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Jansson, Sven-Arne
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Publications (10 of 42) Show all publications
Hedman, L., Strinnholm, Å., Jansson, S.-A. & Winberg, A. (2024). Diagnostic intervention improved health-related quality of life among teenagers with food allergy. PLOS ONE, 19(1 January), Article ID e0296664.
Open this publication in new window or tab >>Diagnostic intervention improved health-related quality of life among teenagers with food allergy
2024 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 19, no 1 January, article id e0296664Article in journal (Refereed) Published
Abstract [en]

Objectives:  The aim was to examine if a diagnostic intervention set up to assess current food allergy to cow’s milk, hen’s egg, fish, or wheat among teenagers had an impact on generic and disease specific health-related quality of life (HRQL). The study compared HRQL scoring before and two years after the intervention, and in relation to age matched controls without reported food allergy.

Methods: The study was performed within the Obstructive Lung Disease in Northern Sweden (OLIN) studies where a cohort study on asthma and allergic diseases among 8-year-old schoolchildren was initiated in 2006. At age 12 years, the 125/2612 (5%) children who reported allergy to cow’s milk, hen’s egg, fish, or wheat were invited to a diagnostic intervention including clinical examination, blood tests and evaluation by a pediatric allergist. Of 94 participants, 79 completed generic and disease specific HRQL questionnaires. Additionally, a random sample of 200 (62% of invited) children without food allergy from the OLIN cohort answered the generic HRQL questionnaire. The respondents of the HRQL questionnaires were reexamined two years later and 57 teenagers with and 154 without reported allergy participated.

Results: There were no significant differences in generic HRQL scores between teenagers with and without reported food allergy at study entry, or after the intervention. Among those with reported food allergy, we found a significant improvement in disease specific HRQL after the intervention (mean values: 3.41 vs 2.80, p<0.001). Teenagers with only food allergy had better disease specific HRQL compared to those with one, two or three concomitant allergic diseases, both before and after the intervention. Children with only food allergy significantly improved their HRQL after the intervention, 1.84 vs. 2.87 (p<0.001) but this association was not seen in children with one other allergic disorder (3.16 vs. 3.65, p = 0.121) or those with two or more allergic disorders (3.72 vs. 3.90, p = 0.148).

Conclusion: The diagnostic intervention showed a long-term improvement of disease specific HRQL but not generic HRQL.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2024
National Category
Immunology in the medical area Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-219833 (URN)10.1371/journal.pone.0296664 (DOI)38206952 (PubMedID)2-s2.0-85182102443 (Scopus ID)
Funder
Swedish Asthma and Allergy Association, 2010013-KSwedish Heart Lung Foundation, 20140264Visare Norr, 370491Region Västerbotten, VLL-233971Region Västerbotten, RV-158921Region Västerbotten, RV-46700Sven Jerring Foundation, 20111208Sven Jerring Foundation, 20131209Sven Jerring Foundation, 141208Sven Jerring Foundation, 151208Sven Jerring Foundation, 161215Kempe-Carlgrenska Foundation, 20151111Kempe-Carlgrenska Foundation, 20141114Kempe-Carlgrenska Foundation, 20130520Samariten foundation for paediatric research, 20131122Samariten foundation for paediatric research, 20141120
Available from: 2024-01-22 Created: 2024-01-22 Last updated: 2024-01-22Bibliographically approved
Backman, H., Vanfleteren, L., Lindberg, A., Ekerljung, L., Stridsman, C., Axelsson, M., . . . Lundbäck, B. (2020). Decreased COPD prevalence in Sweden after decades of decrease in smoking. Respiratory Research, 21(1), Article ID 283.
Open this publication in new window or tab >>Decreased COPD prevalence in Sweden after decades of decrease in smoking
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2020 (English)In: Respiratory Research, ISSN 1465-9921, E-ISSN 1465-993X, Vol. 21, no 1, article id 283Article in journal (Refereed) Published
Abstract [en]

Background: COPD has increased in prevalence worldwide over several decades until the first decade after the millennium shift. Evidence from a few recent population studies indicate that the prevalence may be levelling or even decreasing in some areas in Europe. Since the 1970s, a substantial and ongoing decrease in smoking prevalence has been observed in several European countries including Sweden. The aim of the current study was to estimate the prevalence, characteristics and risk factors for COPD in the Swedish general population. A further aim was to estimate the prevalence trend of COPD in Northern Sweden from 1994 to 2009.

