| 1. |
- Ahlborg, Gunnar, 1948, et al.
(författare)
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Shift work, nitrous oxide exposure and subfertility among Swedish midwives
- 1996
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Ingår i: International Journal of Epidemiology. - 0300-5771. ; 25:4, s. 783-90
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Shift work and nitrous oxide exposure have both been suspected of having adverse influence on the reproductive performance of health workers. Time to pregnancy has been suggested as a sensitive measure of fecundity in occupationally exposed groups. We investigated the effects of shift work and nitrous oxide exposure on the fertility of Swedish midwives. METHODS: A questionnaire was mailed to all members of the Swedish Midwives Association who were born 1940 or thereafter, 3985 in all. Eighty-four per cent responded. Detailed information on the number of menstrual cycles required to achieve pregnancy and the working conditions during that period were obtained concerning the most recent, planned pregnancy occurring after 1983. The per cycle probability of becoming pregnant was calculated for each exposure category, and the relation to the unexposed was expressed as fecundability ratios. RESULTS: Midwives who worked two-shift, three-shift rotas, or only nights had reduced fertility compared to those working in the day time. The fecundability ratios were 0.78 (95% confidence interval [CI]: 0.65-0.94), 0.77 (95% CI: 0.60-0.98), and 0.82 (95% CI: 0.64-1.03), respectively, after adjustment for covariates. No effect of nitrous oxide exposure was noted except in the small group reporting that they assisted at more than 30 deliveries per month when nitrous oxide was used (fecundability ratio = 0.64; 95% CI: 0.44-0.95). CONCLUSION: Shift work and frequent, high occupational exposure to nitrous oxide may have a negative influence on the ability of women to become pregnant.
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| 2. |
- Axelsson, Gösta, 1950, et al.
(författare)
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Annoyance and worry in a petrochemical industrial area - prevalence, time trends and risk indicators
- 2013
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 10:4, s. 1418-1438
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Tidskriftsartikel (refereegranskat)abstract
- Abstract: In 1992, 1998, and 2006, questionnaires were sent to stratified samples of residents aged 18–75 years living near petrochemical industries (n = 600–800 people on each occasion) and in a control area (n = 200–1,000). The aims were to estimate the long-term prevalence and change over time of annoyance caused by industrial odour, industrial noise, and worries about possible health effects, and to identify risk indicators. In 2006, 20% were annoyed by industrial odour, 27% by industrial noise (1–4% in the control area), and 40–50% were worried about health effects or industrial accidents (10–20% in the control area). Multiple logistic regression analyses revealed significantly lower prevalence of odour annoyance in 1998 and 2006 than in 1992, while industrial noise annoyance increased significantly over time. The prevalence of worry remained constant. Risk of odour annoyance increased with female sex, worry of health effects, annoyance by motor vehicle exhausts and industrial noise. Industrial noise annoyance was associated with traffic noise annoyance and worry of health effects of traffic. Health-risk worry due to industrial air pollution was associated with female sex, having children, annoyance due to dust/soot in the air, and worry of traffic air pollution.
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| 3. |
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| 4. |
- Axelsson, Gösta, 1950, et al.
(författare)
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Cancer incidence in a petrochemical industry area in Sweden
- 2010
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697. ; 408:20, s. 4482-4487
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Tidskriftsartikel (refereegranskat)abstract
- Emissions from petrochemical industries may contain suspected or established carcinogens. As increased incidence of cancer in residential areas close to petrochemical industries has been reported in the literature, we conducted a study of cancer incidence in Stenungsund, Sweden, where petrochemical industries were established in the mid 1960s. A number of cancer cases in the central parts of Stenungsund were collected from the regional cancer registry for each year between 1974 and 2005. In addition to the total number of cases, the numbers of leukemia, lymphoma, liver cancer, lung cancer, and brain cancer were also collected. Expected numbers for each year were calculated based on age- and sex-specific incidence rates in reference areas. Levels of carcinogenic volatile hydrocarbons (VOC) were estimated from measurements and emission data. A dispersion model was used to classify Stenungsund into a "low" and "high" ethylene level area. Standardized Incidence Ratio (SIR) for all cancer for the entire period was 1.02 (95% CI 0.97-1.08). The occurrence of leukemia, lymphoma, and cancer in the central nervous system was slightly lower than expected for the entire period. SIR for lung cancer was 1.37 (95% CI 1.10-1.69), and SIR for liver cancer was 1.50 (0.82-2.53). VOC levels were low. Taking estimated exposure and demographic factors into account, our assessment is that occurrence of cancer was not affected by industrial emissions in any of the studied sites.
