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Sökning: WFRF:(Rönmark E)

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  • Rönmark, E, et al. (författare)
  • Factors related to tobacco use among teenagers.
  • 2007
  • Ingår i: Respiratory medicine. - 0954-6111. ; 101:3, s. 496-502
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To examine tobacco use among teenagers, identify factors related to tobacco use, as well as evaluate the outcome of a smoking prevention program.METHODS: From age 7/8 to 14/15, annual questionnaires about asthma and allergy have been completed in the OLIN paediatric study in Northern Sweden. From 12/13 years, questions about tobacco use, i.e. smoking and snuff, were added. A smoking prevention program was performed during 2 years.RESULTS: Any tobacco use increased from 5.0% at age 12/13 years, to 14.4% at age 14/15. At age 14/15 years, the prevalence of tobacco use was significantly higher among boys than girls (16.7 and 12.0%, respectively). More girls than boys smoked (8.9 and 2.8%, respectively), while use of snuff was more common among the boys (15.6 and 4.2%, respectively). Significant risk factors for smoking were any of the family members currently smoking, OR 6.1 (95% CI 4.0-9.3) and a physician-diagnosed asthma at the age of 14/15 years, OR 1.9 (95% CI 1.2-3.0). A protective factor against tobacco use was participation in sports, OR 0.3 (95% CI 0.2-0.4). The prevention program did not result in less tobacco use, although it may have delayed smoking initiation.CONCLUSION: The patterns of tobacco use differed significantly between boys and girls. Though any tobacco use was more common among boys, girls were more likely to smoke, and boys were more likely to use snuff. Having asthma did not prevent the teenagers from smoking. Since having a smoking family member was the major risk factor for tobacco use, prevention programs should be directed at smoking families in addition to the individuals.
  • Andersson, Martin, et al. (författare)
  • Remission and Persistence of Asthma Followed From 7 to 19 Years of Age
  • 2013
  • Ingår i: Pediatrics. - 0031-4005. ; 132:2, s. 435-442
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND OBJECTIVE: To date, a limited number of population-based studies have prospectively evaluated the remission of childhood asthma. This work was intended to study the remission and persistence of childhood asthma and related factors. METHODS: In 1996, a questionnaire was distributed to the parents of all children aged 7 to 8 years in 3 municipalities in northern Sweden, and 3430 (97%) participated. After a validation study, 248 children were identified as having asthma; these children were reassessed annually until age 19 years when 205 (83%) remained. During the follow-up period lung function, bronchial challenge testing, and skin prick tests were performed. Remission was defined as no use of asthma medication and no wheeze during the past 12 months as reported at endpoint and in the 2 annual surveys preceding endpoint (ie, for >= 3 years). RESULTS: At age 19 years, 21% were in remission, 38% had periodic asthma, and 41% persistent asthma. Remission was more common among boys. Sensitization to furred animals and a more severe asthma (asthma score >= 2) at age 7 to 8 years were both inversely associated with remission, odds ratio 0.14 (95% confidence interval 0.04-0.55) and 0.19 (0.07-0.54), respectively. Among children with these 2 characteristics, 82% had persistent asthma during adolescence. Asthma heredity, damp housing, rural living, and smoking were not associated with remission. CONCLUSIONS: The probability of remission of childhood asthma from age 7- to 8-years to age 19 years was largely determined by sensitization status, particularly sensitization to animals, asthma severity, and female gender, factors all inversely related to remission.
  • Commins, Scott P, et al. (författare)
  • Galactose-α-1,3-galactose-specific IgE is associated with anaphylaxis but not asthma.
  • 2012
  • Ingår i: American journal of respiratory and critical care medicine. - 1535-4970. ; 185:7, s. 723
  • Tidskriftsartikel (refereegranskat)abstract
    • IgE antibodies to the mammalian oligosaccharide galactose-α-1,3-galactose (α-gal) are common in the southeastern United States. These antibodies, which are induced by ectoparasitic ticks, can give rise to positive skin tests or serum assays with cat extract.
  • Cornmins, Scott P., et al. (författare)
  • Galactose-alpha-1,3-Galactose-Specific IgE Is Associated with Anaphylaxis but Not Asthma
  • 2012
  • Ingår i: American Journal of Respiratory and Critical Care Medicine. - 1073-449X. ; 185:7, s. 723-730
  • Tidskriftsartikel (refereegranskat)abstract
    • Rationale: IgE antibodies to the mammalian oligosaccharide galactose-alpha-1,3-galactose (alpha-gal) are common in the southeastern United States. These antibodies, which are induced by ectoparasitic ticks, can give rise to positive skin tests or serum assays with cat extract. Objectives: To evaluate the relationship between IgE antibodies to alpha-gal and asthma, and compare this with the relationship between asthma and IgE antibodies to Fel d 1 and other protein allergens. Methods: Patients being investigated for recurrent anaphylaxis, angioedema, or acute urticaria underwent spirometry, exhaled nitric oxide, questionnaires, and serum IgE antibody assays. The results were compared with control subjects and cohorts from the emergency department in Virginia (n = 130), northern Sweden (n = 963), and rural Kenya (n = 131). Measurements and Main Results: Patients in Virginia with high-titer IgE antibodies to a-gal had normal lung function, low levels of exhaled nitric oxide, and low prevalence of asthma symptoms. Among patients in the emergency department and children in Kenya, there was no association between IgE antibodies to a-gal and asthma (odds ratios, 1.04 and 0.75, respectively). In Sweden, IgE antibodies to cat were closely correlated with IgE antibodies to Fel d 1 (r = 0.83) and to asthma (P < 0.001). Conclusions: These results provide a model of an ectoparasite-induced specific IgE response that can increase total serum IgE without creating a risk for asthma, and further evidence that the main allergens that are causally related to asthma are those that are inhaled.
