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  • 101.
    Norbäck, Dan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Markowicz, Pawel
    Cai, Guihong
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Hashim, Zailina
    Ali, Faridah
    Zheng, Yi-Wu
    Lai, Xu-Xin
    Spangfort, Michael Dho
    Larsson, Lennart
    Hashim, Jamal Hisham
    Endotoxin, Ergosterol, Fungal DNA and Allergens in Dust from Schools in Johor Bahru, Malaysia-Associations with Asthma and Respiratory Infections in Pupils2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 2, p. e88303-Article in journal (Refereed)
    Abstract [en]

    There are few studies on associations between respiratory health and allergens, fungal and bacterial compounds in schools in tropical countries. The aim was to study associations between respiratory symptoms in pupils and ethnicity, chemical microbial markers, allergens and fungal DNA in settled dust in schools in Malaysia. Totally 462 pupils (96%) from 8 randomly selected secondary schools in Johor Bahru, Malaysia, participated. Dust was vacuumed from 32 classrooms and analysed for levels of different types of endotoxin as 3-hydroxy fatty acids (3-OH), muramic acid, ergosterol, allergens and five fungal DNA sequences. Multiple logistic regression was applied. Totally 13.1% pupils reported doctor's diagnosed asthma, 10.3% wheeze and 21.1% pollen or pet allergy. Indian and Chinese children had less atopy and asthma than Malay. Carbon dioxide levels were low (380-690 ppm). No cat (Fel d1), dog (Can f 1) or horse allergens (Ecu cx) were detected. The levels of Bloomia tropicalis (Blo t), house dust mite allergens (Der p 1, Der f 1, Der m 1) and cockroach allergens (Per a 1 and Bla g 1) were low. There were positive associations between levels of Aspergillus versicolor DNA and daytime breathlessness, between C14 3-OH and respiratory infections and between ergosterol and doctors diagnosed asthma. There were negative (protective) associations between levels of C10 3-OH and wheeze, between C16 3-OH and day time and night time breathlessness, between cockroach allergens and doctors diagnosed asthma. Moreover there were negative associations between amount of fine dust, total endotoxin (LPS) and respiratory infections. In conclusion, endotoxin at school seems to be mainly protective for respiratory illness but different types of endotoxin could have different effects. Fungal contamination measured as ergosterol and Aspergillus versicolor DNA can be risk factors for respiratory illness. The ethnical differences for atopy and asthma deserve further attention.

  • 102.
    Norbäck, Dan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Nordström, Klas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Zhao, Zhuohui
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Carbon dioxide (CO2) demand-controlled ventilation in university computer classrooms and possible effects on headache, fatigue and perceived indoor environment: an intervention study2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 2, p. 199-209Article in journal (Refereed)
    Abstract [en]

    Purpose

    To study the effects of a CO2 demand-controlled ventilation system (variable flow) in computer classrooms on perceived air quality and sick building syndrome.

    Methods

    University students (27 % women) participated in a blinded study. Two classrooms had variable flow (mean 5.56 ac/h); two others had constant ventilation flow (mean 5.07 ac/h). After one week, ventilation conditions were shifted. The students reported symptoms/perceptions during the last hour on rating scales. Temperature, air humidity, CO2, PM10 and number concentration of particles were measured simultaneously. Cat (Fel d 1), dog (Can f 1), horse (Equ cx) and house dust mites (Der f 1 and Der p 1) allergens were measured in dust. Those participating twice in the same classroom (N = 61) were analysed longitudinally.

    Results

    Mean CO2 was 784 ppm (9 % of time >1,000 ppm) with variable flow and 809 ppm with constant flow conditions (25 % of time >1,000 ppm). Mean temperature (22.6 °C), PM10 (18 μg/m3) and number concentration (1,860 pt/cm3) were unchanged. The median levels of cat, dog, horse and Der f 1 allergens were 10,400 ng/g, 4,900 ng/g, 13,700 U/ng and 260 ng/g dust, respectively. There were slightly less headache (p = 0.003), tiredness (p = 0.007) and improved perceived air quality (p = 0.02) with variable flow.

    Conclusions

    Use of a CO2-controlled ventilation system, reducing elevated levels of CO2, may slightly reduce headache and tiredness and improve perceived air quality. The high levels of pet allergens, due to track in of allergens from the home and possible accumulation due to electrostatic forces, illustrate a need for improved cleaning.

  • 103.
    Norbäck, Dan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Wieslander, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Zhang, X.
    Zhao, Zhuohui
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Respiratory symptoms, perceived air quality and physiological signs in elementary school pupils in relation to displacement and mixing ventilation system: an intervention study2011In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 21, no 5, p. 427-437Article in journal (Refereed)
    Abstract [en]

    Schools may be poorly ventilated and may contain furry pet allergens, particles and microorganisms. We studied health effects when changing from mixing ceiling ventilation to two types of displacement ventilation, front ventilation system (FVS) and floor master system (FMS). The study included pupils in three elementary school classes (N = 61), all with floor heating. One class received blinded interventions; the two others were unchanged (controls). Ventilation flow and supply air temperature was kept constant. The medical investigation included tear film stability (BUT), nasal patency and a questionnaire containing rating scales. When changing from mixing ventilation to FVS, the pupils (N = 26) perceived better air quality (P = 0.006) and less dyspnoea (P = 0.007) as compared to controls (N = 35), and BUT was improved (P = 0.03). At desk level, mean CO(2) was reduced from 867 to 655 ppm. Formaldehyde and viable bacteria were numerically lower, while total bacteria and molds were higher with displacement ventilation. There was no difference in symptoms or signs when changing from FVS to FMS. Cat (Der p1), dog (Can f1) and horse allergen (Equ cx) were common in air at all conditions. In conclusion, displacement ventilation may have certain positive health effects among pupils, as compared to conventional mixing ceiling systems.

  • 104.
    Norbäck, Dan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Zhang, Xin
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Fan, Qiannan
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Zhang, Zefei
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Zhang, Yinping
    Tsinghua Univ, Sch Architecture, Beijing, Peoples R China.
    Li, Baizhan
    Chongqing Univ, Key Lab Three Gorges Reservoir Reg Ecoenvironm, Chongqing, Peoples R China.
    Zhao, Zhuohui
    Fudan Univ, Dept Environm Hlth, Shanghai, Peoples R China.
    Huang, Chen
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Dept Bldg Environm & Energy Engn, Shanghai, Peoples R China.
    Deng, Qihong
    Cent S Univ, XiangYa Sch Publ Hlth, Changsha, Hunan, Peoples R China;Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Lu, Chan
    Cent S Univ, XiangYa Sch Publ Hlth, Changsha, Hunan, Peoples R China;Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Qian, Hua
    Southeast Univ, Sch Energy & Environm, Nanjing, Jiangsu, Peoples R China.
    Yang, Xu
    Cent China Normal Univ, Coll Life Sci, Wuhan, Hubei, Peoples R China.
    Sun, Yuexia
    Tianjin Univ, Sch Environm Sci & Engn, Tianjin, Peoples R China.
    Sundell, Jan
    Tianjin Univ, Sch Environm Sci & Engn, Tianjin, Peoples R China.
    Wang, Juan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Home environment and health: Domestic risk factors for rhinitis, throat symptoms and non-respiratory symptoms among adults across China2019In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 681, p. 320-330Article in journal (Refereed)
    Abstract [en]

    Few studies exist from China on associations between home environment and adult health. We studied associations between home environment factors (other than dampness and mould) and rhinitis, throat and dermal symptoms and headache and fatigue among young parents in six cities across China (N = 36,541). They were recruited as parents from day care centers selected randomly and answered a questionnaire on medical symptoms and the home environment. Odds ratios (OR) were calculated by multilevel logistic regression adjusting for gender, atopy, smoking, home size and dampness/mould. Overall, 4.8% had skin symptoms 3.1% rhinitis, 2.8% eye, 4.1% throat symptoms, 3.0% headache and 13.9% had fatigue (all as weekly symptoms). Redecoration was associated with rhinitis, eye and skin symptoms, headache and fatigue. New furniture was associated with eye, throat and skin symptoms and fatigue. Gas cooking was associated with eye and throat symptoms, headache and fatigue. Biomass cooking was associated with eye and throat symptoms and headache. Burning incense was associated with eye, throat and skin symptoms, headache and fatigue. Presence of cockroaches and mosquitos or flies was associated with all six symptoms. Rats or mice were associated with eye and dermal symptoms. Cat keeping was associated with eye symptoms while dog keepers had less fatigue. Living near major roads was associated with rhinitis, eye, throat and skin symptoms and fatigue. Daily cleaning, a mechanical ventilation system in the kitchen or in the bathroom, living in older buildings and living in less urbanized areas were protective factors. In conclusion, urbanization, traffic exhaust, indoor emissions from redecoration and new furniture, gas cooking and air pollution from burning incense and biomass may cause dermal and mucosal symptoms, headache and fatigue among adults in China. Indoor animals (cats, mice/rats, cockroaches) were other risk factors. Daily cleaning, mechanical ventilation and living in older buildings can be protective. 

  • 105.
    Norbäck, Dan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Zhao, Z.-H.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Wang, Z-H
    Wieslander, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Mi, Y.-H.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Zhang, Z
    Asthma, eczema, and reports on pollen and cat allergy among pupils in Shanxi province, China2007In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 80, no 3, p. 207-216Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To study self-reported asthma, eczema, and pollen and furry pet allergy among pupils (9-20 years) in Shanxi province, China, in relation to dietary and environmental factors. METHODS: A standardised questionnaire was distributed to pupils in two primary and two secondary schools, one in Taiyuan city (3.0 milj. inhabitants), the others in Qingxu county, a rural area 30 km outside Taiyuan. Totally, 2,116 pupils (90%) participated. RESULTS: Fifty percent were girls, 61% had been growing up on the countryside, 18% lived in Taiyuan now, 1.7% had ever had asthma, 0.8% had doctor's diagnosed asthma, 1.4% pollen allergy, 1.7% cat allergy, and 0% had dog allergy. Multiple logistic regression was applied, controlling for age, gender, diet, indoor exposures, rural childhood, and current urban residency. Girls had less eczema (OR = 0.51; 95%CI 0.28-0.92). Pupils in the city had more eczema (OR = 5.05; 95% CI 1.11-23.3). Those with a rural childhood had less asthma (OR = 0.17; 95% CI 0.05-0.60), eczema (OR = 0.15; 95% CI 0.13-0.66) and pollen/cat allergy (OR = 0.50; 95%CI 0.25-0.99). None of the indoor variables was related to asthma or allergy. Children with frequent fruit consumption had less asthma (OR = 0.40; 95% CI 0.19-0.82) and pollen/cat allergy (OR = 0.49; 95% CI 0.29-0.84). Those with frequent fish consumption had less asthma (OR = 0.32; 95% CI 0.11-0.97). Those with frequent hamburgers consumption had more asthma (OR = 2.05; 95% CI 1.09-3.87) and eczema (OR = 1.85; 95% CI 1.12-3.04). CONCLUSION: Asthma, eczema, and pollen or pet allergy was uncommon, compared with western countries and other areas in China. Pupils with a rural childhood had less asthma and allergy, which is consistent with the "hygiene hypothesis". Fruit and fish consumption may reduce, and fast food consumption may increase the risk for asthma. Finally, the higher prevalence of asthma and eczema among younger children, born in the 1990s, indicates a cohort effect similar to that observed in western countries.

