| 1. |
- Axelsson, Malin, 1964, et al.
(author)
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Chronic bronchitis in West Sweden - a matter of smoking and social class
- 2016
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In: European Clinical Respiratory Journal. - : Informa UK Limited. - 2001-8525. ; 3
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Journal article (peer-reviewed)abstract
- Background: Although chronic bronchitis is associated with impaired quality of life, hospitalisations and increased mortality, it has been less in focus after the introduction of the term chronic obstructive pulmonary disease (COPD). There are no recent published data on the prevalence of chronic bronchitis from the Scandinavian countries. Aim: The main aim of the present study was to estimate the prevalence of chronic bronchitis in West Sweden by using data from a large-scale epidemiological study of the general population. A further aim was to identify current risk factors for chronic bronchitis in a population with a major decrease in the proportion of smokers. Methods: From the 18,087 questionnaire responders out of 30,000 invited to participate at the West Sweden Asthma Study, 2,000 subjects were randomly selected and invited to detailed clinical examinations performed during 2009-2013. A total of 1,172 subjects aged 17-79 participated in the examinations which included, among others, spirometry and structured interviews. Chronic bronchitis was defined according to reported symptoms. Results: The overall prevalence of chronic bronchitis was 7.2% (men 7.6%; women 6.8% ns), and it was 8.7% in subjects older than age 60. Chronic bronchitis was strongly associated with smoking, defined both as current smoking status and pack-years. Other risk factors were increasing age, low socio-economic class and urban living. Of those with chronic bronchitis, 22% fulfilled the GOLD criteria of COPD. Conclusion: The prevalence of chronic bronchitis was somewhat lower than found by studies in Sweden in the 1980s and the prevalence was now similar in men and women. Although smoking was still the dominating risk factor for chronic bronchitis, the relative importance of smoking had decreased parallel with a decreasing smoking prevalence, while the relative importance of other factors than smoking had increased compared to previous studies.
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| 2. |
- Baresel, Christian, et al.
(author)
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Experimentell utpovning av tekniker för avskiljning av flytslam (surfcleaner) i Henriksdals reningsverk
- 2015
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Reports (other academic/artistic)abstract
- Olika flytande föroreningar påverkar hanteringen av det vatten de befinner sig i. I avloppsreningsverk är det framförallt flytslam som uppstår under olika processförhållanden som innebär problem i driften av de berörda processerna till exempel genom igensättningar och därmed reducerat kapacitet i olika reningssteg. Förutom drifttekniska problem och ökade kostnader för omhändertagandet medför ytföroreningarna även en arbetsmiljöbelastning då föroreningarna vanligtvis behöver tas om hand av driftpersonal i en icke-optimal miljö. Andra vattenrelaterade processer som t.ex. ytvattenreservoarer som används för dricksvattenproduktion och vattentorn för distribution kan också påverkas av ytföroreningar. Under 2013-2015 har Surfcleaner, en teknik utvecklat för framförallt oljesanering, testats och vidareutvecklats för att uppnå en resurseffektiv hantering av flytslamproblematiken. Det långsiktiga syftet är att minska driftstörningar, underhållsbehov, och samtidigt att skapa förutsättningar för att ta till vara slammet som en resurs. Stockholm Vatten AB och IVL Svenska Miljöinstitutet AB har tillsammans med miljöteknikföretaget Inovacor använt sig av både Henriksdal och Bromma reningsverk för att pröva, anpassa och utvärdera tekniken genom användning av befintliga modeller och en ny specifikt framtagen prototyp för flytslam. Tekniken baseras på en separation av slammet från vattenfasen och förutsättning finns därför att kunna tillföra det separerade slammet till den vanliga slambehandlingen (anaerob stabilisering) och därmed tillnyttogöra det som en resurs. Även om olika försvårande omständigheter som t.ex. flytslammets oförutsägbara uppkomst har försvårat testerna så har SurfCleanern, som tekniken kallas, visat sig vara effektiv i att ta upp och separera flytslam. Under projektets gång har även olika andra problem identifierats och alternativa lösningar förslagits och testats i mindre skala. Trots lovande resultat med SurfCleanern framstår en tillämpning i dagens processutformning inte som det mest resurseffektivaste alternativet. Istället föreslås ett annat tekniskt hjälpmedel för att förebygga driftproblem orsakat av flytslam.
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| 3. |
- Forsberg, Bertil, et al.
