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- Figueroa, Jonine D., et al.
(author)
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Identification of a novel susceptibility locus at 13q34 and refinement of the 20p12.2 region as a multi-signal locus associated with bladder cancer risk in individuals of European ancestry
- 2016
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In: Human Molecular Genetics. - : Oxford University Press. - 0964-6906 .- 1460-2083. ; 25:6, s. 1203-1214
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Journal article (peer-reviewed)abstract
- Candidate gene and genome-wide association studies (GWAS) have identified 15 independent genomic regions associated with bladder cancer risk. In search for additional susceptibility variants, we followed up on four promising single-nucleotide polymorphisms (SNPs) that had not achieved genome-wide significance in 6911 cases and 11 814 controls (rs6104690, rs4510656, rs5003154 and rs4907479, P < 1 × 10−6), using additional data from existing GWAS datasets and targeted genotyping for studies that did not have GWAS data. In a combined analysis, which included data on up to 15 058 cases and 286 270 controls, two SNPs achieved genome-wide statistical significance: rs6104690 in a gene desert at 20p12.2 (P = 2.19 × 10−11) and rs4907479 within the MCF2L gene at 13q34 (P = 3.3 × 10−10). Imputation and fine-mapping analyses were performed in these two regions for a subset of 5551 bladder cancer cases and 10 242 controls. Analyses at the 13q34 region suggest a single signal marked by rs4907479. In contrast, we detected two signals in the 20p12.2 region—the first signal is marked by rs6104690, and the second signal is marked by two moderately correlated SNPs (r2 = 0.53), rs6108803 and the previously reported rs62185668. The second 20p12.2 signal is more strongly associated with the risk of muscle-invasive (T2-T4 stage) compared with non-muscle-invasive (Ta, T1 stage) bladder cancer (case–case P ≤ 0.02 for both rs62185668 and rs6108803). Functional analyses are needed to explore the biological mechanisms underlying these novel genetic associations with risk for bladder cancer.
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| 3. |
- Furberg, Maria, 1970-, et al.
(author)
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Facing the limit of resilience : perceptions of climate change among reindeer herding Sami in Sweden
- 2011
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In: Global Health Action. - Häggeby : Co-Action publishing. - 1654-9716 .- 1654-9880. ; 4:8417, s. 11-
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Journal article (peer-reviewed)abstract
- BACKGROUND: The Arctic area is a part of the globe where the increase in global temperature has had the earliest noticeable effect and indigenous peoples, including the Swedish reindeer herding Sami, are amongst the first to be affected by these changes.OBJECTIVE: To explore the experiences and perceptions of climate change among Swedish reindeer herding Sami.STUDY DESIGN: In-depth interviews with 14 Swedish reindeer herding Sami were performed, with purposive sampling. The interviews focused on the herders experiences of climate change, observed consequences and thoughts about this. The interviews were analysed using content analysis.RESULTS: ONE CORE THEME EMERGED FROM THE INTERVIEWS: facing the limit of resilience. Swedish reindeer-herding Sami perceive climate change as yet another stressor in their daily struggle. They have experienced severe and more rapidly shifting, unstable weather with associated changes in vegetation and alterations in the freeze-thaw cycle, all of which affect reindeer herding. The forecasts about climate change from authorities and scientists have contributed to stress and anxiety. Other societal developments have lead to decreased flexibility that obstructs adaptation. Some adaptive strategies are discordant with the traditional life of reindeer herding, and there is a fear among the Sami of being the last generation practising traditional reindeer herding.CONCLUSIONS: The study illustrates the vulnerable situation of the reindeer herders and that climate change impact may have serious consequences for the trade and their overall way of life. Decision makers on all levels, both in Sweden and internationally, need improved insights into these complex issues to be able to make adequate decisions about adaptive climate change strategies.
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| 5. |
- Furberg, Maria, et al.
