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  • 1.
    Abong'o, Deborah
    et al.
    University of Nairobi, Kenya.
    Wandiga, Shem
    University of Nairobi, Kenya.
    Jumba, Isaac
    University of Nairobi, Kenya.
    Madadi, Vincent
    University of Nairobi, Kenya.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies. Linköping University, Faculty of Arts and Sciences.
    Impacts of pesticides on human health and environment in the River Nyando catchment, Kenya2014In: International Journal of Humanities, Arts, Medicine and Sciences, ISSN 2348-0521, Vol. 2, no 3, p. 1-14Article in journal (Other academic)
    Abstract [en]

    The population of the River Nyando catchment largely relies on rain fed agriculture for their subsistence.

    Important crops grown include cereals, cash crops fruits and vegetables. Farming is one of the contributors of pollution to Lake Victoria. Organophosphates and other banned organochlorine pesticides such as lindane, aldrin and dieldrin were used by farmers. The pesticides transport was by storm water run-off and air drift into the lake. Environmental risk assessment background information was collected through questionnaire and interviews of farmers to determine knowledge and safe use of pesticides. Fourteen pesticides were identified as commonly used of which four are toxic to bees and five to birds. The farmers identified declines in the number of pollinating insects, the disappearance of Red-billed Oxpecker (Buphagus erythrorthynchus) and wild bird’s fatalities. The general knowledge among farmers about chemicals risks, safety, and chronic illnesses was low. Activities that increases environmental awareness and safety of pesticides should be initiated by the agrochemical firms and government.

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    River Nyando catchment 1
  • 2.
    Ainsbury, Elizabeth A.
    et al.
    Publ Hlth England, England.
    Samaga, Daniel
    Bundesamt Strahlenschutz, Germany.
    Della Monaca, Sara
    Ist Super Sanita, Italy.
    Marrale, Maurizio
    Univ Palermo, Italy; Univ Palermo, Italy.
    Bassinet, Celine
    Inst Radioprotect and Surete Nucl, France.
    Burbidge, Christopher I.
    Environm Protect Agcy, Ireland.
    Correcher, Virgilio
    Ctr Moncloa, Spain.
    Discher, Michael
    Univ Salzburg, Austria.
    Eakins, Jon
    Publ Hlth England, England.
    Fattibene, Paola
    Ist Super Sanita, Italy.
    Guclu, Inci
    Turkish Atom Energy Commiss, Turkey.
    Higueras, Manuel
    Basque Ctr Appl Math, Spain.
    Lund, Eva
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Maltar-Strmecki, Nadica
    Rudjer Boskovic Inst, Croatia.
    McKeever, Stephen
    Oklahoma State Univ, OK 74078 USA.
    Raaf, Christopher L.
    Lund Univ, Sweden.
    Sholom, Sergey
    Oklahoma State Univ, OK 74078 USA.
    Veronese, Ivan
    Univ Milan, Italy; Natl Inst Nucl Phys, Italy.
    Wieser, Albrecht
    Helmholtz Zentrum Munchen, Germany.
    Woda, Clemens
    Helmholtz Zentrum Munchen, Germany.
    Trompier, Francois
    Inst Radioprotect and Surete Nucl, France.
    UNCERTAINTY ON RADIATION DOSES ESTIMATED BY BIOLOGICAL AND RETROSPECTIVE PHYSICAL METHODS2018In: Radiation Protection Dosimetry, ISSN 0144-8420, E-ISSN 1742-3406, Vol. 178, no 4, p. 382-404Article in journal (Refereed)
    Abstract [en]

    Biological and physical retrospective dosimetry are recognised as key techniques to provide individual estimates of dose following unplanned exposures to ionising radiation. Whilst there has been a relatively large amount of recent development in the biological and physical procedures, development of statistical analysis techniques has failed to keep pace. The aim of this paper is to review the current state of the art in uncertainty analysis techniques across the EURADOS Working Group 10-Retrospective dosimetry members, to give concrete examples of implementation of the techniques recommended in the international standards, and to further promote the use of Monte Carlo techniques to support characterisation of uncertainties. It is concluded that sufficient techniques are available and in use by most laboratories for acute, whole body exposures to highly penetrating radiation, but further work will be required to ensure that statistical analysis is always wholly sufficient for the more complex exposure scenarios.

  • 3.
    Albers, Bianca
    et al.
    Univ Zurich, Switzerland.
    Rapley, Tim
    Northumbria Univ, England; NIHR ARC North East North Cumbria, England.
    Nilsen, Per
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Clack, Lauren
    Univ Zurich, Switzerland; Univ Hosp Zurich, Switzerland.
    Tailoring in implementation science2023In: FRONTIERS IN HEALTH SERVICES, ISSN 2813-0146, Vol. 3, article id 1233597Article in journal (Other academic)
  • 4.
    Alehagen, Urban
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Aaseth, Jan
    Innlandet Hosp Trust, Norway.
    Alexander, Jan
    Norwegian Inst Publ Hlth, Norway.
    Johansson, Peter
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping.
    Larsson, Anders
    Uppsala Univ, Sweden.
    Supplemental selenium and coenzyme Q10 reduce glycation along with cardiovascular mortality in an elderly population with low selenium status - A four-year, prospective, randomised, double-blind placebo-controlled trial2020In: Journal of Trace Elements in Medicine and Biology, ISSN 0946-672X, E-ISSN 1878-3252, Vol. 61, article id UNSP 126541Article in journal (Refereed)
    Abstract [en]

    Background: A low intake of selenium has been shown to increase the risk of cardiovascular mortality, and supplementation of selenium and coenzyme Q10 influences this. The mechanism behind is unclear although effects on inflammation, oxidative stress and microRNA expression have been reported. Fructosamine, a marker of long-term glycaemic control, is also a marker of increased risk of heart disease and death, even in non-diabetics. Objective: To analyse the impact of selenium and coenzyme Q10 supplementation on the concentration of fructosamine. Also, the relation between pre-intervention serum selenium concentration and the effect on fructosamine of the intervention was studied. Methods: Fructosamine plasma concentration was determined in 219 participants after six and 42 months of intervention with selenium yeast (200 mu g/day) and coenzyme Q10 (200 mg/ day) (n = 118 of which 20 had diabetes at inclusion), or placebo (n = 101 of which 18 had diabetes at inclusion). Pre-intervention, the serum selenium levels were 67 mu g/L (active treatment group: 66.6 mu g/L; placebo group: 67.4 mu g/L), corresponding to an estimated intake of 35 mu g/day. Changes in concentrations of fructosamine following intervention were assessed by the use of T-tests, repeated measures of variance, and ANCOVA analyses. Results: Post-intervention selenium concentrations were 210 mu g/L in the active group and 72 mu g/L in the placebo group. A lower concentration of fructosamine could be seen as a result of the intervention in the total population (P = 0.001) in both the males (P = 0.04) and in the females (P = 0.01) in the non-diabetic population (P = 0.002), and in both the younger ( < 76 years) (P = 0.01) and the older (>= 6 years) participants (P = 0.03). No difference could be demonstrated in fructosamine concentration in the diabetic patients, but the total sample was small (n = 38). In subjects with a low pre-intervention level of serum selenium the intervention gave a more pronounced decrease in fructosamine compared with those with a higher baseline selenium level. Conclusion: A significantly lower concentration of fructosamine was observed in the elderly community-living participants supplemented with selenium and coenzyme Q10 for 42 months compared to those on the placebo. As oxidative mechanisms are involved in the glycation of proteins, less glycoxidation could be a result of the supplementation of selenium and coenzyme Q10, which could have contributed to lower cardiac mortality and less inflammation, as has earlier been reported.

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  • 5.
    Alehagen, Urban
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Johansson, Peter
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping.
    Aaseth, Jan
    Innlandet Hosp Trust, Norway.
    Alexander, Jan
    Norwegian Inst Publ Hlth, Norway.
    Surowiec, Izabella
    AcureOmics AB, Sweden.
    Lundstedt-Enkel, Katrin
    AcureOmics AB, Sweden.
    Lundstedt, Torbjorn
    AcureOmics AB, Sweden.
    Significant Changes in Metabolic Profiles after Intervention with Selenium and Coenzyme Q10 in an Elderly Population2019In: BIOMOLECULES, ISSN 2218-273X, Vol. 9, no 10, article id 553Article in journal (Refereed)
    Abstract [en]

    Selenium and coenzyme Q10 (SeQ10) are important for normal cellular function. Low selenium intake leads to increased cardiovascular mortality. Intervention with these substances with healthy elderly persons over a period of four years in a double-blind, randomised placebo-controlled prospective study showed reduced cardiovascular mortality, increased cardiac function, and a lower level of NT-proBNP. Therefore, we wanted to evaluate changes in biochemical pathways as a result of the intervention with SeQ10 using metabolic profiling. From a population of 443 healthy elderly individuals that were given 200 µg selenium and 200 mg coenzyme Q10, or placebo daily for four years, we selected nine males on active intervention and nine males on placebo for metabolic profiling in the main study. To confirm the results, two validation studies (study 1 n = 60 males, study 2 n = 37 males) were conducted. Principal component analyses were used on clinical and demographic data to select representative sets of samples for analysis and to divide the samples into batches for analysis. Gas chromatography time-of-flight mass spectrometry-based metabolomics was applied. The metabolite data were evaluated using univariate and multivariate approaches, mainly T-tests and orthogonal projections to latent structures (OPLS) analyses. Out of 95 identified metabolites, 19 were significantly decreased due to the intervention after 18 months of intervention. Significant changes could be seen in the pentose phosphate, the mevalonate, the beta-oxidation and the xanthine oxidase pathways. The intervention also resulted in changes in the urea cycle, and increases in the levels of the precursors to neurotransmitters of the brain. This adds information to previous published results reporting decreased oxidative stress and inflammation. This is the first-time metabolic profiling has been applied to elucidate the mechanisms behind an intervention with SeQ10. The study is small and should be regarded as hypothesis-generating; however, the results are interesting and, therefore, further research in the area is needed.

