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Oudin, Anna
Publications (10 of 41) Show all publications
Carlsen, H. K., Oudin, A., Steingrimsson, S. & Oudin Åström, D. (2019). Ambient Temperature and Associations with Daily Visits to a Psychiatric Emergency Unit in Sweden. International Journal of Environmental Research and Public Health, 16(2), Article ID E286.
Open this publication in new window or tab >>Ambient Temperature and Associations with Daily Visits to a Psychiatric Emergency Unit in Sweden
2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 2, article id E286Article in journal (Refereed) Published
Abstract [en]

High or low ambient temperatures pose a risk factor for the worsening or onset of psychiatric disorders. The aim of this study was to investigate the association between ambient temperature and psychiatric emergency visits in an urban region in a temperate climate. The daily number of visits to a psychiatric emergency room (PEVs) at Sahlgrenska University Hospital, Gothenburg, Sweden and the daily mean temperature were extracted for the study period 1 July 2012 to 31 December 2017. Case-crossover analysis with distributed lag non-linear models was used to analyse the data by season. The warm season was defined as May to August and the cold season as November to February. Shorter lags periods were used for the warm season than the cold season. In the analysis, temperatures at the 95th percentile was associated with 14% (95% confidence interval (CI): 2%, 28%) increase in PEVs at lag 0⁻3 and 22% (95%CI: 6%, 40%) for lags 0⁻14 during the warm season, relative to the seasonal minimum effect temperature (MET). During the cold season temperatures at the 5th percentile were associated with 25% (95% CI: -8%, 13%) and 18% (95% CI: -30%, 98%) increase in PEVs at lags 0⁻14 and 0⁻21 respectively. We observed an increased number of PEVs at high and low temperatures; however, not to a statistically significant extent for low temperatures. Our findings are similar to what has been found for somatic diseases and in studies of other mental health outcomes in regions with more extreme climates. This merits the inclusion of individuals with psychiatric disorders in awareness planning for climate warning systems.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
climate, environmental epidemiology, mental illness, psychiatric disorders
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-155863 (URN)10.3390/ijerph16020286 (DOI)000459112100121 ()30669579 (PubMedID)
Available from: 2019-01-30 Created: 2019-01-30 Last updated: 2019-04-16Bibliographically approved
Oudin, A., Frondelius, K., Haglund, N., Källén, K., Forsberg, B., Gustafsson, P. & Malmqvist, E. (2019). Prenatal exposure to air pollution as a potential risk factor for autism and ADHD. Environment International, 133, Article ID 105149.
Open this publication in new window or tab >>Prenatal exposure to air pollution as a potential risk factor for autism and ADHD
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 133, article id 105149Article in journal (Refereed) Published
Abstract [en]

