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Eriksson, Kåre
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Andersson, M., Backman, H., Nordberg, G., Hagenbjörk, A., Hedman, L., Eriksson, K., . . . Rönmark, E. (2018). Early life swimming pool exposure and asthma onset in children: a case-control study. Environmental health, 17, Article ID 34.
Open this publication in new window or tab >>Early life swimming pool exposure and asthma onset in children: a case-control study
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2018 (English)In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 17, article id 34Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Trichloramine exposure in indoor swimming pools has been suggested to cause asthma in children. We aimed to investigate the risk of asthma onset among children in relation to individual trichloramine exposure.

METHODS: A longitudinal nested case-control study of 337 children with asthma (cases) and 633 controls aged 16-17 years was performed within a population-based cohort from The Obstructive Lung Disease in Northern Sweden studies (OLIN). Year of asthma onset and exposure time at different ages were obtained in telephone interviews. Trichloramine concentrations in the pool buildings were measured. Skin prick test results for inhalant allergens were available from previous examinations of the cohort. The risk for asthma was analyzed in relation to the cumulative trichloramine exposure before onset of asthma.

RESULTS: Swimming pool exposure in early life was associated with a significantly higher risk of pre-school asthma onset. A dose-response relationship between swimming pool exposure and asthma was indicated in children with asthma onset at 1 year of age. Children who were both sensitized and exposed had a particularly high risk.

CONCLUSIONS: Early life exposure to chlorinated swimming pool environments was associated with pre-school asthma onset.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Asthma, Children, Swimming, Trichloramine
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-146654 (URN)10.1186/s12940-018-0383-0 (DOI)000429733700001 ()29642932 (PubMedID)
Available from: 2018-04-16 Created: 2018-04-16 Last updated: 2018-06-09Bibliographically approved
Eriksson, K., Bryngelsson, I.-L. & Hagström, K. (2017). Temporal Trend in Wood Dust Exposure During the Production of Wood Pellets. Annals of work exposures and health, 61(4), 429-439
Open this publication in new window or tab >>Temporal Trend in Wood Dust Exposure During the Production of Wood Pellets
2017 (English)In: Annals of work exposures and health, ISSN 2398-7316, Vol. 61, no 4, p. 429-439Article in journal (Refereed) Published
Abstract [en]

Objective: Wood dust data collected in the production of wood pellets during 2001 to 2013 were evaluated to study a temporal trend in inhalation exposure.

Methods: A linear mixed effects model of natural ln-transformed data was used to express the relative annual difference in inhalation wood dust exposure.

Results: There was an annual decrease of -20.5% of the geometric mean wood dust exposure during 2001 until 2013. The results were based on 617 inhalable dust samples collected at 14 different production units. The exposure to wood dust at the industrial premises investigated has decreased from a relatively high level of 6.4 mg m-3 in 2001 to 1.0 mg-3 in 2013. The Swedish Occupational Exposure Limit (SOEL) of 2 mg m-3 may still be exceeded.

Conclusion: Analysis of the temporal trend in soft wood production units revealed declines in exposure of 20.5% per annum. It is important that precautions are taken to protect workers from a hazardous exposure to wood dust at the premises as the SOEL of 2 mg m-3 at some occasions is still exceeded. Additional measurements of wood dust exposure should be carried out on a regular basis in wood pellet production units in Sweden as well in other countries.