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  • 6.
    Alkner, Björn A.
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine. Reg Jonkoping Cty, Linkoping, Sweden.
    Norrbrand, Lena
    KTH Royal Institute Technology, Sweden.
    Tesch, Per A.
    Karolinska Institute, Sweden.
    Neuromuscular Adaptations Following 90 Days Bed Rest With or Without Resistance Exercise2016In: AEROSPACE MEDICINE AND HUMAN PERFORMANCE, ISSN 2375-6314, Vol. 87, no 7, p. 610-617Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: This study examined the effects of long-term bed rest with or without a concurrent resistance exercise protocol on different muscle function indices of the knee extensors and their influence on previously shown atrophy, neural impairment, and slow-to-fast phenotype shift. METHODS: Nine men underwent 90 d of bed rest only (BR), while eight men in addition performed maximal supine squats every third day (BRE). Before and at day 1 and 5 following bed rest, surface quadriceps electromyographic (EMG) activity was measured during a sustained (60-s) submaximal isometric action and rate of force development (RFD) was assessed during a maximal isometric action, both in the supine squat position. Maximal torque was measured during isokinetic knee extensions at different angular velocities before and after (day 2 and 11) bed rest. RESULTS: EMG amplitude at a fixed submaximal load increased in BR, but not in BRE. The increase in amplitude during the sustained action was elevated in BR but not in BRE. RFD decreased in BR; this effect was attenuated day 1 and normalized day 5 in BRE. RFD expressed relative to maximal force was maintained in both groups. Angle-specific torque decreased equally for all velocities in BR. The decrease in isokinetic strength was attenuated day 2 in BRE. DISCUSSION: Phenotype changes were not reflected in muscle function measurements, probably because they were overridden by the effects of atrophy and neural adaptation. The protective effect of resistance exercise was more pronounced in tasks similar to the training action, inferring great impact of neural mechanisms.

  • 7.
    Alkner, Björn
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Orthopaedics, Eksjö, Region Jönköping County, Linköping, Sweden.
    Bring, Daniel K- I
    Division of Orthopedics and Biotechnology, Clintec, Karolinska Institutet, Stockholm, Sweden.
    Muscle Activation During Gravity-Independent Resistance Exercise Compared to Common Exercises2019In: Aerospace Medicine and Human Performance, ISSN 2375-6314, E-ISSN 2375-6322, Vol. 90, no 6, p. 506-512Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The aim was to study quadriceps muscle activation during resistance exercise using a flywheel device, developed as a gravity-independent resistance exercise device to be used during spaceflight, compared with traditional strength training exercises. METHODS: Eight healthy men experienced in resistance exercise performed the following exercises in random order: flywheel leg press (FW), knee extension isokinetic dynamometry (ID), barbell front squat (FS), weight stack leg press (LP), and weight stack knee extension (KE). They accomplished eight repetitions of coupled concentric and eccentric actions with simultaneous recordings of surface electromyography (EMG) from the three superficial quadriceps muscles and knee angles using electrogoniometry. Maximal voluntary contraction (MVC) in knee extension was performed before and after these measurements. RESULTS: EMG averaged across muscles and angles and normalized to MVC was 99/76% in FW, 48/41% FS, 65/47% LP, 81/52% KE, and 93/84% ID in concentric/eccentric phases, respectively. FW and ID showed higher mean EMG activity than LP and FS concentrically and higher than all other exercises eccentrically. No difference in activity between FW and ID was found. Pre- and post-MVC torque was comparable. DISCUSSION: Quadriceps muscle activation was superior in FW and ID exercises compared to the other exercises. The difference was most pronounced in the eccentric phase, but even concentric activation was lower in traditional closed chain exercises. This data supports that FW is an effective training tool and should be considered when designing strength training programs for spaceflights and on Earth.

  • 8.
    Almstrand, Ann-Charlotte
    et al.
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Bredberg, Anna
    Res Inst Sweden, Sweden.
    Eden, Gunilla Runstrom
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Karlsson, Helen
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Occupational and Environmental Medicine Center.
    Assenhöj, Maria
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Occupational and Environmental Medicine Center.
    Koca, Hatice
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Olin, Anna-Carin
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Tinnerberg, Hakan
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    An explorative study on respiratory health among operators working in polymer additive manufacturing2023In: Frontiers In Public Health, ISSN 2296-2565, Vol. 11, article id 1148974Article in journal (Refereed)
    Abstract [en]

    Additive manufacturing (AM), or 3D printing, is a growing industry involving a wide range of different techniques and materials. The potential toxicological effects of emissions produced in the process, involving both ultrafine particles and volatile organic compounds (VOCs), are unclear, and there are concerns regarding possible health implications among AM operators.The objective of this study was to screen the presence of respiratory health effects among people working with liquid, powdered, or filament plastic materials in AM. MethodsIn total, 18 subjects working with different additive manufacturing techniques and production of filament with polymer feedstock and 20 controls participated in the study. Study subjects filled out a questionnaire and underwent blood and urine sampling, spirometry, impulse oscillometry (IOS), exhaled NO test (FeNO), and collection of particles in exhaled air (PEx), and the exposure was assessed. Analysis of exhaled particles included lung surfactant components such as surfactant protein A (SP-A) and phosphatidylcholines. SP-A and albumin were determined using ELISA. Using reversed-phase liquid chromatography and targeted mass spectrometry, the relative abundance of 15 species of phosphatidylcholine (PC) was determined in exhaled particles. The results were evaluated by univariate and multivariate statistical analyses (principal component analysis). ResultsExposure and emission measurements in AM settings revealed a large variation in particle and VOC concentrations as well as the composition of VOCs, depending on the AM technique and feedstock. Levels of FeNO, IOS, and spirometry parameters were within clinical reference values for all AM operators. There was a difference in the relative abundance of saturated, notably dipalmitoylphosphatidylcholine (PC16:0_16:0), and unsaturated lung surfactant lipids in exhaled particles between controls and AM operators. ConclusionThere were no statistically significant differences between AM operators and controls for the different health examinations, which may be due to the low number of participants. However, the observed difference in the PC lipid profile in exhaled particles indicates a possible impact of the exposure and could be used as possible early biomarkers of adverse effects in the airways.

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  • 9.
    Arapovic-Johansson, B.
    et al.
    Karolinska Institute, Sweden.
    Wåhlin, Charlotte
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center. Karolinska Institute, Sweden.
    Kwak, L.
    Karolinska Institute, Sweden.
    Björklund, C.
    Karolinska Institute, Sweden.
    Jensen, I.
    Karolinska Institute, Sweden.
    Work-related stress assessed by a text message single-item stress question2017In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, Vol. 67, no 8, p. 601-608Article in journal (Refereed)
    Abstract [en]

    Background Given the prevalence of work stress-related ill-health in the Western world, it is important to find cost-effective, easy-to-use and valid measures which can be used both in research and in practice. Aims To examine the validity and reliability of the single-item stress question (SISQ), distributed weekly by short message service (SMS) and used for measurement of work-related stress. Methods The convergent validity was assessed through associations between the SISQ and subscales of the Job Demand-Control-Support model, the Effort-Reward Imbalance model and scales measuring depression, exhaustion and sleep. The predictive validity was assessed using SISQ data collected through SMS. The reliability was analysed by the test-retest procedure. Results Correlations between the SISQ and all the subscales except for job strain and esteem reward were significant, ranging from -0.186 to 0.627. The SISQ could also predict sick leave, depression and exhaustion at 12-month follow-up. The analysis on reliability revealed a satisfactory stability with a weighted kappa between 0.804 and 0.868. Conclusions The SISQ, administered through SMS, can be used for the screening of stress levels in a working population.

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  • 10.
    Arapovic-Johansson, Bozana
    et al.
    Karolinska Inst, Sweden.
    Wåhlin, Charlotte
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Occupational and Environmental Medicine Center. Karolinska Inst, Sweden.
    Hagberg, Jan
    Karolinska Inst, Sweden.
    Kwak, Lydia
    Karolinska Inst, Sweden.
    Axen, Iben
    Karolinska Inst, Sweden.
    Bjorklund, Christina
    Karolinska Inst, Sweden.
    Jensen, Irene
    Karolinska Inst, Sweden.
    Experience of Stress Assessed by Text Messages and Its Association with Objective Workload-A Longitudinal Study2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 3, article id 680Article in journal (Refereed)
    Abstract [en]

    Exploring stress trajectories in detail and over a long time may give valuable information in terms of both understanding and practice. We followed a group of primary health care employees in a randomized controlled trial. The objective was to describe their experience of stress, explore the intra-individual variability and examine the association between the experience of stress and the objective workload. Weekly text messages with a single item stress question were distributed in two time series: 12 weeks at the beginning of the trial and 26 weeks after the 6-month follow up. Aggregated objective data about workload were collected from their administration office and related to stress levels. There was a seasonal variation, with higher stress during the fall than in spring and summer. The analysis comparing high and low stress subgroups showed that the stress trajectory of a high-stress subgroup was different from that of a low-stress subgroup. Individuals with high exhaustion scores had higher odds of belonging to a subgroup of individuals with high intra-individual variability in stress experience. The objective workload was measured in two ways and was strongly associated with the stress experience. We found that the lower the productivity, the higher the feeling of stress.

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  • 11.
    Arlinger, Stig
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Hörsel och hörselskador i arbetslivet: Kunskapssammanställning2013Report (Refereed)
    Abstract [sv]

    Rapporten baserar sig på sammanställning av publicerade artiklar i vetenskapliga tidskrifter med tyngdpunkt på perioden från år 2000. Vissa äldre publikationer har också inkluderats när de har haft innehåll av betydelse för rapporten. Sökning har främst skett i databaserna PubMed och Google Scholar samt i referenslistor från identifierade relevanta arbeten. Söktermer har varit noise, hearing, noise-induced hearing loss, TTS, PTS, tinnitus, impulse noise, solvent, vibration i olika kombinationer.

    Fokus avseende hörselskador har traditionellt varit inriktat på hörselnedsättning, den försämrade känslighet som ofta men inte alltid är den uppenbara konsekvensen av en skada på hörselorganet. Men senare års forskning har visat att skador kan uppstå utan påtaglig påverkan på hörtrösklarna men i form av tinnitus, överkänslighet för starka ljud, förvrängd ljudupplevelse av olika slag, försämrad förmåga att uppfatta tal i svåra lyssningsmiljöer etc. Det har därför varit angeläget att lyfta fram dessa vidare aspekter på hörselskada.

    Många arbetsmiljöer domineras av en relativt kontinuerlig ljudnivå, men ibland förekommer också impulsbuller, d.v.s. ljudtoppar med kortvariga mycket höga ljudnivåer. Nya metoder som föreslagits för att mäta och säkrare värdera hörselskaderiskerna vid exponering för impulsbuller beskrivs också i rapporten.

    Följderna av bullerexponering på en individs hörsel beror inte alltid enbart på bullerexponeringen utan kan påverkas av andra faktorer. Dessa kan vara relaterade till arbetsmiljön men också till egenskaper hos den exponerade individen och kan därför behöva beaktas i skaderiskbedömningar.

    Djurförsök ha påvisat möjligheten att med farmakologiska medel minimera bullerskada efter en exponering och också att åtminstone delvis återskapa hörselfunktionen efter en bullerskada. Strävan är naturligtvis att kunna överföra denna kunskap och metodik till människa, men ännu återstår mycket arbete innan sådan behandling är tillgänglig.

