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  • 601. Xu, Feng
    et al.
    Zou, Zhijun
    Yan, Shuxian
    Li, Fei
    Kan, Haidong
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Xu, Jinhua
    Zhao, Zhuohui
    Fractional Exhaled Nitric Oxide in Relation to Asthma, Allergic Rhinitis, and Atopic Dermatitis in Chinese Children2011Ingår i: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 48, nr 10, s. 1001-1006Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    Fractional exhaled nitric oxide (FeNO) is a non-invasive biomarker of airway inflammation. Our aim was to analyze the interrelationship and differentiate the predicting effects of asthma, allergic rhinitis (AR), and atopic dermatitis (AD) on the FeNO levels in children from mainland China.

    METHODS:

    A case-control study with age- and gender matched 1:1 was designed based on a larger cross-sectional survey on asthma, AR, and AD in Shanghai. A self-administered questionnaire was used to collect information on children's health information. Children with positive reports on physician-diagnosed asthma and/or AR and/or AD were recruited as cases, and children with no report of any of the diseases were designated as controls. The FeNO measurement was performed online, using the NIOX MINO® instrument (Aerocrine AB, Solna, Sweden) at 50 ml/min.

    RESULTS:

    A total of 130 subjects (65 cases and 65 controls, average age = 10 years) were recruited in this study. The average FeNO level was significantly higher in the cases (29.8 ± 1.9 ppb) than that in the controls (13.3 ± 1.7 ppb) (p < .001). Using multiple linear regression analysis controlling for confounding factors, including parental asthma/allergic diseases and home exposure, asthma (β = 0.330, p < .001) and AR (β = 0.157, p = .006) showed significant predicting effects for high FeNO levels, whereas AD was not related to the FeNO levels.

    CONCLUSIONS:

    Both asthma and AR could independently increase the FeNO levels in Chinese schoolchildren. Other diseases besides asthma should be considered when applying FeNO as a screening tool for asthma in Chinese children.

  • 602. YinPing, Zhang
    et al.
    BaiZhan, Li
    Chen, Huang
    Xu, Yang
    Hua, Qian
    QiHong, Deng
    ZhuoHui, Zhao
    AnGui, Li
    JiaNing, Zhao
    Xin, Zhang
    Fang, Qu
    Yu, Hu
    Qin, Yang
    Juan, Wang
    Ming, Zhang
    Fang, Wang
    XiaoHong, Zheng
    Chan, Lu
    ZhiJian, Liu
    YueXia, Sun
    JinHan, Mo
    YiLi, Zhao
    Wei, Liu
    TingTing, Wang
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Bornehag, Carl-Gustaf
    Sundell, Jan
    Ten cities cross-sectional questionnaire survey of children asthma and other allergies in China2013Ingår i: Chinese Science Bulletin, ISSN 1001-6538, E-ISSN 1861-9541, Vol. 58, nr 34, s. 4182-4189Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Asthma, rhinitis and eczema (allergic or non-allergic) have increased throughout the world during the last decades, especially among children. Changes in the indoor environment are suspected to be important causes. China has experienced a dramatic change in indoor environmental exposures during the past two decades. However, such changes and their associations with children's asthma and other health aspects have not been thoroughly studied. China, Children, Homes, Health (CCHH), Phase I, was a cross-sectional questionnaire survey of 48219 children 1-8 years old in 10 Chinese cities during 2010-2012. The questionnaire includes the International Study of Asthma and Allergies in Childhood (ISAAC) core health questions and additional questions regarding housing, life habits and outdoor environment. In health analyses, children aged 3-6 years old were included. The prevalences of doctor diagnosed asthma varied from 1.7% to 9.8% (mean 6.8%), a large increase from 0.91% in 1999 and 1.50% in 2000. The prevalence of wheeze, rhinitis and atopic eczema (last 12 months) varied from 13.9% to 23.7%, 24.0% to 50.8% and 4.8% to 15.8%, respectively. Taiyuan had the lowest prevalences of all illnesses and Shanghai the highest, except for wheeze-where the highest value was for Urumqi. We found (1) no obvious association between disease prevalences and ambient PM10 concentrations and (2) higher prevalences of disease in humid climates with hot summers and cold winters, but with no centrally heated buildings. Associations between the diseases and economic status as indexed by Gross Domestic Product (GDP) requires further study.

  • 603.
    Zetterberg, Camilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Högskolan i Gävle, Avdelningen för arbets- och folkhälsovetenskap, Centrum för belastningsskadeforskning. University of Gävle, Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research..
    The impact of visually demanding near work on neck/shoulder discomfort and trapezius muscle activity: Laboratory studies2016Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Introduktion: Muskelrelaterade besvär i nack- och skulderområdet är vanligt förekommande, framförallt hos individer som utför synkrävande datorarbete. En orsak till sådana besvär anses vara långvarig lågintensiv aktivitet i dessa muskler. Det är i dagsläget oklart om de belastningar som synsystemet utsätts för vid synkrävande arbete bidrar till ökad muskelaktivitet i nack/skulderregionen. Syfte: Syftet var att undersöka om experimentellt synkrävande närarbete påverkar muskelaktivitet och besvär i nack/skulderregionen, och att undersöka om aktivitet i trapezius muskeln (kappmuskeln) påverkas av ögats ackommodation, d.v.s. när linsens brytkraft förändras för att se skarpt på nära håll. Metod: De fyra delstudierna baseras på två laborativa experiment där försökspersoner (66 respektive 26 stycken) genomförde olika synkrävande uppgifter (fem och sju minuter långa). För att göra synuppgifterna mer eller mindre ansträngande för synsystemet användes linser med olika grad av brytkraft (dioptrier). Dessutom, eftersom monokulärt seende inte kräver aktiv konvergens, genomfördes tre av de fyra synuppgifterna i ena experimentet med ett öga för att undersöka den enskilda effekten av ackommodation. En autorefraktor mätte ögats ackommodation under synuppgifterna och aktiviteten i trapeziusmuskeln registreades kontinuerligt med elektromyografi (EMG). I samband med det ena experimentet skattade deltagarna sina upplevda ögon- och nack/skulderbesvär, både före experimentet (baslinje) och efter varje synuppgift. Resultat: Det synkrävande arbetet ökade både de självskattade nack/skulderbesvären och muskelaktiviteten i trapezius. De personer som upplevde en högre ökning av ögonbesvär (i förhållande till baslinjen), rapporterade också mer nack/skulderbesvär över tid. Det var varken någon signifikant skillnad i grad av muskelaktivitet mellan synuppgifterna, eller något signifikant samband mellan monokulär ackommodation och muskelaktivitet. Slutsats: Resultaten indikerar att ögats ackommodation, i sig, inte påverkar muskelaktiviteten i trapezius. Ökad muskelaktivitet i nack/skulderregionen i anslutning till synkrävande arbete kan istället bero på en kombination av höga krav på visuell uppmärksamhet och ett ökat behov av att stabilisera ögonen (huvudet) i förhållande till objektet i fokus (t.ex. texten på en bildskärm). Eftersom resultaten tyder på att synkrävande närarbete leder till ökade besvär i nack/skuldraregionen över tid, är det viktigt att utforma arbetsplatser och synkrävande arbetsuppgifter (t.ex. vid datorn) på ett sätt som främjar visuell hälsa.

