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2. |
- Andersson, Eva, 1955, et al.
(författare)
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Lung function and paper dust exposure among workers in a soft tissue paper mill.
- 2020
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Ingår i: International archives of occupational and environmental health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131.
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Tidskriftsartikel (refereegranskat)abstract
- To study respiratory effects of exposure to soft paper dust exposure, a relationship that is rarely studied.Soft tissue paper mill workers at a Swedish paper mill were investigated using a questionnaire and lung function and atopy screening. Spirometry without bronchodilation was performed with a dry wedge spirometer, and forced vital capacity (FVC) and forced expiratory volume in 1s (FEV1) were obtained and expressed as percent predicted. Exposure to soft paper dust was assessed from historical stationary and personal measurements of total dust, in addition to historical information about the work, department, and production. The impact of high exposure to soft paper dust (>5mg/m3) vs. lower exposure≤5mg/m3, as well as cumulative exposure, was analyzed using multiple linear regression models. Multivariate models were adjusted for smoking, atopy, gender, and body mass index.One hundred ninety-eight current workers (124 male and 74 female) were included. There were significant associations between both cumulative exposure and years of high exposure to soft paper dust and impaired lung function. Each year of high exposure to soft paper dust was associated with a 0.87% decrease in FEV1 [95% confidence interval (CI) -1.39 to -0.35] and decreased FVC (-0.54%, 95% CI -1.00 to -0.08) compared to the lower exposed workers.The present study shows that occupational exposure to soft paper dust (years exceeding 5mg/m3 total dust) is associated with lung function impairment and increased prevalence of obstructive lung function impairment.
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3. |
- Axelsson, Malin, 1964-, et al.
(författare)
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Personality, adherence, asthma control and health-related quality of life in young adult asthmatics
- 2009
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Ingår i: Respiratory Medicine. - : Elsevier. - 0954-6111 .- 1532-3064. ; 103:7, s. 1033-1040
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundStriving for improved adherence and asthma control is of vital concern in today's asthma management. Several influential factors have been identified, but the importance of personality traits has been insufficiently explored. The aim was first to determine whether personality traits in young adult asthmatics are related to asthma control and health-related quality of life (HRQL), and second to examine the influences of personality traits on adherence to regular asthma medication treatment.MethodsYoung adult asthmatics, 22 years of age (n = 268) completed questionnaires. Statistical analyses were performed.ResultsThe personality traits Negative Affectivity and Impulsivity correlated negatively with asthma control, whereas in women Hedonic Capacity correlated positively with asthma control. Negative Affectivity, Impulsivity, Hedonic Capacity, Alexithymia and asthma control predicted the mental dimension of HRQL. Asthma control and physical activity predicted the physical dimension of HRQL. Among respondents with regular asthma medication (n = 109), Impulsivity correlated negatively with adherence. In men, Antagonism and Alexithymia were associated with low adherence. Additionally, Alexithymia, Hedonic Capacity and Negative Affectivity showed non-linear relationships with adherence, meaning that initially increased scores on these personality traits scales were associated with increased adherence but higher scores did not increase adherence. Respondents who were prescribed a single inhaler combining ICS and LABA reported higher adherence than those with monotherapies.ConclusionThese data suggest that personality can influence how asthma patients adhere to asthma medication treatment, and report their control and HRQL. Tools determining personality traits may be useful in the future in individualizing management of asthma patients.
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- Bjerg, Anders, et al.
(författare)
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Increased Prevalence of Symptoms of Rhinitis but Not of Asthma between 1990 and 2008 in Swedish Adults : Comparisons of the ECRHS and GA(2)LEN Surveys
- 2011
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 6:2, s. e16082-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The increase in asthma prevalence until 1990 has been well described. Thereafter, time trends are poorly known, due to the low number of high quality studies. The preferred method for studying time trends in prevalence is repeated surveys of similar populations. This study aimed to compare the prevalence of asthma symptoms and their major determinants, rhinitis and smoking, in Swedish young adults in 1990 and 2008. Methods: In 1990 the European Community Respiratory Health Survey (ECRHS) studied respiratory symptoms, asthma, rhinitis and smoking in a population-based sample (86% participation) in Sweden. In 2008 the same symptom questions were included in the Global Allergy and Asthma European Network (GA(2)LEN) survey (60% participation). Smoking questions were however differently worded. The regions (Gothenburg, Uppsala, Umea) and age interval (20-44 years) surveyed both in 1990 (n = 8,982) and 2008 (n = 9,156) were analysed. Results: The prevalence of any wheeze last 12 months decreased from 20% to 16% (p<0.001), and the prevalence of "asthma-related symptoms" was unchanged at 7%. However, either having asthma attacks or using asthma medications increased from 6% to 8% (p<0.001), and their major risk factor, rhinitis, increased from 22% to 31%. Past and present smoking decreased. Conclusion: From 1990 to 2008 the prevalence of obstructive airway symptoms common in asthma did not increase in Swedish young adults. This supports the few available international findings suggesting the previous upward trend in asthma has recently reached a plateau. The fact that wheeze did not increase despite the significant increment in rhinitis, may at least in part be due to the decrease in smoking.
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5. |
- Fardell, Camilla, et al.
(författare)
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High IQ in Early Adulthood is Associated with Parkinson´s Disease
- 2020
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Ingår i: Journal of Parkinson's Disease. - : IOS Press. - 1877-7171 .- 1877-718X. ; 10:4, s. 1649-1656
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Tidskriftsartikel (refereegranskat)abstract
- Background: High education level and high occupational complexity have been implicated as risk factors for Parkinson’s disease (PD). Objective: The objective was to determine whether cognitive capacity, measured as IQ, in early adulthood is associated with the subsequent development of PD. Method: Data on IQ were retrieved from the Swedish Military Service Conscription Registry, comprising Swedish males who enlisted for military service in the period 1968–1993 (N=1,319,235). After exclusion, 1,189,134 subjects in total were included in the present study. Individuals who later developed PD (N=1,724) were identified using the Swedish National Patient Register and the Swedish Cause of Death Register. Results: High education level was associated with PD. High IQ was associated with PD (p<0.0001), both when analyzed as a continuous variable and when divided into three categories. The hazard ratio for the high IQ category compared to the low IQ category was 1.35 (95% confidence interval 1.17–1.55). Strong test results on the subtests, measuring verbal, logic, visuospatial and technical abilities, were also associated with PD. In a subgroup, smoking was inversely associated with PD, as well as with IQ. Conclusions: This study identifies high IQ to be a risk factor for PD.
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6. |
- Fardell, Camilla, et al.
(författare)
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The erythrocyte sedimentation rate in male adolescents and subsequent risk of Parkinson’s disease: an observational study
- 2021
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Ingår i: Journal of Neurology. - : Springer Science and Business Media LLC. - 0340-5354 .- 1432-1459. ; 268, s. 1508-1516
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Tidskriftsartikel (refereegranskat)abstract
- Systemic inflammation may be implicated in the pathophysiology of Parkinson’s disease (PD). Since PD occurs usually in later life, most studies of causal factors are conducted in older populations, so potentially important influences from early life cannot be adequately captured. We investigated whether the erythrocyte sedimentation rate (ESR) in early adulthood is associated with the subsequent development of PD in men. As part of Swedish national conscription testing conducted from 1968 through 1983 (N = 716,550), the erythrocyte sedimentation rate, as a measure of inflammation, was measured in 659,278 young men. The cohort was observed for subsequent PD events (N = 1513) through December 2016. Cox proportional hazards models were used to estimate the hazard ratios (HR) with 95% CI with adjustment for potential confounders. Individuals with higher ESRs were significantly less likely to be diagnosed with PD, as ESR was linearly and inversely associated with PD risk. The magnitude of the association between ESR and PD risk was similar for increases up to 15mm/h, leveled off thereafter, and was non-significant for ESR values > 20mm/h. The HR for PD with basic adjustments (age at conscription, year of conscription, test center and erythrocyte volume fraction) was 0.94 (95% CI 0.89–0.99, P = 0.02) per log2 increase in ESR, corresponding to a two-fold increase in ESR. Further adjustments for potential confounders (parental education, systolic and diastolic blood pressures, and IQ) scarcely altered the HR. The results suggest a prospective association between high ESR and reduced risk for PD.
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7. |
- Fredriksson, Sofie, 1983, et al.
