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Nilsson Sommar, JohanORCID iD iconorcid.org/0000-0002-8854-498x
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Publications (10 of 71) Show all publications
Kriit, H. K., Forsberg, B. & Nilsson Sommar, J. (2024). Increase in sick leave episodes from short-term fine particulate matter exposure: a case-crossover study in Stockholm, Sweden. Environmental Research, 244, Article ID 117950.
Open this publication in new window or tab >>Increase in sick leave episodes from short-term fine particulate matter exposure: a case-crossover study in Stockholm, Sweden
2024 (English)In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 244, article id 117950Article in journal (Refereed) Published
Abstract [en]

Air pollution's short-term effects on a wide range of health outcomes have been studied extensively, primarily focused on vulnerable groups (e.g., children and the elderly). However, the air pollution effects on the adult working population through sick leave have received little attention. This study aims to 1) estimate the associations between particulate matter ≤2.5 μm3 (PM2.5) and sick leave episodes and 2) calculate the attributable number of sick leave days and the consequential productivity loss in the City of Stockholm, Sweden. Individual level daily sick leave data was obtained from Statistics Sweden for the years 2011–2019. Daily average concentrations of PM2.5 were obtained from the main urban background monitoring station in Stockholm. A case-crossover study design was applied to estimate the association between short-term PM2.5 and onset of sick leave episodes. Conditional logistic regression was used to estimate the relative increase in odds of onset per 10 μg/m3 of PM2.5, adjusting for temperature, season, and pollen. A human capital method was applied to estimate the PM2.5 attributable productivity loss. In total, 1.5 million (M) individual sick leave occurrences were studied. The measured daily mean PM2.5 concentration was 4.2 μg/m3 (IQR 3.7 μg/m3). The odds of a sick leave episode was estimated to increase by 8.5% (95% CI: 7.8–9.3) per 10 μg/m3 average exposure 2–4 days before. Sub-group analysis showed that private sector and individuals 15–24 years old had a lower increase in odds of sick leave episodes in relation to PM2.5 exposure. In Stockholm, 4% of the sick leave episodes were attributable to PM2.5 exposure, corresponding to €17 M per year in productivity loss. Our study suggests a positive association between PM2.5 and sick leave episodes in a low exposure area.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Air pollution, Case-crossover, Economic evaluation, Health impact assessment, PM2.5, Sick leave episode
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-220459 (URN)10.1016/j.envres.2023.117950 (DOI)38104916 (PubMedID)2-s2.0-85183348531 (Scopus ID)
Available from: 2024-02-14 Created: 2024-02-14 Last updated: 2024-02-15Bibliographically approved
Krachler, B., Söderholm, A., Ekman, F., Lindberg, F., Lindbäck, J., Nilsson Sommar, J., . . . Lindahl, B. (2024). Intensive lifestyle intervention for cardiometabolic prevention implemented in healthcare: higher risk predicts premature dropout. American Journal of Lifestyle Medicine
Open this publication in new window or tab >>Intensive lifestyle intervention for cardiometabolic prevention implemented in healthcare: higher risk predicts premature dropout
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2024 (English)In: American Journal of Lifestyle Medicine, ISSN 1559-8276, E-ISSN 1559-8284Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aims: Patient characteristics and treatment setting are potential predictors of premature dropout from lifestyle interventions, but their relative importance is unknown.

Methods: From the quality registry of the unit for behavioral medicine, Umeå University hospital, we identified 2589 patients who had been enrolled in a multimodal lifestyle intervention for cardiometabolic risk reduction between 2006 and 2015. Baseline characteristics predicting dropout before 1-year follow-up were selected by a stepwise logistic regression algorithm.

Results: Better physical health and older age predicted full participation, with odds ratios for premature dropout (ORs) of.44 (95% confidence interval (CI).31-.63), and.47 (95% CI.34-.65) in the highest compared to the lowest quartile, respectively. Odds of premature dropout were also lower among female participants,.71 (95% CI.58-.89). Premature dropout was predicted by higher BMI, snuffing tobacco, and smoking, with ORs of 1.53 (95% CI 1.13-2.08) in the highest compared to the lowest quartile of BMI, 1.37 (95% CI 1.03-1.81) comparing snuff user with non-users and 2.53 (95% CI 1.79-3.61) comparing smokers with non-smokers. Odds ratio for premature dropout among inpatients compared with outpatients was.84 (95% CI.68-1.04).

