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  • 51. Blanco, Luis E.
    et al.
    Aragon, Aurora
    Lundberg, Ingvar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wesseling, Catharina
    Nise, Gun
    The determinants of dermal exposure ranking method (DERM): A pesticide exposure assessment approach for developing countries2008Ingår i: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 52, nr 6, s. 535-544Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 52. Blanco, Luis E.
    et al.
    Aragón, Aurora
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Lundberg, Ingvar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wesseling, Catharina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Nise, Gun
    The Accuracy of DERM may be a Self-fulfilling DREAM Reply2008Ingår i: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 52, nr 8, s. 784-785Artikel i tidskrift (Refereegranskat)
  • 53. Bogo, Renata
    et al.
    Farah, Ahmed
    Johnson, Ann-Christin
    Karlsson, Kjell K.
    Pedersen, Nancy L.
    Svartengren, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Skjonsberg, Asa
    The Role of Genetic Factors for Hearing Deterioration Across 20 Years: A Twin Study2015Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 70, nr 5, s. 647-653Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Hearing deterioration at advanced ages is associated with environmental exposures (eg, to noise and solvents) and genetic influences may also be important. Little is known about the role of genetic influences on hearing when evaluated longitudinally. We sought to investigate longitudinal hearing loss in a cohort of adult male twins to evaluate the importance of genetic and environmental factors for hearing deterioration over time. Methods. Hearing using conventional clinical audiometry was assessed in 583 male twins (128 monozygotic twin pairs and 111 dizygotic twin pairs) aged 34-79 at baseline and again two decades later. The hearing thresholds at two time points were compared at each frequency and in two different frequency regions. Genetic analyses were based on structural equation models. Bivariate Cholesky decomposition was used for longitudinal analysis. Results. The prevalence of hearing loss increased over time in better and worse ear. The hearing threshold shift was more pronounced in the high-frequency region, especially at 8000 Hz. Genetic influences were moderate (heritability: 53%-65%) for pure-tone averages at both lower and higher frequencies, and were of equal magnitude at baseline and follow-up. In contrast, environmental influences were of substantial importance (55%-88%) for rate of change of the hearing threshold over the 18-year period. Conclusions. Genetic factors are of considerable importance for level of hearing acuity, but environmental factors are more important for rate of change over an 18-year period.

  • 54.
    Bogo, Renata
    et al.
    Karolinska Inst, Sect Audiol, Dept Clin Sci Intervent & Technol, Alfred Nobels Alle 10, SE-14183 Huddinge, Sweden; Karolinska Univ Hosp, Dept Audiol & Neurotol, Huddinge, Sweden.
    Farah, Ahmed
    Publ Hlth Agcy Sweden, Stockholm, Sweden.
    Karlsson, Kjell K
    Karolinska Univ Hosp, Dept Audiol & Neurotol, Huddinge, Sweden.
    Pedersen, Nancy L
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.
    Svartengren, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Skjönsberg, Åsa
    Karolinska Inst, Sect Audiol, Dept Clin Sci Intervent & Technol, Alfred Nobels Alle 10, SE-14183 Huddinge, Sweden; Karolinska Univ Hosp, Dept Audiol & Neurotol, Huddinge, Sweden.
    Prevalence, Incidence Proportion, and Heritability for Tinnitus: A Longitudinal Twin Study2017Ingår i: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 38, nr 3, s. 292-300Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The purpose of this longitudinal twin study was to explore the effect of tinnitus on hearing thresholds and threshold shifts over two decades and to investigate the genetic contribution to tinnitus in a male twin cohort (n = 1114 at baseline and 583 at follow-up). The hypothesis was that participants with faster hearing deterioration had a higher risk for developing tinnitus and there is an underlying role of genetic influences on tinnitus.

    DESIGN: Male mono- and dizygotic twin pairs, born between 1914 and 1958 were included. Mixed models were used for comparison of hearing threshold shifts, adjusted for age. A co-twin comparison was made within pairs discordant for tinnitus. The relative influence of genetic and environmental factors was estimated by genetic modeling.

    RESULTS: The overall prevalence of tinnitus was 13.5% at baseline (x age 50) and 34.4% at follow-up (x age 67). The overall incidence proportion was 27.8%. Participants who reported tinnitus at baseline or at both time points were older. At baseline, the hearing thresholds differed between tinnitus cases and controls at all frequencies. New tinnitus cases at follow-up had the greatest hearing threshold shift at the high-frequency area compared with the control group. Within pairs, the tinnitus twin had poorer hearing than his unaffected co-twin, more so for dizygotic than monozygotic twin pairs. The relative proportion of additive genetic factors was approximately 0.40 at both time points, and the influence of individual-specific environment was 0.56 to 0.61. The influence of genetic factors on tinnitus was largely independent of genetic factors for hearing thresholds.

    CONCLUSIONS: Our hypotheses were confirmed: The fastest hearing deterioration occurred for new tinnitus cases. A moderate genetic influence for tinnitus was confirmed.

  • 55. Bohman, Tony
    et al.
    Alfredsson, Lars
    Hallqvist, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Vingård, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Skillgate, Eva
    The influence of self-reported leisure time physical activity and the body mass index on recovery from persistent back pain among men and women: a population-based cohort study2013Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, s. 385-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There is limited knowledge about leisure time physical activity and the body mass index (BMI) as prognostic factors for recovery from persistent back pain. The aim of this study was to assess the influence of leisure time physical activity and BMI on recovery from persistent back pain among men and women in a general population. Methods: The study population (n=1836) in this longitudinal cohort study consisted of participants reporting persistent back pain in the baseline questionnaire in 2002-2003. Data on leisure time physical activity, BMI and potential confounders were also collected at baseline. Information on recovery from persistent back pain (no back pain periods >= 7 days during the last 5 years) was obtained from the follow-up questionnaire in 2007. Log-binomial models were applied to calculate Risk Ratios with 95 percent Confidence Intervals (CI) comparing physically active and normal weight groups versus sedentary and overweight groups. Results: Compared to a sedentary leisure time, all measured levels of leisure time physical activity were associated with a greater chance of recovery from persistent back pain among women. The adjusted Risk Ratios was 1.46 (95% CI: 1.06, 2.01) for low leisure time physical activity, 1.51 (95% CI: 1.02, 2.23) for moderate leisure time physical activity, and 1.67 (95% CI: 1.08, 2.58) for high leisure time physical activity. There were no indications that leisure time physical activity influenced recovery among men, or that BMI was associated with recovery from persistent back pain either among men or among women. Conclusions: Regular leisure time physical activity seems to improve recovery from persistent back pain among women.

  • 56. Bohman, Tony
    et al.
    Alfredsson, Lars
    Jensen, Irene
    Hallqvist, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Vingård, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Skillgate, Eva
    Does a healthy lifestyle behaviour influence the prognosis of low back pain among men and women in a general population? A population-based cohort study2014Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 4, nr 12, artikel-id e005713Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES:

    To study the influence of healthy lifestyle behaviour on the prognosis of occasional low back pain among men and women in a general population.

    DESIGN:

    Cohort study with a 4-year follow-up.

    SETTINGS:

    General population in Stockholm County, Sweden.

    PARTICIPANTS:

    The study sample comprised 3938 men and 5056 women aged 18-84 from the Stockholm Public Health Cohort reporting occasional low back pain in the baseline questionnaire 2006.

    MEASURES:

    Lifestyle factors and potential confounders were assessed at baseline. The lifestyle factors smoking habits, alcohol consumption, leisure physical activity and consumption of fruit and vegetables were dichotomised using recommendations for a health-enhancing lifestyle and combined to form the exposure variable 'healthy lifestyle behaviour'. The exposure was categorised into five levels according to the number of healthy lifestyle factors met. The follow-up questionnaire in 2010 gave information about the outcome, long duration troublesome low back pain. Crude and adjusted binomial regression models were applied to estimate the association between the exposure and the outcome analysing men and women separately.

    RESULTS:

    The risk of developing long duration troublesome low back pain among women with occasional low back pain decreased with increasing healthy lifestyle behaviour (trend test: p=0.006). 21% (28/131) among women with no healthy lifestyle factor (reference) experienced the outcome compared to 9% (36/420) among women with all four factors. Compared to the reference group, the risk was reduced by 35% (RR 0.65, 95% CI 0.44 to 0.96) for women with one healthy lifestyle factor and 52% (RR 0.48, 95% CI 0.31 to 0.77) for women with all four healthy lifestyle factors. There were no clear associations found among men.

    CONCLUSIONS:

    Healthy lifestyle behaviour seems to decrease the risk of developing long duration troublesome low back pain among women with occasional low back pain and may be recommended to improve the prognosis.

  • 57.
    Bramberg, Elisabeth Björk
    et al.
    Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Nobels Vag 13, S-17177 Stockholm, Sweden..
    Nyman, Teresia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Nobels Vag 13, S-17177 Stockholm, Sweden.;KTH Royal Inst Technol, Sch Technol & Hlth, Ergon Unit, Stockholm, Sweden..
    Kwak, Lydia
    Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Nobels Vag 13, S-17177 Stockholm, Sweden..
    Alipour, Akbar
    Storvretens Primary Hlth Clin, Stockholm, Sweden..
    Bergstrom, Gunnar
    Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Nobels Vag 13, S-17177 Stockholm, Sweden.;Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden..
    Elinder, Liselotte Schafer
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Hermansson, Ulric
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Jensen, Irene
    Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Nobels Vag 13, S-17177 Stockholm, Sweden..
    Development of evidence-based practice in occupational health services in Sweden: a 3-year follow-up of attitudes, barriers and facilitators2017Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, nr 4, s. 335-348Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The Swedish government initiated an investigation of how to secure and develop the competence of the occupational health services. The primary aim of the present study was to investigate whether the development of evidence-based practice (EBP) in the Swedish occupational health services in relation to attitudes, knowledge and use improved during the first 3 years of the government's initiative. The study has a mixed methods design combining questionnaires and interviews with data collection at baseline and at 3-year follow-up. The response rate was 66% at baseline and 63% at follow-up. The results show that practitioners' knowledge of EBP was moderate at baseline and improved at follow-up (p = 0.002; 95% CI 0.01; 0.21). Practitioners experienced lower levels of organizational and managerial support for EBP at follow-up (p < 0.001; 95% CI 0.18; 0.38). The results revealed that managers viewed responsibility for implementing EBP as a matter for individual practitioners rather than as an organizational issue. Occupational health service managers and practitioners are generally positive to EBP. However, the findings emphasize the need to educate managers in how to support EBP at the organizational level by creating an infrastructure for EBP in the OHS.

  • 58.
    Brittebo, Eva
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
    Andersson, Helén
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
    Rönn, Monika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Lind, Monica
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Lind, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Kardiovaskulär epidemiologi.
    Brandt, Ingvar
    Uppsala universitet, Teknisk-naturvetenskapliga vetenskapsområdet, Biologiska sektionen, Institutionen för organismbiologi, Ekotoxikologi.
    Bioactivation and effects of environmental pollutants in human and rodent blood vessel endothelial cells2012Ingår i: Organohalogen compound database (http://www.dioxin20xx.org/ohc_database_search.htm), 2012Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction

    Recent epidemiological studies reveal associations between exposure to environmental pollutants and cardiovascular disorders in humans. Elevated serum concentrations of polychlorinated biphenyls (PCBs) have for instance been associated with cardiovascular risk factors such as hypertension (1-3). Exposure to the carbonate plastic monomer bisphenol A (BPA) has been associated with an increased incidence of cardiovascular disease and atherogenic changes in the vascular wall (4-6). The contention that the human cardiovascular system is a sensitive target for toxic chemicals gain support from our earlier and recent experimental studies in rodents, birds and fish, as well as in cultured human primary endothelial cells. It is also compatible with earlier observations that certain polycyclic aromatic hydrocarbons (PAHs) are environmental carcinogens that may also contribute to atherosclerosis in mice and birds (7,8).

    In this presentation we will briefly discuss effects of Ah receptor (AhR) agonists (e.g. the coplanar PCB126 or BNF, ß-naphthoflavone) on the expression of cytochrome P450 (CYP)1 enzymes in various endothelia in rodents in vivo or ex vivo, as well as in cultured human umbilical vein endothelial cells (HUVEC). The CYP1-dependent bioactivation and irreversible binding of prototype polyaromatic hydrocarbons (PAH) and heterocyclic amines such as benzo(a)pyrene (BaP), 7,12-dimethyl- benz(a)anthracene (DMBA) and 3-amino-1,4-dimethyl-5H-pyrido- [4,3-b]indole (Trp-P1) in these endothelia will be reviewed. We will also report how PCB126 affects vasoactive factors in HUVEC, and how these effects are modulated by physiological 17ß-oestradiol concentrations. Some effects of PCB126, 1-nitropyrene (1-NP) and bisphenol A (BPA) on biomarkers for endothelial dysfunction, cell stress and DNA damage in HUVEC will finally be presented.

    Material and methods

    Human umbilical vein endothelial cells (HUVEC) were purchased from Science Cell Research laboratories, Carlsbad, CA. C57Bl mice and Wistar or Sprague Dawley rats were purchased from various suppliers. All animal experiments were approved by the Local Ethical Committee for Research on Animals in Uppsala and the studies followed the guidelines laid down by the Swedish and European Union legislation on animal experimentation. Rodents, tissue-slices and cultured cells were treated with model chemicals as previously described. Tape section and light microscopy autoradiographic imaging using 3H-labelled BaP, DMBA and Trp-P-1 and immunohistochemistry was performed as previously described (9-19). Precision-cut tissue slices for in vitro autoradiography were prepared as described in (14) and the slices were incubated with various 3H-labelled chemicals. HUVEC were exposed to various compounds and the detection of biomarkers of endothelial dysfunction, DNA damage were performed as described (20-22). Finally, female Fischer rats were exposed to BPA (0.025, 0.25 and 2.5 mg/l) and fructose (50 g/l) in the drinking water from 5 to 15 weeks of age to mimic human exposure (unpublished data).