  • 106.
    Norbäck, Dan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Zock, Jan-Paul
    Plana, Estel
    Heinrich, Joachim
    Svanes, Cecilie
    Sunyer, Jordi
    Kuenzli, Nino
    Villani, Simona
    Olivieri, Mario
    Soon, Argo
    Jarvis, Deborah
    Mould and dampness in dwelling places, and onset of asthma: the population-based cohort ECRHS2013In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 70, no 5, p. 325-331Article in journal (Refereed)
    Abstract [en]

    Objectives To study new onset of adult asthma in relation to dampness and moulds in dwelling places. Methods Totally, 7104 young adults from 13 countries who participated in the European Community Respiratory Health Survey (ECRHS I and II) who did not report respiratory symptoms or asthma at baseline were followed prospectively for 9 years. Asthma was assessed by questionnaire data on asthmatic symptoms and a positive metacholine challenge test at follow-up. Data on the current dwelling was collected at the beginning and at the end of the follow-up period by means of an interviewer-led questionnaire, and by inspection. Relative risks (RR) for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking and study centre. Results There was an excess of new asthma in subjects in homes with reports on water damage (RR 1.46; 95% CI 1.09 to 1.94) and indoor moulds (RR=1.30; 95% CI 1.00 to 1.68) at baseline. A dose-response effect was observed. The effect was stronger in those with multisensitisation and in those sensitised to moulds. Observed damp spots were related to new asthma (RR=1.49; 95% CI 1.00 to 2.22). The population-attributable risk was 3-10% for reported, and 3-14% for observed dampness/moulds. Conclusions Dampness and mould are common in dwellings, and contribute to asthma incidence in adults.

  • 107.
    Norbäck, Dan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Zock, J-P
    Ctr Res Environm Epidemiol CREAL, Barcelona, Spain.; IMIM Hosp del Mar, Municipal Inst Med Res, Barcelona, Spain.; CIBERESP, Madrid, Spain.
    Plana, E
    Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain.; CIBER Epidemiologia y Salud Publica, (CIBERESP), Madrid, Spain.
    Heinrich, J
    German Research Centre for Environmental Health, Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
    Tischer, C
    Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain.; CIBER Epidemiologia y Salud Publica, (CIBERESP), Madrid, Spain.
    Jacobsen Bertelsen, R
    Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
    Sunyer, J
    Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain.; CIBER Epidemiologia y Salud Publica, (CIBERESP), Madrid, Spain.; Pompeu Fabra Univ UFP, Barcelona, Spain.
    Künzli, N
    Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.; Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.; University of Basel, Basel, Switzerland.
    Villani, S
    Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy.
    Olivieri, M
    Occupational Medicine, University of Verona, Verona, Italy.
    Verlato, G
    Epidemiology and Medical Statistics, University of Verona, Verona, Italy.
    Soon, A
    Department of Public Health, University of Tartu, Tartu, Estonia.; Estonian Research Council, Tartu, Estonia.
    Schlünssen, V
    Department of Public health, Aarhus University, Aarhus, Denmark.; The National Research Center for the Working Environment, Copenhagen, Denmark.
    Gunnbjörnsdottir, M I
    Allergy Department, Landspitali University Hospital, Reykjavik, Iceland.
    Jarvis, D
    Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College, London, UK.
    Building dampness and mold in European homes in relation to climate, building characteristics and socio-economic status: The European Community Respiratory Health Survey ECRHS II2017In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 27, no 5, p. 921-932Article in journal (Refereed)
    Abstract [en]

    We studied dampness and mold in homes in relation to climate, building characteristics and socio-economic status (SES) across Europe, for 7127 homes in 22 centers. A subsample of 3118 homes was inspected. Multilevel analysis was applied, including age, gender, center, SES, climate, and building factors. Self-reported water damage (10%), damp spots (21%), and mold (16%) in past year were similar as observed data (19% dampness and 14% mold). Ambient temperature was associated with self-reported water damage (OR=1.63 per 10°C; 95% CI 1.02-2.63), damp spots (OR=2.95; 95% CI 1.98-4.39), and mold (OR=2.28; 95% CI 1.04-4.67). Precipitation was associated with water damage (OR=1.12 per 100 mm; 95% CI 1.02-1.23) and damp spots (OR=1.11; 95% CI 1.02-1.20). Ambient relative air humidity was not associated with indoor dampness and mold. Older buildings had more dampness and mold (P<.001). Manual workers reported less water damage (OR=0.69; 95% CI 0.53-0.89) but more mold (OR=1.27; 95% CI 1.03-1.55) as compared to managerial/professional workers. There were correlations between reported and observed data at center level (Spearman rho 0.61 for dampness and 0.73 for mold). In conclusion, high ambient temperature and precipitation and high building age can be risk factors for dampness and mold in homes in Europe.

  • 108.
    Olivieri, M.
    et al.
    Univ Hosp Verona, Unit Occupat Med, Verona, Italy..
    Heinrich, J.
    Inst Epidemiol I, German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Neuherberg, Germany.;Univ Munich, Univ Hosp Munich, Inst & Outpatient Clin Occupat Social & Environm, Munich, Germany..
    Schlünssen, V.
    Aarhus Univ, Danish Ramazzini Ctr, Dept Publ Hlth, Sect Environm Occupat & Hlth, Aarhus, Denmark..
    Anto, J. M.
    Ctr Res Environm Epidemiol CREAL, Barcelona, Spain.;Hosp del Mar, Med Res Inst, IMIM, Barcelona, Spain.;UPF, Barcelona, Spain.;CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain..
    Forsberg, B.
    Umea Univ, Dept Publ Hlth & Clin Med, Div Occupat & Environm Med, Umea, Sweden..
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Leynaert, B.
    INSERM, UMR 1152, Pathophysiol & Epidemiol Resp Dis, Paris, France.;Univ Paris 07, UMR 1152, Paris, France..
    Norbäck, D.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Sigsgaard, T.
    Aarhus Univ, Danish Ramazzini Ctr, Dept Publ Hlth, Sect Environm Occupat & Hlth, Aarhus, Denmark..
    Svanes, C.
    Univ Bergen, Ctr Int Hlth, Bergen, Norway.;Haukeland Hosp, Dept Occupat Med, N-5021 Bergen, Norway..
    Tischer, C.
    Inst Epidemiol I, German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Neuherberg, Germany.;Ctr Res Environm Epidemiol CREAL, Barcelona, Spain.;UPF, Barcelona, Spain.;CIBER Epidemiol & Salud Publ CIBERESP, Barcelona, Spain..
    Villani, S.
    Univ Pavia, Unit Biostat & Clin Epidemiol, Dept Publ Hlth Expt & Forens Med, Via Palestro 3, I-27100 Pavia, Italy..
    Jarvis, D.
    Univ London Imperial Coll Sci Technol & Med, Resp Epidemiol & Publ Hlth Grp, London, England.;Univ London Imperial Coll Sci Technol & Med, MRC PHE Ctr Environm & Hlth, London, England..
    Verlato, G.
    Univ Verona, Dept Diagnost & Publ Hlth, Unit Epidemiol & Med Stat, Verona, Italy..
    The risk of respiratory symptoms on allergen exposure increases with increasing specific IgE levels2016In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 71, no 6, p. 859-868Article in journal (Refereed)
    Abstract [en]

    Background: The relation between IgE sensitization and allergic respiratory symptoms has usually been evaluated by dichotomizing specific IgE levels. The aim of this study was to evaluate the association between specific IgE levels and risk of symptoms on allergen-related exposure, with special reference to allergen-related asthma-rhinitis comorbidity.

    Methods: We considered 6391 subjects enrolled within the European Community Respiratory Health Survey 2, having information on cat/grass/D. pteronyssinus IgE levels and symptoms on exposure to animals/pollen/dust. The risk of oculonasal/asthmalike/both symptoms was evaluated by a multinomial logistic model.

    Results: A clear positive association was observed between specific IgE levels to cat/grass/mite and the risk of symptoms on each allergen-related exposure (test for trend with P < 0.001). This trend was particularly pronounced when considering the coexistence of asthmalike and oculonasal symptoms. Compared to nonsensitized subjects, subjects with specific IgE to cat >= 3.5 kU/l presented relative risk ratios of 11.4 (95% CI 6.7-19.2), 18.8 (8.2-42.8), and 55.3 (30.5-100.2) when considering, respectively, only oculonasal symptoms, only asthmalike symptoms, or both. A similar pattern was observed when considering specific IgE to grass/mite and symptoms on exposure to pollen/dust. Also the proportion of people using inhaled medicines or visiting a general practitioner for breathing problems in the previous year increased with increasing sum of specific IgE to cat/grass/mite.

    Conclusion: Specific IgE level is the most important predictor of allergen-related symptoms. The risk of both oculonasal/asthmalike symptoms increases with specific IgE levels, suggesting that specific IgE contributes to the 'united airways disease'.

  • 109.
    Olivieri, Mario
    et al.
    Univ Verona, Dept Diagnost & Publ Hlth, Unit Occupat Med, Verona, Italy.
    Murgia, Nicola
    Univ Perugia, Sect Occupat Med Resp Dis & Toxicol, Perugia, Italy.
    Carsin, Anne-Elie
    ISGlobal Inst Salud Global Barcelona, Campus MAR,Barcelona Biomed Res Pk PRBB, Barcelona, Spain.
    Heinrich, Joachim
    Ludwig Maximilians Univ Munchen, Univ Hosp Munich, Inst & Outpatient Clin Occupat Social & Environm, Munich, Germany.
    Benke, Geza
    Monash Univ, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia.
    Bono, Roberto
    Univ Turin, Dept Publ Hlth & Pediat, Turin, Italy.
    Corsico, Angelo Guido
    IRCCS Policlin San Matteo Fdn, Div Resp Dis, Pavia, Italy.
    Demoly, Pascal
    Univ Hosp Montpellier, Dept Pneumol & Addictol, Montpellier, France.
    Forsberg, Bertil
    Umea Univ, Dept Publ Hlth & Clin Med, Occupat & Environm Med, Umea, Sweden.
    Gislason, Thorarinn
    Univ Iceland, Landspitali Univ Hosp, Fac Med, Reykjavik, Iceland;Univ Iceland, Landspitali Univ Hosp, Dept Sleep, Reykjavik, Iceland.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Jogi, Rain
    Tartu Univ Hosp, Lung Clin, Tartu, Estonia.
    Leynaert, Benedicte
    Univ Paris Diderot, Inserm UMR Equipe Epidemiol 1152, Paris, France.
    Martinez-Moratalla Rovira, Jesus
    CHUA, Unit Pneumol, Albacete, Spain.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Nowak, Dennis
    Klinikum Univ Munchen, WHO Collaborating Ctr Occupat Hlth, Inst & Poliklin Arbeits Sozial & Umweltmed, Munich, Germany.
    Pascual, Silvia
    Galdakao Hosp, Pulmonol Dept, Biscay, Spain.
    Pin, Isabelle
    CHU Grenoble Alpes, Dept Pediat, Grenoble, France.
    Probst-Hensch, Nicole
    Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland.
    Raherison, Chantal
    Bordeaux Univ, Inst Publ Hlth & Epidemiol, INSERM U897, Bordeaux, France.
    Sigsgaard, Torben
    Aarhus Univ, Danish Ramazzini Ctr, Sect Environm Occupat & Hlth, Dept Publ Hlth, Aarhus, Denmark.
    Svanes, Cecilie
    Univ Bergen, Ctr Int Hlth, Bergen, Norway.
    Toren, Kjell
    Univ Gothenburg, Sect Occupat & Environm Med, Gothenburg, Sweden.
    Urrutia, Isabel
    Galdakao Hosp, Pulmonol Dept, Biscay, Spain.
    Weyler, Joost
    Univ Antwerp, Epidemiol & Social Med, Antwerp, Belgium;Univ Antwerp, StatUA Stat Ctr, Antwerp, Belgium.
    Jarvis, Deborah
    Imperial Coll, Natl Heart & Lung Inst, Resp Epidemiol Occupat Med & Publ Hlth, London, England.
    Zock, Jan-Paul
    ISGlobal Inst Salud Global Barcelona, Campus MAR,Barcelona Biomed Res Pk PRBB, Barcelona, Spain.
    Verlato, Giuseppe
    Univ Verona, Dept Diagnost & Publ Hlth, Unit Epidemiol & Med Stat, Verona, Italy.
    Effects of smoking bans on passive smoking exposure at work and at home: The European Community respiratory health survey2019In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 29, no 4, p. 670-679Article in journal (Refereed)
    Abstract [en]

