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Biomedical subjects

U Strömberg

Publications and source records attributed to U Strömberg.

At least 19 recordsLinked to original sources
PubMed1997

Monitoring of polychlorinated biphenyls in human blood plasma: methodological developments and influence of age, lactation, and fish consumption.

Human plasma samples from 50 wives of fishermen have been analyzed with respect to PCBs. The non-ortho-substituted PCB congeners CB-126 and CB-169 were determined by mass spectrometry in negative ion chemical ionization mode, which demonstrated a limit of detection of 30 fg. The recoveries of the internal standards used for determination of ortho-substituted CBs were approximately 95%. Two methods, one gravimetric and the other based on enzymatic determinations of triglycerides, cholesterol and phospholipids, were compared for the determination of total amount of lipids in the plasma samples; the correlation coefficient was 0.82 and the slope 0.98. For practical reasons, enzymatic determinations are recommended for further use. The total, lipid-adjusted concentrations of PCBs in plasma were influenced by age, total lactation time and consumption of fatty fish from the Baltic Sea.

Adult↗
PubMed1996

Collapsing ordered outcome categories: a note of concern.

When analyzing and interpreting data from an epidemiologic study where ordinal (ordered categorical) outcomes have been measured in different exposure groups, an effect parameter of interest is the common odds ratio implied by the proportional odds model. This model can sometimes be applied to a collapsed outcome variable, instead of the measured variable, without reducing efficiency considerably. However, in a given data set, changing the outcome categories can affect the effect estimate as well as the inference being drawn from the data, even if the true effect itself has not changed. In particular, one should be careful in dichotomizing the measured outcome variable.

Bias↗
PubMed1996

Cancer incidence and specific occupational exposures in the Swedish leather tanning industry: a cohort based case-control study.

OBJECTIVE: To study the effect on the incidence of cancer of exposure to chemicals handled in the leather tanning industry. MATERIALS AND METHODS: A case-control study was performed within a cohort of 2487 workers employed for at least six months during the period 1900-89 in three Swedish leather tanneries. 68 cancer cases (lung, stomach, bladder, kidney, nasal, and pancreatic cancers and soft tissue sarcomas) and 178 matched controls were studied. Effects of chemical exposures on cancer incidence, adjusted for age at risk, sex, and plant were estimated with a conditional logistic regression model. RESULTS: A significant association was found between exposure to leather dust and pancreatic cancer (odds ratio (OR) 7.19, 95% confidence interval (95% CI) 1.44 to 35-89). An association was indicated between leather dust from vegetable tanning and lung cancer. After adjustment for smoking habits a tentative association between organic solvents and lung cancer lost its significance. No association was found between exposure to chlorophenols and soft tissue sarcomas. CONCLUSIONS: The significant association between leather tanning and soft tissue sarcomas that was found in our previous cohort analysis could not be explained by exposure to chlorophenols. On the other hand a significant association was found between exposure to leather dust and pancreatic cancer, and exposure to leather dust from vegetable tanning was often present in cases with lung cancer. Due to the small numbers of cases, the results can, however, only lead to tentative conclusions.

Adult↗
PubMed1996

Dietary intake of fish contaminated with persistent organochlorine compounds in relation to low birthweight.

OBJECTIVES: The purpose of this study was to assess the hypothesized association between persistent organochlorine compounds through the consumption of fatty fish from the Baltic Sea (at the Swedish east coast) and low birthweight. MATERIALS AND METHODS: During the period 1973-1991, 72 cases of low birthweight (1500-2750 g) were selected from among infants born to fishermen's wives within a cohort from the Swedish east coast. For each case two referents were selected. The mothers were interviewed about their dietary and smoking habits and place of living during childhood and adolescence. RESULTS: A high total current intake of fish from the Baltic Sea (> or = 4 meals per month) tended to increase the risk of having an infant with low birthweight [adjusted odds ratio (OR) 1.9, 95% confidence interval (95% CI) 0.9-3.9]. The effect was more conspicuous for the boys (OR 3.4, 95% CI 1.1-11). No such effects were observed when the estimated intake of fish was considered for the period in which the infant was born. However, mothers who had grown up in a fishing village had an increased risk of having an infant with low birthweight (OR 2.1, 95% CI 1.0-4.3). CONCLUSIONS: The variable "grown up in a fishing village" can be interpreted as an indirect measure of a mother's accumulated consumption of fish from the Baltic Sea. This idea supports an association between a high consumption of contaminated fish from the Baltic Sea and an increased risk for low birthweight. The effect estimates based on the mothers' reported fish consumptions were dependent on the period under consideration and therefore were somewhat ambiguous.

