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| 2. |
- Oudin, Anna, et al.
(författare)
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Air pollution and stroke
- 2012
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Ingår i: Epidemiology. - : Wolters Kluwer. - 1044-3983 .- 1531-5487. ; 23:3, s. 505-506
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Tidskriftsartikel (refereegranskat)
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| 3. |
- Oudin, Anna, et al.
(författare)
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Estimation of Short-Term Effects of Air Pollution on Stroke Hospital Admissions in Southern Sweden.
- 2010
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Ingår i: Neuroepidemiology. - : S. Karger AG. - 1423-0208 .- 0251-5350. ; 34:3, s. 131-142
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Tidskriftsartikel (refereegranskat)abstract
- Background: Short-term exposure to high levels of air pollution can increase stroke risk. In this study we investigated the short-term effects of air pollution on hospital admissions for stroke in a setting where pollutant levels are rather low. We also addressed methodological issues in evaluating the short-term effects of air pollution. Methods: Daily admissions of ischemic (n = 11,267) and hemorrhagic (n = 1,681) stroke were obtained from a Swedish quality register for stroke, Riks-Stroke. We used two types of exposure data: (1) daily measured background levels of ozone, temperature and particles with a diameter <10 mum (PM(10)) and (2) modeled levels of a mixture of NO and NO(2) (NO(x)) at the residential address of each individual. Results: We estimated a 13% (95% confidence interval, 4-22%) increased risk for hospital admissions for ischemic stroke for levels of PM(10) above 30 mug/m(3) compared to <15 mug/m(3), whereas temperature above 16 degrees C decreased the risk. No consistent associations were found for hemorrhagic stroke or for ischemic stroke and ozone or NO(x). Conclusion: Particulate air pollution and temperature seemed to be associated with ischemic stroke hospital admissions. Individual exposure modeling facilitates a detailed exposure assessment but may also be more prone to misclassification errors. The time series and case crossover approaches yielded similar effect estimates.
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| 4. |
- Oudin, Anna, et al.
(författare)
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Hospital admissions for ischemic stroke : does long-term exposure to air pollution interact with major risk factors?
- 2011
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Ingår i: Cerebrovascular Diseases. - : S. Karger. - 1015-9770 .- 1421-9786. ; 31:3, s. 284-293
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim was to investigate whether the effects of major risk factors for ischemic stroke were modified by long-term exposure to air pollution in Scania, southern Sweden.Methods: Cases were defined as first-ever ischemic strokes in patients born between 1923 and 1965 during 2001-2006 (n = 7,244). Data were collected from The Swedish National Stroke Register (Riks-stroke) and the Malmö and Lund Stroke Registers. Population controls were matched on age and sex. Modeled outdoor annual mean NO(x) concentrations were used as proxy for long-term exposure to air pollution. Heterogeneity across NO(x) categories was tested for smoking, hypertension, diabetes mellitus, atrial fibrillation and physical inactivity. Data were analyzed as case-control data and to some extent as case-only data, with logistic regression analysis.Results: The case-control odds ratios for ischemic stroke in association with diabetes were 1.3 [95% confidence interval (CI): 1.1-1.6] and 2.0 (95% CI: 1.2-3.4) in the lowest and highest NO(x) category, respectively (p value for testing heterogeneity across the categories = 0.056). The case-only approach gave further support for the risk associated with diabetes to increase with NO(x) (p for trend = 0.033). We observed no main effect of mean NO(x) or any conclusive effect modifications between NO(x) and smoking, hypertension, atrial fibrillation or physical inactivity.Conclusions: In a low-level air pollution area, the risk for ischemic stroke associated with diabetes seemed to increase with long-term exposure to air pollution.
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| 5. |
- Oudin, Anna, et al.
(författare)
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Long-term exposure to air pollution and hospital admissions for ischemic stroke. A register-based case-control study using modelled NOx as exposure proxy
- 2009
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Long-term exposure to air pollution is a hypothesized risk factor for ischemic stroke. In a large case-control study with a complete study base, we investigated whether hospital admissions for ischemic stroke were associated with residential concentrations of outdoor NOx, as a proxy for exposure to air pollution, in the region of Scania, Southern Sweden. Methods: We used a two-phase case-control study design, including as first-phase controls all individuals born between 1923 and 1965 and residing in Scania in 2002 (N=556 912). We defined first-phase cases as first-time ischemic stroke patients residing in Scania and registered in the Swedish stroke register between 2001 and 2005 (N=4 904) and second-phase cases as cases for whom we had information on smoking status, diabetes, and medication for hypertension (N=4 375). For the controls, information on these covariables was collected from a public health survey, resulting in 4 716 second-phase controls. With a geographical information system and an emission database, individual residential outdoor annual mean NOx concentration was modelled. The data were analyzed with logistic regression. Results: We found no evident association between NOx and ischemic stroke. For example, the odds ratio for ischemic stroke associated with the NOx category 20-30 mu g/m(3) compared to the reference category of <10 mu g/m(3) was 0.95 (95% CI 0.86-1.06). Conclusion: In this study area, with generally low levels of air pollution, using a complete study base, high-quality ascertainment of cases, and individually modelled exposure, we did not observe any clear association between NOx and ischemic stroke hospital admissions.
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| 8. |
- Oudin, Anna, et al.