(författare)
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Preschool teachers have an increased risk of hearing-related symptoms and report more occupational noise exposure compared to randomly selected women
- 2016
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Ingår i: Occupational Health: Think Globally, Act Locally, EPICOH 2016, September 4–7, 2016, Barcelona, Spain. Occupational & Environmental Medicine. ; 73:A191
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Noise-induced hearing disorder has been thoroughly studied among workers in industry-like settings, but less so in female-dominated occupations. In Sweden, noise-related occupational disease among women are reported most frequently in the education sector. We analysed questionnaires from 4,932 women with preschool teacher’s degree who have worked in preschool compared to 5,065 randomly selected women without preschool work-history (response rate 51% vs. 38%). The age range was 24–71 in both cohorts (mean 46 [SD 11] among preschool teachers and 51 [11] among controls). Prevalence and prevalence ratio in age-strata and Mantel-Haenszel pooled risk were calculated for hearing-related symptoms. Noise exposure was compared between the cohorts. A 5% level of significance was applied. Occupational noise exposure and noise annoyance were significantly more common among teachers than controls: 75% vs.31% and 69% vs.26%, respectively. Still, significantly fewer teachers used hearing protection: 3% vs. 4%. Prevalence of hearing-related symptoms was much higher among teachers than controls: sound-induced auditory fatigue (71% [95% CI: 70–72] vs. 31% [30–32]), difficulty perceiving speech (46% [45–47] vs. 26% [25–27] and hyperacusis (38% [37–39] vs. 18% [17–19] and slightly higher for hearing loss (19% [18–20] vs. 17% [6–18] and tinnitus (19% [18–20] vs. 15% [14–16]. Teachers had a twofold risk of sound-induced auditory fatigue (PR-MH 2.2 [95% CI: 2.1–2.3] and hyperacusis (PR-MH 2.1 [1.9–2.2] compared to controls, when adjusted for age. The risk was also increased for difficulty perceiving speech (PR-MH 1.8 [1.7–1.9], tinnitus (PR-MH 1.4 [1.3–1.6] and hearing loss (PR-MH 1.4 [1.3–1.5]. Mean age of onset was significantly lower among teachers for all symptoms, except for hyperacusis (p = 0.902). Leisure-noise was significantly more common among controls. Family history of hearing loss did not differ (p = 0.411). The study is the first to show that preschool teachers have an increased risk of hearing-related symptoms, which may be caused by the work environment.
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10. |
- Kim, Jeong-Lim, et al.
(författare)
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Trends in the prevalence of asthma, rhinitis, and eczema in 15 year old adolescents over an 8 year period
- 2014
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111. ; 108:5, s. 701-708
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Tidskriftsartikel (refereegranskat)abstract
- Background: Trends in prevalence of asthma and allergic diseases are still controversial, and rarely studied among adolescents at midpoint of puberty. Methods: In 2000, a questionnaire was mailed to adolescents (n = 18,158) attending 9th grade at school and living in Vastra Gotaland County, Sweden. Eight years later, the same questionnaire was mailed to adolescents (n = 21,651), using identical inclusion criteria as previously. Altogether, 10,837 adolescents completed the questionnaire in 2000 and 11,754 in 2008. Differences in prevalence of physician diagnosed asthma, asthma symptoms, rhinitis, and eczema between the periods were analyzed by Chi-square test. Multiple logistic regression models were performed to test for trends in prevalence of these diseases, adjusting for potential con-founders. Results: Physician diagnosed asthma and lifetime and current rhinitis were increased in 2008, while wheeze decreased (p < 0.05). Taking sex, foreign descent, body mass index, and parents' education into account, the prevalence of physician diagnosed asthma (OR 1.3 [95% CI 1.2-1.4]) and lifetime (1.7 [1.6-1.8]) and current rhinitis (1.5 [1.4-1.6]) had increased. Eczema had decreased (0.9 [0.8-0.98]). These trends were consistent in boys and girls, but more prominent in those with obesity. In physician diagnosed asthmatics, there was no change in wheeze, asthma symptoms, or asthma medication. Conclusions: The prevalence of physician diagnosed asthma has increased over the last decade, maybe due to combinations of changes in diagnostics and increased general awareness, rather than a real increase. Results showed an increase in rhinitis and a decrease in eczema. Obesity seems to have a modifying effect, which calls for further investigation. (C) 2014 Elsevier Ltd. All rights reserved.
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11. |
- Malinovschi, Andrei, 1978-, et al.
(författare)
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Assessment of Global Lung Function Initiative (GLI) reference equations for diffusing capacity in relation to respiratory burden in the Swedish CArdioPulmonary bioImage Study (SCAPIS)
- 2020
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Ingår i: European Respiratory Journal. - Lausanne, Switzerland : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 56:2
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Tidskriftsartikel (refereegranskat)abstract
- The Global Lung Function Initiative (GLI) has recently published international reference values for diffusing capacity of the lung for carbon monoxide (DLCO). Lower limit of normal (LLN), i.e. the 5th percentile, usually defines impaired DLCO. We examined if the GLI LLN for DLCO differs from the LLN in a Swedish population of healthy, never-smoking individuals and how any such differences affect identification of subjects with respiratory burden.Spirometry, DLCO, chest high-resolution computed tomography (HRCT) and questionnaires were obtained from the first 15 040 participants, aged 50–64 years, of the Swedish CArdioPulmonary bioImage Study (SCAPIS). Both GLI reference values and the lambda-mu-sigma (LMS) method were used to define the LLN in asymptomatic never-smokers without respiratory disease (n=4903, of which 2329 were women).Both the median and LLN for DLCO from SCAPIS were above the median and LLN from the GLI (p<0.05). The prevalence of DLCO DLCO >GLI LLN but DLCO >GLI LLN but versus 4.5%, p<0.001), chronic airflow limitation (8.5% versus 3.9%, p<0.001) and chronic bronchitis (8.3% versus 4.4%, p<0.01) than subjects (n=13 600) with normal DLCO (>GLI LLN and >SCAPIS LLN). No differences were found with regard to physician-diagnosed asthma.The GLI LLN for DLCO is lower than the estimated LLN in healthy, never-smoking, middle-aged Swedish adults. Individuals with DLCO above the GLI LLN but below the SCAPIS LLN had, to a larger extent, an increased respiratory burden. This suggests clinical implications for choosing an adequate LLN for studied populations.
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13. |
- Neitzel, Richard L, et al.
(författare)
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Dust Exposures in Swedish Soft Tissue Paper Mills.
- 2022
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Ingår i: Annals of work exposures and health. - : Oxford University Press (OUP). - 2398-7316 .- 2398-7308. ; 66:1, s. 14-26
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Tidskriftsartikel (refereegranskat)abstract
- Paper dust has previously been linked to adverse health effects. However, a comprehensive dataset of paper dust exposures does not appear to have been published previously. Our study was intended to address this need by describing a large dataset of measurements made in Swedish soft tissue paper mills.We compiled personal and area total dust exposure measurements collected from a range of operations by our research staff at four soft tissue paper mills in Sweden. We also compiled measurements made by the occupational health staff at each mill and the Swedish Work Environment Authority. We analyzed these measurements to describe patterns and trends in exposures and used mixed-effects regression models to identify measurement characteristics that predicted exposure levels.We compiled 1578 measurements from 1971 to 2009, of which 1026 (65%) were personal samples. Statistically significant differences were found between measurements made by research, mill, and Swedish Work Environment Authority staff, as well as between personal and area measurements. The measurement data suggest that, beginning in the 1980s, exposures declined at three of the four mills, but that overexposures were still common at the end of the period. Papermaking and converting operations had the highest observed dust exposures. One mill had significantly lower exposures than the others. Type of measurement (personal versus area) and source of measurement (research staff, company, or regulatory agency) were not significant predictors of measured total dust exposure after controlling for mill, operation, and time.Our analysis of measured paper dust exposures may be useful for historical and contemporary exposure assessment in our own and other epidemiological studies. We have identified specific characteristics (i.e. papermaking operations and mill) and time trends that are important data features to consider, and documented continuing overexposure situations. Our results highlight the ongoing need for application of exposure controls to reduce paper dust exposures in the soft tissue paper industry.
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14. |
- Patelis, Antonios, et al.
