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Backman, H., Lindberg, A., Hedman, L., Stridsman, C., Jansson, S.-A., Sandström, T., . . . Rönmark, E. (2020). FEV1 decline in relation to blood eosinophils and neutrophils in a population-based asthma cohort. The World Allergy Organization journal, 13(3), Article ID 100110.
Open this publication in new window or tab >>FEV1 decline in relation to blood eosinophils and neutrophils in a population-based asthma cohort
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2020 (English)In: The World Allergy Organization journal, ISSN 1939-4551, Vol. 13, no 3, article id 100110Article in journal (Refereed) Published
Abstract [en]

Background: The relationship between lung function decline and eosinophils and neutrophils has important therapeutic implications among asthmatics, but it has rarely been studied in large cohort studies.

Objective: The aim is to study the relationship between blood eosinophils and neutrophils and FEV1 decline in a long-term follow-up of a population-based adult asthma cohort.

Methods: In 2012-2014, an adult asthma cohort was invited to a follow-up including spirometry, blood sampling, and structured interviews, and n = 892 participated (55% women, mean age 59 y, 32-92 y). Blood eosinophils, neutrophils and FEV 1 decline were analyzed both as continuous variables and divided into categories with different cut-offs. Regression models adjusted for smoking, exposure to vapors, gas, dust, or fumes (VGDF), use of inhaled and oral corticosteroids, and other possible confounders were utilized to analyze the relationship between eosinophils and neutrophils at follow-up and FEV1 decline.

Results: The mean follow-up time was 18 years, and the mean FEV 1 decline was 27 ml/year. The annual FEV1 decline was related to higher levels of both blood eosinophils and neutrophils at follow-up, but only the association with eosinophils remained when adjusted for confounders. Further, the association between FEV1 decline and eosinophils was stronger among those using ICS. With EOS <0.3 × 109/L as reference, a more rapid decline in FEV1 was independently related to EOS ≥0.4 × 109/L in adjusted analyses.

Conclusions and clinical relevance: Besides emphasizing the importance of smoking cessation and reduction of other harmful exposures, our real-world results indicate that there is an independent relationship between blood eosinophils and FEV1 decline among adults with asthma.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
ANOVA, Analysis of variance, ATS, American Thoracic Society, Asthma, BMI, Body mass index, Cohort, ECRHS, European Community Respiratory Health Survey, EOS, Eosinophils, ERS, European Respiratory Society, Eosinophils, FEV1, FEV1, Forced Expiratory Volume in 1 s, FEV1pp, FEV1 percent of predicted, FVC, Forced Expiratory Volume, GLI, Global Lung function Initiative, ICS, Inhaled corticosteroids, IgE, Immunoglobulin E, L, Liters, Ml, Milliliters, N, Number, NEU, Neutrophils, Neutrophils, OCS, Oral corticosteroids, OLIN, Obstructive Lung Disease in Northern Sweden, OLS, Ordinary Least Squares, VGDF, Vapors, gas, dust or fumes
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-169223 (URN)10.1016/j.waojou.2020.100110 (DOI)32206161 (PubMedID)
Funder
Swedish Heart Lung FoundationSwedish Research CouncilVästerbotten County CouncilNorrbotten County CouncilSwedish Asthma and Allergy AssociationVisare Norr
Available from: 2020-03-26 Created: 2020-03-26 Last updated: 2020-03-27Bibliographically approved
Irewall, T., Söderström, L., Lindberg, A. & Stenfors, N. (2020). High incidence rate of asthma among elite endurance athletes: a prospective 4-year survey. Journal of Asthma
Open this publication in new window or tab >>High incidence rate of asthma among elite endurance athletes: a prospective 4-year survey
2020 (English)In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: The prevalence of asthma among elite endurance athletes is high, but less is known about the incidence of asthma among athletes. The aim of this study was to examine the incidence rate of physician-diagnosed asthma among elite endurance athletes.

Method: An annual postal questionnaire was sent to an open prospective cohort of elite endurance athletes between 2011 and 2015. Athletes from Swedish National teams, students at universities with elite sport partnership, and pupils at Swedish National elite sport schools, competing in cross-country skiing, biathlon, ski orienteering, or orienteering were invited (n = 666). Incidence rate of physician-diagnosed asthma was calculated among those without asthma at baseline (n = 449). Risk factors for incident physician-diagnosed asthma were identified using a multivariate logistic regression analysis.

Results: Response rate was 88.7% (n = 591) at baseline. The median age of participants was 17 (range 15–36) years at inclusion. The study population included 407 (69%) skiers and 184 (31%) orienteers. The prevalence of asthma at baseline was 23.9% (n = 141). Incidence rate (95% confidence interval [CI]) of physician-diagnosed asthma was 61.2 (45.7–80.3) per 1,000 person-years. Risk factors (odds ratio [OR (95% CI)]) for incident physician-diagnosed asthma were family history of asthma (1.97 [1.04–3.68]), being a skier (3.01 [1.42–7.21]), and wheezing without having a cold (4.15 [1.81–9.26]).

