| 1. |
- Malinovschi, Andrei, 1978-, et al.
(författare)
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Assessment of Global Lung Function Initiative (GLI) reference equations for diffusing capacity in relation to respiratory burden in the Swedish CArdioPulmonary bioImage Study (SCAPIS)
- 2020
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Ingår i: European Respiratory Journal. - Lausanne, Switzerland : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 56:2
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Tidskriftsartikel (refereegranskat)abstract
- The Global Lung Function Initiative (GLI) has recently published international reference values for diffusing capacity of the lung for carbon monoxide (DLCO). Lower limit of normal (LLN), i.e. the 5th percentile, usually defines impaired DLCO. We examined if the GLI LLN for DLCO differs from the LLN in a Swedish population of healthy, never-smoking individuals and how any such differences affect identification of subjects with respiratory burden.Spirometry, DLCO, chest high-resolution computed tomography (HRCT) and questionnaires were obtained from the first 15 040 participants, aged 50–64 years, of the Swedish CArdioPulmonary bioImage Study (SCAPIS). Both GLI reference values and the lambda-mu-sigma (LMS) method were used to define the LLN in asymptomatic never-smokers without respiratory disease (n=4903, of which 2329 were women).Both the median and LLN for DLCO from SCAPIS were above the median and LLN from the GLI (p<0.05). The prevalence of DLCO DLCO >GLI LLN but DLCO >GLI LLN but versus 4.5%, p<0.001), chronic airflow limitation (8.5% versus 3.9%, p<0.001) and chronic bronchitis (8.3% versus 4.4%, p<0.01) than subjects (n=13 600) with normal DLCO (>GLI LLN and >SCAPIS LLN). No differences were found with regard to physician-diagnosed asthma.The GLI LLN for DLCO is lower than the estimated LLN in healthy, never-smoking, middle-aged Swedish adults. Individuals with DLCO above the GLI LLN but below the SCAPIS LLN had, to a larger extent, an increased respiratory burden. This suggests clinical implications for choosing an adequate LLN for studied populations.
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| 2. |
- Albin, Maria, et al.
(författare)
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Incidence of asthma in female Swedish hairdressers.
- 2002
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1470-7926 .- 1351-0711. ; 59:2, s. 119-23.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the risk of asthma in hairdressers. METHODS: The incidence of asthma was retrospectively estimated in a Swedish nationwide study including all female hairdressers certified from vocational schools from 1970 to 1995, and a stratified sample of women from the general population were referents. A postal questionnaire included questions on respiratory tract symptoms, atopy, smoking, working periods as a hairdresser, and number of specific hair treatments performed/week. Reported exposures were validated by occupational hygienists. Rate ratios of incidence (IRRs) of asthma were estimated by Poisson regression, adjusted for calendar year of observation, hay fever, smoking, and region of domicile. RESULTS: The crude incidences of asthma/1000 person-years were: 3.9 during active years as a hairdresser, 2.8 among the hairdressers when not working in the profession, and 3.1 among the referents. The corresponding IRR for being an active hairdresser compared with the referents was 1.3 (95% confidence interval (95% CI) 1.0 to 1.6). Moderate effects on risk of asthma were found both from hairdressing work (IRR=1.6 (1.1 to 2.2) among never-smokers) and from smoking (IRR=1.6 (1.2 to 2.2) among referents). However, the combined effect from hairdressing work and smoking (IRR=1.5 (1.0 to 2.1)) was less than expected (p=0.02). No effect modification by respiratory atopy was found. The hairdressers most often performing hair bleaching treatments (IRR=1.5 (0.7 to 3.0)) or using hair spray (IRR=1.4 (0.8 to 2.4)) had, compared with the most infrequent users, a slightly, but not significantly higher incidence of asthma. Exposure to persulphates in hair bleach was estimated to be 0.04-0.15 mg/m(3) during mixing of the powder. Reported average number of bleaching treatments agreed well with those performed according to a diary. CONCLUSIONS: Active hairdressing work was associated with a moderately increased incidence of asthma among lifelong non-smokers. The results are moderately supportive, but not conclusive, of associations between asthma and exposure to hair bleach or hair spray.
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| 3. |
- Bergström, Göran, 1964, et al.
(författare)
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Body weight at age 20 and in midlife is more important than weight gain for coronary atherosclerosis: Results from SCAPIS.
