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  • 1.
    Aström, Daniel Oudin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Edvinsson, Sören
    Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS). Ageing & Living Condit Programme, Umeå University.
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Acute Fatal Effects of Short-Lasting Extreme Temperatures in Stockholm, Sweden: Evidence Across a Century of Change.2013In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 24, no 6, 820-829 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Climate change is projected to increase the frequency of extreme weather events. Short-term effects of extreme hot and cold weather and their effects on mortality have been thoroughly documented, as have epidemiologic and demographic changes throughout the 20th century. We investigated whether sensitivity to episodes of extreme heat and cold has changed in Stockholm, Sweden, from the beginning of the 20th century until the present.

    METHODS: We collected daily mortality and temperature data for the period 1901-2009 for present-day Stockholm County, Sweden. Heat extremes were defined as days for which the 2-day moving average of mean temperature was above the 98th percentile; cold extremes were defined as days for which the 26-day moving average was below the 2nd percentile. The relationship between extreme hot/cold temperatures and all-cause mortality, stratified by decade, sex, and age, was investigated through time series modeling, adjusting for time trends.

    RESULTS: Total daily mortality was higher during heat extremes in all decades, with a declining trend over time in the relative risk associated with heat extremes, leveling off during the last three decades. The relative risk of mortality was higher during cold extremes for the entire period, with a more dispersed pattern across decades. Unlike for heat extremes, there was no decline in the mortality with cold extremes over time.

    CONCLUSIONS: Although the relative risk of mortality during extreme temperature events appears to have fallen, such events still pose a threat to public health.

  • 2. Beelen, Rob
    et al.
    Stafoggia, Massimo
    Raaschou-Nielsen, Ole
    Andersen, Zorana Jovanovic
    Xun, Wei W
    Katsouyanni, Klea
    Dimakopoulou, Konstantina
    Brunekreef, Bert
    Weinmayr, Gudrun
    Hoffmann, Barbara
    Wolf, Kathrin
    Samoli, Evangelia
    Houthuijs, Danny
    Nieuwenhuijsen, Mark
    Oudin, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Olsson, David
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Salomaa, Veikko
    Lanki, Timo
    Yli-Tuomi, Tarja
    Oftedal, Bente
    Aamodt, Geir
    Nafstad, Per
    De Faire, Ulf
    Pedersen, Nancy L
    Östenson, Claes-Göran
    Fratiglioni, Laura
    Penell, Johanna
    Korek, Michal
    Pyko, Andrei
    Eriksen, Kirsten Thorup
    Tjønneland, Anne
    Becker, Thomas
    Eeftens, Marloes
    Bots, Michiel
    Meliefste, Kees
    Wang, Meng
    Bueno-de-Mesquita, Bas
    Sugiri, Dorothea
    Krämer, Ursula
    Heinrich, Joachim
    de Hoogh, Kees
    Key, Timothy
    Peters, Annette
    Cyrys, Josef
    Concin, Hans
    Nagel, Gabriele
    Ineichen, Alex
    Schaffner, Emmanuel
    Probst-Hensch, Nicole
    Dratva, Julia
    Ducret-Stich, Regina
    Vilier, Alice
    Clavel-Chapelon, Françoise
    Stempfelet, Morgane
    Grioni, Sara
    Krogh, Vittorio
    Tsai, Ming-Yi
    Marcon, Alessandro
    Ricceri, Fulvio
    Sacerdote, Carlotta
    Galassi, Claudia
    Migliore, Enrica
    Ranzi, Andrea
    Cesaroni, Giulia
    Badaloni, Chiara
    Forastiere, Francesco
    Tamayo, Ibon
    Amiano, Pilar
    Dorronsoro, Miren
    Katsoulis, Michail
    Trichopoulou, Antonia
    Vineis, Paolo
    Hoek, Gerard
    Long-term exposure to air pollution and cardiovascular mortality: an analysis of 22 European cohorts2014In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 25, no 3, 368-378 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death.

