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Biomedical subjects

Bengt Järvholm

Publications and source records attributed to Bengt Järvholm.

At least 19 recordsLinked to original sources
PubMed2006

Impaired lung function and lung cancer incidence in a cohort of Swedish construction workers.

BACKGROUND: Although impaired lung function in general has been associated with an increased risk of lung cancer, past studies typically have not attempted to investigate separately the obstructive and restrictive components of respiratory impairment. To deal with this question further, data from a large (n = 176 997) cohort of male Swedish construction workers, for whom spirometry measurements before follow-up were available, were analysed. METHODS: Cancer incidence for 1971-2001 was obtained through linkage with the national cancer registry. Using a modification of the Global Initiative for Chronic Obstructive Lung Disease criteria for chronic obstructive pulmonary disease (COPD), subjects were classified into five categories of lung function: normal, mild COPD, moderate COPD, severe COPD and restrictive lung disease (RLD). Rate ratios (RR) and 95% confidence intervals (CI) for lung cancer across lung function categories were calculated using Poisson regression, adjusted for age and smoking. Other end points (histological types of lung cancer, non-lung tobacco-related cancers, other cancers, total mortality) were also investigated. RESULTS: 834 incident cases of lung cancer were identified. Increased rates of lung cancer were observed for both COPD (mild: RR 1.5, 95% CI 1.2 to 1.9; moderate/severe: RR 2.2, 95% CI 1.8 to 2.7) and RLD (RR 2.0, 95% CI 1.6 to 2.5) relative to normal lung function. These associations did not meaningfully change on applying follow-up lag times of 5, 10 and 15 years after spirometry. When analysed by histological type, associations with both COPD and RLD were stronger for squamous cell carcinoma and small cell carcinoma, and weaker for adenocarcinoma. Both COPD and RLD were associated with increased rates of total mortality. CONCLUSIONS: Obstructive and restrictive impairments in lung function are associated with increased lung cancer risk.

Adult↗
PubMed2006

Self-reported skin exposure -- a population-based study.

The aim was to study self-reported skin exposure in individuals from the general population with or without hand eczema. In a population-based study in 1996 using postal questionnaires to 3000 individuals, 215 of 2218 (9.7%) reported hand eczema during the past 12 months. 182 (85%) of those with hand eczema and 182 without hand eczema, matched for age and sex, participated in telephone interviews in 1997 regarding exposure to skin irritants at work and in leisure time. No differences were shown in occupational exposure to water, hand washing or chemicals in individuals with or without hand eczema. Women reported more wet exposure than men at work and in leisure time. A correlation was found between occupational wet exposure and wet work at home. Persons in high-risk occupations reported more frequent exposure to skin irritants. However, 53% in high-risk occupations reported exposure to water and detergents for less than half-hour a day and 11% in low-risk occupations for more than half-hour a day. In conclusion, individuals with or without hand eczema seem to have similar exposure to skin irritants. Using job titles as a proxy for exposure gives misclassification, which may result in underestimation of the hand eczema risk.

Adult↗
PubMed2006

Carcinogens in the construction industry.

The construction industry is a complex work environment. The work sites are temporary and rapidly changing. Asbestos has been widely used in construction industry, but the risks were primarily detected in specialized trades, such as insulation workers and plumbers. Today, the majority of cases related to asbestos exposure will occur in other occupational groups in the construction industry. In a large cohort of Swedish construction workers, insulators and plumbers constituted 37% of all cases of pleural mesothelioma between 1975 and 1984 while they constituted 21% of the cases between 1998 and 2002. It is estimated that 25-40% of all male cases of pleural mesothelioma in Sweden are caused by asbestos exposure in the construction trades. There are many other known carcinogens occurring in the construction industry, including PAHs, diesel exhausts, silica, asphalt fumes, solvents, etc., but it is difficult to estimate exposures and thus the size of the risk. The risk of cancer is less easy to detect with traditional epidemiological methods in the construction industry than in other industrial sectors. It is not sufficient to rely upon broad epidemiological data to estimate the risk of cancer due chemicals in the construction industry. Thus, a strategy to decrease exposure, e.g., to dust, seems a feasible way to reduce the risk.

