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Sökning: WFRF:(Gerhardsson Lars)

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1.
  • Lundström, Nils-Göran, et al. (författare)
  • Cumulative lead exposure : relationship to mortality and lung cancer morbidity in a cohort of smelter workers
  • 1997
  • Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 23:1, s. 24-30
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The purpose of this study was to determine the mortality and cancer incidence of long-term lead smelter workers at a primary smelter.Methods: A cohort of 3979 workers employed for at least 1 year during 1928-1979 and a subcohort of 1992 workers employed in lead-exposed departments (lead only workers) was formed. The expected mortality in 1955-1987 and cancer incidence in 1958-1987 were calculated relative to the county rates, specified for cause, gender, 5-year age groups, and calendar year. A cumulative blood-lead index was used for the dose-response analyses.Results: The lung cancer incidence of the total cohort [standardized incidence ratio (SIR) 2.8, 95% confidence interval (95% CI) 2.1-3.8] and the group with the highest exposure (SIR 3.1, 95% CI 2.0-4.6) was high. Similar risk estimates were observed with a latency of 15 years. The workers hired before 1950 had higher lung cancer risk estimates (SIR 3.6, 95% CI 2.6-5.0) than the workers hired later (SIR 1.3, 95% CI 0.6-2.6, no latency period). The risk estimates for lung cancer were further elevated in the subcohort of lead-only workers (SIR 5.1, 95% CI 2.0-10.5 in the highest exposed subgroup; latency period of 15 years). No excesses of other malignancies were noted.Conclusions: The increased relative risks were probably mainly due to interactions between lead and other carcinogenic exposures, including arsenic. Further study is required concerning such possible interactions before a role in the induction of lung cancer can be ascribed to lead.
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3.
  • Gerhardsson, Lars, et al. (författare)
  • Blood lead concentration after a shotgun accident.
  • 2002
  • Ingår i: Environmental Health Perspectives. - 1552-9924. ; 110:1, s. 115-117
  • Tidskriftsartikel (refereegranskat)abstract
    • In an accidental shooting, a man in his late forties was hit in his left shoulder region by about 60 lead pellets from a shotgun. He had injuries to the vessels, the clavicle, muscles, and nerves, with total paralysis of the left arm due to axonal injury. After several surgical revisions and temporary cover with split skin, reconstructive surgery was carried out 54 days after the accident. The brachial plexus was swollen, but the continuity of the nerve trunks was not broken (no neuroma present). We determined the blood lead (BPb) concentration during a follow-up period of 12 months. The BPb concentration increased considerably during the first months. Although 30 lead pellets were removed during the reconstructive surgery, the BPb concentration continued to rise, and reached a peak of 62 microg/dL (3.0 micromol/L) on day 81. Thereafter it started to decline. Twelve months after the accident, BPb had leveled off at about 30 microg/dL. At that time, muscle and sensory functions had partially recovered. The BPb concentration exceeded 30 microg/dL for 9 months, which may have influenced the recovery rate of nerve function. Subjects with a large number of lead pellets or fragments embedded in the body after shooting accidents should be followed for many years by regular determinations of BPb. To obtain a more stable basis for risk assessment, the BPb concentrations should be corrected for variations in the subject's hemoglobin concentration or erythrocyte volume fraction.
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4.
  • Bergdahl, Ingvar A, et al. (författare)
  • Plasma-lead concentration: investigations into its usefulness for biological monitoring of occupational lead exposure.
  • 2006
  • Ingår i: American journal of industrial medicine. - New York : Wiley. - 0271-3586 .- 1097-0274. ; 49:2, s. 93-101
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The lead concentration in plasma is correlated to that in whole blood with a two to fourfold variation. It has never been investigated if this variation is inter-individual. METHODS: Lead and hemoglobin were determined in blood and plasma from 13 lead workers with a history of relatively high blood-lead concentrations, sampled three times during 1 day. The variation in the distribution of lead between cells and plasma was studied, but not the variation in the lead concentrations as such. RESULTS: Blood hemoglobin decreased with rising plasma lead (0.9-3.0 microg/L). Regarding the distribution of lead, no effect of current exposure during the day or of recent meals appeared. As much as 84% of the overall variance of the distribution of lead between cells and plasma could be attributed to individual factors. After adjustment for erythrocyte volume fraction this decreased to 67%. Plasma samples with elevated hemoglobin concentrations (due to in vitro hemolysis) had somewhat elevated lead concentrations. CONCLUSIONS: Plasma lead is not significantly altered by variation in a single day's exposure and, therefore, the choice of time of the day is not critical for sampling. However, plasma lead is negatively correlated to blood hemoglobin and mild hemolysis (not visible by the eye) in a sample may increase plasma lead with up to 30%. Finally, plasma provides lead exposure information that differs from whole blood, but it is not clear which one of these is the biomarker with the closest relation to exposure and/or effects.
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6.
  • Boström, Fredrik, et al. (författare)
  • Cerebrospinal fluid total tau is associated with shorter survival in dementia with Lewy bodies.
  • 2009
  • Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 28:4, s. 314-9
  • Tidskriftsartikel (refereegranskat)abstract
    • A pathology typical of dementia with Lewy bodies (DLB) has been demonstrated to increase mortality to a greater extent than the pathology of Alzheimer's disease (AD). However, mortality in DLB has also been shown to increase with concomitant AD pathology. Furthermore, in a recent publication, we showed that there is a robust and specific increase in CSF calcium and magnesium in DLB patients compared to both AD patients and controls. Thus, in order to explore the influence of CSF AD markers and trace element concentrations on mortality in DLB, we undertook a longitudinal prospective study of 47 clinically diagnosed DLB patients and 157 AD patients as well as 49 healthy volunteers. Both AD and DLB patients showed an increased mortality compared to the healthy controls (relative risk: 10 and 8, respectively; p < 0.001). Increased levels of CSF total tau were associated with increased mortality among the DLB patients (p < 0.05), but not among the AD patients or controls. Gender, age, MMSE score, Abeta42 concentration and phosphorylated tau, and CSF trace element concentrations did not influence survival in the obtained models.
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7.
  • Boström, Fredrik, et al. (författare)
  • CSF Mg and Ca as diagnostic markers for dementia with Lewy bodies.
  • 2008
  • Ingår i: Neurobiology of aging. - : Elsevier BV. - 1558-1497 .- 0197-4580. ; 30:8, s. 1265-1271
  • Tidskriftsartikel (refereegranskat)abstract
    • Accumulating evidence implicates a role for altered metal homeostasis in the pathogenesis of neurodegenerative disorders such as Alzheimer's disease (AD). However, few investigations have addressed this issue in dementia with Lewy bodies (DLB). The aim of the present study was to investigate metal concentrations in cerebrospinal fluid (CSF) and plasma from patients with DLB and other neurodegenerative disorders. To that end, CSF and plasma samples were collected from 29 patients with DLB, 174 patients with AD, 90 patients with AD with minor vascular components, and 51 healthy volunteers. Total concentrations of Mg, Ca, Mn, Fe, Cu, Zn, Rb, Sr, and Cs were determined using mass spectrometry. Patients with DLB had elevated Ca and Mg levels in CSF and Mg levels in plasma as compared to all other groups (p<0.001). Furthermore, a combination of CSF-Mg and CSF-Ca could distinguish DLB from AD with a sensitivity of 93% and a specificity of 85%. Cu levels in both CSF and plasma tended to be higher in DLB compared to the other groups, but these trends failed to reach significance after correction for multiple comparisons. Mn, Fe, Zn, Rb, and Sr concentration in CSF or plasma were similar in all groups. The observed elevations of CSF-Mg, CSF-Ca and CSF-Cu may contribute to or be associated with the neurodegenerative process in DLB. Furthermore, determination of CSF-Mg and CSF-Ca concentration may be a valuable tool in distinguishing DLB from AD.
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8.
  • Börjesson, Jimmy, et al. (författare)
  • Kidney cadmium as compared to other markers of cadmium exposure in workers at a secondary metal smelter
  • 2001
  • Ingår i: American Journal of Industrial Medicine. - 0271-3586. ; 39:1, s. 19-28
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The aim of the study was to evaluate whether cadmium concentrations in kidney (K-Cd), blood (B-Cd) or urine (U-Cd) could reveal previous occupational cadmium exposure at a metal smelter. METHODS: The study included 90 smelters and 35 controls (B-Cd and U-Cd determination). In a subgroup (N = 33), K-Cd was also determined. RESULTS: B-Cd (median 4.6; range 0.5-53 nmol/L), U-Cd (0. 29; 0.04-1.9 micromol/mol creatinine) and K-Cd (14; 3-61 microg/g wet weight) were similar to reported concentrations in the general Swedish population. In the subgroup, significant associations (P<0. 001) were obtained between B-Cd and K-Cd (r = 0.70), U-Cd and K-Cd (r = 0.60) and between U-Cd and B-Cd (r = 0.62). Multiple regression analyses revealed smoking as the major predictor of K-Cd, B-Cd, and U-Cd. B-Cd and U-Cd were both associated with the duration of employment at the smelter. CONCLUSIONS: There was no statistically significant evidence of previous occupational exposure at the smelter from measurement of K-Cd.
