Acid precipitation affects the solubility of several metals in aquatic systems and in soil. Cadmium levels in tap water samples from geological areas having low resistance to acidic pollution were significantly higher than those in samples from a neighbouring reference area where there was a different geological structure. The median cadmium levels and pH values were 0.14 microgram l-1 and 5.6 respectively, for the acidic areas compared with 0.07 microgram l-1 and 6.4 respectively for the reference area. Further, there was a significant inverse relationship between both cadmium and lead contents and the pH values of the samples. The mobility of the metals was thus dependent on the acidity. The blood lead levels in 195 subjects from the acidic areas were lower than those in 91 subjects from the reference area (medians 60 vs. 70 micrograms l-1); no significant differences were found in blood cadmium or blood mercury levels. Subjects in the acidic areas had lower plasma selenium levels than those from the reference area (medians 85 vs. 90 micrograms l-1); the difference was mainly attributed to subjects with private wells. The data may indicate a negative effect of the acidic pollution on selenium intake via water and/or foods. There was also a positive relationship between intake of fish on the one hand and blood mercury and plasma selenium on the other, which is in accordance with the role of fish as a source of these metals.
Samples of vertebral bone were obtained by skeletal biopsy and lead concentrations were determined by atomic absorption spectroscopy. The median level of lead in bone in 27 active lead workers was 29 micrograms/g wet weight (range 2-155), corresponding to 370 micrograms/g calcium (range 30-1,120). In 9 retired workers, the corresponding levels were 19 micrograms/g (5-76) and 250 micrograms/g calcium (60-700); in 14 reference subjects without occupational exposure, 1.3 micrograms/g (1-4) and 13 micrograms/g calcium (8-40). The bone lead content rose with time of exposure. Comparison of levels in vertebra with those in fingerbone, as measured by in vivo x-ray fluorescence in the same subjects, strongly suggested the presence of lead pools with different kinetics. The accumulation pattern, as well as the relation between levels in vertebra and fingerbone, suggests a much shorter half-time of lead in the mainly trabecular vertebral bone as compared to the mainly cortical fingerbone. Further, there was an association between vertebral and blood lead levels in the retired workers, which shows a considerable endogenous lead exposure from the skeletal pool.
Risk assessments of contaminated land often involve the use of generic bioconcentration factors (BCFs), which express contaminant concentrations in edible plant parts as a function of the concentration in soil, in order to assess the risks associated with consumption of homegrown vegetables. This study aimed to quantify variability in BCFs and evaluate the implications of this variability for human exposure assessments, focusing on cadmium (Cd) and lead (Pb) in lettuce and potatoes sampled around 22 contaminated glassworks sites. In addition, risks associated with measured Cd and Pb concentrations in soil and vegetable samples were characterized and a probabilistic exposure assessment was conducted to estimate the likelihood of local residents exceeding tolerable daily intakes. The results show that concentrations in vegetables were only moderately elevated despite high concentrations in soil, and most samples complied with applicable foodstuff legislation. Still, the daily intake of Cd (but not Pb) was assessed to exceed toxicological thresholds for about a fifth of the study population. Bioconcentration factors were found to vary more than indicated by previous studies, but decreasing BCFs with increasing metal concentrations in the soil can explain why the calculated exposure is only moderately affected by the choice of BCF value when generic soil guideline values are exceeded and the risk may be unacceptable.
The physical housing environment is important to facilitate activities of daily living (ADL) for older people. A hindering environment may lead to ADL dependence and thus increase the need for home services, which is individually restricting and a growing societal burden. This study presents simulations of policy changes with regard to housing accessibility that estimates the potential impact specifically on instrumental activities of daily living (I-ADL), usage of home services, and related costs. The models integrate empirical data to test the hypothesis that a policy providing funding to remove the five most severe environmental barriers in the homes of older people who are at risk of developing dependence in I-ADL, can maintain independence and reduce the need for home services. In addition to official statistics from state agencies in Sweden and Germany, we utilized published results from the ENABLE-AGE and other scientific studies to generate the simulations. The simulations predicted that new policies that remove potentially hindering housing features would improve I-ADL performance among older people and reduce the need for home services. Our findings suggest that a policy change can contribute to positive effects with regard to I-ADL independence among older people and to a reduction of societal burden.
In aging societies, zest for work may be pivotal when deciding to stay occupationally active longer. Psychosocial work stress is a prevalent public health problem and may have an impact on zest for work. Work over-commitment (WOC) is a personal coping strategy for work stress with excessive striving and a health risk. However, the long-term effect of WOC on zest for work is poorly understood.
