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Biomedical subjects

B Järvholm

Publications and source records attributed to B Järvholm.

At least 19 recordsLinked to original sources
PubMed2006

Persistence of respiratory symptoms in ex-underground iron ore miners.

AIMS: To assess the persistence of respiratory symptoms in ex-miners after cessation of mining exposure. METHODS: Population-based cross-sectional study using a postal questionnaire comparing prevalence of symptoms between ex-miners who had stopped mining at least 1 year before the study and referents not occupationally exposed to irritants or dust. Age, smoking and a family history of asthma were considered as possible confounders in the analysis. RESULTS: A total of 206 ex-miners and 4,560 referents participated. Ex-miners had on average been working as miners for 13 years and had stopped mining 16 years before the study. Chronic productive cough and physician-diagnosed chronic bronchitis were significantly more common among ex-miners (P < 0.05 and <0.01, respectively). Furthermore, there was a trend that other respiratory symptoms were more common in ex-miners. CONCLUSION: Ex-miners had an increased risk of chronic productive cough and physician-diagnosed chronic bronchitis many years after they had stopped working as a miner.

Bronchitis, Chronic↗
PubMed2006

Vehicle exhaust exposure in an incident case-control study of adult asthma.

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.

Adult↗
PubMed2006

Airway inflammation in iron ore miners exposed to dust and diesel exhaust.

The aim of the present study was to investigate if underground miners exposed to dust and diesel exhaust in an iron ore mine would show signs of airway inflammation as reflected in induced sputum. In total, 22 miners were studied, once after a holiday of at least 2 weeks and the second time after 3 months of regular work. Control subjects were 21 "white-collar" workers. All subjects completed a questionnaire regarding medical and occupational history, and underwent lung function testing and induced sputum collection. Total and differential cell counts and analyses of the fluid phase of the induced sputum were performed. Sampling of personal exposure to elemental carbon, nitrogen dioxide and inhalable dust was recorded. The average concentrations of inhalable dust, nitrogen dioxide and elemental carbon were 3.2 mg.m-3, 0.28 mg.m-3 and 27 microg.m-3, respectively. Miners had increased numbers of inflammatory cells, mainly alveolar macrophages and neutrophils, and increased concentrations of fibronectin, metalloproteinase-9 and interleukin-10 in induced sputum compared with controls. In conclusion, miners in an underground iron ore mine demonstrated persistent airway inflammation that was as pronounced after a 4-week holiday as after a 3-month period of work underground in the mine.

Adult↗
PubMed2005

Fifteen-year follow-up of hand eczema: persistence and consequences.

BACKGROUND: Hand eczema is a skin disease often with a long-lasting and relapsing course. The long-term prognosis in the general population is unknown. OBJECTIVES: The aims were to examine the extent to which hand eczema had persisted and the medicosocial consequences of the disease. METHODS: In a 15-year follow-up of hand eczema, patients diagnosed in a previous population-based study were sent a questionnaire with 20 questions concerning the persistence and course of the disease, and its occupational and medicosocial consequences. RESULTS: Addresses were available for 1115 persons, of whom 868 answered the questionnaire. Sixty-six per cent of the respondents reported periods of hand eczema and 44% reported symptoms during the previous year, with no sex difference. Twelve per cent reported continuous eczema. However, 74% of those reporting symptoms considered that their hand eczema had improved; of these more were women than men (78% vs. 66%, P < 0.01). Twenty people, 3% of those who were gainfully employed in 1983, reported a change to another occupation because of their hand eczema, 15 of these reporting improvement after the job change. A considerable need for medical consultation was reported, as was the influence on psychosocial functions among those who had eczema the previous year, e.g. sleep disturbances (36%) and hampered leisure activities (72%). Job changes related to hand eczema and psychosocial impairment were also reported by individuals who had not sought medical help for their hand eczema. CONCLUSIONS: This study demonstrates a variable and poor long-term prognosis for hand eczema in the general population. One-third sought medical care during follow-up, while the vast majority with ongoing hand eczema experienced negative psychosocial consequences. For about 5%, the hand eczema gave far-reaching consequences including long sick-leave periods, sick pension and changes of occupation.

