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  • 1. Backé, Eva-Maria
    et al.
    Seidler, Andreas
    Latza, Ute
    Rossnagel, Karin
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    The role of psychosocial stress at work for the development of cardiovascular diseases: a systematic review.2012Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 85, nr 1, s. 67-79Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 2.
    Benebo, Faith Owunari
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Vaezghasemi, Masoud
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Intimate partner violence against women in Nigeria: a multilevel study investigating the effect of women's status and community norms2018Ingår i: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 18, artikel-id 136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Intimate partner violence (IPV) against women has been recognised as a public health problem with far-reaching consequences for the physical, reproductive, and mental health of women. The ecological framework portrays intimate partner violence as a multifaceted phenomenon, demonstrating the interplay of factors at different levels: individual, community, and the larger society. The present study examined the effect of individual- and community-level factors on IPV in Nigeria, with a focus on women's status and community-level norms among men.

    METHODS: A cross-sectional study based on the latest Nigerian Demographic Health Survey (2013) was conducted involving 20,802 ever-partnered women aged 15-49 years. Several multilevel logistic regression models were calibrated to assess the association of individual- and community-level factors with IPV. Both measures of association (fixed effect) and measures of variations (random effect) were reported.

    RESULTS: Almost one in four women in Nigeria reported having ever experienced intimate partner violence. Having adjusted for other relevant covariates, higher women's status reduced the odds of IPV (OR = 0.47; 95% CI = 0.32-0.71). However, community norms among men that justified IPV against women modified the observed protective effect of higher women's status against IPV and reversed the odds (OR = 1.89; 95% CI = 1.26-2.83).

    CONCLUSIONS: Besides women's status, community norms towards IPV are an important factor for the occurrence of IPV. Thus, addressing intimate partner violence against women calls for community-wide approaches aimed at changing norms among men alongside improving women's status.

  • 3. Bergmann, Annekatrin
    et al.
    Bolm-Audorff, Ulrich
    Ditchen, Dirk
    Ellegast, Rolf
    Grifka, Joachim
    Haerting, Johannes
    Hofmann, Friedrich
    Jäger, Matthias
    Linhardt, Oliver
    Luttmann, Alwin
    Meisel, Hans Jörg
    Michaelis, Martina
    Petereit-Haack, Gabriela
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Seidler, Andreas
    Do occupational risks for low back pain differ from risks for specific lumbar disc diseases?: Results of the German Lumbar Spine Study (EPILIFT)2017Ingår i: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 42, nr 20, s. E1204-E1211Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study design: A multicenter, population based, case-control study.

    Objective: The aim of the present analysis is to clarify potential differences in the "occupational risk profiles" of structural lumbar disc diseases on the one hand, and low back pain (LBP) on the other hand.

    Summary of background data: Physical workplace factors seem to play an important etiological role.

    Methods: We recruited 901 patients with structural lumbar disc diseases (disc herniation or severe disc space narrowing) and 233 control subjects with "low-back-pain." Both groups were compared with 422 "low-back pain free" control subjects. Case history, pain data, neurological deficits, and movement restrictions were documented. LBP was recorded by the Nordic questionnaire on musculoskeletal symptoms. All magnetic resonance imaging, computed tomography, and X-rays were inspected by an independent study radiologist. The calculation of cumulative physical workload was based on a computer-assisted interview and a biomechanical analysis by 3-D-dynamic simulation tool. Occupational exposures were documented for the whole working life.

    Results: We found a positive dose-response relationship between cumulative lumbar load and LBP among men, but not among women. Physical occupational risks for structural lumbar disc diseases [odds ratio (OR) 3.7; 95% confidence interval (95% CI) 2.3-6.0] are higher than for LBP (OR 1.9; 95% CI 1.0-3.5).

    Conclusion: Our finding points to potentially different etiological pathways in the heterogeneous disease group of LBP. Results suggest that not all of the structural disc damage arising from physical workload leads to LBP.