(författare)
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Natural History of Perceived Food Hypersensitivity and IgE Sensitisation to Food Allergens in a Cohort of Adults
- 2014
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: No longitudinal studies exist on the natural history of food hypersensitivity and IgE sensitisation to food allergens in adults. Objective: To examine the natural history of food hypersensitivity, the natural history of IgE sensitisation to food allergens and to investigate the risk factors for new onset food hypersensitivity. Methods: Food hypersensitivity was questionnaire-assessed in 2307 individuals (aged 20-45 years) from Iceland and Sweden during the European Community Respiratory Health Survey both at baseline and follow-up 9 years later. IgE food and aeroallergen sensitisation were assessed in a subgroup of these individuals (n = 807). Values of 0.35 kU/L and above were regarded as positive sensitisation. Results: Food hypersensitivity was reported by 21% of the subjects and this proportion remained unchanged at follow-up (p = 0.58). Fruits, nuts and vegetables were the three most common causes of food hypersensitivity, with a similar prevalence at baseline and follow-up. The prevalence IgE sensitisation to food allergens decreased in general by 56% (p < 0.001) and IgE sensitisation to peanut decreased in particular by 67% (p = 0.003). The prevalence of timothy grass IgE sensitisation decreased by 15% (p = 0.003) while cat, mite and birch IgE sensitisation did not decrease significantly. Female sex, rhinitis, eczema and presence of IgE sensitisation to aeroallergens were independently associated with new onset food hypersensitivity. Conclusion: The prevalence of food hypersensitivity remained unchanged while the prevalence of IgE sensitisation to food allergens decreased in adults over a 9-year follow-up period. The decrease in prevalence of IgE sensitisation to food allergens was considerably larger than the change in prevalence of IgE sensitisation to aeroallergens.
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15. |
- Rask-Andersen, Anna, 1952-, et al.
(författare)
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Health-related quality of life as associated with asthma control, psychological status and insomnia
- 2022
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Ingår i: Upsala Journal of Medical Sciences. - Uppsala : Upsala Medical Society. - 0300-9734 .- 2000-1967. ; 127
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Tidskriftsartikel (refereegranskat)abstract
- Background: Asthma is associated not only with lower health-related quality of life (HRQL) but also with psychological health and insomnia. The aim of this study was to investigate associations between HRQL, asthma symptoms, psychological status and insomnia in adults from three Nordic countries.Methods: This study comprised 2,270 subjects aged 29–55 from Sweden, Iceland and Norway. HRQL was measured with the 36-Item Short Form Health Survey (SF-36). The physical (PCS) and mental health (MCS) component scores were calculated with higher values, indicating better health status. Symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Insomnia was assessed with the Basic Nordic Sleep Questionnaire. An asthma score consisting of a sum of the positive answers to five respiratory symptoms was used in the analysis. Spirometry and allergy tests were also performed.Results: High HADS and sleep disturbance scores were both related to a low PCS and MCS, respectively, after adjusting for confounders. High age and high body mass index (BMI) were associated with low scores on the PCS, whilst the opposite was found for the MCS. A higher asthma score was related to a low PCS. An interaction between the HADS and the asthma symptom score was observed for the PCS (P = 0.0002), where associations between psychological status and the PCS were more pronounced for individuals with more symptoms than for individuals without symptoms.Conclusions: In this study, we found that HRQL of life was independently related to the HADS, insomnia and asthma symptoms. Further prospective studies to identify the most efficient target for intervention in order to improve asthma control are needed.
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16. |
- Sterner, Thomas, 1952, et al.
(författare)
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How to Promote Prevention Economics Incentives, Legal Regulations or Both?
- 2003
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Ingår i: Scandinavian Journal of Work, Environment and Health.
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Tidskriftsartikel (refereegranskat)abstract
- Legal regulations of the work environment are probably regarded as the main tools to promote prevention at the work-place. The legal regulations are expressed as occupational exposure limits, bans and taxes. Taxes can be regarded as economic incentives as well, and other economic incentives are insurance systems for employers and consumers´ actions. The latter have been found to have profound effects regarding environmental issues, and may also in future be a powerful tool for work-place related prevention. The research in this area is rather limited, but there are some research results that can be obtained from the area of environmental economy. The paper will discuss some examples where legal regulations, economic incentives or both have been used. Described examples will be the control of silicosis, 2-naphthylamine, trichloroethylene and the process chemicals used in pulp and paper bleaching.
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17. |
- Torén, Kjell, 1952, et al.
(författare)
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How to promote prevention--economic incentives or legal regulations or both?
- 2003
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Ingår i: Scand J Work Environ Health. ; 29:3
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Tidskriftsartikel (refereegranskat)abstract
- Legal regulations of the work environment are probably regarded as the main tools for promoting prevention at the workplace. Legal regulations are expressed as occupational exposure limits, bans, and taxes. Taxes can be regarded as economic incentives as well, and other economic incentives are insurance systems for employers' and consumers' actions. The latter have been found to have profound effects regarding environmental issues and may also, in the future, be a powerful tool for workplace-related prevention. The research in this area is rather limited, but there are some research results that can be obtained from the area of environmental economics. This paper discusses some examples in which legal regulations, economic incentives, or both have been used. Legal regulations and market-based economic incentives may produce similar results, but the economic cost and political feasibility typically differ. This situation makes the selection and design of instruments an important field for future research.
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18. |
- Torén, Kjell, 1952, et al.
(författare)
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Klinisk diagnostik av astma hos barn och vuxna
- 2009
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Ingår i: Allergi och astma. Hedlin G & Larsson K, red. Studentlitteratur. - 9789144029962 ; , s. 213-227
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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19. |
- Torén, Kjell, 1952, et al.
(författare)
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Occupational exposure to soft paper dust and mortality
- 2020
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 77:8, s. 549-54
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Tidskriftsartikel (refereegranskat)abstract
- © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objectives: Occupational exposure to soft paper dust is associated with impaired lung function. Whether there is an increased risk for asthma or chronic obstructive pulmonary disease (COPD) is unclear. Methods: We studied 7870 workers from three Swedish soft paper mills, and defined high-exposed workers, as having been exposed to soft paper dust exceeding 5 mg/m3 for at least 5 years. The remaining workers were classified as â € low exposed'. Person-years at risk were calculated and stratified according to gender, age and calendar-year. The follow-up time was from 1960 to 2013. The expected numbers of deaths were calculated using the Swedish population as reference and standardised mortality ratios (SMRs) with 95% CIs were assessed. Results: There was an increased mortality due to obstructive lung disease (asthma and COPD), among high-exposed workers, SMR 1.89, 95% CI 1.20 to 2.83, based on 23 observed cases. High-exposed workers had an increased mortality from asthma, SMR 4.13, 95% CI 1.78 to 8.14, based on eight observed cases. The increased asthma mortality was also observed among high-exposed men, SMR 4.38, 95% CI 1.42 to 10.2, based on five observed cases. The asthma mortality among low-exposed workers, both men and women, was not increased. The COPD mortality was not clearly increased among high-exposed workers (SMR 1.52, 95% CI 0.85 to 2.50). Conclusion: High occupational exposure to soft paper dust increases the mortality due to asthma, and the results suggest that soft paper dust levels in workplaces should be below 5 mg/m3
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21. |
- Winkvist, Anna, 1962, et al.
(författare)
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Dietary intake, leisure time activities and obesity among adolescents in Western Sweden: a cross-sectional study
- 2016
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Ingår i: Nutrition Journal. - : Springer Science and Business Media LLC. - 1475-2891. ; 15:41
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Tidskriftsartikel (refereegranskat)abstract
- Background: Overweight and obesity among adolescents are increasing worldwide. Risk factors include dietary intake characteristics and high levels of physical inactivity. In Sweden, few large comprehensive population-based surveys of dietary intake and lifestyle among adolescents have been carried out. Thus, the purpose of the current study was to describe dietary intake and food choices as well as leisure time activities in relation to overweight and obesity in a total sample of all schoolchildren aged 15 years in Western Sweden. Methods: In 2008, a questionnaire was sent to all 21,651 adolescents born in 1992 in Vastra Gotaland Region, Sweden. Participation rate was 54.3 % (50.7 % girls/49.3 % boys). The questionnaire included a 73-item semi-quantitative food frequency questionnaire and questions on lifestyle. Results were evaluated against the Nordic Nutrition Recommendations and Swedish indicators of healthy diet and exercise habits. Associations with concurrent overweight and obesity were evaluated in multiple linear regression analysis. Results: Among girls, 49.5 % reached the goal of consuming fruit and vegetables at least daily, whereas for boys the figure was 34.4 %. Among both sexes, 15 % reached the goal of consuming fish at least twice weekly. Two-thirds of both sexes reached the goal of regular moderate or vigorous physical activity weekly. In total, 12.4 % were overweight and 2.4 % were obese. More girls than boys were underweight, whereas more boys than girls were overweight or obese (p < 0.001). Boys exhibited a more frequent intake of sodas and concentrated fruit juices, milk 3 % fat, bread and potatoes and fast food (p < 0.001). Frequent intake of candies and chocolate was reported by both sexes. Among girls and boys, living in rural areas, living in apartments and reporting no frequent leisure time physical activity were significant risk factors for being overweight or obese, also when adjusted for other risk factors. Conclusions: Dietary habits of adolescents in Western Sweden warrant improvements. Public health actions should be taken to increase consumption of fruit, vegetables and fish, and decrease consumption of sodas and candies and also to increase frequency of physical activity. These actions may be helpful in reducing risks for overweight and obesity.