Activities of Daily Living↗
PubMed2005

Obesity increases the risk of incident asthma among adults.

The annual incidence of asthma in adults in northern Sweden has been estimated at 2.3 per thousand population. Risk factors for incident asthma among adults were studied in a case-referent study based on incident cases of asthma during 1995-1999. The healthcare providers reported suspected cases of incident asthma. After clinical examination, 309 (65% female) of 473 reported subjects were included. Inclusion criteria were a history of incident asthma (onset <12 months) and verified bronchial variability. Referents were randomly selected and stratified by age, sex and area of residence. The significant risk factors were hay fever, a family history of asthma, ex-smoking status and elevated body mass index (25.0-29.9 and > or =30). The risk factor pattern was similar for females and males, and increased body mass index was a significant risk factor for both males and females, as well as for allergic and nonallergic subjects. In conclusion, in addition to hay fever, a family history of asthma, allergic sensitisation and ex-smoking status, increased body mass index was a significant risk factor for incident asthma independent of sex and allergic status.

Adult↗
PubMed2004

Increased mortality in COPD among construction workers exposed to inorganic dust.

The aim of this study was to find out if occupational exposure to dust, fumes or gases, especially among never-smokers, increased the mortality from chronic obstructive pulmonary disease (COPD). A cohort of 317,629 Swedish male construction workers was followed from 1971 to 1999. Exposure to inorganic dust (asbestos, man-made mineral fibres, dust from cement, concrete and quartz), gases and irritants (epoxy resins, isocyanates and organic solvents), fumes (asphalt fumes, diesel exhaust and metal fumes), and wood dust was based on a job-exposure matrix. An internal control group with "unexposed" construction workers was used, and the analyses were adjusted for age and smoking. When all subjects were analysed, there was an increased mortality from COPD among those with any airborne exposure (relative risk 1.12 (95% confidence interval (CI) 1.03-1.22)). In a Poisson regression model, including smoking, age and the major exposure groups, exposure to inorganic dust was associated with an increased risk (hazard ratio (HR) 1.10 (95% CI 1.06-1.14)), especially among never-smokers (HR 2.30 (95% CI 1.07-4.96)). The fraction of COPD among the exposed attributable to any airborne exposure was estimated as 10.7% overall and 52.6% among never-smokers. In conclusion, occupational exposure among construction workers increases mortality due to chronic obstructive pulmonary disease, even among never-smokers.

Cohort Studies↗
PubMed2004

Risk of fatal industrial accidents and death from other external causes among asphalt workers.

The hypothesis that asphalt workers are at increased risk of mortality from industrial accidents and other external causes was tested. Mortality rates for external and violent causes of death in a cohort of asphalt industry employees from seven European countries and Israel were compared to that of the general population. There was no evidence that mortality from external causes was increased among long term employees in asphalt application and mixing. There was an increased risk for mortality due to external causes among short term workers. However, none of the fatal accidents among short term workers appear to have occurred during employment in the studied asphalt companies. Overall, no evidence was found supporting the hypothesis that asphalt workers are at increased risk of fatal industrial or road accidents. Mortality from other external causes did not increase in this population as a whole, but increased risks among short term workers deserve further attention.

Accidents, Occupational↗
PubMed2003

Hand eczema in 45 bakers - a clinical study.