- 2023
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Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 373, s. 46-54
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Tidskriftsartikel (refereegranskat)abstract
- Elevated body weight in adolescence is associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, weight in midlife or to weight gain is not known. The aim of this study is to assess the risk of midlife coronary atherosclerosis being associated with body weight at age 20, body weight in midlife and body weight change.We used data from 25,181 participants with no previous myocardial infarction or cardiac procedure in the Swedish CArdioPulmonary bioImage Study (SCAPIS, mean age 57 years, 51% women). Data on coronary atherosclerosis, self-reported body weight at age 20 and measured midlife weight were recorded together with potential confounders and mediators. Coronary atherosclerosis was assessed using coronary computed tomography angiography (CCTA) and expressed as segment involvement score (SIS).The probability of having coronary atherosclerosis was markedly higher with increasing weight at age 20 and with mid-life weight (p < 0.001 for both sexes). However, weight increase from age 20 until mid-life was only modestly associated with coronary atherosclerosis. The association between weight gain and coronary atherosclerosis was mainly seen in men. However, no significant sex difference could be detected when adjusting for the 10-year delay in disease development in women.Similar in men and women, weight at age 20 and weight in midlife are strongly related to coronary atherosclerosis while weight increase from age 20 until midlife is only modestly related to coronary atherosclerosis.
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| 4. |
- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 5. |
- Bonde, Jens Peter Ellekilde, et al.
(författare)
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Occupational risk of COVID-19 related hospital admission in Denmark 2020–2021 : a follow-up study
- 2023
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 49:1, s. 84-94
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Mounting evidence indicates increased risk of COVID-19 among healthcare personnel, but the evidence on risks in other occupations is limited. In this study, we quantify the occupational risk of COVID-19-related hospital admission in Denmark during 2020-2021.Methods: The source population included 2.4 million employees age 20-69 years. All information was retrieved from public registers. The risk of COVID-19 related hospital admission was examined in 155 occupations with at least 2000 employees (at-risk, N=1 620 231) referenced to a group of mainly office workers defined by a COVID-19 job exposure matrix (N=369 341). Incidence rate ratios (IRR) were computed by Poisson regression.Results: During 186 million person-weeks of follow-up, we observed 2944 COVID-19 related hospital admissions in at-risk occupations and 559 in referents. Adjusted risk of such admission was elevated in several occupations within healthcare (including health care assistants, nurses, medical practitioners and laboratory technicians but not physiotherapists or midwives), social care (daycare assistants for children aged 4-7, and nursing aides in institutions and private homes, but not family daycare workers) and transportation (bus drivers, but not lorry drivers). Most IRR in these at-risk occupations were in the range of 1.5-3. Employees in education, retail sales and various service occupations seemed not to be at risk.Conclusion: Employees in several occupations within and outside healthcare are at substantially increased risk of COVID-19. There is a need to revisit safety measures and precautions to mitigate viral transmission in the workplace during the current and forthcoming pandemics.
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| 6. |
- Brisman, Jonas, 1954, et al.
(författare)
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The incidence of respiratory symptoms in female Swedish hairdressers
- 2003
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Ingår i: American Journal of Industrial Medicine. - : Wiley. - 0271-3586. ; 44:6, s. 673-8.
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Tidskriftsartikel (refereegranskat)abstract
- Background Airway diseases in hairdressers are a concern. The objective of this investigation is to evaluate the risk for three respiratory symptoms, wheeze, dry cough, and nasal blockage, in hairdressers. Methods A questionnaire on respiratory symptoms, atopy, smoking, and work history was answered by 3,957 female hairdressers and 4,905 women from the general population as referents. Incidence rates (IR) and incidence rate ratios (IRRs)for the three symptoms were estimated. Results The IRs of all three studied symptoms were higher in the hairdressers compared with the referents. Smoking modified the effects of cohort affiliationfor all threesymptoms; the combined effect from hairdressing work and smoking was less than expected. In addition, the effect of cohort affiliation for wheeze was also modified by atopy, and the effect of cohort affiliation for nasal blockage was also modified by calendar year. Conclusions Hairdressing work was associated with increased incidences of respiratory symptoms. Smoking had a negative modifying effect.
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| 7. |
- Carlsson, Linnea, et al.
(författare)
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Ever Smoking is Not Associated with Performed Spirometry while Occupational Exposure and Respiratory Symptoms are
- 2023
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Ingår i: International Journal of COPD. - 1176-9106. ; 18, s. 341-348
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Despite recommendations, assessment using spirometry or peak expiratory flow is insufficient in the clinical evaluation of suspected obstructive pulmonary disease. The aim was to investigate factors associated with performing spirometry or peak flow expiratory flow assessment. Methods: Randomly selected subjects from the general population aged 50–65 completed a respiratory questionnaire with items about the history of previously performed spirometry or peak expiratory flow. The association between ever having had spirometry or peak expiratory flow performed was analyzed for smoking, age, sex, occupational exposures, dyspnea, wheeze, self-reported physician diagnosed asthma and COPD using multivariable logistic regression models. The results are presented as odds ratios (OR) with 95% confidence intervals (95% CIs). Results: Of the 1105 participants, 43.4% (n=479) had a history of previously performed spirometry or peak expiratory flow. Occupational exposure (OR 1.72, [95% CI] 1.30–2.27), wheeze (OR 2.29, 1.41–3.70), and dyspnea (OR 1.70, 1.11–2.60) were associated with previously performed spirometry. Compared to men, women had spirometry or peak expiratory flow performed less often (OR 0.67, 0.51–0.86). Neither current smoking (OR 0.83, 0.57–1.20) or former smoking (OR 1.27, 0.96–1.67) were associated with performed spirometry or peak expiratory flow. Conclusion: We found no relation between smoking status and a history of previously performed spirometry or peak expiratory flow in a population-based sample of middle-aged people. This is surprising regarding the strong guidelines which highlight the importance for spirometry surveillance on current smokers due to their increased risk of lung disease. Male sex, respiratory symptoms and occupational exposures to air pollution were associated with previously performed spirometry or peak expiratory flow. The association with occupational exposure may be an effect of pre-employment screening and workplace surveillance, and the findings indicate that females do not receive the same attention regarding spirometry or peak expiratory flow.