    METHODS: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2 and NOx); particles with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 10 μm to 2.5 μm (PMcoarse); PM2.5 absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates.

    RESULTS: The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM2.5, the hazard ratio was 1.21 (95% confidence interval = 0.87-1.69) per 5 μg/m and for PM10, 1.22 (0.91-1.63) per 10 μg/m.

    CONCLUSION: In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association.

  • 3. Bero Bedada, Getahun
    et al.
    Raza, Auriba
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lind, Tomas
    Ljungman, Petter
    Pershagen, Göran
    Bellander, Tom
    Short-term Exposure to Ozone and Mortality in Subjects With and Without Previous Cardiovascular Disease2016In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 27, no 5, 663-669 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Exposure to ground level ozone (O3) is a public health problem associated with a range of risks across population subgroups. Our aim was to investigate the role of previous cardiovascular diseases (CVDs) in mortality related to short-term O3 exposure.

    METHODS: Deaths between 1990 and 2010 in Stockholm County were matched with previous hospitalizations in Swedish registries. An urban background monitoring station provided hourly values of air quality data, from which we calculated 8-hour running averages and daily 8-hour maximum. We analyzed associations between daily O3 concentrations and mortality among persons with and without previous CVD hospitalization with a generalized additive model adjusted for time trend, influenza, and weather. We also performed two-pollutant models.

    RESULTS: There were 302,283 nontrauma-related deaths, out of which 196,916 had previous CVD hospitalization. The mean concentration of daily maximum 8-hour O3 was 62.9 μg/m. An average 10 μg/m increase in the same and preceding day was associated with an increased mortality of 1.72% (95% confidence interval: 0.44%, 3.02%) in those with prior admission for acute myocardial infarction (AMI), which was more than three times higher than for those with no previous AMI (0.50, 95% confidence interval: 0.10%, 0.89%, P value for interaction 0.098). The association between O3 and mortality remained essentially unchanged in two-pollutant models with NO2, NOx, and PM10.

    CONCLUSIONS: Our study indicates that short-term exposure to O3 is associated with increased mortality in those with a previous hospitalization for AMI.

  • 4. Dragano, Nico
    et al.
    Siegrist, Johannes
    Nyberg, Solja T.
    Lunau, Thorsten
    Fransson, Eleonor I.
    Alfredsson, Lars
    Bjorner, Jakob B.
    Borritz, Marianne
    Burr, Hermann
    Erbel, Raimund
    Fahlen, Goran
    Goldberg, Marcel
    Hamer, Mark
    Heikkila, Katriina
    Joeckel, Karl-Heinz
    Knutsson, Anders
    Madsen, Ida E. H.
    Nielsen, Martin L.
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology. Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Oksanen, Tuula
    Pejtersen, Jan H.
    Pentti, Jaana
    Rugulies, Reiner
    Salo, Paula
    Schupp, Juergen
    Singh-Manoux, Archana
    Steptoe, Andrew
    Theorell, Tores
    Vahtera, Jussi
    Westerholm, Peter J. M.
    Westerlund, Hugo
    Virtanen, Marianna
    Zins, Marie
    Batty, G. David
    Kivimaki, Mika
    Effort-Reward Imbalance at Work and Incident Coronary Heart Disease A Multicohort Study of 90,164 Individuals2017In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 28, no 4, 619-626 p.Article in journal (Refereed)
    Abstract [en]

    Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease.

    Methods: This multicohort study (the “IPD-Work” consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort–reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis.

    Results: At baseline, 31.7% of study members reported effort–reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00–1.35) was observed for effort–reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01–1.34) for having either effort–reward imbalance or job strain and 1.41 (1.12–1.76) for having both these stressors compared to having neither effort–reward imbalance nor job strain.

    Conclusions: Individuals with effort–reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress.

