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  • 51.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Lewold, Stefan
    Malchau, Henrik
    Vingård, Eva
    Age, bodyweight, smoking habits and the risk of severe osteoarthritis in the hip and knee in men.2005Ingår i: Eur J Epidemiol, ISSN 0393-2990, Vol. 20, nr 6, s. 537-42Artikel i tidskrift (Refereegranskat)
  • 52.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Lundström, Ronnie
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Malchau, Henrik
    Rehn, Börje
    Vingård, Eva
    Osteoarthritis in the hip and whole-body vibration in heavy vehicles.2004Ingår i: Int Arch Occup Environ Health, ISSN 0340-0131, Vol. 77, nr 6, s. 424-6Artikel i tidskrift (Refereegranskat)
  • 53.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Mannelqvist, Ruth
    Umeå universitet, Samhällsvetenskapliga fakulteten, Juridiska institutionen.
    Ersättning vid arbetsskada2019Ingår i: Arbets- och miljömedicin: en lärobok om hälsa och miljö / [ed] Christer Edling, Gunnar Nordberg, Maria Albin, Monica Nordberg, Lund: Studentlitteratur AB, 2019, 4, s. 397-402Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 54.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Mannelqvist, RuthUmeå universitet, Samhällsvetenskapliga fakulteten, Juridiska institutionen.Olofsson, ChristerKallinge Vårdcentral, Karlskrona.Torén, KjellGöteborgs universitet.
    Försäkringsmedicin2013Samlingsverk (redaktörskap) (Övrigt vetenskapligt)
    Abstract [sv]

    Boken beskriver centrala försäkringsmedicinska begrepp ur ett både principiellt och kritiskt perspektiv samt ger en överblick över gällande regelverk. I boken framgår hur personförsäkringar utvecklats med tonvikt på svenska förhållanden men här finns även en jämförelse med andra närliggande länder. Försäkringsmedicinens medicinska och juridiska bedömningar belyses liksom dess kopplingar till juridiken och särskilt till skadeståndsrätten. Försäkringarnas innehåll och hur enskilda ärenden handläggs har förändrats varför flera områden, särskilt inom socialförsäkringen, är föremål för diskussion. Boken innehåller en kritisk analys av vissa sådana aspekter, bl.a. olika etiska perspektiv. Regelverken förändras i snabb takt och aktuella regler hämtas i dag framför allt via webben. Boken innehåller de viktigaste reglerna, framför allt inom socialförsäkringen, på en övergripande nivå.

    Syftet är att ge läsaren en fördjupad förståelse för de medicinska och juridiska principer som är centrala inom försäkringsmedicinen. Den innehåller också en övergripande beskrivning av gällande regelverk i Sverige och vissa andra länder.

    Boken vänder sig till personer som behöver en fördjupad förståelse för försäkringsmedicinska frågor, t.ex. läkare och annan sjukvårdspersonal, jurister och handläggare av personförsäkringar.

  • 55.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Reuterwall, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    A comparison of occupational and non-occupational exposure to diesel exhausts and its consequences for studying health effects2012Ingår i: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 69, nr 11, s. 851-52Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 56.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Reuterwall, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Arbetsmiljöns bidrag till hjärt-kärlsjukdom2012Rapport (Övrigt vetenskapligt)
  • 57.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Reuterwall, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Bystedt, Jennie
    Sundsvalls Hospital, Sundsvall, Sweden.
    Mortality attributable to occupational exposure in Sweden2013Ingår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 39, nr 1, s. 106-111Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The objective of this study was to estimate the mortality from cancer, cardiovascular, and respiratory diseases attributable to occupational exposure in Sweden. METHODS: Estimates were calculated for men and women separately, and we considered only deaths between 25-74 years of age. We considered cancer exposures/sites classified as I or 2a according to the International Agency for Research on Cancer (IARC). Acute myocardial infarction was the only included cardiovascular disease. Respiratory diseases comprised chronic obstructive pulmonary disease (COPD) asthma, pneumoconiosis and alveolitis. All deaths of pneumoconiosis and alveolitis were considered work-related. Estimates were based on the Swedish mortality in 2007. RESULTS: In total, we estimate that there are about 800 work-related deaths per year in the studied causes. The majority are due to acute myocardial infarction, with 126 deaths among women and 337 deaths among men attributable to job strain, shift work, exhaust gases, combustion products, or environmental tobacco smoke (ETS). There are 99 respiratory disease-related deaths, the vast majority from COPD (N=92). In total, 270 cancer deaths are estimated to be work-related. For men, half of the cases are attributed to asbestos exposure. CONCLUSIONS: Our results indicate that preventive measures to decrease occupational mortality should consider factors associated with myocardial infarction such as job strain, shift work and exhaust gases from vehicles and combustion products. Exposures to factors associated with COPD, such as dust, also seem important to prevent.

  • 58.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Stattin, Mikael
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Robroek, Suzan JW
    Janlert, Urban
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Karlsson, Bernt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burdorf, Alex
    Heavy work and disability pension: a long term follow-up of Swedish construction workers2014Ingår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 40, nr 4, s. 335-342Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The objective of this study was to investigate the occurrence of disability pensions over time among workers with physically demanding jobs.

    METHODS: The occurrence of disability pension was prospectively studied between 1980-2008 among 325 549 Swedish construction workers. The risks for disability pension and years lost of working life were compared among 22 occupational groups, adjusting for age, body mass index, height, and smoking habits.

    RESULTS: The risk varied considerably among blue-collar workers. For example, rock workers had double the risk of disability pension [relative risk (RR) 2.16, 95% confidence interval (95% CI) 1.96-2.39] compared to electricians. Most working years lost due to disability pensions (about 75%) were found among men >50 years, mainly due to musculoskeletal and cardiovascular diseases. The years of working life lost due to disability pension varied from 0.7 (salaried employees) to 3.2 years (rock workers) among occupational groups.

    CONCLUSION: Work environment is an important predictor for disability pension among construction workers with those in physically heavy jobs having the highest burden of disability. If the purpose is to increase labor force participation for workers with heavy jobs, strategies to reduce physical demands at work among elderly workers are important.

  • 59.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Svartengren, Magnus
    Allvarlig silikos finns fortfarande i Sverige2015Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, nr 49, artikel-id DL7FArtikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Silikos orsakas av kvarts och kan inte botas, bara förebyggas. Vid tidiga tecken på sjukdomen kan avbruten exponering minska risken för att sjukdomen blir allvarlig. Stora insatser gjordes i Sverige för att eliminera sjukdomen under mitten av 1900-talet. Trots detta angavs silikos som bidragande eller underliggande dödsorsak hos 70 män och 1 kvinna mellan 2007 och 2012. Bearbetning av berg i stenindustri eller gruva var de vanligaste arbetsmiljöerna för dessa fall. Alla personer utom tre var födda i Sverige. Studien visar att arbetsmiljön i Sverige fortfarande kan innebära en risk för allvarlig silikos. Risken förebyggs bäst genom noggrann kontroll av dammhalterna.

  • 60.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Vingård, Eva
    Englyst, Vagn
    Elgstrand, Kaj
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Sverige bör vara förebild för säkerhet och miljö i gruvindustrin2014Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, nr 18-19, s. 111CT6U-Artikel i tidskrift (Refereegranskat)
  • 61.
    Järvholm, Bengt
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Åström, Evelina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    The risk of lung cancer after cessation of asbestos exposure in construction workers using pleural malignant mesothelioma as a marker of exposure.2014Ingår i: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 56, nr 12, s. 1297-1301Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study the risk of lung cancer in heavily asbestos-exposed workers after the exposure to asbestos has ended.

    METHODS: Lung cancer was studied in a cohort of 189,896 Swedish construction workers through a linkage with the Swedish Cancer Registry. Asbestos exposure was estimated by the incidence of malignant mesothelioma in the occupational group.

    RESULTS: There were in total 2835 cases of lung cancer. Workers with heavy exposure to asbestos had an increased risk of lung cancer (relative risks = 1.74; 95% confidence interval, 1.25 to 2.41) before exposure ended and a similar risk to those with low exposure 20 years after the exposure had ceased (relative risks = 0.94; 95% confidence interval, 0.77 to 1.15).

