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Urban air pollution, and asthma and COPD hospital emergency room visits.

https://arctichealth.org/en/permalink/ahliterature158866
Source
Thorax. 2008 Jul;63(7):635-41
Publication Type
Article
Date
Jul-2008
Author
J I Halonen
T. Lanki
T. Yli-Tuomi
M. Kulmala
P. Tiittanen
J. Pekkanen
Author Affiliation
National Public Health Institute (KTL), Environmental Epidemiology Unit, PO Box 95, FIN-70701 Kuopio, Finland. jaana.halonen@ktl.fi
Source
Thorax. 2008 Jul;63(7):635-41
Date
Jul-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Air Pollution - adverse effects
Asthma - chemically induced
Emergency Service, Hospital - utilization
Finland
Humans
Middle Aged
Particulate Matter - toxicity
Patient Acceptance of Health Care - statistics & numerical data
Pulmonary Disease, Chronic Obstructive - chemically induced
Urban health
Vehicle Emissions - toxicity
Abstract
There is little previous information of the effects of size fractioned particulate air pollution and source specific fine particles (PM(2.5); or=65 years).
Three to 5 day lagged increases in asthma visits were found among children in association with nucleation (
Notes
Comment In: Thorax. 2008 Jul;63(7):574-618587030
PubMed ID
18267984 View in PubMed
Less detail

Increased mercury exposure in inhabitants living in the vicinity of a hazardous waste incinerator: a 10-year follow-up.

https://arctichealth.org/en/permalink/ahliterature205761
Source
Arch Environ Health. 1998 Mar-Apr;53(2):129-37
Publication Type
Article
Author
P. Kurttio
J. Pekkanen
G. Alfthan
M. Paunio
J J Jaakkola
O P Heinonen
Author Affiliation
National Public Health Institute, Unit of Environmental Epidemiology, Kuopio, Finland.
Source
Arch Environ Health. 1998 Mar-Apr;53(2):129-37
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Animals
Child
Environmental Exposure - analysis - statistics & numerical data
Environmental Monitoring - statistics & numerical data
Environmental pollution - analysis
Epidemiological Monitoring
Female
Finland - epidemiology
Fish Products
Fishes
Follow-Up Studies
Food Habits
Hair - chemistry
Hazardous Waste - statistics & numerical data
Humans
Incineration
Logistic Models
Male
Mercury - analysis - blood
Middle Aged
Occupational Exposure - statistics & numerical data
Sex Distribution
Smoking - epidemiology
Water Supply - analysis - statistics & numerical data
Abstract
A hazardous-waste-treatment plant that housed an incinerator began operation in 1984, before which a baseline survey of the surrounding population and environment was conducted; 10 y later, investigators studied the same subjects. Researchers focused on mercury exposure because mercury concentrations were present in the stack emissions, and environmental monitoring revealed mercury concentrations near the plant. In 1984 and 1994 the median hair mercury concentrations were 0.5 mg/kg and 0.8 mg/kg, respectively. During the 10-y period, median hair total mercury concentrations increased by 0.35 mg/kg in workers (n = 11); by 0.16 mg/kg, 0.13 mg/kg, and 0.03 mg/kg in individuals who lived 2 km (n = 45), 2-4 km (n = 38), and 5 km (n = 30) from the plant, respectively; and by 0.02 mg/kg in the reference group (n = 55). In summary, mercury exposure increased as distance from the plant decreased; however, the increase in exposure was minimal and, on the basis of current knowledge, did not pose a health risk.
PubMed ID
9577936 View in PubMed
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Effects of ultrafine and fine particles in urban air on peak expiratory flow among children with asthmatic symptoms.

https://arctichealth.org/en/permalink/ahliterature209915
Source
Environ Res. 1997;74(1):24-33
Publication Type
Article
Date
1997
Author
J. Pekkanen
K L Timonen
J. Ruuskanen
A. Reponen
A. Mirme
Author Affiliation
Unit of Environmental Epidemiology, National Public Health Institute, Kuopio, Finland. Juha.Pekkanen@ktl.fi
Source
Environ Res. 1997;74(1):24-33
Date
1997
Language
English
Publication Type
Article
Keywords
Air Pollutants - chemistry - poisoning
Asthma - physiopathology
Child
Finland
Humans
Particle Size
Respiratory Function Tests
Vehicle Emissions
Abstract
It has been suggested that ultrafine particles in urban air may cause the health effects associated with thoracic particles (PM10). We therefore compared the effects of daily variations in particles of different sizes on peak expiratory flow (PEF) during a 57-day follow-up of 39 asthmatic children aged 7-12 years. The main source of particulate air pollution in the area was traffic. In addition to the measurements of PM10 and black smoke (BS) concentrations, an electric aerosol spectrometer was used to measure particle number concentrations in six size classes ranging from 0.01 to 10.0 microns. Daily variations in BS and particle number concentrations in size ranges between 0.032 and 0.32 micron and between 1.0 and 10.0 microns were highly intercorrelated (correlation coefficients about 0.9). Correlations with PM10 were somewhat lower (below 0.7). All these pollutants tended also to be associated with declines in morning PEF. However, the only statistically significant associations were observed with PM10 and BS. Different time lags of PM10 were also most consistently associated with declines in PEF. Therefore, in the present study on asthmatic children, the concentration of ultrafine particles was no more strongly associated with variations in PEF than PM10 or BS, as has earlier been suggested.
PubMed ID
9339211 View in PubMed
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[An international epidemiologic comparison of allergies].

