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  • 251.
    Blom, Victoria
    et al.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Sverke, Magnus
    Department of Psychology, Stockholm University, Stockholm, Sweden; WorkWell, Research Unit for Economic and Management Sciences, North-West University, Westonaria, South Africa.
    Bodin, Lennart
    Division of Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bergström, Gunnar
    Division of Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lindfors, Petra
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Svedberg, Pia
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Work-Home Interference and Burnout A Study Based on Swedish Twins2014In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 56, no 4, p. 361-366Article in journal (Refereed)
    Abstract [en]

    Objective: This study sets out to investigate the impact of work-home interference on burnout in women and men, while taking genetic and family environmental factors into account.

    Methods: A total of 4446 Swedish twins were included in the study. The effects of work-home conflict (WHC) and home-work conflict (HWC) on burnout between and within pairs were analyzed with co-twin control analyses.

    Results: Both WHC and HWC were significantly associated with burnout. Genetic factors may be involved in the association between HWC and burnout in women. Familial factors were not involved for WHC and burnout, neither for women nor for men.

    Conclusions: This study shows the importance to encounter WHC per se to prevent burnout. Because of genetic confounding in HWC and burnout in women, preventive efforts may also take into account individual characteristics.

  • 252.
    Blomstrand, Eva
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Eva Blomstrand's research group.
    Eliasson, Jörgen
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Eva Blomstrand's research group.
    Karlsson, Håkan K R
    Köhnke, Rickard
    Branched-chain amino acids activate key enzymes in protein synthesis after physical exercise2006In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 136, no 1 Suppl, p. 269S-273SArticle in journal (Refereed)
  • 253.
    Bodin Danielsson, Christina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    An explorative review of the Lean office concept2013In: Journal of Corporate Real Estate, ISSN 1463-001X, E-ISSN 1479-1048, Vol. 15, no 3/4, p. 167-180Article in journal (Refereed)
    Abstract [en]

    Purpose – The concept of Lean office design has emerged, claiming to support an efficient labour process. This article aims to investigate how the two main perspectives identified in the Lean office: the neo-Tayloristic approach and the team-based approach, based in different historical backgrounds, use the office design to shorten lead time and free up time.

    Design/methodology/approach – An extensive review is done in the article of what the Lean office concept means for different research areas and to practitioners.

    Findings – The study presents the two Lean office perspectives in relation to each other, something that has not been done before since it is only recently the team-based Lean office was introduced. The study also presents possible risk and benefits of two perspectives from an employee and organizational perspective.

    Research limitations/implications – Since this is a first exploratory review of the Lean office concept based on theories and examples from design practice, further empirical studies are needed to determine risks and benefits of the concept.

    Practical implications – The clarifying examples in the article make it useful for people involved in the design and building process of offices.

    Originality/value – The article brings together the fields of labour process, office research and facility management with the design practice and presents the two perspectives Lean office design in relation to each other, which has not been done before since the team-based Lean office has only recently been introduced.

  • 254.
    Bodin Danielsson, Christina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lean i arbetslivet: Lean inom kontorsdesign2013In: Lean i arbetslivet / [ed] Per Sederblad, Stockholm: Liber, 2013, 1, p. 162-189Chapter in book (Other academic)
  • 255.
    Bodin Danielsson, Christina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    L'impact de la conception architecturale des bureaux sur le confort et le bien-être des employés [The impact of architectural design offices in the comfort and well-being of employees]2013In: Le confort au travail: Que nous apprend la psychologie environnementale? [Comfort at work: What can we learn from environmental psychology?] / [ed] Liliane Rioux, Jeanne Le Roy, Lolita Rubens, Johanna Le Conte, Presses de l'Université Laval , 2013, p. 17-39Chapter in book (Other academic)
  • 256.
    Bodin Danielsson, Christina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. School of Architecture, School of Architecture & Built Environment, The Royal Institute of Technology, Sweden.
    Office type's association to employees' welfare: Three studies2016In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 54, no 4, p. 779-790Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The workplace is important for employees' daily life and well-being. This article investigates exploratory the office design's role for employees' welfare from different perspectives.

    OBJECTIVE: By comparing different studies of the office, type's influence on different factors of employees' welfare the aim is to see if any common patterns exist in office design's impact.

    METHODS: The three included studies investigate office type's association with employees' welfare by measuring its influence on: a) perception of leadership, b) sick leave, and c) job satisfaction.The sample consists of office employees from a large, national representative work environment survey that work in one of the seven identified office types in contemporary office design: (1) cell-offices; (2) shared-room offices; (3) small, (4) medium-sized and (5) large open-plan offices; (6) flex-offices and (7) combi-offices. Statistical method used is multivariate logistic and linear regression analysis with adjustment for background factors.

    RESULTS: Overall results show that shared-room office, traditional open plan offices and flex-office stand out negatively, but to different degree(s) on the different outcomes measured.

    CONCLUSIONS: This explorative comparison of different studies finds a pattern of office types that repeatedly show indications of negative influence on employees' welfare, but further studies are needed to clarify this.

  • 257.
    Bogale, Tesfahun Yonas
    et al.
    Wolaita Sodo Univ, Hlth Sci & Med Coll, Wolaita Sodo, Ethiopia.
    Tadesse Balla, Elazar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition.
    Tadesse, Minyahil
    Wolaita Sodo Univ, Hlth Sci & Med Coll, Wolaita Sodo, Ethiopia.
    Asamoah, Benedict Oppong
    Lund Univ, Dept Clin Sci, Social Med & Global Hlth, Malmo, Sweden.
    Prevalence and associated factors for stunting among 6-12 years old school age children from rural community of Humbo district, Southern Ethiopia2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, article id 653Article in journal (Refereed)
    Abstract [en]

    Background: Stunting is one of the most serious and challenging public health problems in Ethiopia, which constitute a significant obstacle to achieving better child health outcomes. This study aimed to assess the prevalence and factors associated with stunting among 6-12 years old children in Humbo district, Southern Ethiopia. Methods: This was a cross-sectional study conducted among 633 children 6-12 years old living in Humbo district, Southern Ethiopia, from March to April, 2015. A multistage cluster sampling technique was used to select participants from households in eight Villages in the study area. Height was measured using standard methods and height for age Z-score was computed to assess stunting. EPI info version 3.5.4 was used for data entry, whereas Anthroplus software and SPSS version 20.0 were used for computation of height for age Z-scores and statistical analyses respectively. Simple and multiple logistic regression analyses were used to examine factors associated with stunting in the study sample, using 95% confidence limits (statistical significance set at p < 0.050). Results: Prevalence of stunting was 57%, about, 3.5% were severely stunted, 27.3% moderately stunted and 26.4% mildly stunted, and the mean (SD) was -1.1 (+/- 1.2). About 7 (1.1%) boys and 15 (2.4%) girls were severely stunted. Age groups 10-12 years had significantly higher rate of stunting than others. Age (AOR = 1.7, 95% CI = 1.1-2.6), big family size (AOR = 4.6, 95% CI = 2.2-9.5) and field disposal of wastes (AOR = 2.7, 95% CI = 1.2-5.8) were factors significantly associated with stunting. Conclusion: This study exposed high rate of stunting among school age children. Stunting remains a noticeable attribute of rural school age children. Findings suggest the need to implement evidence-based school-aged rural children nutrition policy and strategies as well as need for intervention to improve domestic waste management system in the rural community.

  • 258. Bogdanska, Jasna
    et al.
    Borg, Daniel
    Sundström, Maria
    Bergström, Ulrika
    Halldin, Krister
    Abedi-Valugerdi, Manuchehr
    Bergman, Ake
    Nelson, Buck
    Depierre, Joseph
    Nobel, Stefan
    Tissue distribution of ³⁵S-labelled perfluorooctane sulfonate in adult mice after oral exposure to a low environmentally relevant dose or a high experimental dose.2011In: Toxicology, ISSN 0300-483X, E-ISSN 1879-3185, Vol. 284, no 1-3, p. 54-62Article in journal (Refereed)
    Abstract [en]

    The widespread environmental pollutant perfluorooctane sulfonate (PFOS), detected in most animal species including the general human population, exerts several effects on experimental animals, e.g., hepatotoxicity, immunotoxicity and developmental toxicity. However, detailed information on the tissue distribution of PFOS in mammals is scarce and, in particular, the lack of available information regarding environmentally relevant exposure levels limits our understanding of how mammals (including humans) may be affected. Accordingly, we characterized the tissue distribution of this compound in mice, an important experimental animal for studying PFOS toxicity. Following dietary exposure of adult male C57/BL6 mice for 1-5 days to an environmentally relevant (0.031 mg/kg/day) or a 750-fold higher experimentally relevant dose (23 mg/kg/day) of ³⁵S-PFOS, most of the radioactivity administered was recovered in liver, bone (bone marrow), blood, skin and muscle, with the highest levels detected in liver, lung, blood, kidney and bone (bone marrow). Following high daily dose exposure, PFOS exhibited a different distribution profile than with low daily dose exposure, which indicated a shift in distribution from the blood to the tissues with increasing dose. Both scintillation counting (with correction for the blood present in the tissues) and whole-body autoradiography revealed the presence of PFOS in all 19 tissues examined, with identification of thymus as a novel site for localization for PFOS and bone (bone marrow), skin and muscle as significant body compartments for PFOS. These findings demonstrate that PFOS leaves the bloodstream and enters most tissues in a dose-dependent manner.