Methods: Two large random population samples were invited to spirometry with bronchodilator testing and structured interviews in 2009-2012, one in south-western and one in northern Sweden, n = 1839 participants in total. The results from northern Sweden were compared to a study performed 15 years earlier in the same area and age-span. The diagnosis of COPD required both chronic airway obstruction (CAO) and the presence of respiratory symptoms, in line with the GOLD documents since 2017. CAO was defined as post-bronchodilator FEV1/FVC < 0.70, with sensitivity analyses based on the FEV1/FVC < lower limit of normal (LLN) criterion.

Results: Based on the fixed ratio definition, the prevalence of COPD was 7.0% (men 8.3%; women 5.8%) in 2009-2012. The prevalence of moderate to severe (GOLD >= 2) COPD was 3.5%. The LLN based results were about 30% lower. Smoking, occupational exposures, and older age were risk factors for COPD, whereof smoking was the most dominating risk factor. In northern Sweden the prevalence of COPD, particularly moderate to severe COPD, decreased significantly from 1994 to 2009, and the decrease followed a decrease in smoking.

Conclusions: The prevalence of COPD has decreased in Sweden, and the prevalence of moderate to severe COPD was particularly low. The decrease follows a major decrease in smoking prevalence over several decades, but smoking remained the dominating risk factor for COPD.

Place, publisher, year, edition, pages
BioMed Central, 2020
Keywords
COPD, Prevalence, Risk, Population study, Epidemiology
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-176800 (URN)10.1186/s12931-020-01536-4 (DOI)000582887600001 ()33115506 (PubMedID)2-s2.0-85094149463 (Scopus ID)
Available from: 2020-11-18 Created: 2020-11-18 Last updated: 2024-04-08Bibliographically approved
Backman, H., Lindberg, A., Hedman, L., Stridsman, C., Jansson, S.-A., Sandström, T., . . . Rönmark, E. (2020). FEV1 decline in relation to blood eosinophils and neutrophils in a population-based asthma cohort. World Allergy Organization Journal, 13(3), Article ID 100110.
Open this publication in new window or tab >>FEV1 decline in relation to blood eosinophils and neutrophils in a population-based asthma cohort
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2020 (English)In: World Allergy Organization Journal, E-ISSN 1939-4551, Vol. 13, no 3, article id 100110Article in journal (Refereed) Published
Abstract [en]

Background: The relationship between lung function decline and eosinophils and neutrophils has important therapeutic implications among asthmatics, but it has rarely been studied in large cohort studies.

Objective: The aim is to study the relationship between blood eosinophils and neutrophils and FEV1 decline in a long-term follow-up of a population-based adult asthma cohort.

Methods: In 2012-2014, an adult asthma cohort was invited to a follow-up including spirometry, blood sampling, and structured interviews, and n = 892 participated (55% women, mean age 59 y, 32-92 y). Blood eosinophils, neutrophils and FEV 1 decline were analyzed both as continuous variables and divided into categories with different cut-offs. Regression models adjusted for smoking, exposure to vapors, gas, dust, or fumes (VGDF), use of inhaled and oral corticosteroids, and other possible confounders were utilized to analyze the relationship between eosinophils and neutrophils at follow-up and FEV1 decline.

Results: The mean follow-up time was 18 years, and the mean FEV 1 decline was 27 ml/year. The annual FEV1 decline was related to higher levels of both blood eosinophils and neutrophils at follow-up, but only the association with eosinophils remained when adjusted for confounders. Further, the association between FEV1 decline and eosinophils was stronger among those using ICS. With EOS <0.3 × 109/L as reference, a more rapid decline in FEV1 was independently related to EOS ≥0.4 × 109/L in adjusted analyses.