    Delarbeten
    1. Neck/shoulder discomfort due to visually demanding near work is influenced by previous neck pain, task duration, astigmatism, eye discomfort and accommodation.
    Öppna denna publikation i ny flik eller fönster >>Neck/shoulder discomfort due to visually demanding near work is influenced by previous neck pain, task duration, astigmatism, eye discomfort and accommodation.
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Visually demanding near work can cause eye discomfort, and eye and neck/shoulder discomfort during, e.g., computer work are associated. Here, to investigate direct effects of experimental near work on eye and neck/shoulder discomfort, 33 individuals with chronic neck pain and 33 healthy control subjects performed four visual tasks, rating eye and neck/shoulder discomfort at baseline and after each task. The cumulative performance time (reflected in the temporal order of the tasks), astigmatism, concurrent eye discomfort, and extent of accommodation all aggravated neck/shoulder discomfort. There was an interaction effect between the temporal order and eye discomfort: participants with a greater mean increase in eye discomfort also developed more neck/shoulder discomfort with time. Since moderate musculoskeletal symptoms are a risk factor for more severe symptoms, it is important to ensure a good visual environment in occupations involving visually demanding near work.

    Nyckelord
    astigmatism, computer vision syndrome, musculoskeletal disorder, oculomotor load, visual ergonomics
    Nationell ämneskategori
    Arbetsmedicin och miljömedicin
    Identifikatorer
    urn:nbn:se:uu:diva-285213 (URN)
    Tillgänglig från: 2016-04-19 Skapad: 2016-04-19 Senast uppdaterad: 2018-01-10
    2. Effects of visually demanding near work on trapezius muscle activity
    Öppna denna publikation i ny flik eller fönster >>Effects of visually demanding near work on trapezius muscle activity
    2013 (Engelska)Ingår i: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 23, nr 5, s. 1190-1198Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Poor visual ergonomics is associated with visual and neck/shoulder discomfort, but the relation between visual demands and neck/shoulder muscle activity is unclear. The aims of this study were to investigate whether trapezius muscle activity was affected by: (i) eye-lens accommodation; (ii) incongruence between accommodation and convergence; and (iii) presence of neck/shoulder discomfort. Sixty-six participants (33 controls and 33 with neck pain) performed visually demanding near work under four different trial-lens conditions. Results showed that eye-lens accommodation per se did not affect trapezius muscle activity significantly. However, when incongruence between accommodation and convergence was present, a significant positive relationship between eye-lens accommodation and trapezius muscle activity was found. There were no significant group-differences. It was concluded that incongruence between accommodation and convergence is an important factor in the relation between visually demanding near work and trapezius muscle activity. The relatively low demands on accommodation and convergence in the present study imply that visually demanding near work may contribute to increased muscle activity, and over time to the development of near work related neck/shoulder discomfort.

    Nyckelord
    Accommodation, Computer work, Electromyography, Gaze stabilization, Visual ergonomics
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-208638 (URN)10.1016/j.jelekin.2013.06.003 (DOI)000324024800027 ()
    Tillgänglig från: 2013-10-07 Skapad: 2013-10-07 Senast uppdaterad: 2017-12-06Bibliografiskt granskad
    3. Temporal Co-Variation between Eye Lens Accommodation and Trapezius Muscle Activity during a Dynamic Near-Far Visual Task
    Öppna denna publikation i ny flik eller fönster >>Temporal Co-Variation between Eye Lens Accommodation and Trapezius Muscle Activity during a Dynamic Near-Far Visual Task
    2015 (Engelska)Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 5, artikel-id e0126578Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Near work is associated with increased activity in the neck and shoulder muscles, but the underlying mechanismis still unknown. This study was designed to determine whether a dynamic change in focus, alternating between a nearby and a more distant visual target, produces a direct parallel change in trapezius muscle activity. Fourteen healthy controls and 12 patients with a history of visual and neck/shoulder symptoms performed a Near-Far visual task under three different viewing conditions; one neutral condition with no trial lenses, one condition with negative trial lenses to create increased accommodation, and one condition with positive trial lenses to create decreased accommodation. Eye lens accommodation and trapeziusmuscle activity were continuously recorded. The trapezius muscle activity was significantly higher during Near than during Far focusing periods for both groups within the neutral viewing condition, and there was a significant co-variation in time between accommodation and trapezius muscle activity within the neutral and positive viewing conditions for the control group. In conclusion, these results reveal a connection between Near focusing and increased muscle activity during dynamic changes in focus between a nearby and a far target. A direct link, from the accommodation/vergence system to the trapezius muscles cannot be ruled out, but the connection may also be explained by an increased need for eye-neck (head) stabilization when focusing on a nearby target as compared to a more distant target.

    Nationell ämneskategori
    Arbetsmedicin och miljömedicin
    Identifikatorer
    urn:nbn:se:uu:diva-256526 (URN)10.1371/journal.pone.0126578 (DOI)000354542500115 ()25961299 (PubMedID)
    Tillgänglig från: 2015-06-26 Skapad: 2015-06-24 Senast uppdaterad: 2018-01-11Bibliografiskt granskad
    4. Trapezius muscle activity increases during near work activity regardless of accommodation/vergence demand level
    Öppna denna publikation i ny flik eller fönster >>Trapezius muscle activity increases during near work activity regardless of accommodation/vergence demand level
    2015 (Engelska)Ingår i: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 115, nr 7, s. 1501-1512Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    To investigate if trapezius muscle activity increases over time during visually demanding near work. The vision task consisted of sustained focusing on a contrast-varying black and white Gabor grating. Sixty-six participants with a median age of 38 (range 19-47) fixated the grating from a distance of 65 cm (1.5 D) during four counterbalanced 7-min periods: binocularly through -3.5 D lenses, and monocularly through -3.5 D, 0 D and +3.5 D. Accommodation, heart rate variability and trapezius muscle activity were recorded in parallel. General estimating equation analyses showed that trapezius muscle activity increased significantly over time in all four lens conditions. A concurrent effect of accommodation response on trapezius muscle activity was observed with the minus lenses irrespective of whether incongruence between accommodation and convergence was present or not. Trapezius muscle activity increased significantly over time during the near work task. The increase in muscle activity over time may be caused by an increased need of mental effort and visual attention to maintain performance during the visual tasks to counteract mental fatigue.

    Nyckelord
    Attention fatigue, Accommodation, Bekesy test, Compensatory effort, Contrast threshold tracking, Electromyography, Visual ergonomics
    Nationell ämneskategori
    Arbetsmedicin och miljömedicin
    Identifikatorer
    urn:nbn:se:uu:diva-256983 (URN)10.1007/s00421-015-3125-9 (DOI)000355872200011 ()25697148 (PubMedID)
    Tillgänglig från: 2015-07-01 Skapad: 2015-06-29 Senast uppdaterad: 2018-01-11Bibliografiskt granskad
  • 604.
    Zetterberg, Camilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. University of Gävle, Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research.
    Forsman, M.
    Richter, H. O.
    Effects of visually demanding near work on trapezius muscle activity2013Ingår i: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 23, nr 5, s. 1190-1198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Poor visual ergonomics is associated with visual and neck/shoulder discomfort, but the relation between visual demands and neck/shoulder muscle activity is unclear. The aims of this study were to investigate whether trapezius muscle activity was affected by: (i) eye-lens accommodation; (ii) incongruence between accommodation and convergence; and (iii) presence of neck/shoulder discomfort. Sixty-six participants (33 controls and 33 with neck pain) performed visually demanding near work under four different trial-lens conditions. Results showed that eye-lens accommodation per se did not affect trapezius muscle activity significantly. However, when incongruence between accommodation and convergence was present, a significant positive relationship between eye-lens accommodation and trapezius muscle activity was found. There were no significant group-differences. It was concluded that incongruence between accommodation and convergence is an important factor in the relation between visually demanding near work and trapezius muscle activity. The relatively low demands on accommodation and convergence in the present study imply that visually demanding near work may contribute to increased muscle activity, and over time to the development of near work related neck/shoulder discomfort.

