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  • 101.
    Rönmark, E
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Andersson, C
    Nyström, Lennarth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Forsberg, B
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, B
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Lundbäck, B
    Obesity increases the risk of incident asthma among adults.2005Ingår i: Eur Respir J, ISSN 0903-1936, Vol. 25, nr 2, s. 282-8Artikel i tidskrift (Refereegranskat)
  • 102. Samanic, Claudine
    et al.
    Chow, Wong-Ho
    Gridley, Gloria
    Jarvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Fraumeni, Joseph F
    Relation of body mass index to cancer risk in 362,552 Swedish men.2006Ingår i: Cancer Causes Control, ISSN 0957-5243, Vol. 17, nr 7, s. 901-9Artikel i tidskrift (Refereegranskat)
  • 103. Schiöler, Linus
    et al.
    Söderberg, Mia
    Rosengren, Annika
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Torén, Kjell
    Psychosocial work environment and risk of ischemic stroke and coronary heart disease: a prospective longitudinal study of 75 236 construction workers2015Ingår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 41, nr 3, s. 280-287Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 104.
    Stattin, Mikael
    et al.
    Umeå universitet, Samhällsvetenskaplig fakultet, Sociologi.
    Järvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Occupation, work environment, and disability pension: A prospective study of construction workers2005Ingår i: Scand J Public Health, ISSN 1403-4948, Vol. 33, nr 2, s. 84-90Artikel i tidskrift (Refereegranskat)
  • 105. Sundström, Johan
    et al.
    Söderholm, Martin
    Söderberg, Stefan
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Alfredsson, Lars
    Andersson, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Bellocco, Rino
    Björck, Martin
    Broberg, Per
    Eriksson, Maria
    Eriksson, Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Forsberg, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Fransson, Eleonor I
    Giedraitis, Vilmantas
    Theorell-Haglöw, Jenny
    Hallqvist, Johan
    Hansson, Per-Olof
    Heller, Susanne
    Håkansson, Niclas
    Ingelsson, Martin
    Janson, Christer
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Khalili, Payam
    Knutsson, Anders
    Lager, Anton
    Lagerros, Ylva Trolle
    Larsson, Susanna C
    Leander, Karin
    Leppert, Jerzy
    Lind, Lars
    Lindberg, Eva
    Magnusson, Cecilia
    Magnusson, Patrik K E
    Malfert, Mauricio
    Michaëlsson, Karl
    Nilsson, Peter
    Olsson, Håkan
    Pedersen, Nancy L
    Pennlert, Johanna
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Rosenblad, Andreas
    Rosengren, Annika
    Torén, Kjell
    Wanhainen, Anders
    Wolk, Alicja
    Engström, Gunnar
    Svennblad, Bodil
    Wiberg, Bernice
    Risk factors for subarachnoid haemorrhage: a nationwide cohort of 950 000 adults2019Ingår i: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 48, nr 6, s. 2018-2025Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium.

    METHODS: We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries.

    RESULTS: During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4-10.6)/100 000 person-years] in men and 13.8 [(11.4-16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95-2.57) in women and 1.62 (1.47-1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81-0.92) in women and 1.02 (0.96-1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH.

    CONCLUSIONS: The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives.

  • 106. Söderberg, Mia
    et al.
    Mannelqvist, Ruth
    Umeå universitet, Samhällsvetenskapliga fakulteten, Juridiska institutionen.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Schiöler, Linus
    Stattin, Mikael
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Impact of changes in welfare legislation on the incidence of disability pension. A cohort study of construction workers2018Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, artikel-id 1403494818754747Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: Study objectives were to investigate how changes in social insurance legislation influenced the incidence of disability pension.

    METHODS: The study included 295,636 male construction workers who attended health examinations between 1971 and 1993, aged 20-60 years and without previous disability pension. Via the Swedish National Insurance Agency national register we identified 66,046 subjects who were granted disability pension up until 2010. The incidence rates were calculated and stratified according to age and diagnosis.

