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  • 1. Accordini, Simone
    et al.
    Corsico, Angelo G.
    Braggion, Marco
    Gerbase, Margaret W.
    Gislason, David
    Gulsvik, Amund
    Heinrich, Joachim
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Jarvis, Deborah
    Jõgi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Pin, Isabelle
    Schoefer, Yvonne
    Bugiani, Massimiliano
    Cazzoletti, Lucia
    Cerveri, Isa
    Marcon, Alessandro
    de Marco, Roberto
    The Cost of Persistent Asthma in Europe: An International Population-Based Study in Adults2013In: International Archives of Allergy and Immunology, ISSN 1018-2438, E-ISSN 1423-0097, Vol. 160, no 1, p. 93-101Article in journal (Refereed)
    Abstract [en]

    Background: This study is aimed at providing a real-world evaluation of the economic cost of persistent asthma among European adults according to the degree of disease control [as defined by the 2006 Global Initiative for Asthma (GINA) guidelines]. Methods: A prevalence-based cost-of-illness study was carried out on 462 patients aged 30-54 years with persistent asthma (according to the 2002 GINA definition), who were identified in general population samples from 11 European countries and examined in clinical settings in the European Community Respiratory Health Survey II between 1999 and 2002. The cost estimates were computed from the societal perspective following the bottom-up approach on the basis of rates, wages and prices in 2004 (obtained at the national level from official sources), and were then converted to the 2010 values. Results: The mean total cost per patient was EUR 1,583 and was largely driven by indirect costs (i.e. lost working days and days with limited, not work-related activities 62.5%). The expected total cost in the population aged 30-54 years of the 11 European countries was EUR 4.3 billion (EUR 19.3 billion when extended to the whole European population aged from 15 to 64 years). The mean total cost per patient ranged from EUR 509 (controlled asthma) to EUR 2,281 (uncontrolled disease). Chronic cough or phlegm and having a high BMI significantly increased the individual total cost. Conclusions: Among European adults, the cost of persistent asthma drastically increases as disease control decreases. Therefore, substantial cost savings could be obtained through the proper management of adult patients in Europe.

  • 2. Amaral, Andre F. S.
    et al.
    Ramasamy, Adaikalavan
    Castro-Giner, Francesc
    Minelli, Cosetta
    Accordini, Simone
    Sorheim, Inga-Cecilie
    Pin, Isabelle
    Kogevinas, Manolis
    Jõgi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Balding, David J.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Verlato, Giuseppe
    Olivieri, Mario
    Probst-Hensch, Nicole
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Zock, Jan-Paul
    Heinrich, Joachim
    Jarvis, Deborah L.
    Interaction between gas cooking and GSTM1 null genotype in bronchial responsiveness: results from the European Community Respiratory Health Survey2014In: Thorax, ISSN 0040-6376, E-ISSN 1468-3296, Vol. 69, no 6, p. 558-564Article in journal (Refereed)
    Abstract [en]

    Background Increased bronchial responsiveness is characteristic of asthma. Gas cooking, which is a major indoor source of the highly oxidant nitrogen dioxide, has been associated with respiratory symptoms and reduced lung function. However, little is known about the effect of gas cooking on bronchial responsiveness and on how this relationship may be modified by variants in the genes GSTM1, GSTT1 and GSTP1, which influence antioxidant defences. Methods The study was performed in subjects with forced expiratory volume in one second at least 70% of predicted who took part in the multicentre European Community Respiratory Health Survey, had bronchial responsiveness assessed by methacholine challenge and had been genotyped for GSTM1, GSTT1 and GSTP1-rs1695. Information on the use of gas for cooking was obtained from interviewer-led questionnaires. Effect modification by genotype on the association between the use of gas for cooking and bronchial responsiveness was assessed within each participating country, and estimates combined using meta-analysis. Results Overall, gas cooking, as compared with cooking with electricity, was not associated with bronchial responsiveness (beta=-0.08, 95% CI -0.40 to 0.25, p=0.648). However, GSTM1 significantly modified this effect (beta for interaction=-0.75, 95% CI - 1.16 to -0.33, p=4x10(-4)), with GSTM1 null subjects showing more responsiveness if they cooked with gas. No effect modification by GSTT1 or GSTP1-rs1695 genotypes was observed. Conclusions Increased bronchial responsiveness was associated with gas cooking among subjects with the GSTM1 null genotype. This may reflect the oxidant effects on the bronchi of exposure to nitrogen dioxide.

  • 3. Birgisdóttir, Alda
    et al.
    Asbjörnsdottir, Hulda
    Cook, E
    Gislason, David
    Jansson, Christer
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Olafsson, Isleifur
    Gislason, Thorarinn
    Jögi, Rain
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Thjodleifsson, Bjarni
    Seroprevalence of Toxoplasma gondii in Sweden, Estonia and Iceland.2006In: Scand J Infect Dis, ISSN 0036-5548, Vol. 38, no 8, p. 625-31Article in journal (Refereed)
  • 4. Christensen, Stine Holmegaard
    et al.
    Timm, Signe
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Benediktsdóttir, Bryndis
    Forsberg, Bertil
    Holm, Mathias
    Jõgi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Johannessen, Ane
    Omenaas, Ernst
    Sigsgaard, Torben
    Svanes, Cecilie
    Schlünssen, Vivi
    A clear urban-rural gradient of allergic rhinitis in a population-based study in Northern Europe2016In: European clinical respiratory journal, ISSN 2001-8525, Vol. 3, article id 33463Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The protective effect of farm upbringing on allergic rhinitis is well known, but how upbringing in other environments influences the development of allergic rhinitis is scarcely investigated. The aim of this study was to investigate the association between place of upbringing and pet keeping in childhood and allergic rhinitis and nasal symptoms in adulthood.