Keywords
analysis, dust, model, mixed, wood
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-133309 (URN)10.1093/annweh/wxx019 (DOI)000410530600006 ()28355460 (PubMedID)
Available from: 2017-04-04 Created: 2017-04-04 Last updated: 2018-06-09Bibliographically approved
Hagström, K., Schlünssen, V. & Eriksson, K. (2016). Exposure to softwood dust in the wood industry (30ed.). In: Series Editor D. Barcelo; Volume Editors Miguel de la Guardia, Sergio Armenta (Ed.), The quality of air: (pp. 801-823). Amsterdam: Elsevier
Open this publication in new window or tab >>Exposure to softwood dust in the wood industry
2016 (English)In: The quality of air / [ed] Series Editor D. Barcelo; Volume Editors Miguel de la Guardia, Sergio Armenta, Amsterdam: Elsevier, 2016, 30, p. 801-823Chapter in book (Other academic)
Place, publisher, year, edition, pages
Amsterdam: Elsevier, 2016 Edition: 30
Series
Comprehensive analytical chemistry, ISSN 0166-526X ; 73
Keywords
Determinants of exposure, Inhalable dust, Personal exposure measurements, Variation in exposure, Wood dust, Wood industry
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-124895 (URN)978-0-444-63605-8 (ISBN)978-0-444-63606-5 (ISBN)
Available from: 2016-08-30 Created: 2016-08-30 Last updated: 2018-06-07Bibliographically approved
Löfstedt, H., Westerlund, J., Graff, P., Bryngelsson, I., Mölleby, G., Olin, A., . . . Westberg, H. (2016). Respiratory and Ocular Symptoms Among Employees at Swedish Indoor Swimming Pools. Journal of Occupational and Environmental Medicine, 58(12), 1190-1195
Open this publication in new window or tab >>Respiratory and Ocular Symptoms Among Employees at Swedish Indoor Swimming Pools
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2016 (English)In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 58, no 12, p. 1190-1195Article in journal (Refereed) Published
Abstract [en]

Background: This study investigated trichloramine exposure and prevalence of respiratory and ocular symptoms among Swedish indoor swimming pool workers.

Methods: Questionnaires were distributed to pool workers and referents. Lung function and fraction of exhaled nitric oxide (FeNO) were measured before and after work. Exposure to trichloramine and trihalomethanes was measured over work shifts.

Results: The mean personal trichloramine exposure was 36 μg/m3. Significantly more exposed workers reported ocular and nasal symptoms. There were significant differences between groups in FeNO change following work, with exposed showing increased FeNO, which grew when analyses included only nonsmokers.

Conclusions: The findings indicate that indoor swimming pool environments may have irritating effects on mucous membranes. FeNO data also indicate an inflammatory effect on central airways, but the clinical relevance is unclear. Low trichloramine levels found in this study were not associated with health effects.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-128843 (URN)10.1097/JOM.0000000000000883 (DOI)000390238500008 ()
Available from: 2016-12-16 Created: 2016-12-16 Last updated: 2018-06-09Bibliographically approved
Westerlund, J., Graff, P., Bryngelsson, I.-L., Westberg, H., Eriksson, K. & Löfstedt, H. (2015). Occupational exposure to trichloramine and trihalomethanes in Swedish indoor swimming pools: evaluation of personal and stationary monitoring. Annals of Occupational Hygiene, 59(8), 1074-1084
Open this publication in new window or tab >>Occupational exposure to trichloramine and trihalomethanes in Swedish indoor swimming pools: evaluation of personal and stationary monitoring
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2015 (English)In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 59, no 8, p. 1074-1084Article in journal (Refereed) Published
Abstract [en]

Introduction: Chlorination is a method commonly used to keep indoor swimming pool water free from pathogens. However, chlorination of swimming pools produces several potentially hazardous by-products as the chlorine reacts with nitrogen containing organic matter. Up till now, exposure assessments in indoor swimming pools have relied on stationary measurements at the poolside, used as a proxy for personal exposure. However, measurements at fixed locations are known to differ from personal exposure. Methods: Eight public swimming pool facilities in four Swedish cities were included in this survey. Personal and stationary sampling was performed during day or evening shift. Samplers were placed at different fixed positions around the pool facilities, at similar to 1.5 m above the floor level and 0-1 m from the poolside. In total, 52 personal and 110 stationary samples of trichloramine and 51 personal and 109 stationary samples of trihalomethanes, were collected. Results: The average concentration of trichloramine for personal sampling was 71 µg m-3, ranging from 1 to 240 µg m-3 and for stationary samples 179 µg m-3, ranging from 1 to 640 µg m-3. The air concentrations of chloroform were well below the occupational exposure limit (OEL). For the linear regression analysis and prediction of personal exposure to trichloramine from stationary sampling, only data from personal that spent > 50% of their workday in the pool area were included. The linear regression analysis showed a correlation coefficient (r2) of 0.693 and a significant regression coefficient β of 0.621; (95% CI = 0.329-0.912, P = 0.001). Conclusion: The trichloramine exposure levels determined in this study were well below the recommended air concentration level of 500 µg m-3; a WHO reference value based on stationary sampling. Our regression data suggest a relation between personal exposure and area sampling of 1:2, implying an OEL of 250 µg m-3 based on personal sampling.

