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Persson, Bodil
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Westberg, H., Elihn, K., Andersson, E., Persson, B., Andersson, L., Bryngelsson, I.-L., . . . Sjogren, B. (2016). Inflammatory markers and exposure to airborne particles among workers in a Swedish pulp and paper mill. International Archives of Occupational and Environmental Health, 89(5), 813-822
Open this publication in new window or tab >>Inflammatory markers and exposure to airborne particles among workers in a Swedish pulp and paper mill
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2016 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 5, p. 813-822Article in journal (Refereed) Published
Abstract [en]

To study the relationship between exposure to airborne particles in a pulp and paper mill and markers of inflammation and coagulation in blood. Personal sampling of inhalable dust was performed for 72 subjects working in a Swedish pulp and paper mill. Stationary measurements were used to study concentrations of total dust, respirable dust, PM10 and PM2.5, the particle surface area and the particle number concentrations. Markers of inflammation, interleukins (IL-1b, IL-6, IL-8, and IL-10), C-reactive protein (CRP), serum amyloid A (SAA), and fibrinogen and markers of coagulation factor VIII, von Willebrand, plasminogen activator inhibitor, and D-dimer were measured in plasma or serum. Sampling was performed on the last day of the work free period of 5 days, before and after the shift the first day of work and after the shifts the second and third day. In a mixed model analysis, the relationship between particulate exposures and inflammatory markers was determined. Sex, age, smoking, and BMI were included as covariates. The average 8-h time-weighted average (TWA) air concentration levels of inhalable dust were 0.30 mg/m(3), range 0.005-3.3 mg/m(3). The proxies for average 8-h TWAs of respirable dust were 0.045 mg/m(3). Significant and consistent positive relations were found between several exposure metrics (PM 10, total and inhalable dust) and CRP, SAA and fibrinogen taken post-shift, suggesting a dose-effect relationship. This study supports a relationship between occupational particle exposure and established inflammatory markers, which may indicate an increased risk of cardiovascular disease.

Place, publisher, year, edition, pages
SPRINGER, 2016
Keywords
C-reactive protein (CRP); Fibrinogen; Interleukins (IL-1b, IL-6 IL-8 and IL-10); PM10; PM2.5; Respirable dust; Serum amyloid A (SAA)
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:liu:diva-129138 (URN)10.1007/s00420-016-1119-5 (DOI)000376408900010 ()26875192 (PubMedID)
Note

Funding Agencies|Swedish Research Council for Health, Working Life and Welfare [2006-0152]

Available from: 2016-06-13 Created: 2016-06-13 Last updated: 2018-01-10
Andersson, E., Westberg, H., Bryngelsson, I.-L., Magnuson, A. & Persson, B. (2013). Cancer incidence among Swedish pulp and paper mill workers: a cohort study of sulphate and sulphite mills. International Archives of Occupational and Environmental Health, 86(5), 529-540
Open this publication in new window or tab >>Cancer incidence among Swedish pulp and paper mill workers: a cohort study of sulphate and sulphite mills
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2013 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 5, p. 529-540Article in journal (Refereed) Published
Abstract [en]

Associations between various malignancies and work in the pulp and paper industry have been reported but mostly in analyses of mortality rather than incidence. We aimed to study cancer incidence by main mill pulping process, department and gender in a Swedish cohort of pulp and paper mill workers. The cohort (18,113 males and 2,292 females, enrolled from 1939 to 1999 with greater than 1 year of employment) was followed up for cancer incidence from 1958 to 2001. Information on the workers department and employment was obtained from the mills personnel files, and standardized incidence ratios (SIRs) were calculated using the Swedish population as reference. Overall cancer incidence, in total 2,488 cases, was not increased by work in any department. However, risks of pleural mesothelioma were increased among males employed in sulphate pulping (SIR, 8.38; 95 % CI, 3.37-17) and maintenance (SIR, 6.35; 95 % CI, 3.47-11), with no corresponding increase of lung cancer. Testicular cancer risks were increased among males employed in sulphate pulping (SIR, 4.14; 95 % CI, 1.99-7.61) and sulphite pulping (SIR, 2.59; 95 % CI, 0.95-5.64). Female paper production workers showed increased risk of skin tumours other than malignant melanoma (SIR, 2.92; 95 % CI, 1.18-6.02). Incidence of pleural mesothelioma was increased in the cohort, showing that asbestos exposure still has severe health consequences, and highlighting the exigency of strict asbestos regulations and elimination. Testicular cancer was increased among pulping department workers. Shift work and endocrine disruptors could be of interest in this context.