Conclusions and clinical relevance: Besides emphasizing the importance of smoking cessation and reduction of other harmful exposures, our real-world results indicate that there is an independent relationship between blood eosinophils and FEV1 decline among adults with asthma.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
ANOVA, Analysis of variance, ATS, American Thoracic Society, Asthma, BMI, Body mass index, Cohort, ECRHS, European Community Respiratory Health Survey, EOS, Eosinophils, ERS, European Respiratory Society, Eosinophils, FEV1, FEV1, Forced Expiratory Volume in 1 s, FEV1pp, FEV1 percent of predicted, FVC, Forced Expiratory Volume, GLI, Global Lung function Initiative, ICS, Inhaled corticosteroids, IgE, Immunoglobulin E, L, Liters, Ml, Milliliters, N, Number, NEU, Neutrophils, Neutrophils, OCS, Oral corticosteroids, OLIN, Obstructive Lung Disease in Northern Sweden, OLS, Ordinary Least Squares, VGDF, Vapors, gas, dust or fumes
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-169223 (URN)10.1016/j.waojou.2020.100110 (DOI)000528838100007 ()32206161 (PubMedID)2-s2.0-85081702790 (Scopus ID)
Funder
Swedish Heart Lung FoundationSwedish Research CouncilVästerbotten County CouncilNorrbotten County CouncilSwedish Asthma and Allergy AssociationVisare Norr
Available from: 2020-03-26 Created: 2020-03-26 Last updated: 2024-03-06Bibliographically approved
Jansson, S.-A., Hedman, L., Stridsman, C., Axelsson, M., Lindberg, A., Lundbäck, B., . . . Backman, H. (2020). Life-years lost due to asthma and COPD. European Respiratory Journal, 56
Open this publication in new window or tab >>Life-years lost due to asthma and COPD
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2020 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 56Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
European Respiratory Society, 2020
Keywords
Quality of life, Asthma, Asthma - diagnosis
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-180188 (URN)10.1183/13993003.congress-2020.1400 (DOI)000606501402366 ()
Note

 Supplement: 64

 Meeting Abstract: 1400

Available from: 2021-02-19 Created: 2021-02-19 Last updated: 2021-02-19Bibliographically approved
Backman, H., Stridsman, C., Jansson, S.-A., Hedman, L., Kankaanranta, H., Lindberg, A., . . . Rönmark, E. (2020). Risk factors for severe asthma among adults with asthma. European Respiratory Journal, 56
Open this publication in new window or tab >>Risk factors for severe asthma among adults with asthma
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2020 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 56Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
European Respiratory Society, 2020
Keywords
Asthma, Adults, Severe asthma
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-180199 (URN)10.1183/13993003.congress-2020.4642 (DOI)000606501407446 ()
Note

Supplement:64

Meeting Abstract:4642

Available from: 2021-02-23 Created: 2021-02-23 Last updated: 2021-02-23Bibliographically approved
Jansson, S.-A., Backman, H., Andersson, M., Telg, G., Lindberg, A., Stridsman, C., . . . Rönmark, E. (2020). Severe asthma is related to high societal costs and decreased health related quality of life. Respiratory Medicine, 162, Article ID 105860.
Open this publication in new window or tab >>Severe asthma is related to high societal costs and decreased health related quality of life
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2020 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 162, article id 105860Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The aim of the present study was to estimate the societal costs and the key cost drivers for patients with severe asthma in Sweden. In addition, health-related quality of life (HRQOL) and morbidity of patients with severe asthma is described.

METHODS: The study population comprised adults with severe asthma recruited from a large asthma cohort within the Obstructive Lung Disease in Northern Sweden (OLIN) studies. During 2017, patients were interviewed quarterly over telephone regarding their resource utilization and productivity losses.

