| 1. |
- Johanson, G., et al.
(författare)
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Quantitative relationships of perfluoroalkyl acids in drinking water associated with serum concentrations above background in adults living near contamination hotspots in Sweden
- 2023
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Ingår i: Environmental Research. - : Elsevier BV. - 0013-9351 .- 1096-0953. ; 219
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Tidskriftsartikel (refereegranskat)abstract
- Contaminated drinking water (DW) is a major source of exposure to per- and polyfluoroalkyl substances (PFAS) at locations around PFAS production/use facilities and military airports. This study aimed to investigate quantitative relationships between concentrations in DW and serum of nine perfluoroalkyl acids (PFAAs) in Swedish adult populations living near contamination hotspots. Short-chained (PFPeA, PFHxA, PFHpA, and PFBS) and long-chained PFAAs (PFOA, PFNA, PFDA, PFHxS and PFOS) were measured in DW and serum. We matched DW and serum concentrations for a total of 398 subjects living or working in areas receiving contaminated DW and in one non-contaminated area. Thereafter, linear regression analysis with and without adjustments for co-variates was conducted. This enabled to derive (i) serum concentrations at background exposure (CB) from sources other than local DW exposure (i.e. food, dust and textiles) at 0 ng/L DW concentration, (ii) population-mean PFAA serum:water ratios (SWR) and (iii) PFAA concentrations in DW causing observable elevated serum PFAA concentrations above background variability. Median concentrations of the sum of nine PFAAs ranged between 2.8 and 1790 ng/L in DW and between 7.6 and 96.9 ng/mL in serum. DW concentration was the strongest predictor, resulting in similar unadjusted and adjusted regression coefficients. Mean CB ranged from <0.1 (PFPeA, PFHpA, PFBS) to 5.1 ng/mL (PFOS). Serum concentrations increased significantly with increasing DW concentrations for all PFAAs except for PFPeA with SWRs ranging from <10 (PFHxA, PFHpA and PFBS) to 111 (PFHxS). Observed elevated serum concentrations above background variability were reached at DW concentrations between 24 (PFOA) and 357 ng/L (PFHxA). The unadjusted linear regression predictions agreed well with serum concentrations previously reported in various populations exposed to low and high DW levels of PFOA, PFHxS and PFOS. The quantitative relationships derived herein should be helpful to translate PFAA concentrations in DW to concentrations in serum at the population level.
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| 2. |
- Engelhardt, A. Josefin, 1992-, et al.
(författare)
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Anthropogenic Organic Contaminants Analysed in Human Blood and Combined Risk
- 2023
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Ingår i: Exposure and Health. - : Springer Science and Business Media LLC. - 2451-9766 .- 2451-9685. ; 15:3, s. 551-565
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Forskningsöversikt (refereegranskat)abstract
- The number of chemicals in the anthroposphere is increasing and some of them end up in humans. A literature search was made to assess which anthropogenic organic contaminants (OCs) that have been analysed in blood from the general population. The reviewed articles were used to create a database of studies [human blood database (HBDB), containing 559 OCs] reporting blood analyses made worldwide. All studies analysing blood from the Swedish population were compiled into a second database [Swedish exposure database (SEDB), containing 166 OCs] listing blood concentrations of OCs. Data from the SEDB showed decreasing levels of regulated chemicals in blood over time, indicating that regulation had made an impact. The Hazard Index (HI) approach was used as a qualitative mixture risk assessment of the OCs with established human biomonitoring guidance values (HBM-GVs) and blood levels in the SEDB. Nine HBM-GVs were found and the HI of the corresponding OCs/groups of OCs showed that a risk of adverse effects in the general population could not be excluded, which is a cause for concern considering that only a fraction of the analysed OCs in the SEDB were included. This study presents the OCs identified in human blood and concentration time trends. The study highlights the lack of HBM-GVs needed for mixture risk assessments to assess the combined risk of chemical exposure to the general population.
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| 3. |
- Ford, Amanda K., et al.
