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  • Kim, Jeong-Lim, 1981- (författare)
  • Environmental Factors in Relation to Asthma and Respiratory Symptoms among Schoolchildren in Sweden and Korea
  • 2006
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This thesis studied environmental factors in relation to asthma and respiratory symptoms among schoolchildren in two countries. In Sweden, 1014 pupils (5-14 year) in 8 schools participated. Wheeze was reported by 7.8%, current asthma by 5.9%, doctor-diagnosed asthma by 7.7%, cat allergy by 6.8% and dog allergy by 4.8%. Current asthma was less common among those consuming more fresh milk and fish. Doctor-diagnosed asthma was less common among those consuming olive oil. Cat, dog and horse allergens were common in settled dust and related to respiratory symptoms. Pupils consuming butter and fresh milk had less respiratory symptoms in relation to allergen exposure. In schools with increased levels of microbial volatile organic compounds and selected plasticizers (Texanol and TXIB) asthma and respiratory symptoms were more common.In Korea, 2365 pupils (9-11 year) in 12 schools participated (96%). In total, wheeze was reported by 8.0%, current asthma by 5.7%, doctor-diagnosed asthma by 5.4%, cat allergy by 2.6% and dog allergy by 4.9%. Contamination of dog and mite (Dermatophagoides farinae) allergen was common while cat allergen was uncommon. Remodelling, changing floor and building dampness at home were positively associated with asthma and respiratory symptoms. The strongest associations were found for floor dampness. Indoor/outdoor concentration of NO2, formaldehyde and ultrafine particles (UFP) at schools were positively associated with asthma and respiratory symptoms. When comparing Sweden and Korea, Korean pupils had more breathlessness and asthma but reported less cat and pollen allergy. Swedish schools had CO2-levels below 1000 ppm, while most Korean schools exceeded this standard. Since both home and school environment may affect pupil’s asthma and respiratory symptoms, air quality should be an important health issue. Moreover, changes in dietary habits may be beneficial to decrease asthma and allergies. Furthermore, interaction between diet and environment needs to be further investigated.
  • Kim, Jeong-Lim, et al. (författare)
  • Fish consumption and school grades in Swedish adolescents: a study of the large general population.
  • 2010
  • Ingår i: Acta Paediatrica. - 1651-2227. ; 99, s. 72-7
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To study the associations between fish intake and academic achievement as cognitive parameter among Swedish adolescents. METHODS: In 2000, a questionnaire including respiratory items, socioeconomic conditions and dietary information was mailed to all schoolchildren (n = 18 158), aged 15 and living in Västra Götaland region of Sweden. The questionnaire was returned by 10 837 subjects. One year later, the total school grades for each subject who had completed the questionnaire and who included their full personal identification number were obtained from the national registers. Multiple linear regression models were applied to evaluate the association between fish intake and academic grades among 9448 schoolchildren, while adjusting for potential confounders, e.g. parents' education. RESULTS: Grades were higher in subjects with fish consumption once a week compared with subjects with fish consumption of less than once a week (reference group) [increment in estimate 14.5, 95% confidence interval (CI) 11.8-17.1]. Grades were even higher in subjects with fish consumption of more than once a week compared with the reference group (increment in estimate 19.9, 95% CI 16.5-23.3). In the model stratified for parents' education, there were still higher grades among subjects with frequent fish intake in all educational strata (p < 0.01). CONCLUSION: Frequent fish intake among schoolchildren may provide benefits in terms of academic achievement.
  • Kim, Jeong-Lim, et al. (författare)
  • Impact of occupational exposures on exacerbation of asthma: a population-based asthma cohort study.
