| 1. |
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| 2. |
- Balidemaj, Festina, et al.
(författare)
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Prenatal Exposure to Locally Emitted Air Pollutants Is Associated with Birth Weight : An Administrative Cohort Study from Southern Sweden
- 2022
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Ingår i: Toxics. - : MDPI. - 2305-6304. ; 10:7
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Tidskriftsartikel (refereegranskat)abstract
- While prenatal exposure to ambient air pollution has been shown to be associated with reduced birth weight, there is substantial heterogeneity across studies, and few epidemiological studies have utilized source-specific exposure data. The aim of the present study was, therefore, to investigate the associations between local, source-specific exposure to fine particulate matter (PM2.5) during pregnancy and birth weight. An administrative cohort comprising 40,245 singleton births from 2000 to 2009 in Scania, Sweden, was combined with data on relevant covariates. Investigated sources of PM2.5 included all local sources together as well as tailpipe exhaust, vehicle wear-and-tear, and small-scale residential heating separately. The relationships between these exposures, rep-resented as interquartile range (IQR) increases, and birth weight (continuous) and low birth weight (LBW; <2500 g) were analyzed in crude and adjusted models. Each local PM2.5 source investigated was associated with reduced birth weight; average decreases varied by source (12–34 g). Only small-scale residential heating was clearly associated with LBW (adjusted odds ratio: 1.14 (95% confidence interval: 1.04–1.26) per IQR increase). These results add to existing evidence that prenatal exposure to ambient air pollution disrupts fetal growth and suggest that PM2.5 from both vehicles and small-scale residential heating may reduce birth weight.
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| 3. |
- Björk, Jonas, et al.
(författare)
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Exploring inter-rater reliability and measurement properties of environmental ratings using kappa and colocation quotients
- 2014
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Ingår i: Environmental Health. - 1476-069X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Available evidence suggest that perceptions or ratings of the neighborhood, e.g. as being green, walkable or noisy, are important for effects on health and wellbeing, also after controlling for objective measures of identical or similar features. When evaluating effects of the perceived environment, it is important that measurement properties and the reliability of the environmental ratings are evaluated before decisions about how these ratings should be handled in the statistical analyses are made. In this paper we broaden the usage of two association measures, the well-known kappa statistic and the novel colocation quotient (CLQ), to studies of inter-rater reliability and of associations between different categorical ratings in spatial contexts. Methods: We conducted reliability analysis of a survey instrument for assessing perceived greenness at geographical point locations, here the close outdoor environment within 5-10 minutes walking distance from home. Data were obtained from a public health survey conducted in 2008 in Scania, southern Sweden (n = 27 967 participants). Results: The results demonstrate the usefulness of kappa and CLQ as tools for assessing reliability and measurement properties of environmental rating scales when used at geographical point locations. We further show that the two measures are interchangeable, i.e. kappa can be accurately approximated from CLQ and vice versa, but can be used for somewhat different purposes in reliability analyses. Inter-rater reliability between the nearest neighbors was demonstrated for all five items of the evaluated instrument for assessing perceived greenness, albeit with clear differences across the items. Conclusion: Reliability analysis employing kappa and CLQ can be used as a basis for informed decisions about, for instance, how dichotomizations of the ratings should be defined and how missing or indefinite ratings should be handled. Such reliability analyses can thus serve as guidance for subsequent epidemiological studies of associations between environmental ratings, health and wellbeing.
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| 4. |
- Bodin, Theo, et al.
(författare)
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Road traffic noise, air pollution and myocardial infarction: a prospective cohort study.
- 2016
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 89:5, s. 793-802
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Tidskriftsartikel (refereegranskat)abstract
- Both road traffic noise and air pollution have been linked to cardiovascular disease. However, there are few prospective epidemiological studies available where both road traffic noise and air pollution have been analyzed simultaneously. The aim of this study was to investigate the relation between road traffic noise, air pollution and incident myocardial infarction in both current (1-year average) and medium-term (3-year average) perspective.
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| 5. |
- Flanagan, Erin, et al.
(författare)
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Exposure to local, source-specific ambient air pollution during pregnancy and autism in children : a cohort study from southern Sweden
- 2023
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Evidence of air pollution exposure, namely, ambient particulate matter (PM), during pregnancy and an increased risk of autism in children is growing; however, the unique PM sources that contribute to this association are currently unknown. The aim of the present study was to investigate local, source-specific ambient PM exposure during pregnancy and its associations with childhood autism, specifically, and autism spectrum disorders (ASD) as a group. A cohort of 40,245 singleton births from 2000 to 2009 in Scania, Sweden, was combined with data on locally emitted PM with an aerodynamic diameter < 2.5 µm (PM2.5). A flat, two-dimensional dispersion model was used to assess local PM2.5 concentrations (all-source PM2.5, small-scale residential heating- mainly wood burning, tailpipe exhaust, and vehicle wear-and-tear) at the mother’s residential address during pregnancy. Associations were analyzed using binary logistic regression. Exposure to local PM2.5 during pregnancy from each of the investigated sources was associated with childhood autism in the fully adjusted models. For ASD, similar, but less pronounced, associations were found. The results add to existing evidence that exposure to air pollution during pregnancy may be associated with an increased risk of childhood autism. Further, these findings suggest that locally produced emissions from both residential wood burning and road traffic-related sources (tailpipe exhaust and vehicle wear-and-tear) contribute to this association.
