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2.
  • Andernord, D., et al. (författare)
  • Contact allergy to haptens in the Swedish baseline series: Results from the Swedish Patch Test Register (2010 to 2017)
  • 2022
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 86:3, s. 175-188
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Allergic contact dermatitis has considerable public health impact and causative haptens vary over time. Objectives To report the prevalence of contact allergy to allergens in the Swedish baseline series 2010 to 2017, as registered in the Swedish Patch Test Register. Methods Results and demographic information for patients tested with the Swedish baseline series in 2010 to 2017 were analysed. Results Data for 21 663 individuals (females 69%) were included. Females had significantly more positive patch tests (54% vs 40%). The reaction prevalence rates were highest for nickel sulfate (20.7%), fragrance mix I (7.1%), Myroxylon pereirae (6.9%), potassium dichromate (6.9%), cobalt chloride (6.8%), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI; 6.4%), MI (3.7%), colophonium (3.5%), fragrance mix II (3.2%), and formaldehyde (3.2%). Myroxylon pereirae reaction prevalence increased from 5% in 2010 to 9% in 2017 and that for methyldibromo glutaronitrile from 3.1% to 4.6%. MCI/MI and MI reactions decreased in prevalence after 2014. Nickel reaction prevalence decreased among females aged 10 to 19 years. Conclusions Nickel remains the most common sensitizing agent, with reaction prevalence decreasing among females younger than 20 years. The changes in MCI/MI and MI reaction prevalence mirrored those in Europe. The register can reveal changes in contact allergy prevalence over time among patients patch tested in Sweden.
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  • Andersson, Linus, et al. (författare)
  • Brain responses to olfactory and trigeminal exposure in idiopathic environmental illness (IEI) attributed to smells : An fMRI study
  • 2014
  • Ingår i: Journal of Psychosomatic Research. - : Elsevier. - 0022-3999 .- 1879-1360. ; 77:5, s. 401-408
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Idiopathic environmental intolerance (IEI) to smells is a prevalent medically unexplained illness. Sufferers attribute severe symptoms to low doses of non-toxic chemicals. Despite the label, IEI is not characterized by acute chemical senses. Theoretical models suggest that sensitized responses in the limbic system of the brain constitute an important mechanism behind the symptoms. The aim was to investigate whether and how brain reactions to low-levels of olfactory and trigeminal stimuli differ in individuals with and without IEI. METHODS: Brain responses to intranasally delivered isoamyl acetate and carbon dioxide were assessed in 25 women with IEI and 26 non-ill controls using functional magnetic resonance imaging. RESULTS: The IEI group had higher blood-oxygenated-level-dependent (BOLD) signal than controls in the thalamus and a number of, mainly, parietal areas, and lower BOLD signal in the superior frontal gyrus. The IEI group did not rate the exposures as more intense than the control group did, and there were no BOLD signal differences between groups in the piriform cortex or olfactory regions of the orbitofrontal cortex. CONCLUSIONS: The IEI reactions were not characterized by hyper-responsiveness in sensory areas. The results can be interpreted as a limbic hyperreactivity and speculatively as an inability to inhibit salient extemal stimuli.
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5.
  • Atakora, Michael, et al. (författare)
  • Assessment of Workers' Knowledge and Views of Occupational Health Hazards of Gold Mining in Obuasi Municipality, Ghana
  • 2020
  • Ingår i: International Journal of Occupational Safety and Health. - : Occupational Health and Safety Society of Nepal. - 2738-9707 .- 2091-0878. ; 10:1, s. 38-52
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Small-scale mining in Ghana has been a major community and national concern due to its contribution to the destruction of farmlands and bodies of water, and to the loss of human life. Small-scale mining exposes workers to varying degrees of health hazards and problems.Objectives: The study aimed to assess the knowledge and views of workers about the occupational health hazards and problems related to small-scale gold mining in Obuasi Municipality, Ghana, to help improve workers' safety at the mining sites.Methods: A cross-sectional study was done between May and December 2011. Simple random sampling was used to select 150 small-scale miners take part in this study. The workers were asked about their knowledge and views of occupational health hazards and problems related to gold mining. Data were entered with EpiData Entry 3.1 and analyzed using Stata 11.Results: Most workers (95, 63.3%) had low knowledge of occupational health and safety regulations. Multivariable logistic regression analysis showed that knowledge about regulations was associated with level of education (OR = 8.5; 95% CI: 7-10.5). The common effects of mining that workers expressed awareness of were land pollution (30%), water pollution (28%), air pollution (18.7%), and noise pollution (16%). The factors influencing exposure to health hazards related to mining were low educational levels (14%), little work experience (30.7%), incorrect handling of equipment or chemicals (26%), poor law enforcement (12.7%), and negligence (16.7%). In general, occupational lung disease (16%), occupational hearing loss (14%), heat illnesses (12%), eye infections (16%), malaria (24%), and skin infections (18%) were the most common health problems study participants mentioned.Conclusion: High levels of occupational health hazards and problems related to gold mining exist among workers in private mines. Safety program should be offered as part of associated public health programs to limit the most significant risks. We further recommend education and training on regulations and the use of personal protective equipment.
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6.
  • Bergdahl, Jan, et al. (författare)
  • Coping and self-image in patients with visual display terminal-related skin symptoms and perceived hypersensitivity to electricity
  • 2004
  • Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 77:8, s. 538-542
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The aim of the present study was to measure coping resources and self-image in patients with visual display terminal (VDT)-related skin symptoms and hypersensitivity to electricity (HE).Methods: From 1980 to 1998, 350 patients with electrical sensitivity were registered. The patients were subdivided into two groups: patients with skin symptoms evoked by VDTs, television screens, and fluorescent-light tubes and patients with so-called hypersensitivity to electricity with multiple symptoms evoked by exposure to different electrical environments. A questionnaire was sent to all patients and contained the coping resources inventory (CRI) and the structural analysis of social behaviour (SASB) in order for us to measure coping resources and self-image, respectively. The CRI and SASB scores were compared with those of control groups. Two hundred and fifty respondents (73%) returned the questionnaire, 200 (78.5% women) in the VDT group and 50 (62% women) in the HE group.Results: The patient group rated high on the CRI spiritual/philosophical scale and high on the SASB spontaneous, positive and negative clusters but low on the controlled cluster. The female patients scored high on the CRI emotional scale. The VDT group rated lower than the controls on the SASB controlled cluster and higher on both the positive and negative cluster. The HE group scored higher than the control group on the SASB spontaneous and positive clusters. The women in the HE group scored higher on the CRI cognitive and CRI total scale than the VDT group and control group and higher on the CRI emotional scale than the controls. The women in the HE group rated higher than both the women in the VDT and control groups on the SASB spontaneous and positive clusters.Conclusions: The deviant self-image found in these patients, especially the female HE patients, support the view that VDT and HE symptoms can be stress related. In the clinic, a trustful alliance should be established with the patient in order for a more realistic view to be achieved of the capacity.
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7.
  • Bäck, Ove, et al. (författare)
  • Does vitamin D intake during infancy promote the development of atopic allergy?
  • 2009
  • Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 89:1, s. 28-32
  • Tidskriftsartikel (refereegranskat)abstract
    • The active metabolite of vitamin D, 1,25-(OH)2D3, has immunomodulatory properties in addition to its more established action on bone and calcium metabolism. Recently vitamin D has been proposed as one of several environmental factors responsible for the increase in atopic diseases during the last decades. The objective of this study was to determine whether the estimated dose of dietary vitamin D3 during the first year of life is associated with atopic diseases up to the age of 6 years. In a prospective birth cohort study 123 six-year-old children were investigated for the cumulative incidence of atopic dermatitis, allergic rhinitis or asthma by means of a postal questionnaire. Their vitamin D3 intake during infancy was recorded in a previous study and the relationship between lower or higher vitamin D3 intake and atopic illness later in childhood was assessed. Atopic manifestations were more prevalent in the group with higher intake of vitamin D3. Although small, this study supports previous investigations suggesting a role of vitamin D intake during infancy in the development of atopic allergy later in childhood. If these findings are confirmed in prospective controlled clinical trials, prevention through modified vitamin D3 supplementation in infancy could be discussed to reduce the burden of atopic illnesses.
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8.
