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  • 1151. Zeng, Xiangbin
    et al.
    Jin, Taiyi
    Jiang, Xuezi
    Kong, Qinhu
    Ye, Tingting
    Nordberg, Gunnar F
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Effects on the prostate of environmental cadmium exposure--a cross-sectional population study in China.2004In: Biometals, ISSN 0966-0844, Vol. 17, no 5, p. 559-65Article in journal (Refereed)
  • 1152. Zheng, Guang
    et al.
    Tian, Liting
    Liang, Yihuai
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Broberg, Karin
    Lei, Lijian
    Guo, Weijun
    Nilsson, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Skerfving, Staffan
    Jin, Taiyi
    δ-Aminolevulinic acid dehydratase genotype predicts toxic effects of lead on workers' peripheral nervous system2011In: Neurotoxicology, ISSN 0161-813X, E-ISSN 1872-9711, Vol. 32, no 4, p. 374-382Article in journal (Refereed)
    Abstract [en]

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

  • 1153. Zhu, Guoying
    et al.
    Wang, Hongfu
    Shi, Yongxin
    Weng, Shifang
    Jin, Taiyi
    Kong, Qinghu
    Nordberg, Gunnar F
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Environmental cadmium exposure and forearm bone density.2004In: Biometals, ISSN 0966-0844, Vol. 17, no 5, p. 499-503Article in journal (Refereed)
  • 1154.
    Zingmark, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Nilsson, Ingeborg
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University, Fort Collins, USA.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Occupation-focused health promotion for well older people: a cost-effectiveness analysis2016In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 79, no 3, p. 153-162Article in journal (Refereed)
    Abstract [en]

    Introduction The aim of this study was to evaluate three occupational therapy interventions, focused on supporting continued engagement in occupation among older people, to determine which intervention was most cost effective, evaluated as the incremental cost/quality adjusted life year gained. Method The study was based on an exploratory randomized controlled trial. Participants were 77-82 years, single living and without home help. One hundred and seventy seven persons were randomized to an individual intervention, an activity group, a discussion group or a no intervention control group. All interventions focused on supporting the participants to maintain or improve occupational engagement. Outcomes were evaluated at baseline, three and 12 months and included general health and costs (intervention, municipality and health care). Based on linear regression models, we evaluated how outcomes had changed at each follow-up for each intervention group in relation to the control group. Results Both group interventions resulted in quality adjusted life years gained at three months. A sustained effect on quality adjusted life years gained and lower total costs indicated that the discussion group was the most cost-effective intervention. Conclusion Short-term, occupation-focused occupational therapy intervention delivered in group formats for well older people resulted in quality-adjusted life years gained. A one-session discussion group was most cost effective.

  • 1155.
    Ädelroth, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine. Lungmedicin.
    Hedlund, Ulf
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Blomberg, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine. Lungmedicin.
    Helleday, Ragnberth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine. Lungmedicin.
    Ledin, M-C
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Levin, Jan-Olof
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Pourazar, Jamshid
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine. Lungmedicin.
    Sandström, Thomas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine. Lungmedicin.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Yrkes- och miljömedicin.
    Airway inflammation in iron ore miners exposed to dust and diesel exhaust.2006In: Eur Respir J, ISSN 0903-1936, Vol. 27, no 4, p. 714-719Article in journal (Refereed)
  • 1156.
    Åberg, Annika
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Tysklind, Mats
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Nilsson, Thor
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    MacLeod, Matt
    Hanberg, Annika
    Andersson, Rolf
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Bergek, Sture
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Lindberg, Rickard
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Wiberg, Karin
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Exposure assessment at a PCDD/F contaminated site in Sweden: field measurements of exposure media and serum analysis2010In: Environmental science and pollution research international, ISSN 0944-1344, E-ISSN 1614-7499, Vol. 17, no 1, p. 26-39Article in journal (Refereed)
    Abstract [en]

