umu.sePublications
Change search
Refine search result
1 - 35 of 35
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1. Ahlroth Pind, C.
    et al.
    Gunnbjörnsdottír, M.
    Bjerg, A.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lundbäck, B.
    Malinovschi, A.
    Middelveld, R.
    Nilsson Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Norbäck, D.
    Janson, C.
    Patient-reported signs of dampness at home may be a risk factor for chronic rhinosinusitis: a cross-sectional study2017In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 47, no 11, p. 1383-1389Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: An association between dampness at home and respiratory conditions has been convincingly demonstrated in children. Fewer studies have been performed in adults, and data are lacking for chronic rhinosinusitis (CRS). With a prevalence of 10.9% in Europe, CRS imposes a significant burden on quality of life, as well as economy.

    OBJECTIVE: Our aim was to study CRS and other respiratory conditions in relation to dampness at home in a representative sample of adults.

    METHODS: The Swedish GA(2) LEN questionnaire was answered by 26 577 adults (16-75 years) and included questions on respiratory symptoms, smoking, education and environmental exposure. CRS was defined according to the EP(3) OS criteria. Dampness was defined as reporting water damage, floor dampness or visible moulds in the home during the last 12 months. The dampness score was ranked from 0 to 3, counting the number of signs of dampness reported.

    RESULTS: Dampness at home was reported by 11.3% and was independently related to respiratory conditions after adjustment for demographic and socio-economic factors and smoking: CRS odds ratio (OR) 1.71; allergic rhinitis OR 1.24; current asthma OR 1.21; wheeze OR 1.37; nocturnal dyspnoea OR 1.80; nocturnal coughing OR 1.34; and chronic bronchitis OR 1.64. The risk of CRS and most of the other respiratory conditions was further elevated in subjects reporting multiple signs of dampness.

    CONCLUSIONS AND CLINICAL RELEVANCE: This study demonstrated an independent association between dampness at home and CRS in adults. The high burden of this and the other respiratory conditions studied is a strong argument in favour of countering indoor dampness by improving building standards.

  • 2. Al-Shamkhi, N.
    et al.
    Alving, K.
    Dahlen, S. E.
    Hedlin, G.
    Middelveld, R.
    Bjerg, A.
    Ekerljung, L.
    Olin, A. C.
    Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Janson, C.
    Malinovschi, A.
    Important non-disease-related determinants of exhaled nitric oxide levels in mild asthma: results from the Swedish GA(2)LEN study2016In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 46, no 9, p. 1185-1193Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Exhaled nitric oxide (FeNO) has a potential clinical role in asthma management. Constitutive factors such as age, height and male gender, as well as individual characteristics, as IgE sensitisation and smoking, affect levels of FeNO in population-based studies. However their effect on FeNO in subjects with asthma has been scarcely studied.

    OBJECTIVE: To study the effects on FeNO of these commonly regarded determinants, as demonstrated in healthy subjects, as well as menarche age and parental smoking, in a population of asthmatics.

    MATERIAL AND METHODS: FeNO was measured in 557 subjects with asthma from the Swedish GA2LEN study. Allergic sensitisation was assessed by skin prick tests to most common aeroallergens. Upper airway comorbidities, smoking habits, smoking exposure during childhood, hormonal status (for women) were questionnaire-assessed.

    RESULTS: Male gender (p<0.001), greater height (p<0.001) and sensitisation to both perennial allergens and pollen (p<0.001) related to higher FeNO levels. Current smoking (p<0.001) and having both parents smoking during childhood, vs having neither (p<0.001) or only one parent smoking (p=0.002), related to lower FeNO. Women with menarche between 9-11 years of age had lower FeNO than those with menarche between 12-14 years of age (p = 0.03) or 15-17 years of age (p=0.003).

    CONCLUSIONS AND CLINICAL RELEVANCE: Interpreting FeNO levels in clinical practice is complex and constitutional determinants, as well as smoking and IgE sensitization, are of importance in asthmatic subjects and should be accounted for when interpreting FeNO levels. Furthermore, menarche age and parental smoking during childhood and their effects on lowering FeNO deserve further studies.

  • 3. Andersen, Zorana J.
    et al.
    Pedersen, Marie
    Weinmayr, Gudrun
    Stafoggia, Massimo
    Galassi, Claudia
    Jørgensen, Jeanette T.
    Nilsson Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Olsson, David
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Oftedal, Bente
    Aasvang, Gunn Marit
    Schwarze, Per
    Pyko, Andrei
    Pershagen, Göran
    Korek, Michal
    De Faire, Ulf
    Östenson, Claes-Göran
    Fratiglioni, Laura
    Eriksen, Kirsten T.
    Poulsen, Aslak H.
    Tjønneland, Anne
    Vaclavik Bräuner, Elvira
    Peeters, Petra H.
    Bueno-de-Mesquita, Bas
    Jaensch, Andrea
    Nagel, Gabriele
    Lang, Alois
    Wang, Meng
    Tsai, Ming-Yi
    Grioni, Sara
    Marcon, Alessandro
    Krogh, Vittorio
    Ricceri, Fulvio
    Sacerdote, Carlotta
    Migliore, Enrica
    Vermeulen, Roel
    Sokhi, Ranjeet
    Keuken, Menno
    de Hoogh, Kees
    Beelen, Rob
    Vineis, Paolo
    Cesaroni, Giulia
    Brunekreef, Bert
    Hoek, Gerard
    Raaschou-Nielsen, Ole
    Long-term Exposure to Ambient Air Pollution and Incidence of Brain Tumor: the European Study of Cohorts for Air Pollution Effects (ESCAPE)2018In: Neuro-Oncology, ISSN 1522-8517, E-ISSN 1523-5866, Vol. 20, no 3, p. 420-432Article in journal (Refereed)
    Abstract [en]

    Background: Epidemiological evidence on the association between ambient air pollution and brain tumor risk is sparse and inconsistent.

    Methods: In 12 cohorts from 6 European countries, individual estimates of annual mean air pollution levels at the baseline residence were estimated by standardized land-use regression models developed within the ESCAPE and TRANSPHORM projects: particulate matter (PM) ≤2.5, ≤10, and 2.5–10 μm in diameter (PM2.5, PM10, and PMcoarse), PM2.5 absorbance, nitrogen oxides (NO2 and NOx) and elemental composition of PM. We estimated cohort-specific associations of air pollutant concentrations and traffic intensity with total, malignant, and nonmalignant brain tumor, in separate Cox regression models, adjusting for risk factors, and pooled cohort-specific estimates using random-effects meta-analyses.

    Results: Of 282194 subjects from 12 cohorts, 466 developed malignant brain tumors during 12 years of follow-up. Six of the cohorts also had data on nonmalignant brain tumor, where among 106786 subjects, 366 developed brain tumor: 176 nonmalignant and 190 malignant. We found a positive, statistically nonsignificant association between malignant brain tumor and PM2.5 absorbance (hazard ratio and 95% CI: 1.67; 0.89–3.14 per 10–5/m3), and weak positive or null associations with the other pollutants. Hazard ratio for PM2.5 absorbance (1.01; 0.38–2.71 per 10–5/m3) and all other pollutants were lower for nonmalignant than for malignant brain tumors.

    Conclusion: We found suggestive evidence of an association between long-term exposure to PM2.5 absorbance indicating traffic-related air pollution and malignant brain tumors, and no association with overall or nonmalignant brain tumors.

  • 4. Andersson Kallin, Sandra
    et al.
    Lindberg, Eva
    Nilsson Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bossios, Apostolos
    Ekerljung, Linda
    Malinovschi, Andrei
    Middelveld, Roelinde
    Janson, Christer
    Excessive daytime sleepiness in asthma: what are the risk factors?2016In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Previous studies have found that excessive daytime sleepiness (EDS) is a more common problem in asthmatic subjects than in the general population. The aim of this study was to investigate whether the prevalence of EDS is increased in asthmatic subjects and, if so, to analyse the occurrence of potential risk factors for EDS in asthmatics.

    METHODS: Cross-sectional epidemiological study. In 2008, a postal questionnaire was sent out to a random sample of 45,000 individuals aged 16-75 years in four Swedish cities.

    RESULTS: Of the 25,160 persons who participated, 7.3% were defined as having asthma. The prevalence of EDS was significantly higher in asthmatic subjects (42.1% vs 28.5%, p<0.001) compared with non-asthmatic subjects. Asthma was an independent risk factor for EDS (adjusted OR 1.29) and the risk of having EDS increased with asthma severity. Risk factors for EDS in subjects with asthma included insomnia (OR, 3.87; 95% CI, 3.10-4.84), chronic rhinosinusitis (OR, 2.00; 95% CI, 1.53-2.62), current smoking (OR, 1.60; 95% CI, 1.15-2.22) and obesity (OR, 1.53; 95% CI, 1.09-2.13).

    CONCLUSIONS: EDS is a common problem among subjects with asthma. Asthma is an independent risk factor for having EDS. Furthermore, subjects with asthma often have other risk factors for EDS, many of them potentially modifiable.