Adult↗
PubMed1995

Adjustment of a sparse and irregular reference rate matrix.

Regional sex-specific rates of a rare disease often show conspicuous fluctuations over conventional strata of age and calendar time. In a cohort study, when such rates are used as references in the calculation of the expected number of cases, the accumulated person-time of the study cohort may somewhat haphazardly contribute to the result. For example, only the person-time observed in the strata with at least one reference case registered contributes to the expected number of cases. It may therefore be important to evaluate whether the regional rates seem to differ systematically from the more stable national rates. When such differences may be indicated, a fairly simple method is proposed for smoothing rates. This method aims to produce rates that better reflect the underlying, supposedly smooth, rate pattern over age and calendar time in a population of interest. The present paper illustrates the technique by considering right-sided colon cancer incidence rates from a regional male population, which the authors use to calculate the expected number of such cases in an occupational cohort.

Cohort Studies↗
PubMed1995

Radiological changes in asbestos cement workers.

OBJECTIVE: To explore associations between exposure to asbestos cement dust and radiographic findings in lung parenchyma and pleura. METHODS: Radiographs from 174 blue collar workers and 29 white collar workers from an asbestos cement plant formed one part of the study. Progression of small opacities was further studied in those 124 blue collar workers, for whom two radiographs taken after the end of employment were available. The median readings from five readers who used the full ILO 1980 classification were used. As exposure indices, time since start of employment, duration of employment, cumulative exposure, and average intensity of asbestos exposure were used. The influence of age and smoking was also considered in multiple logistic regression analyses. RESULTS: Small opacities (profusion > or = 1/0) were closely correlated with time related exposure variables, and showed weaker association with intensity based exposure variables. The odds ratio (OR) for small opacities was equal to 2.8 (90% CI 1.2, 6.7) in the > 30 f(fibre)-y/ml group, compared with those in the 0-10 f-y/ml group. Progression of at least two minor ILO categories after the end of employment was seen in 20%. Also, pleural thickening was closely related to time. By contrast, costophrenic angle obliterations were not associated with the time related variables, but closely associated with the intensity of asbestos exposure, and tended to occur during employment. The OR was 4.5 (90% CI 1.3, 15) in the > 2 f/ml group, compared with those in the 0-1 f/ml group. CONCLUSIONS: In these workers, exposed mainly to chrysotile but also to small amounts of amphibole, the risk of radiographically visible parenchymal abnormality was substantially increased and strongly dependent on time related exposure variables. Progression was found long after the end of exposure. The findings on costophrenic angle obliterations, supposed to be sequelae of benign pleural effusions, were consistent with an immediate reaction triggered by intense asbestos exposure.

Adult↗
PubMed1995

Substantial decrease of blood lead in Swedish children, 1978-94, associated with petrol lead.

OBJECTIVES: To study the potential impact of environmental exposure to petrol lead, residential area, age, sex, and lead exposing hobby, on blood lead concentrations (BPb) in children. METHODS: In the south of Sweden, yearly from 1978-94, BPb was measured in 1230 boys and 1211 girls, aged between 3 and 19 (median 10; quartiles 9 and 12) years. RESULTS: For the samples of 1978, the geometric mean (GM) was 67 (range 30-250) micrograms/l in boys and 53 (18-161) micrograms/l in girls, whereas the corresponding GMs for 1994 were 27 (12-122) and 23 (12-97) micrograms/l. The sex difference was present only in children over eight. Moreover, residential area affected BPb; in particular, children living near a smelter area had raised BPbs. There was a clear ecological relation between BPb (adjusted GM) and annual lead quantity in petrol sold in Sweden, which was estimated to be 1637 tonnes in 1976 and 133 tonnes in 1993 (P < 0.001, ecological linear regression analysis, where a two year lag of petrol lead was applied). In the 171 boys and 165 girls who were sampled twice with an interval of one to four years, the decreases in BPb were estimated to be 6% (95% confidence interval 4%-8%) and 10% (8%-13%)/year, respectively. CONCLUSIONS: The present report points out the considerable beneficial effect of the gradual banning of petrol lead on the lead exposure affecting the population and differential sex specific BPb patterns due to a pronounced age effect in girls, which may be caused by older girls' lower food intake per kg of body weight, lower lung ventilation, cleaner life style, and loss of blood lead through menstrual bleedings.

