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2.
  • Andernord, D., et al. (författare)
  • Contact allergy to haptens in the Swedish baseline series: Results from the Swedish Patch Test Register (2010 to 2017)
  • 2022
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 86:3, s. 175-188
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Allergic contact dermatitis has considerable public health impact and causative haptens vary over time. Objectives To report the prevalence of contact allergy to allergens in the Swedish baseline series 2010 to 2017, as registered in the Swedish Patch Test Register. Methods Results and demographic information for patients tested with the Swedish baseline series in 2010 to 2017 were analysed. Results Data for 21 663 individuals (females 69%) were included. Females had significantly more positive patch tests (54% vs 40%). The reaction prevalence rates were highest for nickel sulfate (20.7%), fragrance mix I (7.1%), Myroxylon pereirae (6.9%), potassium dichromate (6.9%), cobalt chloride (6.8%), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI; 6.4%), MI (3.7%), colophonium (3.5%), fragrance mix II (3.2%), and formaldehyde (3.2%). Myroxylon pereirae reaction prevalence increased from 5% in 2010 to 9% in 2017 and that for methyldibromo glutaronitrile from 3.1% to 4.6%. MCI/MI and MI reactions decreased in prevalence after 2014. Nickel reaction prevalence decreased among females aged 10 to 19 years. Conclusions Nickel remains the most common sensitizing agent, with reaction prevalence decreasing among females younger than 20 years. The changes in MCI/MI and MI reaction prevalence mirrored those in Europe. The register can reveal changes in contact allergy prevalence over time among patients patch tested in Sweden.
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  • Andersson, Linus, et al. (författare)
  • Brain responses to olfactory and trigeminal exposure in idiopathic environmental illness (IEI) attributed to smells : An fMRI study
  • 2014
  • Ingår i: Journal of Psychosomatic Research. - : Elsevier. - 0022-3999 .- 1879-1360. ; 77:5, s. 401-408
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Idiopathic environmental intolerance (IEI) to smells is a prevalent medically unexplained illness. Sufferers attribute severe symptoms to low doses of non-toxic chemicals. Despite the label, IEI is not characterized by acute chemical senses. Theoretical models suggest that sensitized responses in the limbic system of the brain constitute an important mechanism behind the symptoms. The aim was to investigate whether and how brain reactions to low-levels of olfactory and trigeminal stimuli differ in individuals with and without IEI. METHODS: Brain responses to intranasally delivered isoamyl acetate and carbon dioxide were assessed in 25 women with IEI and 26 non-ill controls using functional magnetic resonance imaging. RESULTS: The IEI group had higher blood-oxygenated-level-dependent (BOLD) signal than controls in the thalamus and a number of, mainly, parietal areas, and lower BOLD signal in the superior frontal gyrus. The IEI group did not rate the exposures as more intense than the control group did, and there were no BOLD signal differences between groups in the piriform cortex or olfactory regions of the orbitofrontal cortex. CONCLUSIONS: The IEI reactions were not characterized by hyper-responsiveness in sensory areas. The results can be interpreted as a limbic hyperreactivity and speculatively as an inability to inhibit salient extemal stimuli.
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5.
  • Atakora, Michael, et al. (författare)
  • Assessment of Workers' Knowledge and Views of Occupational Health Hazards of Gold Mining in Obuasi Municipality, Ghana
  • 2020
  • Ingår i: International Journal of Occupational Safety and Health. - : Occupational Health and Safety Society of Nepal. - 2738-9707 .- 2091-0878. ; 10:1, s. 38-52
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Small-scale mining in Ghana has been a major community and national concern due to its contribution to the destruction of farmlands and bodies of water, and to the loss of human life. Small-scale mining exposes workers to varying degrees of health hazards and problems.Objectives: The study aimed to assess the knowledge and views of workers about the occupational health hazards and problems related to small-scale gold mining in Obuasi Municipality, Ghana, to help improve workers' safety at the mining sites.Methods: A cross-sectional study was done between May and December 2011. Simple random sampling was used to select 150 small-scale miners take part in this study. The workers were asked about their knowledge and views of occupational health hazards and problems related to gold mining. Data were entered with EpiData Entry 3.1 and analyzed using Stata 11.Results: Most workers (95, 63.3%) had low knowledge of occupational health and safety regulations. Multivariable logistic regression analysis showed that knowledge about regulations was associated with level of education (OR = 8.5; 95% CI: 7-10.5). The common effects of mining that workers expressed awareness of were land pollution (30%), water pollution (28%), air pollution (18.7%), and noise pollution (16%). The factors influencing exposure to health hazards related to mining were low educational levels (14%), little work experience (30.7%), incorrect handling of equipment or chemicals (26%), poor law enforcement (12.7%), and negligence (16.7%). In general, occupational lung disease (16%), occupational hearing loss (14%), heat illnesses (12%), eye infections (16%), malaria (24%), and skin infections (18%) were the most common health problems study participants mentioned.Conclusion: High levels of occupational health hazards and problems related to gold mining exist among workers in private mines. Safety program should be offered as part of associated public health programs to limit the most significant risks. We further recommend education and training on regulations and the use of personal protective equipment.