Asbestos↗
PubMed2006

Occupational exposures and head and neck cancers among Swedish construction workers.

OBJECTIVES: Occupational exposures in the construction industry may increase the risk of head and neck cancers, although the epidemiologic evidence is limited by problems of low study power and inadequate adjustment for tobacco use. In an attempt to address this issue, the relationship between selected occupational exposures and head and neck cancer risk was investigated using data from a large cohort of Swedish construction workers. METHODS: Altogether 510 squamous cell carcinomas of the head and neck (171 in the oral cavity, 112 in the pharynx, 227 in the larynx) were identified during 1971-2001 among 307 799 male workers in the Swedish construction industry. Exposure to diesel exhaust, asbestos, organic solvents, metal dust, asphalt, wood dust, stone dust, mineral wool, and cement dust was assessed using a semi-quantitative job-exposure matrix. Rate ratios (RR) and 95% confidence intervals (95% CI) were calculated for head and neck cancers in relation to occupational exposure, using Poisson regression with adjustment for age and smoking status. RESULTS: Asbestos exposure was related to an increased laryngeal cancer incidence (RR 1.9, 95% CI 1.2-3.1). Excesses of pharyngeal cancer were observed among workers exposed to cement dust (RR 1.9, 95% CI 1.2-3.1). No occupational exposures were associated with oral cavity cancer. These findings did not materially change upon additional adjustment for cigarette pack-years. CONCLUSIONS: These findings offer further evidence that asbestos increases the risk of laryngeal cancer. The observation of a positive association between cement dust exposure and pharyngeal cancer warrants further investigation.

Adult↗
PubMed2005

Explaining differences in incidence rates of pleural mesothelioma between Sweden and the Netherlands.

In recent years in several countries a deceleration or leveling off of pleural mesothelioma rates has been observed. The impact of asbestos used was analysed by comparing a country with a relative modest incidence rate of mesothelioma (Sweden) and an early response to asbestos use with a country with one of the highest incidence rates of mesothelioma in Western Europe (The Netherlands). In Sweden the Cancer Register provided information on the annual incidence of pleural mesothelioma, whereas in The Netherlands mortality data were provided by Statistics Netherlands for the period 1969-2001. In The Netherlands among men the incidence rate was consistently higher (1.5-2 times) than in Sweden, whereas among women similar rates were observed. Assuming that none of the female cases was caused by occupational exposure to asbestos, minimum estimates of the etiologic fraction for occupational exposure to asbestos in men would be 82% in Sweden and 92% in The Netherlands. Possible explanations for the consistently higher incidence rates in the Netherlands than in Sweden include differences in exposure levels, the proportion of exposed subjects in the workforce and types of asbestos fibres used. Measures to decrease the exposure to asbestos seem to have decreased the risk of pleural mesothelioma in both countries among age groups below 60 years. This effect will result in a leveling off of the increase in pleural mesothelioma in both countries in the next decade.

Adult↗
PubMed2005

Age, bodyweight, smoking habits and the risk of severe osteoarthritis in the hip and knee in men.

BACKGROUND: The objective of this study was to estimate the risk of severe osteoarthritis, with the need for arthroplasty, in the knee and/or hip according to body mass index (BMI) both within a normal range and in persons with high BMI. Furthermore, we wanted to study the significance of smoking. METHODS: This study identifies male construction workers participating in a national health control program (n = 320,192). The incidence rate for joint replacement was found by matching with the Swedish hospital discharge register between 1987 and 1998. BMI and smoking habit was registered at the time of the health examination. RESULTS: In total 1495 cases of osteoarthritis of the hip and 502 cases of osteoarthritis of the knee were identified and included in this analysis. The incidence rate was found to increase linearly to the BMI even within low and 'normal' BMI. The relative risk for osteoarthritis of the hip was more than two times higher in persons with a BMI of 20-24 than in men with a BMI 17-19. There was almost a doubling of the risk of severe knee osteoarthritis with an increase in BMI of 5 kg/m2. Smoker had a lower risk of osteoarthritis than non-smokers and ex-smokers. CONCLUSIONS: BMI is an important predictor of osteoarthritis even within normal BMI. A decreased risk of osteoarthritis of the hip was found in smokers, but the effect was weak compared to that of BMI or age. Contrary to studies of radiographic osteoarthritis our study indicates higher risk of hip than of knee osteoarthritis.

