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Sökning: WFRF:(Bråbäck Lennart) > Forsberg Bertil

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1.
  • Accordini, S., et al. (författare)
  • A three-generation study on the association of tobacco smoking with asthma
  • 2018
  • Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 47:4, s. 1106-1117
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Mothers' smoking during pregnancy increases asthma risk in their offspring. There is some evidence that grandmothers' smoking may have a similar effect, and biological plausibility that fathers' smoking during adolescence may influence offspring's health through transmittable epigenetic changes in sperm precursor cells. We evaluated the three-generation associations of tobacco smoking with asthma. Methods: Between 2010 and 2013, at the European Community Respiratory Health Survey III clinical interview, 2233 mothers and 1964 fathers from 26 centres reported whether their offspring (aged <= 51 years) had ever had asthma and whether it had coexisted with nasal allergies or not. Mothers and fathers also provided information on their parents' (grandparents) and their own asthma, education and smoking history. Multilevel mediation models within a multicentre three-generation framework were fitted separately within the maternal (4666 offspring) and paternal (4192 offspring) lines. Results: Fathers' smoking before they were 15 [relative risk ratio (RRR) = 1.43, 95% confidence interval (CI): 1.01-2.01] and mothers' smoking during pregnancy (RRR = 1.27, 95% CI: 1.01-1.59) were associated with asthma without nasal allergies in their offspring. Grandmothers' smoking during pregnancy was associated with asthma in their daughters [odds ratio (OR) = 1.55, 95% CI: 1.17-2.06] and with asthma with nasal allergies in their grandchildren within the maternal line (RRR = 1.25, 95% CI: 1.02-1.55). Conclusions: Fathers' smoking during early adolescence and grandmothers' and mothers' smoking during pregnancy may independently increase asthma risk in offspring. Thus, risk factors for asthma should be sought in both parents and before conception.
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2.
  • Accordini, S., et al. (författare)
  • Prenatal and prepubertal exposures to tobacco smoke in men may cause lower lung function in future offspring: a three-generation study using a causal modelling approach
  • 2021
  • Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 58:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Mechanistic research suggests that lifestyle and environmental factors impact respiratory health across generations by epigenetic changes transmitted through male germ cells. Evidence from studies on humans is very limited. We investigated multigeneration causal associations to estimate the causal effects of tobacco smoking on lung function within the paternal line. We analysed data from 383 adult offspring (age 18-47 years; 52.0% female) and their 274 fathers, who had participated in the European Community Respiratory Health Survey (ECRHS)/Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) generation study and had provided valid measures of pre-bronchodilator lung function. Two counterfactual-based, multilevel mediation models were developed with: paternal grandmothers' smoking in pregnancy and fathers' smoking initiation in prepuberty as exposures; fathers' forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), or FEV1/FVC z-scores as potential mediators (proxies of unobserved biological mechanisms that are true mediators); and offspring's FEV1 and FVC, or FEV1/FVC z-scores as outcomes. All effects were summarised as differences (Delta) in expected z-scores related to fathers' and grandmothers' smoking history. Fathers' smoking initiation in prepuberty had a negative direct effect on both offspring's FEV1 (Delta z-score -0.36, 95% CI -0.63--0.10) and FVC (-0.50, 95% CI -0.80--0.20) compared with fathers' never smoking. Paternal grandmothers' smoking in pregnancy had a negative direct effect on fathers' FEV1/FVC -0.57, 95% CI -1.09--0.05) and a negative indirect effect on offspring's FEV1/FVC (-0.12, 95% CI -0.21--0.03) compared with grandmothers' not smoking before fathers' birth nor during fathers' childhood. Fathers' smoking in prepuberty and paternal grandmothers' smoking in pregnancy may cause lower lung function in offspring. Our results support the concept that lifestyle-related exposures during these susceptibility periods influence the health of future generations.
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3.
  • Bråbäck, Lennart, et al. (författare)
  • Childhood asthma and smoking exposures before conception - a three-generational cohort study.
