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Oudin, Anna
Publications (10 of 37) Show all publications
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: 2018-12-19
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)
Available from: 2018-06-15 Created: 2018-06-15 Last updated: 2018-12-13Bibliographically 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
Oudin, A., Bråbäck, L., Oudin Åström, D. & Forsberg, B. (2017). Air pollution and dispensed medications for asthma, and possible effect modifiers related to mental health and socio-economy: a longitudinal cohort study of Swedish children and adolescents. International Journal of Environmental Research and Public Health, 14(11), Article ID 1392.
Open this publication in new window or tab >>Air pollution and dispensed medications for asthma, and possible effect modifiers related to mental health and socio-economy: a longitudinal cohort study of Swedish children and adolescents
2017 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, no 11, article id 1392Article in journal (Refereed) Published
Abstract [en]

It has been suggested that children that are exposed to a stressful environment at home have an increased susceptibility for air pollution-related asthma. The aim here was to investigate the association between air pollution exposure and asthma, and effect modification by mental health and by socio-economic status (as markers of a stressful environment). All individuals under 18 years of age in four Swedish counties during 2007 to 2010 (1.2 million people) were included. The outcome was defined as dispensing at least two asthma medications during follow up. We linked data on NO₂ from an empirical land use regression to data from national registers on outcome and potential confounders. Data was analyzed with logistic regression. There was an odds ratio (OR) of 1.02 (95% Confidence Interval (CI: 1.01-1.03) for asthma associated with a 10 µg·m(-3) increase in NO₂. The association only seemed to be present in areas where NO₂ was higher than 15 µg·m(-3) with an OR of 1.09 (95% CI: 1.07-1.12), and the association seemed stronger in children with parents with a high education, OR = 1.05 (95% CI: 1.02-1.09) and OR = 1.04 (95% CI: 1.01-1.07) in children to mothers and father with a high education, respectively. The association did not seem to depend on medication history of psychiatric disorders. There was weak evidence for the association between air pollution and asthma to be stronger in neighborhoods with higher education levels. In conclusion, air pollution was associated with dispensed asthma medications, especially in areas with comparatively higher levels of air pollution, and in children to parents with high education. We did not observe support for our hypothesis that stressors linked to socio-economy or mental health problems would increase susceptibility to the effects of air pollution on the development of asthma.

Place, publisher, year, edition, pages
Basel: MDPI AG, 2017
Keywords
air pollution, asthma, childhood asthma, mental health, socio-economy, stress
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-142065 (URN)10.3390/ijerph14111392 (DOI)000416545200108 ()29144419 (PubMedID)
Available from: 2017-11-20 Created: 2017-11-20 Last updated: 2018-06-09Bibliographically approved
Oudin, A., Forsberg, B., Lind, N., Nordin, S., Oudin Åström, D., Sundström, A. & Nordin, M. (2017). Is long-term exposure to air pollution associated with episodic memory?: a longitudinal study from northern Sweden. Scientific Reports, 7, Article ID 12789.
Open this publication in new window or tab >>Is long-term exposure to air pollution associated with episodic memory?: a longitudinal study from northern Sweden
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2017 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, article id 12789Article in journal (Refereed) Published
Abstract [en]

Associations between long-term exposure to ambient air pollution and cognitive function have been observed in a few longitudinal studies. Our aim was to investigate the association between long-term exposure to air pollution and episodic memory, a marker of early cognitive decline. We used data from the Betula study in Northern Sweden, and included participants 60 to 85 of age at inclusion, 1,469 persons in total. The participants were followed for up to 22 years, five years apart between 1988 and 2010. A composite of five tasks was used as a measure of episodic memory measure (EMM), and the five-year change in EMM score (ΔEMM) was calculated such that a participant could contribute with up to four measurement pairs. A Land Use Regression Model was used to estimate cumulative annual mean of NOx at the residential address of the participants (a marker for long-term exposure to traffic-related air pollution). There did not seem to be any association between exposure to traffic air pollution and episodic memory change, with a ΔEMM estimate of per 1 µg/m3 increase in NOx of 0.01 (95% Confidence Interval: -0.02,0.03). This is in contrast to a growing body of evidence suggesting associations between air pollution and cognitive function.