Genetic and environmental factors both contribute to the development of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). One suggested environmental risk factor for ASD and ADHD is air pollution, but knowledge of its effects, especially in low-exposure areas, are limited. Here, we investigate risks for ASD and ADHD associated with prenatal exposure to air pollution in an area with air pollution levels generally well below World Health Organization (WHO) air quality guidelines. We used an epidemiological database (MAPSS) consisting of virtually all (99%) children born between 1999 and 2009 (48,571 births) in the study area, in southern Sweden. MAPSS consists of data on modelled nitrogen oxide (NOx) levels derived from a Gaussian dispersion model; maternal residency during pregnancy; perinatal factors collected from a regional birth registry; and socio-economic factors extracted from Statistics Sweden. All ASD and ADHD diagnoses in our data were undertaken at the Malmö and Lund Departments of Child and Adolescent Psychiatry, using standardized diagnostic instruments. We used logistic regression analyses to obtain estimates of the risk of developing ASD and ADHD associated with different air pollution levels, with adjustments for potential perinatal and socio-economic confounders. In this longitudinal cohort study, we found associations between air pollution exposure during the prenatal period and and the risk of developing ASD. For example, an adjusted Odds Ratio (OR) of 1.40 and its 95% Confidence Interval (CI) (95% CI: 1.02-1.93) were found when comparing the fourth with the first quartile of NOx exposure. We did not find similar associations on the risk of developing ADHD. This study contributes to the growing evidence of a link between prenatal exposure to air pollution and autism spectrum disorders, suggesting that prenatal exposure even below current WHO air quality guidelines may increase the risk of autism spectrum disorders.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-164277 (URN)10.1016/j.envint.2019.105149 (DOI)31629172 (PubMedID)2-s2.0-85073223126 (Scopus ID)
Available from: 2019-10-21 Created: 2019-10-21 Last updated: 2019-10-31Bibliographically approved
Oudin, A., Andersson, J., Sundström, A., Nordin Adolfsson, A., Oudin Åström, D., Adolfsson, R., . . . Nordin, M. (2019). Traffic-Related Air Pollution as a Risk Factor for Dementia: No Clear Modifying Effects of APOEɛ4 in the Betula Cohort. Journal of Alzheimer's Disease, 71(3), 733-740
Open this publication in new window or tab >>Traffic-Related Air Pollution as a Risk Factor for Dementia: No Clear Modifying Effects of APOEɛ4 in the Betula Cohort
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2019 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 71, no 3, p. 733-740Article in journal (Refereed) Published
Abstract [en]

It is widely known that the apolipoprotein E (APOE) ɛ4 allele imposes a higher risk for Alzheimer’s disease (AD). Recent evidence suggests that exposure to air pollution is also a risk factor for AD, and results from a few studies indicate that the effect of air pollution on cognitive function and dementia is stronger in APOE ɛ4 carriers than in non-carriers. Air pollution and interaction with APOE ɛ4 on AD risk thus merits further attention. We studied dementia incidence over a 15-year period from the longitudinal Betula study in Northern Sweden. As a marker for long-term exposure to traffic-related air pollution, we used modelled annual mean nitrogen oxide levels at the residential address of the participants at start of follow-up. Nitrogen oxide correlate well with fine particulate air pollution levels in the study area. We had full data on air pollution, incidence of AD and vascular dementia (VaD), APOE ɛ4 carrier status, and relevant confounding factors for 1,567 participants. As expected, air pollution was rather clearly associated with dementia incidence. However, there was no evidence for a modifying effect by APOE ɛ4 on the association (p-value for interaction > 0.30 for both total dementia (AD+VaD) and AD). The results from this study do not imply that adverse effects of air pollution on dementia incidence is limited to, or stronger in, APOE ɛ4 carriers than in the total population.

Place, publisher, year, edition, pages
IOS Press, 2019
Keywords
Air pollution, Alzheimer’s disease, apolipoprotein E, dementia
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-163266 (URN)10.3233/JAD-181037 (DOI)31450491 (PubMedID)
Available from: 2019-09-12 Created: 2019-09-12 Last updated: 2019-11-15Bibliographically approved
Oudin, A., Segersson, D., Adolfsson, R. & Forsberg, B. (2018). Association between air pollution from residential wood burning and dementia incidence in a longitudinal study in Northern Sweden. PLoS ONE, 13(6), Article ID e0198283.
Open this publication in new window or tab >>Association between air pollution from residential wood burning and dementia incidence in a longitudinal study in Northern Sweden
2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 6, article id e0198283Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: There is highly suggestive evidence for an effect of air pollution exposure on dementia-related outcomes, but evidence is not yet present to clearly pinpoint which pollutants are the probable causal agents. The aims of this study was to assess the longitudinal association between exposures of fine ambient particulate matter (PM2.5) from residential wood burning, and vehicle exhaust, with dementia.

