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| 2. |
- Bergkvist, Charlotte
(författare)
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Characterizing life-long human exposure to persistent environmental pollutants
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Humans are exposed to a variety of potentially harmful contaminants on a daily basis. Characterizing the exposure in different subgroups of the general population is important in order to protect public health sufficiently. The overall aim of this thesis was to refine human exposure assessment by applying different methodological approaches for characterizing the exposure to harmful contaminants such as polychlorinated biphenyls (PCBs), dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in different subgroups of the Swedish general population. We assessed the exposure to PCBs and PCDD/Fs in breastfed infants (up to 6 months of age), children and adolescents (1 – 24 year of age) and first-time mothers based on food consumption data (1989) and contaminant concentrations in food (1998 - 2004) and breast milk (2000 - 2006). A food concentration database was developed for the assessment of food frequency questionnaire (FFQ)-based PCB153 exposure in middle-aged and elderly women (born 1914 - 1948). Median exposure to PCBs and PCDD/Fs declined from 44 pg/kg body weight in 1 month old breastfed infants to less than 1.4 pg/kg body weight in adults 15 - 40 years of age. The proportion of individuals exceeding the current TDI of 2 pg TEQ/kg body weight decreased from 100% in infants and young children to less than 26% in adults. Mean exposure to PCBs and PCDD/Fs was comparable when using either the probabilistic or the deterministic approach, whereas the deterministic worst-case scenario estimate was up to 1.7 times higher than the probabilistic estimated 95th percentile. We obtained a reasonable validity of the FFQ for estimating concurrent (Spearman correlation rs 0.37; p<0.001) and long-term (rs 0.32; p<0.05) dietary PCB153 exposure assessment against serum PCB153 concentrations. Based on the validated FFQ we found a significantly increased risk (hazard ratio 1.67; 95% CI 1.17 – 2.40) of myocardial infarction in middle-aged and elderly women of the highest exposure group (median 280 ng/day) compared to the lowest (median 98 ng/day) using a Cox regression model. Highly exposed individuals were characterized by a high fish consumption independent of age. A high dietary PCB153 exposure and a low intake of fish fatty acids (<0.20 g/day of EPA - DHA) were associated with a greater risk of myocardial infarction (hazard ratio 2.22; 95% CI 1.25 to 3.94) compared to a low exposure and a high intake of EPA and DHA (> 0.29 g/day). Thus, continued actions are needed to reduce environmental levels and at the same time conduct risk-benefit analysis for efficient dietary recommendations. This thesis provides new and detailed knowledge of exposure to environmental contaminants in different subgroups of the population by using different methodological approaches, necessary to increase the precision in the exposure estimates. Refining the exposure assessment is a prerequisite for sustaining public health.
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| 3. |
- Bergkvist, Charlotte, et al.
(författare)
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Dietary exposure to polychlorinated biphenyls and risk of myocardial infarction - A population-based prospective cohort study
- 2015
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Ingår i: International Journal of Cardiology. - : ELSEVIER IRELAND LTD. - 0167-5273 .- 1874-1754. ; 183, s. 242-248
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fish consumption may promote cardiovascular health. The role of major food contaminants, such as polychlorinated biphenyls (PCBs) common in fatty fish, is unclear. We assessed the association between dietary PCB exposure and risk of myocardial infarction taking into account the intake of long-chain omega-3 fish fatty acids. Methods: In the prospective population-based Swedish Mammography Cohort, 33,446 middle-aged and elderly women, free from cardiovascular disease, cancer and diabetes at baseline (1997) were followed-up for 12 years. Validated estimates of dietary PCB exposure and intake of fish fatty acids (eicosapentaenoic acid and docosahexaenoic acid; EPA-DHA) were obtained via a food frequency questionnaire at baseline. Results: During follow-up 1386 incident cases of myocardial infarction were ascertained through register-linkage. Women in the highest quartile of dietary PCB exposure (median 286 ng/day) had a multivariable-adjusted RR of myocardial infarction of 1.21 (95% confidence interval [CI], 1.01-1.45) compared to the lowest quartile (median 101 ng/day) before, and 1.58 (95% CI, 1.10-2.25) after adjusting for EPA-DHA. Stratification by low and high EPA-DHA intake, resulted in RRs 2.20 (95% CI, 1.18-4.12) and 1.73 (95% CI, 0.81-3.69), respectively comparing highest PCB tertile with lowest. The intake of dietary EPA-DHA was inversely associated with risk of myocardial infarction after but not before adjusting for dietary PCB. Conclusion: Exposure to PCBs was associated with increased risk of myocardial infarction, while some beneficial effect was associated with increasing EPA and DHA intake. To increase the net benefits of fish consumption, PCB contamination should be reduced to a minimum. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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| 4. |
- Bergkvist, Charlotte, et al.