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  • Custodio, Hipolito M, et al. (författare)
  • Genetic influences on the retention of inorganic mercury.
  • 2005
  • Ingår i: Archives of environmental & occupational health. - 1933-8244. ; 60:1, s. 17-23
  • Tidskriftsartikel (refereegranskat)abstract
    • Mercury is eliminated as glutathione (GSH) conjugates. GSH production is mediated by glutamyl-cysteine ligase (GCL), and conjugation by glutathione S-transferases (GST). This study tested if polymorphisms in GCL and GST genes modify mercury retention in humans exposed to elemental mercury vapor. Total mercury concentrations in whole blood, plasma and urine, and genotypes for GCLC, GCLM, GSTA1, GSTM1, GSTP1, and GSTT1 were determined in 309 gold miners, gold buyers and controls. The presence of the GCLM-588T allele was associated with increased blood, plasma and urine mercury levels. These results indicate that genotypes with decreased GSH availability for mercury conjugation affect the metabolism of inorganic mercury.
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11.
  • Edlund, Maria, 1972, et al. (författare)
  • A prospective cohort study investigating an exposure-response relationship among vibration-exposed male workers with numbness of the hands
  • 2014
  • Ingår i: Scandinavian Journal of Work Environment & Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 40:2, s. 203-209
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective The aim of this study was to investigate the exposure response relationship of hand-arm vibration (HAY) exposure to neurological symptoms (numbness) of the hand in a cohort of vibration-exposed workers. Methods The baseline cohort comprised 241 office and manual workers with and without exposure to HAY. Numbness (the symptom or event) in the hand was assessed for all subjects at baseline and follow-ups after 5, 10, and 16 years. The workers were stratified into quartiles with no exposure in the first quartile and increasing intensity of exposure in quartiles 2-4 (groups 1-3). Data analysis was performed using survival analysis (time-to-event). Information on cumulative exposure and years of exposure to event was collected via questionnaires. Measurements were performed in accordance with the International Organization for Standardization (ISO) 5349-1. Results The hazard ratio (HR) of risk of event (numbness) differed statistically significantly between the non-exposed group (group 0) and the two higher exposure groups (groups 2 and 3). There was also a significant ratio difference between the lowest exposure group (group 1) and the two higher groups. The ratio for group 1 was 1.77 [95% confidence interval (95% CI) 0.96-3.26] compared with 3.78 (95% CI 2.15-6.62) and 5.31(95% CI 3.06-9.20) for groups 2 and 3, respectively. Conclusion The results suggest a dose response relationship between vibration exposure and numbness of the hands. This underlines the importance of keeping vibration levels low to prevent neurological injury to the hands.
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12.
  • Edlund, Maria, 1972, et al. (författare)
  • Physical capacity and psychological mood in association with self-reported work ability in vibration-exposed patients with hand symptoms.
  • 2012
  • Ingår i: Journal of occupational medicine and toxicology (London, England). - : Springer Science and Business Media LLC. - 1745-6673. ; 7:1
  • Tidskriftsartikel (refereegranskat)abstract
    • ABSTRACT: BACKGROUND: The aim of this study was to investigate whether self-reports of work ability correlated to the results of quantitative tests measuring physical capacity and a questionnaire assessing psychological mood in vibration-exposed patients with hand symptoms. METHODS: The participants comprised 47 patients (36 men and eleven women) with exposure to hand vibration and vascular and/or neurological symptoms in the hands. They performed several quantitative tests (manual dexterity, hand grip strength, finger strength) and completed the Work Ability Index (WAI) and Hospital Anxiety and Depression Scale (HADS) questionnaires. RESULTS: Correlation analysis revealed statistically significant associations between the WAI results, the HADS indices, hand grip and finger strength, and manual dexterity measured using the Purdue Pegboard(R). Multiple regression analysis revealed age and HADS indices as the strongest predictors of work ability. CONCLUSIONS: The patient's age and psychological mood may be stronger predictors of work ability compared with results from tests measuring physical capacity of the hands in vibration-exposed patients with hand symptoms. When using the WAI as an instrument for assessing work ability in these patients, health care providers need to be more aware of the impact of the psychological mood.
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13.
  • Engström, Gunnar, et al. (författare)
  • BP Variability and Cardiovascular Autonomic Function in Relation to Forced Expiratory Volume : A Population-Based Study
  • 2009
  • Ingår i: Chest. - : Elsevier BV. - 0012-3692 .- 1931-3543. ; 136:1, s. 177-183
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Cardiovascular autonomic dysfunction is associated with increased incidence of cardiovascular diseases (CVD). This population-based study explored whether low FEV(1) or low vital capacity (VC) is associated with autonomic dysfunction, as measured by the spontaneous heart rate variability (HRV) and systolic BP variability (SBPV). Methods SBPV and HRV were recorded during 5 min of controlled breathing in men and women, aged 70 years. FEV(1) and VC were recorded in 901 subjects. Of them, information on HRV and SBPV was available in 820 and 736 subjects, respectively. Measures of autonomic function, ie, SBPV in the low-frequency (LF) and high-frequency (HF) domains, HRV and baroreceptor sensitivity (BRS), were studied in sex-specific quartiles of FEV1 and VC. Results Low FEV(1) was associated with high SBPV in the HF domain. Mean SBPV-HF was 5.2, 4.5, 4.1 and 3.8 mm Hg, respectively, in subjects with FEV(1) in the first (low), second, third and fourth quartile (trend: p < 0.001). This relationship persisted after adjustments for potential confounding factors. Low VC was significantly associated with high SBPV-HF in the crude analysis, but not after adjustment for confounding factors. Neither FEV(1) nor VC showed any significant relationship with BRS, HRV or SBPV in the LF domain. Conclusion In this population-based study, low FEV(1) was associated with high systolic BP variability in the HF domain. It is suggested that high beat-to-beat variability in BP could contribute to the increased cardiovascular risk in subjects with moderately reduced FEV(1).
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14.
  • Gerhardsson, Lars, 1952 (författare)
  • A follow-up study of vibration-induced injuries in workers exposed to transient and high frequency vibrations
  • 2024
  • Ingår i: JOURNAL OF OCCUPATIONAL MEDICINE AND TOXICOLOGY. - 1745-6673. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background In a previous study from 2018, 38 wheel loader assembly workers were examined, showing high exposures to transient and high-frequency vibrations. After the investigation, preventive measures were immediately implemented to reduce the vibration exposure. In 2022, a follow-up study was carried out to examine the effect of these measures.Methods The follow-up study included 35 (27 men and 8 women) of the original 38 workers. They were divided into two groups, 24 workers with ongoing vibration exposure and 11 workers, not vibration exposed since 2018. All participants completed a questionnaire and underwent a thorough examination, including several neurophysiological tests and a comprehensive assessment of musculoskeletal symptoms. The questionnaire responses and on-site vibration level measurements formed the basis for the individual vibration exposure assessment.Results In 2018, clear differences were noted between the two groups regarding vibration perception thresholds (VPT), needle test, 2-PD (2-point discrimination), and monofilament test with deviating results in the unexposed group. The difference between the two groups was significantly smaller at the follow-up examination in 2022, where differences remained for VPT and monofilament tests, with deviating test results in the unexposed group. When comparing variable values between 2018 and 2022 within the exposed and unexposed groups, respectively, the unexposed group showed mostly unchanged values, while a deterioration was observed for VPT, needle test and temperature sensitivity test among the exposed workers during follow-up. The prevalence of VWF (Vibration white fingers) was around 30-40% and neuropathy around 75% among exposed workers during follow-up compared to about 60% and 85% respectively, in the unexposed group.Conclusion The overall categorization of white fingers and neuropathy, according to the Stockholm Workshop Scale, remained largely unchanged in both study groups from 2018 to 2022. The introduction of cost-effective and relatively simple preventive measures may have contributed to this result. Throughout the follow-up period, the number of exposed workers who developed musculoskeletal disorders and newly reported cases of vibration injuries at the factory decreased. Without this preventive program, increased vascular and nerve symptoms would most likely have occurred during follow-up due to continued vibration exposure.