Adolescent↗
PubMed1995

Mortality and cancer incidence among Swedish fishermen with a high dietary intake of persistent organochlorine compounds.

OBJECTIVES: The objective of this study was to determine mortality and cancer incidence in two cohorts of Swedish fishermen with different dietary intakes of persistent organochlorine compounds. METHODS: The following two cohorts of Swedish fishermen were established: a cohort of 2896 subjects from the Swedish east coast (on the Baltic Sea), and a cohort of 8477 subjects from the Swedish west coast. Mortality and cancer incidence were studied in these cohorts and comparisons were made both with the regional populations and between the cohorts. RESULTS: The incidences of stomach and squamous cell skin cancers among the eastcoast fishermen were elevated as compared with those of the regional population [standardized incidence ratio (SIR 1.6, 95% confidence interval (95% CI) 1.0-2.4 and SIR 2.3, 95% CI 1.5-3.5 respectively] and with the westcoast cohort (IRR 2.2, 95% CI 1.3-3.5 and IRR 1.9, 95% CI 1.2-3.1, respectively), while that of colon cancer was decreased. Moreover, mortality from multiple myelomas was increased among the eastcoast fishermen as compared with that of the general population [standardized mortality ratio (SMR) 3.1, 95% CI 1.2-6.4) and the westcoast fishermen (IRR 3.2, 95% CI 1.2-8.7). A 12% decreased mortality in ischemic heart disease was found for the eastcoast cohort. A slight, but significant increase in such deaths was noted among the westcoast fishermen. CONCLUSIONS: High consumers of fatty fish, contaminated with organochlorine compounds, had an increased risk for stomach and skin cancer. They also had a suggestive decrease in mortality from ischemic heart diseases.

Animals↗
PubMed1995

Decreased birthweight among infants born to women with a high dietary intake of fish contaminated with persistent organochlorine compounds.

OBJECTIVES: The purpose of the study was to assess reproductive outcomes, especially birthweight, and the consumption of fatty fish from the Baltic Sea, contaminated with persistent organochlorine compounds, among women from the Swedish east coast. MATERIAL AND METHODS: Cohorts of fishermen's wives from the Swedish east and west coasts were established and linked to the Swedish Medical Birth Register for 1973-1991; 1501 children were born in the eastcoast cohort and 3553 in the westcoast cohort. Comparisons were made with regional populations and between the cohorts. Dietary interviews were made with 69 randomly selected women from the cohorts and 69 referents. RESULTS: The women interviewed from the east- and westcoast cohorts ate locally caught fish more than twice as often as their referents. Compared with the regional population, the women in the eastcoast cohort gave birth to an increased number of infants with low birthweights (< 3000 g), whereas the opposite was seen in the westcoast cohort. Infants in the eastcoast cohort had significantly lower birthweights than infants from the westcoast cohort (median 3530 versus 3610 g, P < 0.001). Even after adjustment for potential confounders, eastcoast affiliation showed an increased risk for low birthweight (odds ratio 1.44, 95% confidence interval 1.18-1.76). The effect was more conspicuous for boys (odds ratio 1.95) and heavy smokers (odds ratio 3.00). CONCLUSIONS: The present data support, but do not prove, an association between a high consumption of contaminated fish from the Baltic Sea and an increased risk for low birthweight.

Adolescent↗
PubMed1995

The effect of desmopressin on reducing blood loss in cardiac surgery--a meta-analysis of double-blind, placebo-controlled trials.

The effect of desmopressin (DDAVP) on reducing postoperative blood loss after cardiac surgery has been studied in several randomized clinical trials with conflicting outcomes. Since most trials had insufficient statistical power to detect true differences in blood loss, we performed a meta-analysis of data from relevant studies. Seventeen randomized, double-blind, placebo-controlled trials were analyzed, which included 1171 patients undergoing cardiac surgery for various indications; 579 of them were treated with desmopressin and 592 with placebo. Efficacy parameters were blood loss volumes and transfusion requirements. Desmopressin significantly reduced postoperative blood loss by 9%, but had no statistically significant effect on transfusion requirements. A subanalysis revealed that desmopressin had no protective effects in trials in which the mean blood loss in placebo-treated patients fell in the lower and middle thirds of distribution of blood losses (687-1108 ml/24 h). In contrast, in trials in which the mean blood loss in placebo-treated patients fell in the upper third of distribution (> 1109 ml/24 h), desmopressin significantly decreased postoperative blood loss by 34%. Insufficient data were available to perform a sub-analysis on transfusion requirements. Therefore, desmopressin significantly reduces blood loss only in cardiac operations which induce excessive blood loss. Further studies are called to validate the results of this meta-analysis and to identify predictors of excessive blood loss after cardiac surgery.

