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  • 1. Aasa, Ulrika
    et al.
    Kalezic, Nebojsa
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Lyskov, Eugene
    Ängquist, Karl-Axel
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Barnekow-Bergkvist, Margareta
    Stress monitoring of ambulance personnel during work and leisure time.2006In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 80, no 1, p. 51-59Article in journal (Refereed)
  • 2.
    Andersson, Linus
    et al.
    Department of Occupational and Public Health Sciences, University of Gävle.
    Claeson, Anna-Sara
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Dantoft, Thomas Meinertz
    Department of Systems Biology, Center for Biological Sequence Analysis, Technical University of Denmark.
    Skovbjerg, Sine
    Danish Research Centre for Chemical Sensitivities, Copenhagen University Hospital Gentofte.
    Lind, Nina
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Chemosensory perception, symptoms and autonomic responses during chemical exposure in multiple chemical sensitivity2016In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 1, p. 79-88Article in journal (Refereed)
    Abstract [en]

    Purpose: Multiple chemical sensitivity (MCS) is a prevalent medically unexplained symptom characterized by symptom reactions to everyday chemical exposure below hygienic thresholds. The aim of this study was to investigate the expressions of hyper-reactivity in MCS during whole-body exposure to low concentrations of the odorant n-butanol.

    Methods: We exposed 18 participants with MCS and 18 non-ill controls to a low concentration of the odorantn-butanol using an exposure chamber. The first 10 min constituted blank exposure, after which then-butanol concentration increased and reached a plateau at 11.5 mg/m3.

    Results: MCS participants, compared with controls, reported greater perceived odor intensities, more unpleasantness to the exposure and increasing symptoms over time. MCS participants also expressed higher pulse rate and lower pulse rate variability than controls did. No group differences were found for breathing rate or tonic electrodermal activity responses.

    Conclusions: We conclude that MCS sufferers differ from healthy controls in terms of autonomic responses, symptoms and chemosensory perception during chemical exposure.

  • 3.
    Andersson, Linus
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Millqvist, E
    Sahlgrenska University Hospital Asthma and Allergy Research Group Göteborg, Sweden.
    Bende, M
    Central Hospital Department of Otorhinolaryngology Skövde Sweden.
    On the relation between capsaicin sensitivity and responsiveness to CO2: detection sensitivity and event-related brain potentials2009In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 82, no 3, p. 285-290Article in journal (Refereed)
    Abstract [en]

    Sensory hyperreactivity (SHR) with predominantly airway symptoms is a subgroup of chemical intolerance to various environmental substances with pungent/odorous properties. The hallmark of SHR is sensitivity to capsaicin inhalation, resulting in extensive coughing likely to be mediated by a C-fiber hyperreactivity of the airway sensory neurons. However, it is not clear whether capsaicin sensitivity implies a greater sensitivity to chemosomatosensory substances in general. Therefore, the present study tested the hypothesis of an association between capsaicin cough sensitivity and sensitivity to CO2 with respect to detection sensitivity and electrophysiological brain response.

    Methods A correlational study was employed to investigate the relation between capsaicin cough sensitivity and detection thresholds and chemosomatosensory event-related potentials (ERPs) for CO2 presented in the nasal cavity in 35 persons varying in capsaicin cough sensitivity.

    Results Number of coughs were found to correlate negatively with CO2 threshold and tended to correlate negatively also with N1 and P2 latencies of the chemosomatosensory ERP for CO2. No tendencies of correlations were found between number of coughs and latencies for olfactory and auditory ERPs, recorded for comparison, but, unexpectedly, were found between number of coughs and auditory N1 amplitude.

    Conclusions The results imply that capsaicin cough sensitivity, such as in SHR, is related to higher detection sensitivity, and tends to be related to faster cortical processing of other chemosomatosensory substances, at least of CO2.

  • 4. Backé, Eva-Maria
    et al.
    Seidler, Andreas
    Latza, Ute
    Rossnagel, Karin
    Schumann, Barbara
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    The role of psychosocial stress at work for the development of cardiovascular diseases: a systematic review.2012In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 85, no 1, p. 67-79Article in journal (Refereed)
    Abstract [en]

    PURPOSE: A systematic review was carried out to assess evidence for the association between different models of stress at work, and cardiovascular morbidity and mortality.

    METHODS: A literature search was conducted using five databases (MEDLINE, Cochrane Library, EMBASE, PSYNDEX and PsycINFO). Inclusion criteria for studies were the following: self-reported stress for individual workplaces, prospective study design and incident disease (myocardial infarction, stroke, angina pectoris, high blood pressure). Evaluation, according to the criteria of the Scottish Intercollegiate Guidelines Network, was done by two readers. In case of disagreement, a third reader was involved.

    RESULTS: Twenty-six publications were included, describing 40 analyses out of 20 cohorts. The risk estimates for work stress were associated with a statistically significant increased risk of cardiovascular disease in 13 out of the 20 cohorts. Associations were significant for 7 out of 13 cohorts applying the demand-control model, all three cohorts using the effort-reward model and 3 out of 6 cohorts investigating other models. Most significant results came from analyses considering only men. Results for the association between job stress and cardiovascular diseases in women were not clear. Associations were weaker in participants above the age of 55.

    CONCLUSIONS: In accordance with other systematic reviews, this review stresses the importance of psychosocial factors at work in the aetiology of cardiovascular diseases. Besides individual measures to manage stress and to cope with demanding work situations, organisational changes at the workplace need to be considered to find options to reduce occupational risk factors for cardiovascular diseases.

  • 5.
    Bergdahl, Ingvar A.
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ahlqwist, Margareta
    Department of Oral and Maxillofacial Radiology, The Sahlgrenska Academy, University of Gothenburg.
    Barregard, Lars
    Department of Occupational and Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg.
    Björkelund, Cecilia
    Department of Public Health and Community Medicine/Primary Health Care, The Sahlgrenska Academy, University of Gothenburg.
    Blomstrand, Ann
    Department of Public Health and Community Medicine/Primary Health Care, The Sahlgrenska Academy, University of Gothenburg.
    Skerfving, Staffan
    Division of Occupational and Environmental Medicine, Lund University.
    Sundh, Valter
    Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lissner, Lauren
    Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg .
    Mercury in serum predicts low risk of death and myocardial infarction in Gothenburg women2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 1, p. 71-77Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Markers of mercury (Hg) exposure have shown both positive and negative associations with cardiovascular disease (CVD). We assessed the association between serum Hg (S-Hg) and risk of cardiovascular disease in a prospective population-based cohort, with attention to the roles of dental health and fish consumption.

    METHODS: Total mortality, as well as morbidity and mortality from acute myocardial infarction (AMI) and stroke, was followed up for 32 years in 1,391 women (initially age 38-60), in relation to S-Hg at baseline, using Cox regression models. Potential confounders (age, socioeconomic status, serum lipids, alcohol consumption, dental health, smoking, hypertension, waist-hip ratio, and diabetes) and other covariates (e.g., fish consumption) were also considered.

    RESULTS: Hazard ratios (HR) adjusted only for age showed strong inverse associations between baseline S-Hg and total mortality [highest quartile: hazard ratio (HR) 0.76; 95% confidence interval (CI) 0.59-0.97], incident AMI (HR 0.56; CI 0.34-0.93), and fatal AMI (HR 0.31; CI 0.15-0.66). Adjustment for potential confounding factors, especially dental health, had a strong impact on the risk estimates, and after adjustment, only the reduced risk of fatal AMI remained statistically significant.

    CONCLUSIONS: There was a strong inverse association between Hg exposure and CVD. Likely, reasons are confounding with good dental health (also correlated with the number of amalgam fillings in these age groups) and/or fish consumption. The results suggest potential effects of dental health and/or fish consumption on CVD that deserve attention in preventive medicine.

  • 6.
    Bergdahl, Jan
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Dermatology and Venerology.
    Eriksson, N
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Lindén, G
    Widman, L
    Coping and self-image in patients with visual display terminal-related skin symptoms and perceived hypersensitivity to electricity2004In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 77, no 8, p. 538-542Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the present study was to measure coping resources and self-image in patients with visual display terminal (VDT)-related skin symptoms and hypersensitivity to electricity (HE).