  • 2018
  • Ingår i: Pediatric Allergy and Immunology. - : Wiley. - 0905-6157 .- 1399-3038. ; 29:4, s. 361-368
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Some human and animal studies have recently shown that maternal grandmother's smoking during pregnancy increases the risk of asthma in the grandchildren. We have investigated whether sex of the exposed parent and/or grandchild modifies the association between grandmaternal smoking and grandchild asthma.METHODS: We formed a cohort study based on linkage of national registries with prospectively collected data over three generations. Smoking habits in early pregnancy were registered since 1982 and purchases of prescribed medication since 2005. In all, 10329 children born since 2005 had information on maternal and grandmaternal smoking on both sides and were followed from birth up to 6 years of age. Ages when medication was purchased were used to classify the cohort into never, early transient (0-3 years), early persistent (0-3 and 4-6 years) and late-onset (4-6 years) phenotypes of childhood asthma.RESULTS: Maternal grandmother's smoking was associated with an increased odds of early persistent asthma after adjustment for maternal smoking and other confounders (odds ratio 1.29, 95% confidence interval 1.10-1.51). Grandchild sex did not modify the association. Paternal grandmother's smoking was not associated with any of the asthma phenotypes.CONCLUSION: Maternal but not paternal exposure to nicotine before conception was related to an increased risk of early persistent childhood asthma, but not other asthma phenotypes. Our findings are possibly consistent with a sex specific mode of epigenetic transfer. 
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4.
  • Bråbäck, Lennart, et al. (författare)
  • Does traffic exhaust contribute to the development of asthma and allergic sensitization in children : findings from recent cohort studies.
  • 2009
  • Ingår i: Environmental Health. - 1476-069X. ; 8:17, s. 1-11
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this review was to assess the evidence from recent prospective studies that long-term traffic pollution could contribute to the development of asthma-like symptoms and allergic sensitization in children. We have reviewed cohort studies published since 2002 and found in PubMed in Oct 2008. In all, 13 papers based on data from 9 cohorts have evaluated the relationship between traffic exposure and respiratory health. All surveys reported associations with at least some of the studied respiratory symptoms. The outcome varied, however, according to the age of the child. Nevertheless, the consistency in the results indicates that traffic exhaust contributes to the development of respiratory symptoms in healthy children. Potential effects of traffic exhaust on the development of allergic sensitization were only assessed in the four European birth cohorts. Long-term exposure to outdoor air pollutants had no association with sensitization in ten-year-old schoolchildren in Norway. In contrast, German, Dutch and Swedish preschool children had an increased risk of sensitization related to traffic exhaust despite fairly similar levels of outdoor air pollution as in Norway. Traffic-related effects on sensitization could be restricted to individuals with a specific genetic polymorphism. Assessment of gene-environment interactions on sensitization has so far only been carried out in a subgroup of the Swedish birth cohort. Further genetic association studies are required and may identify individuals vulnerable to adverse effects from traffic-related pollutants. Future studies should also evaluate effects of traffic exhaust on the development and long term outcome of different phenotypes of asthma and wheezing symptoms.
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7.
  • Dratva, Julia, et al. (författare)
  • Validation of self-reported figural drawing scales against anthropometric measurements in adults
  • 2016
  • Ingår i: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 19:11, s. 1944-1951
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim of the present study was to validate figural drawing scales depicting extremely lean to extremely obese subjects to obtain proxies for BMI and waist circumference in postal surveys.Design: Reported figural scales and anthropometric data from a large population-based postal survey were validated with measured anthropometric data from the same individuals by means of receiver-operating characteristic curves and a BMI prediction model.Setting: Adult participants in a Scandinavian cohort study first recruited in 1990 and followed up twice since.Subjects: Individuals aged 38-66 years with complete data for BMI (n 1580) and waist circumference (n 1017).Results: Median BMI and waist circumference increased exponentially with increasing figural scales. Receiver-operating characteristic curve analyses showed a high predictive ability to identify individuals with BMI > 25.0 kg/m(2) in both sexes. The optimal figural scales for identifying overweight or obese individuals with a correct detection rate were 4 and 5 in women, and 5 and 6 in men, respectively. The prediction model explained 74% of the variance among women and 62% among men. Predicted BMI differed only marginally from objectively measured BMI.Conclusions: Figural drawing scales explained a large part of the anthropometric variance in this population and showed a high predictive ability for identifying overweight/obese subjects. These figural scales can be used with confidence as proxies of BMI and waist circumference in settings where objective measures are not feasible.