  • 5. Gallo, Valentina
    et al.
    Neasham, David
    Airoldi, Luisa
    Ferrari, Pietro
    Jenab, Mazda
    Boffetta, Paolo
    Overvad, Kim
    Tjønneland, Anne
    Clavel-Chapelon, Francoise
    Boeing, Heiner
    Pala, Valeria
    Palli, Domenico
    Panico, Salvatore
    Tumino, Rosario
    Arriola, Larraitz
    Lund, Eiliv
    Bueno-De-Mesquita, Bas
    Peeters, Petra H
    Melander, Olle
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Riboli, Elio
    Saracci, Rodolfo
    Vineis, Paolo
    Second-hand smoke, cotinine levels, and risk of circulatory mortality in a large cohort study of never-smokers2010In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 21, no 2, 207-214 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:: Exposure to second-hand smoke has been shown to be associated with increased cardiovascular mortality in several, but not all, epidemiologic studies. Our aim was to investigate the risk of circulatory death associated with exposure to second-hand smoke in never-smokers in a very large prospective study, the European Prospective Investigation into Cancer and Nutrition. A secondary aim was to use cotinine levels for cross-validating self-reported second-hand smoke exposure. METHODS:: Cox proportional hazard models were used to investigate the risk of death due to circulatory causes associated with second-hand smoke exposure in 135,233 never-smokers. Exposure to second-hand smoke was assessed through a questionnaire at enrollment and then validated against plasma cotinine measurements in a subsample. RESULTS:: Study participants who reported second-hand smoke exposure at home had higher cotinine levels (median plasma cotinine concentration in exposed = 0.82 mug/L; in those unexposed 0.02 mug/L). Second-hand smoke exposure at home was associated with an increased risk of dying from cardiovascular diseases (hazard ratio [HR] = 1.38 [95% confidence interval = 1.01-1.90]), all circulatory diseases (1.28 [0.98-1.69]), and coronary heart disease (1.31 [0.83-2.08]) after adjustment for age, sex, education, physical activity, and body mass index. Dose-response relationships were observed between exposure to second-hand smoke at home and risk of circulatory death (HR per each additional hour/d = 1.25 [1.04-1.50]). Having a partner who smokes more than 30 cigarettes per day considerably increased the risk of a circulatory death (2.94 [1.11-7.78]). Second-hand smoke exposure at home was not associated with total mortality (1.03 [0.93-1.13]). DISCUSSION:: Exposure to second-hand smoke at home (as confirmed by plasma cotinine levels) increases the risk of cardiovascular mortality.

  • 6. Hardell, Lennart
    et al.
    Carlberg, Michael
    Soderqvist, Fredrik
    Hansson Mild, Kjell
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Mobile Phones and Cancer Next Steps2014In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 25, no 4, 617-618 p.Article in journal (Refereed)
  • 7. Hergens, Maria-Pia
    et al.
    Galanti, Rosaria
    Hansson, Jenny
    Fredlund, Peeter
    Ahlbom, Anders
    Alfredsson, Lars
    Bellocco, Rino
    Eriksson, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Fransson, Eleonor I
    Hallqvist, Johan
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Knutsson, Anders
    Pedersen, Nancy
    Lagerros, Ylva Trolle
    Ostergren, Per-Olof
    Magnusson, Cecilia
    Use of Scandinavian Moist Smokeless Tobacco (Snus) and the Risk of Atrial Fibrillation.2014In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 25, no 6, 872-876 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:: Snus is a smokeless tobacco product, widely used among Swedish men and increasingly so elsewhere. There is debate as to whether snus is an acceptable "harm-reduction" tobacco product. Since snus use delivers a dose of nicotine equivalent to cigarettes, and has been implicated in cardiac arrhythmia because of associations with sudden cardiovascular death, a relation with atrial fibrillation is plausible and important to investigate.

    METHODS:: To assess the relation between use of snus and risk of atrial fibrillation, we carried out a pooled analysis of 7 prospective Swedish cohort studies. In total, 274,882 men, recruited between 1978 and 2004, were followed via the National Patient Register for atrial fibrillation. Primary analyses were restricted to 127,907 never-smokers. Relative risks were estimated using Cox proportional hazard regression.