    RESULTS: The incidence rate of disability pension was fairly stable until the 1990s when large variations occurred, followed by a strong decreasing trend from the early 2000s to 2010. Trends in incidence rates, stratified by age and diagnosis, showed a consistent decrease in cardiovascular disease for all age groups. In subjects aged 30-49 years there was a high peak around 2003 for musculoskeletal diseases and psychiatric diseases. For the age group 50-59 years, musculoskeletal diagnosis, the most common cause of disability pension, had a sharp peak around 1993 and then a decreasing trend. In the 60-64 age group, the incidence rate for psychiatric diagnosis was stable, while incidence rates for musculoskeletal diagnosis varied during the 1990s.

    CONCLUSIONS: There are considerable variations in the incidence rate of disability pension over time, with different patterns depending on age and diagnosis. Changes in social insurance legislation, as well as in administration processes, seem to influence the variation.

  • 107. Söderberg, Mia
    et al.
    Schiöler, Linus
    Stattin, Mikael
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Burdorf, Alex
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Mortality in persons with disability pension due to common mental disorders: A cohort study of Swedish construction workers2019Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: This study investigated mortality in disability pensions due to common mental disorder, and variation over time after first receiving disability pension. Methods: Objectives were explored in 301,863 construction workers (97.2% men) recruited through healthcare examinations from 1971-1993. By linking with the Swedish National Insurance Agency registers, disability pensions until 2014 were identified. Common mental disorder was defined as disability pension diagnosis due to anxiety, stress-related disorders or moderate depression. Mortality was calculated in all-psychiatric diagnosis and diagnostic sub-groups, and compared to persons without disability pensions, using Poisson regression. Additional analyses were stratified by age at follow-up. Results: In total 6030 subjects received disability pensions based on psychiatric diagnoses, and 2624 constituted common mental disorder. Analyses in an all-psychiatric diagnosis displayed increased mortality risks in men (relative risk 3.6; 95% confidence interval 3.3-3.9) and women (relative risk 2.1; 95% confidence interval 1.6-2.6). Common mental disorder was associated with mortality, especially in men (relative risk 2.5; 95% confidence interval 2.2-2.8). Increased relative risks in alcohol and substance abuse were also observed. Results in analyses stratified by age at follow-up displayed persistent high relative risks for mortality in older ages (75-89 years) in men in all-psychiatric disability pensions diagnosis (relative risk 2.8; 95% confidence interval 2.1-3.7) and common mental disorder diagnosis (relative risk 2.6; 95% confidence interval 1.8-3.6), compared to men without disability pensions. Similar results were found in women, but few cases lowered the precision of estimates. Conclusions: This study shows that disability pension based on common mental disorders, often regarded as a 'lighter' psychiatric diagnosis, is a risk for early mortality in construction workers, even several years after first receiving disability pension.

