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  • 1.
    Ahlm, Clas
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Thelin, Anders
    Elgh, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Virology.
    Juto, Per
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Virology.
    Stiernström, E L
    Holmberg, S
    Tärnvik, Arne
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Prevalence of antibodies specific to Puumala virus among farmers in Sweden1998In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 24, no 2, 104-108 p.Article in journal (Refereed)
    Abstract [en]

    Serological evidence confirmed that the exposure of humans to Puumala virus is firmly restricted to the northern and central parts of Sweden. In addition the evidence indicated that, in this region, farming is associated with an increased risk of contracting hantavirus infection.

  • 2.
    Björ, Ove
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Damber, Lena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Edström, Clarence
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Long-term follow-up study of mortality and the incidence of cancer in a cohort of workers at a primary aluminum smelter in Sweden2008In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 34, no 6, 463-470 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Previous studies on mortality and the incidence of cancer among workers at primary aluminum smelters have produced conclusive results indicating an elevated risk of bladder cancer. An increased risk of lung cancer has also been reported several times. The objective of this study was to examine mortality and the incidence of cancer at a Swedish aluminum smelter when different neighboring reference populations were used to evaluate any relationships to the length of employment. METHODS: A historical cohort--comprised of 2264 male nonoffice workers employed from 1942 on and tracked up to the year 2000--was examined. With the use of three reference populations for mortality and four for cancer incidence, standardized mortality and incidence ratios were calculated, together with hazard ratios derived from Cox regression models. RESULTS: This study showed an excess risk of mortality due to chronic obstructive lung disease, mental disorders, and diseases of the digestive system among the short-term workers. An elevated risk of cancer was found for the lungs, central nervous system, and esophagus. The highest lung cancer risk was observed for the workers employed for > or = 10 years in the factory when they were compared with the reference group from northern Sweden (standardized incidence ratio 1.99, 95% confidence ratio 1.21-3.07). CONCLUSIONS: The results support previous studies that demonstrated an excess risk of lung cancer, but, in contrast to the results of most studies, cancer of the central nervous system was also elevated. This study did not, however, verify an association between this type of exposure and cancer of the urinary organs.

  • 3. Burdorf, Alex
    et al.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Harma, Mikko
    The importance of preventing work-related disability2014In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 40, no 4, 331-333 p.Article in journal (Refereed)
  • 4.
    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. Department of Occupational and Environmental Medicine, University Hospital of Northern Sweden, Umeå, Sweden.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Department of Occupational and Environmental Medicine, Sundsvall Hospital, Sundsvall, SE-851 86 Sweden.
    Wahlström, Jens
    Department of Occupational and Environmental Medicine, University Hospital of Northern Sweden, Umeå, Sweden.
    White fingers, cold environment, and vibration: exposure among Swedish construction workers2010In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, ISSN 1795-990X, Vol. 36, no 6, 509-513 p.Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to examine the association between white fingers, cold environment, and exposure to hand–arm vibration (HAV). The hypothesis was that working in cold climate increases the risk of white fingers.

    Methods The occurrence of white fingers was investigated as a cross-sectional study in a cohort of Swedish male construction workers (N=134 757). Exposure to HAV was based on a job-exposure matrix. Living in the north or south of Sweden was, in a subgroup of the cohort, used as an indicator of the exposure to cold environment (ie, living in the north meant a higher exposure to cold climate). The analyses were adjusted for age and use of nicotine products (smoking and snuff).

    Results HAV-exposed workers living in a colder climate had a higher risk for white fingers than those living in a warmer climate [odds ratio (OR) 1.71, 95% confidence interval (95% CI) 1.42–2.06]. As expected, we found that HAV-exposed workers had an increased risk compared to controls (OR 2.02, 95% CI 1.75–2.34). The risk for white fingers increased with increased level of exposure to HAV and also age.

    Conclusions Cold environment increases the risk for white fingers in workers occupationally exposed to HAV. The results underscore the need to keep exposure to HAV at workplaces as low as possible especially in cold climate.

  • 5.
    Carlsson, Daniel
    et al.
    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.
    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.
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Neurosensory and vascular function after 14 months of military training comprising cold winter conditions2016In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 42, no 1, 61-70 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study aimed to examine the effects of 14 months of military training comprising cold winter conditions on neurosensory and vascular function in the hands and feet.

