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Donat-Vargas, C., Bergdahl, I. A., Tornevi, A., Wennberg, M., Sommar, J., Koponen, J., . . . Åkesson, A. (2019). Associations between repeated measure of plasma perfluoroalkyl substances and cardiometabolic risk factors. Environment International, 124, 58-65
Open this publication in new window or tab >>Associations between repeated measure of plasma perfluoroalkyl substances and cardiometabolic risk factors
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 124, p. 58-65Article in journal (Refereed) Published
Abstract [en]

Background: Perfluoroalkyl substances (PFAS) are persistent synthetic chemicals that may affect components of metabolic risk through the peroxisome proliferator-activated receptor but epidemiological data remain scarce and inconsistent.

Objective: To estimate associations between repeated measurements of the main PFAS in plasma and total cholesterol, triglycerides and hypertension among the control subjects from a population-based nested case-control study on diabetes type 2 in middle-aged women and men.

Methods: Participants (n = 187) were free of diabetes at both baseline and follow-up visits to the Västerbotten Intervention Programme, 10 years apart: during 1990 to 2003 (baseline) and 2001 to 2013 (follow-up). Participants left blood samples, completed questionnaires on diet and lifestyle factors, and underwent medical examinations, including measurement of blood pressure. PFAS and lipids were later determined in stored plasma samples. Associations for the repeated measurements were assessed using generalized estimating equations.

Results: Six PFAS exceeded the limit of quantitation. Repeated measures of PFAS in plasma, cardiometabolic risk factors and confounders, showed an average decrease of triglycerides from −0.16 mmol/l (95% confidence interval [CI]: −0.33, 0.02 for PFOA) to −0.26 mmol/l (95% CI: −0.50, −0.08 for PFOS), when comparing the highest tertile of PFAS plasma levels with the lowest. Associations based on average PFAS measurements and follow-up triglycerides revealed similar inverse associations, although attenuated. The estimates for cholesterol and hypertension were inconsistent and with few exception non-significant.

Conclusions: This study found inverse associations between PFAS and triglycerides, but did not support any clear link with either cholesterol or hypertension.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Cardiometabolic risk factors, Environmental epidemiology, Hypertension, Lipids, Plasma perfluoroalkyl substances, Prospective assessment, Repeated measurements
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-156228 (URN)10.1016/j.envint.2019.01.007 (DOI)000457122700007 ()30639908 (PubMedID)2-s2.0-85059696116 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-0758Västerbotten County CouncilSwedish Research Council, 2017-00822
Available from: 2019-02-08 Created: 2019-02-08 Last updated: 2019-02-22Bibliographically approved
Tornevi, A., Sommar, J., Rantakokko, P., Åkesson, A., Donat-Vargas, C., Kiviranta, H., . . . Bergdahl, I. A. (2019). Chlorinated persistent organic pollutants and type 2 diabetes - A population-based study with pre- and post- diagnostic plasma samples. Environmental Research, 174, 35-45
Open this publication in new window or tab >>Chlorinated persistent organic pollutants and type 2 diabetes - A population-based study with pre- and post- diagnostic plasma samples
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2019 (English)In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 174, p. 35-45Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Persistent organic pollutants (POPs) have been associated with type 2 diabetes (T2D), but causality is uncertain.

OBJECTIVE: Within longitudinal population-based data from northern Sweden, we assessed how POPs associated with T2D prospectively and cross-sectionally, and further investigated factors related to individual changes in POP concentrations.

METHODS: For 129 case-controls pairs matched by age, sex and date of sampling, plasma concentrations of hexachlorobenzene (HCB), dichlorodiphenyl-dichloroethylene (p,p'-DDE), dioxin-like (DL) polychlorinated biphenyl congeners (PCB-118 and PCB-156), and non-dioxin like (NDL-PCB: PCB-74, -99, -138 -153, -170, -180, -183 and PCB-187) were analyzed twice (baseline and follow-up, 9-20 years apart). The cases received their T2D diagnose between baseline and follow-up. Prospective (using baseline data) and cross-sectional (using follow-up data) odds ratios (ORs) for T2D on lipid standardized POPs (HCB, p,p'-DDE, ∑DL-PCBs, ∑NDL-PCBs) were estimated using conditional logistic regression, adjusting for body mass index (BMI) and plasma lipids. The influence of BMI, weight-change, and plasma lipids on longitudinal changes in POP concentrations were evaluated among non-diabetic individuals (n = 306).