  • 4.
    Fonseca Rodriguez, Osvaldo
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Häggström Lundevaller, Erling
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Sheridan, Scott C
    Department of Geography, Kent State University, Kent, OH 4242, USA.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Association between Weather Types based on the Spatial Synoptic Classification and All-Cause Mortality in Sweden, 1991⁻20142019Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, nr 10, artikel-id 1696Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Much is known about the adverse health impact of high and low temperatures. The Spatial Synoptic Classification is a useful tool for assessing weather effects on health because it considers the combined effect of meteorological factors rather than temperature only. The aim of this study was to assess the association between oppressive weather types and daily total mortality in Sweden. Time-series Poisson regression with distributed lags was used to assess the relationship between oppressive weather (Dry Polar, Dry Tropical, Moist Polar, and Moist Tropical) and daily deaths over 14 days in the extended summer (May to September), and 28 days during the extended winter (November to March), from 1991 to 2014. Days not classified as oppressive weather served as the reference category. We computed relative risks with 95% confidence intervals, adjusting for trends and seasonality. Results of the southern (Skåne and Stockholm) and northern (Jämtland and Västerbotten) locations were pooled using meta-analysis for regional-level estimates. Analyses were performed using the dlnm and mvmeta packages in R. During summer, in the South, the Moist Tropical and Dry Tropical weather types increased the mortality at lag 0 through lag 3 and lag 6, respectively. Moist Polar weather was associated with mortality at longer lags. In the North, Dry Tropical weather increased the mortality at shorter lags. During winter, in the South, Dry Polar and Moist Polar weather increased mortality from lag 6 to lag 10 and from lag 19 to lag 26, respectively. No effect of oppressive weather was found in the North. The effect of oppressive weather types in Sweden varies across seasons and regions. In the North, a small study sample reduces precision of estimates, while in the South, the effect of oppressive weather types is more evident in both seasons.

  • 5.
    Furberg, Maria
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Anticona Huaynate, Cynthia
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Post-infectious fatigue following Puumala virus infection2019Ingår i: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243, Vol. 51, nr 7, s. 519-526Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Puumala virus infection or nephropathia epidemica (NE) is common in northern Sweden. NE causes haemorrhagic fever with renal syndrome. Most patients make a full recovery, but a convalescent phase with fatigue has been reported. Although post-infectious fatigue has been demonstrated for other viral infections, it is not well studied in relation to NE. This study assessed recovery time and levels of fatigue in former NE patients, as compared to the general population.

    METHODS: NE patients diagnosed in northern Sweden between 2007 and 2011, together with a comparison sample from the general population, answered a questionnaire on demographic and health-related factors, including the Fatigue Severity Scale (FSS), and characteristics of NE infection. Self-reported recovery time was assessed, and fatigue levels were compared across the two groups by multiple linear regression, stratified by gender.

    RESULTS: In total, 1132 NE patients and 915 comparison group subjects participated. Time to complete recovery was reported to exceed 3 months for 47% and 6 months for 32% of the NE patients. Recovery time differed by gender and age. NE patients had significantly higher FSS scores than the comparison group. Differences were greater among women than men, and adjustments for current illness, body mass index, smoking and current residence only slightly modified the estimates.

    CONCLUSIONS: Individuals with previous NE infection show higher fatigue scores than non-infected individuals, even 5 years following the infection. Full recovery takes half a year or longer for a substantial proportion of former NE patients.

  • 6.
    Greiser, K. H.
    et al.
    German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany.
    Tiller, D.
    Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
    Kuss, O.
    Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
    Kluttig, A.
    Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany .
    Rudge, G.
    Public Health, Epidemiology and Biostatistics Unit, The College of Medical and Dental Sciences, The University of Birmingham, Birmingham, UK.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Werdan, K.
    University Clinic for Internal Medicine III, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
    Haerting, J.
    Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
    Association of neighbourhood socioeconomic status and individual socioeconomic status with cardiovascular risk factors in an Eastern German population: the CARLA Study 2002–20062011Ingår i: IEA World Congress of Epidemiology, 7–11 August 2011, Edinburgh International Conference Centre, Edinburgh, Scotland Programme and abstracts, 2011, Vol. 65, nr A249, s. A249-Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction/objectives: Individual socioeconomic status (SES) is a determinant of cardiovascular risk factors (RF). Recent studies suggest an independent association of neighbourhood SES with cardiovascular RF, but the mechanisms have not fully been understood. Our aim was to assess the association of neighbourhood and individual SES with cardiovascular RF in an Eastern German population.

    Methods: We used cross-sectional data of 1779 participants aged 45–83 years of the population-based CARLA study. We calculated linear mixed models to assess the age-adjusted influence of neighbourhood-specific unemployment rates and individual SES on smoking, systolic blood pressure (SBP), and body mass index (BMI). Spatial dependencies within and between neighbourhoods were adjusted for by using ICAR models.

    Results: Neighbourhood-specific unemployment rates varied between 6.3 and 35.3%. Per 1% increase in the neighbourhood's unemployment rate, the number of cigarettes smoked/day increased by 0.11 in men (95% CI 0.09 to 0.12) and 0.05, (CI 0.04 to 0.07) in women. In women, SBP increased by 0.04 mm Hg with unemployment rate (CI 0.03 to 0.06), while there was no statistically significant association of SBP with SES in men. BMI was only in women significantly associated with unemployment (increase in BMI per 1% increase in unemployment rate 0.04 (CI 0.02 to 0.05)). Associations of RF with individual SES were stronger than with neighbourhood SES in multiple models.