Adolescent↗
PubMed2005

Occupation, work environment, and disability pension: a prospective study of construction workers.

AIMS: This study investigated the importance of occupation and work environment for the risk of disability pension among construction workers in Sweden. METHODS: The data include around 389,000 construction workers who participated in health examinations from 1971 to 1992. During that period 68,000 participants received disability pension in some form. Between 1985 and 1992 questionnaires were used to collect data regarding hazards in the work environment. Some 87,000 participants answered that questionnaire, and almost 6,000 of these were in receipt of a disability pension. To analyse the risk of disability pension in different occupations, incidence rates (SIR) were calculated according to the person-year method. Logistic regression was used to calculate age-controlled odds ratios according to physical and psychosocial work environment factors. RESULTS: The results show considerable variation in risk for disability pension between different occupations within the construction industry. Furthermore, analysis of work environment factors indicated associations with physical, ergonomic, and psychosocial work environment factors. DISCUSSION: A considerable variation between occupations indicates that characteristics in the work situation are important when explaining the risk of disability pension. The results from this study indicate that improvements in working conditions are an important area of intervention in order to facilitate and prolong labour market participation among elderly people.

Adult↗
PubMed2005

Fifteen-year follow-up of hand eczema: predictive factors.

The aim of this study was to identify factors of importance for the long-term prognosis of hand eczema in the general population. In a 15-y follow-up, 868 (78%) individuals with hand eczema, diagnosed and clinically examined in a previous population-based study, answered a postal questionnaire with questions concerning persistence of the disease. In a logistic regression model, the extent of eczema involvement at the initial examination was the strongest negative factor for the prognosis, followed by history of childhood eczema and age below 20 y at onset of hand eczema. These factors significantly influenced both the total time with hand eczema during the 15 y follow-up and occurrence of hand eczema the previous year. The predictive factor for hand eczema 15 y later was doubled for an individual with all three risk factors compared with one without them, 72%vs 35%. Contact allergy to any of the standard allergens also related significantly to current hand eczema. In conclusion, the main determinant for a poor long-term prognosis was widespread hand dermatitis at the initial examination. Other important factors were low age at onset of hand eczema, history of childhood eczema, and contact allergy.

Adult↗
PubMed2005

4-Aminobiphenyl-hemoglobin adducts and risk of smoking-related disease in never smokers and former smokers in the European Prospective Investigation into Cancer and Nutrition prospective study.

The aim of this study was to evaluate whether biomarkers of environmental tobacco smoke exposure [i.e., 4-aminobiphenyl-hemoglobin (4-ABP-Hb) adducts] were predictive of the risk of tobacco-related cancers and diseases. We did a case-control study nested within the European Prospective Investigation into Cancer and Nutrition, involving 190 controls and 149 cases (incident cancer of the lung, bladder, pharynx, larynx, oral cavity, leukemias, and chronic obstructive pulmonary disease or emphysema deaths). All individuals were never smokers or ex smokers for >10 years. 4-ABP-Hb adducts were analyzed in peripheral blood collected before the onset of the disease (median, 7 years). Overall, 4-ABP-Hb adducts were higher, although not statistically significantly so, in cases (as a whole) than controls. In the control population, high fruit and vegetable consumption significantly lowered the frequency of detectable adducts (Fisher's exact test, P = 0.025). Restricting the analysis to women, 4-ABP-Hb adducts were higher in cases than controls (Mann-Whitney P = 0.036) and the odds ratio (OR) for the presence/absence of adducts was 2.42 [95% confidence interval (95% CI), 1.18-4.98]. Moreover, the association of adducts with the individual cancer types was stronger in women than in the whole study population, although statistically significant only for leukemias (OR, 2.77; 95% CI, 1.06-7.20). The results provide some evidence that women may be more susceptible to environmental tobacco smoke, as suggested by their higher adduct levels. The most important finding of this prospective study is that, at least in women, 4-ABP-Hb adducts may help identify subjects at high risk of cancers related to environmental tobacco smoke exposure.

