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  • 201. Franceschi, Silvia
    et al.
    Lise, Mauro
    Trépo, Christian
    Berthillon, Pascale
    Chuang, Shu-Chun
    Nieters, Alexandra
    Travis, Ruth C
    Vermeulen, Roel
    Overvad, Kim
    Tjønneland, Anne
    Olsen, Anja
    Bergmann, Manuela M
    Boeing, Heiner
    Kaaks, Rudolf
    Becker, Nikolaus
    Trichopoulou, Antonia
    Lagiou, Pagona
    Bamia, Christina
    Palli, Domenico
    Sieri, Sabina
    Panico, Salvatore
    Tumino, Rosario
    Sacerdote, Carlotta
    Bueno-de-Mesquita, Bas
    Peeters, Petra HM
    Rodríguez, Laudina
    Barroso, Leila Luján
    Dorronsoro, Miren
    Sánchez, María-José
    Navarro, Carmen
    Barricarte, Aurelio
    Regnér, Sara
    Borgquist, Signe
    Melin, Beatrice
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Khaw, Kay-Tee
    Wareham, Nick
    Rinaldi, Sabina
    Hainaut, Pierre
    Riboli, Elio
    Vineis, Paolo
    Infection with hepatitis B and C viruses and risk of lymphoid malignancies in the European Prospective Investigation into Cancer and Nutrition (EPIC)2011Ingår i: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 20, nr 1, s. 208-214Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Chronic HBV infection may increase the risk of lymphoid malignancies among healthy European volunteers. Impact: Treatment directed at control of HBV infection should be evaluated in HBsAg-seropositive patients with lymphoid tissue malignancies. Cancer Epidemiol Biomarkers Prev; 20(1); 208-14. ©2011 AACR.

  • 202. Franco, L.
    et al.
    Serre, N.
    Poluda, D.
    Kurolt, I.
    Molero, F.
    Zarzuela, F.
    Neumayr, A.
    Hatz, C.
    Wilder-Smith, Annelies
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Tenorio, A.
    Deciphering the origin of dengue virus introduced in Madeira, Portugal2013Konferensbidrag (Övrigt vetenskapligt)
  • 203.
    Frankel, Jennifer
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.
    Wilén, Jonna
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.
    Hansson Mild, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.
    Assessing exposures to Magnetic resonance imaging's complex Mixture of Magnetic Fields for In Vivo, In Vitro, and epidemiologic studies of Health effects for staff and Patients2018Ingår i: Frontiers In Public Health, ISSN 2296-2565, Vol. 6, artikel-id 66Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A complex mixture of electromagnetic fields is used in magnetic resonance imaging (MRI): static, low-frequency, and radio frequency magnetic fields. Commonly, the static magnetic field ranges from one to three Tesla. The low-frequency field can reach several millitesla and with a time derivative of the order of some Tesla per second. The radiofrequency (RF) field has a magnitude in the microtesla range giving rise to specific absorption rate values of a few Watts per kilogram. Very little attention has been paid to the case where there is a combined exposure to several different fields at the same time. Some studies have shown genotoxic effects in cells after exposure to an MRI scan while others have not demonstrated any effects. A typical MRI exam includes muliple imaging sequences of varying length and intensity, to produce different types of images. Each sequence is designed with a particular purpose in mind, so one sequence can, for example, be optimized for clearly showing fat water contrast, while another is optimized for high-resolution detail. It is of the utmost importance that future experimental studies give a thorough description of the exposure they are using, and not just a statement such as "An ordinary MRI sequence was used." Even if the sequence is specified, it can differ substantially between manufacturers on, e.g., RF pulse height, width, and duty cycle. In the latest SCENIHR opinion, it is stated that there is very little information regarding the health effects of occupational exposure to MRI fields, and long-term prospective or retrospective cohort studies on workers are recommended as a high priority. They also state that MRI is increasingly used in pediatric diagnostic imaging, and a cohort study into the effects of MRI exposure on children is recommended as a high priority. For the exposure assessment in epidemiological studies, there is a clear difference between patients and staff and further work is needed on this. Studies that explore the possible differences between MRI scan sequences and compare them in terms of exposure level are warranted.

  • 204. Fransson, Eleonor I.
    et al.
    Nyberg, Solja T.
    Heikkila, Katriina
    Alfredsson, Lars
    Bacquer, De Dirk
    Batty, G. David
    Bonenfant, Sebastien
    Casini, Annalisa
    Clays, Els
    Goldberg, Marcel
    Kittel, France
    Koskenvuo, Markku
    Knutsson, Anders
    Leineweber, Constanze
    Hanson, Linda L. Magnusson
    Nordin, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Singh-Manoux, Archana
    Suominen, Sakari
    Vahtera, Jussi
    Westerholm, Peter
    Westerlund, Hugo
    Zins, Marie
    Theorell, Tores
    Kivimaki, Mika
    Comparison of alternative versions of the job demand-control scales in 17 European cohort studies: the IPD-Work consortium2012Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, s. 62-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Job strain (i.e., high job demands combined with low job control) is a frequently used indicator of harmful work stress, but studies have often used partial versions of the complete multi-item job demands and control scales. Understanding whether the different instruments assess the same underlying concepts has crucial implications for the interpretation of findings across studies, harmonisation of multi-cohort data for pooled analyses, and design of future studies. As part of the 'IPD-Work' (Individual-participant-data meta-analysis in working populations) consortium, we compared different versions of the demands and control scales available in 17 European cohort studies. Methods: Six of the 17 studies had information on the complete scales and 11 on partial scales. Here, we analyse individual level data from 70 751 participants of the studies which had complete scales (5 demand items, 6 job control items). Results: We found high Pearson correlation coefficients between complete scales of job demands and control relative to scales with at least three items (r > 0.90) and for partial scales with two items only (r = 0.76-0.88). In comparison with scores from the complete scales, the agreement between job strain definitions was very good when only one item was missing in either the demands or the control scale (kappa > 0.80); good for job strain assessed with three demand items and all six control items (kappa > 0.68) and moderate to good when items were missing from both scales (kappa = 0.54-0.76). The sensitivity was > 0.80 when only one item was missing from either scale, decreasing when several items were missing in one or both job strain subscales. Conclusions: Partial job demand and job control scales with at least half of the items of the complete scales, and job strain indices based on one complete and one partial scale, seemed to assess the same underlying concepts as the complete survey instruments.

  • 205. Fransson, Eleonor
    et al.
    Nordin, Maria
    Knutsson, Anders
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Westerlund, Hugo
    Westerholm, Peter
    Alfredsson, Lars
    Associations between physically demanding work and life-style: results from the Swedish WOLF study2014Ingår i: 11th International Symposium on Human Factors in Organisational Design and Management & 46th Annual Nordic Ergonomics Society Conference, 2014, s. 45-46Konferensbidrag (Refereegranskat)
  • 206. Fridell, Erik
    et al.
    Haeger-Eugensson, Marie
    Moldanova, Jana
    Forsberg, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Sjöberg, Karin
    A modelling study of the impact on air quality and health due to theemissions from E85 and petrol fuelled cars in Sweden2014Ingår i: Atmospheric Environment, ISSN 1352-2310, E-ISSN 1873-2844, Vol. 82, s. 1-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Alternative fuels are becoming more and more important for road traffic and one fuel that has been usedfor several years is ethanol (E85). The main discussion points regarding the environmental performancefor ethanol as a fuel are related to the production. However, there are also some notable differences inthe emissions between E85 and petrol fuelled vehicles. This relates to some extent to the emissions ofnitrogen oxides (NOx) and particulate matter (PM) but mainly to the composition of the emitted organiccompounds. In the present study two fuel scenarios for passenger cars are investigated for the VästraGötaland Region in Sweden; one where the cars with Otto engines run on petrol and one where they runon E85. Two emission scenarios for 2020 are constructed for the whole Europe and coupled dispersionchemistrymodelling is applied to obtain the population exposure to key pollutants. The differencesobtained from the modelling show decreased levels of NOx, ozone and benzene with E85 and increasedlevels of acetaldehyde in the Västra Götaland Region. For the latter the increase may be up to 80%, whileNOx and ozone show decreases of up to a few per cent and a few tenths of per cent, respectively.Exposure to the different air pollutants is calculated as population-weighted concentrations. The healthrisk assessment, using the calculated exposure and published exposureeresponse functions for therelevant pollutants, shows decreased health risks in the E85 scenario relative the all-petrol scenario, dueto the decreased NOx exposure, correlated with both preterm deaths and asthma. However, NOx (andNO2) may partly be indicators of unmeasured causal exhaust components in the epidemiological studiesand thus the exposureeresponse functions for these may not be applicable in the present case wherethere is a difference in NOx exposure but not a proportional difference in exposure to other exhaustcomponents normally associated with NOx. Smaller effects are expected from the changes in ozone,acetaldehyde, PM2.5 and benzene exposure. The overall difference is about 1.6 preterm deaths per yearfor the Västra Götaland Region, with lower values for the E85 scenario, when the uncertain differencesdue to the differences in NOx exposure are not considered.

  • 207. Friel, Sharon
    et al.
    Hancock, Trevor
    Kjellström, Tord
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    McGranahan, Gordon
    Monge, Patricia
    Roy, Joyashree
    Urban health inequities and the added pressure of climate change: an action-oriented research agenda2011Ingår i: Journal of urban health, ISSN 1099-3460, E-ISSN 1468-2869, Vol. 88, nr 5, s. 886-895Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Climate change will likely exacerbate already existing urban social inequities and health risks, thereby exacerbating existing urban health inequities. Cities in low- and middle-income countries are particularly vulnerable. Urbanization is both a cause of and potential solution to global climate change. Most population growth in the foreseeable future will occur in urban areas primarily in developing countries. How this growth is managed has enormous implications for climate change given the increasing concentration and magnitude of economic production in urban localities, as well as the higher consumption practices of urbanites, especially the middle classes, compared to rural populations. There is still much to learn about the extent to which climate change affects urban health equity and what can be done effectively in different socio-political and socio-economic contexts to improve the health of urban dwelling humans and the environment. But it is clear that equity-oriented climate change adaptation means attention to the social conditions in which urban populations live-this is not just a climate change policy issue, it requires inter-sectoral action. Policies and programs in urban planning and design, workplace health and safety, and urban agriculture can help mitigate further climate change and adapt to existing climate change. If done well, these will also be good for urban health equity.

