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Biomedical subjects

A Thörn

Publications and source records attributed to A Thörn.

At least 19 recordsLinked to original sources
PubMed2001

[Sick building syndrome should be treated more from a reasonable than an evidence-based point of view].

During the past decades, several non-specific syndromes have gradually appeared and eventually been given generic denominations such as "diseases of modern life". One of these is the so called Sick Building Syndrome (SBS), which consists of various combinations of common, non-specific symptoms as well as an absence of signs demonstrable by laboratory tests and other medical examinations or means. The lack of demonstrable biological correlates together with vague etiologic attributions make it unusually problematic to study, resulting in the production of a general, non-specific and sometimes contradictory fund of knowledge. This often transforms instances of SBS to theaters of conflict people by parties with divergent interests. Technical/scientific expertise can provide general advice but not unambiguously contribute to the resolution of the conflicts.

Concept Formation↗
PubMed2001

[Qualitative research methods in clinical practice].

Evidence-based medicine (EBM) corresponds to the physician's ambition to integrate his/her experience with the best current scientific knowledge, applying this integrated proficiency to clinical problems. The concept of EBM has become widely accepted and given rise to a global network usually emphasizing the randomized clinical trial (RCT) as the most important scientific method. However, clinical situations are very complex. To a greater or less extent they are all composed of diverse factors, ranging from bio-medical ones to inter-subjective relations, values and beliefs. In addition to RCT and other quantitative procedures, qualitative scientific methods could be used to explore complex clinical problems. Clinical problems always deserve to be addressed from various perspectives. Unfortunately, RCT has acquired such a dominant position as to give the impression that it is the sole preferred method within the EBM framework. Based on three examples, the present article claims that it is the questions asked by an investigation that should determine one's choice of methods, not the reverse. Consequently, we argue that it is important to remember that RCT is just one out of several potential scientific methods. The respective utility of any one method depends on the clinical issue at hand.

Decision Making↗
PubMed2000

Emergence and preservation of a chronically sick building.

STUDY OBJECTIVE: To investigate the merits of case studies as complementary methodological approaches in the study of the sick building syndrome. SETTING AND PARTICIPANTS: A Swedish office building with longstanding health problems, and its inhabitants. DESIGN: This paper is a case study based both on historical and present, quantitative as well as qualitative, documentary material, produced over the years by distinct parties, and on semi-structured interviews. RESULTS: Long drawn conflictive processes within the building were identified. It was revealed that the organisation for dealing with environmental problems was split, and ineffective with poor patterns of communication. It was suggested that this generated a situation of chronic stress leading to the persistence of symptoms. CONCLUSIONS: By their capacity to identify internal processes within building contexts, case study methodology can contribute to a better understanding and management of sick building syndrome. The results of this study suggest that psychosocial factors, among them organisational structures and communication patterns, should be given close attention.

Adult↗
PubMed2000

Mortality and cancer incidence among Swedish lumberjacks exposed to phenoxy herbicides.

OBJECTIVES: To determine mortality and cancer incidence relative to exposure to phenoxy herbicides. METHODS: A cohort of Swedish lumberjacks of which 261 were exposed to phenoxy herbicides, and 250 were unexposed, was followed up for mortality from 1954 to 1994, and for cancer incidence from 1958 to 1992. The number of days of exposure to phenoxy herbicides was determined from pay slips. With the county population as a reference, standardised mortality ratios and cancer incidence ratios (SMR and SIR) were calculated. RESULTS: Mortality and cancer incidence were low with two exceptions; a small but highly exposed group of foremen showed an increased cancer incidence (SIR 274, 95% confidence interval (95% CI) 100 to 596), and over all mortality (SMR 141, 95% CI 68 to 260). Of three cases of non-Hodgkin's lymphoma, two were found among the most exposed workers. CONCLUSIONS: The results provide some support to claims of previous studies that exposure to phenoxy herbicides might be related to non-Hodgkin's lymphoma and to an increased overall cancer risk.

Cohort Studies↗
PubMed1998

The sick building syndrome: a diagnostic dilemma.