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8.
  • Forsberg, Bertil, et al. (författare)
  • An expert assessment on climate change and health : with a European focus on lungs and allergies
  • 2012
  • Ingår i: Environmental Health. - 1476-069X. ; 11:Supplement 1, s. S4-
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundFor almost 20 years, the Intergovernmental Panel on Climate Change has been assessing the potential health risks associated with climate change; with increasingly convincing evidence that climate change presents existing impacts on human health. In industrialized countries climate change may further affect public health and in particular respiratory health, through existing health stressors, including, anticipated increased number of deaths and acute morbidity due to heat waves; increased frequency of cardiopulmonary events due to higher concentrations of air pollutants; and altered spatial and temporal distribution of allergens and some infectious disease vectors. Additionally exposure to moulds and contaminants from water damaged buildings may increase.MethodsWe undertook an expert elicitation amongst European researchers engaged in environmental medicine or respiratory health. All experts were actively publishing researchers on lung disease and air pollution, climate and health or a closely related research. We conducted an online questionnaire on proposed causal diagrams and determined levels of confidence that climate change will have an impact on a series of stressors. In a workshop following the online questionnaire, half of the experts further discussed the results and reasons for differences in assessments of the state of knowledge on exposures and health effects.ResultsOut of 16 experts, 100% expressed high to very high confidence that climate change would increase the frequency of heat waves. At least half expressed high or very high confidence that climate change would increase levels of pollen (50%), particulate matter (PM2.5) (55%), and ozone (70%). While clarity is needed around the impacts of increased exposures to health impacts of some stressors, including ozone and particulate matter levels, it was noted that definitive knowledge is not a prerequisite for policy action. Information to the public, preventive measures, monitoring and warning systems were among the most commonly mentioned preventative actions.ConclusionsThis group of experts identifies clear health risks associated with climate change, and express opinions about these risks even while they do not necessarily regard themselves as covering all areas of expertise. Since some changes in exposure have already been observed, the consensus is that there is already a scientific basis for preventative action, and that the associated adaptation and mitigation policies should also be evidence based.
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9.
  • Forsell, Karl, et al. (författare)
  • Miljöhälsorapport barn i norr 2021 : Barns hälsa och miljö i norra Sverige
  • 2021
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Denna rapport behandlar barns hälsa och miljöi Sveriges fyra nordligaste län, och baserasfrämst på nationella barnmiljöhälsoenkäter,särskilt den senaste från 2019. Dessa enkätundersökningarom tre åldersgrupper ger en bildav hur de som svarat upplevt barnens miljöochhälsoförhållanden, men har inte syftet attvetenskapligt fastställa samband mellan orsakoch verkan. Därför beskrivs enkätresultaten iljuset av bredare kunskaper, främst från forskningoch objektiva mätningar. Resultaten gerockså en viktig signal om hur läget och trendernaär i förhållandet till olika mål som berörmiljö och hälsa. De globala målen för hållbarutveckling som är grunden för Agenda 2030inrymmer i många fall de svenska miljö- ochfolkhälsomålen.Andelen barn i norra Sverige som rapporteratsha astma och/eller allergisk snuva har ökatfrån enkäten 2011 till enkäten 2019, och i denäldsta åldersgruppen (12-åringar) uppges astmavanligare i norra Sverige än i resten av landet.För besvär som upplevs bero på problem i inomhusmiljönses inga tydliga skillnader varkensedan förra enkäten eller mellan norra Sverigeoch övriga delar av landet. Trots att en ganskastor andel rapporterar