    CONCLUSIONS: Workers with heavy exposure to asbestos have a similar risk of lung cancer as persons with low or no exposure 20 years after the exposure has ended.

  • 62.
    Knutsson, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Mukka, Sebastian
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Sayed-Noor, Arkan S
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    The association between tobacco smoking and surgical intervention for lumbar spinal stenosis: cohort study of 331,941 workers2018Ingår i: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 18, nr 8, s. 1313-1317Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND CONTEXT: Tobacco smoking is an injurious habit associated with a number of chronic disorders. Its influence on disc metabolism and degeneration including lumbar spinal stenosis (LSS) has been investigated in the literature.

    PURPOSE: We aimed to investigate whether tobacco smoking is an independent risk factor for undergoing surgical intervention for LSS.

    STUDY DESIGN/SETTING: This is a prospective cohort study.

    PATIENT SAMPLE: The patient sample of 331,941 workers was derived from a Swedish nationwide occupational surveillance program for construction workers.

    OUTCOME MEASURE: The outcome measure included the incidence of undergoing surgical intervention for LSS in tobacco smokers versus no smokers.

    MATERIALS AND METHODS: At inclusion, age, sex, body mass index (BMI), workers' job title, and self-reported smoking habits were registered. The workers were divided into four categories: never smoked, former smoker, moderate current (1-14 cigarettes/day), and heavy current (≥15 cigarettes/day). Patients who underwent a surgically treated LSS were defined using the relevant International Classification of Diseases (ICD) disease code derived from the Swedish National Patient Register.

    RESULTS: A total of 331,941 participants were included in the analysis. Forty-four percent of the participants were non-smokers, 16% were former smokers, 26% were moderate smokers, and 14% were heavy smokers. The vast majority of construction workers were males (95%). During the average follow-up of 30.7 years, 1,623 participants were surgically treated for LSS. The incidence rate ratio (IRRs) of LSS varied across smoking categories, with the highest values found in heavy smokers. Compared with non-smokers, all smoking categories show an increased incidence of surgically treated LSS. The findings were consistent even when the comparison was performed for participants with BMIs between 18.5 and 25 and for participants aged between 40 and 74 years.

    CONCLUSIONS: Tobacco smoking is associated with an increased incidence of surgically treated LSS. The effect seems to be dose related, whereby heavy smokers have a higher risk than moderate or former smokers.

  • 63. Knutsson, Björn
    et al.
    Sandén, Bengt
    Sjödén, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Michaëlsson, Karl
    Body mass index and risk for clinical lumbar spinal stenosis: a cohort study2015Ingår i: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 40, nr 18, s. 1451-1456Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STRUCTURED ABSTRACT: Study Design. A prospective cohort study that used a Swedish nationwide occupational surveillance program for construction workers (period of registration from 1971-1992). In all, 364 467 participants (mean age at baseline 34 years) were included in the study.

    OBJECTIVE: To determine whether overweight and obesity are associated with a higher risk of lumbar spinal stenosis (LSS).

    SUMMARY OF BACKGROUND DATA: During recent decades, LSS has become the most common indication for spine surgery, a change that coincides with a higher prevalence of obesity.

    METHODS: A diagnosis of LSS was collected through individual linkage to the Swedish National Patient Register through December 31, 2011. Poisson regression models were employed to estimate multivariable-adjusted incidence rate ratios (IRRs) for LSS.

    RESULTS: At baseline, 65% had normal weight (BMI 18.5 to 24.99 kg/m), 29% were overweight (BMI 25 to 29.99 kg/m), 5% were obese (BMI≥30 kg/m) and 2% were underweight (BMI<18.5 kg/m). During 11,190,944 person-years of follow-up, with a mean of 31 years, 2381 participants were diagnosed with LSS. Compared with normal weight individuals, obese workers had an IRR of 2.18 (95% confidence interval (CI), 1.87 to 2.53) for LSS and overweight workers had an IRR of 1.68 (95% CI, 1.54 to 1.83). Workers who were underweight halved their risk of LSS (IRR 0.52, 95% CI 0.30 to 0.90).

    CONCLUSION: Obese and overweight persons are at a higher risk of developing LSS. Further, our results indicate that obesity might be a novel explanation for the increased number of patients with clinical LSS.

  • 64.
    Liljelind, IE
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Strömbäck, AE
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, BG
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Levin, JO
    Strangert, BL
    Sunesson, A-LK
    Self-assessment of exposure: a pilot study of assessment of exposure to benzene in tank truck drivers2000Ingår i: Applied occupational and environmental hygiene, ISSN 1047-322X, Vol. 15, nr 2, s. 195-202Artikel i tidskrift (Refereegranskat)
  • 65.
    Liljelind, Ingrid E
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin.
    Rappaport, Stephen M
    School of Public Health, University of North Carolina, Chapel Hill, North Carolina, United States.
    Levin, Jan-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin. National Institute for Working Life, Programme for Chemical Exposure Assessment, Umeå.
    Pettersson-Strömbäck, Anita E
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin.
    Sunesson, Anna-Lena
    National Institute for Working Life, Programme for Chemical Exposure Assessment, Umeå.
    Järvholm, Bengt G
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin.
    Comparison of self-assessment and expert assessment of occupational exposure to chemicals2001Ingår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 27, nr 5, s. 311-317Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Occupational assessments of chemical exposure are often inadequate because of difficulties in obtaining sufficient numbers of measurements by trained professionals (experts). The objective of this study was to determine whether workers can provide unbiased data via self-assessments of exposure facilitated by the use of simple passive monitors for personal sampling.

    METHODS: Untrained workers obtained personal measurements of their exposures to gaseous contaminants (terpenes in sawmills and styrene in reinforced plastics factories) with passive monitors and written instructions. To study the validity of the self-assessments, an occupational hygienist performed exposure measurements on the same occupational groups after the workers had obtained two or more measurements independently. The potential bias of the self-assessments was evaluated by comparing the self-assessments with the expert assessments in mixed-effects statistical models.

    RESULTS: A total of 153 terpene (97 self and 56 expert) and 216 styrene (159 self and 57 expert) measurements were obtained from four sawmills and six reinforced plastics factories, respectively. No significant differences in the geometric mean exposures were observed between the self-assessments and the expert assessments in 3 of 4 sawmills and 5 of 6 reinforced plastics factories (P > 0.10). The potential bias of the self-assessments of exposure ranged from less than 0.1% to 102% and was less than 17% in 9 of the 10 groups investigated.

    CONCLUSIONS: The results indicate that untrained, unsupervised workers are able to collect consistently unbiased exposure data by employing currently available passive monitors.

  • 66. Lillienberg, Linnea
    et al.
    Andersson, Eva M.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Toren, Kjell
    Respiratory Symptoms and Exposure-Response Relations in Workers exposed to Metalworking Fluid Aerosols2010Ingår i: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 54, nr 4, s. 403-411Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to identify specific health risks and exposure-response relationships associated with exposure to metalworking fluid (MWF) aerosols. In a cross-sectional study of machine workers exposed to MWF aerosols in five companies in Sweden, a self-administered questionnaire about health symptoms, work tasks, and exposure situations was sent out to 2294 employees, 1632 exposed and 662 referents. Referents were office workers and metal workers not working with MWFs. In four of the companies, there were recent measurements of personal exposure to MWF aerosols. Log-binomial regression models were used to estimate prevalence ratios with 95% confidence intervals for different health outcomes in relation to different variables of exposure. The response rate after two reminders was 67% resulting in 1048 (923 male, 125 female) workers exposed to MWF aerosols and 451 (374 male, 77 female) referents. The study indicates that metal workers in Sweden currently exposed to a mean value of MWF aerosols of 0.4 mg m(-3) have a significantly higher prevalence of wheeze, chronic bronchitis, chronic rhinitis, and eye irritation compared to the referents. At a mean exposure of 0.4 mg m(-3), a level below the Swedish 8-h exposure limit value of 1 mg m(-3), machine operators showed increased prevalence of symptoms in eyes and airways. Thus, the current exposure limit value does not seem to protect the workers from such symptoms.