  • 259.
    Bogo, Renata
    et al.
    Karolinska Inst, Sect Audiol, Dept Clin Sci Intervent & Technol, Alfred Nobels Alle 10, SE-14183 Huddinge, Sweden; Karolinska Univ Hosp, Dept Audiol & Neurotol, Huddinge, Sweden.
    Farah, Ahmed
    Publ Hlth Agcy Sweden, Stockholm, Sweden.
    Karlsson, Kjell K
    Karolinska Univ Hosp, Dept Audiol & Neurotol, Huddinge, Sweden.
    Pedersen, Nancy L
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.
    Svartengren, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Skjönsberg, Åsa
    Karolinska Inst, Sect Audiol, Dept Clin Sci Intervent & Technol, Alfred Nobels Alle 10, SE-14183 Huddinge, Sweden; Karolinska Univ Hosp, Dept Audiol & Neurotol, Huddinge, Sweden.
    Prevalence, Incidence Proportion, and Heritability for Tinnitus: A Longitudinal Twin Study2017In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 38, no 3, p. 292-300Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this longitudinal twin study was to explore the effect of tinnitus on hearing thresholds and threshold shifts over two decades and to investigate the genetic contribution to tinnitus in a male twin cohort (n = 1114 at baseline and 583 at follow-up). The hypothesis was that participants with faster hearing deterioration had a higher risk for developing tinnitus and there is an underlying role of genetic influences on tinnitus.

    DESIGN: Male mono- and dizygotic twin pairs, born between 1914 and 1958 were included. Mixed models were used for comparison of hearing threshold shifts, adjusted for age. A co-twin comparison was made within pairs discordant for tinnitus. The relative influence of genetic and environmental factors was estimated by genetic modeling.

    RESULTS: The overall prevalence of tinnitus was 13.5% at baseline (x age 50) and 34.4% at follow-up (x age 67). The overall incidence proportion was 27.8%. Participants who reported tinnitus at baseline or at both time points were older. At baseline, the hearing thresholds differed between tinnitus cases and controls at all frequencies. New tinnitus cases at follow-up had the greatest hearing threshold shift at the high-frequency area compared with the control group. Within pairs, the tinnitus twin had poorer hearing than his unaffected co-twin, more so for dizygotic than monozygotic twin pairs. The relative proportion of additive genetic factors was approximately 0.40 at both time points, and the influence of individual-specific environment was 0.56 to 0.61. The influence of genetic factors on tinnitus was largely independent of genetic factors for hearing thresholds.

    CONCLUSIONS: Our hypotheses were confirmed: The fastest hearing deterioration occurred for new tinnitus cases. A moderate genetic influence for tinnitus was confirmed.

  • 260. Bohman, Tony
    et al.
    Alfredsson, Lars
    Jensen, Irene
    Hallqvist, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Vingård, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Skillgate, Eva
    Does a healthy lifestyle behaviour influence the prognosis of low back pain among men and women in a general population? A population-based cohort study2014In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 4, no 12, article id e005713Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    To study the influence of healthy lifestyle behaviour on the prognosis of occasional low back pain among men and women in a general population.

    DESIGN:

    Cohort study with a 4-year follow-up.

    SETTINGS:

    General population in Stockholm County, Sweden.

    PARTICIPANTS:

    The study sample comprised 3938 men and 5056 women aged 18-84 from the Stockholm Public Health Cohort reporting occasional low back pain in the baseline questionnaire 2006.

    MEASURES:

    Lifestyle factors and potential confounders were assessed at baseline. The lifestyle factors smoking habits, alcohol consumption, leisure physical activity and consumption of fruit and vegetables were dichotomised using recommendations for a health-enhancing lifestyle and combined to form the exposure variable 'healthy lifestyle behaviour'. The exposure was categorised into five levels according to the number of healthy lifestyle factors met. The follow-up questionnaire in 2010 gave information about the outcome, long duration troublesome low back pain. Crude and adjusted binomial regression models were applied to estimate the association between the exposure and the outcome analysing men and women separately.

    RESULTS:

    The risk of developing long duration troublesome low back pain among women with occasional low back pain decreased with increasing healthy lifestyle behaviour (trend test: p=0.006). 21% (28/131) among women with no healthy lifestyle factor (reference) experienced the outcome compared to 9% (36/420) among women with all four factors. Compared to the reference group, the risk was reduced by 35% (RR 0.65, 95% CI 0.44 to 0.96) for women with one healthy lifestyle factor and 52% (RR 0.48, 95% CI 0.31 to 0.77) for women with all four healthy lifestyle factors. There were no clear associations found among men.

    CONCLUSIONS:

    Healthy lifestyle behaviour seems to decrease the risk of developing long duration troublesome low back pain among women with occasional low back pain and may be recommended to improve the prognosis.

  • 261.
    Bohman, Tony
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Bottai, Matteo
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Björklund, Martin
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
    Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 4, article id e024557Article in journal (Refereed)
    Abstract [en]

    Objectives To develop predictive models for short-term and long-term clinically important improvement in women with non-specific chronic disabling neck pain during the clinical course of physiotherapy. Design Longitudinal cohort study based on data from a randomised controlled trial evaluating short-term and long-term effects on sensorimotor function over 11 weeks of physiotherapy. Participants and settings Eighty-nine women aged 31-65 years with non-specific chronic disabling neck pain from Gavle, Sweden. Measures The outcome, clinically important improvement, was measured with the Patient Global Impression of Change Scale (PGICS) and the Neck Disability Index (NDI), assessed by self-administered questionnaires at 3, 9 and 15 months from the start of the interventions (baseline). Twelve baseline prognostic factors were considered in the analyses. The predictive models were built using random-effects logistic regression. The predictive ability of the models was measured by the area under the receiver operating characteristic curve (AUC). Internal validity was assessed with cross-validation using the bootstrap resampling technique. Results Factors included in the final PGICS model were neck disability and age, and in the NDI model, neck disability, depression and catastrophising. In both models, the odds for short-term and long-term improvement increased with higher baseline neck disability, while the odds decreased with increasing age (PGICS model), and with increasing level of depression (NDI model). In the NDI model, higher baseline levels of catastrophising indicated increased odds for short-term improvement and decreased odds for long-term improvement. Both models showed acceptable predictive validity with an AUC of 0.64 (95% CI 0.55 to 0.73) and 0.67 (95% CI 0.59 to 0.75), respectively. Conclusion Age, neck disability and psychological factors seem to be important predictors of improvement, and may inform clinical decisions about physiotherapy in women with chronic neck pain. Before using the developed predictive models in clinical practice, however, they should be validated in other populations and tested in clinical settings.

  • 262. Bokenberger, Kathleen
    et al.
    Ström, Peter
    Aslan, Anna K. Dahl
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Pedersen, Nancy L.
    Shift work and cognitive aging: a longitudinal study2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 5, p. 485-493Article in journal (Refereed)
    Abstract [en]

    Objectives The few studies of shift work and late life cognitive functioning have yielded mixed findings. The aim of the present study is to estimate the association between shift-work experience and change in cognitive performance before and after retirement age among older adults who were gainfully employed. Methods Five hundred and ninety five participants with no dementia were followed up for a mean of 17.6 standard deviation (SD) 8.8 years from a Swedish population-based sample. Participants had self-reported information on any type of shift-work experience (ever/never) in 1984 and measures of cognitive performance (verbal, spatial, memory, processing speed, and general cognitive ability) from up to 9 waves of cognitive assessments during 1986-2012. Night work history (ever/never) from 1998-2002 was available from a subsample (N = 320). Early adult cognitive test scores were available for 77 men. Results In latent growth curve modeling, there were no main effects of any-type or night shift work on the mean scores or rate of change in any of the cognitive domains. An interaction effect between any-type shift work and education on cognitive performance at retirement was noted. Lower-educated shift workers performed better on cognitive tests than lower-educated day workers at retirement. Sensitivity analyses, however, indicated that the interactions appeared to be driven by selection effects. Lower-educated day workers demonstrated poorer cognitive ability in early adulthood than lower-educated shift workers, who may have selected jobs entailing higher cognitive demand. Conclusion There was no difference in late-life cognitive aging between individuals with a history of working shifts compared to those who had typical day work schedules during midlife.

  • 263.
    Bombardi, C.
    et al.
    Department of Veterinary Morphophysiology and Animal Productions, University of Bologna, Ozzano dell'Emilia, Italy.
    Grandis, A.
    Department of Veterinary Morphophysiology and Animal Productions, University of Bologna, Ozzano dell'Emilia, Italy.
    Chiocchetti, R.
    Department of Veterinary Morphophysiology and Animal Productions, University of Bologna, Ozzano dell'Emilia, Italy.
    Bortolami, R.
    Department of Veterinary Morphophysiology and Animal Productions, University of Bologna, Ozzano dell'Emilia, Italy.
    Johansson, Håkan
    University of Gävle, Centre for Musculoskeletal Research.
    Lucchi, M. L.
    Department of Veterinary Morphophysiology and Animal Productions, University of Bologna, Ozzano dell'Emilia, Italy.
    Immunohistochemical localization of alpha(1a)-adrenoreceptors in muscle spindles of rabbit masseter muscle2006In: Tissue & Cell, ISSN 0040-8166, E-ISSN 1532-3072, Vol. 38, no 2, p. 121-125Article in journal (Refereed)
    Abstract [en]

    The expression of alpha(1a)-adrenoreceptors (alpha(1a)-ARs) within the muscle spindles of rabbit masseter muscle was investigated. The alpha(1a)-ARs were detected by immunohistochemical fluorescent method and examined along the entire length of 109 cross serially sectioned spindles. The sympathetic fibers were visualized by the immunofluorescent labeling of the noradrenaline synthesizing enzymes tyrosine hydroxylase (TH) and dopamine beta-hydroxylase (DBH). In order to recognize the intrafusal muscle fiber types, antibodies for different myosin heavy chain isoforms (MyHCI) were used. TH and DBH immunolabeled nerve fibers have been observed within the capsule lamellar layers, in the periaxial fluid space and close to intrafusal muscle fibers. The alpha(1a)-ARs were detected on the smooth muscle cells of the blood vessels coursing in the muscle and in the capsule lamellar layers or within the periaxial fluid space of the spindles. Moreover, at the polar regions of a high percentage (88.1%) of muscle spindles a strong alpha(1a)-ARs immunoreactivity was present on the intrafusal muscle fibers. In double immunostained sections for alpha(1a)-ARs and MyHCI it was evidenced that both bag, and nuclear chain fibers express alpha(1a)-ARs. The receptors that we have detected by immunofluorescence may support a direct control by adrenergic fibers on muscle spindle.

