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J Kongerud

Publications and source records attributed to J Kongerud.

At least 55 records · Page 3Linked to original sources
PubMed1995

Bronchial responsiveness decreases in relocated aluminum potroom workers compared with workers who continue their potroom exposure.

We have compared the bronchial responsiveness (BR) of 12 aluminum potroom workers (index group) who were relocated due to work-related asthmatic symptoms (WASTH) and 26 subjects (reference group) with WASTH who continued to work in potrooms. The subjects were examined at regular intervals during a 2-year follow-up period. BR was expressed as the log-transformed dose-response slope [Ln(DRS 5)]. The monthly change in BR (delta BR) in the index group was -4.87 x 10(-2) compared with -1.58 x 10(-2) in the reference group. After adjustment for potential confounders, the difference between the index group and the reference group was -2.39 x 10(-2) (95% CI: -4.07 x 10(-2) to -0.71 x 10(-2)), i.e. 49% of the decrease in BR in the index group could be explained by the removal from exposure. No improvement in lung function was found in the index group compared with the reference group. The results indicate that the removal of potroom workers from exposure causes a decrease in BR.

Adult↗
PubMed1995

Comparison of three methods for estimating environmental tobacco smoke exposure among children aged between 12 and 36 months.

BACKGROUND: The methods currently used for measuring environmental tobacco smoke (ETS) exposure among small children all have their limitations. The aim of this study was to compare the results of questionnaire assessments of children's ETS exposure with cotinine measurements in urine and nicotine measurements in hair, a new method for estimating average ETS exposure. METHODS: Questionnaire information on ETS exposure and a sample of hair were collected from 94 children aged 12-36 months. A urine sample for cotinine analysis was obtained from 72 of the children. RESULTS: Nicotine was found in all hair samples and cotinine in all urine samples. Compared to children registered as unexposed by the questionnaire, hair nicotine levels were 12.4 times higher among children exposed to more than 10 DNC (daily number of cigarettes) (P < 0.001) and 3.6 times higher among children exposed to 1-10 DNC (P < 0.001). The median cotinine creatinine ratio (CCR) was 2.4 times higher among children exposed to more than 10 DNC compared to unexposed children (P < 0.001). No significant difference in median CCR was found between unexposed children and children exposed to 1-10 DNC. The correlation coefficient was 0.64 between children's hair nicotine levels and DNC, 0.50 between CCR and DNC and 0.56 between children's hair nicotine levels and CCR. CONCLUSION: Nicotine measurement in hair is a practical and valid method for estimating average ETS exposure in children. An underreporting of ETS exposure was indicated.

Age Factors↗
PubMed1995

Lung function impairment in long-term survivors of Hodgkin's disease.

BACKGROUND: Treatment of Hodgkin's disease (HD) involves radiation and chemotherapy, modalities known to cause lung injury. PATIENTS AND METHODS: In Norway, between 1980 and 1988, 129 patients aged less than 50 years at the time of diagnosis, had curative treatment with thoracic radiation alone or combined-modality therapy for supradiaphragmatic HD. We have examined 116 (90%) of these patients by interview, chest X-ray and lung function tests, 5-13 years after treatment. RESULTS: Nearly 30% of the patients had dyspnoea on exertion and associated reductions in total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and gas transfer (TLCO) (p < 0.05). Radiographic evidence of no, slight or moderate fibrosis occurred in 32%, 54% and 14% of the patients, respectively. Moderate fibrosis was associated with reductions in FVC, FEV1 and TLCO (p < 0.05). Radiation plus chemotherapy containing bleomycin-anthracyclines (median cumulative bleomycin dose 120 mg) was associated with decreases in FVC and TLCO (p < 0.05). In the multivariate analysis, chemotherapy with bleomycin-anthracyclines was the only significant predictor for lung function impairment. CONCLUSION: More than five years after therapy, respiratory symptoms and reduction in lung function were diagnosed in nearly one-third of otherwise healthy HD survivors.

Adolescent↗
PubMed1995

Bronchial responsiveness, eosinophilia, and short term exposure to air pollution.