  • Carlsson, Annica, et al. (författare)
  • Scoring of hand eczema : good reliability of hand eczema extent score
  • 2017
  • Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 97:2, s. 193-197
  • Tidskriftsartikel (refereegranskat)abstract
    • There is good agreement between dermatological staff and patients using the Hand Eczema Extent Score (HEES). The aim of this study was to assess inter- and intra-observer reliability of the HEES in dermatologists and intra-observer reliability of the HEES in patients with hand eczema. Six dermatologists assessed 18 patients twice. Only the hands of the patients were visible to the assessors. Patients performed a self-assessment twice. Inter- and intra-observer reliability was tested with intraclass correlation coefficient (ICC). The mean HEES score for all dermatologists' assessments was 21.0 (range 3.6-46.3). The corresponding mean scores for all patients' own assessments were 24.9 (range 4.0-54.0). Inter-observer reliability in the dermatologists' observations ICC classification was very good, median value 0.82 (range 0.56-0.92). The overall intra-observer reliability for the 6 dermatologists' ICC classification was very good (range 0.88-0.94). Intra-observer reliability in the patients' 2 self-assessments ICC classification was very good (ICC 0.95). In conclusion, HEES is a reliable tool for both dermatologists and patients to grade the extent of hand eczema.
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9.
  • Carlsson, Annica, et al. (författare)
  • Scoring of hand eczema: good agreement between patients and dermatological staff
  • 2011
  • Ingår i: British Journal of Dermatology. - : Blackwell Publishing Ltd. - 0007-0963 .- 1365-2133. ; 165:1, s. 123-128
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Assessment of hand eczema in a clinical study has been achieved using a scoring system which documents extent of eczema on different areas of the hand. Objectives To investigate whether the same scoring system could be used by patients to communicate current status of hand eczema. Methods In a study of 62 patients (36 women and 26 men, age range 1975 years), the patients own assessment was compared with the assessment by a dermatologist and a dermatological nurse. Standardized information was given to the patient and the form was filled in independently by the patient, the nurse and the dermatologist, during the patients visit to the clinic. Individual area scores were summed to a total score. Results The overall agreement was good, with an interclass correlation (ICC) of 0.61 between patient and dermatologist for the total score. The ICC between nurse and dermatologist was 0.78. Differences between observers were more pronounced for the more severe cases - those with higher numerical scores as assessed by the dermatologist. There was a tendency for women and for patients over the median age of 44 years to set a lower point score than the dermatologist. The concordance of observations from individual anatomical areas was higher for fingertips and nails and lower for the palm and dorsum of the hand. Conclusions Patients are able to report the extent of hand eczema with good accuracy. Self-assessment protocols for hand eczema may well have a place in the monitoring of hand eczema extent over time.
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  • Edvardsson, Berit, et al. (författare)
  • Coping and Self-image in Patients With Symptoms Attributed to Indoor Environment
  • 2013
  • Ingår i: Archives of Environmental & Occupational Health. - : Informa UK Limited. - 1933-8244 .- 2154-4700. ; 68:3, s. 145-152
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigated self-image and coping ability in a group of patients with symptoms from indoor environment. A follow-up questionnaire was sent to 239 patients previously referred with nonspecific building-related symptoms at University Hospital in Umeå, Sweden. One hundred seventy-four women and 14 men answered and the patient group rated their self-image as more spontaneous, more positive, and less negative than a control group. The patient group rated higher on the cognitive scale in the Coping Resources Inventory (CRI) than the control group. The female patients had an increased risk of not being able to work associated with a low score on negative self-image. The authors conclude that certain personality traits may be potential risk factors that increase the probability of encountering and experiencing stressful work situations. The resulting stress may increase workers' susceptibility to indoor environment exposure.
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  • Edvardsson, Berit, 1953- (författare)
  • "Det är inte mig det är fel på, det är huset" : en studie av prognosfaktorer och bemötande med fokus på sjuka hus-syndromet
  • 2015
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Bakgrund: Sick Building Syndrome, SBS, är fortfarande 2015 ett tillstånd som vållar mycket diskussion. Symtomen kan grupperas i slemhinnesymtom, hudsymtom och allmänna symtom. I definitionen ingår att personen/ personerna som fått symtom har exponerats för dålig inomhusluft i en speciell byggnad. När personen inte är i byggnaden så förbättras eller försvinner symtomen. Många olika faktorer kan orsaka eller medverka till uppkomst eller försämringar av SBS-symtom, som t.ex. luftens innehåll av olika ämnen, luftflöden, temperatur, buller, fukt och mögel. Utbredd enighet finns om att fukt och mögel i byggnaderna påverkar eller ger upphov till symtom hos vissa personer som exponeras där. Psykosociala faktorer som arbetets organisation och krav och individuella faktorer som kön och personlighet påverkar också.Syfte: Hypotesen är att faktorer som tidigare hälsa, åtgärder på arbetet, tid, behandling, personlighet och copingresurser alla kan påverka prognosen för SBS-patienterna. Syftet med avhandlingen är att undersöka hur symtomen påverkar arbetsförmågan och om patienterna återhämtar sig från SBS-symtomen. Ett annat syfte är att undersöka bemötande och de erfarenheter som SBS-symtomen gett en grupp av informanter med SBS. För att förstå om personlighet mätt med självbild och coping hade någon betydelse för progressionen av SBS-symtom och arbetsförmåga gjordes jämförelser av personlighet mellan en patientgrupp med SBS, en patientgrupp med handeksem, en patientgrupp med elkänslighet och en normalpopulation.Metod:  En uppföljningsenkät skickades till 239 patienter med SBS-symtom som under åren 1986–1998 blivit undersökta och bedömda på Universitets-sjukhuset i Umeå, Sverige. Frågorna innehöll social och medicinsk status, nuvarande symtom, behandlingar, åtgärder på arbetsplatsen, coping och självbild och svarsfrekvensen var 79,1%. Prognos och riskfaktorer för prognos beräknades för SBS-patienterna. Mätningar av personlighetsfaktorer gjordes med instrumentet Structural analysis of Social Behaviour, SASB, och coping mättes med Coping Resources Inventory, CRI. Likadana uppföljningsenkäter skickades till en grupp patienter med handeksem och patienter med upplevd elkänslighet. Svarsfrekvensen var 68% respektive 73% och enkätsvaren har sedan analyserats och jämförts genom beräknngar av prognos med fokus på självbild och coping för SBS-patienterna och handeksempatienterna. Jämförelser gjordes också mellan de tre olika grupperna och en kontrollgrupp vad gäller självbild och coping. För att undersöka erfarenheterna av SBS-symtomen och bemötandet genomfördes kvalitativa intervjuer med 10 informanter som hade eller hade haft SBS-symtom. Fem av dem hade diagnostiserats en längre tid tillbaka medan de andra fem hade haft SBS-symtomen en kortare period. Semi-strukturerade intervjuformulär användes vid intervjuerna och anlyserades med kvalitativ innehållsanalys.Resultat: Graden och svårigheten av SBS-symtomen minskade över tid trots att nästan hälften av SBS-patienterna beskrev att symtomen var mer eller mindre oförändrade efter 7 år eller mer. Risken att ha symtom vid uppföljningen var större för de patienter som remitterats sent efter symtomdebut men även för de som hade kort uppföljningstid. Risken att inte ha någon arbetsförmåga vid uppföljningen var signifikant ökad om det var mer än ett års skillnad mellan symtomdebut och första läkarbesöket p.g.a. SBS-symtomen eller om patienten vid första undersökningen hade fler än 5 SBS-symtom. Dagliga aktiviteter som t.ex. bussåkning förvärrade också symtomen för patienterna. Informanternas upplevelser av SBS-symtomen från början visar en influensaliknande bild med rinnande näsa och ögon, heshet, hosta och huvudvärk. Informanterna agerar för att klara av situationen när symtomen förvärras. Genom hela processen upplever de en brist på bekräftelse och stöd från arbetsgivare, primärvård, företagshälsovård och fastighetsförvaltare.Alla tre patientgrupperna hade högre värden i spontan och positiv självbild i jämförelse med en kontrollgrupp. De hade också alla lägre värden i kontroll medan patienterna med handeksem och de med elkänslighet hade högre värden i sin negativa självbild. När det gäller coping skilde sig inte patientgrupperna från kontrollgruppen utom i CRI kognitiv där SBS-patienterna hade hög poäng i motsats till handeksempatienterna som hade låg poäng i samma domän. De elkänsliga patienterna hade i stället höga poäng i domänen andlig/filosofisk. Självbild eller copingförmåga var inte associerade med SBS-symtom eller symtom av handeksem vid uppföljningen och deras personlighet påverkade inte arbetsförmågan. Tidigare atopisk dermatit var en signifikant risk för kvarvarande symtom men inte för arbetsförmågan hos handeksempatienterna.Slutsats: En grupp av patienter som tidigare diagnostiserats för symtom från inomhusmiljön har kroniska symtom och påverkan på sitt sociala liv. Över tid minskar symtomen. Resultaten pekar på att ett tidigt omhändertagande är av vikt. SBS-symtomen är från början svåra att upptäcka för alla inblandade och kunskap om hur symtomen kan uppstå i dagligt liv kan bidra till bredare förståelse. Erfarenheterna från personer med SBS visar på avsaknad av bekräftelse och stöd från vården, företagshälsan, arbetsgivare och fastighetsförvaltare. Sambandet mellan symtom och inomhusmiljö får inte glömmas bort. Stöd och bekräftelse innebär också kunskap om skyldigheter för arbetsgivare och fastighetsförvaltare.Skillnad i självbild i jämförelse med en kontrollgrupp ses hos patientgrupperna med symtom som är delvis oförklarade men också hos handeksempatienter med ett väletablerat tillstånd. Det kan innebära att patienter med kroniska tillstånd överlag kan avvika från den allmänna populationen. Patienterna visar som grupp en hög positiv och hög spontan självbild som kan leda till svårigheter att sätta gränser. Detta kan leda till en mental stress och i förlängningen också ge en ökad känslighet/sårbarhet för miljöfaktorer. 
