| 1. |
- Claeson, Magdalena, 1976, et al.
(författare)
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Incidence of cutaneous melanoma in Western Sweden, 1970-2007.
- 2012
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Ingår i: Melanoma research. - 1473-5636. ; 22:5, s. 392-8
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the increasing incidence of cutaneous malignant melanoma (CMM) in Western Sweden during the period 1970-2007. A secondary aim was to show a geographical variation in incidence between coastal and inland areas, considering the effects of the local average duration of sunshine, and the sun exposure-related behavior in the populations. The Swedish Cancer Registry provided data on invasive melanomas during 1970-2007. Meteorological maps showed the annual average duration of sunshine during 1961-1990. A survey from 2007 with 2871 participants, carried out by the National Board of Health and Welfare, provided data on self-reported sun exposure. During the period studied, the age-standardized incidence for men in Western Sweden more than quadrupled to 31.1/100 000 inhabitants, whereas it tripled for women to 27.1/100 000. Coastal areas, including Gothenburg city, had a high average duration of sunshine (1701-1900 h of sun/year), whereas inland areas had lower average duration of sunshine (≤1700 h). The incidence of CMM was higher in coastal areas and in Gothenburg city, compared with inland areas. This may be linked to ultraviolet radiation, a consequence of the higher average duration of sunshine. The sun exposure survey showed additional factors, which possibly led to the increased incidence, for example high sun exposure on holidays abroad. The alarming increase in the incidence of CMM in Western Sweden, during the period 1970-2007, shows the need for additional primary preventive measures, for example sun protection programs targeted at populations in this area.
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| 2. |
- Andersson, Eva M., 1968, et al.
(författare)
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Incidence of cutaneous squamous cell carcinoma in coastal and inland areas of Western Sweden.
- 2011
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Ingår i: Cancer epidemiology. - : Elsevier BV. - 1877-783X .- 1877-7821. ; 35:6
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Tidskriftsartikel (refereegranskat)abstract
- The incidence of squamous cell carcinoma (SCC) has increased in recent decades, both in Sweden and worldwide. The aim of this study was to investigate the development of SCC over time (1970-2007) in the western part of Sweden (WS), with emphasis on the incidence trends on the coast and in the inland areas.
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| 3. |
- Bast-Pettersen, Rita, et al.
(författare)
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Tremor measurements in a 22-year cohort study of workers exposed to hand-held vibrating tools.
- 2021
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Ingår i: International archives of occupational and environmental health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 94, s. 1049-1059
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Tidskriftsartikel (refereegranskat)abstract
- The objectives of this cohort study were to evaluate possible long-term effects of occupational exposure to hand-arm vibration (HAV) in terms of increased tremor. The aims were to evaluate whether exposure during follow-up, baseline hand-arm vibration syndrome (HAVS), baseline manual dexterity or current medical conditions or life-style habits might be associated with increased tremor. A further aim was to compare two different activation conditions: postural vs rest tremor.Forty men (current age: 60.4years) who had previously worked as manual workers in a specialized engineering and construction company enrolled in the study. Their hand functions had been examined in 1994. At the baseline examination, 27 had been diagnosed with HAVS, while 13 were not exposed. The follow-up examination in 2016-2017 comprised the CATSYS Tremor Pen® for measuring postural and rest tremor and the Grooved Pegboard Test for assessing manual dexterity. Blood samples were taken for assessing biomarkers that might have impact on tremor.Neither cumulative exposure to HAV during follow-up nor HAVS at baseline were associated with increased tremor. A test for manual dexterity at baseline was significantly associated with increased tremor (Tremor Intensity) at follow-up. Blood markers of current medical conditions and tobacco consumption were associated with increased tremor. Rest tremor frequency was higher than postural tremor frequency (p<0.001).The main findings of this 22-year cohort study were no indications of long-term effects on tremor related to HAV exposure and previous HAVS status. However, baseline manual dexterity was significantly associated with increased tremor at follow-up. Activation conditions (e.g., hand position) are important when testing tremor.
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| 4. |
- Bejerot, Eva, 1951-, et al.