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6.
  • Bergdahl, Jan, et al. (författare)
  • Coping and self-image in patients with visual display terminal-related skin symptoms and perceived hypersensitivity to electricity
  • 2004
  • Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 77:8, s. 538-542
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The aim of the present study was to measure coping resources and self-image in patients with visual display terminal (VDT)-related skin symptoms and hypersensitivity to electricity (HE).Methods: From 1980 to 1998, 350 patients with electrical sensitivity were registered. The patients were subdivided into two groups: patients with skin symptoms evoked by VDTs, television screens, and fluorescent-light tubes and patients with so-called hypersensitivity to electricity with multiple symptoms evoked by exposure to different electrical environments. A questionnaire was sent to all patients and contained the coping resources inventory (CRI) and the structural analysis of social behaviour (SASB) in order for us to measure coping resources and self-image, respectively. The CRI and SASB scores were compared with those of control groups. Two hundred and fifty respondents (73%) returned the questionnaire, 200 (78.5% women) in the VDT group and 50 (62% women) in the HE group.Results: The patient group rated high on the CRI spiritual/philosophical scale and high on the SASB spontaneous, positive and negative clusters but low on the controlled cluster. The female patients scored high on the CRI emotional scale. The VDT group rated lower than the controls on the SASB controlled cluster and higher on both the positive and negative cluster. The HE group scored higher than the control group on the SASB spontaneous and positive clusters. The women in the HE group scored higher on the CRI cognitive and CRI total scale than the VDT group and control group and higher on the CRI emotional scale than the controls. The women in the HE group rated higher than both the women in the VDT and control groups on the SASB spontaneous and positive clusters.Conclusions: The deviant self-image found in these patients, especially the female HE patients, support the view that VDT and HE symptoms can be stress related. In the clinic, a trustful alliance should be established with the patient in order for a more realistic view to be achieved of the capacity.
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7.
  • Bäck, Ove, et al. (författare)
  • Does vitamin D intake during infancy promote the development of atopic allergy?
  • 2009
  • Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 89:1, s. 28-32
  • Tidskriftsartikel (refereegranskat)abstract
    • The active metabolite of vitamin D, 1,25-(OH)2D3, has immunomodulatory properties in addition to its more established action on bone and calcium metabolism. Recently vitamin D has been proposed as one of several environmental factors responsible for the increase in atopic diseases during the last decades. The objective of this study was to determine whether the estimated dose of dietary vitamin D3 during the first year of life is associated with atopic diseases up to the age of 6 years. In a prospective birth cohort study 123 six-year-old children were investigated for the cumulative incidence of atopic dermatitis, allergic rhinitis or asthma by means of a postal questionnaire. Their vitamin D3 intake during infancy was recorded in a previous study and the relationship between lower or higher vitamin D3 intake and atopic illness later in childhood was assessed. Atopic manifestations were more prevalent in the group with higher intake of vitamin D3. Although small, this study supports previous investigations suggesting a role of vitamin D intake during infancy in the development of atopic allergy later in childhood. If these findings are confirmed in prospective controlled clinical trials, prevention through modified vitamin D3 supplementation in infancy could be discussed to reduce the burden of atopic illnesses.
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8.
  • Carlsson, Annica, et al. (författare)
  • Scoring of hand eczema : good reliability of hand eczema extent score
  • 2017
  • Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 97:2, s. 193-197
  • Tidskriftsartikel (refereegranskat)abstract
    • There is good agreement between dermatological staff and patients using the Hand Eczema Extent Score (HEES). The aim of this study was to assess inter- and intra-observer reliability of the HEES in dermatologists and intra-observer reliability of the HEES in patients with hand eczema. Six dermatologists assessed 18 patients twice. Only the hands of the patients were visible to the assessors. Patients performed a self-assessment twice. Inter- and intra-observer reliability was tested with intraclass correlation coefficient (ICC). The mean HEES score for all dermatologists' assessments was 21.0 (range 3.6-46.3). The corresponding mean scores for all patients' own assessments were 24.9 (range 4.0-54.0). Inter-observer reliability in the dermatologists' observations ICC classification was very good, median value 0.82 (range 0.56-0.92). The overall intra-observer reliability for the 6 dermatologists' ICC classification was very good (range 0.88-0.94). Intra-observer reliability in the patients' 2 self-assessments ICC classification was very good (ICC 0.95). In conclusion, HEES is a reliable tool for both dermatologists and patients to grade the extent of hand eczema.