To investigate the age-related associations of work over-commitment with zest for work.
During 1996-1998 and 2000-2003, predominantly industrial workers (n?=?2940) participated in the WOLF-Norrland study and responded to a questionnaire referring to socio-demographics, WOC, zest for work, effort-reward imbalance proxies, and mental health. Age-adjusted multiple logistic regressions were performed with original and imputed datasets.
Cross-sectionally, work overcommitted middle-aged employees had an increased prevalence of poor zest for work compared to their contemporaries without WOC (OR: 3.74 [95%-CI 2.19; 6.40]). However, in a longitudinal analysis associations between onset of 'poor zest for work' and the WOC subscales 'need for approval' (OR: 3.29 [95%-CI 1.04; 10.37]) and 'inability to withdraw from work' (OR: 5.14 [95%-CI 1.32; 20.03]) were observed.
The longitudinal findings among older employees could be relevant regarding the expected need to remain occupationally active longer.
To characterise mercury (Hg) exposure in Daubenton's bat (Myotis daubentonii, Kuhl 1817) in southern Sweden, 17 specimens were captured in 2013 and back fur samples were taken for analysis to determine Hg concentrations. The fur Hg levels determined [1.15?±?0.27 (mean?±?standard deviation, n?=?17) µg Hg g-1 fresh weight (fw)] represent a baseline for comparison in future assessments of Hg exposure in bat populations in northern Europe. Mercury concentrations were close to those reported in fur from other bat species, but were lower than proposed toxicological thresholds in bats (>?30 µg Hg g-1 fw) and mice (5 µg Hg g-1 fw). This is the first study to examine Hg exposure in bats in Scandinavia.
Cites: Environ Sci Technol. 2013 May 21;47(10):4967-83 PMID 23590191
Cites: Environ Sci Technol. 2015 Feb 17;49(4):2059-65 PMID 25591047
Cites: Environ Res. 1977 Aug;14(1):30-4 PMID 560962
Marginal structural model to evaluate the joint effect of socioeconomic exposures on the risk of developing end-stage renal disease in patients with type 1 diabetes: a longitudinal study based on data from the Swedish Childhood Diabetes Study Group.
Diabetic nephropathy is a severe complication of type 1 diabetes (T1D) that may lead to renal failure and end-stage renal disease (ESRD) demanding dialysis and transplantation. The etiology of diabetic nephropathy is multifactorial and both genes and environmental and life style-related factors are involved. In this study, we investigate the effect of the socioeconomic exposures, unemployment and receiving income support, on the development of ESRD in T1D patients, using a marginal structural model (MSM) in comparison with standard logistic regression models.
The study is based on the Swedish Childhood Diabetes Register which in 1977 started to register patients developing T1D before 15 years of age. In the analyses, we include patients born between 1965 and 1979, developing diabetes between 1977 and 1994, and followed until 2013 (n = 4034). A MSM was fitted to adjust for both baseline and time-varying confounders.
The main results of the analysis indicate that being unemployed for more than 1 year and receiving income support are risk factors for the development of ESRD. Multiple exposures over time to these risk factors increase the risk associated with the disease.
Using a MSM is an advanced method well suited to investigate the effect of exposures on the risk of complications of a chronic disease with longitudinal data. The results show that socioeconomic disadvantage increases the risk of developing ESRD in patients with T1D.
Exposure to moldy or damp indoor environments is associated with allergic disease in young children, but it is unclear whether the effects persist to adolescence. Our objective was to assess whether exposure to mold or dampness during infancy increases the risk of asthma, rhinitis, or IgE sensitization in children followed from birth to 16 years of age.
We collected questionnaire derived reports of mold or dampness indicators and allergic outcomes from 3798 children in a Swedish birth cohort (BAMSE). Sensitization was assessed from blood samples in 3293 children. Longitudinal associations between prevalent asthma, rhinitis, and IgE sensitization and mold or dampness indicators were assessed using generalized estimating equations.
Exposure to any mold or dampness indicator was associated with asthma up to 16 years of age (OR 1.31; 95% CI 1.08-1.59), while exposure to mold odor (OR 1.29; 95% CI 1.03-1.62) and visible mold (OR 1.28; 95% CI 1.04-1.58) were associated with rhinitis. Increased risks were observed for nonallergic asthma (OR 1.80; 95% CI 1.27-2.55) and rhinitis (OR 1.41; 95% CI 1.03-1.93). No association was observed between mold or dampness indicators and IgE sensitization. Exposure to any mold or dampness indicator was associated with persistent asthma (OR 1.73; 95% CI 1.20-2.50), but not with early-transient or late-onset asthma.