https://arctichealth.org/en/permalink/ahliterature190657
Source
Duodecim. 1999;115(17):1817-8
Publication Type
Article
Date
1999

Children's homes--determinants of moisture damage and asthma in Finnish residences.

https://arctichealth.org/en/permalink/ahliterature169352
Source
Indoor Air. 2006 Jun;16(3):248-55
Publication Type
Article
Date
Jun-2006
Author
U. Haverinen-Shaughnessy
J. Pekkanen
A. Hyvärinen
A. Nevalainen
T. Putus
M. Korppi
D. Moschandreas
Author Affiliation
National Public Health Institute, Department of Environmental Health, Kuopio, Finland. haverinen@fulbrightweb.org
Source
Indoor Air. 2006 Jun;16(3):248-55
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Air Pollution, Indoor - adverse effects
Asthma - etiology - pathology
Child
Child Welfare
Child, Preschool
Family Health
Finland
Housing
Humans
Infant
Logistic Models
Ventilation
Water
Abstract
Certain housing characteristics increase the risk for moisture damage, which has been associated with increased risk for asthma in children. Modeling moisture damage as a function of these characteristics could therefore provide a simple tool to estimate building-related risk for asthma. This study aimed to find out specific associations between asthma case-control status of children and moisture damage and housing characteristics. The data consisted of information on 121 asthmatic children and predominately two age-, gender- and place of residence-matched control children for every case, and information on moisture damage and housing characteristics in the homes of the children. In a previous study, we found a statistically significant association between moisture damage observations in main living areas and asthma in children. Using logistic regression, five models were formulated to predict moisture damage status of the homes and moisture damage status of living areas. The models were able to classify the damage status correctly in 65.0-87.7% of the homes (kappa values 0.10-0.47) as functions of housing characteristics. None of the models qualified as a significant determinant of the case-control status of the children.
It can be hypothesized that building-related risk for asthma could be roughly estimated using models predicting moisture damage status of buildings as a function of easily obtainable housing characteristics. The results of this study indicated that, with a moderate certainty, it is possible to model moisture damage status of buildings using housing characteristics. However, the models developed did not associate with asthma in children. In conclusion, it was not possible to estimate the risk for asthma by studying housing characteristics only, but detailed information on moisture damage (e.g. location of damage) was crucial for such estimation.
PubMed ID
16683943 View in PubMed
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Social class, health behaviour, and mortality among men and women in eastern Finland.

https://arctichealth.org/en/permalink/ahliterature214334
Source
BMJ. 1995 Sep 2;311(7005):589-93
Publication Type
Article
Date
Sep-2-1995
Author
J. Pekkanen
J. Tuomilehto
A. Uutela
E. Vartiainen
A. Nissinen
Author Affiliation
Department of Environmental Epidemiology, National Public Health Institute, Kuopio, Finland.
Source
BMJ. 1995 Sep 2;311(7005):589-93
Date
Sep-2-1995
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cardiovascular Diseases - mortality
Cause of Death
Employment
Female
Finland - epidemiology
Follow-Up Studies
Health Behavior
Humans
Male
Middle Aged
Prospective Studies
Risk factors
Sex Factors
Social Class
Abstract
To evaluate the associations between social class as defined by occupation, health behaviour, and mortality from all causes and coronary heart disease among middle aged men and women in eastern Finland.
Prospective observational study of two independent, random population samples examined in 1972 and 1977.
North Karelia and Kuopio, Finland.
8967 men and 9694 women aged 30-64 years at the beginning of the follow up study. The subjects were followed up for mortality up till 1987 by using the National Death Registry.
Altogether 1429 men and 620 women died during the follow up, 603 men and 164 women of coronary heart disease. Among both sexes, compared with white collar workers unskilled blue collar workers had more adverse risk factors and also higher mortality due to coronary heart disease, other cardiovascular diseases, cancer, violent causes, and all other causes. Among men the age adjusted relative risk for all cause mortality in unskilled blue collar workers v white collar workers was reduced from 1.86 (95% confidence interval 1.55 to 2.22) to 1.47 (1.23 to 1.77) when adjusted for smoking, serum cholesterol concentration, hypertension, body mass index, and physical activity in leisure time. Among women the corresponding reduction in hazard ratio was from 1.49 (1.15 to 1.92) to 1.39 (1.07 to 1.81). The respective hazard ratios for coronary heart disease were 1.54 (1.16 to 2.02) and 1.22 (0.92 to 1.61) among men and 1.74 (1.05 to 2.90) and 1.66 (0.99 to 2.79) among women.
Unfavourable cardiovascular risk factors and high mortality are concentrated among lower social classes in Finland. Among men about half of the excess coronary and all cause mortality among unskilled blue collar workers was associated with their unfavourable risk factor profile. The association was smaller in women.
Notes
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PubMed ID
7663252 View in PubMed
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Dietary factors determining diabetes and impaired glucose tolerance. A 20-year follow-up of the Finnish and Dutch cohorts of the Seven Countries Study.

