilinear with a peak at age 3 of 11.4% among boys and 9.8% among girls. In addition the prevalence increased by municipality population density, a proxy for degree of urbanisation. There was a highly significant co-occurrence between all asthma-atopic manifestations, but there was no evidence of ordered sequence of manifestation onset. The asthma incidence was highly dependent on presence or absence of co-occurrence variables. Given the variable mix in the present study population, the annual asthma incidence ranged from 0.6% to 1.2%. Conclusions: AADCs had more strict rules and a better indoor environment than ODCs. The asthma prevalence was affected by age, sex and degree of urbanisation. There was close co-occurrence between all asthma and atopic manifestations but no evidence of ordered sequence of onsets. The annual asthma incidence was strongly dependent of co-occurrence conditions.
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| 2. |
- Cai, Guihong, 1981-
(författare)
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Fungal DNA, Mould, Dampness and Allergens in Schools and Day Care Centers and Respiratory Health
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Day care centers and schools are important environments for children, but few epidemiological studies exist from these environments. Mould, dampness, fungal DNA and allergens levels in these environments and respiratory health effects in school children were investigated in this thesis. In the day care centers studies, Allergen Avoidance Day care Centers (AADCs) and Ordinary Day care Centers were included. One third of the Swedish day care centers had a history of dampness or mould growth. Total fungal DNA levels were positively associated with risk construction buildings, reported dampness/moulds, rotating heat exchangers, linoleum floors and allergens (cat, dog, horse allergen) levels. The two school studies included secondary schools in Johor Bahru, Malaysia and elementary schools from five European countries (Italy, Denmark, Sweden, Norway, and France) (HESE-study). In Malaysia, 13 % of the pupils reported doctor-diagnosed asthma but only 4 % had asthma medication. The prevalence of wheeze in the last 12 months was 10 % in Malaysia and 13 % in the HESE-study. Cough and rhinitis were common among children in the HESE-study. There were associations between fungal DNA and reported dampness or mould growth. Fungal DNA levels and viable mould (VM) concentration in the classrooms were associated with respiratory symptoms (wheeze, rhinitis, cough, daytime breathlessness) in school children. In the HESE-study, associations were found between total fungal DNA, Aspergillus/Penicillium DNA and respiratory symptoms among children. Moreover, Aspergillus versicolor DNA and Streptomyces DNA were associated with respiratory symptoms in Malaysia and the HESE-study, as well as reduced lung function [forced vitality capacity (FVC) and forced expiratory volume in 1 second (FEV1)] among children in the HESE-study. In conclusion, fungal DNA and pet allergens were common in day care centers and schools and respiratory symptoms in school children were common. The associations between VM concentration and fungal DNA levels in the schools and respiratory health effects in school children indicated a need for improvement of these environments. Moreover, risk constructions should be avoided and buildings should be maintained to avoid dampness and microbial growth. Health relevance of microbial exposure and biodiversity needs to be further studied using molecular methods.
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| 3. |
- Fu, Xi, 1984-
(författare)
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Self-rated health and respiratory symptoms among civil aviation pilots : Occupational and non-occupational risk factors
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is concern about the indoor environment in aircraft but few stud-ies exist on self-rated health (SRH) and respiratory symptoms among pilots. Occupational and non-occupational risk factors for SRH, respira-tory symptoms and other symptoms among commercial pilots were investigated in this thesis. One cohort study and one prevalence study were performed among pilots in one Scandinavian airline company. Fungal DNA, furry pet allergens and volatile organic compounds of microbial origin (MVOC) were measured on board. Cat (fel d1), dog (Can f1) and horse (Ecu cx) allergens were found in all dust samples and allergen levels were 27-75 times higher in aircraft with textile seats as compared to leather surfaces. The sum of MVOCs in the cabin air was 3.7 times higher than in homes in Uppsala and 2-methyl-1-butanol and 3-methyl-1-butanol concentrations were 15-17 times higher. Asper-gillus/Penicillium DNA and Aspergillus versicolor DNA were more common in aircraft with textile seats. One fifth reported SRH as poor or fair, 62% had fatigue, 46% overweight/obesity and 71% insomnia. Poor or fair SRH was associated with overweight/obesity, lack of exercise, insomnia, low sense of coherence (SOC) and high work demand. Re-covery from work was worse among those with insomnia and low social support at work. Fatigue was more common among young or female pilots and related to insomnia and high work demand. Pilots flying MD80 or Saab 2000 aircraft had less fatigue. Pilots exposed to environmental tobacco (ETS) on board had more eye symptoms and fatigue which were reduced after the ban of smoking (in 1997). Pilots with increased work demand developed more rhinitis, dermal symptoms and fartigue and those with decreased work control developed more eye symptoms. The incidence of doctors’ diagnosed asthma and atopy were 2.4 and 16.6 per 1000 person years, respectively. Pilots changing type of flight got more airway infections. Those reporting decreased work control had a higher incidence of atopy. Risk factors in the home environment included ETS, dampness or mould, window pane condensation in winter and living in houses built after 1975. In conclusion, SRH and respiratory health among pilots are associated with specific occupational and non-occupational risk factors.