RESULTS: POPs were associated with T2D in both the prospective and cross-sectional assessments. Of a standard deviation increase in POPs, prospective ORs ranged 1.42 (95% CI: 0.99, 2.06) for ∑NDL-PCBs to 1.55 (95% CI: 1.01, 2.38) for HCB (p < 0.05 only for HCB), and cross-sectional ORs ranged 1.62 (95% CI: 1.13; 2.32) for p,p'-DDE to 2.06 (95% CI: 1.29, 3.28) for ∑DL-PCBs (p < 0.05 for all POPs). In analyses of non-diabetic individuals, higher baseline BMI, decreased weight and decreased plasma lipid concentrations were associated with a slower decrease of POPs. Cases had, besides a higher BMI, reduced cholesterol and weight gain at follow-up compared to controls, which can explain the higher ORs in the cross-sectional assessments.

DISCUSSION: The association between POPs and T2D was confirmed, but an indication that individuals body fat history might influence POP-T2D associations weakens the epidemiological support for a causal association. It also warrants studies based on other exposure metrics than biomonitoring. In addition, we note that a cross-sectional design overestimates the ORs if T2D cases have successfully intervened on weight and/or blood lipids, as changes in these factors cause changes in POPs.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Biomonitoring, Longitudinal data, POPs, Polychlorinated biphenyl congeners, Type 2 diabetes
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-158688 (URN)10.1016/j.envres.2019.04.017 (DOI)000470801100005 ()31029940 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-0758Swedish Research Council, VR 2017-00650
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-07-10Bibliographically approved
Wang, J., Pindus, M., Janson, C., Sigsgaard, T., Kim, J.-L., Holm, M., . . . Norbäck, D. (2019). Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis. European Respiratory Journal, 53(5), Article ID 1801921.
Open this publication in new window or tab >>Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 53, no 5, article id 1801921Article in journal (Refereed) Published
Abstract [en]

THE QUESTION ADDRESSED BY THE STUDY: Is dampness and indoor mould associated with onset and remission of respiratory symptoms, asthma and rhinitis among adults?

MATERIALS AND METHODS: Associations between dampness, mould and mould odour at home and at work and respiratory health were investigated in cohort of 11 506 adults from Iceland, Norway, Sweden, Denmark and Estonia. They answered a questionnaire at baseline and ten years later, with questions on respiratory health, home and work environment.

RESULTS: Baseline water damage, floor dampness, mould and mould odour at home were associated with onset of respiratory symptoms and asthma (ORs from 1.23 to 2.24). Dampness at home during follow up was associated with onset of respiratory symptoms, asthma and rhinitis (ORs from 1.21 to 1.52). Dampness at work during follow up was associated with onset of respiratory symptoms, asthma and rhinitis (ORs from 1.31 to 1.50). Combined dampness at home and at work increased the risk of onset of respiratory symptoms and rhinitis. Dampness and mould at home and at work decreased remission of respiratory symptoms and rhinitis.

THE ANSWER TO THE QUESTION: Dampness and mould at home and at work can increase onset of respiratory symptoms, asthma and rhinitis, and decrease remission.

Place, publisher, year, edition, pages
European Respiratory Society, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-157885 (URN)10.1183/13993003.01921-2018 (DOI)000470244000010 ()30880288 (PubMedID)
Funder
Swedish Heart Lung FoundationForte, Swedish Research Council for Health, Working Life and WelfareAFA Insurance, 467801100
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2019-06-20Bibliographically approved
Kriit, H. K., Stewart Williams, J., Lindholm, L., Forsberg, B. & Sommar, J. (2019). Health economic assessment of a scenario to promote bicycling as active transport in Stockholm, Sweden. BMJ Open, 9(9), Article ID e030466.
Open this publication in new window or tab >>Health economic assessment of a scenario to promote bicycling as active transport in Stockholm, Sweden
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 9, article id e030466Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To conduct a health economic evaluation of a proposed investment in urban bicycle infrastructure in Stockholm County, Sweden.

