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Biomedical subjects

P Westerholm

Publications and source records attributed to P Westerholm.

At least 37 records · Page 2Linked to original sources

Occurrence of pleural plaques in workers with exposure to mineral wool.

The objective of this study was to investigate whether occurrence of pleural plaques is associated with exposure to mineral wool. The occurrence of pleural plaques on routine chest radiographs of 933 persons employed in the mineral wool manufacturing industry and 865 referents was compared. Twelve men from the mineral wool industry had pleural plaques, as against three of the referents (P > 0.05). The occurrence of pleural plaques among men in the mineral wool industry was not associated with an increased exposure to mineral wool or with length of time between start of employment and time of chest radiograph. The results do not support the notion that inhalation of man-made mineral fibers causes pleural plaques. It must, however, be conceded--keeping in mind the limits imposed by the study size--that nor do they provide grounds for refutation of such a hypothesis.

Adolescent↗

Fiber exposure assessment in the Swedish rock wool and slag wool production industry in 1938-1990.

OBJECTIVE: A multiplicative model was developed to assess past exposure to respirable fibers among rock wool and slag wool production workers in Sweden in 1938-1990. METHODS: Information on the job titles, work tasks and employment times of 1487 workers exposed to man-made vitreous fibers was obtained from company records and interviews with older employees. A mathematical model developed earlier for assessing historical fiber exposure, based on factory averages, was further developed. Matrices of multipliers for each plant that were specific for job title were modified to assess fiber exposure with respect to job title and calendar period. The model was based on measurements made in 1977. Two methods of exposure assessment were compared, cumulative exposure based on factory average (model I) and cumulative exposure based on job title (model II). RESULTS: The exposure changed considerably in the two factories during the period 1938-1990, and it varied also between job titles. The estimated average fiber (f) exposure level at the two plants in the middle of the 1940s was 1.32 and 0.78 f.ml-1. These values are 26 and 16 times higher, respectively, than the exposure in 1980. Process changes, as well as the addition of binders and oil, reduced the exposure drastically around 1950. The mean cumulative respirable fiber exposure for the 1487 subjects was 1.44 (range 0.05-18.40) f.ml-1.year. The cleaners had 14 times higher annual fiber exposure than the preproduction workers. CONCLUSIONS: Model II was judged to be more valid than model I in assessing exposure to man-made vitreous fibers.

Adult↗

Cancer incidence, mortality and exposure-response among Swedish man-made vitreous fiber production workers.

OBJECTIVE: The objective of this study was to provide an extended follow-up of workers in three Swedish plants producing man-made vitreous fibers (MMVF). METHOD: Mortality and cancer incidence was investigated among 3539 male and female workers, employed for at least one year before 1978. Mortality was followed from 1952 to 1990 and cancer incidence from 1958 to 1989. National and regional mortality and cancer incidence rates were used to calculate the expected numbers. RESULTS: Twenty-seven lung cancer deaths were observed compared with 23 expected (standardized mortality ratio 117, 95% confidence interval 81-176), based on regional mortality. With a latency time of 30 years, the lung cancer risk was significantly elevated, but not trend was found for the standardized mortality ratio with increasing duration of exposure to MMVF. The lung cancer and stomach cancer mortality was higher in the rock wool industry than in the fiber glass industry. Fiber exposure from 1938 to 1990 was estimated in the two rock wool plants by applying a model for historical fiber exposure estimation, specific for different job titles in the rock wool production industry. No relationship was found between individually cumulated rock wool fiber exposure and lung cancer or stomach cancer risk. CONCLUSIONS: The numbers of lung cancers and stomach cancer cases were low and did not therefore allow more general conclusions regarding the cancer hazard for exposed workers. A large European study in progress will probably allow more precise conclusions.

Adult↗

The role of the psychologist in multidisciplinary treatments for chronic neck and shoulder pain: a controlled cost-effectiveness study.

This study was designed to determine a cost-effective use of psychologist resources in multimodal cognitive-behavioural treatments (MMCBT) for chronic neck/shoulder pain. A randomised controlled trial was conducted with 66 patients divided in two groups. The first group (A) was treated following the approach of MMCBT with the clinical psychologist only functioning as a "coach" to the other health professionals. In this group, the psychologist had on average 5 hours of input per patients. The second group (B) was treated with the same inpatient MMCBT but with the behavioural component administered by the clinical psychologist directly to the patients. In this second group the psychologist had on average 17 hours of input per patient in the entire intervention. The outcome variables included physical, emotional and social factors, and sick-leave. Both groups showed significant improvements over time. The improvements were evident only in sub-groups, specifically in women. The only significant difference between the groups was in "perceived helplessness" favouring the "psychologist contact" setting. It is concluded that in terms of input of clinical psychology, the treatment setting with the "coaching" technique proved to be the most cost-effective use of the psychologist in the two treatment settings investigated.