  • 264.
    Bond, Lisa
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences.
    Effekt av höj- och sänkbara skrivbord efter arbetstid: Påverkas fysisk aktivitet samt skattning av fysiska besvär efter arbetstid hos kontorsanställda som använt ett höj och sänkbart skrivbord2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Several studies show that sedentary is harmful to humans. Despite this, the degree of sedentary increases and 75% of the total time of sedentary is at the workplace. A common way to reduce sedentary is to introduce sit-stand workstations. Studies show that this gives good effects during working hours but few have studied what those providing for effects after working hours. Objective: Study office workers to see if there is a difference in the frequency and duration of physical activity and estimation of physical problems after a working day if they were sedentary or varied its working position by using a sit-stand workstation.

    Method: 20 office workers measured the frequency and duration of physical activity and estimated physical problems through a diary and a questionnaire after work.

    Results: No significant differences were detected.

    Conclusions: It is not possible to draw any general conclusions from this study as the sample is small and measurement methods are only subjective. More studies are needed where you look at what happens after working hours in the future to ensure the pros and cons of sit-stand worskstations.

  • 265.
    Bonita, Ruth
    et al.
    School of Population Health, University of Auckland, Auckland, New Zealand;.
    Brändström, Anders
    Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Malmberg, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Social and Economic Geography. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Linnaeus: Alive and well2011In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 4, p. 5760-2Article in journal (Refereed)
  • 266. Bonn, Stephanie E.
    et al.
    Wiklund, Fredrik
    Sjölander, Arvid
    Szulkin, Robert
    Stattin, Pär
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Holmberg, Erik
    Grönberg, Henrik
    Bälter, Katarina
    Body mass index and weight change in men with prostate cancer: progression and mortality2014In: Cancer Causes and Control, ISSN 0957-5243, E-ISSN 1573-7225, Vol. 25, no 8, p. 933-943Article in journal (Refereed)
    Abstract [en]

    Body mass index (BMI) is a modifiable lifestyle factor that has been associated with an increased risk of fatal prostate cancer and biochemical recurrence. The main purpose of the present study was to investigate the association between the exposure BMI at the time of a prostate cancer diagnosis and weight change after diagnosis, and the outcomes of prostate cancer progression and mortality in a large cohort study. Data from 4,376 men diagnosed with clinically localized prostate cancer between 1997 and 2002 were analyzed. BMI and weight change were self-reported in 2007. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were estimated in complete-case analysis (n = 3,214) using Cox proportional hazards models. Progression was experienced among 639 (14.6 %) of the study participants, and in total, 450 (10.3 %) deaths of any cause and 134 (3.1 %) prostate cancer-specific deaths were recorded during follow-up. Obese men had a 47 % increased rate of overall mortality compared to normal weight men (HR 1.47, 95 % CI 1.03-2.10). No statistically significant associations were found for BMI and prostate cancer progression or prostate cancer-specific mortality. A weight loss > 5 % after diagnosis almost doubled the rate of overall mortality compared to maintaining a stable weight (HR 1.94, 95 % CI 1.41-2.66), while a weight gain > 5 % was associated with an almost doubled increased rate of prostate cancer-specific mortality (HR 1.93, 95 % CI 1.18-3.16). Being obese was associated with an increased rate of overall mortality, and gaining weight after a prostate cancer diagnosis was associated with an increased rate of prostate cancer-specific mortality.

  • 267.
    Borg Tornberg, Anette
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Hurtig, Anna
    KTH, School of Technology and Health (STH), Ergonomics.
    Bärbara datorer, en möjlig källa för nickel- och koboltexponering av hud?: Direktvisande tester för nickel och kobolt på bärbara datorer och frisättningsförsök på en bärbar dator2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Since1994, the EU NickelDirective is limiting the release of nickel from objects that are in prolongedcontact with skin. Despite this, nickel is still the most common cause of contactallergy in industrialized countries. This could implicate that other productswith short contact to the skin, which are not restricted by EU´s legislation inREACH (Registration, Evaluation, Authorisation and Restriction of Chemicalsubstances), could be a source of nickel or cobalt exposure. There is no limitfor cobalt release within REACH. To determine if there is cobalt or nickelpresent on the surface of a material and if metal can be released in contactwith the skin, there are quantitative and qualitative methods, such as the DMG(dimethylglyoxime)-test, the cobalt spot-test and a method for releasedetermination according to EN1811.Objectives: Laptops are not included in the REACH legislation. The purpose of thisstudy was to investigate whether nickel or cobalt can be found on computersurfaces and if nickel and cobalt can be released from surfaces that are incontact with skin, during work with laptops. Are there any variations betweendifferent models or different brands of laptops (two years old or less) andwhat levels of nickel and cobalt are released from different surfaces on a specificHP computer, that gave positive results for nickel and cobalt in the spot- tests? Methodand materials: In this study 30laptops (7 Hewlett Packard (HP), 18 Dell, 3 Sony Vaio, 1Fujitsu and 1 Macbook), weretested by using DMG-test and cobalt spot-test. To measure the release of nickeland cobalt on one specific laptop (HP2560p), the standard method EN1811 and amodified version of the method, were used. Results: Laptopsof different models and manufacturers were tested for nickel by using theDMG-test. The test turned out positive for all tested laptops from HP and 4 of18 of the laptops from Dell. For cobalt, onlyone laptop (HP) of the total 30 computers, gave a positive result. The resultsfrom the release test of a specific laptop, was lower than the limit thresholdvalue within REACH (0.5µg/cm2/week). The highest amounts of nickel,0.1μg/cm2/week, were measured for the computer components thatwere derived from the palm rest. All the cobalt levels, except one, were belowthe detection limit for the analysis. Conclusions: Our study indicatesthat laptops are a potential source for nickel deposition onto skin. In this study, computers from five differentmanufacturers have been tested, and it turned out that the tested models from HPand Dell released nickel. Cobalt was only released in very low concentrations,at a level near the LOD for the analysis.

  • 268.
    Borgestig, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    The impact of gaze-based assistive technology on daily activities in children with severe physical impairments2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim: The aim of the thesis was to investigate the impact of gaze-based assistive technology on daily activities in children with severe physical impairments and without speech. The objectives were to develop and pilot a gaze-based assistive technology intervention (GAT intervention) at home and in school for these children and to understand its impact on daily activities as experienced by their parents.

    Methods: Study I was a pilot study in which the basic components that were developed for the intervention were evaluated for students with physical impairments. The study aimed at improving the use of computers as assistive technology (AT) in school. Based on the findings in Study I, the GAT intervention was developed. The GAT intervention aimed at implementing gaze-based AT in daily activities. It consisted of two parts; having access to gaze-based AT and having access to services from a multi professional communication team during nine to ten months. Studies II-IV concerned gazebased AT for children with severe physical impairments without speech who participated in the GAT intervention. The participants were ten children (ages 1-15) (Studies II, III), and their parents (Study IV). Studies II and III had longitudinal designs and children were followed during 15-20 months with repeated measurements before, after and at follow-up. In Study II children’s repertoire of computer activities, extent of use, and goal attainment with gaze-based AT was evaluated, as well as parents’ satisfaction with the AT and with services. In Study III children’s eye gaze performance when using gaze-based AT was examined. In Study IV, parents were interviewed twice with the aim of  exploring their experiences of children’s gaze-based AT use in daily life. In Study IV a hermeneutical approach was used.

    Results: The findings of Study I showed that the basic components of intervention improved the use of computers in school. Study II showed an increased repertoire of computer activities with the gazebased AT, maintained use in daily activities for all at follow up, and that all children attained goals for gaze-based AT use in daily activities. Parents were satisfied with the gaze-based AT, and with the services in the GAT intervention. In study III, nine children improved in eye gaze performance over time when using the gaze-based AT in daily activities. Study IV revealed that children’s gaze-based AT usage in daily activities made a difference to parents since the children demonstrated agency, and showed their personality and competencies by using gaze-based AT, and for the parents this opened up infinite possibilities for the child to do and learn things. Overall, children’s gaze-based AT usage provided parents with hope of a future in which their children could develop and have influence in life.

    Conclusions: This thesis shows that these children with severe physical impairments and without speech acquired sufficient gaze control skills to use gaze-based AT for daily activities in the home and at school. The gaze-based AT had a positive impact on performing activities, for example, play activities and communication- and interaction-related activities. For the parents, children’s gaze-based AT usage made a difference since it shaped a hope of a better future for their children, where they can develop and gain influence in their future life. Furthermore, the children continued to perform daily activities with gaze-based AT over time. This finding suggests that key persons were provided with sufficient knowledge and skills to support children in maintained use of gaze-based AT after withdrawal of the services provided in the GAT intervention.

  • 269.
    Borgestig, Maria
    Linköpings universitet, Linköping, Sweden.
    The impact of gaze-based assistive technology on daily activities in children with severe physical impairments2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim: The aim of the thesis was to investigate the impact of gaze-based assistive technology on daily activities in children with severe physical impairments and without speech. The objectives were to develop and pilot a gaze-based assistive technology intervention (GAT intervention) at home and in school for these children and to understand its impact on daily activities as experienced by their parents.