    Results and discussion

    Co-localization of CYP1A1 expression and BaP, DMBA and Trp-P-1 adduct formation in endothelial linings As demonstrated by immunohistochemistry, a high CYP1A immunoreactivity occurred in capillaries of the heart, skeletal muscle, uterus and in blood-brain interfaces such as the leptomeninges and plexus choroideus, whereas no expression was observed for instance in cerebral capillary endothelial cells of mice treated with AhR agonists (9-11). No, or very low constitutive immunoreactivities were observed in these endothelia in vehicle-treated animals. No basal or induced CYP1B1 expression was observed in endothelial cells, while a weak CYP1B1 immunostaining was detected in the muscle layer of small arteries. It should be noted that in subcellular preparations of whole organs, e.g. heart and brain, the CYP1A1 in endothelial cells is diluted due to cells that do not express high levels of CYP1A1, for examples myocytes or neurons, in excess. A cell-specific metabolism in endothelial cells may therefore remain undetected due to the presence of metabolically inactive cells. In order to detect minor sites of bioactivation such as endothelial linings we employed light microscopic autoradiographic imaging to examine the bioactivation and subsequent irreversible binding of the radiolabelled prototype toxicants in tissues of animals pretreated with AhR-agonists. As determined by light microscopic autoradiography of AhR-agonist-treated mice exposed to 3H-labelled BaP, DMBA or Trp-P-1 and birds exposed to 3H-Trp-P-1 a significant accumulation of non-extractable radioactivity occurred in endothelial linings (9-18). The bound radioactivity occurred in the nuclei and the perinuclear cytoplasm, suggesting that the autoradiograms depict both DNA- and protein-bound adducts. Since the binding sites of 3H-labelled BaP, DMBA or Trp-P-1 corresponded with the sites of CYP1A1 induction, we concluded that rodents express a constitutively low but highly inducible and functional CYP1A1 in endothelial cells. The binding of reactive metabolites in endothelial cells exceeded the binding in all other cell types in AhR-agonist treated mice and was abolished by pretreatment with the CYP1A1 inhibitor ellipticine, supporting a CYP1A1-catalysed metabolic activation in situ to a reactive species (9, 10,12). These findings imply that there is a preferential CYP1A1-catalysed formation of reactive metabolites from all three carcinogens in endothelial cells expressing high CYP1A1 levels. Interestingly, however, carcinogenesis in endothelial cells is a relative rare finding, suggesting that degenerative lesions and cell death may be more prevalent responses to metabolism-activated carcinogens/mutagens in these cells. Experiments with 3H-DMBA and 3H-Trp-P-1 in HUVEC confirmed that AhR-agonists induced an increased bioactivation, suggesting that also human endothelial cells should be targets for toxicity of reactive intermediates formed from CYP1A1- activated carcinogens/mutagens (17-18). This conclusion is supported by immunohistochemical studies on the heavily vascularized human endometrium demonstrating an expression of CYP1A1 and CYP1B1 protein in and around human endometrial blood vessels, although a large interindividual

    variation was observed (19). None of the endometrial biopsy samples displayed vascular expression of CYP2A6, CYP2B6, CYP2C8/2C9/2C19, CYP2D6, or CYP3A4/5 protein.

    Effects of PCB 126, 1-NP, and BPA on biomarkers of endothelial dysfunction and cell stress in endothelial cells In vitro studies demonstrated that PCB126 increased the levels of vasoconstriction factors and decreased the levels of vasodilating factors in cultured HUVEC in a fashion that is characteristic for endothelial dysfunction related to human hypertension. The study showed that the co-planar PCB126 induced expression of the endothelium-derived vasoconstriction factor COX-2 and stimulated formation of the vasoconstrictor prostaglandin PGF2 via the AhR in HUVEC (20). COX-2 is known to play a role in hypertension by catalysing the formation of vasoconstriction prostaglandins and by stimulating reactive oxygen species (ROS) production. Further studies demonstrated that PCB126 increased the production of the vasoconstriction prostaglandin PGF2 and ROS in HUVEC. The relationship between increased ROS production and human hypertension is well established, ROS promotes vasoconstriction by stimulating the production of vasoconstriction prostaglandins and by reducing bioavailability of the vasorelaxing factor NO. Indeed, exposure to PCB126 slightly reduced the production of NO in HUVEC. Furthermore, the PCB126-induced mRNA expressions of CYP1A1, CYP1B1 and COX-2 in HUVEC were enhanced in the presence of physiological levels of 17- estradiol. This suggests that increased levels of oestrogen stimulate AhR-dependent transcription of genes previously associated with endothelial dysfunction and hypertension.

    In another study we have examined the effects of a nitrated PAH, 1-nitropyrene, that is abundant in diesel exhausts (21). The results revealed that 1-NP induced DNA damage, increased levels of ROS and increased protein expression of the endoplasmic reticulum stress chaperone GRP78 in cultured HUVEC. Induction of CYP1A1 by PCB126 as well as inhibition of nitroreductive metabolism by dicoumarol attenuated the induction of DNA damage, intracellular ROS levels and GRP78 expression. This suggests that the effects of 1-NP on HUVEC were mediated by metabolites mainly formed at nitroreduction and not by CYP1-dependent bioactivation to reactive intermediates.

    Recent in vitro studies demonstrated that bisphenol A increased the mRNA expression of genes that regulate vasoconstriction and angiogenesis in HUVEC (eNOS, VEGF, VEGFR2, connexin 43 and ACE1) and in human cardiomyocytes (eNOS and ACE1) (22). The results also showed that BPA increased the expression of P-eNOS(ser1177) and the production of NO in HUVEC. NO is the main effector molecule in angiogenesis downstream of VEGF. Based on the findings that BPA increase the expression of proangiogenic factors we investigated whether BPA could stimulate in vitro angiogenesis in HUVEC using the endothelial tube formation assay. The results demonstrated that BPA increased HUVEC tube formation suggesting that BPA can act directly on the endothelium and stimulate angiogenesis. Long-term exposure in rats revealed that environmentally relevant levels of BPA, increased the cardiac mRNA expression of genes that regulate vasoconstriction and angiogenesis. Ten weeks exposure of rats from preadolescence to adulthood to BPA in the drinking water increased the

    expression of eNOS, VEGF, VEGFR2 and ACE1 in the heart. Taken together, the genes that were upregulated in rat cardiac tissues in vivo were also upregulated in human endothelial cells and cardiomyocytes in vitro. The heart is a heavily vascularized tissue that consists mainly of cardiac endothelial cells and cardiomyocytes and although cardiomyocytes dominate the volume of the myocardium the number of endothelial cells exceeds the number of cardiomyocytes by approximately three to one. Thus, the effects of BPA on eNOS VEGF, VEGFR2 and ACE1 mRNA expression in rat cardiac tissues are most likely to be related to an effect of BPA on endothelial cells but may also involve cardiomyocytes.

    We conclude that endothelial cells may be targets for bioactivation and toxicity of environmental pollutants. The immunohistochemical and autoradiographic data demonstrated a differential expression of CYP1 enzymes and metabolic activation of pollutants in various endothelial linings suggesting that some but not all endothelial linings may be targets for xenobiotics metabolised by AhR-regulated enzymes. Studies on the effects of PCB126, 1-nitropyrene and BPA in cultured human primary endothelial cells demonstrated up-regulation of various biomarkers for endothelial dysfunction and cell stress suggesting that the human endothelium may be a sensitive target for these pollutants. The bioactivation and effects of environmental pollutants in endothelial cells should be further studied in order to unravel the role of these chemicals in human cardiovascular disease.

  • 59.
    Bröms, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Eriksson, Margaretha
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Svärdsudd, Kurt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    A nationwide study of asthma incidence and its determinants in preschool children during five years of follow upManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Background: Many studies on asthma prevalence have been published, but the number of studies on asthma incidence in preschool children is limited.

    A number of studies on asthma prevalence have been published, but there are few studies on asthma incidence in preschool children. In this project a nationwide sample of preschool children were followed with the aim to estimate 5-year asthma incidence and its determinants.

    Methods: Parents of 5886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded in 2002 to a baseline postal questionnaire with questions regarding symptoms indicating possible asthma or atopic conditions, and a number of other variables. In 2007, 4255 of the parents responded to an almost identical questionnaire.

    Results: A large number of potential baseline determinants for 5-year asthma incidence were identified. Of these, food allergy, wheezing last 12 months, rhinitis, parental rhinitis, parental asthma, ever asthma, age, and eczema, on rank order of importance, remained significant in multivariate logistic regression analysis. The asthma incidence was highly dependent on presence or absence of these variables. Given the variable mix in the present study population, the incidence ranged from 2.9% in the oldest to 5.8% in the youngest children, corresponding to an annual asthma incidence of 0.6% to 1.2%.

    Conclusions: The incidence of asthma is highly dependent on the composition of the underlying population. However, an annual incidence in range a half to one percent in preschool children in the general population appears probable.

  • 60.
    Bröms, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Eriksson, Margaretha
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Sundelin, Claes
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Svärdsudd, Kurt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Prevalence and co-occurrence of parentally reported possible asthma and allergic manifestations in pre-school children2013Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, s. 764-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The aim of this study was to make an in-depth analysis of the prevalence and co-occurrence in pre-school children of possible asthma and atopic manifestations. Methods: In Sweden 74%-84% of preschool children, depending on age, attend municipality organised day-care centres. Parents of 5,886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded to a postal questionnaire regarding symptoms indicating prevalent possible asthma, allergic rhinitis, eczema, and food, furred pet and pollen allergy and other data in their children. Possible asthma was defined as any of the four criteria wheezing four times or more during the last year, physician diagnosis and current wheezing, ever had asthma and current wheezing, and current use of inhalation steroids, all based on questionnaire responses. Results: The overall prevalence of possible asthma was 8.9%, of eczema 21.7%, of rhinitis 8.1%, and of food allergy 6.6%. There was a highly significant co-occurrence between possible asthma and all atopic manifestations, 35.7% having any of the manifestations. Presence of pet allergy was the manifestation showing the closest co-occurrence with presence of possible asthma, presence of pollen allergy with presence of rhinitis, and presence of food allergy with presence of eczema. Assessed from plots of age-specific prevalence of possible asthma, rhinitis, eczema and food allergy, the prevalence of all manifestations increased from one to three years of age and then decreased, except for rhinitis where the prevalence increased until six years of age, indicating no specific ordered sequence. Conclusions: Parentally reported possible asthma, eczema and food allergy had a curvilinear prevalence course across age with a maximum at age 3, while rhinitis prevalence increased consistently with age. Co-occurrence between possible asthma and atopic manifestations was common, and some combinations were more common than others, but there was no evidence of a specific ordered onset sequence.

  • 61.
    Bröms, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Eriksson, Margaretha
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Sundelin, Claes
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Svärdsudd, Kurt F
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Effect of degree of urbanisation on age and sex-specific asthmaprevalence in Swedish preschool children2009Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 9, s. 303-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There are few studies on age and sex-specific asthma   prevalence in the age range 1-6 years. The purpose of this report was   to estimate age and sex specific asthma prevalence in preschool   children and to analyse the influence of possible demographic and   geographic determinants.   Methods: All 70 allergen avoidance day-care centres and 140 matched   ordinary day-care centres across Sweden were sampled. The parents of   all 8,757 children attending these day-care centres received the   International Study of Asthma and Allergies in Childhood (ISAAC)   written questionnaire, supplemented with questions on medical   treatment, physician assessed asthma diagnosis, and other asthma   related questions. The response rate was 68%.   Results: The age specific asthma prevalence, adjusted for the   underlying municipality population size, was among boys 9.7% at age 1,   11.1% at age 2, 11.4 at age 3, 10.5 at age 4, 8.7 at age 5, and 6.4 at   age 6. The corresponding proportions among girls were 8.9%, 9.9%, 9.8%,   8.8%, 7.0%, and 5.0%, on average 9.6% for boys and 8.2% for girls,   altogether 8.9%. In addition to age and sex the prevalence increased by   municipality population density, a proxy for degree of urbanisation.   Moreover, there was a remaining weak geographical gradient with   increasing prevalence towards the north and the west.   Conclusion: The age-specific asthma prevalence was curvilinear with a   peak around age 3 and somewhat higher for boys than for girls. The   asthma prevalence increased in a slowly accelerating pace by   municipality population density as a proxy for degree of urbanisation.

  • 62.
    Bröms, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Erikssson, Margaretha
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Sundelin, Claes
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Svärdsudd, Kurt F
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Prevalence and co-occurrence of asthma and allergic manifestations in preschool childrenManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Background: It has been claimed that preschool children may embark on ‘the atopic march’, which means that atopic manifestations show up one after another in a certain order. The aim of this study was to make an in-depth analysis of the co-occurrence of asthma and atopic manifestations.

    Methods: Parents of 5886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded to a postal questionnaire regarding symptoms indicating prevalent asthma, allergic rhinitis, eczema, food allergy, furred pet and pollen allergy and other data in their children. Age specific prevalence of asthma, rhinitis, eczema, and food allergy was computed, adjusted for municipality population size.

    Results: The overall prevalence of asthma was 8.9%, of eczema 21.7%, of rhinitis 8.1%, and of food allergy 6.6%. There was a highly significant co-occurrence between all asthma-atopic manifestations. Presence of pet allergy was the manifestation showing the closest co-occurrence with presence of asthma, presence of pollen allergy with presence of rhinitis, and presence of food allergy with presence of eczema. Assessed from plots of age specific prevalence of asthma, rhinitis, eczema and food allergy the prevalence of all manifestations increased from one to three years of age and then decreased, except for rhinitis where the prevalence increased until six years of age. There was no evidence of a rank order of asthma and allergy manifestation onset.

    Conclusions: There was close co-occurrence between all asthma-atopic manifestations but no evidence of a rank order of onsets.

