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Bjerg, Anders
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Publications (10 of 36) Show all publications
Bjerg, A., Winberg, A., Berthold, M., Mattsson, L., Borres, M. P. & Rönmark, E. (2015). A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren. Pediatric Allergy and Immunology, 26(6), 557-563
Open this publication in new window or tab >>A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren
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2015 (English)In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 6, p. 557-563Article in journal (Refereed) Published
Abstract [en]

Background: Animal sensitization is a major determinant of asthma in children. Component-resolved studies of unselected pediatric populations are lacking. The aim was to describe sensitization to animal components and the association with asthma and rhinitis in animal-sensitized schoolchildren. Methods: A random sample of 696 children (11-12years) from a Swedish population-based cohort was tested for sensitization to cat, dog, and horse dander using ImmunoCAP. Sera from animal-sensitized children were further analyzed by microarray including three allergen components from cat, four from dog, and two from horse. The parents completed an expanded ISAAC questionnaire. Results: Of 259 animal-sensitized children (0.1 kU(A)/l), 51% were sensitized to all three, 23% to two, and 25% to one species. Current asthma and asthma symptoms following contact with cats were associated with co-sensitization to Fel d 1 and Fel d 4. This association was seen already at moderate-level sensitization (1-15 ISU) to Fel d 4, at which level most children were sensitized to Fel d 1, as well. In dog-sensitized children, the majority was sensitized to more than one dog component, and co-sensitization to Can f 5 and Can f 1/f 2 conferred the greatest risk for asthma. Sensitization to the highly cross-reactive serum albumins was uncommon and not associated with asthma. Conclusions: Among schoolchildren in northern Sweden, where mite allergy is uncommon, furry animals were the primary perennial sensitizers. Asthma was associated with higher levels of component sensitization, and sensitization to more than one component from the same animal conferred the greatest risk.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
Keywords
children, allergy, furry animals, allergen components, component-resolved diagnosis, asthma, rhinitis
National Category
Immunology in the medical area Pediatrics
Identifiers
urn:nbn:se:umu:diva-109914 (URN)10.1111/pai.12422 (DOI)000361476700011 ()26059105 (PubMedID)
Available from: 2015-10-14 Created: 2015-10-09 Last updated: 2018-06-07Bibliographically approved
Eriksson, J., Ekerljung, L., Bossios, A., Bjerg, A., Wennergren, G., Rönmark, E., . . . Lundbäck, B. (2015). Aspirin-intolerant asthma in the population: prevalence and important determinants. Clinical and Experimental Allergy, 45(1), 211-219
Open this publication in new window or tab >>Aspirin-intolerant asthma in the population: prevalence and important determinants
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2015 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 45, no 1, p. 211-219Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Population-based studies on aspirin-intolerant asthma are very few and no previous population study has investigated risk factors for the condition.

OBJECTIVE: To investigate the prevalence and risk factors of aspirin-intolerant asthma in the general population.

METHODS: A questionnaire on respiratory health was mailed to 30 000 randomly selected subjects aged 16-75 years in West Sweden, 29 218 could be traced and 18 087 (62%) responded. The questionnaire included questions on asthma, respiratory symptoms, aspirin-induced dyspnea and possible determinants.

RESULTS: The prevalence of aspirin-intolerant asthma was 0.5%, 0.3% in men and 0.6% in women (p=0.014). Sick leave, emergency visits due to asthma and all investigated lower respiratory symptoms were more common in aspirin-intolerant asthma than in aspirin-tolerant asthma. Obesity was a strong risk factor for aspirin-intolerant asthma (BMI>35: OR 12.1; 95% CI 2.49-58.5) and there was a dose-response relationship between increasing body mass index and risk of aspirin-intolerant asthma. Obesity, airborne occupational exposure and visible mold at home were considerably stronger risk factors for aspirin-intolerant asthma than for aspirin-tolerant asthma. Current smoking was a risk factor for aspirin-intolerant asthma (OR 2.55; 95% CI 1.47-4.42), but not aspirin-tolerant asthma.