The number of capillary blood eosinophils and the prevalence of bronchial hyperresponsiveness (BHR) were compared between schoolchildren living in a polluted area (Ardal) and unpolluted area (Laerdal). In Ardal there is an aluminium smelter emitting sulphur dioxide and fluoride to the environment. Daily measurements of these pollutants in ambient air were available. The mean number of eosinophils in Ardal was 220 x 10(6)/l compared with 106 x 10(6)/l in Laerdal. The prevalence of BHR was 15.9% in Ardal and 11.8% in Laerdal. The odds ratio of having BHR in relation to these pollutants during the last 24 hours were: 1.12 (95% confidence interval (CI) 1.01 to 1.24) by increasing sulphur dioxide with 10 micrograms/m3, and 1.31 (95% CI 1.07 to 1.60) when fluoride exposure increased with 1 micrograms/m3. Similarly, these exposures were associated with a decrease in eosinophils of -21 x 10(6)/l (95% CI -36 to -6) and -52 x 10(6)/l (95% CI -98 to -8), respectively, in atopics. It is hypothesised that recent exposure to irritants induces changes in the airways leading to BHR in addition to recruitment of eosinophils to the airways in atopic subjects.

Adolescent↗
PubMed1995

Decreased lung function in one year survivors of allogeneic bone marrow transplantation conditioned with high-dose busulphan and cyclophosphamide.

Conditioning with busulphan (BU) and cyclophosphamide (CY) prior to allogeneic bone marrow transplantation (BMT) is an alternative to regimens that include total body irradiation (TBI). The aim of the study was to assess the occurrence and degree of lung function impairment after this treatment. Prospectively, 43 consecutive patients, aged 17-51 (median 31) yrs, were examined by lung function measurements and clinical and radiographic evaluation, prior to BMT and at 3 month intervals up to 1 yr after BMT. All patients had normal chest radiographs before BMT and at the 12 month follow-up. Mean baseline values were above 100% of predicted normal for lung volumes and above 90% for gas transfer. Excluded from the lung function follow-up analyses were nine patients who had suffered infectious pneumonia and/or developed obliterative bronchiolitis. For the remaining patients (n = 34), mean alveolar volume (VA), forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) had dropped by nearly 10% compared with baseline 3 months after BMT, but were restored within 1 yr. FEV1/FVC x 100 (FEV1%) was increased, reflecting the restrictive pattern. Hb-adjusted transfer factor of the lungs for carbon monoxide (TL,CO) had dropped by 20% after 3 months, and remained reduced by 15% after 1 year. Prior to BMT the smokers had significantly lower TL,CO than the nonsmokers, and after BMT the difference was accentuated. Reductions in lung function were independent of sex, age and type of haematological disorder. We conclude that BMT with BU/CY is associated with transient declines in lung volumes and a persistent reduction in gas transfer 1 yr after therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Postnatal maternal smoking increases the prevalence of asthma but not of bronchial hyperresponsiveness or atopy in their children.

We have compared the prevalence of asthma, bronchial hyperresponsiveness (BHR), and atopy in relation to parental smoking in children aged 7 to 13 years. Information on the presence of asthma was obtained from a questionnaire, BHR was assessed by a methacholine challenge test, and atopy was defined as a positive response to a skin prick test. A complete history of the parents' smoking habits during their children's life, including prenatal smoking habits, was recorded. The prevalence of maternal smoking increased from 37.9% during pregnancy to 45.3% at the cross-sectional survey. None of the outcomes was significantly related to paternal smoking, whereas postnatal maternal smoking was positively associated with asthma (odds ratio [OR] = 2.8; 95% confidence interval [CI], 1.3 to 6.1). A negative association between prenatal maternal smoking and atopy was found (OR = 0.6; 95% CI, 0.3 to 0.9). We found no significant association between BHR and parental smoking. Our results indicate that postnatal maternal smoking increases the prevalence of asthma in the offspring without inducing BHR.

Adolescent↗
PubMed1994

Interval censoring in longitudinal data of respiratory symptoms in aluminium potroom workers: a comparison of methods.