    This longitudinal study investigated whether smoking bans influence passive smoking at work and/or at home in the same subjects. Passive smoking at work and/or at home was investigated in random population samples (European Community Respiratory Health Survey) in 1990-1995, with follow-up interviews in 1998-2003 and 2010-2014. National smoking bans were classified as partial (restricted to public workplaces) or global (extended to private workplaces). Multivariable analysis was accomplished by three-level logistic regression models, where level-1, level-2, and level-3 units were, respectively, questionnaire responses, subjects, and centers. Passive smoking at work was reported by 31.9% in 1990-1995, 17.5% in 1998-2003, and 2.5% in 2010-2014. Concurrently, passive smoking at home decreased from 28.9% to 18.2% and 8.8%. When controlling for sex, age, education, smoking status, and ECHRS wave, the odds of passive smoking at work was markedly reduced after global smoking bans (OR = 0.45, 95% CI 0.25-0.81), particularly among non-smokers, while the protective effect of global smoking bans on passive smoking at home was only detected in non-smokers. Smoking bans both in public and private workplaces were effective in reducing passive smoking at work in Europe. However, given the inefficacy of smoking bans in current smokers' dwellings, better strategies are needed to avoid smoking indoors.

  • 110. Olivieri, Mario
    et al.
    Zock, Jan-Paul
    Accordini, Simone
    Heinrich, Joachim
    Jarvis, Deborah
    Künzli, Nino
    Antó, Josep M
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Svanes, Cecilie
    Verlato, Giuseppe
    Risk factors for new-onset cat sensitization among adults: A population-based international cohort study2012In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 129, no 2, p. 420-425Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Cat exposure during childhood has been shown to increase the risk of developing cat sensitization, while the effect of cat exposure in adulthood has not yet been established.

    OBJECTIVE:

    To evaluate new-onset sensitization to cat in adulthood in relation to changes in cat keeping.

    METHODS:

    A total of 6292 European Community Respiratory Health Survey I (ECRHS I) participants aged 20 to 44 years from 28 European centers, who were not sensitized to cat, were reevaluated 9 years later in ECRHS II. Present and past cat ownership and total and specific IgE levels were assessed in both surveys. Allergen-specific sensitization was defined as a specific serum IgE level of 0.35 kU/L or more.

    RESULTS:

    A total of 4468 subjects did not have a cat in ECRHS I or ECRHS II, 473 had a cat only at baseline, 651 acquired a cat during the follow-up, and 700 had a cat at both evaluations. Two hundred thirty-one subjects (3.7%) became sensitized to cat. In a 2-level multivariable Poisson regression model, cat acquisition during follow-up was significantly associated with new-onset cat sensitization (relative risk = 1.85, 95% CI 1.23-2.78) when compared with those without a cat at both surveys. Preexisting sensitization to other allergens, a history of asthma, nasal allergies and eczema, and high total IgE level were also significant risk factors for developing cat sensitization, while cat ownership in childhood was a significant protective factor.

    CONCLUSION:

    Our data support that acquiring a cat in adulthood nearly doubles the risk of developing cat sensitization. Hence, cat avoidance should be considered in adults, especially in those sensitized to other allergens and reporting a history of allergic diseases.

  • 111.
    Real, Francisco Gomez
    et al.
    Univ Bergen, Dept Clin Sci, N-5020 Bergen, Norway;Haukeland Hosp, Dept Obstet & Gynaecol, Bergen, Norway.
    Burgess, John A.
    Villani, Simona
    Univ Melbourne, Sch Populat & Global Hlth, Allergy & Lung Hlth Unit, Melbourne, Vic, Australia;Univ Pavia, Dept Publ Hlth Expt & Forens Med, Unit Biostat & Clin Epidemiol, Pavia, Italy.
    Dratva, Julia
    Swiss Trop Inst, Inst Social & Prevent Med, Basel, Switzerland.
    Heinrich, Joachim
    Natl Res Ctr Environm & Hlth, Mol Epidemiol, Forschungszentrum Umwelt & Gesundheit, Neuherberg, Germany.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Jarvis, Debbie
    Imperial Coll, Dept Publ Hlth Sci, London, England.
    Koplin, Jennifer
    Univ Melbourne, Sch Populat & Global Hlth, Allergy & Lung Hlth Unit, Melbourne, Vic, Australia.
    Leynaert, Benedicte
    Inserm, UMR 1152, Pathophysiol & Epidemiol Resp Dis, Paris, France;Univ Paris Diderot Paris 7, Paris, France.
    Lodge, Caroline
    Univ Melbourne, Sch Populat & Global Hlth, Allergy & Lung Hlth Unit, Melbourne, Vic, Australia.
    Laerum, Birger N.
    Univ Bergen, Dept Clin Sci, N-5020 Bergen, Norway.
    Matheson, Melanie C.
    Univ Melbourne, Sch Populat & Global Hlth, Allergy & Lung Hlth Unit, Melbourne, Vic, Australia.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Omenaas, Ernst R.
    Univ Bergen, Dept Clin Sci, N-5020 Bergen, Norway;Haukeland Hosp, Ctr Clin Res, Bergen, Norway.
    Skulstad, Svein M.
    Univ Bergen, Dept Clin Sci, N-5020 Bergen, Norway;Haukeland Hosp, Dept Occupat Med, Bergen, Norway.
    Sunyer, Jordi
    Ctr Recerca Epidemiol & Ambiental, Barcelona, Spain.
    Dharmage, Shyamali C.
    Univ Melbourne, Sch Populat & Global Hlth, Allergy & Lung Hlth Unit, Melbourne, Vic, Australia.
    Svanes, Cecilie
    Haukeland Hosp, Dept Occupat Med, Bergen, Norway;Univ Bergen, Ctr Int Hlth, Bergen, Norway.
    Maternal age at delivery, lung function and asthma in offspring: a population-based survey2018In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 51, no 6, article id 1601611Article in journal (Refereed)
    Abstract [en]

    There is limited information about potential impact of maternal age on the respiratory health of offspring. We investigated the association of maternal age at delivery with adult offspring's lung function, respiratory symptoms and asthma, and potential differences according to offspring sex. 10 692 adults from 13 countries participating in the European Community Respiratory Health Survey (ECRHS) II responded to standardised interviews and provided lung function measurements and serum for IgE measurements at age 25-55 years. In logistic and linear multilevel mixed models we adjusted for participants' characteristics (age, education, centre, number of older siblings) and maternal characteristics (smoking in pregnancy, education) while investigating for differential effects by sex. Maternal age was validated in a subsample using data from the Norwegian birth registry. Increasing maternal age was associated with increasing forced expiratory volume in 1 s (2.33 mL per year, 95% CI 0.34-4.32 mL per year), more consistent in females (p(trend) 0.025) than in males (ptrend 0.14). Asthma (OR 0.85, 95% CI 0.79-0.92) and respiratory symptoms (OR 0.87, 95% CI 0.82-0.92) decreased with increasing maternal age (per 5 years) in females, but not in males (p(interaction) 0.05 and 0.001, respectively). The results were consistent across centres and not explained by confounding factors. Maternal ageing was related to higher adult lung function and less asthma/symptoms in females. Biological characteristics in offspring related to maternal ageing are plausible and need further investigation.

  • 112. Real, Gomez F.
    et al.
    Villani, S.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Jarvis, D.
    Sunyer, J.
    Heinrich, J.
    Dratva, J.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Leynaert, B.
    Koplin, J.
    Dharmage, S.
    Svanes, C.
    Maternal Age at Delivery and Asthma, Atopy and Lung Function in Offspring: A Question of Sex?2015In: Respirology (Carlton South. Print), ISSN 1323-7799, E-ISSN 1440-1843, Vol. 20, p. 42-42Article in journal (Other academic)
  • 113.
    Runeson, Roma
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Associations among sick building syndrome, psychosocial factors, and personality traits.2005In: Percept Mot Skills, ISSN 0031-5125, Vol. 100, no 3 Pt 1, p. 747-59Article in journal (Refereed)
  • 114.
    Runeson, Roma
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    af Klinteberg, Britt
    Edling, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    The infuence of personality, measured by the Karolinska Scales of Personality (KSP), on symptoms among subjects in suspected sick buildings2004In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, no 14, p. 394-404Article in journal (Refereed)
    Abstract [en]

    The aim was to study possible relationships between personality traitsas measured by the Karolinska Scales of Personality (KSP), a self-report personalityinventory based on psychobiological theory, and medical symptoms, insubjects with previous work history in suspected sick buildings. The studycomprised 195 participants from 19 consecutive cases of suspected sick buildings,initially collected in 1988–92. In 1998–89, the KSP inventory and a symptomsquestionnaire were administered in a postal follow-up study. There were 16questions on symptoms, including symptoms from the eyes, nose, throat, skin,and headache, tiredness, and a symptom score (SC), ranging from 0 to 16, wascalculated. The questionnaire also requested information on personal factors,including age, gender, smoking habits, allergy and diagnosed asthma. The KSPratings in the study group did not differ from the mean personality scale normscores, calculated from an external reference group. Females had higher scoresfor somatic anxiety (P < 0.01), muscular tension (P < 0.001), psychic anxiety(P < 0.01), psychasthenia (P < 0.05), indirect aggression (P < 0.05), and guilt(P < 0.05), while males scored higher on detachment (P < 0.001). Subjects withhigher SC were found to display higher degree of somatic anxiety (P < 0.001),muscular tension (P < 0.001), psychic anxiety (P < 0.001), psychasthenia(P < 0.001), inhibition of aggression (P < 0.05), detachment (P < 0.05), suspicion(P < 0.01), indirect aggression (P < 0.01), and verbal aggression(P < 0.05). In addition, ocular, respiratory, dermal, and systemic symptoms(headache and tiredness) were significantly related to anxiety- and aggressivityrelatedscales. There were associations between personality scales and change ofsymptom score (SC) during the 9-year period. The associations between KSPpersonality traits and symptoms were more pronounced in females. In conclusion,there are gender differences in personality and SBS symptoms. Personalitymay play a role in the occurrence of symptoms studied in indoor environmentalepidemiology. Our results support a view that measurement of personality couldbe of value in future studies and vulnerability to environmental stress.