Conclusion: The incidence rate of physician-diagnosed asthma is high among Swedish elite endurance athletes.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Incidence, physician-diagnosed asthma, risk factors, sport, athlete, cross-country skiing, orienteering, biathlon
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168882 (URN)10.1080/02770903.2020.1728769 (DOI)000514976900001 ()32077348 (PubMedID)
Funder
Visare Norr, 557141
Available from: 2020-03-19 Created: 2020-03-19 Last updated: 2020-03-19
Jansson, S.-A., Backman, H., Andersson, M., Telg, G., Lindberg, A., Stridsman, C., . . . Rönmark, E. (2020). Severe asthma is related to high societal costs and decreased health related quality of life. Respiratory Medicine, 162, Article ID 105860.
Open this publication in new window or tab >>Severe asthma is related to high societal costs and decreased health related quality of life
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2020 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 162, article id 105860Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The aim of the present study was to estimate the societal costs and the key cost drivers for patients with severe asthma in Sweden. In addition, health-related quality of life (HRQOL) and morbidity of patients with severe asthma is described.

METHODS: The study population comprised adults with severe asthma recruited from a large asthma cohort within the Obstructive Lung Disease in Northern Sweden (OLIN) studies. During 2017, patients were interviewed quarterly over telephone regarding their resource utilization and productivity losses.

RESULTS: Estimated mean annual asthma-related costs per patient with severe asthma amounted to €6,500, of which approximately €2400 and €4100 were direct and indirect costs, respectively. The main cost drivers for direct costs were hospitalizations followed by drugs: approximately €1000 and €800, respectively. Patients on treatment with regular oral corticosteroids (OCS) had greater direct costs compared with those without regular OCS treatment. Co-morbid conditions were common and the costs were substantial also for co-morbid conditions, with a total cost of approximately €4200. The OCS group had significantly lower HRQOL compared to the non-OCS group.

CONCLUSIONS: The societal costs due to severe asthma were substantial. Costs for co-morbid conditions contributed substantially to both direct and indirect costs. The direct costs were significantly higher in the maintenance OCS-group compared to the non-maintenance OCS-group. These results indicate a need for improved management and treatment regimens for patients with severe asthma.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Costs, Health-related quality of life, Oral corticosteroids, Severe asthma
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168152 (URN)10.1016/j.rmed.2019.105860 (DOI)000512923100011 ()32056670 (PubMedID)
Available from: 2020-02-18 Created: 2020-02-18 Last updated: 2020-03-20Bibliographically approved
Backman, H., Stridsman, C., Hedman, L., Lindberg, A., Andersson, M., Lundback, B. & Rönmark, E. (2019). Characterization of adults with asthma per GINA treatment steps. Paper presented at European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.. European Respiratory Journal, 54
Open this publication in new window or tab >>Characterization of adults with asthma per GINA treatment steps
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sheffield: European Respiratory Society Journals, 2019
Keywords
Asthma, Asthma - management, Spirometry
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168197 (URN)10.1183/13993003.congress-2019.PA4417 (DOI)000507372405429 ()
Conference
European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.
Note

Supplement: 63. Meeting Abstract: PA4417.

Available from: 2020-03-11 Created: 2020-03-11 Last updated: 2020-03-11Bibliographically approved
Hedman, L., Backman, H., Stridsman, C., Lindberg, A., Lundback, B. & Rönmark, E. (2019). E-cigarette use is most common in persistent smokers in a Swedish prospective population study. Paper presented at European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.. European Respiratory Journal, 54
Open this publication in new window or tab >>E-cigarette use is most common in persistent smokers in a Swedish prospective population study
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sheffield: European Respiratory Society Journals, 2019
Keywords
Adults, Smoking
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168191 (URN)10.1183/13993003.congress-2019.OA3313 (DOI)000507372400230 ()
Conference
European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.
Note

Supplement: 63. Meeting Abstract: OA3313.

