| 1. |
- Oudin, Anna, et al.
(författare)
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The association between daily concentrations of air pollution and visits to a psychiatric emergency unit: a case-crossover study
- 2018
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Ingår i: Environmental Health. - : Springer Science and Business Media LLC. - 1476-069X. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Air pollution is one of the leading causes of mortality and morbidity worldwide. Experimental studies, and a few epidemiological studies, suggest that air pollution may cause acute exacerbation of psychiatric disorders, and even increase the rate of suicide attempts, but epidemiological studies on air pollution in association with psychiatric disorders are still few. Our aim was to investigate associations between daily fluctuations in air pollution concentrations and the daily number of visits to a psychiatric emergency unit. Methods: Data from Sahlgrenska University Hospital, Gothenburg, Sweden, on the daily number of visits to the Psychiatric emergency unit were combined with daily data on monitored concentrations of respirable particulate matter(PM10), ozone(O-3), nitrogen dioxides(NO2) and temperature between 1st July 2012 and 31st December 2016. We used a case-crossover design to analyze data with conditional Poisson regression models allowing for over-dispersion. We stratified data on season. Results: Visits increased with increasing PM10 levels during the warmer season (April to September) in both single-pollutant and two-pollutant models. For example, an increase of 3.6% (95% Confidence Interval, CI, 0.4-7.0%) was observed with a 10 mu g/m(3) increase in PM10 adjusted for NO2. In the three-pollutant models (adjusting for NO2 and O-3 simultaneously) the increase was 3.3% (95% CI, -0.2-6.9). There were no clear associations between the outcome and NO2, O-3, or PM10 during the colder season (October to March). Conclusions: Ambient air particle concentrations were associated with the number of visits to the Psychiatric emergency unit in the warm season. The results were only borderline statistically significant in the fully adjusted (three-pollutant) models in this small study. The observation could be interpreted as indicative of air pollution as either exacerbating an underlying psychiatric disorder, or increasing mental distress, even in areas with comparatively low levels of air pollution. In combination with the severe impact of psychiatric disorders and mental distress on society and individuals, our results are a strong warrant for future research in this area.
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| 2. |
- Oudin Åström, Daniel, et al.
(författare)
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High Summer Temperatures and Mortality in Estonia
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: On-going climate change is predicted to result in a growing number of extreme weather events-such as heat waves-throughout Europe. The effect of high temperatures and heat waves are already having an important impact on public health in terms of increased mortality, but studies from an Estonian setting are almost entirely missing. We investigated mortality in relation to high summer temperatures and the time course of mortality in a coastal and inland region of Estonia.METHODS: We collected daily mortality data and daily maximum temperature for a coastal and an inland region of Estonia. We applied a distributed lag non-linear model to investigate heat related mortality and the time course of mortality in Estonia.RESULTS: We found an immediate increase in mortality associated with temperatures exceeding the 75th percentile of summer maximum temperatures, corresponding to approximately 23°C. This increase lasted for a couple of days in both regions. The total effect of elevated temperatures was not lessened by significant mortality displacement.DISCUSSION: We observed significantly increased mortality in Estonia, both on a country level as well as for a coastal region and an inland region with a more continental climate. Heat related mortality was higher in the inland region as compared to the coastal region, however, no statistically significant differences were observed. The lower risks in coastal areas could be due to lower maximum temperatures and cooling effects of the sea, but also better socioeconomic condition. Our results suggest that region specific estimates of the impacts of temperature extremes on mortality are needed.
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| 3. |
- Taj, Tahir, et al.
(författare)
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Short-Term Associations between Air Pollution Concentrations and Respiratory Health-Comparing Primary Health Care Visits, Hospital Admissions, and Emergency Department Visits in a Multi-Municipality Study
- 2017
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 14:6
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Tidskriftsartikel (refereegranskat)abstract
- Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 mu g/m(3) increase in nitrogen dioxide (NO2) levels in Malmo, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 mu g/m(3) increase in PM10). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area.
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| 4. |
- Gasparrini, Antonio, et al.
