| 1. |
- Holmström, Anna, et al.
(författare)
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SIMSAM-nätverket i Umeå strävar mot att bli ett framstående center för registerforskning som knyter samman barndomen med livslång hälsa och välfärd
- 2011
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Ingår i: SVEPET - Medlemstidning för Svensk Epidemiologisk Förening (SVEP). - Göteborg : Svensk epidemiologisk förening. - 1101-4385. ; 29:3, s. 8-9
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Vetenskapsrådets SIMSAM initiativ syftar till att stärka multidisciplinär registerforskning i Sverige. Inom SIMSAM-nätverket i Umeå arbetar vi tvärvetenskapligt med sikte på att utvecklas till ett center med excellens kring mikrodataforskning som knyter samman barndomen med livslång hälsa och välfärd. Just nu fokuserar vi på att få tillgång till sammanlänkade data från ett flertal nationella och regionala register för att komma vidare med vår planerade forskning. Dessutom har Umeå-nätverket nyligen fått i uppdrag att leda den nationella samordningen av SIMSAM initiativet.
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| 2. |
- Leander, Mai, et al.
(författare)
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Impact of anxiety and depression on respiratory symptoms
- 2014
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 108:11, s. 1594-1600
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Tidskriftsartikel (refereegranskat)abstract
- Psychological factors such as anxiety and depression are prevalent in patients with asthma. The purpose of this study was to investigate the relationship between respiratory symptoms and psychological status and to estimate the importance of psychological status in comparison with other factors that are known to be associated with respiratory symptoms. This study included 2270 subjects aged 20-44 (52% female) from Sweden, Iceland, and Norway. Each participant underwent a clinical interview including questions on respiratory symptoms. Spirometry and methacholine challenge were performed. Symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Eighty-two percent of the subjects reported no anxiety or depression whatsoever, 11% reported anxiety, 2.5% depression and 4% reported both anxiety and depression. All respiratory symptoms, such as wheezing, breathlessness and nightly symptoms, were more common, at a statistically significant level, in participants who had depression and anxiety, even after adjusting for confounders (ORs 1.33-1.94). The HADS score was the most important determinant for nightly symptoms and attacks of breathlessness when at rest whereas bronchial responsiveness was the most important determinant for wheezing, and breathlessness when wheezing. The probability of respiratory symptoms related to HADS score increased with increasing HADS score for all respiratory symptoms. In conclusion, there is a strong association between respiratory symptoms and psychological status. There is therefore a need for interventional studies designed to improve depression and anxiety in patients with respiratory symptoms. (C) 2014 Elsevier Ltd. All rights reserved.
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| 3. |
- Beelen, Rob, et al.
(författare)
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Effects of long-term exposure to air pollution on natural-cause mortality : an analysis of 22 European cohorts within the multicentre ESCAPE project
- 2014
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 383:9919, s. 785-795
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Tidskriftsartikel (refereegranskat)abstract
- Background Few studies on long-term exposure to air pollution and mortality have been reported from Europe. Within the multicentre European Study of Cohorts for Air Pollution Effects (ESCAPE), we aimed to investigate the association between natural-cause mortality and long-term exposure to several air pollutants. Methods We used data from 22 European cohort studies, which created a total study population of 367 251 participants. All cohorts were general population samples, although some were restricted to one sex only. With a strictly standardised protocol, we assessed residential exposure to air pollutants as annual average concentrations of particulate matter (PM) with diameters of less than 2.5 mu m (PM2.5), less than 10 mu m (PM10), and between 10 mu m and 2.5 mu m (PMcoarse), PM2.5 absorbance, and annual average concentrations of nitrogen oxides (NO2 and NOx), with land use regression models. We also investigated two traffic intensity variables-traffic intensity on the nearest road (vehicles per day) and total traffic load on all major roads within a 100 m buff er. We did cohort-specific statistical analyses using confounder models with increasing adjustment for confounder variables, and Cox proportional hazards models with a common protocol. We obtained pooled effect estimates through a random-effects meta-analysis. Findings The total study population consisted of 367 251 participants who contributed 5 118 039 person-years at risk (average follow-up 13.9 years), of whom 29 076 died from a natural cause during follow-up. A significantly increased hazard ratio (HR) for PM2.5 of 1.07 (95% CI 1.02-1.13) per 5 mu g/m(3) was recorded. No heterogeneity was noted between individual cohort effect estimates (I-2 p value=0.95). HRs for PM2.5 remained significantly raised even when we included only participants exposed to pollutant concentrations lower than the European annual mean limit value of 25 mu g/m(3) (HR 1.06, 95% CI 1.00-1.12) or below 20 mu g/m(3) (1.07, 1.01-1.13). Interpretation Long-term exposure to fine particulate air pollution was associated with natural-cause mortality, even within concentration ranges well below the present European annual mean limit value.
