| 1. |
- Andersson, Tommy, 1970-, et al.
(författare)
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Patients without comorbidities at the time of diagnosis of atrial fibrillation : causes of death during long-term follow-up compared to matched controls
- 2017
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Ingår i: Clinical Cardiology. - : John Wiley & Sons. - 0160-9289 .- 1932-8737. ; 40:11, s. 1076-1082
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Little is known about the long-term, cause-specific mortality risk in patients without comorbidities at the time of diagnosis of atrial fibrillation (AF).METHODS: From a nation-wide registry of patients hospitalized with incident AF between 1995 and 2008 we identified 9 519 patients with a first diagnosed AF and no comorbidities at the time of AF diagnosis. They were matched with 12 468 controls. The follow-up continued until December 2008. Causes of death were classified according to the ICD-10 codes.RESULTS: During follow-up, 11.1% of patients with AF and 8.3% of controls died. Cardiovascular diseases were the most common causes of death and the only diagnoses which showed significantly higher relative risk in patients with AF than controls (HR 2.0, 95% CI 1.8-2.3), and the relative risk was significantly higher in women than in men. Stroke was a more common cause among patients with AF, 13.1% versus 9.7% (HR 2.7, 95% CI 1.8-4.0), while cerebral hemorrhage was more common among controls, 4.7% versus 10.2% (HR 0.9, 95% CI 0.6-1.5). The time from AF diagnosis to death was 6.0 ± 3.1 years.CONCLUSIONS: In patients with incident AF and no known comorbidities at the time of AF diagnosis, only cardiovascular diseases were more often causes of death as compared to controls. Women carried a significantly higher relative risk than men.
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| 2. |
- Löfstedt, Håkan, 1963-, et al.
(författare)
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Respiratory symptoms and lung function in relation to wood dust and monoterpene exposure in the wood pellet industry
- 2017
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Ingår i: Upsala Journal of Medical Sciences. - : Taylor & Francis. - 0300-9734 .- 2000-1967. ; 122:2, s. 78-84
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Wood pellets are used as a source of renewable energy for heating purposes. Common exposures are wood dust and monoterpenes, which are known to be hazardous for the airways. The purpose of this study was to study the effect of occupational exposure on respiratory health in wood pellet workers.MATERIALS AND METHODS: Thirty-nine men working with wood pellet production at six plants were investigated with a questionnaire, medical examination, allergy screening, spirometry, and nasal peak expiratory flow (nasal PEF). Exposure to wood dust and monoterpenes was measured.RESULTS: The wood pellet workers reported a higher frequency of nasal symptoms, dry cough, and asthma medication compared to controls from the general population. There were no differences in nasal PEF between work and leisure time. A lower lung function than expected (vital capacity [VC], 95%; forced vital capacity in 1 second [FEV1], 96% of predicted) was noted, but no changes were noted during shifts. There was no correlation between lung function and years working in pellet production. Personal measurements of wood dust at work showed high concentrations (0.16-19 mg/m(3)), and exposure peaks when performing certain work tasks. Levels of monoterpenes were low (0.64-28 mg/m(3)). There was no association between exposure and acute lung function effects.CONCLUSIONS: In this study of wood pellet workers, high levels of wood dust were observed, and that may have influenced the airways negatively as the study group reported upper airway symptoms and dry cough more frequently than expected. The wood pellet workers had both a lower VC and FEV1 than expected. No cross-shift changes were found.
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| 3. |
- Papakokkinou, Eleni, et al.
(författare)
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Excess Morbidity Persists in Patients With Cushing’s Disease During Long-term Remission : A Swedish Nationwide Study
- 2020
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - Washington : Oxford University Press. - 0021-972X .- 1945-7197. ; 105:8, s. 2616-2624
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Tidskriftsartikel (refereegranskat)abstract
- Context: Whether multisystem morbidity in Cushing's disease (CD) remains elevated during long-term remission is still undetermined.Objective: To investigate comorbidities in patients with CD.Design, setting, and patients: A retrospective, nationwide study of patients with CD identified in the Swedish National Patient Register between 1987 and 2013. Individual medical records were reviewed to verify diagnosis and remission status.Main outcomes: Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were calculated by using the Swedish general population as reference. Comorbidities were investigated during three different time periods: (i) during the 3 years before diagnosis, (ii) from diagnosis to 1 year after remission, and (iii) during long-term remission.Results: We included 502 patients with confirmed CD, of whom 419 were in remission for a median of 10 (interquartile range 4 to 21) years. SIRs (95% CI) for myocardial infarction (4.4; 1.2 to 11.4), fractures (4.9; 2.7 to 8.3), and deep vein thrombosis (13.8; 3.8 to 35.3) were increased during the 3-year period before diagnosis. From diagnosis until 1 year after remission, SIRs (95% CI were increased for thromboembolism (18.3; 7.9 to 36.0), stroke (4.9; 1.3 to 12.5), and sepsis (13.6; 3.7 to 34.8). SIRs for thromboembolism (4.9; 2.6 to 8.4), stroke (3.1; 1.8 to 4.9), and sepsis (6.0; 3.1 to 10.6) remained increased during long-term remission.Conclusion: Patients with CD have an increased incidence of stroke, thromboembolism, and sepsis even after remission, emphasizing the importance of early identification and management of risk factors for these comorbidities during long-term follow-up.