(författare)
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Poor housing conditions in association with child health in a disadvantaged immigrant population : a cross-sectional study in Rosengård, Malmö, Sweden
- 2016
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe the home environment in terms of housing conditions and their association with child health in a disadvantaged immigrant population.DESIGN: A cross-sectional observational study.SETTING: Enrolment took place during 2010-2011 in Rosengård, Malmö, Sweden.PARTICIPANTS: Children aged 0-13 years in 2 study neighbourhoods were recruited from local health records and from schools. 359 children participated, with a participation rate of 40%. Data on health, lifestyle and apartment characteristics from questionnaire-led interviews with the mothers of the children were obtained together with data from home inspections carried out by trained health communicators.OUTCOME MEASURES: Logistic regression analysis was used to estimate ORs for various health outcomes, adjusted for demographic information and lifestyle factors.RESULTS: The housing conditions were very poor, especially in one of the study neighbourhoods where 67% of the apartments had been sanitised of cockroaches, 27% were infested with cockroaches and 40% had a visible mould. The association between housing conditions and health was mostly inconclusive, but there were statistically significant associations between current asthma and dampness (OR=4.1, 95% CI 1.7 to 9.9), between asthma medication and dampness (OR=2.8, 95% CI 1.2 to 6.4), and between mould and headache (OR=4.2, 95% CI 1.2 to 14.8). The presence of cockroaches was associated with emergency care visits, with colds, with headache and with difficulty falling asleep, and worse general health was associated with mould and presence of cockroaches.CONCLUSIONS: The associations between dampness and asthma, and the association between mould and headache, are in line with current knowledge. The presence of cockroaches seemed to be associated with various outcomes, including those related to mental well-being, which is less described in the literature. The results of the present study are hypothesis generating and provide strong incentives for future studies in this study population.
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| 9. |
- Richter, Jens C., et al.
(författare)
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An investigation of child health in relation to housing renovations for a disadvantaged immigrant population in Malmo, Sweden
- 2023
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 51:3, s. 472-482
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of the study was to describe child health in relation to housing renovations in more than 800 rental units, consisting of repairs of dilapidated kitchens and bathrooms, in the disadvantaged neighbourhood of Herrgarden in Rosengard, Malmo, Sweden. Methods: Data on housing conditions and self-reported health were collected during home visits to families living in Herrgarden (building renovations area) and a comparison area (neighbouring Tornrosen, with generally better housing conditions). At baseline, 130 families with 359 children participated, while 51 families with 127 children participated at follow-up. All data were collected between 2010 and 2012. Additionally, regional register data on health-care usage/in- and outpatient contacts within the public health-care system between 2008 and 2013 were also collected for all 8715 children registered as living in the two areas. Results: Self-reported health seemed to somewhat improve in both areas, with 74% versus 86% and 78% versus 88% reporting good or very good health in Herrgarden and in the comparison area at baseline and follow-up, respectively. In Herrgarden, crowdedness increased, while it decreased in the comparison area. The number of health-care contacts remained stable over time in Herrgarden, while it decreased in the comparison area. Conclusions: Partial housing renovations did not seem to result in clear health improvements as measured with the indicators used in the present study. This could possibly be due to persisting health effects due to increased crowdedness or persisting poor housing conditions, as only kitchens and bathrooms were renovated.
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| 10. |
- Richter, Jens, et al.
(författare)
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High burden of atopy in immigrant families in substandard apartments in Sweden - on the contribution of bad housing to poor health in vulnerable populations
- 2018
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Ingår i: World Allergy Organization Journal. - : Elsevier BV. - 1939-4551. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Atopic disorders are a global concern. Studies in migrant populations can illuminate the interplay of genetic and environmental factors. Exposures related to bad housing (indoor dampness, mould growth, crowding etc.) are likely to play a role in how socioeconomic inequalities can turn into health disparities for disadvantaged populations. The sizable immigrant population living in very poor-quality housing in Malmo, Sweden, became the focus of a cross-sectional study. Objective: To describe atopic disorders and sensitizations in a population living in substandard housing in Malmo, Sweden, with an emphasis on their relation to harmful exposures from the built environment. Methods: Families were recruited via identification of any children with symptomatic airway afflictions from health care records, and also asymptomatic children from school lists. Interviewer-led health questionnaire data and data from self-reports about living conditions were obtained together with data from home inspections carried out by health communicators. Families underwent skin prick tests (SPT) against common aeroallergens. Results: As could be expected from background demographic information, it turned out that we effectively studied an immigrant population inhabiting very precarious housing outside the center of Malmo. A total of 359 children from 130 families (total 650 participants) were included. Overall the prevalence of potentially harmful environmental exposures was high (signs of moisture or mould in more than 50% of apartments, indoor smoking in 37% of households). Atopic disorders were common among both adults and children. SPTs showed a spectrum of sensitizations consistent with unselected populations in Sweden. Paternal sensitization in the SPT was associated with higher risk of sensitization for offspring than maternal sensitization. Few statistically significant associations of atopic sensitization with studied environmental exposures were detected (for example objective signs of dampness /mould in bathrooms). There were marked discrepancies between asthma diagnoses obtained from the health records and parental reports of such diagnoses and treatment for their children. Conclusions: The atopic burden in this selected immigrant population was high, and results point to unmet medical needs. Health care systems caring for such populations need to be aware of their specific health needs; comprehensive asthma and allergy care should include consideration of harmful environmental exposures, adhering to the precautionary principle.
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