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9.
  • Carlsson, Annica, et al. (författare)
  • Scoring of hand eczema: good agreement between patients and dermatological staff
  • 2011
  • Ingår i: British Journal of Dermatology. - : Blackwell Publishing Ltd. - 0007-0963 .- 1365-2133. ; 165:1, s. 123-128
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Assessment of hand eczema in a clinical study has been achieved using a scoring system which documents extent of eczema on different areas of the hand. Objectives To investigate whether the same scoring system could be used by patients to communicate current status of hand eczema. Methods In a study of 62 patients (36 women and 26 men, age range 1975 years), the patients own assessment was compared with the assessment by a dermatologist and a dermatological nurse. Standardized information was given to the patient and the form was filled in independently by the patient, the nurse and the dermatologist, during the patients visit to the clinic. Individual area scores were summed to a total score. Results The overall agreement was good, with an interclass correlation (ICC) of 0.61 between patient and dermatologist for the total score. The ICC between nurse and dermatologist was 0.78. Differences between observers were more pronounced for the more severe cases - those with higher numerical scores as assessed by the dermatologist. There was a tendency for women and for patients over the median age of 44 years to set a lower point score than the dermatologist. The concordance of observations from individual anatomical areas was higher for fingertips and nails and lower for the palm and dorsum of the hand. Conclusions Patients are able to report the extent of hand eczema with good accuracy. Self-assessment protocols for hand eczema may well have a place in the monitoring of hand eczema extent over time.
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  • Edvardsson, Berit, et al. (författare)
  • Coping and Self-image in Patients With Symptoms Attributed to Indoor Environment
  • 2013
  • Ingår i: Archives of Environmental & Occupational Health. - : Informa UK Limited. - 1933-8244 .- 2154-4700. ; 68:3, s. 145-152
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigated self-image and coping ability in a group of patients with symptoms from indoor environment. A follow-up questionnaire was sent to 239 patients previously referred with nonspecific building-related symptoms at University Hospital in Umeå, Sweden. One hundred seventy-four women and 14 men answered and the patient group rated their self-image as more spontaneous, more positive, and less negative than a control group. The patient group rated higher on the cognitive scale in the Coping Resources Inventory (CRI) than the control group. The female patients had an increased risk of not being able to work associated with a low score on negative self-image. The authors conclude that certain personality traits may be potential risk factors that increase the probability of encountering and experiencing stressful work situations. The resulting stress may increase workers' susceptibility to indoor environment exposure.
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  • Edvardsson, Berit, 1953- (författare)
  • "Det är inte mig det är fel på, det är huset" : en studie av prognosfaktorer och bemötande med fokus på sjuka hus-syndromet
  • 2015
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Bakgrund: Sick Building Syndrome, SBS, är fortfarande 2015 ett tillstånd som vållar mycket diskussion. Symtomen kan grupperas i slemhinnesymtom, hudsymtom och allmänna symtom. I definitionen ingår att personen/ personerna som fått symtom har exponerats för dålig inomhusluft i en speciell byggnad. När personen inte är i byggnaden så förbättras eller försvinner symtomen. Många olika faktorer kan orsaka eller medverka till uppkomst eller försämringar av SBS-symtom, som t.ex. luftens innehåll av olika ämnen, luftflöden, temperatur, buller, fukt och mögel. Utbredd enighet finns om att fukt och mögel i byggnaderna påverkar eller ger upphov till symtom hos vissa personer som exponeras där. Psykosociala faktorer som arbetets organisation och krav och individuella faktorer som kön och personlighet påverkar också.Syfte: Hypotesen är att faktorer som tidigare hälsa, åtgärder på arbetet, tid, behandling, personlighet och copingresurser alla kan påverka prognosen för SBS-patienterna. Syftet med avhandlingen är att undersöka hur symtomen påverkar arbetsförmågan och om patienterna återhämtar sig från SBS-symtomen. Ett annat syfte är att undersöka bemötande och de erfarenheter som SBS-symtomen gett en grupp av informanter med SBS. För att förstå