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| 6. |
- Hansson, Gert-Åke, et al.
(författare)
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Physical workload in various types of work: Part I. Wrist and forearm
- 2009
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Ingår i: International Journal of Industrial Ergonomics. - : Elsevier BV. - 0169-8141. ; 39:1, s. 221-233
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Tidskriftsartikel (refereegranskat)abstract
- The quantitative relationship between exposure to physical risk factors and upper extremity work-related musculoskeletal disorders (UE-WMSDs) is virtually unknown. To explore the variation, objective measurements were derived in 43 types of work (686 individuals), using goniometry for the wrists and electromyography (EMG) for the forearm extensor muscles. The variations due to work were great for wrist movements, wrist positions, muscular rest, as well as peak load, ranging 1.4-54 degrees/s (flexion velocity; 50th percentile), -30 degrees-3 degrees (flexion angle; 50th percentile), 0.2-23% of time, and 3.4-41% of maximal EMG (90th percentile), respectively. Even within work categories, e.g. "repetitive industrial", there were large variations for all measures. Hence, classification without measurements has limited value. All movement measures were highly correlated (vertical bar r(s)vertical bar=0.82-0.99), but only weakly so to positions (vertical bar r(s)vertical bar = 0.01-0.43). Muscular rest and "static load" (10th percentile), were highly correlated (r(s) = -0.92), but not associated to peak load (90th percentile; vertical bar r(s)vertical bar= 0.05 and 0.08, respectively). Most low-velocity work was accompanied by much muscular rest; however, the low velocity for mouse-intensive computer-work meant very little rest. Technical measurements are suitable as exposure measures in epidemiological studies, as well as a base for decisions about interventions. The multidimensional character of exposure - wrist movements, wrist postures, muscular recovery, and peak load - has to be considered. Relevance to industry: Direct measurements provide objective and quantitative measures of the main physical risk factors for UE-WMSDs, appropriate for estimating the risk, as well as giving priority to, and evaluating, interventions. (c) 2008 Elsevier B.V. All rights reserved.
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| 7. |
- Hansson, Gert-Åke, et al.
(författare)
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Physical workload in various types of work: Part II. Neck, shoulder and upper arm
- 2010
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Ingår i: International Journal of Industrial Ergonomics. - : Elsevier BV. - 0169-8141. ; 40:3, s. 267-281
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Tidskriftsartikel (refereegranskat)abstract
- To explore the correlation between, and the variation in, various measures of exposure to potential risk factors for work-related upper extremity musculoskeletal disorders (UE-WMSDs), physical workload was measured in 43 types of work (713 individuals), using inclinometry for the head and upper arms, and electromyography (EMG) for the trapezius muscles. Many exposure measures were highly correlated. Head flexion (90th percentile), extension (1st percentile), and movements (50th percentile); arm elevation (99th percentile) and movements (50th percentile); trapezius muscular rest (fraction of time) and peak load (90th percentile), constitute main exposure dimensions. The variations were large: head: flexion 9 degrees-63 degrees, extension -39 degrees-4 degrees, movements 2.3-33 degrees/s; arm: elevation 49 degrees-124 degrees, movements 3.0-103 degrees/s; trapezius: muscular rest 0.8%-52% of time, peak load 3.1%-24% of maximal EMC. Even within work categories, e.g. "repetitive industrial", there were large variations. Somewhat higher loads were recorded on the right as compared to the left side (differences: arm elevation 2, arm movements 19%; trapezius peak load 18%), but these were small compared to the differences due to work. There were high correlations between movements of arm and head (r(s) = 0.96), as well as arm and wrist (r(s) = 0.92), and between, on the one hand, trapezius muscular rest and peak load, and on the other, arm and head movements (vertical bar r(s)vertical bar = 0.47-0.62), as well as arm elevation (vertical bar r(s)vertical bar = 0.54-0.85), which has to be considered when assessing exposure-response relations. Relevance to industry: Direct measurements provide objective and quantitative data of the main physical risk factors for UE-WMSDs, appropriate for estimating the risk, as well as giving priority to and evaluating interventions. (C) 2009 Elsevier B.V. All rights reserved.
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| 8. |
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| 9. |
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| 10. |
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| 11. |
- Hede ́n, Bo, et al.