    METHODS: Military conscripts (N=54) were assessed with quantitative sensory testing comprising touch, temperature, and vibration perception thresholds and finger systolic blood pressure (FSBP) after local cooling and a questionnaire on neurosensory and vascular symptoms at both baseline and follow-up. Ambient air temperature was recorded with body worn temperature loggers.

    RESULTS: The subjects showed reduced sensitivity to perception of touch, warmth, cold and vibrations in both the hands and feet except from vibrotactile perception in digit two of the right hand (right dig 2). Cold sensations, white fingers, and pain/discomfort when exposed to cold as well as pain increased in both prevalence and severity. There were no statistically significant changes in FSBP after local cooling.

    CONCLUSION: Fourteen months of winter military training comprising cold winter conditions reduced sensation from touch, warmth, cold, and vibrotactile stimulus in both hands and feet and increased the severity and prevalence of symptoms and pain. The vascular function in the hands, measured by FSBP after local cooling, was not affected.

  • 6. Crenshaw, Albert G
    et al.
    Lyskov, Eugene
    Heiden, Marina
    Flodgren, Gerd
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Centre for Musculoskeletal Research, University of Gävle, Umeå, Sweden.
    Hellström, Fredrik
    Impact of time pressure and pauses on physiological responses to standardized computer mouse use: a review of three papers focusing on mechanisms behind computer-related disorders2007In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, no Suppl 3, 68-75 p.Article in journal (Refereed)
    Abstract [en]

    This paper reviews three computer mouse studies in our laboratory in which our emphasis was on mechanisms behind computer-related disorders. Our approach was sequentially (i) to determine the validity of a laboratory model for computer mouse use (painting rectangles) for studying musculoskeletal disorders, (ii) to use this model to study time pressure and precision demands on position sense and muscular oxygenation, and (iii) to use this model to determine the effect of pauses (active versus passive) on these parameters. Kinematic data for the painting model showed constrained movements of the wrist similar to that of CAD (computer-aided design) work, a support for its validity for a real-life situation. Changes in forearm oxygenation were associated with time pressure and precision demands, a potential for insight into the underlying pathophysiological mechanisms. Increasing trends in oxygenation and blood volume were associated with pauses, especially active pauses, a possible explanation for the alleviating effect of discomfort experienced in real-life situations when a pause is implemented.

  • 7. Edlund, Maria
    et al.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Gerhardsson, Lars
    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.
    Sandén, Helena
    Hagberg, Mats
    A prospective cohort study investigating an exposure-response relationship among vibration-exposed male workers with numbness of the hands2014In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 40, no 2, 203-209 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to investigate the exposure-response relationship of hand-arm vibration exposure to neurological symptoms (numbness) of the hand in a cohort of vibration-exposed workers.

    METHODS: The baseline cohort comprised 241 office and manual workers with or without exposure to hand-arm vibration. Numbness (the symptom or event) in the hand was assessed for all subjects at baseline and follow-ups after 5, 10, and 16 years. The workers were stratified into quartiles with no exposure in the first quartile and increasing intensity of exposure in quartiles 2-4 (groups 1-3). Data analysis was performed using survival analysis (time to event). Information on cumulative exposure and years of exposure to event was collected via questionnaires. Measurements were performed in accordance with the International Organization for Standardization (ISO) 5349-1.

    RESULTS: The hazard ratio (HR) of risk of event (numbness) differed statistically significantly between the non-exposed group (group 0) and the two higher exposure groups (groups 2 and 3). There was also a significant ratio difference between the lowest exposure group (group 1) and the two higher groups. The ratio for group 1 was 1.77 [95% confidence interval (95% CI) 0.96-3.26] compared with 3.78 (95% CI 2.15-6.62) and 5.31 (95% CI 3.06-9.20) for groups 2 and 3, respectively.

    CONCLUSION: The results suggest a dose-response relationship between vibration exposure and numbness of the hands. This underlines the importance of keeping vibration levels low to prevent neurological injury to the hands.