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| 4. |
- Beelen, Rob, et al.
(författare)
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Long-term Exposure to Air Pollution and Cardiovascular Mortality An Analysis of 22 European Cohorts
- 2014
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Ingår i: Epidemiology. - : Lippincott Williams & Wilkins. - 1044-3983 .- 1531-5487. ; 25:3, s. 368-378
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Tidskriftsartikel (refereegranskat)abstract
- Background: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death. Methods: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2 and NOx); particles with diameters of less than 2.5 mu m (PM2.5), less than 10 mu m (PM10), and 10 mu m to 2.5 mu m (PMcoarse); PM2.5 absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates. Results: The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM2.5, the hazard ratio was 1.21 (95% confidence interval = 0.87-1.69) per 5 mu g/m(3) and for PM10, 1.22 (0.91-1.63) per 10 mu g/m(3). Conclusion: In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association.
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| 5. |
- Biggar, Robert J, et al.
(författare)
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Digoxin use and the risk of breast cancer in women
- 2011
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Ingår i: Journal of Clinical Oncology. - : American Society of Clinical Oncology. - 0732-183X .- 1527-7755. ; 29:16, s. 2165-2170
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE Digoxin resembles estrogen chemically and may have estrogenic effect. We hypothesized that digoxin use might increase breast cancer incidence and examined if use might be associated with risk of breast cancer, categorized by estrogen receptor (ER) status. To determine if being under care for heart disease biased the findings, rate ratios in users of angina drugs were similarly evaluated as a control exposure group. PATIENTS AND METHODS Women using digoxin and angina drugs were identified in the nationwide Danish Prescription Database, available between 1995 and 2008. Incident breast cancers were identified in the Danish Cancer Registry and further classifying by ER status. Relative risks (RR) were compared to nonusers using age- and period-adjusted incidence rate ratios. RESULTS Two thousand one hundred forty-four of 104,648 women using digoxin developed breast cancer. Current digoxin users were at increased risk of breast cancer (RR, 1.39; 95% CI, 1.32 to 1.46), but risk was not increased in former users (RR, 0.91; 95% CI, 0.83 to 1.00). The increased risks in digoxin users were marginally higher for ER-positive breast cancers (RR, 1.35; 95% CI, 1.26 to 1.45) and ER unknown breast cancers (RR, 1.51; 95% CI, 1.38 to 1.64) than for ER-negative breast cancers (RR, 1.20; 95% CI, 1.03 to 1.40). Among 137,493 women exposed to angina drugs only (a comparison group with cardiovascular disease; n = 2,658 breast cancers), incidence was not increased in current or former users. CONCLUSION Women currently using digoxin had a significantly increased risk of breast cancer. Risk normalized when digoxin was stopped. No risk increases were observed in women using angina drugs only. The higher risk of developing ER-positive breast cancers supports an estrogen-mimicking mechanism.