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| 4. |
- Gunnbjörnsdóttir, María Ingibjörg, 1966-
(författare)
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Asthma and Respiratory Symptoms in Nordic Countries, Environmental and Personal Risk Factors
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aims of our studies were to identify risk factors for respiratory symptoms and asthma in indoor environment but even to look at some personal risk factors such as body mass index and gastroesophageal reflux. The study population is based on participants of the European Community Respiratory Health Survey I and II. In the first study, water damage and visible moulds were reported in 7.4% and 17% of the homes respectively. The combination of water damage and visible moulds was independently associated with attacks of breathlessness when resting and after activity and also to long term cough. In the second study, the prevalence of nocturnal GER increased with higher BMI and the same pattern could be seen for habitual snoring. Reported onset of asthma, wheeze and night-time symptoms increased in prevalence along with the BMI gradient. In the multivariable analysis, obesity and nocturnal GER were independent risk factors for onset of asthma, wheeze and night-time symptoms. Habitual snoring was an independent risk factor for onset of wheeze and night-time symptoms, but not for onset of asthma. In the third study, a total of 18% of the subjects reported indoor dampness in the last 12 months and 27% of the subjects reported indoor dampness since the previous survey. Respiratory symptoms and asthma were significantly more prevalent in individuals exposed to indoor dampness and indoor dampness was a risk factor for respiratory symptoms and asthma after adjusting for possible confounders. Indoor dampness was an independent risk factor for onset of respiratory symptoms but not for asthma onset. Remission of respiratory symptoms was less likely to occur if subjects reported indoor dampness. In the fourth study, the lowest prevalence of atopy and the lowest levels of all indoor allergens, bacteria and moulds were found in Iceland. A positive association was found, between cat allergen exposure and asthma symptoms and between bronchial hyperresponsiveness and the amount of viable mould in indoor air.
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| 5. |
- Kim, Jeong-Lim, 1981-
(författare)
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Environmental Factors in Relation to Asthma and Respiratory Symptoms among Schoolchildren in Sweden and Korea
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis studied environmental factors in relation to asthma and respiratory symptoms among schoolchildren in two countries. In Sweden, 1014 pupils (5-14 year) in 8 schools participated. Wheeze was reported by 7.8%, current asthma by 5.9%, doctor-diagnosed asthma by 7.7%, cat allergy by 6.8% and dog allergy by 4.8%. Current asthma was less common among those consuming more fresh milk and fish. Doctor-diagnosed asthma was less common among those consuming olive oil. Cat, dog and horse allergens were common in settled dust and related to respiratory symptoms. Pupils consuming butter and fresh milk had less respiratory symptoms in relation to allergen exposure. In schools with increased levels of microbial volatile organic compounds and selected plasticizers (Texanol and TXIB) asthma and respiratory symptoms were more common.In Korea, 2365 pupils (9-11 year) in 12 schools participated (96%). In total, wheeze was reported by 8.0%, current asthma by 5.7%, doctor-diagnosed asthma by 5.4%, cat allergy by 2.6% and dog allergy by 4.9%. Contamination of dog and mite (Dermatophagoides farinae) allergen was common while cat allergen was uncommon. Remodelling, changing floor and building dampness at home were positively associated with asthma and respiratory symptoms. The strongest associations were found for floor dampness. Indoor/outdoor concentration of NO2, formaldehyde and ultrafine particles (UFP) at schools were positively associated with asthma and respiratory symptoms. When comparing Sweden and Korea, Korean pupils had more breathlessness and asthma but reported less cat and pollen allergy. Swedish schools had CO2-levels below 1000 ppm, while most Korean schools exceeded this standard. Since both home and school environment may affect pupil’s asthma and respiratory symptoms, air quality should be an important health issue. Moreover, changes in dietary habits may be beneficial to decrease asthma and allergies. Furthermore, interaction between diet and environment needs to be further investigated.
