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Carlsen, Hanne Krage
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Publications (10 of 13) Show all publications
Oudin, A., Åström, D. O., Asplund, P., Steingrimsson, S., Szabo, Z. & Carlsen, H. K. (2018). The association between daily concentrations of air pollution and visits to a psychiatric emergency unit: a case-crossover study. Environmental health, 17, Article ID 4.
Open this publication in new window or tab >>The association between daily concentrations of air pollution and visits to a psychiatric emergency unit: a case-crossover study
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2018 (English)In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 17, article id 4Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Air pollution is one of the leading causes of mortality and morbidity worldwide. Experimental studies, and a few epidemiological studies, suggest that air pollution may cause acute exacerbation of psychiatric disorders, and even increase the rate of suicide attempts, but epidemiological studies on air pollution in association with psychiatric disorders are still few. Our aim was to investigate associations between daily fluctuations in air pollution concentrations and the daily number of visits to a psychiatric emergency unit.

METHODS: Data from Sahlgrenska University Hospital, Gothenburg, Sweden, on the daily number of visits to the Psychiatric emergency unit were combined with daily data on monitored concentrations of respirable particulate matter(PM10), ozone(O3), nitrogen dioxides(NO2) and temperature between 1st July 2012 and 31st December 2016. We used a case-crossover design to analyze data with conditional Poisson regression models allowing for over-dispersion. We stratified data on season.

RESULTS: Visits increased with increasing PM10 levels during the warmer season (April to September) in both single-pollutant and two-pollutant models. For example, an increase of 3.6% (95% Confidence Interval, CI, 0.4-7.0%) was observed with a 10 μg/m3 increase in PM10 adjusted for NO2. In the three-pollutant models (adjusting for NO2 and O3 simultaneously) the increase was 3.3% (95% CI, -0.2-6.9). There were no clear associations between the outcome and NO2, O3, or PM10 during the colder season (October to March).

CONCLUSIONS: Ambient air particle concentrations were associated with the number of visits to the Psychiatric emergency unit in the warm season. The results were only borderline statistically significant in the fully adjusted (three-pollutant) models in this small study. The observation could be interpreted as indicative of air pollution as either exacerbating an underlying psychiatric disorder, or increasing mental distress, even in areas with comparatively low levels of air pollution. In combination with the severe impact of psychiatric disorders and mental distress on society and individuals, our results are a strong warrant for future research in this area.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
acute effects of air pollution, air pollution, environmental epidemiology, mental distress, particles, psychiatric disorders
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-144248 (URN)10.1186/s12940-017-0348-8 (DOI)000419965500001 ()29321054 (PubMedID)
Available from: 2018-01-29 Created: 2018-01-29 Last updated: 2018-06-09Bibliographically approved
Carlsen, H. K., Bäck, E., Eneroth, K., Gislason, T., Holm, M., Janson, C., . . . Orru, H. (2017). Indicators of residential traffic exposure: Modelled NOX, traffic proximity, and self-reported exposure in RHINE III. Atmospheric Environment, 167, 416-425
Open this publication in new window or tab >>Indicators of residential traffic exposure: Modelled NOX, traffic proximity, and self-reported exposure in RHINE III
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2017 (English)In: Atmospheric Environment, ISSN 1352-2310, Vol. 167, p. 416-425Article in journal (Refereed) Published
Abstract [en]