    BACKGROUND, AIM, AND SCOPE: The main pathway for human exposure to the highly toxic polychlorinated-p-dioxins and polychlorinated furans [polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs)] is via dietary intake. Other exposure pathways may, however, be important in close proximity to point sources, such as wood preservation sites, where PCDD/F contaminated chlorophenols (CP) were previously used. In this study, a heavily PCDD/F contaminated CP saw mill site in Sweden was investigated. Human exposure through a broad spectrum of exposure pathways was assessed. Such studies are in demand since the question whether contaminated sites represent a current or future risk can only be answered by detailed site-specific risk assessments. MATERIALS AND METHODS: Sampling of exposure media (soil, air, groundwater, raspberries, carrots, potatoes, grass, milk, eggs, and chicken fodder) was made. Exposure media concentrations and congener distribution patterns were used to investigate the mobilization of PCDD/Fs from soil to the environment and to calculate exposure levels for adults. Blood serum levels from site-exposed and control individuals were also analyzed. RESULTS: Congener distribution patterns at the site were generally dominated by a specific marker congener (1234678-HpCDF), which is highly abundant in the polluted soil. The dioxin toxic equivalents (TEQ) concentrations were notably elevated as compared to national reference samples for most exposure media, and the marker congener was a major contributor to increased TEQ levels. There were also indications of soil-to-air volatilization of tetra- and penta-CDD/Fs. People who participated in the restoration of a contaminated building showed higher levels of 1234678-HpCDF compared to controls, and calculated exposure levels suggest that several site-specific exposure routes may be of importance for the daily intake of PCDD/F. CONCLUSIONS, RECOMMENDATIONS, AND PERSPECTIVES: Despite low mobility of higher chlorinated PCDD/Fs, these contaminants were transferred from the polluted soil to the surroundings and into human tissue. The extent of increased exposure from contaminated sites depends on the PCDD/F source strength of the soil, composition of the pollution, human activities, and dietary patterns of the residents. Impact from the contaminated soil on other exposure media was seen also for areas with low to moderate soil contamination. In the future, not only the levels of PCDD/F soil pollution but also the composition must be considered in risk assessments of contaminated sites.

  • 1157. Åkerstedt, Torbjörn
    et al.
    Nordin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Alfredsson, Lars
    Westerholm, Peter
    Kecklund, Göran
    Predicting changes in sleep complaints from baseline values and changes in work demands, work control, and work preoccupation - The WOLF-project2012In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 13, no 1, p. 73-80Article in journal (Refereed)
    Abstract [en]

    Study objective: Stress as a cause of disturbed sleep is often taken for granted, but the longitudinal evidence is limited. The aim of this study was to evaluate new cases of poor sleep as a function of changes in reported work demands, work control, and work preoccupation. Methods: Longitudinal study of change with measures occurring twice within a 5-year interval during a period when the prevalence of impaired sleep was increasing in Sweden. The sample of companies was taken from northern Sweden (Norrland) and included 3637 individuals from the "WOLF Norrland" longitudinal cohort, collected through company health services. Measurement and results: During the measurement period, 16% of those studied developed new cases of impaired sleep. Logistic regressions adjusted for demographics, work environment factors, and disturbed sleep at T1 period one showed a significant increase in new cases for high work demands and high work preoccupation (OR = 1.37; Ci = 1.09-1.72 and OR = 1.80; CI = 1.42-2.28, respectively). The analysis of change in the predictors showed effects of a change from low to high work demands (OR = 1.39; Ci = 1.00-1.95) on new cases of impaired sleep. Consistent high work demands (high at both points) showed a similar increase (OR = 1.49; Ci = 1.06-2.11) but no effect was seen for reduced demands. Change in work preoccupation yielded stronger effects with OR = 2.47 (1.78-2.47) for increased work preoccupation and OR = 3.79 (2.70-5.31) for consistent high work preoccupation. Also, a reduction in work preoccupation was associated with a reduction in new cases of disturbed sleep. Control at work was not related to sleep. Stratification with respect to gender mainly led to fewer significant results (particularly for women) due to larger confidence intervals. Conclusions: It was concluded that self-reported work preoccupation predicts subsequent impairment of sleep and that increased preoccupation is associated with new cases of impaired sleep. Similar, but weaker, results were obtained for work demands. (C) 2011 Elsevier B.V. All rights reserved.