Biomarkers↗
PubMed2005

Comparative health impact assessment of local and regional particulate air pollutants in Scandinavia.

The ongoing program Clean Air for Europe (CAFE) is an initiative from the EU Commission to establish a coordinated effort to reach better air quality in the EU. The focus is on particulate matter as it has been shown to have large impact on human health. CAFE requested that WHO make a review of the latest findings on air pollutants and health to facilitate assessments of the different air pollutants and their health effects. The WHO review project on health aspects of air pollution in Europe confirmed that exposure to particulate matter (PM), despite the lower levels we face today, still poses a significant risk to human health. Using the recommended uniform risk coefficients for health impact assessment of PM, regardless of sources, premature mortality related to long-range transported anthropogenic particles has been estimated to be about 3500 deaths per year for the Swedish population, corresponding to a reduction in life expectancy of up to about seven months. The influence of local sources is more difficult to estimate due to large uncertainties when linking available risk coefficients to exposure data, but the estimates indicate about 1800 deaths brought forward each year with a life expectancy reduction of about 2-3 months. However, some sectors of the population are exposed to quite high locally induced concentrations and are likely to suffer excessive reductions in life expectancy. Since the literature increasingly supports assumptions that combustion related particles are associated with higher relative risks, further studies may shift the focus for abatement strategies. CAFE sets out to establish a general cost effective abatement strategy for atmospheric particles. Our results, based on studies of background exposure, show that long-range transported sulfate rich particles dominate the health effects of PM in Sweden. The same results would be found for the whole of Scandinavia and many countries influenced by transboundary air pollution. However, several health studies, including epidemiological studies with a finer spatial resolution, indicate that engine exhaust particles are more damaging to health than other particles. These contradictory findings must be understood and source specific risk estimates have to be established by expert bodies, otherwise it will not be possible to find the most cost effective abatement strategy for Europe. We are not happy with today's situation where every strategy to reduce PM concentrations is estimated to have the same impact per unit change in the mass concentration. Obviously there is a striking need to introduce more specific exposure variables and a higher geographical resolution in epidemiology as well as in health impact assessments.

Air Pollutants↗
PubMed2004

Osteoarthritis in the hip and whole-body vibration in heavy vehicles.

BACKGROUND: Farmers have an increased risk of osteoarthritis in the hip, but the mechanism is not known. It has been suggested that the driving of tractors and jumping up and down from the tractor cabin is of importance. In this study, we test the hypothesis that driving vehicles with high levels of whole-body vibration (WBV) is associated with an increased risk of osteoarthritis in the hip. METHODS: This is a cohort study of male operators of heavy vehicles working in the construction industry. They participated in a national health control program. The incidence rate for joint replacement in the hip was found in the Swedish Hospital Discharge Register for 1987 to 1998 and compared with the incidence in reference groups. Their exposure to WBV was estimated from their job titles. The rates were adjusted to body mass index (BMI) and smoking habits and compared to referents participating in the same health control program. RESULTS: Drivers exposed to WBV had not an increased risk of joint replacement due to osteoarthritis in the hip (RR = 0.82; 95% CI 0.51-1.24). CONCLUSIONS: This study does not support the hypothesis that exposure to WBV during operating a vehicle cause an increased risk of osteoarthritis in the hip.

Adolescent↗
PubMed2004

Neuromusculoskeletal disorders in the neck and upper extremities among drivers of all-terrain vehicles--a case series.