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    Hörsel och hörselskador i arbetslivet: Kunskapssammanställning
  • 12.
    Arnison, Tor
    et al.
    Orebro Univ, Sweden.
    Schrooten, Martien G. S.
    Orebro Univ, Sweden.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Orebro Univ, Sweden.
    Jansson-Frojmark, Markus
    Karolinska Inst, Sweden.
    Persson, Jonas
    Orebro Univ, Sweden; Karolinska Inst, Sweden.
    Longitudinal, bidirectional relationships of insomnia symptoms and musculoskeletal pain across adolescence: the mediating role of mood2022In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 163, no 2, p. 287-298Article in journal (Refereed)
    Abstract [en]

    Previous studies have established a bidirectional relationship between sleep and pain, and mood has been proposed as a mediator of this relationship. There are only a limited number of longitudinal studies examining the mediational role of mood, and the directionality of effects between sleep, pain, and mood is uncertain. In addition, despite the high prevalence of pain and sleep problems during adolescence, these relationships have rarely been examined in a longitudinal sample of adolescents. Here, longitudinal survey data with 5 yearly measurements were used to examine the bidirectional relationship between insomnia symptoms and pain across adolescence (M-baseline age = 13.65 years, N-baseline = 2767). We also explored if depressed mood, positive affect, and anxious mood are mediators in both directions of the sleep-pain relationship. Using latent variables for insomnia, pain, and mood at multiple time points, the data were analyzed with cross-lagged panel models for longitudinal data with structural equation modeling. Current results confirmed a bidirectional relationship between insomnia symptoms and pain, where the effect of insomnia symptoms on pain was stronger than vice versa. Depressed mood and anxious mood mediated the effect of insomnia symptoms on pain, but not the reverse effect of pain on insomnia symptoms. Positive affect did not serve as a mediator in either direction. These findings add novel insights into the temporal directionality of sleep, pain, and mood during adolescence, suggesting a temporal path from sleep to pain, through mood, rather than a reciprocal relationship between the constructs.

  • 13.
    Aronsson, Gunnar
    et al.
    University of Stockholm, Sweden.
    Theorell, Tores
    University of Stockholm, Sweden; Karolinska Institute, Sweden.
    Grape, Tom
    Health Care Centre, Sweden.
    Hammarstrom, Anne
    University of Umeå, Sweden.
    Högstedt, Christer
    Karolinska Institute, Sweden.
    Marteinsdottir, Ina
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Skoog, Ingmar
    University of Gothenburg, Sweden.
    Traskman-Bendz, Lil
    Lund University, Sweden.
    Hall, Charlotte
    Swedish Council Health Technology Assessment, Sweden.
    A systematic review including meta-analysis of work environment and burnout symptoms2017In: BMC Public Health, E-ISSN 1471-2458, Vol. 17, article id 264Article, review/survey (Refereed)
    Abstract [en]

    Background: Practitioners and decision makers in the medical and insurance systems need knowledge on the relationship between work exposures and burnout. Many burnout studies -original as well as reviews-restricted their analyses to emotional exhaustion or did not report results on cynicism, personal accomplishment or global burnout. To meet this need we carried out this review and meta-analyses with the aim to provide systematically graded evidence for associations between working conditions and near-future development of burnout symptoms. Methods: A wide range of work exposure factors was screened. Inclusion criteria were: 1) Study performed in Europe, North America, Australia and New Zealand 1990-2013. 2) Prospective or comparable case control design. 3) Assessments of exposure (work) and outcome at baseline and at least once again during follow up 1-5 years later. Twenty-five articles met the predefined relevance and quality criteria. The GRADE-system with its 4-grade evidence scale was used. Results: Most of the 25 studies focused emotional exhaustion, fewer cynicism and still fewer personal accomplishment. Moderately strong evidence (grade 3) was concluded for the association between job control and reduced emotional exhaustion and between low workplace support and increased emotional exhaustion. Limited evidence (grade 2) was found for the associations between workplace justice, demands, high work load, low reward, low supervisor support, low co-worker support, job insecurity and change in emotional exhaustion. Cynicism was associated with most of these work factors. Reduced personal accomplishment was only associated with low reward. There were few prospective studies with sufficient quality on adverse chemical, biological and physical factors and burnout. Conclusion: While high levels of job support and workplace justice were protective for emotional exhaustion, high demands, low job control, high work load, low reward and job insecurity increased the risk for developing exhaustion. Our approach with a wide range of work exposure factors analysed in relation to the separate dimensions of burnout expanded the knowledge of associations, evidence as well as research needs. The potential of organizational interventions is illustrated by the findings that burnout symptoms are strongly influenced by structural factors such as job demands, support and the possibility to exert control.

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  • 14.
    Assenhöj, Maria
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Occupational and Environmental Medicine Center.
    Almstrand, Ann-Charlotte
    Reg Vastra Gotaland, Sweden; Univ Gothenburg, Sweden.
    Kokelj, Spela
    Univ Gothenburg, Sweden.
    Ljunggren, Stefan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Occupational and Environmental Medicine Center.
    Olin, Anna-Carin
    Reg Vastra Gotaland, Sweden; Univ Gothenburg, Sweden.
    Karlsson, Helen
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Occupational and Environmental Medicine Center.
    Occupational exposure and health surveys at metal additive manufacturing facilities2023In: Frontiers In Public Health, ISSN 2296-2565, Vol. 11, article id 1292420Article in journal (Refereed)
    Abstract [en]

    Introduction: Additive manufacturing is a novel state-of-the art technology with significant economic and practical advantages, including the ability to produce complex structures on demand while reducing the need of stocking materials and products. Additive manufacturing is a technology that is here to stay; however, new technologies bring new challenges, not only technical but also from an occupational health and safety perspective. Herein, leading Swedish companies using metal additive manufacturing were studied with the aim of investigating occupational exposure and the utility of chosen exposure- and clinical markers as predictors of potential exposure-related health risks.Methods: Exposure levels were investigated by analysis of airborne dust and metals, alongside particle counting instruments measuring airborne particles in the range of 10 nm-10 mu m to identify dusty work tasks. Health examinations were performed on a total of 48 additive manufacturing workers and 39 controls. All participants completed a questionnaire, underwent spirometry, and blood and urine sampling. A subset underwent further lung function tests.Results: Exposure to inhalable dust and metals were low, but particle counting instruments identified specific work tasks with high particle emissions. Examined health parameters were well within reference values on a group level. However, statistical analysis implied an impact on workers kidney function and possible airway inflammation.Conclusion: The methodology was successful for investigating exposure-related health risks in additive manufacturing. However, most participants have been working <5 years. Therefore, long-term studies are needed before we can conclusively accept or reject the observed effects on health.

  • 15.
    Assenhöj, Maria
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Occupational and Environmental Medicine Center.
    Ward, Liam J.
    Karolinska Inst, Sweden.
    Ghafouri, Bijar
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Graff, Pal
    Natl Inst Occupat Hlth, Norway.
    Ljunggren, Stefan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Medicine Center, Occupational and Environmental Medicine Center.
    Metal exposure from additive manufacturing and its effect on the nasal lavage fluid proteome - a pilot study2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 8, article id e0256746Article in journal (Refereed)
    Abstract [en]

    The use of metal additive manufacturing (AM) is steadily increasing and is an emerging concern regarding occupational exposure. In this study, non-invasive sampled nasal lavage fluid (NLF) from the upper airways was collected from metal AM operators at the beginning and end of a workweek during two consecutive years with preventive interventions in the occupational setting in-between (n = 5 year 1, n = 9 year 2). During year one, NLF was also collected from welders (n = 6) from the same company to get a comparison with a traditional manufacturing technique with known exposure and health risks. The samples were investigated using untargeted proteomics, as well as using multi-immunoassay to analyze a panel of 71 inflammatory protein markers. NLF in AM operators from year 1 showed decreased levels of Immunoglobulin J and WAP four-disulfide core domain protein 2 and increased levels of Golgi membrane protein 1, Uteroglobin and Protein S100-A6 at the end of the workweek. At year two, after preventive interventions, there were no significant differences at the end of the workweek. In welders, Annexin A1 and Protein S100-A6 were increased at the end of the workweek. The analysis of 71 inflammatory biomarkers showed no significant differences between the beginning and the end of workweek year 1 in AM operators. We identified several proteins of interest in the AM operators that could serve as possible markers for exposure in future studies with a larger cohort for validation.

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  • 16.
    Back, A.
    et al.
    Karolinska Institute, Sweden; Stockholm County Council, Sweden.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    von Thiele Schwarz, U.
    Karolinska Institute, Sweden.
    Richter, A.
    Karolinska Institute, Sweden; Stockholm County Council, Sweden.
    Hasson, H.
    Karolinska Institute, Sweden; Stockholm County Council, Sweden.
    Walking the tightrope-perspectives on local politicians role in implementing a national social care policy on evidence-based practice2016In: International Journal of Mental Health Systems, E-ISSN 1752-4458, Vol. 10, article id 75Article in journal (Refereed)
    Abstract [en]

    Background: Despite national policy recommending evidence-based practice (EBP), its application in social care has been limited. While local politicians can affect the process, little is known about their knowledge, attitudes and roles regarding EBP. The aim here is twofold: to explore the role of local politicians in the implementation of EBP in social care from both their own and a management perspective; and to examine factors politicians perceive as affecting their decisions and actions concerning the implementation of EBP policy. Methods: Local politicians (N = 13) and managers (N = 22) in social care were interviewed. Qualitative thematic analysis with both inductive and deductive codes was used. Results: Politicians were rather uninformed regarding EBP and national policy. The factors limiting their actions were, beside the lack of awareness, lack of ability to question existing working methods, and a need for support in the steering of EBP. Thus, personal interest played a significant part in what role the politicians assumed. This resulted in some politicians taking a more active role in steering EBP while others were not involved. From the managers perspective, a more active steering by politicians was desired. Setting budget and objectives, as well as active follow-up of work processes and outcomes, were identified as means to affect the implementation of EBP. However, the politicians seemed unaware of the facilitating effects of these actions. Conclusions: Local politicians had a possibility to facilitate the implementation of EBP, but their role was unclear. Personal interest played a big part in determining what role was taken. The results imply that social care politicians might need support in the development of their steering of EBP. Moving the responsibility for EBP facilitation upwards in the political structure could be an important step in developing EBP in social care.

