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- Fransson, Eleonor, et al.
(författare)
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Indications of recall bias found in a retrospective study of physical activity and myocardial infarction
- 2008
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Ingår i: Journal of Clinical Epidemiology. - : Elsevier BV. - 0895-4356 .- 1878-5921. ; 61:8, s. 840-847
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the presence of recall bias in retrospective studies of physical activity and myocardial infarction. Study Design and Setting: In 2005, seventy-eight cases who had suffered from a myocardial infarction and 243 control subjects, who had previously participated in the Swedish WOLF (Work, Lipids, and Fibrinogen) study, were asked about their physical activity level during 1990-2005. The answers about recalled past leisure time, occupational, and household physical activity level were compared with physical activity level as reported at the baseline examination of the WOLF study in 1992-1998. Results: The proportion who recalled the same activity level as originally reported ranged from 69% to 96% (cases) and 69% to 89% (controls), and the kappa values ranged from 0.30 to 0.91 (cases) and 0.46 to 0.59 (controls), with the exception of perceived physical workload in household work, which showed low agreement between the originally stated and later recalled activity levels. Some differences were found between cases and controls regarding recall of past occupational activity, indicating the presence of recall bias in this domain of physical activity. Conclusion: We cannot preclude the existence of recall bias when using retrospectively recalled information about occupational physical activity in studies of physical activity and myocardial infarction.
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| 4. |
- Westerberg, P, et al.
(författare)
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Psykisk arbetsskada
- 2008
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Ingår i: Arbete och Hälsa, skriftserie, red Kjell Torén. Göteborgs universitet, Arbets- och miljömedicin. ; 42:I, s. 1-91
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Tidskriftsartikel (refereegranskat)
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| 7. |
- Kälvemark Sporrong, Sofia, et al.
(författare)
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Developing ethical competence in health care organizations
- 2007
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 14:6, s. 825-837
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Tidskriftsartikel (refereegranskat)abstract
- Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy.
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| 8. |
- Lundström, Nils-Göran, 1946-
(författare)
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Mortality and morbidity in lead smelter workers with concomitant exposure to arsenic
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Arsenic is a well-known lung carcinogen in humans. In 2006, IARC upgraded inorganic lead as a possible human carcinogen (2A). The aim of this thesis has been to evaluate the lung cancer mortality and incidence in long-term exposed primary lead smelter workers and also to estimate present exposures to arsenic and lead in relation to those occurring in the past. The basic cohort (N=3832 workers; hired before 1967 and followed up from 1950-1981; SMR comparisons with general and local reference populations) showed an excess of deaths for total mortality, malignant neoplasms (e.g. lung and stomach cancer), ischaemic heart diseases, and cerebrovascular diseases compared to the general population. In a subcohort of lead workers (N=437; regular blood lead sampling since 1950) only the raised SMR for lung cancer (162) was sustained. In a follow-up study of the basic cohort (N=3979), a subcohort of lead exposed workers (N=1992) was formed. The expected mortality in 1955-1987 and cancer incidence in 1958-1987 were calculated relative to county rates. A cumulative blood lead index (CBLI) was used for dose-response analyses. The lung cancer incidence was raised in the total cohort (SIR 2.8; 95 % CI 2.1 3.8). A higher lung cancer risk was observed in workers hired before 1950 (SIR 3.6; 95 % CI 2.6-5.0). The increased lung cancer risks were further elevated in the subcohort of lead exposed workers, especially in the highest exposed subgroup (SIR 5.1; 95 % 2.0-10.5; latency period of 15 y). No excesses of other malignancies were observed. The increased relative risks for lung cancer may have been caused by interactions between inorganic lead and other substances at the smelter, e.g. arsenic. To further analyze the effects from inorganic lead, two subcohorts of workers at the lead departments were formed from the original cohort (N=3979), one of 710 workers and the other of 383 workers. The lung cancer incidence was raised in both subcohorts (Lead subcohort 1; SIR 2.4; 95 % CI 1.2-4.5; Lead subcohort 2; SIR 3.6; 95 % CI 1.2-8.3). Among the 10 workers that had developed lung cancer in lead subcohort 1 all but one had a considerable exposure also to arsenic. Thus, a possible interaction effect between lead and arsenic may explain the increased lung cancer risks. To further elucidate the impact from lead and arsenic a case control study was undertaken. In the basic cohort (N=3979), 46 male workers had contracted respiratory malignancies. They were compared with 141 agematched male referents from the primary smelter by conditional logistic regression analysis using smoking habits, cumulative blood lead and air arsenic exposure as predictor variables. The lung cancer cases showed a significantly higher smoking rate than referents (Odds ratio, OR = 4.0; 95 % CI 1.6-10.1; p=0.003). When restricted to smokers, the cumulative arsenic air exposure index, but not the lead exposure indices, were significantly higher among the cases (OR=1.07; 95 % CI 1.02-1.11; p = 0.005). Accordingly, cumulative arsenic exposure and smoking were identified as significant risk factors for the development of lung cancer in the final analyses, while lead exposure was not a significant risk factor. However, inorganic lead still may play a minor role in the multifactorial genesis of lung cancer. These studies describe risks from exposures occurring from time periods before 1950 up to 1981. Because of the long latency period for lung cancer, exposures after 1970 probably have had limited impact on the reported results. Compared to the levels in the early 1970´s present exposures to arsenic are lower by a factor of ten or more and risks probably correspondingly lower.
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| 10. |
- Fahlén, Göran, et al.
(författare)
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Effort-reward imbalance, sleep disturbances and fatigue
- 2006
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 79:5, s. 371-378
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objective of this study was to investigate the validity of the effort-reward imbalance (ERI) model in relation to disturbed sleep and fatigue. Methods: The study population derived from a subset of the WOLF (WOrk, Lipids, Fibrinogen) cohort study of cardiovascular risk in a working population who replied to the ERI-questionnaire comprising 789 men and 214 women. Cox regression analysis was used to calculate the prevalence ratio (PR) for sleep disorders and fatigue in relation to the components of ERI. Results: As sleep disturbances and fatigue, based on literature, were defined to be represented by the uppermost quintile, 14% of the men and 23% of the women were affected by sleep disturbances while 14 and 26%, respectively, were affected by fatigue. Higher levels of exposure for the ERI components were associated with increased prevalence of sleep disturbances and fatigue. For men, the strongest association was seen between high overcommitment and fatigue (PR 5.77, 95% confidence interval 2.89-11.5). For women, high effort and sleep disturbances (PR 4.04, CI 1.53-10.7), high effort/reward ratio and sleep disturbances (PR 4.13, CI 1.62-10.5), and between low reward and fatigue (PR 4.36, CI 1.79-10.6) yielded the most obvious associations. Conclusions: The present study adds sleep disturbances and fatigue to the list of adverse consequences of effort-reward imbalance.
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