  • 63.
    Bröms, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Sundelin, Claes
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Eriksson, Margaretha
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Svärdsudd, Kurt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    A nationwide study of asthma incidence rate and its determinants in Swedish pre-school children2012Ingår i: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 27, nr 9, s. 695-703Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    While many studies on asthma prevalence have been published, the number of studies on asthma incidence in pre-school children is limited. In this project, a nationwide sample of pre-school children was followed with the aim of estimating cumulative 5-year asthma incidence and its determinants. Parents of 5,886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded in 2002 to a baseline postal questionnaire with questions regarding symptoms indicating possible asthma or atopic conditions, and a number of other variables. In 2007, parents of 4,255 children responded to an almost identical follow-up questionnaire. Of these, the 3,715 children who were free from asthma at baseline constitute the study population for this report. A large number of potential baseline determinants for cumulative 5-year asthma incidence were identified. Of these, food allergy, rhinitis, incomplete asthma diagnosis criteria (wheezing last 12 months, and ever had asthma but no current symptoms), parental rhinitis, parental asthma, age, and eczema, in ranking order of importance, remained significant in multivariate logistic regression analysis. The asthma incidence rate was highly dependent on presence or absence of these variables, the average annual rate ranging from 2/1,000/year in 6-year-olds with no determinants to154/1,000/year in 1-year-olds with all determinants, corresponding to 11/1,000/year based on the whole study population.

  • 64.
    Bröms, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Svärdsudd, Kurt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Allergibarns hälsa i allergiförskolor och konventionella förskolor: en nationell studie2006Konferensbidrag (Övrigt vetenskapligt)
  • 65.
    Cai, G-H
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Bröms, Kristina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Mälarstig, B
    Zhao, Z-H
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Kim, J L
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Svärdsudd, Kurt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Quantitative PCR analysis of fungal DNA in Swedish day care centers and comparison with building characteristics and allergen levels2009Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 19, nr 5, s. 392-400Artikel i tidskrift (Refereegranskat)
    Abstract [en]

     Sweden has had allergen-avoidance day care centers (AADCs) since 1979. The aim of this study was to measure fungal DNA by quantitative polymerase chain reaction (qPCR), a new method, in AADCs and ordinary day care centers (ODCs) and examine associations between allergen levels and building characteristics. Dust samples were collected by swabbing doorframes, vacuum-cleaning, and using Petri dishes. In total, 11 AADCs and 11 ODCs were studied (70 rooms). Total fungal DNA, measured by qPCR in the swab dust, was detected in 89%, Aspergillus or Penicillium (Asp/Pen) DNA in 34%, and Stachybotrys chartarum DNA in 6% of the rooms. Total fungal DNA was significantly higher in rooms with linoleum floor (P = 0.02), textile carpets (P = 0.03), reported dampness/molds (P = 0.02) and reported odor (P < 0.001) in the buildings, and significantly lower in wooden facade buildings (P = 0.003). Reported odor was related to the amount of sieved fine dust, reported dampness/molds and type of building construction. Total fungal DNA was related to cat, dog, horse and total allergen levels (P = 0.003) in the day care centers. In conclusion, total fungal DNA is related to reported dampness/molds, reported odor, and type of wall construction. The association between fungal and allergen contamination indicated a general 'hygiene factor' related to biological contaminants. Practical Implications The associations between fungal DNA, reported dampness/molds, and odor support the view that buildings with odor problems should be investigated for possible hidden fungal growth. There is a need to measure fungal biomass in different types of building constructions by monitoring fungal DNA. Analysis of fungal DNA with quantitative PCR can be a fast and practical way to study indoor fungal contamination. Swabbing dust from the doorframe of the main entrance to the room can be a convenient method of sampling dust for fungal DNA analysis. The high prevalence of reported dampness/molds and the common occurrence of fungal DNA indicate the need to improve the indoor environment of Swedish day care centers.

  • 66.
    Cai, Gui-Hong
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Hashim, Jamal Hisham
    Hashim, Zailina
    Ali, Faridah
    Bloom, Erica
    Larsson, Lennart
    Lampa, Erik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Fungal DNA, allergens, mycotoxins and associations with asthmatic symptoms among pupils in schools from Johor Bahru, Malaysia2011Ingår i: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 22, nr 3, s. 290-297Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    P>While there is a large variation of prevalence of asthma symptoms worldwide, what we do know is that it is on the rise in developing countries. However, there are few studies on allergens, moulds and mycotoxin exposure in schools in tropical countries. The aims were to measure selected fungal DNA, furry pet allergens and mycotoxins in dust samples from schools in Malaysia and to study associations with pupils' respiratory health effects. Eight secondary schools and 32 classrooms in Johor Bahru, Malaysia were randomly selected. A questionnaire with standardized questions was used for health assessment in 15 randomly selected pupils from each class. The school buildings were inspected and both indoor and outdoor climate were measured. Dust samples were collected by cotton swabs and Petri dishes for fungal DNA, mycotoxins and allergens analysis. The participation rate was 96% (462/480 invited pupils), with a mean age of 14 yr (range 14-16). The pupils mostly reported daytime breathlessness (41%), parental asthma or allergy (22%), pollen or pet allergy (21%) and doctor-diagnosed asthma (13%) but rarely reported night-time breathlessness (7%), asthma in the last 12 months (3%), medication for asthma (4%) or smoking (5%). The inspection showed that no school had any mechanical ventilation system, but all classrooms had openable windows that were kept open during lectures. The mean building age was 16 yr (range 3-40) and the mean indoor and outdoor CO2 levels were 492 ppm and 408 ppm, respectively. The mean values of indoor and outdoor temperature and relative humidity were the same, 29 degrees C and 70% respectively. In cotton swab dust samples, the Geometric Mean (GM) value for total fungal DNA and Aspergillus/Penicillium (Asp/Pen) DNA in swab samples (Cell Equivalents (CE)/m2) was 5.7*108 and 0.5*108, respectively. The arithmetic mean (CE/m2) for Aspergillus versicolor DNA was 8780, Stachybotrys chartarum DNA was 26 and Streptomyces DNA was 893. The arithmetic means (pg/m2) for the mycotoxins sterigmatocystin and verrucarol were 2547 and 17, respectively. In Petri dish dust samples, the GM value for total fungal DNA and Asp/Pen DNA (CE/m2 per day) was 9.2*106 and 1.6*106, respectively. The arithmetic mean (CE/m2 per day) for A. versicolor DNA was 1478, S. chartarum DNA was 105 and Streptomyces DNA was 1271, respectively. The GM value for cat (Fel d1) allergen was 5.9 ng/m2 per day. There were positive associations between A. versicolor DNA, wheeze and daytime breathlessness and between Streptomyces DNA and doctor-diagnosed asthma. However, the associations were inverse between S. chartarum DNA and daytime breathlessness and between verrucarol and daytime breathlessness. In conclusion, fungal DNA and cat allergen contamination were common in schools from Malaysia and there was a high prevalence of respiratory symptoms among pupils. Moreover, there were associations between levels of some fungal DNA and reported respiratory health in the pupils.

  • 67.
    Cai, Gui-Hong
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Mälarstig, Björn
    Kumlin, Anders
    Johansson, Ingrid
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Fungal DNA and pet allergen levels in Swedish day care centers and associations with building characteristics2011Ingår i: Journal of Environmental Monitoring, ISSN 1464-0325, E-ISSN 1464-0333, Vol. 13, nr 7, s. 2018-2024Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Pet allergens and mold growth related to damp are common phenomena in day care centers in Sweden but exposure measurements of these factors are lacking. The aim of this study was to investigate the relationship between building construction and indoor environment quality in Swedish day care centers and the potential for exposure to fungi (analyzed by quantitative PCR) and animal allergens (analyzed by ELISA). Measurements were performed in 21 day care centers (103 rooms) from one municipality in Sweden, which were identified as constructions at risk of dampness (85% of the buildings) and with visible damage and mold growth (54% of the buildings). Dust samples were collected using cotton swab and Petri dishes. Total fungal DNA was detected in 99% and 100%, Aspergillus/Penicillium DNA in 54% and 68%, and Stachybotrys chartarum DNA in 4% and 9% of the investigated rooms in cotton swab and Petri dish samples, respectively. The total fungal DNA levels (Geometric Mean, GM) were 4.2 × 106 cell equivalents per m2 and 2.9 × 105 cell equivalents per m2 per day in the swab and Petri dish samples, respectively. The concentrations (GM) of cat (Fel d1), dog (Can f1), and horse (Equ cx) allergens were 9.4, 7.2 ng m−2 day−1, and 5.0 unit per m2 per day, respectively. Total fungal DNA levels were higher in risk construction buildings (p = 0.01), in rooms with linoleum flooring material (p = 0.003), and in buildings with rotating heat exchangers (p = 0.02). There were associations between total fungal DNA levels and cat (p = 0.02), dog (p < 0.001), and horse (p = 0.001) allergens. In conclusion, risk constructions, damp constructions, mould growth, fungal DNA, and animal allergens were common exposure factors in Swedish day care centers. Building constructions that represent a high risk for internal dampness should be avoided in the future, and measures to reduce allergen levels should be considered to protect pet-allergic children from asthmatic problems.

  • 68.
    Cai, Gui-Hong
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Theorell-Haglöw, Jenny
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Svartengren, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Elmstahl, Solve
    Lund Univ, Div Geriatr Med, Dept Hlth Sci, Sweden CRC,Skane Univ Hosp, Malmo, Sweden.
    Lind, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Kardiovaskulär epidemiologi.
    Lindberg, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lung- allergi- och sömnforskning.
    Insomnia symptoms and sleep duration and their combined effects in relation to associations with obesity and central obesity2018Ingår i: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 46, s. 81-87Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Previous studies have shown that both sleep duration and insomnia have an impact on obesity and central obesity. However, studies of the joint effects of these sleep disorders are still sparse. Methods: The present study utilized data from the Swedish EpiHealth cohort study. Participants (45 - 78 y) were asked to fill out an internet-based questionnaire. Body mass index (BMI) and central obesity (calculated from waist circumference) were based on measured data. Results: A total of 18,823 participants (mean age = 60 ys) were included in this study. The reported prevalence of short (<6 h/night) and long (>9 h/night) sleep duration was 8% and 4% respectively, and insomnia symptoms was 19%. Of the study population, 16% were obese (BMI >= 30 kg/m(2)) and 40% had central obesity. There was a U-shaped association between sleep duration and obesity and central obesity, and significant associations between insomnia symptoms and obesity. When stratifying sleep duration by concurrent insomnia symptoms, there were associations (odds ratios, (95% confidence intervals)) between the combination of both short (1.48, (1.22-1.80)) and long sleep duration (1.77 (1.00 - 3.16)) with insomnia symptoms and obesity and central obesity (1.36 (1.16-1.61) and 2.44 (1.41-3.24) respectively). However, there was no significant association between insomnia symptoms and obesity or central obesity in participants with normal sleep duration. For central obesity there was an association with long sleep duration regardless of insomnia symptoms, while the association with short sleep duration was significant only if insomnia symptoms were present. Conclusions: Both short and long sleep duration, as well as insomnia symptoms, are associated with obesity and central obesity. There is an important joint effect of sleep duration and insomnia symptoms and there is no association between insomnia symptoms and obesity, as long as a normal sleeping time can be attained. This indicates that sleep duration rather than insomnia symptoms per se is of importance for the relationship between sleep and obesity.

  • 69.
    Cai, Jiao
    et al.
    Chongqing Univ, Minist Educ, Joint Int Res Lab Green Bldg & Built Environm, Chongqing 400045, Peoples R China;Chongqing Univ, Natl Ctr Int Res Low Carbon & Green Bldg, Minist Sci & Technol, Chongqing, Peoples R China.
    Li, Baizhan
    Chongqing Univ, Minist Educ, Joint Int Res Lab Green Bldg & Built Environm, Chongqing 400045, Peoples R China;Chongqing Univ, Natl Ctr Int Res Low Carbon & Green Bldg, Minist Sci & Technol, Chongqing, Peoples R China.
    Yu, Wei
    Chongqing Univ, Minist Educ, Joint Int Res Lab Green Bldg & Built Environm, Chongqing 400045, Peoples R China;Chongqing Univ, Natl Ctr Int Res Low Carbon & Green Bldg, Minist Sci & Technol, Chongqing, Peoples R China.
    Wang, Han
    Chongqing Univ, Minist Educ, Joint Int Res Lab Green Bldg & Built Environm, Chongqing 400045, Peoples R China;Chongqing Univ, Natl Ctr Int Res Low Carbon & Green Bldg, Minist Sci & Technol, Chongqing, Peoples R China.
    Du, Chenqiu
    Chongqing Univ, Minist Educ, Joint Int Res Lab Green Bldg & Built Environm, Chongqing 400045, Peoples R China;Chongqing Univ, Natl Ctr Int Res Low Carbon & Green Bldg, Minist Sci & Technol, Chongqing, Peoples R China.
    Zhang, Yinping
    Tsinghua Univ, Sch Architecture, Beijing, Peoples R China.
    Huang, Chen
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai, Peoples R China.
    Zhao, Zhuohui
    Fudan Univ, Key Lab Hlth Technol Assessment, Natl Hlth & Family Planning Commiss Peoples Repub, Sch Publ Hlth,Key Lab Publ Hlth Safety,Minist Edu, Shanghai, Peoples R China.
    Deng, Qihong
    Cent S Univ, Sch Publ Hlth, Changsha, Hunan, Peoples R China.
    Yang, Xu
    Cent China Normal Univ, Coll Life Sci, Wuhan, Hubei, Peoples R China.
    Zhang, Xin
    Shanxi Univ, Res Ctr Environm Sci & Engn, Taiyuan, Shanxi, Peoples R China.
    Qian, Hua
    Southeast Univ, Sch Energy & Environm, Nanjing, Jiangsu, Peoples R China.
    Sun, Yuexia
    Tianjin Univ, Sch Environm Sci & Engn, Tianjin, Peoples R China.
    Liu, Wei
    Tsinghua Univ, Sch Architecture, Beijing, Peoples R China.
    Wang, Juan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Chongqing Univ, Minist Educ, Joint Int Res Lab Green Bldg & Built Environm, Chongqing 400045, Peoples R China.
    Yang, Qin
    Chongqing Univ, Minist Educ, Joint Int Res Lab Green Bldg & Built Environm, Chongqing 400045, Peoples R China;Chongqing Univ, Natl Ctr Int Res Low Carbon & Green Bldg, Minist Sci & Technol, Chongqing, Peoples R China.
    Zeng, Fanbin
    Chongqing Univ, Minist Educ, Joint Int Res Lab Green Bldg & Built Environm, Chongqing 400045, Peoples R China;Chongqing Univ, Natl Ctr Int Res Low Carbon & Green Bldg, Minist Sci & Technol, Chongqing, Peoples R China.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Sundell, Jan
    Tianjin Univ, Sch Environm Sci & Engn, Tianjin, Peoples R China.
    Household dampness-related exposures in relation to childhood asthma and rhinitis in China: A multicentre observational study2019Ingår i: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 126, s. 735-746Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    During 2010-2012, we conducted an observational study on household environment and health outcomes among 40,010 preschool children from seven cities of China. Here we examined associations of six dampness-related indicators (visible mold spots, visible damp stains, damp clothing and/or bedding, water damage, condensation on windowpane, moldy odor) in the current residence and three dampness-related indicators (visible mold spots, condensation on windowpane, moldy odor) in the early residence with childhood asthma and rhinitis. In the multi-level logistic regression analyses, visible mold spots and visible damp stains in the current residence were significantly associated with the increased odds of doctor-diagnosed asthma and allergic rhinitis during lifetime-ever (adjusted odd ratios (AORs) range: 1.18-1.35). All dampness-related indicators were significantly associated with increased odds of wheeze and rhinitis during lifetime-ever and in the past 12 months (AORs range: 1.16-2.64). The cumulative numbers of damp indicators had positively dose-response relationships with the increased odds of the studied diseases. These associations for wheeze and rhinitis were similar between northern children and southern children. Similar results were found in the sensitive analyses among children without a family history of allergies and among children without asthma and allergic rhinitis. For 3-6 years-old children in mainland of China in 2011, we speculated that about 90,000 (2.02%) children with asthma and about 59,000 (1.09%) children with allergic rhinitis could be attributable to exposing to visible mold spots in the current residence. Our results suggested that early and lifetime exposures to household dampness indicators are risk factors for childhood asthma and rhinitis.

