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1.
  • Kim, Jeong-Lim, et al. (författare)
  • Impact of occupational exposures on exacerbation of asthma: a population-based asthma cohort study.
  • 2016
  • Ingår i: BMC pulmonary medicine. - : Springer Science and Business Media LLC. - 1471-2466. ; 16:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Asthma is a prevalent chronic disease and occupation contributes to approximately 15% of cases among adults. However, there are still few studies on risk factors for work-exacerbated asthma. The current study investigated the association between asthma exacerbations and occupational exposures.The study comprised all currently working adults (n=1356) who reported ever asthma in prior population-based cohorts. All subjects completed a questionnaire about exposures, occupations and exacerbations of asthma. Exposure to high and low molecular weight agents, irritating agents and asthmagens were classified using the asthma-specific job exposure matrix for northern Europe (N-JEM). Severe exacerbation of asthma was defined as sought emergency care at a hospital, admitted to a hospital overnight, or made an urgent visit to a primary care physician or district medical office due to breathing problems during the last 12months. Moderate exacerbation was defined as both being not severe exacerbation and an additional visit to a primary care physician or district medical office, or had extra treatments with corticosteroid tablets. Mild exacerbation was defined as being neither severe nor moderate exacerbation, and increasing usage of inhaled corticosteroids. Multiple logistic regression was applied to investigate the association between exacerbation of asthma and occupational exposures while adjusting for potential confounders.Approximately 26% of the working asthmatics reported exacerbation, and more than two-thirds of them had moderate or severe exacerbation. From 23 to 49% of the asthmatics reported occupational exposure to a variety of different types of agents. Exposure to any gas, smoke or dust (OR 1.7[95 % CI 1.2-2.6]) was associated with severe exacerbation of asthma, as were organic dust (OR 1.7[1.2-2.5]), dampness and mold (OR 1.8[1.2-2.7]), cold conditions (OR 1.7[1.1-2.7]), and a physically strenuous job (OR 1.6[1.03-2.3]). Asthmagens and low molecular weight agents classified by the N-JEM were associated with mild exacerbation, with OR 1.6[1.1-2.5] and OR 2.2[1.1-4.4], respectively.Self-reported exposure to any gas, smoke or dust, organic dust, dampness and mold, cold conditions and physically strenuous work, and jobs handling low molecular weight agents were associated with exacerbation of asthma. Reduction of these occupational exposures may help to reduce exacerbation of asthma.
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2.
  • Murgia, Nicola, et al. (författare)
  • Occupational risk factors for airway obstruction in a population-based study in Northern Europe
  • 2021
  • Ingår i: American Journal of Industrial Medicine. - : Wiley. - 0271-3586 .- 1097-0274. ; 64:7, s. 576-584
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Airway obstruction is a key feature of asthma and chronic obstructive pulmonary diseases (COPD). Smoking habits and workplace exposures to vapors, gas, dusts, and fumes (VGDF) could cause or exacerbate airway obstruction. The aim of this study is to evaluate the risk of airway obstruction due to smoking and workplace exposure, and their interaction, in a large population-based study. Methods In this cross-sectional study, a sample (n = 6153) of the Swedish population aged between 24 and 76 years underwent a questionnaire, clinical examination, blood test, and spirometry to gather information on airway obstruction classified by Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria or American Thoracic Society (ATS)/European Respiratory Society (ERS) criteria, risk factors, and confounders. Occupational exposures to VGDF were rated according to a specific job-exposure matrix. Adjusted logistic regression models were used to evaluate risk factors for airway obstruction in smokers and nonsmokers. Results In total, 9.8% had airway obstruction by GOLD criteria and 10.3% by ATS/ERS. Smokers with a high likelihood of exposure to VGDF had a higher risk of airway obstruction than those not exposed (odds ratio [OR]: 1.74, 95% confidence interval [CI]: 1.15-2.65 by GOLD; OR: 1.58, 95% CI: 1.06-2.37 by ATS/ERS) especially those >50 years of age. In smokers highly exposed to VGDF, risk estimates were higher than in the whole population, and the interaction between high exposure to VGDF and smoking further increased the risk of airway obstruction. Conclusions This study suggests a possible role for interaction between cigarette smoking and VGDF exposure on the risk of airway obstruction.
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3.
  • Albin, Maria, et al. (författare)
  • Incidence of asthma in female Swedish hairdressers.
  • 2002
  • Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1470-7926 .- 1351-0711. ; 59:2
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To investigate the risk of asthma in hairdressers. METHODS: The incidence of asthma was retrospectively estimated in a Swedish nationwide study including all female hairdressers certified from vocational schools from 1970 to 1995, and a stratified sample of women from the general population were referents. A postal questionnaire included questions on respiratory tract symptoms, atopy, smoking, working periods as a hairdresser, and number of specific hair treatments performed/week. Reported exposures were validated by occupational hygienists. Rate ratios of incidence (IRRs) of asthma were estimated by Poisson regression, adjusted for calendar year of observation, hay fever, smoking, and region of domicile. RESULTS: The crude incidences of asthma/1000 person-years were: 3.9 during active years as a hairdresser, 2.8 among the hairdressers when not working in the profession, and 3.1 among the referents. The corresponding IRR for being an active hairdresser compared with the referents was 1.3 (95% confidence interval (95% CI) 1.0 to 1.6). Moderate effects on risk of asthma were found both from hairdressing work (IRR=1.6 (1.1 to 2.2) among never-smokers) and from smoking (IRR=1.6 (1.2 to 2.2) among referents). However, the combined effect from hairdressing work and smoking (IRR=1.5 (1.0 to 2.1)) was less than expected (p=0.02). No effect modification by respiratory atopy was found. The hairdressers most often performing hair bleaching treatments (IRR=1.5 (0.7 to 3.0)) or using hair spray (IRR=1.4 (0.8 to 2.4)) had, compared with the most infrequent users, a slightly, but not significantly higher incidence of asthma. Exposure to persulphates in hair bleach was estimated to be 0.04-0.15 mg/m(3) during mixing of the powder. Reported average number of bleaching treatments agreed well with those performed according to a diary. CONCLUSIONS: Active hairdressing work was associated with a moderately increased incidence of asthma among lifelong non-smokers. The results are moderately supportive, but not conclusive, of associations between asthma and exposure to hair bleach or hair spray.