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  • Gerhardsson, Lars, et al. (författare)
  • Cadmium, copper and zinc in tissues of deceased copper smelter workers
  • 2002
  • Ingår i: Journal of Trace Elements in Medicine and Biology. - 1878-3252. ; 16:4, s. 261-266
  • Tidskriftsartikel (refereegranskat)abstract
    • Workers at a copper and lead smelter in northern Sweden have a multifactorial exposure to a number of heavy metals. The concentrations of cadmium, copper and zinc in Liver, Lung, kidney and brain tissues have been deters mined by atomic absorption spectrometry in 32 deceased tong-term exposed male lead smelter workers, and compared with those of 10 male controls. Furthermore, copper and zinc Levels in hair and nails were determined by energy-dispersive X-ray fluorescence. The highest cadmium concentrations among both workers and controls were observed in kidney, followed in order by liver, lung and brain. The levels in kidney, Liver and Lung were all significantly higher in the workers than in the controls (p < 0.03). Among the workers relatively strong positive correlations (p < 0.03) were observed between cadmium concentrations in liver and lung, liver and kidney, liver and brain, and lung and brain. In the exposed workers a positive correlation was observed between cadmium and zinc concentrations in the kidney (r(s) = 0.38; p = 0.034). This is probably mainly due to the protein metallothionein, which is stored in the kidney, binding equimolar amounts of these two metals. The highest concentrations of copper were found in hair and nails among both workers and controls, followed in order by liver, brain, kidney and Lung. The tissue concentrations of copper in brain, Lung and kidney were all significantly higher among the smelter workers than in the controls (p less than or equal to 0.036). Copper Levels in lung and age at time of death were positively correlated among the exposed workers (r(s) = 0.39; p = 0.029). In the same group, positive correlations between copper and zinc concentrations in kidney (r(s) = 0.45; p = 0.009) and nails (r(s) = 0.68; p < 0.001) were also observed, reflecting possible biological interactions between these two metals. Among both workers and controls, the highest zinc concentrations were found in hair, followed in order by nails, liver, kidney, brain and lung. Significantly higher tissue concentrations among the workers as compared with the reference group were noted in kidney, liver and brain (p &LE; 0.033). Neither copper nor zinc concentrations in hair and nails seemed to provide a useful measure of the trace element status of the smelter workers.Workers at a copper and lead smelter in northern Sweden have a muttifactodal exposure to a number of heavy metals. The concentrations of cadmium, copper and zinc in Liver, Lung, kidney and brain tissues have been deters mined by atomic absorption spectrometry in 32 deceased tong-term exposed male lead smelter workers, and compared with those of 10 male controls. Furthermore, copper and zinc Levels in hair and nails were determined by energy-dispersive X-ray fluorescence. The highest cadmium concentrations among both workers and controls were observed in kidney, followed in order by liver, lung and brain. The levels in kidney, Liver and Lung were all significantly higher in the workers than in the controls (p < 0.03). Among the workers reLativety strong positive correlations (p < 0.03) were observed between cadmium concentrations in liver and lung, liver and kidney, liver and brain, and lung and brain. In the exposed workers a positive correlation was observed between cadmium and zinc concentrations in the kidney (r, = 0.38; p = 0.034). This is probably mainly due to the protein meta llothionei n, which is stored in the kidney, binding equimolar amounts of these two metals. The highest concentrations of copper were found in hair and nails among both workers and controls, followed in order by liver, brain, kidney and Lung. The tissue concentrations of copper in brain, Lung and kidney were all significantLy higher among the smelter workers than in the controls (p &LE;0.036). Copper Levels in lung and age at time of death were positively correlated among the exposed workers (r(s) = 0.39; p = 0.029). In the same group, positive correlations between copper and zinc concentrations in kidney (r(s) = 0.45; p = 0.009) and nails (r(x) = 0.68; p < 0.001) were also observed, reflecting possible biological interactions between these two metals. Among both workers and controls, the highest zinc concentrations were found in hair, followed in order by naits, liver, kidney, brain and lung. Significantly higher tissue concentrations among the workers as compared with the reference group were noted in kidney, liver and brain (p < 0.033). Neither copper nor zinc concentrations in hair and nails seemed to provide a useful measure of the trace element status of the smelter workers.
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16.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Cerebrospinal fluid/plasma quotients of essential and non-essential metals in patients with Alzheimer's disease.
  • 2011
  • Ingår i: Journal of neural transmission (Vienna, Austria : 1996). - : Springer Science and Business Media LLC. - 1435-1463 .- 0300-9564. ; 118:6, s. 957-62
  • Tidskriftsartikel (refereegranskat)abstract
    • In this study, the quotients (Q) between metal concentrations in cerebrospinal fluid (CSF) and plasma were studied in subjects with Alzheimer's disease (AD) and referents to investigate if the leakage through the blood-CSF barrier (BCB) increased with increased duration and severity of the disease. Concentrations of 18 metals (Mg, Ca, Mn, Fe, Co, Ni, Cu, Zn, Se, Rb, Sr, Mo, Cd, Sn, Sb, Cs, Hg, and Pb) were determined by ICP-MS in plasma and cerebrospinal fluid in 264 patients with AD, and in 54 healthy referents. The quotients Q (Mn), Q (Rb), Q (Sb), Q (Pb) and Q (Hg) were significantly lower (p≤0.003) and Q (Co) significantly higher (p≤0.001) in subjects with AD as compared with the controls. Subjects in a subgroup with more severe AD, showed the same pattern. The metal leakage into CSF did not increase with increased duration and/or severity of the disease. The permeability of BCB varied considerably between the studied metals with low median quotients (Q≤0.02) for Cd, Cu, Sb, Se and Zn and higher median quotients for Ca (Q~0.5) and Mg (Q~1.3), probably partly depending on differences in size and lipophilicity of metal-carrier complexes and specific carrier mechanisms.
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  • Gerhardsson, Lars, 1952, et al. (författare)
  • Concentrations of metals, beta-amyloid and tau-markers in cerebrospinal fluid in patients with Alzheimer's disease.
  • 2009
  • Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 28:1, s. 88-94
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND/AIMS: In this study, metal concentrations were related to the levels of well-known Alzheimer markers in cerebrospinal fluid (CSF), such as amyloid-beta (Abeta), total tau (T-tau) and phosphorylated-tau (P-tau). METHODS: Concentrations of 19 metals (Mg, Ca, V, Mn, Fe, Co, Ni, Cu, Zn, Se, Rb, Sr, Mo, Cd, Sn, Sb, Cs, Hg and Pb by inductively coupled plasma-mass spectrometry) and the levels of Abeta, T-tau and P-tau in CSF were determined (xMAP technology) in 264 patients with Alzheimer's disease (AD), and in 54 healthy referents. RESULTS: The AD subjects showed positive correlations between CSF-T-tau and CSF-P-tau versus CSF-Mn (r(s) = 0.22, p = 0.004; r(s) = 0.18, p = 0.021). CSF-T-tau, however, showed a negative correlation with CSF-Cs (r(s) = -0.17; p = 0.027). In subjects with severe AD, CSF-Abeta showed a strong positive correlation with CSF-Cs (r(s) = 0.49; p = 0.026), while CSF-T-tau showed a strong negative correlation with CSF-Cs (r(s) = -0.49; p = 0.026). Also, CSF P-tau was negatively associated with CSF-Cs (r(s) = -0.41; p = 0.06). CONCLUSION: The different relationships between the CSF-levels of Abeta and tau-markers versus the levels of CSF-Mn and CSF-Cs may be due to different binding affinity between these metals and metal binding proteins in the CSF and the surrounding brain.
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18.
  • Gerhardsson, Lars, et al. (författare)
  • Copper allergy from dental copper amalgam?
  • 2002
  • Ingår i: Science of the Total Environment. - 1879-1026. ; 290:1-3, s. 41-46
  • Tidskriftsartikel (refereegranskat)abstract
    • A 65-year-old female was investigated due to a gradually increasing greenish colour change of her plastic dental splint, which she used to prevent teeth grinding when sleeping. Furthermore, she had noted a greenish/bluish colour change on the back of her black gloves, which she used to wipe her tears away while walking outdoors. The investigation revealed that the patient had a contact allergy to copper, which is very rare. She had, however, had no occupational exposure to copper. The contact allergy may be caused by long-term exposure of the oral mucosa to copper from copper-rich amalgam fillings, which were frequently used in childhood dentistry up to the 1960s in Sweden. The deposition of a copper-containing coating on the dental splint may be caused by a raised copper intake from drinking water, increasing the copper excretion in saliva, in combination with release of copper due to electrochemical corrosion of dental amalgam. The greenish colour change of the surface of the splint is probably caused by deposition of a mixture of copper compounds, e.g. copper carbonates. Analysis by the X-ray diffraction technique indicates that the dominant component is copper oxide (Cu2O and CuO). The corresponding greenish/bluish discoloration observed on the back of the patient's gloves may be caused by increased copper excretion in tears.
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19.