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  • 17.
    Bidleman, Terry
    et al.
    Umeå University, Sweden.
    Kurt-Karakus, Perihan
    Bahcesehir University, Istanbul, Turkey.
    Armitage, James
    University of Toronto, Ontario, Canada.
    Brown, Tanya
    University of Victoria, British Columbia, Canada.
    Danon Schaffer, Monica
    University of British Columbia, Vancouver, Canada.
    Helm, Paul
    Ontario Ministry of the Environment, Toronto, Canada.
    Hung, Haley
    Meteorological Services Canada .
    Jantunen, Liisa
    Environment Canada.
    Kylin, Henrik
    Linköping University, The Tema Institute, Tema Environmental Change. Linköping University, Faculty of Arts and Sciences.
    Li, Yi-Fan
    Environment, Canada.
    Loock, Daniela
    Royal Military College of Canada.
    Luttmer, Carol
    Royal Military College of Canada.
    Ma, Jianmin
    Lanzhou University, Peoples Republic of China.
    Macdonald, Robie
    Fisheries and Oceans, Canada.
    Mackay, Don
    Trent University, Peterborough, Ontario, Canada.
    Reid, Liisa
    Trent University, Peterborough, Ontario, Canada.
    Reimer, Ken
    Royal Military College of Canada.
    Chapter 2: Properties, sources, global fate and transport2013In: Canadian Arctic Contaminants Assessment Report III 2013: Persistent Organic Pollutants in Canada’ s North / [ed] Derek Muir, Perihan Kurt-Karakus and Peter Stow, Ottawa: Northern Contaminants Program, Aboriginal Affairs and Northern Development Canada , 2013, p. 19-146Chapter in book (Refereed)
    Abstract [en]

    Part II of the second Canadian Arctic Contaminants Assessment Report (CACAR-II) began with a section on “Physicochemical Properties of Persistent Organic Pollutants”, which identified key physicochemical (pchem) properties, provided the rationale for their measurement or prediction and tabulated literature citations for chemicals that are of concern to the NCP (Bidleman et al. 2003). The section also discussed temperature dependence of pchem properties and their applications to describing partitioning in the physical environment.

    There is, and will continue to be, emphasis on predictive approaches to screening chemicals for persistence, bioaccumulation and toxic (PB&T)properties, as well as long-range atmospheric transport (LRAT) potential (Brown and Wania 2008, Czub et al. 2008, Fenner et al. 2005, Gouin andWania 2007, Howard and Muir 2010, Klasmeier et al. 2006, Matthies et al. 2009, Muir and Howard 2006). This has created the need for determining pchem properties of new and emerging chemicals of concern.

    Predicting gas exchange cycles of legacy persistent organic pollutants (POPs) and new and emerging chemicals of concern places a high demand on the accuracy of pchem properties, particularly the air/water partition coefficient, KAW. Hexachlorocyclohexanes (HCHs) in Arctic Ocean surface waters are close to air-water equilibrium, with excursions toward net volatilization or deposition that vary with location and season (Hargrave et al. 1993, Jantunen et al. 2008a, Lohmann et al. 2009, Su et al. 2006, Wong et al. 2011) while hexachlorobenzene (HCB) (Lohmann et al. 2009, Su et al. 2006, Wong et al. 2011) and some current use pesticides (CUPs) (Wong et al. 2011) are undergoing net deposition. The predicted Arctic Contamination Potential (ACP) for persistent organic chemicals is strongly influenced by ice cover due to its effect on air-water gas exchange (Meyer and Wania 2007).

    Many advances have taken place and numerous papers have been published since CACAR-II, which present new measurements and predictions of pchem properties. This section does not attempt to provide a comprehensive review of the field, or to compile pchem properties from the many studies. The approach taken is to highlight the reports which are most relevant to polar science, particularly in areas of improving reliability of pchem properties for POPs, improving experimental techniques and comparing predictive methods. The section ends with a discussion of polyparameter linear free energy relationships (pp-LFERs), which goes beyond partitioning descriptions based on single pchem properties by taking into account specific chemical interactions that can take place in airsurface and water-surface exchange processes. A detailed list of chemical names and nomenclature are provided in the Glossary.

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  • 18.
    Billingsley, Sunnee
    et al.
    Stockholm Univ, Sweden.
    Brandén, Maria
    Linköping University, Department of Management and Engineering, The Institute for Analytical Sociology, IAS. Linköping University, Faculty of Arts and Sciences. Stockholm Univ, Sweden.
    Aradhya, Siddartha
    Stockholm Univ, Sweden.
    Drefahl, Sven
    Stockholm Univ, Sweden.
    Andersson, Gunnar
    Stockholm Univ, Sweden.
    Mussino, Eleonora
    Stockholm Univ, Sweden.
    COVID-19 mortality across occupations and secondary risks for elderly individuals in the household: A population register-based study2022In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 48, no 1, p. 52-60Article in journal (Refereed)
    Abstract [en]

    Objectives This is the first population-level study to examine inequalities in COVID-19 mortality according to working-age individuals occupations and the indirect occupational effects on COVID-19 mortality of older individuals who live with them. Methods We used early-release data for the entire population of Sweden of all recorded COVID-19 deaths from 12 March 2020 to 23 February 2021, which we linked to administrative registers and occupational measures. Cox proportional hazard models assessed relative risks of COVID-19 mortality for the working-aged population registered in an occupation in December 2018 and the older population who lived with them. Results Among working aged-adults, taxi/bus drivers had the highest relative risk of COVID-19 mortality: over four times that of skilled workers in IT, economics, or administration when adjusted only for basic demographic characteristics. After adjusting for socioeconomic factors (education, income and country of birth), there are no occupational groups with clearly elevated (statistically significant) COVID-19 mortality. Neither a measure of exposure within occupations nor the share that generally can work from home were related to working-aged adults risk of COVID-19 mortality. Instead of occupational factors, traditional socioeconomic risk factors best explained variation in COVID-19 mortality. Elderly individuals, however, faced higher COVID-19 mortality risk both when living with a delivery or postal worker or worker(s) in occupations that generally work from home less, even when their socioeconomic factors are taken into account. Conclusions Inequalities in COVID-19 mortality of working-aged adults were mostly based on traditional risk factors and not on occupational divisions or characteristics in Sweden. However, older individuals living with those who likely cannot work from home or work in delivery or postal services were a vulnerable group.

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  • 19.
    Bjorvatn, Bjorn
    et al.
    Univ Bergen, Norway; Haukeland Hosp, Norway.
    Merikanto, Ilona
    Univ Helsinki, Finland; Orton Orthopaed Hosp, Finland.
    Reis, Catia
    Univ Catolica Portuguesa, Portugal; Fac Med Lisbon, Portugal.
    Korman, Maria
    Ariel Univ, Israel.
    Bjelajac, Adrijana Koscec
    Inst Med Res & Occupat Hlth, Croatia.
    Holzinger, Brigitte
    Med Univ Vienna, Austria.
    De Gennaro, Luigi
    Sapienza Univ Rome, Italy; IRCCS Fdn Santa Lucia, Italy.
    Wing, Yun Kwok
    Chinese Univ Hong Kong, Peoples R China.
    Morin, Charles M.
    Univ Laval, Canada.
    Espie, Colin A.
    Univ Oxford, England.
    Benedict, Christian
    Uppsala Univ, Sweden.
    Landtblom, Anne-Marie
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Uppsala Univ, Sweden.
    Matsui, Kentaro
    Natl Ctr Hosp, Japan.
    Hrubos-Strom, Harald
    Akershus Univ Hosp, Norway; Univ Oslo, Norway.
    Mota-Rolim, Sergio
    Univ Fed Rio Grande do Norte, Brazil; Univ Fed Rio Grande do Norte, Brazil.
    Nadorff, Michael R.
    Mississippi State Univ, MS USA.
    Plazzi, Giuseppe
    IRCCS Ist Sci Neurol Bologna, Italy; Univ Modena & Reggio Emilia, Italy.
    Chan, Rachel Ngan Yin
    Chinese Univ Hong Kong, Peoples R China.
    Partinen, Markku
    Univ Helsinki, Finland; Helsinki Sleep Clin, Finland.
    Dauvilliers, Yves
    Univ Montpellier, France.
    Chung, Frances
    Univ Hlth Network, Canada.
    Forthun, Ingeborg
    Univ Bergen, Norway; Haukeland Hosp, Norway.
    Shift workers are at increased risk of severe COVID-19 compared with day workers: Results from the international COVID sleep study (ICOSS) of 7141 workers2023In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 40, no 2, p. 114-122Article in journal (Refereed)
    Abstract [en]

    The present study had two main aims. First, to investigate whether shift/night workers had a higher prevalence and severity of COVID-19 compared with day workers. Second, to investigate whether people regularly working in face-to-face settings during the pandemic exhibited a higher prevalence and severity of COVID-19 compared with those having no need to be in close contact with others at work. Data consisted of 7141 workers from 15 countries and four continents who participated in the International COVID Sleep Study-II (ICOSS-II) between May and December 2021. The associations between work status and a positive COVID-19 test and several indications of disease severity were tested with chi-square tests and logistic regressions adjusted for relevant confounders. In addition, statistical analyses were conducted for the associations between face-to-face work and COVID-19 status. Results showed that shift/night work was not associated with an increased risk of COVID-19 compared to day work. Still, shift/night workers reported higher odds for moderate to life-threatening COVID-19 (adjusted odds ratio (aOR) = 2.71, 95%-confidence interval = 1.23-5.95) and need for hospital care (aOR = 5.66, 1.89-16.95). Face-to-face work was associated with an increased risk of COVID-19 (aOR = 1.55, 1.12-2.14) but not with higher disease severity. In conclusion, shift/night work was not associated with an increased risk of COVID-19, but when infected, shift/night workers reported more severe disease. Impaired sleep and circadian disruption commonly seen among shift/night workers may be mediating factors. Working face-to-face increased the risk of COVID-19, likely due to increased exposure to the virus. However, face-to-face work was not associated with increased disease severity.

  • 20. Order onlineBuy this publication >>
    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.

    List of papers
    1. Improving computer usage for students with physical disabilities through a collaborative approach: A pilot study
    Open this publication in new window or tab >>Improving computer usage for students with physical disabilities through a collaborative approach: A pilot study
    2013 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 6, p. 463-470Article in journal (Refereed) Published
    Abstract [en]

    Objective: The aim of this study was to evaluate the effect of an assistive technology (AT) intervention to improve the use of available computers as assistive technology in educational tasks for students with physical disabilities during an ongoing school year. Methods: Fifteen students (aged 12-18) with physical disabilities, included in mainstream classrooms in Sweden, and their teachers took part in the intervention. Pre-, post-, and follow-up data were collected with Goal Attainment Scaling (GAS), a computer usage diary, and with the Psychosocial Impact of Assistive Devices Scale (PIADS). Teachers opinions of goal setting were collected at follow-up. Results: The intervention improved the goal-related computer usage in educational tasks and teachers reported they would use goal setting again when appropriate. At baseline, students reported a positive impact from computer usage with no differences over time regarding the PIADS subscales independence, adaptability, or self-esteem. Discussion: The AT intervention showed a positive effect on computer usage as AT in mainstream schools. Some additional support to teachers is recommended as not all students improved in all goal-related computer usage. A clinical implication is that students computer usage can be improved and collaboratively established computer-based strategies can be carried out by teachers in mainstream schools.