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4.
  • Bonlokke, Jakob H., et al. (författare)
  • Exposures and Health Effects of Bioaerosols in Seafood Processing Workers - a Position Statement
  • 2019
  • Ingår i: Journal of Agromedicine. - 1059-924X .- 1545-0813. ; 24:4, s. 441-448
  • Tidskriftsartikel (refereegranskat)abstract
    • © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Occupational hazards exist in the processing of seafood both in land-based facilities as well as on board vessels. Recent findings on occupational injury and respiratory health risks among seafood processing workers were presented and discussed at the IFISH5 conference. Particular emphasis was put on the challenges that im/migrant workers encounter, the greater risks onboard factory vessels, especially where processing machinery are retrofitted to older vessels not primarily designed for this purpose, and the difficulties in assessing and preventing bioaerosol exposures and associated respiratory health risks despite recent advances in characterising agents responsible for allergic and non-allergic reactions. Based on appraisal of existing knowledge in the published literature and new findings presented at the conference, recommendations for immediate actions as well as for future research have been proposed. Among these include the importance of improving extraction ventilation systems, optimising machinery performance, enclosure of bioaerosol sources, improved work organization, and making special efforts to identify and support the needs of im/migrant workers to ensure they also benefit from such improvements. There is a need for studies that incorporate longitudinal study designs, have improved exposure and diagnostic methods, and that address seafood processing in countries with high seafood processing activities such as Asia and those that involve im/migrant workers worldwide. The medical and scientific community has an important role to play in prevention but cannot do this in isolation and should cooperate closely with hygienists, engineers, and national and international agencies to obtain better health outcomes for workers in the seafood industry.
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5.
  • Brisman, Jonas, 1954, et al. (författare)
  • The incidence of respiratory symptoms in female Swedish hairdressers
  • 2003
  • Ingår i: American Journal of Industrial Medicine. - : Wiley. - 0271-3586. ; 44:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Airway diseases in hairdressers are a concern. The objective of this investigation is to evaluate the risk for three respiratory symptoms, wheeze, dry cough, and nasal blockage, in hairdressers. Methods A questionnaire on respiratory symptoms, atopy, smoking, and work history was answered by 3,957 female hairdressers and 4,905 women from the general population as referents. Incidence rates (IR) and incidence rate ratios (IRRs)for the three symptoms were estimated. Results The IRs of all three studied symptoms were higher in the hairdressers compared with the referents. Smoking modified the effects of cohort affiliationfor all threesymptoms; the combined effect from hairdressing work and smoking was less than expected. In addition, the effect of cohort affiliation for wheeze was also modified by atopy, and the effect of cohort affiliation for nasal blockage was also modified by calendar year. Conclusions Hairdressing work was associated with increased incidences of respiratory symptoms. Smoking had a negative modifying effect.
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6.
  • Dahlman-Höglund, Anna, 1964, et al. (författare)
  • Antibodies given orally in the neonatal period can affect the immune response for two generations: evidence for active maternal influence on the newborn's immune system.
  • 1999
  • Ingår i: Scandinavian journal of immunology. - 0300-9475. ; 50:6, s. 651-6
  • Tidskriftsartikel (refereegranskat)abstract
    • Two day old Wistar rats were tube fed with 1 or 10 micrograms of a mouse IgG1 monoclonal anti-idiotypic (a-Id) antibody that was directed against an anti-Escherichia coli-K13 capsular polysaccharide antibody. A control group was given 10 micrograms of an unrelated control antibody. Six weeks after the administration of antibodies, the rats were intestinally colonised with an ovalbumin (OVA)-producing E. coli O6K13 strain. At 8 weeks of age, the male rats (first generation) and the offsprings of the female rats (second generation), were parenterally immunised with OVA and dead wild type E. coli O6K13, and the immune response was followed. In the rats of the first generation, there were no major differences between the groups in the immune response to the bacterium. However, the offspring of the neonatally a-Id administered rats had a profoundly affected immune response to the idiotypically connected antigen K13, but also to other antigens on the bacteria. Thus, a-Id treatment in the first generation gave, in the second generation, a greatly enhanced serum antibody response to the spatially related antigens OVA and O6 LPS, as well as to the idiotypically connected antigen K13. Concurrently, the in vitro spleen cell proliferative response to both OVA and the wild type bacterium was lowered. Overall, greater effects were seen with the higher dose of a-Id. In conclusion, our results demonstrate that by giving monoclonal antibodies idiotypically connected to a single bacterial component to neonatal rats, one profoundly influence the immune response also to other-spatially related-bacterial antigens in their offsprings.
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7.