CONCLUSION: Aspirin-intolerant asthma identified in the general population was associated with a high burden of symptoms, uncontrolled disease and a high morbidity. Increasing body mass index increased the risk of aspirin-intolerant asthma in a dose-response manner. A number of risk factors, including obesity and current smoking, were considerably stronger for aspirin-intolerant asthma than for aspirin-tolerant asthma.

Place, publisher, year, edition, pages
John Wiley & Sons, 2015
Keywords
aspirin-intolerant asthma, epidemiology, risk factors, obesity, population survey
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-96072 (URN)10.1111/cea.12359 (DOI)000346910800024 ()24961377 (PubMedID)
Available from: 2014-11-11 Created: 2014-11-11 Last updated: 2018-06-07Bibliographically approved
Berthold, M., Bjerg, A., Winberg, A., Mattsson, L., Borres, M. & Rönmark, E. (2015). Association of Sensitization to Specific Pet Allergen Components with Asthma Symptoms in School Children. Paper presented at Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI), Houston, TX, February 20-24, 2015. Journal of Allergy and Clinical Immunology, 135(2), AB22-AB22
Open this publication in new window or tab >>Association of Sensitization to Specific Pet Allergen Components with Asthma Symptoms in School Children
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2015 (English)In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 135, no 2, p. AB22-AB22Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Animal sensitization is a known determinant of asthma in children. The objective was to study the association of asthma with sensitization to pet allergen components in schoolchildren. Methods: A random sample of 696 children (11-12 y) from a Swedish population-based cohort was analyzed for sensitization (≥0.1 kUA/L) to cat, dog and horse dander extracts using ImmunoCAP. Sensitized children were further analyzed for IgE antibodies to animal allergen components using ImmunoCAP ISAC112. An expanded ISAAC questionnaire was completed by the parents. Results: Of 259 animal-sensitized children (37%) the majority (75%) were sensitized to more than one species. Among the 11 % (n=77) with current asthma 69 % were sensitized to at least one animal extract, as compared to one third of children without current asthma (p<0.001). Current asthma and asthma symptoms upon contact with cats were associated with co-sensitization to Fel d 1 and Fel d 4. Already at moderate levels of IgE antibodies to Fel d 4 (1-15 ISU), at which level most children were sensitized also to Fel d 1, the prevalence of asthma symptoms upon contact with cats was significantly increased. Dog-sensitized children were commonly sensitized to several dog components, and the greatest risk for asthma was seen in children co-sensitized to Can f 5 and Can f 1/f 2. Conclusions: Among Northern Swedish schoolchildren furry animals were the main perennial sensitizers. Asthma symptoms were associated with sensitizations to multiple components within an animal species. In particular, cat Fel d 4 sensitization was strongly related to asthma symptoms.

Place, publisher, year, edition, pages
Elsevier, 2015
National Category
Respiratory Medicine and Allergy Immunology in the medical area
Identifiers
urn:nbn:se:umu:diva-109955 (URN)10.1016/j.jaci.2014.12.1005 (DOI)000361129600071 ()
Conference
Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI), Houston, TX, February 20-24, 2015
Available from: 2015-10-12 Created: 2015-10-09 Last updated: 2018-06-07Bibliographically approved
Bjerg, A., Hedman, L., Perzanowski, M., Wennergren, G., Lundbäck, B. & Rönmark, E. (2015). Decreased importance of environmental risk factors for childhood asthma from 1996 to 2006. Clinical and Experimental Allergy, 45(1), 146-153
Open this publication in new window or tab >>Decreased importance of environmental risk factors for childhood asthma from 1996 to 2006
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2015 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 45, no 1, p. 146-153Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The large increase in asthma prevalence continues in several, but not all areas. Despite the individual risk factors that have been identified, the reasons for the observed trends in prevalence are largely unknown.

OBJECTIVE: This study sought to characterize what trends in risk factors accompanied trends in asthma prevalence.