BACKGROUND: The purpose of this study was to investigate whether professional drivers of all-terrain vehicles (ATVs) with neck pain have a different array of neuromusculoskeletal disorders in the neck and upper extremities than a referent group with neck pain from the general population. It is hypothesized that exposure to shock-type vibration and unfavorable working postures in ATVs have the capacity to cause peripheral nervous lesions. METHODS: This study was based on a case series analyzed according to a case-case comparison design. The study population consisted of 60 male subjects, including professional drivers of forest machines (n = 15), snowmobiles (n = 15), snowgroomers (n = 15) and referents from the general population (n = 15) all of whom had reported neck pain in a questionnaire and underwent an extensive physical examination of the neck and upper extremities. Based on symptom history, symptoms and signs, and in some cases chemical, electroneurographical and radiological findings, subjects were classified as having a nociceptive or neuropathic disorder or a mix of these types. RESULTS: The occurrence of asymmetrical and focal neuropathies (peripheral nervous lesion), pure or in a mix with a nociceptive disorder was common among cases in the ATV driver groups (47%-79%). This contrasted with the referents that were less often classified as having asymmetrical and focal neuropathy (27%), but instead had more nociceptive disorders. The difference was most pronounced among drivers of snowgroomers, while drivers of forest machines were more frequently classified as having a nociceptive disorder originating in the muscles. CONCLUSION: This study found a high prevalence of assymetrical and focal neuropathies among drivers with pain in the neck, operating various ATVs. It seems as if exposure to shock-type whole-body vibration (WBV) and appurtenant unfavorable postures in ATVs may be associated to peripheral nervous lesions.

Adult↗
PubMed2004

Respiratory symptoms and obstructive lung diseases in iron ore miners: report from the obstructive lung disease in northern Sweden studies.

This is a population-based study on the prevalence of respiratory symptoms assessed by a mail questionnaire. The objective was to examine if work in an iron mine increased the risk of airway symptoms or obstructive diseases. The exposed group consisted of 114 previous or current male miners. Referents, 2472 males from the province, had never been employed by the mining company or worked as miners. Age, smoking and a family history of asthma were considered as possible confounders. The miners had an increased risk for respiratory symptoms (OR=2.2, 95% CI=1.4-3.1) including recurrent wheeze (OR= 2.4, 95% CI= 1.5-3.9), longstanding cough (OR= 1.8, 95% CI = 1.0-3.2), and for physician-diagnosed chronic bronchitis (OR=2.2, 95% CI= 1.0-4.5). Attacks of shortness of breath and asthma manifestations were similar between miners and referents. Higher risks in miners were found particularly among the non-smokers for physician-diagnosed chronic bronchitis (OR=9.2, 95% CI= 3.0-28) and for symptoms as well. A family history of asthma was less common among miners (9.2% vs. 17%, p < 0.05). We conclude that miners in a modern underground iron mine had an increased risk of respiratory symptoms. In contrast to other studies, this increased risk was particularly found in nonsmokers. A family history of asthma may be an important confounder in occupational studies of respiratory diseases.

Adult↗
PubMed2004

Incidence of hand eczema-a population-based retrospective study.

When etiological relationship is of interest, the incidence rate is a preferred measure. The aim of the present retrospective study was to estimate the incidence rate of self-reported hand eczema in a sample from the general population and to study the relation of this to age, sex, and atopy. A questionnaire was mailed to 3000 individuals aged 20-65 y, randomly selected from the population register of Göteborg, Sweden. This gave a response rate of 73.9%. Questions were asked about ever having had hand eczema, time of onset of the disease, history of childhood eczema, and history of asthma/hay fever. The crude incidence rate of self-reported hand eczema was 5.5 cases per 1000 person-years (females 7.1 and males 4.0). There was no difference, however, in incidence rate between women and men above 30 y of age. In a Poisson regression analysis, female sex, childhood eczema, and asthma/hay fever were all significantly associated with hand eczema, but only at ages below 30 y. A moderate influence of recall bias and a probable tendency to underreport imply that the incidence rates presented are to be considered as minimum rates.

