| 1. |
- Gard, Gunvor, et al.
(author)
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Test of Swedish anti-skid devices on five different slippery surfaces
- 2001
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In: Accident Analysis and Prevention. - 0001-4575 .- 1879-2057. ; 33:1, s. 1-8
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Journal article (peer-reviewed)abstract
- AB - The interest for effective preventive strategies for slips and falls is growing. Much remains to be done, however, to prevent slips and falls in the traffic environment. Some pedestrians are injured because of slippery pavements and roadways. Using an appropriate anti-skid device may reduce the risk of slips and falls on different surfaces outdoors during winter. The aim of this study was to evaluate new anti-skid devices on the Swedish market representing three different designs of anti-skid devices; heel device, fore-foot device and whole-foot device on different slippery surfaces, gravel, sand, salt, snow and ice. The evaluations were done according to subject's perceived walking safety and balance, videorecordings of walking postures and movements, time to take on and off each anti-skid device, advantages/disadvantages with each anti-skid device and a list of priority for own use according to three criteria; safety, balance and appearance. Practical tests were carried out on different slippery surfaces, gravel, sand, salt, snow and ice. The subject's were randomly selected from the registered population over 55 years in a city in northern Sweden. The results showed that eight or more of the ten subjects perceived all four anti-skid devices as fairly good or good regarding walking safety and balance when walking on gravel, sand, and salt. Anti-skid device 3, a whole-foot device was perceived as having none or bad walking safety and balance on snow by seven subjects and anti-skid device 4, a heel device, as having none or bad walking balance on ice by all ten subjects. Eight subjects walked with a normal muscle function in the hip and knee with all anti-skid devices on all surfaces. Small deviations in walking posture and movements were noted in one to two subjects when walking on different surfaces, but no systematic difference between the devices. Anti-skid device 1 'Rewa', a fixed heel device, was perceived as the most rapid one to take on. All four devices were perceived as easy to use and as giving good foothold. Anti-skid device 1 'Rewa' and 4 'Thulin-spike', both heel devices, had the highest priority according to walking safety. 'Rewa' also had the highest priority according to walking balance as well as own use. When combining the criterias 'Rewa' had the highest priority according to walking safety and balance, priority for own use, time to take on and easiness to use.
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| 2. |
- Andersson, Eva, 1955, et al.
(author)
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A case-referent study of cancer mortality among sulfate mill workers in Sweden.
- 2001
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In: Occupational and environmental medicine. - 1351-0711. ; 58:5, s. 321-4
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Journal article (peer-reviewed)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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| 3. |
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| 4. |
- Axmon, Anna, et al.
(author)
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Polychlorinated biphenyls in blood plasma among Swedish female fish consumers in relation to time to pregnancy
- 2001
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In: Journal of Toxicology and Environmental Health. Part A: Current Issues. - : Informa UK Limited. - 1087-2620 .- 1528-7394. ; 64:6, s. 485-498
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Journal article (peer-reviewed)abstract
- The purpose of this study was to assess the association between 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) in plasma, a biomarker of exposure to polychlorinated biphenyls (PCB), and time to pregnancy (TTP) in a group of women with a varying dietary exposure to PCB. For 121 Swedish east coast fishermen's wives (median year of birth 1956, range 1945-1968), information on selt-reported TTP for the first planned pregnancy (median 2 mo, range 0-48) and CB-153 concentrations from blood samples drawn in 1995 (median 144 ng/g lipid, range 16-566) were available. Each woman's CB-153 concentration in plasma at the time immediately preceding her pregnancy was estimated, taking into account reduction of body burden of CB-153 due to lactation, the yearly reduction of PCB in Baltic Sea fish, as well as the biological half-life of CB-153. Based on the estimated CB-153 concentrations, subjects were categorized into tertiles as low (37-206 ng/g lipid), medium (207-330 ng/g lipid), and high (331-,1036 ng/g lipid) exposure groups. TTP in the medium- and high-exposure groups were then compared to TTP in the low-exposure group by estimating the corresponding success rate (i.e., the number of pregnancies per person month) ratios (SuRR) using discrete Cox regression, taking into account essential confounders. No obvious association between estimated CB-153 concentration and TTP was observed (medium vs. low: SuRR 0.77 [95% CI 0.47-1.28] and high vs. low: SuRR 0.95 10.74-1.23]). The present data give no support for a negative association between the plasma CB-153 concentrations observed in the present study and TTP. It should, however, be borne in mind that the study group was rather small and mainly included relatively young women, likely to have been only moderately exposed.