  • Dahlman-Höglund, Anna, 1964, et al. (författare)
  • Endotoxin in Size-Separated Metal Working Fluid Aerosol Particles
  • 2016
  • Ingår i: Annals of Occupational Hygiene. - : Oxford University Press (OUP). - 0003-4878 .- 1475-3162. ; 60:7, s. 836-844
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients with airway symptoms working in metal working industries are increasing, despite efforts to improve the environmental air surrounding the machines. Our aim was to analyse the amount of endotoxin in size-separated airborne particles of metal working fluid (MWF) aerosol, by using the personal sampler Sioutas cascade impactor, to compare filter types, and to compare the concentration of airborne endotoxin to that of the corresponding MWFs. In a pilot field study, aerosols were collected in two separate machine halls on totally 10 occasions, using glass fibre and polytetrafluoroethylene (PTFE) filters in parallel at each station. Airborne endotoxin was distributed over all size fractions. While a major part was found in the largest size fraction (72%, 2.5-10 μm), up to 8% of the airborne endotoxin was detected in the smallest size fraction (<0.25 μm). Comparing the efficiency of the filter types, a significantly higher median endotoxin level was found with glass fibres filters collecting the largest particle-size fraction (1.2-fold) and with PTFE filters collecting the smallest ones (5-fold). The levels of endotoxin in the size-separated airborne particle fractions correlated to those of the MWFs supporting the aerosol-generating machines. Our study indicates that a significant part of inhalable aerosols of MWFs consists of endotoxin-containing particles below the size of intact bacteria, and thus small enough to readily reach the deepest part of the lung. Combined with other chemical irritants of the MWF, exposure to MWF aerosols containing endotoxin pose a risk to respiratory health problems. © 2016 The Author 2016. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.
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8.
  • Dahlman-Höglund, Anna, 1964, et al. (författare)
  • Exposure to parvalbumin allergen and aerosols among herring processing workers.
  • 2013
  • Ingår i: The Annals of occupational hygiene. - : Oxford University Press (OUP). - 1475-3162. ; 57:8, s. 1020-9
  • Tidskriftsartikel (refereegranskat)abstract
    • There are increasing reports of allergies and respiratory symptoms among workers in the fish processing industry, coinciding with an increasing use of high-pressure water in the processing plants. However, few studies have measured exposure in these work environments.
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9.
  • Dahlman-Höglund, Anna, 1964, et al. (författare)
  • Immune response against ovalbumin in rats colonized with an ovalbumin-producing Escherichia coli and the influence of feeding ovalbumin.
  • 1994
  • Ingår i: International archives of allergy and immunology. - 1018-2438. ; 105:4, s. 381-5
  • Tidskriftsartikel (refereegranskat)abstract
    • The influence of feeding ovalbumin (OA) on the development of IgE/IgG antibodies and delayed-type hypersensitivity (DTH) against OA was studied in rats colonized from birth with an Escherichia coli genetically manipulated to produce OA. At 21 days of age, colonized pups and pups with a normal intestinal flora were weaned onto either an OA-containing or a conventional diet without OA. At 2 months of age the colonized rats showed an increased DTH reaction to OA, but they did not have any anti-OA antibodies in serum. The rats were then immunized intracutaneously with OA in Freund's complete adjuvant. After immunization the colonized rats fed the conventional diet had a significantly higher DTH reaction to OA and significantly higher serum levels of IgE anti-OA antibodies than the uncolonized rats on the same diet. The colonized rats eating the OA-containing diet showed a 73% decrease in the DTH reaction to OA and also significantly lower levels of IgE and IgG antibodies against OA compared with the colonized rats fed conventional diet. The dams colonized as adults by the OA-producing E. coli developed IgE anti-lipopolysaccharide antibodies in serum while the pups colonized via the dams at birth did not. Neonatal colonization with an E. coli strain producing OA resulted in increased DTH reactivity against OA and priming for secondary IgE anti-OA response. Feeding the animals an OA-containing diet from weaning abrogated this intestinally induced hypersensitivity and rendered the animals orally tolerant to OA.
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10.
  • Dahlman-Höglund, Anna, 1964, et al. (författare)
  • Induction of IgE antibodies and T-cell reactivity to ovalbumin in rats colonized with Escherichia coli genetically manipulated to produce ovalbumin.
  • 1992
  • Ingår i: Immunology. - 0019-2805. ; 76:2, s. 225-8
  • Tidskriftsartikel (refereegranskat)abstract
    • The immune response to ovalbumin (OA) and the bacterial antigens, lipopolysaccharide (LPS) and fimbriae were studied in conventional rats colonized from birth with an Escherichia coli strain producing OA. The colonized rats had developed IgE antibodies against OA, but not against the fimbrial or the LPS antigens from the E. coli at 2 months of age. At this time all rats were primed with OA given intracutaneously in Freund's complete adjuvant. Two weeks later the colonized rats showed a 35% greater delayed-type hypersensitivity (DTH) reaction to OA, measured as ear swelling, than the controls. Thus bacteria carrying antigens resembling potential allergens might aggravate, or participate in the induction of allergic symptoms. In addition such bacteria could be efficient vaccine vectors in protection against parasites. The study illustrates the importance of the mode of antigen presentation for the subsequent immune response.
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11.
  • Dahlman-Höglund, Anna, 1964, et al. (författare)
  • Salmon allergen exposure, occupational asthma, and respiratory symptoms among salmon processing workers.
  • 2012
  • Ingår i: American journal of industrial medicine. - : Wiley. - 1097-0274 .- 0271-3586. ; 55:7, s. 624-30
  • Tidskriftsartikel (refereegranskat)abstract
    • This investigation was triggered by three cases of asthma-about 10% of the workforce-occurring in a salmon processing plant over a short period of time. The aim of the investigation was to characterize the work exposure of inhalable organic particles with personal measurements. Respiratory symptoms at work among workers were also assessed.