  • 8. Gold, Judith E.
    et al.
    Hallman, David M.
    Hellström, Fredrik
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
    Crenshaw, Albert G.
    Djupsjobacka, Mats
    Heiden, Marina
    Mathiassen, Svend Erik
    Piligian, George
    Barbe, Mary F.
    Systematic review of biochemical biomarkers for neck and upper-extremity musculoskeletal disorders2016In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 42, no 2, 103-124 p.Article, review/survey (Refereed)
    Abstract [en]

    Objective This study systematically summarizes biochemical biomarker research in non-traumatic musculoskeletal disorders (MSD). Two research questions guided the review: (i) Are there biochemical markers associated with neck and upper-extremity MSD? and (ii) Are there biochemical markers associated with the severity of neck and upper-extremity MSD?

    Methods A literature search was conducted in PubMed and SCOPUS, and 87 studies met primary inclusion criteria. Following a quality screen, data were extracted from 44 articles of sufficient quality.

    Results Most of the 87 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. A response rate was explicitly stated in only 11 (13%) studies. Less than half of the studies controlled for potential confounding through restriction or in the analysis. Most sufficient-quality studies were conducted in older populations (mean age in one or more analysis group >50 years). In sufficient-quality articles, 82% demonstrated at least one statistically significant association between the MSD and biomarker(s) studied. Evidence suggested that: (i) the collagen-repair marker TIMP-1 is decreased in fibroproliferative disorders, (ii) 5-HT (serotonin) is increased in trapezius myalgia, and (iii) triglycerides are increased in a variety of MSD. Only 5 studies showed an association between a biochemical marker and MSD severity.

    Conclusion While some MSD biomarkers were identified, limitations in the articles examined included possible selection bias, confounding, spectrum effect (potentially heterogeneous biomarker associations in populations according to symptom severity or duration), and insufficient attention to comorbid conditions. A list of recommendations for future studies is provided.

    The full text will be freely available from 2018-03-01 00:00
  • 9.
    Hedlund, Ulf
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Rönmark, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Eriksson, Kåre
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lundbäck, Bo
    Department of Internal Medicine/Respiratory Medicine & Allergology, Sahlgrenska Academy, University of Göteborg, Göteborg.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Occupational exposure to dust, gases and fumes, a family history of asthma and impaired respiratory health2008In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 34, no 5, 381-386 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: This study assessed the impact of occupational exposure to dust, gases, and fumes on respiratory symptoms, obstructive lung diseases, or the use of asthma medication among persons with and without a family history of asthma.

    Methods: A population-based cohort was followed for 10 years. This study included all 1739 men and 1594 women occupationally active at the first survey. Exposure and respiratory health were assessed from questionnaires. Multiple logistic regression was used to estimate the effects in relation to occupational groups, with age, gender, and smoking habits as possible confounders, using both cross-sectional and longitudinal analyses. The susceptibility to impaired respiratory health was determined from a family history of asthma.

    Results: A family history of asthma was reported by 27% of the men and 34% of the women. Both occupational exposure and a family history of asthma were associated with impaired respiratory health. The etiologic fractions showed that up to about 70% of the symptoms could be explained by a family history of asthma among those exposed to low levels of air pollutants, as well as among those with high exposure. However, high exposure contributed up to 35% of the symptoms both among those with and among those without a family history of asthma. The study indicates that the relative risk of occupational exposure to pollutants is similar for both persons with and those without a family history of asthma.

    Conclusions: The relative risk for impaired respiratory health after exposure to occupational air pollutants seems to be similar for persons with and those without a susceptibility to impaired respiratory health.

  • 10. Jood, Katarina
    et al.
    Karlsson, Nadine
    Medin, Jennie
    Pessah-Rasmussen, Helene
    Wester, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital.
    Ekberg, Kerstin
    The psychosocial work environment is associated with risk of stroke at working age2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 4, 367-374 p.Article in journal (Refereed)
    Abstract [en]

    Objective The aim of this study was to explore the relation between the risk of first-ever stroke at working age and psychological work environmental factors. Methods A consecutive multicenter matched 1:2 case control study of acute stroke cases (N=198, age 30-65 years) who had been working full-time at the time of their stroke and 396 sex- and age-matched controls. Stroke cases and controls answered questionnaires on their psychosocial situation during the previous 12 months. The psychosocial work environment was assessed using three different measures: the job control demand model, the effort reward imbalance (ERI) score, and exposures to conflict at work. Results Among 198 stroke cases and 396 controls, job strain [odds ratio (OR) 1.30, 95% confidence interval (95% CI) 1.05-1.62], ERI (OR 1.28, 95% CI 1.01-1.62), and conflict at work (OR 1.75, 95% CI 1.07-2.88) were independent risk factors of stroke in multivariable regression models. Conclusions Adverse psychosocial working conditions during the past 12 months were more frequently observed among stroke cases. Since these factors are presumably modifiable, interventional studies targeting job strain and emotional work environment are warranted.