    METHODS: The population-based Respiratory Health in Northern Europe study includes subjects from Denmark, Norway, Sweden, Iceland, and Estonia born in 1945-1973. This paper analyses 13,376 participants of the third study wave. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb, and inner city. Pets in the home at birth and during childhood were recorded. Data were analysed using adjusted logistic regression models.

    RESULTS: Livestock farm upbringing predicted less adult allergic rhinitis [odds ratio (OR) 0.68, 0.54-0.85] and nasal symptoms (OR 0.82, 0.68-0.99) than city upbringing, and an urban-rural gradient with decreasing risk per level of urbanisation was observed (OR 0.92, 0.88-0.94). Pets in the home at birth (OR 0.78, 0.68-0.88) and during childhood (OR 0.83, 0.74-0.93) were associated with less subsequent allergic rhinitis. Pet keeping did not explain the protective effect of place of upbringing.

    CONCLUSION: Risk of allergic rhinitis and nasal symptoms in adulthood was inversely associated with the level of urbanisation during upbringing. Pets at birth decreased the risk further, but did not explain the urban-rural gradient. Persistent beneficial effects of microbial diversity in early life might be an explanation for the findings.

  • 5. de Marco, Roberto
    et al.
    Marcon, Alessandro
    Jarvis, Deborah
    Accordini, Simone
    Almar, Enrique
    Bugiani, Massimiliano
    Carolei, Adriana
    Cazzoletti, Lucia
    Corsico, Angelo
    Gislason, David
    Gulsvik, Amund
    Jögi, Rain
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Marinoni, Alessandra
    Martinez-Moratalla, J
    Pin, Isabelle
    Janson, Christer
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Prognostic factors of asthma severity: a 9-year international prospective cohort study.2006In: J Allergy Clin Immunol, ISSN 0091-6749, Vol. 117, no 6, p. 1249-56Article in journal (Refereed)
  • 6. de Marco, Roberto
    et al.
    Marcon, Alessandro
    Jarvis, Deborah
    Accordini, Simone
    Bugiani, Massimiliano
    Cazzoletti, Lucia
    Cerveri, Isa
    Corsico, Angelo
    Gislason, David
    Gulsvik, Amund
    Jögi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Martinez-Moratalla, J.
    Pin, Isabelle
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Inhaled steroids are associated with reduced lung function decline in subjects with asthma with elevated total IgE2007In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 119, no 3, p. 611-617Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Few studies have investigated the long-term association between inhaled corticosteroids (ICSs) and lung function decline in asthma. OBJECTIVE: To evaluate whether prolonged treatment with ICSs is associated with FEV(1) decline in adults with asthma. METHODS: An international cohort of 667 subjects with asthma (20-44 years old) was identified in the European Community Respiratory Health Survey (1991-1993) and followed up from 1999 to 2002. Spirometry was performed on both occasions. FEV(1) decline was analyzed according to age, sex, height, body mass index, total IgE, time of ICS use, and smoking, while adjusting for potential confounders. RESULTS: As ICS use increased, the decline in FEV(1) was lower (P trend = .025): on average, decline passed from 34 mL/y in nonusers (half of the sample) to 20 mL/y in subjects treated for 48 months or more (18%). When adjusting for all covariates, there was an interaction (P = .02) between ICS use and total IgE: in subjects with high (>100 kU/L) IgE, ICS use for 4 years or more was associated with a lower FEV(1) decline (23 mL/y; 95% CI, 8-38 compared with nonusers). This association was not seen in those with lower IgE. CONCLUSION: Although confirming a beneficial long-term association between ICSs and lung function in asthma, our study suggests that subjects with high IgE could maximally benefit from a prolonged ICS treatment. CLINICAL IMPLICATIONS: This study adds further evidence to the beneficial effect of inhaled steroids on lung function in asthma; future studies will clarify whether calibrating the corticosteroid dose according to the level of total IgE is a feasible approach in asthma management.

  • 7. Gomez Real, F
    et al.
    Svanes, C
    Björnsson, E H
    Franklin, K A
    Franklin, K
    Gislason, D
    Gislason, T
    Gulsvik, A
    Janson, C
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Jögi, R
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Kiserud, T
    Norbäck, D
    Nyström, L
    Torén, K
    Wentzel-Larsen, T
    Omenaas, E
    Hormone replacement therapy, body mass index and asthma in perimenopausal women: a cross sectional survey.2006In: Thorax, ISSN 0040-6376, Vol. 61, no 1, p. 34-40Article in journal (Refereed)
  • 8.
    Gunnbjörnsdóttir, Maria I
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Franklin, K A
    Norbäck, Dan
    Björnsson, E
    Gislason, D
    Lindberg, Eva
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Svanes, C
    Omenaas, E
    Norrman, E
    Jögi, Rain
    Jensen, E J
    Dahlman-Höglund, A
    Janson, Christer
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Prevalence and incidence of respiratory symptoms in relation to indoor dampness: the RHINE study.2006In: Thorax, ISSN 0040-6376, Vol. 61, no 3, p. 221-5Article in journal (Refereed)
  • 9. Hellgren, Johan
    et al.
    Omenaas, Ernst
    Gí­slason, T.
    Jögi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Franklin, Karl A.
    Lindberg, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Torén, Kjell
    Perennial non-infectious rhinitis--an independent risk factor for sleep disturbances in Asthma2007In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 101, no 5, p. 1015-1020Article in journal (Refereed)
    Abstract [en]