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  • Edvardsson, Berit, et al. (författare)
  • Exploring coping and self-image in patients with hand eczema through a comparison with patients attributing their symptoms to indoor environment or electromagnetic fields
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • PurposeThe aim of this study was to investigate self-image and coping ability among patients with hand eczema and to compare those findings with a normal population to find out if these personality components are important prognostic factors for the progress of symptoms and for work capability.  Furthermore we compared the self-image and coping ability of the hand eczema patients with other patients whose symptoms are attributed to their indoor environment (SBS) and patients whose symptoms are attributed to electromagnetic fields, IEI/EMF.MethodsThe patients were examined, diagnosed and given treatment at appropriate clinics in Norrlands University Hospital, in Umeå, Sweden. For follow-up a postal questionnaire containing questions including medical and social status, treatment , self-image and coping skills was sent to 383 patients, response rate 68.1 %. Measurement of personality traits was done using the Structural analysis of Social Behaviour (SASB) and the Coping Resources Inventory (CRI) to assess coping skills. Similar follow-up questionnaires for patient groups with SBS and perceived electrical sensitivity were used and response rates were 79.1 % respectively 73%. Comparisons were made between self-image and coping among patients with hand eczema, SBS patients and patients with electrical hypersensitivity, and a selection from the general population.  ResultsHand eczema patients scored higher on spontaneous and positive self-image (SASB) than a comparison group. They also had a high score on negative self-image similar to IEI/EMF patients.  On the CRI cognitive domain, hand eczema patients had a lower score than the comparison group. Self-image or coping ability was not associated with persistent hand eczema symptoms or work capability at follow-up. Previous atopic dermatitis was the only consistent predictor of hand eczema at follow-up.ConclusionsDifferences in personality traits were seen in a well-established condition and not only in patients with medically unexplained symptoms such as SBS and perceived sensitivity to electromagnetic fields. This can imply that patients with chronic symptoms in general can deviate from the general population with respect to self-image and coping ability. 
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15.
  • Edvardsson, Berit, et al. (författare)
  • Medical and social prognoses of non-specific building-related symptoms (Sick Building Syndrome) : a follow-up study of patients previously referred to hospital
  • 2008
  • Ingår i: International Archives of Occupational and Environmental Health. - : Springer-Verlag New York. - 0340-0131 .- 1432-1246. ; 81:7, s. 805-812
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives The aim of this study was to describe and analysethe medical and social prognoses of patients with nonspeciWcbuilding-related symptoms.Methods A follow-up questionnaire focusing on current medical and social status, care, treatment, other actions taken and personality traits was sent to 239 patients with non-speciWc building-related symptoms assessed during theperiod between1986 and 1998 at University Hospital in Umeå, Sweden. The response rate was 79%.Results Fatigue, irritation of the eyes, and facial erythemawere the most common weekly symptoms reported atfollow-up. As females constituted 92% of the respondents,statistical analyses were restricted to women. The level andseverity of symptoms decreased over time, although nearlyhalf of the patients claimed that symptoms were more or lessunchanged after 7 years or more, despite actions taken.Twenty-Wve percent of the patients were on the sick-list, and20% drew disability pension due to persistent symptoms atfollow-up. The risk of having no work capabilities at followupwas signiWcantly increased if the time from onset to Wrstvisit at the hospital clinic was more than 1 year. This riskwas also signiWcantly higher if the patient at the Wrst visithad Wve or more symptoms. All risk assessments wereadjusted for length of follow-up. Symptoms were oftenaggravated by diVerent situations in everyday life.Conclusions Long-lasting symptoms aggravated by environmentalfactors exist within this group of patients. Theresults support that early and comprehensive measures forrehabilitation are essential for the patients.
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16.
  • Edvardsson, Berit, et al. (författare)
  • Patient experiences of developing Sick Building Syndrome (SBS) symptoms and related encounters – a qualitative study
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Objective:This study aimed to describe the experiences and encounters of a group of people with Sick Building Syndrome (SBS) as their symptoms emerged.Design, methods and subjects:A semi-structured interview was performed with 10 informants with symptoms of SBS. Five of them were previously diagnosed and had participated in an earlier follow-up study. The remaining five had had SBS symptoms for a shorter period. The interviews were analysed using qualitative content analysis. To ensure trustworthiness triangulation was used. Results:The analysis resulted in a main theme: Conflicting Interpretations of SBS Symptoms, and three subthemes: Gradual Understanding of SBS Symptoms, Experience of Rejection and Experience of Confirmation. The main theme and the sub-themes together represent a process where the informants’ experiences of belief and support, lack of support and disbelief and limited understanding occurs when they are perceiving symptoms, looking for explanations, understanding  the connection between symptoms and being  in a poor indoor environment  and while managing their SBS symptoms.The symptoms, when they first appear, often appear similar to that of flu. When the informants realise the connection between the symptoms and the building some of them decide that “Okay, enough is enough, there’s nothing wrong with me, it’s the building”. Many of the informants act to  change the way they manage the situation as a result of increased symptoms. During this whole process the informants/patients perceived a lack of confirmation and support from e.g. employers, primary health care and occupational health care centres. The informants were confirmed by colleagues acting for a better indoor environment.Conclusion:The symptoms of SBS are diffuse and difficult to recognise for all involved. The experiences of those who have dealt with this issue are in line with knowledge relating to other diseases not recognised as legitimate. It is important for healthcare personnel to be aware of the possible connection between symptoms and the indoor environment. For employers and facility managers, knowledge of their obligations in terms of the working environment is important. The importance of confirmation in encounters has to be underlined. 
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17.
  • Edvardsson, Berit, et al. (författare)
  • The medical and social prognosis of Sick Building Syndrome : a follow-up study focusing on female patients
  • 2005
  • Ingår i: Indoor air 2005. - Beijing : Tsinghua university press. ; , s. 3706-3710
  • Konferensbidrag (refereegranskat)abstract
    • A follow-up questionnaire focusing medical and social status, actions taken and personality traits was sent to 239 patients with Sick Building Syndrome (SBS) registered at the University Hospital in Umea, Sweden. The response rate was 79 percent. As females constituted 92 percent of the respondents all statistical analyses were restricted to women. Almost half of the respondents had been exposed to environments with visible water damages. Fatigue, irritated eyes and facial erythema were the most common symptoms. Nearly half of the patients claimed that the symptoms were more or less unchanged after 7 years or more. Twenty-five percent of the patients were on the sick-list and twenty percent drew disability pension due to SBS-symptoms at follow-up. Symptoms were often aggravated in different situations in everyday life. No important deviations concerning personality factors were found. The results support that early and comprehensive measures for rehabilitation are essential for these patients.
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18.