om personlighet mätt med självbild och coping hade någon betydelse för progressionen av SBS-symtom och arbetsförmåga gjordes jämförelser av personlighet mellan en patientgrupp med SBS, en patientgrupp med handeksem, en patientgrupp med elkänslighet och en normalpopulation.Metod:  En uppföljningsenkät skickades till 239 patienter med SBS-symtom som under åren 1986–1998 blivit undersökta och bedömda på Universitets-sjukhuset i Umeå, Sverige. Frågorna innehöll social och medicinsk status, nuvarande symtom, behandlingar, åtgärder på arbetsplatsen, coping och självbild och svarsfrekvensen var 79,1%. Prognos och riskfaktorer för prognos beräknades för SBS-patienterna. Mätningar av personlighetsfaktorer gjordes med instrumentet Structural analysis of Social Behaviour, SASB, och coping mättes med Coping Resources Inventory, CRI. Likadana uppföljningsenkäter skickades till en grupp patienter med handeksem och patienter med upplevd elkänslighet. Svarsfrekvensen var 68% respektive 73% och enkätsvaren har sedan analyserats och jämförts genom beräknngar av prognos med fokus på självbild och coping för SBS-patienterna och handeksempatienterna. Jämförelser gjordes också mellan de tre olika grupperna och en kontrollgrupp vad gäller självbild och coping. För att undersöka erfarenheterna av SBS-symtomen och bemötandet genomfördes kvalitativa intervjuer med 10 informanter som hade eller hade haft SBS-symtom. Fem av dem hade diagnostiserats en längre tid tillbaka medan de andra fem hade haft SBS-symtomen en kortare period. Semi-strukturerade intervjuformulär användes vid intervjuerna och anlyserades med kvalitativ innehållsanalys.Resultat: Graden och svårigheten av SBS-symtomen minskade över tid trots att nästan hälften av SBS-patienterna beskrev att symtomen var mer eller mindre oförändrade efter 7 år eller mer. Risken att ha symtom vid uppföljningen var större för de patienter som remitterats sent efter symtomdebut men även för de som hade kort uppföljningstid. Risken att inte ha någon arbetsförmåga vid uppföljningen var signifikant ökad om det var mer än ett års skillnad mellan symtomdebut och första läkarbesöket p.g.a. SBS-symtomen eller om patienten vid första undersökningen hade fler än 5 SBS-symtom. Dagliga aktiviteter som t.ex. bussåkning förvärrade också symtomen för patienterna. Informanternas upplevelser av SBS-symtomen från början visar en influensaliknande bild med rinnande näsa och ögon, heshet, hosta och huvudvärk. Informanterna agerar för att klara av situationen när symtomen förvärras. Genom hela processen upplever de en brist på bekräftelse och stöd från arbetsgivare, primärvård, företagshälsovård och fastighetsförvaltare.Alla tre patientgrupperna hade högre värden i spontan och positiv självbild i jämförelse med en kontrollgrupp. De hade också alla lägre värden i kontroll medan patienterna med handeksem och de med elkänslighet hade högre värden i sin negativa självbild. När det gäller coping skilde sig inte patientgrupperna från kontrollgruppen utom i CRI kognitiv där SBS-patienterna hade hög poäng i motsats till handeksempatienterna som hade låg poäng i samma domän. De elkänsliga patienterna hade i stället höga poäng i domänen andlig/filosofisk. Självbild eller copingförmåga var inte associerade med SBS-symtom eller symtom av handeksem vid uppföljningen och deras personlighet påverkade inte arbetsförmågan. Tidigare atopisk dermatit var en signifikant risk för kvarvarande symtom men inte för arbetsförmågan hos handeksempatienterna.Slutsats: En grupp av patienter som tidigare diagnostiserats för symtom från inomhusmiljön har kroniska symtom och påverkan på sitt sociala liv. Över tid minskar symtomen. Resultaten pekar på att ett tidigt omhändertagande är av vikt. SBS-symtomen är från början svåra att upptäcka för alla inblandade och kunskap om hur symtomen kan uppstå i dagligt liv kan bidra till bredare förståelse. Erfarenheterna från personer med SBS visar på avsaknad av bekräftelse och stöd från vården, företagshälsan, arbetsgivare och fastighetsförvaltare. Sambandet mellan symtom och inomhusmiljö får inte glömmas bort. Stöd och bekräftelse innebär också kunskap om skyldigheter för arbetsgivare och fastighetsförvaltare.Skillnad i självbild i jämförelse med en kontrollgrupp ses hos patientgrupperna med symtom som är delvis oförklarade men också hos handeksempatienter med ett väletablerat tillstånd. Det kan innebära att patienter med kroniska tillstånd överlag kan avvika från den allmänna populationen. Patienterna visar som grupp en hög positiv och hög spontan självbild som kan leda till svårigheter att sätta gränser. Detta kan leda till en mental stress och i förlängningen också ge en ökad känslighet/sårbarhet för miljöfaktorer. 