Exposure to mold or dampness during infancy increased the risk of asthma and rhinitis up to 16 years of age, particularly for nonallergic disease. Early exposure to mold or dampness appeared particularly associated with persistent asthma through adolescence.
Cites: PLoS One. 2014 Aug 19;9(8):e105125 PMID 25136984
Wood pellets are used as a source of renewable energy for heating purposes. Common exposures are wood dust and monoterpenes, which are known to be hazardous for the airways. The purpose of this study was to study the effect of occupational exposure on respiratory health in wood pellet workers.
Thirty-nine men working with wood pellet production at six plants were investigated with a questionnaire, medical examination, allergy screening, spirometry, and nasal peak expiratory flow (nasal PEF). Exposure to wood dust and monoterpenes was measured.
The wood pellet workers reported a higher frequency of nasal symptoms, dry cough, and asthma medication compared to controls from the general population. There were no differences in nasal PEF between work and leisure time. A lower lung function than expected (vital capacity [VC], 95%; forced vital capacity in 1?second [FEV1], 96% of predicted) was noted, but no changes were noted during shifts. There was no correlation between lung function and years working in pellet production. Personal measurements of wood dust at work showed high concentrations (0.16-19?mg/m3), and exposure peaks when performing certain work tasks. Levels of monoterpenes were low (0.64-28?mg/m3). There was no association between exposure and acute lung function effects.
In this study of wood pellet workers, high levels of wood dust were observed, and that may have influenced the airways negatively as the study group reported upper airway symptoms and dry cough more frequently than expected. The wood pellet workers had both a lower VC and FEV1 than expected. No cross-shift changes were found.
Cites: J Occup Environ Hyg. 2008 May;5(5):296-304 PMID 18322870
OBJECTIVES: Potroom workers in aluminum reduction plants have increased risks for bladder and lung cancer due to exposure from polycyclic aromatic hydrocarbons (PAH). In this study correlations between measures of the external, internal, and biological effective dose have been studied for PAH. METHODS: Venous blood samples were obtained from 98 male potroom workers and 55 unexposed male blue-collar workers, for the analysis of aromatic adducts to DNA (deoxyribonucleic acid) in lymphocytes, using the 32P-postlabeling technique. 1-Hydroxypyrene in urine was analyzed with high-pressure liquid chromatography. Personal sampling of both particulate and gas phase PAH was performed during a full workday for the potroom workers and for 5 referents. Individual PAH congeners were determined with liquid chromatographic-mass spectrometric and gas chromatographic-mass spectrometric techniques. RESULTS: The respiratory-zone airborne level of the sum of 22 particulate (median 13.2 micro/m3) and the 7 gas phase PAH-congeners (median 16.3 microg/m3) among the potroom workers was a hundred times higher than among the referents. The urinary concentration of 1-hydroxypyrene before work was 30 times higher for the potroom workers (median 3.43 micromol/mol creatinine) than for the referents. Most airborne PAH congeners correlated with the excretion of 1-hydroxypyrene in urine. The frequency of aromatic DNA adducts did not, however, differ between the potroom workers and the referents, and no correlation was found for 1-hydroxypyrene in urine. CONCLUSIONS: Despite an obvious occupational exposure to PAH, no increase in aromatic DNA adducts in lymphocytes was found among the potroom workers.
The relationship between knowledge, attitude and sun-related behaviour among Swedish students was examined in the present study. A total of 296 of 305 questionnaires, distributed among university students (medical school and economy programme) were analysed (157 men, 139 women, mean age 24 years). The percentage of students sunbathing with the intention of getting a tan was 75%. Thirteen per cent reported having experienced at least one painful sunburn every year and 93% stated at least one burn during the last ten years. The majority of the students had used a sun bed, 12% more than ten times during the last year. Subjects with high frequency of sun bed use also scored high on sunbathing and sunburns. Significantly more women (70%) than men (51%) used sunscreen. The overall knowledge of melanoma was high. No difference in knowledge was found between the high- and low-exposure group. Medical students scored higher on knowledge than economy students, but did not differ in exposure score. Our findings reveal an excessive sun exposure among university students. A high level of knowledge of risk does not lead to a sun-protective behaviour. Future preventative campaigns targeting young people must focus on strategies to change attitudes towards tanning as being healthy and attractive.