Adult↗

Coping with long-term musculoskeletal pain and its consequences: is gender a factor?

We did a descriptive study of 121 patients (71 women and 50 men) to explore the role of gender in coping with long-term intractable pain of the neck, shoulder and back and to determine the consequences of pain. Questionnaires used to assess the dependent variables were the Coping Strategy Questionnaire (CSQ) and the Multidimensional Pain Inventory (MPI). Distinctions were found between men and women. In particular, the coping strategies used by women were those which in previous research had been found to be associated with dysfunction and poor outcome in terms of rehabilitation. Moreover, considering the consequences of pain on daily living, a more complex pattern of related factors was found in women rather than men. Given the high proportion of working women in Sweden with long-term musculoskeletal pain and considering recent observations in controlled studies showing that the benefits of cognitive behaviourally based treatments are confined to women, our findings suggest the need to tailor rehabilitative strategies differently for men and women and point to a research agenda which pays more attention to the distinctive challenges of women in the workplace when they are affected by chronic ailments.

Adaptation, Psychological↗

A comparison of cognitive and behavioral inductions of negative mood.

Sixty undergraduate subjects were exposed to one of three depressive mood inductions: cognitive, behavioral, or control. Subjects in the cognitive induction group read negative self-statements consistent with Beck's (1974) cognitive theory of depression. Subjects in the behavioral induction group were exposed to insoluble discrimination problems consistent with Lewinsohn's (1974) behavioral theory that lack of reinforcement produces depression. The control group read a neutral passage. Following the mood induction, subjects rated their current moods using the Multiple Affect Adjective Checklist (MAACL; Zuckerman & Lubin, 1965). The cognitive and behavioral inductions produced significantly higher MAACL total and subscale scores than did the control condition; however, the cognitive and behavioral inductions did not differ from one another. Because the cognitive and behavioral mood inductions appear equally powerful, they may be used by researchers who are attempting to identify variables that are related to subjects' differing responses to behavioral and cognitive influences on depression.

Cognition↗

Mortality and cancer incidence among PVC-processing workers in Sweden.

The mortality pattern and the cancer incidence were investigated among 717 men who had been employed for at least 3 months during 1964-1974 in three Swedish PVC-processing plants. The mortality was followed 1964-1986 and the cancer incidence 1964-1984. Expected figures were calculated from Swedish national rates. Among Swedish citizens, the observed mortality and cancer incidence was close to the expected in most diagnoses. Among immigrants, mostly from Finland, there was a marked excess of circulatory deaths. This finding was probably due to the higher incidence of coronary mortality in Finland compared to Sweden. In the whole cohort, five cases of malignant melanoma had occurred as compared to 1.5 expected (SMR = 3.4, 95% confidence limit 1.1-7.9). This may be due to chance but merits further investigation since an increased incidence of malignant melanoma has previously been found among Norwegian PVC-manufacturing workers.

Chemical Industry↗

Lung cancer incidence among Swedish ceramic workers with silicosis.

The incidence of lung cancer among 280 silicotic men working in the ceramics industry and notified to the Swedish Silicosis Registry has been investigated. During the study period 1958-83, the risk of lung cancer (nine cases) was double that expected based on national rates. There was no increased incidence of cancer at any other site. The results are in agreement with those of both animal and epidemiological studies of quartz exposure and point to an increased risk of lung cancer, especially among silicotics. Various possible explanations of this increased risk are discussed, but further studies are required.

Ceramics↗

Silicosis and risk of lung cancer or lung tuberculosis: a cohort study.

This is a study of cancer mortality, cancer incidence, and incidence of lung tuberculosis among cases of silicosis reported to the National Swedish Pneumoconiosis Register during 1959-1977. Two occupational categories were extracted--"mining, tunneling, and quarrying" (n = 284) and "iron and steel foundries" (n = 428), respectively. Control groups were drawn from a national register of persons undergoing periodic health examinations with regard to silicosis risk. The controls were matched for occupation, age, and time of first exposure. The follow-up was performed through record-linkage operations to computerized information in Swedish Death Statistics, Swedish Cancer Register, and the Swedish Tuberculosis Index. End of follow-up was set at December 31, 1980. In cases drawn from mining, quarrying, and tunneling workers seven deaths in lung cancer were observed and two among the controls. Among iron and steel foundry workers the corresponding numbers were 10 and 6. The values for expected numbers, based on general population statistics, were 1.3 and 2.6, respectively, for these two occupational groups. When cancer incidence statistics were used, the case/control ratio for lung cancer was 2.1 for "mining, quarrying, and tunneling" and 0.6 for "iron and steel foundries." There were 29 cases of lung tuberculosis registered among the silicosis cases during the follow-up period. Only one tuberculosis case was observed among the controls. The results demonstrate that persons with silicosis contracted in the mining, quarrying, and tunneling occupations are subject to an increased risk of lung cancer. The risk is observed when both the general population and a closely matched control population from the same occupations are used for values of reference. The results also demonstrate the high risk of persons with silicosis to contract lung tuberculosis.