  • 5. Donat-Vargas, Carolina
    et al.
    Åkesson, Agneta
    Tornevi, Andreas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Kiviranta, Hannu
    Rantakokko, Panu
    Bergdahl, Ingvar A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Persistent Organochlorine Pollutants in Plasma, Blood Pressure, and Hypertension in a Longitudinal Study2018In: Hypertension, ISSN 0194-911X, E-ISSN 1524-4563, Vol. 71, no 6, p. 1258-1268Article in journal (Refereed)
    Abstract [en]

    Persistent organochlorine pollutants (POPs) have shown to be involved in the atherosclerotic process and to cause endothelial cell dysfunction. To assess longitudinally whether plasma concentrations of different POPs were associated with blood pressure and risk of hypertension in middle-aged women and men. Study subjects were 850 participants in the VIP (Västerbotten Intervention Programme) with 2 blood samples and blood pressure measurements, 10 years apart, during 1990 to 2003 (baseline) and during 2000 to 2013 (follow-up). Dioxin-like and nondioxin-like polychlorinated biphenyls (DL-PCBs, NDL-PCBs) and p,p'-dichlorodiphenyldichloroethylene (DDE) were measured. Associations were assessed using generalized estimating equations. At baseline sampling 49% and at follow-up 64% had hypertension. DL-PCBs and DDE, but not NDL-PCBs or hexachlorobenzene, were associated with hypertension. Only the association for DL-PCBs remained statistically significant after lipid-standardization and adjustment for body mass index and total serum lipids. The multivariable-adjusted odds ratio of hypertension based on repeated measurements were 1.52 (95% confidence interval, 1.08-2.13) for DL-PCBs (third versus first tertile of lipid-standardized POPs). In stratified adjusted analyses, odds ratio for those born after 1950 increased to 3.99 (95% confidence interval, 2.15-7.43), whereas no association was observed among those born earlier. Based on repeated measurements, the accumulated exposure to DL-PCBs and DDE, although less clear for the latter, may disrupt the normal blood pressure levels and increase the odds of hypertension. Moreover, individuals experiencing early-life POP exposure may be at elevated risk of vascular POP effects.

  • 6. Eneroth, Hanna
    et al.
    Wallin, Stina
    Leander, Karin
    Nilsson Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Åkesson, Agneta
    Risks and Benefits of Increased Nut Consumption: Cardiovascular Health Benefits Outweigh the Burden of Carcinogenic Effects Attributed to Aflatoxin B1 Exposure2017In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 9, no 12, article id 1355Article in journal (Refereed)
    Abstract [en]

    Nuts are rich in nutrients and mounting evidence shows that consumption reduces cardiovascular disease (CVD) incidence. Nuts may also be a major source of aflatoxin B₁, a potent liver carcinogen and the risk/benefit balance is unknown. Based on national statistics and data from the PREDIMED intervention trial, we estimated the potential CVD-reduction if Swedes aged 55-79 consumed 30 g nuts/day, instead of the current national average of five grams per day. We also assessed the reduction in disability-adjusted life years (DALYs) due to myocardial infarction (MI) and stroke. We estimated the aflatoxin B₁ exposure from nuts and calculated the margin of exposure. The approximation that one nanogram aflatoxin B₁/kg body weight/day results in one additional liver cancer case/10 million person-years was used to estimate the number of liver cancer cases. The increased nut consumption scenario prevented more than 7000 CVDs in 2013 (306/100,000 person-years) and contributed to about 55,000 saved DALYs for stroke and 22,000 for MI. The concomitant increase in aflatoxin B₁ exposure caused an estimated zero to three additional cases of liver cancer, corresponding to 159 DALYs spent, emphasizing the associated risks. Increased nut consumption, as part of a varied healthy diet, is warranted even when aflatoxin B₁ exposure is taken into account. However, efforts to reduce aflatoxin exposure from food are essential.

  • 7.
    Englund, Undis
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nilsson, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Bucht, Gustaf
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Svensson, Olle
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Pettersson Kymmer, Ulrika
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology.
    Physical activity in middle-aged women and hip fracture risk: the UFO study2011In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 22, no 2, p. 499-505Article in journal (Refereed)
    Abstract [en]

    Summary: In a population-based case-control study, we demonstrate that middle-aged women who were active with walking or in different physical spare time activities were at lower risk of later sustaining a hip fracture compared to more sedentary women.

    Introduction: In middle-aged women participating in the Umeå Fracture and Osteoporosis (UFO) study, we investigated whether physical activity is associated with a subsequent decreased risk of sustaining a hip fracture.

    Methods: The UFO study is a nested case-control study investigating associations between bone markers, lifestyle, and osteoporotic fractures. We identified 81 female hip fracture cases that had reported lifestyle data before they sustained their fracture. Each case was compared with two female controls who were identified from the same cohort and matched for age and week of reporting data, yielding a total cohort of 237 subjects. Mean age at baseline was 57.2 ± 5.0 years, and mean age at fracture was 65.4 ± 6.4 years.

    Results: Conditional logistic regression analysis with adjustments for height, weight, smoking, and menopausal status showed that subjects who were regularly active with walking or had a moderate or high frequency of physical spare time activities (i.e. berry/mushroom picking and snow shovelling) were at reduced risk of sustaining a hip fracture (OR 0.14; 95% CI; 0.05–0.53 for walking and OR 0.19; 95% CI; 0.08–0.46, OR 0.17, 95% CI; 0.05–0.64 for moderate and high frequency of spare time activities, respectively) compared to more sedentary women.

    Conclusion: An active lifestyle in middle age seems to reduce the risk of future hip fracture. Possible mechanisms may include improved muscle strength, coordination, and balance resulting in a decreased risk of falling and perhaps also direct skeletal benefits.

  • 8.
    Englund, Undis
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nilsson, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Svensson, Olle
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Bergström, Ulrica
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Pettersson Kymmer, Ulrika
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology.
    Active commuting reduces the risk of wrist fractures in middle-aged women: the UFO study2013In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 24, no 2, p. 533-540Article in journal (Refereed)
    Abstract [en]

    Middle-aged women with active commuting had significantly lower risk for wrist fracture than women commuting by car/bus.

    INTRODUCTION: Our purpose was to investigate whether a physically active lifestyle in middle-aged women was associated with a reduced risk of later sustaining a low-trauma wrist fracture.

    METHODS: The Umeå Fracture and Osteoporosis (UFO) study is a population-based nested case-control study investigating associations between lifestyle and fragility fractures. From a cohort of ~35,000 subjects, we identified 376 female wrist fracture cases who had reported data regarding their commuting habits, occupational, and leisure physical activity, before they sustained their fracture. Each fracture case was compared with at least one control drawn from the same cohort and matched for age and week of reporting data, yielding a total of 778 subjects. Mean age at baseline was 54.3 ± 5.8 years, and mean age at fracture was 60.3 ± 5.8 years.

    RESULTS: Conditional logistic regression analysis with adjustments for height, body mass index, smoking, and menopausal status showed that subjects with active commuting (especially walking) were at significantly lower risk of sustaining a wrist fracture (OR 0.48; 95 % CI 0.27-0.88) compared with those who commuted by car or bus. Leisure time activities such as dancing and snow shoveling were also associated with a lower fracture risk, whereas occupational activity, training, and leisure walking or cycling were unrelated to fracture risk.

    CONCLUSION: This study suggests that active commuting is associated with a lower wrist fracture risk, in middle-aged women.

  • 9. Fuertes, Elaine
    et al.
    Markevych, Iana
    Jarvis, Deborah
    Vienneau, Danielle
    de Hoogh, Kees
    Antó, Josep Maria
    Bowatte, Gayan
    Bono, Roberto
    Corsico, Angelo G
    Emtner, Margareta
    Gislason, Thorarinn
    Gullón, José Antonio
    Heinrich, Joachim
    Henderson, John
    Holm, Mathias
    Johannessen, Ane
    Leynaert, Bénédicte
    Marcon, Alessandro
    Marchetti, Pierpaolo
    Moratalla, Jesús Martínez
    Pascual, Silvia
    Probst-Hensch, Nicole
    Sánchez-Ramos, José Luis
    Siroux, Valerie
    Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Weyler, Joost
    Kuenzli, Nino
    Jacquemin, Bénédicte
    Garcia-Aymerich, Judith
    Residential air pollution does not modify the positive association between physical activity and lung function in current smokers in the ECRHS study.2018In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 120, p. 364-372, article id S0160-4120(18)30837-7Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Very few studies have examined whether a long-term beneficial effect of physical activity on lung function can be influenced by living in polluted urban areas.

    OBJECTIVE: We assessed whether annual average residential concentrations of nitrogen dioxide (NO2) and particulate matter with aerodynamic diameters < 2.5 μm (PM2.5) and <10 μm (PM10) modify the effect of physical activity on lung function among never- (N = 2801) and current (N = 1719) smokers in the multi-center European Community Respiratory Health Survey.

    METHODS: Associations between repeated assessments (at 27-57 and 39-67 years) of being physically active (physical activity: ≥2 times and ≥1 h per week) and forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were evaluated using adjusted mixed linear regression models. Models were conducted separately for never- and current smokers and stratified by residential long-term NO2, PM2.5 mass and PM10 mass concentrations (≤75th percentile (low/medium) versus >75th percentile (high)).