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14.
  • Edvardsson, Berit, et al. (författare)
  • Exploring coping and self-image in patients with hand eczema through a comparison with patients attributing their symptoms to indoor environment or electromagnetic fields
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • PurposeThe aim of this study was to investigate self-image and coping ability among patients with hand eczema and to compare those findings with a normal population to find out if these personality components are important prognostic factors for the progress of symptoms and for work capability.  Furthermore we compared the self-image and coping ability of the hand eczema patients with other patients whose symptoms are attributed to their indoor environment (SBS) and patients whose symptoms are attributed to electromagnetic fields, IEI/EMF.MethodsThe patients were examined, diagnosed and given treatment at appropriate clinics in Norrlands University Hospital, in Umeå, Sweden. For follow-up a postal questionnaire containing questions including medical and social status, treatment , self-image and coping skills was sent to 383 patients, response rate 68.1 %. Measurement of personality traits was done using the Structural analysis of Social Behaviour (SASB) and the Coping Resources Inventory (CRI) to assess coping skills. Similar follow-up questionnaires for patient groups with SBS and perceived electrical sensitivity were used and response rates were 79.1 % respectively 73%. Comparisons were made between self-image and coping among patients with hand eczema, SBS patients and patients with electrical hypersensitivity, and a selection from the general population.  ResultsHand eczema patients scored higher on spontaneous and positive self-image (SASB) than a comparison group. They also had a high score on negative self-image similar to IEI/EMF patients.  On the CRI cognitive domain, hand eczema patients had a lower score than the comparison group. Self-image or coping ability was not associated with persistent hand eczema symptoms or work capability at follow-up. Previous atopic dermatitis was the only consistent predictor of hand eczema at follow-up.ConclusionsDifferences in personality traits were seen in a well-established condition and not only in patients with medically unexplained symptoms such as SBS and perceived sensitivity to electromagnetic fields. This can imply that patients with chronic symptoms in general can deviate from the general population with respect to self-image and coping ability. 
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15.
  • Edvardsson, Berit, et al. (författare)
  • Medical and social prognoses of non-specific building-related symptoms (Sick Building Syndrome) : a follow-up study of patients previously referred to hospital
  • 2008
  • Ingår i: International Archives of Occupational and Environmental Health. - : Springer-Verlag New York. - 0340-0131 .- 1432-1246. ; 81:7, s. 805-812
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives The aim of this study was to describe and analysethe medical and social prognoses of patients with nonspeciWcbuilding-related symptoms.Methods A follow-up questionnaire focusing on current medical and social status, care, treatment, other actions taken and personality traits was sent to 239 patients with non-speciWc building-related symptoms assessed during theperiod between1986 and 1998 at University Hospital in Umeå, Sweden. The response rate was 79%.Results Fatigue, irritation of the eyes, and facial erythemawere the most common weekly symptoms reported atfollow-up. As females constituted 92% of the respondents,statistical analyses were restricted to women. The level andseverity of symptoms decreased over time, although nearlyhalf of the patients claimed that symptoms were more or lessunchanged after 7 years or more, despite actions taken.Twenty-Wve percent of the patients were on the sick-list, and20% drew disability pension due to persistent symptoms atfollow-up. The risk of having no work capabilities at followupwas signiWcantly increased if the time from onset to Wrstvisit at the hospital clinic was more than 1 year. This riskwas also signiWcantly higher if the patient at the Wrst visithad Wve or more symptoms. All risk assessments wereadjusted for length of follow-up. Symptoms were oftenaggravated by diVerent situations in everyday life.Conclusions Long-lasting symptoms aggravated by environmentalfactors exist within this group of patients. Theresults support that early and comprehensive measures forrehabilitation are essential for the patients.
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16.