Place, publisher, year, edition, pages
Springer Verlag (Germany), 2013
Keywords
Pleural mesothelioma; Skin tumours; Sulphate pulping; Sulphite pulping; Testicular cancer
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-96182 (URN)10.1007/s00420-012-0785-1 (DOI)000320394300004 ()
Available from: 2013-08-14 Created: 2013-08-14 Last updated: 2017-12-06
Tondel, M., Murgia, N., Persson, B., Lindh, J., Vrethem, M. & Fredrikson, M. (2011). 2,5-Hexanedione in the General Population: Environmental Exposure or Endogenous Production? in EPIDEMIOLOGY, vol 22, issue 1, pp S34-S35. In: EPIDEMIOLOGY (pp. S34-S35). Williams and Wilkins, 22(1)
Open this publication in new window or tab >>2,5-Hexanedione in the General Population: Environmental Exposure or Endogenous Production? in EPIDEMIOLOGY, vol 22, issue 1, pp S34-S35
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2011 (English)In: EPIDEMIOLOGY, Williams and Wilkins , 2011, Vol. 22, no 1, p. S34-S35Conference paper, Published paper (Refereed)
Abstract [en]

n/a

Place, publisher, year, edition, pages
Williams and Wilkins, 2011
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-65950 (URN)000285400800072 ()
Available from: 2011-02-28 Created: 2011-02-28 Last updated: 2011-02-28
Lindh, J., Tondel, M., Persson, B. & Vrethem, M. (2011). Health-related quality of life in patients with cryptogenic polyneuropathy compared with the general population. DISABILITY AND REHABILITATION, 33(7), 617-623
Open this publication in new window or tab >>Health-related quality of life in patients with cryptogenic polyneuropathy compared with the general population
2011 (English)In: DISABILITY AND REHABILITATION, ISSN 0963-8288, Vol. 33, no 7, p. 617-623Article in journal (Refereed) Published
Abstract [en]

Purpose. To evaluate the quality of life (QOL) in patients with cryptogenic polyneuropathy. Method. Two validated instruments (SF-36 and EQ-5D) were sent to 86 patients with a 72% response rate (44 men, 18 women). As reference, 2721 individuals (1292 men, 1429 women; 59% response rate) from the general population responded to the same QOL instruments. Results. Compared to the general population, QOL was significantly more affected in patients with polyneuropathy concerning motor functions, with 42% of the patients reporting problems with walking, 7% having difficulties with washing and dressing, and 31% having problems with usual activities (work, study, household work, and family or leisure activities). The EQ-5D results showed that 85% of the patients were suffering from pain compared to 56% of the general population. Mental health was preserved among patients with polyneuropathy. Mobility was declining with increasing age in patients, but was not affected by disease duration. Conclusions. Our study showed that patients with cryptogenic polyneuropathy have a lower QOL compared to the general population, although mental health scores did not differ between the groups. This information may be helpful when explaining the disease and its impact on newly diagnosed patients.