    Conclusions: Our findings confirm the previously described association of neighbourhood SES with smoking independent of individual SES, while we found inconsistent associations with SBP and BMI. The neighbourhood environment may be more relevant for behavioural than for biomedical risk factors.

  • 7.
    Hedlund, Christina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Blomstedt, Yulia
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Association of climatic factors with infectious diseases in the Arctic and subarctic region: a systematic review2014Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, s. 1-16Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background:

    The Arctic and subarctic area are likely to be highly affected by climate change, with possible impacts on human health due to effects on food security and infectious diseases.

    Objectives:

    To investigate the evidence for an association between climatic factors and infectious diseases, and to identify the most climate-sensitive diseases and vulnerable populations in the Arctic and subarctic region.

    Methods:

    A systematic review was conducted. A search was made in PubMed, with the last update in May 2013. Inclusion criteria included human cases of infectious disease as outcome, climate or weather factor as exposure, and Arctic or subarctic areas as study origin. Narrative reviews, case reports, and projection studies were excluded. Abstracts and selected full texts were read and evaluated by two independent readers. A data collection sheet and an adjusted version of the SIGN methodology checklist were used to assess the quality grade of each article.

    Results:

    In total, 1953 abstracts were initially found, of which finally 29 articles were included. Almost half of the studies were carried out in Canada (n = 14), the rest from Sweden (n = 6), Finland (n = 4), Norway (n = 2), Russia (n = 2), and Alaska, US (n = 1). Articles were analyzed by disease group: food-and waterborne diseases, vector-borne diseases, airborne viral-and airborne bacterial diseases. Strong evidence was found in our review for an association between climatic factors and food-and waterborne diseases. The scientific evidence for a link between climate and specific vector-and rodent-borne diseases was weak due to that only a few diseases being addressed in more than one publication, although several articles were of very high quality. Air temperature and humidity seem to be important climatic factors to investigate further for viral-and bacterial airborne diseases, but from our results no conclusion about a causal relationship could be drawn.

    Conclusions:

    More studies of high quality are needed to investigate the adverse health impacts of weather and climatic factors in the Arctic and subarctic region. No studies from Greenland or Iceland were found, and only a few from Siberia and Alaska. Disease and syndromic surveillance should be part of climate change adaptation measures in the Arctic and subarctic regions, with monitoring of extreme weather events known to pose a risk for certain infectious diseases implemented at the community level.

  • 8.
    Ingole, Vijendra
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Kovats, S
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Hajat, S
    Rocklöv, Joacim
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Juvekar, S
    Armstrong, B
    Socio-environmental factors associated with heat and cold related mortality in Vadu HDSS, western India: A  Population based case-crossover study designArtikel i tidskrift (Refereegranskat)
  • 9.
    Ingole, Vijendra
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Vadu Rural Health Program, KEM Hospital Research Centre, Pune 411011, India; INDEPTH Network, Accra, Ghana.
    Kovats, Sari
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Hajat, Shakoor
    Rocklöv, Joacim
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Juvekar, Sanjay
    Armstrong, Ben
    Socioenvironmental factors associated with heat and cold-related mortality in Vadu HDSS, western India: a population-based case-crossover study2017Ingår i: International journal of biometeorology, ISSN 0020-7128, E-ISSN 1432-1254, Vol. 61, nr 10, s. 1797-1804Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Ambient temperatures (heat and cold) are associated with mortality, but limited research is available about groups most vulnerable to these effects in rural populations. We estimated the effects of heat and cold on daily mortality among different sociodemographic groups in the Vadu HDSS area, western India. We studied all deaths in the Vadu HDSS area during 2004-2013. A conditional logistic regression model in a case-crossover design was used. Separate analyses were carried out for summer and winter season. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for total mortality and population subgroups. Temperature above a threshold of 31 A degrees C was associated with total mortality (OR 1.48, CI = 1.05-2.09) per 1 A degrees C increase in daily mean temperature. Odds ratios were higher among females (OR 1.93; CI = 1.07-3.47), those with low education (OR 1.65; CI = 1.00-2.75), those owing larger agricultural land (OR 2.18; CI = 0.99-4.79), and farmers (OR 1.70; CI = 1.02-2.81). In winter, per 1 A degrees C decrease in mean temperature, OR for total mortality was 1.06 (CI = 1.00-1.12) in lag 0-13 days. High risk of cold-related mortality was observed among people occupied in housework (OR = 1.09; CI = 1.00-1.19). Our study suggests that both heat and cold have an impact on mortality particularly heat, but also, to a smaller degree, cold have an impact. The effects may differ partly by sex, education, and occupation. These findings might have important policy implications in preventing heat and cold effects on particularly vulnerable groups of the rural populations in low and middle-income countries with hot semi-arid climate.