    Aim of the study: To evaluate if perennial non-infectious rhinitis is associated with sleep disturbances in asthma. Materials and methods: This is a questionnaire based study in a random population sample from Denmark, Estonia, Iceland, Norway and Sweden aged 30-54 yr. A total of 1127 individuals reporting asthma from an original random population sample of 16,191 were analysed regarding their quality of sleep in relation to perennial non-infectious rhinitis. Perennial non-infectious rhinitis was defined as having nasal symptoms such as nasal blockage and secretion in the absence of common cold, always. Asthma was defined as both ever having had asthma and having physician diagnosed asthma. Odds ratios (OR) for difficulties inducing sleep, difficulties maintaining sleep, early morning awakenings and daytime sleepiness were calculated in a multiple logistic regression controlling for other risk factors for sleep disturbances such as snoring, wheeze, obesity and smoking. Results: The response rate was 74%. A total of 189 (17%) of the subjects with asthma reported perennial non-infectious rhinitis. Perennial non-infectious rhinitis was associated with an increased OR for difficulties maintaining sleep (1.6 (95% confidence interval (CI) 1.1-2.3)), early morning awakenings (1.5 (95% CI 1.1-2.2)) and daytime sleepiness (1.8 (95% CI 1.2-2.9)). The result show that perennial non-infectious rhinitis is an independant risk factor for sleep disturbances in asthma.

  • 10. Holm, M
    et al.
    Kim, J-L
    Lillienberg, L
    Storaas, T
    Jögi, Rain
    Svanes, C
    Schlünssen, V
    Forsberg, B
    Gíslason, T
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Torén, K
    Incidence and prevalence of chronic bronchitis: impact of smoking and welding. The RHINE study2012In: The International Journal of Tuberculosis and Lung Disease, ISSN 1027-3719, E-ISSN 1815-7920, Vol. 16, no 4, p. 553-557Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the prevalence and incidence rate of chronic bronchitis (CB) in relation to smoking habits and exposure to welding fumes in a general population sample.

    METHODS: Subjects from Northern Europe born between 1945 and 1971 who participated in Stage 1 (1989-1994) of the European Community Respiratory Health Survey were mailed a respiratory questionnaire in 1999-2001 (the RHINE study); 15 909 answered the questionnaire and gave complete data on smoking. CB was defined as chronic productive cough of at least 3 months a year for 2 consecutive years. The questionnaire comprised an item about age when CB started and items about exposure to welding fumes. The incidence of CB was retrospectively assessed for the observation period 1980-2001.

    RESULTS: CB had a prevalence of 5.4%, and was associated with current smoking and welding exposure. The incidence rate of CB was 1.9 per 1000 person-years, and was increased in relation to welding exposure (low exposure HR 1.4, 95%CI 1.1-1.8; high exposure HR 2.0, 95%CI 1.6-2.7) and in relation to smoking (HR 2.1, 95%CI 1.8-2.5).

    CONCLUSION: Smoking and occupational exposure to welding fumes are both associated with an increased risk of CB.

  • 11. Holm, M.
    et al.
    Omenaas, E.
    Gíslason, T.
    Svanes, C.
    Jögi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Norrman, E.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Torén, K.
    Remission of asthma: a prospective longitudinal study from northern Europe (RHINE study)2007In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 30, no 1, p. 62-65Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate the remission rate of adult asthma in a general population sample in relation to age, sex, asthma symptoms, allergic rhinitis and smoking. A follow-up of the random population samples from the European Community Respiratory Health Survey in Northern Europe was conducted from 1999-2001 on 1,153 individuals (aged 26-53 yrs) with reported asthma. Remission was defined as no asthmatic symptoms in two consecutive years and no current use of asthma medication. Remission rates per 1,000 person-yrs were calculated and Cox regression models, adjusting for confounders, were used to estimate hazard ratios (HR) with 95% confidence intervals (CI). An average remission rate of 20.2 per 1,000 person-yrs was found. There was no significant difference according to sex; the remission rates were 21.7 and 17.8 per 1,000 person-yrs in females and males, respectively. An increased remission rate was observed among subjects who quit smoking during the observation period. Subjects not reporting any asthma symptom at baseline had an increased remission rate. In the Cox regression model, ex-smoking (HR 1.65P 95% Cl 1.01-2.71) was associated with increased remission rate, and reporting any asthma symptom at baseline was associated with decreased remission rate (HR 0.7, 95% Cl 0.40-0.90). In conclusion, the present prospective longitudinal study showed that quitting smoking and the presence of mild disease appeared to favour remission.

  • 12.
    Janson, Christer
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Asbjornsdottir, Hulda
    Birgisdottir, Alda
    Sigurjonsdottir, R B
    Gunnbjörnsdottir, María
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Gislason, D
    Olafsson, Isleifur
    Cook, E
    Jögi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Gislason, Thorarinn
    Thjodleifsson, Bjarni
    The effect of infectious burden on the prevalence of atopy and respiratory allergies in Iceland, Estonia, and Sweden2007In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 120, no 3, p. 673-679Article in journal (Refereed)
    Abstract [en]