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| 5. |
- Balogh, Istvan
(author)
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Exposure assessment for the prevention of musculoskeletal disorders
- 2001
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Doctoral thesis (other academic/artistic)abstract
- Work-related musculoskeletal disorders of shoulder/neck are a major and increasing problem. Beside the pain, they involve high cost for the employer and society. The total expenditure for the musculoskeletal disorders of the neck and upper limb have been estimated to 0.5-2.0% of the Gross National Product (GNP) in the Nordic countries. Due to the lack of precise knowledge of exposure/response relationship, ergonomic intervention has seldom been successful. Further, the exposure comprises many different aspects to be considered. The present paper shows that the constructed exposure index, based on questionnaire from 14,555 men and women between 45 and 65 years of age in the Malmö Shoulder Neck Study (MSNS) cohort, had good psychometric properties for mechanical exposure. The index comprised 11 items, assessed on a 3-point impact scale. Musculoskeletal problems were reported on a slightly modified version of the Standardized Nordic Questionnaire. In the one year follow up, the index was a significant predictor of the development of shoulder/neck pain. Exposure to job strain (the combination of high psychological job demand and low job decision latitude) was associated with higher risk only among women. A synergistic interaction was shown between high mechanical exposure and job strain. Cleaners and office workers, two of the largest occupational groups in MSNS, with presumed high and low exposure were selected for study of influence of complaints on the self-assessed exposure. They discriminate well in both self-reported and technical measured mechanical workload. However, musculoskeletal complaints lead to higher assessed loads, in spite of lower objectively measured activities as sitting, walking and heart rate. Field methods for quantification in manual work of physical workloads on the neck and the upper limbs, were further developed. A biaxial flexible electrogoniometer was used to derive measures reflecting both static and dynamic properties of workload. With a sampling frequency of 20 Hz, calculation of movements and repetitiveness can be done with sufficient accuracy in field studies. The main error showed to bee crosstalk between flexion and deviation movements, but the results were not invalidated by that. Relative (RVE) and maximal (MVE) normalization was used to minimize variability in electromyography in a standardized work-task. High interindividual variation was obtained. The variation was smaller, but still high for values normalized to RVE. No relation between shoulder muscle activities (trapezius and infraspinatus) and work pace or disorders was observed. Wrist movements had low variance, and showed a close relation to work pace. In conclusion, the developed index, mainly reflecting postures, is a useful tool for risk assessment, but needs to be supplemented by technical measurements for successful prevention. Measurement might be biased by concurrent complaints.
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| 6. |
- Balogh, Istvan, et al.
(author)
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Questionnaire-based mechanical exposure indices for large population studies--reliability, internal consistency and predictive validity
- 2001
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In: Scandinavian Journal of Work, Environment and Health. - 0355-3140. ; 27:1, s. 41-41
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Journal article (peer-reviewed)abstract
- OBJECTIVES: This study attempts to construct valid indices for mechanical exposure of the shoulder-neck region with relation to the development of shoulder-neck pain in a 1-year perspective study of a general population. METHODS: A comprehensive questionnaire was presented to 14 556 subjects aged 45 or 65 years and repeated after 12 months. Twenty-four questions concerning positions, movements, and manual materials handling were registered on a 3-point impact scale. Musculoskeletal problems were reported on a slightly modified version of the Standardized Nordic Questionnaire for the Analysis of Musculoskeletal Symptoms. Test-retest stability after 2 weeks was calculated for 232 consecutive participants. Based on mechanistic theories, 4 exposure indices were formed. Another 5 constructs were obtained by factor analysis. RESULTS: All the indices showed good test-retest stability, and 5 of them had very good internal consistency. Due to overlaps between the indices, 2 indices stood out as having unique properties. One of them concerned mainly postures and the other dealt primarily with measured lifting. However, the latter was not related to the shoulder-neck pain outcome when adjusted for the posture index. The posture index showed an exposure-effect relationship with the outcome. The job titles implied a large degree of exposure misclassification. CONCLUSIONS: The posture index is recommended as a mechanical exposure index for analyses of interaction with other possible determinants of shoulder-neck pain (ie, psychosocial factors). The use of such an index instead of job titles in large population studies will reduce the risk of misclassification.