(författare)
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Projections of temperature-related excess mortality under climate change scenarios
- 2017
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Ingår i: The Lancet Planetary Health. - 2542-5196. ; 1:9, s. e360-e367
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Tidskriftsartikel (refereegranskat)abstract
- Background: Climate change can directly affect human health by varying exposure to non-optimal outdoor temperature. However, evidence on this direct impact at a global scale is limited, mainly due to issues in modelling and projecting complex and highly heterogeneous epidemiological relationships across different populations and climates.Methods: We collected observed daily time series of mean temperature and mortality counts for all causes or non-external causes only, in periods ranging from Jan 1, 1984, to Dec 31, 2015, from various locations across the globe through the Multi-Country Multi-City Collaborative Research Network. We estimated temperature-mortality relationships through a two-stage time series design. We generated current and future daily mean temperature series under four scenarios of climate change, determined by varying trajectories of greenhouse gas emissions, using five general circulation models. We projected excess mortality for cold and heat and their net change in 1990-2099 under each scenario of climate change, assuming no adaptation or population changes.Findings: Our dataset comprised 451 locations in 23 countries across nine regions of the world, including 85 879 895 deaths. Results indicate, on average, a net increase in temperature-related excess mortality under high-emission scenarios, although with important geographical differences. In temperate areas such as northern Europe, east Asia, and Australia, the less intense warming and large decrease in cold-related excess would induce a null or marginally negative net effect, with the net change in 2090-99 compared with 2010-19 ranging from -1·2% (empirical 95% CI -3·6 to 1·4) in Australia to -0·1% (-2·1 to 1·6) in east Asia under the highest emission scenario, although the decreasing trends would reverse during the course of the century. Conversely, warmer regions, such as the central and southern parts of America or Europe, and especially southeast Asia, would experience a sharp surge in heat-related impacts and extremely large net increases, with the net change at the end of the century ranging from 3·0% (-3·0 to 9·3) in Central America to 12·7% (-4·7 to 28·1) in southeast Asia under the highest emission scenario. Most of the health effects directly due to temperature increase could be avoided under scenarios involving mitigation strategies to limit emissions and further warming of the planet.Interpretation: This study shows the negative health impacts of climate change that, under high-emission scenarios, would disproportionately affect warmer and poorer regions of the world. Comparison with lower emission scenarios emphasises the importance of mitigation policies for limiting global warming and reducing the associated health risks.
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| 5. |
- Norén, Erika, et al.
(författare)
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Tidstrender för urinhalter av bekämpningsmedelsrester hos unga män – Resultat från fyra undersökningar mellan 2000 - 2013
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The increased use of synthetic chemicals in society poses possible harmful risks for the environment and human health. There are difficulties in predicting and evaluating consequences and effects of long-time exposure of different chemicals. Biomonitoring is one way to observe the level of exposure in the human population.Agricultural pesticides are a widely used group of chemicals to which we are mainly exposed by occupation or by diet. Long-term exposure to pesticides might have a negative impact on human health, especially in children and foetuses, due to genotoxic, neurotoxic and endocrine disrupting characteristics of many pesticides.This study focuses on the exposure assessment of 14 different metabolites from about 20 pesticides in urinary samples. The pesticides and their biomarkers of exposure included in the analysis were the fungicides thiabendazole (OH-T), pyrimetanil (OH-P), tebuconazole (TEB-OH), mancozeb and several ethylenebisdithiocarbamates (ETU), propineb (PTU), the insecticides chlorpyrifos (TCP), some pyrethroid insecticides, which have the same corresponding biomarkers (3-PBA, DCCA), and some specific pyrethroid biomarkers (4F-3-PBA, CFCA), the herbicides 2,4-dichlorophenoxyacetic acid (2,4-D) and 2-methyl-4-chlorophenoxyacetic acid (MCPA) and the growth regulators chlormequat (CCC) and mepiquat (MQ). The samples were collected years 2000, 2004, 2009 and 2013 from young men in the enrolment for military service in the south of Sweden. The last year of measurement (2013) both young men and women in upper secondary school were included. All samples were analysed in 2016 with liquid chromatography-tandem mass spectrometry (LC/MS/MS). The emphasis of the statistical analysis was temporal trends between the years 2000 and 2013.The highest concentrations were found for TCP and CCC in all samples from all four years. In general, the concentrations were below the levels seen in previous studies of other Swedish populations.The only increasing trend near significance was that for TCP, although the increasing gradient was fairly low ( = 0,28). The concentrations of CCC decreased over the years, but not statistically significantly so. The biomarkers 3-PBA, 2,4-D, DCCA and MQ were detected above the limit of detection (LOD), but in fairly low concentrations in the majority of samples and without significant trends. The remaining residues were mainly below the LOD and could not be further statistically analysed.
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| 6. |
- Oudin Åström, Daniel, et al.
(författare)
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Attributing mortality from extreme temperatures to climate change in Stockholm, Sweden
- 2013
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Ingår i: Nature Climate Change. - : Nature Publishing Group. - 1758-678X .- 1758-6798. ; 3:12, s. 1050-1054
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Tidskriftsartikel (refereegranskat)abstract
- A changing climate is increasing the frequency, intensity, duration and spatial extent of heat waves. These changes are associated with increased human mortality during heat extremes. At the other end of the temperature scale, it has been widely speculated that cold-related mortality could decrease in a warmer world. We aim to answer a key question; the extent to which mortality due to temperature extremes in Stockholm, Sweden during 1980–2009 can be attributed to climate change that has occurred since our reference period (1900–1929). Mortality from heat extremes in 1980–2009 was double what would have occurred without climate change. Although temperature shifted towards warmer temperatures in the winter season, cold extremes occurred more frequently, contributing to a small increase of mortality during the winter months. No evidence was found for adaptation over 1980–2009.
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