  • Gerhardsson, Lars, 1952 (författare)
  • Diagnosis and treatment of metal poisoning general aspects
  • 2021
  • Ingår i: Handbook on the Toxicology of Metals: Volume I: General Considerations. - 9780128232927 ; , s. 663-684
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Metal poisoning may or may not be apparent from the clinical features induced. The exposure pattern in terms of time, concentration, and route of exposure is a determinant of the clinical effect. Short-term high-level and long-term low-level exposure by ingestion are seen more often in the domestic environment and inhalation exposure is seen more often in occupational settings. Acute and chronic clinical effects of metal toxicity may involve the gastrointestinal, respiratory, cardiovascular, renal, hemopoietic, skin, and central nervous systems. In the diagnosis of metal poisoning, the presenting features may be nonspecific, with clinical examination giving no indication of the cause of illness. A full occupational history is required, along with knowledge of the work processes involved, and a detailed history is required where poisoning may occur in the domestic environment, particularly when poisoning results from the long-term absorption of cumulative metals. However, metal accumulation and poisoning may occur in the absence of environmental exposure, as, for example, transfusional siderosis in thalassemias, iron overload in idiopathic hemochromatosis, and copper accumulation in Wilson disease. In addition to history and clinical examination, trace metal analysis in body fluids, tissues, and environmental samples is required, together with biochemical and physiological investigation. In the treatment of metal poisoning, priorities should be to prevent further absorption by removal from exposure; minimize absorption from the gastrointestinal tract; provide general supportive therapy to maintain respiration, circulation, and water and electrolyte balance; and control nervous system effects. Elimination of the absorbed poison may be promoted by diuresis, blocking enterohepatic circulation, hemodialysis, or exchange transfusion. A number of therapeutic agents counteract the effects of an absorbed toxic metal by combining to form a less toxic compound that may be excreted more effectively by displacing it from its receptor site or by promoting translocation into a tissue where it cannot exert its toxic effects. Toxic metal antagonists, i.e., chelating agents, compete for toxic metals with ligands essential for their physiological function by forming a stable complex with the metal in the form of a heterocyclic ring. Chelating agents possess electron donor groups with a high affinity for the metal to be removed, thus causing its release from complexes with proteins or other endogenous ligands in a form that can be readily excreted. Chelation is indicated in the treatment of metal poisoning and metal storage diseases, in blood transfusion in iron overload, and to aid the elimination of metallic nuclides. However, chelation may result in depletion of essential metals or redistribution of toxic metals to other tissues such as the brain. Chelators themselves may also have toxic effects. Classical chelators, e.g., the polyaminopolycarboxylic acid ethylenediaminetetraacetic acid and the thiols dimercaprol [British anti-Lewisite (BAL), 2, 3-dimercaptopropanol] and d-penicillamine are of limited use today. Recent research activities have shown that meso-2, 3-dimercaptosuccinic acid (DMSA; succimer) and 2, 3-dimercaptopropane-1-sulfonate (DMPS; Dimaval, unithiol) are effective in the treatment of lead, arsenic, mercury, and to some extent also in polonium poisoning. Succimer and Dimaval have a significantly lower toxicity than BAL and DMPS can be administered both orally and intravenously. Due to its low toxicity, Succimer may turn out to be the drug of choice for the treatment of Wilson disease, with trientine or thiomolybdate as therapeutic alternatives. Deferoxamine (desferrioxamine, Desferal) is the drug of choice for antidotal management of acute iron overdose. Other orally given agents such as deferasirox (Exjade) and deferiprone (Ferriprox) can be used for the treatment of iron poisoning from metabolic sources and transfusional siderosis. These two agents can be administered in combination. In addition, the combination f deferiprone perorally and deferoxamine subcutaneously have shown promising results for the treatment of these conditions.
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20.
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21.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Lead concentrations in cortical and trabecular bones in deceased smelter workers.
  • 2005
  • Ingår i: Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS). - : Elsevier BV. - 0946-672X .- 1878-3252. ; 19:2-3, s. 209-15
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the study was to compare bone lead concentrations in cortical and trabecular bones in long-term exposed primary copper and lead smelter workers, and to relate the measured concentrations to the previous lead exposure of the workers. Lead concentrations in seven bones (trabecular: sternum, vertebrae, iliac crest, rib; cortical: femur, left forefinger, and temporal bone) were determined by electrothermal atomic absorption spectrometry in 32 male, long-term exposed copper and lead smelter workers, and compared with levels in 10 male occupationally unexposed reference persons. A time-integrated blood lead index (cumulative blood lead index, CBLI) was calculated for each worker. The lead levels in the seven studied bones were all significantly higher in active and retired lead workers as compared with the reference group (p
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22.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Metal concentrations in blood and hair in pregnant females in southern Sweden.
  • 2010
  • Ingår i: Journal of environmental health. - 0022-0892. ; 72:6, s. 37-41
  • Tidskriftsartikel (refereegranskat)abstract
    • The study described here was comprised of 100 pregnant females from two prenatal care units at the cities of Hassleholm and Simrishamn in southern Sweden. It included a questionnaire as well as whole blood (total mercury, cadmium, and lead) and hair (total mercury) sampling (collection period 2002-2003). The median values of total mercury (B-Hg 0.70 microg/L; range 0.27-2.1 microg/L), cadmium (0.30 microg/L, 0.05-4.8 microg/L) and lead (11.0 microg/L, 4.2-79 microg/L) in whole blood were low in the total material, as were the hair mercury concentrations (Hair-Hg 0.22 microg/g, 0.04-0.83 microg/g). In a multiple linear regression model, B-Hg was related to the number of fish meals per week and to the number of occlusal amalgam fillings (multiple r = 0.51; p < .001). The levels of mercury, cadmium, and lead in whole blood were lower than suggested biological reference intervals, and did not indicate risks for adverse health effects.
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23.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Metal concentrations in plasma and cerebrospinal fluid in patients with Alzheimer's disease.
  • 2008
  • Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 25:6, s. 508-15
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND/AIMS: The homeostasis of essential metals such as copper, iron, selenium and zinc may be altered in the brain of subjects with Alzheimer's disease (AD). METHODS: Concentrations of metals (magnesium, calcium, vanadium, manganese, iron, cobalt, nickel, copper, zinc, selenium, rubidium, strontium, molybdenum, cadmium, tin, antimony, cesium, mercury and lead) were determined in plasma and cerebrospinal fluid (CSF) by inductively coupled plasma mass spectrometry in 173 patients with AD and in 87 patients with the combination of AD and minor vascular components (AD + vasc). Comparison was made with 54 healthy controls. RESULTS: The plasma concentrations of manganese and total mercury were significantly higher in subjects with AD (p < 0.001) and AD + vasc (p
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24.
  • Gerhardsson, Lars, et al. (författare)
  • Metallmätningar hos gravida kvinnor
  • 2005
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Denna undersökning av 104 gravida kvinnor från mödravårdscentralerna vid Hässleholms sjukhus (51 st) och Simrishamns sjukhus (53 st) har finansierats genom Naturvårdsverkets miljöövervakningsprogram. Undersökningen genomfördes perioden 2002-2003 och innefattade frågeformulär (Bilaga 1), blodprover (totalkvicksilver, organiskt och oorganiskt kvicksilver samt bly och kadmium) och hårprover (totalkvicksilver). Medianvärdena i helblod bland samtliga kvinnor låg genomgående lågt i början av graviditeten: för kvicksilver (B-Hg totalt medianvärde 0,64 μg/L; range 0,04-2,05 μg/L; B-Hg org 0,30; 0-1,68; B-Hg oorg 0,25; 0-1,35) samt för bly (11,0 μg/L; 4,2- 79,0) och kadmium (0,30 μg/L; 0,05-4,8). Även kvicksilverkoncentrationerna i hår var genomgående låga (median 0,22 μg/g; range 0,04-0,83). De gravida kvinnorna från kuststaden Simrishamn hade signifikant högre koncentrationer av kadmium (p=0,004) och totalkvicksilver (p=0,005) i helblod liksom av kvicksilver i hår (p=0,015) jämfört med inlandsstaden Hässleholm. Den grupp som åt insjöfisk under graviditetens sista 6 månader hade ungefär samma halter av totalkvicksilver, oorganiskt och organiskt kvicksilver i helblod, liksom av totalkvicksilver i hår, som den grupp som enbart åt havsfisk. Kvinnor som emellertid ätit krabba under motsvarande period hade något högre halter av organiskt (p=0,037) resp totalkvicksilver (p=0,013) i helblod jämfört med kvinnor som ej ätit krabba. Halterna av oorganiskt kvicksilver i helblod visade ett positivt samband med såväl antalet occlusala (rs=0,27; p=0,008) som med det totala antalet amalgamfyllningar (rs=0,25; p=0,014) i munnen. Vid en linjär regressionsanalys var kvicksilverhalten i helblod relaterad till såväl antalet fiskmåltider per vecka som till antalet occlusala amalgamfyllningar i munnen. Kvicksilverkoncentrationen i hår visade det starkaste sambandet med totalkvicksilverhalten i helblod. Värdena av totalkvicksilver och metylkvicksilver i helblod var klart lägre i denna undersökning från södra Sverige i jämförelse med resultaten från motsvarande studier från västkusten och Uppsala län. Så var även fallet för kvicksilverhalterna i hår. Baserat på data från NRC (2000) och EPA (2001), har med hänsyn taget till använda säkerhetsfaktorer, följande referensvärden föreslagits: B-Hg totalt 5 μg/L, B-Hg org 4 μg/L, Hår-Hg 1 μg/g. Samtliga kvinnor i vår undersökning låg under dessa referensvärden. Fortsatt hälsorelaterad miljöövervakning kan emellertid vara motiverad, för att säkerställa att denna känsliga grupp även fortsättningsvis har en kvicksilver-, bly- och kadmiumbelastning, som inte innebär hälsorisker för mödrar eller foster.
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25.