(författare)
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Local Human Impacts Disrupt Relationships Between Benthic Reef Assemblages and Environmental Predictors
- 2020
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Ingår i: Frontiers in Marine Science. - : Frontiers Media SA. - 2296-7745. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Human activities are changing ecosystems at an unprecedented rate, yet large-scale studies into how local human impacts alter natural systems and interact with other aspects of global change are still lacking. Here we provide empirical evidence that local human impacts fundamentally alter relationships between ecological communities and environmental drivers. Using tropical coral reefs as a study system, we investigated the influence of contrasting levels of local human impact using a spatially extensive dataset spanning 62 outer reefs around inhabited Pacific islands. We tested how local human impacts (low versus high determined using a threshold of 25 people km(-2) reef) affected benthic community (i) structure, and (ii) relationships with environmental predictors using pre-defined models and model selection tools. Data on reef depth, benthic assemblages, and herbivorous fish communities were collected from field surveys. Additional data on thermal stress, storm exposure, and market gravity (a function of human population size and reef accessibility) were extracted from public repositories. Findings revealed that reefs subject to high local human impact were characterised by relatively more turf algae (>10% higher mean absolute coverage) and lower live coral cover (9% less mean absolute coverage) than reefs subject to low local human impact, but had similar macroalgal cover and coral morphological composition. Models based on spatio-physical predictors were significantly more accurate in explaining the variation of benthic assemblages at sites with low (mean adjusted-R-2 = 0.35) rather than high local human impact, where relationships became much weaker (mean adjusted-R-2 = 0.10). Model selection procedures also identified a distinct shift in the relative importance of different herbivorous fish functional groups in explaining benthic communities depending on the local human impact level. These results demonstrate that local human impacts alter natural systems and indicate that projecting climate change impacts may be particularly challenging at reefs close to higher human populations, where dependency and pressure on ecosystem services are highest.
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| 4. |
- Hu, Xiao-Lei, et al.
(författare)
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Study protocol for a randomized, controlled, multicentre, pragmatic trial with Rehabkompassen®-a digital structured follow-up tool for facilitating patient-tailored rehabilitation in persons after stroke
- 2023
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Ingår i: Trials. - : BioMed Central (BMC). - 1745-6215. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundStroke is a leading cause of disability among adults worldwide. A timely structured follow-up tool to identify patients' rehabilitation needs and develop patient-tailored rehabilitation regimens to decrease disability is largely lacking in current stroke care. The overall purpose of this study is to evaluate the effectiveness of a novel digital follow-up tool, Rehabkompassen (R), among persons discharged from acute care settings after a stroke.MethodsThis multicentre, parallel, open-label, two-arm pragmatic randomized controlled trial with an allocation ratio of 1:1 will be conducted in Sweden. A total of 1106 adult stroke patients will have follow-up visits in usual care settings at 3 and 12 months after stroke onset. At the 3-month follow-up, participants will have a usual outpatient visit without (control group, n = 553) or with (intervention group, n = 553) the Rehabkompassen (R) tool. All participants will receive the intervention at the 12-month follow-up visit. Feedback from the end-users (patient and health care practitioners) will be collected after the visits. The primary outcomes will be the patients' independence and social participation at the 12-month visits. Secondary outcomes will include end-users' satisfaction, barriers and facilitators for adopting the instrument, other stroke impacts, health-related quality of life and the cost-effectiveness of the instrument, calculated by incremental cost per quality-adjusted life year (QALY).DiscussionThe outcomes of this trial will inform clinical practice and health care policy on the role of the Rehabkompassen (R) digital follow-up tool in the post-acute continuum of care after stroke.Trial registrationClinicalTrials.gov NCT04915027. Registered on 4 June 2021. ISRCTN registry ISRCTN63166587. Registered on 21 August 2023.
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| 5. |
- Nilsson, T., et al.