  • 605.
    Zetterberg, Camilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Högskolan i Gävle, Avdelningen för arbets- och folkhälsovetenskap, Centrum för belastningsskadeforskning. University of Gävle, Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research..
    Forsman, Mikael
    Karolinska Institutet, Institutet för miljömedicin.
    Richter, Hans O
    Högskolan i Gävle, Avdelningen för arbets- och folkhälsovetenskap, Centrum för belastningsskadeforskning. University of Gävle, Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research..
    Neck/shoulder discomfort due to visually demanding near work is influenced by previous neck pain, task duration, astigmatism, eye discomfort and accommodation.Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Visually demanding near work can cause eye discomfort, and eye and neck/shoulder discomfort during, e.g., computer work are associated. Here, to investigate direct effects of experimental near work on eye and neck/shoulder discomfort, 33 individuals with chronic neck pain and 33 healthy control subjects performed four visual tasks, rating eye and neck/shoulder discomfort at baseline and after each task. The cumulative performance time (reflected in the temporal order of the tasks), astigmatism, concurrent eye discomfort, and extent of accommodation all aggravated neck/shoulder discomfort. There was an interaction effect between the temporal order and eye discomfort: participants with a greater mean increase in eye discomfort also developed more neck/shoulder discomfort with time. Since moderate musculoskeletal symptoms are a risk factor for more severe symptoms, it is important to ensure a good visual environment in occupations involving visually demanding near work.

  • 606.
    Zetterberg, Camilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. University of Gävle, Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research.
    Richter, Hans O.
    Forsman, Mikael
    Temporal Co-Variation between Eye Lens Accommodation and Trapezius Muscle Activity during a Dynamic Near-Far Visual Task2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 5, artikel-id e0126578Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Near work is associated with increased activity in the neck and shoulder muscles, but the underlying mechanismis still unknown. This study was designed to determine whether a dynamic change in focus, alternating between a nearby and a more distant visual target, produces a direct parallel change in trapezius muscle activity. Fourteen healthy controls and 12 patients with a history of visual and neck/shoulder symptoms performed a Near-Far visual task under three different viewing conditions; one neutral condition with no trial lenses, one condition with negative trial lenses to create increased accommodation, and one condition with positive trial lenses to create decreased accommodation. Eye lens accommodation and trapeziusmuscle activity were continuously recorded. The trapezius muscle activity was significantly higher during Near than during Far focusing periods for both groups within the neutral viewing condition, and there was a significant co-variation in time between accommodation and trapezius muscle activity within the neutral and positive viewing conditions for the control group. In conclusion, these results reveal a connection between Near focusing and increased muscle activity during dynamic changes in focus between a nearby and a far target. A direct link, from the accommodation/vergence system to the trapezius muscles cannot be ruled out, but the connection may also be explained by an increased need for eye-neck (head) stabilization when focusing on a nearby target as compared to a more distant target.

  • 607.
    Zhang, X.
    et al.
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Fan, Q.
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Bai, X.
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Li, T.
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Zhao, Z.
    Fudan Univ, Sch Publ Hlth, Shanghai, Peoples R China.
    Fan, X.
    Taiyuan Univ Technol, Coll Chem & Chem Engn, Taiyuan, Shanxi, Peoples R China.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Levels of fractional exhaled nitric oxide in children in relation to air pollution in Chinese day care centres2018Ingår i: The International Journal of Tuberculosis and Lung Disease, ISSN 1027-3719, E-ISSN 1815-7920, Vol. 22, nr 7, s. 813-819Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study fractional exhaled nitric oxide (FeNO) levels among pre-school children in day care centres (DCCs) in relation to indoor and outdoor air pollution in northern China.

    DESIGN: This was a cross-sectional study among children aged 5 years from 34 classrooms at 10 randomly selected DCCs in Taiyuan, China. A total of 507 (99%) children participated. Air pollution and carbon dioxide (CO2) levels were measured in the classroom and outside the school. Linear mixed models were applied for statistical analysis.

    RESULTS: The geometric mean FeNO was 9.1 +/- 1.5 parts per billion; 11.6% of children had wheeze, 6.0% had dry cough, 26.4% rhinitis symptoms, 1.6% ever physician-diagnosed asthma and 29.2% ever physician diagnosed pneumonia. FeNO levels were associated with current wheeze (P = 0.04) and ever physician diagnosed pneumonia (P = 0.05). The mean indoor concentrations were particulate matter with a diameter of <2.5 pm (PM2,5) 268 mu g/m(3), sulfur dioxide (SO2) 40.5 mu g/m(3), nitrogen dioxide (NO2) 43.0 pg/m(3) and CO2 827 parts per million. Outdoor concentrations were PM2.5 244 mu g,/m(3), SO2 106.6 mu g/m(3) and NO2 40.9 pg/m(4). PM2,5 levels inside (P= 0.002) and outside DCCs (P = 0.05) were associated with FeNO levels.

    CONCLUSION: PM2.5 levels inside and outside DCCs in China can contribute to airway inflammation in preschool children. Children with current wheeze and ever physician-diagnosed pneumonia may have higher FeNO levels.

  • 608. Zhang, X
    et al.
    Zhao, Z
    Nordquist, Tobias
    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.
    The prevalence and incidence of sick building syndrome in Chinese pupils in relation to the school environment: a two-year follow-up study2011Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 21, nr 6, s. 462-471Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There are few incidence studies on sick building syndrome (SBS). We studied two-year change of SBS in Chinese pupils in relation to parental asthma/allergy (heredity), own atopy, classroom temperature, relative humidity (RH), absolute humidity (AH), crowdedness, CO₂, NO₂, and SO₂. A total of 1993 participated at baseline, and 1143 stayed in the same classrooms after two years. The prevalence of mucosal and general symptoms was 33% and 28% at baseline and increased during follow-up (P < 0.001). Twenty-seven percent reported at least one symptom improved when away from school. Heredity and own atopy were predictors of SBS at baseline and incidence of SBS. At baseline, SO₂ was associated with general symptoms (OR=1.10 per 100 μg/m³), mucosal symptoms (OR=1.12 per 100 μg/m³), and skin symptoms (OR=1.16 per 100 μg/m³). NO₂ was associated with mucosal symptoms (OR=1.13 per 10 μg/m³), and symptoms improved when away from school (OR=1.13 per 10 μg/m³). Temperature, RH, AH, and CO₂ were negatively associated with prevalence of SBS. Incidence or remission of SBS was not related to any exposure, except a negative association between SO₂ and new skin symptoms. In conclusion, heredity and atopy are related to incidence and prevalence of SBS, but the role of the measured exposures for SBS is more unclear. PRACTICAL IMPLICATIONS: We found high levels of CO₂ indicating inadequate ventilation and high levels of SO₂ and NO₂, both indoors and outdoors. All schools had natural ventilation, only. Relying on window opening as a tool for ventilation in China is difficult because increased ventilation will decrease the level of CO₂ but increase the level of NO₂ and SO₂ indoors. Prevalence studies of sick building syndrome (SBS) might not be conclusive for causal relationships, and more longitudinal studies on SBS are needed both in China and other parts of the world. The concept of mechanical ventilation and air filtration should be introduced in the schools, and when planning new schools, locations close to heavily trafficked roads should be avoided.