  • Gerhardsson, Lars, et al. (författare)
  • Metallmätningar hos gravida kvinnor, SNV nr 2150204
  • 2005
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Denna undersökning av 104 gravida kvinnor från mödravårdscentralerna vidHässleholms sjukhus (51 st) och Simrishamns sjukhus (53 st) har finansierats genomNaturvårdsverkets miljöövervakningsprogram. Undersökningen genomfördesperioden 2002-2003 och innefattade frågeformulär (Bilaga 1), blodprover(totalkvicksilver, organiskt och oorganiskt kvicksilver samt bly och kadmium) ochhårprover (totalkvicksilver).Medianvärdena i helblod bland samtliga kvinnor låg genomgående lågt i början avgraviditeten: för kvicksilver (B-Hg totalt medianvärde 0,64 μg/L; range 0,04-2,05μg/L; B-Hg org 0,30; 0-1,68; B-Hg oorg 0,25; 0-1,35) samt för bly (11,0 μg/L; 4,2-79,0) och kadmium (0,30 μg/L; 0,05-4,8). Även kvicksilverkoncentrationerna i hårvar genomgående låga (median 0,22 μg/g; range 0,04-0,83). De gravida kvinnornafrån kuststaden Simrishamn hade signifikant högre koncentrationer av kadmium(p=0,004) och totalkvicksilver (p=0,005) i helblod liksom av kvicksilver i hår(p=0,015) jämfört med inlandsstaden Hässleholm. Den grupp som åt insjöfisk undergraviditetens sista 6 månader hade ungefär samma halter av totalkvicksilver,oorganiskt och organiskt kvicksilver i helblod, liksom av totalkvicksilver i hår, somden grupp som enbart åt havsfisk. Kvinnor som emellertid ätit krabba undermotsvarande period hade något högre halter av organiskt (p=0,037) resptotalkvicksilver (p=0,013) i helblod jämfört med kvinnor som ej ätit krabba.Halterna av oorganiskt kvicksilver i helblod visade ett positivt samband med såvälantalet occlusala (rs=0,27; p=0,008) som med det totala antalet amalgamfyllningar(rs=0,25; p=0,014) i munnen. Vid en linjär regressionsanalys var kvicksilverhalten ihelblod relaterad till såväl antalet fiskmåltider per vecka som till antalet occlusalaamalgamfyllningar i munnen. Kvicksilverkoncentrationen i hår visade det starkastesambandet med totalkvicksilverhalten i helblod.Värdena av totalkvicksilver och metylkvicksilver i helblod var klart lägre i dennaundersökning från södra Sverige i jämförelse med resultaten från motsvarande studierfrån västkusten och Uppsala län. Så var även fallet för kvicksilverhalterna i hår.Baserat på data från NRC (2000) och EPA (2001), har med hänsyn taget till användasäkerhetsfaktorer, följande referensvärden föreslagits: B-Hg totalt 5 μg/L, B-Hg org 4μg/L, Hår-Hg 1 μg/g. Samtliga kvinnor i vår undersökning låg under dessareferensvärden. Fortsatt hälsorelaterad miljöövervakning kan emellertid varamotiverad, för att säkerställa att denna känsliga grupp även fortsättningsvis har enkvicksilver-, bly- och kadmiumbelastning, som inte innebär hälsorisker för mödrar eller foster.
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26.
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27.
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28.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Neurophysiologic symptoms and vibration perception thresholds in young vibration-exposed workers - a follow-up study
  • 2011
  • Ingår i: Canadian Acoustics, June 2011. Proceedings of The Twelfth International Conference on Hand-Arm Vibration.. - 0711-6659 .- 2291-1391. ; 39:2, s. 16-17
  • Tidskriftsartikel (refereegranskat)abstract
    • Vibration exposure may cause the hand-arm vibration syndrome (HAVS), including digital vasospasms (vibration white fingers; VWF), sensorineural symptoms and/or muscular weakness and fatigue (Gemne, 1997). Neurophysiologic symptoms include numbness and/or tingling, impaired touch sensitivity, impaired manual dexterity and reduced grip strength in the hands. The Stockholm Workshop Scale is commonly used for sensorineural (SN) staging (OSN - 3 SN). Sensorineural symptoms of this in combination with difficulties in handling small objects may interfere both with the workers social- and work-related activities (Sakakibara et al., 2005).
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29.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Noise disturbances in daycare centers before and after acoustical treatment.
  • 2013
  • Ingår i: Journal of environmental health. - 0022-0892. ; 75:7, s. 36-40
  • Tidskriftsartikel (refereegranskat)abstract
    • The authors' aim was to study noise-related problems in personnel at Swedish daycare centers. The authors' study comprised staff (N = 81) who completed a questionnaire (noise, illumination, indoor climate, hearing problems) at five daycare centers with noise problems. After basic and activity sound measurements, absorbers were attached to the ceilings and to two adjacent walls in the playing and dining rooms. Thereafter, basic and activity sound measures were repeated and the questionnaire was also repeated six months later. The acoustical treatment reduced the sound pressure levels by 2 to 6 dB in the playing rooms and by 0 to 3 dB in the dining rooms. The reverberation time was reduced by 20% to 50%. After the treatment the perceived noise disturbance level decreased slightly but not significantly and the proportion of the staff who often or very often planned the daily activities to reduce the noise level had decreased from about 39% to 25%. Similarly, the percentage that often or very often had a need for silence after work had decreased from 42% to 37%.
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30.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Quantitative neurosensory findings, symptoms and signs in young vibration exposed workers.
  • 2013
  • Ingår i: Journal of occupational medicine and toxicology (London, England). - : Springer Science and Business Media LLC. - 1745-6673. ; 8:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract Background: Long-term exposure to hand-held vibrating tools may cause the hand arm vibration syndrome (HAVS) including vibration induced white fingers and sensorineural symptoms. The aim was to study early neurosensory effects by quantitative vibrotactile and monofilament tests in young workers with hand-held vibration exposure. Methods: This cross-sectional study consisted of 142 young, male machine shop and construction workers with hand-held exposure to vibrating tools. They were compared with 41 non-vibration exposed subjects of the same age-group. All participants passed a structured interview, answered several questionnaires and had a physical examination including the determination of vibrotactile perception thresholds (VPTs) at two frequencies (31.5 and 125 Hz) and Semmes Weinstein ’ s Monofilament test. Results: In the vibration exposed group 8% of the workers reported episodes of tingling sensations and 10% numbness in their fingers. Approximately 5 – 10% of the exposed population displayed abnormal results on monofilament tests. The vibrotactile testing showed significantly increased VPTs for 125 Hz in dig II bilaterally (right hand, p = 0.01; left hand, p = 0.024) in the vibration exposed group. A multiple regression analysis (VPT - dependent variable; age, height, examiner and five different vibration dose calculations – predictor variables) in dig II bilaterally showed rather low R 2 -values. None of the explanatory variables including five separately calculated vibration doses were included in the models, neither for the total vibration exposed group, nor for the highest exposed quartile. A logistic multiple regression analysis (result of monofilament testing - dependent variable; age, height, examiner and five vibration dose calculations – predictor variables) of the results of monofilament testing in dig II bilaterally gave a similar outcome. None of the independent variables including five calculated vibration doses were included in the models neither for the total exposed group nor for the highest exposed quartile. Conclusion: In spite of the fairly short vibration exposure, a tendency to raised VPTs as well as pathologic monofilament test results was observed. Thus, early neurophysiologic symptoms and signs of vibration exposure may appear after short-term exposure also in young workers.
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31.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Style: J of occupational medicine and toxicology vibration induced injuries in hands in long-term vibration exposed workers
  • 2019
  • Ingår i: Journal of Occupational Medicine and Toxicology. - : Springer Science and Business Media LLC. - 1745-6673. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • IntroductionLong-term vibration exposure may cause neurophysiological disturbances such as numbness and tingling, reduced grip strength and difficulties in handling small objects. The dominant hand will usually have a higher vibration exposure than the non-dominant hand, which may cause more severe neurological symptoms and signs in the dominant hand.MethodsThe study is based on 47 (36 males and 11 females) vibration exposed workers, all former patients from the department of Occupational and Environmental medicine, Gothenburg university. The comparison group consisted of 18 randomly selected subjects from the general population of Gothenburg. All participants completed several questionnaires and had a standardized medical examination. Thereafter, neurophysiological tests such as the determination of vibration and thermal perception thresholds were performed, as well as muscle strength tests in hands and fingers.ResultsThe temperature perception thresholds (TPTs) and the vibration perception thresholds (VPTs) did not differ significantly between the dominant and non-dominant hand in vibration exposed workers. The referents showed a significantly better performance (p <= 0.02 and p <= 0.034, respectively) than the workers for both TPTs and VPTs, indicating a negative effect on the A ss, as well as on the A delta and C-fibers among the exposed workers.The Purdue Pegboard test showed a significantly better performance in the dominant vs non-dominant hand in both workers (p=0.001) and referents (p=0.033). The referents showed a better performance than the workers in both hands (p<0.001). The Baseline handgrip, the Pinch grip and 3-Chuck grip tests did not differ significantly between the dominant and non-dominant hand in neither workers nor referents.ConclusionsIn this study, minor differences between the dominant and non-dominant hand were noted for the Purdue Pegboard test in both workers and referents. Despite a probably higher vibration exposure in the dominant hand (mostly the right hand), however, quite similar test results were noted for VPTs, TPTs, Baseline handgrip, Pinch grip and 3-Chuck grip when comparing the dominant and non-dominant hand in the vibration exposed workers. In case of lack of time and financial obstacles, neurological tests in solely the dominant hand, will probably satisfactory reflect the conditions in the non-dominant hand.
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32.