  • 208.
    Frumence, Gasto
    et al.
    Department of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
    Emmelin, Maria
    Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Malmö.
    Eriksson, Malin
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Kwesigabo, Gideon
    Department of Biostatistics and Epidemiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
    Killewo, Japhet
    Department of Biostatistics and Epidemiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
    Moyo, Sabrina
    Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania..
    Nyström, Lennarth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Access to social capital and risk of HIV infectionin Bukoba urban district, Kagera region, Tanzania2014Ingår i: Archives of Public Health, ISSN 0778-7367, E-ISSN 2049-3258, Vol. 72, nr 38, s. 1-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Kagera is one of the 22 regions of Tanzania mainland, which has witnessed a decline in HIV prevalence during the past two decades; decreasing from 24% in 1987 to 4.7 in 2009 in the urban district of Bukoba. Access to social capital, both structural and cognitive, might have played a role in this development. The aim was to examine the association between individual structural and cognitive social capital and socio-economic characteristics and the likelihood of being HIV infected.

    METHODS:

    We conducted a population-based cross-sectional study of 3586 participants, of which 3423 (95%) agreed to test for HIV following pre-test counseling. The HIV testing was performed using enzyme-linked immunosorbent assay (ELISA) antibody detection tests. Multiple logistic regression analysis was applied to estimate the impact of socio-economic factors, individual structural and cognitive social capital and HIV sero-status.

    RESULTS:

    Individuals who had access to low levels of both structural and cognitive individual social capital were four and three times more likely to be HIV positive compared to individuals who had access to high levels. The associations remained statistically significant for both individual structural and cognitive social capital after adjusting for potential confounding factors such as age, sex, marital status, occupation, level of education and wealth index (OR =8.6, CI: 5.7-13.0 and OR =2.4, CI: 1.6-3.5 for individual structural and cognitive social capital respectively). For both women and men access to high levels of individual structural and cognitive social capital decreased the risk of being HIV infected. This study confirms previous qualitative studies indicating that access to structural and cognitive social capital is protective to HIV infection.

    CONCLUSIONS:

    We suggest that policy makers and programme managers of HIV interventions may consider strengthening and facilitating access to social capital as a way of promoting HIV preventive information and interventions in order to reduce new HIV infections in Tanzania.

  • 209. Frykman, Mandus
    et al.
    Lundmark, Robert
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. LIME, Karolinska Institutet, Stockholm, Sweden.
    Schwarz, Ulrica von Thiele
    Villaume, Karin
    Hasson, Henna
    Line managers' influence on employee usage of a web-based system for occupational health management2018Ingår i: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836X, Vol. 11, nr 4, s. 193-209Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose The purpose of this paper is to investigate line managers' influence on employee usage of a web-based system for occupational health management. Design/methodology/approach Questionnaires were used to measure line managers' transformational leadership at baseline and their change-supportive managerial activities during weeks 16-52. Employee initial (weeks 16-52) and sustained (weeks 53-144) use of the web-based system was measured by extracting their frequency of logins to the system from electronic records. Data were collected from six white-collar organizations from 2011 through 2013. Mixed Poisson regressions were used to analyze the influence of transformational leadership and change-supportive managerial activities on employee usage. Findings As predicted, line managers' change-supportive activities influenced the employees' initial and sustained use of the system. Line managers' transformational leadership had no direct effect on employees' use of the system, however transformational leadership was indirectly associated with employees' initial and sustained use of the system through line managers' change-supportive activities. Originality/value The study adds to the understanding of the role line managers' play during the implementation of occupational health interventions. The findings suggest that the line managers' change-supportive activities directed toward the intervention are important for employees' initial and sustained use of the system. The influence of transformational leadership was indirect, suggesting that line managers may need to direct their leadership behaviors toward the intervention to facilitate implementation.

  • 210. Fuertes, Elaine
    et al.
    Markevych, Iana
    Jarvis, Deborah
    Vienneau, Danielle
    de Hoogh, Kees
    Antó, Josep Maria
    Bowatte, Gayan
    Bono, Roberto
    Corsico, Angelo G
    Emtner, Margareta
    Gislason, Thorarinn
    Gullón, José Antonio
    Heinrich, Joachim
    Henderson, John
    Holm, Mathias
    Johannessen, Ane
    Leynaert, Bénédicte
    Marcon, Alessandro
    Marchetti, Pierpaolo
    Moratalla, Jesús Martínez
    Pascual, Silvia
    Probst-Hensch, Nicole
    Sánchez-Ramos, José Luis
    Siroux, Valerie
    Sommar, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Weyler, Joost
    Kuenzli, Nino
    Jacquemin, Bénédicte
    Garcia-Aymerich, Judith
    Residential air pollution does not modify the positive association between physical activity and lung function in current smokers in the ECRHS study2018Ingår i: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 120, s. 364-372Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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

  • 211. Fuks, Kateryna B.
    et al.
    Weinmayr, Gudrun
    Foraster, Maria
    Dratva, Julia
    Hampel, Regina
    Houthuijs, Danny
    Oftedal, Bente
    Oudin, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Panasevich, Sviatlana
    Penell, Johanna
    Nilsson Sommar, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Sørensen, Mette
    Tiittanen, Pekka
    Wolf, Kathrin
    Xun, Wei W.
    Aguilera, Inmaculada
    Basagaña, Xavier
    Beelen, Rob
    Bots, Michiel L.
    Brunekreef, Bert
    Bueno-de-Mesquita, H. Bas
    Caracciolo, Barbara
    Cirach, Marta
    de Faire, Ulf
    de Nazelle, Audrey
    Eeftens, Marloes
    Elosua, Roberto
    Erbel, Raimund
    Forsberg, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Fratiglioni, Laura
    Gaspoz, Jean-Michel
    Hilding, Agneta
    Jula, Antti
    Korek, Michal
    Krämer, Ursula
    Künzli, Nino
    Lanki, Timo
    Leander, Karin
    Magnusson, Patrik K.
    Marrugat, Jaume
    Nieuwenhuijsen, Mark J.
    Östenson, Claes-Göran
    Pedersen, Nancy L.
    Pershagen, Göran
    Phuleria, Harish C.
    Probst-Hensch, Nicole M.
    Raaschou-Nielsen, Ole
    Schaffner, Emmanuel
    Schikowski, Tamara
    Schindler, Christian
    Schwarze, Per E.
    Søgaard, Annee J.
    Sugiri, Dorothea
    Swart, Wim J.
    Tsai, Ming-Yi
    Turunen, Anu W.
    Vineis, Paolo
    Peters, Annette
    Hoffmann, Barbara
    Arterial blood pressure and long-term exposure to traffic-related air pollution: an analysis in the European Study of Cohorts for Air Pollution Effects (ESCAPE)2014Ingår i: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 122, nr 9, s. 896-905Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

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

  • 212.
    Furberg, Maria
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Hondula, David
    Saha, Michael
    Nilsson, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    In the light of change: correspondence between observational data and perceptions of climate in northern Sweden - a mixed methods study2016Ingår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 75, s. 12-12, artikel-id 33200Artikel i tidskrift (Refereegranskat)
  • 213.
    Furberg, Maria
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Johansson, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi.
    Tularemia mapping in northernmost Sweden: seroprevalence and a case-control study of risk factors2016Ingår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 75, artikel-id 33200Artikel i tidskrift (Refereegranskat)
  • 214. Garcia-Larsen, Vanessa
    et al.
    Arthur, Rhonda
    Potts, James F
    Howarth, Peter H
    Ahlström, Matti
    Haahtela, Tari
    Loureiro, Carlos
    Bom, Ana Todo
    Brożek, Grzegorz
    Makowska, Joanna
    Kowalski, Marek L
    Thilsing, Trine
    Keil, Thomas
    Matricardi, Paolo M
    Torén, Kjell
    van Zele, Thibaut
    Bachert, Claus
    Rymarczyk, Barbara
    Janson, Christer
    Forsberg, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Niżankowska-Mogilnicka, Ewa
    Burney, Peter G J
    Is fruit and vegetable intake associated with asthma or chronic rhino-sinusitis in European adults? Results from the Global Allergy and Asthma Network of Excellence (GA(2)LEN) Survey2017Ingår i: Clinical and Translational Allergy, ISSN 2045-7022, E-ISSN 2045-7022, Vol. 7, artikel-id 3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Fruits and vegetables are rich in compounds with proposed antioxidant, anti-allergic and anti-inflammatory properties, which could contribute to reduce the prevalence of asthma and allergic diseases.

    OBJECTIVE: We investigated the association between asthma, and chronic rhino-sinusitis (CRS) with intake of fruits and vegetables in European adults.

    METHODS: A stratified random sample was drawn from the Global Allergy and Asthma Network of Excellence (GA(2)LEN) screening survey, in which 55,000 adults aged 15-75 answered a questionnaire on respiratory symptoms. Asthma score (derived from self-reported asthma symptoms) and CRS were the outcomes of interest. Dietary intake of 22 subgroups of fruits and vegetables was ascertained using the internationally validated GA(2)LEN Food Frequency Questionnaire. Adjusted associations were examined with negative binomial and multiple regressions. Simes procedure was used to control for multiple testing.

    RESULTS: A total of 3206 individuals had valid data on asthma and dietary exposures of interest. 22.8% reported having at least 1 asthma symptom (asthma score ≥1), whilst 19.5% had CRS. After adjustment for potential confounders, asthma score was negatively associated with intake of dried fruits (β-coefficient -2.34; 95% confidence interval [CI] -4.09, -0.59), whilst CRS was statistically negatively associated with total intake of fruits (OR 0.73; 95% CI 0.55, 0.97). Conversely, a positive association was observed between asthma score and alliums vegetables (adjusted β-coefficient 0.23; 95% CI 0.06, 0.40). None of these associations remained statistically significant after controlling for multiple testing.

    CONCLUSION AND CLINICAL RELEVANCE: There was no consistent evidence for an association of asthma or CRS with fruit and vegetable intake in this representative sample of European adults.