  • 10.
    Ingole, Vijendra
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Vadu Rural Health Program, KEM Hospital Research Centre, Pune 411011, India.
    Rocklöv, Joacim
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Juvekar, Sanjay
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Impact of Heat and Cold on Total and Cause-Specific Mortality in Vadu HDSS: A Rural Setting in Western India2015Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 12, nr 12, s. 15298-15308Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Many diseases are affected by changes in weather. There have been limited studies, however, which have examined the relationship between heat and cold and cause-specific mortality in low and middle-income countries. In this study, we aimed to estimate the effects of heat and cold days on total and cause-specific mortality in the Vadu Health and Demographic Surveillance System (HDSS) area in western India. We used a quasi-Poisson regression model allowing for over-dispersion to examine the association of total and cause-specific mortality with extreme high (98th percentile, >39 °C) and low temperature (2nd percentile, <25 °C) over the period January 2003 to December 2012. Delays of 0 and 0-4 days were considered and relative risks (RR) with 95% confidence intervals (CI) were calculated. Heat was significantly associated with daily deaths by non-infectious diseases (RR = 1.57; CI: 1.18-2.10). There was an increase in the risk of total mortality in the age group 12-59 years on lag 0 day (RR = 1.43; CI: 1.02-1.99). A high increase in total mortality was observed among men at lag 0 day (RR = 1.38; CI: 1.05-1.83). We did not find any short-term association between total and cause-specific mortality and cold days. Deaths from neither infectious nor external causes were associated with heat or cold. Our results showed a strong and rather immediate relationship between high temperatures and non-infectious disease mortality in a rural population located in western India, during 2003-2012. This study may be used to develop targeted interventions such as Heat Early Warning Systems in the area to reduce mortality from extreme temperatures.

  • 11.
    Ivarsson, Anneli
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Kinsman, John
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Johansson, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Mohamud, Khalif Bile
    Weinehall, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Freij, Lennart
    Wall, Stig
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Dalmar, Abdirisak Ahmed
    Ibrahim, Abdirashid Omer
    Hagi, Abdisamad Abikar
    Abdi, Abshir Ali
    Hussein, Abdullahi Sheik
    Shirwa, Abdulkadir Mohamed
    Warsame, Amina
    Ereg, Derie Ismail
    Aden, Mohamed Hussain
    Qasim, Maryan
    Ali, Mohamed Khalid
    Elmi, Abdullahi
    Afrah, Abdullahi Warsame
    Sabtiye, Faduma Omar
    Guled, Fatuma Ege
    Ahmed, Hinda Jama
    Mohamed, Halima
    Tinay, Halima Ali
    Mohamud, Kadigia Ali
    Yusuf, Mariam Warsame
    Omar, Mayeh
    Abdi, Yakoub Aden
    Abdulkadir, Yusuf
    Johansson, Annika
    Kulane, Asli Ali
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Essen, Birgitta
    Kalengayi, Faustine Nkulu
    Elgh, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    Norström, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Lönnberg, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Norder, Helene
    Schröders, Julia
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Erlandsson, Kerstin
    Edin, Kerstin
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Sahlen, Klas-Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Gustafsson, Lars L.
    Persson, Lars-Ake
    Eriksson, Malin
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Emmelin, Maria
    Hasselberg, Marie
    Klingberg, Marie
    Preet, Raman
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Hogberg, Ulf
    Sjostrom, Urban
    Omar, Saif
    Healing the health system after civil unrest2015Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 8, s. 1-4Artikel i tidskrift (Övrigt vetenskapligt)
  • 12. Kluttig, Alexander
    et al.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
    Swenne, Cees A
    Kors, Jan A
    Kuss, Oliver
    Schmidt, Hendrik
    Werdan, Karl
    Haerting, Johannes
    Greiser, Karin H
    Association of health behaviour with heart rate variability: a population-based study2010Ingår i: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 10, s. 58-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Reduced heart rate variability (HRV), a non-invasive marker of autonomic dysfunction, and an unhealthy lifestyle are associated with an increased morbidity and mortality of cardiovascular diseases (CVD). The autonomic dysfunction is a potential mediator of the association of behavioural risk factors with adverse health outcomes. We studied the association of HRV with behavioural risk factors in an elderly population.