  • Edvardsson, Berit, et al. (författare)
  • Patient experiences of developing Sick Building Syndrome (SBS) symptoms and related encounters – a qualitative study
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Objective:This study aimed to describe the experiences and encounters of a group of people with Sick Building Syndrome (SBS) as their symptoms emerged.Design, methods and subjects:A semi-structured interview was performed with 10 informants with symptoms of SBS. Five of them were previously diagnosed and had participated in an earlier follow-up study. The remaining five had had SBS symptoms for a shorter period. The interviews were analysed using qualitative content analysis. To ensure trustworthiness triangulation was used. Results:The analysis resulted in a main theme: Conflicting Interpretations of SBS Symptoms, and three subthemes: Gradual Understanding of SBS Symptoms, Experience of Rejection and Experience of Confirmation. The main theme and the sub-themes together represent a process where the informants’ experiences of belief and support, lack of support and disbelief and limited understanding occurs when they are perceiving symptoms, looking for explanations, understanding  the connection between symptoms and being  in a poor indoor environment  and while managing their SBS symptoms.The symptoms, when they first appear, often appear similar to that of flu. When the informants realise the connection between the symptoms and the building some of them decide that “Okay, enough is enough, there’s nothing wrong with me, it’s the building”. Many of the informants act to  change the way they manage the situation as a result of increased symptoms. During this whole process the informants/patients perceived a lack of confirmation and support from e.g. employers, primary health care and occupational health care centres. The informants were confirmed by colleagues acting for a better indoor environment.Conclusion:The symptoms of SBS are diffuse and difficult to recognise for all involved. The experiences of those who have dealt with this issue are in line with knowledge relating to other diseases not recognised as legitimate. It is important for healthcare personnel to be aware of the possible connection between symptoms and the indoor environment. For employers and facility managers, knowledge of their obligations in terms of the working environment is important. The importance of confirmation in encounters has to be underlined. 
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17.
  • Edvardsson, Berit, et al. (författare)
  • The medical and social prognosis of Sick Building Syndrome : a follow-up study focusing on female patients
  • 2005
  • Ingår i: Indoor air 2005. - Beijing : Tsinghua university press. ; , s. 3706-3710
  • Konferensbidrag (refereegranskat)abstract
    • A follow-up questionnaire focusing medical and social status, actions taken and personality traits was sent to 239 patients with Sick Building Syndrome (SBS) registered at the University Hospital in Umea, Sweden. The response rate was 79 percent. As females constituted 92 percent of the respondents all statistical analyses were restricted to women. Almost half of the respondents had been exposed to environments with visible water damages. Fatigue, irritated eyes and facial erythema were the most common symptoms. Nearly half of the patients claimed that the symptoms were more or less unchanged after 7 years or more. Twenty-five percent of the patients were on the sick-list and twenty percent drew disability pension due to SBS-symptoms at follow-up. Symptoms were often aggravated in different situations in everyday life. No important deviations concerning personality factors were found. The results support that early and comprehensive measures for rehabilitation are essential for these patients.
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18.
  • Ekelund, Mats, et al. (författare)
  • A Higher Score on the Dermatology Life Quality Index, Being on Systemic Treatment and Having a Diagnosis of Psoriatic Arthritis is Associated with Increased Costs in Patients with Plaque Psoriasis
  • 2013
  • Ingår i: Acta Dermato-Venereologica. - : Acta Dermato-Venereologica. - 0001-5555 .- 1651-2057. ; 93:6, s. 684-688
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to examine the relationship between measures of disease severity and costs from a socie-tal perspective in patients with plaque psoriasis. Dermatologists in Sweden recruited 443 consecutive patients who had had no biological treatment during the past 12 months. Following a Psoriasis Area and Severity Index (PASI) assessment, subjects completed self-assessments on health status/quality of life and a healthcare resource utilization/work status questionnaire. The costs of healthcare resources and sick-leave due to plaque psoriasis were estimated and related to the subject's health status. A patient's Dermatology Life Quality Index (DLQI) and being on systemic therapy, or having diagnosis of psoriatic arthritis, appeared to be more strongly associated with direct and indirect costs than did their PASI. The cost of biological therapy should be considered from the perspective of the already high costs of patients with high DLQI undergoing traditional systemic treatment.
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19.