  • 11.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    How should methods for return to work be evaluated?2012In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 38, no 2, 89-91 p.Article in journal (Refereed)
  • 12.
    Järvholm, Bengt
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Albin, Maria
    Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
    Johansson, Gunn
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Wadensjö, Eskil
    Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden.
    Perspectives of working life research2009In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 35, no 5, 394-396 p.Article in journal (Refereed)
    Abstract [en]

    We recently finished a position paper on Swedish working life research for the Swedish Council for Working Life and Social Research. An obvious question was the definition of "working life research". Searching the literature, we found a plethora of terms used to describe this area and lack of a generally accepted definition. It also became clear that the primary goals of such research varied widely between international organizations and governments. In this paper, our aim is to discuss the definition and goals of working life research.

  • 13.
    Järvholm, Bengt
    et al.
    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.
    Bystedt, Jennie
    Sundsvalls Hospital, Sundsvall, Sweden.
    Mortality attributable to occupational exposure in Sweden2013In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 39, no 1, 106-111 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The objective of this study was to estimate the mortality from cancer, cardiovascular, and respiratory diseases attributable to occupational exposure in Sweden. METHODS: Estimates were calculated for men and women separately, and we considered only deaths between 25-74 years of age. We considered cancer exposures/sites classified as I or 2a according to the International Agency for Research on Cancer (IARC). Acute myocardial infarction was the only included cardiovascular disease. Respiratory diseases comprised chronic obstructive pulmonary disease (COPD) asthma, pneumoconiosis and alveolitis. All deaths of pneumoconiosis and alveolitis were considered work-related. Estimates were based on the Swedish mortality in 2007. RESULTS: In total, we estimate that there are about 800 work-related deaths per year in the studied causes. The majority are due to acute myocardial infarction, with 126 deaths among women and 337 deaths among men attributable to job strain, shift work, exhaust gases, combustion products, or environmental tobacco smoke (ETS). There are 99 respiratory disease-related deaths, the vast majority from COPD (N=92). In total, 270 cancer deaths are estimated to be work-related. For men, half of the cases are attributed to asbestos exposure. CONCLUSIONS: Our results indicate that preventive measures to decrease occupational mortality should consider factors associated with myocardial infarction such as job strain, shift work and exhaust gases from vehicles and combustion products. Exposures to factors associated with COPD, such as dust, also seem important to prevent.

  • 14.
    Järvholm, Bengt
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Stattin, Mikael
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Robroek, Suzan JW
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Karlsson, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burdorf, Alex
    Heavy work and disability pension: a long term follow-up of Swedish construction workers2014In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 40, no 4, 335-342 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The objective of this study was to investigate the occurrence of disability pensions over time among workers with physically demanding jobs.

    METHODS: The occurrence of disability pension was prospectively studied between 1980-2008 among 325 549 Swedish construction workers. The risks for disability pension and years lost of working life were compared among 22 occupational groups, adjusting for age, body mass index, height, and smoking habits.

    RESULTS: The risk varied considerably among blue-collar workers. For example, rock workers had double the risk of disability pension [relative risk (RR) 2.16, 95% confidence interval (95% CI) 1.96-2.39] compared to electricians. Most working years lost due to disability pensions (about 75%) were found among men >50 years, mainly due to musculoskeletal and cardiovascular diseases. The years of working life lost due to disability pension varied from 0.7 (salaried employees) to 3.2 years (rock workers) among occupational groups.

    CONCLUSION: Work environment is an important predictor for disability pension among construction workers with those in physically heavy jobs having the highest burden of disability. If the purpose is to increase labor force participation for workers with heavy jobs, strategies to reduce physical demands at work among elderly workers are important.