(författare)
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Nyexaminerade om lärarutbildningen i Sverige och i Finland
- 2018
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Ingår i: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 24:3-4, s. 66-84
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Tidskriftsartikel (refereegranskat)abstract
- En professionsutbildning utmärks av en spänning mellan teoretisk kunskap och praktisk yrkeskunskap. Vi vet dock inte mycket om hur en professionsutbildning bäst utformas för att förbereda studenter inför yrket. Utifrån tre enkäter, två i Sverige och en i Finland, analyseras nyexaminerade lärares uppfattning om hur förberedda de var för sitt arbete efter lärarutbildningen. Området metodik och praktik hade tydligast samband med känslan av att vara väl förberedd. I flera områden var de finska respondenterna mer kritiska än de svenska. De många positiva omdömena om den finska lärarutbildningen gjorde att vi förväntat oss ett mer positivt resultat i den finska studien.
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| 5. |
- Björk, Lisa, 1981, et al.
(författare)
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Beginning teachers’ work satisfaction, self-efficacy and willingness to stay in the profession: a question of job demands-resources balance?
- 2019
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Ingår i: Teachers and Teaching: Theory and Practice. - : Informa UK Limited. - 1354-0602 .- 1470-1278. ; 25:8, s. 955-971
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Tidskriftsartikel (refereegranskat)abstract
- As many other countries around the world, Sweden is currently facing an urgent need for new teachers. Creating sound work environments that can retain beginning teachers in the profession—as well as attract new ones—is one way to address the problem. In order to accomplish this task, research must be able to reflect the complex nature of work environments. In the present study, a cluster analysis of four job demands and five job resources among 328 Swedish teachers in their first year of teaching, resulted in four typical work situations: the advantageous situation (n =103); the balanced situation (n =148); the threat situation (n =34); and the pressed situation (n =43). Clear differences were found in how teachers in these different clusters perceived their work satisfaction, self-efficacy and willingness to stay, with the teachers in the former two work situations scoring significantly higher than the latter two. The results indicate that teachers can have a very different experience of work at the start of their careers. These findings imply that work environment interventions and induction programmes to support new teachers and prevent them from leaving the profession must be well adapted to the context.
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| 6. |
- Edlund, Maria, 1972, et al.
(författare)
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Quantitatively measured tremor in hand-arm vibration-exposed workers
- 2015
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 88:3, s. 305-310
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to investigate the possible increase in hand tremor in relation to hand-arm vibration (HAV) exposure in a cohort of exposed and unexposed workers. Participants were 178 male workers with or without exposure to HAV. The study is cross-sectional regarding the outcome of tremor and has a longitudinal design with respect to exposure. The dose of HAV exposure was collected via questionnaires and measurements at several follow-ups. The CATSYS Tremor Pen(A (R)) was used for measuring postural tremor. Multiple linear regression methods were used to analyze associations between different tremor variables and HAV exposure, along with predictor variables with biological relevance. There were no statistically significant associations between the different tremor variables and cumulative HAV or current exposure. Age was a statistically significant predictor of variation in tremor outcomes for three of the four tremor variables, whereas nicotine use was a statistically significant predictor of either left or right hand or both hands for all four tremor variables. In the present study, there was no evidence of an exposure-response association between HAV exposure and measured postural tremor. Increase in age and nicotine use appeared to be the strongest predictors of tremor.
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| 7. |
- Lindegård Andersson, Agneta, 1955, et al.
(författare)
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Longitudinal associations between cardiorespiratory fitness and stress-related exhaustion, depression, anxiety and sleep disturbances.