Place, publisher, year, edition, pages
Informa Healthcare, 2011
Keywords
Activities of daily living, EuroQol, polyneuropathy, neurological disease, neuropathy
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-67316 (URN)10.3109/09638288.2010.505996 (DOI)000287451200008 ()
Available from: 2011-04-08 Created: 2011-04-08 Last updated: 2011-10-10
Lindh, J., Söderkvist, P., Fredrikson, M., Hosseininia, S., Tondel, M., Persson, B. & Vrethem, M. (2011). Polymorphisms of GSTT1, GSTM1 and EPHX genotypes in patients with cryptogenic polyneuropathy: a case control study. Brain and Behavior, 1(2), 135-141
Open this publication in new window or tab >>Polymorphisms of GSTT1, GSTM1 and EPHX genotypes in patients with cryptogenic polyneuropathy: a case control study
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2011 (English)In: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 1, no 2, p. 135-141Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to analyze whether polymorphisms for the null alleles of Glutathione S-Transferase Mu-1 (GSTM1) and Theta-1 (GSTT1) and a low activity genetic variation of epoxide hydrolase exon three (EPHX*3) affect the risk of developing polyneuropathy. The enzymes of these genes are important in the metabolism of toxic compounds. 79 patients with cryptogenic polyneuropathy (equivalent to chronic idiopathic axonal neuropathy) and 398 controls were tested for the genetic polymorphism. Medical records were reviewed to collect data regarding clinical findings at diagnosis, and exposure data was collected via questionnaires. The odds ratios (OR) for the null forms of GSTM1 and GSTT1 and the normal activity YY form of EPHX*3 were close to one except GSTT1, which reached 1.86. The highest risk of polyneuropathy was found in smokers with GSTT1 null, who had a 3.7 times increased risk. Interactions between genes were analyzed and confirmed the increased odds ratio for GSTT1, which was strongest if the patients had the low activity HH form of EPHX*3 (OR 2.37). Our hypothesis is that the GSTT1 null polymorphism may be related to an impaired metabolism of toxic substances that could lead to nerve damage in the peripheral nervous system.

Place, publisher, year, edition, pages
Hoboken, New Jersey, USA: John Wiley & Sons, Inc, 2011
Keywords
Polyneuropathy
National Category
Neurology
Identifiers
urn:nbn:se:liu:diva-70979 (URN)10.1002/brb3.26 (DOI)000209173700009 ()
Projects
kryptogen polyneuropati
Available from: 2011-10-03 Created: 2011-09-23 Last updated: 2017-12-08Bibliographically approved
Andersson, E., Persson, B., Bryngelsson, I.-L., Magnuson, A. & Westberg, H. (2010). Cancer mortality in a Swedish cohort of pulp and paper mill workers. INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH, 83(2), 123-132
Open this publication in new window or tab >>Cancer mortality in a Swedish cohort of pulp and paper mill workers
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2010 (English)In: INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH, ISSN 0340-0131, Vol. 83, no 2, p. 123-132Article in journal (Refereed) Published
Abstract [en]

To study cancer mortality among Swedish pulp and paper mill workers by main mill pulping process and department, and to present the Swedish part of an international exposure measurements database. A cohort of 18,163 male and 2,290 female workers at four sulfate and four sulfite mills, enrolled from 1939 to 1999, was followed up for mortality during 1952-2001. Standardized mortality ratios (SMRs) relative to the general Swedish population were calculated. There were 1,340 malignant cases out of 5,898 deaths. Total cancer mortality was not increased in either sulfate or sulfite mill workers, or by gender. Lung cancer mortality was increased among female workers (SMR 1.70, 95% CI 1.04-2.63), especially in paper production, but not among male workers (SMR 0.91, 95% CI 0.79-1.04). Exposure to wood dust and sulfur dioxide frequently exceeded occupational exposure limits. Female paper production workers had an increased mortality from lung cancer.