  • 108. Takaro, Tim K
    et al.
    Davis, Devra
    Van Rensburg, Sue Janse
    Arroyo Aguilar, Ruth Sara
    Algranti, Eduardo
    Bailar, John C, III
    Belpoggi, Fiorella
    Berlin, Mathis
    Bhattacharya, Shelley
    Viger, Y V Bonnier
    Brophy, James
    Bustinza, Ray
    Cameron, Robert B
    Dement, John M
    Egilman, David
    Castleman, Barry
    Chaturvedi, Sanjay
    Cherniack, Martin
    Choudhury, Harlal
    Demers, Paul A
    Digangi, Joseph
    Ana Digon, Medica
    Edwards, John G
    Englund, Anders
    Erikson, Björn
    Correa Filho, Heleno Rodrigues
    Franco, Giuliano
    Frank, Arthur L
    Freund, Alice
    Gee, David
    Giordano, Antonio
    Gochfeld, Michael
    Gilberg, Marcel
    Goldsmith, David F
    Goldstein, Bernard D
    Grandjean, Philippe
    Greenberg, Morris
    Gut, Ivan
    Harari, Raul
    Hindry, Marc
    Hogstedt, Christer
    Huff, James
    Infante, Peter F
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Kern, David G
    Keifer, Matthew
    Khatter, Kapil
    Kjuus, Helge
    Keith, Margaret
    Koo, Linda C
    Kumar, Arun
    LaDou, Joseph
    Landrigan, Philip J
    Lemen, Richard A
    Last, John M
    Lee, Christopher W
    Leigh, James
    Levin, Stephen M
    Lippman, Abby
    Aguilar Madrid, Guadalupe
    McCulloch, Jock
    McDiarmid, Melissa A
    Merchant, James A
    Monforton, Celeste
    Morse, Tim
    Muir, David C F
    Mukerjee, Debdas
    Mulloy, Karen B
    Myers, J
    Nuwayhid, Iman
    Orris, Peter
    Ozonoff, David
    Paek, Domyung
    Patra, Manomita
    Pelclova, Daniela
    Pepper, Lew
    Poje, Gerald V
    Rahman, Qamar
    Reyes, Bernardo
    Robinson, Bruce W S
    Rodriguez, Eduardo
    Rose, Cecile
    Rosenman, Kenneth D
    Rosenstock, Linda
    Ruchirawat, Mathuros
    Rydzynski, Konrad
    Schneider, Joachim
    Silverstein, Barbara
    Siqueira, C Eduardo
    Slatin, Craig
    Soffritti, Morando
    Soskoline, Colin
    Sparer, Judy
    Stayner, Leslie Thomas
    Tarkowski, Stanislaw
    Teitelbaum, Daniel Thau
    Tompa, Anna
    Trosic, Ivancica
    Turcotte, Fernand
    Vilela, Rodolfo A G
    Waterman, Yvonne R K
    Watterson, Andrew
    Wegman, David H
    Welch, Laura S
    Woitowitz, Hans-Joachim
    Yanri, Zulmiar
    Zavariz, Cecilia
    Scientists Appeal to Quebec Premier Charest to Stop Exporting Asbestos to the Developing World2010Ingår i: International journal of occupational and environmental health, ISSN 1077-3525, E-ISSN 2049-3967, Vol. 16, nr 2, s. 241-248Artikel i tidskrift (Refereegranskat)
  • 109.
    Tillberg, Anders
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Odontologisk materialvetenskap.
    Järvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Berglund, Anders
    Umeå universitet, Medicinsk fakultet, Odontologi, Tandteknikerprogrammet.
    Risks with dental materials2008Ingår i: Dental Materials, ISSN 0109-5641, E-ISSN 1879-0097, Vol. 24, nr 7, s. 940-943Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Dental materials are among the most used substitutes for biological tissue in the human body. The possible health effects of amalgam have been studied extensively and have sometimes been replaced with other less well-examined materials. The aim was to study the hazards of other dental materials than amalgam. METHODS: Toxicological information was collected from the Swedish Dental Materials Register 2003 (DentMr). The material safety data sheets (MSDS) included in the DentMR was examined regarding the given composition of the products, the occurrence of CAS-numbers and risk and safety phrases of the substances. Furthermore, complementary information about risk and safety phrases for substances with missing information in the MSDS was collected by using two easily available databases. RESULTS: There were 482 products that included 377 substances of which 219 could be identified. Only 26% of 219 substances had risk and safety phrases. However, via the Swedish Chemicals Inspectorate Classification Register and the Sigma-Aldrich product register, risk and safety phrases could be found for 37 substances. A literature search indicated that some of the listed substances had possible hazards, e.g. substances with embryotoxic and neurotoxic potential. SIGNIFICANCE: The information about hazards with dental materials seems insufficiently described in MSDS and there might be materials with side effects unknown to both patients and dental personnel. There is a need for stronger regulation of dental materials, at least substances that the patients will be exposed to for decades.