- 2019
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- In the last few years, so-called "common mental disorders", including adjustment disorder and stress-related exhaustion, have outrivalled musculoskeletal disorders as being the leading cause of long-term sick leave in Sweden. Cardiorespiratory fitness level defined as "the maximal amount of physiological work that an individual can do as measured by oxygen consumption" has in many studies shown to reduce the risk of several life-style related diseases and moreover to improve mood, well-being and physical performance. The aim of the present study was to investigate, longitudinal associations between cardiorespiratory fitness and self-reported physical activity levels and the severity of symptoms connected to stress-related exhaustion, depression, anxiety, and sleep disturbances among women clinically diagnosed with stress-related exhaustion disorder (ED).The study was that of a longitudinal cohort study consisting of women (n=88) diagnosed with stress-related ED in a specialist clinic in Gothenburg, Sweden. Cardiorespiratory fitness was measured with the Åstrand indirect test of maximal oxygen uptake (VO2max) and subjective measures of physical activity levels were rated on 4-graded physical activity scale. To measure and follow symptoms of ED over time the SMBQ-questionnaire (Shirom Melamed Burnout Questionnaire) was used. The Hospital Anxiety and Depression Scale (HADS) was used to measure depression and anxiety. A proxy variable for capturing overall disturbed sleep used to measure sleep. Longitudinal associations for continuous outcome variables and the dichotomous variable sleep were analysed using mixed- effects regression models with random intercepts. Regression coefficients along with the 95% confidence interval (CI) are presented as measures of association. Both exposures and the outcome were measured simultaneously over six waves (T1-T6).The results showed statistically significant associations between level of fitness and reduced symptoms of stress-related exhaustion over time. Best improvements over time were seen in patients having a medium cardiorespiratory fitness level. No associations could be found between cardiorespiratory fitness level over time and anxiety, depression or sleep disturbances.Having medium cardiorespiratory fitness was positivity associated with a more sustained reduction in symptoms of ED overtime compared to those having low or high cardiorespiratory fitness levels. The clinical implication following this result is that an individual recommendation based on a medium level of physical activity in line with the recommendations from ACSM (American College of Sports Medicine) is preferable compared to recommendations including more vigorous physical activity in order to restore and sustainably reduce symptoms of exhaustion disorder over time.
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| 8. |
- Söderberg, Mia, 1977, et al.
(författare)
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En rapport om studiemiljö, stress och hälsa bland Sahlgrenska akademins studenter
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Rapporter från både Göteborgs universitets Akademihälsa och Sahlgrenska akademin Studentkår har uppmärksammat en hög förekomst av överbelastning och psykisk ohälsa bland studenter vid Sahlgrenska akademin. Därför beslöt Sahlgrenska akademins dåvarande dekan Olle Larkö, att utföra en studie om upplevd stress, studiemiljö och hälsa bland Sahlgrenska akademins studenter. Uppdraget att genomföra studien tilldelades Avdelningen för Arbets- och miljömedicin, Institutionen för medicin, Sahlgrenska Akademin & Göteborgs universitet. Det övergripande syftet var att undersöka studiemiljöns betydelse för studenternas grad av upplevd stress och hälsa som underlag för förebyggande åtgärder. Övriga frågeställningar var om det fanns skillnader avseende sådana variabler mellan könen eller mellan studenter på olika program. Frågeställningarna undersöktes via en webenkät som skickades till alla studenter som under HT-2016 aktivt studerade vid något grundutbildningsprogram vid Sahlgrenska akademin. Enkäten mätte företrädelsevis olika psykosociala aspekter i studiemiljön, såsom studieintensitet, möjligheter till inflytande, socialt klimat och hur man upplevde föreläsare och kursledare. Som utfall utvärderades grad av utmattning, ångest- och depressionssyndrom, om man sökt vård pga. sina studier eller starkt övervägt att avbryta sin utbildning. Utav 3961 tillfrågade, besvarades enkäten av 2398 studenter, vilket innebär en svarsfrekvens på 61%. Svarsfrekvenserna skiljde sig mycket mellan olika program, vilket man bör ha i åtanke när man tolkar resultaten