In a longitudinal study of workers in seven Norwegian aluminium plants, the time to development of asthmatic symptoms could only be determined to lie in the interval between two consecutive health examinations. In a previous paper we analysed the data by survival techniques for interval censored data. In the present paper the data are reanalysed in two ways and compared to the previous analyses. First, it is assumed that occurrence of symptoms coincided with reporting, in which case the data can be analysed as right censored. Secondly, the follow-up times are completely disregarded and the effects of covariates are analysed on the binary outcomes of symptoms. Comparing the estimated effects of the covariates between the three approaches, only minor differences were found. However, the estimates on incidence were strongly influenced by whether the data were analysed as right or interval censored.

Adult↗
PubMed1994

[Tracheal stenosis and autoimmune thyroiditis].

After exposure to ammonia, a 63 year old woman experienced dyspnoea and respiratory infections. A stenosis was diagnosed in the proximal part of the trachea. High levels of antibodies against thyroperoxidase suggested thyroiditis. After treatment with corticosteroids both the antibodies and the stenosis decreased and the patient's symptoms improved. A few months later the patient developed therapy-resistant uveitis. Cyclosporin was added to the treatment and the condition was stabilized. The diagnosis was unclear. Tracheal stenosis may have developed secondary to autoimmune thyroiditis, while the uveitis probably was another organ manifestation of the autoimmune disease. The ammonia may have caused mucosal oedema, increasing the obstruction to symptomatic level.

Ammonia↗
PubMed1994

Deaths from pulmonary tuberculosis in a low-incidence country.

OBJECTIVES: To study the validity of official mortality statistics regarding deaths from pulmonary tuberculosis, and to identify factors contributing to death. DESIGN: A retrospective study. SETTING: Cases were enrolled from the data of the Central Bureau of Statistics from where the official mortality statistics are issued, the National Tuberculosis Register and all Autopsy Registers in the region. SUBJECTS: Case and autopsy reports from all patients who died from active pulmonary tuberculosis in two Norwegian counties between 1977 and 1989. MAIN OUTCOME MEASURES: Patients identified from all three registers with active pulmonary tuberculosis, concomitant diseases/risk-factors, chest X-rays, symptoms, number of patients investigated and treated for tuberculosis, duration from hospital admission until start of treatment and/or death. RESULTS: Ninety-six patients, median age 75 years, died from pulmonary tuberculosis, 51 without treatment. Thirty-four patients had not been registered at the Central Bureau of Statistics. Thirty-nine patients had cough on admission. Weight loss and generalized malaise occurred just as frequently. Forty-two patients had infiltrates on chest X-ray located elsewhere than in the apical region. In 42 patients, no diagnostic tests for tuberculosis were performed. The median length of stay in hospital was 24 days before death in the untreated group, and 21 days before start of treatment in the treated group. CONCLUSION: Reliable figures of patients who died from pulmonary tuberculosis could not be obtained from the official statistics because of under-notification and erroneous codification of diseases. Deaths occurred mainly because the diagnosis was established too late: in half of the patients at autopsy. Eighty-one patients had concomitant diseases known to lower resistance against tuberculosis. Lack of diagnostic suspicion may have been caused by nonspecific symptoms and atypical chest X-ray findings.

Adult↗
PubMed1994

Relation between exposure to fluoride and bronchial responsiveness in aluminium potroom workers with work-related asthma-like symptoms.

BACKGROUND: The relation between plasma fluoride levels and bronchial responsiveness was investigated in a longitudinal study in aluminium potroom workers who reported work-related asthmatic symptoms. METHODS: From a cross-sectional respiratory survey, 26 men who reported work-related asthmatic symptoms on a validated questionnaire were selected for repeated measurements of bronchial responsiveness to methacholine. Regular analyses of plasma fluoride levels were performed. Exposure to fluoride and total particulates was assessed from routine surveillance of the workplace. Bronchial responsiveness was expressed as the dose-response slope of the line through the origin and last data point. RESULTS: A positive association was found between bronchial responsiveness and plasma fluoride levels, such that an increase in the plasma fluoride level of 10 ng/ml was associated with an increase in the dose-response slope by a factor of 1.11 (95% confidence interval 1.05 to 1.17). Plasma fluoride levels were associated with the total atmospheric fluoride concentration in mg/m3 (beta = 28.1), but not with total particulates in the environment. CONCLUSIONS: Bronchial responsiveness in aluminium potroom workers reporting work-related asthmatic symptoms appears to be related to plasma levels of fluoride. The underlying mechanism is, however, unknown.