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| 5. |
- Axelsson, Gösta, 1950, et al.
(författare)
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Lung cancer risk from radon exposure in dwellings in Sweden: how many cases can be prevented if radon levels are lowered?
- 2015
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Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 0957-5243 .- 1573-7225. ; 26:4, s. 541-547
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Tidskriftsartikel (refereegranskat)abstract
- Residential exposure to radon is considered to be the second cause of lung cancer after smoking. The purpose of this study was to estimate the number of lung cancer cases prevented from reducing radon exposure in Swedish dwellings. METHODS: Measurements of indoor radon are available from national studies in 1990 and 2008 with 8992 and 1819 dwellings, considered representative of all Swedish dwellings. These data were used to estimate the distribution of radon in Swedish dwellings. Lung cancer risk was assumed to increase by 16 % per 100 becquerels per cubic meter (Bq/m(3)) indoor air radon. Estimates of future and saved cases of lung cancer were performed at both constant and changed lung cancer incidence rates over time. RESULTS: The arithmetic mean concentration of radon was 113 Bq/m(3) in 1990 and 90 Bq/m(3) in 2008. Approximately 8 % of the population lived in houses with >200 Bq/m(3). The estimated current number of lung cancer cases attributable to previous indoor radon exposure was 591 per year, and the number of future cases attributable to current exposure was 473. If radon levels above 100 Bq/m(3) are lowered to 100 Bq/m(3), 183 cases will be prevented. If levels >200 Bq/m(3) are lowered to 140 Bq/m(3) (mean in the present stratum 100-200 Bq/m(3)), 131 cases per year will be prevented. CONCLUSIONS: Although estimates are somewhat uncertain, 35-40 % of the radon attributed lung cancer cases can be prevented if radon levels >100 Bq/m(3) are lowered to 100 Bq/m(3).
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| 6. |
- Axelsson, Gösta, 1950, et al.
(författare)
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Miljöns påverkan på foster och reproduktion
- 2010
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Ingår i: Arbets- och miljömedicin - en lärobok om hälsa och miljö. Redaktion Edling C, Nordberg G, Albin M, Nordberg M. - Lund : Studentlitteratur. - 9789144053998 ; , s. 189-203
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Axelsson, Gösta, 1950, et al.
(författare)
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Shift work, nitrous oxide exposure, and spontaneous abortion among Swedish midwives
- 1996
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Ingår i: Occupational and Environmental Medicine. - 1351-0711. ; 53:6, s. 374-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To study the relation between irregular work hours, nitrous oxide (N2O) exposure, and the risk of spontaneous abortion. METHODS: All 3985 female members of the Swedish Midwives Association in 1989, born in 1940 or later, received a questionnaire on exposure before and during all of their pregnancies. Questions on work conditions covered occupation, extent of employment, workplace, work schedules, use of anaesthetics, and work load. The association between exposure variables and spontaneous abortion was analysed by logistic regression models. RESULTS: Night work and three shift schedules among midwives showed increased odds ratios (ORs) (95% confidence intervals (95% CI)) 1.63 (0.95-2.81) and 1.49 (0.86-2.59), respectively. The ORs of late spontaneous abortions (after the 12th week of pregnancy) was increased for night work 3.33 (1.13-9.87). Use of N2O (> 50% of the deliveries) was not associated with increased risk of spontaneous abortion OR 0.95 (0.62-1.47). Frequent or permanent shortage of staff was related to an increased risk of spontaneous abortions before the 13th week of pregnancy. CONCLUSIONS: The results support the hypothesis that night work and high work load increase the risk of spontaneous abortion.
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| 8. |
- Barregård, Lars, 1948, et al.
(författare)
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Response to Fornalski et al
- 2015
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Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 0957-5243 .- 1573-7225. ; 26
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 9. |
- Bodin, L., et al.