  • 67.
    Lindgren, Helena
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för datavetenskap.
    Burström, Lage
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Developing Ambient Support Technology for Risk Management in the Mining Industry2014Ingår i: Ambient Intelligence - Software and Applications: 5th International Symposium on Ambient Intelligence / [ed] Carlos Ramos, Paulo Novais, Céline Ehrwein Nihan, Juan M. Corchado Rodríguez, Springer, 2014, Vol. 291, s. 161-69Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    There is a major goal in the mining industry to reduce risks and maintain health in work environments. Moreover, the industry is obliged to monitor the risks in work environment as well as employers’ health statuses. The potentials in using ambient information for the purpose to reduce risks, prevent work-related injuries and monitor health in individuals has been explored. Applications tailored to the individual are being developed to aid the worker in mining or mining-related work environments in valuing the risks of their work situation and create awareness in the individual about how he or she can decrease risks for primarily physical damages. The purpose is to encourage the worker to act upon the level of risk for injuries, and upon the new insights the worker gain from the applications. The identified opportunities for and obstacles to integrating ambient information in these health applications are discussed.

  • 68. Ludvigsson, Jonas F.
    et al.
    Nordenvall, Caroline
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Smoking, use of moist snuff and risk of celiac disease: a prospective study2014Ingår i: BMC Gastroenterology, ISSN 1471-230X, E-ISSN 1471-230X, Vol. 14, s. 120-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Smoking status has been linked to several chronic inflammatory conditions but earlier research on smoking and celiac disease (CD) is contradictive. There are little data on moist snuff use and CD. The purpose of this study was to investigate the association between smoking, moist snuff use and later CD. Methods: We identified individuals with biopsy-verified CD (villous atrophy, histopathology stage Marsh III) through biopsy-reports from Sweden's 28 pathology departments. Data on smoking and moist snuff were collected from the Swedish construction worker database "Bygghalsan" that includes preventive health care check-up data. Through poisson regression we calculated relative risks (RRs) for later CD according to smoking status (n = 305,722), and moist snuff status (n = 199,200) adjusting for age, sex and decade. Results: During follow-up 488 individuals with smoking data, and 310 with moist snuff data had a diagnosis of CD. The risk of CD was independent of smoking status with all RRs being statistically insignificant and ranging between 0.9 and 1.0. Compared to non-smokers, neither current smokers (RR = 0.93; 95% CI = 0.76-1.14) nor ex-smokers (RR = 0.98; 95% CI = 0.75-1.28) were at increased or decreased risk of CD. Risk estimates were similar in moderate smokers (RR = 0.92; 0.72-1.16) and heavy smokers (RR = 0.95; 0.74-1.24), and did not change when we examined the risk more than ten years after health examination (RR-moderate: 0.90; and RR-heavy: 0.95; both p > 0.05). Moist snuff use was not associated with later CD (RR = 1.00; 0.78-1.28), or with CD after more than ten years of follow-up (RR = 1.05; 0.80-1.38). Conclusions: We found no association between smoking, moist snuff use and future CD.

  • 69.
    Mannelqvist, Ruth
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Juridiska institutionen.
    Karlsson, Berndt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. Arbets- och miljömedicin vid Norrlands universitetssjukhus.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Arbete och arbetsmarknad i sjukförsäkringen2016Rapport (Refereegranskat)
  • 70.
    Mannelqvist, Ruth
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Juridiska institutionen.
    Karlsson, Berndt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Arbetsförmåga i sjukförsäkringen - så beskrivs begreppet i lagstiftningen2009Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, nr 17, s. 1178-1181Artikel i tidskrift (Refereegranskat)
  • 71.
    Mannelqvist, Ruth
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Juridiska institutionen.
    Karlsson, Berndt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Läkarintyg om bedömning av arbetsförmåga klarar inte alltid rättslig prövning.2010Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, nr 49, s. 3125-3127Artikel i tidskrift (Refereegranskat)
  • 72.
    Mannelqvist, Ruth
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Juridiska institutionen.
    Karlsson, Berndt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Sickness certificates as a basis for decisions regarding work capacity not always sufficient for legal trials: Difficult for the physician to understand law--and for the lawyer to understand medicine2010Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, nr 49, s. 3125-3127Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    I en studie av arbetsförmågebegreppet i sjukförsäkringen har medicinska intyg som använts i förvaltningsdomstol granskats.

    Intygens kvalitet och hur de använts och tolkats i domstolarna har kartlagts. Huvudsakligen beskrevs patientens funktionsförmåga i intygen, och kvaliteten på dessa uppgifter var i allmänhet god.

    I fyra av fem intyg saknades där­emot beskrivning av arbetets krav och bedömning av sambandet mellan funktionsförmåga och arbetets krav.

    I domstolen hänvisades ofta till en samlad bedömning av den medicinska utredningen, och det framgick i mycket få fall om och hur domstolen valt att värdera olika intyg.

    Vidare saknades koppling mellan intyg av god kvalitet och domstolens bedömning; intyg av dålig kvalitet behövde inte innebära att patienten förlorade sin rätt till ersättning i domstolen och intyg av god kvalitet övertygade inte alltid domstolen.

    Detta kan bero på att läkaren inte alltid förstår de rättsliga kraven på intygen eller att juristen inte förstår den medi­cinska informationen.

  • 73. Manuguerra, M
    et al.
    Matullo, G
    Veglia, F
    Autrup, H
    Dunning, A M
    Garte, S
    Gormally, E
    Malaveille, C
    Guarrera, S
    Polidoro, S
    Saletta, F
    Peluso, M
    Airoldi, L
    Overvad, K
    Raaschou-Nielsen, O
    Clavel-Chapelon, F
    Linseisen, J
    Boeing, H
    Trichopoulos, D
    Kalandidi, A
    Palli, D
    Krogh, V
    Tumino, R
    Panico, S
    Bueno-De-Mesquita, H B
    Peeters, P H
    Lund, E
    Pera, G
    Martinez, C
    Amiano, P
    Barricarte, A
    Tormo, M J
    Quiros, J R
    Berglund, G
    Janzon, L
    Jarvholm, B
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Day, N E
    Allen, N E
    Saracci, R
    Kaaks, R
    Ferrari, P
    Riboli, E
    Vineis, P
    Multi-factor dimensionality reduction applied to a large prospective investigation on gene-gene and gene-environment interactions.2007Ingår i: Carcinogenesis, ISSN 0143-3334, E-ISSN 1460-2180, Vol. 28, nr 2, s. 414-22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It is becoming increasingly evident that single-locus effects cannot explain complex multifactorial human diseases like cancer. We applied the multi-factor dimensionality reduction (MDR) method to a large cohort study on gene-environment and gene-gene interactions. The study (case-control nested in the EPIC cohort) was established to investigate molecular changes and genetic susceptibility in relation to air pollution and environmental tobacco smoke (ETS) in non-smokers. We have analyzed 757 controls and 409 cases with bladder cancer (n=124), lung cancer (n=116) and myeloid leukemia (n=169). Thirty-six gene variants (DNA repair and metabolic genes) and three environmental exposure variables (measures of air pollution and ETS at home and at work) were analyzed. Interactions were assessed by prediction error percentage and cross-validation consistency (CVC) frequency. For lung cancer, the best model was given by a significant gene-environment association between the base excision repair (BER) XRCC1-Arg399Gln polymorphism, the double-strand break repair (DSBR) BRCA2-Asn372His polymorphism and the exposure variable 'distance from heavy traffic road', an indirect and robust indicator of air pollution (mean prediction error of 26%, P<0.001, mean CVC of 6.60, P=0.02). For bladder cancer, we found a significant 4-loci association between the BER APE1-Asp148Glu polymorphism, the DSBR RAD52-3'-untranslated region (3'-UTR) polymorphism and the metabolic gene polymorphisms COMT-Val158Met and MTHFR-677C>T (mean prediction error of 22%, P<0.001, mean CVC consistency of 7.40, P<0.037). For leukemia, a 3-loci model including RAD52-2259C>T, MnSOD-Ala9Val and CYP1A1-Ile462Val had a minimum prediction error of 31% (P<0.001) and a maximum CVC of 4.40 (P=0.086). The MDR method seems promising, because it provides a limited number of statistically stable interactions; however, the biological interpretation remains to be understood.