Conclusion: Higher risk at baseline predicts premature dropout.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
early medical intervention, health behavior, lifestyle risk reduction, preventive health programs, primary prevention, treatment adherence
National Category
General Practice
Identifiers
urn:nbn:se:umu:diva-227327 (URN)10.1177/15598276241259961 (DOI)2-s2.0-85196478353 (Scopus ID)
Funder
Umeå University
Available from: 2024-07-02 Created: 2024-07-02 Last updated: 2024-07-02
Kilbo Edlund, K., Andersson, E. M., Asker, C., Barregard, L., Bergström, G., Eneroth, K., . . . Stockfelt, L. (2024). Long-term ambient air pollution and coronary atherosclerosis: results from the Swedish SCAPIS study. Atherosclerosis, Article ID 117576.
Open this publication in new window or tab >>Long-term ambient air pollution and coronary atherosclerosis: results from the Swedish SCAPIS study
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2024 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, article id 117576Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background and aims: Despite firm evidence for an association between long-term ambient air pollution exposure and cardiovascular morbidity and mortality, results from epidemiological studies on the association between air pollution exposure and atherosclerosis have not been consistent. We investigated associations between long-term low-level air pollution exposure and coronary atherosclerosis.

Methods: We performed a cross-sectional analysis in the large Swedish CArdioPulmonary bioImaging Study (SCAPIS, n = 30 154), a random general population sample. Concentrations of total and locally emitted particulate matter <2.5 μm (PM2.5), <10 μm (PM10), and nitrogen oxides (NOx) at the residential address were modelled using high-resolution dispersion models. We estimated associations between air pollution exposures and segment involvement score (SIS), coronary artery calcification score (CACS), number of non-calcified plaques (NCP), and number of significant stenoses, using ordinal regression models extensively adjusted for potential confounders.

Results: Median 10-year average PM2.5 exposure was 6.2 μg/m3 (range 3.5–13.4 μg/m3). 51 % of participants were women and 51 % were never-smokers. None of the assessed pollutants were associated with a higher SIS or CACS. Exposure to PM2.5 was associated with NCP (adjusted OR 1.34, 95 % CI 1.13, 1.58, per 2.05 μg/m3). Associations with significant stenoses were inconsistent.

Conclusions: In this large, middle-aged general population sample with low exposure levels, air pollution was not associated with measures of total burden of coronary atherosclerosis. However, PM2.5 appeared to be associated with a higher prevalence of non-calcified plaques. The results suggest that increased risk of early-stage atherosclerosis or rupture, but not increased total atherosclerotic burden, may be a pathway for long-term air pollution effects on cardiovascular disease.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Air pollution, Atherosclerosis, Cardiovascular diseases, Coronary artery disease, Nitrogen oxides, Particulate matter
National Category
Cardiac and Cardiovascular Systems Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-225313 (URN)10.1016/j.atherosclerosis.2024.117576 (DOI)38797616 (PubMedID)2-s2.0-85193925845 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 2016-0315Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-0315Forte, Swedish Research Council for Health, Working Life and Welfare, 2020-01044
Available from: 2024-06-10 Created: 2024-06-10 Last updated: 2024-06-10
Kriit, H. K., Nilsson Sommar, J. & Åström, S. (2024). Socioeconomic per-case costs of stroke, myocardial infarction, and preterm birth attributable to air pollution in Sweden. PLOS ONE, 19(1), Article ID e0290766.
Open this publication in new window or tab >>Socioeconomic per-case costs of stroke, myocardial infarction, and preterm birth attributable to air pollution in Sweden
2024 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 19, no 1, article id e0290766Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Incident cases of stroke, myocardial infarction, and preterm birth have established exposure-response functions associated with air pollution. However, there are no studies reporting detailed costs per case for these health outcomes that are adapted to the cost-benefit tools that guide the regulation of air pollution.

OBJECTIVES: The primary objective was to establish non-fatal per-case monetary estimates for stroke, myocardial infarction, and preterm birth attributable to air pollution in Sweden, and the secondary objective was to ease the economic evaluation process of air pollution morbidity effects and their inclusion in cost-benefit assessments.