    Background: Epidemiologic reports on the effect of microbe exposure on the development of atopy and allergic asthma are inconsistent. Objectives: The study investigates the association between serologic markers of infections and occurrence of atopy, allergic asthma, and rhinitis among adults in Iceland, Sweden, and Estonia. Methods: Individuals (n = 1249; mean age, 42 years) from Iceland, Sweden, and Estonia underwent a structured interview and blood sampling. Specific IgE was measured against 4 allergens, and IgG antibodies were measured against Helicobacter pylori, Toxoplasmosis gondii, hepatitis A virus, herpes simplex virus 1, Chlamydia pneumoniae, EBV, and cytomegalovirus. Results: Nonatopic subjects more often had positive serology for Helicobacter pylori, herpes simplex virus 1, Chlamydia pneumoniae, and cytomegalovirus. Having a low number (≤3) of IgG antibodies against the various infectious agents was an independent risk factor for atopy (odds ratio [OR], 1.43; 95% CI, 1.06-1.93), allergic asthma (OR, 1.82; 95% CI, 1.12-2.98), and allergic rhinitis (OR, 1.69; 95% CI, 1.21-2.37). The proportion of atopy that can be explained by a lower number (≤3) of infections was 6.7% in Iceland, 9.2% in Estonia, and 16.4% in Sweden, and 6.7%, 48.2%, and 33.4% for allergic asthma, respectively. Conclusion: Our data are consistent with cumulative protective effect of infections against atopy and respiratory allergies irrespective of route of infection. Clinical implications: The study indicates what microbes or combination of microbes play a role in the complex interplay between hygiene and allergy and may contribute toward the understanding of the allergy epidemic.Background: Epidemiologic reports on the effect of microbe exposure on the development of atopy and allergic asthma are inconsistent. Objectives: The study investigates the association between serologic markers of infections and occurrence of atopy, allergic asthma, and rhinitis among adults in Iceland, Sweden, and Estonia. Methods: Individuals (n = 1249; mean age, 42 years) from Iceland, Sweden, and Estonia underwent a structured interview and blood sampling. Specific IgE was measured against 4 allergens, and IgG antibodies were measured against Helicobacter pylori, Toxoplasmosis gondii, hepatitis A virus, herpes simplex virus 1, Chlamydia pneumoniae, EBV, and cytomegalovirus. Results: Nonatopic subjects more often had positive serology for Helicobacter pylori, herpes simplex virus 1, Chlamydia pneumoniae, and cytomegalovirus. Having a low number (≤3) of IgG antibodies against the various infectious agents was an independent risk factor for atopy (odds ratio [OR], 1.43; 95% CI, 1.06-1.93), allergic asthma (OR, 1.82; 95% CI, 1.12-2.98), and allergic rhinitis (OR, 1.69; 95% CI, 1.21-2.37). The proportion of atopy that can be explained by a lower number (≤3) of infections was 6.7% in Iceland, 9.2% in Estonia, and 16.4% in Sweden, and 6.7%, 48.2%, and 33.4% for allergic asthma, respectively. Conclusion: Our data are consistent with cumulative protective effect of infections against atopy and respiratory allergies irrespective of route of infection. Clinical implications: The study indicates what microbes or combination of microbes play a role in the complex interplay between hygiene and allergy and may contribute toward the understanding of the allergy epidemic.

  • 13.
    Janson, Christer
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    de Marco, R
    Accordini, S
    Almar, E
    Bugiani, M
    Carolei, A
    Cazzoletti, L
    Cerveri, I
    Corsico, A
    Duran-Tauleria, E
    Gislason, D
    Gulsvik, Amund
    Jögi, Rain
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Marinoni, A
    Martínez-Moratalla, J
    Pin, I
    Vermeire, P
    Jarvis, D
    Changes in the use of anti-asthmatic medication in an international cohort.2005In: Eur Respir Journal, ISSN 0903-1936, Vol. 26, no 6, p. 1047-1055Article in journal (Refereed)
  • 14.
    Janson, Christer
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Künzli, N
    de Marco, R
    Chinn, S
    Jarvis, D
    Svanes, C
    Heinrich, J
    Jögi, R
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Gislason, T
    Sunyer, J
    Ackermann-Liebrich, U
    Antó, J M
    Cerveri, I
    Kerhof, M
    Leynaert, B
    Luczynska, C
    Neukirch, F
    Vermeire, P
    Wjst, M
    Burney, P
    Changes in active and passive smoking in the European Community Respiratory Health Survey.2006In: Eur Respir J, ISSN 0903-1936, Vol. 27, no 3, p. 517-24Article in journal (Refereed)
  • 15.
    Janson, Christer
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Norbäck, Dan
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Omenaas, Ernst
    Gislason, Thorarinn
    Nyström, Lennart
    Jögi, Rain
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Lindberg, Eva
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Gunnbjörnsdóttir, Maria
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Norrman, Eva
    Wentzel-Larsen, T
    Svanes, C
    Jensen, E J
    Torén, Kjell
    Insomnia is more common among subjects living in damp buildings.2005In: Occup Environ Med, ISSN 1470-7926, Vol. 62, no 2, p. 113-8Article in journal (Other scientific)
  • 16.
    Jönsson, Ulla-Britt
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Douhan Håkansson, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Jõgi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Venge, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Associations of ECP (eosinophil cationic protein)-gene polymorphisms to allergy, asthma, smoke habits and lung function in two Estonian and Swedish sub cohorts of the ECRHS II study2010In: BMC Pulmonary Medicine, ISSN 1471-2466, E-ISSN 1471-2466, Vol. 10, p. 36-Article in journal (Refereed)
    Abstract [en]

    Background: The Eosinophil Cationic Protein (ECP) is a potent multifunctional protein. Three common polymorphisms are present in the ECP gene, which determine the function and production of the protein. The aim was to study the relationship of these ECP gene polymorphisms to signs and symptoms of allergy and asthma in a community based cohort (The European Community Respiratory Health Survey (ECRHS)).