    Place, publisher, year, edition, pages
    Informa Healthcare, 2013
    Keywords
    Assistive technology, children with disabilities, goal setting, intervention, self-help devices
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-102984 (URN)10.3109/11038128.2013.837506 (DOI)000328280300008 ()
    Note

    Funding Agencies|Swedish Research Council||Swedish Institute of Assistive Technology||Norrbacka-Eugeniastiftelsen||

    Available from: 2014-01-09 Created: 2014-01-09 Last updated: 2020-08-13
    2. Gaze-based assistive technology in daily activities in children with severe physical impairments: an intervention study
    Open this publication in new window or tab >>Gaze-based assistive technology in daily activities in children with severe physical impairments: an intervention study
    Show others...
    2017 (English)In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 3, p. 129-141Article in journal (Refereed) Published
    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.

    Place, publisher, year, edition, pages
    Taylor & Francis, 2017
    Keywords
    Cerebral palsy, computer activities, eye-tracking technology, goal achievement, self-help devices
    National Category
    Occupational Health and Environmental Health Occupational Therapy
    Identifiers
    urn:nbn:se:liu:diva-123300 (URN)10.3109/17518423.2015.1132281 (DOI)000399489800003 ()26930111 (PubMedID)
    Note

    Funding agencies|Swedish Research Council; Jimmy Dahlstens Fond; Stiftelsen Sunnerdahls Handikappfond

    At the time for thesis presentation publication was in status: Manuscript.

    Available from: 2015-12-10 Created: 2015-12-10 Last updated: 2020-08-13Bibliographically approved
    3. Eye gaze performance for children with severe physical impairments using gaze-based assistive technology: a longitudinal study
    Open this publication in new window or tab >>Eye gaze performance for children with severe physical impairments using gaze-based assistive technology: a longitudinal study
    Show others...
    2016 (English)In: Assistive technology, ISSN 1040-0435, E-ISSN 1949-3614, Vol. 28, no 2, p. 93-102Article in journal (Refereed) Published
    Abstract [en]

    Gaze-based assistive technology (gaze-based AT) has the potential to provide children affected by severe physical impairments with opportunities for communication and activities. This study aimed to examine changes in eye gaze performance over time (time on task and accuracy) in children with severe physical impairments, without speaking ability, using gaze-based AT. A longitudinal study with an AB design was conducted on ten children (aged 1–15 years) with severe physical impairments, who were beginners to gaze-based AT at baseline. Thereafter, all children used the gaze-based AT in daily activities over the course of the study. Compass computer software was used to measure time on task and accuracy with eye selection of targets on screen, and tests were performed with the children at baseline, after 5 months, 9–11 months, and after 15–20 months. Findings showed that the children improved in time on task after 5 months and became more accurate in selecting targets after 15–20 months. This study indicates that these children with severe physical impairments, who were unable to speak, could improve in eye gaze performance. However, the children needed time to practice on a long-term basis to acquire skills needed to develop fast and accurate eye gaze performance.

    Keywords
    assistive devices, computer access, physical disability
    National Category
    Pediatrics Psychology (excluding Applied Psychology)
    Identifiers
    urn:nbn:se:liu:diva-123301 (URN)10.1080/10400435.2015.1092182 (DOI)000376031400004 ()26496529 (PubMedID)
    Note

    Funding agencies: Swedish Research Council; Stiftelsen Sunnerdahls Handikappfond; Jimmy Dahlstens Fond

    Available from: 2015-12-10 Created: 2015-12-10 Last updated: 2020-08-13Bibliographically approved
    4. Gaze-based assistive technology used in daily life by children with severe physical impairments: parents’ experiences
    Open this publication in new window or tab >>Gaze-based assistive technology used in daily life by children with severe physical impairments: parents’ experiences
    2017 (English)In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 5, p. 301-308Article in journal (Refereed) Published
    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.

    Place, publisher, year, edition, pages
    Taylor & Francis, 2017
    Keywords
    Activities in daily life, cerebral palsy, eye tracking controlled system, self-help devices, parental hope, qualitative
    National Category
    Occupational Health and Environmental Health Occupational Therapy
    Identifiers
    urn:nbn:se:liu:diva-123302 (URN)10.1080/17518423.2016.1211769 (DOI)000406527400008 ()
    Note

    Funding agencies: Swedish Research Council; Jimmy Dahlstens Fond; Stiftelsen Sunnerdahls Handikappfond

    Available from: 2015-12-10 Created: 2015-12-10 Last updated: 2020-08-13Bibliographically approved
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  • 21.
    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.

  • 22.
    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.

  • 23.
    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.

  • 24.
    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.

  • 25.
    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.'

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  • 26.
    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)
  • 27.
    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)
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  • 28.
    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)
  • 29.
    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)
  • 30.
    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)
  • 31.
    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

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  • 32.
    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)
  • 33.
    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.
    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

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  • 34.
    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.

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  • 35.
    Brusselaers, Nicolas
    Vrije Universiteit Brussel.
    The impact of off-site construction transport on air quality2023Book (Refereed)
    Abstract [en]

    While transport is inevitable in our economy and daily lives, it also engenders negative effects on the society and environment. The effects of air pollution are responsible for more than 364,200 premature deaths in Europe each year. Most urban areas still exceed the NOx and PM WHO air quality guidelines, of which a large share of pollutants is attributable to freight transport. The construction sector forms no exception, as it intrinsically strongly relies on off-site logistics activities, i.e. transports to and from sites. Although construction works lead to an urban economic uptake on the long-haul, the environmental nuisances from construction logistic (CL) activities during the works have so far been overlooked. This thesis focuses on the air quality impact of off-site construction transport, covering four main parts. First, as there is a lack of knowledge within cities on how to set construction transport demands and how to involve actors in these processes, a stakeholder framework is presented. Next, I identify the available and required transport data (and digitization possibilities) to assess the sector’s environmental impact, such as On-Board Units. Secondly, impact assessments were conducted across various construction supply chain implementations, on single-site, city-wide and national level. Hence, a methodological approach to derive construction-related vehicles from Heavy-Goods Vehicle (HGV) traffic based on algorithmic and geospatial analyses is proposed. Results indicate that construction transport represents 26.40% of total HGV traffic in the Brussels-Capital Region (BCR), generating €45,631.85 of external costs per workday, and 17.58% in Belgium (or €1.45mio per day). Subsequently, the framework was deployed to assess the transport performance of the multimodal Brussels Construction Consolidation Centre. The use of this setup can mitigate external costs by up to 59% compared to business-as-usual operations, most notably on congestion and climate change costs. However, improvements are necessary to tackle local emissions, attributable to less performant -yet ubiquitous- vessel engines. Air pollution damage costs also remain high on city level analyses, with CL inflicting €55,123.07 per month (or €2,505.59 per workday) in the BCR. A fortiori, with the growing concern on urban air quality, this raises the question of where, when and by whom the most exposure costs are inflicted. So far, the geo-temporal link between the emitting freight vehicle and its receptor densities was considered static. The third part introduces a dynamic impact-pathway approach, highlighting that PM & NO2 source impacts engender €61.604 of health costs in the BCR each day. Large differences were found on the local level compared to the traditional static approach, indicating that the proposed dynamic methodology should be used for micro-scale analyses (on link, building or neighborhood level). Striking is that vulnerable population segments such as toddlers, school children and elderly, who are more sensible to the effects of air pollution, incur 60.28% of the total health costs, although these segments represent only a quarter of the BCR population. Moreover, a strong overlap was found between the receptor’s presence (in particular children) and peak freight traffic movements. The fourth part investigates the exposure effects when off-site construction transport flows are spatiotemporally rerouted around air pollution hotspots. Although an increase in emissions is observed due to higher travelled distances and slower driving speeds, results show that the inflicted health costs can be mitigated up to 25.53%. Conclusively, this study suggests to decouple policies from absolute transport emissions and focus on the actual health impact, considering the spatiotemporal relationship of both emissions and receptors. Although tailoring a one-size-fits-all construction logistic plan can initially prove to be difficult due to the unique character of each construction site’s supply chain, the conducted studies also show that this individual complexity can be overcome by overall better integrated urban transport planning, and can ultimately lead to significant sustainability benefits.

  • 36.
    Brusselaers, Nicolas
    et al.
    Dept. of Business Technology and Operations, Faculty of Economic and Social Sciences and Solvay Business School, Vrije Universiteit Brussel, Elsene, Belgium.
    Macharis, Cathy
    Dept. of Business Technology and Operations, Faculty of Economic and Social Sciences and Solvay Business School, Vrije Universiteit Brussel, Elsene, Belgium.
    Mommens, Koen
    Dept. of Business Technology and Operations, Faculty of Economic and Social Sciences and Solvay Business School, Vrije Universiteit Brussel, Elsene, Belgium.
    The health impact of freight transport-related air pollution on vulnerable population groups2023In: Environmental Pollution, ISSN 0269-7491, E-ISSN 1873-6424, Vol. 329Article in journal (Refereed)
    Abstract [en]

    Every year, over 364,200 people in Europe die prematurely due to the effects of air pollution, in which the transportation sector plays an important role. In Brussels, freight transport generates €61,604 of air pollution health costs daily. Research has shown that dynamic spatiotemporal modeling of both emission sources and exposed people (using mobile phone data) renders more accurate impact results when analyzed in microenvi- ronments. However, mobile data underrepresent population segments that are more sensitive to the effects of air pollution, such as toddlers, children and elderly individuals. This paper examined the link between vulnerable people aged 0–3, 3–18 and >65 years and freight transport-related air pollution concentrations in the Brussels- Capital Region (BCR). To this end, dynamic tailpipe emissions and their spatiotemporal dispersion were calcu- lated using output from the Transport Agent-Based Model (TRABAM) on a daily basis. Population densities were calculated as a function of the residences’ occupancy rate and school/class size and opening hours. The effects of exposure were then evaluated using age- and sex-differentiated exposure-response functions and monetized using local hospital cost factors. Data were compiled for 2021. A strong overlap between people’s presence at the institutions’ locations was noticed with a peak in (freight) transportation movements in the city. The results showed that €37,000 [€34,517.47–€40,047.13] of freight transport-related air pollution health costs were incurred daily by vulnerable population segments. While these vulnerable groups made up 25.34% of the total BCR population, they incurred 60% [56.03%–65.01%] of the engendered transportation air pollution costs. The results were then geographically analyzed to identify 465 traffic-related air pollution hotspots across the terri- tory, which accounted for €36,000 [€33,677.85–€39,101.31] of total costs. The latter can be used in future studies to assess sector-specific freight transportation policies, which should take into consideration spatio- temporal population densities on the local level.