https://arctichealth.org/en/permalink/ahliterature214653
Source
Diabetes Care. 1995 Aug;18(8):1104-12
Publication Type
Article
Date
Aug-1995
Author
E J Feskens
S M Virtanen
L. Räsänen
J. Tuomilehto
J. Stengård
J. Pekkanen
A. Nissinen
D. Kromhout
Author Affiliation
Department of Chronic Diseases and Environmental Epidemiology, National Institute of Public Health and Environmental Protection, Bilthoven, The Netherlands.
Source
Diabetes Care. 1995 Aug;18(8):1104-12
Date
Aug-1995
Language
English
Publication Type
Article
Keywords
Cohort Studies
Diabetes Mellitus - blood - epidemiology
Diet
Finland
Follow-Up Studies
Food Habits
Glucose Intolerance - blood - epidemiology
Glucose Tolerance Test
Humans
Male
Middle Aged
Netherlands
Predictive value of tests
Reference Values
Regression Analysis
Risk factors
Time Factors
Abstract
To investigate the role of diet as a predictor of glucose intolerance and non-insulin-dependent diabetes mellitus (NIDDM).
At the 30-year follow-up survey of the Dutch and Finnish cohorts of the Seven Countries Study, in 1989/1990, men were examined according to a standardized protocol including a 2-h oral glucose tolerance test. Information on habitual food consumption was obtained using the cross-check dietary history method. Those 338 men in whom information on habitual diet was also available 20 years earlier were included in this study. Subjects known as having diabetes in 1989/1990 were excluded from the analyses.
Adjusting for age and cohort, the intake of total, saturated, and monounsaturated fatty acids and dietary cholesterol 20 years before diagnosis was higher in men with newly diagnosed diabetes in the survey than in men with normal or impaired glucose tolerance. After adjustment for cohort, age, past body mass index, and past energy intake, the past intake of total fat was positively associated with 2-h postload glucose level (P
PubMed ID
7587845 View in PubMed
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Home dampness, moulds and their influence on respiratory infections and symptoms in adults in Finland.

https://arctichealth.org/en/permalink/ahliterature210484
Source
Eur Respir J. 1996 Dec;9(12):2618-22
Publication Type
Article
Date
Dec-1996
Author
I. Pirhonen
A. Nevalainen
T. Husman
J. Pekkanen
Author Affiliation
Dept of Environmental Epidemiology, National Public Health Institute, Kuopio, Finland.
Source
Eur Respir J. 1996 Dec;9(12):2618-22
Date
Dec-1996
Language
English
Publication Type
Article
Keywords
Adult
Air pollution, indoor
Female
Finland - epidemiology
Fungi
Housing
Humans
Humidity
Male
Middle Aged
Prevalence
Questionnaires
Respiratory Tract Infections - epidemiology
Risk factors
Abstract
The aim of this study was to analyse the prevalence of mouldy homes and their association with respiratory symptoms and diseases in a subarctic climate. A questionnaire was mailed to a random sample of 2,000 males and females, aged 25-64 yrs, living in the county of Kuopio, Finland. A total of 1,521 (76%) responded and 1,460 were selected for the final analysis. The prevalence of homes with visible mould was 4%; with the odour of mould 5%; with damp spots, visible mould or the odour of mould 15%; and with moisture/ water damage, damp spots, visible mould or the odour of mould 23%. The number of reports of bronchitis, common cold, atopy, allergic rhinitis, rhinitis, fever and chills, hoarseness, fatigue, difficulties in concentration, lumbar backache and stomach ache were strongly associated with living in a damp home. Bronchitis, hoarseness and difficulties in concentration had the strongest associations, with adjusted odds ratios (95% confidence limits) of: 2.04 (1.49-2.78), 2.23 (1.37-3.63) and 2.17 (1.35-3.50), respectively. After controlling for a possible reporting bias by excluding those subjects reporting lumbar backache and recurrent stomach pain, eye irritation and tiredness remained significant. In conclusion, living in a home with mould problems may increase the risk of respiratory infections and symptoms in adults.
PubMed ID
8980978 View in PubMed
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Coronary risk factor levels: differences between educational groups in 1972-87 in eastern Finland.