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12.
  • Dahlman-Höglund, Anna, 1964, et al. (författare)
  • Work-related Symptoms and Asthma among Fish Processing Workers
  • 2020
  • Ingår i: Journal of Agromedicine. - 1059-924X .- 1545-0813. ; 27:1, s. 98-105
  • Tidskriftsartikel (refereegranskat)abstract
    • © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. After observing several clinical patients with respiratory symptoms, we initiated a questionnaire survey to assess prevalence of and predictors for asthma and work-related symptoms among workers in fish processing plants. A questionnaire with items on work conditions, work-related symptoms, and respiratory symptoms/diseases was sent to 916 fish processing workers, the 1836 licenced fishermen in Sweden, and 1965 controls; of those, 43%, 57%, and 53%, respectively, responded. Risks, hazard ratios (HRs), and prevalence ratios (PRs) were calculated with Cox regression, and 95% confidence intervals (CIs) were computed. The risk of asthma among fish filleting workers was increased during the years working in the fish processing industry when compared to the other fish processing workers and controls (HR 3.6, 95% CI 1.6–8.1, adjusted for atopy, gender, and ever smoking). The filleters had an increased PR for most of the work-related respiratory symptoms investigated. All fish processing workers had a higher PR for flu-like symptoms. Use of a pressure sprayer was identified as a risk for asthma and respiratory symptoms among both fish processing workers and controls. Filleters had changed work tasks because of respiratory symptoms more often (Fisher’s exact test, p = 0.02) than other fish processing workers. In conclusion the fish filleters and pressure sprayer users reported more adult asthma and cough with phlegm compared to the other fish processing workers and controls. The use of pressure sprayers must be reduced and machinery should be completely encased to reduce workers’ exposure to bioaerosols and its effects on the respiratory tract.
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13.
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14.
  • Gustafson, T., et al. (författare)
  • Occupational exposure and severe pulmonary fibrosis
  • 2007
  • Ingår i: Respir Med. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 101:10, s. 2207-12
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: External agents, especially metal and wood dust, are believed to be risk factors for development of idiopathic pulmonary fibrosis (IPF). The aim of this case-control study was to investigate which occupational exposure types are associated with development of severe pulmonary fibrosis (PF), and especially IPF. METHODS: An extensive postal questionnaire including 30 specific items regarding occupational exposure was completed by 181 patients with severe PF and respiratory failure reported to the Swedish Oxygen Register, among whom 140 were judged as having IPF. The questionnaire was also completed by 757 control subjects. We stratified data for age, sex and smoking and calculated odds ratios (ORs). RESULTS: We found increased risk for IPF in men with exposure to birch dust (OR 2.7, 95% confidence interval (95% CI) 1.30-5.65) and hardwood dust (OR 2.7, 95% CI 1.14-6.52). Men also had slightly increased ORs associated with birds. We did not find any increased risk in association with metal dust exposure. CONCLUSION: Exposure for birch and hardwood dust may contribute to the risk for IPF in men.
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15.
  • Henneberger, P K, et al. (författare)
  • The occupational contribution to severe exacerbation of asthma.
  • 2010
  • Ingår i: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 36:4, s. 743-50
  • Tidskriftsartikel (refereegranskat)abstract
    • The goal of this study was to identify occupational risk factors for severe exacerbation of asthma and estimate the extent to which occupation contributes to these events. The 966 participants were working adults with current asthma who participated in the follow-up phase of the European Community Respiratory Health Survey. Severe exacerbation of asthma was defined as self-reported unplanned care for asthma in the past 12 months. Occupations held in the same period were combined with a general population job-exposure matrix to assess occupational exposures. 74 participants reported having had at least one severe exacerbation event, for a 1-yr cumulative incidence of 7.7%. From regression models that controlled for confounders, the relative risk (RR) was statistically significant for low (RR 1.7, 95% CI 1.1-2.6) and high (RR 3.6, 95% CI 2.2-5.8) biological dust exposure, high mineral dust exposure (RR 1.8, 95% CI 1.02-3.2), and high gas and fumes exposure (RR 2.5, 95% CI 1.2-5.5). The summary category of high dust, gas, or fumes exposure had RR 3.1 (95% CI 1.9-5.1). Based on this RR, the population attributable risk was 14.7% among workers with current asthma. These results suggest occupation contributes to approximately one in seven cases of severe exacerbation of asthma in a working population, and various agents play a role.
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16.
  • Holm, Mathias, 1969, et al. (författare)
  • Acute effects after occupational endotoxin exposure at a spa.
  • 2009
  • Ingår i: Scandinavian journal of work, environment & health. - 0355-3140. ; 35:2, s. 153-5
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • OBJECTIVES: Two spa workers reported such symptoms as fever, shivering, palpitation, arthralgia, and diarrhea after performing seaweed massages on clients at a spa center. This study was carried out to determine whether the symptoms were related to exposure to endotoxin. METHODS: Personal and stationary air sampling for the measurement of airborne endotoxin was carried out at the spa during the preparation of a bath and the following seaweed massage. In addition, the impact of storage time on the concentration of endotoxin in the seaweed was investigated. RESULTS: The measurements confirmed exposure to aerosolized endotoxin at the spa (11 ng/m (2)and 22 ng/m (3)). The endotoxin concentration in the stored seaweed increased as the storage time increased, from 360 ng/g seaweed for fresh seaweed to 33100 ng/g seaweed for seaweed stored for >20 weeks. CONCLUSIONS: Organic dust toxic syndrome was diagnosed for two workers who performed seaweed massages at a spa center at which aerosolized endotoxin was measured. In order to minimize entotoxin exposure during massages, it is important to use fresh seaweed or seaweed kept well cooled for no more than 2-3 weeks.