Place, publisher, year, edition, pages
Oxford University Press, 2015
Keywords
exposure assessment, exposure assessment methodology, trichloramine, trihalomethanes
National Category
Public Health, Global Health, Social Medicine and Epidemiology Pharmacology and Toxicology
Identifiers
urn:nbn:se:umu:diva-111152 (URN)10.1093/annhyg/mev045 (DOI)000362788900011 ()26155991 (PubMedID)
Available from: 2015-11-11 Created: 2015-11-06 Last updated: 2018-06-07Bibliographically approved
Andersson, M., Hedman, L., Nordberg, G., Forsberg, B., Eriksson, K. & Rönmark, E. (2015). Swimming pool attendance is related to asthma among atopic school children: a population-based study. Environmental health, 14(14), Article ID 37.
Open this publication in new window or tab >>Swimming pool attendance is related to asthma among atopic school children: a population-based study
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2015 (English)In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 14, no 14, article id 37Article in journal (Refereed) Published
Abstract [en]

Background: By-products of water disinfectants have been suggested to cause asthma, especially in atopic children. However, studies on indoor swimming pool attendance and asthma in children have presented conflicting results. The present study examined the relationship between indoor swimming pool attendance and asthma among sensitized and non-sensitized children aged 11-12 years.

Methods: An extended ISAAC questionnaire was sent to the families of all children attending fifth or sixth grade, aged 11-12 years, in two municipalities in Northern Sweden in 2010. A total of 1866 participated (96% of those invited) in the questionnaire study and 1652 (89%) also participated in skin prick testing for 10 standard airborne allergens. Asthma was defined as physician-diagnosed asthma in combination with wheeze or use of asthma medication in the last 12 months. Current swimming pool attendance was reported as >= 1/week or <1/week. Logistic regression models were used for data analysis.

Results: The prevalence of current asthma was 8.9% (10.0% of boys; 7.9% of girls) and 14% had attended indoor pools >= 1/week. Children currently attending swimming pools >= 1/week had an increased risk of current asthma. Stratified analyses for allergic sensitization adjusted for sex, parental smoking, parental asthma, and damp housing, showed a statistically significant association for current asthma only among sensitized subjects (OR 95% CI 1.90 1.09-3.32). No association was found between current pool attendance and wheeze, sensitization, rhinitis or eczema.

Conclusions: The present study supports the proposed link between indoor swimming pool attendance and asthma in sensitized children.

Keywords
Asthma, Children, Swimming pools, Trichloramines, Sensitization
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-103215 (URN)10.1186/s12940-015-0023-x (DOI)000353534400001 ()
Available from: 2015-05-19 Created: 2015-05-18 Last updated: 2018-06-07Bibliographically approved
Mousavi, M., Jonsson, P., Antti, H., Adolfsson, R., Nordin, A., Bergdahl, J., . . . Nyberg, L. (2014). Serum metabolomic biomarkers of dementia. Dementia and geriatric cognitive disorders extra, 4(2), 252-62
Open this publication in new window or tab >>Serum metabolomic biomarkers of dementia
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2014 (English)In: Dementia and geriatric cognitive disorders extra, E-ISSN 1664-5464, Vol. 4, no 2, p. 252-62Article in journal (Refereed) Published
Abstract [en]

Aims: This study compared serum metabolites of demented patients (Alzheimer's disease and vascular dementia) and controls, and explored serum metabolite profiles of nondemented individuals 5 years preceding the diagnosis. Methods: Cognitively healthy participants were followed up for 5-20 years. Cognitive assessment, serum sampling, and diagnosis were completed every 5 years. Multivariate analyses were conducted on the metabolite profiles generated by gas chromatography/time-of-flight mass spectrometry. Results: A significant group separation was found between demented patients and controls, and between incident cases and controls. Metabolites that contributed in both analyses were 3,4-dihydroxybutanoic acid, docosapentaenoic acid, and uric acid. Conclusions: Serum metabolite profiles are altered in demented patients, and detectable up to 5 years preceding the diagnosis. Blood sampling can make an important contribution to the early prediction of conversion to dementia.