    Methods: From 1980 to 1998, 350 patients with electrical sensitivity were registered. The patients were subdivided into two groups: patients with skin symptoms evoked by VDTs, television screens, and fluorescent-light tubes and patients with so-called hypersensitivity to electricity with multiple symptoms evoked by exposure to different electrical environments. A questionnaire was sent to all patients and contained the coping resources inventory (CRI) and the structural analysis of social behaviour (SASB) in order for us to measure coping resources and self-image, respectively. The CRI and SASB scores were compared with those of control groups. Two hundred and fifty respondents (73%) returned the questionnaire, 200 (78.5% women) in the VDT group and 50 (62% women) in the HE group.

    Results: The patient group rated high on the CRI spiritual/philosophical scale and high on the SASB spontaneous, positive and negative clusters but low on the controlled cluster. The female patients scored high on the CRI emotional scale. The VDT group rated lower than the controls on the SASB controlled cluster and higher on both the positive and negative cluster. The HE group scored higher than the control group on the SASB spontaneous and positive clusters. The women in the HE group scored higher on the CRI cognitive and CRI total scale than the VDT group and control group and higher on the CRI emotional scale than the controls. The women in the HE group rated higher than both the women in the VDT and control groups on the SASB spontaneous and positive clusters.

    Conclusions: The deviant self-image found in these patients, especially the female HE patients, support the view that VDT and HE symptoms can be stress related. In the clinic, a trustful alliance should be established with the patient in order for a more realistic view to be achieved of the capacity.

  • 7.
    Björ, Bodil
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Karlsson, Marcus
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Näslund, Ulf
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Wiklund, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Acute effects on heart rate variability when exposed to hand transmitted vibration and noise.2007In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 81, no 2, p. 193-199Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This study investigates possible acute effects on heart rate variability (HRV) when people are exposed to hand transmitted vibration and noise individually and simultaneously. METHODS: Ten male and 10 female subjects were recruited by advertisement. Subjects completed a questionnaire concerning their work environment, general health, medication, hearing, and physical activity level. The test started with the subject resting for 15 min while sitting down. After resting, they were exposed to one of four exposure conditions: (1) only vibration; (2) only noise; (3) both noise and vibration; or (4) a control condition of exposure to the static load only. All four exposures lasted 15 min and the resting time between the exposures was 30 min. A continuous electrocardiogram (ECG) signal was recorded and the following HRV parameters were calculated: total spectral power (P(TOT)); the spectral power of the very low frequency component (P(VLF)); the low frequency component (P(LF)); the high frequency component (P(HF)); and the ratio LF/HF. RESULTS: Exposure to only vibration resulted in a lower P(TOT) compared to static load, whereas exposure to only noise resulted in a higher P(TOT). The mean values of P(TOT), P(VLF), P(LF), and P(HF) were lowest during exposure to vibration and simultaneous exposure to vibration and noise. CONCLUSIONS: Exposure to vibration and/or noise acutely affects HRV compared to standing without these exposures. Being exposed to vibration only and being exposed to noise only seem to generate opposite effects. Compared to no exposure, P(TOT) was reduced during vibration exposure and increased during noise exposure.

  • 8. Boschman, J S
    et al.
    Noor, A
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sluiter, J K
    Hagberg, M
    Relationships between work-related factors and musculoskeletal health with current and future work ability among male workers2017In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, no 6, p. 517-526Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The purpose was to increase job-specific knowledge about individual and work-related factors and their relationship with current and future work ability (WA). We studied cross-sectional relationships between mental demands, physical exertion during work, grip strength, musculoskeletal pain in the upper extremities and WA and the relationships between these variables and WA 11 years later.

    METHODS: We used a dataset of a prospective cohort study (1997-2008) among employees of an engineering plant (n = 157). The cohort was surveyed by means of tests and written questions on work demands, musculoskeletal health, WA score (WAS; 0-10), and mental and physical WA. Spearman correlation coefficients and logistic regression analysis were used.

    RESULTS: Among manual workers, we found weak correlations between grip strength and current and future physical WA. We did not find predictors for future poor WA among the manual workers. Among the office workers, we found that musculoskeletal pain was moderately and negatively related to current WAS and physical WA. More handgrip strength related to better future WAS and physical WA. Musculoskeletal pain (OR 1.67 p < 0.01) and lower handgrip strength (OR 0.91 p < 0.05) predicted future poor WA among office workers.

    CONCLUSIONS: Our results showed cross-sectional and longitudinal relationships between musculoskeletal health and work ability depending on occupation. However, the present implies that predicting work ability in the far future based on health surveillance data is rather difficult. Testing the musculoskeletal system (grip strength) and asking workers' about their musculoskeletal health seems relevant when monitoring work ability.

  • 9.
    Brändström, Helge
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
    Wiklund, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Marcus
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ängquist, Karl-Axel
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Haney, Michael
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
    Autonomic nerve system responses for normal and slow rewarmers after hand cold provocation: effects of long-term cold climate training2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 3, p. 357-365Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Differences among individuals concerning susceptibility to local cold injury following acute cold exposure may be related to function of the autonomic nervous system. We hypothesized that there are differences in heart rate variability (HRV) between individuals with normal or more pronounced vasoconstriction following cold exposure and that there is an adaptation related to prolonged cold exposure in autonomic nervous system response to cold stimuli.

    METHODS: Seventy-seven young men performed a cold provocation test, where HRV was recorded during cold hand immersion and recovery. Forty-three subjects were re-examined 15 months later, with many months of cold weather training between the tests. Subjects were analyzed as 'slow' and 'normal' rewarmers according to their thermographic rewarming pattern.

    RESULTS: For the 'pre-training' test, before cold climate exposure, normal rewarmers had higher power for low-frequency (P(LF)) and high-frequency (P(HF)) HRV components during the cold provocation test (ANOVA for groups: p = 0.04 and p = 0.005, respectively). There was an approximately 25 % higher P(HF) at the start in normal rewarmers, in the logarithmic scale. Low frequency-to-high frequency ratio (P(LF)/P(HF)) showed lower levels for normal rewarmers (ANOVA for groups: p = 0.04). During the 'post-training' cold provocation test, both groups lacked the marked increase in heart rate that occurred during cold exposure at the 'pre-training' setting. After cold acclimatization (post-training), normal rewarmers showed lower resting power values for the low-frequency and high-frequency HRV components. After winter training, the slow rewarmers showed reduced low-frequency power for some of the cold provocation measurements but not all (average total P(LF), ANOVA p = 0.05), which was not present before winter training.

    CONCLUSIONS: These HRV results support the conclusion that cold adaptation occurred in both groups. We conclude that further prospective study is needed to determine whether cold adaptation provides protection to subjects at higher risk for cold injury, that is, slow rewarmers.

  • 10.
    Burström, Lage
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Arctic Research Centre at Umeå University.
    Björ, Bodil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Arctic Research Centre at Umeå University.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Arctic Research Centre at Umeå University.
    Pettersson, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Arctic Research Centre at Umeå University.
    Rödin, Ingemar
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Arctic Research Centre at Umeå University.
    Thermal perception thresholds among workers in a cold climate2017In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, no 7, p. 645-652Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate whether exposure to cold could influence the thermal perception thresholds in a working population.

    METHODS: This cross-sectional study was comprised of 251 males and females and was carried out at two mines in the northern part of Norway and Sweden. The testing included a baseline questionnaire, a clinical examination and measurements of thermal perception thresholds, on both hands, the index (Digit 2) and little (Digit 5) fingers, for heat and cold.

    RESULTS: The thermal perception thresholds were affected by age, gender and test site. The thresholds were impaired by experiences of frostbite in the fingers and the use of medication that potentially could affect neurosensory functions. No differences were found between the calculated normative values for these workers and those in other comparative investigations conducted in warmer climates.

    CONCLUSIONS: The study provided no support for the hypothesis that living and working in cold climate will lead to impaired thermal perception thresholds. Exposure to cold that had caused localized damage in the form of frostbite was shown to lead to impaired thermal perception.

