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  • 1.
    Bergsten, Eva L.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76 Gävle, Sweden.
    Mathiassen, Svend Erik
    Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76 Gävle, Sweden.
    Kwak, Lydia
    Unit of Intervention and Implementation Research for worker health, Institute of Environmental Medicine, Karolinska Institutet, SE- 171 77 Stockholm, Sweden.
    Vingård, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Daily shoulder pain among flight baggage handlers and its association with work tasks and upper arm postures on the same day2017In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 61, no 9, p. 1145-1153Article in journal (Refereed)
    Abstract [en]

    Objectives

    This study of flight baggage handlers aimed at examining the extent to which shoulder pain developed during single work shifts, and whether a possible development was associated with biomechanical exposures and psychosocial factors during the same shift.

    Methods

    Data were collected during, in total, 82 work shifts in 44 workers. Right and left shoulder pain intensity was rated just before and just after the shift (VAS scale 0–100 mm). Objective data on ‘time in extreme’ and ‘time in neutral’ upper arm postures were obtained for the full shift using accelerometers, and the baggage handlers registered the number of ‘aircrafts handled’ in a diary. During half of the shift, workers were recorded on video for subsequent task analysis of baggage handling. ‘Influence’ at work and ‘support’ from colleagues were measured by use of Copenhagen Psychosocial Questionnaire (COPSOQ). Associations between exposures and the increase in pain intensity during the shift (‘daily pain’) were analysed for the right and left shoulder separately using Generalized Estimating Equations (GEE).

    Results

    ‘Daily pain’ was observed in approximately one third of all shifts. It was significantly associated with the number of ‘aircrafts handled’ for both the right and left shoulder. In multivariate models including both biomechanical exposures and the psychosocial factors ‘influence’ at work and ‘support’ from colleagues, ‘aircrafts handled’ was still significantly associated with ‘daily pain’ in both shoulders, and so was ‘influence’ and ‘support’, however in opposite directions.

    Conclusions

    ‘Daily pain’ was, in general, associated with biomechanical exposures during the same shift and with general ‘influence’ and ‘support’ in the job. In an effort to reduce pain among flight baggage handlers, it may therefore be justified to consider a reduction of biomechanical exposures during handling of aircrafts, combined with due attention to psychosocial factors at work.

  • 2. Blanco, Luis E.
    et al.
    Aragon, Aurora
    Lundberg, Ingvar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Wesseling, Catharina
    Nise, Gun
    The determinants of dermal exposure ranking method (DERM): A pesticide exposure assessment approach for developing countries2008In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 52, no 6, p. 535-544Article in journal (Refereed)
    Abstract [en]

    A new method for assessment of dermal exposure to pesticides in subsistence farmers by use of determinants of dermal exposure is described. The method, called the determinants of dermal exposure ranking method (DERM), is a combination of checklists and expert rating assessment. Thus, determinants are listed in a form, which is used to check their presence and to assess them using a simple algorithm based on two factors, the type of transport process (T value) and the area of body surface exposed (A value). In addition, the type of clothing worn during applications is included as a protection factor. We applied the DERM to real pesticide applications, characterizing dermal exposure and comparing DERM estimates with earlier developed semiquantitative visual scores based on fluorescent tracer, the total visual score (TVS) and contaminated body area (CBA). DERM showed a very good level of agreement with both the TVS (r = 0.69, P = 0.000) and the CBA (r = 0.67, P = 0.000). DERM allowed identification of the determinants that had the highest effect on exposure and the farmers with the highest exposure. In conclusion, DERM provided information on the determinants responsible for dermal exposure in a group of subsistence farmers. This can be useful to design monitoring and preventive programs, define priorities for intervention and prioritize and select most adequate measurement strategies. DERM promises to be a low-cost easy-to-use method to assess dermal exposure to pesticides in developing country conditions.