Adult↗
PubMed1994

Aluminium potroom asthma: the Norwegian experience.

Work-related asthma in aluminium potroom workers, is reviewed and discussed, mainly on the basis of own investigations. The occurrence of work-related asthma has been shown to be associated with the duration of potroom employment, although the prevalence of asthmatic symptoms is not significantly different from that of the general population. Typical manifestations of occupational asthma are described in potroom workers, and a close relationship between the levels of fluoride exposure and work-related asthmatic symptoms has been observed. The existence of occupational asthma in aluminium potroom workers has been confirmed by characteristic patterns of repeated peak flow measurements, supported by changes in methacholine responsiveness in workers with suspected work-related asthma. However, no immunological test is available to establish the diagnosis. Methacholine challenge appears to be inappropriate for screening aluminium potroom workers in order to detect work-related asthma. Current smoking, but not self-reported allergy, is a risk factor for potroom asthma. A family history of asthma and previous occupational exposure may have some effect on the risk of developing symptoms. The prognosis of potroom asthma seems to depend on early replacement to unexposed work. The pathogenetic mechanisms are unknown, although some studies indirectly imply a hypersensitivity reaction. Future studies involving specific bronchial challenge appear to be necessary to find the causal agent(s) of aluminium potroom asthma.

Aluminum↗
PubMed1994

Reversible airflow limitation in adults with respiratory infection.

The aim of the study was to determine the occurrence of airflow limitation and the frequency of significant reversibility in respiratory infections in adults without known asthma or chronic obstructive pulmonary disease (COPD). We also wanted to study the association between airflow limitation and aetiological agents diagnosed by serological analyses. Spirometry was performed in 574 adult general practice patients with upper or lower respiratory tract infection, and follow-up measurement was obtained in 429 of them. In the latter group, we also obtained paired sera for analysis of anti-bodies against respiratory viruses, chlamydial and mycoplasmal agents. Median forced expiratory volume in one second (FEV1) in all patients included was 90% of predicted; significantly lower in patients with an established diagnosis of asthma or COPD, compared to those without, 77 and 91% predicted, respectively. Among the patients without known asthma or COPD there was a strong association between low FEV1 and the symptoms cough and dyspnoea. Both acute-phase and follow-up FEV1 was measured in 395 of the patients without known asthma or COPD, and a significant increase in median value from 92 to 96% was registered. A reversibility of FEV1 of > 15% was measured in 23% of the 395 patients, uninfluenced by anti-asthma treatment in the great majority. Patients with an established viral, mycoplasmal or chlamydial infection had a significantly lower FEV1 at entry and a greater reversibility, compared to those without such aetiological diagnosis. We conclude that reversible obstruction was particularly common in the patients diagnosed as having acute bronchitis, but that it was found in the patients patients diagnosed as having upper respiratory tract infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Bronchial responsiveness and decline in FEV1 in aluminium potroom workers.

We have investigated the relationship between annual decline in forced expiratory volume in one second (delta FEV1) and bronchial responsiveness (BR) in aluminium potroom workers. BR was measured in a cross-sectional study of 337 aluminium potroom workers half-way through a 6 yr follow-up study of lung function. A skin-prick test (SPT) was also performed. During follow-up the mean number of measurements of lung function (FEV1) in each subject was 6.8. Mean delta FEV1 was 21.3 ml.yr-1 (within subject SD = 30.5 ml.yr-1). Mean delta FEV1 was 57.0, 44.5 and 16.6 ml.yr-1 in subjects who had provocative concentration producing a 20% fall in FEV1 (PC20) < or = 8.0, 8.1-32.0 and > 32.0 mg.ml-1, respectively. After adjustment for gender, atopy, smoking habit, FEV1, age and familial asthma the association between BR and delta FEV1 was weakened, and was not statistically significant. A significantly accelerated decline in FEV1 with age was found. The difference in delta FEV1 between smokers and nonsmokers was 39.3 ml.yr-1, and between subjects who had a positive skin-prick test compared to subjects with a negative skin-prick test 39.6 ml.yr-1. In subjects reporting work-related asthmatic symptoms the decline in FEV1 was 43.2 ml.yr-1 greater than in asymptomatic subjects. In asymptomatic subjects, positive skin-prick test was also associated with increased delta FEV1. These data indicate that a single measurement of BR is not a predictor of delta FEV1 in aluminium potroom workers. Smoking, work-related asthmatic symptoms, and positive reaction to skin-prick test in asymptomatic workers were risk factors of increased delta FEV1.