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17.
  • Holm, Mathias, 1969, et al. (författare)
  • Respiratory health effects and exposure to superabsorbent polymer and paper dust - an epidemiological study.
  • 2011
  • Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11:1
  • Tidskriftsartikel (refereegranskat)abstract
    • ABSTRACT: BACKGROUND: The primary aim of the present study was to investigate if exposure to dust from absorbent hygiene products containing superabsorbent polymer is related to symptoms from the airways and from the eyes. The secondary aim was to estimate the current exposure to superabsorbent polymer among production and maintenance workers in a plant producing hygiene products. METHODS: The cohort comprised 1043 workers of whom 689 were exposed to super absorbent polymer and 804 were exposed to paper dust (overlapping groups). There was 186 workers not exposed to either superabsorbent polymer or to paper dust They were investigated with a comprehensive questionnaire about exposure, asthma, rhinitis and symptoms from eyes and airways. The results were analyzed with logistic regression models adjusting for sex, age, atopy and smoking habits. An aerosol sampler equipped with a polytetrafluoroethylene filter with 1 um pore size was used for personal samplings in order to measure inhalable dust and superabsorbent polymer. RESULTS: The prevalence of nasal crusts (OR 1.4, 95% CI 1.01-2.0) and nose-bleeding (OR 1.7, 95% CI 1.2-2.4) was increased among the paper dust exposed workers (adjusted for superabsorbent polymer exposure). There were no significant effects associated with exposure to superabsorbent polymer (adjusted for paper dust exposure). The average exposure to inhalable levels of total dust (paper dust) varied between 0.40 and 1.37 mg/m3. For superabsorbent polymer dust the average exposure varied between 0.02 and 0.81 mg/m3. CONCLUSIONS: In conclusion, our study shows that workers manufacturing diapers in the hygiene industry have an increased prevalence of symptoms from the nose, especially nose-bleeding. There was no relation between exposure to superabsorbent polymer and symptoms from eyes, nose or respiratory tract, but exposure to paper dust was associated with nose-bleeding and nasal crusts. This group of workers had also a considerable exposure to superabsorbent polymer dust.
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18.
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19.
  • Kisiel, Marta, 1984-, et al. (författare)
  • The risk of respiratory tract infections and antibiotic use in a general population and among people with asthma
  • 2021
  • Ingår i: ERJ Open Research. - : European Respiratory Society (ERS). - 2312-0541. ; 7:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim The aim of this study was to investigate occupational, environmental, early life and other risk factors associated with respiratory infections and antibiotics use in a general population and among asthmatic individuals. Method This study included 15842 participants of the Respiratory Health in Northern Europe (RHINE) study aged 25–54 years from five Nordic countries, who answered a questionnaire covering respiratory outcomes, exposures, demographic characteristics and numbers of infections and courses of antibiotics in the last 12 months. Multiple logistic regression with and without adjustment for age, sex, smoking status, body mass index and centre were used to study the risk of infection and antibiotics in relation to asthma, and also the association between infection and antibiotics and occupations. Results In the whole population, 11.6% reported having three or more respiratory infections, and 14.7% had used antibiotics because of respiratory tract infections within the last year. Asthmatic participants reported tripled odds for such infections (adjusted OR 2.98, 95% CI 2.53–3.52) and antibiotics use (adjusted OR 3.67, 95% CI 3.18–4.24) as compared to non-asthmatic participants. Both in the general and the asthmatic population, female sex, obesity and exposure to building dampness were associated with respiratory infections. Female sex and current smoking and living in Tartu were associated with antibiotic use. The use of antibiotics was doubled in people hospitalised for severe respiratory infection in childhood. Conclusion In this study we identified several factors associated with increased respiratory infections and use of antibiotics in a general population and among asthmatic individuals. The frequency of respiratory infections and subsequent antibiotic treatment were increased among those with asthma. © The authors 2021.
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20.
  • Kogevinas, Manolis, et al. (författare)
  • Exposure to substances in the workplace and new-onset asthma : an international prospective population-based study (ECRHS-II)
  • 2007
  • Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 370:9584, s. 336-341
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The role of exposure to substances in the workplace in new-onset asthma is not well characterised in population-based studies. We therefore aimed to estimate the relative and attributable risks of new-onset asthma in relation to occupations, work-related exposures, and inhalation accidents. Methods We studied prospectively 6837 participants from 13 countries who previously took part in the European Community Respiratory Health Survey (1990-95) and did not report respiratory symptoms or a history of asthma at the time of the first study. Asthma was assessed by methacholine challenge test and by questionnaire data on asthma symptoms. Exposures were defined by high-risk occupations, an asthma-specific job exposure matrix with additional expert judgment, and through self-report of acute inhalation events. Relative risks for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking, and study Centre. Findings A significant excess asthma risk was seen after exposure to substances known to cause occupational asthma (Relative risk=1.6, 95% CI 1.1-2.3, p=0.017). Risks were highest for asthma defined by bronchial hyper-reactivity in addition to symptoms (2.4,1.3-4.6, p=0.008). Of common occupations, a significant excess risk of asthma was seen for nursing (2.2,1.3-4.0, p=0.007). Asthma risk was also increased in participants who reported an acute symptomatic inhalation event such as fire, mixing cleaning products, or chemical spills (RR=3.3, 95% CI 1.0-11.1, p=0.051). The population-attributable risk for adult asthma due to occupational exposures ranged from 10% to 25%, equivalent to an incidence of new-onset occupational asthma of 250-300 cases per million people per year. Interpretation Occupational exposures account for a substantial proportion of adult asthma incidence. The increased risk of asthma after inhalation accidents suggests that workers who have such accidents should be monitored closely.