METHODS: Two population-based cohorts of 7-8-year-old children from the same Swedish study areas examined by expanded ISAAC questionnaires were compared 10 years apart. In 1996 3,430 (97% participation) and in 2006 2,585 (96% participation) questionnaires were completed. A subset was skin-prick tested: in 1996, 2,148 (88% participation) and in 2006, 1,700 (90% participation) children. The adjusted population attributable fraction (aPAF) was calculated using the prevalence and multivariate odds ratio of each risk factor.

RESULTS: The prevalence of current asthma and wheeze were similar in 1996 and 2006. Allergic sensitisation however increased from 21% to 30%. The prevalence of parental asthma increased from 17% to 24% while respiratory infections and maternal smoking decreased (60% to 29% and 32% to 16%, respectively). The aPAFs of non-environmental risk factors for current asthma increased 1996-2006: Allergic sensitization from 35% to 41%, parental asthma from 27% to 45% and male sex from 20% to 25%. Conversely, the aPAFs of environmental risk factors decreased: Respiratory infections from 36% to 32% and damp home and maternal smoking from 14% and 19% respectively to near zero in 2006.

CONCLUSIONS AND CLINICAL RELEVANCE: From 1996 to 2006 the non-environmental risk factors parental asthma, allergic sensitisation and male sex had an increasing or constant importance for current asthma in 7-8-year-old children. The importance of the environmental exposures damp home, respiratory infections and maternal smoking decreased. This counter-balancing in risk factors may explain the level prevalence of current asthma.

Keywords
asthma, children, epidemiology, population-attributable fraction, risk factors, wheeze
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-95999 (URN)10.1111/cea.12439 (DOI)000346910800017 ()25323476 (PubMedID)
Available from: 2014-11-11 Created: 2014-11-11 Last updated: 2018-06-07Bibliographically approved
Hedman, L., Andersson, M., Bjerg, A., Forsberg, B., Lundbäck, B. & Rönmark, E. (2015). Environmental risk factors related to the incidence of wheeze and asthma in adolescence. Clinical and Experimental Allergy, 45(1), 184-191
Open this publication in new window or tab >>Environmental risk factors related to the incidence of wheeze and asthma in adolescence
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2015 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 45, no 1, p. 184-191Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Asthma is common among adolescents, but there are few population-based studies on the risk factors for incident asthma and wheeze at this age group OBJECTIVE: To study risk factors for incident asthma and wheeze in adolescence.

METHOD: Within the Obstructive Lung Disease In Northern Sweden (OLIN) studies, a cohort of 3430 school children (age 7-8y) was recruited in 1996. In the present study, this cohort was followed from age 12 to 19y. At baseline (age 12y), 3151 participated and skin prick tests (SPT) were performed. The cohort was resurveyed annually and risk factors for the cumulative incidence of asthma and wheeze from age 12 to19y were analysed using multivariate Cox regression.

RESULTS: Female sex (wheeze: HR1.4 95%CI 1.2-1.6; asthma: HR1.8 95%CI1.2-2.5) and a positive SPT to cat, dog or horse at baseline (wheeze: HR 1.6 95%CI 1.2-2.1; asthma: HR2.3 95%CI 1.4-4.0) were significantly associated with the cumulative incidence of wheeze and asthma. Increasing numbers of siblings were inversely related to the incidence of wheeze (HR0.9 95%CI 0.8-0.97) and asthma (HR0.8 95%CI 0.7-0.97). Parental asthma was related to the incidence of asthma (HR 1.8 95%CI 1.2-2.6) while ever smoking (HR 2.0 95%CI 1.6-2.4) and house dampness (HR 1.3 95%CI 1.1-1.6) were risk factors for the incidence of wheeze. Maternal ETS exposure increased the risk of incident asthma in non-sensitized subjects (HR 1.9 95%CI 1.0-3.7).