Keywords
Exposure database, Lung cancer, Sulfate pulping, Sulfite pulping
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-53687 (URN)10.1007/s00420-009-0446-1 (DOI)
Available from: 2010-02-01 Created: 2010-02-01 Last updated: 2010-02-01
Tondel, M., Lindgren, P., Garvin, P. & Persson, B. (2008). Parish classification or dwelling coordinate for exposure assessment in environmental epidemiology: A comparative study using Geographical information System. Science of the Total Environment, 405(1-3), 324-329
Open this publication in new window or tab >>Parish classification or dwelling coordinate for exposure assessment in environmental epidemiology: A comparative study using Geographical information System
2008 (English)In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 405, no 1-3, p. 324-329Article in journal (Refereed) Published
Abstract [en]

Background: Two previous epidemiological studies on the incidence of total malignancies in Sweden after the Chernobyl accident have shown consistently increased risks. The first study used an analogue map on (CS)-C-137 from 1986 to classify individuals in terms of the parish they lived in. In the second study, dwelling coordinates were matched to a digital map from the year 2000 to assess the individual exposure. To establish the accuracy of the exposure assessment using the larger unit of parish, instead of coordinates, we decided to compare the methods.

Methods: On the analogue map eleven isolines on the deposition of Cs-137 (kBq/m(2)) were used to classify all individuals in each of the 450 parishes. Using the digital map, by contrast, each dwelling with its inhabitants could be matched to Cs-137 deposition at a coordinate level. A population-weighted average of Cs-137 deposition was calculated for each parish. In total, 1,126,960 individuals and 450 parishes were included and analysed into six different exposure categories.

Results: Using the new parish exposure index, 111 out of the 450 parishes were reclassified as a result of the increased resolution of the digital map (86 parishes) or unequal distribution of the population compared with the deposition (25 parishes). Seventy-five per cent of the parishes remained in the same exposure category as on the analogue map.

Conclusion: Using dwelling coordinates for exposure assessment may not always be superior to parish classification. Nor is it always a cost-effective way of estimating the exposure, especially if the exposure in a parish is relatively homogenous or if parishes can be merged into broader categories with little intra-parish difference.

Keywords
Analysis, Caesium-137, Chernobyl, Disease, GIS, Health, Malignancies, Method, Spatial
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16141 (URN)10.1016/j.scitotenv.2008.07.019 (DOI)
Available from: 2009-01-08 Created: 2009-01-07 Last updated: 2017-12-14
Hellström, L., Persson, B., Brudin, L., Petersson Grawé, K., Öborn, I. & Järup, L. (2007). Cadmium exposure pathways in a population living near a battery plant. Science of the Total Environment, 373( 2-3), 447-455
Open this publication in new window or tab >>Cadmium exposure pathways in a population living near a battery plant
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2007 (English)In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 373, no 2-3, p. 447-455Article in journal (Refereed) Published
Abstract [en]

Objectives: The objectives of the present study were to assess the relative impact of different pathways of environmental cadmium (Cd) exposure and to evaluate the contribution from locally produced vegetables and root crops to the total dietary intake of Cd. Methods: Cadmium in urine was determined for 492 individuals living near a closed down battery factory in Sweden. For each individual we created an environmental exposure-index based on Cd emissions to ambient air and number of years living at various distances from the plant. This information as well as dietary data were collected via questionnaires. Samples of soil, carrots and/or potatoes were collected from 37 gardens and analysed for Cd concentration. Results: Eating homegrown vegetables/potatoes, environmental Cd-exposure-index, female gender, age above 30 years and smoking more than one pack of cigarettes daily for at least 10 years were found to be significantly associated with increased urine concentrations of Cd (UCd > 1.0 nmol/mmol creatinine). We found a statistically significant relation between Cd in urine and environmental Cd-exposure-index in persons eating homegrown vegetables/potatoes regularly. Cd concentrations in homegrown carrots, potatoes and in garden soil were highest in the area closest to the factory. Daily consumption of potatoes and vegetables cultivated in the vicinity of the closed battery factory was estimated to increase Cd intake by 18-38%. Conclusion: The present study shows that consumption of locally grown vegetables and root crops was an important exposure pathway, in subjects living near a nickel-cadmium battery plant, whereas direct exposure via ambient air was less important. © 2006 Elsevier B.V. All rights reserved.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-39894 (URN)10.1016/j.scitotenv.2006.11.028 (DOI)51633 (Local ID)51633 (Archive number)51633 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Persson, B., Magnusson, A., Westberg, H., Andersson, E., Torén, K., Wingren, G. & Axelson, O. (2007). Cardiovascular mortality among Swedish pulp and paper mill workers. American Journal of Industrial Medicine, 50(3), 221-226
Open this publication in new window or tab >>Cardiovascular mortality among Swedish pulp and paper mill workers
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2007 (English)In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 50, no 3, p. 221-226Article in journal (Refereed) Published
Abstract [en]