  • 37.
    Burstrom, Kristina
    et al.
    Karolinska Inst, Sweden.
    Teni, Fitsum Sebsibe
    Karolinska Inst, Sweden.
    Gerdtham, Ulf-G.
    Lund Univ, Sweden.
    Leidl, Reiner
    German Res Ctr Environm Hlth, Germany; Ludwig Maximilians Univ Munchen, Germany.
    Helgesson, Gert
    Karolinska Inst, Sweden.
    Rolfson, Ola
    Karolinska Inst, Sweden; Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden; Ctr Registers Vastra Gotaland, Sweden.
    Henriksson, Martin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Experience-Based Swedish TTO and VAS Value Sets for EQ-5D-5L Health States2020In: PharmacoEconomics (Auckland), ISSN 1170-7690, E-ISSN 1179-2027, Vol. 38, p. 839-856Article in journal (Refereed)
    Abstract [en]

    Background and Objective Although value sets for the five-level version of the generic health-related quality-of-life instrument EQ-5D are emerging, there is still no value set available in the literature based on time trade-off valuations made by individuals experiencing the valued health states. The aim of this study was to estimate experience-based value sets for the EQ-5D-5L for Sweden using time trade-off and visual analogue scale valuation methods. Methods In a large, cross-sectional, population-based, self-administered postal health survey, the EQ-5D-5L descriptive system, EQ visual analogue scale and a time trade-off question were included. Time trade-off and visual analogue scale valuations of the respondents current health status were used in statistical modelling to estimate a single-index value of health for each of the 3125 health states. Ordinary least-squares and generalised linear models were estimated with the main effect within each of the five dimensions represented by 20 dummy variables reflecting the additional decrement in value for levels 2-5 when the severity increases by one level sequentially beginning from having no problem. Interaction variables representing the occurrence of severity levels in at least one of the dimensions were tested: severity level 2 or worse (N2); severity level 3 or worse (N3); severity level 4 or worse (N4); severity level 5 (N5). Results A total of 896 health states (28.7% of the 3125 possible EQ-5D-5L health states) were reported by the 25,867 respondents. Visual analogue scale (n = 23,899) and time trade-off (n = 13,381) responders reported valuations of their currently experienced health state. The preferred regression models used ordinary least-squares estimation for both time trade-off and visual analogue scale values and showed consistency in all coefficients after combining certain levels. Levels 4 and 5 for the dimensions of mobility, self-care and usual activities were combined in the time trade-off model. Including the interaction variable N5, indicating severity level 5 in at least one of the five dimensions, made it possible to distinguish between the two worst severity levels where no other dimension is at level 5 as this coefficient is applied only once. In the visual analogue scale regression model, levels 4 and 5 of the mobility dimension were combined. The interaction variables N2-N4 were included, indicating that each of these terms reflect a statistically significant decrement in visual analogue scale value if any of the dimensions is at severity level 2, 3 or 4, respectively. Conclusions Time trade-off and visual analogue scale value sets for the EQ-5D-5L are now available for Sweden. The time trade-off value set is the first such value set based on experience-based time trade-off valuation. For decision makers with a preference for experience-based valuations of health states from a representative population-based sample, the reported value sets may be considered fit for purpose to support resource allocation decision as well as evaluating population health and healthcare performance.

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  • 38.
    Cherma Yeste, Maria Dolores
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Artillerigatan 12, S-58758 Linkoping, Sweden.
    Nilsson, Gunnel H.
    Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Artillerigatan 12, S-58758 Linkoping, Sweden.
    Johansson, Anna
    Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Artillerigatan 12, S-58758 Linkoping, Sweden.
    Jönsson, Anna K
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Artillerigatan 12, S-58758 Linkoping, Sweden.
    Ahlner, Johan
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Artillerigatan 12, S-58758 Linkoping, Sweden.
    Use of Lisdexamfetamine or Amphetamine? Interpretation of Chiral Amphetamine Analyses2022In: Journal of Analytical Toxicology, ISSN 0146-4760, E-ISSN 1945-2403, Vol. 46, no 1, p. 10-16Article in journal (Refereed)
    Abstract [en]

    Amphetamine is frequently detected in forensic toxicological cases. Differentiating between the two isomers of amphetamine (d-amphetamine and l-amphetamine) and determining their relative proportion are fundamental to correctly interpret the results of toxicological analyses. The aim of this study was to examine the profile of amphetamine as well as storage stability of the isomers in authentic samples from patients chronically treated with lisdexamfetamine (LDX), the most prescribed medical amphetamine product in Sweden. Blood and urine samples were collected from 18 patients. The samples were analyzed with an achiral (racemate) method for quantification of amphetamine and with a chiral method to determine the proportion of each isomer of amphetamine. The median daily dose of LDX was 40 mg (range, 20-70 mg). The median amphetamine concentration was 0.06 mu g/g (range, 0.02-0.15 mu g/g) in blood and 6 mu g/mL (range, 1-22 mu g/mL) in urine. Only d-amphetamine was found in the blood and urine samples from the included patients. Furthermore, no formation of l-amphetamine occurred during the storage for 3 months at 4 degrees C, 9 months at -20 degrees C and three freeze-thaw cycles. The results from this study may be helpful in the interpretation of whether the source of identified amphetamine in biological samples is from LDX drug intake or not.

  • 39.
    Chew, Michelle S
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, ANOPIVA US.
    Longrois, Dan
    Department of Anaesthesia and Intensive Care, Hôpital Bichat–Claude-Bernard, CHU de Paris, France.
    Bruder, Nicolas
    Department of Anaesthesia and Intensive Care, CHU Timone, Aix-Marseille University, France.
    Comments: Occupational exposure and risk of transmission of SARS-CoV2 among European anaesthetists (vol. 38, Issue 12, page 1293-1295)2021In: European Journal of Anaesthesiology, ISSN 0265-0215, E-ISSN 1365-2346, Vol. 38, no 12, p. 1272-1273Article in journal (Other academic)
  • 40.
    Cotgreave, Ian
    et al.
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Ghavanini, Ali Alavian
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Alfaro-Moreno, Ernesto
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Bergman, Åke
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Cederbrant, Karin
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Forsby, Anna
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Förare, Jonas
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Gustafsson, Åke
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Hellmond, Heike
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Lindberg, Johan
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Lupu, Diana
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Norinder, Ulf
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Rüegg, Joelle
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Tang, Mandy
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Öberg, Mattias
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Kylin, Henrik
    Linköping University, The Tema Institute, Tema Environmental Change. Linköping University, Faculty of Arts and Sciences.
    Andersson, Patrik
    Department of Chemistry, Umeå University, Sweden.
    Zhang, Jin
    Department of Chemistry, Umeå University, Sweden.
    Bergdahl, Ingvar
    Department of Public Health and Clinical Medicine, Umeå University, Swetox.
    Jakobsson, Kristina
    Department of Public Health and Community Medicine, University of Gothenburg, Swetox.
    Lindh, Christian
    Division of Occupational and Environmental Medicine, Lund University.
    Demeneix, Barbara
    UMR CNRS/ MNHN 7221 Muséum National d'Histoire Naturelle, Paris France.
    Knudsen, Lisbeth
    Department of Public Health, Section of Occupational and Environmental Health, University of Copenhagen, Copenhagen Denmark.
    Pyriproxifen and microcephaly: an investigation of potential ties to the ongoing "Zika epidemic"2016Report (Other academic)
    Abstract [en]

    As part of the Swetox mission to react to emerging concerns in chemical health and environmental safety, a preliminary litterature investigation was undertaken to gather all readily available scientific information on PPF with respect to safety assessment, in order to better understand potential links between chemical exposure and the devopment of microcephaly in affected areas. Therefore the contents of the report do not constitute an attempt at either questioning the use of existing regulatory data in the manner prescribed by international regulatory proceedures, or as a new risk assessment, based on the scientific information and concepts discussed. Here we report our findings, with particular emphasis on exisiting regulatory information, potential for lack of translation of results from regulatory animal testing to humans, lack of human exposure data and suggestions on plausible mode(s) of action of PPF in human neurodevelopmental adversities such as microcephaly.

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  • 41.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Arbetslivsinriktad rehabilitering2010In: Arbets- och Miljömedicin - en lärobok om hälsa och miljö / [ed] Christer Edling, Gunnar Nordberg, Maria Albin, Monica Nordberg, Lund: Studentlitteratur , 2010, 3, p. 117-130Chapter in book (Other academic)
    Abstract [sv]

    Arbets- och miljömedicin

    – en lärobok om hälsa och miljö

    Läroboken i arbets- och miljömedicin tar upp dagsaktuella frågor och ger förslag på hantering av arbets- och miljömedicinska ärenden.

    Detta är den svenska lärobok som försöker samla hela det stora kunskapsområdet inom arbets- och miljömedicin. Med hänsyn till dynamiken inom området har i denna 3:e upplaga skett en uppdatering, förnyelse och komplettering. Den har fem nyskrivna kapitel: Arbets- och miljörelaterade hudsjukdomar – särskilt kontakteksem och prevention, Belastningsrelaterade sjukdomar, Ersättning vid arbetsskada, Företagshälsovård samt Luftföroreningar, global klimatpåverkan och hälsa. Liksom tidigare ges epidemiologi och toxikologi ett stort utrymme då dessa redskap utgör grunden för riskbedömning och riskkommunikation. Handläggning av arbets- och miljömedicinska larm presenteras som ett exempel på riskkommunikation. I särskilda kapitel behandlas psykosociala frågor och arbetsorganisation, hjärt-kärlsjukdomar samt arbetslivsinriktad rehabilitering. Kemiska hälsorisker är fortfarande aktuella och fordrar ofta miljöövervakning i form av biologiska exponeringsmarkörer och markörer för biologisk effekt, ex. genetiska förändringar. Miljöns påverkan på foster, reproduktion och cancer beskrivs, liksom miljörelaterade luftvägssjukdomar. Traditionella områden som buller, vibrationer, bekämpningsmedel, livsmedel och matförgiftning behandlas också. Översiktligt diskuteras aktuella arbets- och miljömedicinska frågor som klorering och hälsa, perfluorerade ämnen, nanomaterial och effekter av arbetslöshet. Ett särskilt kapitel ägnas åt etiska frågor inom arbets- och miljömedicin.