  • 15.
    Karlsson, Berndt
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Alfredsson, Lars
    Knutsson, Anders
    Andersson, Eva
    Torén, Kjell
    Total mortality and cause-specific mortality of Swedish shift- and dayworkers in the pulp and paper industry in 1952-2001.2005In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 31, no 1, 30-35 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The study investigated the relationship between shiftwork and mortality, both total mortality and cause-specific mortality from coronary heart disease (CHD), stroke, and diabetes. Methods The cohort consisted of 2354 shiftworkers and 3088 dayworkers in two pulp and paper manufacturing plants. The mortality of the cohort was monitored from 1 January 1952 to 31 December 2001 by linkage to the national Cause of Death Register. Groups of workers defined by different durations of shiftwork exposure were compared with dayworkers by calculating standardized relative rates (SRR). RESULTS: Death due to any cause (total mortality) was not higher among the shiftworkers than among the dayworkers [SRR 1.02, 95% confidence interval (95% CI) 0.93-1.11]. A longer duration of shiftwork was associated with an increased risk of CHD, and shiftworkers with >30 years of shiftwork had the highest risk of CHD (SRR 1.24, 95% CI 1.04-1.49) Diabetes was more common as the number of shift years of exposure increased [b(linear coefficient) = 4.14 x 10(-5), 95% CI 2.46 x 10(-5) -5.81 x 10(-5)]. Compared with dayworkers, shiftworkers had a greater risk of death due to stroke (SRR 1.56, 95% CI 0.98-2.51). CONCLUSIONS: In the present study, no general increase in mortality was observed among shiftworkers when they were compared with dayworkers. However, the results demonstrate an increased mortality from CHD among shiftworkers with a long duration of shiftwork exposure. Mortality due to diabetes also increased as the number of shift years and mortality due to ischemic stroke in shiftworkers increased.

  • 16. Knutsson, Anders
    et al.
    Alfredsson, Lars
    Karlsson, Berndt
    Clinic of Occupational and Environmental Medicine, Norrlands University Hospital, Umeå, Sweden.
    Åkerstedt, Torbjörn
    Fransson, Eleonor I
    Westerholm, Peter
    Westerlund, Hugo
    Breast cancer among shift workers: results of the WOLF longitudinal cohort study2013In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 39, no 2, 170-177 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to investigate whether shift work (with or without night work) is associated with increased risk of breast cancer.

    METHODS: The population consisted of 4036 women. Data were obtained from WOLF (Work, Lipids, and Fibrinogen), a longitudinal cohort study. Information about baseline characteristics was based on questionnaire responses and medical examination. Cancer incidence from baseline to follow-up was obtained from the national cancer registry. Two exposure groups were identified: shift work with and without night work. The group with day work only was used as the reference group in the analysis. Cox regression analysis was used to calculate relative risk.

    RESULTS: In total, 94 women developed breast cancer during follow-up. The average follow-up time was 12.4 years. The hazard ratio for breast cancer was 1.23 [95% confidence interval (95% CI) 0.70-2.17] for shifts without night work and 2.02 (95% CI 1.03-3.95) for shifts with night work. When including only women >60 years of age, the risk estimates were 1.18 (95% CI 0.67-2.07) for shifts without night work, and 2.15 (95% CI 1.10-4.21) for shifts with night work.

    CONCLUSIONS: Our results indicate an increased risk for breast cancer among women who work shifts that includes night work.

  • 17.
    Liljelind, Ingrid E
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Rappaport, Stephen M
    School of Public Health, University of North Carolina, Chapel Hill, North Carolina, United States.
    Levin, Jan-Olof
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine. National Institute for Working Life, Programme for Chemical Exposure Assessment, Umeå.
    Pettersson-Strömbäck, Anita E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Sunesson, Anna-Lena
    National Institute for Working Life, Programme for Chemical Exposure Assessment, Umeå.
    Järvholm, Bengt G
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational Medicine.
    Comparison of self-assessment and expert assessment of occupational exposure to chemicals2001In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 27, no 5, 311-317 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Occupational assessments of chemical exposure are often inadequate because of difficulties in obtaining sufficient numbers of measurements by trained professionals (experts). The objective of this study was to determine whether workers can provide unbiased data via self-assessments of exposure facilitated by the use of simple passive monitors for personal sampling.