CONCLUSION AND CLINICAL RELEVANCE: Several environmental risk factors related to the incidence of asthma and wheeze in adolescence were identified and may be possible targets for intervention and prevention.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-91518 (URN)10.1111/cea.12335 (DOI)000346910800021 ()24773259 (PubMedID)
Available from: 2014-08-10 Created: 2014-08-10 Last updated: 2018-06-07Bibliographically approved
James, H. R., Perzanowski, M. S., Rönmark, E., Hedman, L., Bjerg, A., Schuyler, A. J., . . . Platts-Mills, T. A. (2015). IgE Antibodies to Mammalian Allergens Are a Major Risk Factor for Prevalence, Severity, and Persistence of Asthma in Northern Sweden. Paper presented at Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI), Houston, TX, February 20-24, 2015. Journal of Allergy and Clinical Immunology, 135(2), AB22-AB22
Open this publication in new window or tab >>IgE Antibodies to Mammalian Allergens Are a Major Risk Factor for Prevalence, Severity, and Persistence of Asthma in Northern Sweden
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2015 (English)In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 135, no 2, p. AB22-AB22Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

IgE to mammalian allergens can contribute significantly to asthma risk. Studying the details of the relationship between animal sensitization and asthma is simpler in an environment where mite, fungal, and cockroach allergens make little or no contribution to asthma risk. Methods: Quantitative assays for IgE to eight allergens were carried out on 963 sera from 19-year-olds in a population-based cohort in northern Sweden, and associations with questionnaire data from ages 7, 12, and 19 on asthma symptoms, diagnosis, and treatment were tested. Results: Overall, 79 (53%) of the students with a physician diagnosis of asthma were positive to one or more of the mammalian allergens (cat, dog, or horse danders) tested. Of the allergens assessed, only mammalian allergens, birch, and timothy grass pollen showed a significant relationship with asthma diagnosis. Multivariate analysis showed that high titer (>17.5 IU/ml) IgE to any mammalian allergen had the strongest relationship with asthma at age 19 (odds ratio 5.1 [3.0-8.6]). Furthermore, IgE to mammalian allergens gave an odds ratio of 8.5 [4.9-15] for asthma that started before age 12 and was still present at age 19. Sensitization to Fel d 1 and Fel d 4 was strongly associated with asthma and significantly reduced in cat owners. Conclusions: Sensitization to cat and dog related allergens, and specifically to the components Fel d 1 and Fel d 4, is a major risk factor for the persistence and severity of asthma in an area where these are the only significant perennial allergens.

Place, publisher, year, edition, pages
Elsevier, 2015
National Category
Respiratory Medicine and Allergy Immunology in the medical area
Identifiers
urn:nbn:se:umu:diva-109958 (URN)10.1016/j.jaci.2014.12.1004 (DOI)000361129600070 ()
Conference
Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI), Houston, TX, February 20-24, 2015
Available from: 2015-10-12 Created: 2015-10-09 Last updated: 2018-06-07Bibliographically approved
Sjölander, S., Bjerg, A., Ekerljung, L., Bengtsson-Gref, O., Borres, M., Rönmark, E., . . . Lundbäck, B. (2015). IgE to Furry Animal Allergen Components Was Associated with Asthma in a Population-Based Study of Adults. Paper presented at Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI), Houston, TX, February 20-24, 2015. Journal of Allergy and Clinical Immunology, 135(2), AB22-AB22
Open this publication in new window or tab >>IgE to Furry Animal Allergen Components Was Associated with Asthma in a Population-Based Study of Adults
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2015 (English)In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 135, no 2, p. AB22-AB22Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Atopic sensitization increases the risk of asthma. Our aim was to investigate patterns of sensitization to allergens and allergen components in relation to asthma among adults in a Swedish population-based sample. Methods: A questionnaire targeting asthma was sent to 30 000 randomly selected adults (16-75 y) in west Sweden. Of the 18 087 responders, a randomly selected sample of 2000 subjects and in addition all 1536 subjects reporting asthma were invited to clinical examinations. Sera were received from 906 subjects with asthma and from 1000 without reported asthma (controls) and were tested for three IgE panels of inhalant and food allergens. Samples with a level of IgE >0.35 kUA/l were further analyzed for IgE against each individual allergen and nine allergen components related to furry animals. Results: The risk of being sensitized to any of the 21 tested allergens was significantly higher in the asthma group. The risk was highest for individuals sensitized to furry animals (risk ratios 4,5-7,9). The level of IgE to animal allergens was also significantly higher in the asthma group. Co-sensitization to more than one cat and/or dog allergen component conferred a greater risk for asthma. Simultaneous sensitization to the cat allergens Fel d 1 and Fel d 4 was associated with asthma. Conclusions: In this large population-based study subjects with asthma were commonly co-sensitized to more than one animal allergen component, especially to Fel d 1 and Fel d 4. Component-resolved analysis has the potential to increase precision when assessing asthma in adults.