  • 1158. Åkerstedt, Torbjörn
    et al.
    Nordin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Alfredsson, Lars
    Westerholm, Peter
    Kecklund, Göran
    Sleep and sleepiness: impact of entering or leaving shiftwork--a prospective study.2010In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 27, no 5, p. 987-996Article in journal (Refereed)
    Abstract [en]

    Very little is known about the effects on sleep and sleepiness of entering or exiting shiftwork. The present study used a longitudinal database (n = 3637). Participants completed a questionnaire on work hours, sleep, and work environment at the start and end of a 5-yr period. Changes in shift/day work status were related to change in a number of subjective sleep variables using logistic regression analysis. The analyses were adjusted for age, sex, and differences in socioeconomic status, work demands, work control, physical workload, marriage status, and number of children. In comparison with constant day work, entering shiftwork (with or without night shifts) from day work increased the risk of difficulties in falling asleep, and leaving shiftwork reduced this risk (odds ratio [OR] = 2.8 [confidence interval, CI = 1.8-4.5]). Also falling asleep at work showed a consistent pattern; an increased risk of falling asleep for those with shiftwork on both occasions, and for those with night work on both occasions. Also entering night work was associated with a strongly increased risk of falling asleep at work (OR = 2.9 [CI = 1.3-6.7]). These results suggest that entering and leaving shiftwork has a considerable impact on sleep and alertness. However, there is a need for large and more extended longitudinal studies to support our findings.

  • 1159.
    Åkesson, Marie-Louise
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Warnberg Gerdin, Elisabeth
    Soderstrom, Ulf
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Health-related quality of life and prospective caries development2016In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 16, article id 15Article in journal (Refereed)
    Abstract [en]

    Background: The present study was conducted to prospectively assess the association between health-related quality of life (HRQoL) and the development of dental caries in adults in northern Sweden. The SF-36 questionnaire was used to estimate HRQoL. Methods: Adults who had (i) participated in a population-based health screening in northern Sweden between 2003 and 2009 and had completed the SF-36 questionnaire, and (ii) received a dental check-up within 1 year (n = 15,615) were included in the study. Of these, 9,838 had a second caries examination 2-7 years after the baseline recording. Information regarding SF-36, lifestyle factors and medical conditions was retrieved by questionnaires, and anthropometric status and blood lipid levels were measured. The association between dental caries (outcome) and SF-36 scores (exposure) with the inclusion of potential confounders was analysed by linear and logistic regression. Results: Caries increment increased significantly with decreasing scores for both physical and mental dimensions of SF-36 in women, but no association was seen in men. However, lifelong caries experience (DMFS) increased linearly with decreasing physical HRQoL in both men and women; this was also observed for the single dimension of mental HRQoL. The crude odds ratio for being in the highest caries quintile compared to the lowest when having the poorest physical HRQoL compared with the best physical HRQoL was 1.88 (95 % CI: 1.54-2.3). Several factors were identified as potential confounders in the associations between DMFS and SF-36 scores, including education level, smoking, age, medications, higher levels of total cholesterol, triglycerides, systolic blood pressure, body mass index and sugar intake. Except for education level and smoking, the effect sizes for the association between gradually decreasing SF-36 scores and increasing caries were generally moderate. Conclusions: Increased development of caries was associated with low physical HRQoL and some aspects of mental HRQoL. The mechanisms underlying these associations, which are likely confounded by both biological and lifestyle factors, remain to be elucidated. The study implies that, when possible, subjects with poor HRQoL would benefit from caries prevention measures meeting the underlying situation.

  • 1160.
    Åstrom, Christofer
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Hales, Simon
    Beguin, Andreas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Louis, Valerie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Sauerborn, Rainer
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Potential Distribution of Dengue Fever Under Scenarios of Climate Change and Economic Development2012In: EcoHealth, ISSN 1612-9202, E-ISSN 1612-9210, Vol. 9, no 4, p. 448-454Article in journal (Refereed)
    Abstract [en]