    METHODS: Untrained workers obtained personal measurements of their exposures to gaseous contaminants (terpenes in sawmills and styrene in reinforced plastics factories) with passive monitors and written instructions. To study the validity of the self-assessments, an occupational hygienist performed exposure measurements on the same occupational groups after the workers had obtained two or more measurements independently. The potential bias of the self-assessments was evaluated by comparing the self-assessments with the expert assessments in mixed-effects statistical models.

    RESULTS: A total of 153 terpene (97 self and 56 expert) and 216 styrene (159 self and 57 expert) measurements were obtained from four sawmills and six reinforced plastics factories, respectively. No significant differences in the geometric mean exposures were observed between the self-assessments and the expert assessments in 3 of 4 sawmills and 5 of 6 reinforced plastics factories (P > 0.10). The potential bias of the self-assessments of exposure ranged from less than 0.1% to 102% and was less than 17% in 9 of the 10 groups investigated.

    CONCLUSIONS: The results indicate that untrained, unsupervised workers are able to collect consistently unbiased exposure data by employing currently available passive monitors.

  • 18.
    Lundström, Nils-Göran
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    Nordberg, Gunnar
    Englyst, Vagn
    Gerhardsson, Lars
    Hagmar, Lars
    Jin, Taiyi
    Rylander, Lars
    Wall, Stig
    Cumulative lead exposure: relationship to mortality and lung cancer morbidity in a cohort of smelter workers1997In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 23, no 1, 24-30 p.Article in journal (Refereed)
  • 19. Nyrén, Miruna
    et al.
    Lindberg, Magnus
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Dermatology and Venerology.
    Svensson, Margareta
    Svensson, Ake
    Meding, Birgitta
    Influence of childhood atopic dermatitis on future worklife.2005In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 31, no 6, 474-478 p.Article in journal (Refereed)
  • 20. Oxenstierna, Gabriel
    et al.
    Widmark, Maria
    Umeå University, Faculty of Medicine, Department of Nursing.
    Finnholm, Kristina
    Elofsson, Stig
    A new questionnaire and model for research into the impact of work and the work environment on employee health2008In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, no Suppl 6, 150-162 p.Article in journal (Refereed)
    Abstract [en]

    The research questions of this study were "Are there other organizational conditions or dimensions that generate ill health and that can complement the work-environment dimensions previously employed, and, if so, what are they, and how do they relate to earlier dimensions and employee health? A new survey questionnaire was built on a critical analysis of the demand-control-support model and the effort-reward imbalance model. Interviews carried out in eight strategically selected focus groups, along with one expert interview and one case study, made up the qualitative basis for the development of the new questions. The results from a pilot study involving a nationally representative sample provided the basis for the work and workplace dimensions studied and the construction of the hypothetical "causal" model. Factors of work and the workplace had an impact on employees' stress symptoms and health. However, only "demands" and "humanity and social support" had a direct connection.

  • 21.
    Robroek, Suzan
    et al.
    Research Group Occupational Health Department om public Health Erasmus MC, Rotterdam, the Netherlands.
    Schuring, M
    Croezen, S
    Stattin, Mikael
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Burdorf, A
    Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
    Poor health, unhealthy, and unfavorable work charactaristics unfluence on exit from paid empoyment among older workers in Europé: a four year follow-up study2013In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 39, no 2, 125-133 p.Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to get insight into the role of poor health, unhealthy behaviors, and unfavorable work characteristics on exit from paid employment due to disability pension, unemployment, and early retirement among older workers.

    Methods Respondents of the longitudinal Survey of Health, Ageing, and Retirement in Europe (SHARE) in 11 European countries were selected when (i) aged between 50 years and the country-specific retirement age, and having (ii) paid employment at baseline and (iii) information on employment status during the 4-year follow-up period (N=4923). Self-perceived health, health behaviors, and physical and psychosocial work characteristics were measured by interview at baseline. Employment status was derived from follow-up interviews after two and four years. Cox proportional hazards regression analyses were used to identify determinants of unemployment, disability pension, and early retirement.

    Results Poor health was a risk factor for disability pension [hazard ratio (HR) 3.90, 95% confidence interval (95% CI) 2.51–6.05], and a lack of physical activity was a risk factor for disability pension (HR 3.05, 95% CI 1.68–5.55) and unemployment (HR 1.84, 95% CI 1.13–3.01). A lack of job control was a risk factor for disability pension, unemployment, and early retirement (HR 1.30–1.77).