Place, publisher, year, edition, pages
Nature Publishing Group, 2017
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-140373 (URN)10.1038/s41598-017-13048-1 (DOI)000412492400015 ()28986549 (PubMedID)
Available from: 2017-10-09 Created: 2017-10-09 Last updated: 2018-06-09Bibliographically approved
Andersen, Z. J., Stafoggia, M., Weinmayr, G., Pedersen, M., Galassi, C., Jørgensen, J. T., . . . Raaschou-Nielsen, O. (2017). Long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in 15 European cohorts within the ESCAPE project. Journal of Environmental Health Perspectives, 125(10), Article ID 107005.
Open this publication in new window or tab >>Long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in 15 European cohorts within the ESCAPE project
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2017 (English)In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 125, no 10, article id 107005Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Epidemiological evidence on the association between ambient air pollution and breast cancer risk is inconsistent.

OBJECTIVE: We examined the association between long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in European women.

METHODS: In 15 cohorts from nine European countries, individual estimates of air pollution levels at the residence were estimated by standardized land-use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE) and Transport related Air Pollution and Health impacts – Integrated Methodologies for Assessing Particulate Matter (TRANSPHORM) projects: particulate matter (PM) ≤2.5μm, ≤10μm, and 2.5–10μm in diameter (PM2.5, PM10, and PMcoarse, respectively); PM2.5 absorbance; nitrogen oxides (NO2 and NOx); traffic intensity; and elemental composition of PM. We estimated cohort-specific associations between breast cancer and air pollutants using Cox regression models, adjusting for major lifestyle risk factors, and pooled cohort-specific estimates using random-effects meta-analyses.

RESULTS: Of 74,750 postmenopausal women included in the study, 3,612 developed breast cancer during 991,353 person-years of follow-up. We found positive and statistically insignificant associations between breast cancer and PM2.5 {hazard ratio (HR)=1.08 [95% confidence interval (CI): 0.77, 1.51] per 5 μg/m(3)}, PM10 [1.07 (95% CI: 0.89, 1.30) per 10 μg/m(3)], PMcoarse[1.20 (95% CI: 0.96, 1.49 per 5 μg/m(3)], and NO(2) [1.02 (95% CI: 0.98, 1.07 per 10 μg/m(3)], and a statistically significant association with NOx [1.04 (95% CI: 1.00, 1.08) per 20 μg/m(3), p=0.04].

CONCLUSIONS: We found suggestive evidence of an association between ambient air pollution and incidence of postmenopausal breast cancer in European women.

Place, publisher, year, edition, pages
Research triangle park: US department of health, 2017
Keywords
use regression models, polycyclic aromatic hydrocarbons, particulate matter, California teachers, lung cancer, environmental pollutants, PM2.5 absorbency, Great Britain, New York, risk
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-141105 (URN)10.1289/EHP1742 (DOI)000413793300017 ()29033383 (PubMedID)
Available from: 2017-10-25 Created: 2017-10-25 Last updated: 2018-06-09Bibliographically approved
Taj, T., Malmqvist, E., Stroh, E., Oudin Åström, D., Jakobsson, K. & Oudin, A. (2017). Short-Term Associations between Air Pollution Concentrations and Respiratory Health-Comparing Primary Health Care Visits, Hospital Admissions, and Emergency Department Visits in a Multi-Municipality Study. International Journal of Environmental Research and Public Health, 14(6), Article ID 587.
Open this publication in new window or tab >>Short-Term Associations between Air Pollution Concentrations and Respiratory Health-Comparing Primary Health Care Visits, Hospital Admissions, and Emergency Department Visits in a Multi-Municipality Study
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2017 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, no 6, article id 587Article in journal (Refereed) Published
Abstract [en]

Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 mu g/m(3) increase in nitrogen dioxide (NO2) levels in Malmo, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 mu g/m(3) increase in PM10). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area.

Place, publisher, year, edition, pages
MDPI AG, 2017
Keywords
air pollution, primary health care, respiratory health, hospital admissions and ER visits, case crossover
National Category
Environmental Sciences Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-137807 (URN)10.3390/ijerph14060587 (DOI)000404107600035 ()
Available from: 2017-07-26 Created: 2017-07-26 Last updated: 2018-06-09Bibliographically approved
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