  • 110. Toren, Kjell
    et al.
    Qvarfordt, Ingemar
    Bergdahl, Ingvar A.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Increased mortality from infectious pneumonia after occupational exposure to inorganic dust, metal fumes and chemicals2011Ingår i: Thorax, ISSN 0040-6376, E-ISSN 1468-3296, Vol. 66, nr 11, s. 992-996Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: There are epidemiological studies indicating that exposure to metal fumes is a risk factor for infectious pneumonia. Whether occupational exposure to other agents, such as inorganic dust or chemicals, also increases the risk for infectious pneumonia is not clear. The aim of the present study was to elucidate whether occupational exposure to respiratory pollutants and irritants increases the risk for infectious pneumonia.

    Design: Prospective cohort study. Setting Swedish male construction workers. Participants 320 143 male construction workers exposed to inorganic dust (asbestos, man-made mineral fibres, dust from cement, concrete and quartz), wood dust, metal fumes and chemicals (organic solvents, diisocyanates and epoxi resins) or unexposed.

    Main outcome measures: The cohort was followed from 1971 to 2003 and the main outcome measures were mortality to infectious pneumonia, lobar pneumonia or pneumococcal pneumonia. RRs were obtained by the person-years method and from Poisson regression models, adjusting for baseline values of age and smoking habits.

    Results: Among men aged 20e64 years there was increased mortality from infectious pneumonias among construction workers exposed to metal fumes (RR 2.31, 95% CI 1.35 to 3.95), inorganic dust (RR 1.87, 95% CI 1.22 to 2.87) and chemicals (RR 1.91, 95% CI 1.37 to 3.22). The mortality was also increased from both lobar pneumonia and pneumococcal pneumonia. Among men aged 65-84 years the occupational exposure to inorganic dust and chemicals was associated with slightly increased mortality from infectious pneumonia. Among groups with mutually exclusive exposures there was increased mortality from infectious pneumonias among construction workers exposed to inorganic dust, but not among those exposed to wood dust or chemicals. There were no cases among workers exposed only to metal fumes.

    Conclusions: Our findings indicate that exposure to inorganic dust increases the mortality from infectious pneumonias, especially lobar pneumonia and pneumococcal pneumonia. The mechanism is unclear, but the effect may be mediated through induced airways inflammation.

  • 111.
    Torén, Kjell
    et al.
    Section of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Andersson, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Olin, Anna-Carin
    Section of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414, SE-405 30, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Blanc, Paul D.
    Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, CA, USA.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Airflow limitation classified with the fixed ratio or the lower limit of normal and cause-specific mortality: a prospective study2018Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 144, s. 36-41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: There is controversy as to whether airflow limitation should be defined as forced expiratory volume in 1 s (FEV1)/vital capacity (VC) < 0.7 or as FEV1/VC< the lower limit of normal (LLN). The aim was to examine whether different definitions of airflow limitation differ in predicting mortality.

    METHODS: Longitudinal prospective study of a national cohort of Swedish workers (199,408 men; 7988 women), aged 20-64 years with spirometry without bronchodilation at baseline followed from 1979 until death, or censorship at 2010. Airflow limitation (AL) by Global Obstructive Lung Disease criteria, ALGOLD, was defined as FEV1/VC < 0.7; ALLLN as FEV1/VC < LLN. All all-cause, COPD and cardiovascular disease mortality was analyzed among men and women in relation to ALGOLD and ALLLN, adjusted for age and smoking.

    RESULTS: Among men, all-cause mortality risks were similar by airflow limitation criteria: ALGOLD RR = 1.32, 95% CI 1.26-1.38; ALLLN, RR = 1.37, 95% CI 1.31-1.44. The risk estimates were also similar by airflow limitation definition for cardiovascular mortality and for COPD mortality. Among women, all-cause mortality was also similar by airflow limitation criteria, but significantly higher as compared to men: ALGOLD RR = 2.10, 95% CI 1.66-2.66; ALLLN, RR = 2.09, 95% CI 1.66-2.62. Also cardiovascular and COPD mortality by airflow limitation criteria was significantly higher among women as compared to men.