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| 6. |
- Runeson, Roma, 1951-
(författare)
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Personality, Stress, and Indoor Environmental Symptomatology
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The sick building syndrome (SBS) comprises eye, nose, skin, and throat symptoms, headache and fatigue. Gender, personality aspects, and psychosocial factors at work have lately been at focus in health research. The main aim of this thesis was to investigate the relationships between SBS and personal factors, personality traits, and psychosocial work stress. Two different populations were studied: a cohort of 195 subjects working in suspected “sick buildings” followed 1988-1999, and a random sample of 695 subjects from the Swedish population, 20-65 y. Two personality scales were used; the Karolinska Scales of Personality (KSP) and the Sense of Coherence (SOC). Two stress questionnaires were used: the 3-dimensional demands-control-support model (DCS) and the Assessment of Perceived Psychosocial Work Environment (PPWE). SBS and personal factors were assessed by a postal symptoms questionnaire and a symptom score (SC) was calculated. Personality was assessed by means of two verbal personality scales, the KSP and the SOC. Females in problem buildings had more SBS than men, and females had a lower SOC and more anxiety and aggressivity in the KSP. Females and males in the general working population reported differences in psychosocial work environment. Moreover, the associations between personality traits and SBS, and between DCS and SBS, differed between males and females. Over all, the investigated occupants of suspected sick-buildings were within the normal range for both KSP and SOC norms. However, those with symptoms showed prominent personality vulnerability, especially in anxiety, aggressivity, and lower SOC, compared to those that were not reporting symptoms. Female gender, low age, asthma, and a history of atopy were related to SBS in the general working population. A combination of low social support and either passive, strained, or active work situation, as well as a combination of high social support and active work situation, were associated with SBS. In conclusion, measurements of personality and psychosocial work environment could be of value in future studies on environmental syndromes. Moreover, the demans-control-support model can predict SBS, but in a more complex way than indicated by earlier research.
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| 7. |
- Sahlberg, Bo, 1963-
(författare)
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Indoor Environment in Dwellings and Sick Building Syndrome (SBS) : Longitudinal Studies
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- People spend most of their time indoors and mostly in the dwelling. It is therefore important to investigate associations between indoor exposure in dwellings and health. Symptoms that may be related to the indoor environment are sometimes referred to as the "sick building syndrome" (SBS). SBS involves symptoms such as eye, skin and upper airway irritation, headache and fatigue. Three longitudinal studies and one prevalence study on personal and environmental risk factors for SBS in adults were performed. The prevalence study included measurements of indoor exposures in the dwellings. The longitudinal studies, with 8-10 years follow-up time, showed that smoking and indoor paint emissions were risk factors for SBS. Moreover, building dampness and moulds in dwellings were risk factors for onset (incidence) of general symptoms, skin symptoms and mucosal symptoms. In addition subjects living in damp dwellings have a lower remission of general symptoms and skin symptoms. Hay fever was a risk factor for onset of skin symptoms and mucosal symptoms, and asthma was a risk factor for onset of general and mucosal symptoms. Biomarkers of allergy and inflammation (bronchial reactivity, total IgE, ECP and eosinophil count) were predictors of onset of SBS symptoms, in particular mucosal symptoms. In the prevalence study, any SBS-symptom was associated with some individual volatile organic compounds of possible microbial origin (MVOC) e.g. 2-pentanol, 2-hexanon, 2-pentylfuran and 1-octen-3ol. Moreover, there were associations between indoor levels of formaldehyde and the plasticizer Texanol and any SBS. The result from the study indicates that individual MVOC are better indicators of SBS than the total value of MVOC. A final conclusion is that smoking, dampness and moulds and emissions from indoor painting may increase the onset of SBS. The indoor environment in dwellings over time has improved, but there is still a need for further improvements of the indoor environment in dwellings. More longitudinal SBS studies are needed.