  • 609. Zhang, Xin
    et al.
    Li, Fan
    Zhang, Li
    Zhao, Zhuohui
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    A Longitudinal Study of Sick Building Syndrome (SBS) among Pupils in Relation to SO2, NO2, O-3 and PM10 in Schools in China2014Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, nr 11, s. e112933-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There are fewer longitudinal studies from China on symptoms as described for the sick building syndrome (SBS). Here, we performed a two-year prospective study and investigated associations between environmental parameters such as room temperature, relative air humidity (RH), carbon dioxide (CO2), nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O-3), particulate matter (PM10), and health outcomes including prevalence, incidence and remission of SBS symptoms in junior high schools in Taiyuan, China. Totally 2134 pupils participated at baseline, and 1325 stayed in the same classrooms during the study period (2010-2012). The prevalence of mucosal symptoms, general symptoms and symptoms improved when away from school (school-related symptoms) was 22.7%, 20.4% and 39.2%, respectively, at baseline, and the prevalence increased during follow-up (P<0.001). At baseline, both indoor and outdoor SO2 were found positively associated with prevalence of school-related symptoms. Indoor O-3 was shown to be positively associated with prevalence of skin symptoms. At follow-up, indoor PM10 was found to be positively associated with new onset of skin, mucosal and general symptoms. CO2 and RH were positively associated with new onset of mucosal, general and school-related symptoms. Outdoor SO2 was positively associated with new onset of skin symptoms, while outdoor NO2 was positively associated with new onset of skin, general and mucosal symptoms. Outdoor PM10 was found to be positively associated with new onset of skin, general and mucosal symptoms as well as school-related symptoms. In conclusion, symptoms as described for SBS were commonly found in school children in Taiyuan City, China, and increased during the two-year follow-up period. Environmental pollution, including PM10, SO2 and NO2, could increase the prevalence and incidence of SBS and decrease the remission rate. Moreover, parental asthma and allergy (heredity) and pollen or pet allergy (atopy) can be risk factors for SBS.

  • 610.
    Zhang, Xin
    et al.
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin. Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Fan, Qiannan
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Bai, Xu
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Li, Tian
    Shanxi Univ, Inst Environm Sci, Taiyuan, Shanxi, Peoples R China.
    Zhang, Yinping
    Tsinghua Univ, Sch Architecture, Beijing, Peoples R China.
    Li, Baizhan
    Chongqing Univ, Key Lab Three Gorges Reservoir Reg Ecoenvironm, Chongqing, Peoples R China.
    Zhao, Zhuohui
    Fudan Univ, Dept Environm Hlth, Shanghai, Peoples R China.
    Huang, Chen
    Univ Shanghai Sci & Technol, Dept Bldg Environm & Energy Engn, Sch Environm & Architecture, Shanghai, Peoples R China.
    Deng, Qihong
    Cent S Univ, XiangYa Sch Publ Hlth, Changsha, Hunan, Peoples R China;Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Lu, Chan
    Cent S Univ, XiangYa Sch Publ Hlth, Changsha, Hunan, Peoples R China;Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China.
    Qian, Hua
    Southeast Univ, Sch Energy & Environm, Nanjing, Jiangsu, Peoples R China.
    Xu, Yang
    Cent China Normal Univ, Coll Life Sci, Wuhan, Hubei, Peoples R China.
    Sun, Yuexia
    Tianjin Univ, Sch Environm Sci & Engn, Tianjin, Peoples R China.
    Sundell, Jan
    Tianjin Univ, Sch Environm Sci & Engn, Tianjin, Peoples R China.
    Wang, Juan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Dampness and mold in homes across China: Associations with rhinitis, ocular, throat and dermal symptoms, headache and fatigue among adults2019Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 29, nr 1, s. 30-42Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We studied dampness and mold in China in relation to rhinitis, ocular, throat and dermal symptoms, headache and fatigue. A questionnaire study was performed in six cities including 36 541 randomized parents of young children. Seven self-reported signs of dampness were evaluated. Multilevel logistic regression models were used to calculate odds ratios (ORs). Totally, 3.1% had weekly rhinitis, 2.8% eye, 4.1% throat and 4.8% skin symptoms, 3.0% headache and 13.9% fatigue. Overall, 6.3% of the homes had mold, 11.1% damp stains, 35.3% damp bed clothing, 12.8% water damage, 45.4% window pane condensation, 11.1% mold odor, and 37.5% humid air. All dampness signs were associated with symptoms (ORs from 1.2 to 4.6; P < 0.001), including rhinitis (ORs from 1.4 to 3.2; P < 0.001), and ORs increased by number of dampness signs. The strongest associations were for mold odor (ORs from 2.3 to 4.6) and humid air (ORs from 2.8 to 4.8). Associations were stronger among men and stronger in Beijing as compared to south China. In conclusion, dampness and mold are common in Chinese homes and associated with rhinitis and ocular, throat and dermal symptoms, headache and fatigue. Men can be more sensitive to dampness and health effects of dampness can be stronger in northern China.

  • 611. Zhang, Xin
    et al.
    Sahlberg, Bo
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Janson, Christer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi.
    Gislason, Thorarinn
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Dampness and moulds in workplace buildings: Associations with incidence and remission of sick building syndrome (SBS) and biomarkers of inflammation in a 10 year follow-up study2012Ingår i: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 430, s. 75-81Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There are few longitudinal studies on health effects of dampness and moulds in workplace buildings. We studied associations between dampness and indoor moulds in workplace buildings and selected biomarkers as well as incidence and remission of sick building syndrome (SBS). The study was based on a ten-year prospective study (1992-2002) in a random sample of adults (N=429) from the Uppsala part of the European Community Respiratory Health Survey (ECRHS). The 10-year incidence (onset) of general, mucosal, dermal symptoms and any symptom improved when away from the workplace (work-related symptoms) was 7.2%, 11.6%, 6.4% and 9.4% respectively. The 10-year remission of general, mucosal, dermal symptoms and work-related symptoms was 71.4%, 57.1%, 70.4% and 72.2% respectively. Signs of dampness in the floor construction in any workplace building during follow up (cumulative exposure) was associated with incidence of mucosal symptoms (OR=2.43). Cumulative exposure to moldy odor was associated with incidence of work-related symptoms (OR=2.69). Cumulative exposure to dampness or moulds was associated with decreased remission of work-related symptoms (OR=0.20 for water leakage, OR=0.17 for floor dampness, and OR=0.17 for visible indoor mould growth). Working in a building repaired because of dampness (repaired building) or mould was associated with decreased remission of work-related symptoms (OR=0.32). Any dampness or moulds at baseline in the workplace building was associated with increased bronchial responsiveness (BR) and higher levels of Eosinphilic Cationic Protein (ECP) in serum and Eosinophilic counts in blood at baseline. Cumulative exposure to dampness and moulds, and work in a repaired building, was associated with increased BR at follow-up. In general, dampness and moulds in the workplace building is associated with increased incidence and decreased remission of SBS, as well as increased bronchial responsiveness and eosinophilic inflammation.