(författare)
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The association of shift work and nitrous oxide exposure in pregnancy with birth weight and gestational age
- 1999
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Ingår i: Epidemiology. - 1044-3983. ; 10:4, s. 429-36
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Tidskriftsartikel (refereegranskat)abstract
- We examined the relation between shift work and occupational nitrous oxide exposure in the second trimester of pregnancy and birth weight and gestational age at delivery among the members of the Swedish Midwives Association. Eighty-four per cent of members who were registered in 1989 responded to a postal questionnaire concerning occupational exposures, including work schedule and the use of nitrous oxide, in relation to each of their pregnancies. We obtained information on births from the Swedish Medical Birth Register. We used models with allowance for dependence between births for the same woman and found that night work was associated with preterm birth (<37 weeks) [odds ratio (OR) = 5.6; 95% confidence limits (CL) = 1.9, 16.4] and to a lesser extent with low birth weight [OR = 1.9 (95% CL = 0.6, 5.8)]. Three-shift work schedule (day, evening, and night rotation) showed a possible association with preterm birth [OR = 2.3 (95% CL = 0.7, 7.3)]. Exposure to nitrous oxide use was associated with reduced birth weight (-77 gm; 95% CL = -129, -24) and an increase in the odds of infants being small for gestational age (< or = 10th percentile of weight for gestational week) (OR = 1.8; 95% CL = 1.1, 2.8).
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| 10. |
- Malm, Annika, 1970, et al.
(författare)
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The association of drinking water treatment and distribution network disturbances with Health Call Centre contacts for gastrointestinal illness symptoms
- 2013
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Ingår i: Water Research. - : Elsevier BV. - 0043-1354 .- 1879-2448. ; 47:13, s. 4474-4484
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Tidskriftsartikel (refereegranskat)abstract
- There are relatively few studies on the association between disturbances in drinking waterservices and symptoms of gastrointestinal (GI) illness. Health Call Centres data concerningGI illness may be a useful source of information. This study investigates if there is anincreased frequency of contacts with the Health Call Centre (HCC) concerning gastrointestinal symptoms at times when there is a risk of impaired water quality due to disturbances at water works or the distribution network. The study was conducted inGothenburg, a Swedish city with 0.5 million inhabitants with a surface water source ofdrinking water and two water works. All HCC contacts due to GI symptoms (diarrhoea,vomiting or abdominal pain) were recorded for a three-year period, including also sex, age,and geocoded location of residence. The number of contacts with the HCC in the affectedgeographical areas were recorded during eight periods of disturbances in the water works(e.g. short stops of chlorine dosing), six periods of large disturbances in the distributionnetwork (e.g. pumping station failure or pipe breaks with major consequences), and 818pipe break and leak repairs over a three-year period. For each period of disturbance theobserved number of calls was compared with the number of calls during a control periodwithout disturbances in the same geographical area. In total about 55, 000 calls to the HCCdue to GI symptoms were recorded over the three-year period, 35 per 1000 inhabitants andyear, but much higher (>200) for children
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| 11. |
- Norrhall, Maria Fässberg, 1968, et al.
(författare)
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A feasible lifestyle program for early intervention in patients with chronic obstructive pulmonary disease (COPD): a pilot study in primary care.
- 2009
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Ingår i: Primary care respiratory journal : journal of the General Practice Airways Group. - : Springer Science and Business Media LLC. - 1475-1534. ; 18:4, s. 306-12
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate the feasibility of a lifestyle program for early intervention in patients with COPD in a primary care population. METHODS: The study was performed in a Primary Health Care Centre in Western Sweden. During a four-week period, all smokers between 40-70 years of age were invited to answer a questionnaire and to perform spirometry. The intervention program included a specially designed smoking cessation program and programs for physical activity and diet. RESULTS: 84 smokers were included. 42% fulfilled the criteria for COPD. All of the COPD patients were in GOLD stage I and II. Among the COPD subjects, 38% were underweight and 56% had a low fat-free mass - both together indicating malnutrition and the need for nutritional treatment. By the end of the intervention program, 47% of the COPD patients had stopped smoking. CONCLUSIONS: The intervention program was feasible and effective with a very high smoking cessation rate.
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| 12. |
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| 13. |
- Svensson, Mikael, 1980, et al.