https://arctichealth.org/en/permalink/ahliterature215401
Source
J Epidemiol Community Health. 1995 Apr;49(2):144-9
Publication Type
Article
Date
Apr-1995
Author
J. Pekkanen
A. Uutela
T. Valkonen
E. Vartiainen
J. Tuomilehto
P. Puska
Author Affiliation
Department of Environmental Epidemiology, National Public Health Institute, Kuopio, Finland.
Source
J Epidemiol Community Health. 1995 Apr;49(2):144-9
Date
Apr-1995
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Blood pressure
Cholesterol - blood
Coronary Disease - blood - mortality - physiopathology
Cross-Sectional Studies
Educational Status
Female
Finland - epidemiology
Humans
Male
Middle Aged
Population Surveillance
Risk factors
Smoking - mortality
Abstract
To compare differences in coronary heart disease (CHD) risk factor levels between educational groups in the 1970s and 1980s in eastern Finland.
Independent, cross sectional population surveys were undertaken in 1972, 1977, 1982, and 1987 of randomly selected men and women aged 30-59 living in two provinces in eastern Finland. Altogether 20,096 subjects participated. The lowest observed level of participation in either sex or province in any year was 77%. Serum cholesterol values and blood pressure measurements, body mass index, smoking, and the level of education were determined in each survey using comparable methodology.
More poorly educated men and women had higher levels of all risk factors at the end of the study period (1987). There was no change between 1972 and 1987 in differences between educational groups in mean serum cholesterol values and the diastolic blood pressure level in either sex, and in smoking in men. In women, the proportion of smokers was highest in the better educated in the 1970s but lowest in this group in the 1980s (interaction between year of examination and educational level p
Notes
Cites: Am J Clin Nutr. 1988 Sep;48(3):544-513414569
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Cites: Prev Med. 1978 Dec;7(4):539-49756003
Cites: J Epidemiol Community Health. 1982 Dec;36(4):294-77166686
Cites: Lancet. 1984 May 5;1(8384):1003-66143919
Cites: Cardiology. 1985;72(1-2):35-512858266
Cites: Annu Rev Public Health. 1985;6:147-933873246
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Cites: N Engl J Med. 1993 Jul 8;329(2):103-98510686
Cites: J Epidemiol Community Health. 1993 Apr;47(2):103-88326266
Cites: N Engl J Med. 1993 Sep 30;329(14):1008-128366901
Cites: N Engl J Med. 1993 Sep 30;329(14):1036-78366906
Cites: Int J Health Sci. 1992;3(3-4):157-6612345858
PubMed ID
7798041 View in PubMed
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Ultrafine particles in urban air and respiratory health among adult asthmatics.

https://arctichealth.org/en/permalink/ahliterature194339
Source
Eur Respir J. 2001 Mar;17(3):428-35
Publication Type
Article
Date
Mar-2001
Author
P. Penttinen
K L Timonen
P. Tiittanen
A. Mirme
J. Ruuskanen
J. Pekkanen
Author Affiliation
Unit of Environmental Epidemiology, National Public Health Institute, Kuopio, Finland.
Source
Eur Respir J. 2001 Mar;17(3):428-35
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Adult
Air Pollution - analysis
Asthma - physiopathology
Finland
Humans
Particle Size
Peak Expiratory Flow Rate
Urban health
Abstract
Airborne particles are associated with adverse health effects and contribute to excess mortality in epidemiological studies. A recent hypothesis proposes that the high numbers of ultrafine (
PubMed ID
11405521 View in PubMed
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Small area estimation of incidence of cancer around a known source of exposure with fine resolution data.

https://arctichealth.org/en/permalink/ahliterature195023
Source
Occup Environ Med. 2001 May;58(5):315-20
Publication Type
Article
Date
May-2001
Author
E. Kokki
J. Ranta
A. Penttinen
E. Pukkala
J. Pekkanen
Author Affiliation
Unit of Environmental Epidemiology, National Public Health Institute, PO Box 95, FIN-70701 Kuopio, Finland. Esa.Kokki@ktl.fi
Source
Occup Environ Med. 2001 May;58(5):315-20
Date
May-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Asbestos - adverse effects
Child
Child, Preschool
Finland - epidemiology
Humans
Incidence
Infant
Infant, Newborn
Lung Neoplasms - epidemiology
Middle Aged
Mining
Registries
Risk factors
Small-Area Analysis
Abstract
To describe the small area system developed in Finland. To illustrate the use of the system with analyses of incidence of lung cancer around an asbestos mine. To compare the performance of different spatial statistical models when applied to sparse data.
In the small area system, cancer and population data are available by sex, age, and socioeconomic status in adjacent "pixels", squares of size 0.5 km x 0.5 km. The study area was partitioned into sub-areas based on estimated exposure. The original data at the pixel level were used in a spatial random field model. For comparison, standardised incidence ratios were estimated, and full bayesian and empirical bayesian models were fitted to aggregated data. Incidence of lung cancer around a former asbestos mine was used as an illustration.
The spatial random field model, which has been used in former small area studies, did not converge with present fine resolution data. The number of neighbouring pixels used in smoothing had to be enlarged, and informative distributions for hyperparameters were used to stabilise the unobserved random field. The ordered spatial random field model gave lower estimates than the Poisson model. When one of the three effects of area were fixed, the model gave similar estimates with a narrower interval than the Poisson model.
The use of fine resolution data and socioeconomic status as a means of controlling for confounding related to lifestyle is useful when estimating risk of cancer around point sources. However, better statistical methods are needed for spatial modelling of fine resolution data.
Notes
Cites: Occup Environ Med. 1999 Nov;56(11):774-8010658564
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Cites: Stat Med. 2000 Sep 15-30;19(17-18):2217-4110960849
PubMed ID
11303080 View in PubMed
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Total and HDL cholesterol and their correlates in elderly men in Finland, Italy, and The Netherlands.