    CONCLUSIONS: Defined either as FEV1/VC < 0.7 or as FEV1/VC < LLN, airflow limitation predicted excess mortality risk of similar magnitude. Mortality in relation to airflow limitation was higher among women compared to men.

  • 112. Torén, Kjell
    et al.
    Bergdahl, Ingvar A
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Occupational exposure to particulate air pollution and mortality due to ischaemic heart disease and cerebrovascular disease.2007Ingår i: Occupational and environmental medicine, ISSN 1470-7926, Vol. 64, nr 8, s. 515-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: A growing number of epidemiological studies are showing that ambient exposure to particulate matter air pollution is a risk factor for cardiovascular disease; however, whether occupational exposure increases this risk is not clear. The aim of the present study was to examine whether occupational exposure to particulate air pollution increases the risk for ischaemic heart disease and cerebrovascular disease. METHODS: The study population was a cohort of 176,309 occupationally exposed Swedish male construction workers and 71,778 unexposed male construction workers. The definition of exposure to inorganic dust (asbestos, man-made mineral fibres, dust from cement, concrete and quartz), wood dust, fumes (metal fumes, asphalt fumes and diesel exhaust) and gases and irritants (organic solvents and reactive chemicals) was based on a job-exposure matrix with focus on exposure in the mid-1970s. The cohort was followed from 1971 to 2002 with regard to mortality to ischaemic heart disease and cerebrovascular disease. Relative risks (RR) were obtained by the person-years method and from Poisson regression models adjusting for baseline values of blood pressure, body mass index, age and smoking habits. RESULTS: Any occupational particulate air pollution was associated with an increased risk for ischemic heart disease (RR 1.13, 95% CI 1.07 to 1.19), but there was no increased risk for cerebrovascular disease (RR 0.97, 95% CI 0.88 to 1.07). There was an increased risk for ischaemic heart disease and exposure to inorganic dust (RR 1.07, 95% CI 1.03 to 1.12) and exposure to fumes (RR 1.05, 95% CI 1.00 to 1.10), especially diesel exhaust (RR 1.18, 95% CI 1.13 to 1.24). There was no significantly increased risk for cerebrovascular disease and exposure to inorganic dust, fumes or wood dust. CONCLUSIONS: Occupational exposure to particulate air pollution, especially diesel exhaust, among construction workers increases the risk for ischaemic heart disease.

  • 113. Torén, Kjell
    et al.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Occupational exposure to vapors, gases, dusts and fumes and mortality in relation to chronic obstructive pulmonary disease among Swedish construction workers: a longitudinal cohort study2014Ingår i: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 145, nr 5, s. 992-997Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The aim of the present study was to elucidate whether occupational exposure to vapors, gases, dusts and fumes increases the mortality risk for chronic obstructive pulmonary disease (COPD), especially among never-smokers.

    METHODS: The study population was a cohort of 354,718 male construction workers; of these 196,329 were exposed to vapors, gases, dusts and fumes and 117,964 were unexposed. Exposure to inorganic dust, wood dust, vapors, fumes and gases, and irritants was based on a job-exposure matrix with a focus on exposure in the mid-1970s. The cohort was followed from 1972 to 2011. Relative risks (RR) were obtained using Poisson regression models adjusting for age, body mass index and smoking habits.

    RESULTS: There were 1,085 deaths from COPD among the exposed workers, including 49 never-smokers. Workers with any occupational exposure to vapors, gases, fumes and dust showed an increased mortality due to COPD (RR=1.32, 95% confidence interval (CI) 1.18-1.47). When comparing different exposure groups, there was a significantly increased mortality due to COPD among those exposed to fumes (RR 1.20, 95% CI 1.07-1.36) and inorganic dust (RR 1.19, 95% CI 1.07-1.33) . Among never-smokers, there was high mortality due to COPD among workers with any occupational airborne exposure (RR 2.11, 95% CI 1.17-3.83). The fraction of COPD attributable to occupational exposure was 0.24 among all workers and 0.53 among never-smoking workers.