METHODS: Based on recommendations from the literature, the case-cost analysis considered direct and indirect medical costs, as well as production losses and informal costs relevant for the calculation of the net present value. A literature search was conducted to estimate the costs of each category for each incident case in Sweden. Informal costs were estimated using the quality-adjusted life-years approach and the corresponding willingness-to-pay in the Swedish population. The total average per-case cost was estimated based on specific health outcome durations and severity and was discounted by 3.5% per year. Sensitivity analysis included varying discount rates, severity of health outcome, and the range of societal willingness to pay for quality-adjusted life years.

RESULTS: The average net present value cost estimate was €2016 460k (185k-1M) for non-fatal stroke, €2016 24k (16k-38k) for myocardial infarction, and €2016 34k (19k-57k) for late preterm birth. The main drivers of the per-case total cost estimates were health outcome severity and societal willingness to pay for risk reduction. Varying the discount rate had the largest effect on preterm birth, with costs changing by ±30% for the discount rates analysed.

RECOMMENDATION: Because stroke, myocardial infarction, and preterm birth have established exposure-response functions linking these to air pollution, cost-benefit analyses should include the costs for these health outcomes in order to adequately guide future air pollution and climate change policies.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2024
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-219826 (URN)10.1371/journal.pone.0290766 (DOI)38206924 (PubMedID)2-s2.0-85182284791 (Scopus ID)
Funder
Swedish Environmental Protection Agency, 03730-1616/87NordForsk, 75007
Available from: 2024-01-22 Created: 2024-01-22 Last updated: 2024-01-22Bibliographically approved
Englund, A., Nilsson Sommar, J. & Krachler, B. (2024). The behaviour change technique: profile of a multimodal lifestyle intervention. Lifestyle Medicine, 5(1), Article ID e97.
Open this publication in new window or tab >>The behaviour change technique: profile of a multimodal lifestyle intervention
2024 (English)In: Lifestyle Medicine, E-ISSN 2688-3740, Vol. 5, no 1, article id e97Article in journal (Refereed) Published
Abstract [en]

Introduction: The behaviour change technique taxonomy version 1 was developed to identify the smallest active ingredients of a lifestyle intervention, that is, behaviour change techniques (BCTs) based on a written description. By participation and direct observation of an intervention, we intend to not only identify BCTs but also assess exposure time for each BCT. Adding the dimension of exposure time should enable us to make quantitative comparisons between the different BCTs employed. We intend to demonstrate this by studying the hypotheses that exposure to information-related BCTs is similar for all targeted lifestyle modalities but decreases in the course of the intervention.

Methods: During 5-week intensive multimodal lifestyle interventions at a Swedish clinic for lifestyle medicine, we identified BCTs according to behaviour change technique taxonomy version 1 and noted exposure times to BCTs in all mandatory parts of the behaviour change intervention.

Results: Two hundred thirty-one independent intervention components were evaluated. BCTs 8.1 Behavioural practice/rehearsal (126 h), 4.1 Instruction on how to perform the behaviour (98 h) and 6.1 Demonstration of the behaviour (65 h) were the most common in terms of exposure time. Relative exposure to BCTs with an informative nature was similar for the different treatment phases (33%−37%−28%; p = 0.09) but higher for physical activity compared to food habits, stress management and unspecific lifestyle medicine (63%−25%−22%−25%; p < 0.001).

Conclusions: The behaviour change technique taxonomy version 1 can be extended by adding exposure time for different BCTs. The resulting BCT–exposure profile can be used for assessing the relative importance of different behaviour change strategies.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
behaviour change techniques, lifestyle interventions, taxonomy
National Category
Environmental Management
Identifiers
urn:nbn:se:umu:diva-220144 (URN)10.1002/lim2.97 (DOI)2-s2.0-85182717976 (Scopus ID)
Available from: 2024-02-13 Created: 2024-02-13 Last updated: 2024-02-13Bibliographically approved
Hrubá, F., Černá, M., Chen, C., Harari, F., Horvat, M., Koppová, K., . . . Bergdahl, I. (2023). A regional comparison of children's blood cadmium, lead, and mercury in rural, urban and industrial areas of six European countries, and China, Ecuador, and Morocco. International Journal of Occupational Medicine and Environmental Health, 36(3), 349-364
Open this publication in new window or tab >>A regional comparison of children's blood cadmium, lead, and mercury in rural, urban and industrial areas of six European countries, and China, Ecuador, and Morocco
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2023 (English)In: International Journal of Occupational Medicine and Environmental Health, ISSN 1232-1087, E-ISSN 1896-494X, Vol. 36, no 3, p. 349-364Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The authors aimed to evaluate whether blood cadmium (B-Cd), lead (B-Pb) and mercury (B-Hg) in children differ regionally in 9 countries, and to identify factors correlating with exposure.