  • Gerdtham, Ulf, et al. (författare)
  • Factors affecting chronic obstructive pulmonary disease (COPD)-related costs:
  • 2009
  • Ingår i: The European journal of health economics : HEPAC : health economics in prevention and care. - 1618-7598. ; 10:2, s. 217-26
  • Tidskriftsartikel (refereegranskat)abstract
    • Chronic obstructive pulmonary disease (COPD) is an increasing public health problem, generating considerable costs. The objective of this study was to identify factors affecting COPD-related costs. A cohort of 179 subjects with COPD was interviewed over the telephone on four occasions about their annual use of COPD-related resources. The data set and explanatory variables were analysed by means of multivariate regression techniques for six different types of cost: societal (or total), direct (health care) and indirect (productivity), and three subcomponents of direct costs-hospitalisation, outpatient and medication. Poor lung function, dyspnoea and asthma were independently associated with higher costs. Poor lung function (severity of COPD) significantly increased all six examined cost types. Dyspnoea (breathing problems) also increased costs, though to a varying extent. The presence of reported asthma increased total, direct, outpatient and medication costs. Poor lung function and, to a lesser extent, extent of dyspnoea and concomitant asthma, were all strongly associated with higher COPD-related costs. Strong efforts should be made to prevent the progression of COPD and its symptoms.
  • Hagstad, Stig, et al. (författare)
  • COPD among non-smokers - Report from the Obstructive Lung Disease in Northern Sweden (OLIN) studies
  • 2012
  • Ingår i: Respiratory Medicine. - 0954-6111. ; 106:7, s. 980-988
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In westernized countries smoking and increasing age are the most important risk factors for COPD. Prevalence and risk factors of COPD among non-smokers are not well studied. Aim: To study the prevalence and risk factors of COPD among non-smokers and to determine the proportion of non-smokers among subjects with COPD. Methods: A random sample of 2470 subjects drawn from a population-based postal survey of 10,040 (85-88% participation) adults (aged 20-77) in Norrbotten, Sweden, were invited to structured interviews and lung function tests, and 1897 participated. COPD was classified using the fixed ratio (GOLD) definition and for comparison the lower limit of normal (LLN). Results: The prevalence of airway obstruction was 6.9% among non-smokers and strongly age related. The prevalence of GOLD stage >= II among non-smokers was 15%. Both among subjects with airway obstruction and among subjects with GOLD stage >= II, the proportions of nonsmokers were 20%. Of men with airway obstruction, 14.1% were non-smokers versus 26.8% among women. Non-smokers with GOLD stage >= II had significantly more symptoms and higher co-morbidity than non-smokers without airway obstruction. Sex, area of domicile and exposure to environmental tobacco smoke was not significantly associated to airway obstruction among non-smokers. Using LLN for defining airway obstruction yielded a similar prevalence. Conclusion: The prevalence of airway obstruction among non-smokers was close to 7% and was associated with increasing age. One out of seven men with airway obstruction, defined using the fixed ratio, versus one out of four women had never smoked. (C) 2012 Elsevier Ltd. All rights reserved.
  • Hagstad, Stig, et al. (författare)
  • Passive Smoking Exposure Is Associated With Increased Risk of COPD in Never Smokers
  • 2014
  • Ingår i: Chest. - 0012-3692. ; 145:6, s. 1298-1304
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND Passive smoking, or environmental tobacco smoke (ETS), is a risk factor for lung cancer, cardiovascular disease and childhood asthma, but a relationship with COPD has not been fully established.AIM To study ETS as a risk factor for COPD in never-smokers.METHODS Data from three cross-sectional studies within the Obstructive Lung Disesease in Northern Sweden (OLIN) database were pooled. Of the 2182 lifelong never-smokers 2118 completed structured interviews and spirometry of acceptable quality. COPD was defined according to the GOLD criteria using post-bronchodilator spirometry. The association of COPD with ETS in single and multiple settings was calculated by multivariate logistic regression adjusting for known risk factors for COPD.RESULTS COPD prevalence was associated with increased ETS exposure: 4.2% (no ETS), 8.0% (ETS ever at home), 8.3% (ETS at previous work) and 14.7% (ETS ever at home and at both previous and current work), test for trend p=0.003. Exclusion of subjects aged ≥65 years and subjects reporting asthma yielded similar results. ETS in multiple settings, such as ever at home and at both previous and current work was strongly associated to COPD, OR 3.80 (95% CI 1.29-11.2).CONCLUSIONS In this population-based sample of never-smokers, ETS was independently associated with COPD. The association was stronger for ETS in multiple settings. ETS in multiple settings was, after age, the strongest risk factor for COPD and comparable to personal smoking of up to 14 cigarettes/day in comparable materials. The findings strongly advocate measures against smoking in public places.
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