    CONCLUSIONS: Occupational exposure to airborne pollution increases the mortality risk for COPD, especially among never-smokers.

  • 114.
    Torén, Kjell
    et al.
    Univ Gothenburg, Sect Occupat & Environm Med, Gothenburg, Sweden.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Who is the expert for the evaluation of work ability?2015Ingår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 41, nr 1, s. 102-104Artikel i tidskrift (Refereegranskat)
  • 115. Vaissière, Thomas
    et al.
    Cuenin, Cyrille
    Paliwal, Anupam
    Vineis, Paolo
    Hoek, G
    Krzyzanowski, M
    Airoldi, L
    Dunning, A
    Garte, S
    Hainaut, P
    Malaveille, C
    Overvad, K
    Clavel-Chapelon, F
    Linseisen, J
    Boeing, H
    Trichopoulou, A
    Trichopoulos, D
    Kaladidi, A
    Palli, D
    Krogh, V
    Tumino, R
    Panico, S
    Bueno-De-Mesquita, H B
    Peeters, P H
    Kumle, M
    Gonzalez, C A
    Martinez, C
    Dorronsoro, M
    Barricarte, A
    Navarro, C
    Quiros, J R
    Berglund, G
    Janzon, L
    Jarvholm, B
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Day, N E
    Key, T J
    Saracci, R
    Kaaks, R
    Riboli, E
    Hainaut, Pierre
    Herceg, Zdenko
    Quantitative analysis of DNA methylation after whole bisulfitome amplification of a minute amount of DNA from body fluids.2009Ingår i: Epigenetics : official journal of the DNA Methylation Society, ISSN 1559-2308, Vol. 4, nr 4, s. 221-30Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cell-free circulating DNA isolated from the plasma of individuals with cancer has been shown to harbor cancer-associated changes in DNA methylation, and thus it represents an attractive target for biomarker discovery. However, the reliable detection of DNA methylation changes in body fluids has proven to be technically challenging. Here we describe a novel combination of methods that allows quantitative and sensitive detection of DNA methylation in minute amounts of DNA present in body fluids (quantitative Methylation Analysis of Minute DNA amounts after whole Bisulfitome Amplification, qMAMBA). This method involves genome-wide amplification of bisulphite-modified DNA template followed by quantitative methylation detection using pyrosequencing and allows analysis of multiple genes from a small amount of starting DNA. To validate our method we used qMAMBA assays for four genes and LINE1 repetitive sequences combined with plasma DNA samples as a model system. qMAMBA offered high efficacy in the analysis of methylation levels and patterns in plasma samples with extremely small amounts of DNA and low concentrations of methylated alleles. Therefore, qMAMBA will facilitate methylation studies aiming to discover epigenetic biomarkers, and should prove particularly valuable in profiling a large sample series of body fluids from molecular epidemiology studies as well as in tracking disease in early diagnostics.