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21.
  • Lillienberg, Linnea, 1942, et al. (författare)
  • Exposures and Asthma Outcomes Using Two Different Job Exposure Matrices in a General Population Study in Northern Europe
  • 2014
  • Ingår i: Annals of Occupational Hygiene. - : Oxford University Press (OUP). - 0003-4878 .- 1475-3162. ; 58:4, s. 469-481
  • Tidskriftsartikel (refereegranskat)abstract
    • We have recently published a study on new-onset asthma in a large population in northern Europe using a modified job exposure matrix (N-JEM) to better reflect exposure assignment in these countries. The aim of this paper was to investigate how the N-JEM differs in exposure assignment and asthma risks from an already established JEM. The study comprised 6253 men and 7031 women from northern Europe, born 19451973, who had answered both a screening (19891992) and a follow-up questionnaire (19992001). During the study period (19802000), there were 136 men and 293 women with new-onset asthma. Hazard ratios of new-onset asthma were calculated for both JEMs using Cox regression models. The analyses were made separately for men and women and were also stratified for atopy. Cohens kappa () was used to show agreements in exposure assignment (yes/no) between the JEMs. Population attributable risks (PARs) were calculated as well. The agreement in exposure assignment between the JEMs was substantial for the group any exposure to asthma agents ( 0.78). The agreement between comparable exposure groups in the JEMs varied from 1.00 (pharmaceutical product antigens, textile dust, cleaning agents) to 0.27 (low molecular weight agents). Significant increased asthma risks were seen for men exposed to isocyanates and accidental peak exposure with both JEMs. With the N-JEM, increased asthma risks were seen for men exposed to plant-associated antigens (all and non-atopic), epoxy compounds (all and non-atopic), and acrylates (non-atopic). With the other JEM, increased asthma risks were seen in men and women exposed to possible exposure to irritant gases or fumes (all and non-atopic), a group classified as having low asthma risk. Men and women exposed to cleaning agents also showed significant asthma risks with both JEMs. PAR with the N-JEM was 14.3% for men and 6.6% for women, compared with 12.9% and 8.3% with the other JEM. Acrylates, epoxy compounds, and isocyanates are three exposure groups in the modified asthma JEM that might better reflect exposure situations in northern Europe than the already established JEM. Exposure to possible exposure to irritant gases or fumes, a low asthma risk group in the established JEM, seems to be a group with high asthma risk in northern Europe. It is important to continuously update JEMs, which are based only on occupational titles, in order to find new risk groups and to better reflect changes in work exposures when old risks disappear and new emerge.
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22.
  • Lillienberg, Linnea, 1942, et al. (författare)
  • Occupational Exposure and New-onset Asthma in a Population-based Study in Northern Europe (RHINE)
  • 2013
  • Ingår i: Annals of Occupational Hygiene. - Oxford : Oxford University Press (OUP). - 0003-4878 .- 1475-3162. ; 57:4, s. 482-492
  • Tidskriftsartikel (refereegranskat)abstract
    • In a large population-based study among adults in northern Europe the relation between occupational exposure and new-onset asthma was studied. The study comprised 13 284 subjects born between 1945 and 1973, who answered a questionnaire 19891992 and again 19992001. Asthma was defined as Asthma diagnosed by a physician with reported year of diagnose. Hazard ratios (HR), for new-onset adult asthma during 19802000, were calculated using a modified job-exposure matrix as well as high-risk occupations in Cox regression models. The analyses were made separately for men and women and were also stratified for atopy. During the observation period there were 429 subjects with new-onset asthma with an asthma incidence of 1.3 cases per 1000 person-years for men and 2.4 for women. A significant increase in new-onset asthma was seen for men exposed to plant-associated antigens (HR 3.6; 95% CI [confidence interval] 1.49.0), epoxy (HR 2.4; 95% CI 1.34.5), diisocyanates (HR 2.1; 95% CI 1.23.7) and accidental peak exposures to irritants (HR 2.4; 95% CI 1.34.7). Both men and women exposed to cleaning agents had an increased asthma risk. When stratifying for atopy an increased asthma risk were seen in non-atopic men exposed to acrylates (HR 3.3; 95% CI 1.47.5), epoxy compounds (HR 3.6; 95% CI 1.67.9), diisocyanates and accidental peak exposures to irritants (HR 3.0; 95% CI 1.27.2). Population attributable risk for occupational asthma was 14% for men and 7% for women. This population-based study showed that men exposed to epoxy, diisocyanates and acrylates had an increased risk of new-onset asthma. Non-atopics seemed to be at higher risk than atopics, except for exposure to high molecular weight agents. Increased asthma risks among cleaners, spray painters, plumbers, and hairdressers were confirmed.
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23.