    Conclusions Poor health, a lack of physical activity, and a lack of job control played a role in exit from paid employment, but their relative importance differed by pathway of labor force exit. Primary preventive interventions focusing on promoting physical activity as well as increasing job control may contribute to reducing premature exit from paid employment.

  • 22. Schiöler, Linus
    et al.
    Söderberg, Mia
    Rosengren, Annika
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Torén, Kjell
    Psychosocial work environment and risk of ischemic stroke and coronary heart disease: a prospective longitudinal study of 75 236 construction workers2015In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 41, no 3, 280-287 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The present study aimed to investigate whether different dimensions of psychosocial stress, as measured by the job demand-control model (JDC), were associated with increased risks of ischemic stroke and coronary heart disease (CHD).

    METHODS: A cohort of 75 236 male construction workers was followed from 1989-2004. Exposure to psychosocial stress was determined by a questionnaire answered in 1989-1993. Events of ischemic stroke and CHD were found by linkage to the Swedish Causes of Death and National Patient registers. Hazard ratios (HR) were obtained from Cox regression models, adjusted for age, smoking habits, body mass index and systolic blood pressure.

    RESULTS: There were 1884 cases of CHD and 739 cases of ischemic stroke. Regarding ischemic stroke, no association was found between job demands [HR 1.12, 95% confidence interval (95% CI) 0.89-1.40, highest versus lowest quintile] or job control (HR 1.04, 95% CI 0.82-1.32, lowest versus highest quintile). Regarding CHD, job demands were associated to CHD (HR 1.18, 95% CI 1.02-1.37, highest vs. lowest quintile), but no consistent trend was seen among quintiles. The results were inconsistent in relation to job control. The division of JDC into four categories showed no significant associations with either ischemic stroke or CHD.

    CONCLUSIONS: This exploratory study showed no significant associations between psychosocial work environment and ischemic stroke, and the associations between job demands and control and CHD were inconsistent and weak. The combination of job control and job demand showed no significant associations with either ischemic stroke or CHD.

  • 23.
    Torén, Kjell
    et al.
    Univ Gothenburg, Sect Occupat & Environm Med, Gothenburg, Sweden.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Who is the expert for the evaluation of work ability?2015In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 41, no 1, 102-104 p.Article in journal (Refereed)
  • 24. Trask, Catherine
    et al.
    Mathiassen, Svend Erik
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Univ Gävle, Dept Occupat & Publ Hlth Sci, Ctr Musculoskeletal Res, SE-80176 Gävle, Sweden.
    Forsman, Mikael
    Cost-efficient assessment of biomechanical exposure in occupational groups, exemplified by posture observation and inclinometry2014In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 40, no 3, 252-265 p.Article in journal (Refereed)
    Abstract [en]

    Objectives This study compared the cost efficiency of observation and inclinometer assessment of trunk and upper-arm inclination in a population of flight baggage handlers, as an illustration of a general procedure for addressing the trade-off between resource consumption and statistical performance in occupational epidemiology. Methods Trunk and upper-arm inclination with respect to the line of gravity were assessed for three days on each of 27 airport baggage handlers using simultaneous inclinometer and video recordings. Labor and equipment costs associated with data collection and processing were tracked throughout. Statistical performance was computed from the variance components within and between workers and bias (with inclinometer assumed to produce "correct" inclination angles). The behavior of the trade-off between cost and efficiency with changed sample size, as well as with changed logistics for data collection and processing, was investigated using simulations. Results At similar total costs, time spent at trunk and arm inclination angles >60 degrees as well as 90th percentile arm inclination were estimated at higher precision using inclinometers, while median inclination and 90th percentile trunk inclination was determined more precisely using observation. This hierarchy remained when the study was reproduced in another population, while inclinometry was more cost-efficient than observation for all three posture variables in a scenario where data were already collected and only needed to be processed. Conclusions When statistical performance was measured only in terms of precision, inclinometers were more cost-efficient than observation for two out of three posture metrics investigated. Since observations were biased, inclinometers consistently outperformed observation when both bias and precision were included in statistical performance. This general model for assessing cost efficiency may be used for designing exposure assessment strategies with considerations not only of statistical but also cost criteria. The empirical data provide a specific basis for planning assessments of working postures in occupational groups. 

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