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| 8. |
- Castenbrandt, Helene, et al.
(författare)
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Differences in Health: The Influence of Gender and Institutional Settings on Sickness Claims in Gothenburg, Sweden (1898-1950)
- 2020
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Ingår i: Social History of Medicine. - : Oxford University Press (OUP). - 0951-631X .- 1477-4666. ; 33:4, s. 1259-1281
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Tidskriftsartikel (refereegranskat)abstract
- Sickness funds information has given conflicting evidence on the evolution of morbidity during the mortality decline. Evidence on increased morbidity has been explained by an actual increase of morbidity, a cultural inflation of morbidity or changing institutional settings, however, morbidity rates have also been shown to be stable over time when age composition of members is controlled for. Most previous studies have been confined to data on men; however, in an earlier article, Castenbrandt found large gender differences in historical sick leave by using national statistics on both men and women. To move forward, this article aims to analyse trends in sickness claims during the mortality decline in the early twentieth century using individual level data from Swedish sickness funds covering the period 1898-1950. Concretely, we investigate gender differences in sickness claims (incidence and duration) and how institutional settings (member composition and fund-specific regulations) affected the sick leave patterns.
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| 9. |
- Ekström, Magnus, et al.
(författare)
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Absolute lung size and the sex difference in breathlessness in the general population
- 2018
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Ingår i: Plos One. - San Francisco, USA : Public Library of Science (PLoS). - 1932-6203. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Breathlessness is associated with major adverse health outcomes and is twice as common in women as men in the general population. We evaluated whether this is related to their lower absolute lung volumes. Cross-sectional analysis of the population-based Swedish CardioPulmonarybioImage Study (SCAPIS) Pilot, including static spirometry and diffusing capacity (n = 1,013; 49% women). Breathlessness was measured using the modified Medical Research Council (mMRC) scale and analyzed using ordinal logistic regression adjusting for age, pack-years of smoking, body mass index, chronic airway limitation, asthma, chronic bronchitis, depression and anxiety in all models. Breathlessness was twice as common in women as in men; adjusted odds ratio (OR) 2.20 (95% confidence interval, 1.32-3.66). Lower absolute lung volumes were associated with increased breathlessness prevalence in both men and women. The sex difference in breathlessness was unchanged when adjusting for lung function in %predicted, but disappeared when controlling for absolute values of total lung capacity (OR 1.12; 0.59-2.15), inspiratory capacity (OR 1.26; 0.68-2.35), forced vital capacity (OR 0.84; 0.42-1.66), forced expiratory volume in one second (OR 0.70; 0.36-1.35) or lung diffusing capacity (OR 1.07; 0.58-1.97). In the general population, the markedly higher prevalence of breathlessness in women is related to their smaller absolute lung volumes.
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| 10. |
- Ekström, Magnus, et al.
(författare)
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Effects of smoking, gender and occupational exposure on the risk of severe pulmonary fibrosis: A population-based case-control study
- 2014
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To estimate the effects of smoking, gender and occupational exposure on the risk of developing severe pulmonary fibrosis (PF), including dose-response and interaction effects. Methods: National case.control study of 171 patients (cases) who had started a long-term oxygen therapy for PF in Sweden between February 1997 and April 2000, and 719 random control participants from the general population. Of these cases, 137 had probable idiopathic PF (IPF). The ORs for smoking, gender and occupational exposure were estimated using Mantel-Haenszel analysis and conditional logistic regression, controlling for age and year of diagnosis. Results: The adverse effect of smoking was amplified by male gender and occupational exposure, OR 4.6 (95% CI 2.1 to 10.3) for PF, and OR 3.0 (1.3 to 6.5) for IPF, compared with in non-exposed women. Higher cumulative smoking exposure was linearly associated with increased risks. Compared with smoking less than 10 pack-years, smoking ≥20 pack-years was associated with increased risk of PF and IPF, OR 2.6 (1.4 to 4.9) and OR 2.5 (1.3 to 5.0), respectively. Conclusions: Smoking has a dose-related association with increased risk of severe PF. Men with a history of smoking and occupational exposure is a particular risk group for developing severe PF.
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