  • 215. Garde, Anne Helene
    et al.
    Karlsson, Berndt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hansen, Åse Marie
    Persson, Roger
    Åkerstedt, Torbjörn
    Sleep and Salivary Cortisol2012Ingår i: The Role of Saliva Cortisol Measurement in Health and Disease / [ed] Margareta Kristenson, Peter Garvin, Ulf Lundberg, Bentham eBooks, 2012, s. 116-128Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    The aim of the present chapter was to analyze whether measures of cortisol in saliva were associated with measures of sleep and to explore if divergent results were related to underlying differences in theoretic assumptions and methods. Measures of sleep quality included sleep duration, overall sleep quality, difficulty falling asleep, disturbed sleep, and sleep deprivation. Twenty-three papers were found to fulfil the inclusion criteria. Cortisol measures were grouped into single time points at different times during the day, deviations at different time periods during the day, reactivity and recovery after a standardized laboratory test, area under the curve and response to dexamethasone test. A large proportion of the studies included showed nonsignificant findings, which, in several cases, may be a result of low power. The most consistent results were a positive association between sleep duration and single measures of salivary cortisol at awakening, which was observed in 3 studies. In these studies, sleep duration was also associated with low evening cortisol levels, steep diurnal deviation of cortisol and/or high area under the curve. Together these findings suggest that longer sleep duration is related to a more dynamic cortisol secretion. Two of the 6 studies on disturbed or restless sleep showed relations to flat diurnal deviation and low laboratory stress test reactivity. This to some extent corroborates the findings on sleep duration. However, the many nonsignificant findings as well as the theoretical and methodological differences (e.g., heterogeneity in measures) complicate comparisons. Conflicting results may be at least partially due to differences in methods and underlying assumptions.

  • 216. Gasparrini, Antonio
    et al.
    Guo, Yuming
    Sera, Francesco
    Vicedo-Cabrera, Ana Maria
    Huber, Veronika
    Tong, Shilu
    de Sousa Zanotti Stagliorio Coelho, Micheline
    Nascimento Saldiva, Paulo Hilario
    Lavigne, Eric
    Matus Correa, Patricia
    Valdes Ortega, Nicolas
    Kan, Haidong
    Osorio, Samuel
    Kyselý, Jan
    Urban, Aleš
    Jaakkola, Jouni J. K.
    Ryti, Niilo R. I.
    Pascal, Mathilde
    Goodman, Patrick G.
    Zeka, Ariana
    Michelozzi, Paola
    Scortichini, Matteo
    Hashizume, Masahiro
    Honda, Yasushi
    Hurtado-Diaz, Magali
    Cesar Cruz, Julio
    Seposo, Xerxes
    Kim, Ho
    Tobias, Aurelio
    Iñiguez, Carmen
    Forsberg, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Oudin Åström, Daniel
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Ragettli, Martina S.
    Guo, Yue Leon
    Wu, Chang-Fu
    Zanobetti, Antonella
    Schwartz, Joel
    Bell, Michelle L.
    Dang, Tran Ngoc
    Van, Dung Do
    Heaviside, Clare
    Vardoulakis, Sotiris
    Hajat, Shakoor
    Haines, Andy
    Armstrong, Ben
    Projections of temperature-related excess mortality under climate change scenarios2017Ingår i: The Lancet Planetary Health, ISSN 2542-5196, Vol. 1, nr 9, s. e360-e367Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Climate change can directly affect human health by varying exposure to non-optimal outdoor temperature. However, evidence on this direct impact at a global scale is limited, mainly due to issues in modelling and projecting complex and highly heterogeneous epidemiological relationships across different populations and climates.

    Methods: We collected observed daily time series of mean temperature and mortality counts for all causes or non-external causes only, in periods ranging from Jan 1, 1984, to Dec 31, 2015, from various locations across the globe through the Multi-Country Multi-City Collaborative Research Network. We estimated temperature-mortality relationships through a two-stage time series design. We generated current and future daily mean temperature series under four scenarios of climate change, determined by varying trajectories of greenhouse gas emissions, using five general circulation models. We projected excess mortality for cold and heat and their net change in 1990-2099 under each scenario of climate change, assuming no adaptation or population changes.

    Findings: Our dataset comprised 451 locations in 23 countries across nine regions of the world, including 85 879 895 deaths. Results indicate, on average, a net increase in temperature-related excess mortality under high-emission scenarios, although with important geographical differences. In temperate areas such as northern Europe, east Asia, and Australia, the less intense warming and large decrease in cold-related excess would induce a null or marginally negative net effect, with the net change in 2090-99 compared with 2010-19 ranging from -1·2% (empirical 95% CI -3·6 to 1·4) in Australia to -0·1% (-2·1 to 1·6) in east Asia under the highest emission scenario, although the decreasing trends would reverse during the course of the century. Conversely, warmer regions, such as the central and southern parts of America or Europe, and especially southeast Asia, would experience a sharp surge in heat-related impacts and extremely large net increases, with the net change at the end of the century ranging from 3·0% (-3·0 to 9·3) in Central America to 12·7% (-4·7 to 28·1) in southeast Asia under the highest emission scenario. Most of the health effects directly due to temperature increase could be avoided under scenarios involving mitigation strategies to limit emissions and further warming of the planet.

    Interpretation: This study shows the negative health impacts of climate change that, under high-emission scenarios, would disproportionately affect warmer and poorer regions of the world. Comparison with lower emission scenarios emphasises the importance of mitigation policies for limiting global warming and reducing the associated health risks.

  • 217. Gaudet, Mia M
    et al.
    Deubler, Emily L
    Kelly, Rachel S
    Diver, W Ryan
    Teras, Lauren R
    Hodge, James M
    Levine, Keith E
    Haines, Laura G
    Lundh, Thomas
    Lenner, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Palli, Domenico
    Vineis, Paolo
    Bergdahl, Ingvar
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Medicinska fakulteten, Enheten för biobanksforskning.
    Gapstur, Susan M
    Kyrtopoulos, Soterios A
    Blood Levels of Cadmium and Lead in Relation to Breast Cancer Risk in Three Prospective Cohorts.2019Ingår i: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 144, nr 5, s. 1010-1016Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cadmium and lead have been classified as carcinogens by the International Agency for Research on Cancer. However, their associations with breast cancer risk are unknown despite their persistence in the environment and ubiquitous human exposure. We examined associations of circulating levels of cadmium and lead with breast cancer risk in three case-control studies nested within the Cancer Prevention Study-II (CPS-II) LifeLink Cohort, European Prospective Investigation into Cancer and Nutrition - Italy (EPIC-Italy), and the Northern Sweden Health and Disease Study (NSHDS) cohorts. Metal levels were measured in stored erythrocytes from 1,435 cases and 1,433 controls using inductively coupled plasma-mass spectrometry. Summary relative risks (RR) and 95% confidence intervals (CI) were calculated using random-effects models with each study result weighted by the within- and between-study variances. I2 values were calculated to estimate proportion of between study variation. Using common cut-points, cadmium levels were not associated with breast cancer risk in the CPS-II cohort (continuous RR=1.01, 95% CI 0.76 - 1.34), but were inversely associated with risk in the EPIC- Italy (continuous RR=0.80, 95% CI 0.61 - 1.03) and NSHDS cohorts (continuous RR=0.73, 95% CI 0.54 - 0.97). The inverse association was also evident in the meta-analysis (continuous RR=0.84, 95% CI 0.69 - 1.01) with low between-study heterogeneity. Large differences in lead level distributions precluded a meta-analysis of their association with breast cancer risk; no associations were found in the three studies. Adult cadmium and lead levels were not associated with higher risk of breast cancer in our large meta-analysis. 

  • 218. Gaziano, Thomas A.
    et al.
    Bertram, Melanie
    Tollman, Stephen M.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Hofman, Karen J.
    Hypertension education and adherence in South Africa: a cost-effectiveness analysis of community health workers2014Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, s. 240-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To determine whether training community health workers (CHWs) about hypertension in order to improve adherence to medications is a cost-effective intervention among community members in South Africa. Methods: We used an established Markov model with age-varying probabilities of cardiovascular disease (CVD) events to assess the benefits and costs of using CHW home visits to increase hypertension adherence for individuals with hypertension and aged 25-74 in South Africa. Subjects considered for CHW intervention were those with a previous diagnosis of hypertension and on medications but who had not achieved control of their blood pressure. We report our results in incremental cost-effectiveness ratios (ICERs) in US dollars per disability-adjusted life-year (DALY) averted. Results: The annual cost of the CHW intervention is about $8 per patient. This would lead to over a 2% reduction in CVD events over a life-time and decrease DALY burden. Due to reductions in non-fatal CVD events, lifetime costs are only $6.56 per patient. The CHW intervention leads to an incremental cost-effectiveness ratio of $320/DALY averted. At an annual cost of $6.50 or if the blood pressure reduction is 5 mmHg or greater per patient the intervention is cost-saving. Conclusions: Additional training for CHWs on hypertension management could be a cost-effective strategy for CVD in South Africa and a very good purchase according to World Health Organization (WHO) standards. The intervention could also lead to reduced visits at the health centres freeing up more time for new patients or reducing the burden of an overworked staff at many facilities.

  • 219. Georgiadis, Panagiotis
    et al.
    Gavriil, Marios
    Rantakokko, Panu
    Ladoukakis, Efthymios
    Botsivali, Maria
    Kelly, Rachel S
    Bergdahl, Ingvar
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Umeå universitet, Medicinska fakulteten, Enheten för biobanksforskning.
    Kiviranta, Hannu
    Vermeulen, Roel C H
    Späth, Florentin
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Hebbels, Dennie G A J
    Kleinjans, Jos C S
    de Kok, Theo M C M
    Palli, Domenico
    Vineis, Paolo
    Kyrtopoulos, Soterios A
    DNA methylation profiling implicates exposure to PCBs in the pathogenesis of B-cell chronic lymphocytic leukemia2019Ingår i: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 126, s. 24-36Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To characterize the impact of PCB exposure on DNA methylation in peripheral blood leucocytes and to evaluate the corresponding changes in relation to possible health effects, with a focus on B-cell lymphoma.