    RESULTS:: The prevalence of snus use was 25% among never-smokers. During follow-up, 3,069 cases of atrial fibrillation were identified. The pooled relative risk of atrial fibrillation was 1.07 (95% confidence interval = 0.97-1.19) in current snus users, compared with nonusers.

    CONCLUSION:: Findings from this large national pooling project indicate that snus use is unlikely to confer any important increase in risk of atrial fibrillation.

  • 8.
    Häggström, Christel
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Stocks, Tanja
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Nagel, Gabriele
    Manjer, Jonas
    Bjørge, Tone
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Engeland, Anders
    Ulmer, Hanno
    Lindkvist, Bjorn
    Selmer, Randi
    Concin, Hans
    Tretli, Steinar
    Jonsson, Håkan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Stattin, Pär
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Prostate Cancer, Prostate Cancer Death, and Death from Other Causes, Among Men with Metabolic Aberrations2014In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 25, no 6, 823-828 p.Article in journal (Refereed)
    Abstract [en]

    Background: Few previous studies of metabolic aberrations and prostate cancer risk have taken into account the fact that men with metabolic aberrations have an increased risk of death from causes other than prostate cancer. The aim of this study was to calculate, in a real-life scenario, the risk of prostate cancer diagnosis, prostate cancer death, and death from other causes.

    Methods: In the Metabolic Syndrome and Cancer Project, prospective data on body mass index, blood pressure, glucose, cholesterol, and triglycerides were collected from 285,040 men. Risks of prostate cancer diagnosis, prostate cancer death, and death from other causes were calculated by use of competing risk analysis for men with normal (bottom 84%) and high (top 16%) levels of each factor, and a composite score.

    Results: During a mean follow-up period of 12 years, 5,893 men were diagnosed with prostate cancer, 1,013 died of prostate cancer, and 26,328 died of other causes. After 1996, when prostate-specific antigen testing was introduced, men up to age 80 years with normal metabolic levels had 13% risk of prostate cancer, 2% risk of prostate cancer death, and 30% risk of death from other causes, whereas men with metabolic aberrations had corresponding risks of 11%, 2%, and 44%.

    Conclusions: In contrast to recent studies using conventional survival analysis, in a real-world scenario taking risk of competing events into account, men with metabolic aberrations had lower risk of prostate cancer diagnosis, similar risk of prostate cancer death, and substantially higher risk of death from other causes compared with men who had normal metabolic levels.

  • 9. Jacquemin, Bénédicte
    et al.
    Sunyer, Jordi
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Aguilera, Inmaculada
    Briggs, David
    García-Esteban, Raquel
    Götschi, Thomas
    Heinrich, Joachim
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Jarvis, Debbie
    Vienneau, Danielle
    Künzli, Nino
    Home outdoor NO2 and new onset of self-reported asthma in adults2009In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 20, no 1, 119-126 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Few studies have investigated new onset of asthma in adults in relation to air pollution. The aim of this study is to investigate the association between modeled background levels of traffic-related air pollution at the subjects' home addresses and self-reported asthma incidence in a European adult population. METHODS: Adults from the European Respiratory Health Survey were included (n = 4185 from 17 cities). Subjects' home addresses were geocoded and linked to outdoor nitrogen dioxide (NO2) estimates, as a marker of local traffic-related pollution. We obtained this information from the 1-km background NO2 surface modeled in APMoSPHERE (Air Pollution Modelling for Support to Policy on Health and Environmental Risk in Europe). Asthma incidence was defined as reporting asthma in the follow-up (1999 to 2001) but not in the baseline (1991 to 1993). RESULTS: A positive association was found between NO2 and asthma incidence (odds ratio 1.43; 95% confidence interval = 1.02 to 2.01) per 10 microg/m. Results were homogeneous among centers (P value for heterogeneity = 0.59). CONCLUSIONS: We found an association between a marker of traffic-related air pollution and asthma incidence in European adults.