  • Ekelund, Mats, et al. (författare)
  • A Higher Score on the Dermatology Life Quality Index, Being on Systemic Treatment and Having a Diagnosis of Psoriatic Arthritis is Associated with Increased Costs in Patients with Plaque Psoriasis
  • 2013
  • Ingår i: Acta Dermato-Venereologica. - : Acta Dermato-Venereologica. - 0001-5555 .- 1651-2057. ; 93:6, s. 684-688
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to examine the relationship between measures of disease severity and costs from a socie-tal perspective in patients with plaque psoriasis. Dermatologists in Sweden recruited 443 consecutive patients who had had no biological treatment during the past 12 months. Following a Psoriasis Area and Severity Index (PASI) assessment, subjects completed self-assessments on health status/quality of life and a healthcare resource utilization/work status questionnaire. The costs of healthcare resources and sick-leave due to plaque psoriasis were estimated and related to the subject's health status. A patient's Dermatology Life Quality Index (DLQI) and being on systemic therapy, or having diagnosis of psoriatic arthritis, appeared to be more strongly associated with direct and indirect costs than did their PASI. The cost of biological therapy should be considered from the perspective of the already high costs of patients with high DLQI undergoing traditional systemic treatment.
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19.
  • Engfeldt, Malin, et al. (författare)
  • Can patch testing with methylchloroisothiazolinone/methylisothiazolinone be optimized using a new diagnostic mix? - A multicenter study from the Swedish Contact Dermatitis Research Group
  • 2020
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 82:5, s. 283-289
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and methylisothiazolinone (MI) are tested to detect contact allergy to these isothiazolinones. Objectives To study if an aqueous patch test preparation with MCI and MI in a mix of 0.015% and 0.2%, respectively, detects more contact allergies than the commonly used preparations of MCI/MI in 0.02% aq. and MI in 0.2% aq. Methods A total of 1555 patients with dermatitis in five Swedish dermatology departments were tested consecutively with MCI/MI 0.215% aq., MCI/MI 0.02% aq., and MI 0.2% aq. Results The share of contact allergy to MCI/MI 0.215% aq., MCI/MI 0.02% aq., and MI 0.2% aq. varied in the test centers between 7.9% and 25.9%, 3.2% and 10.3%, and 5.8% and 12.3%, respectively. MCI/MI 0.215% aq. detected significantly more patch-test positive individuals than both MCI/MI 0.02% aq. (P < .001) and MI 0.2% aq. (P < .001), as well as either one of MCI/MI and MI (P < .001). In the patients only reacting to MCI/MI 0.215% aq., 57.7% were recorded as having a dermatitis that was explained or aggravated by exposure to either MCI/MI or MI. Conclusion The results speak in favor of replacing the preparations MCI/MI 0.02% aq. and MI 0.2% aq. with MCI/MI 0.215% aq. as the screening substance in the Swedish baseline series, which has been implemented in 2020.
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20.
  • Engfeldt, Malin, et al. (författare)
  • Patch Testing with a New Composition of Mercapto Mix: A Multi-centre Study by the Swedish Contact Dermatitis Research Group
  • 2019
  • Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 99:11, s. 960-963
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigated whether more patients with contact allergies were detected by patch testing with mercapto mix with a higher concentration of 2-mercaptobenzothiazolinone (MBT) than the commonly used mercapto mix. A total of 3,143 dermatitis patients in 5 Swedish dermatology departments were patch-tested with 3 mercapto test preparations: MBT 2.0% petrolatum (pet.); mercapto mix 2.0% pet.; and mercapto mix 3.5% pet. Positive reactions to these mercapto mixes varied between 0-0.50%, 0-0.93%, and 0-1.4%, respectively, in the 5 centres. Numerically, mercapto mix 3.5% pet. detected all positive patients and more patch-test positive patients than did the 2 other substances, but the difference was not statistically significant. The authors recommend replacing mercapto mix 2.0% pet. in the Swedish baseline series with mercapto mix 3.5% pet., since the latter also detected those patients who would have been missed because MBT 2.0% is not included in the Swedish baseline series.
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21.
  • Engfeldt, Malin, et al. (författare)
  • Patch testing with hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) - a multicentre study of the Swedish Contact Dermatitis Research Group
  • 2017
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 76:1, s. 34-39
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. In 2014, the fragrance hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) was excluded from the Swedish baseline series. Objectives. To study (i) whether fragrance mix (FM) II with 5% HICC detects more positive reactions than usual FM II with 2.5% HICC, and (ii) the reproducibility of patch testing with HICC. Methods. Two thousand one hundred and eighteen dermatitis patients at five Swedish dermatology departments were consecutively tested with FM II 14% pet., FM II 16.5% pet., and duplicate preparations of HICC 5% pet. Results. Of the patients, 3.2% reacted to FMII 14%, and 1.5% reacted to HICC. Separate testing with HICC detected 0.3% reactions without concomitant reactivity to FM II. FM II with 5% HICC did not give rise to more irritant reactions or signs of active sensitization than FM II with 2.5% HICC. Patch testing with duplicate applications of HICC increased the overall prevalence of HICC contact allergy to 1.9%. Conclusion. FMII with5% HICC does not detect more positive reactions than FMII with 2.5% HICC. Separate testing with HICC does not detect a sufficient proportion of patients who react only to HICC, without concomitant reactions to FMII, to warrant its inclusion in a baseline series.
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22.
  • Engfeldt, Malin, et al. (författare)
  • Swedish Experiences From Patch-testing Methylisothiazolinone Separately
  • 2015
  • Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 95:6, s. 717-719
  • Tidskriftsartikel (refereegranskat)abstract
    • The preservative methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is a well-known sensitiser and present in the Swedish baseline series since the 1980s. The proportions of MCI/MI are 3:1. MI alone has been used as a preservative since less than 10 years. This study was conducted on behalf of the Swedish Contact Dermatitis Research Group to evaluate inclusion of MI in the Swedish baseline series since the preparation of MCI/MI might fail to detect contact-allergic reactions to MI alone. Patients with suspected allergic contact dermatitis at 5 Swedish dermatology departments were consecutively patch-tested with MI 2,000 ppm aq and MCI/MI 200 ppm aq. The number of cases with exclusive contact allergy to MI varied between 0.8-4.2%. In total, 1.9% reacted exclusively to MI and not to MCI/MI. Due to the considerable frequency of contact allergy to MI not traced by MCI/MI, MI 2,000 ppm aq is included in the Swedish baseline series from January 2014. This corresponds to a dose of 60 mu g/cm(2).
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23.
  • Eriksson, Nils M, et al. (författare)
  • Baseline prevalence of symptoms related to indoor environment.
  • 2006
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 34:4, s. 387-396
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: Health problems associated with indoor environments have been reported and discussed extensively during the past few decades, not least in Sweden. There is, however, great uncertainty concerning the background prevalence of the symptoms in question. The main objective of the present study was to investigate the prevalence of general, mucosal, and skin symptoms in the Swedish population. Methods: A survey comprising 3,000 randomly selected Swedes, age 18—64, was carried out. The survey addressed 25 symptoms, principally general, mucosal, and skin symptoms. A number of other areas were covered and individual data registered at Statistics Sweden were added. The response rate was 70% (2,154 cases). Results: The prevalence of symptoms in the Swedish population was found to accord with results in studies based on different kinds of samples. Women reported significantly more single symptoms, as well as sets of symptoms, than men. There was no clear connection between age and symptoms. The prevalence of symptoms was slightly lower among employees compared with non-workers. Office workers did not report symptoms related to ``sick building syndrome'' (SBS) more frequently than employees not working in offices. SBS symptoms, skin symptoms, and symptoms similar to those reported by individuals with ``electric hypersensitivity'' were significantly more prevalent among employees with extensive VDU usage. Conclusions: The prevalence of reported health complaints accords with that which has been found in previous studies. The background prevalence reported here can serve as a reference for further studies. The high prevalence of symptoms among individuals with extensive VDU usage gives cause for further studies.
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24.
  • Fall, Sofia, et al. (författare)
  • Contact allergy trends in Sweden - a retrospective comparison of patch test data from 1992, 2000, and 2009
  • 2015
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 72:5, s. 297-304
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Contact allergy prevalence rates change over time as a result of variations in allergen exposure. Data from patch test clinics are often used as markers for allergy trends. Objectives. The aim of the present retrospective study was to describe trends in rates of sensitization to allergens in the Swedish baseline series. Patients/materials/methods. Prevalence rates are described by comparing consecutive patch test data from 1992, 2000 and 2009 in Swedish patch test clinics. In total, 3680 patients were included in 1992, 3825 in 2000, and 3112 in 2009. Results. Among test substances with a sensitization rate above 2% in 2009, significant decreases were noted for nickel sulfate, cobalt chloride, colophonium, and methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI), and a significant increase for p-phenylenediamine, as compared with 1992. Potassium dichromate reactions had increased among younger women, whereas reactions to nickel and cobalt had decreased in this group. Sensitization to chromium, cobalt and fragrance mix I had decreased among older men, and sensitization to nickel had decreased among younger men. Conclusions. It is probable that these changes in 1992-2009 reflect both changes in regulations for nickel, lower levels of chromium in cement and of MCI/MI in cosmetics, and increasing use of hair dyes.