  • 42.
    Ekberg, Kerstin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Eklund, Mona
    Lunds universitet.
    Hensing, Gunnel
    Göteborgs universitet.
    Kunskapsbaserade åtgärder för att främja arbetsförmåga och återgång i arbete2015In: Återgång i arbete: processer, bedömningar, åtgärder / [ed] Kerstin Ekberg, Mona Eklund, Gunnel Hensing, Lund: Studentlitteratur AB, 2015, 1, p. 219-233Chapter in book (Other academic)
  • 43.
    Ekberg, Kerstin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Eklund, Mona
    Lunds universitet.
    Hensing, Gunnel
    Göteborgs universitet.
    Perspektiv på arbetsförmåga2015In: Återgång i arbete: processer, bedömningar, åtgärder / [ed] Kerstin Ekberg, Mona Eklund, Gunnel Mensing, Lund: Studentlitteratur AB, 2015, 1, p. 19-31Chapter in book (Other academic)
  • 44.
    Ekberg, Kerstin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Erlandsson, Lena-Karin
    Lunds universitet, Institutionen för hälsovetenskaper.
    Lättare psykisk ohälsa2015In: Återgång i arbete: processer, bedömningar, åtgärder / [ed] Kerstin Ekberg, Mona Eklund, Gunnel Hensing, Lund: Studentlitteratur AB, 2015, 1, p. 111-128Chapter in book (Other academic)
  • 45.
    Elenstal, Emily
    et al.
    Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Artillerigatan 12, SE-58758 Linkoping, Sweden.
    Gréen, Henrik
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Artillerigatan 12, SE-58758 Linkoping, Sweden.
    Kronstrand, Robert
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry and Pharmacology. Linköping University, Faculty of Medicine and Health Sciences. Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Artillerigatan 12, SE-58758 Linkoping, Sweden.
    Elmsjo, Albert
    Natl Board Forens Med, Dept Forens Genet & Forens Toxicol, Artillerigatan 12, SE-58758 Linkoping, Sweden.
    Intralipid as a matrix additive for evaluating hyperlipidemic postmortem blood2023In: Journal of Analytical Toxicology, ISSN 0146-4760, E-ISSN 1945-2403, Vol. 47, no 6, p. 529-534Article in journal (Refereed)
    Abstract [en]

    Postmortem whole blood samples can differ greatly in quality where hyperlipemia is a frequent variable that can influence the results of analytical methods. The aim of this study was to investigate the influence of lipemia on postmortem analysis as well as demonstrate the usage of Intralipid in comparison to pooled postmortem lipids as matrix additives for meaningful evaluation and validation of hyperlipidemic postmortem samples. Hyperlipidemic blood samples were simulated by adding different concentrations of Intralipid or pooled authentic postmortem lipids to bovine whole blood. The hyperlipidemic blood samples were spiked with 14 benzodiazepines and five sedative and antianxiety drugs (alprazolam, clonazepam, 7-aminoclonazepam, diazepam, flunitrazepam, 7-aminoflunitrazepam, hydroxyzine, lorazepam, midazolam, nitrazepam, 7-aminonitrazepam, nordazepam, oxazepam, propiomazine, dihydropropiomazine, temazepam, triazolam, zolpidem and zopiclone). Samples were prepared with liquid-Liquid extraction followed by ultra-high performance liquid chromatography-mass spectrometry. The effects of lipemia on the recovery of analytes and internal standards (ISs) were evaluated to determine the effect of, and any differences between, the two additives. Lipemia was found to cause major interference when quantifying the analytes. For most analytes, the ISs could compensate for analyte losses. However, the most hydrophilic analytes (7-amino metabolites), together with the most lipophilic analytes (propiomazine and dihydropropiomazine), were greatly affected by lipemia (<50% recovery), and the IS could not compensate for analyte losses. In general, lower analyte recoveries were observed for samples with Intralipid as a lipemic additive in comparison to those containing pooled postmortem lipids. Both Intralipid and pooled postmortem lipids showed marked effects on the analytical results. Intralipid gave a good indication of the effects of lipemia and could be a useful tool for making a meaningful evaluation of hyperlipidemic postmortem samples during the method development and validation.

  • 46.
    Ericsson, Maria
    et al.
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Jensen, Per
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Domestication and ontogeny effects on the stress response inyoung chickens (Gallus gallus)2016In: Scientific Reports, E-ISSN 2045-2322, Vol. 6, article id 6_35818Article in journal (Refereed)
    Abstract [en]

    Domestication is thought to increase stress tolerance. The connection between stressor exposure,glucocorticoids and behavioural responses has been studied in adults, where domestication effectsare evident. Early stress exposure may induce detrimental effects both in short-and long term.Previous research has reported a lack of glucocorticoid response in newly hatched chickens (Gallusgallus), whereas others have found opposite results. Hence it remains unclear whether the HPA-axis isfunctional from hatch, and if domestication has affected the early post-hatch ontogeny of the stressresponse. Our aims were to investigate the early ontogeny of the HPA-axis and characterize behaviouraland hormonal stress responses in ancestral Red Junglefowl and in two domestic layer strains. Plasmacorticosteone and behavioural responses before and after physical restraint was measured on dayone, nine, 16 and 23 post hatch. The results showed significant increases of corticosterone after stressin all three breeds at all the different ages. The HPA-response decreased with age and was lower inRed Junglefowl. Behavioural responses also decreased with age, and tended to be stronger in RedJunglefowl. In summary, the HPA-axis is reactive from day one, and domestication may have affectedits development and reactivity, alongside with related behaviour responses.

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  • 47.
    Fagerlind Ståhl, Anna-Carin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Smith, Peter
    Inst Work and Hlth, Canada; Univ Toronto, Canada; Monash Univ, Australia.
    Longitudinal association between psychological demands and burnout for employees experiencing a high versus a low degree of job resources2018In: BMC Public Health, E-ISSN 1471-2458, Vol. 18, article id 915Article in journal (Refereed)
    Abstract [en]

    Background: Exhaustion and burnout are common causes for sickness absence. This study examines the relationship between psychological demands and burnout over time, and if environmental support modifies the longitudinal relationship between psychological demands and burnout at baseline, with burnout measured 2 years subsequently. Methods: A questionnaire was sent to employees in seven Swedish organizations in 2010-2012 with follow-up after 2 years, n = 1722 responded (64%). Linear regressions were used to examine the associations between burnout and psychological demands at baseline and burnout at follow-up. Stratified regression models examined if relationships between burnout and psychological demands at baseline on burnout at follow-up differed for employees in supportive versus unsupportive work environments. Results: Burnout and psychological demands at baseline were associated with burnout at follow-up, after adjustment for study covariates. No significant differences were observed between estimates for psychological demands and burnout among respondents in supportive work environments versus those in unsupportive work environments. Conclusions: This study shows that high demands are associated with greater risk of burnout, regardless of level of other work supports. This has implications for prevention of sick leave due to burnout and for rehabilitation, where demands such as work pace, workload and conflicting demands at work may need to be reduced.

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  • 48.
    Fernandez-Verdejo, Rodrigo
    et al.
    Pontificia Univ Catolica Chile, Chile.
    Alcantara, Juan M. A.
    Univ Granada, Spain.
    Galgani, Jose E.
    Pontificia Univ Catolica Chile, Chile; Pontificia Univ Catolica Chile, Chile.
    Acosta, Francisco M.
    Univ Granada, Spain.
    Migueles, Jairo Hidalgo
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Univ Granada, Spain.
    Amaro-Gahete, Francisco J.
    Univ Granada, Spain; Univ Granada, Spain.
    Labayen, Idoia
    Univ Publ Navarra, Spain.
    Ortega, Francisco B.
    Univ Granada, Spain.
    Ruiz, Jonatan R.
    Univ Granada, Spain.
    Deciphering the constrained total energy expenditure model in humans by associating accelerometer-measured physical activity from wrist and hip2021In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 12302Article in journal (Refereed)
    Abstract [en]

    The constrained total energy expenditure (TEE) model posits that progressive increases in physical activity (PA) lead to increases in TEE; but after certain PA threshold, TEE plateaus. Then, a compensatory reduction in the expenditure of non-essential activities constrains the TEE. We hypothesized that high PA levels as locomotion associate with a compensatory attenuation in arm movements. We included 209 adults (64% females, mean [SD] age 32.1 [15.0] years) and 105 children (40% females, age 10.0 [1.1] years). Subjects wore, simultaneously, one accelerometer in the non-dominant wrist and another in the hip for >= 4 days. We analyzed the association between wrist-measured (arm movements plus locomotion) and hip-measured PA (locomotion). We also analyzed how the capacity to dissociate arm movements from locomotion influences total PA. In adults, the association between wrist-measured and hip-measured PA was better described by a quadratic than a linear model (Quadratic-R-2=0.54 vs. Linear-R-2=0.52; P=0.003). Above the 80th percentile of hip-measured PA, wrist-measured PA plateaued. In children, there was no evidence that a quadratic model fitted the association between wrist-measured and hip-measured PA better than a linear model (R-2=0.58 in both models, P=0.25). In adults and children, those with the highest capacity to dissociate arm movements from locomotion-i.e. higher arm movements for a given locomotion-reached the highest total PA. We conclude that, in adults, elevated locomotion associates with a compensatory reduction in arm movements (probably non-essential fidgeting) that partially explains the constrained TEE model. Subjects with the lowest arm compensation reach the highest total PA.

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  • 49.
    Flodin, Ulf
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Rolander, B.
    Jonkoping Univ, Sweden; Futurum, Sweden.
    Lofgren, H.
    Ryhov Hosp, Sweden.
    Krapi, Blerim
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Nyqvist, Fredrik
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Wåhlin, Charlotte
    Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Unit of Intervention and Implementation Research, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Risk factors for neck pain among forklift truck operators: a retrospective cohort study2018In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 19, article id 44Article in journal (Refereed)
    Abstract [en]

    Background

    No previous research has been performed into neck pain among forklift operators. This is a common complaint among these workers, who number around 150,000 in Sweden and six million in Europe. The aim of the study was to examine long-term exposure to unnatural neck positions among forklift operators as a risk factor for neck pain.

    Methods

    A retrospective cohort study was conducted of all eligible employees at a high-level warehouse. Forklift operators and office workers answered an 18-page questionnaire comprising questions about joint pain, work tasks, work postures and year of start for all items. By using person years in the exposed and less-exposed groups before start of neck pain we were able to calculate Incident Rate ratios for various exposures.

    Results

    Forty nine percent of the forklift operators reported having experienced neck pain compared to 30 % of office workers. Being a forklift operator was associated with an increased risk of neck pain (OR = 5.1, 95% CI 1.4–18.2). Holding the head in an unnatural position resulted in significantly increased risks for neck pain, irrespective of type of position. The risks for neck pain remained after taking other ergonomic exposures and psychosocial aspects into consideration.

    Conclusions

    This is the first published study showing that forklift operators have an increased risk of neck pain. The results are therefore of significance for improving work schedules, the adjustment of work tasks for these workers and the design of the vehicles.

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  • 50. Order onlineBuy this publication >>
    Fornander, Louise
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Upper Airway Mucosal Inflammation: Proteomic Studies after Exposure to Irritants and Microbial Agents2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    People are, in their daily lives, exposed to a number of airborne foreign compounds that do not normally affect the body. However, depending on the nature of these compounds, dose and duration of exposure, various airway symptoms may arise. Early symptoms are often manifested as upper airway mucosal inflammation which generates changes in protein composition in the airway lining fluid.