This report provides a review of the cadmium exposure situation in Sweden and updates the information on health risk assessment according to recent studies on the health effects of cadmium. The report focuses on the health effects of low cadmium doses and the identification of high-risk groups. The diet is the main source of cadmium exposure in the Swedish nonsmoking general population. The average daily dietary intake is about 15 micrograms/day, but there are great individual variations due to differences in energy intake and dietary habits. It has been shown that a high fiber diet and a diet rich in shellfish increase the dietary cadmium intake substantially. Cadmium concentrations in agricultural soil and wheat have increased continuously during the last century. At present, soil cadmium concentrations increase by about 0.2% per year. Cadmium accumulates in the kidneys. Human kidney concentrations of cadmium have increased several fold during the last century. Cadmium in pig kidney has been shown to have increased by about 2% per year from 1984-1992. There is no tendency towards decreasing cadmium exposure among the general nonsmoking population. The absorption of cadmium in the lungs is 10-50%, while the absorption in the gastrointestinal tract is only a few percent. Smokers have about 4-5 times higher blood cadmium concentrations (about 1.5 micrograms/l), and twice as high kidney cortex cadmium concentrations (about 20-30 micrograms/g wet weight) as nonsmokers. Similarly, the blood cadmium concentrations are substantially elevated in persons with low body iron stores, indicating increased gastrointestinal absorption. About 10-40% of Swedish women of child-bearing age are reported to have empty iron stores (S-ferritin
Erratum In: Scand J Work Environ Health 1998 Jun;24(3):240
OBJECTIVE: To determine whether birth weight is associated with asthmatic disorders in adult life. DESIGN: A case-control study which compared birth weight and other indicators of pregnancy outcome in a group of adult asthmatic patients and in matched healthy controls. The diagnosis of asthma was verified using defined criteria. All asthmatic subjects were excluded from the control group. SETTING: Four primary health care centres in Lund, Sweden. SUBJECTS: 55 asthma patients and 92 healthy controls, all born between 1948 and 1973 in Lund. MAIN OUTCOME MEASURES: Birth weight, birth height, head circumference, placental weight, and gestational age. Data from a self-administered questionnaire on social and medical background factors including smoking, educational level, and a self-reported history of frequent severe respiratory infections in childhood. RESULTS: No significant differences were found between asthma patients and controls in birth weight, 3529 (SD 533) g versus 3536 (501) g, or in other variables associated with pregnancy outcome. There were no differences in current smoking habits or in educational level between the groups. The asthma patients, however, reported a higher number of childhood respiratory infections (p
Lower respiratory disease (LRD) is a common cause of hospitalization in infants, and episodes of obstructive LRD increase the risk for asthma later in life. The purpose of this study was to assess time trends and geographical variation of first time hospitalization for LRD among children in Stockholm County, Sweden. Data on first time admittance for LRD among children aged up to 5 yrs from 1973 through 1992 were obtained from the Stockholm County Council hospital discharge register, and population register data were used for estimation of the population at risk. Municipal data were available for 1982-1992 on outbreaks of respiratory syncytial virus (RSV) infections and socio-economic factors. A total of 12,450 children had been hospitalized for the first time with LRD. For children aged
OBJECTIVES: Motor vehicle exhaust fumes are the main source of atmospheric pollution in cities in industrialised countries. They cause respiratory disease and annoy people exposed to them. The relation between ambient exposure to air pollution mainly from motor vehicles and annoyance reactions in a general population was assessed. Also, the importance of factors such as age, sex, respiratory disease, access to the use of a car, and smoking habits on the reporting of these reactions was studied. METHODS: A postal questionnaire was sent out in 55 urban areas in Sweden that had nearly identical air quality monitoring stations of the urban air monitoring network. From each area, 150 people aged 16-70 were randomly selected. The questionnaire contained questions on perception of air quality as well as a question on how often exhaust fumes were annoying. RESULTS: Six-monthly nitrogen dioxide concentrations correlated consistently with the prevalence of reported annoyance related to air pollution and traffic exhaust fumes. Black smoke and sulphur dioxide had no significant effects. The frequency of reporting annoyance reactions was higher among people with asthma, women, and people with lack of access to a car. CONCLUSIONS: In this study town dwellers could detect poor air quality at concentrations well below current guidelines for outdoor air pollution. This suggests that questionnaire studies have a place in monitoring air quality.