(author)
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In the light of change : a mixed methods investigation of climate perceptions and the instrumental record in northern Sweden
- 2018
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In: Population and environment. - : Springer. - 0199-0039 .- 1573-7810. ; 40:1, s. 67-91
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Journal article (peer-reviewed)abstract
- Significant climate change in the Arctic has been observed by indigenous peoples and reported in scientific literature, but there has been little research comparing these two knowledge bases. In this study, Sami reindeer herder interviews and observational weather data were combined to provide a comprehensive description of climate changes in Northern Sweden. The interviewees described warmer winters, shorter snow seasons and cold periods, and increased temperature variability. Weather data supported three of these four observed changes; the only change not evident in the weather data was increased temperature variability. Winter temperatures increased, the number of days in cold periods was significantly reduced, and some stations displayed a 2 month-shorter snow cover season. Interviewees reported that these changes to the wintertime climate are significant, impact their identity, and threaten their livelihood. If consistency between human observations of changing weather patterns and the instrumental meteorological record is observed elsewhere, mixed methods research like this study can produce a clearer, more societally relevant understanding of how the climate is changing and the impacts of those changes on human well-being.
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| 6. |
- Furberg, Maria, 1970-
(author)
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Towards the Limits – Climate Change Aspects of Life and Health in Northern Sweden : studies of tularemia and regional experiences of changes in the environment
- 2016
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Doctoral thesis (other academic/artistic)abstract
- BackgroundIndigenous peoples with traditional lifestyles worldwide are considered particularly vulnerable to climate change effects. Large climate change impacts on the spread of infectious vector-borne diseases are expected as a health outcome. The most rapid climate changes are occurring in the Arctic regions, and as a part of this region northernmost Sweden might experience early effects. In this thesis, climate change effects on the lives of Sami reindeer herders are described and 30 years of weather changes are quantified. Epidemiology of the climate sensitive human infection tularemia is assessed, baseline serologic prevalence of tularemia is investigated and the disease burden is quantified across inhabitants in the region.MethodsPerceptions and experiences of climate change effects among the indigenous Sami reindeer herders of northern Sweden were investigated through qualitative analyses of fourteen interviews. The results were then combined with instrumental weather data from ten meteorological stations in a mixed-methods design to further illustrate climate change effects in this region. In two following studies, tularemia ecology and epidemiology were investigated. A total of 4,792 reported cases of tularemia between 1984 and 2012 were analysed and correlated to ecological regions and presence of inland water using geographical mapping. The status of tularemia in the Swedish Arctic region was further investigated through risk factor analyses of a 2012 regional outbreak and a cross-sectional serological survey to estimate the burden of disease including unreported cases.ResultsThe reindeer herders described how the winters of northern Sweden have changed since the 1970s – warmer winters with shorter snow season and cold periods, and earlier spring. The adverse effects on the reindeer herders through the obstruction of their work, the stress induced and the threat to their lifestyle was demonstrated, forcing the reindeer herders towards the limit of resilience. Weather data supported the observations of winter changes; some stations displayed a more than two full months shorter snow cover season and winter temperatures increased significantly, most pronounced in the lowest temperatures. During the same time period a near tenfold increase in national incidence of tularemia was observed in Sweden (from 0.26 to 2.47/100,000 p<0.001) with a clear overrepresentation of cases in the north versus the south (4.52 vs. 0.56/100,000 p<0.001). The incidence was positively correlated with the presence of inland water (p<0.001) and higher than expected in the alpine and boreal ecologic regions (p<0.001). In the outbreak investigation a dose-response relationship to water was identified; distance from residence to water – less than 100 m, mOR 2.86 (95% CI 1.79–4.57) and 100 to 500 m, mOR 1.63 (95% CI 1.08–2.46). The prevalence of tularemia antibodies in the two northernmost counties was 2.9% corresponding to a 16 times higher number of cases than reported indicating that the reported numbers represent only a minute fraction of the true tularemia.ConclusionsThe extensive winter changes pose a threat to reindeer herding in this region. Tularemia is increasing in Sweden, it has a strong correlation to water and northern ecoregions, and unreported tularemia cases are quite common.
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| 9. |
- Desvars, Amélie, 1980-, et al.