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| 8. |
- Uddenfeldt, Monica, 1949-
(författare)
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A Longitudinal Study of Asthma : Risk Factors and Prognosis
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to identify risk factors for the onset of adult asthma. Other objectives were to study determinants of smoking habits and the association between sensitization and outcome of asthma. In 1990, a questionnaire was distributed to 12,732 individuals from three age groups (16, 30-39 and 60-69 years) in two counties of Sweden. In a second phase, 2538 subjects who had reported respiratory symptoms and 600 controls were invited to clinical investigations, 81% participated. At the follow-up in 2003 subjects of the remaining cohort (11,282) were re-invited. Analyses are based on the 67% (n=7563) who responded to both questionnaires 1990 and 2003. In 2003, 17.2% of the young adults, 11.4% of the middle-aged and 10.3% of the elderly reported having, or having had, asthma. A total of 791 subjects reported onset of asthma during the 13-year study period. Lifestyle factors such as smoking, obesity, hard physical training and a low consumption of fruit and fish were constant risk factors for onset of asthma after adjusting for socioeconomic group. A smoker’s risk of asthma onset was increased by 37%. The impact of risk factors differed between the age-groups. BMI had a significantly higher impact in the middle-aged and elderly. In subjects participating in the clinical investigations in 1990, sensitization to pets, were determinants of both persistent asthma and onset of asthma in 2003. The risk for persistent asthma was threefold. The risk for onset of asthma was more than doubled. Smoking at baseline in 1990 was the strongest determinant of being a smoker in 2003. Allergic sensitization and clinically verified asthma were not associated with smoking habits in 2003. No differences in changing smoking habits could be identified between smokers with or without asthma. In conclusion, modifiable lifestyle factors are important risk factors for adult onset asthma. The co-occurrence and interplay between asthma and cigarette smoking is still puzzling.
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| 9. |
- Wang, Juan, 1984-
(författare)
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Asthma and Rhinitis among Adults in Sweden and China : Risk Factors in the Home Environment
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main aim of this thesis was to evaluate associations between selected home environment factors and asthma, rhinitis and respiratory symptoms among adults from Sweden, China and northern Europe. Two studies were performed in Sweden, one in China, and one longitudinal cohort study was performed in northern Europe. Dampness/mould was common, and was a main risk factor in all studies. Other risk factors for asthma symptoms in Sweden included window pane condensation in winter, multi-family buildings constructed from 1961-1975, rented apartments, environment tobacco smoke (ETS), and living in a colder climate zone. Higher ventilation flow in Sweden was associated with less asthma symptoms. Risk factors for rhinitis in Sweden included window pane condensation, a higher moisture load, concrete slab foundation constructed before 1991, multi-family buildings constructed from 1976-1985, rented apartments and living in densely populated areas. Risk factors for rhinitis in China included window pane condensation, recent redecoration, new furniture, presence of cockroaches, pet keeping, ETS and living near a main road or highway. Frequently cleaning of the home and putting beddings to sunshine were protective factors for rhinitis in China. Other risk factors for respiratory infections in Sweden included houses with a brick façade, window pane condensation, a higher moisture load, multi-family buildings constructed from 1976-1985, rented apartments and living in densely populated areas. Furthermore, dampness and mould, and mould odour were risk factors for onset of asthma and rhinitis in northern Europe. In conclusion, indoor dampness and mould can be a risk factor for asthma and rhinitis in Sweden, China and northern Europe. Certain construction years (1961-1985), ETS, recent redecoration, new furniture, living in urban areas and exposure to traffic air pollution can be risk factors for asthma, rhinitis or respiratory infections. A high ventilation flow and daily cleaning at home can be protective.
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| 10. |
- Zhao, Zhuohui, 1980-
(författare)
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Indoor and Outdoor Air Pollution in Relation to Allergy and Asthma in Taiyuan, China
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim was to study the prevalence of asthma, eczema, allergy and respiratory symptoms among pupils in Shanxi province, China, in relation to home and school environment and outdoor air pollution. In one study there was a low prevalence of self-reported asthma, eczema and pollen or pet allergy among pupils (9-20y). Rural childhood and consumption of fruit and fish were negatively associated with asthma or allergy, while current urban residency and consumption of hamburgers tended to be risk factors. In another study in junior high school pupils, similar low prevalence of asthma and allergy was found. Compared with pupils at the same age in Uppsala, Sweden, asthma and allergy were less common while daytime attacks of breathlessness were more common in Chinese pupils. Parental asthma or allergy was a predictor of asthma symptoms. Factors in the home environment such as new floor, new furniture and ETS exposure were risk factors for asthma symptoms. Crowdedness, dust amount, CO2, temperature and air humidity were negatively associated with respiratory symptoms. Microbial chemical components like muramic acid and ergosterol, markers for bacteria and fungi, were negatively associated with wheeze or daytime attacks of breathlessness. The associations with endotoxin varied depending on the length of 3-hydroxy fatty acids of the lippopolysaccharides (LPS). Among outdoor air pollutants, SO2 and formaldehyde were positively associated with asthma symptoms or respiratory infections. In addition, indoor SO2, NO2 and formaldehyde were positively associated with asthma symptoms and respiratory infections. In conclusion, rural childhood and dietary factors can be protective for asthma and allergy. ETS and chemical emissions from new material at home can be risk factors for asthmatic symptoms. In the school environment, factors of indoor origin seemed to be generally protective for respirator symptoms while factors of outdoor origin seemed to be risk factors.
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