METHOD: We used data from the Betula study, a longitudinal study of dementia in Umeå, Northern Sweden. The study size was 1 806 and the participants were followed from study entry (1993-1995) to 2010. Modelled levels of source-specific fine particulate matter at the residential address were combined with information on wood stoves or wood boilers, and with validated data on dementia diagnosis and individual-level characteristics from the Betula study. Cox proportional hazards models were used to estimate Hazard Ratios (HRs) and their 95% CIs for dementia incidence (vascular dementia and Alzheimer's disease), adjusted for individual-level characteristics.

RESULTS: The emission of PM2.5 from local residential wood burning was associated with dementia incidence with a hazard ratio of 1.55 for a 1 μg/m3 increase in PM2.5 (95% Confidence Interval (CI): 1.00-2.41, p-value 0.05). Study participants with an address in an area with the highest quartile of PM2.5 from residential wood burning and who also had a wood-burning stove were more likely to develop dementia than those in the lower three quartiles without a wood-burning stove with hazard ratios of 1.74 (CI: 1.10-2.75, p-value 0.018). Particulate matter from traffic exhaust seemed to be associated with dementia incidence with hazard ratios of 1.66, (CI: 1.16-2.39), p-value 0.006, and 1.41 (CI: 0.97-2.23), p-value 0.07, in the third and fourth quartiles, respectively.

CONCLUSIONS: If the associations we observed are causal, then air pollution from residential wood burning, and air pollution from traffic, might be independent important risk factors for dementia.

Place, publisher, year, edition, pages
Public Library of Science, 2018
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-149048 (URN)10.1371/journal.pone.0198283 (DOI)29897947 (PubMedID)
Available from: 2018-06-14 Created: 2018-06-14 Last updated: 2018-10-01Bibliographically approved
Malmqvist, E., Lisberg Jensen, E., Westerberg, K., Stroh, E., Rittner, R., Gustafsson, S., . . . Oudin, A. (2018). Estimated health benefits of exhaust free transport in the city of Malmö, Southern Sweden. Environment International, 118, 78-85
Open this publication in new window or tab >>Estimated health benefits of exhaust free transport in the city of Malmö, Southern Sweden
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2018 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 118, p. 78-85Article in journal (Refereed) Published
Abstract [en]

Air pollution is responsible for one in eight premature deaths worldwide, and thereby a major threat to human health. Health impact assessments of hypothetic changes in air pollution concentrations can be used as a mean of assessing the health impacts of policy, plans and projects, and support decision-makers in choices to prevent disease.

The aim of this study was to estimate health impacts attributable to a hypothetical decrease in air pollution concentrations in the city of Malmö in Southern Sweden corresponding to a policy on-road transportations without tail-pipe emissions in the municipality. We used air pollution data modelled for each of the 326,092 inhabitants in Malmö by a Gaussian dispersion model combined with an emission database with >40,000 sources. The dispersion model calculates Nitrogen Oxides (NOx) (later transformed into Nitrogen Dioxide (NO2)) and particulate matter with an aerodynamic diameter < 2.5 μg/m3 (PM2.5) with high spatial and temporal resolution (85 m and 1 h, respectively).

The average individual reduction was 5.1 (ranging from 0.6 to 11.8) μg/m3 in NO2, which would prevent 55 (2% of all deaths) to 93 (4%) deaths annually, depending on dose-response function used. Furthermore, we estimate that the NO2 reduction would result in 21 (6%) fewer cases of incident asthma in children, 95 (10%) fewer children with bronchitis every year, 30 (1%) fewer hospital admissions for respiratory disease, 87(4%) fewer dementia cases, and 11(11%) fewer cases of preeclampsia every year. The average reduction in PM2.5 of 0.6 (ranging from 0.1 till 1.7) μg/m3 would mean that 2729 (0.3%) work days would not be lost due to sick-days and that there would be 16,472 fewer restricted activity days (0.3%) that year had all on-road transportations been without tail-pipe emissions.