MATERIAL AND METHODS: The authors performed a cross-sectional study of children aged 7-14 years, living in 2007-2008 in urban, rural, or potentially polluted ("hot spot") areas (ca. 50 children from each area, in total 1363 children) in 6 European and 3 non-European countries. The authors analyzed Cd, Pb, and total Hg in blood and collected information on potential determinants of exposure through questionnaires. Regional differences in exposure levels were assessed within each country.

RESULTS: Children living near industrial "hot-spots" had B-Cd 1.6 (95% CI: 1.4-1.9) times higher in the Czech Republic and 2.1 (95% CI:1.6-2.8) times higher in Poland, as compared to urban children in the same countries (geometric means [GM]: 0.13 μg/l and 0.15 μg/l, respectively). Correspondingly, B-Pb in the "hot spot" areas was 1.8 (95% CI: 1.6-2.1) times higher than in urban areas in Slovakia and 2.3 (95% CI: 1.9-2.7) times higher in Poland (urban GM: 19.4 μg/l and 16.3 μg/l, respectively). In China and Morocco, rural children had significantly lower B-Pb than urban ones (urban GM: 64 μg/l and 71 μg/l, respectively), suggesting urban exposure from leaded petrol, water pipes and/or coal-burning. Hg "hot spot" areas in China had B-Hg 3.1 (95% CI: 2.7-3.5) times higher, and Ecuador 1.5 (95% CI: 1.2-1.9) times higher, as compared to urban areas (urban GM: 2.45 μg/l and 3.23 μg/l, respectively). Besides industrial exposure, traffic correlated with B-Cd; male sex, environmental tobacco smoke, and offal consumption with B-Pb; and fish consumption and amalgam fillings with B-Hg. However, these correlations could only marginally explain regional differences.

CONCLUSIONS: These mainly European results indicate that some children experience about doubled exposures to toxic elements just because of where they live. These exposures are unsafe, identifiable, and preventable and therefore call for preventive actions.

Place, publisher, year, edition, pages
Poland: Nofer Institute of Occupational Medicine, 2023
Keywords
biological monitoring, cadmium, child, environmental pollutants, lead, mercury
National Category
Occupational Health and Environmental Health Pediatrics
Identifiers
urn:nbn:se:umu:diva-214412 (URN)10.13075/ijomeh.1896.02139 (DOI)37681424 (PubMedID)2-s2.0-85170188858 (Scopus ID)
Available from: 2023-09-18 Created: 2023-09-18 Last updated: 2023-09-18Bibliographically approved
Lillqvist, J., Nilsson Sommar, J., Gustafsson, P. E., Glader, E.-L., Hamberg, K. & Rolandsson, O. (2023). Are doctors using more preventive medication for cardiovascular disease?: A Swedish cross-sectional study. Scandinavian Journal of Primary Health Care, 41(3), 297-305
Open this publication in new window or tab >>Are doctors using more preventive medication for cardiovascular disease?: A Swedish cross-sectional study
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2023 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 41, no 3, p. 297-305Article in journal (Refereed) Published
Abstract [en]

Background: Despite decreasing mortality from cardiovascular disease (CVD), there are persistent inequities in mortality between socioeconomic groups. Primary preventative medications reduce mortality in CVD; thus, inequitable treatments will contribute to unequal outcomes. Physicians might contribute to inequality by prescribing preventative medication for CVD to themselves in a biased manner.

Aim: To determine whether primary medications for preventing CVD were prescribed inequitably between physicians and non-physicians.

Design and setting: This retrospective study retrieved registry data on prescribed medications for all physicians in Sweden aged 45–74 years, during 2013, and for reference non-physician individuals, matched by sex, age, residence, and level of education. The outcome was any medication for preventing CVD, received at least once during 2013.

Method: Age and the sex-specific prevalence of myocardial infarction (MI) among physicians and non-physicians were used as a proxy for the need for medication. Thereafter, to limit the analysis to preventative medication, we excluded individuals that were diagnosed with CVD or diabetes. To analyse differences in medication usage between physicians and matched non-physicians, we estimated odds ratios (ORs) with conditional logistic regression and adjusted for need and household income.