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| 6. |
- Carlsen, Hanne Krage, 1981-
(författare)
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Health effects of air pollution in Iceland : respiratory health in volcanic environments
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Air pollution has adverse effects on human health. The respiratory system is the most exposed and short-term changes in air pollution levels have been associated with worsening of asthma symptoms and increased rates of heart attacks and stroke. Air pollution in cities due to traffic is the major concern, as many people are exposed. However, natural sources of air pollution such as natural dust storms and ash from volcanic eruptions can also compromise human health. Exposure to volcanic eruptions and other natural hazards can also threaten mental health. Air pollution has not been extensively studied in Iceland, in spite of the presence of several natural pollution sources and a sizeable car fleet in the capital area.The aim of this thesis was to determine if there was a measurable effect on health which could be attributed to air pollution in Iceland. This aim was pursued along two paths; time series studies using register data aimed to determine the short-term association between daily variation in air pollution and on one hand daily dispensing of anti-asthma medication or the daily number of emergency room visits and emergency admissions for cardiopulmonary causes and stroke. The other method was to investigate if exposure to the Eyjafjallajökull volcanic eruption was associated with adverse health outcomes, either at the end of the eruption, or 6 months later.In paper I time series regression was used to investigate the association between the daily number of individuals who were dispensed anti-asthma medication and levels of the air pollutants particle matter with an aerodynamic diameter less than 10 μm (PM10), nitrogen dioxide (NO2), ozone (O3), and hydrogen sulfide (H2S) during the preceding days. For the study period 2006-9, there were significant associations between the daily mean of PM10 and H2S and the sales of anti-asthma medication 3 to 5 days later. Giving the exposure as the highest daily one-hour mean gave more significant results. Air pollution negatively affected the respiratory health of asthma medication users, prompting them to refill their prescriptions before they had originally intended to.In paper II the main outcome was the number of individuals seeking help at Landspitali University Hospital emergency room for cardiopulmonary disease or stroke. Time series regression was used to identify the lag that gave the best predictive power, and models were run for data for 2003-9 pollutants PM10, NO2, and O3. O3 was significantly associated with the number of emergency hospital visits the same day and two days later in all models, and both for men, women and the elderly. Only emergency hospital visits of the elderly were associated with NO2, and there were no associations with PM10.In paper III the aim was to investigate if the health effects of PM10 were affected by the addition of volcanic ash from the 2010 eruption of Eyjafjallajökull and 2011 eruption of Grímsvötn to PM10 in the capital area. Time series regression of emergency hospital visits and PM10 before and after the Eyjafjallajökull eruption showed that the effect tended to be higher after the eruption, but the results were not significant. Analysis with a binary indicator for high levels of PM10 from volcanic ash and other sources showed that volcanic ash was associated with increased emergency hospital visits. There were no associations with high levels of PM10 from other sources.In paper IV, the health of the population exposed to the ongoing eruption of Eyjafjallajökull in 2010 was investigated thoroughly. Lung function in adults was better than in a reference group from the capital area, though many reported sensory organ irritation symptoms and symptoms of stress and mental unhealth, especially those with underlying diseases.Paper V report the results from a questionnaire study which was carried out six months after the Eyjafjallajökull eruption. The study population comprised a cohort of south Icelanders exposed to the eruption to varying degrees and a reference group from north Iceland. Respiratory and eye symptoms were much more common in south Icelanders than in the reference group, after adjusting for demographic characteristics. Mental unhealth rates had declined considerably.In the studies, we found that urban air pollution and natural particles have short-term effects on anti-asthma medication dispensing and emergency room visits and hospital admissions. Exposure to natural particles in the form of volcanic dust was associated with increased respiratory symptoms in a very exposed population. There were indications that volcanic ash particles were associated with increased emergency hospital visits in the following days.
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| 7. |
- Carlsen, Hanne Krage, et al.
(författare)
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Ozone is associated with cardiopulmonary and stroke emergency hospital visits in Reykjavík, Iceland 2003-2009.
- 2013
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Ingår i: Environmental health : a global access science source. - : BioMed Central (BMC). - 1476-069X. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Air pollution exposure is associated with hospital admissions and emergency room visits for cardiopulmonary disease and stroke. Iceland's capital area, Reykjavik, has generally low air pollution levels, but traffic and natural sources contribute to pollution levels. The objective of this study was to investigate temporal associations between emergency hospital visits and air pollutants ozone (O-3), nitrogen dioxide (NO2), and particulate matter (PM10) in the Icelandic capital area. Methods: We constructed a time series of the daily number of adults who visited the emergency room, or were acutely admitted for stroke or cardiorespiratory causes to Landspitali University Hospital 1 January 2003 - 31 December 2009 from the hospital in-patient register. We used generalized additive models assuming Poisson distribution, to analyze the daily emergency hospital visits as a function of the pollutant levels, and adjusted for meteorological variables, day of week, and time trend with splines. Results: Daily emergency hospital visits increased 3.9% (95% confidence interval (CI) 1.7-6.1%) per interquartile (IQR) change in average O-3 the same and two previous days. For females, the increase was 7.8% (95% CI 3.6-12.1) for elderly (70+), the increase was 3.9% (95% CI 0.6-7.3%) per IQR increase of NO2. There were no associations with PM10. Conclusions: We found an increase in daily emergency hospital visits associated with O-3, indicating that low-level exposure may trigger cardiopulmonary events or stroke.
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| 8. |
- Dimakopoulou, Konstantina, et al.