    Dengue fever is the most important viral vector-borne disease with similar to 50 million cases per year globally. Previous estimates of the potential effect of global climate change on the distribution of vector-borne disease have not incorporated the effect of socioeconomic factors, which may have biased the results. We describe an empirical model of the current geographic distribution of dengue, based on the independent effects of climate and gross domestic product per capita (GDPpc, a proxy for socioeconomic development). We use the model, along with scenario-based projections of future climate, economic development, and population, to estimate populations at risk of dengue in the year 2050. We find that both climate and GDPpc influence the distribution of dengue. If the global climate changes as projected but GDPpc remained constant, the population at risk of dengue is estimated to increase by about 0.28 billion in 2050. However, if both climate and GDPpc change as projected, we estimate a decrease of 0.12 billion in the population at risk of dengue in 2050. Empirically, the geographic distribution of dengue is strongly dependent on both climatic and socioeconomic variables. Under a scenario of constant GDPpc, global climate change results in a modest but important increase in the global population at risk of dengue. Under scenarios of high GDPpc, this adverse effect of climate change is counteracted by the beneficial effect of socioeconomic development.

  • 1161.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindkvist, Markus
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Karlsson, J Stefan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Changes in EMG activity in the upper trapezius muscle due to local vibration exposure.2009In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 19, no 3, p. 407-415Article in journal (Refereed)
    Abstract [en]

    Exposure to vibration is suggested as a risk factor for developing neck and shoulder disorders in working life. Mechanical vibration applied to a muscle belly or a tendon can elicit a reflex muscle contraction, also called tonic vibration reflex, but the mechanisms behind how vibration could cause musculoskeletal disorders has not yet been described. One suggestion has been that the vibration causes muscular fatigue. This study investigates whether vibration exposure changes the development of muscular fatigue in the trapezius muscle. Thirty-seven volunteers (men and women) performed a sub-maximal isometric shoulder elevation for 3min. This was repeated four times, two times with induced vibration and two times without. Muscle activity was measured before and after each 3-min period to look at changes in the electromyography parameters. The result showed a significantly smaller mean frequency decrease when performing the shoulder elevation with vibration (-2.51Hz) compared to without vibration (-4.04Hz). There was also a slightly higher increase in the root mean square when exposed to vibration (5.7% of maximal voluntary contraction) compared to without (3.8% of maximal voluntary contraction); however, this was not statistically significant. The results of the present study indicate that short-time exposure to vibration has no negative acute effects on the fatiguing of upper trapezius muscle.

  • 1162.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hand-arm vibration syndrome (HAVS) and musculoskeletal symptoms in the neck and the upper limbs in professional drivers of terrain vehicles: a cross sectional study2006In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 37, no 6, p. 793-799Article in journal (Refereed)
  • 1163.
    Åström, Christofer
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Health effects of heatwaves: short and long term predictions2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Climate change is defined by the Intergovernmental Panel on Climate Change as changes in the state of the climate associated with changes in the mean and/or the variability of its properties. Climate change will affect temperatures both as an increase in mean temperature as well as changes in the frequency of temperature extremes. Health effects associated with extreme heat, both mortality and morbidity, have been observed all over the globe. Groups that are often found to be more vulnerable are the elderly and people diagnosed with certain diseases and/or on taking some specific types of medication. The health effects from climate change in the future depend on a number of underlying sociodemographic and other factors. It is difficult to predict how the underlying societal factors that are likely to alter the health effects from high temperatures will change. The aim of this thesis is to investigate the influence of the underlying assumptions and factors that are key components when predicting and projecting heat-related illness, both in the short and long term. This work aims to identify and to some extent quantify different sources of uncertainty that will have effects on the outcome of health impact assessments.

    Methods: We wanted to evaluate if different statistical models would alter the ability to identify days with elevated heat-related risk. We used observations of temperatures and daily mortality for Greater Stockholm to model different exposure-response relationships (Paper I). Along the observed data, we collected temperature forecasts for the Stockholm area. We defined what constitutes a risk day and compared the model’s ability to identify these days using both observed and forecasted temperatures to evaluate the predictive performance of models based on the different statistical approaches. To estimate how climate change will alter the heat-related health impacts we used climate change projections from a range of climate change scenarios to be able to get stable estimates as well as a measure of the uncertainty in the climate projections (Paper II-III). We estimated the change in respiratory hospital admissions (Paper II) and the future need for adaptation to keep heat-related mortality at current levels (Paper III) in Europe. We also estimated the change in heat-related mortality due to changes in climate, demographics and health status of the population in Stockholm (Paper IV).

