| 1. |
- Hergens, Maria-Pia, et al.
(författare)
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Smokeless tobacco and the risk of stroke
- 2008
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Ingår i: Epidemiology. - 1044-3983 .- 1531-5487. ; 19:6, s. 794-799
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:: In Sweden, use of smokeless tobacco (oral moist snuff) is common among adult men. Research on cerebrovascular effects associated with long-term use of snuff is limited and inconclusive. We aimed to study whether long-term use of snuff affects the risk of stroke. METHODS:: Information on tobacco use was collected by questionnaire among Swedish construction workers attending health check-ups between 1978 and 1993. In total, 118,465 never-smoking men without a history of stroke were followed through 2003. We used the Inpatient Register and Causes of Death Register to identify subsequent morbidity and mortality from stroke and its subtypes (ischemic, hemorrhagic, and unspecified stroke). Relative risk estimates were derived from Cox proportional hazards regression model. RESULTS:: Almost 30% of the nonsmoking men had ever used snuff. Overall, 3248 cases of stroke were identified during follow-up. Compared with nonusers of tobacco, the multivariable-adjusted relative risks for ever-users of snuff were 1.02 (95% confidence interval; 0.92-1.13) for all cases and 1.27 (0.92-1.76) for fatal cases. Further analyses on subtypes of stroke revealed an increased risk of fatal ischemic stroke associated with current snuff use (1.72; 1.06-2.78), whereas no increased risk was noted for hemorrhagic stroke. CONCLUSION:: Snuff use may elevate the risk of fatal stroke, and particularly of fatal ischemic stroke.
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| 2. |
- Hergens, Maria-Pia, et al.
(författare)
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Snuff Use and Stroke Reponse
- 2009
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Ingår i: Epidemiology. - 1044-3983 .- 1531-5487. ; 20:3, s. 469-470
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Tidskriftsartikel (refereegranskat)
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| 3. |
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| 4. |
- Ljungman, Petter L S, et al.
(författare)
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Rapid effects of air pollution on ventricular arrhythmias.
- 2008
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Ingår i: European heart journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 29:23, s. 2894-901
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Air pollution has been associated with ventricular arrhythmias in patients with implantable cardioverter defibrillators (ICDs) for exposure periods of 24-48 h. Only two studies have investigated exposure periods <24 h. We aimed to explore such effects during the 2 and 24 preceding hours as well as in relation to distance from the place of the event to the air pollution monitor. METHODS AND RESULTS: We used a case-crossover design to investigate the effects of particulate matter <10 microm in diameter (PM10) and nitrogen dioxide (NO2) in 211 patients with ICD devices in Gothenburg and Stockholm, Sweden. Events interpreted as ventricular arrhythmias were downloaded from the ICDs, and air pollution data were collected from urban background monitors. We found an association between 2 h moving averages of PM10 and ventricular arrhythmia [odds ratio (OR) 1.31, 95% confidence interval (CI) 1.00-1.72], whereas the OR for 24 h moving averages was 1.24 (95% CI 0.87-1.76). Corresponding ORs for events occurring closest to the air pollution monitor were 1.76 (95% CI 1.18-2.61) and 1.74 (95% CI 1.07-2.84), respectively. Events occurring in Gothenburg showed stronger associations than in Stockholm. CONCLUSION: Moderate increases in air pollution appear to be associated with ventricular arrhythmias in ICD patients already after 2 h, although future studies including larger numbers of events are required to confirm these findings. Representative geographical exposure classification seems important in studies of these effects.
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| 5. |
- Rosenlund, Mats, et al.