  • 115.
    Runeson, Roma
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Stattin, H
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
    Symptoms and sense of coherence - a follow-up study of personnel from workplace buildings with indoor air problems.2003In: Int Arch Occup Environ Health, Vol. 76, p. 29-Article in journal (Refereed)
  • 116.
    Runeson, Roma
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Wahlstedt, Kurt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Pilot study of personality traits assessed by the Karolinska Scales of Personality (KSP) in asthma, atopy, and rhinitis2011In: Perceptual and Motor Skills, ISSN 0031-5125, E-ISSN 1558-688X, Vol. 113, no 3, p. 909-920Article in journal (Refereed)
    Abstract [en]

    Asthma and atopy are common diseases. To study associations between personality and asthma, atopy, rhinitis, and personality traits were measured on the Karolinska Scales of Personality for 193 persons working in 19 buildings with suspected indoor air problems. In addition, information on history of atopy, asthma, and rhinitis was collected by postal questionnaire. In analyses, asthma was associated with higher impulsiveness scores, and atopy in non-asthmatics was associated with higher social desirability scores and lower irritability, guilt, and impulsiveness scores. Non-atopic rhinitis was associated with scores on several anxiety-related scales, while atopic rhinitis was not associated with scores on the Karolinska Scales of Personality. This exploration implies that asthma, atopy, and rhinitis may be associated with various but different personality trait scores. The finding of such personality trait associations in persons with non-asthmatic atopy raises the question of a potential role of an emotional conflict in atopy and the role of personality in asthma, atopy, and rhinitis.

  • 117.
    Runeson, Roma
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Wahlstedt, Kurt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Projective drawings for assessing stress among subjects with medical symptoms compatible with sick building syndrome, and validation of a modified version of the Stress Load Index from the Drawing Personality Profile: a pilot study2007In: Perceptual and Motor Skills, ISSN 0031-5125, E-ISSN 1558-688X, Vol. 104, no 1, p. 111-122Article in journal (Refereed)
    Abstract [en]

    It was hypothesized that subjects with medical symptoms would show more signs of stress in projective drawings. A Stress Load Index, including five signs of stress in drawings, was evaluated. A questionnaire with an instruction to draw "a person in the rain" was sent to a cohort of 195 subjects, and the drawings were analysed blindly for eight stress items. Men had a higher index than women (p < .05) and drew clouds more often (p < .05). Drawing of clouds was associated with headache (adjOR = 4.28; 95% CI 1.75; 11.68). Drawing of puddles was associated with ocular symptoms (adjOR = 3.22; 95% CI 1.38, 7.50), facial dermal symptoms (adjOR= 2.94; 95% CI 1.28, 6.81), and tiredness (adjOR = 2.44; 95% CI 1.05, 5.67). Drawing of long rain strokes was associated with nasal symptoms (adjOR = 2.28; 95% CI 1.05, 2.06) and headache (adjOR = 3.20; 95% CI 1.28, 8.05). Age and stress load were predictors of sick building syndrome symptoms (p < .05). In conclusion, a nonverbal projective drawing test detected sex differences which represent directions opposite to those with verbal methods. These need empirical assessment.

  • 118.
    Runeson, Roma
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Wahlstedt, Kurt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Wieslander, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Personal and psychosocial factors and symptoms compatible with sick building syndrome in the Swedish workforce2006In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 16, no 6, p. 445-453Article in journal (Refereed)
    Abstract [en]

    A random sample of 1000 subjects (20-65 years of age) received a postal questionnaire regarding sick building syndrome (SBS), including the three-dimensional model of demand-control-support (DCS). The response rate was 70% (n = 695), and 532 were occupationally active. Female gender and atopy were the main predictors of symptoms. Eye symptoms were more common at low social support combined with strained work situation [odds ratio (OR) 2.37], and at high social support combined with active work situation (OR 3.00). Throat symptoms were more common at low social support combined with either passive (OR 1.86) or strained situation (OR 2.42). Tiredness was more common at low social support combined with either passive (OR 2.41), strained (OR 2.25), or active situation (OR 1.87), and at high social support combined with active work situation (OR 1.83). Low social support combined with either passive (P = 0.01) or strained job situation (P = 0.01) was associated with a higher symptom score (SC). The lowest SC was found at a relaxed work situation, irrespective of social support. In conclusion, female gender, low age, asthma, atopy and psychosocial work environment are associated with symptoms. The three-dimensional model can predict symptoms compatible with SBS, but in a more complex way than earlier research indicated.

  • 119.
    Runeson-Broberg, Roma
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lindgren, Torsten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Musculoskeletal symptoms and psychosocial work environment, among Swedish commercial pilots2014In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 87, no 7, p. 685-693Article in journal (Refereed)
    Abstract [en]

    The associations between psychosocial work conditions and health in pilots are understudied, and therefore, the associations between the psychosocial work conditions and musculoskeletal problems among Swedish commercial pilots were investigated. In 2010, a self-administered questionnaire study was performed among pilots in one Swedish commercial airline: 354 pilots participated (61 %). Musculoskeletal symptoms and the psychosocial work conditions measured by the demand control social support model were investigated. Odds ratios (OR) with 95 % confidence interval (95 % CI) were expressed per change of one unit on the interquartile score scale. Pilots on long-haul flights had less elbow symptoms (OR 0.34, 95 % CI 0.14-0.85), and women had more hand symptoms (OR 2.90, 95 % CI 1.11-7.52). There were associations between high work demands and symptoms from the neck (OR 2.04, 95 % CI 1.45-2.88), shoulders (OR 1.46, 95 % 1.05-2.03), elbows (OR 1.79, 95 % CI 1.10-2.90) and low back (OR 1.42, 95 % CI 1.02-1.96) in pilots. Low social support was associated with symptoms from the neck (OR 1.87, 95 % 1.35-2.58), shoulders (OR 1.56, 95 % CI 1.14-2.14) and low back (OR 1.63, 95 % CI 1.18-2.24). Low supervisor support was associated with neck (OR 1.67, 95 % CI 1.22-2.27), shoulders (OR 1.38, 95 % CI 1.02-1.87) and low back symptoms (OR 1.48, 95 % CI 1.09-2.01). The associations were mainly found among first officers. Musculoskeletal symptoms in pilots can be affected by poor psychosocial work conditions such as high demands and low social support, especially for first officers. The psychosocial aspects of organisational changes in commercial airlines should be taken into consideration.

  • 120.
    Runeson-Broberg, Roma
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Sick building syndrome (SBS) and sick house syndrome (SHS) in relation to psychosocial stress at work in the Swedish workforce2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 8, p. 915-922Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    Medical symptoms called sick building syndrome (SBS) and sick house syndrome (SHS) are usually investigated separately: in this study, SBS and SHS were explored simultaneously. The significance of personal factors, perceptions of air quality, and psychosocial work situation in explaining SBS and SHS were investigated.

    METHODS:

    A random sample of 1,000 subjects (20-65 year) received a postal questionnaire including questions on personal factors, medical symptoms, and the psychosocial demand-control-support model. The response rate was 70 % (n = 695), of which 532 were occupationally active.

    RESULTS:

    In logistic regression models, atopy, poor air quality at work, and low social support, especially low supervisor support, were associated with both SBS and SHS when age, gender, smoking, and BMI were introduced. The general work-related symptoms (headache, tiredness, nausea, and sensation of a cold) were also related to low control over work.

    CONCLUSIONS:

    The perception of poor physical environmental conditions is associated with common medical symptoms that are both work and home related. The associations between medical symptoms and poor air quality are still present, even when controlling for the psychosocial environment.

  • 121.
    Runeson-Broberg, Roma
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Norbäck, Dan
    Work-Related Psychosocial Stress as a Risk Factor for Asthma, Allergy, and Respiratory Infections in the Swedish Workforce2014In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 114, no 2, p. 377-389Article in journal (Refereed)
    Abstract [en]

    This study examined the association between work-related psychosocial stress and asthma, atopy, and respiratory infections. 532 randomly selected occupationally active people (272 men, 260 women; M age = 41 yr., SD = 13) in Sweden participated. Information on history of asthma, atopy, and respiratory infections was collected by a postal self-report questionnaire. Work stress was assessed based on the demands-control-support model. Current asthma and respiratory infections were associated with work-related psychosocial stress. When stratified for sex, these associations were only found in men. Associations between low control, low support, and current asthma were found among young participants (<40 years), whereas among older participants (>40 years) low supervisor support was associated with frequent respiratory infections.

  • 122.
    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.

  • 123.
    Sahlberg, Bo
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Wieslander, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Gislason, Thorarinn
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Onset of mucosal, dermal, and general symptoms in relation to biomarkers and exposures in the dwelling: a cohort study from 1992 to 20022012In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 22, no 4, p. 331-338Article in journal (Refereed)
    Abstract [en]

    We examined the associations between biomarkers of allergy and inflammation, indoor environment in dwellings, and incidence and remission of symptoms included in the sick building syndrome (SBS) and changes in the home environment of 452 adults who were followed from 1992 to 2002 within the Uppsala part of the European Community Respiratory Health Survey (ECRHS). The 10-year incidence (onset) of general, mucosal, and dermal symptoms was 8.5%, 12.7%, and 6.8%, respectively. Dampness or indoor molds at baseline was a predictor of incidence of general (relative risk [RR] = 1.98), mucosal (RR = 2.28), and dermal symptoms (RR = 1.91). Women had higher incidence of general (RR = 1.74) and mucosal symptoms (RR = 1.71). Indoor painting increased the incidence of general symptoms (RR = 1.62). Bronchial responsiveness (BR), eosinophil counts in blood, total IgE and eosinophilic cationic protein (ECP) in serum at baseline were predictors of incidence of SBS. At follow-up, BR, total IgE, and C-reactive protein (CRP ) were associated with increased incidence of SBS. Moreover, subjects with doctor-diagnosed asthma at baseline had a higher incidence of general (RR = 1.65) and mucosal symptoms (RR = 1.97). In conclusion, female gender, dampness or indoor molds, indoor painting, and biomarkers of allergy and inflammation were associated with a higher incidence of SBS symptoms, in particular mucosal symptoms.