    Methods: This analysis was based on the cross-sectional data of 1671 participants (age range, 45-83 years) of the prospective, population-based Cardiovascular Disease, Living and Ageing in Halle (CARLA) Study. Physical activity, smoking habits, alcohol consumption and dietary patterns were assessed in standardized interviews. Time and frequency domain measures of HRV were computed from 5-min segments of highly standardized 20-min electrocardiograms. Their association with behavioural risk factors was determined by linear and non-parametric regression modelling.

    Results: There were only weak and inconsistent associations of higher physical activity, moderate consumption of alcohol, and non-smoking with higher time and frequency domain HRV in both sexes, and no association with dietary pattern. Results changed only marginally by excluding subjects with CVD, diabetes mellitus and use of cardioactive medication.

    Conclusion: We hypothesized that HRV is associated with behavioural factors and therefore might be a mediator of the effect of behavioural risk factors on CVD, but this hypothesis was not confirmed by our results. These findings support the interpretation that there may be no true causal association of behavioural factors with HRV.

  • 13.
    Lena, Karlsson
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Häggström Lundevaller, Erling
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Season of birth, stillbirths, and neonatal mortality in Sweden: the Sami and non-Sami population, 1800–18992019Ingår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 78, nr 1, artikel-id 1629784Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Seasonal patterns of neonatal mortality and stillbirths have been found around the world. However, little is known about the association between season of birth and infant mortality of pre-industrial societies in a subarctic environment. In this study, we compared how season of birth affected the neonatal and stillbirth risk among the Sami and non-Sami in Swedish Sápmi during the nineteenth century. Using digitised parish records from the Demographic Data Base at Umeå University, we applied logistic regression models for estimating the association of season of birth with stillbirths and neonatal mortality, respectively. Higher neonatal mortality was found among the winter- and autumn-born Sami, compared to summer-born infants. Stillbirth risk was higher during autumn compared to summer among the Sami, whereas we found no seasonal differences in mortality among the non-Sami population. We relate the higher neonatal mortality risk among winter-born Sami to differences in seasonality of living conditions associated with reindeer herding.

  • 14.
    Lena, Karlsson
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Häggström Lundevaller, Erling
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Schumann, Barbara
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    The association between cold extremes and neonatal mortality in Swedish Sápmi from 1800–18952019Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, nr 1, artikel-id 1623609Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Studies in which the association between temperature and neonatal mortality (deaths during the first 28 days of life) is tracked over extended periods that cover demographic, economic and epidemiological transitions are quite limited. From previous research about the demographic transition in Swedish Sápmi, we know that infant and child mortality was generally higher among the indigenous (Sami) population compared to non-indigenous populations.

    Objective: The aim of this study was to analyse the association between extreme temperatures and neonatal mortality among the Sami and non-Sami population in Swedish Sápmi (Lapland) during the nineteenth century.

    Methods: Data from the Demographic Data Base, Umeå University, were used to identify neonatal deaths. We used monthly mean temperature in Tornedalen and identified cold and warm month (5th and 95th) percentiles. Monthly death counts from extreme temperatures were modelled using negative binomial regression. We computed relative risks (RR) with 95% confidence intervals (CI), adjusting for time trends and seasonality.

    Results: Overall, the neonatal mortality rate was higher among Sami compared to non-Sami infants (62/1,000 vs 35/1,000 live births), although the differences between the two populations decreased after 1860. For the Sami population prior 1860, the results revealed a higher neonatal incidence rate during cold winter months (< -15.4 °C, RR=1.60, CI 1.14–2.23) compared to infants born during months of medium temperature). No association was found between extreme cold months and neonatal mortality for non-Sami populations. Warm months (+15.1 °C) had no impact on Sami or non-Sami populations.

    Conclusions: This study revealed the role of environmental factors (temperature extremes) on infant health during the demographic transition where cold extremes mainly affected the Sami population. Ethnicity and living conditions contributed to differential weather vulnerability.

  • 15.
    Odhiambo Sewe, Maquins
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Graduate School in Population Dynamics and Public Policy, Umeå University.
    Bunker, Aditi
    Ingole, Vijendra
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Graduate School in Population Dynamics and Public Policy, Umeå University; Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.
    Egondi, Thaddaeus
    Oudin Åström, Daniel
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Department of Clinical Science, Center for Primary Health Care Research, Lund University, Malmö.
    Hondula, David M.
    Rocklöv, Joacim
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Estimated Effect of Temperature on Years of Life Lost: A Retrospective Time-Series Study of Low-, Middle-, and High-Income Regions2018Ingår i: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 126, nr 1, artikel-id 017004Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Numerous studies have reported a strong association between temperature and mortality. Additional insights can be gained from investigating the effects of temperature on years of life lost (YLL), considering the life expectancy at the time of death.