  • 74. Meding, B
    et al.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Comments on "Prevalence of contact allergy in the general population in different European regions" and "Prevalence of fragrance contact allergy in the general population of five European countries".2016Ingår i: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 175, nr 3, s. 642-Artikel i tidskrift (Refereegranskat)
  • 75. Meding, Birgitta
    et al.
    Järvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Incidence of hand eczema-a population-based retrospective study.2004Ingår i: Journal of Investigative Dermatology, ISSN 0022-202X, E-ISSN 1523-1747, Vol. 122, nr 4, s. 873-7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    When etiological relationship is of interest, the incidence rate is a preferred measure. The aim of the present retrospective study was to estimate the incidence rate of self-reported hand eczema in a sample from the general population and to study the relation of this to age, sex, and atopy. A questionnaire was mailed to 3000 individuals aged 20-65 y, randomly selected from the population register of Göteborg, Sweden. This gave a response rate of 73.9%. Questions were asked about ever having had hand eczema, time of onset of the disease, history of childhood eczema, and history of asthma/hay fever. The crude incidence rate of self-reported hand eczema was 5.5 cases per 1000 person-years (females 7.1 and males 4.0). There was no difference, however, in incidence rate between women and men above 30 y of age. In a Poisson regression analysis, female sex, childhood eczema, and asthma/hay fever were all significantly associated with hand eczema, but only at ages below 30 y. A moderate influence of recall bias and a probable tendency to underreport imply that the incidence rates presented are to be considered as minimum rates.

  • 76. Meding, Birgitta
    et al.
    Wrangsjö, Karin
    Burdorf, Alex
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Disability Pensions due to Skin Diseases: A Cohort Study in Swedish Construction Workers2016Ingår i: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 96, nr 2, s. 232-236Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Disability pensions due to skin diseases in Swedish male construction workers were studied by linking data from pension registers and an occupational health service. Incidence rates of disability pensions for cement workers, painters and plumbers were compared with 2 control groups. A total of 623 disability pensions were granted during 4 decades of follow-up. The main diagnoses were eczema (36%) and psoriasis (49%). Pensions were mostly granted in the age range 55-64 years. Among painters, cement workers and plumbers the incidence rates for disability pensions were 33.3, 24.5 and 20.4 cases/100,000 person-years, respectively, compared with 13.7 and 9.2 cases/100,000 person-years in control groups. Relative risks were highest for eczema, and were notable for psoriasis. Attributable fractions for eczema were 90% in cement workers and painters and 75% in plumbers compared with control groups. Attributable fractions for psoriasis in the occupational groups studied were in the range 54-67%. In conclusion, eczema and psoriasis have a high impact on loss of work ability, as reflected by disability pensions.

  • 77. Meding, Birgitta
    et al.
    Wrangsjö, Karin
    Järvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Fifteen-year follow-up of hand eczema: persistence and consequences.2005Ingår i: J Invest Dermatol, ISSN 0007-0963, Vol. 152, nr 5, s. 975-80Artikel i tidskrift (Refereegranskat)
  • 78. Meding, Birgitta
    et al.
    Wrangsjö, Karin
    Järvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Fifteen-year follow-up of hand eczema: predictive factors.2005Ingår i: J Invest Dermatol, ISSN 0022-202X, Vol. 124, nr 5, s. 893-7Artikel i tidskrift (Refereegranskat)
  • 79. Meding, Birgitta
    et al.
    Wrangsjö, Karin
    Järvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hand eczema extent and morphology--association and influence on long-term prognosis.2007Ingår i: The Journal of investigative dermatology, ISSN 1523-1747, Vol. 127, nr 9, s. 2147-51Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Hand eczema extent was a strong negative prognostic factor in a previously published follow-up study of 868 individuals. The present aims were to study in the same cohort the association between the extent and the morphology of the hand eczema and to examine whether registering both improves the prediction of long-term prognosis. The cohort was divided into subgroups regarding eczema extent and morphology. An association between eczema extent and morphology was found, with a Spearman's correlation coefficient of 0.36. Thus, widespread eczema clearly tended to be polymorphic, and vice versa. More than two-thirds (68%) of the subjects with visible signs of eczema at the examination ended up in corresponding "high" or "low" subgroups according to extent and morphology. Both widespread eczema and polymorphism were negative prognostic factors, but recording morphology did not significantly add any information to the long-term prognosis for the groups with high or low extent scores. In conclusion, the results show a clear association between extent and morphology of hand eczema, both predicting prognosis. Recording morphology did not add significant information when assessing long-term prognosis. Consequently, our study indicates that preference should be given to uncomplicated assessment of eczema extent in studies on hand eczema.

  • 80.
    Modig, Lars
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Rönnmark, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nyström, Lennart
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Lundbäck, B
    Andersson, C
    Forsberg, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Vehicle exhaust exposure in an incident case-control study of adult asthma2006Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 28, nr 1, s. 75-81Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objective of this case–control study was to evaluate whether traffic-related air pollution exposure at home increases the risk of asthma in adults and to compare two commonly used exposure variables and differences between urban and rural living. Incident cases of asthma and matched controls of subjects aged 20–60 yrs were recruited in Luleå, Sweden. In total 203 cases and 203 controls were enrolled in the study. Exposure was estimated by traffic flow and measured levels of outdoor nitrogen dioxide (NO2) in the surrounding environment of each home, respectively. The relationship between measured levels of NO2 and traffic flow was studied using linear regression. The results indicated a nonsignificant tendency between living in a home close to a high traffic flow and an increased risk of asthma. The association between asthma and measured NO2 was weak and not significant, but the skin-prick test result acted as an effect modifier with a borderline significant association among positives. The correlation between traffic flow and outdoor NO2 was low. The results suggest that living close to high traffic flows might increase the asthma incidence in adults, while the tendency for nitrogen dioxide was only seen among atopics. Traffic flow and nitrogen dioxide had a lower than expected correlation.

  • 81.
    Modig, Lars
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Torén, K
    Janson, C
    Jarvholm, B
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Forsberg, B
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Vehicle exhaust outside the home and onset of asthma among adults2009Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 33, nr 6, s. 1261-7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Few studies have investigated the relationship between vehicle exhaust and new onset of asthma among adults. The aim of this prospective cohort study was to investigate the relationship between the cumulative incidence of asthma and onset asthma among adults and vehicle exhaust concentrations at home.Participants from three Swedish cities included in the RHINE (Respiratory Health in Northern Europe) Cohort constituted the study population. Exposure at each participant's home was calculated using dispersion models. We also used less than 50 meter distance to nearest major road as a more simple indicator of exposure. The adjusted model included 3609 participants of which 107 were classified as onset cases and 55 as true incident cases of asthma.There was a positive association between asthma onset (Odds Ratio, OR per 10 microg.m(-3) = 1.46, 95% Confidence Interval (CI) 1.07-1.99) and incident asthma (OR per 10 microg.m(-3) = 1.54, 95% CI 1.00-2.36) and the levels of NO2 which remained statistically significant after adjusting for potential confounders. The relationship between asthma and NO2 was not significantly modified by sex, hay fever or wheeze.This study suggests that elevated levels of vehicle exhaust outside the home increase the risk of onset and incident asthma among adults.