RESULTS: Estimated mean annual asthma-related costs per patient with severe asthma amounted to €6,500, of which approximately €2400 and €4100 were direct and indirect costs, respectively. The main cost drivers for direct costs were hospitalizations followed by drugs: approximately €1000 and €800, respectively. Patients on treatment with regular oral corticosteroids (OCS) had greater direct costs compared with those without regular OCS treatment. Co-morbid conditions were common and the costs were substantial also for co-morbid conditions, with a total cost of approximately €4200. The OCS group had significantly lower HRQOL compared to the non-OCS group.

CONCLUSIONS: The societal costs due to severe asthma were substantial. Costs for co-morbid conditions contributed substantially to both direct and indirect costs. The direct costs were significantly higher in the maintenance OCS-group compared to the non-maintenance OCS-group. These results indicate a need for improved management and treatment regimens for patients with severe asthma.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Costs, Health-related quality of life, Oral corticosteroids, Severe asthma
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168152 (URN)10.1016/j.rmed.2019.105860 (DOI)000512923100011 ()32056670 (PubMedID)2-s2.0-85077923660 (Scopus ID)
Available from: 2020-02-18 Created: 2020-02-18 Last updated: 2023-03-24Bibliographically approved
Selberg, S., Hedman, L., Jansson, S.-A., Backman, H. & Stridsman, C. (2019). Asthma control and acute health care visits among young adults with asthma: A population-based study. Journal of Advanced Nursing, 75(12), 3525-3534
Open this publication in new window or tab >>Asthma control and acute health care visits among young adults with asthma: A population-based study
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2019 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 12, p. 3525-3534Article in journal (Refereed) Published
Abstract [en]

AIMS: To study asthma control and acute health care visits among young adults with asthma.

BACKGROUND: Despite the access to effective treatment and nursing interventions, poor asthma control is still common among individuals with asthma. However, studies describing clinical characteristics among young adults with asthma are rare.

DESIGN: A population-based cohort study.

METHODS: In 2015, as a part of the OLIN pediatric cohort I (recruited in 1996 at age 7-8yr), N=2291 young adults (27-28 yr) completed a postal questionnaire survey including questions on asthma and respiratory symptoms. Of these, N=280 (12%) were identified as having current asthma and were further studied.

RESULTS: Of those with current asthma, women reported respiratory symptoms and smoking to a greater extent than men. Approximately one-fourth had uncontrolled asthma and acute health care visits due to asthma was reported by 15% of women and 8% of men. Uncontrolled asthma was associated with smoking, lower educational level, use of reliever treatment most days and acute health care visits. Acute health care visits due to asthma were associated with periodic use of regular controller treatment also after adjustment for uncontrolled asthma.

CONCLUSION: The result indicate poor adherence to asthma treatment which may lead to decreased asthma control and acute health care visits.

IMPACT: Most young adults with asthma are diagnosed and treated in primary care, ideally in a team with a nurse. The main findings highlight the need for evidenced-based nursing interventions, contributing to a more efficient asthma management in primary care. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
asthma, health services, nurses, nursing, patient care, primary healthcare, quantitative research, smoking, treatment adherence and compliance, young adult
National Category
Respiratory Medicine and Allergy Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-162645 (URN)10.1111/jan.14174 (DOI)000486799500001 ()31441107 (PubMedID)2-s2.0-85074391870 (Scopus ID)
Available from: 2019-08-26 Created: 2019-08-26 Last updated: 2020-05-18Bibliographically approved
Jansson, S.-A., Hedman, L., Stridsman, C., Axelsson, M., Kriit, H. K., Lindberg, A., . . . Backman, H. (2019). Life-years lost due to asthma. Paper presented at European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.. European Respiratory Journal, 54
Open this publication in new window or tab >>Life-years lost due to asthma
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2019 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Sheffield: European Respiratory Society Journals, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168184 (URN)10.1183/13993003.congress-2019.PA5063 (DOI)000507372406417 ()
Conference
European-Respiratory-Society (ERS) International Congress, Madrid, SPAIN, SEP 28-OCT 02, 2019.
Note

Supplement: 63. Meeting Abstract: PA5063.