Adult↗

Mortality and cancer incidence in the man-made mineral fiber industry in Sweden.

This report gives an account of the Swedish contribution to the joint European epidemiologic study on production workers in the man-made mineral fiber (MMMF) industry. The information sources utilized and the follow-up procedure, making extensive use of record-linkage operations extracting data from computerized data banks, are described in some detail. The follow-up with regard to vital status, deaths and causes of death, diagnosed cancers, and emigration could essentially be based on such techniques. The problems of tracing immigrant and emigrant subpopulations are given particular attention. The exposed Swedish cohort consisted of 3,600 persons giving 61,690 person-years of observation. A total of 524 deaths was observed in the cohort, 230 cohort members had emigrated during the period of observation (147 of whom could be traced to other Nordic countries), and 62 other persons were lost to follow-up. It was observed that most of the persons contracting lung cancer in the Swedish cohort had been exposed during relatively short periods of time, ie, during one to four years of employment. This finding applied to both the rock-wool and glass-wool industry. The authors point out that the observed excess risk in lung cancer deaths may also have other explanations than occupational exposure to MMMF.

Construction Materials↗

Pregnancy outcome and social indicators in Sweden.

Perinatal mortality, birth weight, the distribution of gestational age, and the relationship between gestational age and birth weight have been studied with regard to births reported to the Register of Births during 1976-77. In order to determine the influence of socio-economic factors on the parameters studied, the information from the birth register has been combined with that from the 1975 census in Sweden (including occupation of the mother, income of the family, type of family and housing standard). The total population of 190 024 infants was divided into three groups; 6915 infants (3.6%) were assigned to the most privileged group (group I) and 26 430 (13.9%) to the less privileged group (group III). The perinatal mortality rate did not differ significantly between group I and III. A comparison of the three groups showed a socio-economic difference as regards birth weight and the incidence of preterm as well as of postterm births. The less privileged group has a greater proportion of infants of low birth weight and of infants that were small for gestational age.

Birth Weight↗

Clusters of malformations in Sweden: a study with central registers.

Clustering of malformations and especially of spina bifida in Sweden was studied using the Register of Malformations and the Medical Birth Records Register. The incentive to this study was provided by the observation of a cluster of malformations, notably spina bifida, and perinatal deaths, locally thought to be related to the use of herbicides in forestry. This cluster was verified but it was shown that a high rate of spina bifida existed in the region before the introduction of herbicides in forestry. Some other clusters of spina bifida were identified and also a number of clusters of other malformations. Case-history studies were performed but revealed no lead to an explanation. Principles in the origin of the clusters and their analysis are discussed.

Abnormalities, Drug-Induced↗

Nasal and sinonasal cancer. Connection with occupational exposures in Denmark, Finland and Sweden.

A joint Danish-Finnish-Swedish case-referent investigation was initiated in 1977 in order to study the connection between nasal and sinonasal cancer and various occupational exposures. All new cases of nasal and sinonasal cancer were collected from the national cancer registers (Finland and Sweden) or from the hospitals (Denmark). Those still alive who agreed to an interview (N = 167) were individually matched for age and sex with patients with colonic or rectal cancer. A detailed telephone interview was made according to standardized forms. Both cases and referents thought that their condition was the one under study. The exposures were coded blindly by an industrial hygienist. The results showed associations between nasal and sinonasal cancer and exposure to (i) hardwood or mixed wood dust (discordant pairs 14: 2), (ii) softwood dust alone (13:4), (iii) chromium (16: 6), (iv) nickel (12: 5, not significant), (v) welding, flame-cutting and soldering (17: 6), and (vi) lacquers and paints (14: 0). The last finding was probably due to confounding from wood dust exposure. Hardwood dust exposure was associated with adenocarcinoma. Softwood dust exposure alone was associated with epidermoid and anaplastic carcinomas. No associations were found for a number of exposures, including agricultural chemicals, textile dust, asbestos, quartz dust, organic solvents and leather work. Possible exposure to formaldehyde was evenly distributed between the cases and referents.

Adenocarcinoma↗