  • 70. Campbell, B
    et al.
    Raherison, C
    Lodge, C J
    Lowe, A J
    Gislason, T
    Heinrich, J
    Sunyer, J
    Gómez Real, F
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Matheson, M C
    Wjst, M
    Dratva, J
    de Marco, R
    Jarvis, D
    Schlünssen, V
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Leynaert, B
    Svanes, C
    Dharmage, S C
    The effects of growing up on a farm on adult lung function and allergic phenotypes: an international population-based study2017Ingår i: Thorax, ISSN 0040-6376, E-ISSN 1468-3296, Vol. 72, nr 3, s. 236-244Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    RATIONALE: Evidence has suggested that exposure to environmental or microbial biodiversity in early life may impact subsequent lung function and allergic disease risk.

    OBJECTIVES: To investigate the influence of childhood living environment and biodiversity indicators on atopy, asthma and lung function in adulthood.

    METHODS AND MEASUREMENTS: The European Community Respiratory Health Survey II investigated ∼10 201 participants aged 26-54 years from 14 countries, including participants' place of upbringing (farm, rural environment or inner city) before age 5 years. A 'biodiversity score' was created based on childhood exposure to cats, dogs, day care, bedroom sharing and older siblings. Associations with lung function, bronchial hyper-responsiveness (BHR), allergic sensitisation, asthma and rhinitis were analysed.

    MAIN RESULTS: As compared with a city upbringing, those with early-life farm exposure had less atopic sensitisation (adjusted OR 0.46, 95% CI 0.37 to 0.58), atopic BHR (0.54 (0.35 to 0.83)), atopic asthma (0.47 (0.28 to 0.81)) and atopic rhinitis (0.43 (0.32 to 0.57)), but not non-atopic outcomes. Less pronounced protective effects were observed for rural environment exposures. Women with a farm upbringing had higher FEV1 (adjusted difference 110 mL (64 to 157)), independent of sensitisation and asthma. In an inner city environment, a higher biodiversity score was related to less allergic sensitisation.

    CONCLUSIONS: This is the first study to report beneficial effects of growing up on a farm on adult FEV1. Our study confirmed the beneficial effects of early farm life on sensitisation, asthma and rhinitis, and found a similar association for BHR. In persons with an urban upbringing, a higher biodiversity score predicted less allergic sensitisation, but to a lesser magnitude than a childhood farm environment.

  • 71.
    Carlsson, Axel C.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Wandell, Per E.
    Hedlund, Ebba
    Walldius, Goran
    Nordqvist, Tobias
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Jungner, Ingmar
    Hammar, Niklas
    Country of birth-specific and gender differences in prevalence of diabetes in Sweden2013Ingår i: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 100, nr 3, s. 404-408Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim was to investigate country or region of birth-specific prevalence and gender differences of diabetes in residents in Sweden, using Swedish-born men and women as referent. Methods: The Apolipoprotein MOrtality RISk (AMORIS) cohort was used (184,000 men and 151,453 women) aged between 20 and 80 years, with data from the CALAB laboratory, Stockholm, 1985-1996. Diabetes was defined as fasting glucose >= 7.0 mmol/L or a hospital diagnosis of diabetes. Country of birth was obtained by linkage to Swedish Censuses 1970-1990. Standardized prevalence rate ratios (SPRR) with 95% confidence intervals (95% CI) were estimated. Results: Five groups of women and one group of men had a significantly higher prevalence than Swedish-born (based on SPRR): women born in Iraq (6.0 (95% CI 1.3-28.9)), North Africa (6.9 (95% CI 3.1-15.3)), South Asia (3.1 (95% CI 1.0-10.0)), Syria (5.3 (95% CI 1.8-16.0)), Turkey (3.7 (95% CI 1.2-10.9)) and men born in other Middle Eastern countries (2.3 (95% CI 1.0-5.5)). Swedish-born men had a higher age-standardized prevalence of diabetes (3.9%) than Swedish born women ( 2.5%). A higher prevalence among men was also seen in other Western countries. In contrast, a higher age-standardized prevalence among women was observed in immigrants from Turkey (8.9% vs. 3.1%, p < 0.001), Syria (13.1% vs. 4.0%, p = 0.002), and North Africa (16.8% vs. 6.6%, p < 0.001). Conclusion: Female immigrants to Sweden from Iraq, North Africa, South Asia, Syria, and Turkey have an increased prevalence of diabetes of substantial public health concern.

  • 72.
    Carlsson, Lars
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Folkhälsovetenskap.
    Lytsy, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Folkhälsovetenskap.
    Anderzén, I
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Folkhälsovetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Motivationfor return to work and actual return to work among people on long-term sickleave due to pain syndrome or mental health conditions2018Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    ABSTRACTPurpose:The purpose of this study was to investigate associations between motivation for return towork and actual return to work, or increased employability among people on long-term sick leave.Materials and methods:Data by responses to questionnaires was collected from 227 people on long-term sick leave (mean¼7.9years) due to pain syndrome or mild to moderate mental health conditionswho had participated in a vocational rehabilitation intervention. The participants’motivation for return towork was measured at baseline. At 12-month follow-up, change in the type of reimbursement betweenbaseline and at present was assessed and used to categorise outcomes as:“decreased work and employ-ability”,“unchanged”,“increased employability”,and“increased work”. Associations between baselinemotivation and return to work outcome were analysed using logistic and multinomial regression models.Results:Motivation for return to work at baseline was associated with return to work or increasedemployability at 12-month follow-up in the logistic regression model adjusting for potential confounders(OR 2.44, 95% CI 1.25–4.78).Conclusions:The results suggest that motivation for return to work at baseline was associated withactual chances of return to work or increased employability in people on long-term sick leave due topain syndrome or mild to moderate mental health conditions.

  • 73. Carroll, Linda J.
    et al.
    Holm, Lena W.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Ferrari, Robert
    Ozegovic, Dejan
    Cassidy, David
    Recovery in Whiplash-Associated Disorders: Do You Get What You Expect?2009Ingår i: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 36, nr 5, s. 1063-1070Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. Positive expectations predict better outcome in a number of health conditions, but the role of expectations in predicting health recovery after injury is not Well understood. We investigated whether early expectations of recovery in whiplash associated disorders (WAD) predict subsequent recovery, and Studied the role of "expectations" to predict recovery as determined by pain cessation and resolution of pain-related limitations in daily activities. Methods. A cohort of 6,015 adults With traffic-related whiplash injuries was assessed, using multivariable Cox proportional hazards analysis, for association between these expectations and self-perceived recovery over a 1-year period following the injury. Recovery was assessed using 3 indices: self-perceived global recovery (primary outcome), resolution of neck pain severity; and resolution of pain-related limitations in daily activities. Results. After adjusting for the effect of sociodemographic characteristics, post-crash symptoms and pain, prior health status and collision-related factors, those who expected to get better soon recovered over 3 times as quickly (hazard rate ratio = 3.62, 95% confidence interval 2.55-5.13) as those who expected that they Would never get better. Findings were similar for resolution of pain-related limitations and resolution of neck pain intensity, although the effect sizes for the latter outcome were smaller. Conclusion. Patients' early expectations for recovery are all important prognostic factor in recovery after whiplash injury, and are potentially modifiable. Clinicians should assess these expectations ill order to identify those patients at risk of chronic whiplash, and future Studies should focus Oil the effect of changing these early expectations. (First Release Feb 15 2009; J Rheumatol 2009;36:1063-70; doi: 10.3899/jrheum.080680)

  • 74. Castro-Giner, Francesc
    et al.
    Künzli, Nino
    Jacquemin, Bénédicte
    Forsberg, Bertil
    de Cid, Rafael
    Sunyer, Jordi
    Jarvis, Deborah
    Briggs, David
    Vienneau, Danielle
    Norback, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    González, Juan R
    Guerra, Stefano
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Antó, Josep-Maria
    Wjst, Matthias
    Heinrich, Joachim
    Estivill, Xavier
    Kogevinas, Manolis
    Traffic-related air pollution, oxidative stress genes, and asthma (ECHRS)2009Ingår i: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 117, nr 12, s. 1919-1924Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Traffic-related air pollution is related with asthma, and this association may be modified by genetic factors. OBJECTIVES: We investigated the role of genetic polymorphisms potentially modifying the association between home outdoor levels of modeled nitrogen dioxide and asthma. METHODS: Adults from 13 cities of the second European Community Respiratory Health Survey (ECRHS II) were included (n = 2,920), for whom both DNA and outdoor NO(2) estimates were available. Home addresses were geocoded and linked to modeled outdoor NO(2) estimates, as a marker of local traffic-related pollution. We examined asthma prevalence and evaluated polymorphisms in genes involved in oxidative stress pathways [gluthatione S-transferases M1 (GSTM1), T1 (GSTT1), and P1 (GSTP1) and NAD(P)H:quinine oxidoreductase (NQO1)], inflammatory response [tumor necrosis factor alpha (TNFA)], immunologic response [Toll-like receptor 4 (TLR4)], and airway reactivity [adrenergic receptor beta2 (ADRB2)]. RESULTS: The association between modeled NO(2) and asthma prevalence was significant for carriers of the most common genotypes of NQO1 rs2917666 [odds ratio (OR) = 1.54; 95% confidence interval (CI), 1.10-2.24], TNFA rs2844484 (OR = 2.02; 95% CI, 1.30-3.27). For new-onset asthma, the effect of NO(2) was significant for the most common genotype of NQO1 rs2917666 (OR = 1.52; 95% CI, 1.09-2.16). A significant interaction was found between NQO1 rs2917666 and NO(2) for asthma prevalence (p = 0.02) and new-onset asthma (p = 0.04). CONCLUSIONS: Genetic polymorphisms in the NQO1 gene are related to asthma susceptibility among persons exposed to local traffic-related air pollution. This points to the importance of antioxidant pathways in the protection against the effects of air pollution on asthma.

  • 75. Cedervall, Therese
    et al.
    Lind, P. Monica
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Savendahl, Lars
    Expression of the Aryl Hydrocarbon Receptor in Growth Plate Cartilage and the Impact of Its Local Modulation on Longitudinal Bone Growth2015Ingår i: International Journal of Molecular Sciences, ISSN 1422-0067, E-ISSN 1422-0067, Vol. 16, nr 4, s. 8059-8069Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Although dioxin has been reported to impair bone growth in both humans and animals, the underlying mechanisms have not been clarified. We conducted this study to rule out if dioxin may directly target the growth plate, via local modulation of the aryl hydrocarbon receptor (AhR). Initial studies in rare tissue samples of the human growth plate confirmed that the AhR protein is widely expressed in growth plate cartilage. To explore the local role of the AhR, mechanistic studies were performed in a well-established model of cultured fetal rat metatarsal bones. The longitudinal growth of these bones was monitored while being exposed to AhR modulators. The AhR agonist, 2,3,7,8-tetrachlorodibenzo-p-dioxin, did not affect bone growth at any concentrations tested (1 pM-10 nM). In contrast, the AhR antagonist, alpha-naphthoflavone, suppressed bone growth and increased chondrocyte apoptosis, although only at a high, potentially cytotoxic concentration (50 mu M). We conclude that although the AhR is widely expressed in the growth plate, bone growth is not modulated when locally activated, and therefore, dioxin-induced growth failure is likely mediated through systemic rather than local actions.