  • Engfeldt, Malin, et al. (författare)
  • Can patch testing with methylchloroisothiazolinone/methylisothiazolinone be optimized using a new diagnostic mix? - A multicenter study from the Swedish Contact Dermatitis Research Group
  • 2020
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 82:5, s. 283-289
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and methylisothiazolinone (MI) are tested to detect contact allergy to these isothiazolinones. Objectives To study if an aqueous patch test preparation with MCI and MI in a mix of 0.015% and 0.2%, respectively, detects more contact allergies than the commonly used preparations of MCI/MI in 0.02% aq. and MI in 0.2% aq. Methods A total of 1555 patients with dermatitis in five Swedish dermatology departments were tested consecutively with MCI/MI 0.215% aq., MCI/MI 0.02% aq., and MI 0.2% aq. Results The share of contact allergy to MCI/MI 0.215% aq., MCI/MI 0.02% aq., and MI 0.2% aq. varied in the test centers between 7.9% and 25.9%, 3.2% and 10.3%, and 5.8% and 12.3%, respectively. MCI/MI 0.215% aq. detected significantly more patch-test positive individuals than both MCI/MI 0.02% aq. (P < .001) and MI 0.2% aq. (P < .001), as well as either one of MCI/MI and MI (P < .001). In the patients only reacting to MCI/MI 0.215% aq., 57.7% were recorded as having a dermatitis that was explained or aggravated by exposure to either MCI/MI or MI. Conclusion The results speak in favor of replacing the preparations MCI/MI 0.02% aq. and MI 0.2% aq. with MCI/MI 0.215% aq. as the screening substance in the Swedish baseline series, which has been implemented in 2020.
  •  
20.
  • Engfeldt, Malin, et al. (författare)
  • Patch Testing with a New Composition of Mercapto Mix: A Multi-centre Study by the Swedish Contact Dermatitis Research Group
  • 2019
  • Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 99:11, s. 960-963
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigated whether more patients with contact allergies were detected by patch testing with mercapto mix with a higher concentration of 2-mercaptobenzothiazolinone (MBT) than the commonly used mercapto mix. A total of 3,143 dermatitis patients in 5 Swedish dermatology departments were patch-tested with 3 mercapto test preparations: MBT 2.0% petrolatum (pet.); mercapto mix 2.0% pet.; and mercapto mix 3.5% pet. Positive reactions to these mercapto mixes varied between 0-0.50%, 0-0.93%, and 0-1.4%, respectively, in the 5 centres. Numerically, mercapto mix 3.5% pet. detected all positive patients and more patch-test positive patients than did the 2 other substances, but the difference was not statistically significant. The authors recommend replacing mercapto mix 2.0% pet. in the Swedish baseline series with mercapto mix 3.5% pet., since the latter also detected those patients who would have been missed because MBT 2.0% is not included in the Swedish baseline series.
  •  
21.
  • Engfeldt, Malin, et al. (författare)
  • Patch testing with hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) - a multicentre study of the Swedish Contact Dermatitis Research Group
  • 2017
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 76:1, s. 34-39
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. In 2014, the fragrance hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) was excluded from the Swedish baseline series. Objectives. To study (i) whether fragrance mix (FM) II with 5% HICC detects more positive reactions than usual FM II with 2.5% HICC, and (ii) the reproducibility of patch testing with HICC. Methods. Two thousand one hundred and eighteen dermatitis patients at five Swedish dermatology departments were consecutively tested with FM II 14% pet., FM II 16.5% pet., and duplicate preparations of HICC 5% pet. Results. Of the patients, 3.2% reacted to FMII 14%, and 1.5% reacted to HICC. Separate testing with HICC detected 0.3% reactions without concomitant reactivity to FM II. FM II with 5% HICC did not give rise to more irritant reactions or signs of active sensitization than FM II with 2.5% HICC. Patch testing with duplicate applications of HICC increased the overall prevalence of HICC contact allergy to 1.9%. Conclusion. FMII with5% HICC does not detect more positive reactions than FMII with 2.5% HICC. Separate testing with HICC does not detect a sufficient proportion of patients who react only to HICC, without concomitant reactions to FMII, to warrant its inclusion in a baseline series.
  •  
22.
  • Engfeldt, Malin, et al. (författare)
  • Swedish Experiences From Patch-testing Methylisothiazolinone Separately
  • 2015
  • Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 95:6, s. 717-719
  • Tidskriftsartikel (refereegranskat)abstract
    • The preservative methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is a well-known sensitiser and present in the Swedish baseline series since the 1980s. The proportions of MCI/MI are 3:1. MI alone has been used as a preservative since less than 10 years. This study was conducted on behalf of the Swedish Contact Dermatitis Research Group to evaluate inclusion of MI in the Swedish baseline series since the preparation of MCI/MI might fail to detect contact-allergic reactions to MI alone. Patients with suspected allergic contact dermatitis at 5 Swedish dermatology departments were consecutively patch-tested with MI 2,000 ppm aq and MCI/MI 200 ppm aq. The number of cases with exclusive contact allergy to MI varied between 0.8-4.2%. In total, 1.9% reacted exclusively to MI and not to MCI/MI. Due to the considerable frequency of contact allergy to MI not traced by MCI/MI, MI 2,000 ppm aq is included in the Swedish baseline series from January 2014. This corresponds to a dose of 60 mu g/cm(2).