Available from: 2020-03-12 Created: 2020-03-12 Last updated: 2024-07-02Bibliographically approved
Backman, H., Jansson, S.-A., Stridsman, C., Eriksson, B., Hedman, L., Eklund, B.-M., . . . Rönmark, E. (2019). Severe asthma: A population study perspective. Clinical and Experimental Allergy, 49(6), 819-828
Open this publication in new window or tab >>Severe asthma: A population study perspective
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2019 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 49, no 6, p. 819-828Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Severe asthma is a considerable challenge for patients, health care professionals and society. Few studies have estimated the prevalence of severe asthma according to modern definitions of which none based on a population study.

OBJECTIVE: To describe characteristics and estimate the prevalence of severe asthma in a large adult population-based asthma cohort followed for 10-28 years.

METHODS: N=1006 subjects with asthma participated in a follow-up during 2012-14, when 830 (mean age 59y, 56% women) still had current asthma. Severe asthma was defined according to three internationally well-known criteria: the ATS workshop definition from 2000 used in the US Severe Asthma Research Program (SARP), the 2014 ATS/ERS Task force definition and the GINA 2017. All subjects with severe asthma according to any of these criteria were undergoing respiratory specialist care, and were also contacted by telephone to verify treatment adherence.

RESULTS: The prevalence of severe asthma according to the three definitions was 3.6% (US SARP), 4.8% (ERS/ATS Taskforce), and 6.1% (GINA) among subjects with current asthma. Although all were using high ICS doses and other maintenance treatment, >40% had uncontrolled asthma according to the asthma control test. Severe asthma was related to age >50 years, nasal polyposis, impaired lung function, sensitization to aspergillus, and tended to be more common in women. Further, neutrophils in blood significantly discriminated severe asthma from other asthma.

CONCLUSIONS AND CLINICAL RELEVANCE: Severe asthma differed significantly from other asthma in terms of demographic, clinical and inflammatory characteristics, results suggesting possibilities for improved treatment regimens of severe asthma. The prevalence of severe asthma in this asthma cohort was 4-6%, corresponding to approximately 0.5% of the general population.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
IgE, asthma, eosinophils, epidemiology, lung function, neutrophils
National Category
Public Health, Global Health, Social Medicine and Epidemiology Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-157380 (URN)10.1111/cea.13378 (DOI)000475694600009 ()30817038 (PubMedID)2-s2.0-85066803309 (Scopus ID)
Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2023-03-24Bibliographically approved
Backman, H., Jansson, S.-A., Stridsman, C., Muellerova, H., Wurst, K., Hedman, L., . . . Rönmark, E. (2018). Chronic airway obstruction in a population-based adult asthma cohort: Prevalence, incidence and prognostic factors. Respiratory Medicine, 138, 115-122
Open this publication in new window or tab >>Chronic airway obstruction in a population-based adult asthma cohort: Prevalence, incidence and prognostic factors
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2018 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 138, p. 115-122Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Asthma and COPD may overlap (ACO) but information about incidence and risk factors are lacking. This study aimed to estimate prevalence, incidence and risk factors of chronic airway obstruction (CAO) in a population-based adult asthma cohort.

METHODS: /FVC<0.7.

RESULTS: decline and higher levels of neutrophils than asthma only. Smoking, older age and male sex were independently associated with increased risk for both prevalent and incident CAO, while obesity had a protective effect.

CONCLUSIONS: In this prospective adult asthma cohort, the majority did not develop CAO. Smoking, older age and male sex were risk factors for prevalent and incident CAO, similar to risk factors described for COPD in the general population.

Place, publisher, year, edition, pages
W.B. Saunders Ltd, 2018
Keywords
ACO, Asthma, Epidemiology, Longitudinal study, Risk factors
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-147915 (URN)10.1016/j.rmed.2018.03.036 (DOI)000432442400017 ()29724382 (PubMedID)2-s2.0-85045212522 (Scopus ID)
Available from: 2018-05-22 Created: 2018-05-22 Last updated: 2023-03-24Bibliographically approved
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