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1.
  • Hergens, Maria-Pia, et al. (författare)
  • Use of Scandinavian Moist Smokeless Tobacco (Snus) and the Risk of Atrial Fibrillation.
  • 2014
  • Ingår i: Epidemiology. - Wolters Kluwer Health/LWW. - 1531-5487. ; 25:6, s. 872-876
  • Tidskriftsartikel (refereegranskat)abstract
    • Snus is a smokeless tobacco product, widely used among Swedish men and increasingly so elsewhere. There is debate as to whether snus is an acceptable "harm-reduction" tobacco product. Since snus use delivers a dose of nicotine equivalent to cigarettes, and has been implicated in cardiac arrhythmia because of associations with sudden cardiovascular death, a relation with atrial fibrillation is plausible and important to investigate.
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2.
  • Romelsjö, Anders, et al. (författare)
  • Abstention, alcohol use and risk of myocardial infarction in men and women taking account of social support and working conditions : the SHEEP case-control study.
  • 2003
  • Ingår i: Addiction. - 0965-2140 .- 1360-0443. ; 98:10, s. 1453-62
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>AIMS:</strong> Very few studies indicating that low-moderate alcohol consumption protects from myocardial infarction (MI) controlled for social support and working conditions, which could confound the findings. Therefore, a first aim was to study the risk of non-fatal and total MI in relation to volume of alcohol consumption and measures of social support and working conditions. A second aim was to analyse the impact of the volume of earlier alcohol use in abstainers.</p> <p><strong>DESIGN:</strong> Data came from a case-control study, the Stockholm Heart Epidemiology Program (SHEEP), including first MI among Swedish citizens 45-70 years old.</p> <p><strong>SETTING:</strong> Stockholm County 1992-94.</p> <p><strong>PARTICIPANTS:</strong> There were 1095 cases of MI in men and 471 in women (928 and 372 were non-fatal), and 2339 living controls from the general population.</p> <p><strong>MEASUREMENT:</strong> Information about alcohol use at different periods in life and job strain, social anchorage and life control besides pre-existing health problems, smoking, physical activity, socio-economic status and marital status was obtained by a questionnaire from the cases and the controls.</p> <p><strong>FINDINGS:</strong> In multivariate logistic regression analyses, the relative risk for MI (especially non-fatal) was reduced among alcohol consumers. RR for non-fatal MI was 0.52 (95% confidence intervals 0.32, 0.85) in men with a consumption of 50-69.9 g 100% ethanol/day and 0.21 (95% confidence interval 0.06, 0.77) in women with a consumption of 30 g or more per day (reference category 0.1-5 g 100% ethanol/day). Men who were abstainers during the previous 1-10 years and with an earlier average consumption of 5-30 g 100% ethanol/day had a significantly lower relative risk compared to such abstainers with an earlier higher consumption. Earlier consumption among abstainers may also have an impact on gender differences in MI. Analyses showed positive interaction between abstention and low life-control in women, but only 4% of the female cases were due to this interaction. There were no other interactions between measures of alcohol use and social anchorage, life control and working situations.</p> <p><strong>CONCLUSION:</strong> Alcohol use had a protective impact on MI, with little impact of job strain, social anchorage and life control, giving increased support for a protective impact of low-moderate alcohol use. The level of previous alcohol consumption among male 1-10-year-long abstainers influenced the risk of MI.</p>
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3.
  • Agardh, Emilie E, et al. (författare)
  • Work stress and low sense of coherence is associated with type 2 diabetes in middle-aged Swedish women.
  • 2003
  • Ingår i: Diabetes Care. - 0149-5992 .- 1935-5548. ; 26:3, s. 719-24
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>OBJECTIVE:</strong> The risk of type 2 diabetes is suggested to be increased for individuals exposed to stress. We analyzed the association of work stress by high demands, low decision latitude, and job strain (combination of high demands and low decision latitude) with type 2 diabetes. We also studied low sense of coherence (SOC) (a factor for successful coping with stressors) in association with type 2 diabetes. Finally, we investigated the combination of SOC and demands or SOC and decision latitude in association with the disease.</p> <p><strong>RESEARCH DESIGN AND METHODS:</strong> This cross-sectional study recruited 4821 healthy Swedish women (aged 35-56 years) residing in five municipalities in the Stockholm area. An oral glucose tolerance test identified 52 women with type 2 diabetes. Relative risks (RRs) with 95% CIs were estimated in a logistic multiple regression analysis.</p> <p><strong>RESULTS:</strong> No association was found between high demands and type 2 diabetes (RR 1.1 [CI 0.5-2.2]). Low decision latitude was associated with type 2 diabetes with a RR of 2.2 (1.0-4.8). The RR of type 2 diabetes with low SOC was 3.7 (1.2-11.2). The combination of low SOC and low decision latitude was associated with type 2 diabetes with a RR of 2.6 (1.2-5.7). Homeostasis model assessment revealed an association of 4.2 (1.2-15.0) between low SOC and insulin resistance.</p> <p><strong>CONCLUSIONS:</strong> This study provided new evidence that stress factors such as low decision latitude at work and low SOC were associated with type 2 diabetes in middle-aged Swedish women.</p>
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4.