  • Lin, Xiao Ping, et al. (författare)
  • Local allergic reaction in food-hypersensitive adults despite a lack of systemic food-specific IgE
  • 2002
  • Ingår i: J Allergy Clin Immunol. ; 109:5 Pt 1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Objective tools are lacking for the diagnosis of local gastrointestinal inflammatory reactions in skin prick test (SPT)-negative and serum IgE antibody (s-IgE Ab)-negative patients with suspected food allergy. OBJECTIVE: The purpose of this investigation was to evaluate the presence of eosinophils, T cells, local IgE-bearing cells, IL-4, and IFN-gamma in small intestinal biopsy specimens from adult SPT-negative/s-IgE Ab-negative patients with food allergy during symptomatic and nonsymptomatic periods. METHODS: Fourteen patients with food allergy-related gastrointestinal symptoms confirmed by double-blinded, placebo-controlled food challenge (DBPCFC) were investigated. Eleven of the patients were SPT-negative and s-IgE Ab-negative. Sex- and age-matched healthy volunteers were used as controls. Duodenal biopsies were studied with immunostaining through use of a panel of mouse monoclonal antibodies specific for eosinophils, CD3, CD4, CD8, IgE, IL-4, and IFN-gamma. RESULTS: Significant increases in numbers of MBP(+) eosinophils, IgE-bearing cells, and T cells were found in the duodenal mucosa of the patients when they were symptomatic in comparison with when they were asymptomatic and in comparison with healthy controls. Numbers of IL-4(+) cells were increased and numbers of IFN-gamma(+) cells were reduced in the patients when they were symptomatic in comparison with when they were asymptomatic and in comparison with the controls. There were no differences in total s-IgE levels between any of the groups. CONCLUSION: A significant correlation was found between the appearance of symptoms of food hypersensitivity and the duodenal presence of IgE-bearing cells, activated eosinophils, and T cells in patients with negative SPT results and negative s-IgE Ab to the offending food. We suggest that a localized IgE-mediated response caused the gastrointestinal symptoms seen in these patients.
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24.
  • Magnusson, Jenny, 1970, et al. (författare)
  • Seasonal intestinal inflammation in patients with birch pollen allergy
  • 2003
  • Ingår i: J Allergy Clin Immunol. ; 112:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The pathophysiologic interactions of inflammatory reactions between the mucosa of the respiratory tract and that of the gastrointestinal tract in individuals with allergy are poorly studied, despite the fact that allergic symptoms in the airways and the gastrointestinal tract might arise in the same patient. OBJECTIVE: The objective of this study was to examine the inflammatory response histologically by enumerating eosinophils, IgE+ cells, and T cells in duodenal biopsy specimens in adult patients with IgE-mediated birch pollen allergy during the birch pollen season and off-season. METHODS: Nine patients with birch pollen allergy verified by skin prick test and serum IgE antibodies were investigated toward the end of the birch pollen season and again 6 months later (off-season). Duodenal biopsy specimens were obtained and studied by immunostaining for the eosinophil major basic protein (MBP), IgE, and CD3+ T cells. RESULTS: Oral allergy syndrome to birch-associated foods was present in all patients as indicated by questionnaire. Duodenal increases of MBP+ eosinophils and IgE-bearing cells were found in the patients during the birch pollen season as compared with off-season. No seasonal differences in the T-cell numbers in these patients were seen. Off-season, there was no significant difference between the patients and the control subjects regarding the intestinal frequencies of MBP+ eosinophils, mucosal IgE+ cells, and T cells. CONCLUSION: Birch pollen exposure triggered a local inflammation with an increase in duodenal eosinophils and IgE-carrying mast cells in patients with allergy. Our study gives evidence for the interplay between immunologically active cells in the airways and the gut.
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25.
  • Mirabelli, Maria C, et al. (författare)
  • Occupational risk factors for asthma among nurses and related healthcare professionals in an international study
  • 2007
  • Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 64:7, s. 474-479
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The authors examined the relations between self-reported work tasks, use of cleaning products and latex glove use with new-onset asthma among nurses and other healthcare workers in the European Community Respiratory Health Survey (ECRHS II). Methods: In a random population sample of adults from 22 European sites, 332 participants reported working in nursing and other related healthcare jobs during the nine-year ECRHS II follow-up period and responded to a supplemental questionnaire about their principal work settings, occupational tasks, products used at work and respiratory symptoms. Poisson regression models with robust error variances were used to compare the risk of new-onset asthma among healthcare workers with each exposure to that of respondents who reported professional or administrative occupations during the entire follow-up period (n=2481). Results: Twenty (6%) healthcare workers and 131 (5%) members of the referent population reported new-onset asthma. Compared to the referent group, the authors observed increased risks among hospital technicians (RR 4.63; 95% Cl 1.87 to 11.5) and among those using ammonia and/or bleach at work (RR 2.16; 95% Cl 1.03 to 4.53). Conclusions: In the ECRHS II cohort, hospital technicians and other healthcare workers experience increased risks of new-onset current asthma, possibly due to specific products used at work.
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26.
  • Nielsen, Jörn, et al. (författare)
  • Dust-free bleaching powder may not prevent symptoms in hairdressers with bleaching-associated rhinitis
  • 2016
  • Ingår i: Journal of Occupational Health. - 1341-9145 .- 1348-9585. ; 58:5, s. 470-476
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Hairdressers have an increased risk for airway symptoms especially when using hairbleaching powder containing persulfate. To minimize exposure, dust-free bleaching powder (DFP) has been made available. We studied the effects of regular powder (RP) or DFP on the airway symptoms of hairdressers with hair-bleaching associated rhinitis. Methods: Twelve hairdressers each performed three hair-bleachings on a wig in an exposure chamber. Half of the subjects used RP and half used DFP. Exposure to persulfate and ammonia was measured. Before and after each bleaching, the participants stated their degree of airway symptoms on a visual analogue scale. Nasal lavage and blood were sampled before exposure, after the last bleaching, and in the morning after exposure to measure inflammatory markers. Results: Exposure to persulfate was higher when using RP compared to DFP, 22 (11-55) vs. 12 (8- 13) μg/m3; median (min-max). Exposure to ammonia did not differ between the groups. Both groups reported an increase in asthma-like symptoms and this increase was significant. Neutrophils, lymphocytes, and monocytes increased after exposure in both groups; monocytes decreased the day after. In nasal lavage, IL-8 was increased the morning after for both types of powder, and the increase was significant in the total group. IL-6 increased immediately after exposure and the day after only in the group using RP. Conclusions: Although DFP powder emits lower levels of persulfate, effects are still elicited in symptomatic hairdressers.