Few studies have investigated associations between self-reported and modelled exposure to traffic pollution. The objective of this study was to examine correlations between self-reported traffic exposure and modelled (a) NOx and (b) traffic proximity in seven different northern European cities; Aarhus (Denmark), Bergen (Norway), Gothenburg, Ulna and Uppsala (Sweden), Reykjavik (Iceland), and Tartu (Estonia). We analysed data from the RHINE III (Respiratory Health in Northern Europe, www.rhine.nu) cohorts of the seven study cities. Traffic proximity (distance to the nearest road with >10,000 vehicles per day) was calculated and vehicle exhaust (NOx) was modelled using dispersion models and land-use regression (LUR) data from 2011. Participants were asked a question about self-reported traffic intensity near bedroom window and another about traffic noise exposure at the residence. The data were analysed using rank correlation (Kendall's tau) and inter-rater agreement (Cohen's Kappa) between tertiles of modelled NOx and traffic proximity tertile and traffic proximity categories (0-150 metres (m), 150 -200 m, >300 m) in each centre. Data on variables of interest were available for 50-99% of study participants per each cohort. Mean modelled NOx levels were between 6.5 and 16.0 mu g/m(3); median traffic intensity was between 303 and 10,750 m in each centre. In each centre, 7.7-18.7% of respondents reported exposure to high traffic intensity and 3.6-16.3% of respondents reported high exposure to traffic noise. Self-reported residential traffic exposure had low or no correlation with modelled exposure and traffic proximity in all centres, although results were statistically significant (tau = 0.057-0.305). Self reported residential traffic noise correlated weakly (tau = 0.090-0.255), with modelled exposure in all centres except Reykjavik. Modelled NOx\] had the highest correlations between self-reported and modelled traffic exposure in five of seven centres, traffic noise exposure had the highest correlation with traffic proximity in tertiles in three centres. Self-reported exposure to high traffic intensity and traffic noise at each participant's residence had low or weak although statistically significant correlations with modelled vehicle exhaust pollution levels and traffic proximity.

Keywords
Traffic exposure, Noise exposure, Dispersion models, Land-use regression models, NOx, Cohort study
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-142482 (URN)10.1016/j.atmosenv.2017.08.015 (DOI)000412612200036 ()2-s2.0-85028350198 (Scopus ID)
Available from: 2017-11-30 Created: 2017-11-30 Last updated: 2018-06-09Bibliographically approved
Finnbjornsdottir, R. G., Carlsen, H. K., Thorsteinsson, T., Oudin, A., Lund, S. H., Gislason, T. & Rafnsson, V. (2016). Association between Daily Hydrogen Sulfide Exposure and Incidence of Emergency Hospital Visits: A Population-Based Study. PLoS ONE, 11(5), Article ID e0154946.
Open this publication in new window or tab >>Association between Daily Hydrogen Sulfide Exposure and Incidence of Emergency Hospital Visits: A Population-Based Study
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2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 5, article id e0154946Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The adverse health effects of high concentrations of hydrogen sulfide (H2S) exposure are well known, though the possible effects of low concentrations have not been thoroughly studied. The aim was to study short-term associations between modelled ambient low-level concentrations of intermittent hydrogen sulfide (H2S) and emergency hospital visits with heart diseases (HD), respiratory diseases, and stroke as primary diagnosis.

METHODS: The study is population-based, using data from patient-, and population-registers from the only acute care institution in the Reykjavik capital area, between 1 January, 2007 and 30 June, 2014. The study population was individuals (≥18yr) living in the Reykjavik capital area. The H2S emission originates from a geothermal power plant in the vicinity. A model was used to estimate H2S exposure in different sections of the area. A generalized linear model assuming Poisson distribution was used to investigate the association between emergency hospital visits and H2S exposure. Distributed lag models were adjusted for seasonality, gender, age, traffic zones, and other relevant factors. Lag days from 0 to 4 were considered.

RESULTS: The total number of emergency hospital visits was 32961 with a mean age of 70 years. In fully adjusted un-stratified models, H2S concentrations exceeding 7.00μg/m3 were associated with increases in emergency hospital visits with HD as primary diagnosis at lag 0 risk ratio (RR): 1.067; 95% confidence interval (CI): 1.024-1.111, lag 2 RR: 1.049; 95%CI: 1.005-1.095, and lag 4 RR: 1.046; 95%CI: 1.004-1.089. Among males an association was found between H2S concentrations exceeding 7.00μg/m3, and HD at lag 0 RR: 1.087; 95%CI: 1.032-1.146 and lag 4 RR: 1080; 95%CI: 1.025-1.138; and among those 73 years and older at lag 0 RR: 1.075; 95%CI: 1.014-1.140 and lag 3 RR: 1.072; 95%CI: 1.009-1.139. No associations were found with other diseases.