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22. |
- Åberg, Maria A I, 1972, et al.
(författare)
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Risk factors in Swedish young men for amyotrophic lateral sclerosis in adulthood
- 2018
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Ingår i: Journal of Neurology. - : Springer Science and Business Media LLC. - 0340-5354 .- 1432-1459. ; 265:3, s. 460-470
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Tidskriftsartikel (refereegranskat)abstract
- Recent research suggests that the incidence of amyotrophic lateral sclerosis (ALS) may be on the rise. Since ALS becomes predominant in later life, most studies on causal factors are conducted in middle-aged or older populations where potentially important influences from early life can usually not be adequately captured. We aimed to investigate predictors in young Swedish men for ALS in adulthood. Therefore, we performed a prospective cohort study of young men (aged 16-25, n=1,819,817) who enlisted 1968-2005 and took part in comprehensive conscription examinations. Incident cases of ALS (n=526) during up to 46years of follow-up were identified in the National Hospital Register and Swedish Cause of Death Register. Those who developed ALS had lower BMI (body mass index) at conscription than their peers (p=0.03). The risk of ALS during follow-up was calculated with Cox proportional hazards models. No associations were found with physical fitness, erythrocyte sedimentation rate, or non-psychotic mental disorders. Low overall muscle strength compared to high overall muscle strength [hazard ratio (HR) 1.36; 95% confidence interval (CI) 1.01-1.83] and low BMI (a one-unit increase HR 0.96; 95% CI 0.93-0.99) and lower erythrocyte volume fraction (a one-unit increase HR 0.96; 95% CI 0.92-0.998) were the statistically significant predictors for ALS in adjusted models. These findings provide novel epidemiologic evidence of a prospective association between low overall muscle strength and erythrocyte volume fraction in young men and ALS risk.
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23. |
- Abrahamsen, R., et al.
(författare)
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Association of respiratory symptoms and asthma with occupational exposures: findings from a population-based cross-sectional survey in Telemark, Norway
- 2017
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to estimate the prevalence of respiratory symptoms and physiciandiagnosed asthma and assess the impact of current occupational exposure. Design: Cross-sectional analyses of the prevalence of self-reported respiratory health and association with current occupational exposure in a random sample of the general population in Telemark County, Norway. Settings: In 2013, a self-administered questionnaire was mailed to a random sample of the general population, aged 16-50, in Telemark, Norway. The overall response rate was 33%, comprising 16 099 responders. Outcome measures: The prevalence for respiratory symptoms and asthma, and OR of respiratory symptoms and asthma for occupational groups and exposures were calculated. Occupational exposures were assessed using self-reported exposure and an asthma-specific job-exposure matrix (JEM). Results: The prevalence of physician-diagnosed asthma was 11.5%. For the occupational groups, the category with agriculture/fishery workers and craft/related trade workers was associated with wheezing and asthma attack in the past 12 months, showing OR 1.3 (1.1 to 1.6) and 1.9 (1.2 to 2.8), respectively. The group including technicians and associated professionals was also associated with wheezing OR 1.2 (1.0 to 1.3) and asthma attack OR 1.4 (1.1 to 1.9). The JEM data show that exposure to flour was associated with wheezing OR 3.2 (1.4 to 7.3) and woken with dyspnoea OR 3.5 (1.3 to 9.5), whereas exposures to diisocyanates, welding/soldering fumes and exposure to vehicle/motor exhaust were associated with dyspnoea OR 2.9 (1.5 to 5.7), 3.2 (1.6 to 6.4) and 1.4 (1.0 to 1.8), respectively. Conclusions: The observed prevalence of physiciandiagnosed asthma was 11.5%. The 'manual' occupations were associated with respiratory symptoms. Occupational exposure to flour, diisocyanates, welding/soldering fumes and vehicle/motor exhaust was associated with respiratory symptoms in the past 12 months and use of asthma medication. However, prospective data are needed to confirm the observed associations.
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24. |
- Abrahamsen, R., et al.
(författare)
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Non-response in a cross-sectional study of respiratory health in Norway
- 2016
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Declining participation in epidemiological studies has been reported in recent decades and may lead to biased prevalence estimates and selection bias. The aim of the study was to identify possible causes and effects of non-response in a population-based study of respiratory health in Norway. Design: The Telemark study is a longitudinal study that began with a cross-sectional survey in 2013. Setting: In 2013, a random sample of 50 000 inhabitants aged 16-50 years, living in Telemark county, received a validated postal questionnaire. The response rate was 33%. In this study, a random sample of 700 non-responders was contacted first by telephone and then by mail. Outcome measures: Response rates, prevalence and OR of asthma and respiratory symptoms based on exposure to vapours, gas, dust or fumes (VGDF) and smoking. Causes of non-response. Results: A total of 260 non-responders (37%) participated. Non-response was associated with younger age, male sex, living in a rural area and past smoking. The prevalence was similar for responders and non-responders for physician-diagnosed asthma and several respiratory symptoms. The prevalence of chronic cough and use of asthma medication was overestimated in the Telemark study, and adjusted prevalence estimates were 17.4% and 5%, respectively. Current smoking was identified as a risk factor for respiratory symptoms among responders and non-responders, while occupational VGDF exposure was a risk factor only among responders. The Breslow-Day test detected heterogeneity between productive cough and occupational VGDF exposure among responders. Conclusions: The Telemark study provided valid estimates for physician-diagnosed asthma and several respiratory symptoms, while it was necessary to adjust prevalence estimates for chronic cough and use of asthma medication. Reminder letters had little effect on risk factor associations. Selection bias should be considered in future investigations of the relationship between respiratory outcomes and exposures.
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25. |
- Accordini, S., et al.
(författare)
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Prenatal and prepubertal exposures to tobacco smoke in men may cause lower lung function in future offspring: a three-generation study using a causal modelling approach
- 2021
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 58:4
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Tidskriftsartikel (refereegranskat)abstract
- Mechanistic research suggests that lifestyle and environmental factors impact respiratory health across generations by epigenetic changes transmitted through male germ cells. Evidence from studies on humans is very limited. We investigated multigeneration causal associations to estimate the causal effects of tobacco smoking on lung function within the paternal line. We analysed data from 383 adult offspring (age 18-47 years; 52.0% female) and their 274 fathers, who had participated in the European Community Respiratory Health Survey (ECRHS)/Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) generation study and had provided valid measures of pre-bronchodilator lung function. Two counterfactual-based, multilevel mediation models were developed with: paternal grandmothers' smoking in pregnancy and fathers' smoking initiation in prepuberty as exposures; fathers' forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), or FEV1/FVC z-scores as potential mediators (proxies of unobserved biological mechanisms that are true mediators); and offspring's FEV1 and FVC, or FEV1/FVC z-scores as outcomes. All effects were summarised as differences (Delta) in expected z-scores related to fathers' and grandmothers' smoking history. Fathers' smoking initiation in prepuberty had a negative direct effect on both offspring's FEV1 (Delta z-score -0.36, 95% CI -0.63--0.10) and FVC (-0.50, 95% CI -0.80--0.20) compared with fathers' never smoking. Paternal grandmothers' smoking in pregnancy had a negative direct effect on fathers' FEV1/FVC -0.57, 95% CI -1.09--0.05) and a negative indirect effect on offspring's FEV1/FVC (-0.12, 95% CI -0.21--0.03) compared with grandmothers' not smoking before fathers' birth nor during fathers' childhood. Fathers' smoking in prepuberty and paternal grandmothers' smoking in pregnancy may cause lower lung function in offspring. Our results support the concept that lifestyle-related exposures during these susceptibility periods influence the health of future generations.
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26. |
- Ahlgren, Cecilia, 1946, et al.
(författare)
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A population-based case-control study on viral infections and vaccinations and subsequent multiple sclerosis risk.