https://arctichealth.org/en/permalink/ahliterature229177
Source
Am J Epidemiol. 1990 May;131(5):855-63
Publication Type
Article
Date
May-1990
Author
D. Kromhout
A. Nissinen
A. Menotti
B. Bloemberg
J. Pekkanen
S. Giampaoli
Author Affiliation
Department of Epidemiology, National Institute of Public Health and Environmental Protection, Bilthoven, The Netherlands.
Source
Am J Epidemiol. 1990 May;131(5):855-63
Date
May-1990
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Caffeine - adverse effects
Cholesterol - blood
Cholesterol, HDL - blood
Cohort Studies
Coronary Disease - epidemiology
Finland
Follow-Up Studies
Humans
Italy
Male
Netherlands
Risk factors
Time Factors
Abstract
In 1984 and 1985, 25-year follow-up studies were carried out in the Italian, Finnish, and Dutch cohorts of men originally examined around 1960 in the Seven Countries Study. Risk factors for coronary heart disease were determined in 2,255 men aged 65-84 years. The average serum total cholesterol levels of the elderly men in Finland and the Netherlands were similar, at around 236 mg/dl (6.10 mmol/liter). The average serum total cholesterol levels of the elderly men in Italy were about 10 mg/dl (0.26 mmol/liter) lower. During 25 years of follow-up, the average serum total cholesterol level increased by 29 mg/dl (0.75 mmol/liter) among the Italian survivors, decreased by 23 mg/dl (0.59 mmol/liter) in the Finnish survivors, and did not change in the Dutch survivors. Age, Quetelet index, and coffee consumption were the most important correlates of total cholesterol in these elderly men. Quetelet index, alcohol consumption, age, and cigarette smoking were significantly associated with high density lipoprotein (HDL) cholesterol. The results of this study suggest that modifiable risk factors are related to total and HDL cholesterol in elderly men in different cultures.
PubMed ID
2321628 View in PubMed
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Vacuum-assisted delivery is associated with late-onset asthma.

https://arctichealth.org/en/permalink/ahliterature151385
Source
Allergy. 2009 Oct;64(10):1530-8
Publication Type
Article
Date
Oct-2009
Author
L. Keski-Nisula
M. Harju
M-R Järvelin
J. Pekkanen
Author Affiliation
Environmental Health Department, National Institute for Health and Welfare, Kuopio, Finland.
Source
Allergy. 2009 Oct;64(10):1530-8
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Age of Onset
Allergens - diagnostic use - immunology
Asthma - diagnosis - epidemiology - etiology - immunology
Child
Cohort Studies
Delivery, Obstetric - adverse effects
Female
Finland - epidemiology
Humans
Hypersensitivity, Immediate - epidemiology - etiology - immunology
Pregnancy
Prevalence
Rhinitis, Allergic, Seasonal - epidemiology - etiology - immunology
Skin Tests
Vacuum Extraction, Obstetrical - adverse effects
Abstract
Perinatal factors during delivery might modulate fetal immunological development and thereby be associated with the development of allergic diseases and asthma later.
Perinatal data was recorded during pregnancy and at the time of delivery in regard to 5823 children who were born in Northern Finland in 1985-1986. Data from self-administered questionnaires were available at the ages of 7 and 15-16 years and skin prick tests for four main allergens were carried out at the age of 15-16 years. Only singletons delivered by the vaginal route were analyzed.
There was a higher prevalence of doctor-diagnosed asthma at any time of life among children who were delivered by vacuum extraction (RR 1.80, 95% CI 1.27-2.56; P
PubMed ID
19385949 View in PubMed
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Scientific rationale for the Finnish Allergy Programme 2008-2018: emphasis on prevention and endorsing tolerance.