  • 11.
    Burström, Lage
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Back and neck pain due to working in a cold environment: a cross-sectional study of male construction workers2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 7, p. 809-813Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study whether work in a cold environment increased the risk of musculoskeletal symptoms in the neck and low back among construction workers. METHODS: This cross-sectional study is based on a cohort of male workers in the Swedish construction industry that participated in regular health examinations through a nationwide occupational health service. The analysis is based on workers examined from 1971 to 1974, who answered a questionnaire including questions about neck and back pain. The cohort consists of 134,754 male workers, including 16,496 office workers and foremen. The health examinations of the workers were conducted in provinces covering Sweden from the south to the north, and temperature data were collected for the provinces. In the analyses, the results were adjusted for age, BMI and use of nicotine. RESULTS: The prevalence's of neck and low back pain were higher among manual construction workers than among foremen and office workers (24.3 vs. 8.6 % and 16.5 vs. 6.2 %, respectively); the corresponding adjusted ORs for low back and neck pain were 1.59 (95 % CI 1.52-1.66) and 1.39 (95 % CI 1.30-1.49), respectively. Workers in the northern and central provinces had higher ORs for low back and neck pain compared to workers in the southern province. The test for trends showed an increased risk of developing low back and neck pain with decreased outdoor temperature. CONCLUSIONS: Outdoor work in a cold environment may increase the risk of low back and neck pain.

  • 12.
    Burström, Lage
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sjödin, Fredrik
    National Institute for Working Life Department of Work and the Physical Environment Umeå Sweden.
    Lindmark, Asta
    National Institute for Working Life Department of Work and the Physical Environment Umeå Sweden.
    Lindkvist, Markus
    University Hospital of Northern Sweden Department of Biomedical Engineering and Informatics Umeå Sweden.
    Hagberg, Mats
    Sahlgrenska University Hospital Department of Occupational and Environmental Medicine Gothenburg Sweden.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Acute effects of vibration on thermal perception thresholds2008In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 81, no 5, p. 603-611Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study focuses on the acute effects of vibration and how vibrations influence the measures of the thermal perception thresholds during different vibration magnitudes, frequencies, and durations. METHODS: The fingers of ten healthy subjects, five males and five females, were exposed to vibration under 16 conditions with a combination of different frequency, intensity and exposure time. The vibration frequency was 31.5 and 125 Hz and exposure lasted between 2 and 16 min. The energy-equivalent frequency weighted acceleration, according to ISO 5349-1, for the experimental time of 16 min was 2.5 or 5.0 m/s(2) (r.m.s.), corresponding to a 8-h equivalent acceleration, A(8) of 0.46 and 0.92 m/s(2), respectively. A measure of the thermal perception of cold and warmth was conducted before the different exposures to vibration. Immediately after the vibration exposure the acute effect was measured continuously on the exposed index finger for the first 75 s, followed by 30 s of measures at every minute for a maximum of 10 min. If the subject's thermal thresholds had not recovered, the measures continued for a maximum of 30 min with measurements taken every 5 min. RESULTS: For all experimental conditions and 30 s after exposure, the mean changes of the thresholds compared with the pre-test were found to be 0.05 and -0.67 degrees C for the warmth and cold thresholds, respectively. The effect of the vibration exposure was only significant on the cold threshold and only for the first minute after exposure when the threshold was decreased. The warmth threshold was not significantly affected at all. The frequency and the exposure time of the vibration stimuli had no significant influence on the perception thresholds for the sensation of cold or warmth. Increased equivalent frequency weighted acceleration resulted in a significant decrease of the subjects' cold threshold, not the warmth. The thresholds were unaffected when changes in the vibration magnitude were expressed as the frequency weighted acceleration or the unweighted acceleration. CONCLUSION: When testing for the thermotactile thresholds, exposure to vibration on the day of a test might influence the results. Until further knowledge is obtained the previous praxis of 2 h avoidance of vibration exposure before assessment is recommended.

  • 13.
    Burström, Lage
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Whole-body vibration and the risk of low back pain and sciatica: a systematic review and meta-analysis2015In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 4, p. 403-418Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this systematic literature review was to evaluate the association between whole-body vibration (WBV) and low back pain (LBP) and sciatica with special attention given to exposure estimates. Moreover, the aim was to estimate the magnitude of such an association using meta-analysis and to compare our findings with previous reviews.

    METHODS: The authors systematically searched the PubMed (National Library of Medicine, Bethesda), Nioshtic2 (National Institute for Occupational Safety and Health (NIOSH, Morgantown), and ScienceDirect (Elsevier, Amsterdam) databases for records up to December 31, 2013. Two of the authors independently assessed studies to determine their eligibility, validity, and possible risk of bias.

    RESULTS: The literature search gave a total of 306 references out of which 28 studies were reviewed and 20 were included in the meta-analysis. Exposure to WBV was associated with increased prevalence of LBP and sciatica [pooled odds ratio (OR) = 2.17, 95 % confidence interval (CI) 1.61-2.91 and OR 1.92, 95 % CI 1.38-2.67, respectively]. Workers exposed to high vibration levels had a pooled risk estimate of 1.5 for both outcomes when compared with workers exposed to low levels of vibration. The results also indicate that some publication bias could have occurred especially for sciatica.

    CONCLUSIONS: This review shows that there is scientific evidence that exposure to WBV increases the risk of LBP and sciatica.

  • 14.
    Bylund, Sonya H
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    Burström, Lage
    Power absorption in women and men exposed to hand-arm vibration2003In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 76, no 4, p. 313-317Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of the study was to determine whether there are gender differences as regards the quantity of absorbed power, i.e., vibration absorption per unit of time, during exposure to vibration from a specially constructed handle. METHODS: The study was conducted on 24 subjects (12 female and 12 male). The experiments were performed with exposure in two vibration directions, X(h), and Z(h), and with two vibration levels, 3 and 6 m/s(2). RESULTS: The male subjects had significantly higher power absorption during exposure to vibrations in the Z(h) direction at the vibration level of 6 m/s(2) than did the female subjects. When adjusted for anthropometrical measurements the difference did not remain significant. Higher vibration levels resulted in significantly higher absorption of power for both X(h) and Z(h) directions. The absorption was significantly higher in the Z(h) direction than in the X(h) direction. CONCLUSIONS: No gender difference in power absorption was shown.

  • 15. Cherniack, Martin
    et al.
    Brammer, Anthony J
    Institute for Microstructural Sciences, National Research Council, Ottawa, Canada.
    Lundström, Ronnie
    Department of Biomedical Engineering and Informatics, University Hospital, Umeå, Sweden.
    Morse, Tim F.
    Neely, Greg
    Technical Risk Factors, National Institute for Working Life, Umeå, Sweden.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Peterson, Donald
    Toppila, Esko
    Warren, Nicholas
    Diva, Ulysses
    Croteau, Marc
    Dussetschleger, Jefferey
    Syndromes from segmental vibration and nerve entrapment: observations on case definitions for carpal tunnel syndrome2008In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 81, no 5, p. 661-669Article in journal (Refereed)
    Abstract [en]

    Objectives: The purpose of this paper is to assess the overlap and stability of two different case definitions of carpal tunnel syndrome CTS. The analysis considers the association between different case definitions and objective tests (sensory nerve conduction velocities, SNCVs and vibrotactile perception thresholds, TTS), and the natural history of CTS, in the context of two vibration-exposed cohorts.

    Methods: Clinical CTS cases were defined in two ways: (1) by the study physician using fixed criteria, and; (2) by questionnaire and hand diagram. SNCV in median and ulnar nerves was measured for digital, transpalmar, and transcarpal segments, and conventionally as from wrist-digit. Skin temperature was assessed as a point measurement by thermistor and regionally by thermal imaging. VTTs were determined at the bilateral fingertips of the third and fifth digits using a tactometer meeting the requirements of ISO 13091-1 (ISO 2001). The subjects were cohorts of shipyard workers in 2001 and 2004, and dental hygienists in 2002 and 2004.

    Results: Results are reported for 214 shipyard workers in 2001 and 135 in 2004, and for 94 dental hygienists in 2002 and 66 in 2004. In 2001, 50% of shipyard workers were diagnosed as CTS cases by at least one of the diagnostic schemes, but only 20% were positive by both criteria. Among study physician diagnosed cases, 64% were CTS negative in 2001, 76% were negative in 2004, 13% were positive in both years, 22% became negative after being positive, and 11% became positive after being negative. For only study physician diagnosed CTS did VTTs differ between cases differ and non-cases in digit 3; there was no such distinction in digit 5. The dental hygienists had little CTS.