- 2009
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 24:9, s. 541-52
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Tidskriftsartikel (refereegranskat)abstract
- Viral infections are probably involved in the pathogenesis of multiple sclerosis (MS). A recent cohort study in the Gothenburg population revealed no change in MS incidence associated with the introduction of the Swedish measles, mumps and rubella vaccination programmes. The aim of the present study was to clarify whether these infections or vaccinations, and two other infections, varicella and infectious mononucleosis, influence MS risk. We performed a population-based case-control study in Gothenburg that included 509 MS cases and 2,067 controls, born 1959-1986. Data on infections and vaccinations were obtained from questionnaires and from child health and school health records. We found no significant associations between measles, mumps, rubella or varicella and MS risk. These results were consistent between the two source materials. Infectious mononucleosis was associated with significantly higher MS risk (odds ratio 2.03, 95% CI 1.52-2.73). Overall, there was no significant association between measles-mumps-rubella (MMR) vaccination and MS risk, while those MMR vaccinated before age ten only were at significantly higher MS risk (odds ratio 4.92, 95% CI 1.97-12.20). Those MMR vaccinated both before and after age ten had intermediate MS risk. Infection with measles, mumps, rubella and varicella did not influence MS risk in contrast to infectious mononucleosis which conferred doubled MS risk. The association with 'early' MMR vaccination only was an isolated finding, limited by a small number of subjects and multiple testing. Most likely this was a chance finding. Future studies could investigate it on an a priori basis.
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27. |
- Ahlgren, Cecilia, 1946, et al.
(författare)
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Multiple sclerosis incidence in the era of measles-mumps-rubella mass vaccinations.
- 2009
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 119:5, s. 313-20
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Viral childhood infections may be involved in the multiple sclerosis (MS) pathogenesis. Following national Swedish vaccination programs, measles sharply declined in the 1970s, and measles, mumps, and rubella were virtually eliminated in cohorts born from 1981. OBJECTIVES: To examine whether the vaccination induced reduction in these infections influences the MS incidence. In addition, the public health aspect justified an early evaluation of beneficial as well as harmful effects of mass vaccinations. MATERIALS AND METHODS: From an incidence material of 534 MS patients, born 1959-1990, we selected one unvaccinated cohort and four cohorts, each corresponding to a vaccination program (MS patients = 251). RESULTS: With the ability to detect a decrease by 30-35%, and an increase by 37-48% in the MS incidence in the first three cohorts, we found no vaccination related MS incidence changes. The background MS incidence showed a significant gradual age dependent increase. CONCLUSIONS: While the present follow-up provided limited power in the last cohort, there is no evidence as yet that the radical decline in three viral infections influenced the MS incidence. However, the increasing background MS incidence of unknown cause may have concealed a reduction in MS risk associated with mass vaccinations.
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28. |
- Albin, Maria, et al.
(författare)
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Incidence of asthma in female Swedish hairdressers.
- 2002
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1470-7926 .- 1351-0711. ; 59:2, s. 119-23.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the risk of asthma in hairdressers. METHODS: The incidence of asthma was retrospectively estimated in a Swedish nationwide study including all female hairdressers certified from vocational schools from 1970 to 1995, and a stratified sample of women from the general population were referents. A postal questionnaire included questions on respiratory tract symptoms, atopy, smoking, working periods as a hairdresser, and number of specific hair treatments performed/week. Reported exposures were validated by occupational hygienists. Rate ratios of incidence (IRRs) of asthma were estimated by Poisson regression, adjusted for calendar year of observation, hay fever, smoking, and region of domicile. RESULTS: The crude incidences of asthma/1000 person-years were: 3.9 during active years as a hairdresser, 2.8 among the hairdressers when not working in the profession, and 3.1 among the referents. The corresponding IRR for being an active hairdresser compared with the referents was 1.3 (95% confidence interval (95% CI) 1.0 to 1.6). Moderate effects on risk of asthma were found both from hairdressing work (IRR=1.6 (1.1 to 2.2) among never-smokers) and from smoking (IRR=1.6 (1.2 to 2.2) among referents). However, the combined effect from hairdressing work and smoking (IRR=1.5 (1.0 to 2.1)) was less than expected (p=0.02). No effect modification by respiratory atopy was found. The hairdressers most often performing hair bleaching treatments (IRR=1.5 (0.7 to 3.0)) or using hair spray (IRR=1.4 (0.8 to 2.4)) had, compared with the most infrequent users, a slightly, but not significantly higher incidence of asthma. Exposure to persulphates in hair bleach was estimated to be 0.04-0.15 mg/m(3) during mixing of the powder. Reported average number of bleaching treatments agreed well with those performed according to a diary. CONCLUSIONS: Active hairdressing work was associated with a moderately increased incidence of asthma among lifelong non-smokers. The results are moderately supportive, but not conclusive, of associations between asthma and exposure to hair bleach or hair spray.
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29. |
- Amid Hägg, Shadi, et al.
(författare)
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Role of sleep disturbances in occupational accidents among women
- 2015
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Ingår i: Scandinavian Journal of Work Environment & Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 41:4, s. 368-376
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This population-based cohort study was performed to assess the association between sleep disturbances and the risk of occupational accidents among women. Methods Data were collected by questionnaires on two different occasions (2000 and 2010) and data on work injuries were also collected from Swedish government records (ISA). Insomnia symptoms were defined as having severe or very severe problems with (i) difficulty initiating sleep, (ii) difficulty maintaining sleep, or (iii) early morning awakening. Symptom of obstructive sleep apnea syndrome (OSAS) was defined as reporting both snoring and daytime sleepiness. Working-age respondents (20-67 years of age) who responded to both baseline and follow-up questionnaires and had worked for part or all of the 10-year follow-up period (N=4320) were included in the study. Results Of the subjects responding to the questionnaire, 12.2% reported >= 1 accident and 6.3% reported an accident requiring sick leave in the government register. Blue-collar workers and night and shift work were more common in the group with occupational accidents. Subjects with insomnia symptoms both at baseline and follow-up (persistent insomnia symptoms) ran a higher risk of being involved in an self-reported occupational accident [adjusted OR (ORadj) 1.5, 95% confidence interval (95% CI) 1.2-2.0] after adjusting for age, body mass index, smoking, alcohol dependency, white- or blue-collar worker, years at work, night work, and physical activity. Persistent insomnia symptoms did not reach statistical significance as an independent predictor of register-reported occupational accident with sick leave (ORadj 1.4, 95% CI 0.99-2.1). No significant association was found between symptoms of OSAS and self-reported or register-based occupational accidents. Conclusions Persistent insomnia symptoms were associated with an increased risk of self-reported occupational accidents, while no significant association was found with occupational accidents with sick leave reported to government register.
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30. |
- Andersson, Eva, 1955, et al.
(författare)
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A case-referent study of cancer mortality among sulfate mill workers in Sweden.
- 2001
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Ingår i: Occupational and environmental medicine. - 1351-0711. ; 58:5, s. 321-4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate whether workers in Swedish sulfate mills have an increased risk of death from certain malignancies that have previously been linked to the pulping process. METHODS: Subjects of the study (n=2480) were men aged 40-75 at death during 1960-89 in the parishes surrounding four sulfate mills. Exposure assessment was based on information from the personnel files in the mills- 35% of the subjects were recognised there, and work categories were created. RESULTS: Among all sulfate mill workers, the odds ratio (OR) (90% confidence interval (90% CI)) for death from lung cancer was 1.6 (1.1 to 2.3), pleural mesotheliomas 9.5 (1.9 to 48), brain tumours 2.6 (1.2 to 5.3), and liver or biliary tract cancer 2.3 (1.0 to 5.2). There was an increased mortality from leukaemia among workers in the soda recovery plant (5.9 (2.6 to 13)) and bleaching plant and digester house (2.8 (1.0 to 7.5)). CONCLUSIONS: Sulfate mill workers were at increased risk of dying from lung cancer and pleural mesotheliomas, probably due to exposure to asbestos. Increased risks of brain tumours and cancers of the liver or biliary tract were also found but the aetiology is not obvious.
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31. |
- Andersson, Eva, 1955, et al.
(författare)
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Adult-onset asthma and wheeze among irritant-exposed bleachery workers.
- 2003
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Ingår i: American journal of industrial medicine. - : Wiley. - 0271-3586. ; 43:5, s. 532-538
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Tidskriftsartikel (refereegranskat)abstract
- Background Whether new-onset asthma is associated with irritant exposure is unclear. The aim was to investigate if occupational exposure to irritant gases, especially repeated peak exposure (gassings), increased the risk of obstructive airways disease. Methods Data on airway symptoms and exposure among bleachery (n=101) and paper department workers (n=314) were collected by a questionnaire. Incidence rates and hazard ratios (HR) (Cox regression) were calculated. Non-responders were interviewed by telephone. Results The incidence rate for adult-onset physician-diagnosed asthma among bleachery workers reporting gassings giving rise to respiratory symptoms was 7.6/103 person-years and for those without gassings 2.2/103 person-years, compared to 1.0/103 person-years for paper workers. In a Cox regression model for asthma (n=12), stratified for sex, HR for gassings were 5.6 (95% confidence intervals (CI) 1.6–20), for hay fever 3.0 (95% CI 0.8–11), and for ever smoking 0.7 (95% CI 0.2–2.4). The same model for adult-onset wheeze gave HR of 5.2 (95% CI 2.2–12), 1.7 (95% CI 0.6–5.4), and 1.1 (95% CI 0.5–2.7), respectively. Conclusions Repeated peak exposure to irritant gases, here studied as gassings in the pulp industry, increased the risk for both adult-onset asthma and wheeze.