DESIGN: A cost-effectiveness analysis is undertaken from a healthcare perspective. Investment costs over a 50-year life cycle are offset by averted healthcare costs and compared with estimated long-term impacts on morbidity, quantified in disability-adjusted life years (DALYs). The results are re-calculated under different assumptions to model the effects of uncertainty.

SETTING: The Municipality of Stockholm (population 2.27 million) committed funds for bicycle path infrastructure with the aim of achieving a 15% increase in the number of bicycle commuters by 2030. This work is based on a previously constructed scenario, in which individual registry data on home and work address and a transport model allocation to different modes of transport identified 111 487 individuals with the physical capacity to bicycle to work within 30 min but that currently drive a car to work.

RESULTS: Morbidity impacts and healthcare costs attributed to increased physical activity, change in air pollution exposure and accident risk are quantified under the scenario. The largest reduction in healthcare costs is attributed to increased physical activity and the second largest to reduced air pollution exposure among the population of Greater Stockholm. The expected net benefit from the investment is 8.7% of the 2017 Stockholm County healthcare budget, and 3.7% after discounting. The economic evaluation estimates that the intervention is cost-effective and each DALY averted gives a surplus of €9933. The results remained robust under varied assumptions pertaining to reduced numbers of additional bicycle commuters.

CONCLUSION: Investing in urban infrastructure to increase bicycling as active transport is cost-effective from a healthcare sector perspective.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
DALY, commuting, health economic evaluation, health impacts, transport mode shift
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-163491 (URN)10.1136/bmjopen-2019-030466 (DOI)31530609 (PubMedID)
Available from: 2019-09-23 Created: 2019-09-23 Last updated: 2019-09-26Bibliographically approved
Lu, S. S., Stewart Williams, J. & Nilsson Sommar, J. (2019). Inequalities in early childhood mortality in Myanmar: Association between parents' socioeconomic status and early childhood mortality. Global Health Action, 12(1), Article ID 1603516.
Open this publication in new window or tab >>Inequalities in early childhood mortality in Myanmar: Association between parents' socioeconomic status and early childhood mortality
2019 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, no 1, article id 1603516Article in journal (Refereed) Published
Abstract [en]

Background: Despite global achievements in reducing early childhood mortality, disparities remain. There have been empirical studies of inequalities conducted in low- and middle-income countries. However, there have been no epidemiological studies on socioeconomic inequalities and early childhood survival in Myanmar.

Objective: To estimate associations between two measures of parental socioeconomic status - household wealth and education - and age-specific early childhood mortality in Myanmar.

Methods: Using cross-sectional data obtained from the Myanmar Demographic Health Survey (2015-2016), univariate and multiple logistic regressions were performed to investigate associations between household wealth and highest attained parental education, and under-5, neonatal, post-neonatal and child mortality. Data for 10,081 children born to 5,932 married women (aged 15-49 years) 10 years prior to the survey, were analysed.

Results: Mortality during the first five years was associated with household wealth. In multiple logistic models, wealth was protective for post-neonatal mortality. After adjusting for individual proximate determinants, the odds of post-neonatal mortality in the richest households were 85% lower (95% CI: 50-96%) than in the poorest households. However, significant association was not found between wealth and neonatal mortality. Parental education was important for early childhood mortality; the highest benefit from parental education was for child mortality in the one- to five-year age bracket. After adjusting for proximate determinants, children with a higher educated parent had 95% (95% CI 77-99%) lower odds of death in this age group compared with children whose parents' highest educational attainment was at primary level. The association between parental education and neonatal mortality was not significant.