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25.
  • Flytström, I, et al. (författare)
  • Methotrexate Versus Cyklosporine in Psoriasis: effectiveness quality of life and safety. A randomized controlled trial
  • 2008
  • Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 158:1, s. 116-121
  • Tidskriftsartikel (refereegranskat)abstract
    • Background When this study was initiated, no previous studies comparing methotrexate and ciclosporin for moderate to severe plaque psoriasis had been performed. Objectives To compare the effectiveness, quality of life and side-effects of methotrexate and ciclosporin treatments in a context reflecting normal clinical practice. Methods Eighty-four patients with moderate to severe plaque psoriasis were randomized to treatment with methotrexate or ciclosporin for 12 weeks. The primary outcome was the Psoriasis Area and Severity Index (PASI). The secondary outcome was quality of life, measured by the Dermatology Life Quality Index (DLQI) and the 36-item Short Form Health Survey (SF-36). A visual analogue scale (VAS) was used for patients' assessment. Results Sixty-eight patients started treatment and were included in the analysis. Dropout before initiation of treatment was higher in the ciclosporin group. Mean PASI change from baseline at 12 weeks was 58% in the methotrexate group and 72% in the ciclosporin group, showing ciclosporin to be more effective than methotrexate. Improvement of the VAS score was higher in the ciclosporin group. The methotrexate group showed a greater improvement in the subscale Physical Functioning of the SF-36. No significant difference between the groups was found for DLQI. Conclusions Treatment with methotrexate or ciclosporin for chronic plaque psoriasis brings satisfactory disease control, improved quality of life and tolerable side-effects. A statistically significant difference in effectiveness between treatment groups was recorded, showing ciclosporin to be more effective than methotrexate in a short-term perspective.
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26.
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27.
  • Fors, Ronny, et al. (författare)
  • Lifestyle and nickel allergy in a Swedish adolescent population : effects of piercing, tattooing and orthodontic appliances
  • 2012
  • Ingår i: Acta Dermato-Venereologica. - : Society for the Publication of Acta Dermato - Venereologica. - 0001-5555 .- 1651-2057. ; 92:6, s. 664-668
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to estimate the prevalence of life-style practices in adolescents and their association with nickel allergy. Upper secondary school pupils (n = 4,376; 15-23 years) were patch-tested for nickel aller-gy, follow-ing completion of a questionnaire (answered by 6,095). Almost 86% girls and 21% of boys reported piercing. More girls (6%) than boys (3%) had a tattoo. Twenty-six percent of the girls and 18% of the boys were regular smokers. Vegetarian/vegan diets were reported by 20% of girls and by 6% of boys. Piercing, female gender, and vocational programme increased the risk of nickel allergy, whereas orthodontic appliance treat-ment prior to piercing reduced the risk of nickel allergy. Pupils in vocational programmes had the highest prevalence of nickel allergy. Lifestyle behaviours are interconnected and cluster in subgroups of adolescents. Female sex, piercing and choice of educational programme are prominent lifestyle markers. A trend shift is observed, where more girls than boys report tattooing.
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28.
  • Fors, Ronny, et al. (författare)
  • Nickel allergy : prevalence in a population of Swedish youths from patch test and questionnaire data
  • 2008
  • Ingår i: Contact Dermatitis. - Copenhagen : Munksgaard. - 0105-1873 .- 1600-0536. ; 58:2, s. 80-87
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The prevalence of body piercing and orthodontic treatment has increased during recent decades. Such changes in lifestyle may influence the occurrence of nickel allergy.Objectives: The aim of this study was to describe the prevalence of nickel allergy in a Swedish youth population.Methods: In a cross-sectional survey, 6095 adolescents answered a questionnaire on their lifestyle and medical history, and 4439 consented to patch testing for contact allergy. Patch test results were adjusted for dropouts by a missing value analysis.Results: The prevalence of self-reported dermatitis from contact with metal items was 14.8%. Patch testing showed nickel sensitization in 9.9% of the subjects, and in significantly more girls than boys, 13.3% versus 2.5%, respectively. Taking the dropout into account, the estimated true prevalence of nickel sensitivity evaluated by test reading at D4 is 11.8% in girls and 1.6% in boys.Conclusions: The prevalence of nickel sensitization was higher for girls and slightly lower for boys compared with previous Swedish data. Self-reported information on metal dermatitis as an estimate of nickel allergy has low validity. When possible, missing value analysis should be performed to account for dropouts.
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29.
  • Fors, Ronny, 1969- (författare)
  • Nickel allergy in a Swedish adolescent population and its relation to orthodontic treatment and lifestyle factors
  • 2008
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Nickel stands out as the main cause of contact allergy in both children and adults, which has given rise to concern and the introduction of regulations by official bodies. Today´s youths are frequently exposed to body piercing and orthodontic treatment. Changes in youth lifestyle practices are also likely to influence nickel exposure and thus, the occurrence of nickel allergy. However, against patient and parental concern regarding nickel exposure to orthodontic appliances, often evoked by allergies following piercing, stand results from studies indicating that early orthodontic appliance treatment may reduce, rather than increase, prevalence of nickel allergy; a finding that has been suggested to result from tolerance induction by early exposure to nickel via the oral route. The objective of the present thesis was to investigate the association between nickel allergy and exposure to different orthodontic appliances and lifestyle, in particular piercing, as well as to study nickel release from orthodontic appliances into the oral cavity. Furthermore, one objective was to establish baseline prevalence data of nickel allergy in a Swedish adolescent population. Data was generated from a cross-sectional survey, in which about 6000 youths completed a questionnaire and almost 4500 of these were patch-tested for contact allergy. Information on exposure to orthodontic appliances was verified by dental records, whilst nickel content in saliva and dental biofilm was measured in a clinical study. Questionnaire data demonstrated a reduced risk of nickel allergy when orthodontic treatment preceded piercing (OR 0.5; 95 % CI 0.3-0.8) and similar results were found for data verified from dental records, however statistical significance was lost when adjusting for background factors (OR 0.6, 95 % CI 0.4-1.0). Exposure to full fixed appliances with NiTi-containing alloys, as well as a pooled ‘high nickel-releasing’ appliance group prior to piercing correlated with a significantly reduced risk of nickel allergy and a trend towards a reduced risk with exposure duration. Nickel could also be found in significantly higher concentrations from dental plaque samples, but not saliva samples, in orthodontic patients who were well into treatment compared to patients who had not been exposed to orthodontic appliances. The effect was not found to be due to differences in estimated dietary nickel intake between the two groups. Significantly more girls than boys (13.3 % versus 2.5 %) were found to be patch-test positive to nickel. Positive nickel tests were also most prevalent in occupational programmes and least prevalent in natural science programmes, indicating differences in lifestyle and exposure to nickel. Dropout from testing was handled using a missing-value analysis. This internal validation showed that our results overestimated the occurrence of nickel allergy to a minor degree. More girls than boys reported piercing, vegetarian/vegan diet, and smoking practices, whereas an interesting shift in tattooing prevalence was observed with a larger proportion of girls reporting this practice compared to boys. Sex, number of piercings, smoking and orthodontic appliance treatment prior to piercing were found to influence weighted risk estimates of nickel allergy. To conclude, although orthodontic patients are exposed to nickel intraorally, we found no increased risk of sensitising adolescents to nickel by the use of oral orthodontic appliances. On the contrary, early orthodontic treatment preceding piercing reduced the risk of nickel allergy by a factor of 1.5-2.0. This reduced risk appears to be associated with estimated nickel release of the appliance and duration of treatment, in all supporting a hypothesised induction of immunological tolerance via oral administration of nickel. Our study also showed a strong association between lifestyle and nickel allergy. Although there have been changes in lifestyle over time, as indicated by the strong shift in tattooing practices, no large change in nickel allergy prevalence was found compared with previous Swedish data. Our data will serve as a baseline for future studies of the effect of nickel exposure regulations, such as the Nickel Directive, and for studies of lifestyle changes and their effects on nickel allergy.
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30.