(författare)
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Air Pollution and Nonmalignant Respiratory Mortality in 16 Cohorts within the ESCAPE Project
- 2014
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - : American Thoracic Society. - 1073-449X .- 1535-4970. ; 189:6, s. 684-696
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: Prospective cohort studies have shown that chronic exposure to particulate matter and traffic-related air pollution is associated with reduced survival. However, the effects on nonmalignant respiratory mortality are less studied, and the data reported are less consistent. Objectives: We have investigated the relationship of long-term exposure to air pollution and nonmalignant respiratory mortality in 16 cohorts with individual level data within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE). Methods: Data from 16 ongoing cohort studies from Europe were used. The total number of subjects was 307,553. There were 1,559 respiratory deaths during follow-up. Measurements and Main Results: Air pollution exposure was estimated by land use regression models at the baseline residential addresses of study participants and traffic-proximity variables were derived from geographical databases following a standardized procedure within, the ESCAPE study. Cohort-specific hazard ratios obtained by Cox proportional hazard models from standardized individual cohort analyses were combined using metaanalyses. We found no significant associations between air pollution exposure and nonmalignant respiratory mortality. Most hazard ratios were slightly below unity, with the exception of the traffic-proximity indicators. Conclusions: In this study of 16 cohorts, there was no-association between air pollution exposure and nonmalignant respiratory mortality.
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| 9. |
- Ericsson, Pernilla, et al.
(författare)
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Reliability testing of two ergonomic risk assessment tools
- 2012
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- INTRODUCTIONQuick Exposure Check (QEC¹) and Rapid Upper Limb Assessment (RULA²) are two ergonomic risk assessment tools that have been designed to be useful for ergonomists assessing musculoskeletal risk factors in upper extremities at workplaces.AIMThe aim was to describe the variation between and within ergonomists assessments using QEC and RULA, and to compare the two tools regarding within-observer agreement.SUBJECTS & METHODSTwenty ergonomists observed five different work tasks twice with three weeks in between, watching video clips. They made ergonomic risk assessments using both QEC and RULA.The observed work tasks were: Window replacement, nailing a wooden pallet, toilet cleaning, instrumentation in an operating theatre, and sorting post.For the statistical analyses, percent agreement and kappa value was used.RESULTSThere was a variation in assessments between the ergonomists in all positions and movements both when using QEC and RULA, except from assessing armposition when observing window replacement using QEC, where all ergonomists assessed the same position (figure 1).The ergonomists had higher percent agreement between observation one and two using QEC compared with RULA (table 1).CONCLUSIONThere was a variation when assessing positions and movements in different worktasks both between ergonomists and within the same ergonomist using both QEC and RULA. However the agreement between two observations within observers was higher for QEC.
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| 10. |
- Fuks, Kateryna B., et al.
(författare)
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Arterial blood pressure and long-term exposure to traffic-related air pollution : an analysis in the European Study of Cohorts for Air Pollution Effects (ESCAPE)
- 2014
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Ingår i: Journal of Environmental Health Perspectives. - : National Institute of Environmental Health Sciences (NIEHS). - 0091-6765 .- 1552-9924. ; 122:9, s. 896-905
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Long-term exposure to air pollution is hypothesized to elevate arterial blood pressure (BP). The existing evidence is scarce and country-specific. OBJECTIVES: We investigated the cross-sectional association of long-term traffic-related air pollution with BP and prevalent hypertension in European populations. METHODS: Fifteen population-based cohorts, participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE), were analysed. Residential exposure to particulate matter and nitrogen oxides was modelled with land use regression using a uniform protocol. Traffic exposure was assessed with traffic indicator variables. We analysed systolic and diastolic BP in participants medicated and non-medicated with BP lowering medication (BPLM) separately, adjusting for personal and area-level risk factors and environmental noise. Prevalent hypertension was defined as ≥ 140 mmHg systolic, or ≥ 90 mmHg diastolic BP, or intake of BPLM. We combined cohort-specific results using random-effects meta-analysis. RESULTS: In the main meta-analysis of 113,926 participants, traffic load on major roads within 100 m of the residence was associated with increased systolic and diastolic BP in non-medicated participants (0.35 mmHg [95% CI: 0.02-0.68] and 0.22 mmHg [95% CI: 0.04-0.40] per 4,000,000 vehicles × m/day, respectively). The estimated odds ratio for prevalent hypertension was 1.05 [95% CI: 0.99-1.11] per 4,000,000 vehicles × m/day. Modelled air pollutants and BP were not clearly associated. CONCLUSIONS: In this first comprehensive meta-analysis of European population-based cohorts we observed a weak positive association of high residential traffic exposure with BP in non-medicated participants, and an elevated OR for prevalent hypertension. The relationship of modelled air pollutants with BP was inconsistent.
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| 11. |
- Haargaard, Birgitte, et al.