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| 4. |
- Ragnarsson, Oskar, 1971, et al.
(författare)
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Overall and Disease-Specific Mortality in Patients With Cushing Disease: A Swedish Nationwide Study
- 2019
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : ENDOCRINE SOC. - 0021-972X .- 1945-7197. ; 104:6, s. 2375-2384
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Tidskriftsartikel (refereegranskat)abstract
- Context: Whether patients with Cushing disease (CD) in remission have increased mortality is still debatable. Objective: To study overall and disease-specific mortality and predictive factors in an unselected nationwide cohort of patients with CD. Design, Patients, and Methods: A retrospective study of patients diagnosed with CD, identified in the Swedish National Patient Registry between 1987 and 2013. Medical records were systematically reviewed to verify the diagnosis. Standardized mortality ratios (SMRs) with 95% CIs were calculated and Cox regression models were used to identify predictors of mortality. Results: Of 502 identified patients with CD (n = 387 women; 77%), 419 (83%) were confirmed to be in remission. Mean age at diagnosis was 43 (SD, 16) years and median follow-up was 13 (interquartile range, 6 to 23) years. The observed number of deaths was 133 vs 54 expected, resulting in an overall SMR of 2.5 (95% CI, 2.1 to 2.9). The commonest cause of death was cardiovascular diseases (SMR, 3.3; 95% CI, 2.6 to 4.3). Excess mortality was also found associated with infections and suicide. For patients in remission, the SMR was 1.9 (95% CI, 1.5 to 2.3); bilateral adrenalectomy and glucocorticoid replacement therapy were independently associated with increased mortality, whereas GH replacement was associated with improved outcome. Conclusion: Findings from this large nationwide study indicate that patients with CD have excess mortality. The findings illustrate the importance of achieving remission and continued active surveillance, along with adequate hormone replacement and evaluation of cardiovascular risk and mental health.
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| 5. |
- Ragnarsson, Oskar, 1971, et al.
(författare)
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The incidence of Cushing’s disease : a nationwide Swedish study
- 2019
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Ingår i: Pituitary. - : Springer. - 1386-341X .- 1573-7403. ; 22:2, s. 179-186
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies on the incidence of Cushing’s disease (CD) are few and usually limited by a small number of patients. The aim of this study was to assess the annual incidence in a nationwide cohort of patients with presumed CD in Sweden.Methods: Patients registered with a diagnostic code for Cushing’s syndrome (CS) or CD, between 1987 and 2013 were identified in the Swedish National Patient Registry. The CD diagnosis was validated by reviewing clinical, biochemical, imaging, and histopathological data.Results: Of 1317 patients identified, 534 (41%) had confirmed CD. One-hundred-and-fifty-six (12%) patients had other forms of CS, 41 (3%) had probable but unconfirmed CD, and 334 (25%) had diagnoses unrelated to CS. The mean (95% confidence interval) annual incidence between 1987 and 2013 of confirmed CD was 1.6 (1.4–1.8) cases per million. 1987–1995, 1996–2004, and 2005–2013, the mean annual incidence was 1.5 (1.1–1.8), 1.4 (1.0–1.7) and 2.0 (1.7–2.3) cases per million, respectively. During the last time period the incidence was higher than during the first and second time periods (P < 0.05).Conclusion: The incidence of CD in Sweden (1.6 cases per million) is in agreement with most previous reports. A higher incidence between 2005 and 2013 compared to 1987–2004 was noticed. Whether this reflects a truly increased incidence of the disease, or simply an increased awareness, earlier recognition, and earlier diagnosis can, however, not be answered. This study also illustrates the importance of validation of the diagnosis of CD in epidemiological research.
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| 6. |
- Saers, Johannes, 1975-, et al.
(författare)
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Occupational Dust Exposure as a Risk Factor for Developing Lung Function Impairment
- 2024
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Ingår i: Journal of Occupational and Environmental Medicine. - : Lippincott Williams & Wilkins. - 1076-2752 .- 1536-5948. ; 66:3, s. e93-e98
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Dust exposure is high in several industries. We investigated associations of exposure in paper mills, wood pellet plants and iron foundries with lung function impairment.METHODS: Respirable silica, inhalable paper dust or inhalable wood dust were collected in personal samples and spirometry was performed. Multiple linear regression analyzed associations with FEV1%pred and FVC%pred.RESULTS: Wood pellet workers with high exposure to inhalable dust had lower FEV1%pred (95%CI) (-9.4(-16,-2.6)) and FVC%pred (-9.8(-15,-4.0)) compared with lowest exposure level. Workers at paper mills and foundries had no dose-dependent association but lower FEV1%pred and FVC%pred than in workers at wood pellets plants.CONCLUSIONS: Increased exposure to inhalable wood dust is associated with decreased lung function. Foundry and paper mill workers have generally lower lung function than wood pellet workers. Spirometry should be considered in workers in industries with airborne particulate matter pollution.