  • 116. Vineis, P
    et al.
    Veglia, F
    Garte, S
    Malaveille, C
    Matullo, G
    Dunning, A
    Peluso, M
    Airoldi, L
    Overvad, K
    Raaschou-Nielsen, O
    Clavel-Chapelon, F
    Linseisen, J P
    Kaaks, R
    Boeing, H
    Trichopoulou, A
    Palli, D
    Crosignani, P
    Tumino, R
    Panico, S
    Bueno-De-Mesquita, H B
    Peeters, P H
    Lund, E
    Gonzalez, C A
    Martinez, C
    Dorronsoro, M
    Barricarte, A
    Navarro, C
    Quiros, J R
    Berglund, G
    Jarvholm, B
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Day, N E
    Key, T J
    Saracci, R
    Riboli, E
    Autrup, H
    Genetic susceptibility according to three metabolic pathways in cancers of the lung and bladder and in myeloid leukemias in nonsmokers.2007Ingår i: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 18, nr 7, s. 1230-42Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: We chose a set of candidate single nucleotide polymorphisms (SNPs) to investigate gene-environment interactions in three types of cancer that have been related to air pollution (lung, bladder and myeloid leukemia). PATIENTS AND METHODS: The study has been conducted as a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort (409 cancer cases and 757 matched controls). We included never and ex-smokers. SNPs were in genes involved in oxidative stress, phase I metabolizing genes, phase II metabolizing genes and methylenetetrahydrofolate reductase (MTHFR). RESULTS: The most notable findings are: GSTM1 deletion and bladder cancer risk [odds ratio (OR) = 1.60; 95% confidence interval 1.00-2.56]; CYP1A1 and leukemia (2.22, 1.33-3.70; heterozygotes); CYP1B1 and leukemia (0.47, 0.27-0.84; homozygotes); MnSOD and leukemia (1.91, 1.08-3.38; homozygotes) and NQO1 and lung cancer (8.03, 1.73-37.3; homozygotes). Other statistically significant associations were found in subgroups defined by smoking habits (never or ex-smokers), environmental tobacco smoke or gender, with no obvious pattern. When gene variants were organized according to the three main pathways, the emerging picture was of a strong involvement of combined phase I enzymes in leukemia, with an OR of 5 (1.63-15.4) for those having three or more variant alleles. The association was considerably stronger for leukemias arising before the age of 55.

  • 117.
    Wahlström, Jens
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Johnson, Peter W
    Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Exposure to whole-body vibration and hospitalization due to lumbar disc herniation2018Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, nr 6, s. 689-694Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

  • 118.
    Wahlström, Jens
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Risk factors for hospitalization due to lumbar disc disease2012Ingår i: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 37, nr 15, s. 1334-1339Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study Design. Prospective cohort study

    Objective. To study biomechanical factors in relation to symptomatic lumbar disc disease

    Summary of Background Data. The importance of biomechanical factors in lumbar disc disease have been questioned the past decade and knowledge from large prospective studies is lacking.

    Methods. The study basis is a cohort of 263 529 Swedish construction workers who participated in a national occupational health surveillance programme from 1971 until 1992. The workers' job title, smoking habits, body weight, height and age were registered at the examinations. The occurrence of hospitalization due to lumbar disc disease from January 1 1987 until December 31 2003 was collected from a linkage with the Swedish Hospital Discharge Register.

    Results. There was an increased risk for hospitalization due to lumbar disc disease for several occupational groups compared to white-collar workers and foremen. Occupational groups with high biomechanical loads had the highest risks, e.g the relative risk for concrete workers was 1.55 (95% CI 1.29-1.87). A taller stature was consistently associated with an increased risk. The relative risk for a man of 190-199 cm height was 1.55 (95% CI 1.30-1.86) compared to a man being 170-179 cm. Body weight and smoking were also risk factors, but weaker than height. Workers in the age span of 30-39 had the highest relative risk (RR = 1.87; 95% CI 1.58-2.23) compared to those 20-29, while men 60-65 years old had a lower risk (RR = 0.86; 95%CI 0.68-1.09).

    Conclusions. This study indicates that factors increasing the load on the lumbar spine are associated with hospitalization for lumbar disc disease. Occupational biomechanical factors seem to be important, and a taller stature was consistently associated with an increased risk.

  • 119.
    Ädelroth, Ellinor
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin. Lungmedicin.
    Hedlund, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Blomberg, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin. Lungmedicin.
    Helleday, Ragnberth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin. Lungmedicin.
    Ledin, M-C
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Levin, Jan-Olof
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Pourazar, Jamshid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin. Lungmedicin.
    Sandström, Thomas
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin. Lungmedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Yrkes- och miljömedicin.
    Airway inflammation in iron ore miners exposed to dust and diesel exhaust.2006Ingår i: Eur Respir J, ISSN 0903-1936, Vol. 27, nr 4, s. 714-719Artikel i tidskrift (Refereegranskat)
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