Place, publisher, year, edition, pages
Elsevier, 2015
National Category
Respiratory Medicine and Allergy Immunology in the medical area
Identifiers
urn:nbn:se:umu:diva-109956 (URN)10.1016/j.jaci.2014.12.1003 (DOI)000361129600069 ()
Conference
Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI), Houston, TX, February 20-24, 2015
Available from: 2015-10-12 Created: 2015-10-09 Last updated: 2018-06-07Bibliographically approved
Hagstad, S., Backman, H., Bjerg, A., Ekerljung, L., Ye, X., Hedman, L., . . . Lundbäck, B. (2015). Prevalence and risk factors of COPD among never-smokers in two areas of Sweden: Occupational exposure to gas, dust or fumes is an important risk factor. Respiratory Medicine, 109(11), 1439-1445
Open this publication in new window or tab >>Prevalence and risk factors of COPD among never-smokers in two areas of Sweden: Occupational exposure to gas, dust or fumes is an important risk factor
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2015 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 109, no 11, p. 1439-1445Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Although active tobacco smoking is the main risk factor for COPD, COPD is not uncommon also among never-smokers. Different study locations along with different spirometric definitions of COPD have historically yielded different prevalence estimates of the disease.

AIM: To study current prevalence and risk factors of COPD among never-smokers in two areas of Sweden.

METHODS: Data collected in 2008-2012 within the West Sweden Asthma Study and Obstructive Lung Disease in Northern Sweden Studies was pooled. The study population consisted of 1839 subjects who participated in spirometry and interviews. COPD was defined as post-bronchodilator a) FEV1/(F)VC < 0.7, b) FEV1/FVC < 0.7 and c) FEV1/FVC < lower limit of normal.

RESULTS: Of the 1839 subjects, 967 (52.6%) were never-smokers. Among the never-smoking subjects, the prevalence of COPD according to definitions a-c was 7.7%, 4.9% and 3.0%, respectively. The corresponding prevalence of GOLD grade ≥2 was 2.0%, 1.4% and 1.3%. No significant difference in prevalence between the two study areas was observed. In never-smokers, occupational exposure to gas, dust or fumes (GDF) was significantly associated with both COPD (OR 1.85, 95% CI 1.03-3.33), and GOLD ≥2 (OR 4.51, 1.72-11.9) according to definition a), after adjusting for age, educational level and exposure to passive smoking at work.

CONCLUSION: Depending on definition, prevalence of COPD among never-smokers was 3.0-7.7%, whereas GOLD ≥2 was present in 1.3-2.0%. Occupational exposure to GDF remained independently and significantly associated with COPD regardless of spirometric definition of the disease.

Keywords
COPD, Never smokers, Epidemiology, Population study, Risk factors
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-111246 (URN)10.1016/j.rmed.2015.09.012 (DOI)000364820800010 ()26440676 (PubMedID)
Available from: 2015-11-11 Created: 2015-11-11 Last updated: 2018-06-07Bibliographically approved
Bjerg, A., Eriksson, J., Ólafsdóttir, I. S., Middelveld, R., Franklin, K., Forsberg, B., . . . Janson, C. (2015). The association between asthma and rhinitis is stable over time despite diverging trends in prevalence. Respiratory Medicine, 109(3), 312-319
Open this publication in new window or tab >>The association between asthma and rhinitis is stable over time despite diverging trends in prevalence
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2015 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 109, no 3, p. 312-319Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Despite the well-known association between asthma and rhinitis, in Swedish adults the prevalence of rhinitis rose from 22% to 31% between 1990 and 2008 while asthma prevalence was unchanged. We tested whether the association of rhinitis with asthma was stable over time using the same population-based databases.