    This thesis aims at identifying, understanding mechanisms and characterizing protein alterations in the upper airway mucosa that can be used as potential new biomarkers for inflammation in the mucosa. The protein composition in the mucosa was studied by sampling of nasal lavage fluid that was further analyzed with a proteomic approach using twodimensional gel electrophoresis and mass spectrometry. Additionally, by studying factors on site through environmental examination, health questionnaires and biological analyses, we have tried to understand the background to these protein alterations and their impact on health.

    Respiratory symptoms from the upper airways are common among people who are exposed to irritative and microbial agents. This thesis have focused on personnel in swimming pool facilities exposed to trichloramine, metal industry workers exposed to metalworking fluids, employees working in damp and moldy buildings and infants diagnosed with respiratory syncytial virus infection. The common denominator in these four studies is that the subjects experience upper airway mucosal inflammation, which is manifested as cough, rhinitis, phlegm etc. In the three occupational studies, the symptoms were work related. Notably, a high prevalence of perceived mucosal symptoms was shown despite the relatively low levels of airborne irritants revealed by the environmental examination. Protein profiling verified an ongoing inflammatory response by identification of several proteins that displayed altered levels. Interestingly, innate immune proteins dominated and four protein alterations occurred in most of the studies; SPLUNC1, protein S100A8 and S100A9 and alpha-1-antitrypsin. Similarly, these proteins were also found in nasal fluid from children with virus infection and in addition a truncated form of SPLUNC1 and two other S100 proteins (S100A7-like 2 and S100A16), not previously found in nasal secretion, were identified.

    Altogether, the results indicate the potential use of a proteomic approach for identifying new biomarkers for the upper respiratory tract at an early stage in the disease process after exposure to irritant and microbial agents. The results indicate an effect on the innate immunity system and the proteins; SPLUNC1, protein S100A8 and S100A9 and alpha-1-antitrypsin are especially promising new biomarkers. Moreover, further studies of these proteins may help us to understand the molecular mechanisms involved in irritant-induced airway inflammation.

    List of papers
    1. Innate immunity proteins and a new truncated form of SPLUNC1 in nasopharyngeal aspirates from infants with respiratory syncytial virus infection
    Open this publication in new window or tab >>Innate immunity proteins and a new truncated form of SPLUNC1 in nasopharyngeal aspirates from infants with respiratory syncytial virus infection
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    2011 (English)In: PROTEOMICS CLINICAL APPLICATIONS, ISSN 1862-8346, Vol. 5, no 9-10, p. 513-522Article in journal (Refereed) Published
    Abstract [en]

    Purpose: Respiratory syncytial virus (RSV) is the most common cause of severe respiratory tract infection in infants. The aim was to identify host defence components in nasopharyngeal aspirate (NPA) from infants with RSV infection and to study the expression of the novel 25 kDa innate immunity protein SPLUNC1. less thanbrgreater than less thanbrgreater thanExperimental design: NPAs from infants were analyzed with 2-DE and MS in a pilot study. The levels of SPLUNC1 were analyzed with immunoblotting in 47 NPAs, admitted for RSV diagnosis. less thanbrgreater than less thanbrgreater thanResults: Totally, 35 proteins were identified in NPA, including several innate immunity proteins such as group X phospholipase A(2), different S100 proteins and SPLUNC1. In addition, a new truncated 15 kDa form of SPLUNC1 was identified that was detected in about 50% of the aspirates admitted for RSV diagnosis. RSV-positive boys had significantly less 25 kDa SPLUNC1 than RSV-negative boys while there were no significant differences among girls. less thanbrgreater than less thanbrgreater thanConclusions and clinical relevance: Several important innate immunity proteins were identified in NPA. Notably, a new truncated form of the newly suggested anti-bacterial protein SPLUNC1 was found. It is possible that a decrease in SPLUNC1 in the upper airways may increase the risk for severe pneumonia in boys.

    Place, publisher, year, edition, pages
    Wiley-VCH Verlag Berlin, 2011
    Keywords
    MS, Nasopharynx, PLUNC, Respiratory syncytial virus, Two-dimensional gel electrophoresis
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-72142 (URN)10.1002/prca.201100016 (DOI)000296418400005 ()
    Note
    Funding Agencies|The Research Council of South East Sweden|FORSS-36761- 8505|Available from: 2011-11-18 Created: 2011-11-18 Last updated: 2015-04-23
    2. Airway irritation among indoor swimming pool personnel: trichloramine exposure, exhaled NO and protein profiling of nasal lavage fluids
    Open this publication in new window or tab >>Airway irritation among indoor swimming pool personnel: trichloramine exposure, exhaled NO and protein profiling of nasal lavage fluids
    2013 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 5, p. 571-580Article in journal (Refereed) Published
    Abstract [en]

    Purpose

    Occurrence of airway irritation among indoor swimming pool personnel was investigated. The aims of this study were to assess trichloramine exposure levels and exhaled nitric oxide in relation to the prevalence of airway symptoms in swimming pool facilities and to determine protein effects in the upper respiratory tract.

    Methods

    The presence of airway symptoms related to work was examined in 146 individuals working at 46 indoor swimming pool facilities. Levels of trichloramine, as well as exhaled nitric oxide, were measured in five facilities with high prevalence of airway irritation and four facilities with no airway irritation among the personnel. Nasal lavage fluid was collected, and protein profiles were determined by a proteomic approach.

    Results

    17 % of the swimming pool personnel reported airway symptoms related to work. The levels of trichloramine in the swimming pool facilities ranged from 0.04 to 0.36 mg/m3. There was no covariance between trichloramine levels, exhaled nitric oxide and prevalence of airway symptoms. Protein profiling of the nasal lavage fluid showed that the levels alpha-1-antitrypsin and lactoferrin were significantly higher, and S100-A8 was significantly lower in swimming pool personnel.

    Conclusions

    This study confirms the occurrence of airway irritation among indoor swimming pool personnel. Our results indicate altered levels of innate immunity proteins in the upper airways that may pose as potential biomarkers. However, swimming pool facilities with high prevalence of airway irritation could not be explained by higher trichloramine exposure levels. Further studies are needed to clarify the environmental factors in indoor swimming pools that cause airway problems and affect the immune system.

    Place, publisher, year, edition, pages
    Springer, 2013
    Keywords
    Innate immunity, Occupational medicine, roteomics, Upper respiratory tract
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-86713 (URN)10.1007/s00420-012-0790-4 (DOI)000320394300008 ()22729567 (PubMedID)
    Available from: 2012-12-25 Created: 2012-12-25 Last updated: 2017-12-06Bibliographically approved
    3. Airway symptoms and biological markers in nasal lavage fluid in subjects exposed to metalworking fluids
    Open this publication in new window or tab >>Airway symptoms and biological markers in nasal lavage fluid in subjects exposed to metalworking fluids
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    2013 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 8, no 12, p. e83089-Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUNDS: Occurrence of airway irritation among industrial metal workers was investigated. The aims were to study the association between exposures from water-based metal working fluids (MWF) and the health outcome among the personnel, to assess potential effects on the proteome in nasal mucous membranes, and evaluate preventive actions.

    METHODS: The prevalence of airway symptoms related to work were examined among 271 metalworkers exposed to MWF and 24 metal workers not exposed to MWF at the same factory. At the same time, air levels of potentially harmful substances (oil mist, morpholine, monoethanolamine, formaldehyde) generated from MWF was measured. Nasal lavage fluid was collected from 13 workers and 15 controls and protein profiles were determined by a proteomic approach.

    RESULTS: Airway symptoms were reported in 39% of the workers exposed to MWF although the measured levels of MWF substances in the work place air were low. Highest prevalence was found among workers handling the MWF machines but also those working in the same hall were affected. Improvement of the ventilation to reduce MWF exposure lowered the prevalence of airway problems. Protein profiling showed significantly higher levels of S100-A9 and lower levels of SPLUNC1, cystatin SN, Ig J and β2-microglobulin among workers with airway symptoms.

    CONCLUSIONS: This study confirms that upper airway symptoms among metal workers are a common problem and despite low levels of MWF-generated substances, effects on airway immune proteins are found. Further studies to clarify the role of specific MWF components in connection to airway inflammation and the identified biological markers are warranted.

    Place, publisher, year, edition, pages
    Public Library of Science, 2013
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-103739 (URN)10.1371/journal.pone.0083089 (DOI)000329325200035 ()24391738 (PubMedID)
    Available from: 2014-01-24 Created: 2014-01-24 Last updated: 2021-06-14Bibliographically approved
    4. Protein profiles of nasal lavage fluid from individuals with work-related upper airway symptoms associated to moldy and damp buildings
    Open this publication in new window or tab >>Protein profiles of nasal lavage fluid from individuals with work-related upper airway symptoms associated to moldy and damp buildings
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    2016 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 26, no 5, p. 743-754Article in journal (Refereed) Published
    Abstract [en]

    Upper airway irritation is common among individuals working in moldy and damp buildings. The aim was to investigate effects on the protein composition of the nasal lining fluid. The prevalence of symptoms in relation to work was examined in 37 individuals working in two damp buildings. Microbial growth was confirmed in one of the buildings. Nasal lavage fluid was collected from 29 exposed subjects and 13 controls. Protein profiles were investigated with a proteomic approach and evaluated by multivariate statistical models. Subjects from both workplaces reported upper airway and ocular symptoms. Based on protein profiles, symptomatic subjects in the two workplaces were discriminated from each other and separated from healthy controls. The groups differed in proteins involved in inflammation and host defense. Measurements of innate immunity proteins showed a significant increa e of protein S100-A8 and decrease of SPLUNC1 in subjects from one workplace while alpha-1-antitrypsin was elevated in subjects from the other workplace, compared to healthy controls. The results show that protein profiles in nasal lavage fluid can be used to monitor airway mucosal effects in personnel working in damp buildings and indicate that the profile may be separate when the dampness is associated with the presence of molds.

    Place, publisher, year, edition, pages
    Wiley-Blackwell, 2016
    Keywords
    Sick building syndrome, proteomics, nasal mucosa, SPLUNC1, alpha-1-antitrypsin, protein S100-A8
    National Category
    Occupational Health and Environmental Health Infectious Medicine
    Identifiers
    urn:nbn:se:liu:diva-117339 (URN)10.1111/ina.12257 (DOI)000387348500009 ()
    Note

    Funding agencies: Research Council of South East Sweden [FORSS-222751, FORSS-389061]; Cancer and Allergy Foundation [150441]

    Available from: 2015-04-23 Created: 2015-04-23 Last updated: 2018-01-11Bibliographically approved
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