(författare)
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Artificial neural networks for recognition of electrocardiographic lead reversal
- 1995
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Ingår i: American Journal of Cardiology. - 0002-9149. ; 75:14, s. 929-933
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Tidskriftsartikel (refereegranskat)abstract
- Misplacement of electrodes during the recording of an electrocardiogram (ECG) can cause an incorrect interpretation, misdiagnosis, and subsequent lack of proper treatment. The purpose of this study was twofold: (1) to develop artificial neural networks that yield peak sensitivity for the recognition of right/left arm lead reversal at a very high specificity; and (2) to compare the performances of the networks with those of 2 widely used rule-based interpretation programs. The study was based on 11,009 ECGs recorded in patients at an emergency department using computerized electrocardiographs. Each of the ECGs was used to computationally generate an ECG with right/left arm lead reversal. Neural networks were trained to detect ECGs with right/left arm lead reversal. Different networks and rule-based criteria were used depending on the presence or absence of P waves. The networks and the criteria all showed a very high specificity (99.87% to 100%). The neural networks performed better than the rule-based criteria, both when P waves were present (sensitivity 99.1%) or absent (sensitivity 94.5%). The corresponding sensitivities for the best criteria were 93.9% and 39.3%, respectively. An estimated 300 million ECGs are recorded annually in the world. The majority of these recordings are performed using computerized electrocardiographs, which include algorithms for detection of right/left arm lead reversals. In this study, neural networks performed better than conventional algorithms and the differences in sensitivity could result in 100,000 to 400,000 right/left arm lead reversals being detected by networks but not by conventional interpretation programs.
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| 12. |
- Hedén, Bo, et al.
(författare)
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Agreement between artificial neural networks and experienced electrocardiographer on electrocardiographic diagnosis of healed myocardial infarction
- 1996
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Ingår i: Journal of the American College of Cardiology. - 0735-1097. ; 28:4, s. 1012-1016
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. The purpose of this study was to compare the diagnoses of healed myocardial infarction made from the 12-lead electrocardiogram (ECG) by artificial neural networks and an experienced electrocardiographer. Background. Artificial neural networks have proved of value in pattern recognition tasks. Studies of their utility in ECG interpretation have shown performance exceeding that of conventional ECG interpretation programs. The latter present verbal statements, often with an indication of the likelihood for a certain diagnosis, such as 'possible left ventricular hypertrophy'. A neural network presents its output as a numeric value between 0 and 1; however, these values can be interpreted as Bayesian probabilities. Methods. The study was based on 351 healthy volunteers and 1,313 patients with a history of chest pain who had undergone diagnostic cardiac catheterization. A 12-lead ECG was recorded in each subject. An expert electrocardiographer classified the ECGs in five different groups by estimating the probability of anterior myocardial infarction. Artificial neural networks were trained and tested to diagnose anterior myocardial infarction. The network outputs were divided into five groups by using the output values and four thresholds between 0 and 1. Results. The neural networks diagnosed healed anterior myocardial infarctions at high levels of sensitivity and specificity. The network outputs were transformed to verbal statements, and the agreement between these probability estimates and those of an expert electrocardiographer was high. Conclusions. Artificial neural networks can be of value in automated interpretation of ECGs in the near future.
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| 13. |
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| 14. |
- Lindqvist, A, et al.
(författare)
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Artery blood pressure oscillation after active standing up: an indicator of sympathetic function in diabetic patients
- 1997
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Ingår i: Clinical Physiology. - : Wiley. - 1365-2281 .- 0144-5979. ; 17:2, s. 159-169
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Tidskriftsartikel (refereegranskat)abstract
- Dynamic artery blood pressure (Finapres) response to active standing up, normally consisting of initial rise, fall and recovery above the baseline (overshoot), was compared with the early steady-state artery blood pressure level to measure sympathetic vasomotor function in healthy subjects (n = 23, age 35 +/- 9 years; mean +/-SD) and in type I diabetic patients without autonomic neuropathy (AN) (group 1: n = 18, 38 +/- 13 years), with AN but no cardiovascular drugs (group 2a: n = 7, 44 +/- 11 years) and with both AN and cardiovascular drugs (group 2b: n = 10, 47 +/- 7 years). Systolic and diastolic overshoot were similar in the control (15 +/- 13/15 +/- 11 mmHg) and group 1 subjects. Systolic overshoot disappeared in 57% of patients in group 2a (-1 +/- 9 mmHg; P < 0.03), whereas artery blood pressure still overshot in diastole (8 +/- 7 mmHg; NS). Systolic overshoot disappeared in all patients in group 2b (-22 +/- 22 mmHg; P < 0.0006) and diastolic overshoot disappeared in 60% of these patients (-6 +/- 16 mmHg; P = 0.0006). Systolic early steady-state level was not lower in group 2a than in group 1 (NS), but it was impaired in group 2b (P < 0.006), in which six diabetic patients had a pathological response beyond the age-related reference values. There was a strong association between the overshoot and steady-state levels (P for chi 2 < 0.001, n = 58). Overshoot of the control subjects and patients in group 2b correlated to their respective steady-state blood pressure levels (r > or = 0.76; P < or = 0.001). In conclusion, baroreceptor reflex-dependent overshoot of the artery blood pressure after active standing up diminishes with the development of AN and it is associated with the early steady-state level of the artery blood pressure.