Adult↗
PubMed1994

Disorders of the neck and upper limbs in women in the fish processing industry.

OBJECTIVE: The aim was to study the association between personal factors and physical and psychosocial work environment factors and disorders of the neck or upper limbs among women in the fish processing industry. METHODS: A cross sectional study was performed on 206 women in the fish processing industry and 208 control women. Several physical and psychosocial work environment factors were evaluated. Subjective complaints about the neck or upper limbs were assessed by questionnaire and by a clinical examination. RESULTS: The study showed a high prevalence (35%) of diagnoses in the neck or shoulders of the exposed women. All prevalence odds ratios (POR's) were substantially higher in young women. There was a pronounced dose-response relation between disorders of the neck or shoulders and duration of employment for women < 45 years old. When studying 322 former workers, the proportion who claimed musculoskeletal complaints as the reason for leaving was highest among the older women. Muscular tension, stress or worry, work strain, and the largest fraction of the work time spent with highly repetitive work tasks were clearly associated with disorders of the neck or shoulders. The measurements of the wrist movements also showed that the work was performed almost without any pauses and that the median flexion and extension velocity was high (41 degree/s). The results of observation showed good agreement with the measurements of wrist motion. CONCLUSION: Work in the fish processing industry is a risk factor for disorders of the neck and upper limbs. Due to the homogenity of the physical work load in the exposed group, we could not show any associations between the objective measurements and disorders. In cross sectional studies the risk may be underestimated due to a healthy worker effect.

Adolescent↗
PubMed1994

Retention patterns of asbestos fibres in lung tissue among asbestos cement workers.

Retention patterns in lung tissue (determined by transmission electron microscopy and energy dispersive spectrometry) of chrysotile, tremolite, and crocidolite fibres were analysed in 69 dead asbestos cement workers and 96 referents. There was an accumulation of tremolite with time of employment. Among workers who died within three years of the end of exposure, the 13 with high tremolite concentrations had a significantly longer duration of exposure than seven in a low to intermediate category (medians 32 v 20 years; p = 0.018, one sided). Crocidolite showed similar patterns of accumulation. In workers who died more than three years after the end of exposure, there were no correlations between concentrations of amphibole fibres and time between the end of exposure and death. Chrysotile concentrations among workers who died shortly after the end of exposure were higher than among the referents (median difference in concentrations 13 million fibres (f)/g dry weight; p = 0.033, one sided). No quantitative differences in exposure (duration or intensity) could be shown between workers with high and low to intermediate concentrations. Interestingly, all seven workers who had had a high intensity at the end of exposure (> 2.5 f/ml), had low to intermediate chrysotile concentrations at death, whereas those with low exposure were evenly distributed (31 subjects in both concentration categories); hence, there was a dependence between last intensity of exposure and chrysotile concentration (p = 0.014). Among 14 workers with a high average intensity of exposure, both those (n = 5) with high tissue concentrations of chrysotile and those (n = 10) with high tissue concentrations of tremolite fibres had more pronounced fibrosis than those with low to intermediate concentrations (median fibrosis grades for chrysotile: 2 v 1, p = 0.021; for tremolite: 2 v 0.5, p = 0.012). Additionally, workers who died shortly after the end of exposure with high concentrations of chrysotile and crocidolite had smoked more than those with low intermediate concentrations (medians for chrysotile 35 v 15 pack-years, p = 0.030; for crocidolite 37 v 15 pack-years, p = 0.012). The present data indicate that chrysotile has a relatively rapid turnover in human lungs, whereas the amphiboles, tremolite and crocidolite, have a slower turnover. Further, chrysotile retention may be dependent on dose rate. Chrysotile and crocidolite deposition and retention may be increased by tobacco smoking; chrysotile and tremolite by fibrosis.

Aged↗