för enskilda program. De deskriptiva resultaten visade att de flesta studenter var stolta över sitt framtida yrkesval, blev stimulerade av sina studier och kände att man blev väl förberedd för sin yrkesroll. Det var också tydligt att det fanns en god och stöttande social stämning studenter emellan. Ungefär en tredjedel av alla studenter upplevde dock en anspänd studiesituation, dvs. stor arbetsbelastning, men med begränsade möjligheter att påverka sin studiesituation, en typ av psykosocial miljö som är starkt kopplat till psykisk ohälsa. Många kände också en hög grad av oro inför framtida höga stressnivåer och stort ansvar inom det blivande yrket. Det fanns en utbredd förekomst av psykisk ohälsa, ungefär en tredjedel rapporterade nivåer över de standardiserade cut-off värdena för hög grad av utmattning eller ångestsymtom som kan indikera en ångeststörning. Andel personer som sökt vård pga. studierelaterad ohälsa låg på 15%, och ungefär en tredjedel av alla studenter hade någon gång starkt övervägt att avbryta sina studier. Vid jämförelse med andra grupper som besvarat samma typ av frågeformulär går det att se att Sahlgrenska akademins studenter rapporterar högre grad av utmattning, ångest- och depressionssymtom, än t.ex. svenska lärarstudenter eller unga vuxna i den svenska allmänbefolkningen. Noterbara skillnader fanns även mellan könen. Resultaten visade t.ex. att kvinnor lade fler studietimmar per vecka på sina studier och i högre utsträckning hade en anspänd studiesituation, jämfört med männen. Kvinnor rapporterade också en högre förekomst av psykisk ohälsa, avseende både grad av utmattning och ångestsymtom. Det fanns även skillnader mellan olika utbildningsprogram, där de stora programmen, apotekar-, läkar-, tandläkare- och sjuksköterskeprogrammen, utmärker sig avseende variabler såsom hög arbetsbelastning och förekomst av psykisk ohälsa. Den högsta andelen personer som sökt vård pga. studierelaterad ohälsa återfanns bland de kvinnliga läkarstudenterna (27%). Detta kan jämföras med vårdbehov hos manliga läkarstudenter (9%) eller den grupp av kvinnliga studenter med näst högst reliabel förekomst av vårdbehov, kvinnliga tandläkarstudenter (15%). Sambandsanalyserna visade att en av de starkaste riskfaktorerna för utmattning, vårdsökande och övervägandet att avbryta sina studier, var en anspänd studiemiljö (höga krav och låg kontroll). En sådan studiesituation var förknippad med en tredubbelt så hög risk för hög grad av utmattning och dubbelt så högt vårdbehov, jämfört med de som hade låga studiekrav och högt inflytande. Brister från fakulteten, såsom otydliga kursmål eller bristande feedback, var också associerat till en fördubblad risk för hög grad av utmattning och övervägande att avbryta sina studier. Därutöver var oro inför framtida kapacitet och emotionella krav på verksamhetsförlagd utbildning kopplat till psykisk ohälsa. Ett annat intressant resultat var att könsdiskriminering var associerat till att man sökte vård, däremot fanns det inga signifikanta samband mellan att söka vård, och utmattning eller ångest. Mindre förvånande var att den starkaste faktorn för att överväga att avbryta sina studier, var ett bristande engagemang för sin utbildning och kommande yrket. Resultaten visade även samband till viktiga friskfaktorer. Som tidigare påvisats i flera studier, var fysisk aktivitet kopplat till lägre nivåer av utmattning. En annan betydelsefull faktor, som var associerad till både minskad utmattning och ångestsymtom, var tid till återhämtning, vilket också är konsekvent med tidigare forskning. Sammanfattningsvis, trots många positiva aspekter såsom engagemang, stimulans och bra social gemenskap, rapporterade Sahlgrenska akademins studenter en hög förekomst av krävande och stressande studieförhållanden och en utbredd psykisk ohälsa. Studenterna vid Sahlgrenska akademin går på krävande utbildningar som ska förbereda dom för yrken med högt tempo och stort ansvar gentemot andra människor. Detta kräver god stresstålighet, men också att man kan känna igen mekanismer som kan orsaka stress och att man har kunskap om hur man kan skydda sin hälsa. Idag läggs stort ansvar för den egna hälsan på studenterna själva. Man bör diskutera huruvida inte universitet bör ha en tydligare och mer ansvarstagande roll i att minska förekomst av skadliga studieförhållanden och stärka studenternas förmåga att hantera krävande förhållanden och därmed bättre förbereda dom inför arbetslivet. Förslagna åtgärder bör därför fokusera på utökad tillgång till stresshanteringsprogram, förändra kulturer där stress och att må psykiskt dåligt ses som en svaghet, schemaläggning som gynnar tid för återhämtning och lyfta positiva och hälsofrämjande aspekter av fysisk aktivitet.