  • 124. Sakai, K
    et al.
    Norbäck, Dan
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Mi, Yahong
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Shibata, E
    Kamijima, M
    Formaldehyde, nitrogen dioxide and chlorinated volatile organic compounds.2004In: Environmental Research, no 94, p. 75-85Article in journal (Refereed)
  • 125.
    Shi, Wenming
    et al.
    Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai 200032, Peoples R China.
    Lin, Zhijing
    Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai 200032, Peoples R China.
    Liao, Chenxi
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai 200093, Peoples R China.
    Zhang, Jialing
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai 200093, Peoples R China.
    Liu, Wei
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai 200093, Peoples R China.
    Wang, Xueying
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai 200093, Peoples R China.
    Cai, Jiao
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai 200093, Peoples R China.
    Zou, Zhijun
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai 200093, Peoples R China.
    Wang, Heng
    Zhoushan Municipal Ctr Dis Control & Prevent, Zhoushan 316021, Peoples R China.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Kan, Haidong
    Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai 200032, Peoples R China;Natl Hlth & Family Planning Commiss Peoples Repub, Shanghai Key Lab Meteorol & Hlth, Educ Key Lab Hlth Technol Assessment, Key Lab Publ Hlth Safety,Minist Educ, Shanghai 200032, Peoples R China.
    Huang, Chen
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai 200093, Peoples R China.
    Zhao, Zhuohui
    Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai 200032, Peoples R China;Natl Hlth & Family Planning Commiss Peoples Repub, Shanghai Key Lab Meteorol & Hlth, Educ Key Lab Hlth Technol Assessment, Key Lab Publ Hlth Safety,Minist Educ, Shanghai 200032, Peoples R China.
    Urinary phthalate metabolites in relation to childhood asthmatic and allergic symptoms in Shanghai2018In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 121, p. 276-286Article in journal (Refereed)
    Abstract [en]

    Background: Few studies can be found on phthalate exposure in relation to childhood asthma and allergic symptoms from Mainland China, where a persistent increase in prevalence of childhood asthma and allergic disease has been observed. Objectives: This study aimed to assess the exposure levels to phthalates and its relationship with asthmatic and allergic symptoms among children in Shanghai, which has the highest prevalence of childhood asthma in Mainland China. Methods: A follow-up study (2013-2014) of 434 children aged 5-10 years was conducted, based on the China, Children, Homes, Health (CCHH) study (2011-2012) in Shanghai, China. Information on asthmatic and allergic symptoms (wheeze, rhinitis, and eczema) were collected using validated questionnaires. Ten phthalate metabolites in morning urine samples were analyzed by high-performance liquid chromatography with triple quadrupole tandem mass spectrometry (HPLC-MS/MS). Multivariable logistic regression was used to estimate the associations between symptoms and urinary phthalate metabolites controlling for demographics, family history of allergic diseases and other covariates. Results: Nine out of 10 phthalate metabolites were detected in all subjects (average detection rate of 93.2%). By multivariable logistic regression analyses, the 4th quartile of Mono-n-butyl phthalate (MnBP) (reference: 1st quartile) had adjusted prevalence odds ratios (aPORs) and 95% confidence intervals (95%CIs) of 2.27(1.06-4.88), 2.14(1.02-4.46) and 2.98(1.19-7.50) for wheeze, rhinitis and eczema, respectively, while those of Mono-isobutyl phthalate (MiBP) were 2.23(1.08-4.62) and 2.96(1.02-8.60) for rhinitis and eczema, respectively. The highest quartile of mono-2-ethyl-5-hydroxyhexyl phthalate(MEHHP) and mono 2 ethyl 5 ox ohexyl phthalate(MEOHP) had aPORs and 95%CIs of 3.10(1.10-8.74) and 2.63(1.02-6.80) for eczema, respectively. By summing up the 4 low molecular weight metabolites (Sigma 4LMWP) and all 9 metabolites (Sigma(9)Total), the highest quartiles of Sigma 4LMWP and Sigma(9)Total were significantly associated with all symptoms. In most of the above associations, a significantly increasing trend from the 1st to the 4th quartile was observed. Subjects with 2 or 3 concomitant symptoms (reference: no symptoms) had significant positive associations with a higher level (the 4th quartile) of phthalate metabolites. Conclusions: Low MW metabolites such as MnBP and MiBP, high MW DEHP and the total amount of phthalate metabolites might have adverse health effects on asthma and allergic symptoms in Chinese children.

  • 126.
    Shi, Wenming
    et al.
    Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai 200032, Peoples R China.
    Liu, Cong
    Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai 200032, Peoples R China.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Deng, Qihong
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Huang, Chen
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai, Peoples R China.
    Qian, Hua
    Southeast Univ, Sch Energy & Environm, Nanjing, Jiangsu, Peoples R China.
    Zhang, Xin
    Shanxi Univ, Res Ctr Environm Sci & Engn, Taiyuan, Shanxi, Peoples R China.
    Sundell, Jan
    Tianjin Univ, Tianjin Key Lab Indoor Air Environm Qual Control, Tianjin, Peoples R China.
    Zhang, Yinping
    Tsinghua Univ, Dept Bldg Sci, Beijing, Peoples R China.
    Li, Baizhan
    Chongqing Univ, Key Lab Three Gorges Reservoir Reg Ecoenvironm, Chongqing, Peoples R China.
    Kan, Haidong
    Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai 200032, Peoples R China;Fudan Univ, Key Lab Publ Hlth Safety, Minist Educ, Shanghai, Peoples R China;Fudan Univ, Natl Hlth Commiss Key Lab Hlth Technol Assessment, Shanghai, Peoples R China.
    Zhao, Zhuohui
    Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai 200032, Peoples R China;Fudan Univ, Key Lab Publ Hlth Safety, Minist Educ, Shanghai, Peoples R China;Fudan Univ, Natl Hlth Commiss Key Lab Hlth Technol Assessment, Shanghai, Peoples R China.
    Effects of fine particulate matter and its constituents on childhood pneumonia: a cross-sectional study in six Chinese cities2018In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 392, p. 79-79Article in journal (Other academic)
  • 127. Simoni, Marzia
    et al.
    Cai, Gui-Hong
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Annesi-Maesano, Isabella
    Lavaud, François
    Sigsgaard, Torben
    Wieslander, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Nystad, Wenche
    Canciani, Mario
    Viegi, Giovanni
    Sestini, Piersante
    Total viable molds and fungal DNA in classrooms and association with respiratory health and pulmonary function of European schoolchildren2011In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 22, no 8, p. 843-852Article in journal (Refereed)
    Abstract [en]

    Indoor molds are associated with adverse respiratory effects in children. Although schools are important exposure sources of molds, objective measurements were more often taken in homes. Our aim was to assess indoor molds in schools and related effects on schoolchildren health. The Health Effects of the School Environment study (HESE) included 21 schools (46 classrooms) in Italy, Denmark, Sweden, Norway, and France and 654 schoolchildren (mean age 10 yr). Information on schoolchildren was collected by standardized questionnaires. Measurements of total viable molds (VM, colony-forming units, cfu/m(3) ) and total/specific fungal DNA (cell equivalents, CE/g dust) were taken inside all classrooms in the cold season during normal activities, using the same standardized methodology. Pulmonary function tests were performed on 244 pupils. VM (mean, 320 cfu/m(3) ) and total fungal DNA (geometric mean, 2.2 × 10(5)  ± 2.1 CE/g dust) were detectable in all classrooms. The levels were significantly higher in buildings with mold/dampness problems. VM, but not fungal DNA, were inversely related to ventilation rate. VM exceeded the maximum standard of 300 cfu/m(3) in 33% of the classrooms. In the past 12 months, dry cough at night (34%) and rhinitis (32%) were the mostly reported. Children exposed to VM levels ≥300 cfu/m(3) , compared with those exposed to lower levels, showed higher risk for past year dry cough at night (odds ratio, OR: 3.10, 95% confidence interval, CI: 1.61-5.98) and rhinitis (OR: 2.86, 95% CI: 1.65-4.95), as well as for persistent cough (OR: 3.79, 95% CI: 2.40-5.60). Aspergillus/Penicillium DNA was significantly positively associated with wheeze, and Aspergillus versicolor DNA with wheeze, rhinitis, and cough. There were significant inverse associations of Aspergillus versicolor DNA with forced vitality capacity (FVC) and Streptomyces DNA with both FEV(1) and FVC. In conclusion, indoor VM and fungal DNA were commonly found in monitored European schools and adversely related to respiratory health. Schools should be routinely tested through both culturable and non-culturable methods for global indoor molds' evaluation.

  • 128. Smedbolt, H-T
    et al.
    Ahlen, C
    Nilsen, AM
    Norbäck, D
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Hilt, B
    Relationships between indoor environment and nasal inflammation in nursing personnel.2002In: Arch Environ Health, Vol. 57, p. 155-Article in journal (Refereed)
  • 129. Smedbolt, H-T
    et al.
    Ahlen, C
    Nilsen, AM
    Norbäck, Dan
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Hilt, B
    Signs of eye irritation in female hospital workers and the indoor environment.2001In: Indoor Air, Vol. 11, p. 223-Article in journal (Refereed)
  • 130.
    Smedje, Greta
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Asthmatic symptoms in school children in relation to building dampness and atopy.2003In: Indoor Built Environ, Vol. 12, p. 249-Article in journal (Refereed)
  • 131.
    Smedje, Greta
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Incidence of asthma diagnosis and self-reported allergy in relation to the school environment – a four-year follow-up study in schoolchildren. 2001;5(11):1059-1066.2001In: Int J Tuberc Lung Dis, Vol. 11, p. 1059-Article in journal (Refereed)
  • 132.
    Smedje, Greta
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Irritants and allergens at school in relation to furnishings and cleaning.2001In: Indoor Air, Vol. 11, p. 127-Article in journal (Refereed)
  • 133.
    Smedje, Greta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Wang, Juan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Nilsson, Håkan
    KTH Royal Inst Technol, Sch Architecture & Built Environm, Div Bldg Serv & Energy, SE-10044 Stockholm, Sweden..
    Engvall, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala Univ, Dept Med Sci Occupat & Environm Med, SE-75185 Uppsala, Sweden..
    SBS symptoms in relation to dampness and ventilation in inspected single-family houses in Sweden2017In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, no 7, p. 703-711Article in journal (Refereed)
    Abstract [en]

    To investigate the relationships between symptoms compatible with the sick building syndrome (SBS) in adults and building dampness and ventilation in single-family houses. Within the Swedish BETSI study, a national sample of single-family houses were inspected by professional building experts, and adults living in the houses answered a questionnaire on SBS. Relationships between building factors and SBS were analysed using logistic regression. Of the respondents, 23% reported having had weekly SBS symptoms during the last three months. A large proportion of houses exhibited building or construction problems. In total, 40% of houses had dampness problems in the foundation, and this was related to a higher prevalence of both mucous and dermal symptoms, and any SBS symptoms. Furthermore, high air humidity was related to more symptoms, with the relationship with absolute humidity being stronger than that with relative humidity or moisture load. Symptoms were also more prevalent in houses with a high U value, reflecting a poor thermal insulation. Compared to natural ventilation, living in a house with mechanical supply and exhaust ventilation was related to a lower prevalence of general symptoms and any SBS symptoms, but there were only weak associations between measured air exchange rate and symptoms. A large proportion of single-family houses have dampness problems in the foundation, and pollutants may enter the living space of the house and affect the health of the occupants. Furthermore, absolute air humidity should be measured more often in indoor air studies.