  •  
23.
  • Eriksson, Nils M, et al. (författare)
  • Baseline prevalence of symptoms related to indoor environment.
  • 2006
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 34:4, s. 387-396
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: Health problems associated with indoor environments have been reported and discussed extensively during the past few decades, not least in Sweden. There is, however, great uncertainty concerning the background prevalence of the symptoms in question. The main objective of the present study was to investigate the prevalence of general, mucosal, and skin symptoms in the Swedish population. Methods: A survey comprising 3,000 randomly selected Swedes, age 18—64, was carried out. The survey addressed 25 symptoms, principally general, mucosal, and skin symptoms. A number of other areas were covered and individual data registered at Statistics Sweden were added. The response rate was 70% (2,154 cases). Results: The prevalence of symptoms in the Swedish population was found to accord with results in studies based on different kinds of samples. Women reported significantly more single symptoms, as well as sets of symptoms, than men. There was no clear connection between age and symptoms. The prevalence of symptoms was slightly lower among employees compared with non-workers. Office workers did not report symptoms related to ``sick building syndrome'' (SBS) more frequently than employees not working in offices. SBS symptoms, skin symptoms, and symptoms similar to those reported by individuals with ``electric hypersensitivity'' were significantly more prevalent among employees with extensive VDU usage. Conclusions: The prevalence of reported health complaints accords with that which has been found in previous studies. The background prevalence reported here can serve as a reference for further studies. The high prevalence of symptoms among individuals with extensive VDU usage gives cause for further studies.
  •  
24.
  • Fall, Sofia, et al. (författare)
  • Contact allergy trends in Sweden - a retrospective comparison of patch test data from 1992, 2000, and 2009
  • 2015
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 72:5, s. 297-304
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Contact allergy prevalence rates change over time as a result of variations in allergen exposure. Data from patch test clinics are often used as markers for allergy trends. Objectives. The aim of the present retrospective study was to describe trends in rates of sensitization to allergens in the Swedish baseline series. Patients/materials/methods. Prevalence rates are described by comparing consecutive patch test data from 1992, 2000 and 2009 in Swedish patch test clinics. In total, 3680 patients were included in 1992, 3825 in 2000, and 3112 in 2009. Results. Among test substances with a sensitization rate above 2% in 2009, significant decreases were noted for nickel sulfate, cobalt chloride, colophonium, and methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI), and a significant increase for p-phenylenediamine, as compared with 1992. Potassium dichromate reactions had increased among younger women, whereas reactions to nickel and cobalt had decreased in this group. Sensitization to chromium, cobalt and fragrance mix I had decreased among older men, and sensitization to nickel had decreased among younger men. Conclusions. It is probable that these changes in 1992-2009 reflect both changes in regulations for nickel, lower levels of chromium in cement and of MCI/MI in cosmetics, and increasing use of hair dyes.
  •  
25.
  • Flytström, I, et al. (författare)
  • Methotrexate Versus Cyklosporine in Psoriasis: effectiveness quality of life and safety. A randomized controlled trial
  • 2008
  • Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 158:1, s. 116-121
  • Tidskriftsartikel (refereegranskat)abstract
    • Background When this study was initiated, no previous studies comparing methotrexate and ciclosporin for moderate to severe plaque psoriasis had been performed. Objectives To compare the effectiveness, quality of life and side-effects of methotrexate and ciclosporin treatments in a context reflecting normal clinical practice. Methods Eighty-four patients with moderate to severe plaque psoriasis were randomized to treatment with methotrexate or ciclosporin for 12 weeks. The primary outcome was the Psoriasis Area and Severity Index (PASI). The secondary outcome was quality of life, measured by the Dermatology Life Quality Index (DLQI) and the 36-item Short Form Health Survey (SF-36). A visual analogue scale (VAS) was used for patients' assessment. Results Sixty-eight patients started treatment and were included in the analysis. Dropout before initiation of treatment was higher in the ciclosporin group. Mean PASI change from baseline at 12 weeks was 58% in the methotrexate group and 72% in the ciclosporin group, showing ciclosporin to be more effective than methotrexate. Improvement of the VAS score was higher in the ciclosporin group. The methotrexate group showed a greater improvement in the subscale Physical Functioning of the SF-36. No significant difference between the groups was found for DLQI. Conclusions Treatment with methotrexate or ciclosporin for chronic plaque psoriasis brings satisfactory disease control, improved quality of life and tolerable side-effects. A statistically significant difference in effectiveness between treatment groups was recorded, showing ciclosporin to be more effective than methotrexate in a short-term perspective.
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