Conclusions: In Myanmar, household wealth and parental education are important for childhood survival before five years of age. This study identified nuanced age-related differences in associations. Health policy must take socioeconomic determinants into account in order to address unfair inequalities in early childhood mortality.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
Keywords
Household wealth, parental education, neonatal mortality, post-neonatal mortality, under-5 mortality
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-159641 (URN)10.1080/16549716.2019.1603516 (DOI)000467824000001 ()31066344 (PubMedID)
Available from: 2019-06-03 Created: 2019-06-03 Last updated: 2019-12-06Bibliographically approved
Ljungman, P. L., Andersson, N., Stockfelt, L., Andersson, E. M., Sommar, J., Eneroth, K., . . . Pershagen, G. (2019). Long-Term Exposure to Particulate Air Pollution, Black Carbon, and Their Source Components in Relation to Ischemic Heart Disease and Stroke. Journal of Environmental Health Perspectives, 127(10), Article ID 107012.
Open this publication in new window or tab >>Long-Term Exposure to Particulate Air Pollution, Black Carbon, and Their Source Components in Relation to Ischemic Heart Disease and Stroke
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2019 (English)In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 127, no 10, article id 107012Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Long-term exposure to particulate matter (PM) in ambient air has been associated with cardiovascular mortality, but few studies have considered incident disease in relation to PM from different sources.

OBJECTIVES: We aimed to study associations between long-term exposure to different types of PM and sources, and incident ischemic heart disease (IHD) and stroke in three Swedish cities.

METHODS: ), and black carbon (BC) from road wear, traffic exhaust, residential heating, and other sources in Gothenburg, Stockholm, and Umeå. Registry data for participants from four cohorts were used to obtain incidence of IHD and stroke for first hospitalization or death. We constructed time windows of exposure for same-year, 1- to 5-y, and 6- to 10-y averages preceding incidence from annual averages at residential addresses. Risk estimates were based on random effects meta-analyses of cohort-specific Cox proportional hazard models.

RESULTS: exposure from residential heating.

DISCUSSION: Few consistent associations were observed between different particulate components and IHD or stroke. However, long-term residential exposure to locally emitted BC from traffic exhaust was associated with stroke incidence. The comparatively low exposure levels may have contributed to the paucity of associations.

Place, publisher, year, edition, pages
Durham: National Institute of Environmental Health Sciences, 2019
National Category
Occupational Health and Environmental Health Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-164779 (URN)10.1289/EHP4757 (DOI)31663781 (PubMedID)
Available from: 2019-11-01 Created: 2019-11-01 Last updated: 2019-11-06Bibliographically approved
Shirdel, M., Bergdahl A., I., Andersson, B. M., Wingfors, H., Sommar, J. N. & Liljelind, I. E. (2019). Passive personal air sampling of dust in a working environment: A pilot study. Journal of Occupational and Environmental Hygiene, 16(10), 675-684
Open this publication in new window or tab >>Passive personal air sampling of dust in a working environment: A pilot study
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2019 (English)In: Journal of Occupational and Environmental Hygiene, ISSN 1545-9624, E-ISSN 1545-9632, Vol. 16, no 10, p. 675-684Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to make a preliminary evaluation of the University of North Carolina passive aerosol sampler (UNC sampler) for personal air sampling of particles. Nine personal air samplings of respirable fraction were conducted in an open-pit mine, with pairwise UNC samplers and a respirable cyclone mounted on the chest of workers. UNC samples were analyzed with scanning electron microscopy (SEM) and to some extent energy dispersive X-ray spectroscopy (EDS). Respirable cyclone filter samples were weighed. Correlations and particle elemental compositions were described. Microscopic imaging of the collection surface showed that the particles were heterogeneously deposited across the surface of the UNC sampler. Collected particles were shaped as gravel particles and the resulting particle size distribution in air showed a peak at ca. 3 µm aerodynamic diameter, similarly to what has previously been reported from the same mine. The elemental composition indicated mineral origin. All correlations between the airborne mass concentrations from UNC samplers and respirable cyclones (Pearson = 0.54 and Spearman = 0.43) and between pairs of parallel UNC samplers (Pearson = 0.55 and Spearman = 0.67) were weak. The UNC sampler mass concentrations were approximately 30 times higher than those measured with the respirable cyclone. In conclusion, the UNC sampler, when used for personal sampling in a mine, provides a reasonable particle size distribution and the deposited particles appeared to be of mineral origin and not from textile or skin but the approximately 30-fold overestimation of mass concentrations when comparing with respirable cyclone sampling indicates that further improvements are necessary. Positioning of the sampler may be critical and moving the UNC sampler from the chest to e.g. the top of a helmet might be an improvement. Grounding of the sampler in order to avoid static electricity might also be useful. The UNC sampler should continue to be researched for personal sampling, as passive sampling might become a useful alternative to more laborious sampling techniques.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
Keywords
Area factor, UNC passive aerosol sampler, mesh factor, mineral, occupational exposure, respirable cyclone
National Category
Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-162647 (URN)10.1080/15459624.2019.1648814 (DOI)000490322700001 ()31442106 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-0478
Available from: 2019-08-26 Created: 2019-08-26 Last updated: 2019-11-05Bibliographically approved
Donat-Vargas, C., Bergdahl, I., Tornevi, A., Wennberg, M., Sommar, J., Kiviranta, H., . . . Akesson, A. (2019). Perfluoroalkyl substances and risk of type II diabetes: A prospective nested case-control study. Environment International, 123, 390-398
Open this publication in new window or tab >>Perfluoroalkyl substances and risk of type II diabetes: A prospective nested case-control study
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 123, p. 390-398Article in journal (Refereed) Published
Abstract [en]

