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An ecological study of industry in a high-risk region of multiple sclerosis
Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Neurology.
Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Department of Medical Specialist.
Epidemiologist, Greishiem.
2011 (English)In: Journal of the Neurological Sciences, ISSN 0022-510X, E-ISSN 1878-5883, Vol. 311, no 1-2, 50-57 p.Article in journal (Refereed) Published
Abstract [en]

The county of Varmland, Sweden, has shown a high frequency of multiple sclerosis in several investigations. It has been presented in three studies: a period prevalence study in 1925-1934, a mortality study during 1952-1992 and a prevalence investigation in 2002. The aim of this study was to investigate the pattern of industry in this high-risk area for multiple sclerosis. The three investigations were correlated with industry in 1913 and in the 1950s, all analyzed by the Kruskall-Wallis test. Select industries from wood-pulp, paper and iron/mechanical sectors were tested also in whole Sweden. The Spearman rank correlation was used for these data and forestry data in Varmland. In Varmland, industrial data from 1913 revealed that large sawmills were associated with the period prevalence in 1925-1934 and there was a possible correlation with the prevalence for 2002. Wood-pulp factories showed a possible association with the prevalence 1925-1934 and the mortality 1952-1992. Some industries in the 1950s were correlated with the prevalence 2002. Wood and paper industries in Sweden 1913 showed an association with the MS mortality 1952-1992. In summary, data on MS prevalence in Varmland and mortality both in Varmland and all Sweden from the past 100 years suggest an association with wood-related industries in 1913 and in the 1950s, whereas no consistent association was found for other industries.

Place, publisher, year, edition, pages
Elsevier , 2011. Vol. 311, no 1-2, 50-57 p.
Keyword [en]
Multiple sclerosis; Prevalence; Mortality; Environmental; Ecological; Pollutions; Industry
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-73732DOI: 10.1016/j.jns.2011.09.005ISI: 000297893400009OAI: oai:DiVA.org:liu-73732DiVA: diva2:476411
Available from: 2012-01-12 Created: 2012-01-12 Last updated: 2017-12-08
In thesis
1. Epidemiological Studies of Multiple Sclerosis in Sweden with focus on the County of Värmland
Open this publication in new window or tab >>Epidemiological Studies of Multiple Sclerosis in Sweden with focus on the County of Värmland
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to study the frequency of MS in the suggested high-risk area of Värmland county by investigating the current prevalence and analyzing the development over time; secondly to investigate some aetiological factors – the pattern of industry, both in relation to MS in Värmland and in the whole country, and also to examine the possible relation between the distribution of MS and ALS, as it has previously shown a positive correlation in two studies; finally to analyze the women-to-men ratio of MS in Sweden because of international reports of an increasing ratio.

Clinical data was collected from hospitals and other health care units in the county of Värmland, to calculate the prevalence ratio. The prevalence was 170.07 per 100,000 population on the prevalence day, 31 December 2002. The incidence rates analysed during ten years was 6.46 per 100,000 personyears (1991-1995) and 6.39 (1996-2000).

The ecological study used data from the beginning of the 20th century on industries in Värmland and in all Sweden, which were correlated with the two MS prevalence studies (1925-1934 and 2002), and the mortality study on the time period 1952-1990. There was a statistical significant association between large sawmills and the prevalence 1925-1934 (p = 0.022). For all Sweden, wood-pulp factories and papermills correlated significantly with MS mortality 1952-1990 (p = <0.05).

Collected data from Causes of death Register and from the Total Population Register were used when analysing mortality from ALS and MS. The previously shown correlation between ALS and MS mortality distribution in the Swedish counties was not confirmed in this study. However, the mean MS mortality rate was still highest in the county in Värmland. The mean MS mortality rates for whole Sweden was increased from 1.65 per 100,000 person-years (1952-1992) to 2.04 (1990-2010).

For analysing sex ratio in MS, data from the Swedish Multiple Sclerosis Register and data from Total Population Register of the Swedish Statistics Office were used. These data was analysed by birth day cohort and by year of onset. The sex ratios in Sweden showed a stable women-to-men ratio.

These investigations give indication that Värmland is a high-risk region of multiple sclerosis, and particularly the municipality of Säffle.

We conclude that Värmland is a suitable area for continued epidemiological studies with both an environment and genetic focus.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. 52 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1286
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-74177 (URN)978-91-7519-990-0 (ISBN)
Public defence
2012-02-17, Sal Linden, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2012-01-20 Created: 2012-01-20 Last updated: 2012-02-15Bibliographically approved

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Boström, IngerLandtblom, Anne-Marie

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