  • 2016
  • Ingår i: BMC pulmonary medicine. - : Springer Science and Business Media LLC. - 1471-2466. ; 16:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Asthma is a prevalent chronic disease and occupation contributes to approximately 15 % of cases among adults. However, there are still few studies on risk factors for work-exacerbated asthma. The current study investigated the association between asthma exacerbations and occupational exposures.The study comprised all currently working adults (n = 1356) who reported ever asthma in prior population-based cohorts. All subjects completed a questionnaire about exposures, occupations and exacerbations of asthma. Exposure to high and low molecular weight agents, irritating agents and asthmagens were classified using the asthma-specific job exposure matrix for northern Europe (N-JEM). Severe exacerbation of asthma was defined as sought emergency care at a hospital, admitted to a hospital overnight, or made an urgent visit to a primary care physician or district medical office due to breathing problems during the last 12 months. Moderate exacerbation was defined as both being not severe exacerbation and an additional visit to a primary care physician or district medical office, or had extra treatments with corticosteroid tablets. Mild exacerbation was defined as being neither severe nor moderate exacerbation, and increasing usage of inhaled corticosteroids. Multiple logistic regression was applied to investigate the association between exacerbation of asthma and occupational exposures while adjusting for potential confounders.Approximately 26 % of the working asthmatics reported exacerbation, and more than two-thirds of them had moderate or severe exacerbation. From 23 to 49 % of the asthmatics reported occupational exposure to a variety of different types of agents. Exposure to any gas, smoke or dust (OR 1.7[95 % CI 1.2-2.6]) was associated with severe exacerbation of asthma, as were organic dust (OR 1.7[1.2-2.5]), dampness and mold (OR 1.8[1.2-2.7]), cold conditions (OR 1.7[1.1-2.7]), and a physically strenuous job (OR 1.6[1.03-2.3]). Asthmagens and low molecular weight agents classified by the N-JEM were associated with mild exacerbation, with OR 1.6[1.1-2.5] and OR 2.2[1.1-4.4], respectively.Self-reported exposure to any gas, smoke or dust, organic dust, dampness and mold, cold conditions and physically strenuous work, and jobs handling low molecular weight agents were associated with exacerbation of asthma. Reduction of these occupational exposures may help to reduce exacerbation of asthma.
  • Kim, Jeong-Lim, et al. (författare)
  • Indoor molds, bacteria, microbial volatile organic compounds and plasticizers in schools : associations with asthma and respiratory symptoms in pupils
  • 2007
  • Ingår i: Indoor Air. - : Hindawi Limited. - 0905-6947 .- 1600-0668. ; 17:2, s. 153-163
  • Tidskriftsartikel (refereegranskat)abstract
    • We investigated asthma and atopy in relation to microbial and plasticizer exposure. Pupils in eight primary schools in Uppsala (Sweden) answered a questionnaire, 1014 (68%) participated. Totally, 7.7% reported doctor-diagnosed asthma, 5.9% current asthma, and 12.2% allergy to pollen/pets. Wheeze was reported by 7.8%, 4.5% reported daytime breathlessness, and 2.0% nocturnal breathlessness. Measurements were performed in 23 classrooms (May–June), 74% had <1000 ppm CO2 indoors. None had visible mold growth or dampness. Mean total microbial volatile organic compound (MVOC) concentration was 423 ng/m3 indoors and 123 ng/m3 outdoors. Indoor concentration of TMPD-MIB (2,2,4-trimethyl-1,3-pentanediol monoisobutyrate, Texanol) and TMPD-DIB (2,2,4-trimethyl-1,3-pentanediol diisobutyrate, TXIB), two common plasticizers, were 0.89 and 1.64 μg/m3, respectively. MVOC and plasticizer concentration were correlated (r = 0.5; P < 0.01). Mold concentration was 360 cfu/m3 indoors and 980 cfu/m3 outdoors. At higher indoor concentrations of total MVOC, nocturnal breathlessness (P < 0.01) and doctor-diagnosed asthma (P < 0.05) were more common. Moreover, there were positive associations between nocturnal breathlessness and 3-methylfuran (P < 0.01), 3-methyl-1-butanol (P < 0.05), dimethyldisulfide (P < 0.01), 2-heptanone (P < 0.01), 1-octen-3-ol (P < 0.05), 3-octanone (P < 0.05), TMPD-MIB (P < 0.05), and TMPD-DIB (P < 0.01). TMPD-DIB was positively associated with wheeze (P < 0.05), daytime breathlessness (P < 0.05), doctor-diagnosed asthma (P < 0.05), and current asthma (P < 0.05). In conclusion, exposure to MVOC and plasticizers at school may be a risk factor for asthmatic symptoms in children.