  • 76. Chen, Chih-Mei
    et al.
    Thiering, Elisabeth
    Zock, Jan-Paul
    Villani, Simona
    Olivieri, Mario
    Modig, Lars
    Jarvis, Deborah
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Verlato, Giuseppe
    Heinrich, Joachim
    Is There a Threshold Concentration of Cat Allergen Exposure on Respiratory Symptoms in Adults?2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 6, artikel-id e0127457Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and Objective Cat allergen concentrations higher than 8 mu g/g in settled house dust, have been suggested to provoke exacerbation of allergic respiratory symptoms. However, whether the 8 mu g/g of indoor cat allergen concentration is indeed the minimal exposure required for triggering the asthma related respiratory symptoms or the development of sensitization has not yet been confirmed. We studied the associations between domestic cat allergen concentrations and allergic symptoms in the European Community Respiratory Health Survey II, with the aim of confirming this suggested threshold. Methods Cat allergen concentrations were measured in the mattress dust of 3003 participants from 22 study centres. Levels of specific immunoglobulin E to cat allergens were measured in serum samples using an immunoassay. Information on allergic symptoms, medication use, home environment and smoking was obtained from a face-to-face interview. Results Domestic cat allergen concentrations were not associated with allergic/asthmatic symptoms in the entire study population, nor in the subset sensitized to cat allergen. We also found no association among individuals exposed to concentrations higher than 8 mu g/g. However, exposure to medium cat allergen concentrations (0.24-0.63 mu g/g) was positively associated with reported asthmatic respiratory symptoms in subjects who have experienced allergic symptoms when near animals. Conclusions The proposed 8 mu g/g threshold of cat allergen concentrations for the exacerbation of allergic/respiratory symptoms was not confirmed in a general European adult population. Potential biases attributable to avoidance behaviours and an imprecise exposure assessment cannot be excluded.

  • 77. Chen, C-M
    et al.
    Thiering, E
    Doekes, G
    Zock, J-P
    Bakolis, I
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Sunyer, J
    Villani, S
    Verlato, G
    Täubel, M
    Jarvis, D
    Heinrich, J
    Geographical variation and the determinants of domestic endotoxin levels in mattress dust in Europe2012Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 22, nr 1, s. 24-32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Endotoxin exposures have manifold effects on human health. The geographical variation and determinants of domestic endotoxin levels in Europe have not yet been extensively described. To investigate the geographical variation and determinants of domestic endotoxin concentrations in mattress dust in Europe using data collected in the European Community Respiratory Health Survey follow-up (ECRHS II). Endotoxin levels were measured in mattress dust from 974 ECRHS II participants from 22 study centers using an immunoassay. Information on demographic, lifestyle, and housing characteristics of the participants was obtained in face-to-face interviews. The median endotoxin concentration in mattress dust ranged from 772 endotoxin units per gram (EU/g) dust in Reykjavik, Iceland, to 4806 EU/g in Turin, Italy. High average outdoor summer temperature of study center, cat or dog keeping, a high household crowding index, and visible damp patches in the bedroom were significantly associated with a higher endotoxin concentrations in mattress dust. There is a large variability in domestic endotoxin levels across Europe. Average outdoor summer temperature of study center, which explains only 10% of the variation in domestic endotoxin level by center, is the strongest meteorological determinant. The observed variation needs to be taken into account when evaluating the health effects of endotoxin exposures in international contexts.

    PRACTICAL IMPLICATIONS:

    The incoherent observations of the health effects of endotoxin may be partly owing to the geographical heterogeneity of endotoxin exposure. Therefore, the observed variation should be considered in further studies. Measurements of indoor endotoxin are recommended as an indicator for the level of exposures of individual domestic environments.

  • 78.
    Chen, Fei'er
    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..
    Chen, Renjie
    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, Key Lab Hlth Technol Assessment, Key Lab Publ Hlth Safety,Minist Educ, Shanghai 200032, Peoples R China..
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Uppsala Univ, Dept Med Sci Occupat & Environm Med, SE-751 Uppsala, Sweden..
    Liu, Cong
    Fudan Univ, Sch Publ Hlth, Dept Environm Hlth, Shanghai 200032, Peoples R China..
    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, Key Lab Hlth Technol Assessment, Key Lab Publ Hlth Safety,Minist Educ, Shanghai 200032, Peoples R China..
    Deng, Qihong
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China..
    Huang, Chen
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai 200093, Peoples R China..
    Hu, Yu
    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..
    Liu, Wei
    Univ Shanghai Sci & Technol, Sch Environm & Architecture, Shanghai 200093, Peoples R China..
    Wang, Juan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Lu, Chan
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China..
    Qian, Hua
    Southeast Univ, Sch Energy & Environm, Nanjing 210096, Jiangsu, Peoples R China..
    Yang, Xu
    Cent China Normal Univ, Coll Life Sci, Wuhan 430079, Hubei, Peoples R China..
    Zhang, Xin
    Shanxi Univ, Res Ctr Environm Sci & Engn, Taiyuan 030006, Shanxi, Peoples R China..
    Qu, Fang
    Tsinghua Univ, Dept Bldg Sci, Beijing 100084, Peoples R China..
    Sundell, Jan
    Tsinghua Univ, Dept Bldg Sci, Beijing 100084, Peoples R China..
    Zhang, Yinping
    Tsinghua Univ, Dept Bldg Sci, Beijing 100084, Peoples R China..
    Li, Baizhan
    Chongqing Univ, Key Lab Three Gorges Reservoir Reg Ecoenvironm, Chongqing 400030, Peoples R China..
    Sun, Yuexia
    Tianjin Univ, Sch Environm Sci & Engn, Tianjin 300350, 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, Key Lab Hlth Technol Assessment, Key Lab Publ Hlth Safety,Minist Educ, Shanghai 200032, Peoples R China..
    The effects of PM2.5 on asthmatic and allergic diseases or symptoms in preschool children of six Chinese cities, based on China, Children, Homes and Health (CCHH) project2018Ingår i: Environmental Pollution, ISSN 0269-7491, E-ISSN 1873-6424, Vol. 232, s. 329-337Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The urbanization and industrialization in China is accompanied by bad air quality, and the prevalence of asthma in Chinese children has been increasing in recent years. To investigate the associations between ambient PM2.5 levels and asthmatic and allergic diseases or symptoms in preschool children in China, we assigned PM2.5 exposure data from the Global Burden of Disease (GBD) project to 205 kindergartens at a spatial resolution of 0.1° × 0.1° in six cities in China (Shanghai, Nanjing, Chongqing, Changsha, Urumqi, and Taiyuan). A hierarchical multiple logistical regression model was applied to analyze the associations between kindergarten-level PM2.5 exposure and individual-level outcomes of asthmatic and allergic symptoms. The individual-level variables, including gender, age, family history of asthma and allergic diseases, breastfeeding, parental smoking, indoor dampness, interior decoration pollution, household annual income, and city-level variable-annual temperature were adjusted. A total of 30,759 children (average age 4.6 years, 51.7% boys) were enrolled in this study. Apart from family history, indoor dampness, and decoration as predominant risk factors, we found that an increase of 10 μg/m3 of the annual PM2.5 was positively associated with the prevalence of allergic rhinitis by an odds ratio (OR) of 1.20 (95% confidence interval [CI] 1.11, 1.29) and diagnosed asthma by OR of 1.10 (95% CI 1.03, 1.18). Those who lived in non-urban (vs. urban) areas were exposed to more severe indoor air pollution arising from biomass combustion and had significantly higher ORs between PM2.5 and allergic rhinitis and current rhinitis. Our study suggested that long-term exposure to PM2.5 might increase the risks of asthmatic and allergic diseases or symptoms in preschool children in China. Compared to those living in urban areas, children living in suburban or rural areas had a higher risk of PM2.5 exposure.

  • 79. Chinn, Susan
    et al.
    Heinrich, Joachim
    Antó, Josep M
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Olivieri, Mario
    Svanes, Cecilie
    Sunyer, Jordi
    Verlato, Giuseppe
    Wjst, Matthias
    Zock, Jan-Paul
    Burney, Peter G
    Jarvis, Deborah L
    Bronchial responsiveness in atopic adults increases with exposure to cat allergen2007Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 176, nr 1, s. 20-26Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: The association of asthma with sensitization and allergen exposure is known to be complex. There have been few studies of bronchial responsiveness in relation to both risk factors in adults.

    Objectives: To determine the relation of bronchial responsiveness to allergen exposure and IgE sensitization in a community study taking into account the major determinants of bronchial responsiveness in adulthood.

    Methods: Cross-sectional data were drawn from 1,884 participants in 20 centers in the European Community Respiratory Health Survey follow-up, which included measurement of house dust mite and cat allergen in mattress dust samples, and IgE sensitization to four allergens. Bronchial responsiveness to methacholine was expressed as a continuous variable, and analyzed by multiple regression.

    Measurements and Main Results: The trend toward greater bronchial responsiveness with increasing exposure to cat allergen was greater in those sensitized to any of the four allergens than those not sensitized (p = 0.001); there was no significant interaction between cat sensitization and Fel d 1 exposure. No trend was found with house dust mite allergen exposure. The difference in bronchial responsiveness between those exposed to the highest levels compared with the lowest was approximately –2.02 doubling doses of PD20 (95% confidence interval, –3.06 to –0.97), and nearly as great in those exposed to more moderate levels.

    Conclusions: Cat allergen exposure at moderate levels may be harmful to all atopic adults. The clinical implication is that it is insufficient to test patients with asthma for cat sensitization; all atopic individuals may benefit from reduced cat exposure.

  • 80. Corriols, Marianela
    et al.
    Marín, J.
    Berroteran, J.
    Lozano, L. M.
    Lundberg, Ingvar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Incidence of acute pesticide poisonings in Nicaragua: a public health concern2009Ingår i: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 66, nr 3, s. 205-210Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To estimate the cumulative incidence rate of acute pesticide poisoning in the year 2000 among Nicaraguan subjects over 15 years of age. METHODS: Data on pesticide exposure and health effects were assessed in a nationally representative survey. Based on self-reported cases, we estimated the 1-year incidence rate and the number of expected cases of acute pesticide poisonings in Nicaragua. RESULTS: Among the 3169 survey respondents, we identified 72 persons who self-reported one episode of acute pesticide poisoning in 2000. Of these, 65 cases (90%) were related to occupational exposure, five (7%) to domestic exposure and two (3%) to intentional exposure. The cumulative incidence rate/100 individuals of pesticide poisonings in Nicaragua in 2000 was 2.3 (95% CI 1.7 to 2.8). This corresponds to 66 113 cases (95% CI 51 017 to 81 210). The highest rate was found among males in rural areas, particularly among farmers and agricultural workers. CONCLUSION: This study demonstrates an extremely high risk of acute pesticide poisoning in Nicaragua. Considering this, comprehensive measures should be implemented to reduce adverse health effects.

  • 81. Covaciu, Corina
    et al.
    Bergstrom, Anna
    Lind, Tomas
    Svartengren, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Kull, Inger
    Childhood Allergies Affect Health-Related Quality of Life2013Ingår i: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 50, nr 5, s. 522-528Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. The majority of studies investigating the effects of allergy on the children's health-related quality of life (HRQoL) address one particular allergic disease, using a disease-specific HRQoL instrument. This work aims to assess the comparative impact on HRQoL of several allergic conditions of childhood (asthma, rhinitis, eczema, and food hypersensitivity) in a large, population-based sample of Swedish 8-year-olds. Methods. Data were obtained from a Swedish birth cohort (BAMSE). At the 8-year follow-up, parents of 3236 children completed the standardized generic HRQoL instrument EQ-5D and reported on the children's symptoms of asthma, rhinitis, eczema, and food hypersensitivity. Information on allergic sensitization and lung function was available for a sub-sample of the children (n = 2370 and 2425, respectively). Results. Children in the study population had a median EQ visual analog scale (VAS) of 98 (Inter Quartile Range, IQR, 90-100). The median EQ VAS was significantly lower in children with allergic diseases. Children with asthma had the lowest median EQ VAS (90, IQR 85-98) and reported the highest prevalence of problems of "pain or discomfort" (18.2%, compared to 5.5% in children without asthma). Frequent wheezing and effort-induced wheezing were associated with high prevalence of problems of "anxiety or depression" (23.3% and 15.4%, respectively). Conclusions. Swedish 8-year-olds enjoy a good HRQoL, which though is significantly impacted by allergic diseases and particularly by asthma. Asthma symptoms are important determinants of HRQoL and symptom control should be a major goal in asthma management.

  • 82.
    Deng, Qihong
    et al.
    Cent S Univ, XiangYa Sch Publ Hlth, Changsha, Hunan, Peoples R China;Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Deng, Linjing
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Lu, Chan
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Li, Yuguo
    Univ Hong Kong, Dept Mech Engn, Hong Kong, Hong Kong, Peoples R China.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Parental stress and air pollution increase childhood asthma in China2018Ingår i: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 165, s. 23-31Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Although air pollution and social stress may independently increase childhood asthma, little is known on their synergistic effect on asthma, particularly in China with high levels of stress and air pollution.

    Objectives: To examine associations between exposure to a combination of parental stress and air pollution and asthma prevalence in children.

    Methods: We conducted a cohort study of 2406 preschool children in Changsha (2011-2012). A questionnaire was used to collect children's lifetime prevalence of asthma and their parental stress. Parental socioeconomic and psychosocial stresses were respectively defined in terms of housing size and difficulty concentrating. Children's exposure to ambient air pollutants was estimated using concentrations measured at monitoring stations. Associations between exposure to parental stress and air pollution and childhood asthma were estimated by multiple logistic regression models using odds ratio (OR) and 95% confidence interval (CI).

    Results: Life time prevalence of asthma in preschool children (6.7%) was significantly associated with parental socioeconomic and psychosocial stresses with OR (95% CI) respectively 1.48 (1.02-2.16) and 1.64 (1.00-2.71). Asthma was also associated with exposure to air pollutants, with adjusted OR (95% CI) during prenatal and postnatal periods respectively 1.43 (1.10-1.86) and 1.35 (1.02-1.79) for SO2 and 1.61 (1.19-2.18) and 1.76 (1.19-2.61) for NO2. The association with air pollution was significant only in children exposed to high parental stress, the association with parental stress was significant only in children exposed to high air pollution, and the association was the strongest in children exposed to a combination of parental stress and air pollution. Sensitivity analysis showed that the synergistic effects of parental stress and air pollution on childhood asthma were stronger in boys.

