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  • Kokelj, Spela, 1992, et al. (författare)
  • Intra-individual variation of particles in exhaled air and of the contents of Surfactant protein A and albumin
  • 2020
  • Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:1
  • Tidskriftsartikel (refereegranskat)abstract
    • © 2020 Kokelj et al. Introduction Particles in exhaled air (PEx) provide samples of respiratory tract lining fluid from small airways containing, for example, Surfactant protein A (SP-A) and albumin, potential biomarkers of small airway disease. We hypothesized that there are differences between morning, noon, and afternoon measurements and that the variability of repeated measurements is larger between days than within days. Methods PEx was obtained in sixteen healthy non-smoking adults on 11 occasions, within one day and between days. SP-A and albumin were quantified by ELISA. The coefficient of repeatability (CR), intraclass correlation coefficient (ICC), and coefficient of variation (CV) were used to assess the variation of repeated measurements. Results SP-A and albumin increased significantly from morning towards the noon and afternoon by 13% and 25% on average, respectively, whereas PEx number concentration and particle mean mass did not differ significantly between the morning, noon and afternoon. Betweenday CRs were not larger than within-day CRs. Conclusions Time of the day influences the contents of SP-A and albumin in exhaled particles. The variation of repeated measurements was rather high but was not influenced by the time intervals between measurements.
  • Ljungkvist, Göran, 1949, et al. (författare)
  • Exploring a new method for the assessment of metal exposure by analysis of exhaled breath of welders
  • 2022
  • Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 95:6, s. 1255-1265
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose Air monitoring has been the accepted exposure assessment of toxic metals from, e.g., welding, but a method characterizing the actual dose delivered to the lungs would be preferable. Sampling of particles in exhaled breath can be used for the biomonitoring of both endogenous biomarkers and markers of exposure. We have explored a new method for the sampling of metals in exhaled breath from the small airways in a study on welders. Methods Our method for particle sampling, Particles in Exhaled Air (PExA (R)), is based on particle counting and inertial impaction. We applied it on 19 stainless steel welders before and after a workday. In parallel, air monitoring of chromium, manganese and nickel was performed as well as blood sampling after work. Results Despite substantial exposure to welding fumes, we were unable to show any significant change in the metal content of exhaled particles after, compared with before, exposure. However, the significance might be obscured by a substantial analytical background noise, due to metal background in the sampling media and possible contamination during sampling, as an increase in the median metal contents were indicated. Conclusions If efforts to reduce background and contamination are successful, the PExA (R) method could be an important tool in the investigations of metals in exhaled breath, as the method collects particles from the small airways in contrast to other methods. In this paper, we discuss the discrepancy between our findings and results from studies, using the exhaled breath condensate (EBC) methodology.
  • Ljungqvist, Göran, et al. (författare)
  • Lipid composition of particles in exhaled air (PEx) from workers exposed to welding fumes
  • 2016
  • Ingår i: The European respiratory journal. Vol. 48, Suppl 60. PA385. - 0904-1850.
  • Konferensbidrag (refereegranskat)abstract
    • More than two million workers are exposed to pneumotoxic welding aerosols and there is a need for biomarkers of effects on the respiratory system. The lipid composition of the respiratory tract lining fluid (RTLF) is such a potential marker. The most abundant pulmonary surfactant phospholipid is dipalmitoylphosphocholine (DPPC). It is specific for the airways, while palmitoyloleoylphosphatidylcholine (POPC) is a common lipid in tissues and body fluids. We hypothesize that the amounts of or ratio between DPPC and DOPC are changed due to short term and/or long term exposure to welding fumes. We have developed a method for the collection of PEx, based on counting of the exhaled particles and subsequent collection by impaction on a teflon membrane. We have also developed a method for analysis of lipids in PEx based on LC/MS. We measured the exposure to iron, manganese, chromium and nickel of 18 stainless steel welders and also analyzed DPPC and DOPC in PEx samples taken at the end of the exposure measurement day. The welders working history was also recoded and summarized as welding years. Spirometry and nitrogen multiple breath wash out were also measured but the results are not yet evaluated. There were no significant correlations between the short term exposure to either iron, manganese, chromium or nickel and the fraction of DPPC in PEx or the ratio DPPC/DOPC. However, there was a tendency of correlation (Spearman correlation coefficient= 0.407 with p-value 0.09) between welding years and the DPPC/DOPC ratio. In this pilot study we could not establish short term effects of welding exposure on the RTFL lipid composition but a tendency of change due the long time exposure.