    Methods: Study I was a pilot study in which the basic components that were developed for the intervention were evaluated for students with physical impairments. The study aimed at improving the use of computers as assistive technology (AT) in school. Based on the findings in Study I, the GAT intervention was developed. The GAT intervention aimed at implementing gaze-based AT in daily activities. It consisted of two parts; having access to gaze-based AT and having access to services from a multi professional communication team during nine to ten months. Studies II-IV concerned gazebased AT for children with severe physical impairments without speech who participated in the GAT intervention. The participants were ten children (ages 1-15) (Studies II, III), and their parents (Study IV). Studies II and III had longitudinal designs and children were followed during 15-20 months with repeated measurements before, after and at follow-up. In Study II children’s repertoire of computer activities, extent of use, and goal attainment with gaze-based AT was evaluated, as well as parents’ satisfaction with the AT and with services. In Study III children’s eye gaze performance when using gaze-based AT was examined. In Study IV, parents were interviewed twice with the aim of  exploring their experiences of children’s gaze-based AT use in daily life. In Study IV a hermeneutical approach was used.

    Results: The findings of Study I showed that the basic components of intervention improved the use of computers in school. Study II showed an increased repertoire of computer activities with the gazebased AT, maintained use in daily activities for all at follow up, and that all children attained goals for gaze-based AT use in daily activities. Parents were satisfied with the gaze-based AT, and with the services in the GAT intervention. In study III, nine children improved in eye gaze performance over time when using the gaze-based AT in daily activities. Study IV revealed that children’s gaze-based AT usage in daily activities made a difference to parents since the children demonstrated agency, and showed their personality and competencies by using gaze-based AT, and for the parents this opened up infinite possibilities for the child to do and learn things. Overall, children’s gaze-based AT usage provided parents with hope of a future in which their children could develop and have influence in life.

    Conclusions: This thesis shows that these children with severe physical impairments and without speech acquired sufficient gaze control skills to use gaze-based AT for daily activities in the home and at school. The gaze-based AT had a positive impact on performing activities, for example, play activities and communication- and interaction-related activities. For the parents, children’s gaze-based AT usage made a difference since it shaped a hope of a better future for their children, where they can develop and gain influence in their future life. Furthermore, the children continued to perform daily activities with gaze-based AT over time. This finding suggests that key persons were provided with sufficient knowledge and skills to support children in maintained use of gaze-based AT after withdrawal of the services provided in the GAT intervention.

  • 270.
    Borgestig, Maria
    et al.
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden; Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
    Rytterström, Patrik
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
    Hemmingsson, Helena
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
    Gaze-based assistive technology used in daily life by children with severe physical impairments: parents’ experiences2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 5, p. 301-308Article in journal (Refereed)
    Abstract [en]

    Objective: To describe and explore parents’ experiences when their children with severe physical impairments receive gaze-based assistive technology (gaze-based assistive technology (AT)) for use in daily life.

    Methods: Semi-structured interviews were conducted twice, with one year in between, with parents of eight children with cerebral palsy that used gaze-based AT in their daily activities. To understand the parents’ experiences, hermeneutical interpretations were used during data analysis.

    Results: The findings demonstrate that for parents, children’s gaze-based AT usage meant that children demonstrated agency, provided them with opportunities to show personality and competencies, and gave children possibilities to develop. Overall, children’s gaze-based AT provides hope for a better future for their children with severe physical impairments; a future in which the children can develop and gain influence in life.

    Conclusion: Gaze-based AT provides children with new opportunities to perform activities and take initiatives to communicate, giving parents hope about the children’s future.

  • 271.
    Borgestig, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences. Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
    Rytterström, Patrik
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Gaze-based assistive technology used in daily life by children with severe physical impairments: parents’ experiences2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 5, p. 301-308Article in journal (Refereed)
    Abstract [en]

    This study aims to describe and explore parents’ experiences when their children with severe physical impairments receive gaze-based assistive technology (gaze-based AT) for use in daily life. Semi-structured interviews were conducted twice, with one year in between, with parents of eight children with cerebral palsy that used gaze-based AT in their daily activities. To understand the parents’ experiences, hermeneutical interpretations were used during data analysis. The results demonstrate that for parents, children’s gaze-based AT usage meant that children demonstrated agency, provided them with opportunities to show  personality and competencies, and gave children possibilities to develop. Overall, children’s gaze-based AT provides hope to parents for a better future for their children with severe physical impairments; a future in which the children can develop and gain influence in life. In conclusion, gaze-based AT provides children with new opportunities to perform activities and take initiatives to communicate, giving parents hope about the children’s future.

  • 272.
    Borgestig, Maria
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
    Sandqvist, Jan
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Ahlsten, Gunnar
    Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
    Falkmer, Torbjorn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. School of Occupational Therapy & Social Work, Curtin University, Perth, WA, Australia; School of Occupational Therapy, La Trobe University, Melbourne, Victoria, Australia.
    Hemmingsson, Helena
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Gaze-based assistive technology in daily activities in children with severe physical impairments: an intervention study2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 3, p. 129-141Article in journal (Refereed)
    Abstract [en]

    Objective: To establish the impact of a gaze-based assistive technology (AT) intervention on activity repertoire, autonomous use, and goal attainment in children with severe physical impairments, and to examine parents’ satisfaction with the gaze-based AT and with services related to the gaze-based AT intervention.

    Methods: Non-experimental multiple case study with before, after, and follow-up design. Ten children with severe physical impairments without speaking ability (aged 1–15 years) participated in gaze-based AT intervention for 9–10 months, during which period the gaze-based AT was implemented in daily activities.

    Results: Repertoire of computer activities increased for seven children. All children had sustained usage of gaze-based AT in daily activities at follow-up, all had attained goals, and parents’ satisfaction with the AT and with services was high.

    Discussion: The gaze-based AT intervention was effective in guiding parents and teachers to continue supporting the children to perform activities with the AT after the intervention program.

  • 273.
    Borgestig, Maria
    et al.
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden; Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden; Folke Bernadotte Regional Habilitation Centre, Uppsala University, Uppsala, Sweden.
    Sandqvist, Jan
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
    Ahlsten, Gunnar
    School of Occupational Therapy & Social Work, Curtin University, Perth WA, Australia; School of Occupational Therapy, La Trobe University, Melbourne VIC, Australia; Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University & Pain and Rehabilitation Centre (UHL), County Council, Linköping, Sweden.
    Falkmer, Torbjorn
    Avdelningen för samhällsmedicin, Linköpings universitet, Linköping, Sweden.
    Hemmingsson, Helena
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
    Gaze-based assistive technology in daily activities in children with severe physical impairments: an intervention study2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 3, p. 129-141Article in journal (Refereed)
    Abstract [en]

    Objective: To establish the impact of a gaze-based assistive technology (AT) intervention on activity repertoire, autonomous use, and goal attainment in children with severe physical impairments, and to examine parents’ satisfaction with the gaze-based AT and with services related to the gaze-based AT intervention.

    Methods: Non-experimental multiple case study with before, after, and follow-up design. Ten children with severe physical impairments without speaking ability (aged 1–15 years) participated in gaze-based AT intervention for 9–10 months, during which period the gaze-based AT was implemented in daily activities.

    Results: Repertoire of computer activities increased for seven children. All children had sustained usage of gaze-based AT in daily activities at follow-up, all had attained goals, and parents’ satisfaction with the AT and with services was high.

    Discussion: The gaze-based AT intervention was effective in guiding parents and teachers to continue supporting the children to perform activities with the AT after the intervention program.

  • 274.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Phthalate exposure heralds birth defects2015In: TrAC. Trends in analytical chemistry, ISSN 0165-9936, E-ISSN 1879-3142, Vol. 64, p. VI-VIArticle in journal (Other academic)
  • 275.
    Bornehag, Carl-Gustaf
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Carlstedt, Fredrik
    Cty Council Varmland, Karlstad, Sweden..
    Jonsson, Bo A. G.
    Lund Univ, Div Occupat & Environm Med, Lund, Sweden..
    Lindh, Christian H.
    Lund Univ, Div Occupat & Environm Med, Lund, Sweden..
    Jensen, Tina K.
    Univ Southern Denmark, Dept Environm Med, Odense, Denmark..
    Bodin, Anna
    Cty Council Varmland, Karlstad, Sweden..
    Jonsson, Carin
    Cty Council Varmland, Karlstad, Sweden..
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Swan, Shanna H.
    Icahn Sch Med Mt Sinai, New York, NY 10029 USA..
    Prenatal Phthalate Exposures and Anogenital Distance in Swedish Boys2015In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 123, no 1, p. 101-107Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Phthalates are used as plasticizers in soft polyvinyl chloride (PVC) and in a large number of consumer products. Because of reported health risks, diisononyl phthalate (DiNP) has been introduced as a replacement for di(2-ethylhexyl) phthalate (DEHP) in soft PVC. This raises concerns because animal data suggest that DiNP may have antiandrogenic properties similar to those of DEHP. The anogenital distance (AGD)-the distance from the anus to the genitals-has been used to assess reproductive toxicity. OBJECTIVE: The objective of this study was to examine the associations between prenatal phthalate exposure and AGD in Swedish infants. METHODS: AGD was measured in 196 boys at 21 months of age, and first-trimester urine was analyzed for 10 phthalate metabolites of DEP (diethyl phthalate), DBP (dibutyl phthalate), DEHP, BBzP (benzylbutyl phthalate), as well as DiNP and creatinine. Data on covariates were collected by questionnaires. RESULTS: The most significant associations were found between the shorter of two AGD measures (anoscrotal distance; AGDas) and DiNP metabolites and strongest for oh-MMeOP [mono(4-methyl-7-hydroxyloctyl) phthalate] and oxo-MMeOP [mono-(2-ethyl-5-oxohexyl) phthalate]. However, the AGDas reduction was small (4%) in relation to more than an interquartile range increase in DiNP exposure. CONCLUSIONS: These findings call into question the safety of substituting DiNP for DEHP in soft PVC, particularly because a shorter male AGD has been shown to relate to male genital birth defects in children and impaired reproductive function in adult males and the fact that human levels of DiNP are increasing globally.