  • 10.
    Modig, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Dahgam, Santosh
    Olsson, David
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nyberg, Fredrik
    Wass, Kristina
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Olin, Anna-Carin
    Short-Term Exposure to Ozone and Levels of Exhaled Nitric Oxide2014In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 25, no 1, 79-87 p.Article in journal (Refereed)
    Abstract [en]

    Background: Adverse effects of air pollution include respiratory inflammation. A few epidemiologic studies have shown elevations in the fraction of exhaled nitric oxide, a marker of airway inflammation, after exposure to traffic-related pollutants. Methods: We examined whether short-term exposures to ozone (O-3), oxides of nitrogen (NOx), or particulate matter <10 m (PM10) were associated with proximal and distal airway inflammation. The study included 5841 randomly selected Swedish adults from 25 to 75 years of age. Fraction of exhaled nitrogen was measured at two flow rates: 50 ml/s representing the proximal airways and 270 ml/s representing the distal airways. Air pollution data were obtained from an urban monitoring site. We applied linear regression to estimate short-term associations of O-3, NOx, and PM10 with fractions of exhaled NO at 50 and 270 ml/s. Results: An interquartile range increase in 120-hour average O-3 levels was associated with a 5.1% (95% confidence interval = 1.7% to 8.5%) higher level of fraction of exhaled NO at 270 ml/s and 3.6% (-0.4% to 3.4%) higher level of the fraction of exhaled NO at 50 ml/s. For NOx, a small effect was seen for the 24-hour average on the fraction of exhaled NO at 270 ml/s, while for PM10 no clear effects were seen. There was a tendency for a weaker effect of ozone and a stronger effect of NOx in subjects with asthma. Conclusions: Exposure to O-3 was associated with a marker of distal airway inflammation, while the association was less obvious for inflammation of the proximal airways.

  • 11.
    Mogren, I
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Högberg, U
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Winkvist, A
    Stenlund, H
    Familial occurrence of preeclampsia.1999In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 10, no 5, 518-22 p.Article in journal (Refereed)
    Abstract [en]

    We conducted a cohort study on whether preeclampsia during the pregnancy of a mother is a risk factor for preeclampsia during the pregnancy of her daughter. Data from the Medical Birth Registry were combined with data from a local registry of births from 1955 to 1990. We could identify the births of 22,768 elder daughters and 2,959 younger daughters. These daughters had also experienced at least one delivery. If the mother had preeclampsia during her pregnancy with an elder daughter, then the elder daughter had an increased risk for preeclampsia in her first pregnancy (relative risk (RR) = 1.7; 95% confidence interval (CI) = 1.3-2.2). This increased risk persisted into the elder daughter's second pregnancy (RR = 1.7; 95% CI = 1.1-2.6). The risks for the daughters were also increased to a similar level if the mother had experienced preeclampsia in any other pregnancy. Furthermore, the risks were similarly elevated if only mothers with firstborn children were included in the analyses. Hence, preeclampsia during the pregnancy of a mother was a risk factor for development of preeclampsia during the pregnancy of her daughters; however, owing to a relatively small population attributable proportion, genetic predisposition explained only a minor part of the occurrence of preeclampsia in this population.

  • 12. Mostafavi, Nahid
    et al.
    Vlaanderen, Jelle
    Portengen, Lutzen
    Chadeau-Hyam, Marc
    Modig, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Palli, Domenico
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Biobank Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Brunekreef, Bert
    Vineis, Paolo
    Hebels, Dennie G A J
    Kleinjans, Jos C S
    Krogh, Vittorio
    Hoek, Gerard
    Georgiadis, Panagiotis
    Kyrtopoulos, Soterios A
    Vermeulen, Roel
    Associations between genome-wide gene expression and ambient nitrogen oxides (NOx)2017In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 28, no 3, 320-328 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: We hypothesize that biological perturbations due to exposure to ambient air pollution are reflected in gene-expression levels in peripheral blood mononuclear cells.