CONCLUSIONS: The study showed an association between emergency hospital visits with HD as primary diagnosis and same day H2S concentrations exceeding 7.00μg/m3, more pronounced among males and those 73 years and older than among females and younger individuals.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-121142 (URN)10.1371/journal.pone.0154946 (DOI)000376880700004 ()27218467 (PubMedID)
Available from: 2016-05-27 Created: 2016-05-27 Last updated: 2018-06-07Bibliographically approved
Carlsen, H. K., Boman, P., Björ, B., Olin, A.-C. & Forsberg, B. (2016). Coarse Fraction Particle Matter and Exhaled Nitric Oxide in Non-Asthmatic Children. International Journal of Environmental Research and Public Health, 13(6), Article ID 621.
Open this publication in new window or tab >>Coarse Fraction Particle Matter and Exhaled Nitric Oxide in Non-Asthmatic Children
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2016 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 13, no 6, article id 621Article in journal (Refereed) Published
Abstract [en]

Coarse particle matter, PMcoarse, is associated with increased respiratory morbidity and mortality. The aim of this study was to investigate the association between short-term changes in PMcoarse and sub-clininal airway inflammation in children. Healthy children aged 11 years from two northern Swedish elementary schools underwent fraction of exhaled nitrogen oxide (FENO) measurements to determine levels of airway inflammation twice weekly during the study period from 11 April-6 June 2011. Daily exposure to PMcoarse, PM2.5, NO2, NOx, NO and O-3 and birch pollen was estimated. Multiple linear regression was used. Personal covariates were included as fixed effects and subjects were included as a random effect. In total, 95 children participated in the study, and in all 493 FENO measurements were made. The mean level of PMcoarse was 16.1 mu g/m(3) (range 4.1-42.3), and that of O-3 was 75.0 mu g/m(3) (range: 51.3-106.3). That of NO2 was 17.0 mu g/m(3) (range: 4.7-31.3), NOx was 82.1 mu g/m(3) (range: 13.3-165.3), and NO was 65 mu g/m(3) (range: 8.7-138.4) during the study period. In multi-pollutant models an interquartile range increase in 24 h PMcoarse was associated with increases in FENO by between 6.9 ppb (95% confidence interval 0.0-14) and 7.3 ppb (95% confidence interval 0.4-14.9). PMcoarse was associated with an increase in FENO, indicating sub-clinical airway inflammation in healthy children.

Keywords
exhaled NO, respiratory inflammation, coarse particle matter, air pollution, children
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-124193 (URN)10.3390/ijerph13060621 (DOI)000378860100100 ()
Available from: 2016-08-04 Created: 2016-07-28 Last updated: 2018-06-07Bibliographically approved
Carlsen, H. K., Gislason, T., Forsberg, B., Meister, K., Thorsteinsson, T., Jóhannsson, T., . . . Oudin, A. (2015). Emergency Hospital Visits in Association with Volcanic Ash, Dust Storms and Other Sources of Ambient Particles: A Time-Series Study in Reykjavik, Iceland. International Journal of Environmental Research and Public Health, 12(4), 4047-4059
Open this publication in new window or tab >>Emergency Hospital Visits in Association with Volcanic Ash, Dust Storms and Other Sources of Ambient Particles: A Time-Series Study in Reykjavik, Iceland
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2015 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 12, no 4, p. 4047-4059Article in journal (Refereed) Published
Abstract [en]