    Results: The models using a highly complex exposure-response relationship showed lower predictive performance, especially when looking at a longer time-scale. The more complex models did also estimate a lower mortality increase compared to the less complex ones. There was however high agreement of which days to be considered risk days. The estimated increase in heat-related illness from the three health impact assessment studies showed impacts on a similar order of magnitude when looking at changes in climate only. Respiratory hospital admissions were estimated to more than double in Europe and heat-related mortality in Stockholm was estimated to increase to around 257% of current levels. Therefore, adaptation needs to lower the vulnerability to heat by around 50% in the European countries. In study III and IV we take changes in demographics into account and find that the future health burden from heat will increase due to the growing elderly population.

    Conclusion: To be able to make predictions of future health burdens from heat, both in the long and short term, we need to consider the properties of the epidemiological models and how the choice of model might limit its use within a health impact assessment. Climate change seems to be the main driver of the future health burden from extreme temperatures, but our results suggests that changing demographics will add to the burden considerably unless relevant adaptation measures are implemented. Adding this on top of the challenges posed by climate change, we find that need for adaptation will increase substantially in the future.

  • 1164.
    Åström, Christofer
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ebi, Kristie L
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Langner, Joakim
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Developing a heatwave early warning system for Sweden: evaluating sensitivity of different epidemiological modelling approaches to forecast temperatures2015In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 12, no 1, p. 254-267Article in journal (Refereed)
    Abstract [en]

    Over the last two decades a number of heatwaves have brought the need for heatwave early warning systems (HEWS) to the attention of many European governments. The HEWS in Europe are operating under the assumption that there is a high correlation between observed and forecasted temperatures. We investigated the sensitivity of different temperature mortality relationships when using forecast temperatures. We modelled mortality in Stockholm using observed temperatures and made predictions using forecast temperatures from the European Centre for Medium-range Weather Forecasts to assess the sensitivity. We found that the forecast will alter the expected future risk differently for different temperature mortality relationships. The more complex models seemed more sensitive to inaccurate forecasts. Despite the difference between models, there was a high agreement between models when identifying risk-days. We find that considerations of the accuracy in temperature forecasts should be part of the design of a HEWS. Currently operating HEWS do evaluate their predictive performance; this information should also be part of the evaluation of the epidemiological models that are the foundation in the HEWS. The most accurate description of the relationship between high temperature and mortality might not be the most suitable or practical when incorporated into a HEWS.

  • 1165.
    Åström, Christofer
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Orru, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. orru@ut.ee.
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Strandberg, Gustav
    Rossby Centre, SMHI, Norrköping, Sweden.
    Ebi, Kristie L
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Heat-related respiratory hospital admissions in Europe in a changing climate: a health impact assessment2013In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, no 1, p. e001842-Article in journal (Refereed)
    Abstract [en]

    Objectives Respiratory diseases are ranked second in Europe in terms of mortality, prevalence and costs. Studies have shown that extreme heat has a large impact on mortality and morbidity, with a large relative increase for respiratory diseases. Expected increases in mean temperature and the number of extreme heat events over the coming decades due to climate change raise questions about the possible health impacts. We assess the number of heat-related respiratory hospital admissions in a future with a different climate.                                

    Design A Europe-wide health impact assessment.                                

    Setting An assessment for each of the EU27 countries.                                

    Methods Heat-related hospital admissions under a changing climate are projected using multicity epidemiological exposure–response relationships applied to gridded population data and country-specific baseline respiratory hospital admission rates. Times-series of temperatures are simulated with a regional climate model based on four global climate models, under two greenhouse gas emission scenarios.                                

    Results Between a reference period (1981–2010) and a future period (2021–2050), the total number of respiratory hospital admissions attributed to heat is projected to be larger in southern Europe, with three times more heat attributed respiratory hospital admissions in the future period. The smallest change was estimated in Eastern Europe with about a twofold increase. For all of Europe, the number of heat-related respiratory hospital admissions is projected to be 26 000 annually in the future period compared with 11 000 in the reference period.                                

    Conclusions The results suggest that the projected effects of climate change on temperature and the number of extreme heat events could substantially influence respiratory morbidity across Europe.                                