  • 134.
    Storaas, Torgeir
    et al.
    Haukeland Hosp, Dept Occupat Med, N-5021 Bergen, Norway.;Haukeland Hosp, Dept Otolaryngol Head & Neck Surg, N-5021 Bergen, Norway..
    Zock, Jan-Paul
    Ctr Res Environm Epidemiol CREAL, Barcelona, Spain..
    Morano, Ana Espinosa
    Ctr Res Environm Epidemiol CREAL, Barcelona, Spain..
    Holm, Mathias
    Sahlgrens Univ Hosp, Occupat & Environm Med, Gothenburg, Sweden..
    Bjornsson, Eythor
    Univ Hosp, Landspitali, Dept Resp Med & Sleep, Reykjavik, Iceland..
    Forsberg, Bertil
    Umea Univ, Dept Publ Hlth & Clin Med, Occupat & Environm Med, Umea, Sweden..
    Gislason, Thorarinn
    Univ Iceland, Fac Med, Reykjavik, Iceland.;Natl Univ Hosp Iceland, Dept Resp Med & Sleep, Landspitali, Reykjavik, Iceland..
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Omenaas, Ernst
    Haukeland Hosp, Clin Res Ctr, N-5021 Bergen, Norway..
    Schlunssen, Vivi
    Aarhus Univ, Dept Publ Hlth, Sect Environm Occupat & Hlth, Aarhus, Denmark..
    Toren, Kjell
    Sahlgrens Univ Hosp, Occupat & Environm Med, Gothenburg, Sweden..
    Svanes, Cecilie
    Haukeland Hosp, Dept Occupat Med, N-5021 Bergen, Norway.;Univ Bergen, Ctr Int Hlth, Bergen, Norway..
    Incidence of rhinitis and asthma related to welding in Northern Europe2015In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 46, no 5, p. 1290-1297Article in journal (Refereed)
    Abstract [en]

    Welding-related asthma is well recognised but less is known about rhinitis in relation to welding. The aim here, was to study associations between welding, rhinitis and asthma in a general population sample, and factors influencing selection into and out of a welding occupation. Adult-onset asthma and non-infectious rhinitis were investigated in the international multicentre population-based Respiratory Health in Northern Europe (RHINE) study, including 16191 responders aged 26-54 years. Ever welding (n=2181), welding >25% of working time (n=747), and welding in stainless steel >6 months (n=173) were assessed by questionnaire. Subjects with rhinitis or asthma onset when aged <18 years were excluded. Incidence rates for asthma and rhinitis were calculated from year of disease onset, and start and end of welding job. Cox's proportional hazard models adjusting for age, sex, parental education and study centre, and Kaplan-Meier curves were used. Rhinitis incidence was higher among welders (hazard ratio (HR) 1.4, 95% CI 1.3-1.6), consistent in men and women, and across centres (pheterogeneity=0.4). In men, asthma incidence was higher among welders (HR 1.4, 95% CI 1.04-1.97). Quitting welding was indicated higher after adult-onset rhinitis (HR 1.1, 95% CI 1.0-1.3). Adult-onset rhinitis and asthma was higher among welders, consistent across population samples from Northern Europe. No pre-employment selection was found, whereas selection out of welding jobs was suggested.

  • 135. Sunyer, J.
    et al.
    Jarvis, D.
    Gotschi, T.
    Garcia-Esteban, R.
    Jacquemin, B.
    Aguilera, I.
    Ackerman, U.
    de Marco, R.
    Forsberg, B.
    Gislason, T.
    Heinrich, J.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Villani, S.
    Künzli, N.
    Chronic bronchitis and urban air pollution in an international study2006In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 63, no 12, p. 836-843Article in journal (Refereed)
    Abstract [en]

    Objectives: The chronic effects of urban air pollution are not well known. The authors' aim was to investigate the association between the prevalence and new onset of chronic bronchitis and urban air pollution.

    Methods: Subjects from the general population randomly selected for the European Community Respiratory Health Survey (ECRHS I) during 1991 - 93 in 21 centres in 10 countries were followed up from the years 2000 to 2002 (n = 3232 males and 3592 females; average response rate = 65.3%). PM2.5 and elements, with the same equipment at centre level, and home outdoor NO2 in 1634 individuals were measured. Hierarchical models were used.

    Results: The prevalence and new onset of chronic phlegm during follow up were 6.9% and 4.5%, respectively, 5.3% in males and 3.5% in females. Smoking, rhinitis, poor education, and low social class were associated with (prevalence and new onset of) chronic phlegm in both genders, and occupational exposures in males and traffic intensity (adjusted odds ratio for constant traffic, OR = 1.86; 95% CI 1.24 to 2.77) as well as home outdoor NO2 (OR > 50 mu g/m(3) v < 20 mu g(3) = 2.71; 95% CI 1.03 to 7.16) among females. PM2.5 and S content at centre level did not show any association with prevalence or new onset of chronic phlegm. Similar results were obtained with chronic productive cough.

    Conclusion: Individual markers of traffic at household level such as reported intensity and outdoor NO2 were risk factors for chronic bronchitis among females.

  • 136. Sunyer, Jordi
    et al.
    Zock, Jan Paul
    Kromhout, Hans
    Garcia-Esteban, Raquel
    Radon, Katja
    Jarvis, Deborah
    Toren, Kjell
    Künzli, Nino
    Norbäck, Dan
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    d'Errico, Angelo
    Urrutia, Isabel
    Payo, Félix
    Olivieri, Mario
    Villani, Simona
    Van Sprundel, Marc
    Antó, Josep M
    Kogevinas, Manolis
    Lung function decline, chronic bronchitis, and occupational exposures in young adults.2005In: Am J Respir Crit Care Med, ISSN 1073-449X, Vol. 172, no 9, p. 1139-45Article in journal (Refereed)
  • 137. Svanes, C
    et al.
    Dharmage, S
    Sunyer, J
    Zock, J P
    Norbäck, D
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Wjst, M
    Heinrich, J
    Jarvis, D
    de Marco, R
    Plana, E
    Villani, S
    Antó, J M
    Long-term reliability in reporting of childhood pets by adults interviewed twice, 9 years apart. Results from the European Community Respiratory Health Survey I and II2008In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 18, no 2, p. 84-92Article in journal (Refereed)
    Abstract [en]

    Investigation of long-term effects of childhood pet exposure is usually based on retrospective information provided by adults, while there is little knowledge about the reliability in adult reporting of childhood events. We analyzed 8287 adults interviewed about childhood pets twice, on average nine years apart, in the European Community Respiratory Health Survey. Agreement between the surveys in reporting of childhood cats, dogs and birds were investigated with kappa statistics, and potential effects of disease status on agreement were analyzed with kappa statistics and multiple logistic regressions. Cats, dogs and birds in childhood were reported by 44, 41 and 38%, respectively. Cohen's kappa for agreement in adult reporting of childhood pets was 0.714 (95% CI=0.698-0.729) for cat, 0.709 (0.691-0.722) for dog, and 0.606 (0.591-0.626) for bird. Thus, agreement was significantly higher for reporting of cat and dog than for bird. Adult wheeze, asthma or atopy did not influence agreement. Neither did adult cat sensitization influence agreement in adult reporting of childhood cat. Childhood factors such as moving house <5 years, or growing up as a single child, in a large family or in a rural area, were associated with poorer agreement, while adult factors were unrelated to agreement. PRACTICAL IMPLICATIONS: Long-term reliability in adult reporting of childhood pets was substantial, and not influenced by disease status. Thus, collection of information about childhood pets from adults appears to be reliable for the purpose of studying adult allergic disease. Future studies should consider that the reliability was higher for a more important childhood event and influenced by childhood rather than adult characteristics. Imperfect reliability contributed to underestimation of the effects of pets on adult allergy; i.e. with a kappa of 0.71, a true odds ratio (OR) of 0.80 would be attenuated to 0.86. Future studies should account for non-differential misclassification error.

  • 138. Svanes, C
    et al.
    Zock, JP
    Anto, j
    Dharmages, S
    Norbäck, D
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences. Arbets- och miljömedicin.
    Early Life Working Group of the European Respiratory Health Survey2006In: J Allergy Clin Immunol, no 118, p. 696-698Article in journal (Refereed)
  • 139.
    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.

  • 140. Svanes, Cecilie
    et al.
    Zock, Jan-Paul
    Antó, Josep
    Dharmage, Shyamali
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Wjst, Matthias
    Heinrich, Joachim
    Jarvis, Deborah
    de Marco, Roberto
    Plana, Estel
    Raherison, Chantal
    Sunyer, Jordi
    Do asthma and allergy influence subsequent pet keeping? An analysis of childhood and adulthood2006In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 118, no 3, p. 691-698Article in journal (Refereed)
    Abstract [en]

    Background: Asthma and allergy might influence the choice of keeping pets, leading to apparent protective effects of pets on allergic disease.

    Objective: We investigated the effects of asthma and allergy on subsequent pet keeping in childhood and adulthood.

    Methods: Information about asthma and pet keeping at ages 0 to 4, 5 to 15, 20 to 44, and 26 to 56 years was provided by 9812 subjects participating in the 9-year follow-up of the European Community Respiratory Health Survey.

    Results: In childhood asthma debut at younger than 5 years was associated with less cat keeping at 5 to 15 years (odds ratio [OR], 0.60; 95% CI, 0.44-0.82), an effect only observed when the parents did not have asthma or allergy (P-interaction = .045). Childhood asthma did not influence adult pet ownership, unless there were adult symptoms. Adults less often acquired cats at follow-up if they had 3 or more asthma symptoms (OR, 0.78; 95% CI, 0.64-0.95), were taking asthma medication (OR, 0.48; 95% CI, 0.31-0.74), had hay fever (OR, 0.75; 95% CI, 0.620.91), had atopy (OR, 0.75; 95% CI, 0.61-0.91), or had specific IgE to cat (OR, 0.57; 95% CI, 0.39-0.82) at baseline. Adults who already had pets usually continued keeping the same type of pet, except that the presence of 3 or more asthma symptoms was associated with less subsequent dog keeping (OR, 0.69; 95% CI, 0.53-0.89). Pet removal between surveys to reduce allergen was reported by 4.7%.

    Conclusion: Selective avoidance subsequent to asthma or allergy was observed for childhood cat keeping and adult cat acquisition. Avoidance would produce an apparent protective effect of cats on childhood asthma (large OR, 0.83). Avoidance was generally not observed for dogs or birds.

    Clinical implications: A part of the protective effects of childhood cats on asthma and allergy can be attributed to selective avoidance.

  • 141. 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.