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| 15. |
- Malmqvist, Ebba, et al.
(författare)
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Estimated health benefits of exhaust free transport in the city of Malmö, Southern Sweden
- 2018
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 118, s. 78-85
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Tidskriftsartikel (refereegranskat)abstract
- Luftföroreningar står för ett av åtta förtida dödsfall i världen, och utgör därmed ett stort hot mot människors hälsa. HIA (hälsokonsekvensbedömningar) av hypotetiska förändringar i luftföroreningshalter kan användas som ett sätt att bedöma hälsoeffekter, planer och projekt som beslutsfattare behöver för att förhindra sjukdom. Syftet med denna studie var att beräkna hälsoeffekter som kan tillskrivas hypotetisk nedgång i luftföroreningshalter i Malmö i södra Sverige om en policy med avgasfri innerstad skulle genomföras.
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| 16. |
- Malmqvist, Ebba, et al.
(författare)
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Fetal growth and air pollution - A study on ultrasound and birth measures
- 2017
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Ingår i: Environmental Research. - : Elsevier BV. - 0013-9351. ; 152, s. 73-80
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Tidskriftsartikel (refereegranskat)abstract
- Air pollution has been suggested to affect fetal growth, but more data is needed to assess the timing of exposure effects by using ultrasound measures. It is also important to study effects in low exposure areas to assess eventual thresholds of effects. The MAPSS (Maternal Air Pollution in Southern Sweden) cohort consists of linked registry data for around 48,000 pregnancies from an ultrasound database, birth registry and exposure data based on residential addresses. Measures of air pollution exposure were obtained through dispersion modelling with input data from an emissions database (NOx) with high resolution (100–500 m grids). Air pollution effects were assessed with linear regressions for the following endpoints; biparietal diameter, femur length, abdominal diameter and estimated fetal weight measured in late pregnancy and birth weight and head circumference measured at birth. We estimated negative effects for NOx; in the adjusted analyses the decrease of abdominal diameter and femur length were −0.10 (−0.17, −0.03) and −0.13 (−0.17, −0.01) mm, respectively, per 10 µg/m3 increment of NOx. We also estimated an effect of NOx-exposures on birth weight by reducing birth weight by 9 g per 10 µg/m3 increment of NOx. We estimated small but statistically significant effects of air pollution on late fetal and birth size and reduced fetal growth late in pregnancy in a geographic area with levels below current WHO air quality guidelines.
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| 17. |
- Malmqvist, Ebba, et al.
(författare)
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Maternal Exposure to Air Pollution and Birth Outcomes.
- 2011
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Ingår i: Environmental Health Perspectives. - : Environmental Health Perspectives. - 1552-9924 .- 0091-6765. ; 119, s. 553-558
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Tidskriftsartikel (refereegranskat)abstract
- Background: The knowledge about air pollution effects on birth weight, prematurity and small for gestational age [SGA] in low-exposure areas is insufficient. Objectives: The aim of this birth cohort study was to investigate if low-level exposure to air pollution was associated with prematurity and foetal growth and if there are gender specific effects. Method: We combined high quality registry information on 81110 births with individually modeled exposure data at residence for nitrogen oxides [NOx] and proximity to roads with differing traffic density. The data were analyzed by using logistic and linear regression with and without potential confounders. Results: An increased risk for babies being SGA was observed when highest and lowest NOx quartiles were compared, adjusting for maternal age, smoking, gender and year of birth. After additional adjustment for maternal country of origin and parity (which were highly intercorrelated), the increase was no longer statistically significant. However, in subgroup analysis when highest and lowest NOx quartiles were compared, there was still an increased risk for SGA for baby girls Odds Ratio [OR] 1.12 (95% Confidence Interval [CI] 1.01, 1.24), and also if mothers had not changed residency during pregnancy OR 1.09 (95% CI 1.01, 1.18). The confounders with the greatest impact on SGA were parity and country of origin. Concerning prematurity, the prevalence was lower in the three higher NOx exposure quartiles compared to the lowest category. Conclusion: For future studies on air pollution effects on birth outcomes careful control of confounding is crucial.
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| 18. |
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| 19. |
- Mandakh, Yumjirmaa, et al.