  • 82. Neasham, David
    et al.
    Gallo, Valentina
    Guarrera, Simonetta
    Dunning, Alison
    Overvad, Kim
    Tjonneland, Anne
    Clavel-Chapelon, Francoise
    Linseisen, Jakob P
    Malaveille, Christian
    Ferrari, Pietro
    Boeing, Heiner
    Benetou, Vassiliki
    Trichopoulou, Antonia
    Palli, Domenico
    Crosignani, Paolo
    Tumino, Rosario
    Panico, Salvatore
    Bueno-De-Mesquita, H Bas
    Peeters, Petra H
    van Gib, Carla H
    Lund, Eiliv
    Gonzalez, Carlos A
    Martinez, Carmen
    Dorronsoro, Miren
    Barricarte, Aurelio
    Navarro, Carmen
    Quiros, Josè R
    Berglund, Goran
    Jarvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Khaw, Kay Tee
    Key, Timothy J
    Bingham, Sheila
    Diaz, Tormo M Jose
    Riboli, Elio
    Matullo, Giuseppe
    Vineis, Paolo
    Double-strand break DNA repair genotype predictive of later mortality and cancer incidence in a cohort of non-smokers.2009Ingår i: DNA Repair, ISSN 1568-7864, E-ISSN 1568-7856, Vol. 8, nr 1, s. 60-71Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We followed-up for mortality and cancer incidence 1088 healthy non-smokers from a population-based study, who were characterized for 22 variants in 16 genes involved in DNA repair pathways. Follow-up was 100% complete. The association between polymorphism and mortality or cancer incidence was analyzed using Cox Proportional Hazard regression models. Ninety-five subjects had died in a median follow-up time of 78 months (inter-quartile range 59-93 months). None of the genotypes was clearly associated with total mortality, except variants for two Double-Strand Break DNA repair genes, XRCC3 18067 C>T (rs#861539) and XRCC2 31479 G>A (rs#3218536). Adjusted hazard ratios were 2.25 (1.32-3.83) for the XRCC3 C/T genotype and 2.04 (1.00-4.13) for the T/T genotype (reference C/C), and 2.12 (1.14-3.97) for the XRCC2 G/A genotype (reference G/G). For total cancer mortality, the adjusted hazard ratios were 3.29 (1.23-7.82) for XRCC3 C/T, 2.84 (0.81-9.90) for XRCC3 T/T and 3.17 (1.21-8.30) for XRCC2 G/A. With combinations of three or more adverse alleles, the adjusted hazard ratio for all cause mortality was 17.29 (95% C.I. 8.13-36.74), and for all incident cancers the HR was 5.28 (95% C.I. 2.17-12.85). Observations from this prospective study suggest that polymorphisms of genes involved in the repair of DNA double-strand breaks significantly influence the risk of cancer and non-cancer disease, and can influence mortality.

  • 83. Pearce, Neil E
    et al.
    Blair, Aaron
    Vineis, Paolo
    Ahrens, Wolfgang
    Andersen, Aage
    Anto, Josep M
    Armstrong, Bruce K
    Baccarelli, Andrea A
    Beland, Frederick A
    Berrington, Amy
    Bertazzi, Pier A
    Birnbaum, Linda S
    Brownson, Ross C
    Bucher, John R
    Cantor, Kenneth P
    Cardis, Elisabeth
    Cherrie, John W
    Christiani, David C
    Cocco, Pierluigi
    Coggon, David
    Comba, Pietro
    Demers, Paul A
    Dement, John M
    Douwes, Jeroen
    Eisen, Ellen A
    Engel, Lawrence S
    Fenske, Richard A
    Fleming, Lora E
    Fletcher, Tony
    Fontham, Elizabeth
    Forastiere, Francesco
    Frentzel-Beyme, Rainer
    Fritschi, Lin
    Gerin, Michel
    Goldberg, Marcel
    Grandjean, Philippe
    Grimsrud, Tom K
    Gustavsson, Per
    Haines, Andy
    Hartge, Patricia
    Hansen, Johnni
    Hauptmann, Michael
    Heederik, Dick
    Hemminki, Kari
    Hemon, Denis
    Hertz-Picciotto, Irva
    Hoppin, Jane A
    Huff, James
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Kang, Daehee
    Karagas, Margaret R
    Kjaerheim, Kristina
    Kjuus, Helge
    Kogevinas, Manolis
    Kriebel, David
    Kristensen, Petter
    Kromhout, Hans
    Laden, Francine
    Lebailly, Pierre
    LeMasters, Grace
    Lubin, Jay H
    Lynch, Charles F
    Lynge, Elsebeth
    't Mannetje, Andrea
    McMichael, Anthony J
    McLaughlin, John R
    Marrett, Loraine
    Martuzzi, Marco
    Merchant, James A
    Merler, Enzo
    Merletti, Franco
    Miller, Anthony
    Mirer, Franklin E
    Monson, Richard
    Nordby, Karl-Kristian
    Olshan, Andrew F
    Parent, Marie-Elise
    Perera, Frederica P
    Perry, Melissa J
    Pesatori, Angela C
    Pirastu, Roberta
    Porta, Miquel
    Pukkala, Eero
    Rice, Carol
    Richardson, David B
    Ritter, Leonard
    Ritz, Beate
    Ronckers, Cecile M
    Rushton, Lesley
    Rusiecki, Jennifer A
    Rusyn, Ivan
    Samet, Jonathan M
    Sandler, Dale P
    de Sanjose, Silvia
    Schernhammer, Eva
    Seniori Constantini, Adele
    Seixas, Noah
    Shy, Carl
    Siemiatycki, Jack
    Silvermann, Debra T
    Simonato, Lorenzo
    Smith, Allan H
    Smith, Martyn T
    Spinelli, John J
    Spitz, Margaret R
    Stallones, Lorann
    Stayner, Leslie T
    Steenland, Kyle
    Stenzel, Mark
    Stewart, Bernard W
    Stewart, Patricia A
    Symanski, Elaine
    Terracini, Benedetto
    Tolbert, Paige E
    Vainio, Harri
    Vena, John
    Vermeulen, Roel
    Victora, Cesar G
    Ward, Elizabeth M
    Weinberg, Clarice R
    Weisenburger, Dennis
    Wesseling, Catharina
    Weiderpass, Elisabete
    Zahm, Shelia H
    IARC Monographs: 40 Years of Evaluating Carcinogenic Hazards to Humans2015Ingår i: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 123, nr 6, s. 507-514Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Recently the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also the approach used to perform these evaluations. Some critics have claimed that IARC Working Groups' failures to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans.

    OBJECTIVES: The authors of this paper are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We have examined here criticisms of the IARC classification process to determine the validity of these concerns. We review the history of IARC evaluations and describe how the IARC evaluations are performed.

    DISCUSSION: We conclude that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various discipline and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed.

    CONCLUSIONS: The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public's health.

  • 84. Peluso, Marco
    et al.
    Airoldi, Luisa
    Munnia, Armelle
    Colombi, Alessandro
    Veglia, Fabrizio
    Autrup, Herman
    Dunning, Alison
    Garte, Seymour
    Gormally, Emmanuelle
    Malaveille, Christian
    Matullo, Giuseppe
    Overvad, Kim
    Raaschou-Nielsen, Ole
    Clavel-Chapelon, Francoise
    Linseisen, Jacob
    Boeing, Heiner
    Trichopoulou, Antonia
    Palli, Domenico
    Krogh, Vittorio
    Tumino, Rosario
    Panico, Salvatore
    Bueno-De-Mesquita, Bas H
    Peeters, Petra H
    Kumle, Merethe
    Agudo, Antonio
    Martinez, Carmen
    Dorronsoro, Miren
    Barricarte, Aurelio
    Tormo, Marìa Jose
    Quiros, José Ramón
    Berglund, Goran
    Jarvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Day, Nicholas E
    Key, Timothy J
    Saracci, Rodolfo
    Kaaks, Rudolf
    Riboli, Elio
    Bingham, Shelia
    Vineis, Paolo
    Bulky DNA adducts, 4-aminobiphenyl-haemoglobin adducts and diet in the European Prospective Investigation into Cancer and Nutrition (EPIC) prospective study.2008Ingår i: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 100, nr 3, s. 489-95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In contrast to some extensively examined food mutagens, for example, aflatoxins, N-nitrosamines and heterocyclic amines, some other food contaminants, in particular polycyclic aromatic hydrocarbons (PAH) and other aromatic compounds, have received less attention. Therefore, exploring the relationships between dietary habits and the levels of biomarkers related to exposure to aromatic compounds is highly relevant. We have investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort the association between dietary items (food groups and nutrients) and aromatic DNA adducts and 4-aminobiphenyl-Hb adducts. Both types of adducts are biomarkers of carcinogen exposure and possibly of cancer risk, and were measured, respectively, in leucocytes and erythrocytes of 1086 (DNA adducts) and 190 (Hb adducts) non-smokers. An inverse, statistically significant, association has been found between DNA adduct levels and dietary fibre intake (P = 0.02), vitamin E (P = 0.04) and alcohol (P = 0.03) but not with other nutrients or food groups. Also, an inverse association between fibre and fruit intake, and BMI and 4-aminobiphenyl-Hb adducts (P = 0.03, 0.04, and 0.03 respectively) was observed. After multivariate regression analysis these inverse correlations remained statistically significant, except for the correlation adducts v. fruit intake. The present study suggests that fibre intake in the usual range can modify the level of DNA or Hb aromatic adducts, but such role seems to be quantitatively modest. Fibres could reduce the formation of DNA adducts in different manners, by diluting potential food mutagens and carcinogens in the gastrointestinal tract, by speeding their transit through the colon and by binding carcinogenic substances.