Background: Perfluoroalkyl substances (PFAS) have drawn much attention due to bioaccumulation potential and their current omnipresence in human blood. We assessed whether plasma PFAS, suspected to induce endocrine-disrupting effects, were prospectively associated with clinical type 2 diabetes (T2D) risk.

Methods: We established a nested case-control study within the Swedish prospective population-based Västerbotten Intervention Programme cohort. Several PFAS were measured in plasma from a subset of 124 case-control pairs at baseline (during 1990–2003) and at 10-year follow-up. T2D cases were matched (1:1) according to gender, age and sample date with participants without T2D (controls).

Conditional logistic regressions were used to prospectively assess risk of T2D by baseline PFAS plasma concentrations. Associations between long-term PFAS plasma levels (mean of baseline and follow-up) and insulin resistance (HOMA2-IR) and beta-cell function (HOMA2-B%) at follow-up were prospectively explored among 178 and 181 controls, respectively, by multivariable linear regressions.

Results: After adjusting for gender, age, sample year, diet and body mass index, the odds ratio of T2D for the sum of PFAS (Σ z-score PFAS) was 0.52 (95% confidence interval, CI: 0.20, 1.36), comparing third with first tertile; and 0.92 (95% CI: 0.84, 1.00) per one standard deviation increment of sum of log-transformed PFAS. Among the controls, the adjusted β of HOMA2-IR and HOMA-B% for the sum of PFAS were −0.26 (95% CI: −0.52, −0.01) and −9.61 (95% CI: −22.60, 3.39) respectively comparing third with first tertile.

Conclusions: This prospective nested case-control study yielded overall inverse associations between individual PFAS and risk of T2D, although mostly non-significant. Among participants without T2D, long-term PFAS exposure was prospectively associated with lower insulin resistance.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Environmental contaminants, Plasma perfluoroalkyl substances, Environmental risk factors, Diabetes, Insulin resistance, Endocrine disruption, Environmental epidemiology, Nested case-control study, Prospective assessment
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-155947 (URN)10.1016/j.envint.2018.12.026 (DOI)000455532500044 ()30622063 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-0758Västerbotten County Council, 2017-00822Swedish Research Council
Available from: 2019-02-08 Created: 2019-02-08 Last updated: 2019-02-08Bibliographically approved
Nagel, G., Stafoggia, M., Pedersen, M., Andersen, Z. J., Galassi, C., Munkenast, J., . . . Weinmayr, G. (2018). Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE). International Journal of Cancer, 143(7), 1632-1643
Open this publication in new window or tab >>Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE)
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2018 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 143, no 7, p. 1632-1643Article in journal (Refereed) Published
Abstract [en]