(författare)
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Maternal Exposure to Ambient Air Pollution and Risk of Preeclampsia : A Population-Based Cohort Study in Scania, Sweden
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 17:5
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the risk of developing preeclampsia (PE) associated with gestational exposure to ambient air pollutants in southern Sweden, a low-exposure area. We used a cohort of 43,688 singleton pregnancies and monthly mean exposure levels of black carbon (BC), local and total particulate matter (PM2.5 and PM10), and NOX at the maternal residential address estimated by Gaussian dispersion modeling from 2000 to 2009. Analyses were conducted using binary logistic regression. A subtype analysis for small-for-gestational age (SGA) was performed. All analyses were adjusted for obstetrical risk factors and socioeconomic predictors. There were 1286 (2.9%) PE cases in the analysis. An adjusted odds ratio (AOR) of 1.35 with a 95% confidence interval (CI) of 1.11-1.63 was found when comparing the lowest quartile of BC exposure to the highest quartile in the third trimester The AOR for PE associated with each 5 µg/m3 increase in locally emitted PM2.5 was 2.74 (95% CI: 1.68, 4.47) in the entire pregnancy. Similar patterns were observed for each 5 µg/m3 increment in locally emitted PM10. In pregnancies complicated by PE with SGA, the corresponding AOR for linear increases in BC was 3.48 (95% CI: 1.67, 7.27). In this low-level setting, maternal exposure to ambient air pollution during gestation was associated with the risk of developing PE. The associations seemed more pronounced in pregnancies with SGA complications, a finding that should be investigated further.
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| 20. |
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| 21. |
- Nordander, Catarina, et al.
(författare)
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Exposure-response relationships for work-related neck and shoulder musculoskeletal disorders - Analyses of pooled uniform data sets
- 2016
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Ingår i: Applied Ergonomics. - : Elsevier BV. - 1872-9126 .- 0003-6870. ; 55, s. 70-84
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of quantitative data regarding exposure-response relationships between occupational risk factors and musculoskeletal disorders in the neck and shoulders. We explored such relationships in pooled data from a series of our cross-sectional studies. We recorded the prevalence of complaints/discomfort (Nordic Questionnaire) and diagnoses (physical examination) in 33 groups (24 female and 9 male) within which the workers had similar work tasks (3141 workers, of which 817 were males). In representative sub-groups, we recorded postures and velocities of the head (N = 299) and right upper arm (inclinometry; N = 306), right wrist postures and velocities (electrogoniometry; N = 499), and muscular activity (electromyography) in the right trapezius muscle (N = 431) and forearm extensors (N = 206). We also assessed the psychosocial work environment (Job Content Questionnaire). Uni- and multivariate linear meta-regression analysis revealed several statistically significant group-wise associations. Neck disorders were associated with head inclination, upper arm elevation, muscle activity of the trapezius and forearm extensors and wrist posture and angular velocity. Right-side shoulder disorders were associated with head and upper arm velocity, activity in the trapezius and forearm extensor muscles and wrist posture and angular velocity. The psychosocial work environment (low job control, job strain and isostrain) was also associated with disorders. Women exhibited a higher prevalence of neck and shoulder complaints and tension neck syndrome than men, when adjusting for postures, velocities, muscular activity or psychosocial exposure. In conclusion, the analyses established quantitative exposure-response relationships between neck and shoulder disorders and objective measures of the physical workload on the arm. Such information can be used for risk assessment in different occupations/work tasks, to establish quantitative exposure limits, and for the evaluation of preventive measures.
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| 22. |
- Nordander, Catarina, et al.
(författare)
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Exposure-response relationships in work-related musculoskeletal disorders in elbows and hands - A synthesis of group-level data on exposure and response obtained using uniform methods of data collection.
- 2013
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Ingår i: Applied Ergonomics. - : Elsevier BV. - 1872-9126 .- 0003-6870. ; 44:2, s. 214-253
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Tidskriftsartikel (refereegranskat)abstract
- There is a serious lack of quantitative data regarding exposure-response relationships between occupational risk factors and musculoskeletal elbow and hand disorders. This paper explores such relationships in group-level data from our earlier cross-sectional studies. Prevalence of complaints (Nordic Questionnaire) and diagnoses (physical examination) were recorded in 19 groups of female workers (1891 individuals), and 8 groups of male workers (761 individuals), with highly similar work tasks within each group. Linear regression was performed on the group means of wrist postures and angular velocity (obtained by electrogoniometers), as well as muscular load (obtained using electromyography), recorded in representative sub-samples, and psychosocial exposure (Job Content Questionnaire). To tackle within-group variations in physical exposure, sensitivity analyses were performed by bootstrapping simulations, rendering confidence intervals. The sex-adjusted slope of the regression line (β) for wrist angular velocity vs. complaints during the past 7 days was 0.6%/(°/s), (95% CI 0.3-0.9), and for carpal tunnel syndrome (CTS) 0.2%/(°/s), (0.1-0.3). For palmar flexion, p50, β over the past 7 days was 0.8%/° (0.4-1.2); for CTS 0.3%/° (0.1-0.5); β for muscular activity p90: 0.9%/%MVE (0.3-1.6), and 0.3%/%MVE (-0.03-0.6) respectively and finally β for muscular rest: -1.2%/%time (-2.4-0.03) and -0.5%/%time (-0.9 to -0.01). Relationships were also demonstrated for low job control, job strain and isostrain. Women exhibited a higher prevalence of complaints than men. In conclusion, we have established quantitative exposure-response relationships between physical work load and elbow/hand disorders. Wrist angular velocity was the most consistent risk factor.