https://arctichealth.org/en/permalink/ahliterature151405
Source
Allergy. 2009 May;64(5):678-701
Publication Type
Article
Date
May-2009
Author
L C von Hertzen
J. Savolainen
M. Hannuksela
T. Klaukka
A. Lauerma
M J Mäkelä
J. Pekkanen
A. Pietinalho
O. Vaarala
E. Valovirta
E. Vartiainen
T. Haahtela
Author Affiliation
Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland.
Source
Allergy. 2009 May;64(5):678-701
Date
May-2009
Language
English
Publication Type
Article
Keywords
Allergens - immunology
Clinical Trials as Topic
Cytokines - immunology - metabolism
Finland
Gastrointestinal Tract - immunology - metabolism
Humans
Hypersensitivity - economics - immunology - prevention & control
Immune Tolerance - immunology
Immunity, Innate
Immunity, Mucosal
Immunotherapy
National Health Programs - trends
Probiotics - therapeutic use
T-Lymphocyte Subsets - immunology - metabolism
T-Lymphocytes, Regulatory - immunology - metabolism
Toll-Like Receptors - immunology - metabolism
Abstract
In similarity to many other western countries, the burden of allergic diseases in Finland is high. Studies worldwide have shown that an environment rich in microbes in early life reduces the subsequent risk of developing allergic diseases. Along with urbanization, such exposure has dramatically reduced, both in terms of diversity and quantity. Continuous stimulation of the immune system by environmental saprophytes via the skin, respiratory tract and gut appears to be necessary for activation of the regulatory network including regulatory T-cells and dendritic cells. Substantial evidence now shows that the balance between allergy and tolerance is dependent on regulatory T-cells. Tolerance induced by allergen-specific regulatory T-cells appears to be the normal immunological response to allergens in non atopic healthy individuals. Healthy subjects have an intact functional allergen-specific regulatory T-cell response, which in allergic subjects is impaired. Evidence on this exists with respect to atopic dermatitis, contact dermatitis, allergic rhinitis and asthma. Restoration of impaired allergen-specific regulatory T-cell response and tolerance induction has furthermore been demonstrated during allergen-specific subcutaneous and sublingual immunotherapy and is crucial for good therapeutic outcome. However, tolerance can also be strengthened unspecifically by simple means, e.g. by consuming farm milk and spending time in nature. Results so far obtained from animal models indicate that it is possible to restore tolerance by administering the allergen in certain circumstances both locally and systemically. It has become increasingly clear that continuous exposure to microbial antigens as well as allergens in foodstuffs and the environment is decisive, and excessive antigen avoidance can be harmful and weaken or even prevent the development of regulatory mechanisms. Success in the Finnish Asthma Programme was an encouraging example of how it is possible to reduce both the costs and morbidity of asthma. The time, in the wake of the Asthma Programme, is now opportune for a national allergy programme, particularly as in the past few years, fundamentally more essential data on tolerance and its mechanisms have been published. In this review, the scientific rationale for the Finnish Allergy Programme 2008-2018 is outlined. The focus is on tolerance and how to endorse tolerance at the population level.
PubMed ID
19383025 View in PubMed
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Green areas around homes reduce atopic sensitization in children.

https://arctichealth.org/en/permalink/ahliterature266308
Source
Allergy. 2015 Feb;70(2):195-202
Publication Type
Article
Date
Feb-2015
Author
L. Ruokolainen
L. von Hertzen
N. Fyhrquist
T. Laatikainen
J. Lehtomäki
P. Auvinen
A M Karvonen
A. Hyvärinen
V. Tillmann
O. Niemelä
M. Knip
T. Haahtela
J. Pekkanen
I. Hanski
Source
Allergy. 2015 Feb;70(2):195-202
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Agriculture
Allergens - immunology
Child
Child, Preschool
Environment
Environmental Exposure
Estonia - epidemiology
Female
Finland - epidemiology
Forests
Housing
Humans
Hypersensitivity, Immediate - epidemiology - etiology
Immunoglobulin E - blood - immunology
Infant
Male
Microbiota
Odds Ratio
Prevalence
Skin - immunology - microbiology
Young Adult
Abstract
Western lifestyle is associated with high prevalence of allergy, asthma and other chronic inflammatory disorders. To explain this association, we tested the 'biodiversity hypothesis', which posits that reduced contact of children with environmental biodiversity, including environmental microbiota in natural habitats, has adverse consequences on the assembly of human commensal microbiota and its contribution to immune tolerance.
We analysed four study cohorts from Finland and Estonia (n = 1044) comprising children and adolescents aged 0.5-20 years. The prevalence of atopic sensitization was assessed by measuring serum IgE specific to inhalant allergens. We calculated the proportion of five land-use types--forest, agricultural land, built areas, wetlands and water bodies--in the landscape around the homes using the CORINE2006 classification.
The cover of forest and agricultural land within 2-5 km from the home was inversely and significantly associated with atopic sensitization. This relationship was observed for children 6 years of age and older. Land-use pattern explained 20% of the variation in the relative abundance of Proteobacteria on the skin of healthy individuals, supporting the hypothesis of a strong environmental effect on the commensal microbiota.
The amount of green environment (forest and agricultural land) around homes was inversely associated with the risk of atopic sensitization in children. The results indicate that early-life exposure to green environments is especially important. The environmental effect may be mediated via the effect of environmental microbiota on the commensal microbiota influencing immunotolerance.
Notes
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PubMed ID
25388016 View in PubMed
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Comparison of two-level and three-level classifications of moisture-damaged dwellings in relation to health effects.