  • 276.
    Bornman, Riana
    et al.
    University of Pretoria, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    Bouwman, Henk
    Northwest University, South Africa.
    Household behavioural responses following successful IRS malaria control: Challenges for health education and intervention strategies.2012Conference paper (Other academic)
    Abstract [en]

    Control of malaria remains one of the world’s chief current public health challenges, particularly in sub-Saharan Africa where malaria is still responsible for 10% of the total disease burden. Mothers, guardians and caregivers of children play a vital role in the prevention, early detection and management of malaria. The general and daily priorities of caregivers living in a malarial area are not well understood, particularly as they have to balance competing social, economic and health constraints. A better understanding of household behaviour with respect to health education is imperative for the reduction of malaria incidence and the success of malaria control strategies. The investigation compared the relative importance assigned by female caregivers in communities under a successful vertically-managed malaria control programme to malaria awareness on the one hand and to social and economic concerns on the other.

     

    We conducted interviews with 156 caregivers of children using both open-ended and closed fixed-answer questions. The adult female responsible for the day-to-day care of the children was interviewed 1) in two malarial villages subject to annual indoor residual spraying (IRS) a total of 120 persons (60 in each village), and 2) 36 in a reference non-sprayed village.

     

    The mean income was between 27-56% of the national mean, indicating a community under considerable pressure. Male parents were often absent due to work commitments. Unemployment, poverty, crime, and lack of clean water were the main, unprompted, threats, but malaria was volunteered by none. Only when malaria was prompted (caregivers had good knowledge of malaria), did its concern rise to 52% and 38% in the IRS-sprayed villages.

     

    Malaria was not a prominent conscious concern and this apparent discrepancy between actual daily and potential future threats significantly increases the difficulty of mobilising communities for preventive action regarding potential threats. Integrated Vector Management (IVM), a multi-sector (central or local government, together with communities) horizontal control program, may be particularly difficult to implement in communities such as these above. Any changes to this effective system will therefore have to take exceptional care not to impact on the effectiveness other than to improve it. Considerations should be given to study the needs requirements of the caregiver as a crucial component of rural community life as their ‘buy-in’ to any new measures will be crucial for success. Our findings should be considered in malaria control strategies, rural policy development, climate change adaptation, and communication strategies.

  • 277.
    Bornman, Riana
    et al.
    University of Pretoria, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    Sereda, Barbara
    Agricultural Research Council, South Africa.
    Bouwman, Henk
    Norethwest University, South Africa.
    DDT in Brest Milk: Intake, Risk, Lactation Duration, and Effect of Gender.2012Conference paper (Other academic)
    Abstract [en]

    DDT is annually applied indoors of every dwelling at 64-128 g DDT for malaria vector control. We studied 163 breast milk samples from three DDT-sprayed villages and one reference village in South Africa for the presence and levels of DDT. Mean ?DDT levels in breast milk from the DDT-sprayed villages were 18, 11, and 9.5 mg/kg mf (milk fat) (1.4 mg/kg mf reference village). Primipara mothers from DDT-sprayed villages had significantly higher levels ?DDT in their milk. The highest DDT level in breast milk ever reported from South Africa was detected (5.2 mg/l wm (whole milk) and 140 mg/kg mf). The Maximum Residue Limit (MRL) in milk and Provisional Tolerable Daily Intake (PTDI) for DDT by infants were significantly exceeded in DDT-sprayed villages (maximum exceeded the MRL 310 times, and the PTDI 99 times). The differences between villages indicated differences in exposure and uptake due to application, substrate, and/or culture. The duration of completed lactation was similar for all four villages and DDT exposure had no effect on the duration. There were indications (not significant) that first-born female infants drank milk with higher ?DDT levels than first-born male infants and vice versa for multipara male and female infants. These patterns were evident in each of the DDT-spayed villages, suggesting gender involvement on levels of DDT in breast milk. In view of the high levels recorded, effective measures to reduce DDT exposure are urgently needed, over and above the need to find suitable, safe, and sustainable alternatives.

  • 278.
    Bos, Peter MJ
    et al.
    Centre for substances and Integrated Risk Assessment (SIR).
    Ruijten, M
    Gundert-Remy, U
    Bull, S
    Nielsen, E
    Tissot, S
    Wood, M
    Cassel, G
    Russell, D
    Mahieu, K
    Leffler, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Persson, L
    Zitting, A
    Vincent, J-M
    Human risk assessment of single exposure in chemical incidents: present situation and new and increasing chemical incident scenarios2011Report (Other academic)
    Abstract [en]

    The release of chemicals from their containment, either accidentally or deliberately, is one of the most relevant risk scenarios in Europe. A human health risk assessment is a prerequisite for chemical incident prevention, preparedness and response. European guidance and harmonized Acute Exposure Reference Values (AERVs) are urgently needed for effective human health risk assessment in the context of chemical incidents.At present, no broad European consensus is available on guidance for risk assessment, risk management and risk communication purposes in case of chemical incidents. A review of legislation, existing or currently under revision, suggests that harmonized European guidance is not expected to be developed in the short term. An increasing number of European countries are developing their own procedures to assess the human health risk of chemical incident scenarios. The AERVs thus produced serve different purposes and are not interchangeable. Lack of international harmonization seriously obstructs a consistent response in chemical emergencies with transboundary effects within and beyond the EU, will hamper multinational companies attempting to make consistent risk assessments worldwide and will hinder consistent and transparent assessment, and management and communication of risks by different stakeholders.Emerging chemical incident risk scenarios and risk drivers have been identified. It is recommended to monitor more frequently at an early stage for new trends in chemicals, scenarios and risks from chemical incidents. A need for a specific approach to deal with single exposure to mixtures of chemicals is identified, as well as for specific guidance to adequately protect professional first responders.

  • 279.
    Bosch, Tim
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    De Looze, Michiel
    TNO Work & Employment.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Lyskov, Eugene
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Visser, Bart
    Faculty of Human Movement Sciences, VU Amsterdam.
    van Dieën, Jaap
    Faculty of Human Movement Sciences, VU Amsterdam.
    Fatigue, timing strategy and performance during prolonged repetitive work with interposed breaks2012Conference paper (Refereed)
  • 280.
    Bosch, Tim
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    De Looze, Michiel
    TNO, Work& Employment, the Netherlands.
    Lyskov, Eugene
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Visser, Bart
    Amsterdam School of Health Professions, the Netherlands.
    van Dieën, Jaap
    VU Amsterdam, Faculty of Human Movement Sciences, the Netherlands.
    Temporal strategy and performance during a fatiguing short-cycle repetitive task2012In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 55, p. 863-873Article in journal (Refereed)
    Abstract [en]

    This study investigated temporal changes in movement strategy and performance during fatiguing short-cycle work. Eighteen participants performed six 7-minutes work blocks with repetitive reaching movements at 0.5 Hz, each followed by a 5.5-minute rest break for a total duration of one hour. Electromyography (EMG) was collected continuously from the upper trapezius muscle, the temporal movement strategy and timing errors were obtained on a cycle-to-cycle basis, and perceived fatigue was rated before and after each work block. Clear signs of fatigue according to subjective ratings and EMG manifestations developed within each work block, as well as during the entire hour. For most participants, timing errors gradually increased, as did the waiting time at the near target. Changes in temporal movement strategy were negatively correlated with changes in the level and variability of EMG, suggesting that an adaptive temporal strategy offset the development of unstable motor solutions in this fatiguing, short-cycle work

  • 281. Boschman, J S
    et al.
    Noor, A
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sluiter, J K
    Hagberg, M
    Relationships between work-related factors and musculoskeletal health with current and future work ability among male workers2017In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, no 6, p. 517-526Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The purpose was to increase job-specific knowledge about individual and work-related factors and their relationship with current and future work ability (WA). We studied cross-sectional relationships between mental demands, physical exertion during work, grip strength, musculoskeletal pain in the upper extremities and WA and the relationships between these variables and WA 11 years later.

    METHODS: We used a dataset of a prospective cohort study (1997-2008) among employees of an engineering plant (n = 157). The cohort was surveyed by means of tests and written questions on work demands, musculoskeletal health, WA score (WAS; 0-10), and mental and physical WA. Spearman correlation coefficients and logistic regression analysis were used.

    RESULTS: Among manual workers, we found weak correlations between grip strength and current and future physical WA. We did not find predictors for future poor WA among the manual workers. Among the office workers, we found that musculoskeletal pain was moderately and negatively related to current WAS and physical WA. More handgrip strength related to better future WAS and physical WA. Musculoskeletal pain (OR 1.67 p < 0.01) and lower handgrip strength (OR 0.91 p < 0.05) predicted future poor WA among office workers.

    CONCLUSIONS: Our results showed cross-sectional and longitudinal relationships between musculoskeletal health and work ability depending on occupation. However, the present implies that predicting work ability in the far future based on health surveillance data is rather difficult. Testing the musculoskeletal system (grip strength) and asking workers' about their musculoskeletal health seems relevant when monitoring work ability.