  • 612. Zhang, Xin
    et al.
    Zhao, Zhuohui
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Nordquist, Tobias
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Larsson, Lennart
    Sebastian, Aleksandra
    Norback, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    A longitudinal study of sick building syndrome among pupils in relation to microbial components in dust in schools in China2011Ingår i: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 409, nr 24, s. 5253-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There are few longitudinal studies on sick building syndrome (SBS), which include ocular, nasal, throat, and dermal symptoms, headache, and fatigue. We studied the associations between selected microbial components, fungal DNA, furry pet allergens, and incidence and remission of SBS symptoms in schools in Taiyuan, China. The study was based on a two-year prospective analysis in pupils (N=1143) in a random sample of schools in China. Settled dust in the classrooms was collected by vacuum cleaning and analyzed for lipopolysaccharide (LPS), muramic acid (MuA), and ergosterol (Erg). Airborne dust was collected in Petri dishes and analyzed for cat and dog allergens and fungal DNA. The relationship between the concentration of allergens and microbial compounds and new onset of SBS was analyzed by multi-level logistic regression. The prevalence of mucosal and general symptoms was 33% and 28%, respectively, at baseline, and increased during follow-up. At baseline, 27% reported at least one symptom that improved when away from school (school-related symptoms). New onset of mucosal symptoms was negatively associated with concentration of MuA, total LPS, and shorter lengths of 3-hydroxy fatty acids from LPS, C14, C16, and C18. Onset of general symptoms was negatively associated with C18 LPS. Onset of school-related symptoms was negatively associated with C16 LPS, but positively associated with total fungal DNA. In general, bacterial compounds (LPS and MuA) seem to protect against the development of mucosal and general symptoms, but fungal exposure measured as fungal DNA could increase the incidence of school-related symptoms.

  • 613. Zhang, Y
    et al.
    Li, B
    Huang, C
    Norback, D
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Ten cities cross-sectional questionnaire survey of children asthma and other allergies in China2013Ingår i: Chinese Science Bulletin, ISSN 1001-6538, E-ISSN 1861-9541, Vol. 58, nr 34, s. 4182-4189Artikel i tidskrift (Refereegranskat)
  • 614.
    Zhao, Z
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Zhang, X
    Liu, R
    Norback, D
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Prenatal and early life home environment exposure in relation to preschool childrens asthma, allergic rhinitis and eczema in Taiyuan, China.2013Ingår i: Chinese Science Bulletin, ISSN 1001-6538, E-ISSN 1861-9541, Vol. 58, nr 34, s. 4245-4251Artikel i tidskrift (Refereegranskat)
  • 615.
    Zhao, Zhuohui
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Indoor and Outdoor Air Pollution in Relation to Allergy and Asthma in Taiyuan, China2006Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    The aim was to study the prevalence of asthma, eczema, allergy and respiratory symptoms among pupils in Shanxi province, China, in relation to home and school environment and outdoor air pollution. In one study there was a low prevalence of self-reported asthma, eczema and pollen or pet allergy among pupils (9-20y). Rural childhood and consumption of fruit and fish were negatively associated with asthma or allergy, while current urban residency and consumption of hamburgers tended to be risk factors. In another study in junior high school pupils, similar low prevalence of asthma and allergy was found. Compared with pupils at the same age in Uppsala, Sweden, asthma and allergy were less common while daytime attacks of breathlessness were more common in Chinese pupils. Parental asthma or allergy was a predictor of asthma symptoms. Factors in the home environment such as new floor, new furniture and ETS exposure were risk factors for asthma symptoms. Crowdedness, dust amount, CO2, temperature and air humidity were negatively associated with respiratory symptoms. Microbial chemical components like muramic acid and ergosterol, markers for bacteria and fungi, were negatively associated with wheeze or daytime attacks of breathlessness. The associations with endotoxin varied depending on the length of 3-hydroxy fatty acids of the lippopolysaccharides (LPS). Among outdoor air pollutants, SO2 and formaldehyde were positively associated with asthma symptoms or respiratory infections. In addition, indoor SO2, NO2 and formaldehyde were positively associated with asthma symptoms and respiratory infections. In conclusion, rural childhood and dietary factors can be protective for asthma and allergy. ETS and chemical emissions from new material at home can be risk factors for asthmatic symptoms. In the school environment, factors of indoor origin seemed to be generally protective for respirator symptoms while factors of outdoor origin seemed to be risk factors.

  • 616.
    Zhao, Zhuohui
    et al.
    Fudan Univ, Minist Educ, Key Lab Publ Hlth Safety, Sch Publ Hlth,Minist Hlth,Key Lab Hlth Technol As, Shanghai 200433, Peoples R China..
    Chen, Renjie
    Fudan Univ, Minist Educ, Key Lab Publ Hlth Safety, Sch Publ Hlth,Minist Hlth,Key Lab Hlth Technol As, Shanghai 200433, Peoples R China.;Fudan Univ, Shanghai Key Lab Atmospher Particle Pollut & Prev, Shanghai 200433, Peoples R China..
    Lin, Zhijing
    Fudan Univ, Minist Educ, Key Lab Publ Hlth Safety, Sch Publ Hlth,Minist Hlth,Key Lab Hlth Technol As, Shanghai 200433, Peoples R China..
    Cai, Jing
    Fudan Univ, Minist Educ, Key Lab Publ Hlth Safety, Sch Publ Hlth,Minist Hlth,Key Lab Hlth Technol As, Shanghai 200433, Peoples R China.;Fudan Univ, Shanghai Key Lab Atmospher Particle Pollut & Prev, Shanghai 200433, Peoples R China..
    Yang, Yingying
    Fudan Univ, Minist Educ, Key Lab Publ Hlth Safety, Sch Publ Hlth,Minist Hlth,Key Lab Hlth Technol As, Shanghai 200433, Peoples R China..
    Yang, Dandan
    Shanghai Key Lab Meteorol & Hlth, Shanghai, Peoples R China..
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Kan, Haidong
    Fudan Univ, Minist Educ, Key Lab Publ Hlth Safety, Sch Publ Hlth,Minist Hlth,Key Lab Hlth Technol As, Shanghai 200433, Peoples R China.;Fudan Univ, Shanghai Key Lab Atmospher Particle Pollut & Prev, Shanghai 200433, Peoples R China..
    Ambient carbon monoxide associated with alleviated respiratory inflammation in healthy young adults2016Ingår i: Environmental Pollution, ISSN 0269-7491, E-ISSN 1873-6424, Vol. 208, s. 294-298Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There is increasing controversy on whether acute exposure to ambient carbon monoxide (CO) is hazardous on respiratory health. We therefore performed a longitudinal panel study to evaluate the acute effects of ambient CO on fractional exhaled nitric oxide (FeNO), a well-established biomarker of airway inflammation. We completed 4-6 rounds of health examinations among 75 healthy young adults during April to June in 2013 in Shanghai, China. We applied the linear mixed-effect model to investigate the short-term associations between CO and FeNO. CO exposure during 2-72 h preceding health tests was significantly associated with decreased FeNO levels. For example, an interquartile range increase (0.3 mg/m(3)) of 2-h CO exposure corresponded to 10.6% decrease in FeNO. This association remained when controlling for the concomitant exposure to co-pollutants. This study provided support that short-term exposure to ambient CO might be related with reduced levels of FeNO, a biomarker of lower airway inflammation.