  • Kim, Jeong-Lim, et al. (författare)
  • Predictors of respiratory sickness absence: An international population-based study
  • 2013
  • Ingår i: American Journal of Industrial Medicine. - : Wiley. - 0271-3586 .- 1097-0274. ; 56:5, s. 541-549
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Respiratory tract-related occupational disability is common among adults of working age. We examined occupational vapors, gas, dust, or fume (VGDF) exposure as a predictor of disability, based on respiratory sickness absence among the actively employed, at an early point at which prevention may be most relevant. Methods: Currently employed European Community Respiratory Health Survey II participants (n=6,988) were classified into three mutually exclusive, condition/symptom-based categories: physician-diagnosed asthma, self-reported rhinitis, and wheeze/breathlessness (n=4,772). Logistic regression analysis estimated the odds of respiratory sickness absence (past 12 months) by VGDF exposure. Results: In the condition/symptom groups, 327 (6.9%) reported respiratory sickness absence. Exposure to VGDF was associated with increased odds of respiratory sickness absence: asthma odds ratio [OR] 2.0 (95% confidence interval [CI] 1.1-3.6), wheeze/breathlessness OR 2.2 (95% CI 1.01-4.8); rhinitis OR 1.9 (95% CI 1.02-3.4). Conclusion: One in 15 currently employed with asthma, breathlessness, or rhinitis reported respiratory sickness absence. VGDF exposure doubled the odds of respiratory sickness absence, suggesting a focus for disability prevention. Am. J. Ind. Med. 56:541-549, 2013. © 2013 Wiley Periodicals, Inc.
  • Kim, Jeong-Lim, et al. (författare)
  • Respiratory Health among Korean Pupils in Relation to Home, School and Outdoor Environment
  • 2011
  • Ingår i: Journal of Korean medical science. - : Korean Academy of Medical Sciences. - 1011-8934 .- 1598-6357. ; 26:2, s. 166-173
  • Tidskriftsartikel (refereegranskat)abstract
    • There are few studies about school-environment in relation to pupils' respiratory health, and Korean school-environment has not been characterized. All pupils in 4th grade in 12 selected schools in three urban cities in Korea received a questionnaire (n = 2,453), 96% participated. Gaseous pollutants and ultrafine particles (UFPs) were measured indoors (n = 34) and outdoors (n = 12) during winter, 2004. Indoor dampness at home was investigated by the questionnaire. To evaluate associations between respiratory health and environment, multiple logistic- and multi-level regression models were applied adjusting for potential confounders. The mean age of pupils was 10 yr and 49% were boys. No school had mechanical ventilation and CO2-levels exceeded 1,000 ppm in all except one of the classrooms. The indoor mean concentrations of SO2, NO2, O-3 and formaldehyde were 0.6 mu g/m(3), 19 mu g/m(3), 8 mu g/m(3) and 28 mu g/m(3), respectively. The average level of UFPs was 18,230 pt/cm(3) in the classrooms and 16,480 pt/cm(3) outdoors. There were positive associations between wheeze and outdoor NO2, and between current asthma and outdoor UFPs. With dampness at home, pupils had more wheeze. In conclusion, outdoor UFPs and even low levels of NO2 may adversely contribute to respiratory health in children. High CO2-levels in classrooms and indoor dampness/mold at home should be reduced.
  • Kim, Jeong-Lim, et al. (författare)
  • Respiratory Symptoms and Respiratory-Related Absence from Work among Health Care Workers in Sweden
  • 2013
  • Ingår i: Journal of Asthma. - : Informa UK Limited. - 0277-0903 .- 1532-4303. ; 50:2, s. 174-179
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. To investigate respiratory symptoms and respiratory-related absence from work among Swedish health care workers (HCWs). Methods. From a postal questionnaire study among a general Swedish working population ( n ¼ 12,186), we identified 2156 HCW (555 assistant nurses, 377 nurses, 109 physicians, and 1115 others), including 429 with mainly cleaning tasks (HCW-cleaning). The remaining respondents were classified as non-HCW. Multiple logistic regressions with 95% confidence intervals (CIs) were used to compare respiratory symptoms and respiratory-related absence from work between HCW and non-HCW, adjusting for potential confounders. Results. The prevalence of adult onset asthma was 4.3% in HCW and 3.0% in non-HCW ( p ¼ .003). Asthmatic symptoms during the past year were reported mainly by HCW-cleaning, 14.7%, in comparison to 8.3% among non-HCW ( p < .0001). HCW had an increased odds ratio (OR) for asthmatic symptoms during the past year (OR 1.3, 95% CI (1.1 – 1.5)) and more prominent among assistant nurses (OR 1.5, 95% CI (1.1 – 2.0)) and HCW-cleaning (OR 1.9, 95% CI (1.4 – 2.5)). Respiratory-related absence from work in the past year was reported by 1.4% of non-HCW, 3.0% of HCW-cleaning, 2.9% of nurses, and 1.6% of assistant nurses. Taking smoking and age into account, there was still significantly increased respiratory-related absence from work in nurses (OR 2.0, 95% CI (1.1 – 3.8)) and in HCW-cleaning (OR 2.1, 95% CI (1.2 – 3.7)). Conclusions . HCW in Sweden, especially those with cleaning tasks, reported more respiratory symptoms and respiratory-related absence from work than the general working population. There is a need for longitudinal studies with detailed information on both occupational exposures and socioeconomic factors to explore what influences respiratory-related absence from work among HCW.