    Methods: Swedish and Estonian subjects (n = 757) were selected from the larger cohort of the ECRHS II study cohort. The prevalence of the gene polymorphisms ECP434(G>C) (rs2073342), ECP562(G>C) (rs2233860) and ECP c.-38(A>C) (rs2233859) were analysed by DNA sequencing and/or real-time PCR and related to questionnaire-based information of allergy, asthma, smoking habits and to lung functions.

    Results: Genotype prevalence showed both ethnic and gender differences. Close associations were found between the ECP434(G>C) and ECP562(G>C) genotypes and smoking habits, lung function and expression of allergic symptoms. Non-allergic asthma was associated with an increased prevalence of the ECP434GG genotype. The ECP c.-38(A>C) genotypes were independently associated to the subject being atopic.

    Conclusion: Our results show associations of symptoms of allergy and asthma to ECP-genotypes, but also to smoking habits. ECP may be involved in impairment of lung functions in disease. Gender, ethnicity and smoking habits are major confounders in the evaluations of genetic associations to allergy and asthma.

  • 17. Laerum, B N
    et al.
    Svanes, Cecilie
    Wentzel-Larsen, T
    Gulsvik, Amund
    Iversen, M
    Gislason, Thorarinn
    Jögi, Rain
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Norrman, Eva
    Janson, Christer
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Omenaas, Ernst
    The association between birth size and atopy in young North-European adults.2005In: Clin Exp Allergy, ISSN 0954-7894, Vol. 35, no 8, p. 1022-7Article in journal (Refereed)
  • 18. 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.

  • 19.
    Olafsdottir, Inga Sif
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Gíslason, Thórarinn
    Thjódleifsson, Bjarni
    Olafsson, Isleifur
    Gíslason, Davíd
    Jõgi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Gender differences in the association between C-reactive protein, lung function impairment, and COPD2007In: International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, Vol. 2, no 4, p. 635-642Article in journal (Refereed)
    Abstract [en]

    Individuals with COPD have systemic inflammation that can be assessed by measuring C-reactive protein (CRP). In this paper we evaluated whether CRP is related to COPD, lung function and rate of lung function decline. We included 1237 randomly selected subjects (mean age 42, range 28–56 years) from three centers in the European Community Respiratory Health Survey: Reykjavik, Uppsala and Tartu. CRP was measured at the end of the follow-up (mean 8.3 years) and the values were divided into 4 quartiles. Fifty-three non-asthmatic subjects fulfilled spirometric criteria for COPD (FEV1/FVC < 70%). COPD occurred more often in the 4th CRP quartile (OR (95% CI) 3.21 (1.13–9.08)) after adjustment for age, gender, body weight and smoking. High CRP levels were related to lower FEV1 values in both men (−437 (−596, −279) mL) and women (−144 (−243, −44) mL). The negative association between CRP and FEV1 was significantly larger in men than women (p = 0.04). The decline in FEV1 was larger (16 (5, 27) mL) in men with high CRP levels whereas no significant association between CRP and FEV1 decline was found in women. Higher CRP values are significantly associated with COPD and lower lung function in men and women. In men higher CRP values are related to a larger decline in FEV1.

  • 20.
    Sahlberg, Bo
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Gunnbjörnsdottir, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Soon, A.
    Jõgi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Gislason, T.
    Wieslander, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Airborne molds and bacteria, microbial volatile organic compounds (MVOC), plasticizers and formaldehyde in dwellings in three North European cities in relation to sick building syndrome (SBS)2013In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 444, p. 433-440Article in journal (Refereed)
    Abstract [en]

    There are few studies on associations between airborne microbial exposure, formaldehyde, plasticizers in dwellings and the symptoms compatible with the sick building syndrome (SBS). As a follow-up of the European Community Respiratory Health Survey (ECRHS II), indoor measurements were performed in homes in three North European cities. The aim was to examine whether volatile organic compounds of possible microbial origin (MVOCs), and airborne levels of bacteria, molds, formaldehyde, and two plasticizers in dwellings were associated with the prevalence of SBS, and to study associations between MVOCs and reports on dampness and mold.The study included homes from three centers included in ECRHS II. A total of 159 adults (57% females) participated (19% from Reykjavik, 40% from Uppsala, and 41% from Tartu). A random sample and additional homes with a history of dampness were included. Exposure measurements were performed in the 159 homes of the participants. MVOCs were analyzed by GCMS with selective ion monitoring (SIM). Symptoms were reported in a standardized questionnaire. Associations were analyzed by multiple logistic regression.In total 30.8% reported any SBS (20% mucosal, 10% general, and 8% dermal symptoms) and 41% of the homes had a history of dampness and molds There were positive associations between any SBS and levels of 2-pentanol (P=0.002), 2-hexanone (P=0.0002), 2-pentylfuran (P=0.009), 1-octen-3-ol (P=0.002), formaldehyde (P=0.05), and 2,2,4-trimethyl-1,3-pentanediol monoisobutyrate (Texanol) (P=0.05). 1-octen-3-ol (P=0.009) and 3-methylfuran (P=0.002) were associated with mucosal symptoms. In dwellings with dampness and molds, the levels of total bacteria (P=0.02), total mold (P=0.04), viable mold (P=0.02), 3-methylfuran (P=0.008) and ethyl-isobutyrate (P=0.02) were higher.In conclusion, some MVOCs like 1-octen-3-ol, formaldehyde and the plasticizer Texanol, may be a risk factor for sick building syndrome. Moreover, concentrations of airborne molds, bacteria and some other MVOCs were slightly higher in homes with reported dampness and mold.