  • 617.
    Zhao, Zhuohui
    et al.
    Department of Environmental Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.
    Huang, Chen
    Zhang, Xin
    Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, China.
    Xu, Feng
    Kan, Haidong
    Song, Weimin
    Wieslander, Gunilla
    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.
    Fractional exhaled nitric oxide in Chinese children with asthma and allergies: A two-city study2013Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 107, nr 2, s. 161-171Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Fractional exhaled nitric oxide (FeNO) is a non-invasive biomarker of eosinophilic airway inflammation. Our aim was to study associations between FeNO in Chinese children in two cities and asthma, asthmatic symptoms, rhinitis, eczema, and selected childhood and home environmental factors. A random sample of children in Shanghai (n = 187) and Taiyuan (n = 127), and additional randomly selected children reporting current wheeze (n = 115) were invited for FeNO measurements by NIOX MINO. A questionnaire survey was performed among all subjects (12-14 y) in 59 classes in Shanghai and 44 in Taiyuan. Associations were studied using multiple linear regression using 10log transformed FeNO data and mutual adjustment. The geometric mean FeNO in the random sample (GM ± GSD) was higher in Shanghai (16.2 ± 1.9 ppb) as compared to Taiyuan (12.8 ± 1.6 ppb) (P < 0.001). In the total material (n = 429), Shanghai residency (P = 0.001), male gender (P = 0.02), parental asthma/allergy (P = 0.04), doctors' diagnosed asthma (DDA) (P < 0.001) and current wheeze (P < 0.001) were associated with higher FeNO levels. In non-wheezers (n = 291), Shanghai residency (P = 0.007), male gender (P = 0.002), DDA (P = 0.04), current rhinitis (P = 0.004) and reported pollen/furry pet allergy (P = 0.04) were positively associated with FeNO. In wheezers (n = 138), DDA was the only significant factor (P = 0.009). In conclusion, male gender, current wheeze, DDA, parental asthma/allergy, current rhinitis, pollen/furry pet allergy can be independent determinants of increased FeNO. The lower level of FeNO in Taiyuan is in agreement with previous studies showing lower prevalence of asthma and allergy in Taiyuan as compared to Shanghai.

  • 618.
    Zhao, Zhuohui
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Sebastian, Aleksandra
    Larsson, Lennart
    Wang, Zhuanhua
    Zhang, Zheng
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Asthmatic symptoms among pupils in relation to microbial dust exposure in schools in Taiyuan, China2008Ingår i: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 19, nr 5, s. 455-465Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Microbial exposure has been indicated as significant in the development of asthma and allergy among children. The aim of the study was to test whether microbial exposure and allergens in the school environment are associated with asthmatic symptoms in pupils. Data on asthmatic symptoms and respiratory infections were collected through a questionnaire survey among 1993 pupils aged 11-15 yr in 10 randomly selected schools in Taiyuan, China. Settled dust in classrooms was analysed using tandem gas chromatography-mass spectrometry for 3-hydroxy fatty acids, marker of lipopolysaccharide (LPS) from endotoxin, muramic acid (MuA), marker of bacteria and ergosterol (Erg) for fungi, quantifying both culturable and non-culturable microbes. A total of 29.8% reported daytime attacks of breathlessness, 8.4% wheeze and 1.2% had doctor's diagnosed asthma. Generally, MuA was negatively associated with wheeze and daytime attacks of breathlessness, the latter of which was negatively associated with Erg to a weaker extent. Total concentration of LPS was positively associated with daytime attacks of breathlessness, but shorter lengths of LPS, C10, C12 and C14 LPS were negatively associated with either wheezing or daytime attacks of breathlessness. For MuA and C10 and C12 of LPS, the associations were independent of airborne allergens and classroom crowdedness, and even independent of the other two microbial markers for MuA. Microbial exposure indicated by certain chemical markers (e.g. MuA) could be protective for asthmatic symptoms, but for LPS (endotoxin), the picture is more complex, varying by different lengths of fatty acids of LPS.

  • 619.
    Zhao, Zhuohui
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Zhang, Zheng
    Wang, Zhuanhua
    Ferm, Martin
    Liang, Yanling
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Asthmatic Symptoms among Pupils in Relation to Winter Indoor and Outdoor Air Pollution in Schools in Taiyuan, China2008Ingår i: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 116, nr 1, s. 90-97Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There are few studies on associations between children's respiratory heath and air pollution in schools in China. The industrial development and increased traffic may affect the indoor exposure to air pollutants in school environment. Moreover, there is a need to study respiratory effects of environmental tobacco smoke (ETS) and emissions from new building materials in homes in China.

    Objectives: We studied the associations between pupils' asthmatic symptoms and indoor and outdoor air pollution in schools, as well as selected home exposures, in a coal-burning city in north China.

    Methods: A questionnaire survey was administered to pupils (11–15 years of age) in 10 schools in urban Taiyuan, collecting data on respiratory health and selected home environmental factors. Indoor and outdoor school air pollutants and climate factors were measured in winter.

    Results: A total of 1,993 pupils (90.2%) participated ; 1.8% had cumulative asthma, 8.4% wheezing, 29.8% had daytime attacks of breathlessness. The indoor average concentrations of sulfur dioxide, nitrogen dioxide, ozone, and formaldehyde by class were 264.8, 39.4, 10.1, and 2.3 µg/m3, respectively. Outdoor levels were two to three times higher. Controlling for possible confounders, either wheeze or daytime or nocturnal attacks of breathlessness were positively associated with SO2, NO2, or formaldehyde. In addition, ETS and new furniture at home were risk factors for wheeze, daytime breathlessness, and respiratory infections.

    Conclusions: Indoor chemical air pollutants of mainly outdoor origin could be risk factors for pupils' respiratory symptoms at school, and home exposure to ETS and chemical emissions from new furniture could affect pupils' respiratory health.

  • 620.
    Zheng, Xiangrong
    et al.
    Cent S Univ, XiangYa Hosp, Dept Pediat, Changsha, Hunan, Peoples R China.
    Zhang, Weishe
    Cent S Univ, XiangYa Hosp, Dept Obstet, Changsha, Hunan, Peoples R China.
    Lu, Chan
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, 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.
    Deng, Qihong
    Cent S Univ, Sch Energy Sci & Engn, Changsha, Hunan, Peoples R China; Cent S Univ, XiangYa Sch Publ Hlth, Changsha, Hunan, Peoples R China; Cent S Univ, Ctr Environm & Water Resources, Changsha, Hunan, Peoples R China.
    An epidemiological assessment of the effect of ambient temperature on the incidence of preterm births: Identifying windows of susceptibility during pregnancy2018Ingår i: Journal of Thermal Biology, ISSN 0306-4565, E-ISSN 1879-0992, Vol. 74, s. 201-207Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It is well known that exposure to thermal stress during pregnancy can lead to an increased incidence of premature births. However, there is little known regarding window(s) of susceptibility during the course of a pregnancy. We attempted to identify possible windows of susceptibility in a cohort study of 3604 children in Changsha with a hot-summer and cold winter climatic characteristics. We examined the association between PTB and ambient temperature during different timing windows of pregnancy: conception month, three trimesters, birth month and entire pregnancy. We found a U-shaped relation between the prevalence of PTB and mean ambient temperature during pregnancy. Both high and low temperatures were associated with PTB risk, adjusted OR (95% CI) respectively 2.57 (1.98–3.33) and 2.39 (1.93–2.95) for 0.5 °C increase in high temperature range (>18.2°C) and 0.5°C decrease in low temperature range (< 18.2°C). Specifically, PTB was significantly associated with ambient temperature and extreme heat/cold days during conception month and the third trimester. Sensitivity analysis indicated that female fetus were more susceptible to the risk of ambient temperature. Our study indicates that the risk of preterm birth due to high or low temperature may exist early during the conception month.