  • 142.
    Svanes, Øistein
    et al.
    Univ Bergen, Dept Clin Sci, Bergen, Norway; Haukeland Hosp, Dept Occupat Med, Bergen, Norway.
    Bertelsen, Randi J.
    Univ Bergen, Dept Clin Sci, Bergen, Norway.
    Lygre, Stein H. L.
    Haukeland Hosp, Dept Occupat Med, Bergen, Norway.
    Carsin, Anne E.
    ISGlobal, Ctr Res Environm Epidemiol, Barcelona, Spain; Univ Pompeu Fabra, Barcelona, Spain; Ctr Invest Biomed Red Epidemiol Salud & Publ, Barcelona, Spain.
    Anto, Josep M.
    ISGlobal, Ctr Res Environm Epidemiol, Barcelona, Spain.
    Forsberg, Bertil
    Umeå Univ, Div Occupat & Environm Med, Umeå, Sweden.
    García-García, José M.
    Univ Hosp San Agustin, Pneumol Dept, Aviles, Spain.
    Gullon, José A.
    Univ Hosp San Agustin, Pneumol Dept, Aviles, Spain.
    Heinrich, Joachim
    Ludwig Maximillian Univ, Comprehens Pneumol Ctr Munich, German Ctr Lung Res, Clin Ctr, Inst & Outpatient Clin Occupat & Environ, Munich, Germany.
    Holm, Mathias
    Sahlgrens Univ Hosp, Dept Occupat & Environm Med, Gothenburg, Sweden.
    Kogevinas, Manolis
    ISGlobal, Ctr Res Environm Epidemiol, Barcelona, Spain.
    Urrutia, Isabel
    Galdakao Hosp, Pulmonol Dept, Galdakao, Spain.
    Leynaert, Bénedicte
    INSERM, U1152, Pathophysiol & Epidemiol Resp Dis, Paris, France; Univ Paris Diderot Paris7, Unite Mixte Rech 1152, Paris, France.
    Moratalla, Jesús M.
    Complejo Hosp Univ Albacete, Serv Numol, Albacete, Spain.
    Le Moual, Nicole
    INSERM, U1168, Aging & Chron Dis Epidemiol & Publ Hlth Approache, F-94807 Villejuif, France; Univ Versailles St Quentin En Yvelines, Unite Mixte Rech S 1168, Yvelines, France.
    Lytras, Theodore
    ISGlobal, Ctr Res Environm Epidemiol, Barcelona, Spain; Univ Pompeu Fabra, Dept Expt & Hlth Sci, Barcelona, Spain.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Nowak, Dennis
    Ludwig Maximillian Univ, Comprehens Pneumol Ctr Munich, German Ctr Lung Res, Clin Ctr,Inst & Outpatient Clin Occupat & Environ, Munich, Germany.
    Olivieri, Mario
    Univ Hosp Verona, Verona, Italy.
    Pin, Isabelle
    Ctr Invest Clin Grenoble, Pneumol Pediat, Antenne Pediat, La Tronche, France.
    Probst-Hensch, Nicole
    Swiss Trop & Publ Hlth Inst, Basel, Switzerland;Univ Basel, Dept Publ Hlth, Basel, Switzerland.
    Schlünssen, Vivi
    Aarhus Univ, Dept Publ Hlth, Danish Ramazzini Ctr, Aarhus, Denmark; Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Sigsgaard, Torben
    Aarhus Univ, Dept Publ Hlth, Danish Ramazzini Ctr, Aarhus, Denmark.
    Skorge, Trude D.
    Haukeland Hosp, Dept Occupat Med, Bergen, Norway.
    Villani, Simona
    Univ Pavia, Dept Publ Hlth Expt & Forens Med, Unit Biostat & Clin Epidemiol, Pavia, Italy.
    Jarvis, Debbie
    Imperial Coll, Natl Heart & Lung Inst, London, England.
    Zock, Jan P.
    ISGlobal, Ctr Res Environm Epidemiol, Barcelona, Spain.
    Svanes, Cecilie
    Univ Bergen, Ctr Int Hlth, Bergen, Norway; Haukeland Hosp, Dept Occupat Med, Bergen, Norway.
    Cleaning at Home and at Work in Relation to Lung Function Decline and Airway Obstruction2018In: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 197, no 9, p. 1157-1163Article in journal (Refereed)
    Abstract [en]

    Rationale: Cleaning tasks may imply exposure to chemical agents with potential harmful effects to the respiratory system, and increased risk of asthma and respiratory symptoms among professional cleaners and in persons cleaning at home has been reported. Long-term consequences of cleaning agents on respiratory health are, however, not well described.

    Objectives: This study aimed to investigate long-term effects of occupational cleaning and cleaning at home on lung function decline and airway obstruction.

    Methods: The European Community Respiratory Health Survey (ECRHS) investigated a multicenter population-based cohort at three time points over 20 years. A total of 6,235 participants with at least one lung function measurement from 22 study centers, who in ECRHS II responded to questionnaire modules concerning cleaning activities between ECRHS I and ECRHS II, were included. The data were analyzed with mixed linear models adjusting for potential confounders.

    Measurements and Main Results: As compared with women not engaged in cleaning (ΔFEV1 = −18.5 ml/yr), FEV1 declined more rapidly in women responsible for cleaning at home (−22.1; P = 0.01) and occupational cleaners (−22.4; P = 0.03). The same was found for decline in FVC (ΔFVC = −8.8 ml/yr; −13.1, P = 0.02; and −15.9, P = 0.002; respectively). Both cleaning sprays and other cleaning agents were associated with accelerated FEV1 decline (−22.0, P = 0.04; and −22.9, P = 0.004; respectively). Cleaning was not significantly associated with lung function decline in men or with FEV1/FVC decline or airway obstruction.

    Conclusions: Women cleaning at home or working as occupational cleaners had accelerated decline in lung function, suggesting that exposures related to cleaning activities may constitute a risk to long-term respiratory health.

  • 143. Takaoka, M
    et al.
    Lindgren, Torsten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lundgren, H
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Digestive functional symptoms among ground employees in an airline company in relation to diet, insomnia and lifestyle factors2016In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 8, no 11Article in journal (Refereed)
    Abstract [en]

    PURPOSE: There are some epidemiological studies on pilots and cabin staff, but we found few health studies on aviation ground employees. The aim was to study associations between digestive symptoms in airline ground employees and diet, insomnia and lifestyle factors.

    METHODS: A standardized questionnaire was mailed to all Stockholm ground employees in a Scandinavian airline company, 201 service agents (ticketing and gate service) and 564 office workers from the same company participated. Associations were analysed by multiple logistic regression.

    RESULTS: Of the service agents, 13.8% reported poor appetite, 17.5%% heartburn, 14.1%, diarrhea, 51.7% bloating, 18.8% constipation and 15.40% epigastralgia. Service agents reported more bloating (OR=1.56; p<0.01), and poor appetite (OR=2.33; p<0.01) than office workers. The prevalence of insomnia was 77.7% among service agents and 63.1% among office workers (p<0.001). In service agents, insomnia was related to poor appetite (OR=2.49; p<0.01), heartburn (OR=2.14; p<0.01), diarrhea (OR=3.62; p<0.001) bloating (OR=1.62; p<0.01), constipation (OR=2.74; p<0.01) and epigastralgia (OR=3.44; p<0.001). In office workers, there were no associations between insomnia and digestive symptoms. In the total material of ground employees (N=765), higher body mass index (BMI) was related to diarrhea and females suffered from more constipation and epigastralgia. Older age was related to heartburn and bloating. Smoking was related to poor appetite, more heartburn and epigastralgia and less constipation. The number of years employed at the airline company was negatively associated with heartburn, diarrhea and bloating. Frequent fast food consumption was associated with more bloating and heartburn. Frequent vegetables consumption was associated with less heartburn.

    CONCLUSION: Insomnia and digestive symptoms were more common among service agents than office workers in the same airline company, possible partly due to stress. Besides insomnia, BMI, smoking, female gender, age, and diet were associated with digestive symptoms.

  • 144. Takaoka, M
    et al.
    Suzuki, K
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    The home environment of junior high school students in Hyogo, Japan: Associations with asthma, respiratory health and reported allergies2016In: Indoor + Built Environment, ISSN 1420-326X, E-ISSN 1423-0070, Vol. 25, no 1, p. 81-92Article in journal (Refereed)
    Abstract [en]

    Associations between home environment factors and respiratory symptoms, and reported allergiesamong junior high school students in Kobe, Japan (N¼1048) were investigated in the present study.These were mutually adjusted for age, sex, type of school (private/local) and their significant exposuresto the environment. Totally 13.4% of students reported to have doctor’s diagnosed asthma, 9.9% hadwheeze and 50.1% had attacks of daytime breathlessness during past 12 months, 25.7% of studentsreported that they had pollen allergy, 8.8% had cat allergy and 6.1% had dog allergy. Totally 29.4% ofstudents were living in a wooden house and during past 12 months, 18% of students reported that theirhomes had signs of dampness, 38.2% of homes had window condensation in winter and 7.8% of homeshad indoor painting. Window condensation was associated with wheeze (odds ratio (OR)¼1.54; 95%confidence interval (CI) 1.01–2.34), daytime breathlessness (OR¼2.02; 95% CI 1.56–2.63), airway infec-tion during past 12 months (OR¼1.66; 95% CI 1.17–2.37), cat allergy (OR¼1.63; 95% CI 1.05–2.54);mould allergy (OR¼1.84; 95%CI 1.08–3.12) and pollen allergy (OR¼1.54; 95% CI 1.15–2.06). Recentindoor painting was associated with daytime breathlessness (OR 1.83; 95% CI 1.12–3.00), dog allergy(OR¼2.23; 95% CI 1.02–4.85) and mould allergy (OR¼2.43; 95% CI 1.14–5.17). Living in a wooden housewas associated with dog allergy (OR¼2.17; 95% CI 1.18–4.00) and mould allergy (OR¼1.98; 95% CI1.04–3.76). In conclusion, in Japanese homes, the window condensation in winter, recent indoor paint-ing and living in a wooden house could contribute to the increased risk of respiratory symptoms andallergies for young Japanese school children.

  • 145.
    Takaoka, Motoko
    et al.
    Kobe College, School of Human Science, Department of Biosphere Sciences.
    Suzuki, Kyoko
    Kobe College, School of Human Science, Department of Biosphere Sciences.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala University Hospital.
    Current asthma, respiratory symptoms and airway infections among students in relation to the school and home environment in Japan2017In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 54, no 6, p. 652-661Article in journal (Refereed)
    Abstract [en]

    Objective: To study associations between the school and home environment and current asthma, respiratory symptoms and airway infections among Japanese students. Methods: Japanese students (12-15 y) (N = 1048) in four schools responded to a questionnaire on respiratory health, allergy and the home environment. Temperature, relative air humidity (RH) and student density (students/m(2) floor area) was measured in the classrooms: dust was collected from floors and in classroom air and analysed for cat (Fel d 1) and dog (Can f 1) allergens. Health associations were analysed by multi-level logistic regression. Results: Doctor's diagnosed asthma was common (13.4%), 8.8% reported cat allergy and 6.1% dog allergy. The median level in floor dust was 41ng/g (IQR 23-92) for Fel d 1 and 101ng/g (IQR 54-101) for Can f 1. The median level in air was 18.6ng/ m(2)/ day (IQR5.9-25.1) for Fel d 1 and 18.6ng/ m(2)/ day (IQR 6.0-13.3) for Can f 1. High RH, high student density and airborne cat allergen was associated with airway infections. In the home environment, recent indoor painting, new floor materials, odour, having cats as pets, window pane condensation in winter, and dampness in floor construction were associated with respiratory illness. Conclusion: High relative air humidity, high student density and airborne cat allergens at school may increase the risk of airway infections. Having cats as pets, chemical emissions from paint and new floor materials, odour and dampness can constitute domestic risk factors for respiratory symptoms while having dogs as pets could be protective.