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32. |
- Andersson, Eva, 1955, et al.
(författare)
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Cohort mortality study of Swedish pulp and paper mill workers-nonmalignant diseases
- 2007
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 33:6, s. 470-478
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to determine mortality among pulp and paper mill workers according to the main mill pulping process, department, and gender, particular reference being given to diseases of the circulatory and respiratory systems.Methods The cohort of 18 163 men and 2 291 women employed between 1939 and 1999 and with >1 year of employment was followed for mortality from 1952 to 2001 (acute myocardial infarction from 1969). Standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were estimated by comparing the observed number of deaths with the expected number for the entire Swedish population. Exposure was assessed from personnel files in the mills. Data from an exposure measurement database are also presented.Results There were 5898 deaths in the cohort. Total mortality had an SMR of 1.02 (95% CI 0.98–1.06) for the men in the sulfate mills and an SMR of 0.93 (95% CI 0.90–0.97) for the men in the sulfite mills. Mortality from acute myocardial infarction was increased among the men in both the sulfate and sulfite mills [SMR 1.22 (95% CI 1.12–1.32) and SMR 1.11 (95% CI 1.02–1.21), respectively] and by department in sulfate pulping (SMR 1.29, 95% CI 1.07–1.54), paper production (SMR 1.26, 95% CI 1.06–1.49), and maintenance (SMR 1.16, 95% CI 1.02–1.30). Mortality from cerebrovascular disease, diabetes mellitus, and nonmalignant respiratory diseases was not increased.Conclusions Death from acute myocardial infarction, but not cerebrovascular diseases, was increased in this cohort and was probably related to a combination of different occupational exposures (eg, dust, sulfur compounds, shift work, and noise).
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33. |
- Andersson, Eva, 1955, et al.
(författare)
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Gliomas among men employed in the Swedish pulp and paper industry.
- 2002
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Ingår i: Scandinavian journal of work, environment & health. - 0355-3140. ; 28:5, s. 333-40
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study investigated whether previous findings of an increased risk of gliomas among workers in some pulp and paper mills could be confirmed for all Swedish pulp and paper mill workers and whether the increase could be attributed to certain occupational groups. METHODS: The study was based on the Swedish Cancer Environment Register, which links the incidence of cancer from 1971 to 1990 and the 1960 and 1970 census data on codes of occupation and industry for the whole population. Standardized incidence ratios (SIR) were used to estimate the risks for men in different occupations in pulp (N = 28,142) and paper (N = 39,169) mills in 1960, 1970 or both years as compared with those of all gainfully employed men in Sweden. RESULTS: Maintenance workers employed in pulp or paper mills in 1960, 1970 or both years, as well aspulp workers, showed an increased incidence of gliomas in 1971-1990 [SIR 1.5, 95% confidence interval (95% CI) 1.1-2.1 and SIR 1.5,95% CI 1.0-2.2, respectively], whereas the incidence among process workers in paper mills was lower than expected (SIR 0.6, 95% CI 0.3-0.9). Taken together, all employed men in the pulp mill industry had an increased incidence of gliomas (SIR 1.3, 95% CI 1.0-1.7). CONCLUSIONS: Pulp mill workers, but not paper mill workers, were found to have more gliomas in 1971-1990 than expected. There was an increased risk of gliomas among maintenance workers in both pulp and paper mills. Few risk factors for brain tumors are recognized, and the causes of the increase are not obvious.
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34. |
- Andersson, Eva, 1955, et al.
(författare)
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Incidence of asthma among workers exposed to sulfur dioxide and other irritant gases
- 2006
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 27:4, s. 720-5.
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to investigate whether repeated peak exposure (gassings) to sulphur dioxide (SO2) and other irritant gases increases the risk of new-onset asthma. A questionnaire was sent to 4,112 sulphite workers, of whom 1,919 completed the questionnaire and 396 completed the short-form questionnaire, which was sent out as a last reminder. A sample of 130 nonrespondents completed a telephone interview using the short-form questionnaire. The incidence of adult-onset, physician-diagnosed asthma during employment duration was analysed in relation to exposure to SO2 and gassings giving rise to respiratory symptoms. Incidence rates, as well as incidence rate ratios with 95% confidence interval (CI), were calculated. Further Cox regression models were used allowing assessment of hazard ratios (HR) stratified for sex and adjusted for atopy, smoking habits and age. The incidence rate for asthma among sulphite mill workers reporting gassings of SO2 was 6.2 out of 1,000 person-yrs, compared with 1.9 out of 1,000 person-yrs among subjects unexposed to SO2 and any gassings (HR (95% CI) 4.0 (2.1-7.7)). Among males reporting gassings to SO2, the HR (95% CI) for asthma was 5.8 (2.6-13) compared with unexposed males. In conclusion, repeated peak exposure to sulphur dioxide increased the incidence of asthma during work in sulphite pulp mills, which supports the hypothesis of irritant-induced asthma.
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35. |
- Andersson, Eva, 1955, et al.
(författare)
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Incidence of chronic bronchitis in a cohort of pulp mill workers with repeated gassings to sulphur dioxide and other irritant gases
- 2013
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Ingår i: Environmental Health. - : BioMed Central (BMC). - 1476-069X. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Occupational exposure to irritants is associated with chronic bronchitis. The aim of this study was to elucidate whether repeated peak exposures with respiratory symptoms, gassings, to sulphur dioxide (SO2) and other irritant gases could increase the risk of chronic bronchitis.METHODS: The study population comprised 3,060 Swedish pulp mill workers (84% males) from a cohort study, who completed a comprehensive questionnaire with items on chronic bronchitis symptoms, smoking habit, occupational history, and specific exposures, including gassings. 2,037 have worked in sulphite mills. Incidence rates and hazard ratios (HRs) for the observation period, 1970-2000, in relation to exposure and the frequency of repeated gassings to SO2 and other irritant gases were calculated.RESULTS: The incidence rate for chronic bronchitis among workers with repeated gassings was 3.5/1,000 person-years compared with 1.5/1,000 person-years among unexposed workers (HR 2.1, 95% confidence interval (CI) 1.4-3.1). The risk was even higher in the subgroup with frequent gassings (HR 3.2, 95% CI 2.0-5.2), particularly among never-smokers (HR 8.7, 95% CI 3.5-22).CONCLUSIONS: Repeated gassings to irritant gases increased the incidence of chronic bronchitis in our study population during and after work in pulp mills, supporting the hypothesis that occupational exposures to irritants negatively affect the airways. These results underscore the importance of preventive actions in this work environment.
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36. |
- Andersson, Eva, 1955, et al.
(författare)
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Mortality from asthma and cancer among sulfite mill workers.
- 1998
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Ingår i: Scandinavian journal of work, environment & health. - 0355-3140. ; 24:1, s. 12-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aims of the present case-referent study were to investigate whether sulfite workers show increased mortality from asthma, chronic obstructive pulmonary disease or certain malignancies of interest in relation to sulfite mill work. The main exposure from the pulping processes is from sulfur dioxide, wood dust and terpenes. METHODS: The subjects of the study were all the men who died between 1960 and 1989 and who were aged 40 to 75 years at death (N = 780) in the parishes surrounding 3 sulfite mills. The men who died from asthma (N = 13), COPD (N = 20), lung cancer (N = 33), stomach cancer (N = 35), or brain tumor (N = 10) formed the case group. All the subjects, except the cases in question, were used as referents. As a proxy variable of exposure, job titles from the registers of deaths and burials were used, and 24% of the subjects were classified as exposed. RESULTS: There was an increased mortality from asthma [odds ratio(OR) 2.8, 90% confidence interval (90% CI) 1.1-6.8] and brain tumors (OR 3.3, 90% CI 1.2-8.9) among the sulfite workers. The mortality due to lung cancer was not significantly increased (OR 1.4, 90% CI 0.7-2.6), and there was a reduced mortality from stomach cancer (OR 0.4, 90% CI 0.2-0.9). CONCLUSIONS: The increased asthma mortality may be due to accidental exposure to irritating gases, such as sulfur dioxide. The increased risk for brain tumors has no obvious explanation.
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37. |
- Andersson, Eva, 1955, et al.
(författare)
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Pleural mesotheliomas are underreported as occupational cancer in Sweden.