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| 7. |
- Svartengren, Magnus, et al.
(författare)
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Cancer Incidence Among Hardmetal Production Workers : The Swedish Cohort
- 2017
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Ingår i: Journal of Occupational and Environmental Medicine. - Philadelphia, USA : Lippincott Williams & Wilkins. - 1076-2752 .- 1536-5948. ; 59:12, s. e365-e373
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Tidskriftsartikel (refereegranskat)abstract
- The cancer incidence was determined for 3713 workers from three plants from 1958 to 2011. The exposure measures were ever/never exposed, duration, cumulative, and mean cobalt concentrations.The incidence of all malignant neoplasms was increased at one plant, but standardized incidence ratio (SIR) was 0.96 for all workers. Lung cancer incidence was increased for all workers, SIR 1.38 (1.01 to 1.85). The lung cancer incidence was associated with shorter employment time and showed no exposure-response. There was decreased incidence for skin cancer. Increased lip cancer incidence found at one of the production plants might be related to diagnostic intensity.Lung cancer incidence showed no correlation to cobalt exposure based on internal comparison. The increased SIR for all workers might be associated with other factors.
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| 8. |
- Warg, Lars-Erik, et al.
(författare)
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Christian Denominations in Central Sweden: sick leave, work enviornment and ill-health
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Results in research and statistics in Sweden strongly suggest that the work environment in christian churches could be improved. Fuzzy leadership, in-built structural conflicts and inadequate internal communication are apparent. This study takes its departure from this and examines the work environment in four different christian denominations in central Sweden. The specific aim is to study the reasons behind long term sick leave in order to provide preventive measures to avoid ill-health. The study will be conducted in three phases. In Phase I, data from Statistics Sweden will be compared to information from self-administered questionnares. In Phase II, a questionnaire on psychosocial work environment and health will be distributed to all those employed in the four denominations. In Phase III, interviews with church staff, politicians, trade unions and health workers will be conducted. By integrating all the data, ways to improve the work environment for those employed will be presented.
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| 9. |
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| 10. |
- Warg, Lars-Erik, et al.
(författare)
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”KYRKAN ÄR NOG EN LITE SPECIELL ARBETSPLATS” Arbetsmiljö, ohälsa, sjukskrivning i fyra kristna samfund : Slutrapport till AFA Försäkring angående projektet ”Religiösa samfund i DUSTLänen:Sjukfrånvaro, arbetsmiljö och ohälsa”, mars 2013. Dnr 100020
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Rapporten redovisar material från empiriska undersökningar med fokus påarbetsmiljön inom fyra kristna samfund, Svenska kyrkan, Svenska missionskyrkan,Svenska baptistsamfundet och Pingströrelsen. Samfunden låg i Sörmlands län,Västmanlands län, Värmlands län samt Örebro län (DUST‐länen). I FAS I jämfördes desamfundsanställda i DUST‐länen med en grupp ur den arbetande befolkningen i sammalän med avseende på långtidssjukskrivningar. De samfundsanställda uppvisade intehögre eller annorlunda siffror rörande långtidssjukskrivningar, än den arbetandebefolkningen under perioden 2001 – 2009. I FAS II distribuerades en arbetsmiljöenkättill samtliga samfundsanställda inom DUST‐länen, totalt 3 436 anställda (svarsfrekvens61 %). De samfundsanställda uppvisade i jämförelser med en referensgrupp (2 010personer i de nordiska länderna), överlag inte någon annorlunda eller speciellt dåligarbetsmiljö. När vi analyserade de samfundsanställda inbördes om deras värderingarskilde sig från församlingens erhöll vi dock skillnader. Stora värderingsskillnadersignalerade en sämre upplevd arbetsmiljö och även fler långtidssjukskrivningar. Fördem som angav värderingsskillnader noteras överrisker (oddskvoter) för flera avfrågorna i intervallet 4,12 – 5,19 vilket inom arbetsmiljöforskningen anses som myckethöga överrisker. I FAS III intervjuades samfundsanställda samt personer med kunskapom samfundsarbete. Bilden som tecknades var att ledarfunktionen var viktig för enfungerande bra arbetsmiljö. Intervjupersonerna önskade en snabb handläggning avarbetsmiljöproblem, man var dock inte alltid övertygad om att samfunden hadekunskap/verktyg att identifiera problem eller att åtgärda dessa. I rapportenrekommenderas att samfunden följer Arbetsmiljölagen och det systematiskaarbetsmiljöarbete som finns för att hjälpa arbetsplatser att själva övervaka, identifieraoch åtgärda arbetsmiljöproblem. Mer forskning om betydelsen av värderingsskillnaderoch arbetsmiljö efterlyses.
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