Adolescent↗
PubMed1992

[Occupational asthma. Occurrence, diagnosis, course and prevention].

Occupational asthma is defined as variable air flow obstruction caused by inhalation of agents at work. The condition is increasingly recognized as a cause of work-related respiratory disease, and in Norway is estimated to account for approximately 20% of the cases of asthma among adults exposed to dust or gases. These figures are likely to increase when more inhalable reactive chemicals are introduced at places of work. A careful and detailed history, immunological tests, serial measurements of peak expiratory flow (PEF) and demonstration of increased non-specific bronchial reactivity are useful tools for diagnosing occupational asthma. Accurate diagnosis is important because of the economic consequences of the label "occupational disease", and because early recognition and relocation to work not involving exposure to such chemicals might improve the prognosis of the disease.

Adult↗
PubMed1992

[Is fenoterol therapy related to increased asthma mortality?].

Retrospective case-control studies suggest a connection between chronic treatment with fenoterol and other beta-2-agonists and increased mortality from asthma. These studies are extremely difficult to assess from a methodological point of view. They raise important questions, however, and force us to critically reevaluate our present therapeutic approach. In the acute situation, beta-2-agonists might be life-saving, and we must therefore be cautious in readily accepting a causal relationship between beta-2-agonist treatment and death from asthma. Probably, retrospective case-control studies are inadequate to establish a clear-cut association between beta-2-agonist therapy and death from asthma. This will require prospective randomized studies including large asthma populations providing accurate information on both chronic and acute drug treatment, and the end-point is death from asthma.

Asthma↗
PubMed1992

Prevalence of respiratory disorders among aluminium potroom workers in relation to exposure to fluoride.

In a survey of 370 aluminium potroom workers in western Norway, bronchial responsiveness, lung function, and respiratory symptoms were studied in relation to occupational exposure to air contaminants in the potroom. Increased prevalences of respiratory symptoms, work related asthmatic symptoms, and abnormal lung function were found in subjects exposed to total fluorides above 0.5 mg/m3 when compared with workers exposed to total fluorides at concentrations of less than 0.5 mg/m3. No significant association between bronchial responsiveness and exposure to fluoride was found and the prevalence of respiratory symptoms was independent of the degree of dust exposure. These findings indicate that work related asthmatic symptoms in potroom workers may be related to exposure to fluorides.

Adolescent↗
PubMed1992

Serial measurements of peak expiratory flow and responsiveness to methacholine in the diagnosis of aluminium potroom asthma.

BACKGROUND: Obstructive airways disease in aluminium potroom workers has been recognised for over 50 years. There is still controversy about whether this is true occupational asthma. METHODS: A cross sectional survey of 379 potroom workers identified 26 subjects with symptoms suggestive of occupational asthma. Of these 26, 14 were considered by the plant physician to have occupational asthma and had a measurable PC20 methacholine (provocative concentration causing a 20% fall in FEV1). These 14 were further investigated by serial measurements of peak flow at home and work, symptom diaries, and measurements of methacholine reactivity before and after a three week holiday. RESULTS: There was a good correlation between daily symptom scores and minimum peak flow measurements; these showed changes characteristic of occupational asthma in 10 workers, with increased diurnal variation in peak flow and consistent deterioration in relation to work exposure. One further record showed probable occupational asthma and two showed consistent small changes in peak flow related to work exposure more in keeping with an irritant effect. Only one record was inadequate. Methacholine reactivity on a work day was within the normal range in nine of 13 subjects. A doubling of PC20 methacholine occurred in five of nine subjects with occupational asthma in whom repeated estimations were possible. CONCLUSIONS: This study confirms the existence of aluminium potroom asthma. The lack of correlation with measurements of non-specific responsiveness suggests that the primary mechanism is one of hypersensitivity, perhaps enhanced by the bronchial irritants also present in the potroom.

Adult↗