  • Björk, Jonas, et al. (författare)
  • Commonly used estimates of the genetic contribution to disease are subject to the same fallacies as bad luck estimates
  • 2019
  • Ingår i: European Journal of Epidemiology. - Springer. - 0393-2990. ; 34:11, s. 987-992
  • Tidskriftsartikel (refereegranskat)abstract
    • The scientific debate following the initial formulation of the “bad luck” hypothesis in cancer development highlighted how measures based on analysis of variance are inappropriately used for risk communication. The notion of “explained” variance is not only used to quantify randomness, but also to quantify genetic and environmental contribution to disease in heritability coefficients. In this paper, we demonstrate why such quantifications are generally as problematic as bad luck estimates. We stress the differences in calculation and interpretation between the heritability coefficient and the population attributable fraction, the estimated fraction of all disease events that would not occur if an intervention could successfully prevent the excess genetic risk. We recommend using the population attributable fraction when communicating results regarding the genetic contribution to disease, as this measure is both more relevant from a public health perspective and easier to understand.
5.
  • Hansson, Jenny, et al. (författare)
  • Use of snus and acute myocardial infarction: pooled analysis of eight prospective observational studies
  • 2012
  • Ingår i: European Journal of Epidemiology. - Springer. - 1573-7284. ; 27:10, s. 771-779
  • Tidskriftsartikel (refereegranskat)abstract
    • The use of snus (also referred to as Scandinavian or Swedish moist smokeless tobacco), which is common in Sweden and increasing elsewhere, is receiving increasing attention since considered a tobacco smoke "potential reduction exposure product". Snus delivers a high dose of nicotine with possible hemodynamic effects, but its impact on cardiovascular morbidity and mortality is uncertain. The aim of this study was to investigate whether snus use is associated with risk of and survival after acute myocardial infarction (AMI). Data from eight prospective cohort studies set in Sweden was pooled and reanalysed. The relative risk of first time AMI and 28-day case-fatality was calculated for 130,361 men who never smoked. During 2,262,333 person-years of follow-up, 3,390 incident events of AMI were identified. Current snus use was not associated with risk of AMI (pooled multivariable hazard ratio 1.04, 95 % confidence interval 0.93 to 1.17). The short-term case fatality rate appeared increased in snus users (odds ratio 1.28, 95 % confidence interval 0.99 to 1.68). This study does not support any association between use of snus and development of AMI. Hence, toxic components other than nicotine appear implicated in the pathophysiology of smoking related ischemic heart disease. Case fatality after AMI is seemingly increased among snus users, but this relationship may be due to confounding by socioeconomic or life style factors.
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6.
  • Hergens, Maria-Pia, et al. (författare)
  • Use of Scandinavian moist smokeless tobacco (snus) and the risk of atrial fibrillation
  • 2014
  • Ingår i: Epidemiology. - 1044-3983 .- 1531-5487. ; 25:6, s. 872-876
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>BACKGROUND:</strong> Snus is a smokeless tobacco product, widely used among Swedish men and increasingly so elsewhere. There is debate as to whether snus is an acceptable "harm-reduction" tobacco product. Since snus use delivers a dose of nicotine equivalent to cigarettes, and has been implicated in cardiac arrhythmia because of associations with sudden cardiovascular death, a relation with atrial fibrillation is plausible and important to investigate.</p><p><strong>METHODS:</strong> To assess the relation between use of snus and risk of atrial fibrillation, we carried out a pooled analysis of 7 prospective Swedish cohort studies. In total, 274,882 men, recruited between 1978 and 2004, were followed via the National Patient Register for atrial fibrillation. Primary analyses were restricted to 127,907 never-smokers. Relative risks were estimated using Cox proportional hazard regression.</p><p><strong>RESULTS:</strong> The prevalence of snus use was 25% among never-smokers. During follow-up, 3,069 cases of atrial fibrillation were identified. The pooled relative risk of atrial fibrillation was 1.07 (95% confidence interval = 0.97-1.19) in current snus users, compared with nonusers.</p><p><strong>CONCLUSION:</strong> Findings from this large national pooling project indicate that snus use is unlikely to confer any important increase in risk of atrial fibrillation.</p>
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7.
  • Hergens, Maria-Pia, et al. (författare)
  • Use of Scandinavian Moist Smokeless Tobacco (Snus) and the Risk of Atrial Fibrillation
  • 2014
  • Ingår i: EPIDEMIOLOGY. - 1044-3983. ; 25:6, s. 872-876
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background: Snus is a smokeless tobacco product, widely used among Swedish men and increasingly so elsewhere. There is debate as to whether snus is an acceptable "harm-reduction" tobacco product. Since snus use delivers a dose of nicotine equivalent to cigarettes, and has been implicated in cardiac arrhythmia because of associations with sudden cardiovascular death, a relation with atrial fibrillation is plausible and important to investigate. Methods: To assess the relation between use of snus and risk of atrial fibrillation, we carried out a pooled analysis of 7 prospective Swedish cohort studies. In total, 274,882 men, recruited between 1978 and 2004, were followed via the National Patient Register for atrial fibrillation. Primary analyses were restricted to 127,907 never-smokers. Relative risks were estimated using Cox proportional hazard regression. Results: The prevalence of snus use was 25% among never-smokers. During follow-up, 3,069 cases of atrial fibrillation were identified. The pooled relative risk of atrial fibrillation was 1.07 (95% confidence interval = 0.97-1.19) in current snus users, compared with nonusers. Conclusion: Findings from this large national pooling project indicate that snus use is unlikely to confer any important increase in risk of atrial fibrillation.</p>
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8.