    Conclusion: Clinical case definitions of CTS based on diagrams and self-assessment, and clinical evaluation have limited overlap. Combining clinical criteria to create a more narrow or specific case definition of CTS does not appear to predict SNCV. The natural history of CTS suggests a protean disorder with considerable flux in case status over time.

  • 16.
    Claeson, Anna-Sara
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Lidén, Edvard
    Nordin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    The role of perceived pollution and health risk perception in annoyance and health symptoms: a population-based study of odorous air pollution2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 3, p. 367-374Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Health effects associated with air pollution at exposure levels below toxicity may not be directly related to level of exposure, but rather mediated by perception of the air pollution and by top-down processing (e.g., beliefs that the exposure is hazardous). The aim of the study was to test a model that describes interrelations between odorous air pollution at non-toxic exposure levels, perceived pollution, health risk perception, annoyance and health symptoms.

    METHODS: A population-based questionnaire study was conducted in a Swedish community of residents living near a biofuel facility that emitted odorous substances. Individuals aged 18-75 years were selected at random for participation (n = 1,118); 722 (65 %) agreed to participate. Path analyses were performed to test the validity of the model.

    RESULTS: The data support a model proposing that exposure level does not directly influence annoyance and symptoms, and that these relations instead are mediated by perceived pollution and health risk perception.

    CONCLUSIONS: Perceived pollution and health risk perception play important roles in understanding and predicting environmentally induced annoyance and health symptoms in odorous environments at non-toxic levels of exposure.

  • 17. du Prel, Jean-Baptist
    et al.
    Runeson-Broberg, Roma
    Westerholm, Peter
    Alfredsson, Lars
    Fahlen, Goran
    Knutsson, Anders
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology. Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Peter, Richard
    Work overcommitment: Is it a trait or a state?2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 1, p. 1-11Article in journal (Refereed)
    Abstract [en]

    Purpose: Effort–reward imbalance (ERI) is a well-tested work-related stress model with three components, the two extrinsic components “efforts” and “rewards” and the one intrinsic component “overcommitment”. While an imbalance between “efforts” and “rewards” leads to strain reactions, “work-related overcommitment” (OC) has been described as a personal characteristic with a set of attitudes, behaviours, and emotions reflecting excessive striving combined with a strong desire for approval. However, the question whether OC is a personality trait or a response pattern sensitive to changes in the work context (state) is still open.

    Methods: 2940 Swedish industrial employees were included in this longitudinal analysis of the WOLF-Norrland data over 5 years. A change of OC index or its subscales were regressed against a change of freedom of choice at work, extra work, and ERI adjusted for age, sex, and education.

    Results: While OC was insensitive to changes in freedom of choice at work and extra work, it was clearly associated with changes of work-related stress over time. Three of four OC subscales exhibited statistically significant associations with ERI.

    Conclusions: For the first time, we studied fundamental characteristics of OC as an independent personality variable (trait) or an outcome variable subject to changes in the work environment (state). The association between external ERI and OC over time supports our hypothesis of OC being a state. Further investigations are needed to establish OC as a trait or a state.

  • 18. Edlund, Maria
    et al.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Hagberg, Mats
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sanden, Helena
    Wastensson, Gunilla
    Quantitatively measured tremor in hand-arm vibration-exposed workers2015In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 3, p. 305-310Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate the possible increase in hand tremor in relation to hand-arm vibration (HAV) exposure in a cohort of exposed and unexposed workers. Participants were 178 male workers with or without exposure to HAV. The study is cross-sectional regarding the outcome of tremor and has a longitudinal design with respect to exposure. The dose of HAV exposure was collected via questionnaires and measurements at several follow-ups. The CATSYS Tremor Pen(A (R)) was used for measuring postural tremor. Multiple linear regression methods were used to analyze associations between different tremor variables and HAV exposure, along with predictor variables with biological relevance. There were no statistically significant associations between the different tremor variables and cumulative HAV or current exposure. Age was a statistically significant predictor of variation in tremor outcomes for three of the four tremor variables, whereas nicotine use was a statistically significant predictor of either left or right hand or both hands for all four tremor variables. In the present study, there was no evidence of an exposure-response association between HAV exposure and measured postural tremor. Increase in age and nicotine use appeared to be the strongest predictors of tremor.

  • 19.
    Edvardsson, Berit
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Bergdahl, Jan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Eriksson, N
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Lindén, G
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Widman, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Medical and social prognoses of non-specific building-related symptoms (Sick Building Syndrome): a follow-up study of patients previously referred to hospital2008In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 81, no 7, p. 805-812Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to describe and analysethe medical and social prognoses of patients with nonspeciWcbuilding-related symptoms.Methods A follow-up questionnaire focusing on current medical and social status, care, treatment, other actions taken and personality traits was sent to 239 patients with non-speciWc building-related symptoms assessed during theperiod between1986 and 1998 at University Hospital in Umeå, Sweden. The response rate was 79%.Results Fatigue, irritation of the eyes, and facial erythemawere the most common weekly symptoms reported atfollow-up. As females constituted 92% of the respondents,statistical analyses were restricted to women. The level andseverity of symptoms decreased over time, although nearlyhalf of the patients claimed that symptoms were more or lessunchanged after 7 years or more, despite actions taken.Twenty-Wve percent of the patients were on the sick-list, and20% drew disability pension due to persistent symptoms atfollow-up. The risk of having no work capabilities at followupwas signiWcantly increased if the time from onset to Wrstvisit at the hospital clinic was more than 1 year. This riskwas also signiWcantly higher if the patient at the Wrst visithad Wve or more symptoms. All risk assessments wereadjusted for length of follow-up. Symptoms were oftenaggravated by diVerent situations in everyday life.Conclusions Long-lasting symptoms aggravated by environmentalfactors exist within this group of patients. Theresults support that early and comprehensive measures forrehabilitation are essential for the patients.

  • 20. Fahlen, Göran
    et al.
    Goine, Hans
    Edlund, Curt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Department of Health Sciences, Mid Sweden University, 851 70, Sundsvall, Sweden .
    Arrelöv, Britt
    Knutsson, Anders
    Peter, Richard
    Effort-reward imbalance, "locked in" at work, and long-term sick leave2009In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 82, no 2, p. 191-197Article in journal (Refereed)
    Abstract [en]

    The objective was to study the relationship between a situation characterized as being in a "locked-in" position (LIP) in occupation and/or place of work, Effort-reward imbalance (ERI), and long-term sick leave. The study population derived from one section of a cross-sectional study SKA (sick-leave, culture and attitudes), and comprised all employees at the Swedish Social Insurance Agency responsible for management and compensation of illness in the working population. The analyses were performed for 2,951 women and 534 men who had complete data. Logistic regression was used to calculate odds ratio (OR) for ERI and sick-leave, the latter only for women. The results showed a strong association between LIP within the place of work and ERI (for women OR = 3.28 95% CI 2.65-4.07, and for men 2.74 1.75-4.30). Also LIP within occupation resulted in high ERI (for women OR = 1.96 1.57-2.41, and for men 1.92 1.22-3.03). In women, ERI (OR = 1.40 1.15-1.70) as well as LIP within place of work (1.88 1.50-2.36) and within occupation (1.48 1.12-1.86) were associated with sick leave. ERI showed a significant mediating effect between LIP and sick leave, within place of work and within occupation (Z value 2.20 and 2.88, respectively). High ERI is associated with a situation characterized by being locked-in within an occupation or/and within a place of work. The results thereby support the theoretical model of Effort-reward imbalance. The results show that high ERI and being locked in are associated with long-term sick leave. ERI is a potential mediator of the association between being locked in and sick leave.

  • 21. Fahlén, Göran
    et al.
    Knutsson, Anders
    Peter, Richard
    Åkerstedt, Torbjörn
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Alfredsson, Lars
    Westerholm, Peter
    Effort-reward imbalance, sleep disturbances and fatigue.2006In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 79, no 5, p. 371-8Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The objective of this study was to investigate the validity of the effort-reward imbalance (ERI) model in relation to disturbed sleep and fatigue.

    METHODS: The study population derived from a subset of the WOLF (WOrk, Lipids, Fibrinogen) cohort study of cardiovascular risk in a working population who replied to the ERI-questionnaire comprising 789 men and 214 women. Cox regression analysis was used to calculate the prevalence ratio (PR) for sleep disorders and fatigue in relation to the components of ERI.