  • Fors, Ronny, et al. (författare)
  • Nickel allergy in relation to piercing and orthodontic appliances : a population study
  • 2012
  • Ingår i: Contact Dermatitis. - : John Wiley & Sons. - 0105-1873 .- 1600-0536. ; 67:6, s. 342-350
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Studies have shown conflicting results on the association between nickel exposure from orthodontic appliances and nickel sensitization.Objectives & Method. In a cross-sectional study, we investigated the association between nickel sensitization and exposure to orthodontic appliances and piercings. 4376 adolescents were patch tested following a questionnaire asking for earlier piercing and orthodontic treatment. Exposure to orthodontic appliances was verified in dental records.Results. Questionnaire data demonstrated a reduced risk of nickel sensitization when orthodontic treatment preceded piercing (OR 0.46; CI 0.27–0.78). Data from dental records demonstrated similar results (OR 0.61, CI 0.36–1.02), but statistical significance was lost when adjusting for background factors. Exposure to full, fixed appliances with NiTi-containing alloys (OR 0.31, CI 0.10–0.98) as well as a pooled ‘high nickel-releasing’ appliance group (OR 0.56, CI 0.32–0.97) prior to piercing was associated with a significantly reduced risk of nickel sensitization.Conclusion. High nickel-containing orthodontic appliances preceding piercing reduces the risk of nickel sensitization by a factor 1.5–2. The risk reduction is associated with estimated nickel release of the appliance and length of treatment. Sex, age at piercing and number of piercings are also important risk indicators. Research on the role of dental materials in the development of immunological tolerance is needed.
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31.
  • Fu, Xi, 1984- (författare)
  • Self-rated health and respiratory symptoms among civil aviation pilots : Occupational and non-occupational risk factors
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • There is concern about the indoor environment in aircraft but few stud-ies exist on self-rated health (SRH) and respiratory symptoms among pilots. Occupational and non-occupational risk factors for SRH, respira-tory symptoms and other symptoms among commercial pilots were investigated in this thesis. One cohort study and one prevalence study were performed among pilots in one Scandinavian airline company. Fungal DNA, furry pet allergens and volatile organic compounds of microbial origin (MVOC) were measured on board. Cat (fel d1), dog (Can f1) and horse (Ecu cx) allergens were found in all dust samples and allergen levels were 27-75 times higher in aircraft with textile seats as compared to leather surfaces. The sum of MVOCs in the cabin air was 3.7 times higher than in homes in Uppsala and 2-methyl-1-butanol and 3-methyl-1-butanol concentrations were 15-17 times higher. Asper-gillus/Penicillium DNA and Aspergillus versicolor DNA were more common in aircraft with textile seats. One fifth reported SRH as poor or fair, 62% had fatigue, 46% overweight/obesity and 71% insomnia. Poor or fair SRH was associated with overweight/obesity, lack of exercise, insomnia, low sense of coherence (SOC) and high work demand. Re-covery from work was worse among those with insomnia and low social support at work. Fatigue was more common among young or female pilots and related to insomnia and high work demand. Pilots flying MD80 or Saab 2000 aircraft had less fatigue. Pilots exposed to environmental tobacco (ETS) on board had more eye symptoms and fatigue which were reduced after the ban of smoking (in 1997). Pilots with increased work demand developed more rhinitis, dermal symptoms and fartigue and those with decreased work control developed more eye symptoms. The incidence of doctors’ diagnosed asthma and atopy were 2.4 and 16.6 per 1000 person years, respectively. Pilots changing type of flight got more airway infections. Those reporting decreased work control had a higher incidence of atopy. Risk factors in the home environment included ETS, dampness or mould, window pane condensation in winter and living in houses built after 1975. In conclusion, SRH and respiratory health among pilots are associated with specific occupational and non-occupational risk factors.
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32.
  • Glader, Annika (författare)
  • Chemical emissions from building structures : emission sources and their impact on indoor air
  • 2012
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Chemical compounds in indoor air can adversely affect our comfort and health. However, in most cases there is only a limited amount of information available that can be used to assess their health risk. Instead the precautionary principle is often applied, i.e. efforts are made to ensure that the concentrations of pollutants are kept at a minimum when constructing new buildings or conducting renovations by using low-emitting building materials. Today, when investigating buildings in order to solve indoor air quality problems, volatile organic compounds (VOCs) are sampled in the air within rooms. The chemical composition of indoor air is complex and there are many sources for the chemicals present. The potential for emissions from sources in hidden spaces such as wall cavities is poorly understood and little information exists on the toxic potential of chemical releases resulting from moisture-related degradation of building materials. Most of the non-reactive VOCs that have been detected in indoor air in field studies and from building products are not believed to cause health problems. However, reactive compounds and chemical reaction products have the potential to negatively influence our comfort and health even at low concentrations. Even though the impact of chemical compounds on health is unclear in many cases, they can be used to identify technical problems in buildings. When a building is investigated, the air inside building structures could be sampled. This method would eliminate emissions from sources other than the construction materials and the samples would contain higher levels of individual compounds. The aims of this work was to identify emissions profiles for different types of building structures, to see if the emission profiles for moisture damaged and undamaged structures differed, and to determine whether any of the emissions profiles for specific structures also could be found in indoor air. Technical investigations and VOC sampling were performed in 21 different buildings with and without previous moisture damage. Seven of the buildings were investigated in the years 2005-2006 (study 1) and fourteen in the years 2009-2010 (study 2). In study 1, sixty samples were analyzed by PCA at the chemical group level (18 chemical groups, i.e. aldehydes, ketones etc). 41 % of all identified chemical compounds belonged to the hydrocarbon chemical group. The second largest chemical groups, each of which accounted for 5-10 % of all identified compounds, were alcohols, aldehydes, ketones, polyaromatic hydrocarbons (PAHs) and terpenes. The results indicated that one of the main factors that determined the emissions profile of a building structure was the materials used in its construction. Notably, concrete and wooden structures were found to have different emissions profiles. The sum of VOC (TVOC) concentrations for all 241 samples from both study 1 and study 2 was used to compare total emissions between different building elements (ground and higher floors, external walls and roof spaces). Most building elements exhibited relatively low emissions compared to concrete ground floors, which generally had higher TVOC emissions. Emissions from both polystyrene insulation and PVC flooring could be identified in concrete ground floors and were the main cause for the higher emissions found in these structures. Profiles for wood preservatives such as creosote and pentachlorophenol were also identified in external walls. The emission profiles found in the structures could not be identified in the indoor air in the adjacent rooms, although individual compounds were sometimes detected at low concentrations. Our results showed that the main factors influencing emissions in building structures were the construction materials and the nature of the building element in question. Because of difficulties with finding active water damage at the times of sampling and because of sampling inside closed building structures with old dried-out moisture damages, the field method used in this work was unsuitable for identifying differences in emission profiles between moisture damaged and undamaged structures. It will thus be necessary to investigate this difference in a laboratory where the precise composition of all tested structures is known, a range of RH values can be tested and the accumulation of emissions can be followed.
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33.
  • Glas, Bo, 1959-, et al. (författare)
  • A novel approach to evaluation of adsorbents for sampling indoor volatile organic compounds associated with symptom reports
  • 2008
  • Ingår i: Journal of Environmental Monitoring. - : Royal Society of Chemistry (RSC). - 1464-0325 .- 1464-0333. ; 10:11, s. 1297-1303
  • Tidskriftsartikel (refereegranskat)abstract
    • This article addresses problems that complicate attempts to compare methods when several factors may be associated with an effect, but it is not known which factors are relevant. Chemicals that may contribute to 'sick building syndrome' (SBS), and thus should be sampled in investigations of SBS, are not currently known. A study was undertaken to compare the utility of three adsorbents (Carbopack B, Chromosorb 106 and Tenax TA) for detecting differences in personal chemical exposure to volatile organic compounds in indoor air, between persons with and without SBS symptoms (cases and controls). On the basis of office workers' responses to a questionnaire, 15 cases and 15 controls were chosen. They simultaneously carried diffusive samplers with adsorbents during a week at work, and the acquired samples were analysed by gas chromatography/mass spectrometry (GC/MS). The adsorbents were then compared in terms of their ability to separate cases and controls in partial least square discriminant analysis (PLS-DA) models. This method of comparison takes into account detected differences in chemical exposure between cases and controls measured with the different adsorbents. Tenax TA gave the best PLS-DA models for separating cases and controls, but a combination of measurements with Tenax TA and Carbopack B gave better PLS-DA models than models based on measurements from either adsorbent alone. Adding measurements from Chromosorb 106 did not improve the results.
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34.