  • 85. Peluso, Marco
    et al.
    Munnia, Armelle
    Hoek, Gerard
    Krzyzanowski, Michal
    Veglia, Fabrizio
    Airoldi, Luisa
    Autrup, Herman
    Dunning, Alison
    Garte, Seymour
    Hainaut, Pierre
    Malaveille, Christian
    Gormally, Emmanuelle
    Matullo, Giuseppe
    Overvad, Kim
    Raaschou-Nielsen, Ole
    Clavel-Chapelon, Francoise
    Linseisen, Jacob
    Boeing, Heiner
    Trichopoulou, Antonia
    Trichopoulos, Dimitrios
    Kaladidi, Anna
    Palli, Domenico
    Krogh, Vittorio
    Tumino, Rosario
    Panico, Salvatore
    Bueno-De-Mesquita, H Bas
    Peeters, Petra H
    Kumle, Merethe
    Gonzalez, Carlos A
    Martinez, Carmen
    Dorronsoro, Miren
    Barricarte, Aurelio
    Navarro, Carmen
    Quiros, J Ramón
    Berglund, Goran
    Janzon, Lars
    Jarvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Day, Nicholas E
    Key, Tim J
    Saracci, Rodolfo
    Kaaks, Rudolf
    Riboli, Elio
    Vineis, Paolo
    DNA adducts and lung cancer risk: a prospective study.2005Ingår i: Cancer Res, ISSN 0008-5472, Vol. 65, nr 17, s. 8042-8Artikel i tidskrift (Refereegranskat)
  • 86.
    Pettersson, Hans
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Olsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Occupational Exposure to Noise and Cold Environment and the Risk of Death Due to Myocardial Infarction and StrokeIngår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    The present study examined a possible association between occupational exposure to noise, working and living in cold conditions, and the risk of mortality in myocardial infarction and stroke.

    Methods

    The present cohort study consists of 194 501 workers in the Swedish construction industry that participated in health examinations between 1971 and 1993. Noise exposure was defined on a job-exposure matrix based on a survey of the working conditions carried out during the mid 1970s. All workers were categorised into three main regions of Sweden, differing in temperature: Reference (Götaland), colder (Svealand), and coldest (Norrland). Relative risks (RR) were analysed by negative binomial regression adjusting for age, BMI, and smoking habits.

    Results

    Moderate and high noise exposure was associated with increased risk of myocardial infarction (RR 1.10 to 1.13 with 95% CI over unit) and stroke mortality (RR 1.15 to 1.19 with 95% CI over unit). There was an increased risk for myocardial infarction (RR 1.10, 95% CI 1.01 to 1.20), but not for stroke mortality (RR 1.09, 95% CI 0.94 to 1.25) associated with living and working in the coldest region. There was an interaction on the risk of myocardial infarction mortality between different regions and noise exposure (p = 0.016), but not for stroke mortality (p = 0.88).

    Conclusions

    The study indicates an interaction between working at hazardous noise levels and living and working in cold conditions for increased mortality in myocardial infarction.

  • 87.
    Pettersson, Hans
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Olsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Occupational exposure to noise and cold environment and the risk of death due to myocardial infarction and stroke2020Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The present study examined a possible association between occupational exposure to noise, working and living in cold conditions, and the risk of mortality in myocardial infarction and stroke.

    METHODS: The present cohort study consists of 194,501 workers in the Swedish construction industry that participated in health examinations between 1971 and 1993. Noise exposure was defined on a job-exposure matrix based on a survey of the working conditions carried out during the mid 1970s. All workers were categorised into three main regions of Sweden, differing in temperature: Reference (Götaland), colder (Svealand), and coldest (Norrland). Relative risks (RR) were analysed by negative binomial regression adjusting for age, BMI, and smoking habits.

    RESULTS: Moderate and high noise exposure was associated with increased risk of myocardial infarction (RR 1.10-1.13 with 95% CI over unit) and stroke mortality (RR 1.15 to 1.19 with 95% CI over unit). There was an increased risk for myocardial infarction (RR 1.10, 95% CI 1.01-1.20), but not for stroke mortality (RR 1.09, 95% CI 0.94-1.25) associated with living and working in the coldest region. There was an interaction on the risk of myocardial infarction mortality between different regions and noise exposure (p = 0.016), but not for stroke mortality (p = 0.88).

    CONCLUSIONS: The study indicates an interaction between working at hazardous noise levels and living and working in cold conditions for increased mortality in myocardial infarction.

  • 88.
    Pettersson-Strömbäck, Anita E
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Bergdahl, Ingvar A
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt G
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nordin, Steven
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    When and why do experts perform exposure measurements?: An exploratory study of safety engineers, work environment inspectors, and occupational hygienists.2006Ingår i: Journal of Occupational and Environmental Hygiene, ISSN 1545-9624, E-ISSN 1545-9632, Vol. 3, nr 12, s. 713-717Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to describe experts' decision processes leading to measurements of occupational chemical exposure. Safety engineers, clinical occupational hygienists, and work environment inspectors (four from each group) were interviewed according to a semistructured scheme. We analyzed: (i) perceived triggers for measurements, (ii) the experts' decision criteria for performing measurements when there was a trigger, and (iii) sampling strategy. Regarding triggers, all safety engineers reported a “request” from, for example, an employer; all work environment inspectors reported “legal demands;” and all clinical occupational hygienists reported “symptoms among workers.” As a decision criterion, all the interviewees reported that they measured only if they expected sufficiently high levels. The results of the present study highlight factors that trigger measurements and are of importance in determining whether measurements will be performed. These factors appear to be related to the expert's professional role and may bias the assessment of exposure. Thus, when using data from routine measurements done by experts, the possibility of a bias needs to be considered.

  • 89.
    Pettersson-Strömbäck, Anita Elisabeth
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Liljelind, Ingrid Elisabeth
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nordin, Steven
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Workers’ mental models of chemical exposure in the workplace2010Ingår i: Risk Analysis, ISSN 0272-4332, E-ISSN 1539-6924, Vol. 30, nr 3, s. 488-500Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objective of this study was to examine workers’ mental interpretation models developed in response to occupational chemical exposure. The study was performed in six companies within the reinforced plastics industry in northern Sweden, in which styrene was used; 32 workers participated in the study. Each worker performed between four and seven exposure measurements. Before receiving each result of the second to seventh measurements, the workers were asked to predict the level of their next exposure measurement. Their predictions were evaluated with respect to two judgmental principles: coherence (that the predictions are based on logical decision rules, that is, the mean value of the prior exposure levels); and correspondence (the predictions have high empirical accuracy) by calculating the mean absolute percent forcast error (MAPE). The coherence principle was tested by comparing each of the workers’ predictions with the mean, median, and last exposure level (last value) of the prior measurements. The correspondence principle was tested by comparing the worker’s prediction with the outcome of the measurement. The coherence principle was found to be the best descriptor of the workers’ predictions and the median model had the best fit. The mean model had a similar but significantly poorer fit (MAPE values of 29 and 31, respectively). The correspondence model had a poor fit with a MAPE of 54. The workers’ predictions were generally lower than their average exposures. We conclude that the workers’ interpretation model can be best described by a coherence model rather than by a correspondence model.