    RESULTS: As sleep disturbances and fatigue, based on literature, were defined to be represented by the uppermost quintile, 14% of the men and 23% of the women were affected by sleep disturbances while 14 and 26%, respectively, were affected by fatigue. Higher levels of exposure for the ERI components were associated with increased prevalence of sleep disturbances and fatigue. For men, the strongest association was seen between high overcommitment and fatigue (PR 5.77, 95% confidence interval 2.89-11.5). For women, high effort and sleep disturbances (PR 4.04, CI 1.53-10.7), high effort/reward ratio and sleep disturbances (PR 4.13, CI 1.62-10.5), and between low reward and fatigue (PR 4.36, CI 1.79-10.6) yielded the most obvious associations.

    CONCLUSIONS: The present study adds sleep disturbances and fatigue to the list of adverse consequences of effort-reward imbalance.

  • 22.
    Forsell, Karl
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden..
    Eriksson, Helena
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lundh, Monica
    Andersson, Eva
    Nilsson, Ralph
    Work environment and safety climate in the Swedish merchant fleet2017In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, no 2, p. 161-168Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To get knowledge of the work environment for seafarers sailing under the Swedish flag, in terms of safety climate, ergonomical, chemical and psychosocial exposures, and the seafarers self-rated health and work ability.

    METHODS: A Web-based questionnaire was sent to all seafarers with a personal e-mail address in the Swedish Maritime Registry (N = 5608). Comparisons were made mainly within the study population, using Student's t test, prevalence odds ratios and logistic regressions with 95% confidence intervals.

    RESULTS: The response rate was 35% (N = 1972; 10% women, 90% men), with 61% of the respondents working on deck, 31% in the engine room and 7% in the catering/service department (1% not classifiable). Strain on neck, arm or back and heavy lifting were associated with female gender (p = 0.0001) and younger age (below or above 30 years of age, p < 0.0001). Exposures to exhausts, oils and dust were commonly reported. Major work problems were noise, risk of an accident and vibrations from the hull of the ship. The safety climate was high in comparison with that in land-based occupations. One-fourth had experienced personal harassment or bullying during last year of service.

    CONCLUSIONS: Noise, risk of accidents, hand/arm and whole-body vibrations and psychosocial factors such as harassment were commonly reported work environment problems among seafarers within the Swedish merchant fleet.

  • 23.
    Glas, Bo
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sunesson, Anna-Lena
    Exposure to formaldehyde, nitrogen dioxide, ozone, and terpenes among office workers and associations with reported symptoms2015In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 5, p. 613-622Article in journal (Refereed)
    Abstract [en]

    To compare exposure to formaldehyde, nitrogen dioxide, ozone and terpenes among office workers with and without sick building syndrome and the odds ratio for exposure. Are there significant differences? In this cross-sectional study of office workers, we investigated the associations between exposure to formaldehyde, nitrogen dioxide, ozone, alpha-pinene, and d-limonene using a case-control analysis. Data on perceived general, mucosal, and skin symptoms were obtained by questionnaires. Personal exposure measurements of the compounds were performed among cases and controls, and the odds ratios for exposures to the substances, both singly and in combination, were investigated. Exposures varied for formaldehyde between 0.23 and 45 A mu g/m(3), nitrogen dioxide between 0.26 and 110 A mu g/m(3), ozone between < 16 and 165 A mu g/m(3), alpha-pinene between 0.2 and 170 A mu g/m(3), and d-limonene between 0.8 and 1,400 A mu g/m(3). No consistent differences in exposure odds ratios were found between cases and controls or for individual symptoms.

  • 24. Hermansson, Jonas
    et al.
    Gillander Gådin, Katja
    Karlsson, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Reuterwall, Christina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Hallqvist, Johan
    Knutsson, Anders
    Case fatality of myocardial infarction among shift workers2015In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 5, p. 599-605Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Shift work has been associated with an excess risk of cardiovascular disease (CVD) and more specifically myocardial infarction (MI). The majority of the studies that found a positive association between shift work and CVD have been based on incidence data. The results from studies on cardiovascular-related mortality among shift workers have shown little or no elevated mortality associated with shift work. None of the previous studies have analysed short-term mortality (case fatality) after MI. Therefore, we investigated whether shift work is associated with increased case fatality after MI compared with day workers.

    METHODS: Data on incident cases with first MI were obtained from case-control study conducted in two geographical sites in Sweden (Stockholm Heart Epidemiology Program and Västernorrland Heart Epidemiology Program), including 1,542 cases (1,147 men and 395 women) of MI with complete working time information and 65 years or younger. Case fatality was defined as death within 28 days of onset of MI. Risk estimates were calculated using logistic regression.

    RESULTS: The crude odds ratios for case fatality among male shift workers were 1.63 [95 % confidence interval (CI) 1.12, 2.38] and 0.56 (95 % CI 0.26, 1.18) for female shift workers compared with day workers. Adjustments for established cardiovascular risk factors such as diabetes type II and socio-economic status did not alter the results.

    CONCLUSION: Shift work was associated with increased risk of case fatality among male shift workers after the first MI.

  • 25.
    Karlsson, Berndt H
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Knutsson, Anders K
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Lindahl, Bernt O
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Alfredsson, Lars S
    Metabolic disturbances in male workers with rotating three-shift work: results of the WOLF study2003In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 76, no 6, p. 424-430Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the present study was to investigate the relationship between important metabolic risk factors for coronary heart disease (CHD) and type 2 diabetes in shift workers and day workers.

    Methods: Cross-sectional data from a sub-population in the WOLF study consisting of 665 day workers and 659 three-shift workers in two plants were analysed.

    Results: A higher proportion of shift workers than day workers had high triglyceride levels (‡1.7 mmol/l), low levels of HDL-cholesterol (<0.9 mmol/l) and abdominal obesity (waist/hip ratio>0.9). The risk of low HDLcholesterol was doubled in shift workers, (odds ratio (OR): 2.02, 95% confidence interval (95% CI): 1.24– 3.28) after being adjusted for age, socio-economic factors, physical activity, current smoking, social support and job strain. High levels of triglycerides were also significantly associated with shift work (OR: 1.40, 95% CI: 1.08–1.83). The OR for abdominal obesity was 1.19, (95% CI: 0.92–1.56). The prevalence of hyperglycaemia (serum glucose ‡7.0 mmol/l) was similar in day and shift workers. No significant interaction was seen between shift work and abdominal obesity with regard to the associations with triglycerides and HDL-cholesterol.

    Conclusions: We found a significant association between shift work and lipid disturbances (i.e. low HDL-cholesterol and high triglyceride levels). We did not find any association with hyperglycaemia.

  • 26.
    Liljelind, Ingrid
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, L
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Persson, M
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Can we explain the exposure variability found in hand-arm vibrations when using angle grinders?: A round robin laboratory study2010In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 83, no 3, p. 283-290Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To quantify variance components of hand-arm vibration exposure from data collected in a laboratory study of four different angle grinders.

    METHODS: Four different angle grinders were sent to seven laboratories for grinding tests by three operators at each laboratory. Vibration in both the throttle and support handles was measured. For one grinder, the experimental set-up was repeated and two measurements were collected for that specific grinder.

    RESULTS: At least one-third of the estimated variability is attributable to the wheel and less than one-third to the operator. In repeated experiments, between-occasion, operator and wheel factors explained 4, 29 and 17% of the total variability, respectively.

    CONCLUSIONS: Since measured vibrations in the support and throttle handles are significantly differed, measurements should be taken at both locations. Factors influencing vibration variability include the presence/absence of an auto balance unit, wheel and operator, but other factors remain to be elucidated.