    METHODS: We conducted an epigenome-wide association study on 611 adults free of diagnosed disease, living in Italy and Sweden, in whom we also measured plasma concentrations of 6 PCB congeners, DDE and hexachlorobenzene.

    RESULTS: We identified 650 CpG sites whose methylation correlates strongly (FDR < 0.01) with plasma concentrations of at least one PCB congener. Stronger effects were observed in males and in Sweden. This epigenetic exposure profile shows extensive and highly statistically significant overlaps with published profiles associated with the risk of future B-cell chronic lymphocytic leukemia (CLL) as well as with clinical CLL (38 and 28 CpG sites, respectively). For all these sites, the methylation changes were in the same direction for increasing exposure and for higher disease risk or clinical disease status, suggesting an etiological link between exposure and CLL. Mediation analysis reinforced the suggestion of a causal link between exposure, changes in DNA methylation and disease. Disease connectivity analysis identified multiple additional diseases associated with differentially methylated genes, including melanoma for which an etiological link with PCB exposure is established, as well as developmental and neurological diseases for which there is corresponding epidemiological evidence. Differentially methylated genes include many homeobox genes, suggesting that PCBs target stem cells. Furthermore, numerous polycomb protein target genes were hypermethylated with increasing exposure, an effect known to constitute an early marker of carcinogenesis.

    CONCLUSIONS: This study provides mechanistic evidence in support of a link between exposure to PCBs and the etiology of CLL and underlines the utility of omic profiling in the evaluation of the potential toxicity of environmental chemicals.

  • 220. Gerhardsson, Lars
    et al.
    Akantis, Anna
    Lundström, Nils-Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nordberg, Gunnar F
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Schütz, Andrejs
    Skerfving, Staffan
    Lead concentrations in cortical and trabecular bones in deceased smelter workers.2005Ingår i: J Trace Elem Med Biol, ISSN 0946-672X, Vol. 19, nr 2-3, s. 209-15Artikel i tidskrift (Refereegranskat)
  • 221. Gerhardsson, Lars
    et al.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hagberg, Mats
    Lunsdström, Ronnie
    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.
    NEUROPHYSIOLOGIC SYMPTOMS AND VIBRATION PERCEPTION THRESHOLDSIN YOUNG VIBRATION-ExpOSED WORKERS: A FOLLOW-UP STUDY2011Ingår i: Canadian Acoustics, ISSN 0711-6659, E-ISSN 2291-1391, Vol. 39, nr 2, s. 16-17Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Vibration exposure may cause the hand-arm vibration syndrome (HAVS), including digital vasospasms (vibration white fingers; VWF), sensorineural symptoms and/or muscular weakness and fatigue (Gemne, 1997). Neurophysiologic symptoms include numbness and/or tingling, impaired touch sensitivity, impaired manual dexterity and reduced grip strength in the hands. The Stockholm Workshop Scale is commonly used for sensorineural (SN) staging (OSN - 3 SN). Sensorineural symptoms of this in combination with difficulties in handling small objects may interfere both with the workers social- and work-related activities (Sakakibara et al., 2005).

  • 222. Gislason, Thorarinn
    et al.
    Bertelsen, Randi J
    Real, Francisco Gomez
    Sigsgaard, Torben
    Franklin, Karl A
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Lindberg, Eva
    Janson, Christer
    Arnardottir, Erna Sif
    Hellgren, Johan
    Benediktsdottir, Bryndis
    Forsberg, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Johannessen, Ane
    Self-reported exposure to traffic pollution in relation to daytime sleepiness and habitual snoring: a questionnaire study in seven North-European cities2016Ingår i: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 24, s. 93-99Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE/BACKGROUND: Little is known about associations between traffic exposure and sleep disturbances. We examined if self-reported exposure to traffic is associated with habitual snoring and daytime sleepiness in a general population.

    METHODS: In the RHINE III study, 12184 adults answered questions on sleep disturbances and traffic exposure. We analysed bedrooms near roads with traffic, bedrooms with traffic noise, and travelling regularly along busy roads as proxies for traffic exposures, using logistic regression. Adjustment factors were study centre, gender, age, smoking habits, educational level, body mass index, physical activity, obstructive sleep apnoea, and sleep duration.

    RESULTS: One in ten lived near a busy road, 6% slept in a bedroom with traffic noise, and 11% travelled regularly along busy roads. Habitual snoring affected 25% and daytime sleepiness 21%. More men reported snoring and more women reported daytime sleepiness. Having a bedroom with traffic noise was associated with snoring (adjusted OR 1.29, [95% CI 1.12, 1.48]). For daytime sleepiness, on the other hand, bedroom with traffic noise and high exposure to traffic pollution have significant risk factors (adjusted ORs 1.46 [1.11, 1.92] and 1.65 [1.11, 2.45]). Results were consistent across study centres.

    CONCLUSIONS: Daytime sleepiness is associated with traffic pollution and traffic noise, while habitual snoring is only associated with traffic noise. Self-reported traffic exposure should be taken into account when diagnosing and planning treatment for patients with sleep disturbances, because reducing noise and pollution exposure in the bedroom may have a beneficial effect.

  • 223.
    Glader, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Chemical emissions from building structures: emission sources and their impact on indoor air2012Licentiatavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Chemical compounds in indoor air can adversely affect our comfort and health. However, in most cases there is only a limited amount of information available that can be used to assess their health risk. Instead the precautionary principle is often applied, i.e. efforts are made to ensure that the concentrations of pollutants are kept at a minimum when constructing new buildings or conducting renovations by using low-emitting building materials. Today, when investigating buildings in order to solve indoor air quality problems, volatile organic compounds (VOCs) are sampled in the air within rooms. The chemical composition of indoor air is complex and there are many sources for the chemicals present. The potential for emissions from sources in hidden spaces such as wall cavities is poorly understood and little information exists on the toxic potential of chemical releases resulting from moisture-related degradation of building materials. Most of the non-reactive VOCs that have been detected in indoor air in field studies and from building products are not believed to cause health problems. However, reactive compounds and chemical reaction products have the potential to negatively influence our comfort and health even at low concentrations. Even though the impact of chemical compounds on health is unclear in many cases, they can be used to identify technical problems in buildings. When a building is investigated, the air inside building structures could be sampled. This method would eliminate emissions from sources other than the construction materials and the samples would contain higher levels of individual compounds.

    The aims of this work was to identify emissions profiles for different types of building structures, to see if the emission profiles for moisture damaged and undamaged structures differed, and to determine whether any of the emissions profiles for specific structures also could be found in indoor air.

    Technical investigations and VOC sampling were performed in 21 different buildings with and without previous moisture damage. Seven of the buildings were investigated in the years 2005-2006 (study 1) and fourteen in the years 2009-2010 (study 2). In study 1, sixty samples were analyzed by PCA at the chemical group level (18 chemical groups, i.e. aldehydes, ketones etc). 41 % of all identified chemical compounds belonged to the hydrocarbon chemical group. The second largest chemical groups, each of which accounted for 5-10 % of all identified compounds, were alcohols, aldehydes, ketones, polyaromatic hydrocarbons (PAHs) and terpenes. The results indicated that one of the main factors that determined the emissions profile of a building structure was the materials used in its construction. Notably, concrete and wooden structures were found to have different emissions profiles.

    The sum of VOC (TVOC) concentrations for all 241 samples from both study 1 and study 2 was used to compare total emissions between different building elements (ground and higher floors, external walls and roof spaces). Most building elements exhibited relatively low emissions compared to concrete ground floors, which generally had higher TVOC emissions. Emissions from both polystyrene insulation and PVC flooring could be identified in concrete ground floors and were the main cause for the higher emissions found in these structures. Profiles for wood preservatives such as creosote and pentachlorophenol were also identified in external walls. The emission profiles found in the structures could not be identified in the indoor air in the adjacent rooms, although individual compounds were sometimes detected at low concentrations.

    Our results showed that the main factors influencing emissions in building structures were the construction materials and the nature of the building element in question. Because of difficulties with finding active water damage at the times of sampling and because of sampling inside closed building structures with old dried-out moisture damages, the field method used in this work was unsuitable for identifying differences in emission profiles between moisture damaged and undamaged structures. It will thus be necessary to investigate this difference in a laboratory where the precise composition of all tested structures is known, a range of RH values can be tested and the accumulation of emissions can be followed.

  • 224. Glader, Annika
    et al.
    Liljelind, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Kemiska ämnen i byggnadskonstruktioner: påverkar byggnadsmaterial inuti konstruktioner inomhusluftens kvalitet?2012Ingår i: Byggnadsrelaterad ohälsa i Kvarkenregionen: nio delprojekt om miljökänslighet, luftkvalitet och sjuka hus ur ett tvärvetenskapligt perspektiv : slutrapport för projektet Kompetenscentrum Byggnad - Luftkvalitet - Hälsa 2 (KLUCK 2) / [ed] Martina Österberg, Vasa: Yrkeshögskolan Novia , 2012, s. 65-75Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [sv]

    Inomhusmiljön har en betydande inverkan på människors hälsa och välbefinnande. Man är idag överens om att dålig inomhusmiljö kan ge upphov till ohälsa, särskilt hos dem som redan har någon form av överkänslighet. Medicinsk forskning har dock inte kunnat påvisa någon enskild faktor i inomhusmiljön som orsak till ohälsan. Det finns indikationer på att organiska kemiska föreningar i inomhusluften har betydelse, men man kan idag inte peka ut några enskilda föreningar som orsak till hälsoproblemen. Man har även ställt sig frågan hur olika kemiska föreningar samverkar och om kombinationen av många ämnen tillsammans kan vara det som ger upphov till hälsoproblemen. Eftersom vi idag fortfarande har mycket begränsad kunskap om vad det är man blir sjuk av används istället försiktighetsprincipen. Det innebär att man strävar efter så låga koncentrationer av föroreningar som möjligt då man bygger nytt eller renoverar gammalt.