    METHODS: We assessed the association between exposure to ambient air pollution and genome-wide gene-expression levels in peripheral blood mononuclear cells collected from 550 healthy subjects participating in cohorts from Italy and Sweden. Annual air pollution estimates of nitrogen oxides (NOx) at time of blood collection (1990 to 2006) were available from the ESCAPE study. In addition to univariate analysis and two variable selection methods to investigate the association between expression and exposure to NOx, we applied gene set enrichment analysis to assess overlap between our most perturbed genes and gene sets hypothesized to be related to air pollution and cigarette smoking. Finally, we assessed associations between NOx and CpG island methylation at the identified genes.

    RESULTS: Annual average NOx exposure in the Italian and Swedish cohorts was 94.2 µg/m3, and 6.7 µg/m3, respectively. Long-term exposure to NOx was associated with seven probes in the Italian cohort and one probe in the Swedish (and combined) cohorts. For genes AHCYL2 and MTMR2 changes were also seen in the methylome. Genes hypothesized to be downregulated due to cigarette smoking were enriched among the most strongly downregulated genes from our study.

    CONCLUSION: This study provides evidence of subtle changes in gene expression related to exposure to long-term NOx. On a global level the observed changes in the transcriptome may indicate similarities between air pollution and tobacco induced changes in the transcriptome.

  • 13.
    Myte, Robin
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Gylling, Björn
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Schneede, Jörn
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Ueland, Per Magne
    Häggström, Jenny
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Hultdin, Johan
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Biobank Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Palmqvist, Richard
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Van Guelpen, Bethany
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Components of One-carbon Metabolism Other than Folate and Colorectal Cancer Risk2016In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 27, no 6, 787-796 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite extensive study, the role of folate in colorectal cancer remains unclear. Research has therefore begun to address the role of other elements of the folate-methionine metabolic cycles. This study investigated factors other than folate involved in one-carbon metabolism, i.e., choline, betaine, dimethylglycine, sarcosine, and methionine and relevant polymorphisms, in relation to the risk of colorectal cancer in a population with low intakes and circulating levels of folate.

    METHODS: This was a prospective case-control study of 613 case subjects and 1,190 matched control subjects nested within the population-based Northern Sweden Health and Disease Study. We estimated odds ratios (OR) by conditional logistic regression, and marginal risk differences with weighted maximum likelihood estimation using incidence data from the study cohort.

    RESULTS: Higher plasma concentrations of methionine and betaine were associated with modest colorectal cancer risk reductions (OR [95% confidence interval {CI}] for highest versus lowest tertile: 0.76 [0.57, 0.99] and 0.72 [0.55, 0.94], respectively). Estimated marginal risk differences corresponded to approximately 200 fewer colorectal cancer cases per 100,000 individuals on average. We observed no clear associations between choline, dimethylglycine, or sarcosine and colorectal cancer risk. The inverse association of methionine was modified by plasma folate concentrations (OR [95% CI] for highest/lowest versus lowest/lowest tertile of plasma methionine/folate concentrations 0.39 [0.24, 0.64], Pinteraction = 0.06).

    CONCLUSIONS: In this population-based, nested case-control study with a long follow-up time from baseline to diagnosis (median: 8.2 years), higher plasma concentrations of methionine and betaine were associated with lower colorectal cancer risk. See Video Abstract at http://links.lww.com/EDE/B83.