    RESULTS: Among current smokers, physical activity and lung function were positively associated regardless of air pollution levels. Among never-smokers, physical activity was associated with lung function in areas with low/medium NO2, PM2.5 mass and PM10 mass concentrations (e.g. mean difference in FVC between active and non-active subjects was 43.0 mL (13.6, 72.5), 49.5 mL (20.1, 78.8) and 49.7 mL (18.6, 80.7), respectively), but these associations were attenuated in high air pollution areas. Only the interaction term of physical activity and PM10 mass for FEV1 among never-smokers was significant (p-value = 0.03).

    CONCLUSIONS: Physical activity has beneficial effects on adult lung function in current smokers, irrespective of residential air pollution levels in Western Europe. Trends among never-smokers living in high air pollution areas are less clear.

  • 10. Fuks, Kateryna B.
    et al.
    Weinmayr, Gudrun
    Foraster, Maria
    Dratva, Julia
    Hampel, Regina
    Houthuijs, Danny
    Oftedal, Bente
    Oudin, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Panasevich, Sviatlana
    Penell, Johanna
    Nilsson Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sørensen, Mette
    Tiittanen, Pekka
    Wolf, Kathrin
    Xun, Wei W.
    Aguilera, Inmaculada
    Basagaña, Xavier
    Beelen, Rob
    Bots, Michiel L.
    Brunekreef, Bert
    Bueno-de-Mesquita, H. Bas
    Caracciolo, Barbara
    Cirach, Marta
    de Faire, Ulf
    de Nazelle, Audrey
    Eeftens, Marloes
    Elosua, Roberto
    Erbel, Raimund
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Fratiglioni, Laura
    Gaspoz, Jean-Michel
    Hilding, Agneta
    Jula, Antti
    Korek, Michal
    Krämer, Ursula
    Künzli, Nino
    Lanki, Timo
    Leander, Karin
    Magnusson, Patrik K.
    Marrugat, Jaume
    Nieuwenhuijsen, Mark J.
    Östenson, Claes-Göran
    Pedersen, Nancy L.
    Pershagen, Göran
    Phuleria, Harish C.
    Probst-Hensch, Nicole M.
    Raaschou-Nielsen, Ole
    Schaffner, Emmanuel
    Schikowski, Tamara
    Schindler, Christian
    Schwarze, Per E.
    Søgaard, Annee J.
    Sugiri, Dorothea
    Swart, Wim J.
    Tsai, Ming-Yi
    Turunen, Anu W.
    Vineis, Paolo
    Peters, Annette
    Hoffmann, Barbara
    Arterial blood pressure and long-term exposure to traffic-related air pollution: an analysis in the European Study of Cohorts for Air Pollution Effects (ESCAPE)2014In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 122, no 9, p. 896-905Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Long-term exposure to air pollution is hypothesized to elevate arterial blood pressure (BP). The existing evidence is scarce and country-specific. OBJECTIVES: We investigated the cross-sectional association of long-term traffic-related air pollution with BP and prevalent hypertension in European populations. METHODS: Fifteen population-based cohorts, participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE), were analysed. Residential exposure to particulate matter and nitrogen oxides was modelled with land use regression using a uniform protocol. Traffic exposure was assessed with traffic indicator variables. We analysed systolic and diastolic BP in participants medicated and non-medicated with BP lowering medication (BPLM) separately, adjusting for personal and area-level risk factors and environmental noise. Prevalent hypertension was defined as ≥ 140 mmHg systolic, or ≥ 90 mmHg diastolic BP, or intake of BPLM. We combined cohort-specific results using random-effects meta-analysis. RESULTS: In the main meta-analysis of 113,926 participants, traffic load on major roads within 100 m of the residence was associated with increased systolic and diastolic BP in non-medicated participants (0.35 mmHg [95% CI: 0.02-0.68] and 0.22 mmHg [95% CI: 0.04-0.40] per 4,000,000 vehicles × m/day, respectively). The estimated odds ratio for prevalent hypertension was 1.05 [95% CI: 0.99-1.11] per 4,000,000 vehicles × m/day. Modelled air pollutants and BP were not clearly associated. CONCLUSIONS: In this first comprehensive meta-analysis of European population-based cohorts we observed a weak positive association of high residential traffic exposure with BP in non-medicated participants, and an elevated OR for prevalent hypertension. The relationship of modelled air pollutants with BP was inconsistent.

  • 11.
    Hagenbjörk, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Malmqvist, E
    Mattisson, K
    Sommar, Nilsson J.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Modig, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    The spatial variation of O3, NO, NO2 and NOx and the relation between them in two Swedish cities2017In: Environmental Monitoring & Assessment, ISSN 0167-6369, E-ISSN 1573-2959, Vol. 189, no 4, article id UNSP 161Article in journal (Refereed)
    Abstract [en]

    Ozone and nitrogen oxides (NO x ) are air pollutants with known associations to adverse health effects on humans. Few studies have simultaneously measured ozone and nitrogen oxides with high spatial resolution. The main aim of this paper was to assess the levels and variation of ground-level ozone, NO2 and NO x in two Swedish cities. An additional aim was to describe the levels of these pollutants within and between three different types of measurement sites (regional background, urban background and traffic sites) and within and between different measurement periods of the year. Three weekly sampling campaigns of NO x and ozone were conducted simultaneously at 20 sites in two Swedish regions using Ogawa badges. Ozone was measured at 20 additional sites in each area. The median ozone concentration for all measurements was statistically significantly higher in Malmö (67 μg/m(3)) compared to Umeå (56 μg/m(3)), and in both cities, ozone levels were highest in April. Measurement period was a more important factor for describing the variation in ozone concentrations than the type of measurement site. The levels of NO2 and NO x were statistically significantly higher in the Malmö area (8.1 and 12 μg/m(3)) compared to the Umeå area (4.5 and 8.9 μg/m(3)). The levels were generally highest at the sites categorized as traffic, while the variability between different seasons was sparse.

  • 12. Johansson, Christer
    et al.
    Lövenheim, Boel
    Schantz, Peter
    Wahlgren, Lina
    Almström, Peter
    Markstedt, Anders
    Strömgren, Magnus
    Umeå University, Faculty of Social Sciences, Department of Geography and Economic History, Economic and social geography.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Impacts on air pollution and health by changing commuting from car to bicycle2017In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 584-585, p. 55-63Article in journal (Refereed)
    Abstract [en]

    Our study is based on individual data on people's home and work addresses, as well as their age, sex and physical capacity, in order to establish realistic bicycle-travel distances. A transport model is used to single out data on commuting preferences in the County Stockholm. Our analysis shows there is a very large potential for reducing emissions and exposure if all car drivers living within a distance corresponding to a maximum of a 30 min bicycle ride to work would change to commuting by bicycle. It would result in > 111,000 new cyclists, corresponding to an increase of 209% compared to the current situation.

    Mean population exposure would be reduced by about 7% for both NOx and black carbon (BC) in the most densely populated area of the inner city of Stockholm. Applying a relative risk for NOx of 8% decrease in all-cause mortality associated with a 10 μg m− 3decrease in NOx, this corresponds to > 449 (95% CI: 340–558) years of life saved annually for the Stockholm county area with 2.1 million inhabitants. This is more than double the effect of the reduced mortality estimated for the introduction of congestion charge in Stockholm in 2006. Using NO2 or BC as indicator of health impacts, we obtain 395 (95% CI: 172–617) and 185 (95% CI: 158–209) years of life saved for the population, respectively. The calculated exposure of BC and its corresponding impacts on mortality are likely underestimated. With this in mind the estimates using NOx, NO2 and BC show quite similar health impacts considering the 95% confidence intervals.

  • 13.
    Liang, Yihuai
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lei, Lijian
    Department of Occupational Health and Toxicology (Key Laboratory of Public Health Safety, Ministry of Education of China), School of Public Health, Fudan University, Shanghai, People’s Republic of China.
    Nilsson, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Li, Huiqi
    Department of Occupational Health and Toxicology (Key Laboratory of Public Health Safety, Ministry of Education of China), School of Public Health, Fudan University, Shanghai, People’s Republic of China.
    Nordberg, Monica
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bernard, Alfred
    Unit of Toxicology, Université catholique de Louvain, Brussels, Belgium.
    Nordberg, Gunnar F
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Jin, Taiyi
    Department of Occupational Health and Toxicology (Key Laboratory of Public Health Safety, Ministry of Education of China), School of Public Health, Fudan University, Shanghai, People’s Republic of China.
    Renal function after reduction in cadmium exposure: an eight-year follow-up of residents in cadmium-polluted areas2012In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 120, no 2, p. 223-228Article in journal (Refereed)
    Abstract [en]

    Background and objective: Long-term exposure to cadmium (Cd) causes renal dysfunction, but its change with exposure is unknown. We aimed at assessing the evolution of Cd-induced renal effects after a reduction in dietary exposure to Cd in rice.