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27.
  • Zock, Jan-Paul, et al. (författare)
  • Distribution and determinants of house dust mite allergens in Europe : the European Community Respiratory Health Survey II
  • 2006
  • Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier BV. - 0091-6749 .- 1097-6825. ; 118:3, s. 682-690
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Several studies in European homes have described allergen levels from the house dust mite species Dermatophagoides pteronyssinus and to a lesser extent Dermatophagoides farinae, but geographic comparisons of exposure levels and risk factors have been hampered by a lack of standardized methods. Objective: To study the distribution and determinants of the major house dust mite allergens Der p 1 and Der f 1 in 10 European countries using a common protocol. Methods: During home visits with 3580 participants of the European Community Respiratory Health Survey II from 22 study centers, mattress dust was sampled and analyzed for Der p 1, Der f 1, and Der 2 allergen. Information on housing characteristics was obtained by both observations and interview. Results: Der 1 and Der 2 allergens were detectable (>= 0.1 mu g/g) in 68% and 53% of the samples, respectively. Large differences in allergen levels between study centers were observed, and geographic patterns for Der p 1 and Der f 1 were different. Low winter temperatures reduced Der p 1 rather than Der f 1. Important risk factors for high allergen levels included an older mattress, a lower floor level of the bedroom, limited ventilation of the bedroom, and dampness for Der p 1 but not for Der f 1. Conclusion: There are large qualitative and quantitative differences of house dust mite allergen levels in Europe, which can partly be explained by geographic and housing characteristics. Clinical implications: Mite allergen exposure may be reduced by replacing the mattress regularly and increasing ventilation of the bedroom, particularly in winter.
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28.
  • Zock, Jan-Paul, et al. (författare)
  • Domestic use of hypochlorite bleach, atopic sensitization, and respiratory symptoms in adults
  • 2009
  • Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier BV. - 0091-6749 .- 1097-6825. ; 124:4, s. 731-738
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Professional use of hypochlorite (bleach) has been associated with respiratory symptoms. Bleach is capable of inactivating allergens, and there are indications that its domestic use may reduce the risk of allergies in children. OBJECTIVE: To study the associations between household use of bleach and atopic sensitization, allergic diseases, and respiratory health status in adults. METHODS: We identified 3626 participants of the European Community Respiratory Health Survey II in 10 countries who did the cleaning in their homes and for whom data on specific serum IgE to 4 environmental allergens were available. Frequency of bleach use and information on respiratory symptoms were obtained in face-to-face interviews. House dust mite and cat allergens in mattress dust were measured in a subsample. Associations between the frequency of bleach use and health outcomes were evaluated by using multivariable mixed logistic regression analyses. RESULTS: The use of bleach was associated with less atopic sensitization (odds ratio [OR], 0.75; 95% CI, 0.63-0.89). This association was apparent for specific IgE to both indoor (cat) and outdoor (grass) allergens, and was consistent in various subgroups, including those without any history of respiratory problems (OR, 0.85). Dose-response relationships (P < .05) were apparent for the frequency of bleach use and sensitization rates. Lower respiratory tract symptoms, but not allergic symptoms, were more prevalent among those using bleach 4 or more days per week (OR, 1.24-1.49). The use of bleach was not associated with indoor allergen concentrations. CONCLUSION: People who clean their homes with hypochlorite bleach are less likely to be atopic but more likely to have respiratory symptoms.
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29.
  • Zock, Jan-Paul, et al. (författare)
  • The use of household cleaning sprays and adult asthma : an international longitudinal study
  • 2007
  • Ingår i: American Journal of Respiratory and Critical Care Medicine. - 1073-449X .- 1535-4970. ; 176:8, s. 735-741
  • Tidskriftsartikel (refereegranskat)abstract
    • Rationale: Cleaning work and professional use of certain cleaning products have been associated with asthma, but respiratory effects of nonprofessional home cleaning have rarely been studied. Objectives: To investigate the risk of new-onset asthma in relation to the use of common household cleaners. Methods: Within the follow-up of the European Community Respiratory Health Survey in 10 countries, we identified 3,503 persons doing the cleaning in their homes and who were free of asthma at baseline. Frequency of use of 15 types of cleaning products was obtained in a face-to-face interview at follow-up. We studied the incidence of asthma defined as physician diagnosis and as symptoms or medication usage at follow-up. Associations between asthma and the use of cleaning products were evaluated using multivariable Cox proportional hazards or log-binomial regression analysis. Measurements and Main Results: The use of cleaning sprays at least weekly (42% of participants) was associated with the incidence of asthma symptoms or medication (relative risk [RR], 1.49; 95% confidence interval [Cl], 1.12-1.99) and wheeze (RR, 1.39; 95% Cl, 1.06-1.80). The incidence of physician-diagnosed asthma was higher among those using sprays at least 4 days per week (RR, 2.11; 95% Cl, 1.15-3.89). These associations were consistent for subgroups and not modified by atopy. Dose-response relationships (P < 0.05) were apparent for the frequency of use and the number of different sprays. Risks were predominantly found for the commonly used glass-cleaning, furniture, and air-refreshing sprays. Cleaning products not applied in spray form were not associated with asthma. Conclusions: Frequent use of common household cleaning sprays may be an important risk factor for adult asthma.
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