  • Ludvigsson, Jonas F, et al. (författare)
  • External review and validation of the Swedish national inpatient register.
  • 2011
  • Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 11, s. 450-
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The Swedish National Inpatient Register (IPR), also called the Hospital Discharge Register, is a principal source of data for numerous research projects. The IPR is part of the National Patient Register. The Swedish IPR was launched in 1964 (psychiatric diagnoses from 1973) but complete coverage did not begin until 1987. Currently, more than 99% of all somatic (including surgery) and psychiatric hospital discharges are registered in the IPR. A previous validation of the IPR by the National Board of Health and Welfare showed that 85-95% of all diagnoses in the IPR are valid. The current paper describes the history, structure, coverage and quality of the Swedish IPR. METHODS AND RESULTS: In January 2010, we searched the medical databases, Medline and HighWire, using the search algorithm "validat* (inpatient or hospital discharge) Sweden". We also contacted 218 members of the Swedish Society of Epidemiology and an additional 201 medical researchers to identify papers that had validated the IPR. In total, 132 papers were reviewed. The positive predictive value (PPV) was found to differ between diagnoses in the IPR, but is generally 85-95%. CONCLUSIONS: In conclusion, the validity of the Swedish IPR is high for many but not all diagnoses. The long follow-up makes the register particularly suitable for large-scale population-based research, but for certain research areas the use of other health registers, such as the Swedish Cancer Register, may be more suitable.
  • Moitra, Subhabrata, et al. (författare)
  • Effect of asthma on the development of obesity among adults : Results of the European Community Respiratory Health Survey (ECRHS)
  • 2018
  • Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction: Obesity has been associated with asthma, however the reverse relation has recently been observed among children.Objective: To investigate whether asthma contributes to obesity incidence in adults.Methods: The ECRHS is a cohort study with two follow-ups around, 10-years (ECRHS-II) and 20-years (ECRHS-III) after enrolment. Participants with obesity (BMI>30kg/m2) at baseline were excluded (n=957), leaving 8618 non-obese subjects who participated in at least one follow-up. Asthmatics were described if the subjects reported ever having asthma and had an asthma attack or woke up by an attack of shortness of breath in last 12 months or on current asthma medication. We evaluated the association between: (1) asthma at baseline (ECRHS-I) and obesity at ECRHS-II; and (2) newly reported asthma at ECRHS-II and obesity at ECRHS-III.Results: 10.2% of asthmatics at baseline developed obesity after 10 years compared to 7.7% of non-asthmatics (Age, sex & country-adjusted relative risk: 1.26; 95% confidence interval: 1.03-1.55). Further adjustment for BMI at baseline slightly reduced this risk (RR:1.2; 95%CI: 1.0-1.4). Obesity risk was highest for those developing asthma in adulthood (RR:1.37; 95%CI: 1.01-1.86) compared to those with childhood onset asthma (RR: 1.13; 95%CI: 0.83-1.53). Asthmatics who were non-atopic at baseline had a higher risk of developing obesity at 1st follow up (RR: 1.47; 95%CI: 1.15-1.86). Similar trend was observed in newly reported asthmatics in ECRHS-II and increased obesity risk at the final follow up ECRHS-III (RR: 1.22; 95%CI: 0.86-1.73).Conclusion: These results suggest that asthmatics are at a higher risk of developing obesity.
  • Murgia, Nicola, et al. (författare)
  • Risk factors for respiratory work disability in a cohort of pulp mill workers exposed to irritant gases.