  • 21. Schioler, L.
    et al.
    Ruth, M.
    Jogi, R.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Gislason, T.
    Storaas, T.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Forsberg, B.
    Sigsgaard, T.
    Toren, K.
    Hellgren, J.
    Nocturnal GERD - a risk factor for rhinitis/rhinosinusitis: the RHINE study2015In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 70, no 6, p. 697-702Article in journal (Refereed)
    Abstract [en]

    BackgroundIt has been suggested that gastroesophageal reflux disease (GERD) is a risk factor for developing rhinitis/rhinosinusitis, but data are lacking. This is a prospective 10-year follow-up study of a large multicenter cohort from Northern Europe, evaluating the relationship between nocturnal GERD and noninfectious rhinitis (NIR). MethodsThe study comprised 5417 subjects born between 1945 and 1973, who answered a questionnaire in 1999-2001 and again in 2010-2012. Noninfectious rhinitis was defined as having nasal obstruction, secretion, and/or sneezing without having the common cold. Odds ratios for developing NIR in relation to age, gender, BMI, smoking, asthma, and nocturnal GERD were calculated. ResultsDuring the 10-year observation period, 1034 subjects (19.1%) developed NIR. Subjects reporting nocturnal gastroesophageal reflux in both 1999 and 2010 had more NIR in 2010 (2.8% vs 1.2%, P<0.001). There was a significant dose-response relationship between the number of reflux episodes/week in 1999 and the risk of having NIR in 2010, P=0.02. In the multiple regression adjusted for age, gender, BMI, tobacco smoke, and asthma, those with nocturnal GERD in 1999 (3 episodes of nocturnal gastroesophageal reflux symptoms per week) had an OR of 1.6 (95% CI 1.0-2.5, P=0.03) to develop NIR in 2010. Smoking was associated both with an increased risk of developing NIR (30.7% vs 24.0%, P<0.001) and with the development of nocturnal GERD. ConclusionThis large, population-based, 10-year study indicates that nocturnal GERD was a risk factor for noninfectious rhinitis/rhinosinusitis. GERD should therefore be considered in patients with rhinitis of known and unknown origin.

  • 22.
    Svanes, Cecilie
    et al.
    Centre for International Health, University of Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Norway.
    Koplin, Jennifer
    Centre for International Health, University of Bergen, Norway; School of Population and Global Health, University of Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia .
    Skulstad, Svein Magne
    Department of Clinical Science, University of Bergen, Norway; Department of Obstetrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway .
    Johannessen, Ane
    Department of Clinical Science, University of Bergen, Norway; Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
    Bertelsen, Randi Jakobsen
    Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway;Department of Clinical Science, University of Bergen, Norway .
    Benediktsdottir, Byndis
    Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland; University of Iceland, Medical Faculty.
    Bråbäck, Lennart
    Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden.
    Elie Carsin, Anne
    Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
    Dharmage, Shyamali
    Department of Clinical Science, University of Bergen, Norway; School of Population and Global Health, University of Melbourne, Australia.
    Dratva, Julia
    Centre for International Health, University of Bergen, Norway; Department of Epidemiology and Public Health, Gender & Health, Swiss Tropical and Public Health Institute, Basel University, Switzerland.
    Forsberg, Bertil
    Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden.
    Gislason, Thorarinn
    Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland; University of Iceland, Medical Faculty.
    Heinrich, Joachim
    Institute of Epidemiology I, Helmholtz Zentrum, Munich, Germany.
    Holm, Mathias
    Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Jarvis, Deborah
    Faculty of Medicine, National Heart & Lung Institute, Imperial College, London, UK.
    Jögi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research. Lung Clinic, Foundation Tartu University Clinics, Tartu, Estonia; Department of Pulmonary Medicine, Tartu University, Estonia.
    Krauss-Etschmann, Susanne
    Research Center Borstel, Leibniz- Center for Medicine and Biosciences, Divison of Experimental Asthma Research, University of Kiel, Germany.
    Lindberg, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Macsali, Ferenc
    Department of Obstetrics and Gynecology, Haukeland, University Hospital, Bergen, Norway and.
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Modig, Lars
    Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea ̊ University, Sweden.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Omenaas, Ernst
    Department of Clinical Science, University of Bergen, Norway; Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
    Waatevik Saure, Eirunn
    Department of Clinical Science, University of Bergen, Norway.
    Sigsgaard, Torben
    Department of Public Health, Aarhus University, Denmark.
    Skorge, Trude Duelien
    Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
    Svanes, Øistein
    Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Norway.
    Torén, Kjell
    Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Torres, Carl
    Department of Clinical Science, University of Bergen, Norway.
    Schlünssen, Vivi
    Department of Public Health; Aarhus University, Denmark.
    Gomez Real, Francisco
    Department of Clinical Science, University of Bergen, Norway; Department of Obstetrics and Gynecology, Haukeland, University Hospital, Bergen, Norway.
    Father's environment before conception and asthma risk in his children: a multi-generation analysis of the Respiratory Health In Northern Europe study2017In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 46, no 1, p. 235-245Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Whereas it is generally accepted that maternal environment plays a key role in child health, emerging evidence suggests that paternal environment before conception also impacts child health. We aimed to investigate the association between children's asthma risk and parental smoking and welding exposures prior to conception.

    METHODS:

    In a longitudinal, multi-country study, parents of 24 168 offspring aged 2-51 years provided information on their life-course smoking habits, occupational exposure to welding and metal fumes, and offspring's asthma before/after age 10 years and hay fever. Logistic regressions investigated the relevant associations controlled for age, study centre, parental characteristics (age, asthma, education) and clustering by family.