    Methods: 412 residents in previously Cd-polluted and non-polluted areas were examined twice: in 1998 and 2006. Changes in blood Cd, urinary Cd, and kidney function (N-acetyl-β-D-glucosaminidase = NAG, β2-microglobulin, and albumin in urine) were measured. Results: In the most polluted area, mean blood Cd was 8.9 μg/L in 1998 and 3.3 μg/L in 2006, and urinary Cd was 11.6 and 9.0 μg/g creatinine in 1998 and 2006, respectively. Urinary albumin in 1998 increased with urinary Cd but no such exposure-response appeared for 2006 albumin versus urinary Cd 1998, indicating recovery. Other biomarkers of kidney function were also elevated in 1998. Partial recovery was observed for NAG, among women, and suggested for β2-microglobulin, among young individuals. The probability of having a β2-microglobulin above the 95th percentile in 2006 was high in those with an elevated β2-microglobulin in 1998 (odds ratio: 24.8, 95% CI: 11.2-55.3), whereas corresponding estimates for albumin and NAG were 3.0 (1.2-7.5) and 2.6 (1.6-4.4), respectively.

    Conclusions: Results suggest that a Cd-mediated increase in urinary albumin excretion is reversible upon substantial reduction of exposure. For the markers of tubular effects, a tendency towards improvement, but not complete recovery, was observed. Data from repeated observations suggests that β2-microglobulin may be more informative than NAG as an indicator for the individual's future tubular function.

  • 14. Mogensen, Ida
    et al.
    Alving, Kjell
    Bjerg, Anders
    Borres, Magnus P
    Hedlin, Gunilla
    Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Dahlén, Sven-Erik
    Janson, Christer
    Malinovschi, Andrei
    Simultaneously elevated exhaled nitric oxide and serum-ECP relate to recent asthma events in asthmatics in a cross sectional population based study2016In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 46, no 12, p. 1540-1548Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: We have reported that increased fraction of exhaled nitric oxide (FeNO), a measure of TH2 -driven airway inflammation, and blood eosinophil count, a marker of systemic eosinophil inflammation, correlated with asthma attacks in a population-based study.

    OBJECTIVE: To investigate the relation between simultaneously elevated FeNO and serum eosinophil cationic protein (S-ECP) levels and asthma events among asthmatics.

    METHODS: Measurements of FeNO (elevated ≥ 25 ppb) and S-ECP (elevated ≥ 20 ng/mL) were done in 339 adult asthmatics. Asthma events (attacks and symptoms) were self-reported.

    RESULTS: Simultaneously normal S-ECP and FeNO levels were found in 48% of the subjects. Subjects with simultaneously elevated S-ECP and FeNO (13% of the population) had a higher prevalence of asthma attacks in the preceding 3 months than subjects with normal S-ECP and FeNO (51% vs. 25%, p = 0.001). This was not found for subjects with singly elevated S-ECP (p = 0.14) or FeNO (p = 0.34) levels. Elevated S-ECP and FeNO levels was independently associated to asthma attacks in the preceding 3 months after adjusting for potential confounders (OR (95% CI) 4.2 (2.0-8.8).

    CONCLUSIONS: Simultaneous elevated FeNO and S-ECP related to a higher likelihood of asthma attacks in the preceding 3 months. This indicates that there is a value in measuring both FeNO and systemic eosinophilic inflammation in patients with asthma in order to identify individuals at high risk of exacerbations.

  • 15. Nagel, Gabriele
    et al.
    Stafoggia, Massimo
    Pedersen, Marie
    Andersen, Zorana J
    Galassi, Claudia
    Munkenast, Jule
    Jaensch, Andrea
    Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Olsson, David
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Oftedal, Bente
    Krog, Norun H
    Aamodt, Geir
    Pyko, Andrei
    Pershagen, Göran
    Korek, Michal
    De Faire, Ulf
    Pedersen, Nancy L
    Östenson, Claes-Göran
    Fratiglioni, Laura
    Sørensen, Mette
    Tjønneland, Anne
    Peeters, Petra H
    Bueno-de-Mesquita, Bas
    Vermeulen, Roel
    Eeftens, Marloes
    Plusquin, Michelle
    Key, Timothy J
    Concin, Hans
    Lang, Alois
    Wang, Meng
    Tsai, Ming-Yi
    Grioni, Sara
    Marcon, Alessandro
    Krogh, Vittorio
    Ricceri, Fulvio
    Sacerdote, Carlotta
    Ranzi, Andrea
    Cesaroni, Giulia
    Forastiere, Francesco
    Tamayo-Uria, Ibon
    Amiano, Pilar
    Dorronsoro, Miren
    de Hoogh, Kees
    Beelen, Rob
    Vineis, Paolo
    Brunekreef, Bert
    Hoek, Gerard
    Raaschou-Nielsen, Ole
    Weinmayr, Gudrun
    Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE)2018In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215Article in journal (Refereed)
    Abstract [en]

    and gastric cancer, but not UADT cancers, suggesting that air pollution may contribute to gastric cancer risk. This article is protected by copyright. All rights reserved.

  • 16.
    Nilsson Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Prospective and longitudinal human studies of lead and cadmium exposure and the kidney2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Cadmium and lead accumulate in humans and can have toxic effects. Exposure to cadmium is well known to cause kidney damage. Cadmium binds to metallothioneins, proteins that play a role in cadmium transport. Lead exposure’s main effect is on the central nervous system, but associations with kidney disease have also been found, although it is unknown if the latter is a causal association. The main source of both metals within the non-smoking population is from the diet.

    This thesis aims to 1) compare the biomarkers lead and cadmium concentration in whole-blood, plasma and urine with regard to their ability to discriminate between individuals with different mean concentrations, and to describe the effect of urinary dilution, 2) estimate the association between end-stage renal disease and blood concentrations of cadmium, lead and mercury, using prospectively collected samples for exposure evaluation, 3) use longitudinal data on kidney function makers to evaluate kidney recovery after a substantial decrease in cadmium exposure, and 4) assess the influence of metallothionein polymorphisms (MT1A rs11076161, MT2A rs10636 and MT2A rs28366003) on cadmium-associated kidney toxicity and recovery due to a reduction in Cd exposure.

    Repeated sampling of whole-blood, plasma and urine was conducted on 48 occupationally lead-exposed men and 20 individuals under normal environmental lead exposure, for estimation of the day-to-day and between individual-variation. Prospective samples were obtained for 118 cases that later in life developed end-stage renal disease, and 378 matched controls. Erythrocyte cadmium, lead, and mercury concentrations were determined and the risk of developing end-stage renal disease associated with metal concentrations was estimated. For evaluation of kidney recovery after a reduction in cadmium exposure and to test for gene-environment interactions, follow-up data on N-acetyl-β‑d-glucosaminidase, β2‑microglobulin, albumin, and gene polymorphisms were obtained for 412 individuals within the Chinese population and the relation to blood and urinary cadmium was assessed.

    The concentration of lead in blood was found to be the biomarker with the largest fraction of the total variance attributable to between-individual variation, and was therefore the biomarker with the best ability to discriminate between individuals with different mean concentrations, both for individuals under occupational and normal environmental exposure (91 and 95%, respectively). Adjusting for urinary dilution had a great effect on the fraction of the total variance attributable to between-individual variation among individuals with normal lead exposure but only a minor effect among those who were occupationally exposed. Variance analysis showed that blood concentrations were also the best discriminating biomarker for cadmium.

    Erythrocyte lead was, in a univariate model, associated with an increased risk of developing end-stage renal disease [odds ratio (OR) = 1.54 for an interquartile range increase, with a 95% confidence interval (CI) = 1.18-2.00], while erythrocyte mercury was negatively associated (OR = 0.75 for an interquartile range increase, with a 95% CI = 0.56-0.99). For erythrocyte cadmium, the OR was 1.15 with a 95% CI of 0.99-1.34. Associations with lead and cadmium were only seen among men. In the study on kidney recovery, the proportion of individuals with albumin level above the 95th percentile decreased between baseline and follow up, but no decrease was found for the tubular markers N-acetyl-β‑d-glucosaminidase and β2-microglobulin. Metallothionein polymorphisms modified cadmium-associated effects on N-acetyl-β‑d-glucosaminidase and β2-microglobulin levels but did not modify cadmium-associated change in any of the kidney function markers between baseline and follow up after a substantial decrease in exposure.

    Blood concentrations of lead and cadmium are the biomarkers with the best ability to discriminate between individuals with different mean concentrations. Adjustment for urinary dilution has great influence on the fraction of the total variance attributed to between individual variation among urine samples with low lead concentrations, but only a small influence on samples with high lead concentrations. This suggests a difference in excretion. The association between end-stage renal disease and low-level lead exposure, as assessed through prospective erythrocyte samples, gives reason for concern, although further studies are needed to determine causality. A cadmium-associated increase in albumin is reversible after a substantial reduction in exposure, but this is not the case for the observed tubular effects. The tubular kidney effects of cadmium might be modified by the MT1A rs11076161 polymorphism.