att de har fuktskador ibostaden, så är det få som uppger att miljöni bostaden leder till besvär. Bland 12-åringarnaanges skolmiljön mer ofta orsaka besvär.Enligt enkäten utsätts nu endast cirka 1 % avbarnen för miljötobaksrök i bostaden, vilketkan jämföras med att drygt 6 % av de gravida inorra Sverige 2003 rökte under graviditeten .Var tionde tolvåring i norra Sverige lyssnardagligen på musik i hörlurar med hög volym.Fyra procent uppges ha tinnitus. Vidare uppgervar femte tolvåring att de blir mycket störda avljud när de är i skolan. I samma grupp har 12% svårt att somna på grund av trafikbuller.Luftkvaliteten utanför bostaden upplevs avsvarande från norra Sverige vara bättre jämförtmed övriga landet och skillnaden tycks haökat mellan 2011 och 2019. En lägre andel avtolvåringarna besväras ofta eller ibland av luktfrån bilavgaser i norra Sverige jämfört med iövriga landet, däremot förekommer hos en högreandel av barnen i norra Sverige vedeldningi bostaden. Andelen med vedeldande grannarhar dock tydligt minskat sedan 2011.Att ha sitt dricksvatten från egen brunn ärvanligast i Jämtland, övriga län ligger närmarelandet i övrigt. Samtidigt är andelen som testatsitt vatten från egen brunn lägst i Jämtland. Avde som testat uppgav dock ingen att vattnetbedömts otjänligt. Enkäten efterfrågade dockinte vad som testats, det är exempelvis oklartom testerna omfattat även arsenik och radon.Enligt enkäten uppnår knappt 40 % av barneni norra Sverige Livsmedelsverkets rekommenderadeintag av fisk (2-3 ggr/vecka). Närdet gäller fisk med risk för högt innehåll avmiljögifter så var det ovanligt med ett högreintag än Livsmedelsverkets rekommenderademaxintag.Rapporten berör utöver vad som ovannämnts ytterligare några områden av betydelse,t ex fysisk aktivitet och solskydd. Dendiskuterar också möjligheter till förbättringarav miljö-hälsosituationen i norra Sverige, ochutgör därmed ett underlag till det lokala ochregionala förändringsarbetet . Satsningar för attfå ner rökvanor i befolkningen är ett slåendeexempel på att man inom relativt kort tid kanfå effekter – och att miljöhälsoenkäter är ettbra verktyg för att följa ett förändringsarbete.Nästa enkät om barns hälsa och miljö i norraSverige beräknas genomföras 2027.
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10.
  • Kuiper, I. N., et al. (författare)
  • Associations of Preconception Exposure to Air Pollution and Greenness with Offspring Asthma and Hay Fever
  • 2020
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 17:16
  • Tidskriftsartikel (refereegranskat)abstract
    • We investigated if greenness and air pollution exposure in parents' childhood affect offspring asthma and hay fever, and if effects were mediated through parental asthma, pregnancy greenness/pollution exposure, and offspring exposure. We analysed 1106 parents with 1949 offspring (mean age 35 and 6) from the Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) generation study. Mean particulate matter (PM(2.5)and PM10), nitrogen dioxide (NO2), black carbon (BC), ozone (O-3) (mu g/m(3)) and greenness (normalized difference vegetation index (NDVI)) were calculated for parents 0-18 years old and offspring 0-10 years old, and were categorised in tertiles. We performed logistic regression and mediation analyses for two-pollutant models (clustered by family and centre, stratified by parental lines, and adjusted for grandparental asthma and education). Maternal medium PM(2.5)and PM(10)exposure was associated with higher offspring asthma risk (odds ratio (OR) 2.23, 95%CI 1.32-3.78, OR 2.27, 95%CI 1.36-3.80), and paternal high BC exposure with lower asthma risk (OR 0.31, 95%CI 0.11-0.87). Hay fever risk increased for offspring of fathers with medium O(3)exposure (OR 4.15, 95%CI 1.28-13.50) and mothers with high PM(10)exposure (OR 2.66, 95%CI 1.19-5.91). The effect of maternal PM(10)exposure on offspring asthma was direct, while for hay fever, it was mediated through exposures in pregnancy and offspring's own exposures. Paternal O(3)exposure had a direct effect on offspring hay fever. To conclude, parental exposure to air pollution appears to influence the risk of asthma and allergies in future offspring.
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