    RESULTS:

    Non-allergic early-onset asthma (asthma without hay fever, present in 5.8%) was more common in the offspring with fathers who smoked before conception {odds ratio [OR] = 1.68 [95% confidence interval (CI) = 1.18-2.41]}, whereas mothers' smoking before conception did not predict offspring asthma. The risk was highest if father started smoking before age 15 years [3.24 (1.67-6.27)], even if he stopped more than 5 years before conception [2.68 (1.17-6.13)]. Fathers' pre-conception welding was independently associated with non-allergic asthma in his offspring [1.80 (1.29-2.50)]. There was no effect if the father started welding or smoking after birth. The associations were consistent across countries.

    CONCLUSIONS:

    Environmental exposures in young men appear to influence the respiratory health of their offspring born many years later. Influences during susceptible stages of spermatocyte development might be important and needs further investigation in humans. We hypothesize that protecting young men from harmful exposures may lead to improved respiratory health in future generations.

  • 23. Svanes, Cecilie
    et al.
    Real, F. Gomez
    Gislason, Thorarinn
    Jansson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Jögi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Norrman, Eva
    Nyström, Lennart
    Torén, Kjell
    Omenaas, Erenst
    Association of asthma and hay fever with irregular menstruation2005In: Thorax, ISSN 0040-6376, E-ISSN 1468-3296, Vol. 60, no 6, p. 445-450Article in journal (Other academic)
    Abstract [en]

    BACKGROUND: There is some evidence that asthmatic women are more likely to have abnormal sex hormone levels. A study was undertaken to determine whether asthma and allergy were associated with irregular menstruation in a general population, and the potential role of asthma medication for this association. METHODS: A total of 8588 women (response rate 77%) participated in an 8 year follow up postal questionnaire study of participants of the ECRHS stage I in Denmark, Estonia, Iceland, Norway, and Sweden. Only non-pregnant women not taking exogenous sex hormones were included in the analyses (n = 6137). RESULTS: Irregular menstruation was associated with asthma (OR 1.54 (95% CI 1.11 to 2.13)), asthma symptoms (OR 1.47 (95% CI 1.16 to 1.86)), hay fever (OR 1.29 (95% CI 1.05 to 1.57)), and asthma preceded by hay fever (OR 1.95 (95% CI 1.30 to 2.96)) among women aged 26-42 years. This was also observed in women not taking asthma medication (asthma symptoms: OR 1.44 (95% CI 1.09 to 1.91); hay fever: OR 1.27 (95% CI 1.03 to 1.58); wheeze preceded by hay fever: OR 1.76 (95% CI 1.18 to 2.64)). Irregular menstruation was associated with new onset asthma in younger women (OR 1.58 (95% CI 1.03 to 2.42)) but not in women aged 42-54 years (OR 0.62 (95% CI 0.32 to 1.18)). The results were consistent across centres. CONCLUSIONS: Younger women with asthma and allergy were more likely to have irregular menstruation. This could not be attributed to current use of asthma medication. The association could possibly be explained by common underlying metabolic or developmental factors. The authors hypothesise that insulin resistance may play a role in asthma and allergy.

  • 24. Svanes, Oistein
    et al.
    Skorge, Trude Duelien
    Johannessen, Ane
    Bertelsen, Randi Jacobsen
    Bratveit, Magne
    Forsberg, Bertil
    Gislason, Thorarin
    Holm, Mathias
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Joegi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Macsali, Ferenc
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Omenaas, Ernst Reidar
    Real, Francisco Gomez
    Schlunssen, Vivi
    Sigsgaard, Torben
    Wieslander, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Zock, Jan-Paul
    Aasen, Tor
    Dratva, Julia
    Svanes, Cecilie
    Respiratory Health in Cleaners in Northern Europe: Is Susceptibility Established in Early Life?2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 7, article id e0131959Article in journal (Refereed)
    Abstract [en]

    Rationale There is some evidence that maternal smoking increases susceptibility to personal smoking's detrimental effects. One might question whether early life disadvantage might influence susceptibility to occupational exposure. Objectives In this cross-sectional study we investigated respiratory symptoms, asthma and self-reported chronic obstructive pulmonary disease (COPD) as related to working as a cleaner in Northern European populations, and whether early life factors influenced susceptibility to occupational cleaning's unhealthy effects. Methods The RHINE III questionnaire study assessed occupational cleaning in 13,499 participants. Associations with respiratory symptoms, asthma and self-reported COPD were analysed with multiple logistic regressions, adjusting for sex, age, smoking, educational level, parent's educational level, BMI and participating centre. Interaction of occupational cleaning with early life disadvantage (maternal smoking, severe respiratory infection < 5 years, born during winter months, maternal age at birth > 35 years) was investigated. Main Results Among 2138 ever-cleaners the risks of wheeze (OR 1.4, 95% CI 1.3-1.6), adult-onset asthma (1.5 [1.2-1.8]) and self-reported COPD (1.7 [1.3-2.2]) were increased. The risk increased with years in occupational cleaning (adult-onset asthma: <= 1 year 0.9 [0.7-1.3]; 1-4 years 1.5 [1.1-2.0]; >= 4 years 1.6 [1.2-2.1]). The association of wheeze with cleaning activity >= 4 years was significantly stronger for those with early life disadvantage than in those without (1.8 [1.5-2.3] vs. 1.3 [0.96-1.8]; pinteraction 0.035). Conclusions Occupational cleaners had increased risk of asthma and self-reported COPD. Respiratory symptom risk was particularly increased in persons with factors suggestive of early life disadvantage. We hypothesize that early life disadvantage may increase airway vulnerability to harmful exposure from cleaning agents later in life.