    OBJECTIVES: The goal of this work was to assess the association between temperature and YLL at seven low-, middle-, and high-income sites.

    METHODS: We obtained meteorological and population data for at least nine years from four Health and Demographic Surveillance Sites in Kenya (western Kenya, Nairobi), Burkina Faso (Nouna), and India (Vadu), as well as data from cities in the United States (Philadelphia, Phoenix) and Sweden (Stockholm). A distributed lag nonlinear model was used to estimate the association of daily maximum temperature and daily YLL, lagged 0-14 d. The reference value was set for each site at the temperature with the lowest YLL.

    RESULTS: Generally, YLL increased with higher temperature, starting day 0. In Nouna, the hottest location, with a minimum YLL temperature at the first percentile, YLL increased consistently with higher temperatures. In Vadu, YLL increased in association with heat, whereas in Nairobi, YLL increased in association with both low and high temperatures. Associations with cold and heat were evident for Phoenix (stronger for heat), Stockholm, and Philadelphia (both stronger for cold). Patterns of associations with mortality were generally similar to those with YLL.

    CONCLUSIONS: Both high and low temperatures are associated with YLL in high-, middle-, and low-income countries. Policy guidance and health adaptation measures might be improved with more comprehensive indicators of the health burden of high and low temperatures such as YLL.

  • 16.
    Preet, Raman
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Nilsson, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Evengård, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    The gender perspective in climate change and global health2010Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 3, s. 5720-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Despite recognizing the differential effects of climate change on health of women and men as a consequence of complex social contexts and adaptive capacities, the study finds gender to be an underrepresented or non-existing variable both in research and studied policy documents in the field of climate change and health.

  • 17.
    Rocklöv, Joacim
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Edvinsson, Sören
    Umeå universitet, Samhällsvetenskapliga fakulteten, Centrum för befolkningsstudier (CBS). Umeå universitet, Samhällsvetenskapliga fakulteten, Demografiska databasen.
    Arnqvist, Per
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Sjöstedt de Luna, Sara
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Association of seasonal climate variability and age-specific mortality in northern Sweden before the onset of industrialization2014Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 11, nr 7, s. 6940-6954Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND AND AIMS: Little is known about health impacts of climate in pre-industrial societies. We used historical data to investigate the association of temperature and precipitation with total and age-specific mortality in Skellefteå, northern Sweden, between 1749 and 1859.

    METHODS: We retrieved digitized aggregated population data of the Skellefteå parish, and monthly temperature and precipitation measures. A generalized linear model was established for year to year variability in deaths by annual and seasonal average temperature and cumulative precipitation using a negative binomial function, accounting for long-term trends in population size. The final full model included temperature and precipitation of all four seasons simultaneously. Relative risks (RR) with 95% confidence intervals (CI) were calculated for total, sex- and age-specific mortality.

    RESULTS: In the full model, only autumn precipitation proved statistically significant (RR 1.02; CI 1.00-1.03, per 1cm increase of autumn precipitation), while winter temperature (RR 0.98; CI 0.95-1.00, per 1 °C increase in temperature) and spring precipitation (RR 0.98; CI 0.97-1.00 per 1 cm increase in precipitation) approached significance. Similar effects were observed for men and women. The impact of climate variability on mortality was strongest in children aged 3-9, and partly also in older children. Infants, on the other hand, appeared to be less affected by unfavourable climate conditions.

    CONCLUSIONS: In this pre-industrial rural region in northern Sweden, higher levels of rain during the autumn increased the annual number of deaths. Harvest quality might be one critical factor in the causal pathway, affecting nutritional status and susceptibility to infectious diseases. Autumn rain probably also contributed to the spread of air-borne diseases in crowded living conditions. Children beyond infancy appeared most vulnerable to climate impacts.