  • 3. Blanco, Luis E.
    et al.
    Aragón, Aurora
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lundberg, Ingvar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Wesseling, Catharina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Nise, Gun
    The Accuracy of DERM may be a Self-fulfilling DREAM Reply2008In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 52, no 8, p. 784-785Article in journal (Refereed)
  • 4.
    Elfman, Lena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Hogstedt, Carl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Engvall, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lampa, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lindh, Christian H
    Department of Occupational and Environmental Medicine, Lund University Hospital.
    Acute health effects on planters of conifer seedlings treated with insecticides2009In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 53, no 4, p. 383-390Article in journal (Refereed)
    Abstract [en]

    No clear, acute adverse health effects could be found in planters after exposure to conifer seedlings treated with imidacloprid (Merit Forest) or cypermethrin (Forester), as compared with planting untreated seedlings. The metabolite, 3-PBA, was found in low levels in urine and was increased after exposure to cypermethrin. However, no clear relationships could be found between exposure and reported symptoms or between elevated 3-PBA levels and reported symptoms.

  • 5.
    Heiden, Marina
    et al.
    Univ Gavle, Ctr Musculoskeletal Res, Dept Occupat & Publ Hlth Sci, S-80176 Gavle, Sweden..
    Mathiassen, Svend Erik
    Univ Gavle, Ctr Musculoskeletal Res, Dept Occupat & Publ Hlth Sci, S-80176 Gavle, Sweden..
    Garza, Jennifer
    Univ Gavle, Ctr Musculoskeletal Res, Dept Occupat & Publ Hlth Sci, S-80176 Gavle, Sweden.;UConn Hlth, Div Occupat & Environm Med, Farmington, CT 06030 USA..
    Liv, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Univ Gavle, Ctr Musculoskeletal Res, Dept Occupat & Publ Hlth Sci, S-80176 Gavle, Sweden..
    Wahlström, Jens
    Umea Univ, Dept Publ Hlth & Clin Med, Occupat & Environm Med, S-90187 Umea, Sweden..
    A Comparison of Two Strategies for Building an Exposure Prediction Model2016In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 60, no 1, p. 74-89Article in journal (Refereed)
    Abstract [en]

    Cost-efficient assessments of job exposures in large populations may be obtained from models in which 'true' exposures assessed by expensive measurement methods are estimated from easily accessible and cheap predictors. Typically, the models are built on the basis of a validation study comprising 'true' exposure data as well as an extensive collection of candidate predictors from questionnaires or company data, which cannot all be included in the models due to restrictions in the degrees of freedom available for modeling. In these situations, predictors need to be selected using procedures that can identify the best possible subset of predictors among the candidates. The present study compares two strategies for selecting a set of predictor variables. One strategy relies on stepwise hypothesis testing of associations between predictors and exposure, while the other uses cluster analysis to reduce the number of predictors without relying on empirical information about the measured exposure. Both strategies were applied to the same dataset on biomechanical exposure and candidate predictors among computer users, and they were compared in terms of identified predictors of exposure as well as the resulting model fit using bootstrapped resamples of the original data. The identified predictors were, to a large part, different between the two strategies, and the initial model fit was better for the stepwise testing strategy than for the clustering approach. Internal validation of the models using bootstrap resampling with fixed predictors revealed an equally reduced model fit in resampled datasets for both strategies. However, when predictor selection was incorporated in the validation procedure for the stepwise testing strategy, the model fit was reduced to the extent that both strategies showed similar model fit. Thus, the two strategies would both be expected to perform poorly with respect to predicting biomechanical exposure in other samples of computer users.