  • 17.
    Nilsson Sommar, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Liang, Yihuai
    Department of Occupational Health and Toxicology (Key Laboratory of Public Health Safety, Ministry of Education of China), School of Public Health, Fudan University, Shanghai, People’s Republic of China.
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Chen, Xiao
    Department of Bone Metabolism, Institute of Radiation Medicine, Fudan University, Shanghai, China.
    Lei, Lijian
    Department of Occupational Health, School of Public Health, Fudan University, Shanghai, China; Department of Epidemiology, School of Public Health, Shanxi Medical University, Shanxi, China.
    Zhu, Guoying
    Department of Bone Metabolism, Institute of Radiation Medicine, Fudan University, Shanghai, China.
    Rentschler, Gerda
    Division of Occupational and Environmental Medicine, Lund University, Sweden.
    Jin, Taiyi
    Department of Occupational Health, School of Public Health, Fudan University, Shanghai, China.
    Broberg, Karin
    Division of Occupational and Environmental Medicine, Lund University, Sweden.
    Genetic modification of cadmium-related kidney toxicity: a follow up studyManuscript (preprint) (Other academic)
  • 18.
    Nilsson Sommar, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Pettersson-Kymmer, Ulrika
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Lundh, Thomas
    Svensson, Olle
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Bergdahl, Ingvar A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Hip Fracture Risk and Cadmium in Erythrocytes: A Nested Case-Control Study with Prospectively Collected Samples2014In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 94, no 2, p. 183-190Article in journal (Refereed)
    Abstract [en]

    Several studies have investigated the relation between bone mass density and cadmium exposure, but only few studies have been performed on fractures and biomarkers of cadmium. This study analyzed the association between hip fracture risk and cadmium in erythrocytes (Ery-Cd). Prospective samples from the Northern Sweden Health and Disease Study's biobank were used for 109 individuals who later in life had sustained a low-trauma hip fracture, matched with two controls of the same age and gender. The mean concentration of Ery-Cd (±SD) in case samples was 1.3 ± 1.4 versus 0.9 ± 1.0 μg/L in controls. The odds ratio (OR) was 1.63 [95 % confidence interval (CI) 1.10-2.42] for suffering a hip fracture for each microgram per liter increase in Ery-Cd. However, when taking smoking into consideration (never, former, or current), neither Ery-Cd nor smoking showed a statistically significant increase in fracture risk. Using multiple conditional logistic regression with BMI, height, and smoking, the estimated OR for a 1-μg/L increase in Ery-Cd was 1.52 (95 % CI 0.77-2.97). Subgroup analysis showed an increased fracture risk among women (OR = 1.94, 95 % CI 1.18-3.20, for a 1 μg/L increase), which also remained in the multiple analysis (OR = 3.33, 95 % CI 1.29-8.56). This study shows that fracture risk is associated with Ery-Cd. It is, however, not possible to draw firm conclusions on whether cadmium is the causal factor or whether other smoking-related factors cause this association. Subgroup analysis shows that cadmium is a risk factor for hip fracture among women.

  • 19.
    Nilsson Sommar, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Svensson, Maria K
    Department of Molecular and Clinical Medicine-Nephrology, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Björ, Bodil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Elmståhl, Sölve
    Department of Health Sciences, Division of Geriatric Medicine, Lund University, Lund, Sweden.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Lundh, Thomas
    Division of Occupational and Environmental Medicine, University Hospital, Lund, Sweden.
    Schön, Staffan Mi
    Diaverum Renal Services Group, Lund, Sweden & Swedish Renal Registry, Jönköping, Sweden.
    Skerfving, Staffan
    Division of Occupational and Environmental Medicine, University Hospital, Lund, Sweden.
    Bergdahl, Ingvar
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    End-stage renal disease and low level exposure to lead, cadmium and mercury: a population-based, prospective nested case-referent study in Sweden2013In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 12, no 9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Cadmium (Cd), lead (Pb), and mercury (Hg) cause toxicological renal effects, but the clinical relevance at low-level exposures in general populations is unclear. The objective of this study is to assess the risk of developing end-stage renal disease in relation to Cd, Pb, and Hg exposure.

    METHODS: A total of 118 cases who later in life developed end-stage renal disease, and 378 matched (sex, age, area, and time of blood sampling) referents were identified among participants in two population-based prospective cohorts (130,000 individuals). Cd, Pb, and Hg concentrations were determined in prospectively collected samples.

    RESULTS: Erythrocyte lead was associated with an increased risk of developing end-stage renal disease (mean in cases 76 μg/L; odds ratio (OR) 1.54 for an interquartile range increase, 95% confidence interval (CI) 1.18-2.00), while erythrocyte mercury was negatively associated (2.4 μg/L; OR 0.75 for an interquartile range increase, CI 0.56-0.99). For erythrocyte cadmium, the OR of developing end-stage renal disease was 1.15 for an interquartile range increase (CI 0.99-1.34; mean Ery-Cd among cases: 1.3 μg/L). The associations for erythrocyte lead and erythrocyte mercury, but not for erythrocyte cadmium, remained after adjusting for the other two metals, smoking, BMI, diabetes, and hypertension. Gender-specific analyses showed that men carried almost all of the erythrocyte lead and erythrocyte cadmium associated risks.

    CONCLUSIONS: Erythrocyte lead is associated with end-stage renal disease but further studies are needed to evaluate causality. Gender-specific analyses suggest potential differences in susceptibility or in exposure biomarker reliability.

  • 20.
    Nordberg, Gunnar F
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lundström, Nils-Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Hagenbjörk-Gustafsson, Annika
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lagerkvist, Birgitta J-Son
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Svensson, Mona
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Blomberg, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Nilsson, Leif
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Bernard, Alfred
    Dumont, Xavier
    Bertilsson, Helen
    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.
    Lung function in volunteers before and after exposure to trichloramine in indoor pool environments and asthma in a cohort of pool workers2012In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, no 5, p. e000973-Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Exposure to trichloramine (NCl(3)) in indoor swimming-pool environments is known to cause mucous membrane irritation, but if it gives rise to changes in lung function or asthma in adults is not known. (1) We determined lung function in volunteers before and after exposure to indoor pool environments. (2) We studied the occurrence of respiratory symptoms and asthma in a cohort of pool workers.

    DESIGN/METHODS/PARTICIPANTS: (1) We studied two groups of volunteers, 37 previously non-exposed healthy persons and 14 pool workers, who performed exercise for 2 h in an indoor pool environment. NCl(3) in air was measured during pool exposures and in 10 other pool environments. Filtered air exposures were used as controls. Lung function and biomarkers of pulmonary epithelial integrity were measured before and after exposure. (2) We mailed a questionnaire to 1741 persons who indicated in the Swedish census 1990 that they worked at indoor swimming-pools.

    RESULTS: (1) In previously non-exposed volunteers, statistically significant decreases in FEV(1) (forced expiratory volume) and FEV(%) (p=0.01 and 0.05, respectively) were found after exposure to pool air (0.23 mg/m(3) of NCl(3)). In pool workers, a statistically significant decrease in FEV(%) (p=0.003) was seen (but no significant change of FEV(1))(.) In the 10 other pool environments the median NCl(3) concentration was 0.18 mg/m(3). (2) Our nested case/control study in pool workers found an OR for asthma of 2.31 (95% CI 0.79 to 6.74) among those with the highest exposure. Exposure-related acute mucous membrane and respiratory symptoms were also found.

    CONCLUSIONS: This is the first study in adults showing statistically significant decreases in lung function after exposure to NCl(3). An increased OR for asthma among highly exposed pool workers did not reach statistical significance, but the combined evidence supports the notion that current workroom exposures may contribute to asthma development. Further research on sensitive groups is warranted.

  • 21. Pedersen, Marie
    et al.
    Stafoggia, Massimo
    Weinmayr, Gudrun
    Andersen, Zorana J.
    Galassi, Claudia
    Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Olsson, David
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Oftedal, Bente
    Krog, Norun H.
    Aamodt, Geir
    Pyko, Andrei
    Pershagen, Göran
    Korek, Michal
    De Faire, Ulf
    Pedersen, Nancy L.
    Östenson, Claes-Göran
    Fratiglioni, Laura
    Sørensen, Mette
    Eriksen, Kirsten T.
    Tjønneland, Anne
    Peeters, Petra H.
    Bueno-de-Mesquita, Bas
    Vermeulen, Roel
    Eeftens, Marloes
    Plusquin, Michelle
    Key, Timothy J.
    Jaensch, Andrea
    Nagel, Gabriele
    Concin, Hans
    Wang, Meng
    Tsai, Ming-Yi
    Grioni, Sara
    Marcon, Alessandro
    Krogh, Vittorio
    Ricceri, Fulvio
    Sacerdote, Carlotta
    Ranzi, Andrea
    Cesaroni, Giulia
    Forastiere, Francesco
    Tamayo, Ibon
    Amiano, Pilar
    Dorronsoro, Miren
    Stayner, Leslie T.
    Kogevinas, Manolis
    Nieuwenhuijsen, Mark J.
    Sokhi, Ranjeet
    de Hoogh, Kees
    Beelen, Rob
    Vineis, Paolo
    Brunekreef, Bert
    Hoek, Gerard
    Raaschou-Nielsen, Ole
    Is there an association between ambient air pollution and bladder cancer incidence? Analysis of 15 European cohorts.2016In: European Urology Focus, ISSN 1540-0085, E-ISSN 1788-618XArticle in journal (Refereed)
    Abstract [en]

    BACKGROUND: Ambient air pollution contains low concentrations of carcinogens implicated in the etiology of urinary bladder cancer (BC). Little is known about whether exposure to air pollution influences BC in the general population.

    OBJECTIVE: To evaluate the association between long-term exposure to ambient air pollution and BC incidence.