The skin of bakers is heavily exposed to dough, spices, water and detergents. This is follow-up of a previous Swedish questionnaire study showing bakers to have a 3-fold increased risk of hand eczema. The aims were to establish diagnoses and to study consequences of hand eczema. From a cohort study of 2226 bakers, a random sample among bakers reporting hand eczema was examined. Of 60 randomly selected bakers reporting a history of hand eczema, 52 attended an examination comprising a standardized interview, documentation of clinical skin signs, patch testing and prick testing with standard and bakery series, and serum analyses. In all, 45 bakers confirmed a history of hand eczema, for which 11 (24%) had been on sick leave, with a median duration of 14 weeks. 13 (29%) had changed their occupation due to skin disease, 19 had positive patch test reactions to standard contact allergens - and 5 to bakery contact allergens. 16 bakers had positive prick tests to standard allergens, 10 to bakery allergens, of whom 9 reacted to flours. Since considerable medical and social consequences of hand eczema are seen, thorough diagnosis of contact allergy and IgE-mediated allergy in bakers, as well as preventive measures, are essential.

Adult↗
PubMed2003

Lung cancer in heavy equipment operators and truck drivers with diesel exhaust exposure in the construction industry.

BACKGROUND: Several studies indicate that truck drivers have an increased risk of lung cancer, but few studies have examined lung cancer risk in heavy equipment operators. Workers in both occupations are exposed to diesel exhaust. AIMS: To examine the incidence and mortality from lung cancer among truck drivers and among drivers of heavy vehicles. METHODS: A computerised register of Swedish construction workers participating in health examinations between 1971 and 1992 was used. Male truck drivers (n = 6364) and drivers of heavy construction vehicles (n = 14 364) were selected as index groups; carpenters/electricians constituted the reference group (n = 119 984). RESULTS: Operators of heavy construction equipment experienced no increased risk of lung cancer compared to risk among the carpenter/electrician referents (61 cases v 70.1 expected). However, a significant inverse trend risk with increasing use of cabins was apparent. Truck drivers had increased risks of cancer of the lung (61 cases v 47.3 expected) and prostate (124 cases v 99.7 expected), although only mortality for lung cancer was significantly increased. Comparisons with the general population showed similar results. CONCLUSION: Results are consistent with those of previous studies suggesting that heavy equipment operators with potential exposure to diesel exhaust may have little or no increased risk of lung cancer, although the use of cabins seemed to decrease the risk of lung cancer. The results for truck drivers are also consistent with previous reports of increased lung cancer risk among truck drivers exposed to diesel exhaust, as well as recent reports linking diesel exhaust exposure to prostate cancer.

Aged↗
PubMed2003

Exposure assessment of monoterpenes and styrene: a comparison of air sampling and biomonitoring.

BACKGROUND: Within- and between-worker variance components have seldom been reported for both environmental and biological data collected from the same persons. AIMS: To estimate these variance components and their ratio for air contaminants and urinary metabolites in two different work environments and to predict the attenuation of exposure-response relationships based on these measures. METHODS: Parallel measurements of air and urine were performed among workers exposed to monoterpenes in sawmills (urinary metabolite: verbenol) and styrene in reinforced plastics factories (urinary metabolite: mandelic acid). RESULTS: Among the sawmill workers, variance components of the air and urinary verbenol results were similar; for the reinforced plastics workers the estimated between-worker variance component was greater for styrene in air than mandelic acid in urine. This suggests that attenuation bias would be about equal if air or biological monitoring were employed for monoterpene exposures, but would be greater if urinary mandelic acid were used instead of airborne styrene in an investigation of styrene exposure. CONCLUSIONS: Personal air samplers provide data with similar or superior quality to urinary metabolites as measures of exposure to these monoterpenes in sawmills and styrene in reinforced plastics factories.

Air Pollutants, Occupational↗
PubMed2002

Suicide mortality among electricians in the Swedish construction industry.

