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- Fredriksson, Sofie, 1983, et al.
(författare)
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Preschool teachers have an increased risk of hearing-related symptoms and report more occupational noise exposure compared to randomly selected women
- 2016
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Ingår i: Occupational Health: Think Globally, Act Locally, EPICOH 2016, September 4–7, 2016, Barcelona, Spain. Occupational & Environmental Medicine. ; 73:A191
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Noise-induced hearing disorder has been thoroughly studied among workers in industry-like settings, but less so in female-dominated occupations. In Sweden, noise-related occupational disease among women are reported most frequently in the education sector. We analysed questionnaires from 4,932 women with preschool teacher’s degree who have worked in preschool compared to 5,065 randomly selected women without preschool work-history (response rate 51% vs. 38%). The age range was 24–71 in both cohorts (mean 46 [SD 11] among preschool teachers and 51 [11] among controls). Prevalence and prevalence ratio in age-strata and Mantel-Haenszel pooled risk were calculated for hearing-related symptoms. Noise exposure was compared between the cohorts. A 5% level of significance was applied. Occupational noise exposure and noise annoyance were significantly more common among teachers than controls: 75% vs.31% and 69% vs.26%, respectively. Still, significantly fewer teachers used hearing protection: 3% vs. 4%. Prevalence of hearing-related symptoms was much higher among teachers than controls: sound-induced auditory fatigue (71% [95% CI: 70–72] vs. 31% [30–32]), difficulty perceiving speech (46% [45–47] vs. 26% [25–27] and hyperacusis (38% [37–39] vs. 18% [17–19] and slightly higher for hearing loss (19% [18–20] vs. 17% [6–18] and tinnitus (19% [18–20] vs. 15% [14–16]. Teachers had a twofold risk of sound-induced auditory fatigue (PR-MH 2.2 [95% CI: 2.1–2.3] and hyperacusis (PR-MH 2.1 [1.9–2.2] compared to controls, when adjusted for age. The risk was also increased for difficulty perceiving speech (PR-MH 1.8 [1.7–1.9], tinnitus (PR-MH 1.4 [1.3–1.6] and hearing loss (PR-MH 1.4 [1.3–1.5]. Mean age of onset was significantly lower among teachers for all symptoms, except for hyperacusis (p = 0.902). Leisure-noise was significantly more common among controls. Family history of hearing loss did not differ (p = 0.411). The study is the first to show that preschool teachers have an increased risk of hearing-related symptoms, which may be caused by the work environment.
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Försäkringsmedicin
- 2013. - 1
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Boken beskriver centrala försäkringsmedicinska begrepp ur ett både principiellt och kritiskt perspektiv samt ger en överblick över gällande regelverk. I boken framgår hur personförsäkringar utvecklats med tonvikt på svenska förhållanden men här finns även en jämförelse med andra närliggande länder. Försäkringsmedicinens medicinska och juridiska bedömningar belyses liksom dess kopplingar till juridiken och särskilt till skadeståndsrätten. Försäkringarnas innehåll och hur enskilda ärenden handläggs har förändrats varför flera områden, särskilt inom socialförsäkringen, är föremål för diskussion. Boken innehåller en kritisk analys av vissa sådana aspekter, bl.a. olika etiska perspektiv. Regelverken förändras i snabb takt och aktuella regler hämtas i dag framför allt via webben. Boken innehåller de viktigaste reglerna, framför allt inom socialförsäkringen, på en övergripande nivå.Syftet är att ge läsaren en fördjupad förståelse för de medicinska och juridiska principer som är centrala inom försäkringsmedicinen. Den innehåller också en övergripande beskrivning av gällande regelverk i Sverige och vissa andra länder.Boken vänder sig till personer som behöver en fördjupad förståelse för försäkringsmedicinska frågor, t.ex. läkare och annan sjukvårdspersonal, jurister och handläggare av personförsäkringar.