    DESIGN, SETTING, AND PARTICIPANTS: We obtained data from 15 population-based cohorts enrolled between 1985 and 2005 in eight European countries (N=303431; mean follow-up 14.1 yr). We estimated exposure to nitrogen oxides (NO2 and NOx), particulate matter (PM) with diameter <10μm (PM10), <2.5μm (PM2.5), between 2.5 and 10μm (PM2.5-10), PM2.5absorbance (soot), elemental constituents of PM, organic carbon, and traffic density at baseline home addresses using standardized land-use regression models from the European Study of Cohorts for Air Pollution Effects project.

    OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and meta-analyses to estimate summary hazard ratios (HRs) for BC incidence.

    RESULTS AND LIMITATIONS: During follow-up, 943 incident BC cases were diagnosed. In the meta-analysis, none of the exposures were associated with BC risk. The summary HRs associated with a 10-μg/m(3) increase in NO2 and 5-μg/m(3) increase in PM2.5 were 0.98 (95% confidence interval [CI] 0.89-1.08) and 0.86 (95% CI 0.63-1.18), respectively. Limitations include the lack of information about lifetime exposure.

    CONCLUSIONS: There was no evidence of an association between exposure to outdoor air pollution levels at place of residence and risk of BC.

    PATIENT SUMMARY: We assessed the link between outdoor air pollution at place of residence and bladder cancer using the largest study population to date and extensive assessment of exposure and comprehensive data on personal risk factors such as smoking. We found no association between the levels of outdoor air pollution at place of residence and bladder cancer risk.

  • 22. Raaschou-Nielsen, Ole
    et al.
    Andersen, Zorana J
    Beelen, Rob
    Samoli, Evangelia
    Stafoggia, Massimo
    Weinmayr, Gudrun
    Hoffmann, Barbara
    Fischer, Paul
    Nieuwenhuijsen, Mark J
    Brunekreef, Bert
    Xun, Wei W
    Katsouyanni, Klea
    Dimakopoulou, Konstantina
    Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Modig, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Oudin, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Oftedal, Bente
    Schwarze, Per E
    Nafstad, Per
    De Faire, Ulf
    Pedersen, Nancy L
    Ostenson, Claes-Göran
    Fratiglioni, Laura
    Penell, Johanna
    Korek, Michal
    Pershagen, Göran
    Eriksen, Kirsten T
    Sørensen, Mette
    Tjønneland, Anne
    Ellermann, Thomas
    Eeftens, Marloes
    Peeters, Petra H
    Meliefste, Kees
    Wang, Meng
    Bueno-de-Mesquita, Bas
    Key, Timothy J
    de Hoogh, Kees
    Concin, Hans
    Nagel, Gabriele
    Vilier, Alice
    Grioni, Sara
    Krogh, Vittorio
    Tsai, Ming-Yi
    Ricceri, Fulvio
    Sacerdote, Carlotta
    Galassi, Claudia
    Migliore, Enrica
    Ranzi, Andrea
    Cesaroni, Giulia
    Badaloni, Chiara
    Forastiere, Francesco
    Tamayo, Ibon
    Amiano, Pilar
    Dorronsoro, Miren
    Trichopoulou, Antonia
    Bamia, Christina
    Vineis, Paolo
    Hoek, Gerard
    Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE)2013In: The Lancet Oncology, ISSN 1470-2045, E-ISSN 1474-5488, Vol. 14, no 9, p. 813-822Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Ambient air pollution is suspected to cause lung cancer. We aimed to assess the association between long-term exposure to ambient air pollution and lung cancer incidence in European populations.

    METHODS: This prospective analysis of data obtained by the European Study of Cohorts for Air Pollution Effects used data from 17 cohort studies based in nine European countries. Baseline addresses were geocoded and we assessed air pollution by land-use regression models for particulate matter (PM) with diameter of less than 10 μm (PM10), less than 2·5 μm (PM2·5), and between 2·5 and 10 μm (PMcoarse), soot (PM2·5absorbance), nitrogen oxides, and two traffic indicators. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effects models for meta-analyses.

    FINDINGS: The 312 944 cohort members contributed 4 013 131 person-years at risk. During follow-up (mean 12·8 years), 2095 incident lung cancer cases were diagnosed. The meta-analyses showed a statistically significant association between risk for lung cancer and PM10 (hazard ratio [HR] 1·22 [95% CI 1·03-1·45] per 10 μg/m(3)). For PM2·5 the HR was 1·18 (0·96-1·46) per 5 μg/m(3). The same increments of PM10 and PM2·5 were associated with HRs for adenocarcinomas of the lung of 1·51 (1·10-2·08) and 1·55 (1·05-2·29), respectively. An increase in road traffic of 4000 vehicle-km per day within 100 m of the residence was associated with an HR for lung cancer of 1·09 (0·99-1·21). The results showed no association between lung cancer and nitrogen oxides concentration (HR 1·01 [0·95-1·07] per 20 μg/m(3)) or traffic intensity on the nearest street (HR 1·00 [0·97-1·04] per 5000 vehicles per day).

    INTERPRETATION: Particulate matter air pollution contributes to lung cancer incidence in Europe.

    FUNDING: European Community's Seventh Framework Programme.

  • 23. Raaschou-Nielsen, Ole
    et al.
    Pedersen, Marie
    Stafoggia, Massimo
    Weinmayr, Gudrun
    Andersen, Zorana J
    Galassi, Claudia
    Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Olsson, David
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Oftedal, Bente
    Krog, Norun H
    Aasvang, Gunn Marit
    Pyko, Andrei
    Pershagen, Göran
    Korek, Michal
    De Faire, Ulf
    Pedersen, Nancy L
    Östenson, Claes-Göran
    Fratiglioni, Laura
    Sørensen, Mette
    Eriksen, Kirsten T
    Tjønneland, Anne
    Peeters, Petra H
    Bueno-de-Mesquita, Bas
    Plusquin, Michelle
    Key, Timothy J
    Jaensch, Andrea
    Nagel, Gabriele
    Föger, Bernhard
    Wang, Meng
    Tsai, Ming-Yi
    Grioni, Sara
    Marcon, Alessandro
    Krogh, Vittorio
    Ricceri, Fulvio
    Sacerdote, Carlotta
    Migliore, Enrica
    Tamayo, Ibon
    Amiano, Pilar
    Dorronsoro, Miren
    Sokhi, Ranjeet
    Kooter, Ingeborg
    de Hoogh, Kees
    Beelen, Rob
    Eeftens, Marloes
    Vermeulen, Roel
    Vineis, Paolo
    Brunekreef, Bert
    Hoek, Gerard
    Outdoor air pollution and risk for kidney parenchyma cancer in 14 European cohorts2017In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 140, no 7, p. 1528-1537Article in journal (Refereed)
    Abstract [en]

    Several studies have indicated weakly increased risk for kidney cancer among occupational groups exposed to gasoline vapors, engine exhaust, polycyclic aromatic hydrocarbons and other air pollutants, although not consistently. It was the aim to investigate possible associations between outdoor air pollution at the residence and the incidence of kidney parenchyma cancer in the general population. We used data from 14 European cohorts from the ESCAPE study. We geocoded and assessed air pollution concentrations at baseline addresses by land-use regression models for particulate matter (PM10 , PM2.5 , PMcoarse , PM2.5 absorbance (soot)) and nitrogen oxides (NO2 , NOx ), and collected data on traffic. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effects models for meta-analyses to calculate summary hazard ratios (HRs). The 289,002 cohort members contributed 4,111,908 person-years at risk. During follow-up (mean 14.2 years) 697 incident cancers of the kidney parenchyma were diagnosed. The meta-analyses showed higher HRs in association with higher PM concentration, e.g. HR=1.57 (95%CI: 0.81-3.01) per 5μg/m(3) PM2.5 and HR=1.36 (95%CI: 0.84-2.19) per 10(-5) m(-1) PM2.5 absorbance, albeit never statistically significant. The HRs in association with nitrogen oxides and traffic density on the nearest street were slightly above one. Sensitivity analyses among participants who did not change residence during follow-up showed stronger associations, but none were statistically significant. This study provides suggestive evidence that exposure to outdoor PM at the residence may be associated with higher risk for kidney parenchyma cancer; the results should be interpreted cautiously as associations may be due to chance.

  • 24.
    Raza, Wasif
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johansson, Christer
    Nilsson Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Air pollution as a risk factor in health impact assessments of a travel mode shift towards cycling2018In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 11, no 1, article id 1429081Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Promotion of active commuting provides substantial health and environmental benefits by influencing air pollution, physical activity, accidents, and noise. However, studies evaluating intervention and policies on a mode shift from motorized transport to cycling have estimated health impacts with varying validity and precision.

    OBJECTIVE: To review and discuss the estimation of air pollution exposure and its impacts in health impact assessment studies of a shift in transport from cars to bicycles in order to guide future assessments.

    METHODS: A systematic database search of PubMed was done primarily for articles published from January 2000 to May 2016 according to PRISMA guidelines.