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| 7. |
- Björk, Jonas, et al.
(author)
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Are occupational, hobby, or lifestyle exposures associated with Philadelphia chromosome positive chronic myeloid leukaemia?
- 2001
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In: Occupational and Environmental Medicine. - : BMJ. - 1470-7926 .- 1351-0711. ; 58:11, s. 722-727
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To investigate a broad range of occupational, hobby, and lifestyle exposures, suggested as risk factors for Philadelphia chromosome positive (Ph+) chronic myeloid leukaemia (CML). METHODS: A case-control study, comprising 255 Ph+CML patients from southern Sweden and matched controls, was conducted. Individual data on work tasks, hobbies, and lifestyle exposures were obtained by telephone interviews. Occupational hygienists assessed occupational and hobby exposures for each subject individually. Also, occupational titles were obtained from national registries, and group level exposure-that is, the exposure proportion for each occupational title-was assessed with a job exposure matrix. The effects of 11 exposures using individual data and two exposures using group data (organic solvents and animal dust) were estimated. RESULTS: For the individual data on organic solvents, an effect was found for moderate or high intensity of exposure (odds ratio (OR) 3.4, 95% confidence interval (95% CI) 1.1 to 11) and for long duration (15-20 years) of exposure (OR 2.1, 95% CI 1.1 to 4.0). By contrast, the group data showed no association (OR 0.69, 95% CI 0.27 to 1.8; moderate or high intensity versus no exposure). For extremely low frequency electromagnetic fields (EMFs), only individual data were available. An association with long occupational exposure to EMFs was found (OR 2.3, 95% CI 1.2 to 4.5). However, no effect of EMF intensity was indicated. No significant effects of benzene, gasoline or diesel, or tobacco smoking were found. OR estimates below unity were suggested for personal use of hair dye and for agricultural exposures. CONCLUSIONS: Associations between exposure to organic solvents and EMFs, and Ph+CML were indicated but were not entirely consistent.
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| 8. |
- Björk, Jonas
(author)
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Case-control studies on risk factors for myeloid leukemias and myelodysplastic syndromes
- 2001
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Doctoral thesis (other academic/artistic)abstract
- Case-control studies comprising telephone interviews for 333 cases of acute myeloid leukemia (AML), 226 cases of Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML), 330 cases of myelodysplastic syndromes (MDS), and matched controls were conducted. Information had to be obtained from next-of-kin much more often for cases (85%) than for controls (18%). Tobacco smoking was associated with an elevated risk for MDS and, at high cumulative smoking doses, with AML. In contrast, no association with Ph+ CML was discerned. Among nine other exposures evaluated for AML and Ph+ CML (but not for MDS) based on the interview data, consistently increased risks were only observed for exposure to organic solvents. Analyses based on registry data combined with a Swedish re-coding of the Finnish job exposure matrix (FINJEM) did not confirm the findings for organic solvents. This discrepancy may be attributed to underestimated exposure proportions for low-prevalent exposures in FINJEM. For MDS, and possibly for AML, specific associations between smoking and aberrations involving chromosome 7 were suggested. A strong effect from organic solvents on AML with trisomy 8 as sole aberration was observed. The methodological aspects mainly concerned partially ecologic case-control studies, a study setting where group-level exposure data, obtained from an exposure database such as FINJEM are combined with individual-level data on disease status, group membership, and covariates. If the exposure is binary on the individual-level, then the corresponding group-level measure is the exposure proportion (exposure probability). Confidence limits calculated for the log transformed OR under a linear odds ratio (OR) model lead to satisfactory coverage in simulated scenarios without errors in the estimated exposure probabilities. An estimator of the attributable fraction (AF) with 95% confidence intervals was proposed and was found to perform well. Assessment errors that systematically distort the estimated exposure probabilities may produce severe bias of the effect estimates under the linear OR model in either direction. The corresponding AF estimates are generally unbiased unless exposed subjects are present in occupational groups assessed as unexposed, which may lead to pronounced bias towards the null.