  • Glas, Bo, 1959-, et al. (författare)
  • Association of exposure to ozone, formaldehyde, NO2 and terpenes with reported symptoms in office workers
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • A number of risk factors for “sick building syndrome” (SBS) are known, including poor ventilation, but the associated substances in the air that are removed by ventilation are unknown. In this study the exposure of office workers to formaldehyde, d-limonene, nitrogen dioxide, ozone and α-pinene at work and at home was measured during a working week. Data on symptoms were obtained by analyzing responses to a questionnaire and participants were divided into cases and controls. We found no significant differences in chemical exposure between cases and controls. However, correlations were found between a number of individual symptoms and exposure to specific substances or combinations of substances.
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35.
  • Glas, Bo, et al. (författare)
  • Comparison of three adsorbents for diffusive sampling of airborne volatile organic compounds in office environments
  • 2005
  • Ingår i: Indoor air 2005. - Beijing : Tsinghua university press. ; , s. 2713-2717
  • Konferensbidrag (refereegranskat)abstract
    • Volatile organic compounds were personally sampled by people classified as cases (people having certain SBS symptoms) and controls, i.e. people not fulfilling the criteria's for cases. The aim of the study was to find out which adsorbent that gave the best separation between SBS cases and controls based on their chemical exposure of VOCs. The statistical method used was partial least squares discriminant analysis (PLS-DA). The adsorbents compared were Carbopack B, Chromosorb 106 and Tenax TA. The study included 30 office workers wearing diffusive samplers during one working week. The samplers were analysed with thermal desorption-GC-MS, and each chromatographic peak was included in the data evaluation. Tenax TA gave the best separation between cases and controls with a Q(2) = 0.434 and R(2)Y = 0.873 for three components. Analyses of samples taken with Carbopack B and Chromosorb 106 showed no ability to discriminate between the two classes.
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36.
  • Glas, Bo, et al. (författare)
  • Exposure to formaldehyde, nitrogen dioxide, ozone, and terpenes among office workers and associations with reported symptoms
  • 2015
  • Ingår i: International Archives of Occupational and Environmental Health. - Berlin/Heidelberg : Springer Berlin/Heidelberg. - 0340-0131 .- 1432-1246. ; 88:5, s. 613-622
  • Tidskriftsartikel (refereegranskat)abstract
    • To compare exposure to formaldehyde, nitrogen dioxide, ozone and terpenes among office workers with and without sick building syndrome and the odds ratio for exposure. Are there significant differences? In this cross-sectional study of office workers, we investigated the associations between exposure to formaldehyde, nitrogen dioxide, ozone, alpha-pinene, and d-limonene using a case-control analysis. Data on perceived general, mucosal, and skin symptoms were obtained by questionnaires. Personal exposure measurements of the compounds were performed among cases and controls, and the odds ratios for exposures to the substances, both singly and in combination, were investigated. Exposures varied for formaldehyde between 0.23 and 45 A mu g/m(3), nitrogen dioxide between 0.26 and 110 A mu g/m(3), ozone between < 16 and 165 A mu g/m(3), alpha-pinene between 0.2 and 170 A mu g/m(3), and d-limonene between 0.8 and 1,400 A mu g/m(3). No consistent differences in exposure odds ratios were found between cases and controls or for individual symptoms.
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37.
  • Glas, Bo, 1959- (författare)
  • Methodological aspects of unspecific building related symptoms research
  • 2010
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This thesis deals with methological issues in the study of chemical exposure and sick building syndrome (SBS). SBS is a combination of general, mucosal and skin symptoms that some people experience when staying in specific buildings. The aim was to find chemical patterns associated with SBS, but also to address methological problems in such study. The plan was to conduct a case-control study comparing the two groups’ chemical exposure, where cases were defined as those having at least one general, one mucosal and one skin symptom each week the last three months. For the planning it was necessary to know if cases and controls could be selected from the same building. If everyone in a building have the same chemical exposure it is no use to compare exposure between two persons at the same workplace. In the first paper exposure to more than 100 compounds is compared between 79 participants working in eight buildings. It was found that for the majority of compounds the variation in exposure was larger within buildings than between buildings, which means that cases and controls could be allowed to work in the same building. The second paper is a comparison of three adsorbents usability in finding differences in chemical exposure between SBS cases and controls. This was done by using chemometrical methods but comparisons of sampled amounts, blank values and reproducibility were also done. Tenax TA was found to be the best adsorbent, hence used in the case-control study. In recent years ozone and ozone reaction products with unsaturated volatile organic compounds (VOCs) has been in focus. Nitrogen dioxide is another gas affecting oxidation of reactive VOCs. Formaldehyde is an irritant formed when unsaturated VOCs are oxidised, and in some studies a relation with SBS has been found. In paper three the relation between personal exposure to formaldehyde, nitrogen dioxide, ozone, terpenes and SBS has been investigated among more than 200 office workers in a case control study in Umeå and Vasa. Cases (based on symptoms during the week of measurements) had lower ozone exposure than controls. No further associations were found at present exposure levels. A planed analysis of relations to VOCs could not be done due to analytical problems, and problems due to difficulties with consistent identification of compounds in a very large data set. These problems are further discussed in the thesis. In the case-control, study participants answered questionnaires about symptoms during "the past three months", "right now" (when answering the questionnaire), and during the week of exposure measurements. In the fourth paper the stability of symptoms were compared by answers at different occasions. It was found that the case/control concept was as stable as individual symptoms. More participants with atopic disease and those 41 years old or younger changed class compared with those without atopic disease and older participants. Measurement activities appeared to make participants report more symptoms. Fatigue, dry eyes and dry skin are suggested to be symptoms with strongest, and illness/dizziness to be weakest association with IAQ.
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38.
  • Glas, Bo, 1959-, et al. (författare)
  • The stability of office workers’ unspecific building-related symptom reports
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • The stability of reported unspecific building-related symptoms, or sick building syndrome (SBS) was investigated in this study. In Umeå and Vasa, two cities in northern Sweden and Finland, 172 subjects were asked about their symptoms in two questionnaires. The first contained questions about symptoms during the past three months, right now (when answering the questionnaire), and if any symptom ameliorated when they were not at their workplaces. Later on, all of the workers took measurements of their personal chemical exposure at work and at home during one week, and at the end of the week they were asked about symptoms during the week. The stability of a case/control concept was investigated as well as individual symptoms. It was found that 67 % of cases and controls did not change class if classifications were based on answers on symptoms during both the past three months and the week of measurements. Corresponding proportions for general, mucosal and skin symptoms were 71 %, 71 % and 78 % respectively. However, measurement activities appeared to increase symptom reports; on average 43 % of controls reported symptoms compatible with the case definition and 53 % of individual symptoms during the week of chemical measurements were not experienced when asked about symptoms during the past three months. Classification of participants with atopic disease and those 41 years old, or younger, were least stable. Nausea/dizziness does not seem to be strongly associated with indoor air quality while other general symptoms, dry eyes and facial skin symptoms are often attributed to staying within the workplace building
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39.
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40.
  • Hagvall, Lina, 1978, et al. (författare)
  • Contact allergy to citral and its constituents geranial and neral, coupled with reactions to the prehapten and prohapten geraniol
  • 2020
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 82:1, s. 31-38
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Citral is commonly used as a fragrance and flavor material and consists of the aldehydes geranial and neral. Citral is included in fragrance mix (FM) II. Geranial and neral have also been identified in autoxidation of geraniol, a fragrance compound present in FM I. Objectives To study contact allergy to citral, geranial, and neral, and concomitant reactivity to oxidized geraniol and fragrance markers of the baseline series. Methods A total of 1476 dermatitis patients with suspected allergic contact dermatitis were patch tested using geranial, neral, and citral, all 3.5% petrolatum (pet.) as well as geraniol 6.0% and oxidized geraniol 11% pet. in addition to the Swedish baseline series. Results Frequencies of positive reactions to citral, geranial, and neral were 2.9%, 3.4% and 1.9%, respectively. Together, citral and geranial gave 4.2% positive patch test reactions in consecutive dermatitis patients. In patients with positive reactions to citral or its components, 25% to 34% reacted to FM II and 61% reacted to oxidized geraniol. Conclusions Patch testing with citral, its components, or oxidized geraniol detects contact allergic reactions not detected using the baseline series. Patch testing with pure geraniol was shown to be of little value. Geranial and neral, although closely chemically related, are concluded to be separate haptens.
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41.