  • 6. Lillienberg, Linnea
    et al.
    Andersson, Eva
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Dahlman-Hoglund, Anna
    Forsberg, Bertil
    Holm, Mathias
    Gislason, Thorarinn
    Jõgi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Omenaas, Ernst
    Schlunssen, Vivi
    Sigsgaard, Torben
    Svanes, Cecilie
    Toren, Kjell
    Occupational Exposure and New-onset Asthma in a Population-based Study in Northern Europe (RHINE)2013In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 57, no 4, p. 482-492Article in journal (Refereed)
    Abstract [en]

    In a large population-based study among adults in northern Europe the relation between occupational exposure and new-onset asthma was studied. The study comprised 13 284 subjects born between 1945 and 1973, who answered a questionnaire 19891992 and again 19992001. Asthma was defined as Asthma diagnosed by a physician with reported year of diagnose. Hazard ratios (HR), for new-onset adult asthma during 19802000, were calculated using a modified job-exposure matrix as well as high-risk occupations in Cox regression models. The analyses were made separately for men and women and were also stratified for atopy. During the observation period there were 429 subjects with new-onset asthma with an asthma incidence of 1.3 cases per 1000 person-years for men and 2.4 for women. A significant increase in new-onset asthma was seen for men exposed to plant-associated antigens (HR 3.6; 95% CI [confidence interval] 1.49.0), epoxy (HR 2.4; 95% CI 1.34.5), diisocyanates (HR 2.1; 95% CI 1.23.7) and accidental peak exposures to irritants (HR 2.4; 95% CI 1.34.7). Both men and women exposed to cleaning agents had an increased asthma risk. When stratifying for atopy an increased asthma risk were seen in non-atopic men exposed to acrylates (HR 3.3; 95% CI 1.47.5), epoxy compounds (HR 3.6; 95% CI 1.67.9), diisocyanates and accidental peak exposures to irritants (HR 3.0; 95% CI 1.27.2). Population attributable risk for occupational asthma was 14% for men and 7% for women. This population-based study showed that men exposed to epoxy, diisocyanates and acrylates had an increased risk of new-onset asthma. Non-atopics seemed to be at higher risk than atopics, except for exposure to high molecular weight agents. Increased asthma risks among cleaners, spray painters, plumbers, and hairdressers were confirmed.

  • 7. Rezagholi, Mahmoud
    et al.
    Mathiassen, Svend Erik
    Cost-Efficient Design of Occupational Exposure Assessment Strategies- A Review2010In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162Article in journal (Refereed)
    Abstract [en]

    When designing a strategy for collecting occupational exposure data, both economic and statistical performance criteria should be considered. However, very few studies have addressed the trade-off between the cost of obtaining data and the precision/accuracy of the exposure estimate as a research issue. To highlight the need of providing cost-efficient designs for assessing exposure variables in occupational research, the present review explains and critically evaluates the concepts and analytical tools used in available cost efficiency studies. Nine studies were identified through a systematic search using two algorithms in the databases PubMed and ScienceDirect. Two main approaches could be identified in these studies: ‘comparisons’ of the cost efficiency associated with different measurement designs and ‘optimizations’ of resource allocation on the basis of functions describing cost and statistical efficiency. In either case, the reviewed studies use simplified analytical tools and insufficient economic analyses. More research is needed to understand whether these drawbacks jeopardize the guidance on cost-efficient exposure assessment provided by the studies, as well as to support theoretical results by empirical data from occupational life.

  • 8. Sjöström, Mattias
    et al.
    Lewné, Marie
    Alderling, Magnus
    Willix, Pernilla
    Berg, Peter
    Gustavsson, Per
    Svartengren, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    A job-exposure matrix for occupational noise: development and validation.2013In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 57, no 6, p. 774-83Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To develop a job-exposure matrix (JEM) for occupational noise in Sweden and to estimate its validity.

    METHODS: The JEM, developed by a group of experienced occupational hygienists, contains 321 job families with information regarding occupational noise from 1970 to 2004. The occupational noise information derives from measurements collected from different sources. The time period label has a 5-year scale starting in 1970. The estimated average 8h (TWA) noise level in decibel [dB(A)] for every 5-year period was coded either as <75 dB(A), 75-84 dB(A), or ≥85 dB(A) and the risk of peak level exposure assessed. The validity of the JEM is tested, using Svensson's non-parametric methods based on classification consensus, reached by a second group of occupational hygienists.