Sick building syndrome (SBS) is usually defined as an increased occurrence of non-specific symptoms among populations in determined buildings. This definition differs from those of other medical syndromes in that it refers to a system (a building inclusive of its population) rather than to a clinical state in a single individual. Such a definition should make the term SBS impossible to use as a diagnosis applied to individual persons. In spite of this, it is often used in this way, and the aim of the article is to discuss problems with this practice. It is a case study based on an office building with long-standing building-related health problems. Information concerning the building and its inhabitants comes from a large number of separate documentary sources. The study demonstrates that the diagnostic use of SBS suffers from serious weaknesses. It is proposed that such diagnostics could even have a normative force serving to maintain and reinforce building-related, non-specific health problems. It is therefore suggested that the term sick building syndrome should be abandoned.

Absenteeism↗
PubMed1998

Building-related health problems: reflections on different symptom prevalence among pupils and teachers.

The occurrence of non-specific symptoms among populations in modern buildings is common in the northern parts of the world, and is often called the Sick Building Syndrome. Many factors have been shown to be associated with the prevalence of such symptoms. Based on a case study of a primary school in subarctic Sweden, the complicated nature of building-related, non-specific symptoms is reviewed. Preventive and corrective actions in cases of sick buildings often fail. It is suggested that failures of such actions might depend on their predominant origin in biomedical models. The study therefore proposes that the combined and simultaneous use of biomedical and psychosocial models should be tried in the management of building-related health problems.

Adult↗
PubMed1996

Allergic alveolitis in a school environment.

BACKGROUND: A considerable fraction of newly constructed buildings have indoor air problems associated with health effects, usually of the nonspecific sick building syndrome variety. Specific health effects such as asthma, rhinitis, and allergic alveolitis can also occur. CASE: On 1 September 1988 a school teacher showed symptoms of an acute respiratory illness, which was first interpreted as pulmonary embolism and then later as atypical sarcoidosis. The illness slowly progressed over six years, at which time the diagnosis was revised to chronic allergic alveolitis, related to her school environment. The school had had indoor-air quality problems off and on for several years. CONCLUSIONS: The case illustrates the difficulties of diagnosing cases of chronic allergic alveolitis, especially when it appears in environments where it is not generally encountered. It also raises questions regarding a possible relation between environments associated with the sick building syndrome and the occurrence of building-associated illnesses.

Adult↗
PubMed1994

Results from a community intervention project in the Nicaraguan mining community El Limon. An overview.

The first steps of a community involvement health project using the principles of community diagnosis and popular participation were carried out in a small Nicaraguan mining village during the second half of the 1980s. Using existing archives and obtaining new information aided by local organizations, priorities could be established for health and safety surveillance within the mining company, as well as for further investigations concerning what seemed to be dominant health problems in the community: serious accidents among the economically active population and diarrhoea and respiratory tract infections among children, as well as infections, and other health indicators of malnutrition. Workers also presented chronic simple bronchitis, ventilatory obstructive disturbance and hearing loss that were strongly associated with working conditions. These results helped to direct health priorities and educational activities at the local level with both the general and working population. The wide experience gained from this study has encouraged us to strengthen the link between research and action and in performing studies in close cooperation with local organizations.

Adult↗
PubMed1994

Case report on a sick building: analysis and interpretation in the context of its disease history.

The sick building syndrome is a widespread, modern health problem with a probably very multifactorial causation. Studies of the syndrome have shown associations between its occurrence and a wide variety of factors related to the buildings, work environments and the individual occupants. The associations are often inconsistent and contradictory. The presented case report indicates that this might depend on the subjective nature of most of the symptoms of the syndrome, which makes it difficult to study and interpret. The case consists of a municipal office building where the personnel experienced two very protracted episodes of sick building syndrome. The study of it suggests that psychogenic mechanisms sometimes might be a stronger partial causative factor in the etiology of the sick building syndrome than is generally considered, and that quantitative information should be supplemented by qualitative in the study of sick buildings.

Air Pollution, Indoor↗
PubMed1988

Development of a community intervention programme on miners' health and working environment in Nicaragua.

Since 1983, a broad research and development programme has been carried out with the support of Sweden through the Swedish Agency for Research Cooperation in Developing Countries (SAREC). One of the medical research and development projects deals with the environment and state of health of the population of an entire village, and is referred to as the Abdon Vega project. It is pursued by the Department of Social and Preventive Medicine of the University of León, Nicaragua, with the support of the Department of Social Medicine at the Karolinska Institute in Stockholm. The project comprises two stages. The first one centres on the state of health of the workers and the mining environment. This article reports on the objectives of the project and the study area. It presents experience from the development work up to now and the difficulties encountered.

Community Health Services↗