     

  • 1166.
    Åström, Christofer
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Oudin Åström, Daniel
    Lund Universitet.
    Andersson, Camilla
    SMHI.
    Ebi, Kristie L.
    University of Washington.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Future health impact of higher ambient temperatures in Stockholm, SwedenManuscript (preprint) (Other academic)
  • 1167.
    Åström, Christofer
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Oudin Åström, Daniel
    Lund Universitet.
    Andersson, Camilla
    SMHI.
    Ebi, Kristie L.
    University of Washington.
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Vulnerability reduction needed to adapt to projected future heat exposure in Europe: Magnitude and determinantsManuscript (preprint) (Other academic)
  • 1168.
    Åström, Christofer
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Åström, Daniel Oudin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
    Andersson, Camilla
    Ebi, Kristie L
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Vulnerability Reduction Needed to Maintain Current Burdens of Heat-Related Mortality in a Changing Climate-Magnitude and Determinants2017In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, no 7, article id 741Article in journal (Refereed)
    Abstract [en]

    The health burden from heatwaves is expected to increase with rising global mean temperatures and more extreme heat events over the coming decades. Health-related effects from extreme heat are more common in elderly populations. The population of Europe is rapidly aging, which will increase the health effects of future temperatures. In this study, we estimate the magnitude of adaptation needed to lower vulnerability to heat in order to prevent an increase in heat-related deaths in the 2050s; this is the Adaptive Risk Reduction (ARR) needed. Temperature projections under Representative Concentration Pathway (RCP) 4.5 and RCP 8.5 from 18 climate models were coupled with gridded population data and exposure-response relationships from a European multi-city study on heat-related mortality. In the 2050s, the ARR for the general population is 53.5%, based on temperature projections under RCP 4.5. For the population above 65 years in Southern Europe, the ARR is projected to be 45.9% in a future with an unchanged climate and 74.7% with climate change under RCP 4.5. The ARRs were higher under RCP 8.5. Whichever emission scenario is followed or population projection assumed, Europe will need to adapt to a great degree to maintain heat-related mortality at present levels, which are themselves unacceptably high, posing an even greater challenge.

  • 1169.
    Åström, Daniel Oudin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Centre for Primary Health Care Research, Department of Clinical Science, Malmö, Lund University, Lund.
    Edvinsson, Sören
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Hondula, Daniel
    Rocklöv, Joacim
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Schumann, Barbara
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    On the association between weather variability and total and cause-specific mortality before and during industrialization in Sweden2016In: Demographic Research, ISSN 1435-9871, Vol. 35, p. 991-1009Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

  • 1170.
    Öhberg, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Umeå University, Faculty of Science and Technology, Centre for Biomedical Engineering and Physics (CMTF).
    Lundström, Ronnie
    Umeå University, Faculty of Science and Technology, Centre for Biomedical Engineering and Physics (CMTF). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Grip, Helena
    Umeå University, Faculty of Science and Technology, Centre for Biomedical Engineering and Physics (CMTF).
    Comparative analysis of different adaptive filters for tracking lower segments of a human body using inertial motion sensors2013In: Measurement science and technology, ISSN 0957-0233, E-ISSN 1361-6501, Vol. 24, no 8, p. 085703-Article in journal (Refereed)
    Abstract [en]

    For all segments and tests, a modified Kalman filter and a quasi-static sensor fusion algorithm were equally accurate (precision and accuracy similar to 2-3 degrees) compared to normalized least mean squares filtering, recursive least-squares filtering and standard Kalman filtering. The aims were to: (1) compare adaptive filtering techniques used for sensor fusion and (2) evaluate the precision and accuracy for a chosen adaptive filter. Motion sensors (based on inertial measurement units) are limited by accumulative integration errors arising from sensor bias. This drift can partly be handled with adaptive filtering techniques. To advance the measurement technique in this area, a new modified Kalman filter is developed. Differences in accuracy were observed during different tests especially drift in the internal/external rotation angle. This drift can be minimized if the sensors include magnetometers.

  • 1171.
    Öhman, Lena
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Bergdahl, Jan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Slunga Birgander, Lisbeth
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Stigsdotter-Neely, Anna
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Cognitive function in outpatients with perceived chronic stress2007In: Scand J Work Environ Health, ISSN 0355-3140, Vol. 33, no 3, p. 223-232Article in journal (Refereed)
21222324 1151 - 1171 of 1171
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