  • Gerhardsson, Lars, 1952 (författare)
  • Tellurium
  • 2021
  • Ingår i: Handbook on the Toxicology of Metals (Fifth Edition). Gunnar F. Nordberg and Max Costa (red.). - : Academic Press. - 9780128229460 ; , s. 783-794
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Food (e.g., meat, dairy products, and cereals) is the main source of tellurium exposure in the general population. In the working environment, inhalational exposure predominates. Small amounts of organic tellurium compounds can also be absorbed through the skin. No quantitative data have been published regarding the inhalational absorption of tellurium or tellurium compounds in humans. In experiments on healthy volunteers, a gastrointestinal absorption of 10%-25% has been observed. In animal experiments, a similar absorption has been estimated.The highest tissue concentrations have been observed in the kidneys. Lower concentrations have been observed in heart, lung, and spleen. The main accumulation over time is in bone, which harbors more than 90% of the total body burden, which exceeds 500. mg. Tellurium can pass both the placenta and the blood-brain barrier. Parenterally administered tellurium is predominantly excreted in the urine, whereas orally ingested tellurium salts are transferred through biliary secretion and mainly excreted in the feces. Small amounts, probably approximately 0.1%, of absorbed tellurium are exhaled, presumably as dimethyl telluride. In rat experiments, biological half-times ranging from 9. days in blood to 23. days in the kidney have been reported. The whole-body retention model for humans estimates a biological half-time of approximately 3. weeks. Elimination from bone is slow, with an estimated half-time of approximately 600. days.Acute systemic effects of tellurium toxicity in rats include listlessness, decreased locomotor activity, somnolence, anorexia, weight loss, gastrointestinal disturbances, changes in fur, and occasionally epilation and hind leg paralysis. Long-term studies of chronic effects are sparse. Dominant and critical effects have been reported from the nervous system, including peripheral neuropathy characterized by segmental demyelination and minor axonal degeneration. In the brain, black changes caused by dark tellurium particles localized to lipofuscin granules in the neuronal cytoplasm have been observed. Other effects have been reported from the liver (fatty degeneration and necrosis), kidney (proximal tubular lesions, oliguria, or anuria), and heart (cell necrosis, edema, and congestion).Reproductive effects including, for example, hydrocephalus, edema, exophthalmia, and ocular hemorrhage have been described.Acute exposure to tellurium in occupational settings may cause acute respiratory irritation followed by the development of garlicky odor of the breath and sweat, drowsiness, headache, malaise, lassitude, weakness, and dizziness. Gastrointestinal symptoms such as anorexia, nausea, vomiting, metallic taste, dry mouth, and constipation may appear. Dermatitis and blue-black discoloration of the skin may follow exposure to tellurium hexafluoride. Severe intoxication may lead to depression of the respiratory system and circulatory collapse. No specific antidote for tellurium poisoning has been found. After inhalational exposure, treatment with fresh air, oxygen supply, assisted ventilation, β2-adrenergic agonists, and oral or parenteral corticosteroids can be tried. Reviews of tellurium toxicology have been published by Browning (1969), Izrael'son (1973), Fishbein (1977), Alexander et al. (1988), and Kobayashi (2004). © 2022 Elsevier B.V. All rights reserved.
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33.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Test-retest reliability of neurophysiological tests of hand-arm vibration syndrome in vibration exposed workers and unexposed referents
  • 2014
  • Ingår i: Journal of Occupational Medicine and Toxicology. - : Springer Science and Business Media LLC. - 1745-6673. ; 9:38
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Exposure to hand-held vibrating tools may cause the hand-arm vibration syndrome (HAVS). The aim was to study the test-retest reliability of hand and muscle strength tests, and tests for the determination of thermal and vibration perception thresholds, which are used when investigating signs of neuropathy in vibration exposed workers. Methods: In this study, 47 vibration exposed workers who had been investigated at the department of Occupational and Environmental Medicine in Gothenburg were compared with a randomized sample of 18 unexposed subjects from the general population of the city of Gothenburg. All participants passed a structured interview, answered several questionnaires and had a physical examination including hand and finger muscle strength tests, determination of vibrotactile (VPT) and thermal perception thresholds (TPT). Two weeks later, 23 workers and referents, selected in a randomized manner, were called back for the same test-procedures for the evaluation of test-retest reliability. Results: The test-retest reliability after a two week interval expressed as limits of agreement (LOA; Bland-Altman), intra-class correlation coefficients (ICC) and Pearson correlation coefficients was excellent for tests with the Baseline hand grip, Pinch-grip and 3-Chuck grip among the exposed workers and referents (N = 23: percentage of differences within LOA 91 - 100%; ICC-values >= 0.93; Pearson r >= 0.93). The test-retest reliability was also excellent (percentage of differences within LOA 96-100 %) for the determination of vibration perception thresholds in digits 2 and 5 bilaterally as well as for temperature perception thresholds in digits 2 and 5, bilaterally (percentage of differences within LOA 91 - 96%). For ICC and Pearson r the results for vibration perception thresholds were good for digit 2, left hand and for digit 5, bilaterally (ICC >= 0.84; r >= 0.85), and lower (ICC = 0.59; r = 0.59) for digit 2, right hand. For the latter two indices the test-retest reliability for the determination of temperature thresholds was lower and showed more varying results. Conclusion: The strong test-retest reliability for hand and muscle strength tests as well as for the determination of VPTs makes these procedures useful for diagnostic purposes and follow-up studies in vibration exposed workers.
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34.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Vascular and nerve damage in workers exposed to vibrating tools. The importance of objective measurements of exposure time.
  • 2005
  • Ingår i: Applied ergonomics. - : Elsevier BV. - 0003-6870 .- 1872-9126. ; 36:1, s. 55-60
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the present study was to compare the development of vibration white fingers (VWF) in workers in relation to different ways of exposure estimation, and their relationship to the standard ISO 5349, annex A. Nineteen vibration exposed (grinding machines) male workers completed a questionnaire followed by a structured interview including questions regarding their estimated hand-held vibration exposure. Neurophysiological tests such as fractionated nerve conduction velocity in hands and arms, vibrotactile perception thresholds and temperature thresholds were determined. The subjective estimation of the mean daily exposure-time to vibrating tools was 192 min (range 18-480 min) among the workers. The estimated mean exposure time calculated from the consumption of grinding wheels was 42 min (range 18-60 min), approximately a four-fold overestimation (Wilcoxon's signed ranks test, p<0.001). Thus, objective measurements of the exposure time, related to the standard ISO 5349, which in this case were based on the consumption of grinding wheels, will in most cases give a better basis for adequate risk assessment than self-exposure assessment.
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35.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Vibration-induced injuries in workers exposed to transient and high frequency vibrations
  • 2020
  • Ingår i: Journal of Occupational Medicine and Toxicology. - : Springer Science and Business Media LLC. - 1745-6673. ; 15:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The risk of developing vibration white fingers and neurosensory symptoms increases with the duration and intensity of the exposure. The aim of this study was to investigate the risk of developing vibration white fingers (VWF), neurosensory symptoms and musculoskeletal disorders among workers exposed to transient and high frequency vibrations. Methods The study included 38 vibration exposed workers from a loader assembly plant in Sweden (30 males and 8 females). All participants answered questionnaires and had a structured interview about work and medical history. A following medical examination included the determination of vibration and temperature perception thresholds and musculoskeletal symptoms in the neck, shoulder, elbow and hands. The individual vibration exposure expressed as A (8)-values and vibration exposure in minutes per day, were obtained from questionnaires answered by the participants. Results The prevalence of VWF was 30% among the male workers and 50% among the females. The corresponding prevalence of neurosensory symptoms was 70% among the males and 88% among the females. Musculoskeletal findings were common among the male workers. Dominant symptoms/syndromes were tension neck syndrome, biceps tendinitis, carpal tunnel syndrome and ulnar entrapment in hand/wrist. A total of 32 diagnoses were observed among the male workers and four diagnoses among the female workers. Numbness in fingers and age had the strongest impact on perceived work ability. Conclusions ISO 5349-1 considerably underestimates the risks of VWF for this group of workers exposed to transient and high frequency vibrations. It is therefore important to develop a risk assessment standard also covering this frequency range.
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36.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Vibration related symptoms and signs in quarry and foundry workers
  • 2021
  • Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 94, s. 1041-1048
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose The development of vascular and neurosensory findings were studied in two groups of long-term exposed quarry and foundry workers with different vibration exposures, working conditions and work tasks. Methods The study included 10 quarry workers (mean age 43 yrs., mean exposure time 16 yrs.) and 15 foundry workers (35 yrs.; 11 yrs.) at two plants in Sweden. All participants completed a basic questionnaire and passed a medical examination including a number of neurosensory tests, e.g. the determination of vibration (VPT) and temperature (TPT) perception thresholds as well as a musculoskeletal examination of the neck, shoulders, arms and hands. Results A high prevalence of neurosensory findings (40%) was found among the quarry workers. Both groups, however, showed a low prevalence of vibration white fingers (VWF). Foundry workers showed significantly better sensitivity than quarry workers for all monofilament tests (p <= 0.016), TPT warmth in dig 2 (p = 0.048) and 5 dexter (p = 0.008), and in dig 5 sinister (p = 0.005). They also showed a better VPT performance in dig 5 dexter (p = 0.031). Conclusions Despite high vibration exposure, the prevalence of VWF was low. The high prevalence of neurosensory findings among the quarry workers may depend on higher A(8) vibration exposure and higher exposure to high-frequency vibrations. An age-effect and exposure to cold could also be contributing factors. The nervous system seems to be more susceptible to high-frequency vibrations than the vascular system. For neurosensory injuries, the current ISO 5349-1 standard is not applicable.
