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  • 51.
    Uustal Fornell, Eva
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Wingren, Gun
    Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Kjølhede, Preben
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Factors associated with pelvic floor dysfunction with emphasis on urinary and fecal incontinence and genital prolapse: an epidemiological study2004In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 83, no 4, p. 383-389Article in journal (Refereed)
    Abstract [en]

    Objective.  To describe a general population of women with regard to factors associated with urinary and fecal incontinence and genital prolapse symptoms.

    Methods.  A questionnaire about medical background, urinary and fecal incontinence and genital prolapse symptoms was mailed to 1000 40-year-old and 1000 60-year-old Swedish women. Associations were described by odds ratios (ORs) with 95% confidence intervals (CIs).

    Results.  Sixty-seven percent answered the questionnaire. Multivariate analysis showed urinary incontinence to be associated with anal sphincter rupture [OR 4.4 (95%  CI 1.0–18.8)], pelvic heaviness [3.8 (2.1–7.0)], body mass index (BMI) ≥30 kg/m2[3.7 (2.0–6.7)], multiparity [1.8 (1.0–3.4)], varicose veins surgery [1.9 (1.2–3.2)] and age [1.9 (1.2–3.2)]. Univariate analyses revealed statistically significant associations between urinary incontinence and incontinence for flatus [4.8 (3.0–7.8)], for liquid stool [5.0 (2.9–8.6)] and for solid stool [5.9 (2.4–14.2)]. Chronic bronchitis [5.7 (1.7–18.9)] was strongly associated with urinary incontinence but was only reported by the older age group. Prolapse symptoms were strongly associated with both urinary and fecal incontinence. Prolapse symptoms as opposed to urinary and fecal incontinence seemed to be associated more with injuries at delivery than with chronic pelvic floor strain.

    Conclusions.  Women with urinary incontinence are also likely to suffer from fecal incontinence and prolapse and vice versa. Other associated factors for pelvic floor dysfunction were overweight, and especially obesity, chronic bronchitis, vaginal delivery and multiparity, age, heredity and diseases suggestive of collagen disorders. A multidisciplinary management of women with pelvic floor symptoms is suggested and possible prevention is discussed.

  • 52.
    Wijma, Klaas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Samelius, Charlotta
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    The association between ill-health and abuse: a cross-sectional population-based study2007In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 48, no 6, p. 567-575Article in journal (Refereed)
    Abstract [en]

    The lifetime prevalence of physical, sexual and psychological abuse was studied cross-sectionally in a representative sample of Swedish women. The association between the three kinds of abuse and ill-health, and the relation between magnitude of abuse and various health problems were also investigated. The Abuse Screening Inventory (ASI), measuring experiences of physical, sexual and psychological abuse and including questions on health and social situation, was sent by mail to 6,000 women, randomly selected from the population register. The questionnaire was completed and returned by 4,150 (70%) of 5,896 eligible women. Various kinds of abuse were reported by 1,142 women (27.5%). The prevalence rates were 19.4% for physical abuse, 9.2% for sexual abuse and 18.2% for psychological abuse. Abused women reported more ill-health and a less advantageous social situation than non-abused women. There was an association between magnitude of abuse and health problems. Also a low magnitude of abuse was substantially associated with ill-health.

  • 53.
    Wingren, Gun
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Epidemiologic studies of health hazards related to the Swedish art glass industry1992Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The production of glass began a few thousand years B. C. but was not introduced in Sweden until the 16th century. In general, throughout history, technical development has been rapid, but considering the art of glass blowing, methods used today are much the same as when the blowpipe was invented about 2 000 years ago. The composition of glass has changed, however, as a result of production specialization and the introduction of different types of glass (e.g. lead crystal, opal and heat-resistant glass).

    Workers in the Swedish art glass industry are exposed to a variety of hazardous chemicals, some of which are known carcinogens. Most of these substances are components of the glass batch (i.e. the mixture of substances used to make glass), for example, compounds of arsenic, antimony, lead, cadmium, chromium, and nickel. Furthermore, large amounts of hydrofluoric acid and sulphuric acid are used in the polishing process, and, in the past, equipment made of asbestos was used for handling hot glass. Many of these chemicals are found not only within the glassworks themselves, but have also been emitted to the environment, causing general concerns about health hazards among people living inthe vicinity of glassworks. Some glass workers are also exposed to combustion products and constant heat stress when working close to the glass furnaces.

    The present studies show that Swedish art glass workers run increased risks of dying from cancer of the stomach, colon and lung and from cardiovascular diseases. In one of the studies, increased risks were also observed for prostate and pharynx cancer and for cerebrovascular diseases. The worker category showing the highest cancer risks was the glass blowers. The exposure route for this category of workers might be through both inhalation of airborne substances and ingestion of particles entering the mouth by way of the blowpipe. These possibilities are supported by hygienic measurements, including analysis of slag samples from inside the blowpipes.