    RESULTS: We identified 18 studies of health impact assessment of change in transport mode. Most studies investigated future hypothetical scenarios of increased cycling. The impact on the general population was estimated using a comparative risk assessment approach in the majority of these studies, whereas some used previously published cost estimates. Air pollution exposure during cycling was estimated based on the ventilation rate, the pollutant concentration, and the trip duration. Most studies employed exposure-response functions from studies comparing background levels of fine particles between cities to estimate the health impacts of local traffic emissions. The effect of air pollution associated with increased cycling contributed small health benefits for the general population, and also only slightly increased risks associated with fine particle exposure among those who shifted to cycling. However, studies calculating health impacts based on exposure-response functions for ozone, black carbon or nitrogen oxides found larger effects attributed to changes in air pollution exposure.

    CONCLUSION: A large discrepancy between studies was observed due to different health impact assessment approaches, different assumptions for calculation of inhaled dose and different selection of dose-response functions. This kind of assessments would improve from more holistic approaches using more specific exposure-response functions.

  • 25.
    Shirdel, M
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Andersson, Britt M.
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics. Umeå University, Faculty of Science and Technology, Centre for Biomedical Engineering and Physics (CMTF).
    Bergdahl, Ingvar
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Wingfors, H
    Liljelind, Ingrid
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Choosing the number of images and image position when analysing the UNC Passive Aerosol Sampler for occupational exposure assessment.2018In: Journal of Occupational and Environmental Hygiene, ISSN 1545-9624, E-ISSN 1545-9632, p. 1-16Article in journal (Refereed)
    Abstract [en]

    The University of North Carolina passive aerosol sampler (UNC sampler) could be an alternative when measuring occupational dust exposure, but the time required for microscopic imaging of the sampler needs to be reduced to make it more attractive. The aims of this study were to 1) characterise the effect on precision when reducing imaging, in order to shorten analysis time and 2) assess if the position of the images makes a difference. Eighty-eight samplers were deployed in different locations of an open pit mine. Sixty images were captured for each UNC sampler, covering 51% of its collection surface, using scanning electron microscopy. Bootstrapped samples were generated with different image combinations, to assess the within-sampler coefficient of variation (CVws) for different numbers of images. In addition, the particle concentration relative to the distance from the centre of the sampler was studied. Reducing the number of images collected from the UNC sampler led to up to 8.3% CVws for ten images when calculating respirable fraction. As the overall CV has previously been assessed to 36%, the additional contribution becomes minimal, increasing the overall CV to 37%. The mean concentrations of the images were modestly related to distance from the centre of the sampler. The CVws changed from 8.26% to 8.13% for ten images when applying rules for the image collection based on distance. Thus, the benefit of these rules on the precision is small and the images can therefore be chosen at random. In conclusion, reducing the number of images analysed from 60 to 10, corresponding to a reduction of the imaged sampling area from 51% to 8.5%, results in a negligible loss in precision for respirable fraction dust measurements in occupational environments.

  • 26.
    Shirdel, Mariam
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Andersson, Britt M.
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Bergdahl, Ingvar
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sommar, Johan N.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Wingfors, Håkan
    CBRN Defence & Security Division, Swedish Defence Research Agency, Umeå, Sweden.
    Liljelind, Ingrid E.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Improving the UNC passive aerosol sampler model based on comparison with commonly used aerosol sampling methods2018In: Annals of Work Exposures and Health, ISSN 2398-7308, Vol. 62, no 3, p. 328-338Article in journal (Refereed)
    Abstract [en]

    Objectives: In an occupational environment, passive sampling could be an alternative to active sampling with pumps for sampling of dust. One passive sampler is the University of North Carolina passive aerosol sampler (UNC sampler). It is often analysed by microscopic imaging. Promising results have been shown for particles above 2.5 µm, but indicate large underestimations for PM2.5. The aim of this study was to evaluate, and possibly improve, the UNC sampler for stationary sampling in a working environment.

    Methods: Sampling was carried out at 8-h intervals during 24 h in four locations in an open pit mine with UNC samplers, respirable cyclones, PM10 and PM2.5 impactors, and an aerodynamic particle sizer (APS). The wind was minimal. For quantification, two modifications of the UNC sampler analysis model, UNC sampler with hybrid model and UNC sampler with area factor, were compared with the original one, UNC sampler with mesh factor derived from wind tunnel experiments. The effect of increased resolution for the microscopic imaging was examined.

    Results: Use of the area factor and a higher resolution eliminated the underestimation for PM10 and PM2.5. The model with area factor had the overall lowest deviation versus the impactor and the cyclone. The intraclass correlation (ICC) showed that the UNC sampler had a higher precision and better ability to distinguish between different exposure levels compared to the cyclone (ICC: 0.51 versus 0.24), but lower precision compared to the impactor (PM10: 0.79 versus 0.99; PM2.5: 0.30 versus 0.45). The particle size distributions as calculated from the different UNC sampler analysis models were visually compared with the distributions determined by APS. The distributions were obviously different when the UNC sampler with mesh factor was used but came to a reasonable agreement when the area factor was used.

    Conclusions: High resolution combined with a factor based on area only, results in no underestimation of small particles compared to impactors and cyclones and a better agreement with the APS’s particle size distributions. The UNC sampler had lower precision than the impactors, but higher than the respirable cyclone. The UNC sampler with area factor could be used for PM2.5, PM10 and respirable fraction measurements in this working environment without wind.

  • 27.
    Shirdel, Mariam
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sommar, Johan N.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Andersson, Britt M.
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Bergdahl, Ingvar A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Wingfors, Håkan
    Liljelind, Ingrid E.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Choosing the number of images and image position when analysing the UNC passive aerosol sampler for occupational exposure assessmentManuscript (preprint) (Other academic)
  • 28.
    Shirdel, Mariam
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Wingfors, Håkan
    Totalförsvarets forskningsinstitut, FOI.
    Andersson, Britt M.
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Sommar, Johan N.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bergdahl, Ingvar A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Liljelind, Ingrid E.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    A pilot study: the UNC passive aerosol sampler in a working environment2017In: Annals of Work Exposures and Health, ISSN 2398-7308, Vol. 61, no 8, p. 1029-1034Article in journal (Refereed)
    Abstract [en]

    Objectives: Dust is generally sampled on a filter using air pumps, but passive sampling could be a cost-effective alternative. One promising passive sampler is the University of North Carolina passive aerosol sampler (UNC sampler). The aim of this study is to characterize and compare the UNC sampler’s performance with PM10 and PM2.5 impactors in a working environment.

    Methods: Area sampling was carried out at different mining locations using UNC samplers in parallel with PM2.5 and PM10 impactors. Two different collection surfaces, polycarbonate (PC) and carbon tabs (CT), were employed for the UNC sampling. Sampling was carried out for 4–25 hours.

    Results: The UNC samplers underestimated the concentrations compared to PM10 and PM2.5 impactor data. At the location with the highest aerosol concentration, the time-averaged mean of PC showed 24% and CT 35% of the impactor result for PM2.5. For PM10, it was 39% with PC and 58% with CT. Sample blank values differed between PC and CT. For PM2.5, PC blank values were ~7 times higher than those of CT, but only 1.8 times higher for PM10. The blank variations were larger for PC than for CT.

    Conclusions: Particle mass concentrations appear to be underestimated by the UNC sampler compared to impactors, more so for PM2.5 than for PM10. CT may be preferred as a collection surface because the blank values were lower and less variable than for PC. Future validations in the working environment should include respirable dust sampling.

  • 29.
    Sommar, Johan Nilsson
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ek, Alexandra
    Middelveld, Roelinde
    Bjerg, Anders
    Dahlén, Sven-Erik
    Janson, Christer
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Quality of life in relation to the traffic pollution indicators NO2 and NOx: results from the Swedish GA2LEN survey2014In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 1, p. e000039-Article in journal (Refereed)
    Abstract [en]

    Background Asthma is a chronic disease that may affect daily activities and quality of life. Asthmatics have higher incidence of chronic rhinosinusitis (CRS) and asthma is associated with sinonasal inflammation and nasal symptoms, that all impair quality of life. Worsening of asthma has been found associated with levels of nitrogen dioxide as traffic indicator.

    Aims The aim of the study was to evaluate the impact of traffic pollution indicated by nitrogen oxides (NO2 and NOx) on quality of life in asthmatic persons, individuals with CRS and controls.

    Methods Within the Swedish Ga2len (Global Allergy and Asthma European Network), 605 asthmatics with and without CRS, 110 individuals with CRS only and 226 controls from four cities were surveyed. The mini Asthma Quality of life Questionnaire (mAQLQ) and the Euro Quality of Life (EQ-5D) health questionnaire were used. Air pollution concentrations at the home address were modelled using dispersion models.

    Results Levels of NO2 (geometric mean 10.1 μg/m3 (95% CI 9.80 to 10.5) and NOx (12.1 μg/m3, 11.7 to 12.6) were similar among conditions (controls, asthmatics, individuals with CRS and asthmatics with CRS). The mAQLQ overall score was not found associated with levels of NO2 or NOx, with or without adjustments, and neither was scores within each of the four domains of mAQLQ: symptoms, activity limitations, emotional functions and effects of environmental stimuli. The mean EQ-5D index value, based on the five dimensions mobility, self-care, usual activities, pain/discomfort and anxiety depression, was also found unrelated to NO2 and NOx.

    Conclusions At moderate exposure levels traffic pollution appears not to affect quality of life.