    Conclusions: Parental stress and air pollution were synergistically associated with increased childhood asthma, indicating a common biological effect of parental stress and air pollution during both prenatal and postnatal periods.

  • 83.
    Deng, Qihong
    et al.
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.;Cent S Univ, XiangYa Sch Publ Hlth, Changsha, Hunan, Peoples R China..
    Lu, Chan
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China..
    Li, Yuguo
    Univ Hong Kong, Dept Mech Engn, Hong Kong, Hong Kong, Peoples R China..
    Chen, Lv
    Cent S Univ, XiangYa Sch Publ Hlth, Changsha, Hunan, Peoples R China..
    He, Yanrong
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China..
    Sundell, Jan
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.;Tsinghua Univ, Sch Architecture, Beijing, Peoples R China..
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Association between prenatal exposure to industrial air pollution and onset of early childhood ear infection in China2017Ingår i: Atmospheric Environment, ISSN 1352-2310, E-ISSN 1873-2844, Vol. 157, s. 18-26Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Otitis media (OM) is a common infection in early childhood with repeated attacks that lead to long-term complications and sequelae, but its etiology still remains unclear. Objective: To examine the association between early life exposure to air pollution and childhood OM, with the purpose of identifying critical windows of exposure and key components of air pollution in the development of OM. Methods: We conducted a prospective cohort study of 1617 children aged 3-4 years in Changsha, China (2011-2012). The prevalence of OM was assessed by a questionnaire administered by the parents. Individual exposures to nitrogen dioxide (NO2), sulfur dioxide (SO2) and particulate matter with an aerodynamic diameter <= 10 gm (PM10) during prenatal, postnatal, and current windows were estimated using the measured concentrations at monitoring stations. We used logistic regression model to examine the OM risk in terms of odds ratio (OR) and 95% confidence interval (CI) for exposure to different air pollutants during different timing windows, adjusting for covariates, multi-pollutants, and multi windows. Results: Life-time prevalence of doctor-diagnosed OM in preschool children in Changsha was 7.3%. Childhood OM was associated only with prenatal exposure to the industrial air pollution with adjusted OR (95% CI) = 1.44 (1.09-1.88) for a 27 g/m(3) increase in SO2, particularly during the first trimester of pregnancy. We further found that prenatal SO2 exposure was not associated with the repeated attacks but was associated with the onset of OM, adjusted OR (95% CI) = 1.47 (1.10-1.96). The association between prenatal SO2 exposure and early childhood OM was robust after adjusting for other pollutants and windows. Sensitivity analysis indicated that the association was stronger in females, children with parental atopy, and children living in houses with cockroaches, new redecoration, and condensation on window pane during winter. Conclusion: We provide new evidence that prenatal exposure to industrial air pollution is associated with early childhood OM in China and may contribute to the onset of childhood OM. Our findings are helpful in developing more effective preventative strategies for childhood OM. (C) 2017 Elsevier Ltd. All rights reserved.

  • 84.
    Deng, Qihong
    et al.
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China.;Cent S Univ, Sch Publ Hlth, Changsha 410083, Hunan, Peoples R China.;Cent S Univ, Inst Environm Hlth, Changsha 410083, Hunan, Peoples R China..
    Lu, Chan
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China..
    Li, Yuguo
    Univ Hong Kong, Dept Mech Engn, Hong Kong, Hong Kong, Peoples R China..
    Sundell, Jan
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China.;Tsinghua Univ, Sch Architecture, Beijing, Peoples R China..
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China..
    Exposure to outdoor air pollution during trimesters of pregnancy and childhood asthma, allergic rhinitis, and eczema2016Ingår i: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 150, s. 119-127Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Mounting evidence suggests that exposure to ambient air pollution is associated with the development of childhood allergic diseases, but the effect of prenatal exposure to air pollution on the risk of childhood asthma and allergy is unclear. Objectives: We evaluated the association between maternal exposure to outdoor air pollution during different trimesters of pregnancy and incidence of asthma, allergic rhinitis, and eczema in 2598 preschool children aged 3-6 years in China. Methods: Children's lifetime incidence of allergic diseases was obtained using questionnaire. Individual exposure to outdoor air pollutants during trimesters of pregnancy was estimated by an inverse distance weighted (IDW) method based on the measured concentrations at monitoring stations. We used multiple logistic regression method to estimate the odds ratio (OR) of asthma, allergic rhinitis, and eczema for per interquartile range (IQR) increase in the exposure to air pollutant in each trimester, which was adjusted for the effect of other air pollutants and its effect in other trimesters by a multi-pollutant/trimester model. Results: Incidence of asthma (6.8%), allergic rhinitis (7.3%), and eczema (28.6%) in children was associated with maternal exposure to traffic-related pollutant NO2 during entire pregnancy with OR (95% confidence interval [CID respectively 1.63 (0.99-2.70), 1.69 (1.03-2.77), and 1.37 (1.04-1.80). After adjustment for other pollutants and trimesters, we found the association was significant only in specific trimester: the first trimester for eczema (1.54, 1.14-2.09), the second trimester for asthma (1.72, 1.02-2.97), and the third trimester for allergic rhinitis (1.77, 1.09-2.89). Sensitivity analysis indicated that the trimester sensitive to the development of allergic diseases was stable. Conclusion: Maternal exposure to traffic-related air pollutant NO2 during pregnancy, especially in specific trimesters, is associated with an increased risk of developing asthma, rhinitis, and eczema in children. Our results support the hypothesis that childhood allergic diseases originate in fetal life and are triggered by traffic-related air pollution in sensitive trimesters.

  • 85.
    Deng, Qihong
    et al.
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China.;Cent S Univ, Inst Environm Hlth, Changsha 410083, Hunan, Peoples R China..
    Lu, Chan
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China..
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Bornehag, Carl-Gustaf
    Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Zhang, Yinping
    Tsinghua Univ, Sch Architecture, Beijing 100084, Peoples R China..
    Liu, Weiwei
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China.;Cent S Univ, Inst Environm Hlth, Changsha 410083, Hunan, Peoples R China..
    Yuan, Hong
    Cent S Univ, Inst Environm Hlth, Changsha 410083, Hunan, Peoples R China.;Cent S Univ, Xiangya Hosp 3, Changsha 410083, Hunan, Peoples R China..
    Sundell, Jan
    Cent S Univ, Sch Energy Sci & Engn, Changsha 410083, Hunan, Peoples R China.;Tsinghua Univ, Sch Architecture, Beijing 100084, Peoples R China..
    Early life exposure to ambient air pollution and childhood asthma in China2015Ingår i: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 143, s. 83-92Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Early life is suggested to be a critical time in determining subsequent asthma development, but the extent to which the effect of early-life exposure to ambient air pollution on childhood asthma is unclear. Objectives: We investigated doctor-diagnosed asthma in preschool children due to exposure to ambient air pollution in utero and during the first year of life. Methods: In total 2490 children aged 3-6 years participated in a questionnaire study regarding doctor-diagnosed asthma between September 2011 and January 2012 in China. Children's exposure to critical air pollutants, sulfur dioxide (SO2) as proxy of industrial air pollution, nitrogen dioxide (NO2) as proxy of traffic pollution, and particulate matter <= 10 mu m in diameter (PM10) as a mixture, was estimated from the concentrations measured at the ambient air quality monitoring stations by using an inverse distance weighted (IDW) method. Logistic regression analysis was employed to determine the relationship between early-life exposure and childhood asthma in terms of odds ratio (OR) and 95% confidence interval (CI). Results: Association between early-life exposure to air pollutants and childhood asthma was observed. SO2 and NO2 had significant associations with adjusted OR (95% CI) of 1.45 (1.02-2.07) and 1.74 (1.15-2.62) in utero and 1.62 (1.01-2.60) and 1.90 (1.20-3.00) during the first year for per 50 mu g/m(3) and 15 mu g/m(3) increase respectively. Exposure to the combined high level of SO2 and NO2 in China significantly elevated the asthmatic risk with adjusted OR (95% CI) of 1.76 (1.18-2.64) in utero and 1.85 (1.22-2.79) during the first year compared to the low level exposure. The associations were higher for males and the younger children aged 3-4 than females and the older children aged 5-6. Conclusions: Early-life exposure to ambient air pollution is associated with childhood asthma during which the level and source of air pollution play important roles. The high level and nature of combined industrial and traffic air pollution in China may contribute to the recent rapid increase of childhood asthma.

  • 86.
    Deng, Qihong
    et al.
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.;Cent S Univ, XiangYa Sch Publ Hlth, Changsha, Hunan, Peoples R China..
    Lu, Chan
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China..
    Yu, Yichen
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China..
    Li, Yuguo
    Univ Hong Kong, Dept Mech Engn, Hong Kong, Hong Kong, Peoples R China..
    Sundell, Jan
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.;Tsinghua Univ, Sch Architecture, Beijing, Peoples R China..
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China..
    Early life exposure to traffic-related air pollution and allergic rhinitis in preschool children2016Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 121, s. 67-73Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Evidence linking long-term exposure to outdoor air pollution with allergic rhinitis (AR) in children is scare, and the role of components of air pollution and timing of exposure remains unclear. Objective: To assess the association of pre- and post-natal exposure to air pollution with life-time prevalence of AR in preschool children. Methods: We conducted a cohort study of 2598 children aged 3-6 years in Changsha, China. The lifetime prevalence of AR was assessed by a questionnaire administered by parents. Children's exposures to dioxide nitrogen (NO2), sulfur dioxide (SO2) and particulate matter with an aerodynamic diameter <= 10 mu m (PM10) during different pre-and post-natal timing windows were estimated using the measured concentrations at monitoring stations. The odds ratio (OR) and 95% confidence interval (CI) of childhood AR for exposure to different air pollutants during different timing windows were assessed by logistic regression model in terms of an interquartile range (IQR) increase in exposure level. Results: Life-time prevalence of AR in preschool children (7.3%) was associated with both pre-and postnatal exposure to traffic-related air pollution (TRAP), but only significant during the third trimester of pregnancy with adjusted OR = 1.40 (95% CI: 1.08-1.82) for a 15 mu g/m(3) increase in NO2 and during the first-year of life with adjusted OR = 1.36 (95% CI: 1.03-1.78) and 1.54 (95% CI: 1.07-2.21) respectively for 11 and 12 mu g/m(3) increase in NO2 and PM10. The association of early life exposure to TRAP with childhood AR was robust by adjusting for other air pollutants and timing windows. Sensitivity analysis indicated that the association was higher in the children who are male, young, with genetic predisposition by parental atopy, and living in damp houses. Conclusion: Early life exposure to traffic-related air pollutant during pregnancy and first-year of life may contribute to childhood AR.

  • 87. Dharmage, S. C.
    et al.
    Erbas, B.
    Jarvis, D.
    Wjst, M.
    Raherison, C.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Heinrich, J.
    Sunyer, J.
    Svanes, C.
    Do childhood respiratory infections continue to influence adult respiratory morbidity?2009Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 33, nr 2, s. 237-244Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the present study was to examine the influence of childhood respiratory infections on adult respiratory health. In 1992-1994, the European Community Respiratory Health Survey recruited community based samples of 20-44-yr-old people from 48 centres in 22 countries. Study participants completed questionnaires and underwent lung function testing. On average, 8.9 yrs later, 29 centres re-investigated their samples using similar methods. Mixed effects models comprising an estimate for the random variation between centres were used to evaluate the relevant associations. In total, 9,175 patients participated in both studies, of whom 10.9% reported serious respiratory infections (SRI) before 5 yrs of age and 2.8% reported hospitalisation for lung disease (HLD) before 2 yrs if age. SRI was associated with current wheeze (odds ratio (OR) 1.9, 95% confidence interval (CI) 1.7-2.2), asthma (OR 2.5, 95% CI 2.2-3.1), and lower forced expiratory volume in one second (FEV(1); 89 mL; 95% CI 54-126), forced vital capacity (FVC; 49 mL; 95% CI 8-90) and FEV(1)/FVC ratio (-1.2%; 95% CI -1.8- -0.6). Childhood respiratory infections were also associated with new asthma (OR 1.5, 95% CI 1.03-2.0), new wheeze (OR 1.5, 95% CI 1.0-2.4) and persistent wheeze (OR 2.2, 95% CI 1.4-3.6) but not with a decline in lung function. Similar findings were observed for HDL. These associations were significantly consistent across centres. SRI was associated with lower FEV(1) when excluding ever asthmatics and current wheezers. The impact of early infections was significantly larger in subjects exposed to maternal or active smoking. The impact of childhood respiratory infections on the respiratory system may not only last into adulthood but also influence development and persistence of adult respiratory morbidity.

  • 88. Dragano, Nico
    et al.
    Siegrist, Johannes
    Nyberg, Solja T
    Lunau, Thorsten
    Fransson, Eleonor I
    Alfredsson, Lars
    Bjorner, Jakob B
    Borritz, Marianne
    Burr, Hermann
    Erbel, Raimund
    Fahlén, Göran
    Goldberg, Marcel
    Hamer, Mark
    Heikkilä, Katriina
    Jöckel, Karl-Heinz
    Knutsson, Anders
    Madsen, Ida E H
    Nielsen, Martin L
    Nordin, Maria
    Oksanen, Tuula
    Pejtersen, Jan H
    Pentti, Jaana
    Rugulies, Reiner
    Salo, Paula
    Schupp, Jürgen
    Singh-Manoux, Archana
    Steptoe, Andrew
    Theorell, Töres
    Vahtera, Jussi
    Westerholm, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Westerlund, Hugo
    Virtanen, Marianna
    Zins, Marie
    Batty, G David
    Kivimäki, Mika
    Effort-Reward Imbalance at Work and Incident Coronary Heart Disease: A Multicohort Study of 90,164 Individuals.2017Ingår i: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 28, nr 4, s. 619-626Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease.

    METHODS: This multicohort study (the "IPD-Work" consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort-reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis.

    RESULTS: At baseline, 31.7% of study members reported effort-reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00-1.35) was observed for effort-reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01-1.34) for having either effort-reward imbalance or job strain and 1.41 (1.12-1.76) for having both these stressors compared to having neither effort-reward imbalance nor job strain.