  • Kim, Jeong-Lim, et al. (författare)
  • Respiratory symptoms, asthma and allergen levels in schools : comparison between Korea and Sweden
  • 2007
  • Ingår i: Indoor Air. - : Hindawi Limited. - 0905-6947 .- 1600-0668. ; 17:2, s. 122-129
  • Tidskriftsartikel (refereegranskat)abstract
    • We studied reports on respiratory symptoms, asthma and atopic sensitisation in relation to allergen contamination in Korean schools and compared with data from a previous Swedish study performed in eight primary schools. Korean pupils (n = 2365) in 12 primary schools first completed a questionnaire. Then airborne and settled dust were collected from 34 classrooms and analyzed for allergens by ELISA. In both countries, boys reported more symptoms. The prevalence of wheeze was similar, while daytime [odds ratio (OR) = 14.0, 95% confidence interval (CI) = 9.0–21.9] and nocturnal breathlessness (OR = 3.1, 95% CI = 1.5–6.4) were much higher among Korean students. In Korean schools, dog allergen (Can f 1) was the most common followed by mite allergen (Der f 1), while cat (Fel d 1), dog, and horse allergen (Equ cx) were abundant in Sweden. Moreover, CO2 levels were high in most Korean schools (range 907–4113 ppm). There was an association between allergen levels in dust and air samples, and number of pet-keepers in the classrooms. In conclusion, allergen contamination in Korean schools may be an important public issue.
  • Kim, Jeong-Lim, et al. (författare)
  • Trends in the prevalence of asthma, rhinitis, and eczema in 15 year old adolescents over an 8 year period
  • 2014
  • Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111. ; 108:5, s. 701-708
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Trends in prevalence of asthma and allergic diseases are still controversial, and rarely studied among adolescents at midpoint of puberty. Methods: In 2000, a questionnaire was mailed to adolescents (n = 18,158) attending 9th grade at school and living in Vastra Gotaland County, Sweden. Eight years later, the same questionnaire was mailed to adolescents (n = 21,651), using identical inclusion criteria as previously. Altogether, 10,837 adolescents completed the questionnaire in 2000 and 11,754 in 2008. Differences in prevalence of physician diagnosed asthma, asthma symptoms, rhinitis, and eczema between the periods were analyzed by Chi-square test. Multiple logistic regression models were performed to test for trends in prevalence of these diseases, adjusting for potential con-founders. Results: Physician diagnosed asthma and lifetime and current rhinitis were increased in 2008, while wheeze decreased (p < 0.05). Taking sex, foreign descent, body mass index, and parents' education into account, the prevalence of physician diagnosed asthma (OR 1.3 [95% CI 1.2-1.4]) and lifetime (1.7 [1.6-1.8]) and current rhinitis (1.5 [1.4-1.6]) had increased. Eczema had decreased (0.9 [0.8-0.98]). These trends were consistent in boys and girls, but more prominent in those with obesity. In physician diagnosed asthmatics, there was no change in wheeze, asthma symptoms, or asthma medication. Conclusions: The prevalence of physician diagnosed asthma has increased over the last decade, maybe due to combinations of changes in diagnostics and increased general awareness, rather than a real increase. Results showed an increase in rhinitis and a decrease in eczema. Obesity seems to have a modifying effect, which calls for further investigation. (C) 2014 Elsevier Ltd. All rights reserved.
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