OBJECTIVES--Sick building syndrome (SBS) involves symptoms such as irritation to the eyes, skin, and upper airways, headache, and fatigue. The relations between such symptoms and both personal and environmental factors were studied in 225 female hospital workers, working in eight hospital units in the south of Sweden. METHODS--Symptoms of SBS and personal factors were measured by means of a standardised self administered questionnaire. The technical investigation comprised a building survey and measurements of room temperature, supply air temperature, air humidity, and exhaust air flow. RESULTS--The prevalence of symptoms differed from one unit to another. The mean value of weekly complaints of fatigue was 30%, of eye irritation 23%, and of dry facial skin 34%. Eye irritation was related to work stress, self reported exposure to static electricity, and was also more common in buildings with a high ventilation flow and a high noise level (55 dB(A)) from the ventilation system. Nasal symptoms were related to asthma and hay fever only. Throat symptoms were more common in smokers, subjects with asthma or hay fever, new buildings, and in buildings with a high ventilation flow. Facial skin irritation was related to a lack of control of the work conditions, and was more common in new buildings, and buildings with a high ventilation flow and ventilation noise. General symptoms, such as headache and fatigue, were related to current smoking, asthma or hay fever, work dissatisfaction, and static electricity. CONCLUSION--As the prevalence of symptoms was high, there is a need to improve the indoor environment as well as the psychosocial environment in hospitals. These improvements could include a reduction of ventilation noise, minimised smoking, and improvements in the psychosocial climate. Further research is needed to identify indoor climatic factors that cause the increased prevalence of symptoms of SBS in new buildings.
Comment In: Occup Environ Med. 1995 Nov;52(11):7828535503
A questionnaire study regarding airway morbidity in children and environmental factors was performed in April 1985. The parents of 5301 children, aged 6 months to 16 years, from different rural areas in mid Sweden were sent a validated questionnaire and 4990 (94%) responded. The cumulative prevalence of bronchial hyperreactivity was 9.7% and of allergic asthma 5.2%. Children living near a paper pulp plant more often had symptoms suggesting bronchial hyperreactivity (124 (13.0%), relative risk 1.3) and allergic asthma (68 (7.1%), relative risk 1.3). In children living in a damp house problem bronchial hyperreactivity was found in 76 (19.0%) (relative risk 1.9) and allergic asthma in 35 (8.7%) of the children (relative risk 1.9). Children living in a damp house with parents who smoked had the highest figures: bronchial hyperreactivity was found in 44 (23.5%) (relative risk 2.8) and allergic asthma in 22 (11.6%) (relative risk 2.5). The results indicate that various moderate environmental pollutants may act synergistically to increase bronchial hyperreactivity and allergy especially in children with a family history of allergy.
The population living within a small area around a sulphite pulp factory in Northern Sweden was studied with regard to chronic obstructive lung disease. In persons in the age group 20-64 years the prevalence of bronchial asthma was found to be 3.0% for males and 3.2% for females. These figures correspond closely with previous studies in the Central and Southern Sweden. In the same age group the prevalence of chronic bronchitis was 2.8% for males and 1.0% for females, i.e. not differing much from that of other parts of Sweden. These findings, however, were far removed from the high prevalence of chronic bronchitis reported from Northern Finland, viz. 28.2% in males and 5.8% in females. The difference is probably attributable to differences in diagnostic criteria. In this study, those sulphite pulp factory workers who smoke seemed to constitute a population running a high risk of contracting chronic bronchitis.
The aim of the present paper was to explore the oral health-related quality of life in old Swedish people with pain problems, with special reference to demography, socio-economic factors, health, and general health-related quality of life.
Individuals = 80 years (n = 186) who earlier reported pain problems answered two multi-item instruments on oral health-related quality of life (Oral Health Impact Profile, OHIP-14) and general health-related quality of life (Short Form Health Survey, SF-12), respectively. Socio-demographic and health questions were also inquired.
Both the oral and general health-related quality of life were rated very low. Two thirds (67.2%) reported at least one of the aspects in the OHIP-14 fairly often, very often or all the time. The mean additive score of the OHIP-14 was 14.6 (SD 10.5). The mean value of the physical component scale (PCS) of SF-12 was 25.9 (SD 6.2) and of the mental component scale (MCS) 44.1 (SD 11.5). The OHIP-14 was consistently and significantly correlated with self-rated general and oral health, chewing ability and MCS. The associations between self-rated general and oral health in relation to the OHIP-14 were independent of possible confounders: OR 3.63 (95% CI 1.58-8.32) and OR 2.68 (95% CI 1.44-4.99), respectively.
Old people with pain problems experienced very low oral and general health-related quality of life. Personnel caring for the oldest with pain problems should be aware that oral health problems can contribute to a low quality of life and that oral care should be included in the general care.