  • 621. Zheng, Y.
    et al.
    Zhao, D.
    Zhang, C.
    Chen, J.
    Zhang, L.
    Wei, Q.
    Chen, S.
    Liu, E.
    Lai, X.
    Gjesing, B.
    Norback, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Spangfort, M.
    House dust mite major allergen levels in household dust samples from nine cities in China2012Ingår i: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 67, nr S96, s. 536-536Artikel i tidskrift (Övrigt vetenskapligt)
  • 622. Zheng, Yi Wu
    et al.
    Lai, Xu Xin
    Zhao, De Yu
    Zhang, Chun Qing
    Chen, Jian Jun
    Zhang, Luo
    Wei, Qing Yu
    Chen, Shi
    Liu, En Mei
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Gjesing, Birgitte
    Zhong, Nan Shan
    Spangfort, D Michael
    Indoor Allergen Levels and Household Distributions in Nine Cities Across China2015Ingår i: Biomedical and environmental sciences, ISSN 0895-3988, E-ISSN 2214-0190, Vol. 28, nr 10, s. 709-717Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Chinese allergic subjects have high levels of sensitization to house dust mite (HDM) and other indoor allergens. This study quantifies common indoor allergen levels in Chinese households.

    METHODS: Dust samples were collected from nine cities. Major allergens Der p 1 and Der f 1 from Dermatophagoides pteronyssinus and D. farinae, and specific antigens of Blomia tropicalis, Tyrophagus putrescentiae, Acarus siro, and cockroach species Blattella germanica and Periplaneta americana were measured by ELISA.

    RESULTS: HDM allergens were found in dust samples from bedding in 95% of the Chinese households. The median levels varied from <0.006 to 9.2 µg/g of dust, depending on the city. The percentages of households having HDM allergen levels associated with the risk of developing allergy sensitization and asthma were 65% and 25%, respectively. Specific antigens of the storage mite and cockroach were only found in samples from the southern and tropical regions of China. Levels of mite allergens were generally higher in samples from bedding compared to samples from the living room, even for storage mites, whereas levels of cockroach antigens were higher in the living room samples.

    CONCLUSION: HDM allergens are present in bedding dust samples from most Chinese households. Cities in southern and central China have relatively high levels of HDM major allergens compared to cities in northern and western China. Antigens of storage mites and cockroaches are not as common as HDM allergens.

  • 623. ZhuoHui, Zhao
    et al.
    Xin, Zhang
    RanRan, Liu
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Wieslander, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Jie, Chen
    Sundell, Jan
    Prenatal and early life home environment exposure in relation to preschool children's asthma, allergic rhinitis and eczema in Taiyuan, China2013Ingår i: Chinese Science Bulletin, ISSN 1001-6538, E-ISSN 1861-9541, Vol. 58, nr 34, s. 4245-4251Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Prenatal and early life home environment might be related to children's asthma or allergic diseases later in life. A cross-sectional epidemiological study was designed and a questionnaire survey was performed in 3700 preschool children in urban areas in Taiyuan, Shanxi Province, China. Questions on children's asthma and allergic diseases from the International Study on Asthma and Allergies in Childhood (ISAAC) were integrated with questions on home environment from the Swedish Dampness in Buildings and Health (DBH) study, appropriately modified for Chinese life habits. By multivariate regression analyses controlling for age, gender, heredity, location in urban/suburban or rural areas, environmental tobacco smoke (ETS) and breastfeeding, we found that home new furniture (HNF) before birth (referring to 1 year before pregnancy and during pregnancy) was positively associated with wheezing ever (odds ratio(OR) 1.23 with 95% CI of 1.03-1.48) and wheezing last 12 months (1.24,1.00-1.54), allergic rhinitis (AR) (1.26,1.06-1.51), and eczema (1.42,1.01-1.99). HNF between 0-1 years old was also positively associated with wheezing last 12 months. Home new decoration (HND) during 0-1 years old was positively associated with AR symptoms and eczema symptoms, more in the last 12 months. Stronger positive associations were found for signs of home mold and dampness with almost all children's asthmatic and allergic symptoms (OR ranging from 1.23-1.85, P<0.05). By mutual adjustment between HNF before children's birth and home mold or dampness, all the significance remained unchanged. Prenatal HNF and home mold or dampness was independently associated with children's asthmatic and allergic diseases later in life.

  • 624. Zock, Jan-Paul
    et al.
    Heinrich, Joachim
    Jarvis, Deborah
    Verlato, Giuseppe
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Plana, Estel
    Sunyer, Jordi
    Chinn, Susan
    Olivieri, Mario
    Soon, Argo
    Villani, Simona
    Ponzio, Michela
    Dahlman-Höglund, Anna
    Svanes, Cecilie
    Luczynska, Christina
    Distribution and determinants of house dust mite allergens in Europe: the European Community Respiratory Health Survey II2006Ingår i: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 118, nr 3, s. 682-690Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Several studies in European homes have described allergen levels from the house dust mite species Dermatophagoides pteronyssinus and to a lesser extent Dermatophagoides farinae, but geographic comparisons of exposure levels and risk factors have been hampered by a lack of standardized methods.

    Objective: To study the distribution and determinants of the major house dust mite allergens Der p 1 and Der f 1 in 10 European countries using a common protocol.

    Methods: During home visits with 3580 participants of the European Community Respiratory Health Survey II from 22 study centers, mattress dust was sampled and analyzed for Der p 1, Der f 1, and Der 2 allergen. Information on housing characteristics was obtained by both observations and interview.

    Results: Der 1 and Der 2 allergens were detectable (>= 0.1 mu g/g) in 68% and 53% of the samples, respectively. Large differences in allergen levels between study centers were observed, and geographic patterns for Der p 1 and Der f 1 were different. Low winter temperatures reduced Der p 1 rather than Der f 1. Important risk factors for high allergen levels included an older mattress, a lower floor level of the bedroom, limited ventilation of the bedroom, and dampness for Der p 1 but not for Der f 1.

    Conclusion: There are large qualitative and quantitative differences of house dust mite allergen levels in Europe, which can partly be explained by geographic and housing characteristics.

    Clinical implications: Mite allergen exposure may be reduced by replacing the mattress regularly and increasing ventilation of the bedroom, particularly in winter.