  • 25. Thjodleifsson, Bjarni
    et al.
    Asbjörnsdottir, Hulda
    Sigurjonsdottir, R.B.
    Gíslason, D.
    Olafsson, Isleifur
    Cook, Elizabet
    Gí­slason, Thorarinn
    Jögi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Seroprevalence of Helicobacter pylori and cagA antibodies in Iceland, Estonia and Sweden2007In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 39, no 8, p. 683-689Article in journal (Refereed)
    Abstract [en]

    The public health implications from H. pylori infection are considerable but the transmission routes are largely unknown. In this study, the prevalence, patient characteristics and risk factors for Helicobacter pylori infection were comparatively investigated in Iceland, Sweden and Estonia. Blood samples were collected from 1046 subjects aged≈25-50 y (447 in Reykjavik, 359 in Uppsala and 240 in Tartu) for determination of antibodies to H. pylori and its cagA protein. The prevalence of H. pylori antibodies was 69% in Tartu, 36% in Reykjavik and 11% in Uppsala (p<0.0001). There was an increase in prevalence with age in Iceland and Sweden but not in Estonia. The prevalence of antibodies to the cagA protein in subjects seroreactive to H. pylori was lower in Reykjavik (36%) than in Uppsala (69%) and Tartu (62%) (p<0.0001). H. pylori infection, as determined by seroreactivity, was positively associated with smoking and BMI. Overall, socioeconomic development during the childhood period seems to be the most important factor for the prevalence of H. pylori infection. In adults, smoking may be a contributory factor.

  • 26. Thjodleifsson, Bjarni
    et al.
    Olafsson, Isleifur
    Gislason, Davíd
    Gislason, Thorarinn
    Jögi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Infections and obesity: A multinational epidemiological study2008In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 40, no 5, p. 381-386Article in journal (Other academic)
    Abstract [en]

    Viral infections have been associated with the aetiology of obesity in animal models. This study investigates the association between 7 serological markers of infections and body mass index (BMI) in a population based sample. Individuals (n=985, mean age 42+/-97 (28-55) y, mean BMI 25.594.2) from Iceland, Sweden and Estonia underwent a structured interview and blood sampling. IgG antibodies were measured against Helicobacter pylori and the cagA protein, hepatitis A virus, Toxoplasma gondii, herpes simplex virus 1, Chlamydia pneumoniae, Epstein-Barr virus and cytomegalovirus. High-sensitive C-reactive protein (CRP) was measured as a marker of systemic inflammation. A significant positive association between being overweight (BMI25 kg/m2) and IgG antibodies was found for Helicobacter pylori (OR 1.86, CI 1.34-2.60) and Chlamydia pneumoniae (OR 1.39, CI 1.03-1.88) and combined seropositivity had synergistic effect (OR 2.54 (1.62-3.97)). CRP was positively related to BMI (pB0.0001), whereas no significant association was found between CRP and IgG antibodies against Helicobacter pylori and/or Chlamydia pneumoniae and CRP. The results suggest that infections with Chlamydia pneumoniae and Helicobacter pylori are both significantly and synergistically associated with overweight and this association is not related to indicators of systemic inflammation.

  • 27. Timm, Signe
    et al.
    Svanes, Cecilie
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Sigsgaard, Torben
    Johannessen, Ane
    Gislason, Thorarinn
    Jõgi, Rain
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Omenaas, Ernst
    Forsberg, Bertil
    Toren, Kjell
    Holm, Mathias
    Braback, Lennart
    Schlunssen, Vivi
    Place of upbringing in early childhood as related to inflammatory bowel diseases in adulthood: a population-based cohort study in Northern Europe2014In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 29, no 6, p. 429-437Article in journal (Refereed)
    Abstract [en]

    Background The two inflammatory bowel diseases (IBD), ulcerative colitis and Crohn's disease, has increased rapidly during the twentieth century, but the aetiology is still poorly understood. Impaired immunological competence due to decreasing biodiversity and altered microbial stimulation is a suggested explanation. Objective Place of upbringing was used as a proxy for the level and diversity of microbial stimulation to investigate the effects on the prevalence of IBD in adulthood. Methods Respiratory Health in Northern Europe (RHINE) III is a postal follow-up questionnaire of the European Community Respiratory Health Survey (ECRHS) cohorts established in 1989-1992. The study population was 10,864 subjects born 1945-1971 in Denmark, Norway, Sweden, Iceland and Estonia, who responded to questionnaires in 2000-2002 and 2010-2012. Data were analysed in logistic and Cox regression models taking age, sex, smoking and body mass index into consideration. Results Being born and raised on a livestock farm the first 5 years of life was associated with a lower risk of IBD compared to city living in logistic (OR 0.54, 95 % CI 0.31; 0.94) and Cox regression models (HR 0.55, 95 % CI 0.31; 0.98). Random-effect meta-analysis did not identify geographical difference in this association. Furthermore, there was a significant trend comparing livestock farm living, village and city living (p < 0.01). Sub-analyses showed that the protective effect was only present among subjects born after 1952 (OR 0.25, 95 % CI 0.11; 0.61). Conclusion This study suggests a protective effect from livestock farm living in early childhood on the occurrence of IBD in adulthood, however only among subjects born after 1952. We speculate that lower microbial diversity is an explanation for the findings.

  • 28. Ólafsdóttir, Inga Sif
    et al.
    Gislason, Thorarinn
    Thjódleifsson, B
    Olafsson, I
    Gislason, D
    Jögi, Rain
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    Janson, Christer
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Lungmedicin och allergologi.
    C-reactive protein is elevated in non-allergic but not allergic asthma.: a multicentre epidemiological study.2005In: Thorax, ISSN 0040-6376, Vol. 60, no 6, p. 451-4Article in journal (Other scientific)
1 - 28 of 28
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