  • 18. Roda Gracia, J
    et al.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Centrum för befolkningsstudier (CBS).
    Seidler, A
    Climate Variability and the Occurrence of Human Puumala Hantavirus Infections in Europe: A Systematic Review2015Ingår i: Zoonoses and Public Health, ISSN 1863-1959, E-ISSN 1863-2378, Vol. 62, nr 6, s. 465-478Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Hantaviruses are distributed worldwide and are transmitted by rodents. In Europe, the infection usually manifests as a mild form of haemorrhagic fever with renal syndrome (HFRS) known as nephropathia epidemica (NE), which is triggered by the virus species Puumala. Its host is the bank vole (Myodes glareolus). In the context of climate change, interest in the role of climatic factors for the disease has increased. A systematic review was conducted to investigate the association between climate variability and the occurrence of human Puumala hantavirus infections in Europe. We performed a literature search in the databases MEDLINE, EMBASE and Web of Science. Studies that investigated Puumala virus infection and climatic factors in any European country with a minimum collection period of 2 years were included. The selection of abstracts and the evaluation of included studies were performed by two independent reviewers. A total of 434 titles were identified in the databases, of which nine studies fulfilled the inclusion criteria. The majority of studies were conducted in central Europe (Belgium, France and Germany), while only two came from the north (Sweden) and one from the south (Bosnia). Strong evidence was found for a positive association between temperature and NE incidence in central Europe, while the evidence for northern Europe so far appears insufficient. Results regarding precipitation were contradictory. Overall, the complex relationships between climate and hantavirus infections need further exploration to identify specific health risks and initiate appropriate intervention measures in the context of climate change.

  • 19.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Climate change in Lapland and its role in the health of the elderly and rural populations2016Ingår i: Ageing, wellbeing and climate change in the arctic: an interdisciplinary analysis / [ed] Päivi Naskali, Marjaana Seppänen, Shahnaj Begum, Routledge, 2016, s. 93-109Kapitel i bok, del av antologi (Refereegranskat)
  • 20.
    Schumann, Barbara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Federal Institute for Occupational Safety and Health, Berlin, Germany.
    Bolm-Audorff, Ulrich
    Bergmann, Annekatrin
    Ellegast, Rolf
    Elsner, Gine
    Grifka, Joachim
    Haerting, Johannes
    Jäger, Matthias
    Michaelis, Martina
    Seidler, Andreas
    Lifestyle factors and lumbar disc disease: results of a German multi-center case-control study (EPILIFT).2010Ingår i: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 12, nr 5, s. R193-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: In the large-scale case-control study EPILIFT, we investigated the dose-response relationship between lifestyle factors (weight, smoking amount, cumulative duration of different sports activities) and lumbar disc disease.

    METHODS: In four German study regions (Frankfurt am Main, Freiburg, Halle/Saale, Regensburg), 564 male and female patients with lumbar disc herniation and 351 patients with lumbar disc narrowing (chondrosis) aged 25 to 70 years were prospectively recruited. From the regional population registers, 901 population control subjects were randomly selected. In a structured personal interview, we enquired as to body weight at different ages, body height, cumulative smoking amount and cumulative duration of different sports activities. Confounders were selected according to biological plausibility and to the change-in-estimate criterion. Adjusted, gender-stratified odds ratios with 95% confidence intervals were calculated using unconditional logistic regression analysis.

    RESULTS: The results of this case-control study reveal a positive association between weight and lumbar disc herniation as well as lumbar disc narrowing among men and women. A medium amount of pack-years was associated with lumbar disc herniation and narrowing in men and women. A non-significantly lowered risk of lumbar disc disease was found in men with high levels of cumulative body building and strength training.

    CONCLUSIONS: According to our multi-center case-control study, body weight might be related to lumbar disc herniation as well as to lumbar disc narrowing. Further research should clarify the potential protective role of body building or strength training on lumbar disc disease.

  • 21.
    Schumann, Barbara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Centrum för befolkningsstudier (CBS).
    Edvinsson, Sören
    Umeå universitet, Samhällsvetenskapliga fakulteten, Demografiska databasen.
    Evengard, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Infektionssjukdomar.
    Rocklöv, Joacim
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    The influence of seasonal climate variability on mortality in pre-industrial Sweden2013Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 6, s. 1-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Recent studies have shown an association between weather and climatic factors with mortality, cardiovascular and infectious diseases. We used historical data to investigate the impact of seasonal temperature and precipitation on total mortality in Uppsala, Sweden, during the first two stages of the demographic transition, 1749-1859. Design: We retrieved mortality and population numbers of the Uppsala Domkyrka parish from digitised parish records and obtained monthly temperature and precipitation measures recorded in Uppsala during that time. Statistical models were established for year-to-year variability in deaths by annual and seasonal temperature and precipitation, adjusting for longer time trends. In a second step, a model was established for three different periods to study changes in the association of climate variability and mortality over time. Relative risks (RR) with 95% confidence intervals (CI) were calculated. Results: Precipitation during spring and autumn was significantly associated with annual mortality (spring RR 0.982, CI 0.965-1.000; autumn RR 1.018, CI 1.004-1.032, respectively, per centimetre increase of precipitation). Higher springtime temperature decreased annual mortality, while higher summer temperature increased the death toll; however, both were only borderline significant (p = 0.07). The significant effect of springtime precipitation for mortality was present only in the first two periods (1749-1785 and 1786-1824). On the contrary, the overall effect of autumn precipitation was mainly due to its relevance during the last period, 1825-1859 (RR 1.024, CI 0.997-1.052). At that time, higher winter precipitation was found to decrease mortality. Conclusions: In urban Uppsala, during the 18th and 19th century, precipitation appeared to be a stronger predictor for mortality than temperature. Higher spring precipitation decreased and higher autumn precipitation increased the number of deaths. However, this association differed before and during the early stages of industrialisation. Further research shall take age-specific differences into account, as well as changes in socio-economic conditions during that time.

  • 22.
    Schumann, Barbara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Kinsman, John
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Lindvall, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    ClimRef project – Resilient public health in the context of large-scale, drought-related migration in East Africa: Knowledge status and knowledge needs: Ethiopia country report2018Rapport (Övrigt vetenskapligt)
  • 23.
    Schumann, Barbara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Kinsman, John
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Lindvall, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    ClimRef project – Resilient public health in the context of large-scale, drought-related migration in East Africa: Knowledge status and knowledge needs: Kenya country report2018Rapport (Övrigt vetenskapligt)
  • 24.
    Schumann, Barbara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Kinsman, John
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Lindvall, Kristina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    ClimRef project – Resilient public health in the context of large-scale, drought-related migration in East Africa: Knowledge status and knowledge needs: Somalia country report2018Rapport (Övrigt vetenskapligt)
  • 25.
    Schumann, Barbara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Kluttig, Alexander
    Tiller, Daniel
    Werdan, Karl
    Haerting, Johannes
    Greiser, Karin H
    Association of childhood and adult socioeconomic indicators with cardiovascular risk factors and its modification by age: the CARLA Study 2002-20062011Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, s. 289-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population.

    METHODS: Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term.

    RESULTS: In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking.

    CONCLUSIONS: We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects.

  • 26.
    Schumann, Barbara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Seidler, A
    Kluttig, A
    Werdan, K
    Haerting, J
    Greiser, KH
    Association of occupation with prevalent hypertension in an elderly East German population: an exploratory cross-sectional analysis2011Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 84, s. 361-369Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 27.
    Sewe, Maquins
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Bunker, A
    Ingole, Vijendra
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Egondi, Thaddaeus
    Åström, D
    Hondula, D
    Rocklöv, Joacim
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Impact of temperture on years of life lost in high, middle, and low-income settings - a multi-site study across four continentsArtikel i tidskrift (Refereegranskat)
  • 28.
    Trang, Phan Minh
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Rocklöv, Joacim
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Schröders, Julia
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Nilsson, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    The influence of heatwaves on mental and behavioral disorders: A systematic review and meta-analysisArtikel i tidskrift (Refereegranskat)
  • 29.
    Åström, Daniel Oudin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Centre for Primary Health Care Research, Department of Clinical Science, Malmö, Lund University, Lund.
    Edvinsson, Sören
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Hondula, Daniel
    Rocklöv, Joacim
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Schumann, Barbara
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    On the association between weather variability and total and cause-specific mortality before and during industrialization in Sweden2016Ingår i: Demographic Research, ISSN 1435-9871, Vol. 35, s. 991-1009Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: While there is ample evidence for health risks associated with heat and other extreme weather events today, little is known about the impact of weather patterns on population health in preindustrial societies.

    OBJECTIVE: To investigate the impact of weather patterns on population health in Sweden before and during industrialization.

    METHODS: We obtained records of monthly mortality and of monthly mean temperatures and precipitation for Skelleftea parish, northern Sweden, for the period 1800-1950. The associations between monthly total mortality, as well as monthly mortality due to infectious and cardiovascular diseases, and monthly mean temperature and cumulative precipitation were modelled using a time series approach for three separate periods, 1800-1859, 1860-1909, and 1910-1950.

    RESULTS: We found higher temperatures and higher amounts of precipitation to be associated with lower mortality both in the medium term (same month and two-months lag) and in the long run (lag of six months up to a year). Similar patterns were found for mortality due to infectious and cardiovascular diseases. Furthermore, the effect of temperature and precipitation decreased over time.

    CONCLUSIONS: Higher temperature and precipitation amounts were associated with reduced death counts with a lag of up to 12 months. The decreased effect over time may be due to improvements in nutritional status, decreased infant deaths, and other changes in society that occurred in the course of the demographic and epidemiological transition.

    CONTRIBUTION: The study contributes to a better understanding of the complex relationship between weather and mortality and, in particular, historical weather-related mortality.

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