Volcanic ash contributed significantly to particulate matter (PM) in Iceland following the eruptions in Eyjafjallajökull 2010 and Grímsvötn 2011. This study aimed to investigate the association between different PM sources and emergency hospital visits for cardiorespiratory causes from 2007 to 2012. Indicators of PM10 sources; “volcanic ash”, “dust storms”, or “other sources” (traffic, fireworks, and re-suspension) on days when PM10 exceeded the daily air quality guideline value of 50 µg/m3 were entered into generalized additive models, adjusted for weather, time trend and co-pollutants. The average number of daily emergency hospital visits was 10.5. PM10 exceeded the air quality guideline value 115 out of 2191 days; 20 days due to volcanic ash, 14 due to dust storms (two days had both dust storm and ash contribution) and 83 due to other sources. High PM10 levels from volcanic ash tended to be significantly associated with the emergency hospital visits; estimates ranged from 4.8% (95% Confidence Interval (CI): 0.6, 9.2%) per day of exposure in unadjusted models to 7.3% (95% CI: −0.4, 15.5%) in adjusted models. Dust storms were not consistently associated with daily emergency hospital visits and other sources tended to show a negative association. We found some evidence indicating that volcanic ash particles were more harmful than particles from other sources, but the results were inconclusive and should be interpreted with caution.

Keywords
particle matter, volcanic ash, dust storms, emergency hospital visits, respiratory health, cardiovascular health
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-101792 (URN)10.3390/ijerph120404047 (DOI)000353488500041 ()
Available from: 2015-04-13 Created: 2015-04-13 Last updated: 2018-06-07Bibliographically approved
Carlsen, H. K., Modig, L., Levinsson, A., Kim, J.-L., Toren, K., Nyberg, F. & Olin, A.-C. (2015). Exposure to traffic and lung function in adults: a general population cohort study. BMJ Open, 5(6), Article ID e007624.
Open this publication in new window or tab >>Exposure to traffic and lung function in adults: a general population cohort study
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2015 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 6, article id e007624Article in journal (Refereed) Published
Abstract [en]

Objectives: To investigate the association between living near dense traffic and lung function in a cohort of adults from a single urban region. Design: Cross-sectional results from a cohort study. Setting: The adult-onset asthma and exhaled nitric oxide (ADONIX) cohort, sampled during 2001-2008 in Gothenburg, Sweden. Exposure was expressed as the distance from participants' residential address to the nearest road with dense traffic (>10 000 vehicles per day) or very dense traffic (>30 000 vehicles per day). The exposure categories were: low (>500 m; reference), medium (75-500 m) or high (<75 m). Participants: The source population was a population-based cohort of adults (n=6153). The study population included 5441 participants of European descent with good quality spirometry and information about all outcomes and covariates. Outcome measures: Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were measured at a clinical examination. The association with exposure was examined using linear regression adjusting for age, gender, body mass index, smoking status and education in all participants and stratified by sex, smoking status and respiratory health status. Results: We identified a significant dose-response trend between exposure category and FEV1 (p=0.03) and borderline significant trend for FVC (p=0.06) after adjusting for covariates. High exposure was associated with lower FEV1 (-1.0%, 95% CI -2.5% to 0.5%) and lower FVC (-0.9%, 95% CI -2.2% to 0.4%). The effect appeared to be stronger in women. In highly exposed individuals with current asthma or chronic obstructive pulmonary disease, FVC was lower (-4.5%, 95% CI -8.8% to -0.1%). Conclusions: High traffic exposure at the residential address was associated with lower than predicted FEV1 and FVC lung function compared with living further away in a large general population cohort. There were particular effects on women and individuals with obstructive disease.

Keywords
Air Pollution, Cohort Studies, Nitric Oxide
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-111778 (URN)10.1136/bmjopen-2015-007624 (DOI)000363479900068 ()26109116 (PubMedID)2-s2.0-84937239405 (Scopus ID)
Available from: 2015-11-23 Created: 2015-11-23 Last updated: 2018-06-07Bibliographically approved
Carlsen, H. K. (2014). Health effects of air pollution in Iceland: respiratory health in volcanic environments. (Doctoral dissertation). Umeå: Umeå universitet
Open this publication in new window or tab >>Health effects of air pollution in Iceland: respiratory health in volcanic environments
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Air pollution has adverse effects on human health. The respiratory system is the most exposed and short-term changes in air pollution levels have been associated with worsening of asthma symptoms and increased rates of heart attacks and stroke. Air pollution in cities due to traffic is the major concern, as many people are exposed. However, natural sources of air pollution such as natural dust storms and ash from volcanic eruptions can also compromise human health. Exposure to volcanic eruptions and other natural hazards can also threaten mental health. Air pollution has not been extensively studied in Iceland, in spite of the presence of several natural pollution sources and a sizeable car fleet in the capital area.