Keywords
Memory, Early diagnosis, Alzheimer’s disease, Vascular dementia, Gas chromatography
National Category
Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-92543 (URN)10.1159/000364816 (DOI)
Available from: 2014-08-28 Created: 2014-08-28 Last updated: 2018-06-07Bibliographically approved
Nordberg, G. F., Lundström, N.-G., Forsberg, B., Hagenbjörk-Gustafsson, A., Lagerkvist, B.-S. J., Nilsson, J., . . . Eriksson, K. (2012). Lung function in volunteers before and after exposure to trichloramine in indoor pool environments and asthma in a cohort of pool workers. BMJ Open, 2(5), e000973
Open this publication in new window or tab >>Lung function in volunteers before and after exposure to trichloramine in indoor pool environments and asthma in a cohort of pool workers
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2012 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, no 5, p. e000973-Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Exposure to trichloramine (NCl(3)) in indoor swimming-pool environments is known to cause mucous membrane irritation, but if it gives rise to changes in lung function or asthma in adults is not known. (1) We determined lung function in volunteers before and after exposure to indoor pool environments. (2) We studied the occurrence of respiratory symptoms and asthma in a cohort of pool workers.

DESIGN/METHODS/PARTICIPANTS: (1) We studied two groups of volunteers, 37 previously non-exposed healthy persons and 14 pool workers, who performed exercise for 2 h in an indoor pool environment. NCl(3) in air was measured during pool exposures and in 10 other pool environments. Filtered air exposures were used as controls. Lung function and biomarkers of pulmonary epithelial integrity were measured before and after exposure. (2) We mailed a questionnaire to 1741 persons who indicated in the Swedish census 1990 that they worked at indoor swimming-pools.

RESULTS: (1) In previously non-exposed volunteers, statistically significant decreases in FEV(1) (forced expiratory volume) and FEV(%) (p=0.01 and 0.05, respectively) were found after exposure to pool air (0.23 mg/m(3) of NCl(3)). In pool workers, a statistically significant decrease in FEV(%) (p=0.003) was seen (but no significant change of FEV(1))(.) In the 10 other pool environments the median NCl(3) concentration was 0.18 mg/m(3). (2) Our nested case/control study in pool workers found an OR for asthma of 2.31 (95% CI 0.79 to 6.74) among those with the highest exposure. Exposure-related acute mucous membrane and respiratory symptoms were also found.

CONCLUSIONS: This is the first study in adults showing statistically significant decreases in lung function after exposure to NCl(3). An increased OR for asthma among highly exposed pool workers did not reach statistical significance, but the combined evidence supports the notion that current workroom exposures may contribute to asthma development. Further research on sensitive groups is warranted.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2012
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-60838 (URN)10.1136/bmjopen-2012-000973 (DOI)23048058 (PubMedID)
Available from: 2012-10-31 Created: 2012-10-31 Last updated: 2018-06-08Bibliographically approved
Axelsson, S., Eriksson, K. & Nilsson, U. (2011). Determination of resin acids during production of wood pellets-a comparison of HPLC/ESI-MS with the GC/FID MDHS 83/2 method. Journal of Environmental Monitoring, 13(10), 2940-2945
Open this publication in new window or tab >>Determination of resin acids during production of wood pellets-a comparison of HPLC/ESI-MS with the GC/FID MDHS 83/2 method
2011 (English)In: Journal of Environmental Monitoring, ISSN 1464-0325, E-ISSN 1464-0333, Vol. 13, no 10, p. 2940-2945Article in journal (Refereed) Published
Abstract [en]