- 1995
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Ingår i: American journal of industrial medicine. - 0271-3586. ; 27:4, s. 577-80
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to estimate to what degree malignant pleural mesotheliomas were reported as occupational cancers. The study included all malignant pleural mesotheliomas (n = 210) found in the Cancer Registry 1980-1989 from four Swedish counties. Whether or not a case was reported as occupational cancer was found in the Swedish Register of Reported Occupational Diseases. To evaluate the presence of exposure histories, the chest department files for 58 mesotheliomas from one county were reviewed. The reporting was low, with only 75 mesotheliomas (36%) reported. All the cases were men, and for the men, the reporting frequency was 42%. The reporting was significantly lower for the last part of the decade than for the first part. The reporting frequency decreased with age. In the review of the chest department files, an exposure history was found in 93% of the reported cases and in 47% of the unreported cases. It is concluded that physicians must give more priority to exposure histories in patients with pleural mesotheliomas.
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38. |
- Andersson, Eva, 1955, et al.
(författare)
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Testicular cancer among Swedish pulp and paper workers
- 2003
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Ingår i: Am J Ind Med. ; 43:6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The incidence of testicular cancer has increased in recent decades. The aims of the present study were to elucidate whether Swedish paper and pulp mill workers had an increased incidence of testicular cancer, and to investigate whether certain occupational groups within the pulp and paper mill workforce were at increased risk. METHODS: The study was based on the Swedish Cancer Environment Register, which links the incidence of cancer for the period 1971-1990 with 1960 and 1970 National Census data on specific industries and occupations for all employed subjects in Sweden. RESULTS: Among maintenance workers employed both in 1960 and in 1970 in paper mills there was an increased risk for testicular cancer (standardized incidence ratio (SIR) 7.4, 95% confidence intervals (CI) 1.5-22), especially for seminomas (SIR 10.1, 95% CI 2.1-29). Maintenance workers were also at increased risk when analyzing workers employed in 1960, 1970, or both years. CONCLUSIONS: This study indicates an increased risk for testicular cancer, especially seminomas, among maintenance workers, but not among process workers, in Swedish paper mills.
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39. |
- Andersson, Martin, et al.
(författare)
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Smoking, occupational exposures, and idiopathic pulmonary fibrosis among Swedish construction workers
- 2021
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Ingår i: American Journal of Industrial Medicine. - : Wiley. - 0271-3586 .- 1097-0274. ; 64:4, s. 251-257
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Tidskriftsartikel (refereegranskat)abstract
- Background Cigarette smoking and occupational exposures each have been reported to increase the risk of idiopathic pulmonary fibrosis (IPF), a disease previously considered of unknown origin. We investigated the risk of IPF mortality associated with combined smoking and occupational exposures. Methods A registry study of Swedish construction workers (N = 389,132), linked baseline smoking and occupational data with registry data on cause of death and hospital care diagnoses. Occupation was classified by the likelihood of exposure to vapors, gases, dusts, or fumes using a job-exposure matrix. Those likely exposed to asbestos or silica were excluded from the analysis. Age-adjusted relative risks [RRs] were calculated using Poisson regression. Follow-up observation began at age 40 and ended at age 89. Results Heavy smokers at baseline who were exposed to inorganic dusts during their working life had an increased risk of IPF mortality (RR 1.70; 95% confidence interval [CI] 1.11-2.60), while there was no statistically increased risk in the other exposure groups. There were dose-response relationships between smoking at baseline and IPF mortality among both unexposed and dust exposed workers, with similar risk for dust exposed and unexposed, except among baseline heavy smokers, where workers exposed to inorganic dust manifested the highest risk (RR 4.22; 95% CI 2.69-6.60). Excluding workers with chronic obstructive pulmonary disease or emphysema did not affect the results substantively. Conclusion A clear dose-response relationship was seen between smoking at baseline and IPF, supporting a causal relationship. Occupational exposure to inorganic dusts, excluding silica and asbestos, was associated with increased risk of IPF in baseline heavy current smokers.
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40. |
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41. |
- Barnes, H., et al.
(författare)
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Occupation versus environmental factors in hypersensitivity pneumonitis: population attributable fraction
- 2020
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Ingår i: Erj Open Research. - : European Respiratory Society (ERS). - 2312-0541. ; 6:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite well-documented case series of hypersensitivity pneumonitis (HP), epidemiological data delineating relative contributions of risk factors are sparse. To address this, we estimated HP risk in a case-referent study of occupational and nonoccupational exposures. Methods: We recruited cases of HP by ICD-9 codes from an integrated healthcare delivery system (IHCDS) and a tertiary medical care centre. We drew referents, matched for age and sex, from the IHCDS. Participants underwent comprehensive, structured telephone interviews eliciting details of occupational and home environmental exposures. We employed a hierarchical analytic approach for data reduction based on the false discovery rate method within clusters of exposures. We measured lung function and selected biomarkers in a subset of participants. We used multivariate logistic regression to estimate exposure-associated odds ratios (ORs) and population attributable fractions (PAFs) for HP. Results: We analysed data for 192 HP cases (148 IHCDS; 44 tertiary care) and 229 referents. Occupational exposures combined more than doubled the odds of developing HP (OR 2.67; 95% CI 1.73-4.14) with a PAF of 34% (95% CI 21-46%); nonoccupational bird exposure also doubled the HP odds (OR 2.02; 95% CI 1.13-3.60), with a PAF of 12% (3-21%). Lung function and selected biomarkers did not substantively modify the risk estimates on the basis of questionnaire data alone. Discussion: In a case-referent approach evaluating HP risk, identifiable exposures accounted, on an epidemiological basis, for approximately two in three cases of disease; conversely, for one in three, the risk factors for disease remained elusive.
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42. |
- Bedada, G. B., et al.
(författare)
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Urban background particulate matter and allergic sensitization in adults of ECRHS II
- 2007
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Ingår i: Int J Hyg Environ Health. - : Elsevier BV. - 1438-4639. ; 210:6, s. 691-700
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Epidemiological studies have shown weak or inconsistent associations between ambient air pollutants and allergic sensitization. The aim of this study was to evaluate whether regional urban air pollution may partly explain the large variation in the prevalence of allergic sensitization across cities of the European Community Respiratory Health Survey (ECRHS) II. METHODS: ECRHS is a cross-sectional survey initiated in 29 countries across Europe in the 1990s (ECRHS I) with a follow-up conducted 10 years later (ECRHS II). Subject characteristics were measured by questionnaires and blood tests conducted for the measurement of specific immunoglobulin E. Fine particle mass (PM(2.5), <2.5mum) and sulphur on PM(2.5) were measured in 21 centres and annual averages of urban regional background air pollution were calculated. Results were scaled by an interquartile range increase in ambient PM(2.5) (6.03mug/m(3)) and sulphur (1336ng/m(3)). Generalized estimating equations were applied to compute population average effect estimates with adjustment for age, gender, smoking habit, education and number of siblings. RESULTS: A notable variation in pollution level and prevalence of allergic sensitization was observed. Moreover, exposure to urban regional background air pollution was not associated with allergic sensitization; adjusted odds ratios and 95% confidence interval were 1.02 (0.95-1.09) for PM(2.5) and 1.08 (0.86-1.31) for sulphur. These statistically non-significant associations were sensitive to model specification. CONCLUSIONS: The study suggests that regional air pollution measured at fixed sites is not associated with allergic sensitization among adults in ECRHS II.
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43. |
- Berg, Christina, 1963, et al.
(författare)
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Decreased exhaled nitric oxide (FENO) in obese with asthma symptoms: Data from the population study INTERGENE/ADONIX
- 2011
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Ingår i: Chest. - : Elsevier BV. - 0012-3692. ; 139:5, s. 1109-1116
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Tidskriftsartikel (refereegranskat)abstract
- Abstract BACKGROUND: Several studies have demonstrated an association between obesity and asthma. However, it is uncertain if fraction of exhaled nitric oxide (FENO), which is used as a marker of airway inflammation, and atopy are associated with BMI. The aim was to examine if obese with asthma symptoms have a different phenotype of asthma than non-obese as indicated by FENO. METHODS: The subjects (n=2187) consist of women and men, aged 25-74, living in Gothenburg, Sweden, participating in the randomly selected INTERGENE study cohort. Measurements include anthropometric measures, bioelectric impedance, FENO, pulmonary function, blood samples for IgE and questionnaires including items on respiratory symptoms. Obesity was defined as BMI≥30 kg/m(2). In this cross-sectional analysis, general linear models were used to analyse how FENO was associated with anthropometry, body composition, wheezing and atopy. RESULTS: In non-obese subjects, wheezing was associated with raised FENO and atopy, whereas, in contrast, obese with wheezing had lower FENO than obese without wheezing (16.1 v.s. 19.1 ppb, p<0.01). The prevalence of atopy was similar in both those sub-groups (25.0 v.s. 20.7%, p=0.4). Similarly, in 395 subjects (19%) who reported wheezing, FENO was negatively associated with BMI, waist-hip ratio and percentage of body fat, while no significant relationships were observed in those without respiratory symptoms. CONCLUSIONS: Wheezing was significantly associated with reduced FENO in obese subjects, whereas there was a positive association between wheezing and FENO among the non-obese, indicating a possible difference in asthma phenotype, based on body weight.