(författare)
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Risk of retinal detachment after pediatric cataract surgery
- 2014
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Ingår i: Investigative Ophthalmology and Visual Science. - : Association for Research in Vision and Ophthalmology. - 0146-0404 .- 1552-5783. ; 55:5, s. 2947-2951
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To determine the long-term risk of retinal detachment following pediatric cataract surgery and to identify risk factors for retinal detachment.METHODS: We included all children (aged 0 to 17 years) who during the time period of 1977 to 2005 underwent pediatric cataract surgery in Denmark, excluding cataract cases caused by trauma, or acquired systemic or acquired ocular pathology, and cases with ocular anomalies associated with the development of retinal detachment. Cases of cataract were ascertained from the mandatory Danish National Patient Register, and information on retinal detachment was based on medical chart review.RESULTS: Among 1043 eyes of 656 children undergoing surgery for pediatric cataract, 25 eyes (23 children) developed retinal detachment at a median time of 9.1 years after surgery. The overall 20-year risk of retinal detachment was 7% (95% confidence interval [CI]: 3%-11%) among cataract patients. In otherwise normal children having isolated cataract, the risk was 3% (95% CI: 0%-7%). A significantly higher risk of developing retinal detachment was found in children with mental retardation (23% [95% CI: 9%-35%]) or in cataract cases with other ocular or systemic anomalies (16% [95% CI: 6%-24%]).CONCLUSIONS: The estimated overall risk of retinal detachment 20 years after pediatric cataract surgery was 7%, but only 3% for isolated cataract. Particularly high risks of retinal detachment after cataract surgery were associated with mental retardation and having other ocular or systemic diseases.
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| 12. |
- Hansson, Erik, et al.
(författare)
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Mapping snakebite epidemiology in Nicaragua : pitfalls and possible solutions
- 2010
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Ingår i: PLoS neglected tropical diseases. - : Public Library of Science (PLoS). - 1935-2735. ; 4:11, s. e896-
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Tidskriftsartikel (refereegranskat)abstract
- Using publicly available data, we identified areas likely to be underreporting snakebites and highlighted these areas instead of leaving them "white" on the incidence map. The effects of the case detection bias on the distribution of resources against snakebites could decrease. Although not yet verified empirically, our study provides an example of how snake bite epidemiology may be investigated in similar settings worldwide at a low cost.
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| 13. |
- Hernandez, Danilo, et al.
(författare)
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Respiratory Symptoms among Waste-Picking Child Laborers A Cross-Sectional Study
- 2010
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Ingår i: International Journal of Occupational and Environmental Health. - 1077-3525. ; 16:2, s. 124-135
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluates respiratory symptoms, lung function, and exposure to airborne particles among waste-picking children. We enrolled 103 waste-picking children at a dump in Managua, Nicaragua and 103 children who do not pick waste. Exposure to airborne particles was assessed by area sampling. Health data were obtained from a questionnaire, clinical examination, and spirometry. Exposure effects were evaluated with multivariate regression analysis. Exposure to particles exceeded national and international standards. Wheezing among children was related to exposure status, with waste-picking children who are both "never highly exposed" and "ever highly exposed" having greater prevalence of wheezing compared to the children who do not pick waste. FEV1 among "ever highly exposed" waste-picking children with wheeze was 13% lower than non-waste-picking children with wheeze. Exposure to small particles was unacceptably high and associated with wheeze and decreased lung function.
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| 14. |
- Johansson, Mikael, et al.
(författare)
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The soluble form of the tumor suppressor Lrig1 potently inhibits in vivo glioma growth irrespective of EGF receptor status
- 2013
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Ingår i: Neuro-Oncology. - : Oxford University Press (OUP). - 1522-8517 .- 1523-5866. ; 15:9, s. 1200-1211
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Tidskriftsartikel (refereegranskat)abstract
- Deregulated growth factor signaling is a major driving force in the initiation and progression of glioblastoma. The tumor suppressor and stem cell marker Lrig1 is a negative regulator of the epidermal growth factor receptor (EGFR) family. Here, we addressed the therapeutic potential of the soluble form of Lrig1 (sLrig1) in glioblastoma treatment and the mechanism of sLrig1-induced growth inhibition. With use of encapsulated cells, recombinant sLrig1 was locally delivered in orthotopic glioblastoma xenografts generated from freshly isolated patient tumors. Tumor growth and mouse survival were evaluated. The efficacy of sLrig1 and the affected downstream signaling was studied in vitro and in vivo in glioma cells displaying variable expression of wild-type and/or a constitutively active EGFR mutant (EGFRvIII). Continuous interstitial delivery of sLrig1 in genetically diverse patient-derived glioma xenografts led to strong tumor growth inhibition. Glioma cell proliferation in vitro and tumor growth in vivo were potently inhibited by sLrig1, irrespective of EGFR expression levels. Of importance, tumor growth was also suppressed in EGFRvIII-driven glioma. sLrig1 induced cell cycle arrest without changing total receptor level or phosphorylation. Affected downstream effectors included MAP kinase but not AKT signaling. Of importance, local delivery of sLrig1 into established tumors led to a 32 survival advantage in treated mice. To our knowledge, this is the first report demonstrating that sLrig1 is a potent inhibitor of glioblastoma growth in clinically relevant experimental glioma models and that this effect is largely independent of EGFR status. The potent anti-tumor effect of sLrig1, in combination with cell encapsulation technology for in situ delivery, holds promise for future treatment of glioblastoma.