(författare)
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A cost-effectiveness analysis of lowering residential radon levels in Sweden-Results from a modelling study.
- 2018
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Ingår i: Health policy (Amsterdam, Netherlands). - : Elsevier BV. - 1872-6054 .- 0168-8510. ; 122:6, s. 687-92
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Tidskriftsartikel (refereegranskat)abstract
- Residential exposure to radon is considered as the second leading cause of lung cancer after smoking. The purpose of this study was to conduct a cost-effectiveness analysis of reducing the indoor radon levels in Sweden from the current reference level of 200Bq/m3 to the WHO suggested reference level of maximum 100Bq/m3.We constructed a decision-analytic cost-effectiveness model using input data from published literature and administrative records. The model compared the increase in economic costs to the health benefits of lower indoor radon-levels in a Swedish policy context. We estimated the cost per life-year and quality adjusted life year (QALY) gained and assessed the robustness of the results using both deterministic and probabilistic sensitivity analysis.Including (excluding) costs of added life years the cost per QALY for existing homes was €130,000 (€99,000). For new homes the cost per QALY including (excluding) costs of added life years was €39,000 (€25,000).The results indicate that it is not cost-effective to reduce indoor radon levels from 200Bq/m3 to a maximum of 100Bq/m3 in existing homes, whereas it is cost-effective for new homes.
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| 14. |
- Thorn, Jörgen, 1965, et al.
(författare)
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Management of chronic obstructive pulmonary disease (COPD) in primary care: a questionnaire survey in western Sweden.
- 2008
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Ingår i: Primary care respiratory journal : journal of the General Practice Airways Group. - : Springer Science and Business Media LLC. - 1471-4418. ; 17:1, s. 26-31
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To assess the primary care management of chronic obstructive pulmonary disease (COPD) in relation to COPD guidelines. METHOD: A postal questionnaire was sent out to all Primary Health Care Centres (PHCCs) in western Sweden (n=232). The response rate was 75%. RESULTS: A majority of the PHCCs had a nurse and physician responsible for COPD care. They used spirometry equipment regularly, but only 50% reported that they calibrated it at least weekly. Less than 30% of the PHCCs reported access to a dietician, occupational therapist or physiotherapist. There was a structured smoking cessation program in 50% of the PHCCs. Larger PHCCs were more likely to use spirometry equipment regularly and to have specific personnel for COPD care. CONCLUSION: There is a need to establish structured programs for COPD care including smoking cessation programs for COPD patients with special trained staff. Larger PHCCs have a better infrastructure for providing guideline-defined COPD care.
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| 15. |
- Tornevi, Andreas, et al.
(författare)
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Association between precipitation upstream of a drinking water utility and nurse advice calls relating to acute gastrointestinal illnesses
- 2013
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:7
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Tidskriftsartikel (refereegranskat)abstract
- Background: The River Göta Älv is a source of fresh-water for the City of Gothenburg (Sweden). We recently identified a clear association between upstream precipitation and indicator bacteria concentrations in the river water outside the intake to the drinking water utility. This study aimed to determine if variation in the incidence of acute gastrointestinal illnesses is associated with upstream precipitation. Methods: We acquired data, covering 1494 days, on the daily number of telephone calls to the nurse advice line from citizens in Gothenburg living in areas with Göta Älv as a fresh-water supply. We separated calls relating to gastrointestinal illnesses from other medical concerns, and analyzed their association with precipitation using a distributed lag non-linear Poisson regression model, adjusting for seasonal patterns and covariates. We used a 0–21-day lag period for precipitation to account for drinking water delivery times and incubation periods of waterborne pathogens. Results: The study period contained 25,659 nurse advice calls relating to gastrointestinal illnesses. Heavy rainfall was associated with increased calls the same day and around 5–6 days later. Consecutive days of wet weather were also found to be associated with an increase in the daily number of gastrointestinal concerns. No associations were identified between precipitation and nurse advice calls relating to other medical concerns. Conclusion: An increase in nurse advice calls relating to gastrointestinal illnesses around 5–6 days after heavy rainfall is consistent with a hypothesis that the cause could be related to drinking water due to insufficient barriers in the drinking water production, suggesting the need for improved drinking water treatment.
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