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| 23. |
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| 24. |
- Nordander, Catarina, et al.
(författare)
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Risk of musculoskeletal disorders among females and males in repetitive/constrained work
- 2009
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Ingår i: Ergonomics. - : Informa UK Limited. - 0014-0139 .- 1366-5847. ; 52:10, s. 1226-1239
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Tidskriftsartikel (refereegranskat)abstract
- This paper combines epidemiological data on musculoskeletal morbidity in 40 female and 15 male occupational groups (questionnaire data 3720 females, 1241 males, physical examination data 1762 females, 915 males) in order to calculate risk for neck and upper limb disorders in repetitive/constrained vs. varied/mobile work and further to compare prevalence among office, industrial and non-office/non-industrial settings, as well as among jobs within these. Further, the paper aims to compare the risk of musculoskeletal disorders from repetitive/constrained work between females and males. Prevalence ratios (PR) for repetitive/constrained vs. varied/mobile work were in neck/shoulders: 12-month complaints females 1.2, males 1.1, diagnoses at the physical examination 2.3 and 2.3. In elbows/hands PRs for complaints were 1.7 and 1.6, for diagnoses 3.0 and 3.4. Tension neck syndrome, cervicalgia, shoulder tendonitis, acromioclavicular syndrome, medial epicondylitis and carpal tunnel syndrome showed PRs2. In neck/shoulders PRs were similar across office, industrial and non-office/non-industrial settings, in elbows/hands, especially among males, somewhat higher in industrial work. There was a heterogeneity within the different settings (estimated by bootstrapping), indicating higher PRs for some groups. As in most studies, musculoskeletal disorders were more prevalent among females than among males. Interestingly, though, the PRs for repetitive/constrained work vs. varied/mobile were for most measures approximately the same for both genders. In conclusion, repetitive/constrained work showed elevated risks when compared to varied/mobile work in all settings. Females and males showed similar risk elevations. This article enables comparison of risk of musculoskeletal disorders among many different occupations in industrial, office and other settings, when using standardised case definitions. It confirms that repetitive/constrained work is harmful not only in industrial but also in office and non-office/non-industrial settings. The reported data can be used for comparison with future studies.
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| 25. |
- Olstrup, Henrik, et al.
(författare)
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The Long-Term Mortality Effects Associated with Exposure to Particles and NOx in the Malmö Diet and Cancer Cohort
- 2023
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Ingår i: Toxics. - : MDPI. - 2305-6304. ; 11:11
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Tidskriftsartikel (refereegranskat)abstract
- In this study, the long-term mortality effects associated with exposure to PM10 (particles with an aerodynamic diameter smaller than or equal to 10 µm), PM2.5 (particles with an aerodynamic diameter smaller than or equal to 2.5 µm), BC (black carbon), and NOx (nitrogen oxides) were analyzed in a cohort in southern Sweden during the period from 1991 to 2016. Participants (those residing in Malmö, Sweden, born between 1923 and 1950) were randomly recruited from 1991 to 1996. At enrollment, 30,438 participants underwent a health screening, which consisted of questionnaires about lifestyle and diet, a clinical examination, and blood sampling. Mortality data were retrieved from the Swedish National Cause of Death Register. The modeled concentrations of PM10, PM2.5, BC, and NOx at the cohort participants’ home addresses were used to assess air pollution exposure. Cox proportional hazard models were used to estimate the associations between long-term exposure to PM10, PM2.5, BC, and NOx and the time until death among the participants during the period from 1991 to 2016. The hazard ratios (HRs) associated with an interquartile range (IQR) increase in each air pollutant were calculated based on the exposure lag windows of the same year (lag0), 1–5 years (lag1–5), and 6–10 years (lag6–10). Three models were used with varying adjustments for possible confounders including both single-pollutant estimates and two-pollutant estimates. With adjustments for all covariates, the HRs for PM10, PM2.5, BC, and NOx in the single-pollutant models at lag1–5 were 1.06 (95% CI: 1.02–1.11), 1.01 (95% CI: 0.95–1.08), 1.07 (95% CI: 1.04–1.11), and 1.11 (95% CI: 1.07–1.16) per IQR increase, respectively. The HRs, in most cases, decreased with the inclusion of a larger number of covariates in the models. The most robust associations were shown for NOx, with statistically significant positive HRs in all the models. An overall conclusion is that road traffic-related pollutants had a significant association with mortality in the cohort.