  • 2011
  • Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11:1
  • Tidskriftsartikel (refereegranskat)abstract
    • ABSTRACT: BACKGROUND: The association between chronic respiratory diseases and work disability has been demonstrated a number of times over the past 20 years, but still little is known about work disability in occupational cohorts of workers exposed to respiratory irritants. This study investigated job or task changes due to respiratory problems as an indicator of work disability in pulp mill workers occupationally exposed to irritants. METHODS: Data about respiratory symptoms and disease diagnoses, socio-demographic variables, occupational exposures, gassing episodes, and reported work changes due to respiratory problems were collected using a questionnaire answered by 3226 pulp mill workers. Information about work history and departments was obtained from personnel files. Incidence and hazard ratios for respiratory work disability were calculated with 95% confidence intervals (CI). RESULTS: The incidence of respiratory work disability among these pulp mill workers was 1.6/1000 person-years. The hazard ratios for respiratory work disability were increased for workers reporting gassings (HR 5.3, 95% CI 2.7-10.5) and for those reporting physician-diagnosed asthma, chronic bronchitis, and chronic rhinitis, when analyzed in the same model. CONCLUSIONS: This cohort study of pulp mill workers found that irritant peak exposure during gassing episodes was a strong predictor of changing work due to respiratory problems, even after adjustment for asthma, chronic bronchitis, and chronic rhinitis.
  • Persson Waye, Kerstin, 1959, et al. (författare)
  • Acoustic intervention at preschools impact on children´s perception and response to high frequency sound qualities
  • 2016
  • Ingår i: Proceedings of the 22nd International Congress on Acoustics, Buenos Aires, ICA 2016, 5 to 9 September, 2016. - 2415-1599. - 9789872471361
  • Konferensbidrag (refereegranskat)abstract
    • At pre-schools personnel and children are known to be exposed to high sound levels. Tiredness and sound fatigue among the personnel are reported, while less is known about how children are affected. A previously developed interview protocol (INCH) was used to study the effect of an acoustic intervention at seven preschools. Before, 61 children aged 4-6 yrs were interviewed and 59 after. A reduction of the sound level in a range between 1 to 3 dB LpAeq was measured using stationary noise levels meters. The results were analysed using Generalised Estimating Equations accounting for repeated measure of the intervention. The results showed that a change in noise levels in the dining/activity room positively impacted on children’s perception of scraping and screeching sounds, frequency of reported tummy ache, and frequency of children reporting the teacher to speak with a raised voice. Perception of scraping sound per se, also impacted on angry reactions to scraping sounds, and children’s reporting on teachers speaking with raised voice. Although the intervention affected the noise levels only marginally, it seems to have influenced sound quality aspects related to the higher frequencies in the sound. The results are especially interesting given the new knowledge of children’s hearing.
  • Shrine, N, et al. (författare)
  • Multi-ancestry genome-wide association analyses improve resolution of genes and pathways influencing lung function and chronic obstructive pulmonary disease risk
  • 2023
  • Ingår i: Nature genetics. - : Springer Science and Business Media LLC. - 1546-1718 .- 1061-4036. ; 55:3, s. 410-
  • Tidskriftsartikel (refereegranskat)abstract
    • Lung-function impairment underlies chronic obstructive pulmonary disease (COPD) and predicts mortality. In the largest multi-ancestry genome-wide association meta-analysis of lung function to date, comprising 580,869 participants, we identified 1,020 independent association signals implicating 559 genes supported by ≥2 criteria from a systematic variant-to-gene mapping framework. These genes were enriched in 29 pathways. Individual variants showed heterogeneity across ancestries, age and smoking groups, and collectively as a genetic risk score showed strong association with COPD across ancestry groups. We undertook phenome-wide association studies for selected associated variants as well as trait and pathway-specific genetic risk scores to infer possible consequences of intervening in pathways underlying lung function. We highlight new putative causal variants, genes, proteins and pathways, including those targeted by existing drugs. These findings bring us closer to understanding the mechanisms underlying lung function and COPD, and should inform functional genomics experiments and potentially future COPD therapies.
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