    RESULTS/DISCUSSION: Validation results show ~ 80% agreement and no systematic differences, in classification, between the two different groups of occupational hygienists, classifying the occupational noise exposure. However, classification of peak level exposure did show a systematic difference in relative position. The results will give more power to the JEM that it gives a good general estimate for the occupational noise levels in Sweden for different job families during 1970-2004. We, thus, intend to use it in further studies and also make it available to collaborators.

  • 9.
    Svedberg, Urban
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Högberg, Hans-Erik
    Högberg, Johan
    Galle, Bo
    Emission of Hexanal and Carbon Monoxide from Storage of Wood Pellets, a Potential Occupational and Domestic Health Hazard2004In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 48, no 4, p. 339-349Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    The objective of the present study was to investigate and describe the emissions of volatile compounds, particularly hexanal and carbon monoxide, from large- and small-scale storage of wood pellets.

    METHODS:

    Air sampling was performed with Fourier transform infrared spectroscopy and adsorbent sampling in pellet warehouses, domestic storage rooms, lumber kiln dryers and experimental set-ups. Literature studies were included to describe the formation of hexanal and carbon monoxide and the toxicology of hexanal.

    RESULTS:

    A arithmetic mean aldehyde level of 111 +/- 32 mg/m(3) was found in one warehouse, with a peak reading of 156 mg/m(3) [correction]. A maximum aldehyde reading of 457 mg/m(3) was recorded at the surface of a pellet pile. Hexanal (70-80% w/w) and pentanal (10-15% w/w) dominated, but acetone (83 +/- 24 mg/m(3)), methanol (18 +/- 7 mg/m(3)) and carbon monoxide (56 +/- 4 mg/m(3)) were also found. The emissions in a domestic storage room varied with the ambient temperature and peaked after 2 months storage in the midst of the warm season. Aldehyde levels of 98 +/- 4 mg/m(3) and carbon monoxide levels of 123 +/- 10 mg/m(3) were recorded inside such storage rooms. Elevated levels of hexanal (0.084 mg/m(3)) were recorded inside domestic housing and 6 mg/m(3) in a room adjacent to a poorly sealed storage area. Experimental laboratory studies confirmed the findings of the field studies. A field study of the emissions from industrial lumber drying also showed the formation of aldehydes and carbon monoxide.

    CONCLUSIONS:

    High levels of hexanal and carbon monoxide were strongly associated with storage of wood pellets and may constitute an occupational and domestic health hazard. The results from lumber drying show that the emissions of hexanal and carbon monoxide are not limited to wood pellets but are caused by general degradation processes of wood, facilitated by drying at elevated temperature. Emission of carbon monoxide from wood materials at low temperatures (<100 degrees C) has not previously been reported in the literature. We postulate that carbon monoxide is formed due to autoxidative degradation of fats and fatty acids. A toxicological literature survey showed that the available scientific information on hexanal is insufficient to determine the potential risks to health. However, the data presented in this paper seem sufficient to undertake preventive measures to reduce exposure to hexanal.

  • 10.
    Wahlström, Jens
    et al.
    Department of Public Health & Clinical Medicine, Occupational and Environmental Medicine, Umeå University, SE-901 87, Umeå, Sweden.
    Bergsten, Eva L
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76 Gävle, Sweden.
    Trask, Catherine
    Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place PO Box 23, Saskatoon, Saskatchewan, S7N 2Z4 Canada.
    Mathiassen, Svend Erik
    Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76 Gävle, Sweden.
    Jackson, Jennie
    Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, SE-801 76 Gävle, Sweden.
    Forsman, Mikael
    IMM Institute of Environmental Medicine, Karolinska Institutet, SE- 171 77 Stockholm, Sweden.
    Full-shift trunk and upper arm postures and movements among aircraft baggage handlers2016In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162Article in journal (Refereed)
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