  • 27.
    Ljungberg, Jessica
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Neely, Gregory
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Cognitive performance and subjective experience during combined exposures to whole-body vibration and noise.2004In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 77, no 3, p. 217-221Article in journal (Refereed)
  • 28.
    Molin, M
    et al.
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    Schütz, A
    Skerfving, S
    Sällsten, G
    Mobilized mercury in subjects with varying exposure to elemental mercury vapour.1991In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 63, no 3, p. 187-92Article in journal (Refereed)
    Abstract [en]

    In a mercury mobilization test, 0.3 g of the complexing agent sodium 2,3-dimercaptopropane-1-sulfonate (DMPS) was given orally to 10 workers with moderate occupational exposure to elemental mercury vapour, to 8 dentists with slight exposure, to 18 matched controls, and to 5 referents without amalgam fillings. In the workers, DMPS caused an increase in 24-h urinary mercury excretion by a factor of 10; in the dentists, 5.9; in the controls, 5.3; and in the amalgam-free referents, 3.8. Of the mercury excreted during 24 h, 59% appeared during the first 6 h. Close, albeit non-linear, associations were found between mobilized mercury and the premobilization mercury levels in plasma and urine, but not with the duration of occupational exposure or the rough estimate of the integrated function of blood levels vs time. The present data indicate that mercury mobilized after a single DMPS dose in close connection with exposure is mainly an index of recent exposure and is not significantly affected by slow body pools or long-term exposure.

  • 29.
    Nilsson, T
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burström, L
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Hagberg, M
    Occupational and Environmental Medicine, Sahlgrenska Academy and University Hospital, University of Gothenburg.
    Lundström, R
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Thermal perception thresholds among young adults exposed to hand-transmitted vibration2008In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 81, no 5, p. 519-533Article in journal (Refereed)
    Abstract [en]

    Introduction: Quantitative sensory testing assesses non-invasively the function of the sensory pathways from receptors to cortex. Studies of workers exposed to vibration support evidence that neuro-sensory hand-arm vibration syndrome also encompasses neuropathy of the small-diameter nerve fibres. OBJECTIVES: To assess the risk of disturbed thermal perception developing among young adults exposed to vibration and hand-intensive manual work. The aim also encompasses the study of alternative covariates in small-diameter nerve fibre neuropathy assessment.

    Methods: This cross-sectional multi-centre study comprised 202 males and females from vocational school programs in auto mechanics, construction and catering. The testing included a baseline questionnaire, a clinical examination focusing on upper extremity disorders and quantitative somatosensory testing. Thermal perception thresholds were assessed, on both hands, second and fifth digits, using a modified Marstock method for warmth and cold.

    Results: Reduced thermal perception sensitivity was found for digit II compared to digit V, for females compared to males, and between the two study centres. Subjects exposed to vibration at work showed reduced sensitivity to temperature compared to non-vibration exposed. In univariate analyses odds ratios of 1.06 (95% CI 1.006-1.118) and 1.02 (95% CI 0.971-1.078) for reduced perception to cold for the right and left hands, respectively, was found for vibration. This association was lost in multivariate analyses. The study centre was the strongest confounding influence.

    Conclusions: Sensitivity to temperature appears to be reduced despite the subjects short exposure-time and low exposure to vibration. The effect is small in relation to other confounding factors. A low agreement between the modalities indicates the need for separate tests for cold and warmth. Hand-side, age, stature, and BMI were not important for thermal perception but study centre, gender and choice of digit were. Conventional electro-diagnostic investigations are inadequate for evaluating the status of the small-fibre afferent systems leaving QST of thermal perception as the preferred diagnostic tool.

  • 30.
    Nordin, Steven
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology. Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden .
    Andersson, Linus
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Evaluation of a Swedish version of the Quick Environmental Exposure and Sensitivity Inventory2010In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 83, no 1, p. 95-104Article in journal (Refereed)
    Abstract [en]

    Purpose: To psychometrically evaluate a Swedish version of the Quick Environment Exposure Sensitivity Inventory (QEESI), originally developed in the United States, which is a sensitive and fast questionnaire instrument with five scales used to investigate chemical intolerance. Methods: Ninety non-intolerant, 67 mildly intolerant, and 126 moderately/severely intolerant individuals to environmental chemicals responded at test and retest (n = 69, 64, 120, respectively) occasions to the Swedish version of the QEESI. Results  Good internal consistency (α = 0.74–0.95) and test–retest reliability (r = 0.78–0.93) was found in all scales, except for the internal consistency in the Masking Index (Kuder-Richardson coefficient = 0.10). All scales, but the Masking Index, further showed good convergent validity (somewhat lower in the Other Intolerences scale) and predominantly unidimensionality. Conclusions: The Swedish version of the QEESI is reliable and valid for investigation of chemical intolerance, but the Masking Index scale does not represent a unified concept of exposure to masking agents.

  • 31.
    Nordin, Steven
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Palmquist, Eva
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Bende, Mats
    Göteborgs universitet.
    Millqvist, Eva
    Göteborgs universitet.
    Normative data for the chemical sensitivity scale for sensory hyperreactivity: the Västerbotten environmental health study2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 7, p. 749-753Article in journal (Refereed)
    Abstract [en]

    Objectives: The chemical sensitivity scale for sensory hyperreactivity (CSS-SHR) is used to quantify affective reactions to and behavioral disruptions by odorous/pungent substances in the environment and has documented good metric properties. However, normative data have not been available. The main objective of the present study was therefore to establish normative data for reference by means of a large-scale population-based study.

    Materials and methods: From a random sample of 8,520 reachable inhabitants in the county of Västerbotten in Sweden, aged 18–79 years, stratified for age and gender, 3,406 individuals agreed to participate.

    Results: The results show fairly high internal consistency (Cronbach’s α = 0.78–0.83) of the CSS-SHR and that it generates scores with approximately normal distributions (skewness: 0.045–0.454; kurtosis: −0.314 to 0.230), irrespective of age group and gender. Mean scores, standard deviations, confidence intervals, and proportions of individuals who met the diagnostic cutoff score for the CSS-SHR were obtained for reference of normality.

    Conclusions: CSS-SHR can be recommended for quantification of affective reactions to and behavioral disruptions by odorous/pungent environmental substances, and with the advantage of comparing scores with normality.

  • 32.
    Orru, Kati
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology. Institute of Social Studies, Tartu University, Tartu, Estonia.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Harzia, Hedi
    Estonian Health Board, Tallinn, Estonia.
    Orru, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Institute of Family Medicine and Public Health, Tartu University, Tartu, Estonia.
    The role of perceived air pollution and health risk perception in health symptoms and disease: a population-based study combined with modelled levels of PM102018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 5, p. 581-589Article in journal (Refereed)
    Abstract [en]

    Purpose: Adverse health impact of air pollution on health may not only be associated with the level of exposure, but rather mediated by perception of the pollution and by top-down processing (e.g. beliefs of the exposure being hazardous), especially in areas with relatively low levels of pollutants. The aim of this study was to test a model that describes interrelations between air pollution (particles < 10 μ m, PM10), perceived pollution, health risk perception, health symptoms and diseases.

    Methods: A population-based questionnaire study was conducted among 1000 Estonian residents (sample was stratified by age, sex, and geographical location) about health risk perception and coping. The PM10 levels were modelled in 1 × 1 km grids using a Eulerian air quality dispersion model. Respondents were ascribed their annual mean PM10 exposure according to their home address. Path analysis was performed to test the validity of the model.

    Results: The data refute the model proposing that exposure level significantly influences symptoms and disease. Instead, the perceived exposure influences symptoms and the effect of perceived exposure on disease is mediated by health risk perception. This relationship is more pronounced in large cities compared to smaller towns or rural areas.

    Conclusions: Perceived pollution and health risk perception, in particular in large cities, play important roles in understanding and predicting environmentally induced symptoms and diseases at relatively low levels of air pollution.

  • 33.
    Pettersson, Hans
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    The effect on the temporary threshold shift in hearing acuity from combined exposure to authentic noise and hand-arm vibration2011In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 84, no 8, p. 951-957Article in journal (Refereed)
    Abstract [en]

    This study examined and compared the effect on temporary threshold shift in hearing (TTS) in healthy subjects of noise and hand-arm vibration (HAV) combined and separately using controlled and authentic exposure conditions. This study also investigated the effect on TTS in hearing in relation to gender after such exposures.

    Twenty-two healthy subjects (11 men/women, mean age 22 years, range 18-31 years) were exposed both separately and in combination with HAV (6.7 m/s(2)), using vibrating handles and to noise (99dB(A)) using headphones, for 20 min. The HAV and noise were reproduced from recordings from angular grinder in operation. Hearing thresholds at 1, 4, and 8 kHz were measured before and up to 30 min after exposure. 