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| 15. |
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| 16. |
- Oudin, Anna, et al.
(författare)
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Air pollution and stroke
- 2012
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Ingår i: Epidemiology. - : Wolters Kluwer. - 1044-3983 .- 1531-5487. ; 23:3, s. 505-506
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Tidskriftsartikel (refereegranskat)
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| 17. |
- Oudin, Anna, et al.
(författare)
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Estimation of Short-Term Effects of Air Pollution on Stroke Hospital Admissions in Southern Sweden.
- 2010
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Ingår i: Neuroepidemiology. - : S. Karger AG. - 1423-0208 .- 0251-5350. ; 34:3, s. 131-142
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Tidskriftsartikel (refereegranskat)abstract
- Background: Short-term exposure to high levels of air pollution can increase stroke risk. In this study we investigated the short-term effects of air pollution on hospital admissions for stroke in a setting where pollutant levels are rather low. We also addressed methodological issues in evaluating the short-term effects of air pollution. Methods: Daily admissions of ischemic (n = 11,267) and hemorrhagic (n = 1,681) stroke were obtained from a Swedish quality register for stroke, Riks-Stroke. We used two types of exposure data: (1) daily measured background levels of ozone, temperature and particles with a diameter <10 mum (PM(10)) and (2) modeled levels of a mixture of NO and NO(2) (NO(x)) at the residential address of each individual. Results: We estimated a 13% (95% confidence interval, 4-22%) increased risk for hospital admissions for ischemic stroke for levels of PM(10) above 30 mug/m(3) compared to <15 mug/m(3), whereas temperature above 16 degrees C decreased the risk. No consistent associations were found for hemorrhagic stroke or for ischemic stroke and ozone or NO(x). Conclusion: Particulate air pollution and temperature seemed to be associated with ischemic stroke hospital admissions. Individual exposure modeling facilitates a detailed exposure assessment but may also be more prone to misclassification errors. The time series and case crossover approaches yielded similar effect estimates.
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| 18. |
- Oudin, Anna, et al.
(författare)
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Fish consumption and ischemic stroke in southern Sweden
- 2011
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Ingår i: Nutrition Journal. - London : BioMed Central. - 1475-2891. ; 10:109, s. 5-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The relationship between fish intake and stroke incidence has been inconsistent in previous Swedish studies. Here, we report the risk of stroke and fish intake in a cohort from southern Sweden. Findings: Data were obtained from an already available population based case-control study where the cases were defined as incident first-time ischemic stroke patients. Complete data on all relevant variables were obtained for 2722 controls and 2469 cases. The data were analyzed with logistic regression analysis. Stroke risk decreased with fat fish intake ([greater than or equal to] 1/week versus <1/month) in both men and women; adjusted pooled Odds Ratio (OR) 0.69, 95% Confidence Interval (CI): 0.54-0.89. However, stroke risk for women increased with intake of lean fish; adjusted OR 1.63 (95% CI: 1.17-2.28), whereas there was no association with men's lean fish intake; adjusted OR 0.97(95% CI: 0.73-1.27). Fish intake was self-reported retrospectively, yielding uncertain exposure assessment and potential recall bias. The findings regarding lean fish could be explained by recall bias if an individual's inclination to report lean fish consumption depended on both disease status and sex. The fact that the association between fat fish intake and stroke was similar in men and women does not support such a differential in recall. Conclusions: The results suggest fat fish intake to decrease ischemic stroke risk and lean fish intake to increase women's stroke risk. The inconsistent relationship between fish intake and stroke risk reported in previous studies is further stressed by the results of this study.