  • 146. Takaoka, Motoko
    et al.
    Suzuki, Kyoko
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Sick Building Syndrome Among Junior High School Students in Japan in Relation to the Home and School Environment2015In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 8, no 2, p. 165-177Article in journal (Refereed)
    Abstract [en]

    PURPOSE

    There is an increasing concern about sick building syndrome (SBS), especially in Asia. The aim of this study is to investigate associations between SBS and the home, school environment and personal factors among Japanese junior high school students.

    METHODS

    We investigated students in four junior high schools in Hyogo in Kansai area, Japan. A questionnaire study was performed among students (n=1056), 12-15 years old. Temperature and relative air humidity was measured in the classrooms and dust was collected from the classroom floors and air and was analysed for cat and dog allergens. Associations were analysed by multi-level logistic regression.

    RESULTS

    Mucosal symptoms (45.4%), general symptoms (38.9%) and skin symptoms (22.6%) were common. Totally 8.8% reported cat allergy, 6.1% dog allergy, 6.0% mold allergy and 25.7% pollen allergy. Atopy, window pane condensation, floor dampness and odor at home and high relative air humidity in the classrooms were associated with SBS.

    CONCLUSION

    The prevalence of SBS symptoms was high and associated with both home and school environment. Window pane condensation and floor dampness at home can increase the risk for SBS symptoms in students. Moreover high relative air humidity at school may increase the risk for SBS.

  • 147. TingTing, Wang
    et al.
    ZhuoHui, Zhao
    Hua, Yao
    ShuLan, Wang
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Jie, Chen
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    JinFeng, Ma
    XiaoLi, Ji
    Li, Wang
    Sundell, Jan
    Housing characteristics and indoor environment in relation to children's asthma, allergic diseases and pneumonia in Urumqi, China2013In: Chinese Science Bulletin, ISSN 1001-6538, E-ISSN 1861-9541, Vol. 58, no 34, p. 4237-4244Article in journal (Refereed)
    Abstract [en]

    In order to evaluate the prevalence of childhood asthma, allergic diseases and pneumonia in Urumqi City, China, as well as its associations with housing and home characteristics, a cross-sectional study was performed in 4618 children (81.7% response rate, average age 4.7 +/- 0.9 year, boys accounting for 53.7%). Questions on children's asthma and allergic diseases were from the International Study on Asthma and Allergies in Childhood (ISAAC) and were integrated with questions on the home environment from the Dampness in Buildings and Health (DBH) study, slightly modified to account for Chinese building characteristics and life habits. The prevalences of physician diagnosed asthma, allergic rhinitis (AR) and pneumonia were 3.6%, 8.7% and 40.9%, respectively. One fourth of children reported wheezing and more than 40% AR symptoms in the last 12 months. Controlling for confounding factors, positive associations were found for home mold/dampness and wheezing (adjusted odds ratio, aOR 1.33, 95% CI 1.07-1.66), AR symptoms (1.34, 1.09-1.64) last 12 months and physician diagnosed pneumonia (1.33, 1.09-1.62). Floor material by wood, PVC or carpeting; and walls by wallpaper, painting or wood material, were positively associated with AR symptoms. Home environmental tobacco smoke (ETS) was positively associated with wheezing (1.23, 1.04-1.46) and pneumonia (1.25, 1.07-1.45). In conclusion, there was a relatively high prevalence of asthmatic and AR symptoms and diagnosed pneumonia in preschool children in Urumqi. Home signs of mold growth or dampness, windowpane condensation, as well as ETS and interior surface materials emitting chemicals were risk factors for allergic symptoms and pneumonia.

  • 148. Tischer, Christina
    et al.
    Zock, Jan-Paul
    Valkonen, Maria
    Doekes, Gert
    Guerra, Stefano
    Heederik, Dick
    Jarvis, Deborah
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Olivieri, Mario
    Sunyer, Jordi
    Svanes, Cecilie
    Taubel, Martin
    Thiering, Elisabeth
    Verlato, Giuseppe
    Hyvarinen, Anne
    Heinrich, Joachim
    Predictors of microbial agents in dust and respiratory health in the Ecrhs2015In: BMC Pulmonary Medicine, ISSN 1471-2466, E-ISSN 1471-2466, Vol. 15, article id 48Article in journal (Refereed)
    Abstract [en]

    Background: Dampness and mould exposure have been repeatedly associated with respiratory health. However, less is known about the specific agents provoking or arresting health effects in adult populations. We aimed to assess predictors of microbial agents in mattress dust throughout Europe and to investigate associations between microbial exposures, home characteristics and respiratory health. Methods: Seven different fungal and bacterial parameters were assessed in mattress dust from 956 adult ECRHS II participants in addition to interview based home characteristics. Associations between microbial parameters and the asthma score and lung function were examined using mixed negative binomial regression and linear mixed models, respectively. Results: Indoor dampness and pet keeping were significant predictors for higher microbial agent concentrations in mattress dust. Current mould and condensation in the bedroom were significantly associated with lung function decline and current mould at home was positively associated with the asthma score. Higher concentrations of muramic acid were associated with higher mean ratios of the asthma score (aMR 1.37, 95% CI 1.17-1.61). There was no evidence for any association between fungal and bacterial components and lung function. Conclusion: Indoor dampness was associated with microbial levels in mattress dust which in turn was positively associated with asthma symptoms.

  • 149.
    Triebner, Kai
    et al.
    Univ Bergen, Dept Clin Sci, N-5021 Bergen, Norway..
    Johannessen, Ane
    Univ Bergen, Dept Clin Sci, N-5021 Bergen, Norway..
    Puggini, Luca
    Natl Univ Ireland, Dept Elect Engn, Maynooth, Kildare, Ireland..
    Benediktsdottir, Bryndis
    Univ Iceland, Fac Med, Reykjavik, Iceland..
    Bertelsen, Randi J.
    Univ Bergen, Dept Occupat Med, N-5021 Bergen, Norway..
    Bifulco, Ersilia
    Univ Bergen, Dept Clin Sci, N-5021 Bergen, Norway.;Univ Bergen, Core Facil Metab, N-5021 Bergen, Norway..
    Dharmage, Shyamali C.
    Univ Melbourne, Melbourne Sch Populat Hlth, Allergy & Lung Hlth Unit, Melbourne, Vic 3010, Australia..
    Dratva, Julia
    Swiss Trop & Publ Hlth Inst, Dept Publ Hlth & Epidemiol, Basel, Switzerland.;Univ Basel, CH-4003 Basel, Switzerland..
    Franklin, Karl A.
    Umea Univ, Dept Surg & Perioperat Sci, S-90187 Umea, Sweden..
    Gislason, Thorarinn
    Univ Iceland, Fac Med, Reykjavik, Iceland.;Natl Univ Hosp Iceland, Landspitali, Dept Resp Med & Sleep, Reykjavik, Iceland..
    Holm, Mathias
    Gothenburg Univ, Dept Occupat & Environm Med, S-41124 Gothenburg, Sweden..
    Jarvis, Deborah
    Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, Dept Resp Epidemiol Occupat Med & Publ Hlth, London SW7 2AZ, England..
    Leynaert, Benedicte
    Inserm UMR1152 Team Epidemiol, Paris, France..
    Lindberg, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Macsali, Ferenc
    Haukeland Hosp, Dept Gynecol & Obstet, N-5021 Bergen, Norway..
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Omenaas, Ernst R.
    Univ Bergen, Dept Clin Sci, N-5021 Bergen, Norway..
    Rodriguez, Francisco J.
    Univ Malaga, Dept Appl Math, E-29071 Malaga, Spain..
    Saure, Eirunn
    Univ Bergen, Dept Occupat Med, N-5021 Bergen, Norway..
    Schlunssen, Vivi
    Aarhus Univ, Dept Publ Hlth, DK-8000 Aarhus C, Denmark..
    Sigsgaard, Torben
    Aarhus Univ, Dept Publ Hlth, DK-8000 Aarhus C, Denmark..
    Skorge, Trude D.
    Univ Bergen, Dept Occupat Med, N-5021 Bergen, Norway..
    Wieslander, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Zemp, Elisabeth
    Swiss Trop & Publ Hlth Inst, Dept Publ Hlth & Epidemiol, Basel, Switzerland.;Univ Basel, CH-4003 Basel, Switzerland..
    Svanes, Cecilie
    Univ Bergen, Dept Occupat Med, N-5021 Bergen, Norway..
    Hustad, Steinar
    Univ Bergen, Dept Clin Sci, N-5021 Bergen, Norway.;Univ Bergen, Core Facil Metab, N-5021 Bergen, Norway..
    Real, Francisco Gomez
    Univ Bergen, Dept Clin Sci, N-5021 Bergen, Norway.;Haukeland Hosp, Dept Gynecol & Obstet, N-5021 Bergen, Norway..
    Menopause as a predictor of new-onset asthma: A longitudinal Northern European population study2016In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 137, no 1, p. 50-+Article in journal (Refereed)
    Abstract [en]

    Background: There is limited and conflicting evidence on the effect of menopause on asthma. Objectives: We sought to study whether the incidence of asthma and respiratory symptoms differ by menopausal status in a longitudinal population-based study with an average follow-up of 12 years. Methods: The Respiratory Health in Northern Europe study provided questionnaire data pertaining to respiratory and reproductive health at baseline (1999-2001) and follow-up (2010-2012). The study cohort included women aged 45 to 65 years at follow-up, without asthma at baseline, and not using exogenous hormones (n = 2322). Menopausal status was defined as nonmenopausal, transitional, early postmenopausal, and late postmenopausal. Associations with asthma (defined by the use of asthma medication, having asthma attacks, or both) and respiratory symptoms scores were analyzed by using logistic (asthma) and negative binomial (respiratory symptoms) regressions, adjusting for age, body mass index, physical activity, smoking, education, and study center. Results: The odds of new-onset asthma were increased in women who were transitional (odds ratio, 2.40; 95% CI, 1.09-5.30), early postmenopausal (odds ratio, 2.11; 95% CI, 1.06-4.20), and late postmenopausal (odds ratio, 3.44; 95% CI, 1.31-9.05) at follow-up compared with nonmenopausal women. The risk of respiratory symptoms increased in early postmenopausal (coefficient, 0.40; 95% CI, 0.06-0.75) and late postmenopausal (coefficient, 0.69; 95% CI, 0.15-1.23) women. These findings were consistent irrespective of smoking status and across study centers. Conclusions: New-onset asthma and respiratory symptoms increased in women becoming postmenopausal in a longitudinal population-based study. Clinicians should be aware that respiratory health might deteriorate in women during reproductive aging.

  • 150. Vindenes, H. K.
    et al.
    Real, F. G.
    Svanes, C.
    Johannessen, A.
    Skorge, T. D.
    Omenaas, E.
    Jarvis, D.
    Dharmage, S.
    Leynaert, B.
    Norbäck, Dan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lindberg, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Stutz, E. Z.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Dratva, J.
    Russell, M. A.
    Bertelsen, R. J.
    Gender differences in association between body mass index and current eczema in adulthood2014In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 69, p. 239-239Article in journal (Other academic)
1234 101 - 150 of 191
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