    The present studies were initiated due to concern about cancer risks expressed by people living close to glassworks, but the only increased risk found in this population was a cluster of brain cancers. Glass workers represent a large part of the population living in the vicinity of the glassworks, where the cluster of brain cancers occurred, and because of this, registry-based studies of Swedish glass workers seem to have spuriously indicated an occupational risk in this respect. Although the detected cluster of brain cancers might have its origin in some industrial discharge from the glassworks, the chemicals predominating in the emissions are not known to cause brain cancers, and other factors might be involved as well.

    The cancer risks observed among glass workers can probably be explained by the known effects of several of the exposures occurring in glass production. The observed adverse effects on the cardiaand cerebrovascular systems may also be related to exposures at hand, first and foremost probably to lead exposure.

  • 54.
    Wingren, Gun
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine.
    Mortality and cancer incidence in a Swedish art glassworks - An updated cohort study2004In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 77, no 8, p. 599-603Article in journal (Refereed)
    Abstract [en]

    Aim: To study mortality and cancer incidence, in a Swedish art glassworks producing both heavy and semi-crystal glassware, in an extended cohort of workers over a long time period during which some preventive actions had taken place. Methods: In the updated study, 1,22 9 men and women were eligible as cohort members during the period 1964-1997. The observed number of cases was compared with expected numbers, as calculated from cause-, age-, gender- and calendar year-specific national rates for mortality and cancer incidence. Results: Among men only, a significant risk was seen for cancer incidence in the colon and rectum [standardised incidence ratio (SIR) 1.92, 95% confidence interval (CI) 1.05-3.23, 14 cases] and increased, but statistically non-significant, risks were also seen for male cases of tumours in the liver/bile ducts and brain. Among women, statistically non-significant risks were seen for tumours in the liver/bile ducts and in the lymphatic and haematopoietic systems. No increased risk for cancer of the lung was found in this updated study. The risk for cancer in the colon/rectum was slightly increased in all work categories, and the increase was statistically significant among male and female unspecified glassworkers (SIR 3.13, 95% CI 1.35-6.16, five male and three female cases). A statistically significantly increased risk for cancer in the liver/bile ducts was seen among refinement workers (SIR 3.96, 95% CI 1.07-10.14, two male and two female cases). Conclusion: Mo st of the causes of death associated with an elevated standardised mortality ratio (SMR) in the 1985 cohort resulted in lower SMRs in this updated cohort, maybe as a consequence of preventive actions taken at the glassworks. On the other hand, the risk for cancers in the digestive system seems to remain, perhaps due to past asbestos exposure or inhalation/digestion of larger particles in the ambient air. © Springer-Verlag 2004.

  • 55.
    Wingren, Gun
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine.
    Mortality in a Swedish rubber tire manufacturing plant: Occupational risks or an "unhealthy worker" effect?2006In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 49, no 8, p. 617-623Article in journal (Refereed)
    Abstract [en]

    Background: In this cohort study a classification of 12 work categories, with specified common exposures, is used to evaluate the mortality among workers in a Swedish rubber tire plant. Methods: Mortality among the cohort members is compared with expected values from national rates. Standardized mortality ratios (SMR) were calculated for the total cohort, for sub-cohorts and with the inclusion of a latency requirement. Results: Male workers had increased risks for total mortality, circulatory death, respiratory death, mental disorders, epilepsy, injuries/poisoning, and for alcohol-related death. Many risks were noted among workers exposed to dust, fumes, or vapor. No trend in risk with increasing duration of employment was seen. Discussion: Some established risks for rubber workers could be related to some specified work categories. The highest risks were noted among workers having a very short duration of employment indicating a possible "unhealthy worker effect" associated with life-style factors or to tasks offered to unskilled workers. © 2006 Wiley-Liss, Inc.

  • 56.
    Wingren, Gun
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine.
    Axelson, Olav
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Pain and Occupational Centre, Occupational and Environmental Medicine Centre.
    Cancer incidence and mortality in a Swedish rubber tire manufacturing plant2007In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 50, no 12, p. 901-909Article in journal (Refereed)
    Abstract [en]

    Background: A classification of 12 work categories was used to evaluate the cancer incidence and mortality among a cohort of Swedish rubber tire workers. Methods: Cancer incidence and mortality in the cohort was compared with expected values from national rates. Standardized incidence and mortality ratios were calculated for the total cohort, for sub-cohorts and with the inclusion of a latency requirement. Results: Among men, increased incidence and mortality risks were found for cancer in the larynx, SIR = 2.10, 95% confidence intervals (95% CI): 1.05-3.76, SMR = 2.08, 95% CI: 0.42-6.09. Increased risks were also seen for cancer in the trachea, bronchus, and lung, SIR = 1.62, 95% CI: 1.28-2.02, SMR = 1.54, 95% CI: 1.21-1.94, the incidence risk was highest among those with the longest exposure duration and among workers in compounding/mixing, milling, and maintenance. Decreased incidence risks were seen for cancer of the prostate (SIR = 0.74, 95% CI: 059-0.92) and skin (SIR = 0.57, 95% CI: 0.36-0.84). Conclusions: The finding of an excess of tumors in the respiratory system is in agreement with earlier findings in other studies on rubber tire workers. The results on other cancer types are compared to earlier findings and related to work processes and chemical exposures of possible causal importance. © 2007 Wiley-Liss, Inc.

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