    Combined exposure to noise and HAV created significantly greater TTS in hearing than HAV exposure at 4 and 8 kHz alone. After exposure to HAV, there was no significant change in hearing threshold. At 1 kHz, there was a significant difference between noise and HAV exposure in TTS in hearing. There was no significant difference between combined exposure and noise exposure for any test frequency. There was no significant difference in TTS in hearing in relation to gender for 1, 4, and 8 kHz for HAV, noise, or a combined exposure.

    The results indicate that there is no difference in the TTS in hearing after combined exposure compared to noise exposure alone. HAV exposure did not change the hearing threshold. The TTS in hearing did not differ significantly in relation to gender after HAV, noise, or combined exposure.

  • 34.
    Poole, C. J. M.
    et al.
    Centre for Workplace Health, HSE's Health and Safety Laboratory, Harpur Hill, Buxton, UK .
    Bovenzi, M.
    Clinical Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste, Italy.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lawson, I. J.
    Rolls-Royce, Derby, UK.
    House, R.
    Division of Occupational Medicine, Department of Medicine, St Michael's Hospital and University of Toronto, Toronto, ON, Canada.
    Thompson, A.
    Division of Occupational Medicine, Department of Medicine, St Michael's Hospital and University of Toronto, Toronto, ON, Canada.
    Youakim, S.
    Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
    International consensus criteria for diagnosing and staging hand-arm vibration syndrome2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246Article in journal (Refereed)
    Abstract [en]

    Purpose: In the 30 years since the Stockholm Workshop Scale (SWS) was published, the scientific literature on hand-arm vibration syndrome (HAVS) has grown and experience has been gained in its practical application. This research was undertaken to develop an up-to-date evidence-based classification for HAVS by seeking consensus between experts in the field.

    Methods: Seven occupational physicians who are clinically active and have had work published on HAVS in the last 10 years were asked to independently take part in a three-round iterative Delphi process. Consensus was taken when 5/7 (72%) agreed with a particular statement. Experts were asked to provide evidence from the literature or data from their own research to support their views.

    Results: Consensus was achieved for most of the questions that were used to develop an updated staging system for HAVS. The vascular and neurological components from the SWS are retained, but ambiguous descriptors and tests without adequately developed methodology such as tactile discrimination, or discriminating power such as grip strength, are not included in the new staging system. A blanching score taken from photographs of the hands during vasospastic episodes is recommended in place of self-recall and frequency of attacks to stage vascular HAVS. Methods with the best evidence base are described for assessing sensory perception and dexterity.

    Conclusions: A new classification has been developed with three stages for the clinical classification of vascular and neurological HAVS based on international consensus. We recommend it replaces the SWS for clinical and research purposes.

  • 35.
    Schumann, Barbara
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Seidler, A
    Kluttig, A
    Werdan, K
    Haerting, J
    Greiser, KH
    Association of occupation with prevalent hypertension in an elderly East German population: an exploratory cross-sectional analysis2011In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 84, p. 361-369Article in journal (Refereed)
    Abstract [en]

    Purpose   Hypertension is one of the most relevant risk factors for cardiovascular disease; however, little is known about differences in hypertension by occupation. The aim of this study was to explore the association between occupational group and prevalent hypertension.

    Methods   Cross-sectional data of the CARLA study were used, a representative sample of an East German population aged 45–83. Job titles of the current or last held occupation of 967 men and 808 women were coded using the German classification of occupation. Hypertension was defined as blood pressure of ≥140 mmHg (systolic), ≥90 mmHg (diastolic) or use of antihypertensives. Sex-stratified, age-adjusted prevalence risk ratios (PR) with 95% confidence intervals (CI) were calculated for 31 occupational groups.

    Results   Hypertension was prevalent in 79% of the population. In men, highest age-adjusted prevalence ratios were observed in metal-processing workers, carpenters/painters, and electricians with PRs of 1.31 (CI 1.04–1.65), 1.28 (CI 1.00–1.64), and 1.21 (0.95–1.53), respectively, compared to office clerks. In women, highest PRs were found in technicians/forewomen, scrutinisers/storekeepers, and food-processing occupations with PR 1.28 (1.09–1.49), 1.23 (0.99–1.51), and 1.22 (1.01–1.48), respectively. Adjustment for education, smoking, body mass index, and current work hours did not fully explain occupational differences. Excluding currently non-working subjects lead to decreased PRs in men and to increased PR in women.

    Conclusions   Differences in the prevalences of hypertension by occupational group were only partly explained by conventional risk factors and may require workplace interventions targeted at high-risk occupations. Longitudinal data with large cohorts and work-related exposure assessment are needed to confirm a temporal relationship between occupation and incident hypertension.

  • 36. Siegrist, Johannes
    et al.
    Dragano, Nico
    Nyberg, Solja T.
    Lunau, Thorsten
    Alfredsson, Lars
    Erbel, Raimund
    Fahlen, Goran
    Goldberg, Marcel
    Joeckel, Karl-Heinz
    Knutsson, Anders
    Leineweber, Constanze
    Hanson, Linda L. Magnusson
    Nordin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Rugulies, Reiner
    Schupp, Jurgen
    Singh-Manoux, Archana
    Theorell, Tores
    Wagner, Gert G.
    Westerlund, Hugo
    Zins, Marie
    Heikkila, Katriina
    Fransson, Eleonor I.
    Kivimaki, Mika
    Validating abbreviated measures of effort-reward imbalance at work in European cohort studies: the IPD-Work consortium2014In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 87, no 3, p. 249-256Article in journal (Refereed)
    Abstract [en]

    Effort-reward imbalance (ERI) is an established conceptualisation of work stress. Although a validated effort-reward questionnaire is available for public use, many epidemiological studies adopt shortened scales and proxy measures. To examine the agreement between different abbreviated measures and the original instrument, we compared different versions of the effort-reward scales available in 15 European cohort studies participating in the IPD-Work (Individual-participant-data meta-analysis in working populations) consortium. Five of the 15 studies provide information on the original ('complete') scales measuring 'effort' and 'reward', whereas the 10 remaining studies used 'partial' scales. To compare different versions of the ERI scales, we analyse individual-level data from 31,790 participants from the five studies with complete scales. Pearson's correlation between partial and complete scales was very high in case of 'effort' (where 2 out of 3 items were used) and very high or high in case of 'reward', if at least 4 items (out of 7) were included. Reward scales composed of 3 items revealed good to satisfactory agreement, and in one case, a reward scale consisting of 2 items only demonstrated a modest, but still acceptable degree of agreement. Sensitivity and specificity of a composite measure, the ratio of effort and reward, comparing partial versus complete scales ranged between 59-93 and 85-99 %, respectively. Complete and partial scales were strongly associated with poor self-rated health. Our results support the notion that short proxy measures or partial versions of the original scales can be used to assess effort-reward imbalance.

  • 37.
    Sjödin, Fredrik
    et al.
    Högskolan i Gävle, Akademin för teknik och miljö, Avdelningen för bygg- energi- och miljöteknik.
    Kjellberg, Anders
    Högskolan i Gävle, Akademin för teknik och miljö, Avdelningen för bygg- energi- och miljöteknik.
    Knutsson, Anders
    Mittuniversitetet, Folkhälsovetenskap.
    Landström, Ulf
    Högskolan i Gävle, Akademin för teknik och miljö, Avdelningen för bygg- energi- och miljöteknik.
    Lindberg, Lennart
    Högskolan i Gävle, Akademin för teknik och miljö, Avdelningen för bygg- energi- och miljöteknik.
    Measures against preschool noise and its adverse effects on the personnel: an intervention study2014In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 87, no 1, p. 95-110Article in journal (Refereed)
    Abstract [en]

    Purpose

    The aim of the study was to analyze the exposure effects of different types of noise measures carried out at preschools. The project was carried out as an intervention study.

    Methods

    The investigation included 89 employees at 17 preschools in the northern part of Sweden. Individual noise recordings and recordings in dining rooms and play halls were made at two departments in each preschool. The adverse effects on the employees were analyzed with validated questionnaires and saliva cortisol samples. Evaluations were made before and one year after the first measurement. Between the two measurements, measures had been taken to improve the sound environments at the preschools.

