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- Carlsen, Hanne Krage, et al.
(författare)
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Increased respiratory morbidity associated with exposure to a mature volcanic plume from a large Icelandic fissure eruption.
- 2021
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- The 2014-15 Holuhraun eruption in Iceland was the largest fissure eruption in over 200 years, emitting prodigious amounts of gas and particulate matter into the troposphere. Reykjavík, the capital area of Iceland (250km from eruption site) was exposed to air pollution events from advection of (i) a relatively young and chemically primitive volcanic plume with a high sulphur dioxide gas (SO2) to sulphate PM (SO42-) ratio, and (ii) an older and chemically mature volcanic plume with a low SO2/SO42- ratio. Whereas the advection and air pollution caused by the primitive plume were successfully forecast and forewarned in public advisories, the mature plume was not. Here, we show that exposure to the mature plume is associated with an increase in register-measured health care utilisation for respiratory disease by 23% (95% CI 19.7-27.4%) and for asthma medication dispensing by 19.3% (95% CI 9.6-29.1%). Absence of public advisories is associated with increases in visits to primary care medical doctors and to the hospital emergency department. We recommend that operational response to volcanic air pollution considers both primitive and mature types of plumes.
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- Carlsen, Hanne Krage, et al.
(författare)
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Respiratory health among professionals exposed to extreme SO2 levels from a volcanic eruption.
- 2019
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Ingår i: Scandinavian journal of work, environment & health. - : Scandinavian Journal of Work, Environment and Health. - 1795-990X .- 0355-3140. ; 45:3, s. 312-5
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Tidskriftsartikel (refereegranskat)abstract
- Objective The Holuhraun eruption of fall and winter 2014-15 produced large amounts of sulfur dioxide (SO 2). The aim of this study was to determine if exposure to extreme SO 2levels affected the health of individuals working at the eruption site. Methods During January‒March 2015, earth scientists, technicians, and law enforcement personnel who were about to work at the eruption site were invited to a respiratory health examination. Symptom reports and lung function measures, forced expiratory volume in one second (FEV 1) and forced vital capacity (FVC) were collected before and after an eruption site visit. Those with previous exposure (N=27) reported symptoms retrospectively. Results Altogether, 41 individuals were invited to participate, 32 underwent a clinical examination at a hospital respiratory health clinic (baseline); 27 reported symptoms during earlier visits to the eruption site (retrospective symptom reports), 17 were re-examined 1-6 days after visiting the eruption site (follow-up). All participants' lung function was within normal range both before and after exposure. At baseline, average FEV 1was 107.4% of predicted versus 106.6 at follow-up (P =0.82); average FVC was 107.0% of predicted at baseline versus 107.4% at follow-up (P=0.35). Eye and nasal irritation were more frequently reported during eruption site exposure by 24% versus 6% (P =0.37) for both. Conclusion Although "healthy-worker" effects cannot be excluded, our data indicate that SO 2exposure was associated with relatively mild and transient respiratory symptoms with no clinical signs of airway inflammation or airway obstruction.
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- Carlsen, Hanne Krage, et al.
(författare)
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Severe volcanic SO2 exposure and respiratory morbidity in the Icelandic population – a register study
- 2021
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Ingår i: Environmental Health: A Global Access Science Source. - : Springer Science and Business Media LLC. - 1476-069X. ; 20
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Holuhraun volcanic eruption September 2014 to February 2015 emitted large amounts of sulfur dioxide (SO ). The aim of this study was to determine the association between volcanic SO gases on general population respiratory health some 250 km from the eruption site, in the Icelandic capital area. Methods: Respiratory health outcomes were: asthma medication dispensing (AMD) from the Icelandic Medicines Register, medical doctor consultations in primary care (PCMD) and hospital emergency department visits (HED) in Reykjavík (population: 215000) for respiratory disease from 1 January 2010 to 31 December 2014. The associations between daily counts of health events and daily mean SO concentration and high SO levels (24-h mean SO > 125 μg/m3) were analysed using generalized additive models. Results: After the eruption began, AMD was higher than before (129.4 vs. 158.4 individuals per day, p < 0.05). For PCMD and HED, there were no significant differences between the number of daily events before and after the eruption (142.2 vs 144.8 and 18.3 vs 17.5, respectively). In regression analysis adjusted for other pollutants, SO was associated with estimated increases in AMD by 0.99% (95% CI 0.39–1.58%) per 10 μg/m at lag 0–2, in PCMD for respiratory causes 1.26% (95% CI 0.72–1.80%) per 10 μg/m SO at lag 0–2, and in HED by 1.02% (95% CI 0.02–2.03%) per 10 μg/m SO at lag 0–2. For days over the health limit, the estimated increases were 10.9% (95% CI 2.1–19.6%), 17.2% (95% CI 10.0–24.4%) for AMD and PCMD. Dispensing of short-acting medication increased significantly by 1.09% (95% CI 0.49–1.70%), and PCMD for respiratory infections and asthma and COPD diagnoses and increased significantly by 1.12% (95% CI 0.54–1.71%) and 2.08% (1.13–3.04%). Conclusion: High levels of volcanic SO are associated with increases in dispensing of AMD, and health care utilization in primary and tertiary care. Individuals with prevalent respiratory disease may be particularly susceptible. 2 2 2 2 2 2 2 2 2 3 3 3
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- Sigurdsson, Eyjolfur, et al.
(författare)
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Early discharge and home intervention reduces unit costs after total hip replacement: results of a cost analysis in a randomized study
- 2008
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Ingår i: International Journal of Health Care Finance and Economics. - : Springer Science and Business Media LLC. - 1573-6962 .- 1389-6563. ; 8:3, s. 181-192
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Tidskriftsartikel (refereegranskat)abstract
- Total hip replacement (THR) is a common and costly procedure. The number of THR is expected to increase over the coming years. Two pathways of postoperative treatment were compared in a randomized study. Fifty patients from two hospitals were randomized into a study group (SG) of 27 patients receiving preoperative and postoperative education programs, as well as home visits from an outpatient team. A control group (CG) of 23 patients received "conventional" rehabilitation augmented by a stay at a rehabilitation center if needed. All costs for the two groups both in hospitals and after discharge were collected and analyzed. On average total costs for the SG were $8,550 and $11,952 for the CG, a 28% cost reduction. Total inpatient costs were $5,225 for the SG and $6,515 for the CG. In a regression analysis the group difference is statistically significant. Adjusting for changes in the Oxford Hip Score gives effective costs (C/E). The ratio of the SGs C/E to the CGs is 0.60. That is a cost-effectiveness gain of 40%. A shorter hospital stay augmented with better preoperative education and home treatment appears to be more effective and costs less than the traditional in hospital pathway of treatment.
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