  • 225.
    Glader, Annika
    et al.
    Novia Univ Appl Sci, FI-65201 Vaasa, Finland.
    Liljelind, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Patterns of volatile organic compound emissions in building structures2012Ingår i: Indoor + Built Environment, ISSN 1420-326X, E-ISSN 1423-0070, Vol. 21, nr 5, s. 651-662Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A new method for detecting hidden moisture damage was tested in a pilot study. Volatile organic compounds (VOCs) were sampled from within different building structures and the emission profiles were compared using principal component analysis (PCA). When all 60 samples were examined at the chemical group level (i.e. aldehydes, ketones, etc.), the samples separated into two major groups, representing concrete and wooden structures. Alcohols, terpenes, ketones, hydrocarbons, polyaromatic hydrocarbons (PAHs) and a group of unidentified compounds were more strongly associated with structures in which the predominant construction material was concrete, than in structures mainly made of wood. For the 20 samples from wooden structures, 8 chemical groups were more abundant in those sampled in moisture-damaged buildings than in those sampled in the building with no known damage. These were terpenes, phenols, ketones, aldehydes, alcohols, furans, PAH and carboxylic acids. Emissions from moisture-damaged concrete structures were higher than from wooden ones but more chemical groups were emitted from moisture-damaged wooden structures. The results indicate that sampling and analyses of VOCs inside building structures, and using PCA for data analysis, are useful for finding chemical fingerprints for moisture damages but more data are needed to substantiate this.

  • 226.
    Glader, Annika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Liljelind, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Volatile organic compounds in building structures and their impact on indoor airManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    A common approach when investigating indoor air problems is sampling volatile organic compounds (VOCs) in the air within rooms. The chemical composition of indoor air is complex and there are many sources of the chemicals present. Measurements of emissions from building materials are commonly collected only from surface materials when estimating the effects of building structures on indoor air quality. The potential for exposure from sources in hidden spaces such as wall cavities is poorly understood and little information exists on the toxic potential of chemical releases resulting from the moisture-related degradation of building materials. While their impact on health is often unclear, VOCs can be used to indicate technical problems in buildings. Sampling the air inside building structures should exclude emissions from other sources, leaving only those from the construction materials. The aims of this study were to find important emissions profiles in different types of building structures and to determine whether the same profiles were also present in indoor air. The emissions profiles for different building structures were compared using multivariate data analysis techniques, and influential and significant chemical compounds were identified. Emissions profiles typical for PVC flooring, polystyrene insulations and wood preservatives were identified. The specific profiles found in the structures could not be found in indoor air, although small amounts of individual compounds were sometimes found. The combination of sampling inside building structures and data analysis using multivariate methods gave us more information about materials and VOCs present in building structures than could have been obtained using traditional indoor air measurements. This method therefore facilitates technical investigations in problem buildings and aids in locating and removing emission sources with suspected effects on occupant health.

  • 227.
    Glas, Bo
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Dermatologi och venereologi. Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Methodological aspects of unspecific building related symptoms research2010Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    This thesis deals with methological issues in the study of chemical exposure and sick building syndrome (SBS). SBS is a combination of general, mucosal and skin symptoms that some people experience when staying in specific buildings. The aim was to find chemical patterns associated with SBS, but also to address methological problems in such study.

    The plan was to conduct a case-control study comparing the two groups’ chemical exposure, where cases were defined as those having at least one general, one mucosal and one skin symptom each week the last three months. For the planning it was necessary to know if cases and controls could be selected from the same building. If everyone in a building have the same chemical exposure it is no use to compare exposure between two persons at the same workplace. In the first paper exposure to more than 100 compounds is compared between 79 participants working in eight buildings. It was found that for the majority of compounds the variation in exposure was larger within buildings than between buildings, which means that cases and controls could be allowed to work in the same building.

    The second paper is a comparison of three adsorbents usability in finding differences in chemical exposure between SBS cases and controls. This was done by using chemometrical methods but comparisons of sampled amounts, blank values and reproducibility were also done. Tenax TA was found to be the best adsorbent, hence used in the case-control study.

    In recent years ozone and ozone reaction products with unsaturated volatile organic compounds (VOCs) has been in focus. Nitrogen dioxide is another gas affecting oxidation of reactive VOCs. Formaldehyde is an irritant formed when unsaturated VOCs are oxidised, and in some studies a relation with SBS has been found. In paper three the relation between personal exposure to formaldehyde, nitrogen dioxide, ozone, terpenes and SBS has been investigated among more than 200 office workers in a case control study in Umeå and Vasa. Cases (based on symptoms during the week of measurements) had lower ozone exposure than controls. No further associations were found at present exposure levels. A planed analysis of relations to VOCs could not be done due to analytical problems, and problems due to difficulties with consistent identification of compounds in a very large data set. These problems are further discussed in the thesis.

    In the case-control, study participants answered questionnaires about symptoms during "the past three months", "right now" (when answering the questionnaire), and during the week of exposure measurements. In the fourth paper the stability of symptoms were compared by answers at different occasions. It was found that the case/control concept was as stable as individual symptoms. More participants with atopic disease and those 41 years old or younger changed class compared with those without atopic disease and older participants. Measurement activities appeared to make participants report more symptoms. Fatigue, dry eyes and dry skin are suggested to be symptoms with strongest, and illness/dizziness to be weakest association with IAQ.

  • 228.
    Glas, Bo
    et al.
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Dermatologi och venereologi. Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Stenberg, Berndt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Stenlund, Hans
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Sunesson, Anna-Lena
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Association of exposure to ozone, formaldehyde, NO2 and terpenes with reported symptoms in office workersArtikel i tidskrift (Refereegranskat)
    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.

  • 229.
    Glas, Bo
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Stenberg, Berndt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Sunesson, Anna-Lena
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Comparison of three adsorbents for diffusive sampling of airborne volatile organic compounds in office environments2005Ingår i: 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, s. 2713-2717Konferensbidrag (Refereegranskat)
    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.

  • 230.
    Glas, Bo
    et al.
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Dermatologi och venereologi. Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Stenlund, Hans
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Sunesson, Anna-Lena
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Stenberg, Berndt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Dermatologi och venereologi.
    The stability of office workers’ unspecific building-related symptom reportsManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    The stability of reported unspecific building-related symptoms, or sick building syndrome (SBS) was investigated in this study. In Umeå and Vasa, two cities in northern Sweden and Finland, 172 subjects were asked about their symptoms in two questionnaires. The first contained questions about symptoms during the past three months, right now (when answering the questionnaire), and if any symptom ameliorated when they were not at their workplaces. Later on, all of the workers took measurements of their personal chemical exposure at work and at home during one week, and at the end of the week they were asked about symptoms during the week.

    The stability of a case/control concept was investigated as well as individual symptoms. It was found that 67 % of cases and controls did not change class if classifications were based on answers on symptoms during both the past three months and the week of measurements. Corresponding proportions for general, mucosal and skin symptoms were 71 %, 71 % and 78 % respectively. However, measurement activities appeared to increase symptom reports; on average 43 % of controls reported symptoms compatible with the case definition and 53 % of individual symptoms during the week of chemical measurements were not experienced when asked about symptoms during the past three months. Classification of participants with atopic disease and those 41 years old, or younger, were least stable. Nausea/dizziness does not seem to be strongly associated with indoor air quality while other general symptoms, dry eyes and facial skin symptoms are often attributed to staying within the workplace building

  • 231. Glynn, Anders
    et al.
    Lignell, Sanna
    Darnerud, Per Ola
    Aune, Marie
    Halldin Ankarberg, Emma
    Bergdahl, Ingvar A
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Barregård, Lars
    Bensryd, Inger
    Regional differences in levels of chlorinated and brominated pollutants in mother's milk from primiparous women in Sweden2011Ingår i: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 37, nr 1, s. 71-79Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Early life exposure to halogenated persistent organic pollutants, such as polychlorinated biphenyls (PCBs), the DDT metabolite p,p'-dichlorodiphenyldichloroethane (p,p'-DDE), polybrominated diphenylethers (PBDEs), and hexabromocyclododecane (HBCD), may affect human health. We determined if there are regional differences in mother's milk levels of these compounds in Sweden. In year 2000-2004, milk was sampled from 204 randomly recruited primiparas from four regions of Sweden. Levels of the compounds were measured by gas chromatography with dual electron-capture detectors. Women were recruited at delivery in three hospitals located in urban areas in southern and central Sweden (Lund, Gothenburg and Uppsala), and in one hospital located in a more rural area in northern Sweden (Lycksele). Information about dietary habits and medical/life-style factors were collected by questionnaires. Among PCB congeners, CB 153, CB 138 and CB 180 showed the highest median concentrations (18-48 ng/g mother's milk lipid), whereas more than 50% of the women had CB 52, CB 101, CB 114, and CB 157 levels below the LOQ (0.3-1.5 ng/g lipid). Median p,p'-DDE levels were in the range of 46-78 ng/g lipid. BDE 47 showed the highest median concentrations (1-2 ng/g lipid) among the brominated compounds, whereas more than 50% of the women had levels of BDE 28, BDE 66, BDE 138, BDE 154, and HBCD below the LOQ (0.05-0.10 ng/g lipid). Regional differences in median organohalogen compound concentrations were small, less than 2-fold. Lycksele women generally had the lowest levels of Σmono-and Σdi-ortho PCBs, mainly due to a lower average age. In contrast, these women had higher tetra- to penta-brominated PBDE levels, but no diet or life-style factor could explain this finding. Wide ranges of PBDEs and HBCD levels (up to 200-fold) were found, especially in the Lycksele area. The highest levels of PBDE were in the range of average levels found in mother's milk from North America, suggesting that food may not be the only source of exposure to PBDEs among some individuals.

  • 232.
    Godefay, Hagos
    et al.
    Tigray Regional Health Bureau, Mekelle, Ethiopia.
    Abrha, Atakelti
    Tigray Regional Health Bureau, Mekelle, Ethiopia.
    Kinsman, John
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Myléus, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Byass, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Institute of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, United Kingdom.
    Undertaking cause-specific mortality measurement in an unregistered population: an example from Tigray Region, Ethiopia2014Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, s. 25264-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The lack of adequate documentation of deaths, and particularly their cause, is often noted in African and Asian settings, but practical solutions for addressing the problem are not always clear. Verbal autopsy methods (interviewing witnesses after a death) have developed rapidly, but there remains a lack of clarity as to how these methods can be effectively applied to large unregistered populations. This paper sets out practical details for undertaking a representative survey of cause-specific mortality in a population of several million, taking Tigray Region in Ethiopia as a prototype.