    Results

    The effects of the measures varied at lot, both with respect to the sound environments and health. Regarding acoustical measures, significant changes were seen for some of the variables analyzed. For most of the tested effects, the changes however were very small and non-significant. The effects of organizational measures on the objective and subjective noise values were in overall less pronounced.

    Conclusion

    Acoustical measures improved the subjectively rated sound environment more than organizational measures. This may be due to the high work effort needed to implement organizational measures. Even though the sound level was not lower, the personnel experienced improvements of the sound environment.

  • 38. Stadin, Magdalena
    et al.
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology. Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Brostrom, Anders
    Hanson, Linda L. Magnusson
    Westerlund, Hugo
    Fransson, Eleonor I.
    Information and communication technology demands at work: the association with job strain, effort-reward imbalance and self-rated health in different socio-economic strata2016In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 7, p. 1049-1058Article in journal (Refereed)
    Abstract [en]

    The use of information and communication technology (ICT) is common in modern working life. ICT demands may give rise to experience of work-related stress. Knowledge about ICT demands in relation to other types of work-related stress and to self-rated health is limited. Consequently, the aim of this study was to examine the association between ICT demands and two types of work-related stress [job strain and effort-reward imbalance (ERI)] and to evaluate the association between these work-related stress measures and self-rated health, in general and in different SES strata. This study is based on cross-sectional data from the Swedish Longitudinal Occupational Survey of Health collected in 2014, from 14,873 gainfully employed people. ICT demands, job strain, ERI and self-rated health were analysed as the main measures. Sex, age, SES, lifestyle factors and BMI were used as covariates. ICT demands correlated significantly with the dimensions of the job strain and ERI models, especially with the demands (r = 0.42; p < 0.01) and effort (r = 0.51; p < 0.01) dimensions. ICT demands were associated with suboptimal self-rated health, also after adjustment for age, sex, SES, lifestyle and BMI (OR 1.49 [95 % CI 1.36-1.63]), but job strain (OR 1.93 [95 % CI 1.74-2.14) and ERI (OR 2.15 [95 % CI 1.95-2.35]) showed somewhat stronger associations with suboptimal self-rated health. ICT demands are common among people with intermediate and high SES and associated with job strain, ERI and suboptimal self-rated health. ICT demands should thus be acknowledged as a potential stressor of work-related stress in modern working life.

  • 39.
    Stjernbrandt, Albin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Björ, Bodil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Andersson, Martin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Liljelind, Ingrid
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Neurovascular hand symptoms in relation to cold exposure in northern Sweden: a population-based study2017In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, no 7, p. 587-595Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To describe the self-reported ambient cold exposure in northern Sweden and to relate the level of cumulative cold exposure to the occurrence of sensory and vascular hand symptoms. We hypothesize that cold exposure is positively related to reporting such symptoms.

    METHODS: A questionnaire about cold exposure and related symptoms was sent out to 35,144 subjects aged 18-70 years and living in northern Sweden.

    RESULTS: A total of 12,627 out of 35,144 subjects returned the questionnaire (response rate 35.9%). Subjects living in the rural alpine areas reported more extensive cold exposure both during work and leisure time compared to the urbanized coastal regions. Frostbite in the hands was present in 11.4% of men and 7.1% of women, cold sensitivity was present in 9.7 and 14.4%, and Raynaud's phenomenon was present in 11.0% of men and 14.0% of women. There was a positive association between cumulative cold exposure and neurovascular hand symptoms.

    CONCLUSION: The present study demonstrates that the cold environment in northern Sweden might be an underestimated health risk. Our hypothesis that cold exposure is positively related to reporting of neurovascular hand symptoms was supported by our findings. In addition, such symptoms were common not only in conjunction with an overt cold injury. Our results warrant further study on pathophysiological mechanisms and suggest the need for confirmatory prevalence studies to support national public health planning.

  • 40.
    Stjernbrandt, Albin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Carlsson, Daniel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Pettersson, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Liljelind, Ingrid
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Cold sensitivity and associated factors: a nested case–control study performed in Northern Sweden2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 7, p. 785-797Article in journal (Refereed)
    Abstract [en]

    Aim To identify possible risk factors for cold sensitivity, by comparing cases to controls with regard to demographic and anthropometric characteristics, previous illnesses and injuries as well as ambient exposures.

    Methods Through a questionnaire responded to by the general population (n=12,627) cold sensitivity cases (n=502) and matched controls (n=1,004) were identified and asked to respond to a second questionnaire with focus on different aspects of cold sensitivity, hereditary factors, previous diseases, medication, tobacco use as well as exposure to ambient cold climate and hand-arm vibration (HAV).

    Results In total, 997 out of 1506 study subjects answered the second questionnaire, 374 cases and 623 match controls. Identified risk factors among the cases were frostbite of the hands Odds Ratio (OR) 10.3 (95% confidence interval (CI) 5.5-19.3), rheumatic disease OR 3.1 (95% CI 1.7-5.7), upper extremity nerve injury OR 2.0 (95% CI 1.3-3.0), and vascular disease OR 1.9 (95% CI 1.2-2.9). Sex differences in risk factors were HAV exposure for men and cold exposure for women increased the risk of cold sensitivity. Rheumatic diseases and migraine increased the risk of cold sensitivity among women but not among men.

    Conclusions The present study shows that cold sensitivity is associated with both inherent factors, acquired conditions and external exposures. Among acquired conditions, frostbite, vascular disease, nerve injury, joint disorders and migraine are significantly related to the reporting of cold sensitivity. Among external exposures, both cold climate and HAV exposure are significantly associated to cold sensitivity, and thus suitable targets for primary preventive measures. There was a difference in risk factors related to sex. HAV exposure for men and cold exposure for women increased the risk of cold sensitivity.

  • 41.
    Virtanen, Pekka
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Suboptimal health as a predictor of non-permanent employment in middle age: a 12-year follow-up study of the Northern Swedish Cohort2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 2, p. 139-145Article in journal (Refereed)
    Abstract [en]

    Earlier research on health-related selection in the labour market has concentrated on selection of those with poor health into unemployment. The purpose of the present study was to investigate if suboptimal health also predicts non-permanent employment. A population cohort of 517 men and 477 women was surveyed at age 30 and at age 43 about their health and yearly employment. Non-permanent employment during the follow-up was assessed for its occurrence with Cox regression and for the amount (accumulation in months) with generalised linear models. Suboptimal self-rated health, sense functioning and sleep quality in women and suboptimal mood in men predicted high accumulation of non-permanent employment. By contrast, in men, suboptimal self-rated health and sense functioning predicted low accumulation. The gender differences were statistically significant. Smoking predicted high occurrence and accumulation of non-permanent employment equally in men and women, whereas no associations were seen with overweight and alcohol consumption. Selection into non-permanent employment was shown for several indicators of suboptimal health. A gendered pattern was found, with more health selection among women. The findings of this pioneering study should be tested with further research.

  • 42.
    Wahlström, Jens
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johnson, Peter W
    Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Exposure to whole-body vibration and hospitalization due to lumbar disc herniation2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 6, p. 689-694Article in journal (Refereed)
    Abstract [en]

    Objective: The aim was to examine if exposure to whole-body vibration (WBV) increases the risk for hospitalization due to lumbar disc herniation.

    Methods: The study basis is a cohort of 288,926 Swedish construction workers who participated in a national occupational health surveillance programme from 1971 until 1992. Job title, smoking habits, body weight, height and age were registered at the examinations. Assessment of WBV were made for each of the constituent occupations by constructing a job-exposure matrix (JEM). Exposure to WBV was graded on a scale from 0 to 5. In addition, the occurrence of hospitalization due to lumbar disc herniation from January 1st 1987 until December 31st 2010 was collected from a linkage with the Swedish Hospital Discharge Register. Poisson regressions were used to estimate relative risk with 95 percent confidence intervals (95% CI), adjusting for age, height, weight and smoking, using white-collar workers and foremen as a reference group.

    Results: There was an increased risk for hospitalization due to lumbar disc herniation for workers in the construction industry exposed to medium to high WBV compared to white-collar workers and foremen 1.35 (1.12-1.63). When restricting the analyses to include workers 30-49 years of age at the time of the hospital admission the risk was 1.69 (95% CI 1.29-2.21).

    Conclusion: This study further supports that occupational exposure to whole-body vibration increases the risk for hospitalization due to lumbar disc herniation.

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