OBJECTIVES: To investigate the risk of suicide in Swedish electricians employed in the construction industry. A few studies have indicated an increased risk of suicide for electricians in the construction industry and electricians exposed to electromagnetic fields. METHODS: This is a cohort study. Electricians were identified through a computerised register of construction workers who had participated in health examinations in 1971-92. In this register, 33,719 male electricians were identified together with a reference group consisting of 72,653 male glass or woodworkers. Through a linkage with the Swedish Death Register, the cause of death was identified to the end of 1997. Mortality as a result of suicide was also compared with the general population with adjustments for sex, age, and period. RESULTS: The risk of mortality from suicide was decreased for electricians (standardised mortality ratio (SMR) 0.58, 95% confidence interval (95% CI) 0.47 to 0.71) and for the reference group of construction workers (SMR 0.81, 95% CI 0.72 to 0.91) compared with the general population. CONCLUSION: Contrary to some other studies, risk of suicide was not increased among electricians in the construction industry.

Adult↗
PubMed2001

[An observational study requires careful consideration by the reader].

The observational study has its merits when randomized controlled studies are impossible to perform. This review discusses its merits and weaknesses for a reader of such studies. The reader has to consider the internal and external validity of the study and its role in the establishment of causal relationships and estimations of risks. The reader is recommended to primarily evaluate the quality of study design, confounding and measurement bias, rather than to try to understand if an advanced statistical analysis is correct. The possibilities of misleading results are discussed.

Bias↗
PubMed2001

Incidence of lung cancer in a large cohort of non-smoking men from Sweden.

Valid data on the occurrence of lung cancer among non-smokers are sparse and refer mainly to North American populations. The objective of our study is to provide an estimate of the incidence of lung cancer among non-smokers in a large European population. Proceeding from a nation-wide health care program among Swedish construction workers, we estimated the incidence of lung cancer among 143,998 males who reported to be never smokers at 1 or several physical check-ups (average, 2.9 visits) during 1971-92. Cancer incidence data for 1971-95 were obtained through linkage with the virtually complete national cancer registry. Cohort members contributed over 2 million person-years of observation, during which 101 lung cancers occurred. The age-standardized rate was 3.7/100,000 (95% confidence interval [CI] 2.8-4.6). There was a suggestion of a calendar period effect, with rates increasing from 1.5/100,000 in 1976-80 to 5.4/100,000 in 1991-95. A birth cohort effect was also suggested. Rates estimated in this population are comparable to those from North American studies. The increasing rate during the study period might be due to non-smokers who took up the habit, but it might also reflect temporal changes in the effect of other risk factors of lung cancer in non-smokers.

Adolescent↗
PubMed2001

Dampness in buildings and health. Nordic interdisciplinary review of the scientific evidence on associations between exposure to "dampness" in buildings and health effects (NORDDAMP).

Several epidemiological investigations concerning indoor environments have indicated that "dampness" in buildings is associated to health effects such as respiratory symptoms, asthma and allergy. The aim of the present interdisciplinary review is to evaluate this association as shown in the epidemiological literature. A literature search identified 590 peer-reviewed articles of which 61 have been the foundation for this review. The review shows that "dampness" in buildings appears to increase the risk for health effects in the airways, such as cough, wheeze and asthma. Relative risks are in the range of OR 1.4-2.2. There also seems to be an association between "dampness" and other symptoms such as tiredness, headache and airways infections. It is concluded that the evidence for a causal association between "dampness" and health effects is strong. However, the mechanisms are unknown. Several definitions of dampness have been used in the studies, but all seems to be associated with health problems. Sensitisation to mites may be one but obviously not the only mechanism. Even if the mechanisms are unknown, there is sufficient evidence to take preventive measures against dampness in buildings.

Air Pollution, Indoor↗
PubMed2000

Obesity, hypertension, and the risk of kidney cancer in men.