The aim of this thesis was to determine if there was a measurable effect on health which could be attributed to air pollution in Iceland. This aim was pursued along two paths; time series studies using register data aimed to determine the short-term association between daily variation in air pollution and on one hand daily dispensing of anti-asthma medication or the daily number of emergency room visits and emergency admissions for cardiopulmonary causes and stroke. The other method was to investigate if exposure to the Eyjafjallajökull volcanic eruption was associated with adverse health outcomes, either at the end of the eruption, or 6 months later.

In paper I time series regression was used to investigate the association between the daily number of individuals who were dispensed anti-asthma medication and levels of the air pollutants particle matter with an aerodynamic diameter less than 10 μm (PM10), nitrogen dioxide (NO2), ozone (O3), and hydrogen sulfide (H2S) during the preceding days. For the study period 2006-9, there were significant associations between the daily mean of PM10 and H2S and the sales of anti-asthma medication 3 to 5 days later. Giving the exposure as the highest daily one-hour mean gave more significant results. Air pollution negatively affected the respiratory health of asthma medication users, prompting them to refill their prescriptions before they had originally intended to.

In paper II the main outcome was the number of individuals seeking help at Landspitali University Hospital emergency room for cardiopulmonary disease or stroke. Time series regression was used to identify the lag that gave the best predictive power, and models were run for data for 2003-9 pollutants PM10, NO2, and O3. O3 was significantly associated with the number of emergency hospital visits the same day and two days later in all models, and both for men, women and the elderly. Only emergency hospital visits of the elderly were associated with NO2, and there were no associations with PM10.

In paper III the aim was to investigate if the health effects of PM10 were affected by the addition of volcanic ash from the 2010 eruption of Eyjafjallajökull and 2011 eruption of Grímsvötn to PM10 in the capital area. Time series regression of emergency hospital visits and PM10 before and after the Eyjafjallajökull eruption showed that the effect tended to be higher after the eruption, but the results were not significant. Analysis with a binary indicator for high levels of PM10 from volcanic ash and other sources showed that volcanic ash was associated with increased emergency hospital visits. There were no associations with high levels of PM10 from other sources.

In paper IV, the health of the population exposed to the ongoing eruption of Eyjafjallajökull in 2010 was investigated thoroughly. Lung function in adults was better than in a reference group from the capital area, though many reported sensory organ irritation symptoms and symptoms of stress and mental unhealth, especially those with underlying diseases.

Paper V report the results from a questionnaire study which was carried out six months after the Eyjafjallajökull eruption. The study population comprised a cohort of south Icelanders exposed to the eruption to varying degrees and a reference group from north Iceland. Respiratory and eye symptoms were much more common in south Icelanders than in the reference group, after adjusting for demographic characteristics. Mental unhealth rates had declined considerably.