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- Gustafson, Torbjörn, 1953-
(författare)
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Causes and treatment of chronic respiratory failure : experience of a national register
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Long-term oxygen therapy (LTOT) or home mechanical ventilation (HMV) can improve survival time in chronic respiratory failure. A national quality register could be an aid to identifying risk markers and optimizing therapy for respiratory failure. Aims: ▪To identify risk markers for chronic respiratory failure, especially when triggered by chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF). ▪To predict sex-related differences in the future need of LTOT for COPD and to study sex related survival rate in COPD patients starting LTOT. ▪To investigate if HMV is more effective than LTOT alone in treating chronic respiratory failure caused by kyphoscoliosis. ▪To evaluate the use of quality indicators in LTOT. Methods: Swedish national registers for LTOT and HMV were established in 1987 and 1996 respectively. They were reconstructed in 2004 to form the web-based register Swedevox. Indications for LTOT were based on the guidelines from the Swedish Society for Respiratory Medicine. The incidence and prevalence of LTOT for COPD were measured annually from 1987 to 2000, and the future need for LTOT was estimated on the basis of the frequency of ever smoking in Sweden in 2001 in different age groups. A postal questionnaire on occupational exposures was completed by 181 patients with severe pulmonary fibrosis who started LTOT between 1997 and 2000, and by 757 controls. Odds ratios (ORs) were calculated. Time to death was evaluated in kyphoscoliotic patients starting HMV or LTOT alone in 1996-2004. Ten quality indicators were defined and evaluated based on data from patients starting LTOT in 1987-2005. Results: The incidence each year of LTOT in COPD patients increased more rapidly in women than in men (from 2.0 and 2.8/100,000 in 1987 to 7.6 and 7.1/100,000 in 2000 respectively, (p < 0.001)). Women ran a 1.9 times higher risk than men to develop chronic hypoxemia from COPD and had a higher survival rate during LTOT. In men, IPF was associated with exposure to birch dust with an OR 2.7, (95% confidence interval (CI) 1.30–5.65) and with hardwood dust, OR 2.7 (95% CI 1.14–6.52). Patients with kyphoscoliosis showed a better survival rate with HMV than with LTOT alone with a hazard ratio of 0.30 (95%CI 0.18-0.51), adjusted for age, sex, concomitant respiratory diseases, and blood gas levels. There were improvements in the following eight quality indicators for LTOT: access to LTOT, PaO2 ≤ 7.3 kPa without oxygen, no current smoking, low number of thoracic deformity patients without concomitant HMV, LTOT > 16 hours of oxygen/day, mobile oxygen equipment, reassessment of hypoxemia when LTOT was not started in a stable state COPD, and avoidance of continuous oral steroids in COPD. There was a decline in the indicator PaO2 > 8 kPa on oxygen. First-year survival rate in COPD was unchanged. Conclusions: The incidence and prevalence of LTOT increase more rapidly in women than in men. Survival rate during LTOT in COPD is better in women than in men. Exposure to birch and hardwood dust may contribute to the risk of IPF in men. Survival rate in patients with kyphoscoliosis was three times better with HMV than with LTOT alone. The national quality register for LTOT showed improvements in eight out of ten quality indicators. Levels for excellent quality in the indicators are suggested.
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- Hagstrom, Emil, et al.
(författare)
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IMPACT OF BODY WEIGHT AT AGE 20 AND WEIGHT GAIN DURING ADULTHOOD ON MIDLIFE CORONARY ARTERY CALCIUM IN 15,000 MEN AND WOMEN : AN INTERIM ANALYSIS OF THE SWEDISH CARDIOPULMONARY BIOIMAGE STUDY
- 2019
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Ingår i: Journal of the American College of Cardiology. - : ELSEVIER SCIENCE INC. - 0735-1097 .- 1558-3597. ; 73:9, s. 1692-1692
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundElevated body weight in adolescence is strongly associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, or to weight gain with subsequent high adult weight is not known. Using data from the Swedish CArdioPulmonary bioImage Study (SCAPIS), we investigated the association between weight at age 20, weight gain to midlife and coronary artery calcium score (CACS) at midlife.MethodsIn the first 15,810 participants in SCAPIS (mean age 58 years, 52% women), data on CACS at midlife, self-reported body weight at age 20 and weight at examination in SCAPIS were recorded.ResultsCACS in midlife was significantly higher with increasing weight at age 20 (p<0.001 for both sexes), and then increased with weight gain until midlife at all levels of body weight at age 20 after adjusting for age, height, smoking, alcohol intake, education level, exercise levels and LDL cholesterol. However, the association with weight gain was only significant in men (p = 0.047), not in women (p=0.474). No significant interaction was seen between weight at age 20 and midlife weight with CACS. The effect of weight at age 20 on CACS was significantly more marked in men than in women, as was the effect of weight gain (p<0.001 for both interactions).ConclusionWeight at age 20 and weight gain to midlife were both related to CACS, but much more markedly so in men than in women, indicating a generally larger effect of both early adult weight and further weight gain until midlife on CACS in men, compared to women.
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- Holm, Mathias, 1969, et al.
(författare)
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Acute effects after occupational endotoxin exposure at a spa.
- 2009
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Ingår i: Scandinavian journal of work, environment & health. - 0355-3140. ; 35:2, s. 153-5
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVES: Two spa workers reported such symptoms as fever, shivering, palpitation, arthralgia, and diarrhea after performing seaweed massages on clients at a spa center. This study was carried out to determine whether the symptoms were related to exposure to endotoxin. METHODS: Personal and stationary air sampling for the measurement of airborne endotoxin was carried out at the spa during the preparation of a bath and the following seaweed massage. In addition, the impact of storage time on the concentration of endotoxin in the seaweed was investigated. RESULTS: The measurements confirmed exposure to aerosolized endotoxin at the spa (11 ng/m (2)and 22 ng/m (3)). The endotoxin concentration in the stored seaweed increased as the storage time increased, from 360 ng/g seaweed for fresh seaweed to 33100 ng/g seaweed for seaweed stored for >20 weeks. CONCLUSIONS: Organic dust toxic syndrome was diagnosed for two workers who performed seaweed massages at a spa center at which aerosolized endotoxin was measured. In order to minimize entotoxin exposure during massages, it is important to use fresh seaweed or seaweed kept well cooled for no more than 2-3 weeks.
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