(författare)
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Effects of local alcohol prevention initiatives in Swedish municipalities, 2006–2014
- 2020
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Ingår i: Substance Use & Misuse. - : Informa UK Limited. - 1082-6084 .- 1532-2491. ; 55:6, s. 1008-1020
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several components of the Swedish alcohol policy, e.g., pricing and availability, weakened when Sweden joined the EU in 1995. To counteract the possible negative effects of this, emphasis was placed on the local level as an important arena of alcohol prevention. Thus, considerable efforts were made to strengthen alcohol prevention in Swedish municipalities. Objectives: The aim of this study was to examine whether local alcohol prevention reduced consumption and alcohol-related harm in Swedish municipalities. Methods: Alcohol prevention was monitored using a composite measure called the Alcohol Prevention Magnitude Measure (APMM), with subcategories of staff and budget, inspections and licenses, policy, activities, and cooperation. APMM and its categories were analysed in relation to alcohol consumption and harm over time, 2006–2014. A fixed effects model was used with 63% (N¼182, consumption) and 71% (N¼207, harm) of 290 Swedish municipalities, respectively, included in the analyses. Results: The main results suggest that when APMM increases with 1 percent, the alcohol-related mortality decreases with 0.26 percent, controlled for changes in population size, median income, unemployment, and post-secondary education. In light of this result, the estimated effect of APMM on alcohol consumption (sales) is small (0.02 percent decrease); possible explanations for this are discussed in the article. Conclusion:The overall results indicate that local alcohol prevention initiatives in Sweden have reduced some forms of alcohol-related harm, not least alcohol-related mortality, during the period 2006–2014. Further studies are needed to assess the generalizability of the present study.
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| 6. |
- Sjöström, Jenny K., 1978-, et al.
(författare)
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Complex evolution of Holocene hydroclimate, fire and vegetation revealed by molecular, minerogenic and biogenic proxies, Marais Geluk wetland, eastern Free State, South Africa
- 2023
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Ingår i: Quaternary Science Reviews. - 0277-3791 .- 1873-457X. ; 314
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Tidskriftsartikel (refereegranskat)abstract
- The Holocene climate history of Southern Africa remains inconclusive despite the increasing number of proxy records from the region. This might be related to the diversity of proxy records, how the proxies are interpreted, or that proxies may respond to more than one forcing (e.g. hydroclimate, fire, temperature.). Here, a 175-cm peat sequence from Free State, South Africa (28°17′53″S, 29°25′10.9″E), was analyzed using a comprehensive set of novel and conventional proxies, including isotopic (δ13C), elemental (CS-XRF), mineral (pXRD), molecular (FTIR-ATR and pyrolysis-GC-MS), grain size (Malvern 3000) and GSSC phytolith composition. The chronology was constructed through AMS radiocarbon dating (n = 7). The early Holocene (10,380–7000 cal yr BP) was characterized by an initial wet phase, followed by relative dryness, at least seasonally, evidenced by slow accumulation rates, low organic content and dominance of terrestrial vegetation in the organic matter matrix. From 7000 cal yr BP, decreasing temperatures, as evidenced in regional climate reconstructions, were associated at Marias Geluk with higher biogenic silica and organic matter content and an increase of moisture-adapted grasses, indicating increasingly mesic conditions. This trend was amplified after 6000 cal yr BP, co-occurring with a southward displacement of the ITCZ. Complex proxy dynamics were observed between 4300 and 2180 cal yr BP, with bulk organic proxies indicating a drier environment (lower carbon content, slow accumulation rates, enriched δ13C values) but the phytolith record pointing towards relatively mesic conditions. The period was also associated with increased fire frequency, that also reached the local wetland. We suggest that the period was associated with seasonally mesic conditions together with increased fire incidence, which affected some of the organic proxies. Increased fire activity was also recorded in the region, while the hydroclimatic indications differed. The last 2000 years, during which human activity is known to have increased in the region, was characterized by lower fire incidence and variable, but relatively moist, conditions. The hydroclimatic inferences for the last 2000 years are in line with previous studies from the region, but additional studies are needed to decipher if the decline in fire incidence was associated to climate forcings, human activities, or a combination of both. The multiproxy approach applied here - in particular the inclusion of FTIR-ATR and pyrolysis GC-MS - revealed a complex interplay between vegetation dynamics, hydrology and paleofire variability. This study confirms that relatively small Holocene temperature variations (compared to northern higher latitudes) were associated with major hydrological variability at Marais Geluk, and reinforces concerns from earlier studies that the hydroclimate of the region is vulnerable to climate change. The result s also show that the southward displacement of the ITCZ, and associated tropical air masses, likely had significant effects on regional hydrology and fire incidence.
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