(författare)
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Dietary exposure to polychlorinated biphenyls and risk of myocardial infarction in men - A population-based prospective cohort study
- 2016
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Ingår i: Environment International. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0160-4120 .- 1873-6750. ; 88, s. 9-14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Major food contaminants such as polychlorinated biphenyls (PCBs) are proposed to play a role in the etiology of cardiovascular disease (CVD), but to date the impact of PCBs on cardiovascular health need to be explored. Methods and results: We assessed the association between validated food frequency questionnaire-based estimates of dietary PCB exposure and risk of myocardial infarction, ascertained through register-linkage, among 36,759 men from the population-based Swedish Cohort of Men, free of cardiovascular disease, diabetes and cancer at baseline (1997). Relative risks were adjusted for known cardiovascular risk factors, long-chain omega-3 fatty acids (eicosapentaenoic and docosahexaenoic acids) and methyl mercury exposure. During 12 years of follow-up (433,243 person-years), we ascertained 3005 incident cases of myocardial infarction (654 fatal). Compared with the lowest quintile of dietary PCB exposure (median 113 ng/day), men in the highest quintile (median 436 ng/day) had multivariable-adjusted relative risks of 1.74 (95% confidence interval [CI], 1.30-2.33; p-trend < 0.001) for total and 1.97 (95% C11.42-2.75; p-trend < 0.001) for non-fatal myocardial infarction. In mutually adjusted models, dietary PCB exposure was associated with an increased risk of myocardial infarction, while the intake of long-chain omega-3 fish fatty acids was associated with a decreased risk. We also observed an effect modification by adiposity on the association between of dietary PCB exposure and myocardial infarction, with higher risk among lean men (p value for interaction = 0.03). Conclusions: Exposure to PCBs via diet was associated with increased risk of myocardial infarction in men. (C) 2015 Elsevier Ltd. All rights reserved.
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| 5. |
- Bergkvist, Charlotte, et al.
(författare)
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Exposure to dioxin-like pollutants via different food commodities in Swedish children and young adults.
- 2008
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Ingår i: Food and Chemical Toxicology. - : Elsevier BV. - 0278-6915 .- 1873-6351. ; 46:11, s. 3360-3367
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Tidskriftsartikel (refereegranskat)abstract
- The dietary intake of polychlorinated dibenzo-p-dioxins (PCDDs), dibenzofurans (PCDFs) and biphenyls (PCBs) in terms of toxic equivalents (TEQs) was investigated in Swedish children and young adults. Exposure was estimated from concentration data of six groups of individual food commodities (meat, fish, dairy products, egg, edible fats and other foodstuff) combined with food intake data from a 7-day record book obtained from 670 individuals aged 1-24 years. The results showed that Swedish boys and girls, up to the age of ten, had a median TEQ intake that exceeded the tolerable daily intake (TDI) of 2 pg TEQ/kg body weight. Children exceeding the TDI varied from almost all individuals among the youngest children to about 20% among young men and women. Dairy and fish products were the main sources of exposure for the average child, accounting for 59% of the total TEQ intake. The individuals most highly exposed were, on the other hand, characterized by a high consumption of fish. Since children constitute a vulnerable group, results obtained from the present study show that it is essential to perform age specific dietary intake assessments of pollutants and more carefully consider sensitive and/or highly exposed groups in the population in the risk management processes.
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| 6. |
- Bergkvist, Charlotte, et al.
(författare)
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Validation of questionnaire-based long-term dietary exposure to polychlorinated biphenyls using biomarkers
- 2012
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Ingår i: Molecular Nutrition & Food Research. - : Wiley. - 1613-4125 .- 1613-4133. ; 56:11, s. 1748-1754
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Tidskriftsartikel (refereegranskat)abstract
- Scope The health consequences of lifelong low-level exposure to polychlorinated biphenyls (PCBs) via food are largely unknown, mainly due to the lack of large population-based prospective studies addressing this issue. We validated long-term food frequency questionnaire (FFQ)-based dietary PCB exposure against concentrations of six PCB congeners in serum. Methods and results Dietary PCB exposure was estimated in the Swedish Mammography Cohort by constructing a recipe-based database of CB-153, an indicator for total PCBs in food. The Spearman rank correlation (adjusted for within-person variability) was assessed between concurrent (20042006), past (1997), and long-term (mean of 1997 and 20042006) FFQ-based dietary PCB exposure, respectively, and the following serum PCB congeners, CB-118, CB-138, CB-153, CB-156, CB-170, and CB-180, in women (5685 years of age, n = 201). The correlation between FFQ-based dietary PCB exposure and serum CB-153 was 0.41 (p < 0.001) for the concurrent (median 1.6 ng/kg body weight) and 0.34 (p < 0.05) for the past (median 2.6 ng/kg body weight) exposure assessment. Long-term validity of FFQ-based PCB estimates and the six serum PCB congeners ranged from 0.30 to 0.58 (p < 0.05). Conclusion FFQ-based PCB exposure estimates show acceptable validity in relation to PCB concentrations in serum, justifying their use in large-scale epidemiological studies.