Even though the estimates are sensitive to the dose-response functions used and to exposure misclassification errors, even the most conservative estimate of the number of prevented deaths is 7 times larger than the annual traffic fatalities in Malmö, indicating a substantial possibility to reduce the health burden attributed to tail-pipe emissions in the study area.

Keywords
Health impact assessment, HIA, Health effects, Clean air policy, Air pollution
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-148509 (URN)10.1016/j.envint.2018.05.035 (DOI)000438183000010 ()29807292 (PubMedID)
Available from: 2018-06-07 Created: 2018-06-07 Last updated: 2018-09-19Bibliographically approved
Oudin Åström, D., Åström, C., Forsberg, B., Vicedo-Cabrera, A. M., Gasparrini, A., Oudin, A. & Sundquist, K. (2018). Heat wave-related mortality in Sweden: a case-crossover study investigating effect modification by neighbourhood deprivation. Scandinavian Journal of Public Health
Open this publication in new window or tab >>Heat wave-related mortality in Sweden: a case-crossover study investigating effect modification by neighbourhood deprivation
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2018 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIMS: The present study aimed to investigate if set thresholds in the Swedish heat-wave warning system are valid for all parts of Sweden and if the heat-wave warning system captures a potential increase in all-cause mortality and coronary heart disease (CHD) mortality. An additional aim was to investigate whether neighbourhood deprivation modifies the relationship between heat waves and mortality.

METHODS: From 1990 until 2014, in 14 municipalities in Sweden, we collected data on daily maximum temperatures and mortality for the five warmest months. Heat waves were defined according to the categories used in the current Swedish heat-wave warning system. Using a case-crossover approach, we investigated the association between heat waves and mortality in Sweden, as well as a modifying effect of neighbourhood deprivation.

RESULTS: On a national as well as a regional level, heat waves significantly increased both all-cause mortality and CHD mortality by approximately 10% and 15%, respectively. While neighbourhood deprivation did not seem to modify heat wave-related all-cause mortality, CHD mortality did seem to modify the risk.

CONCLUSIONS: It may not be appropriate to assume that heat waves in Sweden will have the same impact in a northern setting as in a southern, or that the impact of heat waves will be the same in affluent and deprived neighbourhoods. When designing and implementing heat-wave warning systems, neighbourhood, regional and national information should be incorporated.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Heat wave, heat-wave warning system, mortality, neighbourhood deprivation
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-152188 (URN)10.1177/1403494818801615 (DOI)30253698 (PubMedID)
Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2019-04-04
Kuiper, I. N., Svanes, C., Abramson, M. J., Benediktsdottir, B., Bertelsen, R. J., Dennekamp, M., . . . Johannessen, A. (2018). Lung health in adulthood after childhood exposure to air pollution and greenness. Paper presented at 28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE. European Respiratory Journal, 52
Open this publication in new window or tab >>Lung health in adulthood after childhood exposure to air pollution and greenness
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2018 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Little is known on childhood exposure to air pollution and adult chronic respiratory outcomes.

Aim: To investigate associations between air pollution and greenness in childhood and adult lung health.

Methods: In selected centres of the RHINESSA study (age 18-52) we analysed the outcomes respiratory symptoms (≥3 symptoms), severe wheeze (wheeze last year with breathlessness, no cold) and late onset asthma (>10 years). We calculated mean annual exposures of PM2.5, PM10, NO2 (µg/m³) and greenness (Normalized Difference Vegetation Index, 100m buffer) from offspring's birth till age 18, categorised into mean exposure <10 years and 11-18 years. We performed multilevel logistic regression clustered by family, stratified by centre and adjusted for childhood passive smoke and parental asthma.