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44. |
- Berg, Christina, 1963, et al.
(författare)
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Eating patterns and portion size associated with obesity in a Swedish population.
- 2009
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Ingår i: Appetite. - : Elsevier BV. - 1095-8304 .- 0195-6663. ; 52:1, s. 21-6
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to describe the association between meal pattern and obesity. The study is based on data from the INTERGENE research programme, and the study population consists of randomly selected women and men, aged 25-74, living in the V?stra G?taland Region in Sweden. A total of 3610 were examined. Participants with measured BMI>/=30 were compared with others (BMI<30) with respect to questionnaire data on habitual meal patterns and intake of energy estimated from food frequencies and standard portions. Odds ratios (OR) with 95% confidence intervals were adjusted for age, sex, smoking and physical activity in logistic regression models. Being obese was significantly associated with omitting breakfast, OR 1.41 (1.05-1.90), omitting lunch OR 1.31 (1.04-1.66) and eating at night OR 1.62 (1.10-2.39). Obesity was also related to significantly larger self-reported portion sizes of main meals. No statistically significant relationship with intake of total energy was revealed. Thus, the results indicate that examination of meal patterns and portion sizes might tell us more about obesogenic food patterns than traditional nutrient analyses of food frequencies. Being obese was associated with a meal pattern shifted to later in the day and significantly larger self-reported portions of main meals.
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45. |
- Berg, Christina, 1963, et al.
(författare)
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Food patterns and cardiovascular disease risk factors: the Swedish INTERGENE research program.
- 2008
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Ingår i: The American journal of clinical nutrition. - : Elsevier BV. - 0002-9165 .- 1938-3207. ; 88:2, s. 289-97
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Analyzing the impact of the intake of many foods simultaneously provides additional knowledge about analyses of nutrients and might make it easier to implement recommendations for the public. OBJECTIVE: The objective was to examine food patterns in a Swedish population and determine how they are related to metabolic risk factors for cardiovascular disease. DESIGN: The study is based on data from the INTERGENE population study of women and men aged 25-74 y in western Sweden. Dietary patterns were identified with cluster analysis of 93 food frequencies reported by 3452 participants. Associations with features of the metabolic syndrome, including blood lipids, blood pressure, and anthropometric measures, were analyzed. RESULTS: Five distinct food patterns were identified, of which one was interpreted as a "healthy" reference pattern. This healthy cluster was distinguished by more frequent consumption of high-fiber and low-fat foods and lower consumption of products rich in fat and sugar. The 4 other clusters differed significantly from the reference cluster with respect to prevalence of cardiovascular disease risk factors and the metabolic syndrome. For example, body mass index and waist-to-hip ratio were significantly higher in a cluster characterized by high consumption of energy-dense drinks and white bread and low consumption of fruit and vegetables (P < 0.0001 and P = 0.004, respectively). CONCLUSIONS: It is possible to distinguish food patterns that are related to obesity and obesity-related cardiovascular disease risk factors in contrast with a more healthy pattern conforming with current dietary guidelines. Thus, the results indicate no reason for questioning the current recommendations.
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46. |
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47. |
- Berg, Christina, 1963, et al.
(författare)
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Trends in blood lipid levels, blood pressure, alcohol and smoking habits from 1985 to 2002: results from INTERGENE and GOT-MONICA.
- 2005
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Ingår i: European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology. - 1741-8267. ; 12:2, s. 115-25
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Favourable trends in cardiovascular disease have been observed in Sweden. The aim of this study was to study secular trends in a variety of cardiovascular risk factors. METHODS: Total-, low-density (LDL) and high-density lipoprotein (HDL) serum cholesterol; serum triglycerides; systolic and diastolic blood pressure; self-reported smoking and alcohol consumption were studied in repeated cross-sectional surveys. Data from four population-based samples in Goteborg, Sweden were used-WHO MONICA project 1985, 1990 and 1995, and INTERGENE 2002. A total of 2931 females and 2691 males aged 25-64 consisting of 1021-1624 randomly selected subjects at each survey period participated. RESULTS: Serum cholesterol levels showed downward trends but the decline in both total- and LDL-cholesterol seems to be levelling off from 1995 and onwards. No significant changes were observed in serum triglyceride, HDL-serum cholesterol or blood pressure levels. The majority of the participants had higher total- and LDL-serum cholesterol levels than currently recommended. Antihypertensive medical treatment increased in women and the oldest men. The prevalence of smoking decreased from 39 to 25% in women and 35 to 20% in men respectively from 1985-2002. In contrast, the prevalence of subjects consuming strong beer and wine, respectively, at least once a week almost doubled from 1990-2002. CONCLUSIONS: Cardiovascular risk factor patterns change continuously and need to be monitored. The favourable trends in LDL-serum cholesterol and smoking in the Goteborg surveys were paralleled by less favourable trends in being overweight and alcohol consumption.
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48. |
- Berg, Christina, 1963, et al.
(författare)
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Trends in overweight and obesity from 1985 to 2002 in Göteborg, West Sweden.
- 2005
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Ingår i: International journal of obesity (2005). - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 29:8, s. 916-24
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study secular trends in overweight and selected correlates in men and women in Göteborg, Sweden. DESIGN: Cross-sequential population-based surveys. SUBJECTS: A total of 2931 female and 2691 male subjects aged 25-64 y participated in WHO MONICA surveys (1985, 1990, 1995) and the INTERGENE study (2002). MEASUREMENTS: Body mass index (BMI), waist-to-hip ratio (WHR), prevalence of overweight (BMI> or =25 kg/m(2)), and obesity (BMI> or =30 kg/m(2)). RESULTS: Mean body weight increased by 3.3 kg for women and 5 kg for men, with a significant upward trend for BMI in men but not women over the 17-y observation period. The prevalence of overweight and obesity increased significantly in both sexes over the period. The largest increase was observed in men, and in women aged 25-34 y. In 2002, the prevalence of overweight was 38% in women and 58% in men, and the prevalence of obesity was 11% in women and 15% in men. No significant secular trends were observed for WHR, but there was an upward trend in prevalence of WHR>0.85 in women. A decreased prevalence of smoking in both sexes was observed together with an increase in reported leisure time physical activity. No significant secular trends were observed in rates of self-reported diabetes, although the risk of diabetes attributable to obesity was 24%. CONCLUSION: The results indicate that 25-64-y-olds in the recent survey were more overweight and obese than earlier studied MONICA participants. The increase in BMI was more pronounced in men while abdominal obesity increased principally in women. Although obesity and overweight are clearly important risk factors for type 2 diabetes, the number of diabetics remains low and any secular increase is not yet apparent.
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49. |
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50. |
- Bergström, Göran, 1964, et al.
(författare)
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Body weight at age 20 and in midlife is more important than weight gain for coronary atherosclerosis: Results from SCAPIS.
- 2023
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Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 373, s. 46-54
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Tidskriftsartikel (refereegranskat)abstract
- Elevated body weight in adolescence is associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, weight in midlife or to weight gain is not known. The aim of this study is to assess the risk of midlife coronary atherosclerosis being associated with body weight at age 20, body weight in midlife and body weight change.We used data from 25,181 participants with no previous myocardial infarction or cardiac procedure in the Swedish CArdioPulmonary bioImage Study (SCAPIS, mean age 57 years, 51% women). Data on coronary atherosclerosis, self-reported body weight at age 20 and measured midlife weight were recorded together with potential confounders and mediators. Coronary atherosclerosis was assessed using coronary computed tomography angiography (CCTA) and expressed as segment involvement score (SIS).The probability of having coronary atherosclerosis was markedly higher with increasing weight at age 20 and with mid-life weight (p<0.001 for both sexes). However, weight increase from age 20 until mid-life was only modestly associated with coronary atherosclerosis. The association between weight gain and coronary atherosclerosis was mainly seen in men. However, no significant sex difference could be detected when adjusting for the 10-year delay in disease development in women.Similar in men and women, weight at age 20 and weight in midlife are strongly related to coronary atherosclerosis while weight increase from age 20 until midlife is only modestly related to coronary atherosclerosis.
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