  •  
37.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Vibration related symptoms and signs in two groups of exposed workers
  • 2023
  • Ingår i: Noise and Vibration Worldwide. - 0957-4565 .- 2048-4062. ; 54:9, s. 425-433
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim was to compare the prevalence of vibration related symptoms and signs in two groups of vibration exposed male workers: 36 vibration exposed patients and 33 truck mechanics. All participants answered a questionnaire, passed a structured interview about work and medical history and several neurophysiological tests. The prevalence of vibration white fingers (VWF) and neurosensory symptoms was significantly higher among the exposed patients than among the truck mechanics. One neurosensory examination method identified 46% of the exposed patients with numbness and tingling, three methods up to 85%. In the total material logistic regression showed that age and increased cold sensitivity were significant predictors of both neurosensory disturbances and vibration white fingers. Muscle cramps in arms and hands, pain in hands and age were significant predictors of reduced grip strength. The differences between the two groups were more pronounced for category variables than for continuous variables.
  •  
38.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Work ability in vibration-exposed workers.
  • 2014
  • Ingår i: Occupational medicine (Oxford, England). - : Oxford University Press (OUP). - 1471-8405 .- 0962-7480. ; 64:8, s. 629-634
  • Tidskriftsartikel (refereegranskat)abstract
    • Hand-arm vibration exposure may cause hand-arm vibration syndrome (HAVS) including sensorineural disturbances.
  •  
39.
  • Gerhardsson, Lars, 1952, et al. (författare)
  • Work-related exposure to organic solvents and the risk for multiple sclerosis-a systematic review
  • 2021
  • Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 94:2, s. 221-229
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose Multiple sclerosis (MS) is a chronic progressive neurological disorder. Several environmental factors have been discussed as possible causing agents, e.g. organic solvents, whose impact on the disease is analysed in this review. Methods Systematic search strategies were used to identify high-quality studies of workers exposed to organic solvents, published up to September 30, 2019, in databases, such as PubMed, Cochrane library and Scopus. The exposure was in most studies obtained by questionnaires, supplemented with telephone interviews. The diagnosis MS was mainly detemined following a thorough neurological examination. Finally, fourteen case-control studies and two cohort studies met the inclusion criteria and were included in the meta-analysis. Random effects models were used to pool the results of the studies. Results The odds ratios from the 14 case-control studies included in the meta-analysis ranged from 0.12-4.0. Five case-control studies and one cohort study showed a significant association between the development of multiple sclerosis and exposure to organic solvents. The results from the other nine case-control studies and from one of the two cohort studies did not reach statistical significance. The pooled data from the 14 case-control studies gave an OR of 1.44 (95% CI 1.03-1.99), which shows a moderately increased risk of developing MS after exposure to organic solvents. Conclusions The final interpretation of the result is that organic solvents may be slightly associated with an increased risk to develop MS. In addition, other factors, e.g. genetic markers and smoking, may contribute to the development of the disease.
  •  
40.
  • Gustavsson, Per, et al. (författare)
  • Intoxication from an accidentally ingested lead shot retained in the gastrointestinal tract.
  • 2005
  • Ingår i: Environmental health perspectives. - : Environmental Health Perspectives. - 0091-6765 .- 1552-9924. ; 113:4, s. 491-3
  • Tidskriftsartikel (refereegranskat)abstract
    • A 45-year-old woman was referred to the Department of Occupational and Environmental Health in January 2002 because of increased blood lead concentrations of unknown origin. She suffered from malaise, fatigue, and diffuse gastrointestinal symptoms. She had a blood lead level of 550 microg/L (normal range < 40 microg/L). The patient had not been occupationally exposed to lead, and no potential lead sources, such as food products or lead-glazed pottery, could be identified. Her food habits were normal, but she did consume game occasionally. Clinical examination, including standard neurologic examination, was normal. No anemia was present. Laboratory tests showed an increased excretion of lead in the urine, but there were no signs of microproteinuria. An abdominal X ray in October 2002 revealed a 6-mm rounded metal object in the colon ascendens. Before the object could be further localized, the patient contracted winter vomiting disease (gastroenteritis) and the metal object was spontaneously released from the colon during a diarrhea attack. The object was a lead shot pellet, possibly but not normally used in Sweden for hunting wild boar or roe deer. Blood lead levels slowly decreased. Nine months later the patient's blood lead levels were almost normal (approximately 70 microg/L) and her symptoms had almost completely disappeared. In this case, a rare source of lead exposure was found. In investigations of blood lead elevations of unknown origin, we recommend abdominal X ray in parallel with repeated blood lead determinations.
  •  
41.
  • Harari, Raul, et al. (författare)
  • Exposure and Toxic Effects of Elemental Mercury in Gold Mining Activities
  • 2009
  • Ingår i: Epidemiology. - : Ovid Technologies (Wolters Kluwer Health). - 1044-3983. ; 20:6, s. 264-265
  • Tidskriftsartikel (refereegranskat)abstract
    • Elemental mercury (Hg0) is widely used in gold-mining activities in South America, Africa and Asia. Miners use Hg0 to extract gold, and are exposed by inhalation when burning the gold amalgam to get rid of the Hg0. Burning is usually performed only once per 1–3 weeks. Gold buyers again burn the gold to be sure that they only buy gold. Hg0 affects the central nervous system (CNS), but the exposure-response relationship for discrete but important effects is not well known. As indicators of exposure, Hg levels in blood, plasma and urine are useful. It is usually assumed that there is a simple relationship between exposure and these biomarkers. However, recent data indicate that genetic traits may modify the retention of Hg. Also, there is a possibility that such factors may influence the exposure-response curves.
  •  
42.
  •  
43.
  • Harari, Raul, et al. (författare)
  • Exposure and toxic effects of elemental mercury in gold-mining activities in Ecuador
  • 2012
  • Ingår i: Toxicology Letters. - : Elsevier BV. - 1879-3169 .- 0378-4274. ; 213:1, s. 75-82
  • Tidskriftsartikel (refereegranskat)abstract
    • Traditional gold mining, using metallic mercury (Hg-0) to form gold amalgam, followed by burning to remove the Hg-0, is widely used in South America, Africa and Asia. The gold is sold to merchants who burn it again to eliminate remaining Hg-0. In Ecuador, 200 gold miners, 37 gold merchants and 72 referents were studied. The median Hg concentrations in urine (U-Hg) were 3.3 (range 0.23-170), 37 (3.2-420), and 1.6 (0.2-13) mu g/g creatinine, respectively, and in whole blood (B-Hg) were 5.2, 30, and 5.0 mu g/L, respectively. Biomarker concentrations among merchants were statistically significantly higher than among miners and referents; also the miners differed from the referents. Burning of gold amalgam among miners was intermittent; U-Hg decreased in the burning-free period. In computerized neuromotor examinations, B-Hg and U-Hg concentrations were associated with increases in the centre frequency of the tremor, as well as in reaction time and postural stability. Retention of Hg (B-Hg), and the elimination rate (U-Hg) appears to be modified by polymorphism in a gene of an enzyme in the glutathione synthesis (GCLM), but there were no significant genetic modifications for the associations between exposure and neurotoxicity. Thus, the gold merchants have a much higher exposure and risk than the miners, in whom the exposure varies over time. The metabolism of Hg is modified by genetic traits. The present exposure to Hg had limited neurotoxic effects. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
  •  
44.
  • Lindell, Hans, et al. (författare)
  • Risk for VWF is underestimated in assembly industry using impact tools
  • 2019
  • Ingår i: 14th International Conference on Hand-Arm Vibration: Abstracts. - 9783864232282
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Long term vibration exposure may cause vibration white fingers (VWF) as well as neurophysiological disturbances such as dampness and tingling in fingers and hands, reduced grip strength and difficulties in handling small objects. In an assembly industry of heavy vehicles in Sweden a high prevalence of VWF has been reported in spite of low vibration when measuring the A(8) value according to ISO 5349. The operation that expose the workers for vibration is very similar in the production line and consists of tightening nuts and bolts with an impact wrench and an anvil in form of a wrench. Measuring vibration at frequencies up to 50 kHz shows high acceleration peaks especially in the anvil but also in the impact wrench. These high amplitude peaks are suspected to constitute a significant contribution to the high prevalence of VWF and are not taken into account in the current ISO 5349 standard which is also stated in the scope.
  •  
45.
  • Lundström, Nils-Göran, et al. (författare)
  • Lung cancer development in primary smelter workers: a nested case-referent study.
  • 2006
  • Ingår i: Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine. - : Ovid Technologies (Wolters Kluwer Health). - 1076-2752 .- 1536-5948. ; 48:4, s. 376-80
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The objective of this study was to study the impact of work-related exposure to mainly arsenic and lead versus smoking in primary smelter workers developing lung cancer. METHODS: In a cohort of 3979 primary smelter workers, 46 subjects had contracted respiratory malignancies. They were compared with 141 age-matched male referents by conditional logistic regression analysis. RESULTS: Cases showed a significantly higher smoking rate as compared with referents: odds ratio (OR) = 4.0; 95% confidence interval (CI) = 1.6-10.1; P = 0.003. When restricted to smokers (33 cases, 63 referents), the cumulative air arsenic exposure index, but not the lead exposure indices, was significantly higher among the cases: OR = 1.07; 95% CI = 1.02-1.11; P = 0.005. CONCLUSIONS: Cumulative arsenic exposure and smoking were identified as risk factors for the development of lung cancer; lead exposure, however, was not.
