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- Jakobsson, Kristina, et al.
(författare)
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Asbestos, cement, and cancer in the right part of the colon
- 1994
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Ingår i: Occupational and Environmental Medicine. - 1470-7926. ; 51:2, s. 95-101
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE--The aim was to investigate associations between exposure to mineral fibres and dust, and cancer in subsites within the large bowel. DESIGN--Pooled retrospective cohort studies. SUBJECTS AND SETTINGS--Blue collar workers, employed for at least one year in different trades; asbestos cement or cement workers (n = 2507), other industrial workers (n = 3965), and fishermen (n = 8092). MAIN OUTCOME MEASURES--Standardised incidence ratios (SIRs, national reference rates) were calculated for cause specific cancer morbidity between 1958 and 1989. The observation period began 15 years after first employment. RESULTS--The asbestos cement and cement workers had a slightly increased risk of colorectal cancer (SIR 1.5; 95% confidence interval (95% CI) 1.1-2.0). This was due to an increase only in the right part of the colon (SIR 2.5; 95% CI 1.6-3.8). The ratio of right (7th revision of the International Classification of Diseases ICD-7) 1530-1531)/left (ICD-7 1532-1533) colon cancer among the asbestos cement and cement workers of 4.8 differed significantly from the ratio both among the other blue collar workers (0.4) and among the fishermen (1.5). As the sensitivity and accuracy was insufficient, mortality data did not show the excess of cancers in the right part of the colon. CONCLUSIONS--An increased incidence of cancer in the right part of the colon was evident in the asbestos cement and cement workers. The distribution of cancers within the colon was noticeably different from that in other blue collar workers, indicating that our findings cannot be explained by socioeconomic confounding factors. A detailed and appropriate disease classification, based on incidence data, is necessary in order not to obscure or underestimate effects of exposure in epidemiological studies on colorectal cancer.
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- Jakobsson, Kristina, et al.
(författare)
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Genetic polymorphism for glutathione-S-transferase mu in asbestos cement workers
- 1994
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Ingår i: Occupational and Environmental Medicine. - 1470-7926. ; 51:12, s. 812-816
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE--To investigate whether a lack of glutathione-S-transferase mu (GSTM1) activity was related to an increased risk for adverse outcome after asbestos exposure. METHODS--A study was made of 78 male former asbestos cement workers, with retrospective cohort data on exposure, radiographical findings, and lung function. Venous blood samples were obtained for the analysis of GSTM1 polymorphism by the polymerase chain reaction technique. Chest x ray films were classified according to the International Labour Organisation (ILO) 1980 classification. Vital capacity (VC) and forced expiratory volume during 1 s (FEV1) were determined. Individual estimates of asbestos exposure were calculated, and expressed as duration of exposure, average exposure intensity, and cumulative dose. Data on smoking were obtained from interviews. RESULTS--The lung function in the study group was reduced, compared with reference equations. 23% of the workers had small opacities > or = 1/0, 29% circumscribed pleural thickenings, 14% diffuse thickenings, and 12% obliterated costophrenic angles. 54% of the workers were GSTM1 deficient. They were comparable with the other workers in age, follow up time (median 30 years), and duration of exposure (median 18 years), but had a slightly higher cumulated dose (median 18 v 10 fibre-years) than the others. Neither in radiographical changes nor lung function variables were there any differences between the different GSTM1 groups. The findings were similar when smoking habits and estimated asbestos exposure were taken into account. CONCLUSIONS--We could not show that lack of GSTM1 activity was related to an increased risk for radiographical or lung function changes in a group of asbestos cement workers, followed up for a long period after the end of exposure.
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- Jakobsson, Liselotte, 1953-, et al.
(författare)
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Patient satisfaction with nursing care : evaluation before and after expenditure cutback and intervention at a surgical clinic
- 1994
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Ingår i: International Journal for Quality in Health Care. - 1353-4505 .- 1464-3677. ; 6:4, s. 361-369
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Tidskriftsartikel (refereegranskat)abstract
- After a major cutback in the budget and staffing of a surgical clinic in southern Sweden there was intervention to improve the quality of nursing care and to evaluate the outcome. The intervention consisted of the implementation of: (1) nursing care organized in such a way that it would secure continuity of the nurse—patient relationship, (2) individually planned care by means of diagnostic reasoning, and (3) quality assurance for aspects believed to be connected with quality of care. Patient satisfaction before and after the intervention was assessed by means of a patient questionnaire survey (May 1991; n = 105 and May 1992; n = 137). Patient satisfaction improved significantly in variables related to nursing care viz. overall satisfaction and satisfaction with information and decision making; satisfaction with contact and staff-patient relationship; ward facilities and physical treatment or examinations; and satisfaction with physical nursing care. The results were interpreted to mean that the intervention may have counteracted any negative impact the reduced budget might have had such as the higher patient turn-over and the shorter in-patient periods, and thus seemed to have improved the quality of the nursing care in terms of patient satisfaction.
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- Johansson, L, et al.
(författare)
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Histological type of lung carcinoma in asbestos cement workers and matched controls
- 1992
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Ingår i: British Journal of Industrial Medicine. - 0007-1072. ; 49:9, s. 626-630
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Tidskriftsartikel (refereegranskat)abstract
- Histological types of lung carcinoma were examined in a case series of workers exposed to asbestos cement dust (n = 29) and matched controls (n = 87). The proportion of adenocarcinomas was 31% among the exposed subjects and 15% among the controls (mid-p = 0.05). Among workers with high exposure the proportion of adenocarcinoma was even higher (45%, 5/11; mid-p = 0.03). The proportion of peripheral tumours tended to be higher among exposed cases than controls (24 v 12%, mid-p = 0.12). Lobe of origin did not differ, however, between exposed cases and controls. Thus the study indicates an association between the degree of exposure to asbestos and adenocarcinoma of the lung, and a peripheral rather than central localisation of the tumours, but with virtually the same distribution of lobe of origin as in the general population.
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