(author)
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Air pollution levels, meteorological conditions and asthma symptoms
- 1993
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In: European Respiratory Journal. - 0903-1936 .- 1399-3003. ; 6:8, s. 1109-1115
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Journal article (peer-reviewed)abstract
- We wanted to assess relations between the daily occurrence of asthma symptoms and fluctuations of air pollution concentrations and meteorological conditions. In a panel of 31 asthmatic patients residing in the town of Piteå in northern Sweden, severe symptoms of shortness of breath, wheeze, cough and phlegm were recorded in an asthma diary together with suspected causes. Sulphur dioxide, nitrogen dioxide, black smoke, relative humidity and temperature were used to evaluate the relationship to the environment. By using multivariate analyses, we found that daily variations in the particulate pollution levels, indicated by black smoke levels below the criteria limits, had significant effects on the risk of developing severe symptoms of shortness of breath. This association was stronger among 10 subjects, who had at least five incident days with severe shortness of breath. Meteorological conditions were not significant in the multivariate models. Cough and phlegm did not show significant relationships to any environmental condition that was evaluated. Only one-third of the subjects reported, at least once during the study, symptoms believed to be related to air pollutants, although we found significant correlations between the pollution levels and the frequency of pollution-related symptoms. We conclude that an association has been established for black smoke as pollutant and shortness of breath as respiratory symptom, and that in certain asthmatics, effects were occurring at lower particulate levels than suggested previously.
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| 4. |
- Hagstad, Stig, 1978, et al.
(author)
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COPD among non-smokers - Report from the Obstructive Lung Disease in Northern Sweden (OLIN) studies
- 2012
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In: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 106:7, s. 980-988
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Journal article (peer-reviewed)abstract
- Background: In westernized countries smoking and increasing age are the most important risk factors for COPD. Prevalence and risk factors of COPD among non-smokers are not well studied. Aim: To study the prevalence and risk factors of COPD among non-smokers and to determine the proportion of non-smokers among subjects with COPD. Methods: A random sample of 2470 subjects drawn from a population-based postal survey of 10,040 (85-88% participation) adults (aged 20-77) in Norrbotten, Sweden, were invited to structured interviews and lung function tests, and 1897 participated. COPD was classified using the fixed ratio (GOLD) definition and for comparison the lower limit of normal (LLN). Results: The prevalence of airway obstruction was 6.9% among non-smokers and strongly age related. The prevalence of GOLD stage >= II among non-smokers was 15%. Both among subjects with airway obstruction and among subjects with GOLD stage >= II, the proportions of nonsmokers were 20%. Of men with airway obstruction, 14.1% were non-smokers versus 26.8% among women. Non-smokers with GOLD stage >= II had significantly more symptoms and higher co-morbidity than non-smokers without airway obstruction. Sex, area of domicile and exposure to environmental tobacco smoke was not significantly associated to airway obstruction among non-smokers. Using LLN for defining airway obstruction yielded a similar prevalence. Conclusion: The prevalence of airway obstruction among non-smokers was close to 7% and was associated with increasing age. One out of seven men with airway obstruction, defined using the fixed ratio, versus one out of four women had never smoked. (C) 2012 Elsevier Ltd. All rights reserved.
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| 5. |
- Hagstad, Stig, 1978, et al.
(author)
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Passive Smoking Exposure Is Associated With Increased Risk of COPD in Never Smokers
- 2014
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In: Chest. - : Elsevier BV. - 0012-3692 .- 1931-3543. ; 145:6, s. 1298-1304
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Journal article (peer-reviewed)abstract
- Background: Passive smoking, or environmental tobacco smoke (ETS), is a risk factor for lung cancer, cardiovascular disease, and childhood asthma, but a relationship with COPD has not been fully established. Our aim was to study ETS as a risk factor for COPD in never smokers. Methods: Data from three cross-sectional studies within the Obstructive Lung Disease in Northern Sweden (OLIN) database were pooled. Of the 2,182 lifelong never smokers, 2,118 completed structured interviews and spirometry of acceptable quality. COPD was defined according to the GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria using postbronchodilator spirometry. The association of COPD with ETS in single and multiple settings was calculated by multivariate logistic regression adjusting for known risk factors for COPD. Results: COPD prevalence was associated with increased ETS exposure: 4.2% (no ETS), 8.0% (ETS ever at home), 8.3% (ETS at previous work), and 14.7% (ETS ever at home and at both previous and current work), test for trend P 5.003. Exclusion of subjects aged >= 65 years and subjects reporting asthma yielded similar results. ETS in multiple settings, such as ever at home and at both previous and current work, was strongly associated to COPD (OR, 3.80; 95% CI, 1.29-11.2). Conclusions: In this population-based sample of never smokers, ETS was independently associated with COPD. The association was stronger for ETS in multiple settings. ETS in multiple settings was, after age, the strongest risk factor for COPD and comparable to personal smoking of up to 14 cigarettes/d in comparable materials. The findings strongly advocate measures against smoking in public places.
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| 6. |
- Hagstad, Stig, 1978, et al.