Results: 12% had ≥3 respiratory symptoms, 7.7% severe wheeze, and 9.4% late onset asthma. Overall estimates: greenness was associated with less respiratory symptoms, PM2.5 and NO2 with more late onset asthma. Exposure <10 years: Greenness was associated with less wheeze in Tartu (OR 0.29, 95%CI 0.11-0.73). PM2.5 (OR 1.22, 95%CI 1.00-1.48) and NO2 (OR 1.06, 95%CI 1.01-1.11) were risk factors for late onset asthma in Bergen. PM10 was a risk factor for respiratory symptoms (OR 1.21, 95%CI 1.04-1.41) in Uppsala and late onset asthma (OR 1.23, 95%CI 1.02-1.45) in Bergen. Exposure 11-18 years: Greenness was protective for respiratory symptoms (OR 0.29, 95%CI 0.10-0.86) and wheeze (OR 0.39, 95%CI 0.19-0.80) in Tartu.

Conclusions: Childhood exposure to greenness was associated with less respiratory symptoms, while air pollutants were associated with more respiratory symptoms (some centres) and late onset asthma.

Place, publisher, year, edition, pages
European Respiratory Society, 2018
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-156004 (URN)10.1183/13993003.congress-2018.OA5185 (DOI)000455567100482 ()
Conference
28th International Congress of the European-Respiratory-Society (ERS), SEP 15-19, 2018, Paris, FRANCE
Note

Supplement: 62

Meeting Abstract: OA5185

Available from: 2019-02-01 Created: 2019-02-01 Last updated: 2019-02-01Bibliographically approved
Oudin, A., Malmqvist, E. & Forsberg, B. (2018). Läkare bör erbjudas fortbildning i miljömedicin. , 115, Article ID E3XP.
Open this publication in new window or tab >>Läkare bör erbjudas fortbildning i miljömedicin
2018 (Swedish)Other (Refereed)
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-146662 (URN)29558007 (PubMedID)
Available from: 2018-04-16 Created: 2018-04-16 Last updated: 2018-06-09
Andersson, J., Oudin, A., Sundström, A., Forsberg, B., Adolfsson, R. & Nordin, M. (2018). Road traffic noise, air pollution, and risk of dementia: results from the Betula project. Environmental Research, 166, 334-339
Open this publication in new window or tab >>Road traffic noise, air pollution, and risk of dementia: results from the Betula project
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2018 (English)In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 166, p. 334-339Article in journal (Refereed) Published
Abstract [en]

Background: There is growing evidence for a negative impact of traffic-related air pollution on risk of dementia. However, the contribution of noise exposure to this association has been rarely examined.

Objective: We aimed to investigate the individual and combined effect of noise and air pollution on risk of dementia.

Methods: Data on dementia incidence over a 15 year period was obtained from the Betula project, a longitudinal study on health and ageing. Estimates of annual mean levels of nitrogen oxides (NOx) at the participants’ residential address were obtained using a land-use regression model. Modelled data provided road traffic noise levels (Leq. 24 h) at the participants’ residential address at baseline. Cox proportional hazard regression was used to calculate hazard ratios (HR).

Results: Of 1721 participants at baseline, 302 developed dementia during the follow up period. Exposure to noise levels (Leq. 24 h) > 55 dB had no significant effect on dementia risk (HR 0.95; CI: 0.57, 1.57). Residing in the two highest quartiles of NOx exposure was associated with an increased risk of dementia. The risk associated with NOx was not modified by adjusting for noise. Moreover, we found no significant interaction effects between NOx and road traffic noise on dementia risk.

Conclusion: We found no evidence that exposure to road traffic noise, either independently or in combination with traffic air pollution, was associated with risk of dementia in our study area. Our results suggest that pollution should be considered the main component in the association between traffic related exposures and dementia.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Epidemiology, Alzheimer's disease, Vascular dementia, Land-use regression model
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-149090 (URN)10.1016/j.envres.2018.06.008 (DOI)000445318200035 ()29909174 (PubMedID)2-s2.0-85048442726 (Scopus ID)
Available from: 2018-06-15 Created: 2018-06-15 Last updated: 2019-11-15Bibliographically approved
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
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