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| 26. |
- Rittner, Ralf
(författare)
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Assessing environmental exposures. Air pollution in Scania, southern Sweden.
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The environment where we humans live provides the fundamental requirements we need to survive – food to eat, water to drink, and air to breathe. The quality of these elements has a major impact on human health, as they can contain substances that are detrimental to health. These we call environmental pollutants. This thesis explores the effects of exposure to air pollutants in particular. A large portion of the earth’s population is exposed to high levels of air pollution, and 7 million premature deaths worldwid are estimated to be attributed to air pollution. In order to study relationships between exposure to air pollution and health outcomes and to quantify associations, epidemiologic research is needed. From these, exposure-response functions, or in this case air pollution concentration-response functions, are established for diseases and mortality, which form a foundation for quantitative health impact assessments (HIA). HIAs then help stakeholders and the public understand health risks and make, broadly accepted, informed decisions about interventions needed to improve public health.Aim: To explore and evaluate methods to assess air pollution exposure in Scania for application in epidemiologic studies as well as health impact assessments. Methods: Using a detailed emission database covering Scania, dispersion modelling of concentrations of particles and nitrogen oxides was conducted at high temporal and spatial resolutions. Modelled concentrations were evaluated against measurements (Papers I and II) and subsequently used as exposure indicators in a health impact assessment (Paper III) on premature mortality, asthma, dementia, autism spectrum disorders, preeclampsia (PE) and low birth weight. The last paper included (Paper IV) is an epidemiological study on air pollution and preeclampsia.Results: Modelling of nitrogen dioxide (NO2) showed a correlation of RS = 0.8 with measurements at residence facades with a mean difference of 1.08 μg/m3. Results were poorer for modelled versus measured personal exposure. Efforts to compensate for time spent at workplace did not improve the results much. Modelling of particle concentrations also showed correlations with monitor measurements. However, a large proportion of particle concentrations in Scania consists of long-range background emissions, which likely results in a high correlation between different monitors themselves, which likely contributes to the high correlation with modelled concentrations. With a mean population exposure to particles with aerodynamic size of 2.5 μm or less (PM2.5) of 11.9 μg/m3, Scania experiences relatively low exposure levels from an international perspective. Still, we estimated 6% of premature deaths and 11% of low birth weight (LBW) births to be attributed to PM2.5. Reaching a maximum PM2.5 exposure of 10 μg/m3 for all residents would reduce deaths and LBW substantially but could not be achieved only by removing local emissions of PM2.5. Additional results include a positive association between air pollution exposure and preeclampsia among pregnant women. Conclusions: Dispersion modelling is a useful tool for assessing outdoor concentrations of ambient air pollution. It should be noted that concentrations recorded outdoors at the residence of study persons do not equal someone’s total personal exposure. Several alternative approaches exist, and future research will help demonstrate their respective strengths and weaknesses. It is likely that combined methods including remote sensing will prove favourable. Further, our results indicate substantial benefits for public health if the air pollution levels in Scania were reduced despite being comparatively low from an international perspective.
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| 27. |
- Rittner, Ralf, et al.
(författare)
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Health Impacts from Ambient Particle Exposure in Southern Sweden
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:14
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Tidskriftsartikel (refereegranskat)abstract
- A health impact assessment (HIA) is an important tool for making informed decisions regarding the design and evaluation of environmental interventions. In this study, we performed a quantitative HIA for the population of Scania (1,247,993), the southernmost county in Sweden, in 2016. The impact of annual mean concentrations of particulate matter with an aerodynamic diameter <2.5 mu m (PM2.5), modeled at their home residences for the year 2011, on mortality, asthma, dementia, autism spectrum disorders, preeclampsia and low birth weight (LBW) was explored. Concentration-response (C-R) functions were taken from epidemiological studies reporting meta-analyses when available, and otherwise from single epidemiological studies. The average level of PM(2.5)experienced by the study population was 11.88 mu g/m(3). The PM(2.5)exposure was estimated to cause 9-11% of cases of LBW and 6% of deaths from natural causes. Locally produced PM(2.5)alone contributed to 2-9% of the cases of diseases and disorders investigated. Reducing concentrations to a maximum of 10 mu g/m(3)would, according to our estimations, reduce mortality by 3% and reduce cases of LBW by 2%. Further analyses of separate emission sources' distinct effects were also presented. Reduction of air pollution levels in the study area would, as expected, have a substantial effect on both mortality and adverse health outcomes. Reductions should be aimed for by local authorities and on national and even international levels.