  • 282.
    Boström, Maria
    et al.
    Sahlgrenska akademin, Göteborgs universitet.
    Dellve, Lotta
    Sahlgrenska akademin, Göteborgs universitet.
    Thomée, Sara
    Sahlgrenska akademin, Göteborgs universitet.
    Hagberg, Mats
    Sahlgrenska akademin, Göteborgs universitet.
    Risk factor for decreased performance among young adults2008In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 34, no 2, p. 120-132Article in journal (Refereed)
  • 283.
    Bouwman, Henk
    et al.
    Northwest University, South Africa.
    Bornman, Riana
    University of Pretoria, South Africa.
    van den Berg, Henk
    Wageningen University, The Netherlands.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies. Linköping University, Faculty of Arts and Sciences.
    DDT: Fifty years since silent spring2013In: Late lessons from early warnings: science, precaution, innovation, Copenhagen: European Environment Agency , 2013, , p. 291p. 272-291Chapter in book (Other academic)
    Abstract [en]

    'There was a strange stillness. The birds for example — where had they gone? Many people spoke about them, puzzled and disturbed. The feeding stations in the backyards were deserted. The few birds seen anywhere were moribund: they trembled violently and could not fly. It was a spring without voices ... only silence lay over the fields and woods and marsh.'

    The book Silent Spring by Rachel Carson is mainly about the impacts of chemicals (in particular in particular dichlorodiphenyltrichlorethane also known as DDT) on the environment and human health. Indeed, the close association between humans and birds remains very apt. Representing the only two warm-blooded groups of life on Earth, mammals and birds share the same environments and threats.

    Carson's claim that she lived in 'an era dominated by industry, in which the right to make a dollar at whatever cost is seldom challenged' still resonates strongly with the problems that societies face all over the world. One chapter heading, 'The obligation to endure', derived from the French biologist and philosopher Jean Rostand's famous observation that, 'the obligation to endure gives us the right to know'. United States President John F. Kennedy responded to the challenge posed by Carson by investigating DDT, leading to its complete ban in the US. The ban was followed by a range of institutions and regulations concerned with environmental issues in the US and elsewhere, driven by public demand for knowledge and protection.

    DDT was the primary tool used in the first global malaria eradication programme during the 1950s and 1960s. The insecticide is sprayed on the inner walls and ceilings of houses. Malaria has been successfully eliminated from many regions but remains endemic in large parts of the world. DDT remains one of the 12 insecticides — and the only organochlorine compound — currently recommended by the World Health Organization (WHO), and under the Stockholm Convention on Persistent Organic Pollutants, countries may continue to use DDT. Global annual use of DDT for disease vector control is estimated at more than 5 000 tonnes.

    It is clear that the social conscience awakened by Rachel Carson 50 years ago gave momentum to a groundswell of actions and interventions that are slowly but steadily making inroads at myriad levels. Chapter 17 of her book, 'The other road' reminds the reader of the opportunities that should have been seized much earlier. With more than 10 % of bird species worldwide now threatened in one way or another, it is clear that we missed early warnings or failed to act on them. Will we continue to miss signposts to 'other roads'? Are our obligations to endure met by our rights to know? As Carson said 50 years ago: 'The choice, after all, is ours to make.'

  • 284.
    Bouwman, Henk
    et al.
    Northwest University, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    Bornman, Riana
    University of Pretoria, South Africa.
    The paradox of the effectiveness or IRS insecticides (including DDT) and its impactson human health: What can we fix if it isn’t broken?2012Conference paper (Other academic)
  • 285.
    Bouwman, Henk
    et al.
    North-Wast University, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies. Linköping University, Faculty of Arts and Sciences.
    Sereda, Barbara
    Plant Protection Research Institute, South Africa.
    Bornman, Rianna
    University of Pretoria, South Africa.
    DDT IN BREAST MILK: INTAKE, GENDER, AND DURATION OF LACTATION2011Conference paper (Other academic)
  • 286.
    Bouwman, Henk
    et al.
    Northwest Univerfsity, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    van den Berg, Henk
    Wageningen University, the Netherlands.
    DDT used in malaria control: It is now time for precaution.2011Conference paper (Other academic)
  • 287.
    Bouwman, Henk
    et al.
    Northwest University, South AFrica.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    van den Berg, Henk
    Wageningen University, the Netherlands.
    The paradox of DDT used in malaria control: It is now time for precaution.2012Conference paper (Other academic)
  • 288.
    Bouwman, Henk
    et al.
    Northwest University, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    van den Berg, Henk
    Wageningen University, South Africa.
    Bornman, Riana
    University of Pretoria, South Africa.
    Is precaution the way to manage the paradox of DDT use in malaria control?2012Conference paper (Other academic)
  • 289.
    Bouwman, Henk
    et al.
    North-West University, Potchefstroom, South Africa.
    van den Berg, Henk
    Wageningen University, Wageningen, the Netherlands.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies. Linköping University, Faculty of Arts and Sciences.
    Letter: DDT Paradox: Bouwman et al. Respond2011In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 119, no 10, p. A424-A425Article in journal (Other academic)
    Abstract [en]

    n/a

  • 290.
    Bouwman, Hindrik
    et al.
    North-West University, South Africa.
    Kylin, Henrik
    Linköping University, Department of Thematic Studies, Tema Environmental Change. Linköping University, Faculty of Arts and Sciences.
    Bornman, Riana
    University of PRetoria, South Africa.
    ENVIRONMENTAL AND HUMAN HEALTH CONSEQUENCES OF DDT USED IN SOUTH AFRICAFOR MALARIA CONTROL2016In: Organohalogen Compounds, ISSN 1026-4892, Vol. 78, p. 1015-1017, article id 2.4001Article in journal (Refereed)
  • 291.
    Bouwman, Hindrik
    et al.
    North-West University, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Tema Environmental Change. Linköping University, Faculty of Arts and Sciences.
    Bornman, Riana
    University of Pretoria, South Africa.
    Is Indoor Residual Spraying broken and what should be fixed?2015In: Proceedings of the 7th International Toxicology Symposium in Africa, 2015, p. 2-3Conference paper (Refereed)
    Abstract [en]

    Indoor residual spraying (IRS) has been and is still a very successful method to controlmalaria. We are concerned that not enough research attention is given to improvingIRS and that most funding goes towards modern but seemingly still ineffectualmethods. We believe that there is ample scope for improving IRS, while reducinginsecticide exposure

  • 292.
    Bouwman, Hindrik
    et al.
    North West University, South Africa .
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies. Linköping University, Faculty of Arts and Sciences.
    Sereda, Barbara
    Plant Protect Research Institute, South Africa .
    Bornman, Riana
    University of Pretoria, South Africa .
    High levels of DDT in breast milk: Intake, risk, lactation duration, and involvement of gender2012In: Environmental Pollution, ISSN 0269-7491, E-ISSN 1873-6424, Vol. 170, p. 63-70Article in journal (Refereed)
    Abstract [en]

    We investigated presence and levels of DDT in 163 breast milk samples from four South African villages where, in three of them, malaria is controlled with DDT-sprayed indoors. Mean Sigma DDT levels in breast milk were 18, 11, and 9.5 mg/kg mf (milk fat) from the three DDT-sprayed villages, respectively, including the highest Sigma DDT level ever reported for breast milk from South Africa (140 mg/kg mf). Understanding the causes for these differences would be informative for exposure reduction intervention. The Provisional Tolerable Daily Intake (PTDI) for DDT by infants, and the Maximum Residue Limit (MRL) were significantly exceeded. DDT had no effect on duration of lactation. There were indications (not significant) from DDT-sprayed villages that first-born female infants drink milk with more Sigma DDT than first-born male infants, and vice versa for multipara male and female infants, suggesting gender involvement on levels of DDT in breast milk - requiring further investigation.

  • 293. Bowen, Kathryn J.
    et al.
    Ebi, Kristie L.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Governing the health risks of climate change: towards multi-sector responses2015In: Current Opinion in Environmental Sustainability, ISSN 1877-3435, E-ISSN 1877-3443, Vol. 12, p. 80-85Article in journal (Refereed)
    Abstract [en]

    Climate change will exacerbate current and create new health risks. Because many upstream drivers of these risks arise from outside the sector, multi-sectoral approaches are required for effective adaptation. This paper focuses on showcasing successful stories of collaboration from four relevant arenas - One Health, Disaster Risk Management, the Commission on Social Determinants of Health, and Health in All Policies (HiAP). Common themes from these case studies include first, the importance of systems-based approaches incorporating partnership with all relevant sectors, and second structural supports, including leadership, sufficient resources and responsive governments, are necessary to provide the supporting conditions for collaboration and partnerships.

  • 294. Bozorgmehr, Kayvan
    et al.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Brenner, Hermann
    Razum, Oliver
    Maier, Werner
    Saum, Kai-Uwe
    Holleczek, Bernd
    Miksch, Antje
    Szecsenyi, Joachim
    Analysing horizontal equity in enrolment in Disease Management Programmes for coronary heart disease in Germany 2008-20102015In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 14, article id 28Article in journal (Refereed)
    Abstract [en]

    Background: Disease Management Programmes (DMPs) have been introduced in Germany ten years ago with the aim to improve effectiveness and equity of care, but little is known about the degree to which enrolment in the programme meets the principles of equity in health care. We aimed to analyse horizontal equity in DMP enrolment among patients with coronary heart disease (CHD). Methods: Cross-sectional analysis of horizontal inequities in physician-reported enrolment in the DMP for CHD in a large population-based cohort-study in Germany (2008-2010). We calculated horizontal inequity indices (HII) and their 95% confidence intervals [95% CI] for predicted need-standardised DMP enrolment across two measures of socio-economic status (SES) (educational attainment, regional deprivation) stratified by sex. Need-standardised DMP enrolment was predicted in multi-level logistic regression models. Results: Among N = 1,280 individuals aged 55-84 years and diagnosed with CHD, DMP enrolment rates were 22.2% (women) and 35.0% (men). Education-related inequities in need-standardised DMP enrolment favoured groups with lower education, but HII estimates were not significant. Deprivation-related inequities among women significantly favoured groups with higher SES (HII = 0.086 [0.007; 0.165]. No such deprivation-related inequities were seen among men (HII = 0.014 [-0.048; 0.077]). Deprivation-related inequities across the whole population favoured groups with higher SES (HII estimates not significant). Conclusion: Need-standardised DMP enrolment was fairly equitable across educational levels. Deprivation-related inequities in DMP enrolment favoured women living in less deprived areas relative to those living in areas with higher deprivation. Further research is needed to gain a better understanding of the mechanisms that contribute to deprivation-related horizontal inequities in DMP enrolment among women.