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| 7. |
- Bäccman, Charlotte, Lektor, 1973-, et al.
(författare)
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Elderly and care personnel's user experiences of a robotic shower
- 2020
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Ingår i: Journal of Enabling Technologies (JET). - : Emerald Group Publishing Limited. - 2398-6263 .- 2398-6271. ; 14:1, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The purpose of this study is to explore the expectations and experiences regarding a robotic shower, from a dual user perspective. Design/methodology/approach This was an explorative qualitative study in which elderly and personnel were interviewed before the robotic shower was installed and again after four or five months of usage. Findings The elderly participants found the robotic shower empowering. The personnel's experiences encompassed their own work conditions, as well as the user value for the elderly. A shared experience for both user groups was a more independent shower situation for the elderly. Originality/value This study presents a dual user experience of a DAT in an intimate care situation and shows the importance of including both elderly and personnel to fully understand the value of DATs.
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| 8. |
- Bäccman, Charlotte, Lektor, 1973-, et al.
(författare)
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Motivational intermissions : Optimizing fitness technology for the co-creation of motivation
- 2022
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Ingår i: Proceedings of the QUIS17 – The 17th International Research Symposium on Service Excellence in Management. - : Universitat Politècnica de València. - 9788413960197 ; , s. 28-36
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Konferensbidrag (refereegranskat)abstract
- This study focuses on how fitness technology services can be designed in order to support the co-creation of motivation to sustain a healthy behavior. The study used an exploratory qualitative design in which we interviewed eight seasoned runners about their running routines and their use of fitness trackers. The result shows that the fitness routines require careful planning and deliberation, and that the maintenance of a healthy lifestyle relies more on what happens between the activities than during said activity. Thus, fitness trackers should focus on feedback that allows users to co-create motivation during intermissions between health promoting behaviors.
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| 10. |
- Bäccman, Charlotte, Lektor, 1973-, et al.
(författare)
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Personalized Coaching via Texting for Behavior Change to Understand a Healthy Lifestyle Intervention in a Naturalistic Setting : Mixed Methods Study
- 2023
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Ingår i: JMIR Formative Research. - : JMIR Publications. - 2561-326X. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Digital health interventions, such as personalized SMS coaching, are considered affordable and scalable methods to support healthy lifestyle changes. SMS, or texting, is a readily available service to most people in Sweden, and personalizedSMS coaching has shown great promise in supporting behavior changes.Objective: This study aims to explore the effectiveness of highly personalized SMS coaching for behavior change according to the Capability, Opportunity, Motivation–Behavior (COM-B) model on a sample of physically inactive adults in a nonprofit fitness organization in Sweden.Methods: The study used a mixed methods design in which clients acted as their own controls. The participants were clients(n=28) and fitness consultants (n=12). Three types of data were collected: (1) quantitative data at baseline and after the SMS intervention and the waitlist from the clients, (2) qualitative data from semistructured interviews with the fitness consultants, and(3) pseudonymized texting conversations between the fitness consultants and clients.Results: Overall, the results showed that personalized SMS coaching was effective in supporting the clients’ behavior changes. The quantitative analysis showed how the clients’ capabilities (Cohen d=0.50), opportunities (Cohen d=0.43), and relationship with the fitness consultants (Cohen d=0.51) improved during the SMS intervention in comparison with baseline. Furthermore, the qualitative analysis revealed how personalized texts added value to existing work methods (eg, increasing continuity and flexibility) and how the relationship between the clients and fitness consultants changed during the intervention, which helped motivate the clients.Conclusions: Personalized SMS coaching is an effective method for supporting healthy behavior changes. The human connection that emerged in this study needs to be further explored to fully understand the effectiveness of a digital health intervention.
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