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| 9. |
- Börjesson, Jimmy, et al.
(author)
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Kidney cadmium as compared to other markers of cadmium exposure in workers at a secondary metal smelter
- 2001
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In: American Journal of Industrial Medicine. - 0271-3586. ; 39:1, s. 19-28
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Journal article (peer-reviewed)abstract
- BACKGROUND: The aim of the study was to evaluate whether cadmium concentrations in kidney (K-Cd), blood (B-Cd) or urine (U-Cd) could reveal previous occupational cadmium exposure at a metal smelter. METHODS: The study included 90 smelters and 35 controls (B-Cd and U-Cd determination). In a subgroup (N = 33), K-Cd was also determined. RESULTS: B-Cd (median 4.6; range 0.5-53 nmol/L), U-Cd (0. 29; 0.04-1.9 micromol/mol creatinine) and K-Cd (14; 3-61 microg/g wet weight) were similar to reported concentrations in the general Swedish population. In the subgroup, significant associations (P<0. 001) were obtained between B-Cd and K-Cd (r = 0.70), U-Cd and K-Cd (r = 0.60) and between U-Cd and B-Cd (r = 0.62). Multiple regression analyses revealed smoking as the major predictor of K-Cd, B-Cd, and U-Cd. B-Cd and U-Cd were both associated with the duration of employment at the smelter. CONCLUSIONS: There was no statistically significant evidence of previous occupational exposure at the smelter from measurement of K-Cd.
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| 10. |
- Carnerup, Martin, et al.
(author)
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Determination of 5-hydroxy-N-methyl-2-pyrrolidone and 2-hydroxy-N-methylsuccinimide in human plasma and urine using liquid chromatography-electrospray tandem mass spectrometry
- 2001
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In: Journal of Chromatography. B. - 1387-2273. ; 761:1, s. 107-113
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Journal article (peer-reviewed)abstract
- A method for simultaneous determination of 5-hydroxy-N-methyl-2-pyrrolidone (5-HNMP) and 2-hydroxy-N-methylsuccinimide (2-HMSI) was developed. These compounds are metabolites from N-methyl-2-pyrrolidone (NMP), a powerful and widely used organic solvent. 5-HNMP and 2-HMSI were purified from plasma and urine by solid-phase extraction using Isolute ENV+ columns, and analysed by liquid chromatography coupled to a mass spectrometer fitted with an atmospheric pressure turbo ion spray ionisation interface in the positive ion mode. The method was validated for plasma and urine concentrations from 0.12 to 25 microg/ml. The recoveries for 5-HNMP and 2-HMSI in plasma were 99 and 98%, respectively, and in urine 111 and 106%, respectively. For 5-HNMP and 2-HMSI, the within-day precision in plasma was 1-4 and 3-6%, respectively, and in urine 2-12 and 3-10%, respectively. The corresponding data for the between-day precision was 5 and 3-6%, respectively, and 4-6 and 7-8%, respectively. The detection limit for 5-HNMP was 4 ng/ml in plasma and 120 ng/ml in urine. For 2-HMSI, it was 5 ng/ml in plasma and 85 ng/ml in urine. The method is applicable for analysis of plasma and urine samples from workers exposed to NMP.
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