  •  
46.
  • Lundström, Nils-Göran, 1946- (författare)
  • Mortality and morbidity in lead smelter workers with concomitant exposure to arsenic
  • 2007
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Arsenic is a well-known lung carcinogen in humans. In 2006, IARC upgraded inorganic lead as a possible human carcinogen (2A). The aim of this thesis has been to evaluate the lung cancer mortality and incidence in long-term exposed primary lead smelter workers and also to estimate present exposures to arsenic and lead in relation to those occurring in the past. The basic cohort (N=3832 workers; hired before 1967 and followed up from 1950-1981; SMR comparisons with general and local reference populations) showed an excess of deaths for total mortality, malignant neoplasms (e.g. lung and stomach cancer), ischaemic heart diseases, and cerebrovascular diseases compared to the general population. In a subcohort of lead workers (N=437; regular blood lead sampling since 1950) only the raised SMR for lung cancer (162) was sustained. In a follow-up study of the basic cohort (N=3979), a subcohort of lead exposed workers (N=1992) was formed. The expected mortality in 1955-1987 and cancer incidence in 1958-1987 were calculated relative to county rates. A cumulative blood lead index (CBLI) was used for dose-response analyses. The lung cancer incidence was raised in the total cohort (SIR 2.8; 95 % CI 2.1 3.8). A higher lung cancer risk was observed in workers hired before 1950 (SIR 3.6; 95 % CI 2.6-5.0). The increased lung cancer risks were further elevated in the subcohort of lead exposed workers, especially in the highest exposed subgroup (SIR 5.1; 95 % 2.0-10.5; latency period of 15 y). No excesses of other malignancies were observed. The increased relative risks for lung cancer may have been caused by interactions between inorganic lead and other substances at the smelter, e.g. arsenic. To further analyze the effects from inorganic lead, two subcohorts of workers at the lead departments were formed from the original cohort (N=3979), one of 710 workers and the other of 383 workers. The lung cancer incidence was raised in both subcohorts (Lead subcohort 1; SIR 2.4; 95 % CI 1.2-4.5; Lead subcohort 2; SIR 3.6; 95 % CI 1.2-8.3). Among the 10 workers that had developed lung cancer in lead subcohort 1 all but one had a considerable exposure also to arsenic. Thus, a possible interaction effect between lead and arsenic may explain the increased lung cancer risks. To further elucidate the impact from lead and arsenic a case control study was undertaken. In the basic cohort (N=3979), 46 male workers had contracted respiratory malignancies. They were compared with 141 agematched male referents from the primary smelter by conditional logistic regression analysis using smoking habits, cumulative blood lead and air arsenic exposure as predictor variables. The lung cancer cases showed a significantly higher smoking rate than referents (Odds ratio, OR = 4.0; 95 % CI 1.6-10.1; p=0.003). When restricted to smokers, the cumulative arsenic air exposure index, but not the lead exposure indices, were significantly higher among the cases (OR=1.07; 95 % CI 1.02-1.11; p = 0.005). Accordingly, cumulative arsenic exposure and smoking were identified as significant risk factors for the development of lung cancer in the final analyses, while lead exposure was not a significant risk factor. However, inorganic lead still may play a minor role in the multifactorial genesis of lung cancer. These studies describe risks from exposures occurring from time periods before 1950 up to 1981. Because of the long latency period for lung cancer, exposures after 1970 probably have had limited impact on the reported results. Compared to the levels in the early 1970´s present exposures to arsenic are lower by a factor of ten or more and risks probably correspondingly lower.
  •  
47.
  • Lundström, Ronnie, et al. (författare)
  • Long-term effect of hand-arm vibration on thermotactile perception thresholds
  • 2018
  • Ingår i: Journal of Occupational Medicine and Toxicology. - : Springer Science and Business Media LLC. - 1745-6673. ; 13
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Occupational exposure to hand-transmitted vibration (HTV) is known to cause neurological symptoms such as numbness, reduced manual dexterity, grip strength and sensory perception. The purpose of this longitudinal study was to compare thermotactile perception thresholds for cold (TPTC) and warmth (TPTW) among vibration exposed manual workers and unexposed white collar workers during a follow-up period of 16 years to elucidate if long-term vibration exposure is related to a change in TPT over time. Methods: The study group consisted of male workers at a production workshop at which some of them were exposed to HTV. They were investigated in 1992 and followed-up in 2008. All participants were physically examined and performed TPT bilaterally at the middle and distal phalanges of the second finger. Two different vibration exposure dosages were calculated for each individual, i.e. the individual cumulative lifetime dose (mh/s2) or a lifetime 8-h equivalent daily exposure (m/s(2)). Results: A significant mean threshold difference was found for all subjects of about 4-5 degrees C and 1-2 degrees C in TPTW and TPTC, respectively, between follow-up and baseline. No significant mean difference in TPTC between vibration exposed and non-exposed workers at each occasion could be stated to exist. For TPTW a small but significant difference was found for the right index finger only. Age was strongly related to thermotactile perception threshold. The 8-h equivalent exposure level (A (8)) dropped from about 1.3 m/s2 in 1992 to about 0.7 m/s(2) in 2008. Conclusions: A lifetime 8-h equivalent daily exposure to hand-transmitted vibration less than 1.3 m/s(2) does not have a significant effect on thermotactile perception. Age, however, has a significant impact on the change of temperature perception thresholds why this covariate has to be considered when using TPT as a tool for health screening.
  •  
48.
  • Nilsson, Erling, et al. (författare)
  • Åtgärder mot buller på daghem
  • 2003
  • Ingår i: Bygg & teknik. - 0281-658X. ; :3
  • Tidskriftsartikel (populärvet., debatt m.m.)
  •  
49.
  • Nordberg, Gunnar F, et al. (författare)
  • Interactions and Mixtures in Metal Toxicology
  • 2015. - 4
  • Ingår i: Handbook on the Toxicology of Metals. - : Academic Press. - 9780123982926 ; , s. 213-238
  • Bokkapitel (refereegranskat)abstract
    • Human exposures to metals, metalloids, and their compounds frequently occur as mixtures, and hence it is important to consider the joint action of these elements in terms of both mechanisms of action and risk assessment purposes. The joint action of these elements may produce additive, synergistic/potentiating, or antagonistic effects that may be manifested as direct cellular toxicity (necrosis or apoptosis) or carcinogenicity. Dose-response relationships may be further influenced by constitutive factors such as age, sex, and the expression of specific proteins. Mechanisms of importance for the development of potentiated or antagonistic toxicity are the expression of metal-binding proteins (metallothioneins or lead-binding proteins) and interference with metal transporters such as DMT-1 and ZIP. Compared to men, women of childbearing age absorb more Cd from the gastrointestinal tract because they have lower iron stores than men. Another example of synergism that occurs in humans is the one between inorganic arsenic and cadmium in inducing kidney toxicity. In many cases, however, direct primary data on the joint action of toxic or essential elements are lacking, and so innovative derivative methods such as the binary weight-of-evidence method have been used to predict potential interactions among groups of metals and metalloids. At present, there is much to be learned about the joint action of both toxic and essential elements, and this is clearly a critical area of research.
  •  
50.
  • Nordberg, Gunnar F., et al. (författare)
  • Interactions and mixtures in metal toxicology
  • 2021
  • Ingår i: Handbook on the Toxicology of Metals: Volume I: General Considerations. - London : Elsevier. - 9780128232927 ; , s. 319-347
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Human exposures to metals, metalloids, and their compounds frequently occur as mixtures; therefore, the joint action of these elements should be considered with respect to mechanisms of action and risk assessment. When present at the same time in a system, multiple chemicals can influence toxicity. The joint action of metallic elements may produce additive, synergistic/potentiating, or antagonistic effects manifesting in an overall toxicity, differing from that of individual components of the mixture. Dose-response relationships may be further influenced by constitutive factors such as age, sex, and the expression of specific proteins. Mechanisms of importance for the development of potentiated or antagonistic toxicity include the expression of metal-binding proteins (metallothioneins or lead-binding proteins) and interference with metal transporters such as Divalent Metal Transporter (DMT-1) and the ZIP family of zinc transporting proteins. Compared to men, women of childbearing age generally absorb more Cd from the gastrointestinal tract because they typically have lower iron stores than men. Another example of synergism that occurs in humans is when inorganic arsenic and cadmium together induce kidney toxicity. In many cases, however, direct primary data on the joint action of toxic or essential elements are lacking, and so innovative derivative methods such as the binary weight-of-evidence method have been used to predict potential interactions among groups of metals and metalloids. Using this method, broad recommendations can be made for assessing the potential impact of interactions on the public health assessment of environmental mixtures. At present, there is much to be learned about the joint action of both toxic and essential elements, and this is clearly a critical area of research.
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