  • Hergens, Maria-Pia, et al. (författare)
  • Use of Scandinavian Moist Smokeless Tobacco (Snus) and the Risk of Atrial Fibrillation
  • 2014
  • Ingår i: Epidemiology. - 1044-3983 .- 1531-5487. ; 25:6, s. 872-876
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>BACKGROUND:</strong> Snus is a smokeless tobacco product, widely used among Swedish men and increasingly so elsewhere. There is debate as to whether snus is an acceptable "harm-reduction" tobacco product. Since snus use delivers a dose of nicotine equivalent to cigarettes, and has been implicated in cardiac arrhythmia because of associations with sudden cardiovascular death, a relation with atrial fibrillation is plausible and important to investigate.</p><p><strong>METHODS::</strong> To assess the relation between use of snus and risk of atrial fibrillation, we carried out a pooled analysis of 7 prospective Swedish cohort studies. In total, 274,882 men, recruited between 1978 and 2004, were followed via the National Patient Register for atrial fibrillation. Primary analyses were restricted to 127,907 never-smokers. Relative risks were estimated using Cox proportional hazard regression.</p><p><strong>RESULTS::</strong> The prevalence of snus use was 25% among never-smokers. During follow-up, 3,069 cases of atrial fibrillation were identified. The pooled relative risk of atrial fibrillation was 1.07 (95% confidence interval = 0.97-1.19) in current snus users, compared with nonusers.</p><p><strong>CONCLUSION::</strong> Findings from this large national pooling project indicate that snus use is unlikely to confer any important increase in risk of atrial fibrillation.</p>
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9.
  • Hergens, Maria-Pia, et al. (författare)
  • Use of Scandinavian Moist Smokeless Tobacco (Snus) and the Risk of Atrial Fibrillation.
  • 2014
  • Ingår i: Epidemiology. - 1044-3983 .- 1531-5487. ; 25:6, s. 872-876
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>BACKGROUND::</strong> Snus is a smokeless tobacco product, widely used among Swedish men and increasingly so elsewhere. There is debate as to whether snus is an acceptable "harm-reduction" tobacco product. Since snus use delivers a dose of nicotine equivalent to cigarettes, and has been implicated in cardiac arrhythmia because of associations with sudden cardiovascular death, a relation with atrial fibrillation is plausible and important to investigate.</p><p><strong>METHODS::</strong> To assess the relation between use of snus and risk of atrial fibrillation, we carried out a pooled analysis of 7 prospective Swedish cohort studies. In total, 274,882 men, recruited between 1978 and 2004, were followed via the National Patient Register for atrial fibrillation. Primary analyses were restricted to 127,907 never-smokers. Relative risks were estimated using Cox proportional hazard regression.</p><p><strong>RESULTS::</strong> The prevalence of snus use was 25% among never-smokers. During follow-up, 3,069 cases of atrial fibrillation were identified. The pooled relative risk of atrial fibrillation was 1.07 (95% confidence interval = 0.97-1.19) in current snus users, compared with nonusers.</p><p><strong>CONCLUSION::</strong> Findings from this large national pooling project indicate that snus use is unlikely to confer any important increase in risk of atrial fibrillation.</p>
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10.
  • Lonn, Stefan, et al. (författare)
  • Long-term mobile phone use and brain tumor risk
  • 2005
  • Ingår i: American Journal of Epidemiology. - Oxford University Press. - 0002-9262. ; 161:6, s. 526-535
  • Tidskriftsartikel (refereegranskat)abstract
    • Handheld mobile phones were introduced in Sweden during the late 1980s. The purpose of this population-based, case-control study was to test the hypothesis that long-term mobile phone use increases the risk of brain tumors. The authors identified all cases aged 20-69 years who were diagnosed with glioma or meningioma during 2000-2002 in certain parts of Sweden. Randomly selected controls were stratified on age, gender, and residential area. Detailed information about mobile phone use was collected from 371 (74%) glioma and 273 (85%) meningioma cases and 674 (71%) controls. For regular mobile phone use, the odds ratio was 0.8 (95% confidence interval: 0.6, 1.0) for glioma and 0.7 (95% confidence interval: 0.5, 0.9) for meningioma. Similar results were found for more than 10 years' duration of mobile phone use. No risk increase was found for ipsilateral phone use for tumors located in the temporal and parietal lobes. Furthermore, the odds ratio did not increase, regardless of tumor histology, type of phone, and amount of use. This study includes a large number of long-term mobile phone users, and the authors conclude that the data do not support the hypothesis that mobile phone use is related to an increased risk of glioma or meningioma.
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