Air pollution has been classified as carcinogenic to humans. However, to date little is known about the relevance for cancersof the stomach and upper aerodigestive tract (UADT). We investigated the association of long-term exposure to ambient airpollution with incidence of gastric and UADT cancer in 11 European cohorts. Air pollution exposure was assigned by land-useregression models for particulate matter (PM) below 10mm (PM10), below 2.5mm (PM2.5), between 2.5 and 10mm (PMcoarse),PM2.5absorbance and nitrogen oxides (NO2and NOX) as well as approximated by traffic indicators. Cox regression modelswith adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined withrandom effects meta-analyses. During average follow-up of 14.1 years of 305,551 individuals, 744 incident cases of gastriccancer and 933 of UADT cancer occurred. The hazard ratio for an increase of 5mg/m3of PM2.5was 1.38 (95% CI 0.99; 1.92)for gastric and 1.05 (95% CI 0.62; 1.77) for UADT cancers. No associations were found for any of the other exposures consid-ered. Adjustment for additional confounders and restriction to study participants with stable addresses did not influencemarkedly the effect estimate for PM2.5and gastric cancer. Higher estimated risks of gastric cancer associated with PM2.5wasfound in men (HR 1.98 [1.30; 3.01]) as compared to women (HR 0.85 [0.5; 1.45]). This large multicentre cohort study showsan association between long-term exposure to PM2.5and gastric cancer, but not UADT cancers, suggesting that air pollutionmay contribute to gastric cancer risk.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
ESCAPE, air pollution, epidemiology, gastric cancer, upper aerodigestive tract cancer
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-147272 (URN)10.1002/ijc.31564 (DOI)000443392100009 ()29696642 (PubMedID)
Available from: 2018-05-02 Created: 2018-05-02 Last updated: 2018-11-05Bibliographically approved
Raza, W., Forsberg, B., Johansson, C. & Nilsson Sommar, J. (2018). Air pollution as a risk factor in health impact assessments of a travel mode shift towards cycling. Global Health Action, 11(1), Article ID 1429081.
Open this publication in new window or tab >>Air pollution as a risk factor in health impact assessments of a travel mode shift towards cycling
2018 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 11, no 1, article id 1429081Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Promotion of active commuting provides substantial health and environmental benefits by influencing air pollution, physical activity, accidents, and noise. However, studies evaluating intervention and policies on a mode shift from motorized transport to cycling have estimated health impacts with varying validity and precision.

OBJECTIVE: To review and discuss the estimation of air pollution exposure and its impacts in health impact assessment studies of a shift in transport from cars to bicycles in order to guide future assessments.

METHODS: A systematic database search of PubMed was done primarily for articles published from January 2000 to May 2016 according to PRISMA guidelines.

RESULTS: We identified 18 studies of health impact assessment of change in transport mode. Most studies investigated future hypothetical scenarios of increased cycling. The impact on the general population was estimated using a comparative risk assessment approach in the majority of these studies, whereas some used previously published cost estimates. Air pollution exposure during cycling was estimated based on the ventilation rate, the pollutant concentration, and the trip duration. Most studies employed exposure-response functions from studies comparing background levels of fine particles between cities to estimate the health impacts of local traffic emissions. The effect of air pollution associated with increased cycling contributed small health benefits for the general population, and also only slightly increased risks associated with fine particle exposure among those who shifted to cycling. However, studies calculating health impacts based on exposure-response functions for ozone, black carbon or nitrogen oxides found larger effects attributed to changes in air pollution exposure.

CONCLUSION: A large discrepancy between studies was observed due to different health impact assessment approaches, different assumptions for calculation of inhaled dose and different selection of dose-response functions. This kind of assessments would improve from more holistic approaches using more specific exposure-response functions.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Active commuting, mode shift, emission factors, population exposure, commuters’ exposure, exposure response function, comparative risk assessment
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-144660 (URN)10.1080/16549716.2018.1429081 (DOI)000424246900001 ()29400262 (PubMedID)
Available from: 2018-02-09 Created: 2018-02-09 Last updated: 2018-06-09Bibliographically approved
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