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| 9. |
- Söderberg, Mia, 1977, et al.
(författare)
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Study Demands, Social Support and Mental Health in Teacher Education Students: A Cross-Sectional Study
- 2020
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Ingår i: Journal of Educational and Social Research. - : Richtmann Publishing. - 2239-978X .- 2240-0524. ; 10:3
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this paper was to investigate relationships between psychosocial factors in a study environment and mental health in teacher education students. Study objectives were explored in 593 Swedish teacher education students (80% women). Psychosocial variables were measured with the standard Swedish demand-control-support questionnaire. Associations to mental health were calculated with logistic regression analyses, stratified by gender. Female students, on average reported higher demands, exhaustion and anxiety, than men. High study demands were associated with severe exhaustion in both men and women, even in models including all potential confounders and social support. Although, social support was related to lower exhaustion in women and less anxiety in men, this variable only contributed to minor effect changes in the associations study demands to mental ill-health. High study demands seem important for mental health in teacher education students. Future studies, perhaps using qualitative methods, would benefit the state of knowledge regarding students’ psychosocial conditions and poor mental health. Such knowledge could assist universities in interventions to enhance both health status and future stress resilience.
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| 10. |
- Wastensson, Gunilla, 1956, et al.
(författare)
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Inorganic chloramines : a critical review of the toxicological and epidemiological evidence as a basis for occupational exposure limit setting
- 2020
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Ingår i: Critical reviews in toxicology. - : Taylor & Francis. - 1040-8444 .- 1547-6898. ; 50:3, s. 219-271
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Tidskriftsartikel (refereegranskat)abstract
- Inorganic chloramines are not commercially available, but monochloramine is produced in situ for disinfection or for use in chemical synthesis. Inorganic chloramines are also formed when free chlorine reacts with nitrogen containing substances, e.g. ammonia and urea, present in chlorinated water sources. Occupational exposure may, therefore, occur in e.g. swimming pool facilities and the food processing industry. Monochloramine is soluble and stable in water and the dominating inorganic chloramine in chlorinated water sources. No clinical effects were seen in healthy volunteers given monochloramine in drinking water during 4 or 12 weeks in doses of 0.043 or 0.034 mg/kg bw/day, respectively. Limited data indicate that monochloramine is weakly mutagenic in vitro but not genotoxic in vivo. One drinking water study indicated equivocal evidence of carcinogenicity in female rats but not in male rats and mice. No reproductive or developmental effects were shown in rodents in the few studies located. Dichloramine is soluble but unstable in water. In the only study located, mild histological effects in kidneys, thyroid and gastric cardia were observed in rats administered dichloramine in drinking water for 13 weeks. Trichloramine is immiscible with water and evaporates easily from water into air. Therefore, the primary exposure route of concern in the occupational setting is inhalation. Occupational exposure to trichloramine has been demonstrated in indoor swimming pool facilities and in the food processing industry where chlorinated water is used for disinfection. Exposure-response relationships between airborne levels and self-reported ocular and upper airway irritation have been shown in several studies. Exposure to trichloramine may aggravate asthma symptoms in individuals with existing asthma. The risk of developing asthma following long-term exposure to trichloramine cannot be evaluated at present. No data on genotoxic, carcinogenic, reproductive or developmental effects were located. The toxicological data for mono- and dichloramine are insufficient to recommend health-based occupational exposure limits (OELs).As regard trichloramine, the critical effect is judged to be irritation observed in several studies on pool workers, starting at approximately 0.4 mg/m3 (stationary sampling). Based on these data, a health-based OEL of 0.1 mg/m3 (8-h time-weighted average) is recommended. This corresponds to 0.2 mg/m3 for stationary measurements in swimming pool facilities. No short-term exposure limit (STEL) is recommended.
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| 11. |
- Wastensson, Gunilla, 1956, et al.
(författare)
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Measuring Tremor - Does Recording Time Matter?