Results: MI prevalences were 5.7% for men and 2.3% for women, among physicians, and 5.4% for men and 1.8% for women, among non-physicians. We included 25,105 physicians and 44,366 non-physicians. The OR for physicians receiving any CVD preventative medication, compared to non-physicians, was 1.65 (95% confidence interval 1.59–1.72).

Conclusion: We found an inequity in prescribed preventative CVD medications, which favoured physicians over non-physicians.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
cardiovascular disease, epidemiology, Healthcare inequities, pharmacoepidemiology, prevention
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-212491 (URN)10.1080/02813432.2023.2234439 (DOI)001029892800001 ()37467115 (PubMedID)2-s2.0-85165481697 (Scopus ID)
Funder
Västerbotten County Council
Available from: 2023-08-01 Created: 2023-08-01 Last updated: 2023-09-27Bibliographically approved
Nilsson Sommar, J., Segersson, D., Flanagan, E. & Oudin, A. (2023). Long-term residential exposure to source-specific particulate matter and incidence of diabetes mellitus: A cohort study in northern Sweden. Environmental Research, 217, Article ID 114833.
Open this publication in new window or tab >>Long-term residential exposure to source-specific particulate matter and incidence of diabetes mellitus: A cohort study in northern Sweden
2023 (English)In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 217, article id 114833Article in journal (Refereed) Published
Abstract [en]

Diabetes mellitus (DM) incidence have been assessed in connection with air pollution exposure in several studies; however, few have investigated associations with source-specific local emissions. This study aims to estimate the risk of DM incidence associated with source-specific air pollution in a Swedish cohort with relatively low exposure. Individuals in the Västerbotten intervention programme cohort were followed until either a DM diagnosis or initiation of treatment with glucose-lowering medication occurred. Dispersion models with high spatial resolution were used to estimate annual mean concentrations of particulate matter (PM) with aerodynamic diameter ≤10 μm (PM10) and ≤2.5 μm (PM2.5) at individual addresses. Hazard ratios were estimated using Cox regression models in relation to moving averages 1-5 years preceding the outcome. During the study period, 1479 incident cases of DM were observed during 261,703 person-years of follow-up. Increased incidence of DM was observed in association with PM10 (4% [95% CI: -54-137%] per 10 μg/m3), PM10-traffic (2% [95% CI: -6-11%] per 1 μg/m3) and PM2.5-exhaust (11% [95% CI: -39-103%] per 1 μg/m3). A negative association was found for both PM2.5 (-18% [95% CI: -99-66%] per 5 μg/m3), but only in the 2nd exposure tertile (-10% [95% CI: -25-9%] compared to the first tertile), and PM2.5-woodburning (-30% [95% CI: -49-4%] per 1 μg/m3). In two-pollutant models including PM2.5-woodburning, there was an 11% [95% CI: -11-38%], 6% [95% CI: -16-34%], 13% [95% CI: -7-36%] and 17% [95% CI: 4-41%] higher risk in the 3rd tertile of PM10, PM2.5, PM10-traffic and PM2.5-exhaust, respectively, compared to the 1st. Although the results lacked in precision they are generally in line with the current evidence detailing particulate matter air pollution from traffic as an environmental risk factor for DM.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Air pollution, Cohort, Diabetes mellitus, Exhaust, Particulate matter, Traffic emissions
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-201854 (URN)10.1016/j.envres.2022.114833 (DOI)000895272700010 ()36402182 (PubMedID)2-s2.0-85145580527 (Scopus ID)
Funder
Swedish Research Council Formas, 2017–00898
Available from: 2022-12-21 Created: 2022-12-21 Last updated: 2023-01-12Bibliographically approved
Veber, T., Pyko, A., Carlsen, H. K., Holm, M., Gislason, T., Janson, C., . . . Orru, H. (2023). Traffic noise in the bedroom in association with markers of obesity: a cross-sectional study and mediation analysis of the respiratory health in Northern Europe cohort. BMC Public Health, 23(1), Article ID 1246.
Open this publication in new window or tab >>Traffic noise in the bedroom in association with markers of obesity: a cross-sectional study and mediation analysis of the respiratory health in Northern Europe cohort
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2023 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 1246Article in journal (Refereed) Published
Abstract [en]

Background: Previous research suggests an association between road traffic noise and obesity, but current evidence is inconclusive. The aim of this study was to assess the association between nocturnal noise exposure and markers of obesity and to assess whether sleep disturbance might be a mediator in this association.