In the studies, we found that urban air pollution and natural particles have short-term effects on anti-asthma medication dispensing and emergency room visits and hospital admissions. Exposure to natural particles in the form of volcanic dust was associated with increased respiratory symptoms in a very exposed population. There were indications that volcanic ash particles were associated with increased emergency hospital visits in the following days.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2014. p. 82
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1659
Keywords
Respiratory health, air pollution, volcanic ash, epidemiology, hydrogen sulfide.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology; Public health
Identifiers
urn:nbn:se:umu:diva-89153 (URN)978-91-7601-082-2 (ISBN)
Public defence
2014-06-13, Triple Helix, Samverkanshuset, Umeå Universitet, Umeå, 13:00 (English)
Opponent
Supervisors
Note

Statement of collaboration

This thesis and the work in it have been produced in collaboration between University of Iceland and Umeå University. The thesis was issued and defended at both institutions. Responsible

Available from: 2014-05-23 Created: 2014-05-23 Last updated: 2018-06-07Bibliographically approved
Carlsen, H. K., Forsberg, B., Meister, K., Gíslason, T. & Oudin, A. (2013). Ozone is associated with cardiopulmonary and stroke emergency hospital visits in Reykjavik, Iceland 2003--2009. Environmental health, 12(1), 28
Open this publication in new window or tab >>Ozone is associated with cardiopulmonary and stroke emergency hospital visits in Reykjavik, Iceland 2003--2009
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2013 (English)In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 12, no 1, p. 28-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Air pollution exposure is associated with hospital admissions and emergency room visits for cardiopulmonary disease and stroke. Iceland's capital area, Reykjavik, has generally low air pollution levels, but traffic and natural sources contribute to pollution levels. The objective of this study was to investigate temporal associations between emergency hospital visits and air pollutants ozone (O3), nitrogen dioxide (NO2), and particulate matter (PM10) in the Icelandic capital area.

METHODS: We constructed a time series of the daily number of adults who visited the emergency room, or were acutely admitted for stroke or cardiorespiratory causes to Landspitali University Hospital 1 January 2003 -- 31 December 2009 from the hospital in-patient register. We used generalized additive models assuming Poisson distribution, to analyze the daily emergency hospital visits as a function of the pollutant levels, and adjusted for meteorological variables, day of week, and time trend with splines.

RESULTS: Daily emergency hospital visits increased 3.9% (95% confidence interval (CI) 1.7-6.1%) per interquartile (IQR) change in average O3 the same and two previous days. For females, the increase was 7.8% (95% CI 3.6-12.1) for elderly (70+), the increase was 3.9% (95% CI 0.6-7.3%) per IQR increase of NO2. There were no associations with PM10.

CONCLUSIONS: We found an increase in daily emergency hospital visits associated with O3, indicating that low-level exposure may trigger cardiopulmonary events or stroke.

Place, publisher, year, edition, pages
BioMed Central, 2013
Keywords
Air pollution; Stroke; Cardiopulmonary; Cardiac; Cardiovascular; Hospital admissions; Emergency room visits
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-68042 (URN)10.1186/1476-069X-12-28 (DOI)000318251500001 ()23566138 (PubMedID)
Available from: 2013-04-11 Created: 2013-04-11 Last updated: 2018-06-08Bibliographically approved
Oudin, A., Carlsen, H. K., Forsberg, B. & Johansson, C. (2013). Volcanic Ash and Daily Mortality in Sweden after the Icelandic Volcano Eruption of May 2011. International Journal of Environmental Research and Public Health, 10(12), 6909-19
Open this publication in new window or tab >>Volcanic Ash and Daily Mortality in Sweden after the Icelandic Volcano Eruption of May 2011
2013 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 10, no 12, p. 6909-19Article in journal (Refereed) Published
Abstract [en]