  • 90.
    Pettersson-Strömbäck, Anita
    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.
    Neely, Greg
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Workers' interpretation of self-assessment of exposure2008Ingår i: The Annals of occupational hygiene, ISSN 1475-3162, Vol. 52, nr 7, s. 663-671Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The aim was to investigate how workers interpret and act upon results from self-assessment of exposure (SAE). METHODS: Workers in four sawmills in Sweden were supplied with diffusive samplers for measurement of terpenes. Workers received both oral and written instructions about terpenes, their medical effects and how to handle the samplers. Responsibility for sampling was left to the individual worker; written feedback about terpene levels was provided after each measurement. The number of measurements was registered. The workers and supervisors were interviewed about their attitudes, perceived control of their work environment, need for preventive actions and future surveillance of the workplace. RESULTS: In total, 28 workers performed 100 terpene measurements. At one sawmill, there was a significant association between exposure levels and the number of measurements performed by each worker (rho = 0.79, P = 0.03). Contrary to instructions, supervisors played an important role in spontaneous organization of the measurements at each mill. Four measurements revealed terpene concentrations that exceeded the occupational exposure limits, and one preventive action was taken as a consequence of high levels. Seventy percent of the workers could not identify any reason for more measurements. Only 15% considered the measurements as their 'own' project, and the rest stated that they participated in order to satisfy the researchers. CONCLUSIONS: Previous studies have shown that workers can perform valid measurements, both select a day and technically perform measurements. This study indicates that this ability is not sufficient to ensure that measurements will be done or that implementing measurements will result in preventive actions. Workers need additional support to take preventive actions and use SAE for ongoing surveillance.

  • 91. Purdue, Mark P
    et al.
    Gold, Laura
    Järvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Alavanja, Michael C R
    Ward, Mary H
    Vermeulen, Roel
    Impaired lung function and lung cancer incidence in a cohort of Swedish construction workers.2007Ingår i: Thorax, ISSN 0040-6376, E-ISSN 1468-3296, Vol. 62, nr 1, s. 51-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Although impaired lung function in general has been associated with an increased risk of lung cancer, past studies typically have not attempted to investigate separately the obstructive and restrictive components of respiratory impairment. To deal with this question further, data from a large (n = 176 997) cohort of male Swedish construction workers, for whom spirometry measurements before follow-up were available, were analysed. METHODS: Cancer incidence for 1971-2001 was obtained through linkage with the national cancer registry. Using a modification of the Global Initiative for Chronic Obstructive Lung Disease criteria for chronic obstructive pulmonary disease (COPD), subjects were classified into five categories of lung function: normal, mild COPD, moderate COPD, severe COPD and restrictive lung disease (RLD). Rate ratios (RR) and 95% confidence intervals (CI) for lung cancer across lung function categories were calculated using Poisson regression, adjusted for age and smoking. Other end points (histological types of lung cancer, non-lung tobacco-related cancers, other cancers, total mortality) were also investigated. RESULTS: 834 incident cases of lung cancer were identified. Increased rates of lung cancer were observed for both COPD (mild: RR 1.5, 95% CI 1.2 to 1.9; moderate/severe: RR 2.2, 95% CI 1.8 to 2.7) and RLD (RR 2.0, 95% CI 1.6 to 2.5) relative to normal lung function. These associations did not meaningfully change on applying follow-up lag times of 5, 10 and 15 years after spirometry. When analysed by histological type, associations with both COPD and RLD were stronger for squamous cell carcinoma and small cell carcinoma, and weaker for adenocarcinoma. Both COPD and RLD were associated with increased rates of total mortality. CONCLUSIONS: Obstructive and restrictive impairments in lung function are associated with increased lung cancer risk.

  • 92. Purdue, Mark P
    et al.
    Järvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Bergdahl, Ingvar A
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Hayes, Richard B
    Baris, Dalsu
    Occupational exposures and head and neck cancers among Swedish construction workers.2006Ingår i: Scand J Work Environ Health, ISSN 0355-3140, Vol. 32, nr 4, s. 270-5Artikel i tidskrift (Refereegranskat)
  • 93. Randem, Britt Grethe
    et al.
    Burstyn, Igor
    Langård, Sverre
    Svane, Ole
    Järvholm, Bengt
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Kauppinen, Timo
    Bergdahl, Ingvar A
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Johansen, Christoffer
    Hansen, Johnni
    Partanen, Timo
    Kromhout, Hans
    Ferro, Gilles
    Boffetta, Paolo
    Cancer incidence of Nordic asphalt workers.2004Ingår i: Scand J Work Environ Health, ISSN 0355-3140, Vol. 30, nr 5, s. 350-5Artikel i tidskrift (Refereegranskat)
  • 94.
    Rehn, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin.
    Lundström, Ronnie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Leif
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Matematisk statistik.
    Liljellind, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Variation in exposure to whole-body vibration for operators of forwarder vehicles - aspects on measurement strategies and prevention2005Ingår i: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 35, nr 9, s. 831-842Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Exposure to whole-body vibration (WBV) may cause health problems, e.g. lumbago. The risk will depend on intensity and duration. Exposure to WBV in vehicles varies due to several factors as the vehicle type, the terrain condition, the driver, the speed etc. To estimate the health risk, the measurement strategy has to consider this variation. Furthermore, to understand the importance of different preventive strategies, the cause of the variation has to be known. The objective of this study was to describe variation in exposure to seated WBV during occupational operation of forwarder vehicles and to investigate sources for variation. WBV was measured in 10 various terrain types for seven forwarders operated by 11 drivers. For each driver there were between four and 35 measurements. The measurement periods varied between 0.2 and 34 min. The vibration total value (av) and total vibration dose value (VDVt) were determined. Results showed that WBV exposure varied considerably and that this variation could result in different conclusions regarding health risk assessments. The highest magnitudes were achieved during travelling activities. During travelling empty, variations in av were significantly dependent upon forwarder model and terrain type. No significant predictor for variation in VDVt was however found for travelling empty. During travelling loaded the forwarder model and operator were the most important predictors for variation in av. Variation in VDVt was also dependent on the forwarder model during travelling loaded.

  • 95.
    Rehn, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin.
    Lundström, 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.
    Bergdahl, Ingvar A
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Ahlgren, Chrisitina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin.
    From, Carin
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Sundelin, Gunnnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Musculoskeletal symptoms among drivers of all-terrain vehicles2002Ingår i: Journal of Sound and Vibration, ISSN 0022-460X, E-ISSN 1095-8568, Vol. 253, nr 1, s. 21-29Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this cross-sectional study was to characterize the risk of experiencing musculoskeletal symptoms in the region of the neck, shoulders and upper and lower back for professional drivers of various categories of all-terrain vehicles and to assess the association between symptoms and duration of exposure to whole-body vibration (WBV) and shock from driving all-terrain vehicles. The study group consisted of 215 drivers of forest machines, 137 drivers of snowmobiles and 79 drivers of snowgroomers and a control group of 167 men randomly selected from the general population. The subjects were all from one of the four most northern counties in Sweden and they were all men. Musculoskeletal symptoms were assessed by use of a standardized questionnaire. In addition, the questionnaire held items about the driving time with all-terrain vehicles and a subjective estimation of exposure to unpleasant movements (shock, jolt, irregular sway). The job strain was measured according to Karasek's demands/control model. The prevalence ratios were adjusted for age, smoking and job strain. Among drivers, significantly increased prevalence ratios within the range of 1∂5–2·9 were revealed for symptoms from the neck–shoulder and thoracic regions during the previous year. None of the driver categories had a statistically significantly increased risk of low back pain. Forest vehicles were those most reported to cause unpleasant movements. In conclusion, drivers of all-terrain vehicles exhibit an increased risk of symptoms of musculoskeletal disorders in the neck–shoulder and thoracic regions. The increased risk is suggested to be related to physical factors such as exposure to whole-body vibration (WBV) and shock, static overload or extreme body postures. However, since symptoms of low back pain were not significantly increased, it appears that factors other than WBV would explain the occurrence of symptoms in the group of all-terrain drivers.