BACKGROUND: Obesity and hypertension have been implicated as risk factors for the development of renal-cell cancer. METHODS: We examined the health records of 363,992 Swedish men who underwent at least one physical examination from 1971 to 1992 and were followed until death or the end of 1995. Men with cancer (renal-cell cancer in 759 and renal-pelvis cancer in 136) were identified by cross-linkage of data with the nationwide Swedish Cancer Registry. Poisson regression analysis was used to estimate relative risks, with adjustments for age, smoking status, body-mass index, and diastolic blood pressure. RESULTS: As compared with men in the lowest three eighths of the cohort for body-mass index, men in the middle three eighths had a 30 to 60 percent greater risk of renal-cell cancer, and men in the highest two eighths had nearly double the risk (P for trend, <0.001). There was also a direct association between higher blood pressures and a higher risk of renal-cell cancer (P for trend, <0.001 for diastolic pressure; P for trend, 0.007 for systolic pressure). After the first five years of follow-up had been excluded to reduce possible effects of preclinical disease, the risk of renal-cell cancer was still consistently higher in men with a higher body-mass index or higher blood pressure. At the sixth-year follow-up, the risk rose further with increasing blood pressures and decreased with decreasing blood pressures, after adjustment for base-line measurements. Men who were current or former smokers had a greater risk of both renal-cell cancer and renal-pelvis cancer than men who were not smokers. There was no relation between body-mass index or blood pressure and the risk of renal-pelvis cancer. CONCLUSIONS: Higher body-mass index and elevated blood pressure independently increase the long-term risk of renal-cell cancer in men. A reduction in blood pressure lowers the risk.

Adult↗
PubMed2000

Natural organic fibers--health effects.

OBJECTIVES: Natural organic fibers are used in large quantities in the production of paper products and textiles. They are also constituents of food and added to food to promote health. The objective of this review is to evaluate the health effects of natural organic fibers. The health effects of dietary fibers are excluded from the review. METHODS: This is a literature review. RESULTS: Exposure to these fibers in industry is usually not characterized as fibers but as dust. Rather dusty conditions have been reported in both paper and textile industries with concentrations up to and above 30 mg/m3. Both in the paper and textile industry inorganic fibers may occur making it hard to evaluate health effects of natural organic fibers from studies of workers in the paper and textile industry. There seems to be no increased risk of mesothelioma, lung cancer or lung fibrosis in workers exposed to natural organic fibers in contrast to workers exposed to inorganic crystalline fibers as asbestos. However, workers with a heavy exposure to paper dust or textile dust seem to have an increased risk of obstructive lung disease and bronchitis. These effects have not been causally linked to the fibrous shape of the particles but rather to the dust, chemicals absorbed on the dust or microorganisms occurring together with the dust. There is some indication that work in the textile industry may increase the risk of sinonasal cancer, but the etiological agents are unknown. CONCLUSION: Natural organic fibers are not causally linked with the well-known effects of some inorganic fibers, i.e. mesothelioma, lung cancer, lung fibrosis or some pleural diseases. The health effects of natural organic fibers, e.g. irritative effects, seem not to be linked to their fibrous shape.

Cellulose↗
PubMed2000

Perceived pain before and after three exercise programs--a controlled clinical trial of women with work-related trapezius myalgia.

The effect of exercise on neck-shoulder pain was studied in 103 women with work-related trapezius myalgia randomized into three exercise groups and a control group. One group trained strength, the second muscular endurance and the third co-ordination. The exercise groups met three times weekly for 10 weeks. Pain assessment was made on three visual analogue scales, indicating pain at present, pain in general and pain at worst. Pain thresholds were measured in the trapezius muscle with a pressure algometer. A pain drawing was completed. The rated pain decreased significantly (P<0.05) on the VAS describing pain at worst in the strength and endurance groups. Pressure sensitivity decreased significantly (P<0.05) in four triggerpoints in the exercise groups. No changes were seen in the extent of painful body area in any group. Comparison of exercisers (n=82) and controls (n=21) showed significantly larger pain reductions on VAS pain at present and VAS pain at worst among exercisers. All three exercise programs showed similar decreases of pain which indicates that the type of exercise is of less importance to achieve pain reduction.

Adult↗