(author)
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Epidemiology and Ecology of Tularemia in Sweden, 1984-2012
- 2015
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In: Emerging Infectious Diseases. - : Centers for Disease Control and Prevention (CDC). - 1080-6040 .- 1080-6059. ; 21:1, s. 32-39
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Journal article (peer-reviewed)abstract
- The zoonotic disease tularemia is endemic in large areas of the Northern Hemisphere, but research is lacking on patterns of spatial distribution and connections with ecologic factors. To describe the spatial epidemiology of and identify ecologic risk factors for tularemia incidence in Sweden, we analyzed surveillance data collected over 29 years (1984-2012). A total of 4,830 cases were notified, of which 3,524 met all study inclusion criteria. From the first to the second half of the study period, mean incidence increased 10-fold, from 0.26/100,000 persons during 1984-1998 to 2.47/100,000 persons during 1999 2012 (p<0.001). The incidence of tularemia was higher than expected in the boreal and alpine ecologic regions (p<0.001), and incidence was positively correlated with the presence of lakes and rivers (p<0.001). These results provide a comprehensive epidemiologic description of tularemia in Sweden and illustrate that incidence is higher in locations near lakes and rivers.
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| 10. |
- Furberg, Anna, 1990, et al.
(author)
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Environmental Risk Assessment of Pharmaceuticals - Effects on Fish in a Swedish River
- 2014
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In: Globaqua-Cytothreat- Endetech-Scarce Workshop, PHARMACEUTICALS IN WASTEWATERS AND SURFACE WATERS UNDER MULTISTRESSORS SITUATION: Fate, Adverse effects, Risks and Removal Technologies.
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Conference paper (other academic/artistic)abstract
- Purpose The aim of this study was to assess exposure and chronic effects on fish from down- the-drain pharmaceuticals in the Swedish Göta Älv river. Both effects of individual pharmaceuticals and mixture effects were evaluated.Methods Spatially resolved exposure of pharmaceuticals was modelled with the Geo- referenced Regional Environmental Assessment Tool for European Rivers (GREAT-ER) and mixture effects were calculated using the concept of concentration addition as a conservative first tier. A habitat comparison was performed by comparing the locations with high concentrations of pharmaceuticals to the locations of known habitats in the Göta Älv river for the fish Salmo salar and Salmo trutta. The modelling results were also validated by comparison with measurements of concentrations performed in other Swedish rivers. In total, 12 pharmaceuticals were studied; diclofenac, propranolol, carbamazepine, ethinylestradiol, ibuprofen, metoprolol, gemfibrozil, estradiol, paracetamol, sertraline, verapamil and estrone.Results and discussion The results of the modelling showed that the predicted pharmaceutical concentrations in the Göta Älv river, when considered individually, generally did not cause adverse chronic effects to fish. An exception was gemfibrozil, which may cause adverse chronic effects to fish in some parts of the river. However, when mixture effects were considered, the results showed that adverse chronic effects might occur in parts of the river. The risk ratios for the mixture were relatively high (between 0.61 and 0.81) in almost all parts of the river. The two parts of the Göta Älv river catchment with the highest concentrations of the studied pharmaceuticals, were also the parts with known habitats for the studied fish species. The validation of the modelling results showed that the predicted pharmaceutical concentrations in the Göta Älv river were much lower than measured concentrations in other Swedish waters. The reasons for this were probably the large difference in both the number of people connected to the WWTPs, affecting the quantity of emitted pharmaceuticals, and the differences in dilution of the WWTP effluents in the respective surface water recipients. There are uncertainties in the results from this study due to the lack of data, especially in chronic toxicity data for the assessment endpoints Salmo salar and Salmo trutta. At the same time, the exposure of pharmaceuticals in the Göta Älv river are most probably underestimated in this study, due to the exclusion of certain sources of pharmaceuticals, having implications for the interpretation of the results.Conclusions and perspectives The results serve as an indication of risk for chronic effects to fish in the Göta Älv river and of the importance of considering mixture effects. Further studies providing site-specific measurements would be required in order to validate these results.
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