    CONCLUSIONS: Individuals with effort-reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress.

  • 89.
    Dratva, Julia
    et al.
    Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Socinstr 57,POB 4002, CH-4002 Basel, Switzerland.;Univ Basel, Basel, Switzerland..
    Bertelsen, Randi
    Haukeland Hosp, Dept Occupat Med, Bergen, Norway..
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Johannessen, Ane
    Haukeland Hosp, Dept Occupat Med, Bergen, Norway.;Univ Bergen, Dept Clin Sci, Bergen, Norway..
    Benediktsdottir, Bryndis
    Landspitali Univ Hosp, Dept Allergy Resp Med & Sleep, Reykjavik, Iceland..
    Bråback, Lennart
    Umea Univ, Dept Publ Hlth & Clin Med, Occupat & Environm Med, Umea, Sweden..
    Dharmage, Shyamali C.
    Univ Melbourne, Melbourne Sch Populat & Global Hlth, Ctr Epidemiol & Biostat, Allergy & Lung Hlth Unit, Melbourne, Vic, Australia..
    Forsberg, Bertil
    Umea Univ, Dept Publ Hlth & Clin Med, Occupat & Environm Med, Umea, Sweden..
    Gislason, Thorarinn
    Landspitali Univ Hosp, Dept Allergy Resp Med & Sleep, Reykjavik, Iceland..
    Jarvis, Debbie
    Imperial Coll, Fac Med, Natl Heart & Lung Inst, London, England..
    Jogi, Rain
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi. Fdn Tartu Univ Clin, Lung Clin, Tartu, Estonia.;Univ Tartu, Dept Pulm Med, Tartu, Estonia..
    Lindberg, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Norback, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Omenaas, Ernst
    Univ Bergen, Dept Clin Sci, Bergen, Norway..
    Skorge, Trude D.
    Haukeland Hosp, Dept Occupat Med, Bergen, Norway..
    Sigsgaard, Torben
    Aarhus Univ, Dept Publ Hlth, Aarhus, Denmark..
    Toren, Kjell
    Univ Gothenburg, Sahlgrenska Acad, Occupat & Environm Med, Gothenburg, Sweden..
    Waatevik, Marie
    Univ Bergen, Dept Clin Sci, Bergen, Norway..
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Schlünssen, Vivi
    Aarhus Univ, Dept Publ Hlth, Aarhus, Denmark..
    Svanes, Cecilie
    Haukeland Hosp, Dept Occupat Med, Bergen, Norway.;Univ Bergen, Ctr Int Hlth, Bergen, Norway..
    Real, Francisco Gomez
    Univ Bergen, Dept Clin Sci, Bergen, Norway.;Haukeland Hosp, Dept Gynecol & Obstet, Bergen, Norway..
    Validation of self-reported figural drawing scales against anthropometric measurements in adults2016Ingår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, nr 11, s. 1944-1951Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of the present study was to validate figural drawing scales depicting extremely lean to extremely obese subjects to obtain proxies for BMI and waist circumference in postal surveys.

    Design: Reported figural scales and anthropometric data from a large population-based postal survey were validated with measured anthropometric data from the same individuals by means of receiver-operating characteristic curves and a BMI prediction model.

    Setting: Adult participants in a Scandinavian cohort study first recruited in 1990 and followed up twice since.

    Subjects: Individuals aged 38-66 years with complete data for BMI (n 1580) and waist circumference (n 1017).

    Results: Median BMI and waist circumference increased exponentially with increasing figural scales. Receiver-operating characteristic curve analyses showed a high predictive ability to identify individuals with BMI > 25.0 kg/m(2) in both sexes. The optimal figural scales for identifying overweight or obese individuals with a correct detection rate were 4 and 5 in women, and 5 and 6 in men, respectively. The prediction model explained 74% of the variance among women and 62% among men. Predicted BMI differed only marginally from objectively measured BMI.

    Conclusions: Figural drawing scales explained a large part of the anthropometric variance in this population and showed a high predictive ability for identifying overweight/obese subjects. These figural scales can be used with confidence as proxies of BMI and waist circumference in settings where objective measures are not feasible.

  • 90.
    Dratva, Julia
    et al.
    Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland.;Univ Basel, Basel, Switzerland..
    Zemp, Elisabeth
    Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland.;Univ Basel, Basel, Switzerland..
    Dharmage, Shyamali C.
    Univ Melbourne, Sch Populat & Global Hlth, Ctr Epidemiol & Biostat, Allergy & Lung Hlth Unit, Melbourne, Vic 3010, Australia..
    Accordini, Simone
    Univ Verona, Dept Publ Hlth & Community Med, Unit Epidemiol & Med Stat, I-37100 Verona, Italy..
    Burdet, Luc
    Hop Intercantonal Broye, Payerne, Switzerland..
    Gislason, Thorarinn
    Landspitali Univ, Hosp Reykjavik, Dept Resp Med & Sleep, Reykjavik, Iceland..
    Heinrich, Joachim
    Helmholtz Ctr Munich, Natl Res Ctr Environm Hlth, Munich, Germany.;Univ Munich, Univ Hosp Munich, Inst & Outpatient Clin Occupat Social & Environm, Munich, Germany.;German Ctr Lung Res DZ, Munich, Germany..
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Jarvis, Deborah
    Univ London Imperial Coll Sci Technol & Med, Dept Publ Hlth Sci, London, England..
    de Marco, Roberto
    Univ Verona, Dept Publ Hlth & Community Med, Unit Epidemiol & Med Stat, I-37100 Verona, Italy..
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Pons, Marco
    Reg Hosp Lugano, Div Pulm Med, Lugano, Switzerland..
    Real, Francisco Gomez
    Univ Bergen, Dept Clin Sci, Bergen, Norway.;Haukeland Hosp, Dept Obstet & Gynaecol, N-5021 Bergen, Norway..
    Sunyer, Jordi
    Ctr Res Environm Epidemiol CREAL, Barcelona, Spain..
    Villani, Simona
    Univ Pavia, Fac Med, Dept Publ Hlth Neurosci Expt & Legal Med, Via Palestro 3, I-27100 Pavia, Italy..
    Probst-Hensch, Nicole
    Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland.;Univ Basel, Basel, Switzerland..
    Svanes, Cecilie
    Univ Bergen, Ctr Int Hlth, Bergen Resp Res Grp, Bergen, Norway.;Haukeland Hosp, Dept Occupat Med, N-5021 Bergen, Norway..
    Early Life Origins of Lung Ageing: Early Life Exposures and Lung Function Decline in Adulthood in Two European Cohorts Aged 28-73 Years2016Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, nr 1, artikel-id e0145127Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives Early life environment is essential for lung growth and maximally attained lung function. Whether early life exposures impact on lung function decline in adulthood, an indicator of lung ageing, has scarcely been studied. Methods Spirometry data from two time points (follow-up time 9-11 years) and information on early life exposures, health and life-style were available from 12862 persons aged 28-73 years participating in the European population-based cohorts SAPALDIA (n = 5705) and ECRHS (n = 7157). The associations of early life exposures with lung function (FEV1) decline were analysed using mixed-effects linear regression. Results Early life exposures were significantly associated with FEV1 decline, with estimates almost as large as personal smoking. FEV1 declined more rapidly among subjects born during the winter season (adjusted difference in FEV1/year of follow-up [95% CI] -2.04ml [-3.29;-0.80]), of older mothers, (-1.82 ml [-3.14;-0.49]) of smoking mothers (-1.82ml [-3.30;-0.34] or with younger siblings (-2.61ml [-3.85;-1.38]). Less rapid FEV1-decline was found in subjects who had attended daycare (3.98ml [2.78; 5.18]), and indicated in subjects with pets in childhood (0.97ml [-0.16; 2.09]). High maternal age and maternal smoking appeared to potentiate effects of personal smoking. The effects were independent of asthma at any age. Conclusion Early life factors predicted lung function decline decades later, suggesting that some mechanisms related lung ageing may be established early in life. Early life programming of susceptibility to adult insults could be a possible pathway that should be explored further.

  • 91.
    du Prel, J. B.
    et al.
    Univ Ulm, Inst Hist Philosophy & Eth Med, D-89069 Ulm, Germany..
    Runeson-Broberg, Roma
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Westerholm, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Nordin, M.
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden..
    Fahlen, G.
    Natl Agcy Special Needs Educ & Sch, Harnosand, Sweden..
    Alfredsson, L.
    Karolinska Inst, Stockholm, Sweden..
    Knutsson, A.
    Mid Sweden Univ, Sundsvall, Sweden..
    Peter, R.
    Univ Ulm, Inst Hist Philosophy & Eth Med, D-89069 Ulm, Germany..
    Work-Related Overcommitment: Is it a State or a Trait? - Results from the Swedish WOLF-Study2015Ingår i: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 44, s. 263-263Artikel i tidskrift (Övrigt vetenskapligt)
  • 92. du Prel, Jean-Baptist
    et al.
    Runeson-Broberg, Roma
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Westerholm, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Alfredsson, Lars
    Fahlén, Göran
    Knutsson, Anders
    Nordin, Maria
    Peter, Richard
    Work overcommitment: Is it a trait or a state?2018Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, nr 1, s. 1-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Effort-reward imbalance (ERI) is a well-tested work-related stress model with three components, the two extrinsic components "efforts" and "rewards" and the one intrinsic component "overcommitment". While an imbalance between "efforts" and "rewards" leads to strain reactions, "work-related overcommitment" (OC) has been described as a personal characteristic with a set of attitudes, behaviours, and emotions reflecting excessive striving combined with a strong desire for approval. However, the question whether OC is a personality trait or a response pattern sensitive to changes in the work context (state) is still open.

    METHODS: 2940 Swedish industrial employees were included in this longitudinal analysis of the WOLF-Norrland data over 5 years. A change of OC index or its subscales were regressed against a change of freedom of choice at work, extra work, and ERI adjusted for age, sex, and education.

    RESULTS: While OC was insensitive to changes in freedom of choice at work and extra work, it was clearly associated with changes of work-related stress over time. Three of four OC subscales exhibited statistically significant associations with ERI.

    CONCLUSIONS: For the first time, we studied fundamental characteristics of OC as an independent personality variable (trait) or an outcome variable subject to changes in the work environment (state). The association between external ERI and OC over time supports our hypothesis of OC being a state. Further investigations are needed to establish OC as a trait or a state.

  • 93.
    Dunder, Linda
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Lejonklou, Margareta Halin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Lind, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Kardiovaskulär epidemiologi.
    Risérus, Ulf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk nutrition och metabolism.
    Lind, P. Monica
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Low-dose developmental bisphenol A exposure alters fatty acid metabolism in Fischer 344 rat offspring2018Ingår i: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 166, s. 117-129Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Bisphenol A (BPA) is an endocrine disruptor and also a suggested obesogen and metabolism-disrupting chemical. Accumulating data indicates that the fatty acid (FA) profile and their ratios in plasma and other metabolic tissues are associated with metabolic disorders. Stearoyl-CoA desaturase 1 (SCD-1) is a key regulator of lipid metabolism and its activity can be estimated by dividing the FA product by its precursor measured in blood or other tissues. Objective: The primary aim of this study was to investigate the effect of low-dose developmental BPA exposure on tissue-specific FA composition including estimated SCD-1 activity, studied in 5- and 52-week (wk)-old Fischer 344 (F344) rat offspring. Methods: Pregnant F344 rats were exposed to BPA via their drinking water corresponding to 0: [CTRL], 0.5: [BPA0.5], or 50 mu g/kg BW/day: [BPA50], from gestational day 3.5 until postnatal day 22. Results: BPA0.5 increased SCD-16 (estimated as the 16:1n-7/16:0 ratio) and SCD-18 (estimated as the 18:1n-9/ 18:0 ratio) indices in inguinal white adipose tissue triglycerides (iWAT-TG) and in plasma cholesterol esters (PL-CE), respectively, in 5-wk-old male offspring. In addition, BPA0.5 altered the FA composition in male offspring, e.g. by decreasing levels of the essential polyunsaturated FA linoleic acid (18:2n-6) in iWAT-and liver-TG. No differences were observed regarding the studied FAs in 52-wk-old offspring, although a slightly increased BW was observed in 52-wk-old female offspring. Conclusions: Low-dose developmental BPA exposure increased SCD-16 in iWAT-TG and SCD-18 in PL-CE of male offspring, which may reflect higher SCD-1 activity in these tissues. Altered desaturation activity and signs of altered FA composition are novel findings that may indicate insulin resistance in the rat offspring. These aforementioned results, together with the observed increased BW, adds to previously published data demonstrating that BPA can act as a metabolism disrupting chemical.

  • 94.
    Elfman, Lena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Hogstedt, Carl
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Engvall, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Lampa, Erik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Lindh, Christian H
    Department of Occupational and Environmental Medicine, Lund University Hospital.
    Acute health effects on planters of conifer seedlings treated with insecticides2009Ingår i: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 53, nr 4, s. 383-390Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 95.
    Elfman, Lena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Riihimäki, Miia
    Pringle, John
    Wålinder, Robert
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Influence of horse stable environment on human airways2009Ingår i: Journal of occupational medicine and toxicology (London, England), ISSN 1745-6673, Vol. 4, s. 10-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Many people spend considerable amount of time each day in equine stable environments either as employees in the care and training of horses or in leisure activity. However, there are few studies available on how the stable environment affects human airways. This study examined in one horse stable qualitative differences in indoor air during winter and late summer conditions and assessed whether air quality was associated with clinically detectable respiratory signs or alterations to selected biomarkers of inflammation and lung function in stable personnel. METHODS: The horse stable environment and stable-workers (n = 13) in one stable were investigated three times; first in the winter, second in the interjacent late summer and the third time in the following winter stabling period. The stable measurements included levels of ammonia, hydrogen sulphide, total and respirable dust, airborne horse allergen, microorganisms, endotoxin and glucan. The stable-workers completed a questionnaire on respiratory symptoms, underwent nasal lavage with subsequent analysis of inflammation markers, and performed repeated measurements of pulmonary function. RESULTS: Measurements in the horse stable showed low organic dust levels and high horse allergen levels. Increased viable level of fungi in the air indicated a growing source in the stable. Air particle load as well as 1,3-beta-glucan was higher at the two winter time-points, whereas endotoxin levels were higher at the summer time-point. Two stable-workers showed signs of bronchial obstruction with increased PEF-variability, increased inflammation biomarkers relating to reported allergy, cold or smoking and reported partly work-related symptoms. Furthermore, two other stable-workers reported work-related airway symptoms, of which one had doctor's diagnosed asthma which was well treated. CONCLUSION: Biomarkers involved in the development of airway diseases have been studied in relation to environmental exposure levels in equine stables. Respirable dust and 1,3-beta-glucan levels were increased at winter stabling conditions. Some employees (3/13) had signs of bronchial obstruction, which may be aggravated by working in the stable environment. This study contributes to the identification of suitable biomarkers to monitor the indoor horse stable environment and the personnel. An improved management of the stable climate will be beneficial for the health of both stable workers and horses.