    SAMPLING: Sampling was designed around an expected level of maternal mortality ratio of 400 per 100,000 live births, which needed measuring within a 95% confidence interval of approximately ±100. Taking a stratified cluster sample within the region at the district level for logistic reasons, and allowing for a design effect of 2, this required a population of around 900,000 people, equating to six typical districts. Since the region is administered in six geographic zones, one district per zone was randomly selected.

    IMPLEMENTATION: The survey was implemented as a two-stage process: first, to trace deaths that occurred in the sampled districts within the preceding year, and second to follow them up with verbal autopsy interviews. The field work for both stages was undertaken by health extension workers, working in their normally assigned areas. Most of the work was associated with tracing the deaths, rather than undertaking the verbal autopsy interviews.

    DISCUSSION: This approach to measuring cause-specific mortality in an unregistered Ethiopian population proved to be feasible and effective. Although it falls short of the ideal situation of continuous civil registration and vital statistics, a survey-based strategy of this kind may prove to be a useful intermediate step on the road towards full civil registration and vital statistics implementation.

  • 233.
    Goicolea, Isabel
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Adolescent pregnancies in the Amazon Basin of Ecuador: a rights and gender approach to adolescents' sexual and reproductive health2010Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 3, artikel-id 5280Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    In the Andean region of Latin America over one million adolescent girls get pregnant every year. Adolescent pregnancy (AP) has been associated with adverse health and social outcomes, but it has also been favorably viewed as a pathway to adulthood. AP can also be conceptualized as a marker of inequity, since it disproportionately affects girls from the poorest households and those who have not been able to attend school. Using results from a study carried out in the Amazon Basin of Ecuador, this paper explores APs and adolescents' sexual and reproductive health from a rights and gender approach. The paper points out the main features of a rights and gender approach, and how it can be applied to explore APs. Afterward it describes the methodologies (quantitative and qualitative) and main results of the study, framing the findings within the rights and gender approach. Finally, some implications that could be generalizable to global research on APs are highlighted. The application of the rights and gender framework to explore APs contributes to a more integral view of the issue. The rights and gender framework stresses the importance of the interaction between rights-holders and duty-bearers on the realization of sexual and reproductive rights, and acknowledges the importance of gender-power relations on sexual and reproductive decisions. A rights and gender approach could lead to more integral and constructive interventions, and it could also be useful when exploring other sexual and reproductive health matters.

  • 234.
    Goicolea, Isabel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Vives-Cases, Carmen
    Minvielle, Fauhn
    Briones-Vozmediano, Erica
    Öhman, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Applying the WHO recommendations on health-sector response to violence against women to assess the Spanish health system: a mixed methods approach2014Ingår i: Gaceta Sanitaria, ISSN 0213-9111, E-ISSN 1578-1283, Vol. 28, nr 3, s. 238-41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This methodological note describes the development and application of a mixed-methods protocol to assess the responsiveness of Spanish health systems to violence against women in Spain, based on the World Health Organization (WHO) recommendations.

    Five areas for exploration were identified based on the WHO recommendations: policy environment, protocols, training, accountability/monitoring, and prevention/promotion. Two data collection instruments were developed to assess the situation of 17 Spanish regional health systems (RHS) with respect to these areas: 1) a set of indicators to guide a systematic review of secondary sources, and 2) an interview guide to be used with 26 key informants at the regional and national levels.

    We found differences between RHSs in the five areas assessed. The progress of RHSs on the WHO recommendations was notable at the level of policies, moderate in terms of health service delivery, and very limited in terms of preventive actions. Using a mixed-methods approach was useful for triangulation and complementarity during instrument design, data collection and interpretation.

  • 235.
    Gouveia-Figueira, Sandra C.
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Karimpour, Masoumeh
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Bosson, Jenny A.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Blomberg, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Unosson, Jon
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Sehlstedt, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Pourazar, Jamshid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Sandström, Thomas
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Behndig, Annelie F.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Nording, Malin L.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Mass spectrometry profiling reveals altered plasma levels of monohydroxy fatty acids and related lipids in healthy humans after controlled exposure to biodiesel exhaust2018Ingår i: Analytica Chimica Acta, ISSN 0003-2670, E-ISSN 1873-4324, Vol. 1018, s. 62-69Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Experimental human exposure studies are an effective tool to study adverse health effects from acute inhalation of particulate matter and other constituents of air pollution. In this randomized and double-blinded crossover study, we investigated the systemic effect on bioactive lipid metabolite levels after controlled biodiesel exhaust exposure of healthy humans and compared it to filtered air at a separate exposure occasion. Eicosanoids and other oxylipins, as well as endocannabinoids and related lipids, were quantified in plasma from 14 healthy volunteers at baseline and at three subsequent time points (2, 6, and 24 h) after 1 h exposure sessions. Protocols based on liquid chromatography (LC) coupled to tandem mass spectrometry (MS/MS) methods were developed to detect temporal changes in circulating levels after biodiesel exhaust exposure. The exhaust was generated by a diesel engine fed with an undiluted rapeseed methyl ester fuel. Among the 51 analyzed lipid metabolites, PGF(2 alpha), 9,10-DiHOME, 9-HODE, 5-HETE, 11-HETE, 12-HETE, and DEA displayed significant responsiveness to the biodiesel exhaust exposure as opposed to filtered air. Of these, 9-HODE and 5-HETE at 24 h survived the 10% false discovery rate cutoff (p < 0.003). Hence, the majority of the responsive lipid metabolites were monohydroxy fatty acids. We conclude that it is possible to detect alterations in circulating bioactive lipid metabolites in response to biodiesel exhaust exposure using LC-MS/MS, with emphasis on metabolites with inflammation related properties and implications on cardiovascular health and disease. These observations aid future investigations on air pollution effects, especially with regard to cardiovascular outcomes.

  • 236.
    Gouveia-Figueira, Sandra
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Karimpour, Masoumeh
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Bosson, Jenny A.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Blomberg, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Unosson, Jon
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Pourazar, Jamshid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Sandström, Thomas
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Behndig, Annelie F.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Nording, Malin L.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Mass spectrometry profiling of oxylipins, endocannabinoids, and N-acylethanolamines in human lung lavage fluids reveals responsiveness of prostaglandin E2 and associated lipid metabolites to biodiesel exhaust exposure2017Ingår i: Analytical and Bioanalytical Chemistry, ISSN 1618-2642, E-ISSN 1618-2650, Vol. 409, nr 11, s. 2967-2980Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The adverse effects of petrodiesel exhaust exposure on the cardiovascular and respiratory systems are well recognized. While biofuels such as rapeseed methyl ester (RME) biodiesel may have ecological advantages, the exhaust generated may cause adverse health effects. In the current study, we investigated the responses of bioactive lipid mediators in human airways after biodiesel exhaust exposure using lipidomic profiling methods. Lipid mediator levels in lung lavage were assessed following 1-h biodiesel exhaust (average particulate matter concentration, 159 mu g/m(3)) or filtered air exposure in 15 healthy individuals in a double-blinded, randomized, controlled, crossover study design. Bronchoscopy was performed 6 h post exposure and lung lavage fluids, i.e., bronchial wash (BW) and bronchoalveolar lavage (BAL), were sequentially collected. Mass spectrometry methods were used to detect a wide array of oxylipins (including eicosanoids), endocannabinoids, Nacylethanolamines, and related lipid metabolites in the collected BWand BAL samples. Six lipids in the human lung lavage samples were altered following biodiesel exhaust exposure, three from BAL samples and three from BW samples. Of these, elevated levels of PGE2, 12,13-DiHOME, and 13-HODE, all of which were found in BAL samples, reached Bonferroni-corrected significance. This is the first study in humans reporting responses of bioactive lipids following biodiesel exhaust exposure and the most pronounced responses were seen in the more peripheral and alveolar lung compartments, reflected by BAL collection. Since the responsiveness and diagnostic value of a subset of the studied lipid metabolites were established in lavage fluids, we conclude that our mass spectrometry profiling method is useful to assess effects of human exposure to vehicle exhaust.

  • 237. Grim, Katarina
    et al.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Svedberg, Petra
    Schön, Ulla-Karin
    Shared decision-making in mental health care: a user perspective on decisional needs in community-based services2016Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, artikel-id 30563Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice.

    Objective: The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden.

    Methods: Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.’s model of SDM.

    Results: The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process.

    Conclusions and Implications for Practice: The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system. 

  • 238.
    Gruber, Michael
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Palmquist, Eva
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Nordin, Steven
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Characteristics of perceived electromagnetic hypersensitivity in the general population2018Ingår i: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 59, nr 4, s. 422-427Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Health problems evoked in the presence of electrical equipment is a concern, calling for better understanding for characteristics of electromagnetic hypersensitivity (EHS) in the general population. The present study investigated demographics, lifestyle factors, frequency and duration, coping strategies, proportion meeting clinical criteria for intolerance attributed to electromagnetic fields (EMF) and comorbidity. Using data from a large-scale population-based questionnaire study, we investigated persons with self-reported (n=91) EHS in comparison to referents (n=3,250). Middle age, female sex and poor perceived health was found to be associated with EHS. More than 50% in the EHS group reported having EMF-related symptoms more often than once a week, and the mean number of years experiencing EHS was 10.5. More than half of the EHS group reported that their symptoms started after a high-dose or long-term EMF exposure, that they actively tried to avoid EMF sources and that they mostly could affect the EMF environment. A minority of the EHS group had sought medical attention, been diagnosed by a physician or received treatment. Exhaustion syndrome, anxiety disorder, back/joint/muscle disorder, depression, functional somatic syndrome and migraine were comorbid with EHS. The results provide ground for future study of these characteristic features being risk factors for development of EHS and or consequences of EHS.

  • 239. Guastadisegni, Cecilia
    et al.
    Kelly, Frank J
    Cassee, Flemming R
    Gerlofs-Nijland, Miriam E
    Janssen, Nicole AH
    Pozzi, Roberta
    Brunekreef, Bert
    Sandström, Thomas
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin.
    Mudway, Ian
    Determinants of the proinflammatory action of ambient particulate matter in immortalized murine macrophages2010Ingår i: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 118, nr 12, s. 1728-1734Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We found no evidence that PM collected from sites in close proximity to traffic sources displayed enhanced proinflammatory activity in RAW264.7 cells.