  • Hagvall, Lina, 1978, et al. (författare)
  • Contact allergy to oxidized geraniol among Swedish dermatitis patients-A multicentre study by the Swedish Contact Dermatitis Research Group
  • 2018
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 79:4, s. 232-238
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Geraniol is a widely used fragrance terpene, and is included in fragrance mix I. Geraniol is prone to autoxidation, forming the skin sensitizers geranial, neral, and geraniol-7-hydroperoxide. Oxidized geraniol has previously been patch tested in 1 clinic, giving 1% to 4.6% positive reactions in consecutive patients when tested at 2% to 11%. Aim: To compare test reactions to pure and oxidized geraniol, to compare 2 different test concentrations of oxidized geraniol and to investigate the pattern of concomitant reactions to fragrance markers of the baseline series in a multicentre setting. Methods: One thousand four hundred and seventy-six consecutive patients referred for patch testing were patch tested with geraniol 6% pet. and oxidized geraniol 6% and 11% pet. Results: Pure geraniol 6% pet., oxidized geraniol 6% pet. and oxidized geraniol 11% pet. gave 1%, 3% and 8% positive patch test reactions and 0.7%, 3% and 5% doubtful reactions, respectively. Approximately 50% of the patients with doubtful reactions to oxidized geraniol 6% pet. had positive reactions to oxidized geraniol 11% pet. Conclusions: Oxidized geraniol 11% pet. provides better detection than oxidized geraniol 6% pet. As most patients reacted only to oxidized geraniol, it is important to explore further whether oxidized geraniol should be included in a baseline patch test series.
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42.
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43.
  • Isaksson, Marléne, et al. (författare)
  • Multicentre patch testing with a resol resin based on phenol and formaldehyde
  • 2011
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 65:1, s. 34-37
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Contact allergy to phenol-formaldehyde resins (PFRs) based on phenol and formaldehyde is not detected by a p-tertiary-butylphenol-formaldehyde resin (PTBP-FR) included in most baseline patch test series. Objectives. To investigate the rate of contact allergy to PFR-2 (a mixture of monomers and dimers from a resol resin based on phenol and formaldehyde) in a Swedish population, and to investigate associated simultaneous allergic reactions. Methods. Five centres representing the Swedish Contact Dermatitis Research Group included PFR-2 in their patch test baseline series for a period of 1.5 years. Results. Of 2504 patients tested, 27 (1.1%) reacted to PFR-2. Of those 27 individuals, 2 had a positive reaction to formaldehyde and 2 to PTBP-FR. Simultaneous allergic reactions were noted to colophonium in 6, to Myroxylon pereirae in 14, and to fragrance mix I in 15. Conclusions. The contact allergy frequency in the tested population (1.1%) merits its inclusion in the Swedish baseline series and possibly also in other baseline series. Simultaneous allergic reactions were noted to colophonium, M. pereirae, and fragrance mix I.
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44.
  • Isaksson, Marléne, et al. (författare)
  • Multicentre patch testing with compositae mix by the Swedish contact dermatitis research group
  • 2011
  • Ingår i: Acta Dermato-Venereologica. - : Society for Publication of Acta Dermato-Venereologica. - 0001-5555 .- 1651-2057. ; 91:3, s. 295-298
  • Tidskriftsartikel (refereegranskat)abstract
    • Sesquiterpene lactone mix detects contact allergy to these compounds present in the plant family Asteraceae. This marker is present in many baseline series. An additional marker is Compositae mix, which is not present in many baseline series. To investigate whether this allergen should be inserted into the Swedish baseline series, sex dermatology centres representing the Swedish Contact Dermatitis Research Group included Compositae mix into their baseline series for 1.5 years. Of 2818 patients tested, 31 (1.1%) reacted to Compositae mix and 26 (0.9%) to Sesquiterpene lactone mix. Active sensitization to Compositae mix was noted in two cases. Only 0.4% of Asteraceae contact allergy cases would have been missed if Compositae mix had not been tested, a frequency too low to merit its inclusion in the baseline series. Due to obvious geographical differences in frequency in frequency of simultaneous allergic reactions to Compositae mix and Sesquiterpene lactone mix, the question as to whether specific baseline series (including Compositae mix or not as a "tail" substance) should be used in the different centres must be addressed. Another option could be to remove Sesquiterpene lactone mix from the baseline series and substitute it with Compositae mix.
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45.
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46.
  • Isaksson, Marléne, et al. (författare)
  • Patch Testing with Formaldehyde 2.0% in Parallel with 1.0% by the Swedish Contact Dermatitis Research Group
  • 2014
  • Ingår i: Acta Dermato-Venereologica. - : Taylor & Francis. - 0001-5555 .- 1651-2057. ; 94:4, s. 408-410
  • Tidskriftsartikel (refereegranskat)abstract
    • In a multicentre study consecutively patch-tested dermatitis patients were tested simultaneously with 1.0% and 2.0% (w/v) formaldehyde in aqua applied with a micro-pipette (15 mu l) to the filter paper disc in Finn Chambers (0.30 mg/cm(2) and 0.60 mg/cm(2), respectively). A total of 2,122 dermatitis patients were patch-tested. In all, 77 (3.6%) patients reacted positively to formaldehyde; 37 reacted only to 2.0%, 35 reacted to both concentrations and 5 patients reacted only to 1.0%. Significantly more patients were thus diagnosed with contact allergy to formaldehyde with 2.0% compared to 1.0% (p<0.001) without causing more irritant reactions. The detected number of isolated allergic reactions to the 2 formaldehyde-releasers in the Swedish baseline series and not to formaldehyde itself raises the question whether quaternium-15 1.0% and diazolidinyl urea 2.0% should be present in the Swedish baseline series.
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47.
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48.
  • Isaksson, Marléne, et al. (författare)
  • Suitable test concentration of cobalt and concomitant reactivity to nickel and chromium. A multicentre study from the Swedish Contact Dermatitis Research Group
  • 2021
  • Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 84:3, s. 153-158
  • Tidskriftsartikel (refereegranskat)abstract
    • Background In Sweden, cobalt chloride 0.5% has been included in the baseline series since the mid-1980s. A recent study from Stockholm showed that cobalt chloride 1% petrolatum (pet.) was more suitable than 0.5%. Cobalt chloride at 1.0% has been patch tested for decades in many European countries and around the world. Objectives To study the suitability of patch testing to cobalt 1.0% vs 0.5% and to analyze the co-occurrence of allergy to cobalt, chromium, and nickel. Results Contact allergy to cobalt was shown in 90 patients (6.6%). Eighty (5.9%) patients tested positive to cobalt 1.0%. Thirty-seven of the 90 patients (41.1%) with cobalt allergy were missed by cobalt 0.5% and 10 (0.7%) were missed by cobalt 1.0% (P < .001). No case of patch test sensitization was reported. Allergy to chromium was seen in 2.6% and allergy to nickel in 13.3%. Solitary allergy to cobalt without nickel allergy was shown in 61.1% of cobalt-positive individuals. Female patients had larger proportions of positive reactions to cobalt (P = .036) and nickel (P < .001) than males. Conclusion The results speak in favor of replacing cobalt chloride 0.5% with cobalt chloride 1.0% pet. in the Swedish baseline series, which will be done 2021.
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49.
  • Johansson, Amanda, et al. (författare)
  • No effect of mobile phone-like RF exposure on patients with atopic dermatitis
  • 2008
  • Ingår i: Bioelectromagnetics. - : Wiley. - 0197-8462 .- 1521-186X. ; 29:5, s. 353-362
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigates the effect of exposure to a mobile phone-like radiofrequency (RF) electromagnetic field on people with atopic dermatitis (AD). Fifteen subjects with AD were recruited and matched with 15 controls without AD. The subjects were exposed for 30 min to an RF field at 1 W/kg via an indoor base station antenna attached to a 900 MHz GSM mobile phone. Blood samples for ELISA analysis of the concentration of substance P (SP), tumor necrosis factor receptor 1 (TNF RI), and brain derived neurotrophic factor (BDNF) in serum were drawn before and after the provocation (exposure/sham). Baseline heart rate and heart rate variability, local blood flow, and electrodermal activity were also recorded. No significant differences between the subject groups were found for baseline neurophysiological data. The cases displayed a serum concentration of TNF RI significantly higher than the control subjects and a significantly lower serum concentration of BDNF in the baseline condition. For SP there was no difference between groups. However, no effects related to RF exposure condition were encountered for any of the measured substances. As to symptoms, a possible correlation with exposure could not be evaluated, due to too few symptom reports. The result of the study does not support the hypothesis of an effect of mobile phone-like RF exposure on serum levels of SP, TNF RI, and BDNF in persons with AD.
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50.
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