- 2016
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Ingår i: Journal of Neurology & Neurophysiology. - : OMICS Publishing Group. - 2155-9562. ; 7:5
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The CATSYS Tremor Pen has been used in several studies for measurement of tremor among workers with occupational exposure to neurotoxins like mercury and manganese. The main purpose of this study was to investigate whether recording time has an impact on the measured tremor characteristics. Other aims were to investigate whether there are interactions between recording time and age, and between recording time and (selfreported) nicotine use, respectively; to assess the test-retest repeatability of the instrument; to investigate a possible practice effect when performing the test repeatedly; and to evaluate agreement with another tremor test. Methods: The participants (n=44) consisted of former shipyard workers (mean age 67 years, range 59–76 years). Postural hand tremor was evaluated using the CATSYS Tremor Pen. Five tremor recordings were made; the first lasted 16.4 s, the next three lasted 8.2 s each and the fifth lasted 65.6 s. Results: There was a significant association between recording time and harmonic index; longer recording time produced higher harmonic index. There was no effect of nicotine use or age that was consistent over all recording times, and no practice effect was seen. The agreement with another tremor test was moderate to good, as was the test-retest reliability. Conclusion: Some of the tremor characteristics are affected by length of recording time and hence care should be taken when comparing results across studies or with follow-up. The results indicate that the use of a recording time longer than 16.4 s seems to be of doubtful value.
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| 12. |
- Wastensson, Gunilla, 1956, et al.
(författare)
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Neuromotor function in ship welders after cessation of manganese exposure.
- 2012
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Ingår i: International archives of occupational and environmental health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 85:6, s. 703-713
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of the present study was to investigate whether previous long-term exposure to manganese (Mn) via inhalation of welding fumes can cause persistent impairment in neuromotor function even long after cessation of exposure. METHODS: Quantitative tests of tremor, motor speed, manual dexterity, diadochokinesis, eye-hand coordination and postural stability were administered to 17 retired ship welders (mean age 69years), with mean exposure time 28years. The welders' exposure had ceased on average 18years before the study. A cumulative exposure index (CEI) was calculated for each of the former welders. The welders were compared with 21 referents from the same shipyards (mean age was 66years). RESULTS: Former welders performed less well than referents in the grooved pegboard test, and poorer performance was associated with CEI. The performance in most of the other neurobehavioral tests was similar between groups, but the welders tended to perform slightly better than the referents in tests demanding hand steadiness. The latter finding may be due to a training effect from their former working tasks or selection bias into or out of this occupation. CONCLUSIONS: In the present study of welders with previous welding fume exposure, former welders and referents performed similarly in most of the neurobehavioral tests. Previous adverse effects on the neuromotor system might have ceased, and decreased neuromotor function due to normal aging processes in both groups might have disguised any slight effect of previous Mn exposure. The poorer performance in the grooved pegboard test among welders may indicate an adverse effect on motor function of long-term exposure to Mn, but this finding has to be confirmed by other studies.
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| 13. |
- Wastensson, Gunilla, 1956, et al.
(författare)
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Parkinson's disease in diphenyl-exposed workers--a causal association?
- 2006
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Ingår i: Parkinsonism & Related Disorders. - : Elsevier BV. - 1353-8020. ; 12:1, s. 29-34
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Tidskriftsartikel (refereegranskat)abstract
- We report a cluster of five cases of Parkinson's disease (PD) among paper mill workers exposed to a fungicide, diphenyl. The cause of PD is still unknown, but epidemiological studies have indicated an elevated risk of developing PD after exposure to pesticides. The five cases of PD were found in a group of 255 diphenyl-exposed workers, and the number of expected cases in the exposed group was estimated to be 0.9, resulting in a relative risk of 5.6 (95% CI 1.8-13). Exposure to diphenyl may have contributed to this PD cluster, but chance is an alternative explanation.
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| 14. |
- Wastensson, Gunilla, 1956, et al.
(författare)
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Quantitative assessment of neuromotor function in workers with current low exposure to mercury vapor.