(författare)
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Long-Term Exposure to Urban Air Pollution and Myocardial Infarction
- 2006
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Ingår i: Epidemiology. - : Ovid Technologies (Wolters Kluwer Health). - 1044-3983 .- 1531-5487. ; 17:4, s. 383-390
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Cohort studies have reported increased risks of cardiopulmonary mortality from long-term air pollution exposure, but the evidence is limited and inconclusive. We studied the association between long-term exposure to source-specific air pollution and myocardial infarction (MI) in a case-control study of first-time MI cases and population controls age 45 to 70 years in Stockholm county in 1992 to 1994. METHODS:Home addresses during several decades were combined with historical emission databases and dispersion models to obtain annual mean levels of pollutants from traffic and heating during 30 years for 1397 cases and 1870 controls. Nitrogen dioxide (NO2), carbon monoxide (CO), and particulate matter with an aerodynamic diameter less than 10 microm (PM10) were used as indicators of traffic emissions and sulfur dioxide (SO2) as an indicator of emissions from residential heating. RESULTS:There was no association between long-term average air pollution exposure and overall MI, but an increased risk of fatal MI was suggested, especially for out-of-hospital death. After adjustment for cardiovascular risk factors, the odds ratio for fatal MI associated with a 5th to 95th percentile difference in 30-year average exposure was 1.51 (95% confidence interval = 0.96-2.16) for NO2, 1.22 (0.98-1.52) for CO, 1.39 (0.94-2.07) for PM10, and 1.24 (0.77-2.02) for SO2. For out-of-hospital death, the odds ratio related to NO2 exposure was 2.17 (1.05-4.51). CONCLUSIONS:This study provides some support for an association between long-term air pollution exposure and fatal cardiovascular disease.
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| 6. |
- Selander, Jenny, et al.
(författare)
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Long-Term Exposure to Road Traffic Noise and Myocardial Infarction
- 2009
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Ingår i: Epidemiology. - : Lippincott Williams & Wilkins, Inc. - 1044-3983 .- 1531-5487. ; 20:2, s. 272-279
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Tidskriftsartikel (refereegranskat)abstract
- Background: An association has been reported between long-term exposure to road traffic noise and the risk of myocardial infarction (MI), but the evidence is limited and inconclusive. No previous study has simultaneously analyzed the role of exposure to noise and air pollution from road traffic in the risk of MI. Methods: A population-based case-control study on MI was conducted 1992-1994 in Stockholm County. Participants answered a questionnaire and underwent a physical examination. Residential exposure to noise and air pollution from road traffic between 1970 and 1992-1994 was assessed for 3666 participants (1571 cases of MI and 2095 controls), based on residential history combined with information on traffic intensity and distance to nearby roads. Information was also obtained on factors potentially affecting the relationship between noise exposure and MI, such as noise annoyance. Results: The correlation between long-term individual exposure to noise and air pollution from traffic was high (r = 0.6). The adjusted odds ratio for MI associated with long-term road traffic noise exposure of 50 dBA or higher was 1.12 (95% confidence interval = 0.95-1.33). In a subsample, defined by excluding persons with hearing loss or exposure to noise from other sources, the corresponding odds ratio was 1.38 (1.11-1.71), with a positive exposure-response trend. No strong effect modification was apparent by sex or cardiovascular risk factors, including air pollution from road traffic. Conclusions: The results lend some support to the hypothesis that long-term exposure to road traffic noise increases the risk for MI.
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| 7. |
- Selander, Jenny, et al.
(författare)
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Saliva cortisol and exposure to aircraft noise in six European countries.
- 2009
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Ingår i: Environmental health perspectives. - : Environmental Health Perspectives. - 1552-9924 .- 0091-6765. ; 117:11, s. 1713-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Several studies show an association between exposure to aircraft or road traffic noise and cardiovascular effects, which may be mediated by a noise-induced release of stress hormones. OBJECTIVE: Our objective was to assess saliva cortisol concentration in relation to exposure to aircraft noise. METHOD: A multicenter cross-sectional study, HYENA (Hypertension and Exposure to Noise near Airports), comprising 4,861 persons was carried out in six European countries. In a subgroup of 439 study participants, selected to enhance the contrast in exposure to aircraft noise, saliva cortisol was assessed three times (morning, lunch, and evening) during 1 day. RESULTS: We observed an elevation of 6.07 nmol/L [95% confidence interval (CI), 2.32-9.81 nmol/L] in morning saliva cortisol level in women exposed to aircraft noise at an average 24-hr sound level (L(Aeq,24h)) > 60 dB, compared with women exposed to L(Aeq,24h) < or = 50 dB, corresponding to an increase of 34%. Employment status appeared to modify the response. We found no association between noise exposure and saliva cortisol levels in men. CONCLUSIONS: Our results suggest that exposure to aircraft noise increases morning saliva cortisol levels in women, which could be of relevance for noise-related cardiovascular effects.
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