  • 625. Zock, Jan-Paul
    et al.
    Plana, Estel
    Antó, Josep M
    Benke, Geza
    Blanc, Paul D
    Carosso, Aurelia
    Dahlman-Höglund, Anna
    Heinrich, Joachim
    Jarvis, Deborah
    Kromhout, Hans
    Lillienberg, Linnéa
    Mirabelli, Maria C
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Olivieri, Mario
    Ponzio, Michela
    Radon, Katja
    Soon, Argo
    van Sprundel, Marc
    Sunyer, Jordi
    Svanes, Cecilie
    Torén, Kjell
    Verlato, Giuseppe
    Villani, Simona
    Kogevinas, Manolis
    Domestic use of hypochlorite bleach, atopic sensitization, and respiratory symptoms in adults2009Ingår i: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 124, nr 4, s. 731-738Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Professional use of hypochlorite (bleach) has been associated with respiratory symptoms. Bleach is capable of inactivating allergens, and there are indications that its domestic use may reduce the risk of allergies in children. OBJECTIVE: To study the associations between household use of bleach and atopic sensitization, allergic diseases, and respiratory health status in adults. METHODS: We identified 3626 participants of the European Community Respiratory Health Survey II in 10 countries who did the cleaning in their homes and for whom data on specific serum IgE to 4 environmental allergens were available. Frequency of bleach use and information on respiratory symptoms were obtained in face-to-face interviews. House dust mite and cat allergens in mattress dust were measured in a subsample. Associations between the frequency of bleach use and health outcomes were evaluated by using multivariable mixed logistic regression analyses. RESULTS: The use of bleach was associated with less atopic sensitization (odds ratio [OR], 0.75; 95% CI, 0.63-0.89). This association was apparent for specific IgE to both indoor (cat) and outdoor (grass) allergens, and was consistent in various subgroups, including those without any history of respiratory problems (OR, 0.85). Dose-response relationships (P < .05) were apparent for the frequency of bleach use and sensitization rates. Lower respiratory tract symptoms, but not allergic symptoms, were more prevalent among those using bleach 4 or more days per week (OR, 1.24-1.49). The use of bleach was not associated with indoor allergen concentrations. CONCLUSION: People who clean their homes with hypochlorite bleach are less likely to be atopic but more likely to have respiratory symptoms.

  • 626. Zock, Jan-Paul
    et al.
    Plana, Estel
    Jarvis, Deborah
    Antó, Josep M
    Kromhout, Hans
    Kennedy, Susan M
    Künzli, Nino
    Villani, Simona
    Olivieri, Mario
    Torén, Kjell
    Radon, Katja
    Sunyer, Jordi
    Dahlman-Hoglund, Anna
    Norbäck, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Kogevinas, Manolis
    The use of household cleaning sprays and adult asthma: an international longitudinal study2007Ingår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 176, nr 8, s. 735-741Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale: Cleaning work and professional use of certain cleaning products have been associated with asthma, but respiratory effects of nonprofessional home cleaning have rarely been studied. Objectives: To investigate the risk of new-onset asthma in relation to the use of common household cleaners. Methods: Within the follow-up of the European Community Respiratory Health Survey in 10 countries, we identified 3,503 persons doing the cleaning in their homes and who were free of asthma at baseline. Frequency of use of 15 types of cleaning products was obtained in a face-to-face interview at follow-up. We studied the incidence of asthma defined as physician diagnosis and as symptoms or medication usage at follow-up. Associations between asthma and the use of cleaning products were evaluated using multivariable Cox proportional hazards or log-binomial regression analysis. Measurements and Main Results: The use of cleaning sprays at least weekly (42% of participants) was associated with the incidence of asthma symptoms or medication (relative risk [RR], 1.49; 95% confidence interval [Cl], 1.12-1.99) and wheeze (RR, 1.39; 95% Cl, 1.06-1.80). The incidence of physician-diagnosed asthma was higher among those using sprays at least 4 days per week (RR, 2.11; 95% Cl, 1.15-3.89). These associations were consistent for subgroups and not modified by atopy. Dose-response relationships (P < 0.05) were apparent for the frequency of use and the number of different sprays. Risks were predominantly found for the commonly used glass-cleaning, furniture, and air-refreshing sprays. Cleaning products not applied in spray form were not associated with asthma. Conclusions: Frequent use of common household cleaning sprays may be an important risk factor for adult asthma.

  • 627. Åkerstedt, Torbjorn
    et al.
    Nordin, Maria
    Alfredsson, Lars
    Westerholm, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Kecklund, Goran
    Sleep and sleepiness: impact of entering or leaving shiftwork - a prospective study2010Ingår i: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 27, nr 5, s. 987-996Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Very little is known about the effects on sleep and sleepiness of entering or exiting shift-work. The present study used a longitudinal database (n = 3637). Participants completed a questionnaire on work hours, sleep, and work environment at the start and end of a 5-yr period. Changes in shift/day work status were related to change in a number of subjective sleep variables using logistic regression analysis. The analyses were adjusted for age, sex, and differences in socioeconomic status, work demands, work control, physical workload, marriage status, and number of children. In comparison with constant day work, entering shiftwork (with or without night shifts) from day work increased the risk of difficulties in falling asleep, and leaving shiftwork reduced this risk (odds ratio [OR] = 2.8 [confidence interval, CI = 1.8-4.5]). Also falling asleep at work showed a consistent pattern; an increased risk of falling asleep for those with shiftwork on both occasions, and for those with night work on both occasions. Also entering night work was associated with a strongly increased risk of falling asleep at work (OR = 2.9 [CI = 1.3-6.7]). These results suggest that entering and leaving shiftwork has a considerable impact on sleep and alertness. However, there is a need for large and more extended longitudinal studies to support our findings. (Author correspondence: Torbjorn.akerstedt@ki.se)

  • 628. Åkerstedt, Torbjörn
    et al.
    Nordin, Maria
    Alfredsson, Lars
    Westerholm, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Kecklund, Göran
    Predicting changes in sleep complaints from baseline values and changes in work demands, work control, and work preoccupation: The WOLF-project2012Ingår i: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 13, nr 1, s. 73-80Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study objective: Stress as a cause of disturbed sleep is often taken for granted, but the longitudinal evidence is limited. The aim of this study was to evaluate new cases of poor sleep as a function of changes in reported work demands, work control, and work preoccupation. Methods: Longitudinal study of change with measures occurring twice within a 5-year interval during a period when the prevalence of impaired sleep was increasing in Sweden. The sample of companies was taken from northern Sweden (Norrland) and included 3637 individuals from the "WOLF Norrland" longitudinal cohort, collected through company health services. Measurement and results: During the measurement period, 16% of those studied developed new cases of impaired sleep. Logistic regressions adjusted for demographics, work environment factors, and disturbed sleep at T1 period one showed a significant increase in new cases for high work demands and high work preoccupation (OR = 1.37; Ci = 1.09-1.72 and OR = 1.80; CI = 1.42-2.28, respectively). The analysis of change in the predictors showed effects of a change from low to high work demands (OR = 1.39; Ci = 1.00-1.95) on new cases of impaired sleep. Consistent high work demands (high at both points) showed a similar increase (OR = 1.49; Ci = 1.06-2.11) but no effect was seen for reduced demands. Change in work preoccupation yielded stronger effects with OR = 2.47 (1.78-2.47) for increased work preoccupation and OR = 3.79 (2.70-5.31) for consistent high work preoccupation. Also, a reduction in work preoccupation was associated with a reduction in new cases of disturbed sleep. Control at work was not related to sleep. Stratification with respect to gender mainly led to fewer significant results (particularly for women) due to larger confidence intervals. Conclusions: It was concluded that self-reported work preoccupation predicts subsequent impairment of sleep and that increased preoccupation is associated with new cases of impaired sleep. Similar, but weaker, results were obtained for work demands.

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