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| 28. |
- Rittner, Ralf, et al.
(författare)
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Particle concentrations, dispersion modelling and evaluation in southern Sweden
- 2020
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Ingår i: SN Applied Science. - : Springer Science and Business Media LLC. - 2523-3971 .- 2523-3963. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Health impact assessments of differential air pollution rely on epidemiologically established relationships between concentration levels where people are exposed and adverse health outcomes. To assess air pollution concentrations, land use regression is commonly used. However, an alternative tool is dispersion modelling, where a detailed inventory of pollution sources together with meteorological data drives calculations of compound dispersion. With this, both spatial and temporal variation can be assessed. In this study, we evaluated results of a Gaussian dispersion model applied to an emissions inventory for Scania, the southernmost county in Sweden. The dispersion considered was particulate matter of aerodynamic diameter < 10 µm (PM10), particulate matter of aerodynamic diameter < 2.5 µm (PM2.5) and black carbon (BC) during an 11-year period (2000–2011). Mean concentrations and 95th percentiles expressed in µg/m3 ranged from 10.1 to 12.6 and 16.6 to 20.7 for PM2.5 and from 14.0 to 18.8 and 22.6 to 27.0 for PM10, respectively. Seven monitoring stations were used for evaluation. Correlations (R2) ranged from 0.44 to 0.86 for PM2.5 (mean bias from − 9.0 to 0.1 µg/m3) and from 0.46 to 0.83 for PM10 (mean bias − 6.1 to 3.5 µg/m3). An evaluated database of PM and BC concentrations for Scania is now available for future exposure assessment projects. Calculations were based on a well-known dispersion model with detailed emission data as input. The evaluation showed correlation coefficients for PM in line with previous literature. The data on PM10, PM2.5 and BC concentrations will, therefore, be used in subsequent studies, epidemiological as well as health impact assessments.
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| 29. |
- Stroh, Emilie, et al.
(författare)
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Measured and modeled personal and environmental NO2 exposure
- 2012
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Ingår i: Population Health Metrics. - : Springer Science and Business Media LLC. - 1478-7954. ; 10:10
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in Undetermined Background: Measured or modeled levels of outdoor air pollution are being used as proxies for individual exposure in a growing number of epidemiological studies. We studied the accuracy of such approaches, in comparison with measured individual levels, and also combined modeled levels for each subject's workplace with the levels at their residence to investigate the influence of living and working in different places on individual exposure levels. Methods: A GIS-based dispersion model and an emissions database were used to model concentrations of NO2 at the subject's residence. Modeled levels were then compared with measured levels of NO2. Personal exposure was also modeled based on levels of NO2 at the subject's residence in combination with levels of NO2 at their workplace during working hours. Results: There was a good agreement between measured facade levels and modeled residential NO2 levels (r(s) = 0.8, p > 0.001); however, the agreement between measured and modeled outdoor levels and measured personal exposure was poor with overestimations at low levels and underestimation at high levels (r(s) = 0.5, p > 0.001 and r(s) = 0.4, p > 0.001) even when compensating for workplace location (r(s) = 0.4, p > 0.001). Conclusion: Modeling residential levels of NO2 proved to be a useful method of estimating facade concentrations. However, the agreement between outdoor levels (both modeled and measured) and personal exposure was, although significant, rather poor even when compensating for workplace location. These results indicate that personal exposure cannot be fully approximated by outdoor levels and that differences in personal activity patterns or household characteristics should be carefully considered when conducting exposure studies. This is an important finding that may help to correct substantial bias in epidemiological studies.
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| 30. |
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| 31. |
- Tekavec, Eva, et al.
(författare)
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Population-based consultation patterns in patients with shoulder pain diagnoses
- 2012
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: To assess the annual consultation prevalence and new onset consultation rate for doctor-diagnosed shoulder pain conditions. Methods: We identified all residents in the southernmost county in Sweden who received a shoulder pain diagnosis during 2006 (ICD-10 code M75). In subjects who did not consult due to such disorders during 2004 and 2005, we estimated the new onset consultation rate. The distribution of specific shoulder conditions and the length of the period of repeated consultation were calculated. Results: Annual consultation prevalence was 103/10 000 women and 98/10 000 men. New onset consultation rate was 80/10 000 women (peak in age 50-59 at 129/10 000) and 74/10 000 men (peak in age 60-69 at 116/10 000). About one fifth of both genders continued to consult more than three months after initial presentation, but only a few percent beyond two years. Rotator cuff - and impingement syndromes were the most frequent diagnoses. Conclusion: The annual consultation prevalence for shoulder pain conditions (1%) was similar in women and men, and about two thirds of patients consulted a doctor only once. Impingement and rotator cuff syndromes were the most frequent diagnoses.
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| 32. |
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| 33. |
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