  • 30.
    Sommar, Johan Nilsson
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Hedmer, Maria
    Lundh, Thomas
    Nilsson, Leif
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Skerfving, Staffan
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Investigation of lead concentrations in whole blood, plasma and urine as biomarkers for biological monitoring of lead exposure2014In: Journal of Exposure Science and Environmental Epidemiology, ISSN 1559-0631, E-ISSN 1559-064X, Vol. 24, no 1, p. 51-57Article in journal (Refereed)
    Abstract [en]

    Lead in blood is a major concept in biomonitoring of exposure but investigations of its alternatives are scarce. The aim of the study was to describe different lead biomarkers' variances, day-to-day and between individuals, estimating their fraction of the total variance. Repeated sampling of whole blood, plasma and urine were conducted for 48 lead-exposed men and 20 individuals under normal environmental lead exposure, in total 603 measurements. For lead workers, the fraction of the total variance attributed to differences between individuals was 91% for whole-blood lead (geometric mean 227 μg/l; geometric standard deviation (GSD): 1.55 μg/l); plasma 78% (0.57 μg/l; GSD: 1.84 μg/l); density-adjusted urine 82%; and unadjusted urine 75% (23.7 μg/l; GSD: 2.48 μg/l). For the individuals under normal lead exposure, the corresponding fractions were 95% of the total variance for whole blood (20.7 μg/l; GSD: 8.6 μg/l), 15% for plasma (0.09 μg/l; GSD: 0.04 μg/l), 87% for creatinine-adjusted urine and 34% for unadjusted (10.8 μg/l; GSD: 6.7 μg/l). Lead concentration in whole blood is the biomarker with the best ability to discriminate between individuals with different mean concentration. Urinary and plasma lead also performed acceptably in lead workers, but at low exposures plasma lead was too imprecise. Urinary adjustments appear not to increase the between-individual fraction of the total variance among lead workers but among those with normal lead exposure.Journal of Exposure Science and Environmental Epidemiology advance online publication, 27 February 2013; doi:10.1038/jes.2013.4.

  • 31.
    Svedmark, Åsa
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    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.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nilsson Sommar, Johan
    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.
    Impact of workplace exposure and stress on neck pain and disabilities in women: a longitudinal follow-up after a rehabilitation intervention2018In: Annals of Work exposure and Health, ISSN 2398-7308, Vol. 62, no 5, p. 591-603Article in journal (Refereed)
    Abstract [en]

    Introduction: The aim was to evaluate if pain, disability, and work productivity are influenced by physical and psychosocial work exposures as well as by stress, up to 1 year after a randomized controlled trial treatment intervention, and to determine whether any such association differed between treatment and control groups.

    Methods: Ninety-seven working women suffering non-specific neck pain (n = 67 treatment group, n = 30 control group) were followed from end of treatment intervention and at 9- and 15-month follow-ups, respectively. Physical and psychosocial exposures, as well as perceived stress, were assessed after the treatment intervention. Pain, neck disability, and work productivity were assessed at baseline, after intervention 3 months later and at 9- and 15-month follow-ups. Longitudinal assessment was conducted using the exposure level at 3 months as predictor of pain, disability, and work productivity at 3, 9, and 15 months, respectively. Mixed models were used to estimate longitudinal associations, accounting for within-individual correlation of repeated outcome measures by incorporation of a random intercept. Age and duration of neck pain were adjusted for in all models. To evaluate group differences, interactions between exposures and treatment groups were estimated.

    Results: High perceived stress was associated with more neck pain, more neck disability, and decreased work productivity in both cross-sectional and longitudinal analyses. High ‘control of decision’ was associated with less neck pain, less neck disability, and higher work productivity in cross-sectional analyses but only to less disability and higher productivity in longitudinal analyses. Shoulder/arm load was the only physical exposure variable that was significantly associated with work productivity in the univariate analyses. Only small differences were observed between treatment and control groups.

    Conclusion: High perceived stress and low ‘control of decision’ were associated with more neck pain, increased neck disability, and decreased work productivity. Treatment interventions for individuals with neck pain should take into account psychosocial workplace exposures and stress to improve intermediate and long-term results.

  • 32. Tian, Liting
    et al.
    Zheng, Guang
    Sommar, Johan Nilsson
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Liang, Yihuai
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lundh, Tomas
    Broberg, Karin
    Lei, Lijian
    Guo, Weijun
    Li, Yulan
    Tan, Mingguang
    Skerfving, Staffan
    Jin, Taiyi
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lead concentration in plasma as a biomarker of exposure and risk, and modification of toxicity by delta-aminolevulinic acid dehydratase gene polymorphism2013In: Toxicology Letters, ISSN 0378-4274, E-ISSN 1879-3169, Vol. 221, no 2, p. 102-109Article in journal (Refereed)
  • 33.
    Wennberg, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Lundh, Thomas
    Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden.
    Nilsson Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bergdahl, Ingvar
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Time trends of lead and cadmium in the adult population of Northern Sweden 1990-20142015Report (Other academic)
  • 34.
    Wennberg, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Lundh, Thomas
    Nilsson Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bergdahl, Ingvar A.
    Umeå University, Faculty of Medicine, Department of Biobank Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Time trends and exposure determinants of lead and cadmium in the adult population of northern Sweden 1990-20142017In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 159, p. 111-117Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: This study follows cadmium and lead concentrations in blood in the adult population in northern Sweden over 24 years.

    MATERIAL AND METHODS: Concentrations of lead and cadmium were measured in single whole blood samples (B-Pb and B-Cd) from 619 men and 926 women participating in the Northern Sweden WHO MONICA Study on one occasion 1990-2014. Associations with smoking and dietary factors were investigated. Consumption of moose meat was asked for in 2014.

    RESULTS: In the adult population in northern Sweden, the median B-Pb in 2014 was 11.0µg/L in young (25-35 years) men and 9.69µg/L in young women. In an older age-group (50-60 years), the median B-Pb was 15.1µg/L in men and 13.1µg/L in women. B-Pb decreased from 1990 to 2009, after which time no further decrease was observed. B-Pb was higher in smokers than in non-smokers. In never-smokers, positive associations were found between B-Pb and consumption of wine and brewed coffee (women only) in 2004-2014. Higher B-Pb with consumption of moose meat was demonstrated in men, but not in women. B-Cd was essentially stable over the whole period, but an increase in B-Cd, of 3% per year, was detected in never-smoking women between 2009 and 2014. In 2014, median B-Cd in never-smokers in the four groups was; 0.11µg/L in younger men, 0.15µg/L in younger women, 0.14µg/L in older men, and 0.21µg/L in older women. B-Cd was higher in smokers than in non-smokers. The only positive association between B-Cd and food items in 2004-2014 was with consumption of brewed coffee (men only).

    CONCLUSIONS: The lack of a decrease in B-Cd from 1990 to 2014 and the absence of a further decrease in B-Pb after 2009 are unsatisfactory considering the health risks these metals pose in the general population at current concentrations.

  • 35. Zheng, Guang
    et al.
    Tian, Liting
    Liang, Yihuai
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Broberg, Karin
    Lei, Lijian
    Guo, Weijun
    Nilsson, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Skerfving, Staffan
    Jin, Taiyi
    δ-Aminolevulinic acid dehydratase genotype predicts toxic effects of lead on workers' peripheral nervous system2011In: Neurotoxicology, ISSN 0161-813X, E-ISSN 1872-9711, Vol. 32, no 4, p. 374-382Article in journal (Refereed)
    Abstract [en]

    There is a wide variation in sensitivity to lead (Pb) exposure, which may be due to genetic susceptibility towards Pb. We investigated whether a polymorphism (rs1800435) in the δ-aminolevulinic acid dehydratase (ALAD) gene affected the toxicokinetics and toxicodynamics of Pb. Among 461 Chinese Pb-exposed storage battery and 175 unexposed workers, allele frequencies for the ALAD1 and ALAD2 alleles were 0.968 and 0.032, respectively. The Pb-exposed workers had a higher fraction of the ALAD1-2/2-2 genotype than unexposed workers (7.8% vs. 2.3%, p=0.01). The Pb levels in blood (B-Pb) and urine (U-Pb) were higher in Pb-exposed workers carrying the ALAD2 allele compared to homozygotes for ALAD1 (median B-Pb: 606 vs. 499 μg/L; U-Pb: 233 vs. 164 μg/g creatinine), while there was no statistically significant difference in the unexposed controls (median: 24 vs. 37 μg/L, and 3.9 vs. 6.4μg/g creatinine, respectively). High B-Pb and U-Pb were associated with statistically significantly lower sensory and motor conduction velocities in the median, ulnar and peroneal nerves. At the same B-Pb and U-Pb, ALAD1 homozygotes had lower conduction velocities than the ALAD2 carriers. There were similar trends for toxic effects on haem synthesis (zinc protoporphyrin and haemoglobin in blood) and renal function (albumin and N-acetyl-d-β-acetylglucosaminidase in urine), but without statistical significance. There was no difference in Pb toxicokinetics and toxicodynamics associated with VDR BsmI polymorphism. Our results show that the ALAD genotype modifies the relationship between Pb and its toxic effects on the peripheral nervous system. This must be considered in the assessment of risks at Pb exposure.

1 - 35 of 35
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf