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  • 1.
    Andersson, Chris D
    et al.
    Linköpings universitetssjukhus, Dermatologi.
    Meding, Birgitta
    Karolinska Institutet, Inst för miljömedicin.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Svensson, Åke
    Malmö Allmänna Sjukhus.
    Working with Population to Treat Individuals: A Report from the Swedish Dermato-Epidemiological Network (SweDEN)2012In: Forum for Nordic Dermato-Venereology, ISSN 1402-2915, Vol. 17, no 2, p. 44-46Article in journal (Refereed)
  • 2.
    Andersson, Chris D.
    et al.
    Linköping University Hospital.
    Meding, Birgitta
    Karolinska Institutet.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Svensson, Åke
    Malmö University Hospital.
    Working with Populations to Treat Individuals: A Report from the Swedish Dermato-Epidemiological Network (SweDEN)2012In: Forum for Nordic Dermato-Venerology, Vol. 17, no 2, p. 44-46Article in journal (Refereed)
  • 3.
    Andersson, Linus
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Claesson, Anna-Sara
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nyberg, Lars
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Brain responses to olfactory and trigeminal exposure in idiopathic environmental illness (IEI) attributed to smells: An fMRI study2014In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 77, no 5, p. 401-408Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Idiopathic environmental intolerance (IEI) to smells is a prevalent medically unexplained illness. Sufferers attribute severe symptoms to low doses of non-toxic chemicals. Despite the label, IEI is not characterized by acute chemical senses. Theoretical models suggest that sensitized responses in the limbic system of the brain constitute an important mechanism behind the symptoms. The aim was to investigate whether and how brain reactions to low-levels of olfactory and trigeminal stimuli differ in individuals with and without IEI. METHODS: Brain responses to intranasally delivered isoamyl acetate and carbon dioxide were assessed in 25 women with IEI and 26 non-ill controls using functional magnetic resonance imaging. RESULTS: The IEI group had higher blood-oxygenated-level-dependent (BOLD) signal than controls in the thalamus and a number of, mainly, parietal areas, and lower BOLD signal in the superior frontal gyrus. The IEI group did not rate the exposures as more intense than the control group did, and there were no BOLD signal differences between groups in the piriform cortex or olfactory regions of the orbitofrontal cortex. CONCLUSIONS: The IEI reactions were not characterized by hyper-responsiveness in sensory areas. The results can be interpreted as a limbic hyperreactivity and speculatively as an inability to inhibit salient extemal stimuli.

  • 4.
    Bergdahl, Jan
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Dermatology and Venerology.
    Eriksson, N
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Lindén, G
    Widman, L
    Coping and self-image in patients with visual display terminal-related skin symptoms and perceived hypersensitivity to electricity2004In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 77, no 8, p. 538-542Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 5. Bäck, Ove
    et al.
    Blomquist, Hans K Son
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Does vitamin D intake during infancy promote the development of atopic allergy?2009In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 89, no 1, p. 28-32Article in journal (Refereed)
    Abstract [en]

    The active metabolite of vitamin D, 1,25-(OH)2D3, has immunomodulatory properties in addition to its more established action on bone and calcium metabolism. Recently vitamin D has been proposed as one of several environmental factors responsible for the increase in atopic diseases during the last decades. The objective of this study was to determine whether the estimated dose of dietary vitamin D3 during the first year of life is associated with atopic diseases up to the age of 6 years. In a prospective birth cohort study 123 six-year-old children were investigated for the cumulative incidence of atopic dermatitis, allergic rhinitis or asthma by means of a postal questionnaire. Their vitamin D3 intake during infancy was recorded in a previous study and the relationship between lower or higher vitamin D3 intake and atopic illness later in childhood was assessed. Atopic manifestations were more prevalent in the group with higher intake of vitamin D3. Although small, this study supports previous investigations suggesting a role of vitamin D intake during infancy in the development of atopic allergy later in childhood. If these findings are confirmed in prospective controlled clinical trials, prevention through modified vitamin D3 supplementation in infancy could be discussed to reduce the burden of atopic illnesses.

  • 6. Carlsson, A
    et al.
    Gånemo, A
    Anderson, C D
    Meding, Birgitta
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Svensson, Åke
    Scoring of hand eczema: good agreement between patients and dermatological staff2011In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, ISSN 0007-0963, Vol. 165, no 1, p. 123-128Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Assessment of hand eczema in a clinical study has been achieved using a scoring system which documents extent of eczema on different areas of the hand.

    OBJECTIVES: To investigate whether the same scoring system could be used by patients to communicate current status of hand eczema.

    METHODS: In a study of 62 patients (36 women and 26 men, age range 19-75 years), the patient's own assessment was compared with the assessment by a dermatologist and a dermatological nurse. Standardized information was given to the patient and the form was filled in independently by the patient, the nurse and the dermatologist, during the patient's visit to the clinic. Individual area scores were summed to a total score.

    RESULTS: The overall agreement was good, with an interclass correlation (ICC) of 0·61 between patient and dermatologist for the total score. The ICC between nurse and dermatologist was 0·78. Differences between observers were more pronounced for the more severe cases - those with higher numerical scores as assessed by the dermatologist. There was a tendency for women and for patients over the median age of 44 years to set a lower point score than the dermatologist. The concordance of observations from individual anatomical areas was higher for fingertips and nails and lower for the palm and dorsum of the hand.

    CONCLUSIONS: Patients are able to report the extent of hand eczema with good accuracy. Self-assessment protocols for hand eczema may well have a place in the monitoring of hand eczema extent over time.

  • 7. Carlsson, Annica
    et al.
    Svensson, Åke
    Anderson, Chris D
    Baranovskaya, Irina
    Hindsén-Stenström, Monica
    Holt, Ingebjörg
    Meding, Birgitta
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Gånemo, Agneta
    Scoring of hand eczema: good reliability of hand eczema extent score2017In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 97, no 2, p. 193-197Article in journal (Refereed)
    Abstract [en]

    There is good agreement between dermatological staff and patients using the Hand Eczema Extent Score (HEES). The aim of this study was to assess inter- and intra-observer reliability of the HEES in dermatologists and intra-observer reliability of the HEES in patients with hand eczema. Six dermatologists assessed 18 patients twice. Only the hands of the patients were visible to the assessors. Patients performed a self-assessment twice. Inter- and intra-observer reliability was tested with intraclass correlation coefficient (ICC). The mean HEES score for all dermatologists' assessments was 21.0 (range 3.6-46.3). The corresponding mean scores for all patients' own assessments were 24.9 (range 4.0-54.0). Inter-observer reliability in the dermatologists' observations ICC classification was very good, median value 0.82 (range 0.56-0.92). The overall intra-observer reliability for the 6 dermatologists' ICC classification was very good (range 0.88-0.94). Intra-observer reliability in the patients' 2 self-assessments ICC classification was very good (ICC 0.95). In conclusion, HEES is a reliable tool for both dermatologists and patients to grade the extent of hand eczema.

  • 8.
    Edvardsson, Berit
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Bergdahl, Jan
    Umeå University, Faculty of Social Sciences, Department of Psychology. Institute of Clinical Dentistry, University of Tromsø, Tromsø, Norway.
    Eriksson, N
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Coping and Self-image in Patients With Symptoms Attributed to Indoor Environment2013In: Archives of Environmental & Occupational Health, ISSN 1933-8244, E-ISSN 2154-4700, Vol. 68, no 3, p. 145-152Article in journal (Refereed)
    Abstract [en]

    This study investigated self-image and coping ability in a group of patients with symptoms from indoor environment. A follow-up questionnaire was sent to 239 patients previously referred with nonspecific building-related symptoms at University Hospital in Umeå, Sweden. One hundred seventy-four women and 14 men answered and the patient group rated their self-image as more spontaneous, more positive, and less negative than a control group. The patient group rated higher on the cognitive scale in the Coping Resources Inventory (CRI) than the control group. The female patients had an increased risk of not being able to work associated with a low score on negative self-image. The authors conclude that certain personality traits may be potential risk factors that increase the probability of encountering and experiencing stressful work situations. The resulting stress may increase workers' susceptibility to indoor environment exposure.

  • 9.
    Edvardsson, Berit
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Bergdahl, Jan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Eriksson, N
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Lindén, G
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Widman, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Medical and social prognoses of non-specific building-related symptoms (Sick Building Syndrome): a follow-up study of patients previously referred to hospital2008In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 81, no 7, p. 805-812Article in journal (Refereed)
    Abstract [en]

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

  • 10.
    Edvardsson, Berit
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Bergdahl, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Eriksson, Nils
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Linden, G
    Widman, L
    The medical and social prognosis of Sick Building Syndrome: a follow-up study focusing on female patients2005In: Indoor air 2005: proceedings of the 10th international conference on indoor air quality and climate, vols 1-5 / [ed] Yang, X; Zhao, B; Zhao, R, Beijing: Tsinghua university press , 2005, p. 3706-3710Conference paper (Refereed)
    Abstract [en]

    A follow-up questionnaire focusing medical and social status, actions taken and personality traits was sent to 239 patients with Sick Building Syndrome (SBS) registered at the University Hospital in Umea, Sweden. The response rate was 79 percent. As females constituted 92 percent of the respondents all statistical analyses were restricted to women. Almost half of the respondents had been exposed to environments with visible water damages. Fatigue, irritated eyes and facial erythema were the most common symptoms. Nearly half of the patients claimed that the symptoms were more or less unchanged after 7 years or more. Twenty-five percent of the patients were on the sick-list and twenty percent drew disability pension due to SBS-symptoms at follow-up. Symptoms were often aggravated in different situations in everyday life. No important deviations concerning personality factors were found. The results support that early and comprehensive measures for rehabilitation are essential for these patients.

  • 11. Ekelund, Mats
    et al.
    Mallbris, Lotus
    Qvitzau, Susanne
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    A Higher Score on the Dermatology Life Quality Index, Being on Systemic Treatment and Having a Diagnosis of Psoriatic Arthritis is Associated with Increased Costs in Patients with Plaque Psoriasis2013In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 93, no 6, p. 684-688Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine the relationship between measures of disease severity and costs from a socie-tal perspective in patients with plaque psoriasis. Dermatologists in Sweden recruited 443 consecutive patients who had had no biological treatment during the past 12 months. Following a Psoriasis Area and Severity Index (PASI) assessment, subjects completed self-assessments on health status/quality of life and a healthcare resource utilization/work status questionnaire. The costs of healthcare resources and sick-leave due to plaque psoriasis were estimated and related to the subject's health status. A patient's Dermatology Life Quality Index (DLQI) and being on systemic therapy, or having diagnosis of psoriatic arthritis, appeared to be more strongly associated with direct and indirect costs than did their PASI. The cost of biological therapy should be considered from the perspective of the already high costs of patients with high DLQI undergoing traditional systemic treatment.

  • 12. Engfeldt, Malin
    et al.
    Bråred-Christensson, Johanna
    Isaksson, Marlene
    Matura, Mihály
    Ryberg, Kristina
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Svedman, Cecilia
    Bruze, Magnus
    Swedish Experiences From Patch-testing Methylisothiazolinone Separately2015In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 95, no 6, p. 717-719Article in journal (Refereed)
    Abstract [en]

    The preservative methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is a well-known sensitiser and present in the Swedish baseline series since the 1980s. The proportions of MCI/MI are 3:1. MI alone has been used as a preservative since less than 10 years. This study was conducted on behalf of the Swedish Contact Dermatitis Research Group to evaluate inclusion of MI in the Swedish baseline series since the preparation of MCI/MI might fail to detect contact-allergic reactions to MI alone. Patients with suspected allergic contact dermatitis at 5 Swedish dermatology departments were consecutively patch-tested with MI 2,000 ppm aq and MCI/MI 200 ppm aq. The number of cases with exclusive contact allergy to MI varied between 0.8-4.2%. In total, 1.9% reacted exclusively to MI and not to MCI/MI. Due to the considerable frequency of contact allergy to MI not traced by MCI/MI, MI 2,000 ppm aq is included in the Swedish baseline series from January 2014. This corresponds to a dose of 60 mu g/cm(2).

  • 13. Engfeldt, Malin
    et al.
    Hagvall, Lina
    Isaksson, Marlene
    Matura, Mihaly
    Mowitz, Martin
    Ryberg, Kristina
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Svedman, Cecilia
    Bruze, Magnus
    Patch testing with hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) - a multicentre study of the Swedish Contact Dermatitis Research Group2017In: Contact Dermatitis, ISSN 0105-1873, E-ISSN 1600-0536, Vol. 76, no 1, p. 34-39Article in journal (Refereed)
    Abstract [en]

    Background. In 2014, the fragrance hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) was excluded from the Swedish baseline series. Objectives. To study (i) whether fragrance mix (FM) II with 5% HICC detects more positive reactions than usual FM II with 2.5% HICC, and (ii) the reproducibility of patch testing with HICC. Methods. Two thousand one hundred and eighteen dermatitis patients at five Swedish dermatology departments were consecutively tested with FM II 14% pet., FM II 16.5% pet., and duplicate preparations of HICC 5% pet. Results. Of the patients, 3.2% reacted to FMII 14%, and 1.5% reacted to HICC. Separate testing with HICC detected 0.3% reactions without concomitant reactivity to FM II. FM II with 5% HICC did not give rise to more irritant reactions or signs of active sensitization than FM II with 2.5% HICC. Patch testing with duplicate applications of HICC increased the overall prevalence of HICC contact allergy to 1.9%. Conclusion. FMII with5% HICC does not detect more positive reactions than FMII with 2.5% HICC. Separate testing with HICC does not detect a sufficient proportion of patients who react only to HICC, without concomitant reactions to FMII, to warrant its inclusion in a baseline series.

  • 14. Engfeldt, Malin
    et al.
    Isaksson, Marléne
    Glas, Bo
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Hagvall, Lina
    Löfnertz Petersson, Anna
    Matura, Mihály
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Svedman, Cecilia
    Bruze, Magnus
    Patch Testing with a New Composition of Mercapto Mix: A Multi-centre Study by the Swedish Contact Dermatitis Research Group2019In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 99, no 11, p. 960-963Article in journal (Refereed)
    Abstract [en]

    This study investigated whether more patients with contact allergies were detected by patch testing with mercapto mix with a higher concentration of 2-mercaptobenzothiazolinone (MBT) than the commonly used mercapto mix. A total of 3,143 dermatitis patients in 5 Swedish dermatology departments were patch-tested with 3 mercapto test preparations: MBT 2.0% petrolatum (pet.); mercapto mix 2.0% pet.; and mercapto mix 3.5% pet. Positive reactions to these mercapto mixes varied between 0-0.50%, 0-0.93%, and 0-1.4%, respectively, in the 5 centres. Numerically, mercapto mix 3.5% pet. detected all positive patients and more patch-test positive patients than did the 2 other substances, but the difference was not statistically significant. The authors recommend replacing mercapto mix 2.0% pet. in the Swedish baseline series with mercapto mix 3.5% pet., since the latter also detected those patients who would have been missed because MBT 2.0% is not included in the Swedish baseline series.

  • 15.
    Eriksson, Nils M
    et al.
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Dermatology and Venerology.
    Baseline prevalence of symptoms related to indoor environment.2006In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 34, no 4, p. 387-396Article in journal (Refereed)
  • 16. Fall, Sofia
    et al.
    Bruze, Magnus
    Isaksson, Marlene
    Liden, Carola
    Matura, Mihaly
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Lindberg, Magnus
    Contact allergy trends in Sweden - a retrospective comparison of patch test data from 1992, 2000, and 20092015In: Contact Dermatitis, ISSN 0105-1873, E-ISSN 1600-0536, Vol. 72, no 5, p. 297-304Article in journal (Refereed)
    Abstract [en]

    Background. Contact allergy prevalence rates change over time as a result of variations in allergen exposure. Data from patch test clinics are often used as markers for allergy trends.

    Objectives. The aim of the present retrospective study was to describe trends in rates of sensitization to allergens in the Swedish baseline series. Patients/materials/methods. Prevalence rates are described by comparing consecutive patch test data from 1992, 2000 and 2009 in Swedish patch test clinics. In total, 3680 patients were included in 1992, 3825 in 2000, and 3112 in 2009.

    Results. Among test substances with a sensitization rate above 2% in 2009, significant decreases were noted for nickel sulfate, cobalt chloride, colophonium, and methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI), and a significant increase for p-phenylenediamine, as compared with 1992. Potassium dichromate reactions had increased among younger women, whereas reactions to nickel and cobalt had decreased in this group. Sensitization to chromium, cobalt and fragrance mix I had decreased among older men, and sensitization to nickel had decreased among younger men.

    Conclusions. It is probable that these changes in 1992-2009 reflect both changes in regulations for nickel, lower levels of chromium in cement and of MCI/MI in cosmetics, and increasing use of hair dyes.

  • 17. Flytström, I
    et al.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Svensson, A
    Bergbrant, I-M
    Methotrexate vs. ciclosporin in psoriasis: effectiveness, quality of life and safety. A randomized controlled trial.2007In: Br J Dermatol, ISSN 0007-0963Article in journal (Refereed)
  • 18. Flytström, Ingela
    et al.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Svensson, Åke
    Bergbrant, Ing-Marie
    Patients' visual analogue scale: a useful method for assessing psoriasis severity2012In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 92, no 4, p. 347-348Article in journal (Refereed)
  • 19.
    Fors, Ronny
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Persson, Maurits
    Umeå University, Faculty of Medicine, Department of Odontology.
    Bergström, Erik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Stymne, Birgitta
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Lifestyle and nickel allergy in a Swedish adolescent population: effects of piercing, tattooing and orthodontic appliances2012In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 92, no 6, p. 664-668Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to estimate the prevalence of life-style practices in adolescents and their association with nickel allergy. Upper secondary school pupils (n = 4,376; 15-23 years) were patch-tested for nickel aller-gy, follow-ing completion of a questionnaire (answered by 6,095). Almost 86% girls and 21% of boys reported piercing. More girls (6%) than boys (3%) had a tattoo. Twenty-six percent of the girls and 18% of the boys were regular smokers. Vegetarian/vegan diets were reported by 20% of girls and by 6% of boys. Piercing, female gender, and vocational programme increased the risk of nickel allergy, whereas orthodontic appliance treat-ment prior to piercing reduced the risk of nickel allergy. Pupils in vocational programmes had the highest prevalence of nickel allergy. Lifestyle behaviours are interconnected and cluster in subgroups of adolescents. Female sex, piercing and choice of educational programme are prominent lifestyle markers. A trend shift is observed, where more girls than boys report tattooing.

  • 20.
    Fors, Ronny
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Persson, Maurits
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Bergström, Erik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Stymne, Birgitta
    Department of Dermatology, Örebro University Hospital, Örebro .
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Nickel allergy: prevalence in a population of Swedish youths from patch test and questionnaire data2008In: Contact Dermatitis, ISSN 0105-1873, E-ISSN 1600-0536, Vol. 58, no 2, p. 80-87Article in journal (Refereed)
    Abstract [en]

    Background: The prevalence of body piercing and orthodontic treatment has increased during recent decades. Such changes in lifestyle may influence the occurrence of nickel allergy.

    Objectives: The aim of this study was to describe the prevalence of nickel allergy in a Swedish youth population.

    Methods: In a cross-sectional survey, 6095 adolescents answered a questionnaire on their lifestyle and medical history, and 4439 consented to patch testing for contact allergy. Patch test results were adjusted for dropouts by a missing value analysis.

    Results: The prevalence of self-reported dermatitis from contact with metal items was 14.8%. Patch testing showed nickel sensitization in 9.9% of the subjects, and in significantly more girls than boys, 13.3% versus 2.5%, respectively. Taking the dropout into account, the estimated true prevalence of nickel sensitivity evaluated by test reading at D4 is 11.8% in girls and 1.6% in boys.

    Conclusions: The prevalence of nickel sensitization was higher for girls and slightly lower for boys compared with previous Swedish data. Self-reported information on metal dermatitis as an estimate of nickel allergy has low validity. When possible, missing value analysis should be performed to account for dropouts.

  • 21.
    Fors, Ronny
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Ortodontics.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology. Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Persson, Maurits
    Umeå University, Faculty of Medicine, Department of Odontology, Ortodontics.
    Nickel allergy in relation to piercing and orthodontic appliances: a population study2012In: Contact Dermatitis, ISSN 0105-1873, E-ISSN 1600-0536, Vol. 67, no 6, p. 342-350Article in journal (Refereed)
    Abstract [en]

    Background. Studies have shown conflicting results on the association between nickel exposure from orthodontic appliances and nickel sensitization.

    Objectives & Method. In a cross-sectional study, we investigated the association between nickel sensitization and exposure to orthodontic appliances and piercings. 4376 adolescents were patch tested following a questionnaire asking for earlier piercing and orthodontic treatment. Exposure to orthodontic appliances was verified in dental records.

    Results. Questionnaire data demonstrated a reduced risk of nickel sensitization when orthodontic treatment preceded piercing (OR 0.46; CI 0.27–0.78). Data from dental records demonstrated similar results (OR 0.61, CI 0.36–1.02), but statistical significance was lost when adjusting for background factors. Exposure to full, fixed appliances with NiTi-containing alloys (OR 0.31, CI 0.10–0.98) as well as a pooled ‘high nickel-releasing’ appliance group (OR 0.56, CI 0.32–0.97) prior to piercing was associated with a significantly reduced risk of nickel sensitization.

    Conclusion. High nickel-containing orthodontic appliances preceding piercing reduces the risk of nickel sensitization by a factor 1.5–2. The risk reduction is associated with estimated nickel release of the appliance and length of treatment. Sex, age at piercing and number of piercings are also important risk indicators. Research on the role of dental materials in the development of immunological tolerance is needed.

  • 22.
    Glas, Bo
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Levin, Jan-Olof
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Sunesson, Anna-Lena
    Variability of personal chemical exposure in eight office buildings in Sweden2004In: Journal of Exposure Analysis And Environmental Epidemiology, ISSN 1053-4245, E-ISSN 1476-5519, Vol. 14, no Suppl 1, p. S49-S57Article in journal (Refereed)
  • 23.
    Glas, Bo
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Sunesson, Anna-Lena
    A novel approach to evaluation of adsorbents for sampling indoor volatile organic compounds associated with symptom reports2008In: Journal of Environmental Monitoring, ISSN 1464-0325, E-ISSN 1464-0333, Vol. 10, no 11, p. 1297-1303Article in journal (Refereed)
    Abstract [en]

    This article addresses problems that complicate attempts to compare methods when several factors may be associated with an effect, but it is not known which factors are relevant. Chemicals that may contribute to 'sick building syndrome' (SBS), and thus should be sampled in investigations of SBS, are not currently known. A study was undertaken to compare the utility of three adsorbents (Carbopack B, Chromosorb 106 and Tenax TA) for detecting differences in personal chemical exposure to volatile organic compounds in indoor air, between persons with and without SBS symptoms (cases and controls). On the basis of office workers' responses to a questionnaire, 15 cases and 15 controls were chosen. They simultaneously carried diffusive samplers with adsorbents during a week at work, and the acquired samples were analysed by gas chromatography/mass spectrometry (GC/MS). The adsorbents were then compared in terms of their ability to separate cases and controls in partial least square discriminant analysis (PLS-DA) models. This method of comparison takes into account detected differences in chemical exposure between cases and controls measured with the different adsorbents. Tenax TA gave the best PLS-DA models for separating cases and controls, but a combination of measurements with Tenax TA and Carbopack B gave better PLS-DA models than models based on measurements from either adsorbent alone. Adding measurements from Chromosorb 106 did not improve the results.

  • 24.
    Glas, Bo
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Dermatology and Venerology. Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Dermatology and Venerology.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Sunesson, Anna-Lena
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Association of exposure to ozone, formaldehyde, NO2 and terpenes with reported symptoms in office workersArticle in journal (Refereed)
    Abstract [en]

    A number of risk factors for “sick building syndrome” (SBS) are known, including poor ventilation, but the associated substances in the air that are removed by ventilation are unknown. In this study the exposure of office workers to formaldehyde, d-limonene, nitrogen dioxide, ozone and α-pinene at work and at home was measured during a working week. Data on symptoms were obtained by analyzing responses to a questionnaire and participants were divided into cases and controls. We found no significant differences in chemical exposure between cases and controls. However, correlations were found between a number of individual symptoms and exposure to specific substances or combinations of substances.

  • 25.
    Glas, Bo
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sunesson, Anna-Lena
    Exposure to formaldehyde, nitrogen dioxide, ozone, and terpenes among office workers and associations with reported symptoms2015In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 5, p. 613-622Article in journal (Refereed)
    Abstract [en]

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

  • 26.
    Glas, Bo
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Sunesson, Anna-Lena
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Comparison of three adsorbents for diffusive sampling of airborne volatile organic compounds in office environments2005In: Indoor air 2005: proceedings of the 10th international conference on indoor air quality and climate, vols 1-5 / [ed] Yang, X; Zhao, B; Zhao, R, Beijing: Tsinghua university press , 2005, p. 2713-2717Conference paper (Refereed)
    Abstract [en]

    Volatile organic compounds were personally sampled by people classified as cases (people having certain SBS symptoms) and controls, i.e. people not fulfilling the criteria's for cases. The aim of the study was to find out which adsorbent that gave the best separation between SBS cases and controls based on their chemical exposure of VOCs. The statistical method used was partial least squares discriminant analysis (PLS-DA). The adsorbents compared were Carbopack B, Chromosorb 106 and Tenax TA. The study included 30 office workers wearing diffusive samplers during one working week. The samplers were analysed with thermal desorption-GC-MS, and each chromatographic peak was included in the data evaluation. Tenax TA gave the best separation between cases and controls with a Q(2) = 0.434 and R(2)Y = 0.873 for three components. Analyses of samples taken with Carbopack B and Chromosorb 106 showed no ability to discriminate between the two classes.

  • 27. Hagvall, Lina
    et al.
    Bruze, Magnus
    Engfeldt, Malin
    Isaksson, Marléne
    Lindberg, Magnus
    Ryberg, Kristina
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Svedman, Cecilia
    Karlberg, Ann-Therese
    Christensson, Johanna Bråred
    Contact allergy to oxidized geraniol among Swedish dermatitis patients: a multicentre study by the Swedish Contact Dermatitis Research Group2018In: Contact Dermatitis, ISSN 0105-1873, E-ISSN 1600-0536, Vol. 79, no 4, p. 232-238Article in journal (Refereed)
    Abstract [en]

    Background: Geraniol is a widely used fragrance terpene, and is included in fragrance mix I. Geraniol is prone to autoxidation, forming the skin sensitizers geranial, neral, and geraniol-7-hydroperoxide. Oxidized geraniol has previously been patch tested in 1 clinic, giving 1% to 4.6% positive reactions in consecutive patients when tested at 2% to 11%.

    Aim: To compare test reactions to pure and oxidized geraniol, to compare 2 different test concentrations of oxidized geraniol and to investigate the pattern of concomitant reactions to fragrance markers of the baseline series in a multicentre setting.

    Methods: One thousand four hundred and seventy-six consecutive patients referred for patch testing were patch tested with geraniol 6% pet. and oxidized geraniol 6% and 11% pet. Results: Pure geraniol 6% pet., oxidized geraniol 6% pet. and oxidized geraniol 11% pet. gave 1%, 3% and 8% positive patch test reactions and 0.7%, 3% and 5% doubtful reactions, respectively. Approximately 50% of the patients with doubtful reactions to oxidized geraniol 6% pet. had positive reactions to oxidized geraniol 11% pet.

    Conclusions: Oxidized geraniol 11% pet. provides better detection than oxidized geraniol 6% pet. As most patients reacted only to oxidized geraniol, it is important to explore further whether oxidized geraniol should be included in a baseline patch test series.

  • 28. Isaksson, Marléne
    et al.
    Bråred-Christensson, Johanna
    Engfeldt, Malin
    Lindberg, Magnus
    Matura, Mihaly
    Möller, Halvor
    Ryberg, Kristina
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Svedman, Cecilia
    Bruze, Magnus
    Patch testing with formaldehyde 2.0% in parallel with 1.0% by the Swedish Contact Dermatitis Research Group2014In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 94, no 4, p. 408-410Article in journal (Refereed)
    Abstract [en]

    In a multicentre study consecutively patch-tested dermatitis patients were tested simultaneously with 1.0% and 2.0% (w/v) formaldehyde in aqua applied with a micropipette (15 µl) to the filter paper disc in Finn Chambers (0.30 mg/cm2 and 0.60 mg/cm2, respectively). A total of 2,122 dermatitis patients were patch-tested. In all, 77 (3.6%) patients reacted positively to formaldehyde; 37 reacted only to 2.0%, 35 reacted to both concentrations and 5 patients reacted only to 1.0%. Significantly more patients were thus diagnosed with contact allergy to formaldehyde with 2.0% compared to 1.0% (p < 0.001) without causing more irritant reactions. The detected number of isolated allergic reactions to the 2 formaldehyde-releasers in the Swedish baseline series and not to formaldehyde itself raises the question whether quaternium-15 1.0% and diazolidinyl urea 2.0% should be present in the Swedish baseline series.

  • 29. Isaksson, Marléne
    et al.
    Hansson, Christer
    Inerot, Annica
    Lidén, Carola
    Matura, Mihaly
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Möller, Halvor
    Bruze, Magnus
    Multicentre patch testing with compositae mix by the Swedish contact dermatitis research group2011In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 91, no 3, p. 295-298Article in journal (Refereed)
    Abstract [en]

    Sesquiterpene lactone mix detects contact allergy to these compounds present in the plant family Asteraceae. This marker is present in many baseline series. An additional marker is Compositae mix, which is not present in many baseline series. To investigate whether this allergen should be inserted into the Swedish baseline series, sex dermatology centres representing the Swedish Contact Dermatitis Research Group included Compositae mix into their baseline series for 1.5 years. Of 2818 patients tested, 31 (1.1%) reacted to Compositae mix and 26 (0.9%) to Sesquiterpene lactone mix. Active sensitization to Compositae mix was noted in two cases. Only 0.4% of Asteraceae contact allergy cases would have been missed if Compositae mix had not been tested, a frequency too low to merit its inclusion in the baseline series. Due to obvious geographical differences in frequency in frequency of simultaneous allergic reactions to Compositae mix and Sesquiterpene lactone mix, the question as to whether specific baseline series (including Compositae mix or not as a "tail" substance) should be used in the different centres must be addressed. Another option could be to remove Sesquiterpene lactone mix from the baseline series and substitute it with Compositae mix.

  • 30. Isaksson, Marléne
    et al.
    Inerot, Annica
    Lidén, Carola
    Lindberg, Magnus
    Matura, Mihaly
    Möller, Halvor
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Bruze, Magnus
    Multicentre patch testing with fragrance mix II and hydroxyisohexyl 3-cyclohexene carboxaldehyde by the Swedish Contact Dermatitis Research Group2014In: Contact Dermatitis, ISSN 0105-1873, E-ISSN 1600-0536, Vol. 70, no 3, p. 187-189Article in journal (Refereed)
  • 31. Isaksson, Marléne
    et al.
    Inerot, Annica
    Lidén, Carola
    Matura, Mihaly
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Möller, Halvor
    Bruze, Magnus
    Multicentre patch testing with a resol resin based on phenol and formaldehyde2011In: Contact Dermatitis, ISSN 0105-1873, E-ISSN 1600-0536, Vol. 65, no 1, p. 34-37Article in journal (Refereed)
    Abstract [en]

    Background. Contact allergy to phenol-formaldehyde resins (PFRs) based on phenol and formaldehyde is not detected by a p-tertiary-butylphenol-formaldehyde resin (PTBP-FR) included in most baseline patch test series.

    Objectives. To investigate the rate of contact allergy to PFR-2 (a mixture of monomers and dimers from a resol resin based on phenol and formaldehyde) in a Swedish population, and to investigate associated simultaneous allergic reactions.

    Methods. Five centres representing the Swedish Contact Dermatitis Research Group included PFR-2 in their patch test baseline series for a period of 1.5 years.

    Results. Of 2504 patients tested, 27 (1.1%) reacted to PFR-2. Of those 27 individuals, 2 had a positive reaction to formaldehyde and 2 to PTBP-FR. Simultaneous allergic reactions were noted to colophonium in 6, to Myroxylon pereirae in 14, and to fragrance mix I in 15.

    Conclusions. The contact allergy frequency in the tested population (1.1%) merits its inclusion in the Swedish baseline series and possibly also in other baseline series. Simultaneous allergic reactions were noted to colophonium, M. pereirae, and fragrance mix I.

  • 32.
    Johansson, Amanda
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsgren, Sture
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Wilén, Jonna
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Kalezic, Nebojsa
    Sandström, Monica
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    No effect of mobile phone-like RF exposure on patients with atopic dermatitis.2008In: Bioelectromagnetics, ISSN 1521-186X, Vol. 29, no 5, p. 353-362Article in journal (Refereed)
    Abstract [en]

    This study investigates the effect of exposure to a mobile phone-like radiofrequency (RF) electromagnetic field on people with atopic dermatitis (AD). Fifteen subjects with AD were recruited and matched with 15 controls without AD. The subjects were exposed for 30 min to an RF field at 1 W/kg via an indoor base station antenna attached to a 900 MHz GSM mobile phone. Blood samples for ELISA analysis of the concentration of substance P (SP), tumor necrosis factor receptor 1 (TNF R1), and brain derived neurotrophic factor (BDNF) in serum were drawn before and after the provocation (exposure/sham). Baseline heart rate and heart rate variability, local blood flow, and electrodermal activity were also recorded. No significant differences between the subject groups were found for baseline neurophysiological data. The cases displayed a serum concentration of TNF R1 significantly higher than the control subjects and a significantly lower serum concentration of BDNF in the baseline condition. For SP there was no difference between groups. However, no effects related to RF exposure condition were encountered for any of the measured substances. As to symptoms, a possible correlation with exposure could not be evaluated, due to too few symptom reports. The result of the study does not support the hypothesis of an effect of mobile phone-like RF exposure on serum levels of SP, TNF R1, and BDNF in persons with AD.

  • 33.
    Khatami, Alireza
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.
    Emmelin, Maria
    Talaee, Rezvan
    Mohammadi, Akram Miramin
    Aghazadeh, Nessa
    Firooz, Alireza
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Lived experiences of patients suffering from acute Old World cutaneous leishmaniasis: A qualitative content analysis study from Iran2018In: Iranian Journal of Arthropod-Borne Diseases, ISSN 1735-7179, E-ISSN 2008-2517, Vol. 12, no 2, p. 180-195Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to explore the experiences of patients who suffer from acute cutaneous leishmaniasis in Iran, focusing on quality of life.

    Methods: The study was conducted at two different sites in Iran in 2010–2011. Individual in-depth interviews were conducted with six men and six women parasitologically confirmed acute cutaneous leishmaniasis. Interviews were recorded, transcribed verbatim, and translated into English. Qualitative content analysis was used for data analysis.

    Results: The participants, aged 23 to 63yr, had mild to severe disease. Based on the analysis four main themes were developed. "Fearing an agonizing disease" reflects patients' experiences of disease development resulting in sadness and depression, "struggling to cope" and "taking on the blame" both illustrate how patients experience living with the disease, which included both felt and enacted stigma as major social concerns. "Longing for being seen and heard" refers to patients' experiences with healthcare as well as their expectations and demands from communities and healthcare to be involved in closing the knowledge and awareness gap.

    Conclusion: Mental and social dimensions of cutaneous leishmaniasis were complex and adversely affected patients' lives by causing psychological burden and limiting their social interactions. Health authorities have to plan programs to increase the disease awareness to prevent the existing stigma to improve patients' social condition and medical care.

  • 34.
    Khatami, Alireza
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Talaee, Rezvan
    Mohammadi, Akram Miramin
    Aghazadeh, Nessa
    Emmelin, Maria
    Firooz, Alireza
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Development of CL-QoL: A disease-specific instrument for measuring quality of life in adult patients with acute Old World cutaneous leishmaniasisIn: Article in journal (Refereed)
  • 35.
    K:son Blomquist, Hans
    et al.
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    Frängsmyr, Agneta
    Hernell, Olle
    Umeå University, Faculty of Medicine, Clinical Sciences, Paediatrics.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Dermatology and Venerology.
    Bäck, Ove
    Dietary intake of vitamin D during the second half of infancy in Swedish infants2004In: Scandinavian Journal of Food & Nutrition, ISSN 1748-2976, Vol. 48, no 4, p. 173-177Article in journal (Refereed)
  • 36. Lazarevic, Vladimir
    et al.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Markuszewska, Alicja
    Häggroth, Jonas
    [Schnitzler syndrome--unknown, rare but treatable]2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, no 46, p. 3348-51Article in journal (Refereed)
  • 37. Lindberg, Magnus
    et al.
    Edman, Björn
    Fischer, Torkel
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Time trends in Swedish patch test data from 1992 to 2000. A multi-centre study based on age- and sex-adjusted results of the Swedish standard series.2007In: Contact Dermatitis, ISSN 0105-1873, Vol. 56, no 4, p. 205-10Article in journal (Refereed)
  • 38.
    Meding, Birgitta
    et al.
    Karolinska Institutet, institutet flr miljömedicin.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Svensson, Åke
    Skånes universitetssjukhus Malmö.
    Lindberg, Magnus
    Universitetssjukhuset Örebro.
    Handeksem - en folksjukdom som påverkar livskvalitet och arbetsförmåga: önskvärt med tidigare behandling och bättre uppföljning2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, no 4, p. 145-148Article in journal (Other academic)
    Abstract [sv]

    Årsprevalensen av handeksem är 10 procent hos vuxna, och handeksem är vanligare hos kvinnor.

    Handeksem påverkar livskvaliteten funktionellt och mentalt.

    Handeksem medför konsekvenser i både privatlivet och arbetslivet.

    Handeksem får socioekonomiska konsekvenser i form av arbetsbyten, sjukvårdskonsumtion, sjukskrivning och produktionsbortfall.

    Prognosen för handeksem är i dag dålig.

    Behandlingen av handeksem omfattar lokalbehandling, sy­stemisk behandling och fysikalisk ljusbehandling.

    Behov finns av flera kontrollerade, randomiserade och jämförande behandlingsstudier.

    Behov finns av ökad kunskap om och förståelse av tidiga insatser och bättre uppfölj­­ning och information till patienterna.

  • 39. Metsävainio, Ann-Sofie
    et al.
    Utter, Annika
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Dermatology and Venerology.
    Lidén, Carola
    Meding, Birgitta
    Svensson, Ake
    [Skin allergy and hypersensitivity surveyed in a Swedish study]2006In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Lakartidningen, Vol. 103, no 41, p. 3075-3078Article in journal (Refereed)
  • 40. Moberg, C
    et al.
    Meding, B
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Dermatology and Venerology. Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Svensson, A
    Lindberg, M
    Remembering childhood atopic dermatitis as an adult: factors that influence recollection.2006In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 155, no 3, p. 557-60Article in journal (Refereed)
  • 41.
    Mårell, Lena
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Bergdahl, Jan
    Umeå University, Faculty of Social Sciences, Department of Psychology. Department of Clinical Dentistry, University of Tromsø, Tromsø, Norway.
    Tillberg, Anders
    Umeå University, Faculty of Social Sciences, Department of Psychology. Public Dental Health Competence Centre for Northern Norway, Tromsø, Norway.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Berglund, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Psychological symptoms and self-image of patients with complaints attributed to dental restorative materials2019In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 23, no 6, p. 2805-2811Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim was to study self-image and the level of psychological symptoms in patients with symptoms attributed to their dental restorative materials.

    Materials and methods: A questionnaire containing questions regarding dental and medical history was answered by 257 participants, one group with local oral symptoms only (LSO), and one group with multi-symptoms (M-S). A reference group was randomly selected from a research database at the Department of Psychology, Umeå University, Sweden. The self-image was assessed using the Structural Analysis of Social Behavior (SASB). Psychological symptoms such as somatization, depression, and anxiety were assessed using the Symptom Check List 90 (SCL-90) and the Global Severity Index (GSI) was used to determine the level of psychological symptoms.

    Results: SASB showed that the M-S group and the LSO-group scored significantly higher on the Bspontaneous^ and Bpositive self-image^ than the reference group. In the SCL-90, the M-S group scored significantly higher than the LSO-group and the references on the somatization subscales. On depression, anxiety, and the GSI scale, the M-S group scored significantly higher than the reference group.

    Conclusions: The two subgroups scored significantly higher on the SASB Spontaneous and Positive clusters which indicates that these patients have an excessively positive self-image, are very spontaneous and have an overconfidence in themselves compared to the reference group. In the M-S group there was a clear tendency to somatization, depression, and anxiety and they were more psychologically stressed than the reference group.

    Clinical relevance: Among the patients with illness attributed to their dental materials, the M-S-patients had a significantly higher level of general psychological distress and somatization than the control group which may lead to mental stress.

  • 42.
    Mörtzell Henriksson, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Newman, E
    Witt, V
    Derfler, K
    Leitner, G
    Eloot, S
    Dhondt, A
    Deeren, D
    Rock, G
    Ptak, J
    Blaha, M
    Lanska, M
    Gasova, Z
    Hrdlickova, R
    Ramlow, W
    Prophet, H
    Liumbruno, G
    Mori, E
    Griskevicius, A
    Audzijoniene, J
    Vrielink, H
    Rombout, S
    Aandahl, A
    Sikole, A
    Tomaz, J
    Lalic, K
    Mazic, S
    Strineholm, V
    Brink, B
    Berlin, G
    Dykes, J
    Toss, F
    Axelsson, C G
    Stegmayr, Bernd
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Nilsson, T
    Norda, R
    Knutson, F
    Ramsauer, Bernd
    Skövde.
    Wahlström, A
    Adverse events in apheresis: an update of the WAA registry data2016In: Transfusion and apheresis science, ISSN 1473-0502, E-ISSN 1878-1683, Vol. 54, no 1, p. 2-15Article, review/survey (Refereed)
    Abstract [en]

    Apheresis with different procedures and devices are used for a variety of indications that may have different adverse events (AEs). The aim of this study was to clarify the extent and possible reasons of various side effects based on data from a multinational registry. The WAA-apheresis registry data focus on adverse events in a total of 50846 procedures in 7142 patients (42% women). AEs were graded as mild, moderate (need for medication), severe (interruption due to the AE) or death (due to AE). More AEs occurred during the first procedures versus subsequent (8.4 and 5.5%, respectively). AEs were mild in 2.4% (due to access 54%, device 7%, hypotension 15%, tingling 8%), moderate in 3% (tingling 58%, urticaria 15%, hypotension 10%, nausea 3%), and severe in 0.4% of procedures (syncope/hypotension 32%, urticaria 17%, chills/fever 8%, arrhythmia/asystole 4.5%, nausea/vomiting 4%). Hypotension was most common if albumin was used as the replacement fluid, and urticaria when plasma was used. Arrhythmia occurred to similar extents when using plasma or albumin as replacement. In 64% of procedures with bronchospasm, plasma was part of the replacement fluid used. Severe AEs are rare. Although most reactions are mild and moderate, several side effects may be critical for the patient. We present side effects in relation to the procedures and suggest that safety is increased by regular vital sign measurements, cardiac monitoring and by having emergency equipment nearby.

  • 43.
    Niklasson, O.
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    The prevalence and characteristics of pruritus in patients with heart failure2015In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 172, no 6, p. 1541-1546Article in journal (Refereed)
    Abstract [en]

    Background Pruritus (itching) can be a distressing symptom, and previous research suggests that it is common in patients with chronic heart failure (CHF).

    Objectives The primary aim was to examine the prevalence of itching in patients with CHF and to compare this first to that among patients with coronary artery disease (CAD) and second to that of a normal Swedish population. The study also explored characteristics and possible causes of pruritus in patients with CHF.

    Methods In this cross-sectional prevalence study, a questionnaire was sent to 130 patients with CHF and to 130 with CAD. A total of 85 patients with CHF (65.4%) and 82 with CAD (63.1%) participated. Data were also compared with those of a previous study examining symptoms in a normal Swedish population.

    Results The prevalence of itching at some point during the last 3 months was 40.0% in patients with CHF and 23.2% in patients with CAD (P = 0.019). This difference was not significant after adjusting for sex, age and medication. Patients with CHF described their pruritus as more disturbing than patients with CAD. In addition, 13.6% of patients with CHF and 3.8% of persons in the normal population experienced itching every week without any rash (P = 0.001).

    Conclusions Pruritus is common and sometimes disturbing in patients with CHF and warrants clinical attention. Medication should be considered as a cause of itching and may explain differences in the prevalence between patients with CHF and those with CAD. However, other causes of itching in patients with CHF should be explored in prospective studies.

  • 44.
    Nordin, Steven
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Palmquist, Eva
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Claeson, Anna-Sara
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    The environmental hypersensitivity symptom inventory: metric properties and normative data from a population-based study2013In: Archives of Public Health, ISSN 0778-7367, E-ISSN 2049-3258, Vol. 71, no 18, p. 1-10Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: High concomitant intolerance attributed to odorous/pungent chemicals, certain buildings, electromagnetic fields (EMF), and everyday sounds calls for a questionnaire instrument that can assess symptom prevalence in various environmental intolerances. The Environmental Hypersensitivity Symptom Inventory (EHSI) was therefore developed and metrically evaluated, and normative data were established. The EHSI consists of 34 symptom items, requires limited time to respond to, and provides a detailed and broad description of the individual's symptomology.

    METHODS: Data from 3406 individuals who took part in the Vasterbotten Environmental Health Study were used. The participants constitute a random sample of inhabitants in the county of Vasterbotten in Sweden, aged 18 to 79 years, stratified for age and gender.

    RESULTS: Exploratory factor analysis identified five significant factors: airway symptoms (9 items; Kuder-Richardson Formula 20 coefficient, KR-20, of internal consistency = 0.74), skin and eye symptoms (6 items; KR-20 = 0.60), cardiac, dizziness and nausea symptoms (4 items; KR-20 = 0.55), head-related and gastrointestinal symptoms (5 items; KR-20 = 0.55), and cognitive and affective symptoms (10 items; KR-20 = 0.80). The KR-20 was 0.85 for the entire 34-item EHSI. Symptom prevalence rates in percentage for having the specific symptoms every week over the preceding three months constitute normative data.

    CONCLUSIONS: The EHSI can be recommended for assessment of symptom prevalence in various types of environmental hypersensitivity, and with the advantage of comparing prevalence rates with normality.

  • 45. Nyrén, Miruna
    et al.
    Lindberg, Magnus
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Dermatology and Venerology.
    Svensson, Margareta
    Svensson, Ake
    Meding, Birgitta
    Influence of childhood atopic dermatitis on future worklife.2005In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 31, no 6, p. 474-478Article in journal (Refereed)
  • 46.
    Palmquist, Eva
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Claeson, Anna-Sara
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Neely, Gregory
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Overlap in prevalence between various types of environmental intolerance2014In: International journal of hygiene and environmental health (Print), ISSN 1438-4639, E-ISSN 1618-131X, Vol. 217, no 4-5, p. 427-434Article in journal (Refereed)
    Abstract [en]

    Environmental intolerance (EI) is characterized by attribution of several, multisystem symptoms to specific environmental exposures, such as exposure to odorous/pungent chemicals, certain buildings, electromagnetic fields (EMFs) and everyday sounds. The symptoms are medically unexplained, non-specific and the symptoms overlap between different types of EI. To approach the issue of underlying mechanisms the matter of overlap in prevalence between intolerances can provide valuable information. The aim of the study was to examine if the overlap between intolerance to odorous/pungent chemicals, certain buildings, EMFs and sounds is larger than the expected overlap if no association would exist between them. The study was using cross-sectional data from the Västerbotten Environmental Health Study in Sweden; a large questionnaire-based survey. 8520 adults (18-79 years) were randomly selected after stratification for age and sex, of whom 3406 (40%) participated. Individuals with the four types of intolerance were identified either through self-report, or by having been physician-diagnosed with a specific EI. The overlaps between the four EIs were greater than predictions based on coincidence for both self-reported and diagnosed cases (except for the overlap between diagnosed intolerance to sounds and EMFs). The results raise the question whether different types of EI share similar underlying mechanisms, or at least that the sufferers of EI share some predisposition to acquire the conditions.

  • 47.
    Palmquist, Eva
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Neely, Gregory
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Who recovers from environmental intolerance?Manuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: Environmental intolerance (EI) is a condition characterized by the attribution of symptoms to, and experience of negative hedonics of certain aspects in the environment (such as odorous/pungent chemicals, everyday sounds, and electromagnetic fields – EMFs). To date few studies have reported the prognosis of EI (i.e. recovery or generalization of a certain EI to an additional EI, thus general EI). Therefore, the purpose of the present study was to assess the chances of recovery from a specific EI as well as the chances of a specific EI to spread into general EI during a six-year period. The study also aimed to investigate whether levels of stress, burnout, anxiety, depression and emotional/behavioral disturbance of environmental sources could predict recovery from a specific EI.

    Methods: Longitudinal data were used (three data-collection waves - T1: 2010, T2: 2013, T3: 2016) from the Västerbotten Environmental Health Study in Sweden. At T1, 539 participants reported a specific EI, constituting the sample. Two different probability calculations were used to estimate the chances of recovering from a specific EI or to develop general EI. The first calculation considered only those individuals who responded to the questionnaire at all three data-collection waves. The second calculation was based on the Chapman-Kolmogorov equation to calculate the 2-step transition probabilities, including all participants from T1. Multinomial logistic regression was used to test whether burnout (Shirom Melamed Burnout Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale), perceived stress (Perceived Stress Scale-10) and emotional and behavioral disturbance by environmental sources (Chemical Sensitivity Scale for Sensory Hyperreactivity, Electromagnetic Field Sensitivity Scale-11, and Noise Sensitivity Scale-11) were predictors of recovering from EI or spreading into general EI.

    Results: The probability of recovering from EI was 44.3% according to the probability calculation based on the participants that remained in the study at T3. The probability of specific EI spreading into general EI was 12.8%. Based on the Chapman-Kolmogorov equation, 34.6% recovered and 10.0% reported general EI. The only significant predictor of recovery found in this study was CSS-SHR, in which one step increase of the scale reduced the odds of recovering by 0.94 times.

    Conclusion: The results indicate that the prognosis for EI is fairly good and that low emotional and behavioral disruption by environmental exposure increases the odds of recovering.

  • 48.
    Palmquist, Eva
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Neely, Gregory
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Coping and social support in environmental intoleranceManuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: Environmental intolerance (EI) is a broad term encompassing several conditions characterized by unspecific symptom patterns attributed to certain environmental exposure, such as odorous/pungent chemicals, electromagnetic fields (EMFs) and sounds. Limited documentation of the role of coping strategies and social support in these EIs motivated the present study of (i) combinations of coping strategies and social support in high and low intolerance severity at baseline, and (ii) combinations of coping strategies and social support at baseline that are associated with recovery from EI at follow-up, three years later.

    Methods: The study used cross-sectional and longitudinal data from the Västerbotten Environmental Health Study in Sweden, which is a large questionnaire-based survey. Individuals with EI attributed to chemicals, EMFs or sounds were identified through self-report (n=301 at baseline, n=213 at follow-up). The extent of use of four problem- and four emotion-focused strategies were assessed as well as perceived emotional, instrumental and informative support from seven sources.

    Results: The low and high intolerance severity groups differed as a function of relatively high problem-focused coping and instrumental support compared to lower reported levels of informational support, emotion-focused coping and emotional support. The groups not recovering and recovering from EI differed as a function of relatively high instrumental support and problem-focused coping compared to lower reported levels of informational support, emotional support and emotion-focused coping.

    Conclusions: The combination of coping strategies and perceived social support seem to be important in recovering from EI, for which emotion-focused coping, emotional and informational support seem to enhance recovery.

  • 49.
    Palmquist, Eva
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Neely, Gregory
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Environmental intolerance and mental ill-health: which comes first?Manuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: Environmental intolerance (EI) is a broad term encompassing several conditions characterized by unspecific symptom patterns attributed to certain environmental exposure. EI has previously been associated with mental ill-health, but prospective studies (enabling the direction of causality) within the field are sparse. This motivated the present study of testing whether (i) burnout, anxiety, depression and perceived stress are predictors of EI attributed to chemicals, certain buildings or sounds, and (ii) EI attributed to chemicals, certain buildings or sounds are predictors of burnout, anxiety or depression.

    Methods: The study used longitudinal data from the Västerbotten Environmental Health Study in Sweden, which is a large questionnaire-based survey. Individuals with EI attributed to chemicals, certain buildings or sounds were identified through self-report. Logistic regression was used to test whether burnout (Shirom Melamed Burnout Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale), and perceived stress (Perceived Stress Scale-10) were predictors of EI, and, vice versa, whether EI attributed to chemicals, certain buildings or sounds were predictors of burnout, anxiety and depression. 

    Results: Burnout, anxiety, depression and perceived stress predicted EI attributed to chemicals and sounds, but not EI attributed to certain buildings (after controlling for age, sex, other EIs and asthma). EI attributed to chemicals, certain buildings or sounds were not predictors of burnout, anxiety or depression, except for EI attributed to certain buildings which was a significant predictor of burnout.

    Conclusion: The results provide important information about the cause-effect relations between EIs and mental ill-health, of value for both treatment and preventive healthcare for EI. 

  • 50.
    Pommer, Linda
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Fick, Jerker
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Sundell, J
    Nilsson, C
    Sjöström, Michael
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Andersson, Barbro
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Class separation of buildings with high and low prevalence of SBS by principal component analysis2004In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 14, no 1, p. 16-23Article in journal (Refereed)
    Abstract [en]

    In this study, we were able to separate buildings with high and low prevalence of sick building syndrome (SBS) using principal component analysis. The prevalence of SBS was defined by the presence of at least one typical skin, mucosal and general (headache and fatigue) symptom. Data from the Swedish Office Illness Study describing the presence and level of chemical compounds in outdoor, supply, and room air, respectively, were evaluated together with information about the buildings in six models. When all data were included the most complex model was able to separate 71% of the high prevalence buildings from the low prevalence buildings. The most important variable that separates the high prevalence buildings from the low prevalence buildings was a more frequent occurrence or a higher concentration of compounds with shorter retention time in the high prevalence buildings. Elevated relative humidity in supply and room air and higher levels of total volatile organic compounds in outdoor and supply air were more common in high prevalence buildings. Ten building variables also contributed to the separation of the two classes of low and high prevalence buildings.

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