  • 295.
    Bramberg, Elisabeth Björk
    et al.
    Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Nobels Vag 13, S-17177 Stockholm, Sweden..
    Nyman, Teresia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Nobels Vag 13, S-17177 Stockholm, Sweden.;KTH Royal Inst Technol, Sch Technol & Hlth, Ergon Unit, Stockholm, Sweden..
    Kwak, Lydia
    Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Nobels Vag 13, S-17177 Stockholm, Sweden..
    Alipour, Akbar
    Storvretens Primary Hlth Clin, Stockholm, Sweden..
    Bergstrom, Gunnar
    Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Nobels Vag 13, S-17177 Stockholm, Sweden.;Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden..
    Elinder, Liselotte Schafer
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Hermansson, Ulric
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Jensen, Irene
    Karolinska Inst, Inst Environm Med, Unit Intervent & Implementat Res Worker Hlth, Nobels Vag 13, S-17177 Stockholm, Sweden..
    Development of evidence-based practice in occupational health services in Sweden: a 3-year follow-up of attitudes, barriers and facilitators2017In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, no 4, p. 335-348Article in journal (Refereed)
    Abstract [en]

    The Swedish government initiated an investigation of how to secure and develop the competence of the occupational health services. The primary aim of the present study was to investigate whether the development of evidence-based practice (EBP) in the Swedish occupational health services in relation to attitudes, knowledge and use improved during the first 3 years of the government's initiative. The study has a mixed methods design combining questionnaires and interviews with data collection at baseline and at 3-year follow-up. The response rate was 66% at baseline and 63% at follow-up. The results show that practitioners' knowledge of EBP was moderate at baseline and improved at follow-up (p = 0.002; 95% CI 0.01; 0.21). Practitioners experienced lower levels of organizational and managerial support for EBP at follow-up (p < 0.001; 95% CI 0.18; 0.38). The results revealed that managers viewed responsibility for implementing EBP as a matter for individual practitioners rather than as an organizational issue. Occupational health service managers and practitioners are generally positive to EBP. However, the findings emphasize the need to educate managers in how to support EBP at the organizational level by creating an infrastructure for EBP in the OHS.

  • 296.
    Brittebo, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Andersson, Helén
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Rönn, Monika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lind, Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Brandt, Ingvar
    Uppsala University, Disciplinary Domain of Science and Technology, Biology, Department of Organismal Biology, Environmental Toxicology.
    Bioactivation and effects of environmental pollutants in human and rodent blood vessel endothelial cells2012In: Organohalogen compound database (http://www.dioxin20xx.org/ohc_database_search.htm), 2012Conference paper (Refereed)
    Abstract [en]

    Introduction

    Recent epidemiological studies reveal associations between exposure to environmental pollutants and cardiovascular disorders in humans. Elevated serum concentrations of polychlorinated biphenyls (PCBs) have for instance been associated with cardiovascular risk factors such as hypertension (1-3). Exposure to the carbonate plastic monomer bisphenol A (BPA) has been associated with an increased incidence of cardiovascular disease and atherogenic changes in the vascular wall (4-6). The contention that the human cardiovascular system is a sensitive target for toxic chemicals gain support from our earlier and recent experimental studies in rodents, birds and fish, as well as in cultured human primary endothelial cells. It is also compatible with earlier observations that certain polycyclic aromatic hydrocarbons (PAHs) are environmental carcinogens that may also contribute to atherosclerosis in mice and birds (7,8).

    In this presentation we will briefly discuss effects of Ah receptor (AhR) agonists (e.g. the coplanar PCB126 or BNF, ß-naphthoflavone) on the expression of cytochrome P450 (CYP)1 enzymes in various endothelia in rodents in vivo or ex vivo, as well as in cultured human umbilical vein endothelial cells (HUVEC). The CYP1-dependent bioactivation and irreversible binding of prototype polyaromatic hydrocarbons (PAH) and heterocyclic amines such as benzo(a)pyrene (BaP), 7,12-dimethyl- benz(a)anthracene (DMBA) and 3-amino-1,4-dimethyl-5H-pyrido- [4,3-b]indole (Trp-P1) in these endothelia will be reviewed. We will also report how PCB126 affects vasoactive factors in HUVEC, and how these effects are modulated by physiological 17ß-oestradiol concentrations. Some effects of PCB126, 1-nitropyrene (1-NP) and bisphenol A (BPA) on biomarkers for endothelial dysfunction, cell stress and DNA damage in HUVEC will finally be presented.

    Material and methods

    Human umbilical vein endothelial cells (HUVEC) were purchased from Science Cell Research laboratories, Carlsbad, CA. C57Bl mice and Wistar or Sprague Dawley rats were purchased from various suppliers. All animal experiments were approved by the Local Ethical Committee for Research on Animals in Uppsala and the studies followed the guidelines laid down by the Swedish and European Union legislation on animal experimentation. Rodents, tissue-slices and cultured cells were treated with model chemicals as previously described. Tape section and light microscopy autoradiographic imaging using 3H-labelled BaP, DMBA and Trp-P-1 and immunohistochemistry was performed as previously described (9-19). Precision-cut tissue slices for in vitro autoradiography were prepared as described in (14) and the slices were incubated with various 3H-labelled chemicals. HUVEC were exposed to various compounds and the detection of biomarkers of endothelial dysfunction, DNA damage were performed as described (20-22). Finally, female Fischer rats were exposed to BPA (0.025, 0.25 and 2.5 mg/l) and fructose (50 g/l) in the drinking water from 5 to 15 weeks of age to mimic human exposure (unpublished data).

    Results and discussion

    Co-localization of CYP1A1 expression and BaP, DMBA and Trp-P-1 adduct formation in endothelial linings As demonstrated by immunohistochemistry, a high CYP1A immunoreactivity occurred in capillaries of the heart, skeletal muscle, uterus and in blood-brain interfaces such as the leptomeninges and plexus choroideus, whereas no expression was observed for instance in cerebral capillary endothelial cells of mice treated with AhR agonists (9-11). No, or very low constitutive immunoreactivities were observed in these endothelia in vehicle-treated animals. No basal or induced CYP1B1 expression was observed in endothelial cells, while a weak CYP1B1 immunostaining was detected in the muscle layer of small arteries. It should be noted that in subcellular preparations of whole organs, e.g. heart and brain, the CYP1A1 in endothelial cells is diluted due to cells that do not express high levels of CYP1A1, for examples myocytes or neurons, in excess. A cell-specific metabolism in endothelial cells may therefore remain undetected due to the presence of metabolically inactive cells. In order to detect minor sites of bioactivation such as endothelial linings we employed light microscopic autoradiographic imaging to examine the bioactivation and subsequent irreversible binding of the radiolabelled prototype toxicants in tissues of animals pretreated with AhR-agonists. As determined by light microscopic autoradiography of AhR-agonist-treated mice exposed to 3H-labelled BaP, DMBA or Trp-P-1 and birds exposed to 3H-Trp-P-1 a significant accumulation of non-extractable radioactivity occurred in endothelial linings (9-18). The bound radioactivity occurred in the nuclei and the perinuclear cytoplasm, suggesting that the autoradiograms depict both DNA- and protein-bound adducts. Since the binding sites of 3H-labelled BaP, DMBA or Trp-P-1 corresponded with the sites of CYP1A1 induction, we concluded that rodents express a constitutively low but highly inducible and functional CYP1A1 in endothelial cells. The binding of reactive metabolites in endothelial cells exceeded the binding in all other cell types in AhR-agonist treated mice and was abolished by pretreatment with the CYP1A1 inhibitor ellipticine, supporting a CYP1A1-catalysed metabolic activation in situ to a reactive species (9, 10,12). These findings imply that there is a preferential CYP1A1-catalysed formation of reactive metabolites from all three carcinogens in endothelial cells expressing high CYP1A1 levels. Interestingly, however, carcinogenesis in endothelial cells is a relative rare finding, suggesting that degenerative lesions and cell death may be more prevalent responses to metabolism-activated carcinogens/mutagens in these cells. Experiments with 3H-DMBA and 3H-Trp-P-1 in HUVEC confirmed that AhR-agonists induced an increased bioactivation, suggesting that also human endothelial cells should be targets for toxicity of reactive intermediates formed from CYP1A1- activated carcinogens/mutagens (17-18). This conclusion is supported by immunohistochemical studies on the heavily vascularized human endometrium demonstrating an expression of CYP1A1 and CYP1B1 protein in and around human endometrial blood vessels, although a large interindividual

    variation was observed (19). None of the endometrial biopsy samples displayed vascular expression of CYP2A6, CYP2B6, CYP2C8/2C9/2C19, CYP2D6, or CYP3A4/5 protein.