In the aftermath of the Icelandic volcano Grimsvötn’s eruption on 21 May 2011, volcanic ash reached Northern Europe. Elevated levels of ambient particles (PM) were registered in mid Sweden. The aim of the present study was to investigate if the Grimsvötn eruption had an effect on mortality in Sweden. Based on PM measurements at 16 sites across Sweden, data were classified into an ash exposed data set (Ash area) and an unexposed data set (No ash area). Data on daily all-cause mortality were obtained from Statistics Sweden for the time period 1 April through 31 July 2011. Mortality ratios were calculated as the ratio between the daily number of deaths in the Ash area and the No ash area. The exposure period was defined as the week following the days with elevated particle concentrations, namely 24 May through 31 May. The control period was defined as 1 April through 23 May and 1 June through 31 July. There was no absolute increase in mortality during the exposure period. However, during the exposure period the mean mortality ratio was 2.42 compared with 2.17 during the control period, implying a relatively higher number of deaths in the Ash area than in the No ash area. The differences in ratios were mostly due to a single day, 31 May, and were not statistically significant when tested with a Mann-Whitney non-parametric test (p > 0.3). The statistical power was low with only 8 days in the exposure period (24 May through 31 May). Assuming that the observed relative differences were not due to chance, the results would imply an increase of 128 deaths during the exposure period 24–31 May. If 31 May was excluded, the number of extra deaths was reduced to 20. The results of the present study are contradicting and inconclusive, but may indicate that all-cause mortality was increased by the ash-fall from the Grimsvötn eruption. Meta-analysis or pooled analysis of data from neighboring countries might make it possible to reach sufficient statistical power to study effects of the Grimsvötn ash on morbidity and mortality. Such studies would be of particular importance for European societies preparing for future large scale volcanic eruptions in Iceland.

Keywords
air pollution, particulate matter, volcano, mortality, ash, Iceland, Grimsvötn
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-83988 (URN)10.3390/ijerph10126909 (DOI)000330219600039 ()
Available from: 2013-12-12 Created: 2013-12-12 Last updated: 2018-06-08Bibliographically approved
Carlsen, H. K., Gislason, T., Benediktsdottir, B., Kolbeinsson, T. B., Hauksdottir, A., Thorsteinsson, T. & Briem, H. (2012). A survey of early health effects of the Eyjafjallajokull 2010 eruption in Iceland: a population-based study. BMJ Open, 2(2), e000343
Open this publication in new window or tab >>A survey of early health effects of the Eyjafjallajokull 2010 eruption in Iceland: a population-based study
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2012 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, no 2, p. e000343-Article in journal (Refereed) Published
Abstract [en]

Objective To estimate physical and mental health effects of the Eyjafjallajökull volcanic eruption on nearby residents.

Design Cross-sectional study.

Setting The Icelandic volcano Eyjafjallajökull erupted on 14 April 2010. The eruption lasted for about 6 weeks and was explosive, ejecting some 8 million tons of fine particles into the atmosphere. Due to prevailing winds, the ash spread mostly to the south and south-east, first over the rural region to the south, later over the Atlantic Ocean and Europe, closing European air space for several days.

Participants Residents (n=207) of the most ash-exposed rural area south and east of the volcano.

Methods The study period was from 31 May to 11 June 2010. Participants were examined by a physician. To ascertain respiratory health, standardised spirometry was performed before and after the use of a bronchodilator. All adult participants answered questionnaires about mental and physical health, their children's health and the use of protective equipment.

Results Every other adult participant reported irritation in eyes and upper airway when exposed to volcanic ash. Adults (n=26) and children (n=5) with pre-existing asthma frequently reported worsening of their symptoms. No serious health problems requiring hospitalisation could be attributed to the eruption. The majority of the participants reported no abnormal physical or mental symptoms to the examining physician. Compared to an age- and gender-matched reference group, the ash-exposed participants reported lower smoking rates and were less likely to have ventilation impairment. Less than 10% of the participants reported symptoms of stress, anxiety or depression.

Conclusions Short-term ash exposure was associated with upper airway irritation symptoms and exacerbation of pre-existing asthma but did not contribute to serious health problems. The exposure did not impair respiratory function compared to controls. Outdoor use of protective glasses and face masks was considered protective against irritation in eyes and upper airway.                                  

Place, publisher, year, edition, pages
BMJ Publishing Group, 2012
Keywords
posttraumatic-stress-disorder; volcanic air-pollution; hazards; ash; instrument; validity
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-89158 (URN)10.1136/bmjopen-2011-000343 (DOI)000315042100008 ()
Available from: 2014-05-23 Created: 2014-05-23 Last updated: 2018-06-07Bibliographically approved
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