  • 96.
    Elfman, Lena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Tooke, Nigel E.
    Patring, Johan D.M.
    Detection of pesticides used in rice cultivation in streams on the island of Leyte in the Philippines2011Ingår i: Agricultural Water Management, ISSN 0378-3774, E-ISSN 1873-2283, Vol. 101, nr 1, s. 81-87Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Targeted sampling of water was performed in streams, the river mouth, and the municipal drinking-water tap in the vicinity of San Francisco, South Leyte, Philippines. Samples were processed on site and transported back to Sweden for analysis by gas chromatography mass spectrometry to identify and quantify the pesticides commonly used in the area. Collaborations were initiated with employees at the local Department of Agriculture and Municipal Disaster Coordinating Council to learn more about the rice cultivation in this area and times for spraying. Detectable levels of pesticides λ-cyhalothrin, cypermethrin and deltamethrin (0.0005–1.4 μg/L) were found in representative water samples. In 47% of samples the detected levels exceeded the recommended limit values for pesticides in surface water according to Swedish guidelines (Swedish Chemicals Agency, 2008). The analysis of samples taken at the river mouth revealed measurable levels of λ-cyhalothrin and cypermethrin, which means that residues of pesticides applied to rice paddy fields were shown to end up at the river mouth. The success of the sampling and analysis methods was confirmed by the data which was in accordance with the expected effect of dilution from day to day. Variable levels of insecticides in the river and all the way down to the sea may have adverse health effects on people using the water and on the aquatic environment, including sensitive coral reefs. This situation is applicable not only to the Philippines, but also to the whole of Southeast Asia, with approximately 70% of their human population living in coastal areas. As Southeast Asia encompasses approximately 34% of the world's coral reefs and between a quarter and a third of the world's mangroves, as well as the global biodiversity triangle formed by the Malay Peninsula, the Philippines, and New Guinea, the need to reduce the impacts of marine pollution in this region is of great importance.

  • 97.
    Elfman, Lena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wålinder, Robert
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Riihimäki, Miia
    Pringle, John
    Air quality in Horse Stables2011Ingår i: Chemistry, emission control, radioactive pollution and indoor air quality / [ed] Nicolás A Mazzeo, Rijeka: IN-TECH, 2011, s. 655-680Kapitel i bok, del av antologi (Refereegranskat)
  • 98.
    Eliasson, Kristina
    et al.
    School of Technology and Health, KTH Royal Institute of Technology, Huddinge, Sweden.
    Palm, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Nyman, Teresia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. School of Technology and Health, KTH Royal Institute of Technology, Huddinge, Sweden.
    Forsman, Mikael
    IMM Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
    Inter- and intra-observer reliability of risk assessment of repetitive work without an explicit method2017Ingår i: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 62, s. 1-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A common way to conduct practical risk assessments is to observe a job and report the observed long term risks for musculoskeletal disorders. The aim of this study was to evaluate the inter- and intra-observer reliability of ergonomists' risk assessments without the support of an explicit risk assessment method. Twenty-one experienced ergonomists assessed the risk level (low, moderate, high risk) of eight upper body regions, as well as the global risk of 10 video recorded work tasks. Intra-observer reliability was assessed by having nine of the ergonomists repeat the procedure at least three weeks after the first assessment. The ergonomists made their risk assessment based on his/her experience and knowledge. The statistical parameters of reliability included agreement in %, kappa, linearly weighted kappa, intraclass correlation and Kendall's coefficient of concordance. The average inter-observer agreement of the global risk was 53% and the corresponding weighted kappa (K-w) was 0.32, indicating fair reliability. The intra-observer agreement was 61% and 0.41 (K-w). This study indicates that risk assessments of the upper body, without the use of an explicit observational method, have non-acceptable reliability. It is therefore recommended to use systematic risk assessment methods to a higher degree.

  • 99. Emdad, R
    et al.
    Alipour, Akbar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Hagberg, J
    Jensen, I B
    The impact of bystanding to workplace bullying on symptoms of depression among women and men in industry in Sweden: an empirical and theoretical longitudinal study2013Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, nr 6, s. 709-716Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Prospective studies on bystanding to workplace bullying and the health outcomes are scarce.

    AIM:

    To investigate the work environmental risk factors of depressive symptoms among bystanders to bullying in both women and men in four large industrial organizations in Sweden.

    METHOD:

    The number of respondents at four large industrial enterprises with more than one year at the workplace at T1: n = 2,563 (Women: n = 342; Men: n = 2,227). Bystanders to bullying at T1: n = 305 (Women: n = 30; Men: n = 275). The total number of those with symptoms of depression at T2: Women: n = 30; Men: n = 161. Two thousand one hundred and seventy-seven employees answered the questionnaire on T1 and T2 with an 18-month interval. "To have depressive symptoms" was defined as not having depressive symptoms at T1 but having depressive symptoms at T2.

    RESULTS:

    The number of men who were bystanders to bullying was larger compared to women. However, the proportion of women who were bystanders to bullying and developed depressive symptoms 18 months later was higher in comparison with men (33.3 and 16.4 %, respectively). Further, "Being a bystander to bullying" 1.69 (1.13-2.53), "Rumors of changes in the workplace" 1.53 (1.10-2.14), "Reduced role clarity" 2.30 (1.21-4.32), "Lack of appreciation of being in the group" 1.76 (1.22-2.53) increased the risk of future symptoms of depression. "Job Strain" was not an adjusted risk factor for depression.

    CONCLUSION:

    Our results support previous findings that bystanding to workplace bullying is related to future depressive symptoms.

  • 100.
    Engvall, Karin
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    A Sociological Approach to Indoor Environment in Dwellings: Risk factors for Sick Building Syndrome (SBS) and Discomfort2003Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The principal aim was to study selected aspects of indoor environment in dwellings and their association with symptoms compatible with the sick building syndrome (SBS). A validated questionnaire was developed specifically for residential indoor investigations, using sociological principles and test procedures. The questionnaire was mailed to 14,243 multi-family dwellings in Stockholm, selected by stratified random sampling. Females, subjects with a history of atopy, those above 65 y, and those in new buildings reported more symptoms. Subjects owning their own dwelling had less symptoms. A multiple regression model was developed, to identify residential buildings with a higher than expected occurrence of SBS. In total, 28.5% reported at least one sign of building dampness in their home (condensation on windows, humidity in the bathroom, mouldy odour, water leakage). All indicators of dampness were related to symptoms, even when adjusting for demographic data, and other building characteristics (OR=2.9-6.0). Associations between symptoms and other building data was evaluated in older houses, built before 1961. Subjects in older buildings with a mechanical ventilation system had fewer symptoms. Heating by electric radiators, and wood heating was associated with an increase of most types of symptoms (OR=1.2-5.0). Multiple sealing measures (OR=1.3), and major reconstruction (OR=1.1-1.9), was associated with an increase of symptoms. The effect of seasonal adapted ventilation (SAV) was studied in a small experimental study. A 20% reduction of ventilation flow from 0.5-0.8 ac/h to 0.4-0.5 ACH during the heating season increased the perception of poor indoor air quality in the dwelling in general, and in the bedroom. In conclusion, low building age, and building dampness in the dwelling are associated with SBS. In older houses, mechanical ventilation is beneficial. The thesis did not support the view that energy saving measures in general is an important risk factor for SBS, but major reconstruction and multiple sealing measures can be risk factor for symptoms. Reducing the outdoor ventilation flow below the current Swedish ventilation standard (0.5 ACH) may increase the perception of impaired air quality.

    Delarbeten
    1. The Stockholm Indoor Environment Questionnaire (SIEQ): A sociological based tool for assessment of indoor environment and health in dwellings
    Öppna denna publikation i ny flik eller fönster >>The Stockholm Indoor Environment Questionnaire (SIEQ): A sociological based tool for assessment of indoor environment and health in dwellings
    2004 (Engelska)Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 14, nr 1, s. 24-33Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    The aim was to develop and validate a standardized questionnaire - the Stockholm Indoor Environment Questionnaire (SIEQ). The validation procedure was based on sociological principles and test procedures for validation. The indicators of indoor environment are air quality, thermal climate, noise, and illumination. The indicators of health are symptoms comprised in the sick building syndrome (SBS). The questionnaire also contains questions about the apartment, individual behavior, and personal factors. The everyday language describing the building and its function was first obtained by qualitative personal interviews, then by standardized questions. The interview questionnaire was transformed into a postal self-administered questionnaire. The reduction of the questionnaire was based on correlation analysis. It was found that to obtain a good validity, general questions are not sufficient, but specific question on perceptions and observations are needed. Good test-retest agreement was found both on an area level, building level, and individually. For each indicator, a set of questions are constructed and validated. SIEQ has been used in several studies, and the results are presented in graphic problem profiles. Reference data has been calculated for the Stockholm area.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-90622 (URN)10.1111/j.1600-0668.2004.00204.x (DOI)14756843 (PubMedID)
    Tillgänglig från: 2003-06-05 Skapad: 2003-06-05 Senast uppdaterad: 2017-12-14Bibliografiskt granskad
    2. Development of a multiple regression model to identify multi-family residential buildings with high prevalence of sick building syndrome (SBS).
    Öppna denna publikation i ny flik eller fönster >>Development of a multiple regression model to identify multi-family residential buildings with high prevalence of sick building syndrome (SBS).
    Visa övriga...
    2000 Ingår i: Indoor Air, ISSN 0905-6947, Vol. 10, nr 2, s. 101-110Artikel i tidskrift (Refereegranskat) Published
    Identifikatorer
    urn:nbn:se:uu:diva-90623 (URN)
    Tillgänglig från: 2003-06-05 Skapad: 2003-06-05Bibliografiskt granskad
    3. Sick building syndrome (SBS) in relation to building dampness in multi-family residential buildings in Stockholm.
    Öppna denna publikation i ny flik eller fönster >>Sick building syndrome (SBS) in relation to building dampness in multi-family residential buildings in Stockholm.
    2001 Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, Vol. 74, nr 4, s. 270-278Artikel i tidskrift (Refereegranskat) Published
    Identifikatorer
    urn:nbn:se:uu:diva-90624 (URN)
    Tillgänglig från: 2003-06-05 Skapad: 2003-06-05Bibliografiskt granskad
    4. Ocular, nasal, dermal and respiratory symptoms in relation to heating, ventilation, energy conservation and reconstruction of older multi-family houses
    Öppna denna publikation i ny flik eller fönster >>Ocular, nasal, dermal and respiratory symptoms in relation to heating, ventilation, energy conservation and reconstruction of older multi-family houses
    2003 (Engelska)Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 13, nr 3, s. 206-211Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    The aim was to study relationships between symptoms compatible with the sick building syndrome, type of heating and ventilation system, energy saving, and reconstruction in older dwellings. In Stockholm, 4815 inhabitants in 231 multi-family buildings built before 1961 were randomly selected, of whom 3241 participated (77%). Symptoms and personal factors were assessed by a postal questionnaire. Independent information on building characteristics, and energy saving measures was gathered from the building owners. Multiple logistic regression analysis was applied to calculate odds ratios (OR) adjusting for age, gender, hay fever, current smoking, population density, type of ventilation, type of heating system, and ownership of the building. Subjects in buildings with a mechanical ventilation system had less ocular and nasal symptoms (OR = 0.29-0.85). Heating by electric radiators, and wood heating was associated with an increase of most symptoms (OR = 1.18-1.74). In total, 48% lived in buildings that had gone through at least one type of reconstruction or energy saving remedies during the latest 10 years, including exchange of heating or ventilation system, and sealing measures (exchange of windows, sealing of window frames, roof/attic insulation, and phasade insulation). Energy saving was associated with both a decrease and increase of different symptoms. Major reconstruction of the interior of the building was associated with an increase of most symptoms (OR = 1.09-1.90), and buildings with more than one sealing measure had an increase of ocular, nasal symptoms, headache and tiredness (OR = 1.22-2.49). In conclusion, major reconstruction of the interior, direct heated electric radiators, wood heating, and multiple sealing of buildings were associated with an increase of some symptoms. The study supports the view that mechanical ventilation in dwellings is beneficial from a health point of view.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-90625 (URN)10.1034/j.1600-0668.2003.00174.x (DOI)12950582 (PubMedID)
    Tillgänglig från: 2003-06-05 Skapad: 2003-06-05 Senast uppdaterad: 2017-12-14Bibliografiskt granskad
    5. Sick building syndrome (SBS) and percived indoor environment in relation to energy saving by reduced ventilation rate during the heating season: a one year intervention study in dwellings.
    Öppna denna publikation i ny flik eller fönster >>Sick building syndrome (SBS) and percived indoor environment in relation to energy saving by reduced ventilation rate during the heating season: a one year intervention study in dwellings.
    Artikel i tidskrift (Refereegranskat) Submitted
    Identifikatorer
    urn:nbn:se:uu:diva-90626 (URN)
    Tillgänglig från: 2003-06-05 Skapad: 2003-06-05Bibliografiskt granskad
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