  • 96.
    Rehn, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Lundström, Ronny
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nilsson, Tor
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Bergdahl, Ingvar
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Ahlgren, Christin
    From, C
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Symptoms of musculoskeletal disorders among drivers of all-terrain vehicles in northern Sweden2005Ingår i: Noise and Vibration Worldwide, ISSN 0957-4565, Vol. 36, nr 1, s. 13-18Artikel i tidskrift (Refereegranskat)
  • 97.
    Rehn, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin.
    Nilsson, Tohr
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkesmedicin.
    Neuromusculoskeletal disorders in the neck and upper extremities among drivers of all-terrain vehicles - a case series.2004Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 5, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The purpose of this study was to investigate whether professional drivers of all-terrain vehicles (ATVs) with neck pain have a different array of neuromusculoskeletal disorders in the neck and upper extremities than a referent group with neck pain from the general population. It is hypothesized that exposure to shock-type vibration and unfavorable working postures in ATVs have the capacity to cause peripheral nervous lesions. METHODS: This study was based on a case series analyzed according to a case-case comparison design. The study population consisted of 60 male subjects, including professional drivers of forest machines (n = 15), snowmobiles (n = 15), snowgroomers (n = 15) and referents from the general population (n = 15) all of whom had reported neck pain in a questionnaire and underwent an extensive physical examination of the neck and upper extremities. Based on symptom history, symptoms and signs, and in some cases chemical, electroneurographical and radiological findings, subjects were classified as having a nociceptive or neuropathic disorder or a mix of these types. RESULTS: The occurrence of asymmetrical and focal neuropathies (peripheral nervous lesion), pure or in a mix with a nociceptive disorder was common among cases in the ATV driver groups (47%-79%). This contrasted with the referents that were less often classified as having asymmetrical and focal neuropathy (27%), but instead had more nociceptive disorders. The difference was most pronounced among drivers of snowgroomers, while drivers of forest machines were more frequently classified as having a nociceptive disorder originating in the muscles. CONCLUSION: This study found a high prevalence of assymetrical and focal neuropathies among drivers with pain in the neck, operating various ATVs. It seems as if exposure to shock-type whole-body vibration (WBV) and appurtenant unfavorable postures in ATVs may be associated to peripheral nervous lesions.

  • 98. Robroek, Suzan J W
    et al.
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    van der Beek, Allard J
    Proper, Karin I
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Burdorf, Alex
    Influence of obesity and physical workload on disability benefits among construction workers followed up for 37 years2017Ingår i: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 74, nr 9, s. 621-627Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The objectives of this study are to investigate the relation between obesity and labour force exit via diagnosis-specific disability benefits, and whether physical workload modifies this association.

    METHODS: A longitudinal analysis was performed among 3 28 743 Swedish construction workers in the age of 15-65 years. Body weight and height were measured at a health examination and enriched with register information on disability benefits up to 37 years later. Diagnoses of disability benefits were categorised into cardiovascular diseases (CVDs), musculoskeletal diseases (MSDs), mental disorders and others. A job exposure matrix, based on self-reported lifting of heavy loads and working in bent forward or twisted position, was applied as a measure of physical workload. Cox proportional hazards regression analyses were performed, and the relative excess risk due to interaction (RERI) between obesity and physical workload was calculated.

    RESULTS: Obese construction workers were at increased risk of receiving disability benefits (HR 1.70, 95% CI 1.65 to 2.76), mainly through CVD (HR 2.30) and MSD (HR 1.71). Construction workers with a high physical workload were also more likely to receive a disability benefit (HR 2.28, 95% CI 2.21 to 2.34), particularly via MSD (HR 3.02). Obesity in combination with a higher physical workload increased the risk of disability benefits (RERI 0.28) more than the sum of the risks of obesity and higher physical workload, particularly for MSD (RERI 0.44).

    CONCLUSIONS: Obesity and a high physical workload are risk factors for disability benefit. Furthermore, these factors are synergistic risk factors for labour force exit via disability benefit through MSD. Comprehensive programmes that target health promotion to prevent obesity and ergonomic interventions to reduce physical workload are important to facilitate sustained employment.

  • 99. Robroek, Suzan JW
    et al.
    Nieboer, Daan
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för hållbar hälsa.
    Burdorf, Alex
    Educational differences in duration of working life and loss of paid employment: working life expectancy in The Netherlands2019Ingår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, artikel-id 3843Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: This study aims to provide insight into educational differences in duration of working life by working life expectancy (WLE) and working years lost (WYL) through disability benefits and other non-employment states in the Netherlands.

    Methods: Monthly information on employment status of the Dutch population (N=4 999 947) between 16 and 66 years from 2001‒2015 was used to estimate working life courses and loss of working years for specific non-employment states. Across educational groups, bi-directional transitions between paid employment and non-employment states were calculated. Using a multistate model, the WLE and WYL at age 16, 30, 50 and up to 66 years as statutory retirement age were estimated for each educational group, stratified by gender.

    Results: Low-educated men and women had a 7.3 (men) and 9.9 (women) years lower WLE at age 30 than high-educated men and women. Among low-educated men, 3.4 working years were lost due to disability benefit compared to 0.8 among high-educated men. Low-educated women lost 3.0 working years due to disability benefit compared to 1.4 among high-educated women.

    Conclusions: There are large educational inequalities over the course of working life. Among low-educated workers, more working years are lost due to unemployment, no income, and especially disability benefits. The latter reflects large educational inequalities in health and working conditions. The metrics of WLE and WYL provide useful insights into the life-course perspective on working careers.

  • 100. Rundle, Andrew
    et al.
    Richie, John
    Steindorf, Karen
    Peluso, Marco
    Overvad, Kim
    Raaschou-Nielsen, Ole
    Clavel-Chapelon, Francoise
    Linseisen, Jacob P.
    Boeing, Heiner
    Trichopoulou, Antonia
    Palli, Domenico
    Krogh, Vittorio
    Tumino, Rosario
    Panico, Salvatore
    Bueno-De-Mesquita, Hendrik B.
    Peeters, Petra H.
    Lund, Eiliv
    Gonzalez, Carlos A.
    Martinez, Carmen
    Dorronsoro, Miren
    Barricarte, Aurelio
    Jose Tormo, M.
    Quiros, Jose R.
    Agudo, Antonio
    Berglund, Goran
    Järvholm, Bengt
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Bingham, Sheila
    Key, Timothy J.
    Gormally, Emmanuelle
    Saracci, Rodolfo
    Kaaks, Rudolf
    Riboli, Elio
    Vineis, Paolo
    Physical activity and lung cancer among non-smokers: a pilot molecular epidemiological study within EPIC2010Ingår i: Biomarkers, ISSN 1354-750X, E-ISSN 1366-5804, Vol. 15, nr 1, s. 20-30Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The association between physical activity, potential intermediate biomarkers and lung cancer risk was investigated in a study of 230 cases and 648 controls nested within the European Prospective Investigation of Cancer and Nutrition. Data on white blood cell aromatic-DNA adducts by 32P-post-labelling and glutathione (GSH) in red blood cells were available from a subset of cases and controls. Compared with the first quartile, the fourth quartile of recreational physical activity was associated with a lower lung cancer risk (odds ratio (OR) 0.56, 95% confidence interval (CI) 0.35-0.90), higher GSH levels (+1.87 μmol GSH g-1 haemoglobin, p = 0.04) but not with the presence of high levels of adducts (OR 1.05, 95% CI 0.38-2.86). Despite being associated with recreational physical activity, in these small-scale pilot analyses GSH levels were not associated with lung cancer risk (OR 0.95, 95% CI 0.84-1.07 per unit increase in GSH levels). Household and occupational activity was not associated with lung cancer risk or biomarker levels.

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