METHODS: Two surveys of adults (20-44 years) living in three regions of Sweden, carried out in 1990 (n = 8982) and 2008 (n = 9156) were compared. Identical questions regarding respiratory symptoms, asthma and rhinitis were used. Asthmatic wheeze: Wheeze with breathlessness apart from colds. Current asthma: Asthma attacks and/or asthma medication use.

RESULTS: Subjects with rhinitis had level time trends in asthmatic wheeze, current asthma and most nocturnal respiratory symptoms between 1990 and 2008, adjusted for age, sex, area and smoking. Any wheeze however decreased slightly. In never-smokers asthma symptoms were similarly associated with rhinitis in 1990 and 2008: any wheeze OR 4.0 vs. 4.4 (p = 0.339); asthmatic wheeze OR 6.0 vs. 5.9 (p = 0.937); and current asthma OR 9.6 vs. 7.7 (p = 0.213). In the whole population there were decreases in the asthma symptoms most closely associated to smoking, which decreased by half 1990-2008. Conversely current asthma, which was strongly associated with rhinitis and not with smoking, increased (p < 0.001).

CONCLUSIONS: The association of rhinitis with asthma was stable between 1990 and 2008. The pattern in the time trends of asthma outcomes strongly suggests that decreased smoking counterbalanced the driving effect of increased rhinitis on asthma prevalence. The findings illustrate the public health benefits of decreased smoking.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
Asthma, Rhinitis, Wheeze, Smoking, Epidemiology, Adults
National Category
Occupational Health and Environmental Health Cardiac and Cardiovascular Systems Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-101788 (URN)10.1016/j.rmed.2015.01.002 (DOI)000351647000004 ()25638411 (PubMedID)
Available from: 2015-04-13 Created: 2015-04-13 Last updated: 2018-06-07Bibliographically approved
Hagstad, S., Bjerg, A., Ekerljung, L., Backman, H., Lindberg, A., Rönmark, E. & Lundbäck, B. (2014). Passive smoking exposure is associated with increased risk of COPD in never-smokers. Chest, 145(6), 1298-1304
Open this publication in new window or tab >>Passive smoking exposure is associated with increased risk of COPD in never-smokers
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2014 (English)In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 145, no 6, p. 1298-1304Article in journal (Refereed) Published
Abstract [en]

BACKGROUND Passive smoking, or environmental tobacco smoke (ETS), is a risk factor for lung cancer, cardiovascular disease and childhood asthma, but a relationship with COPD has not been fully established.

AIM To study ETS as a risk factor for COPD in never-smokers.

METHODS Data from three cross-sectional studies within the Obstructive Lung Disesease in Northern Sweden (OLIN) database were pooled. Of the 2182 lifelong never-smokers 2118 completed structured interviews and spirometry of acceptable quality. COPD was defined according to the GOLD criteria using post-bronchodilator spirometry. The association of COPD with ETS in single and multiple settings was calculated by multivariate logistic regression adjusting for known risk factors for COPD.

RESULTS COPD prevalence was associated with increased ETS exposure: 4.2% (no ETS), 8.0% (ETS ever at home), 8.3% (ETS at previous work) and 14.7% (ETS ever at home and at both previous and current work), test for trend p=0.003. Exclusion of subjects aged ≥65 years and subjects reporting asthma yielded similar results. ETS in multiple settings, such as ever at home and at both previous and current work was strongly associated to COPD, OR 3.80 (95% CI 1.29-11.2).

CONCLUSIONS In this population-based sample of never-smokers, ETS was independently associated with COPD. The association was stronger for ETS in multiple settings. ETS in multiple settings was, after age, the strongest risk factor for COPD and comparable to personal smoking of up to 14 cigarettes/day in comparable materials. The findings strongly advocate measures against smoking in public places.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-85535 (URN)10.1378/chest.13-1349 (DOI)000337355600023 ()24356778 (PubMedID)
Available from: 2014-02-06 Created: 2014-02-06 Last updated: 2018-06-08Bibliographically approved
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