  • 240. Guo, Yuming
    et al.
    Gasparrini, Antonio
    Li, Shanshan
    Sera, Francesco
    Vicedo-Cabrera, Ana Maria
    de Sousa Zanotti Stagliorio Coelho, Micheline
    Saldiva, Paulo Hilario Nascimento
    Lavigne, Eric
    Tawatsupa, Benjawan
    Punnasiri, Kornwipa
    Overcenco, Ala
    Correa, Patricia Matus
    Ortega, Nicolas Valdes
    Kan, Haidong
    Osorio, Samuel
    Jaakkola, Jouni J K
    Ryti, Niilo R I
    Goodman, Patrick G
    Zeka, Ariana
    Michelozzi, Paola
    Scortichini, Matteo
    Hashizume, Masahiro
    Honda, Yasushi
    Seposo, Xerxes
    Kim, Ho
    Tobias, Aurelio
    Íñiguez, Carmen
    Forsberg, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Oudin Åström, Daniel
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Guo, Yue Leon
    Chen, Bing-Yu
    Zanobetti, Antonella
    Schwartz, Joel
    Dang, Tran Ngoc
    Van, Dung Do
    Bell, Michelle L
    Armstrong, Ben
    Ebi, Kristie L
    Tong, Shilu
    Quantifying excess deaths related to heatwaves under climate change scenarios: A multicountry time series modelling study2018Ingår i: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 15, nr 7, artikel-id e1002629Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Heatwaves are a critical public health problem. There will be an increase in the frequency and severity of heatwaves under changing climate. However, evidence about the impacts of climate change on heatwave-related mortality at a global scale is limited.

    METHODS AND FINDINGS: We collected historical daily time series of mean temperature and mortality for all causes or nonexternal causes, in periods ranging from January 1, 1984, to December 31, 2015, in 412 communities within 20 countries/regions. We estimated heatwave-mortality associations through a two-stage time series design. Current and future daily mean temperature series were projected under four scenarios of greenhouse gas emissions from 1971-2099, with five general circulation models. We projected excess mortality in relation to heatwaves in the future under each scenario of greenhouse gas emissions, with two assumptions for adaptation (no adaptation and hypothetical adaptation) and three scenarios of population change (high variant, median variant, and low variant). Results show that, if there is no adaptation, heatwave-related excess mortality is expected to increase the most in tropical and subtropical countries/regions (close to the equator), while European countries and the United States will have smaller percent increases in heatwave-related excess mortality. The higher the population variant and the greenhouse gas emissions, the higher the increase of heatwave-related excess mortality in the future. The changes in 2031-2080 compared with 1971-2020 range from approximately 2,000% in Colombia to 150% in Moldova under the highest emission scenario and high-variant population scenario, without any adaptation. If we considered hypothetical adaptation to future climate, under high-variant population scenario and all scenarios of greenhouse gas emissions, the heatwave-related excess mortality is expected to still increase across all the countries/regions except Moldova and Japan. However, the increase would be much smaller than the no adaptation scenario. The simple assumptions with respect to adaptation as follows: no adaptation and hypothetical adaptation results in some uncertainties of projections.

    CONCLUSIONS: This study provides a comprehensive characterisation of future heatwave-related excess mortality across various regions and under alternative scenarios of greenhouse gas emissions, different assumptions of adaptation, and different scenarios of population change. The projections can help decision makers in planning adaptation and mitigation strategies for climate change.

  • 241.
    Gustafsson, Johanna
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Kunskap och individuellt stöd – en bra grund för beteendeförändringar vid rygg- och nacksmärta.: En intervjustudie.2016Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Arbetsrelaterade besvär är vanligt förekommande i Sverige. Muskuloskeletala besvär står för en stor del av sjukskrivningarna i Sverige och anställda inom vård- och serviceyrken är bland de hårdast drabbade. Brister i både psykosocial och fysisk arbetsmiljö var vanliga på förskolor. Träning var en viktig behandlingsmetod vid smärta från rygg och nacke och tilltron till den egna förmågan har visat sig viktig vid hantering av smärta. Trotts kunskap om riskfaktorer och effektiva behandlingsmetoder besväras många förskollärare av smärta från nacke och rygg.

    Syftet med denna intervjubaserade studie var att undersöka förskollärares upplevelse av en intervention i form av en rygg- och nackgrupp. För att få svar på det genomfördes 4 individuella intervjuer med kvalitativ design. Kunskap och individuellt stöd visade sig vara en bra grund för beteendeförändingar. Vidare identifierades kategorierna: Förändrat beteende gav minskade besvär, ökad tilltro till den egna förmågan, interventionen gav insikt om faktorer som stöttade en förändring och interventionen gav insikt om faktorer som försvårade en förändring. Intervjuerna skapade en förståelse för vilka faktorer som kan vara viktiga för att minska smärta från rygg och nacke samt stödja en beteendeförändring bland förskollärare. Resultatet kan ge företagshälsovården kunskap om förskollärares arbetssituation och hur de på bästa sätt stöttas till en bättre hälsa på arbete.     

  • 242.
    Gustafsson, Per E
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Persson, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Hammarström, Anne
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Life course origins of the metabolic syndrome in middle-aged women and men: the role of socioeconomic status and metabolic risk factors in adolescence and early adulthood2011Ingår i: Annals of Epidemiology, ISSN 1047-2797, E-ISSN 1873-2585, Vol. 21, nr 2, s. 103-110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To assess whether body mass index (BMI), blood pressure, and socioeconomic status in adolescence and early adulthood are independently related to the metabolic syndrome in adult women and men.

    METHODS: We based our work on a Swedish prospective cohort study that recruited participants at 16 years of age (N = 1083 at age 16; 403 women and 429 men at age 43, 78% of those still alive [N = 1071]). Blood pressure (BP) and BMI were assessed when participants were 16 and 21 years of age. At age 43, the metabolic syndrome was defined according to the International Diabetes Federation guidelines. Socioeconomic status (SES) was operationalized by the participant (age 21 and 43) or parent's (age 16) occupational status. Information on smoking, snuff, alcohol, and inactivity was collected at age 43.

    RESULTS: In women, SES at age 16 was independently related to the risk of metabolic syndrome. In women and men, BMI at age 16 was related to metabolic syndrome but was attenuated by BMI at age 21, which was significant in the final model; in women systolic BP displayed similar patterns.

    CONCLUSIONS: Our data seem to suggest two independent life course pathways for metabolic syndrome: one metabolic pathway for both women and men operating through BMI (for women also systolic BP) in adolescence and early adulthood, and for women, an apparently independent pathway through adolescent socioeconomic disadvantage. Ann Epidemiol 2011;21:103-110. (C) 2011 Elsevier Inc. All rights reserved.

  • 243.
    Gyllencreutz, Lina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Rolfsman, Ewa
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för tillämpad utbildningsvetenskap.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Non-minor injuries among children sustained in an outdoor environment: a retrospective register study2015Ingår i: International Journal of Injury Control and Safety Promotion, ISSN 1745-7300, E-ISSN 1745-7319, Vol. 22, nr 1, s. 3-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to investigate non-minor injuries sustained during outdoor activities among 0-12 year old children and to explore self-reported circumstances surrounding these incidents. During 2007-2009, the Umea University Hospital injury database (IDB) registered 795 children with moderate (n = 778) and serious (n = 17) injuries, such as fractures. The IDB includes data from a questionnaire completed in the emergency department by the injured child or a parent. The open-ended questions catch the injured child's description of what circumstances precede the injury incident. The most commonly reported activities contributing to injuries were play, sport, and transport. Surface impacts were also reported as contributing factors along with products such as trampolines, bicycles, and downhill skis. By achieving a deeper knowledge about the activities and circumstances that precede non-minor injury incidents, creating safer outdoor environments may be feasible.

  • 244.
    Gómez Real, Francisco
    et al.
    Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway.
    Pérez Barrionuevo, Laura
    Department of Clinical Science, University of Bergen, Bergen, Norway.
    Franklin, Karl
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Lindberg, Eva
    Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
    Jacobsen Bertelsen, Randi
    Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
    Benediktsdóttir, Bryndís
    University of Iceland, Faculty of Medicine, Reykjavik, Iceland.
    Forsberg, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Gislason, Thorarinn
    University of Iceland, Faculty of Medicine, Reykjavik, Iceland.
    Jögi, Rain
    Lung Clinic, Tartu University Clinics, Tartu, Estonia.
    Johannessen, Ane
    Department of Clinical Science, University of Bergen, Bergen, Norway; Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway .
    Omenaas, Ernst
    Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
    Saure, Eirunn
    Department of Clinical Science, University of Bergen, Bergen, Norway.
    Schlünssen, Vivi
    Department of Public Health, Section for Environment, Occupation and Health, Aarhus University, Aarhus, Denmark.
    Skorge, Trude Duelien
    Department of Clinical Science, University of Bergen, Bergen, Norway.
    Torén, Kjell
    Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Pérez Saavedra, Antonio
    Clinica Dental Pérez Saveedra, Málaga, Spain.
    Svanes, Øistein
    Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
    Nordrehaug Åstrøm, Anne
    Department of Clinical Dentistry, University of Bergen, Bergen Norway.
    Janson, Christer
    Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
    Svanes, Cecilie
    Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
    The Association of Gum Bleeding with Respiratory Health in a Population Based Study from Northern Europe2016Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, nr 1, artikel-id e0147518Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: There is little knowledge about how oral and respiratory health is interrelated even though the mucosa of the oral cavity and airways constitutes a continuum and the exposures to these are partly similar.

    AIMS: To investigate whether gum bleeding is related to asthma, respiratory symptoms and self-reported COPD.

    METHODS: A postal questionnaire including questions about respiratory and oral health was sent to general population samples in seven Northern European centres. In 13,409 responders, gum bleeding when brushing teeth was reported always/often by 4% and sometimes by 20%. Logistic regressions accounted for age, smoking, educational level, centre and gender. Effects of BMI, cardio-metabolic diseases, early life factors, gastro-oesophageal reflux, dental hygiene, nasal congestion, and asthma medication were addressed.