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| 19. |
- Oudin, Anna, et al.
(författare)
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Hospital admissions for ischemic stroke : does long-term exposure to air pollution interact with major risk factors?
- 2011
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Ingår i: Cerebrovascular Diseases. - : S. Karger. - 1015-9770 .- 1421-9786. ; 31:3, s. 284-293
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim was to investigate whether the effects of major risk factors for ischemic stroke were modified by long-term exposure to air pollution in Scania, southern Sweden.Methods: Cases were defined as first-ever ischemic strokes in patients born between 1923 and 1965 during 2001-2006 (n = 7,244). Data were collected from The Swedish National Stroke Register (Riks-stroke) and the Malmö and Lund Stroke Registers. Population controls were matched on age and sex. Modeled outdoor annual mean NO(x) concentrations were used as proxy for long-term exposure to air pollution. Heterogeneity across NO(x) categories was tested for smoking, hypertension, diabetes mellitus, atrial fibrillation and physical inactivity. Data were analyzed as case-control data and to some extent as case-only data, with logistic regression analysis.Results: The case-control odds ratios for ischemic stroke in association with diabetes were 1.3 [95% confidence interval (CI): 1.1-1.6] and 2.0 (95% CI: 1.2-3.4) in the lowest and highest NO(x) category, respectively (p value for testing heterogeneity across the categories = 0.056). The case-only approach gave further support for the risk associated with diabetes to increase with NO(x) (p for trend = 0.033). We observed no main effect of mean NO(x) or any conclusive effect modifications between NO(x) and smoking, hypertension, atrial fibrillation or physical inactivity.Conclusions: In a low-level air pollution area, the risk for ischemic stroke associated with diabetes seemed to increase with long-term exposure to air pollution.
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| 20. |
- Oudin, Anna, et al.
(författare)
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Impact of residential mobility on exposure assessment in longitudinal air pollution studies : A sensitivity analysis within the ESCAPE project
- 2012
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Ingår i: Scientific World Journal. - : Hindawi Limited. - 1537-744X. ; 2012, s. 125818-
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Tidskriftsartikel (refereegranskat)abstract
- Exposure misclassification in longitudinal studies of air pollution exposure and health effects can occur due to residential mobility in a study population over follow-up. The aim of this study was to investigate to what extent residential mobility during follow-up can be expected to cause exposure misclassification in such studies, where exposure at the baseline address is used as the main exposure assessment. The addresses for each participant in a large population-based study (N>25,000) were obtained via national registers. We used a Land Use Regression model to estimate the NOx-concentration for each participant’s all addresses during the entire follow up period (in average 14.6 years) and calculated an average concentration during follow up. The Land Use Regression model explained 83% of the variation in measured levels. In summary, the NOx concentration at the inclusion address was similar to the average concentration over follow-up with a correlation coefficient of 0.80, indicating that air pollution concentration at study inclusion address could be used as indicator of average air pollution concentrations over follow-up. The differences between an individual´s inclusion and average follow-up mean concentration was small, and seemed to be non-differential with respects to a large range of factors and disease statuses, implying that bias due to residential mobility was small.
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| 21. |
- Oudin, Anna, et al.
(författare)
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Volcanic Ash and Daily Mortality in Sweden after the Icelandic Volcano Eruption of May 2011
- 2013
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 10:12, s. 6909-6919
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Tidskriftsartikel (refereegranskat)abstract
- In the aftermath of the Icelandic volcano Grimsvötn’s eruption on 21 May 2011, volcanic ash reached Northern Europe. Elevated levels of ambient particles (PM) were registered in mid Sweden. The aim of the present study was to investigate if the Grimsvötn eruption had an effect on mortality in Sweden. Based on PM measurements at 16 sites across Sweden, data were classified into an ash exposed data set (Ash area) and an unexposed data set (No ash area). Data on daily all-cause mortality were obtained from Statistics Sweden for the time period 1 April through 31 July 2011. Mortality ratios were calculated as the ratio between the daily number of deaths in the Ash area and the No ash area. The exposure period was defined as the week following the days with elevated particle concentrations, namely 24 May through 31 May. The control period was defined as 1 April through 23 May and 1 June through 31 July. There was no absolute increase in mortality during the exposure period. However, during the exposure period the mean mortality ratio was 2.42 compared with 2.17 during the control period, implying a relatively higher number of deaths in the Ash area than in the No ash area. The differences in ratios were mostly due to a single day, 31 May, and were not statistically significant when tested with a Mann-Whitney non-parametric test (p > 0.3). The statistical power was low with only 8 days in the exposure period (24 May through 31 May). Assuming that the observed relative differences were not due to chance, the results would imply an increase of 128 deaths during the exposure period 24–31 May. If 31 May was excluded, the number of extra deaths was reduced to 20. The results of the present study are contradicting and inconclusive, but may indicate that all-cause mortality was increased by the ash-fall from the Grimsvötn eruption. Meta-analysis or pooled analysis of data from neighboring countries might make it possible to reach sufficient statistical power to study effects of the Grimsvötn ash on morbidity and mortality. Such studies would be of particular importance for European societies preparing for future large scale volcanic eruptions in Iceland.