    Effects of PCB 126, 1-NP, and BPA on biomarkers of endothelial dysfunction and cell stress in endothelial cells In vitro studies demonstrated that PCB126 increased the levels of vasoconstriction factors and decreased the levels of vasodilating factors in cultured HUVEC in a fashion that is characteristic for endothelial dysfunction related to human hypertension. The study showed that the co-planar PCB126 induced expression of the endothelium-derived vasoconstriction factor COX-2 and stimulated formation of the vasoconstrictor prostaglandin PGF2 via the AhR in HUVEC (20). COX-2 is known to play a role in hypertension by catalysing the formation of vasoconstriction prostaglandins and by stimulating reactive oxygen species (ROS) production. Further studies demonstrated that PCB126 increased the production of the vasoconstriction prostaglandin PGF2 and ROS in HUVEC. The relationship between increased ROS production and human hypertension is well established, ROS promotes vasoconstriction by stimulating the production of vasoconstriction prostaglandins and by reducing bioavailability of the vasorelaxing factor NO. Indeed, exposure to PCB126 slightly reduced the production of NO in HUVEC. Furthermore, the PCB126-induced mRNA expressions of CYP1A1, CYP1B1 and COX-2 in HUVEC were enhanced in the presence of physiological levels of 17- estradiol. This suggests that increased levels of oestrogen stimulate AhR-dependent transcription of genes previously associated with endothelial dysfunction and hypertension.

    In another study we have examined the effects of a nitrated PAH, 1-nitropyrene, that is abundant in diesel exhausts (21). The results revealed that 1-NP induced DNA damage, increased levels of ROS and increased protein expression of the endoplasmic reticulum stress chaperone GRP78 in cultured HUVEC. Induction of CYP1A1 by PCB126 as well as inhibition of nitroreductive metabolism by dicoumarol attenuated the induction of DNA damage, intracellular ROS levels and GRP78 expression. This suggests that the effects of 1-NP on HUVEC were mediated by metabolites mainly formed at nitroreduction and not by CYP1-dependent bioactivation to reactive intermediates.

    Recent in vitro studies demonstrated that bisphenol A increased the mRNA expression of genes that regulate vasoconstriction and angiogenesis in HUVEC (eNOS, VEGF, VEGFR2, connexin 43 and ACE1) and in human cardiomyocytes (eNOS and ACE1) (22). The results also showed that BPA increased the expression of P-eNOS(ser1177) and the production of NO in HUVEC. NO is the main effector molecule in angiogenesis downstream of VEGF. Based on the findings that BPA increase the expression of proangiogenic factors we investigated whether BPA could stimulate in vitro angiogenesis in HUVEC using the endothelial tube formation assay. The results demonstrated that BPA increased HUVEC tube formation suggesting that BPA can act directly on the endothelium and stimulate angiogenesis. Long-term exposure in rats revealed that environmentally relevant levels of BPA, increased the cardiac mRNA expression of genes that regulate vasoconstriction and angiogenesis. Ten weeks exposure of rats from preadolescence to adulthood to BPA in the drinking water increased the

    expression of eNOS, VEGF, VEGFR2 and ACE1 in the heart. Taken together, the genes that were upregulated in rat cardiac tissues in vivo were also upregulated in human endothelial cells and cardiomyocytes in vitro. The heart is a heavily vascularized tissue that consists mainly of cardiac endothelial cells and cardiomyocytes and although cardiomyocytes dominate the volume of the myocardium the number of endothelial cells exceeds the number of cardiomyocytes by approximately three to one. Thus, the effects of BPA on eNOS VEGF, VEGFR2 and ACE1 mRNA expression in rat cardiac tissues are most likely to be related to an effect of BPA on endothelial cells but may also involve cardiomyocytes.

    We conclude that endothelial cells may be targets for bioactivation and toxicity of environmental pollutants. The immunohistochemical and autoradiographic data demonstrated a differential expression of CYP1 enzymes and metabolic activation of pollutants in various endothelial linings suggesting that some but not all endothelial linings may be targets for xenobiotics metabolised by AhR-regulated enzymes. Studies on the effects of PCB126, 1-nitropyrene and BPA in cultured human primary endothelial cells demonstrated up-regulation of various biomarkers for endothelial dysfunction and cell stress suggesting that the human endothelium may be a sensitive target for these pollutants. The bioactivation and effects of environmental pollutants in endothelial cells should be further studied in order to unravel the role of these chemicals in human cardiovascular disease.

  • 297. Brooks, Steven J.
    et al.
    Harman, Christopher
    Grung, Merete
    Farmen, Eivind
    Ruus, Anders
    Vingen, Sjur
    Godal, Brit F.
    Barsiene, Janina
    Andreikenaite, Laura
    Skarpheoinsdottir, Halldora
    Stockholm University, Faculty of Science, Department of Applied Environmental Science (ITM).
    Liewenborg, Birgitta
    Stockholm University, Faculty of Science, Department of Applied Environmental Science (ITM).
    Sundt, Rolf C.
    Water Column Monitoring of the Biological Effects of Produced Water from the Ekofisk Offshore Oil Installation from 2006 to 20092011In: Journal of Toxicology and Environmental Health, ISSN 1528-7394, E-ISSN 1087-2620, Vol. 74, no 7-9, p. 582-604Article in journal (Refereed)
    Abstract [en]

    The Norwegian water column monitoring program investigates the biological effects of offshore oil and gas activities in Norwegian waters. In three separate surveys in 2006, 2008, and 2009, bioaccumulation and biomarker responses were measured in mussels (Mytilus edulis) and Atlantic cod (Gadus morhua) held in cages at known distances from the produced water (PW) discharge at the Ekofisk oil field. Identical monitoring studies performed in all three years have allowed the biological effects and bioaccumulation data to be compared, and in addition, enabled the potential environmental benefits of a PW treatment system (CTour), implemented in 2008, to be evaluated. The results of the 2009 survey showed that caged animals were exposed to low levels of PW components, with highest tissue concentrations in mussels located closest to the PW discharge. Mussels located approximately 1-2 km away demonstrated only background concentrations of target compounds. Concentrations of polycyclic aromatic hydrocarbons (PAH) and alkyl phenol (AP) metabolites in the bile of caged cod were elevated at stations 200-250 m from the discharge. There was also a signal of exposure relative to discharge for the biomarkers CYP1A in fish and micronuclei in mussels. All other fish and mussel biomarkers showed no significant exposure effects in 2009. The mussel bioaccumulation data in 2009 indicated a lower exposure to the PW effluent than seen previously in 2008 and 2006, resulting in an associated general improvement in the health of the caged mussels. This was due to the reduction in overall discharge of PW components (measured as oil in water) into the area in 2009 compared to previous years as a result of the improved PW treatment system.

  • 298. Brown, M.
    et al.
    Tucker, P.
    Rapport, F.
    Hutchings, H.
    Dahlgren, Anna
    Department of Shipping and Marine Technology, Chalmers University.
    Davies, G.
    Ebden, P.
    The impact of shift patterns on junior doctors' perceptions of fatigue, training, work/life balance and the role of social support2010In: Quality and Safety in Healthcare, ISSN 1475-3898, E-ISSN 1470-7934, Vol. 19, no 6, p. e36-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms.

    METHOD: Interviews and focus groups were used to explore perceptions among junior doctors and hospital managers regarding the impact of the European Working Time Directive on patient care and doctors' well-being.

    RESULTS: Four main themes were identified. Under "Doctors shift rotas", doctors deliberated the merits and demerits of working seven nights in row. They also discussed the impact on fatigue of long sequences of day shifts. "Education and training" focused on concerns about reduced on-the-job learning opportunities under the new working time arrangements and also about the difficulties of finding time and energy to study. "Work/life balance" reflected the conflict between the positive aspects of working on-call or at night and the impact on life outside work. "Social support structures" focused on the role of morale and team spirit. Good support structures in the work place counteracted and compensated for the effects of negative role stressors, and arduous and unsocial work schedules.

    CONCLUSIONS: The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors.

  • 299. Bruckner, Tim .A.
    et al.
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Vågerö, Denny
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Cold ambient temperature in utero and birth outcomes in Uppsala, Sweden, 1915 to 19292014In: Annals of Epidemiology, ISSN 1047-2797, E-ISSN 1873-2585, Vol. 24, no 2, p. 116-121Article in journal (Refereed)
    Abstract [en]

    Purpose

    Although the literature reports adverse birth outcomes following ambient heat, less work focuses on cold. We, moreover, know of no studies of cold that examine stillbirth. We tested the relation between cold ambient temperature during pregnancy in Sweden and four outcomes: stillbirth, preterm, birth weight for gestational age, and birth length. We examined births from 1915 to 1929 in Uppsala, Sweden, which—unlike most societies today—experienced substandard indoor-heating and fewer amenities to provide shelter from cold.

    Methods

    We retrieved data on almost 14,000 deliveries from the Uppsala Birth Cohort Study. We linked a validated, daily ambient temperature series to all pregnancies and applied Cox proportional hazards (stillbirth and preterm) and linear regression models (birth weight and length). We tested for nonlinearity using quadratic splines.

    Results

    The risk of stillbirth rose as ambient temperature during pregnancy fell (hazard ratio for a 1°C decrease in temperature, 1.08; 95% confidence interval, 1.00 to 1.17). Cold extremes adversely affected preterm and birth length, whereas warm extremes increased preterm risk. We observed no relation between cold and birth weight for gestational age.

    Conclusion

    In historical Sweden, cold temperatures during pregnancy increased stillbirth and preterm risk and reduced birth length among live births.

  • 300. Brunekreef, Bert
    et al.
    Künzli, Nino
    Pekkanen, Juha
    Annesi-Maesano, Isabella
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sigsgaard, Torben
    Keuken, Menno
    Forastiere, Francesco
    Barry, Maeve
    Querol, Xavier
    Harrison, Roy M
    Clean air in Europe: beyond the horizon?2015In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 45, no 1, p. 7-10Article in journal (Other academic)
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