    RESULTS: Gum bleeding always/often was significantly associated with ≥3 asthma symptoms (OR 2.58, 95% CI 2.10-3.18), asthma (1.62 [1.23-2.14]) and self-reported COPD (2.02 [1.28-3.18]). There was a dose-response relationship between respiratory outcomes and gum bleeding frequency (≥3 symptoms: gum bleeding sometimes 1.42 [1.25-1.60], often/always 2.58 [2.10-3.18]), and there was no heterogeneity between centres (pheterogeneity = 0.49). None of the investigated risk factors explained the associations. The observed associations were significantly stronger among current smokers (pinteraction = 0.004).

    CONCLUSIONS: A consistent link between gum bleeding and obstructive airways disease was observed, not explained by common risk factors or metabolic factors. We speculate that oral pathogens might have unfavourable impact on the airways, and that the direct continuity of the mucosa of the oral cavity and the airways reflects a pathway that might provide novel opportunities for interventions.

  • 245.
    Hadrevi, Jenny
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Ca 2+ regulatory proteins of muscle contraction: a possible marker of chronic muscle myalgia2014Konferensbidrag (Refereegranskat)
    Abstract [en]

    Aim of Investigation

    Work related illnesses are one of the main reasons for sick-leave in the western world. One of the most common is pain and discomfort in the neck-shoulder region affecting the trapezius muscle, trapezius myalgia (TM). Patients suffering from work related chronic trapezius myalgia experience muscle stiffness, weakness and tension. The biochemical mechanisms behind these sensations are not yet known. Recent proteomic screening results indicate an increased abundance of the calcium regulatory fast myosin light chains in myalgic muscle suggesting an altered contractibility in the myalgic trapezius. To characterize a general increase of Ca2+ in the myalgic muscle the expression level of sarco/endoplasmic reticulum Ca2+-ATPase, (SERCA-1) was analyzed. The aim of this study was to compare the level of Ca2+ regulated proteins in cleaners with trapezius myalgia (TM) and cleaners without trapezius myalgia (CON) and to verify a possible difference in phosphorylation of the contractile regulatory myosin light chains.

    Methods

    Two-dimensional gel electrophoresis was used to separate proteins of interest. The proteomic correlation pattern of the myosin light chain proteins and the differences between healthy and myalgic muscle were investigated using a multivariate Partial Least Square Discriminant Analysis (PLS-DA). Phosphorylations of the fast regulatory myosin light chains were analyzed using serine and tyrosin antibodies. The characterization of myosin isoforms was performed using advanced Orbitrap LC-MS/MS. The expression level of SERCA-1 was analyzed in muscle biopsies from 11 professional cleaners with TM and 11 CON using Simple western size assay (Peggy, Protein simple, CA, US)

    Results

    The detected systematic differences between myosin light chain proteins showed according to the PLS-DA analysis that the fast regulatory light chains were generally more abundant in the MYA group. Ten protein spots were identified as different myosin light chains isoforms according to the amino acid sequencing. Phosphorylated serine was detected in 6 of the isoforms, though there were no differences in amount of phosphorylation between spots. The expression level of Serca-1 was significantly (p = 0.017) higher in TM subjects compared to the CON.

    Conclusions

    There is a higher abundance of fast contracting calcium regulatory myosin light chains in muscle experiencing chronic myalgia. This increased abundance of the regulatory fast myosin light chains supports the previously presented results showing an altered contractibility of the myalgic trapezius muscle. Our results show no difference in phosphorylation between the different spots contradictory to previously published results; suggesting phosphorylation of the protein being the reason for the separation of spots on the two dimensional gels. Instead our results show the spots to have different amino acid sequences. The actual function of the detected myosin light chain proteins remains to be elucidated. The increased abundance of fast contracting regulatory light chains together with the significantly increased abundance of Serca-1 proteins in the MYA muscle supports a higher abundance of Ca2+ in the myalgic muscle. The increased abundance of Serca-1 might be an indication of an adaptation due to peripheral sensitization or increased neuronal signaling altering the contrability of the muscle.       

     

    Acknowledgments

    Supported by Postdoctoral Grant from Swedish Research Council for Health, Working Life and Welfare (Forte) 2013-1259 and Medical Research Council of Southeast Sweden (FORSS-159031,LIO-35923, SC-2013-00395-36).

     

     

     

  • 246.
    Hadrévi, Jenny
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Jonsdottir, Ingibjörg H.
    Institutet för Stressmedicin, Göteborg.
    Jansson, Per-Anders
    Sahlgrenska, Göteborgs Universitet.
    Eriksson, Jan W.
    Uppsala Universitet.
    Sjörs, Anna
    Institutet för Stressmedicin, Göteborg.
    Plasma metabolomic patterns in patients with exhaustion disorder2019Ingår i: Stress, ISSN 1025-3890, E-ISSN 1607-8888, Vol. 22, nr 1, s. 17-26Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Exhaustion disorder (ED) is a stress-related disorder that often implies a great burden on the individual patient as well as on society. Previous studies have shown that ED is associated with metabolic deviations, such as lowered fasting glucose. Several mechanisms have been discussed as a plausible explanation of the lack of energy described by these patients. Metabolic processes and reduced ability to mobilize energy have been suggested as important factors. This study investigated metabolomics in 20 patients diagnosed with ED and compared them with 21 healthy controls. Plasma metabolic profiles were examined in both fasting and nonfasting (postprandial) conditions. Blood plasma samples were analyzed for metabolite content using gas chromatography mass spectrometry. A total of 62 different metabolites were simultaneously detected in each of the samples. Multivariate models indicated systematic differences between patients with ED and healthy controls in both their fasting and nonfasting plasma metabolite levels. Lysine and octadecenoic acid were more abundant and glutamine, glycine, serine and gluconic acid were less abundant in the patients across both conditions. In the present study, we comprehensively and simultaneously screen for changes in a large number of metabolites. Our results show a difference in systemic metabolites between patients with exhaustion disorder and healthy controls both in the fasting and in the postprandial states. Here, we present new potential biomarkers mirroring exhaustion disorder metabolism.

  • 247. Hagberg, L A
    et al.
    Lindahl, Bernt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nyberg, L
    Hellénius, M-L
    Importance of enjoyment when promoting physical exercise2009Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 19, nr 5, s. 740-747Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this study was to investigate the importance of enjoyment of exercise in a health care-based intervention aimed at promoting physical exercise in primary health care patients. In a controlled study design, the intervention group was offered a wide range of group exercises over 3 months, followed by support in designing their own exercise program. The control group received usual care. Enjoyment of exercise and exercise level were measured. Associations between enjoyment and exercise level were analyzed using Spearman's rank correlation coefficients. Changes in enjoyment between and within study groups were analyzed by the independent and paired t-test. Associations were found between enjoyment and exercise level (r=0.36, P<0.01), as well as between changes in enjoyment and changes in exercise level (r=0.34, P<0.01). At the 12-month follow-up, enjoyment of exercise was 25% higher in the intervention group than in the control group (P<0.01). In this group of primary health care patients, enjoyment of exercise was associated with exercise level. Enjoyment of exercise seems to be a mediator of exercise level. Furthermore, health care-based interventions seem to be able to affect enjoyment of exercise. Enjoyment of exercise may be important for the long-term effectiveness, of health care-based interventions.

  • 248.
    Hagenbjörk, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Kvävedioxid- och kväveoxidhalter i Umeå: sammanställning av mätningar gjorda med diffusionsprovtagare mellan november 2009 och december 20162017Rapport (Övrigt vetenskapligt)
  • 249.
    Hagenbjörk, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Kvävedioxid- och kväveoxidhalter i Umeå: Sammanställning av mätningar gjorda med diffusionsprovtagare mellan november 2009 och december 20182019Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Mätning av kvävedioxid (NO2) och kväveoxider (NOx) har utförts med diffusionsprovtagare vid två tillfällen (sommartid respektive vintertid) på 41 platser i Umeå tätort under 2018. Två veckomätningar har gjorts varje år på dessa platser sedan 2009 och totalt nitton mätningar har utförts på samma sätt över åren. Mätplatsernas geografiska läge kan ha varierat något över tid, provtagare har ibland plockats ned av förbipasserande varför alla mätplatser inte har maximalt antal mätningar. Det finns 25 mätplatser där mätningar har gjorts vid alla sjutton tillfällen.De högsta halterna har uppmätts på trafikerade platser under vinterhalvåret p.g.a. större utsläpp och stillastående luft, s.k. inversion. Vid mätningarna 2018 uppmättes de högsta halterna NO2 både sommartid och vintertid vid en husfasad belägen på Västra Esplanaden, centralt i Umeå (22 μg/m3 respektive 54 μg/m3). NOx-halten sommartid var högst vid samma mätpunkt på Västra Esplanaden (54 μg/m3) medan halten vid vintermätningen var högst vid mätvagnen vid Västra Esplanaden (158 μg/m3).

  • 250.
    Hagenbjörk, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Kväveoxid-och kvävedioxidhalter i Umeå: sammanställning av mätningar gjorda med diffusionsprovtagare mellan november 2009 och december 20172018Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Mätning av kvävedioxid (NO2) och kväveoxider (NOx) har utförts med diffusionsprovtagare vid två tillfällen (sommartid respektive vintertid) på 41 platser i Umeå tätort under 2017. Två veckomätningar har gjorts varje år på dessa platser sedan 2009 och totalt sjutton mätningar har utförts på samma sätt över åren. Mätplatsernas geografiska läge kan ha varierat något över tid, provtagare har ibland plockats ned av förbipasserande varför alla mätplatser inte har maximalt antal mätningar. Det finns 25 mätplatser där mätningar har gjorts vid alla sjutton tillfällen.

    De högsta halterna har uppmätts på trafikerade platser under vinterhalvåret p.g.a. större utsläpp och stillastående luft, s.k. inversion. Vid mätningarna 2017 uppmättes de högsta halterna NO2 både sommartid och vintertid vid en husfasad belägen på Västra Esplanaden, centralt i Umeå (21 μg/m3 respektive 51 μg/m3). NOx-halten vintertid var högst vid samma mätpunkt på Västra Esplanaden (134 μg/m3) medan halten vid sommarmätningen var högst vid Östra Kyrkogatan, mittemot simhallen Navet (56 μg/m3).

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