https://arctichealth.org/en/permalink/ahliterature193503
Source
Indoor Air. 2001 Sep;11(3):192-9
Publication Type
Article
Date
Sep-2001
Author
U. Haverinen
T. Husman
M. Vahteristo
O. Koskinen
D. Moschandreas
A. Nevalainen
J. Pekkanen
Author Affiliation
National Public Health Institute, Laboratory of Environmental Microbiology and Unit of Environmental Epidemiology, POB 95, FIN-70701 Kuopio, Finland. ulla.haverinen@ktl.fi
Source
Indoor Air. 2001 Sep;11(3):192-9
Date
Sep-2001
Language
English
Publication Type
Article
Keywords
Adult
Air Pollution, Indoor - analysis
Dose-Response Relationship, Drug
Female
Finland
Humans
Humidity - adverse effects
Male
Public Health
Respiratory Tract Diseases - etiology
Risk assessment
Time Factors
Abstract
A total of 630 randomly selected dwellings were surveyed for visible signs of moisture damage by civil engineers, and questionnaire responses were collected from the occupants (a total of 1,017 adults) to analyse the association between moisture damage and occupant health. A three-level grading system was developed, which took into account the number of damage sites in buildings and estimated the severity of the damage. In the present study, this grading system was tested as an improved model of moisture damage-related exposure in comparison to a conventional two-category system: based on independent, technical criteria it also allowed dose-response to be estimated. The questionnaire probed 28 individual health symptoms, based on earlier reported associations with building moisture and mould-related exposure. Criteria in evaluating the goodness of the selected exposure model were (1) dose-responsiveness and (2) higher risk compared to a two-level classification. Dose-responsiveness was observed with the three-level classification in 7, higher risk in 10, and both criteria in 5 out of 28 health symptoms. Two-level classification had higher risk in 4 health symptoms. Dose-dependent risk increases for respiratory infections and lower respiratory symptoms, and recurrent irritative and skin symptoms were observed with the three-level classification using symptom score variables. Although the results did not unambiguously support the three-level model, they underline the importance of developing more accurate exposure models in assessing the severity of moisture damage.
PubMed ID
11521504 View in PubMed
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Genotypes with the apolipoprotein epsilon4 allele are predictors of coronary heart disease mortality in a longitudinal study of elderly Finnish men.

https://arctichealth.org/en/permalink/ahliterature212078
Source
Hum Genet. 1996 May;97(5):677-84
Publication Type
Article
Date
May-1996
Author
J H Stengård
J. Pekkanen
C. Ehnholm
A. Nissinen
C F Sing
Author Affiliation
National Public Health Institute, Helsinki, Finland.
Source
Hum Genet. 1996 May;97(5):677-84
Date
May-1996
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Alleles
Apolipoprotein E4
Apolipoproteins E - genetics
Blood pressure
Body mass index
Cholesterol - blood
Cohort Studies
Coronary Disease - genetics - mortality - physiopathology
Demography
Finland
Genotype
Geography
Humans
Longitudinal Studies
Male
Prognosis
Reproducibility of Results
Smoking
Abstract
Earlier we reported that allelic variation in the gene coding for apolipoprotein (apoE is a significant predictor of variation in the risk of coronary heart disease (CHD) death in a longitudinal study of elderly Finnish men. Here we address the question: which of the apoE genotypes confers the risk information in these men, and whether such information persists after other CHD risk factors are considered? We followed two cohorts of elderly Finnish men aged 65 to 84 years, one in Eastern (n = 281) and the other in the Southwestern (n = 344) Finland for 5 years during which 26 (9.3%) of the men from the Eastern cohort and 40 (11.6%) of the men in the Southwestern cohort died from CHD. Baseline high density lipoprotein (HDL) cholesterol and (HDL cholesterol)2 in the Eastern cohort and age, and total and HDL cholesterol and smoking status in the Southwestern cohort were significant predictors of CHD death (P
PubMed ID
8655152 View in PubMed
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Seasonal exposure to NO2 and respiratory symptoms in preschool children.

https://arctichealth.org/en/permalink/ahliterature212224
Source
J Expo Anal Environ Epidemiol. 1996 Apr-Jun;6(2):197-210
Publication Type
Article
Author
K. Mukala
J. Pekkanen
P. Tiittanen
S. Alm
R O Salonen
M. Jantunen
J. Tuomisto
Author Affiliation
Unit of Environmental Epidemiology, National Public Health Institute Kuopio, Finland. kristiina.mukala@ktl.fi
Source
J Expo Anal Environ Epidemiol. 1996 Apr-Jun;6(2):197-210
Language
English
Publication Type
Article
Keywords
Air Pollutants - adverse effects - analysis
Child
Child, Preschool
Confidence Intervals
Environmental Exposure - adverse effects
Environmental Monitoring - statistics & numerical data
Epidemiological Monitoring
Female
Finland - epidemiology
Health Status Indicators
Humans
Incidence
Male
Nitrogen Dioxide - adverse effects - analysis
Odds Ratio
Prevalence
Prospective Studies
Regression Analysis
Respiratory Tract Diseases - chemically induced - epidemiology
Seasons
Suburban Population
Urban Population
Abstract
One hundred seventy-two preschool children, aged three to six years, who attended municipal day-care centers in central and suburban areas of Helsinki, were followed up for seven weeks during the winter season and for eight weeks during the spring season in 1991. For each child, the weekly average NO2 exposure was estimated using passive samplers attached to the outer garments of the children during their everyday activities. Respiratory symptoms were recorded in daily diaries by the parents. The median of personally measured seasonal NO2 exposures was 21 micrograms/m3 (range 11-45.8 micrograms/m3). The seasonal median NO2 exposure was significantly larger (p
PubMed ID
8792297 View in PubMed
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Gestational age and occurrence of atopy at age 31--a prospective birth cohort study in Finland.