Available from: 2020-03-12 Created: 2020-03-12 Last updated: 2020-03-12Bibliographically approved
Bals, R., Boyd, J., Esposito, S., Foronjy, R., Hiemstra, P. S., Jimenez-Ruiz, C. A., . . . Blasi, F. (2019). Electronic cigarettes: a task force report from the European Respiratory Society. European Respiratory Journal, 53(2), Article ID 1801151.
Open this publication in new window or tab >>Electronic cigarettes: a task force report from the European Respiratory Society
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 53, no 2, article id 1801151Article in journal (Refereed) Published
Abstract [en]

There is a marked increase in the development and use of electronic nicotine delivery systems or electronic cigarettes (ECIGs). This statement covers electronic cigarettes (ECIGs), defined as "electrical devices that generate an aerosol from a liquid" and thus excludes devices that contain tobacco. Database searches identified published articles that were used to summarise the current knowledge on the epidemiology of ECIG use; their ingredients and accompanied health effects; second-hand exposure; use of ECIGs for smoking cessation; behavioural aspects of ECIGs and social impact; in vitro and animal studies; and user perspectives. ECIG aerosol contains potentially toxic chemicals. As compared to conventional cigarettes, these are fewer and generally in lower concentrations. Second-hand exposures to ECIG chemicals may represent a potential risk, especially to vulnerable populations. There is not enough scientific evidence to support ECIGs as an aid to smoking cessation due to a lack of controlled trials, including those that compare ECIGs with licenced stop-smoking treatments. So far, there are conflicting data that use of ECIGs results in a renormalisation of smoking behaviour or for the gateway hypothesis. Experiments in cell cultures and animal studies show that ECIGs can have multiple negative effects. The long-term effects of ECIG use are unknown, and there is therefore no evidence that ECIGs are safer than tobacco in the long term. Based on current knowledge, negative health effects cannot be ruled out.

Place, publisher, year, edition, pages
EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-157537 (URN)10.1183/13993003.01151-2018 (DOI)000460312500018 ()30464018 (PubMedID)
Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-03-26Bibliographically approved
Lagrange, E., Nilsson, U., Hedman, L., Stridsman, C., Backman, H., Lindberg, A. & Blomberg, A. (2019). Elevated hsCRP is associated with respiratory symptoms in COPD. Paper presented at European-Respiratory-Society (ERS) International Congress, Madrid, Spain, SEP 28-OCT 02, 2019.. European Respiratory Journal, 54
Open this publication in new window or tab >>Elevated hsCRP is associated with respiratory symptoms in COPD
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sheffield: European Respiratory Society Journals, 2019
Keywords
COPD, Biomarkers, Inflammation
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168221 (URN)10.1183/13993003.congress-2019.PA4430 (DOI)000507372405441 ()
Conference
European-Respiratory-Society (ERS) International Congress, Madrid, Spain, SEP 28-OCT 02, 2019.
Note

Supplement: 63. Meeting Abstract: PA4430.

Available from: 2020-02-26 Created: 2020-02-26 Last updated: 2020-02-26Bibliographically approved
Sandin, P., Johansson, S., Backman, H., Blomberg, A., Lindgren, L., Lindberg, A. & Nilsson, U. (2019). Elevated serum high sensitive cardiac Troponin I is associated with mortality among adults with Restrictive Spirometric Pattern. Paper presented at European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.. European Respiratory Journal, 54
Open this publication in new window or tab >>Elevated serum high sensitive cardiac Troponin I is associated with mortality among adults with Restrictive Spirometric Pattern
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sheffield: European Respiratory Society Journals, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168161 (URN)10.1183/13993003.congress-2019.PA2807 (DOI)000507372403304 ()
Conference
European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.
Note

Supplement: 63. Meeting Abstract: PA2807.

Available from: 2020-03-18 Created: 2020-03-18 Last updated: 2020-03-18Bibliographically approved
Jansson, S.-A., Hedman, L., Stridsman, C., Axelsson, M., Kriit, H. K., Lindberg, A., . . . Backman, H. (2019). Life-years lost due to asthma. Paper presented at European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.. European Respiratory Journal, 54
Open this publication in new window or tab >>Life-years lost due to asthma
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sheffield: European Respiratory Society Journals, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168184 (URN)10.1183/13993003.congress-2019.PA5063 (DOI)000507372406417 ()
Conference
European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.
Note

Supplement: 63. Meeting Abstract: PA5063.

Available from: 2020-03-12 Created: 2020-03-12 Last updated: 2020-03-12Bibliographically approved
Schyllert, C., Hedman, L., Stridsman, C., Ilmarinen, P., Piirilä, P., Krokstad, S., . . . Backman, H. (2019). Low income rather than low education is associated with respiratory symptoms in northern Sweden. Paper presented at European-Respiratory-Society (ERS) International Congress, Madrid, Spain, SEP 28-OCT 02, 2019.. European Respiratory Journal, 54
Open this publication in new window or tab >>Low income rather than low education is associated with respiratory symptoms in northern Sweden
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sheffield: European Respiratory Society Journals, 2019
Keywords
Wheezing, Cough, Environment
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168211 (URN)10.1183/13993003.congress-2019.PA2779 (DOI)000507372403278 ()
Conference
European-Respiratory-Society (ERS) International Congress, Madrid, Spain, SEP 28-OCT 02, 2019.
Note

Supplement: 63. Meeting Abstract: PA2779.

Available from: 2020-02-27 Created: 2020-02-27 Last updated: 2020-02-27Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-3292-7471

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