- 2008
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Ingår i: Neurotoxicology. - : Elsevier BV. - 0161-813X. ; 29:4, s. 596-604
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Tidskriftsartikel (refereegranskat)abstract
- Evaluation of neuromotor function has been used in several epidemiological studies of workers with long-term exposure to mercury vapor (Hg 0). Some recent studies indicate adverse effects at relatively low exposure levels. In the present study, we used sensitive quantitative methods, developed specifically to detect subtle effects of exposure to toxins on motor function. After exclusion of individuals with neurological diseases or other conditions that may affect performance, 43 chloralkali workers with current low exposure to Hg 0, and 22 age-matched referents remained for further analysis. The median urinary mercury concentration in exposed workers was 5.9 microg/g (range 1.3-25) creatinine (microg/gC), while that in referents was 0.7 microg/gC (range 0.2-4.1). The mean exposure time was 15 years, and the median cumulative mercury index was 161 years x microg/gC in exposed workers. A eurythmokinesimeter (EKM) was used to quantify eye-hand coordination, and a diadochokinesimeter, to measure rapid alternating rotation of the forearms. In general, the differences in performance between the exposed workers and the referents were small. Age was associated with a decrease in speed, more tremor, and longer contact duration between the stylus and the metal targets in performance of rapid pointing movements. Smokers had significantly more tremor, and more contacts per event in the EKM test, than nonsmokers. Taking age, shift work, and smoking habits into account, no significant associations with current or cumulative mercury exposure were found for the majority of the outcome variables from the quantitative tests. In general, this study indicates no significant adverse effects of Hg 0 on neuromotor function at the exposure levels studied.
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| 15. |
- Wastensson, Gunilla, 1956, et al.
(författare)
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Quantitative Methods for Evaluating the Efficacy of Thalamic Deep Brain Stimulation in Patients with Essential Tremor.
- 2013
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Ingår i: Tremor and other hyperkinetic movements (New York, N.Y.). - 2160-8288. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Deep brain stimulation (DBS) of the thalamus is a safe and efficient method for treatment of disabling tremor in patient with essential tremor (ET). However, successful tremor suppression after surgery requires careful selection of stimulus parameters. Our aim was to examine the possible use of certain quantitative methods for evaluating the efficacy of thalamic DBS in ET patients in clinical practice, and to compare these methods with traditional clinical tests.
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| 16. |
- Wastensson, Gunilla, 1956
(författare)
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Quantitative methods for evaluation of tremor and neuromotor function: Application in workers exposed to neurotoxic metals and patients with essential tremor
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall purpose of this thesis was to investigate the usefulness of certain quantitative methods for detecting or quantifying changes in tremor or other neuromotor functions. Tremor and impairment in neuromotor function may be the early signs of adverse effects due to low-level exposure to neurotoxic metals such as mercury and manganese, and are also common features of neurological diseases. One of the most common movement disorders is essential tremor (ET), which is characterized by postural and kinetic tremor usually affecting the arms. Sensitive quantitative tests of tremor, motor speed, manual dexterity, diadochokinesis, eye–hand coordination, and postural stability were administered to a group of chloralkali workers with current mercury exposure, as well as former ship welders with previous manganese exposure. No effects of low-level mercury exposure on tremor amplitude and the ability to perform rapid pointing movements or rapid alternating forearm movements were shown. However, some findings provided support for a decrease in tremor frequency in the non-dominant hand resulting from mercury exposure. Former welders performed less well than referents in a test of manual dexterity and motor speed, and poorer performance was associated with cumulative manganese exposure, which indicates an irreversible adverse effect of long-term exposure to manganese. However, the performance in most of the other neurobehavioral tests was similar between groups. The use of certain quantitative methods in evaluating the efficacy of thalamic deep brain stimulation (DBS) was examined in a group of ET patients, and these methods were compared with traditional clinical tools for tremor assessment. The agreement between clinical rating of postural tremor and tremor intensity as measured by an accelerometer was relatively high (rs=0.74). Moreover, the quantitative system’s sensitivity and specificity were estimated at 100% and 100%, respectively. The agreement between clinical rating of kinetic tremor and the main outcome variable from a quantitative test was low (rs=0.34), as was the sensitivity for this test (47%), even if the specificity was high (100%). In general, agreement between clinical tremor rating and quantitative measurements of tremor was low at low tremor amplitudes. In conclusion, no effect of low-level mercury exposure was shown, either on tremor amplitude, or on other certain neuromotor functions. Former welders had poorer performance on a test of motor speed and manual dexterity and this finding is probably caused by previous manganese exposure, even long after cessation of exposure. Quantitative methods may be useful tools for detecting subtle changes in tremor or other neuromotor functions at low-level exposure to neurotoxins; qualitative methods may be too insensitive as tools in this situation. Quantitative methods for measurement of tremor could complement clinical assessment in evaluating the efficacy of DBS in clinical practice.