https://arctichealth.org/en/permalink/ahliterature196036
Source
Clin Exp Allergy. 2001 Jan;31(1):95-102
Publication Type
Article
Date
Jan-2001
Author
J. Pekkanen
B. Xu
M R Järvelin
Author Affiliation
Unit of Environmental Epidemiology, National Public Health Institute, Kuopio, Finland.
Source
Clin Exp Allergy. 2001 Jan;31(1):95-102
Date
Jan-2001
Language
English
Publication Type
Article
Keywords
Adult
Agriculture
Asthma - epidemiology
Birth weight
Cohort Studies
Female
Finland - epidemiology
Gestational Age
Humans
Hypersensitivity, Immediate - epidemiology
Infant, Newborn
Infant, Premature
Prevalence
Prospective Studies
Skin Tests
Abstract
It has been suggested that main risk factors for development of allergic diseases operate already during pregnancy and in early childhood.
To study the association between gestational age, birth weight, parity and parental farming with the risk of atopy and asthma in young adults.
In a prospective birth cohort study, 5192 subjects born in Northern Finland in 1966 were followed up at the age of 31. Skin prick tests were done to three of the most common allergens in Finland and to house dust mite. Data on doctor-diagnosed asthma was obtained from questionnaires. Perinatal data had already been collected during pregnancy.
The risk of atopy increased linearly with increasing length of pregnancy among babies born in the 35th weak of gestation or later. Gestational age equal to, or over 40 weeks compared with less than 36 weeks was associated with an increased risk of atopy (multivariate odds ratio 1.65, 95% CI 1.16, 2.34). The association was stronger among farmers' children (P for interaction 0.01). High parity and being a farmer's child (multivariate odds ratio 0.50, 95% CI 0.42-0.60) was associated with decreased risk of atopy. In contrast, no associations were observed for doctor-diagnosed asthma.
The results underline the importance of pregnancy and very early childhood in the development of atopy, and suggest that timing of the environmental exposure is of importance for the immune system. No association was observed for asthma, which may be due to the multifactorial origins of asthma.
PubMed ID
11167956 View in PubMed
Less detail

Farming environment and prevalence of atopy at age 31: prospective birth cohort study in Finland.

https://arctichealth.org/en/permalink/ahliterature134479
Source
Clin Exp Allergy. 2011 Jul;41(7):987-93
Publication Type
Article
Date
Jul-2011
Author
J. Lampi
D. Canoy
D. Jarvis
A-L Hartikainen
L. Keski-Nisula
M-R Järvelin
J. Pekkanen
Author Affiliation
Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland. jussi.lampi@thl.fi
Source
Clin Exp Allergy. 2011 Jul;41(7):987-93
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adult
Agriculture
Allergens - immunology
Animals
Animals, Domestic - immunology
Asthma - epidemiology
Cats
Cohort Studies
Conjunctivitis, Allergic - epidemiology
Cross-Sectional Studies
Dogs
Finland - epidemiology
Humans
Hypersensitivity - epidemiology
Hypersensitivity, Immediate - epidemiology
Prevalence
Prospective Studies
Rhinitis - epidemiology
Skin Tests
Abstract
Cross-sectional studies have shown an association between the farming environment and a decreased risk of atopic sensitization, mainly related to contact with farm animals in the childhood.
Investigate the association of a farming environment, especially farm animal contact, during infancy, with atopic sensitization and allergic diseases at the age of 31.
In a prospective birth cohort study, 5509 subjects born in northern Finland in 1966 were followed up at the age of 31. Prenatal exposure to the farming environment was documented before or at birth. At age 31, information on health status and childhood exposure to pets was collected by a questionnaire and skin prick tests were performed.
Being born to a family having farm animals decreased the risk of atopic sensitization [odds ratio (OR) 0.67; 95% confidence interval (CI) 0.56-0.80], atopic eczema ever (OR 0.77; 95% CI 0.66-0.91), doctor-diagnosed asthma ever (OR 0.74; 95% CI 0.55-1.00), allergic rhinitis at age 31 (OR 0.87; 95% CI 0.73-1.03) and allergic conjunctivitis (OR 0.86; 95% CI 0.72-1.02) at age 31. There was a suggestion that the reduced risk of allergic sensitization was particularly evident among the subjects whose mothers worked with farm animals during pregnancy, and that the reduced risk of the above diseases by farm animal exposure was largely explained by the reduced risk of atopy. Having cats and dogs in childhood revealed similar associations as farm animals with atopic sensitization.
Contact with farm animals in early childhood reduces the risk of atopic sensitization, doctor-diagnosed asthma and allergic diseases at age 31.
PubMed ID
21575087 View in PubMed
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