Methods: We applied data from the Respiratory Health in Northern Europe (RHINE) cohort. We used self-measured waist circumference (WC) and body mass index (BMI) as outcome values. Noise exposure was assessed as perceived traffic noise in the bedroom and/or the bedroom window’s location towards the street. We applied adjusted linear, and logistic regression models, evaluated effect modifications and conducted mediation analysis.

Results: Based on fully adjusted models we found that women, who reported very high traffic noise levels in bedroom, had 1.30 (95% CI 0.24–2.37) kg/m2 higher BMI and 3.30 (95% CI 0.39–6.20) cm higher WC compared to women, who reported no traffic noise in the bedroom. Women who reported higher exposure to road traffic noise had statistically significant higher odds of being overweight and have abdominal obesity with OR varying from 1.15 to 1.26 compared to women, who reported no traffic noise in the bedroom. For men, the associations were rather opposite, although mostly statistically insignificant. Furthermore, men, who reported much or very much traffic noise in the bedroom, had a statistically significantly lower risk of abdominal obesity. Sleep disturbance fully or partially mediated the association between noise in bedroom and obesity markers among women.

Conclusion: Our results suggest that self-reported traffic noise in the bedroom may be associated to being overweight or obese trough sleep disturbance among women, but associations were inconclusive among men.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Adiposity, Indoor, Nocturnal, Noise, Obesity, Overweight, Road Traffic, Self-reported
National Category
Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-212047 (URN)10.1186/s12889-023-16128-2 (DOI)2-s2.0-85163708638 (Scopus ID)
Available from: 2023-07-18 Created: 2023-07-18 Last updated: 2023-08-28Bibliographically approved
Nilsson Sommar, J., Norberg, M., Grönlund, C., Segersson, D., Näslund, U. & Forsberg, B. (2022). Long-term exposure to particulate air pollution and presence and progression of carotid artery plaques: A northern Sweden VIPVIZA cohort study. Environmental Research, 211, Article ID 113061.
Open this publication in new window or tab >>Long-term exposure to particulate air pollution and presence and progression of carotid artery plaques: A northern Sweden VIPVIZA cohort study
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2022 (English)In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 211, article id 113061Article in journal (Refereed) Published
Abstract [en]

AIMS: To estimate the association between long-term exposure to particulate air pollution and sub-clinical atherosclerosis based on the existence of plaque and the carotid intima-media thickness (cIMT).

METHODS: Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a randomised controlled trial integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease (CVD) prevention programme in northern Sweden. Individuals aged 40, 50, or 60 years with one or more conventional CVD risk factors in Umeå municipality were eligible to participate. The 1425 participants underwent an ultrasound assessment of cIMT and plaque formation during the period 2013-2016 and at 3-year follow-up. Source-specific annual mean concentrations of particulate matter with aerodynamic diameter ≤10 μm (PM10) and ≤2.5 μm (PM2.5), and black carbon (BC) at the individual's residential address were modelled for the calendar years 1990, 2001 and 2011. Poisson regression was used to estimate prevalence ratios for presence of carotid artery plaques, and linear regression for cIMT.

RESULTS: The plaque prevalence was 43% at baseline and 47% at follow-up. An interquartile range (IQR) increase in PM10 (range in year 2011: 7.1-13.5 μg/m3) was associated with a prevalence ratio at baseline ultrasound of 1.11 (95% CI 0.99-1.25), 1.08 (95% CI 0.99-1.17), and 1.00 (95% CI 0.93-1.08) for lag 23, 12 and 2 years, and at follow-up 1.04 (95% CI 0.95-1.14), 1.08 (95% CI 1.00-1.16), and 1.01 (95% CI 0.95-1.08). Similar prevalence ratios per IQR were found for PM2.5 and BC, but with somewhat lower precision for the later. Particle concentrations were however not associated with the progression of plaque. No cross-sectional or longitudinal associations of change were found for cIMT.

CONCLUSIONS: This study of individuals with low/moderate risk for CVD give some additional support for an effect of long-term air pollution in early subclinical atherosclerosis.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Air pollution, Atherosclerosis, Carotid artery plaques, Carotid intima-media thickness, Cohort, Longitudinal
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-192989 (URN)10.1016/j.envres.2022.113061 (DOI)000793147100003 ()35257687 (PubMedID)2-s2.0-85127332287 (Scopus ID)
Available from: 2022-03-09 Created: 2022-03-09 Last updated: 2023-09-05Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8854-498x

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