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| 22. |
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| 23. |
- Raaschou-Nielsen, Ole, et al.
(författare)
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Air pollution and lung cancer incidence in 17 European cohorts : prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE)
- 2013
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Ingår i: The Lancet Oncology. - 1470-2045 .- 1474-5488. ; 14:9, s. 813-822
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Ambient air pollution is suspected to cause lung cancer. We aimed to assess the association between long-term exposure to ambient air pollution and lung cancer incidence in European populations.METHODS: This prospective analysis of data obtained by the European Study of Cohorts for Air Pollution Effects used data from 17 cohort studies based in nine European countries. Baseline addresses were geocoded and we assessed air pollution by land-use regression models for particulate matter (PM) with diameter of less than 10 μm (PM10), less than 2·5 μm (PM2·5), and between 2·5 and 10 μm (PMcoarse), soot (PM2·5absorbance), nitrogen oxides, and two traffic indicators. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effects models for meta-analyses.FINDINGS: The 312 944 cohort members contributed 4 013 131 person-years at risk. During follow-up (mean 12·8 years), 2095 incident lung cancer cases were diagnosed. The meta-analyses showed a statistically significant association between risk for lung cancer and PM10 (hazard ratio [HR] 1·22 [95% CI 1·03-1·45] per 10 μg/m(3)). For PM2·5 the HR was 1·18 (0·96-1·46) per 5 μg/m(3). The same increments of PM10 and PM2·5 were associated with HRs for adenocarcinomas of the lung of 1·51 (1·10-2·08) and 1·55 (1·05-2·29), respectively. An increase in road traffic of 4000 vehicle-km per day within 100 m of the residence was associated with an HR for lung cancer of 1·09 (0·99-1·21). The results showed no association between lung cancer and nitrogen oxides concentration (HR 1·01 [0·95-1·07] per 20 μg/m(3)) or traffic intensity on the nearest street (HR 1·00 [0·97-1·04] per 5000 vehicles per day).INTERPRETATION: Particulate matter air pollution contributes to lung cancer incidence in Europe.FUNDING: European Community's Seventh Framework Programme.
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| 24. |
- Stroh, Emilie, et al.
(författare)
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Measured and modeled personal and environmental NO2 exposure
- 2012
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Ingår i: Population Health Metrics. - : Springer Science and Business Media LLC. - 1478-7954. ; 10:10
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in Undetermined Background: Measured or modeled levels of outdoor air pollution are being used as proxies for individual exposure in a growing number of epidemiological studies. We studied the accuracy of such approaches, in comparison with measured individual levels, and also combined modeled levels for each subject's workplace with the levels at their residence to investigate the influence of living and working in different places on individual exposure levels. Methods: A GIS-based dispersion model and an emissions database were used to model concentrations of NO2 at the subject's residence. Modeled levels were then compared with measured levels of NO2. Personal exposure was also modeled based on levels of NO2 at the subject's residence in combination with levels of NO2 at their workplace during working hours. Results: There was a good agreement between measured facade levels and modeled residential NO2 levels (r(s) = 0.8, p > 0.001); however, the agreement between measured and modeled outdoor levels and measured personal exposure was poor with overestimations at low levels and underestimation at high levels (r(s) = 0.5, p > 0.001 and r(s) = 0.4, p > 0.001) even when compensating for workplace location (r(s) = 0.4, p > 0.001). Conclusion: Modeling residential levels of NO2 proved to be a useful method of estimating facade concentrations. However, the agreement between outdoor levels (both modeled and measured) and personal exposure was, although significant, rather poor even when compensating for workplace location. These results indicate that personal exposure cannot be fully approximated by outdoor levels and that differences in personal activity patterns or household characteristics should be carefully considered when conducting exposure studies. This is an important finding that may help to correct substantial bias in epidemiological studies.
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