Adolescent↗
PubMed2004

Cancer incidence of Nordic asphalt workers.

OBJECTIVES: The aim of the study was to investigate cancer risk following employment in the asphalt industry. METHODS: Cancer incidence was studied among 22 362 male asphalt workers employed for more than one season in jobs entailing exposure to bitumen (mainly road pavers) in Denmark, Finland, Norway, and Sweden. These workers are part of a European cohort of asphalt workers, for which results on mortality have been reported. The follow-up was almost complete, and reference rates were obtained from national cancer registries. RESULTS: The incidence of cancer was reduced in all four countries [overall standardized incidence ratio (SIR) 0.89, 95% confidence interval (95% CI) 0.86-0.94]. Lung cancer incidence was increased in all four countries, yielding an overall SIR of 1.21 (95% CI 1.07-1.36), but no trend was detected according to time since first employment. No overall increased incidence of bladder cancer was observed, but there was a suggestion of a tendency towards higher risk with longer time since first employment, with a relative risk of 1.85 (95% CI 0.90-3.78) for more than 30 years versus 1-14 years (P-value for trend 0.1). The incidence of lip and stomach cancer was nonsignificantly increased, and the excess was present mainly in Denmark. No increased incidence was detected for other neoplasms, notably malignant melanoma, nonmelanoma skin cancer, and kidney cancer. CONCLUSIONS: The results of this study confirm the pattern of cancer risk detected in the mortality analysis of the European cohort; in addition, they provide suggestive evidence of an excess risk of bladder cancer among asphalt workers.

Adolescent↗
PubMed2003

Multiple myeloma and diesel and other occupational exposures in swedish construction workers.

We examined the relationships between occupational exposures and the risk of multiple myeloma among male construction workers in Sweden. A total of 446 myeloma subjects were identified among 365,424 male workers followed from 1971 to 1999. Occupational exposure was assessed using a semiquantitative job-exposure matrix, based on a survey carried out by the Construction Industry's Organization for Working Environment, Occupational Safety and Health in Sweden. Rate ratios (RRs) in the exposed groups relative to the unexposed groups were estimated by Poisson regression. We found an increased risk (RR = 1.3, 95% CI 1.04-1.71) among construction workers exposed to diesel exhaust. Adjustment for other occupational exposures did not change this estimate (RR = 1.3, 95% CI 1.00-1.77). However, there was no monotonic increase in risk with estimated level of exposure (RR for low = 1.4, moderate = 1.1, high = 1.4). There was no evidence of increased risk associated with the other occupational exposures among these construction workers, including asbestos, asphalt, cement dust, metal dust, mineral wool, organic solvents, stone dust and wood dust. Occupational exposure to diesel exhaust in the Swedish construction industry may present a small risk of multiple myeloma, but lack of an exposure-response trend tempers our ability to draw clear conclusions.

Aged↗
PubMed2003

Cancer morbidity in Swedish asphalt workers.

BACKGROUND: Some studies have indicated an increased risk of lung cancer among asphalt workers. This study investigates the risk of lung cancer in Swedish asphalt workers. METHODS: A cohort of 6,150 asphalt workers, mainly employed in road construction, was compared to the general population, and to a reference group of construction workers not exposed to asphalt fumes. The exposure to polyaromatic hydrocarbons (PAH) at paving in Sweden during the 1980s and 1990s were estimated to be in the order of one or a few micrograms per cubic meter, but must have been higher in earlier years. RESULTS: Thirty-two lung cancer cases were observed among asphalt workers. The relative risk (SIR) and 95% confidence intervals were 0.98 (0.67-1.39). The corresponding relative risk, as compared to a group of construction workers and adjusted for smoking habits, was 1.03 (0.70-1.45). We found no increased risk for other cancers investigated or death in other lung diseases. CONCLUSIONS: Asphalt workers do not have any increased lung cancer risk from exposure to fumes and gases from asphalt at the exposure levels that occurred in Sweden during the 1960s and 1970s.

Cause of Death↗