Resin acids are constituents of natural and technical products of widespread use. Exposure is known to cause health effects in the airways and on the skin. Liquid chromatography/positive ion electrospray-mass spectrometry (HPLC/pos ESI-MS) was investigated for determination of 7-oxodehydroabietic (7-OXO), dehydroabietic (DHAA) and abietic acid (AA) in wood dust-containing air samples as a derivatisation-free alternative to the GC/FID HSE method 83/2, developed by the Health and Safety Executive UK. The resin acid 7-OXO was measured as a marker for oxidised resin acids, which are known to be the main contact allergens in colophonium. The found detection limits were 0.42 ng m(-3) for 7-OXO, 5.2 ng m(-3) for DHAA and 9.4 ng m(-3) for AA, respectively, which are considerably lower than with the GC/FID method (24, 115 and 89 ng m(-3)). The two methods correlated well, although consistently and significantly lower concentrations of 7-OXO were detected with LC/MS. The higher concentration of this compound with MDHS 83/2 is suggested to be an artefact from the derivatisation step in the presence of soluble wood dust remains.

Place, publisher, year, edition, pages
Cambridge: Royal Society of Chemistry, 2011
National Category
Environmental Sciences Analytical Chemistry
Identifiers
urn:nbn:se:umu:diva-49574 (URN)10.1039/c0em00543f (DOI)000295579000033 ()
Available from: 2011-11-18 Created: 2011-11-14 Last updated: 2018-06-08Bibliographically approved
Liljelind, I., Norberg, C., Egelrud, L., Westberg, H., Eriksson, K. & Nylander-French, L. A. (2010). Dermal and inhalation exposure to methylene bisphenyl isocyanate (MDI) in iron foundry workers.. Annals of Occupational Hygiene, 54(1), 31-40
Open this publication in new window or tab >>Dermal and inhalation exposure to methylene bisphenyl isocyanate (MDI) in iron foundry workers.
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2010 (English)In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 54, no 1, p. 31-40Article in journal (Refereed) Published
Abstract [en]

Diisocyanates are a group of chemically reactive agents, which are used in the production of coatings, adhesives, polyurethane foams, and parts for the automotive industry and as curing agents for cores in the foundry industry. Dermal and inhalation exposure to methylene bisphenyl isocyanate (MDI) is associated with respiratory sensitization and occupational asthma. However, limited research has been performed on the quantitative evaluation of dermal and inhalation exposure to MDI in occupationally exposed workers. The objective of this research was to quantify dermal and inhalation exposure levels in iron foundry workers. Workers involved in mechanized moulding and mechanized production of cores were monitored: 12 core makers, 2 core-sand preparers, and 5 core installers. Personal breathing-zone levels of MDI were measured using impregnated filter sampling. Dermal exposure to MDI was measured using a tape-strip technique. Three or five consecutive tape-strip samples were collected from five exposed skin areas (right and left forefingers, left and right wrists, and forehead). The average personal air concentration was 0.55 microg m(-3), 50-fold lower than the Swedish occupational exposure limit of 30 microg m(-3). The core makers had an average exposure of 0.77 microg m(-3), which was not significantly different from core installers' and core-sand preparers' average exposure of 0.16 microg m(-3) (P = 0.059). Three core makers had a 10-fold higher inhalation exposure than the other core makers. The core makers' mean dermal exposure at different skin sites varied from 0.13 to 0.34 microg while the two other groups' exposure ranged from 0.006 to 0.062 microg. No significant difference was observed in the MDI levels between the skin sites in a pairwise comparison, except for left forefinger compared to left and right wrist (P < 0.05). In addition, quantifiable but decreasing levels of MDI were observed in the consecutive tape strip per site indicating MDI penetration into the skin. This study indicates that exposure to MDI can be quantified on workers' skin even if air levels are close to unquantifiable. Thus, the potential for uncured MDI to deposit on and penetrate into the skin is demonstrated. Therefore, dermal exposure along with inhalation exposure to MDI should be measured in the occupational settings where MDI is present in order to shed light on their roles in the development of occupational isocyanate asthma.

Place, publisher, year, edition, pages
Oxford Journals, 2010
Keywords
dermal, diisocyanate, exposure, foundry workers, inhalation, methylene bisphenyl isocyanate (MDI)
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-30724 (URN)10.1093/annhyg/mep067 (DOI)000273492400005 ()19783835 (PubMedID)
Available from: 2010-01-14 Created: 2010-01-14 Last updated: 2018-06-08Bibliographically approved
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