(author)
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Prevalence and risk factors of COPD among never-smokers in two areas of Sweden : Occupational exposure to gas, dust or fumes is an important risk factor
- 2015
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In: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 109:11, s. 1439-1445
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Journal article (peer-reviewed)abstract
- BACKGROUND: Although active tobacco smoking is the main risk factor for COPD, COPD is not uncommon also among never-smokers. Different study locations along with different spirometric definitions of COPD have historically yielded different prevalence estimates of the disease.AIM: To study current prevalence and risk factors of COPD among never-smokers in two areas of Sweden.METHODS: Data collected in 2008-2012 within the West Sweden Asthma Study and Obstructive Lung Disease in Northern Sweden Studies was pooled. The study population consisted of 1839 subjects who participated in spirometry and interviews. COPD was defined as post-bronchodilator a) FEV1/(F)VC < 0.7, b) FEV1/FVC < 0.7 and c) FEV1/FVC < lower limit of normal.RESULTS: Of the 1839 subjects, 967 (52.6%) were never-smokers. Among the never-smoking subjects, the prevalence of COPD according to definitions a-c was 7.7%, 4.9% and 3.0%, respectively. The corresponding prevalence of GOLD grade ≥2 was 2.0%, 1.4% and 1.3%. No significant difference in prevalence between the two study areas was observed. In never-smokers, occupational exposure to gas, dust or fumes (GDF) was significantly associated with both COPD (OR 1.85, 95% CI 1.03-3.33), and GOLD ≥2 (OR 4.51, 1.72-11.9) according to definition a), after adjusting for age, educational level and exposure to passive smoking at work.CONCLUSION: Depending on definition, prevalence of COPD among never-smokers was 3.0-7.7%, whereas GOLD ≥2 was present in 1.3-2.0%. Occupational exposure to GDF remained independently and significantly associated with COPD regardless of spirometric definition of the disease.
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| 7. |
- Larsson, Matilda, 1981-, et al.
(author)
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State diagrams of the heart - a new approach to describing cardiac mechanics
- 2009
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In: Cardiovascular Ultrasound. - : BMC. - 1476-7120. ; 7
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Journal article (peer-reviewed)abstract
- Background: Cardiac time intervals have been described as a measure of cardiac performance, where prolongation, shortening and delay of the different time intervals have been evaluated as markers of cardiac dysfunction. A relatively recently developed method with improved ability to measure cardiac events is Tissue Doppler Imaging (TDI), allowing accurate measurement of myocardial movements. Methods: We propose the state diagram of the heart as a new visualization tool for cardiac time intervals, presenting comparative, normalized data of systolic and diastolic performance, providing a more complete overview of cardiac function. This study aimed to test the feasibility of the state diagram method by presenting examples demonstrating its potential use in the clinical setting and by performing a clinical study, which included a comparison of the state diagram method with established echocardiography methods (E/E' ratio, LVEF and WMSI). The population in the clinical study consisted of seven patients with non ST-elevation myocardial infarction (NSTEMI) and seven control subjects, individually matched according to age and gender. The state diagram of the heart was generated from TDI curves from seven positions in the myocardium, visualizing the inter-and intraventricular function of the heart by displaying the cardiac phases. Results: The clinical examples demonstrated that the state diagram allows for an intuitive visualization of pathological patterns as ischemia and dyssynchrony. Further, significant differences in percentage duration between the control group and the NSTEMI group were found in eight of the totally twenty phases (10 phases for each ventricle), e.g. in the transition phases (Pre-Ejection and Post-Ejection). These phases were significantly longer (> 2.18%) for the NSTEMI group than for the control group (p < 0.05). No significant differences between the groups were found for the established echocardiography methods. Conclusion: The test results clearly indicate that the state diagram has potential to be an efficient tool for visualization of cardiac dysfunction and for detection of NSTEMI.
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| 8. |
- Rönmark, Erik P, 1981, et al.
(author)
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Different risk factor patterns for adult asthma, rhinitis and eczema : results from West Sweden Asthma Study
- 2016
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In: Clinical and Translational Allergy. - : Wiley. - 2045-7022. ; 6
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Journal article (peer-reviewed)abstract
- BACKGROUND: Atopic diseases including asthma, rhinitis and eczema have increased in the second half of the past century. This has been well studied among children and adolescents but with the exception of asthma to a much lesser extent in adults. The adult risk factor pattern of atopic diseases, in particular of eczema, and their relation to allergic sensitization are yet to be fully elucidated. Studies among adults that have compared the risk factor pattern for these conditions in the same material are very few. The objective of this study was to compare the risk factor patterns for asthma, rhinitis and eczema in a randomly selected adult population.METHODS: A questionnaire survey on atopic diseases was dispatched by mail to 30,000 randomly selected individuals in West Sweden aged 16-75 years and 62 % participated. A subgroup of 2000 individuals was selected for clinical examinations including blood sampling for specific serum Immunoglobulin E to common airborne allergens and 1172 attended.RESULTS: The prevalence of current asthma was 11.8 %, current rhinitis 42.8 %, current eczema 13.5 and 2.3 % had all three conditions while 13.9 % had at least two conditions. No mutual risk factor was identified for all three conditions. Allergic sensitization was a strong risk factor for current asthma (OR 4.1 CI 2.7-6.3) and current rhinitis (OR 5.1 CI 3.8-6.9) but not so for current eczema. Obesity was a risk factor for current asthma and current rhinitis, while farm childhood decreased the risk for current asthma and current rhinitis. Occupational exposure to gas dust or fumes and female sex was associated with an increased risk of current asthma and current eczema.CONCLUSIONS: There are different risk factor patterns for asthma, rhinitis and eczema in adults but some risk factors are overlapping between some of the conditions. The effect of mutable risk factors should be assessed further in longitudinal studies.
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