Background: Malignant diseases but also cardiovascular and respiratory disorders and diabetes mellitus have been associated with work in pulp and paper production. The present cohort focuses on cardiovascular mortality in relation to various exposures in this industry. Methods: The cohort, followed-up for mortality, includes 7,107 workers, 6,350 men and 757 women, from three major old mills in the middle of Sweden. Results: Instead of a healthy-worker effect, a slightly increased risk for death in diseases of the circulatory system was found for male workers. Notably, work with sulfate digestion, steam and power generation and maintenance was associated with significantly increased risks. Cerebrovascular diseases showed non-significantly increased risks for maintenance and paper and paperboard production and manufacture. Conclusions: The differences in risk among various parts of the production are striking although it is hard to pinpoint any specific exposures. Dust and small particles along with sulfur compounds might be suspected. © 2007 Wiley-Liss, Inc.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-39217 (URN)10.1002/ajim.20449 (DOI)47346 (Local ID)47346 (Archive number)47346 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Andersson, E., Persson, B., Bryngelsson, I.-L., Magnuson, A., Toren, K., Wingren, G. & Westberg, H. (2007). Cohort mortality study of Swedish pulp and paper mill workers - nonmalignant diseases. Scandinavian Journal of Work, Environment and Health, 33(6), 470-478
Open this publication in new window or tab >>Cohort mortality study of Swedish pulp and paper mill workers - nonmalignant diseases
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2007 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 33, no 6, p. 470-478Article in journal (Refereed) Published
Abstract [en]

Objectives The aim of this study was to determine mortality among pulp and paper mill workers according to the main mill pulping process, department, and gender, particular reference being given to diseases of the circulatory and respiratory systems. Methods The cohort of 18 163 men and 2291 women employed between 1939 and 1999 and with >1 year of employment was followed for mortality from 1952 to 2001 (acute myocardial infarction from 1969). Standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were estimated by comparing the observed number of deaths with the expected number for the entire Swedish population. Exposure was assessed from personnel files in the mills. Data from an exposure measurement database are also presented. Results There were 5898 deaths in the cohort. Total mortality had an SMR of 1.02 (95% CI 0.98-1.06) for the men in the sulfate mills and an SMR of 0.93 (95% CI 0.90-0.97) for the men in the sulfite mills. Mortality from acute myocardial infarction was increased among the men in both the sulfate and sulfite mills [SMR 1.22 (95% CI 1.12-1.32) and SMR 1.11 (95% CI 1.02-1.21), respectively] and by department in sulfate pulping (SMR 1.29, 95% CI 1.07-1.54), paper production (SMR 1.26, 95% CI 1.06-1.49), and maintenance (SMR 1.16, 95% CI 1.02-1.30). Mortality from cerebrovascular disease, diabetes mellitus, and nonmalignant respiratory diseases was not increased. Conclusions Death from acute myocardial infarction, but not cerebrovascular diseases, was increased in this cohort and was probably related to a combination of different occupational exposures (eg, dust, sulfur compounds, shift work, and noise).

Keywords
cardiovascular, diabetes mellitus, dust, exposure database, myocardial infarction, rheumatoid arthritis, shift work, sulfate pulping, sulfite pulping
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-47980 (URN)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
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