  • 14.
    Oudin, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Jakobsson, Kristina
    Air pollution and stroke2012In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 23, no 3, 505-506 p.Article in journal (Refereed)
  • 15. Pettersson, David
    et al.
    Mathiesen, Tiit
    Prochazka, Michaela
    Bergenheim, Tommy
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Florentzson, Rut
    Harder, Henrik
    Nyberg, Gunnar
    Siesjo, Peter
    Feychting, Maria
    Long-term mobile phone use and acoustic neuroma risk2014In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 25, no 2, 233-241 p.Article in journal (Refereed)
    Abstract [en]

    Background: There is concern about potential effects of radiofrequency fields generated by mobile phones on cancer risk. Most previous studies have found no association between mobile phone use and acoustic neuroma, although information about long-term use is limited. Methods: We conducted a population-based, nation-wide, case-control study of acoustic neuroma in Sweden. Eligible cases were persons aged 20 to 69 years, who were diagnosed between 2002 and 2007. Controls were randomly selected from the population registry, matched on age, sex, and residential area. Postal questionnaires were completed by 451 cases (83%) and 710 controls (65%). Results: Ever having used mobile phones regularly (defined as weekly use for at least 6 months) was associated with an odds ratio (OR) of 1.18 (95% confidence interval = 0.88 to 1.59). The association was weaker for the longest induction time (10 years) (1.11 [0.76 to 1.61]) and for regular use on the tumor side (0.98 [0.68 to 1.43]). The OR for the highest quartile of cumulative calling time (680 hours) was 1.46 (0.98 to 2.17). Restricting analyses to histologically confirmed cases reduced all ORs; the OR for 680 hours was 1.14 (0.63 to 2.07). A similar pattern was seen for cordless land-line phones, although with slightly higher ORs. Analyses of the complete history of laterality of mobile phone revealed considerable bias in laterality analyses. Conclusions: The findings do not support the hypothesis that long-term mobile phone use increases the risk of acoustic neuroma. The study suggests that phone use might increase the likelihood that an acoustic neuroma case is detected and that there could be bias in the laterality analyses performed in previous studies.

  • 16.
    Sandström, Thomas
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Desert dust: an unrecognized source of dangerous air pollution?2008In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 19, no 6, 808-809 p.Article in journal (Refereed)
    Abstract [en]

    ABSTRACT:: Particulate matter (PM10) air pollution is associated with respiratory and cardiovascular morbidity, and mortality. A recent systematic review pointed toward the fine particle fraction (PM2.5) rather than the coarse fraction (PM2.5-10) 2.5 and PM2.5-10as being responsible for increased death rates. With this background, the report by Perez et al that windblown Saharan desert dust causes increased mortality in Barcelona, raises concern over possible underestimation of toxicity from coarse particles coming from desert sources. This may be of concern for large areas of the globe that periodically encounter high levels of windblown desert dust and warrants further attention.

  • 17. Söderberg, Karin C
    et al.
    Naumburg, Estelle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Department of Medical Epidemiology, Karolinska Institutet, Stockholm; Department of Women’s and Children’s Health, Section for Pediatrics, Uppsala University, Uppsala .
    Anger, Gert
    Cnattingius, Sven
    Ekbom, Anders
    Feychting, Maria
    Childhood leukemia and magnetic fields in infant incubators2002In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 13, no 1, 45-49 p.Article in journal (Refereed)
    Abstract [en]

    In studies of magnetic field exposure and childhood leukemia, power lines and other electrical installations close to the children's homes constitute the most extensively studied source of exposure. We conducted a study to assess whether exposure to magnetic fields in infant incubators is associated with an increased leukemia risk. We identified all children with leukemia born in Sweden between 1973 and 1989 from the national Cancer Registry and selected at random one control per case, individually matched by sex and time of birth, from the study base. We retrieved information about treatment in infant incubators from medical records. We made measurements of the magnetic fields inside the incubators for each incubator model kept by the hospitals. Exposure assessment was based on measurements of the magnetic field level inside the incubator, as well as on the length of treatment. For acute lymphoblastic leukemia, the risk estimates were close to unity for all exposure definitions. For acute myeloid leukemia, we found a slightly elevated risk, but with wide confidence intervals and with no indication of dose response. Overall, our results give little evidence that exposure to magnetic fields inside infant incubators is associated with an increased risk of childhood leukemia.

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