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| 17. |
- Wastensson, Gunilla, 1956, et al.
(författare)
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Quantitative tremor assessment in workers with current low exposure to mercury vapor.
- 2006
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Ingår i: Neurotoxicology and Teratology. - : Elsevier BV. - 0892-0362. ; 28:6, s. 681-93
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Tidskriftsartikel (refereegranskat)abstract
- Measurement of tremor has been used in several occupational studies of workers with long-term exposure to mercury vapor (Hg(0)). Recent studies indicate an adverse effect even at relatively low exposure levels. In the present study, we used sensitive quantitative methods to assess tremor in chloralkali workers with current low exposure to Hg(0). Neurological examinations and recordings of tremor using both an accelerometer and a laser-based system were conducted in 43 mercury-exposed workers and 22 age-matched referents. The median urinary mercury concentration in exposed workers was 5.9 (1.3-25) microg/g creatinine (microg/gC), while it was 0.7 (0.2-4.1) microg/gC in referents. The mean exposure time was 15 years, and the median cumulative mercury index was 161 years x microg/gC in exposed workers. There were no differences between the exposed workers and the referents in the clinical evaluation of tremor. In the quantitative tremor tests, no associations were found with current or cumulative mercury exposure for the majority of tremor measures. There were indications that exposure to Hg(0) was associated with a lowering of tremor frequency in the non-dominant hand, and a possible interaction with smoking. The differences were small, however, and overall, this study indicates no significant adverse effects on tremor at these exposure levels.
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| 18. |
- Wastensson, Gunilla, 1956, et al.
(författare)
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The Nordic Expert Group for Criteria Documentation of Health Risks from Chemicals. 152. Inorganic chloramines
- 2019
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Ingår i: Arbete och Hälsa. - : Göteborgs universitet; Arbetsmiljöverket. ; 53:2
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Tidskriftsartikel (refereegranskat)abstract
- Inorganic chloramines, i.e. monochloramine (NH2Cl), dichloramine (NHCl2) and trichloramine (NCl3), are formed when free1 chlorine reacts with nitrogen-containing substances present in e.g. chlorinated (disinfection) water sources. In the occupational setting, this may occur in swimming pool facilities (139) and in the food processing industry (63, 65, 76, 85). Inorganic chloramines may also be formed in industrial processes when liquid waste containing ammoniums ions is mixed with a sodium hypochlorite solution (100). Monochloramine, dichloramine and trichloramine are not known to be commercial products but monochloramine is generated in situ as needed to disinfect drinking water and waste water (68, 132). Monochloramine and dichloramine are water soluble of which the former is the dominating inorganic chloramine in the chlorinated water sources mentioned above. Trichloramine is immiscible with water, has a relatively high vapour pressure at room temperature and thus evaporates relatively fast into the air compartment (67). Trichloramine is therefore the dominating inorganic chloramine in the indoor air of swimming pools (20, 64). In the food processing industry, the fraction of trichloramine in air is considerably lower (63, 65, 76, 85). In recent years there has been an increased reporting of health problems such as irritation and pulmonary effects among staff in indoor chlorinated swimming pool facilities and in the food processing industry where chlorinated water is used. Chlorination of water gives rise to a number of disinfection by-products also in air, mainly inorganic chloramines (6, 83, 108, 138, 139). The aim of this document is to evaluate health effects associated with occupational exposure to inorganic chloramines, and if possible, to recommend health-based occupational exposure limits (OELs).
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