PubMed HealthSearch

Biomedical subjects

C Hogstedt

Publications and source records attributed to C Hogstedt.

At least 19 recordsLinked to original sources

Lung cancer risk among workers exposed to man-made mineral fibers (MMMF) in the Swedish prefabricated house industry.

Mortality and cancer incidence was investigated among 2,807 workers, employed for at least one year before 1972, at 11 Swedish companies manufacturing prefabricated wooden houses. A total of 1,068 workers had been exposed to man-made mineral fibers (MMMF) used for insulation. Mortality was followed from 1969 to 1988 and cancer incidence from 1969 to 1985. Exposure conditions were investigated at all plants. There were 14 deaths from lung cancer in the total cohort, whereas 20.7 would be expected (SMR = 68; 95% CI:37-113), based on regional mortality. After a latency of 20 years of more, two lung cancer cases had occurred among all workers exposed to MMMF, whereas 4.3 would be expected (SMR = 46; 95% CI: 5-168). The exposure levels that have prevailed do not seem to be associated with an increased lung cancer rate, but extended follow-up is necessary for a definitive evaluation.

Cohort Studies

Radiographic osteoarthrosis in the acromioclavicular joint resulting from manual work or exposure to vibration.

The hypothesis that manual work and exposure to vibration are antecedents to the development of osteoarthrosis was assessed employing a cross sectional study design. The frequency of osteoarthrosis in the acromioclavicular joint was studied in three groups of workers in the construction industry. Two groups were manual workers (54 bricklayers and 55 rock blasters); the third group consisted of 98 foremen. The radiographic appearance of the right and left acromioclavicular joints was classified into one of five grades of osteoarthrosis. A protocol was developed to assess exposure on the basis of job title, years of manual work, total weight lifted during working life, and total hours of exposure to vibrating tools. Odds ratios for job titles (manual worker v foreman) and for years of manual work as indicators of exposure were of similar magnitude of around 2.5. Construction workers who had lifted more than 709 tonnes had an increased risk of developing severe osteoarthrosis of the right acromioclavicular joint, odds ratio: 2.62 (95% confidence interval (95% CI), 1.13-6.06). The odds ratio for the left side was 7.67 (95% CI, 2.76-21.34). In the analysis of vibration exposure, workers who had been highly exposed to vibration had an odds ratio of 1.99 (95% CI, 1.00-3.92) on the right side and 2.20 (95% CI, 1.07-4.56) on the left. This effect almost disappeared after simultaneous adjustment for manual work. Occupational and ergonomic factors, such as the sum of lifted tonnes during working life, job title, and the sum of years of manual work seem to be risk factors for osteoarthrosis of the acromioclavicular joint, whereas vibration alone was a weaker risk factor.

Acromioclavicular Joint

Does long-term concrete work cause silicosis?

The machining of cast concrete often produces heavy exposure to respirable silica dust. Work with concrete in general results in considerably less exposure, however, and only a few cases of silicosis due to work with concrete have been reported. Telephone interviews with detailed questions on occupational history were made with 271 construction workers specializing in concrete work for more than 20 years, and exposure data were evaluated for different work tasks. The mean cumulative exposure of subjects to silica was estimated to be 2.4 mg.years.m-3. Chest radiographs were classified according to the International Labour Office classification. There was no suspicion of silicosis for any of the workers. The risk of contracting silicosis from work with concrete in the Swedish construction industry in recent decades is considered to be slight and does not justify general, periodic chest radiographic screening.

Construction Materials

Epidemiology of occupational neurobehavioural hazards. Methodological experiences from organic solvent research.

Neurobehavioral hazards have been identified since long in occupational health, e.g. lead, mercury, certain solvents, and many others agents. There are reviews and books on "Occupational neurology" or "Prevention of neurotoxic illness in working populations". Many methods have been applied for studies of the central and peripheral nervous systems in humans: registered diagnoses, questionnaire ratings, clinical evaluation, psychometric tests, neurophysiological and neuroradiological methods, cerebrospinal fluid components etc. Some neurological disorders are well defined, while neuropsychiatric syndromes often are less precisely diagnosed. Decreased subclinical test results in exposed groups might predict an increased risk for later, more serious disorders but the longitudinal information on clinical importance is often lacking. Some historical lessons from the epidemiology of occupational neurology will be repeated and a few reflections on the suitability of different diagnostic entities for epidemiological research shall be made. Since the beginning of the 1970s' a number of studies from the Scandinavian countries have demonstrated long-term neurobehavioral effects from working conditions with relatively moderate exposure to organic solvents. Similar findings have been verified in studies from some countries outside Scandinavia while other studies have been inconclusive. Those results have caused considerable controversy and have been discussed at international conferences and in scientific journals. Very different outcomes have been investigated in those solvent studies, however, and most studies have had a cross-sectional design with inherent problems. The exposure has been assessed in different ways, e.g. by years of occupation, hygienic measurements of the present working conditions, biological monitoring, retrospective assessments on qualitative or semi-quantitative scales. Sometimes single solvent exposures have been studied but most of the studies concern mixtures of solvents from aromatic and aliphatic hydrocarbons. As the designs have varied the exposure assessment has been crude and many different outcomes have been studied, it is hardly surprising that the results and the interpretations have differed. The first results from a comprehensive investigation on 135 solvent exposed painters and 71 carpenters as referents, selected from active members of the respective trade union 1965-70 and investigated in the late 80s, will be presented. Clinical, including psychiatric, diagnostic work up and neuropsychological as well as neurophysiological tests have been performed. Psychological test results from military conscripts at age 19 were available for all. The individual exposure history has been carefully assessed.(ABSTRACT TRUNCATED AT 400 WORDS)

Case-Control Studies

Occupation and osteoarthrosis of the hip and knee: a register-based cohort study.

A register-based cohort study was performed to investigate if men and women in certain occupations with high physical workload had increased risks of developing severe symptomatic osteoarthrosis of the hip and knee, resulting in hospital care. The study population consisted of 250,217 people from the 1980 census, in blue-collar occupations, who had reported the same occupation in the 1960 and 1970 censuses. The study population was followed for hospital care for osteoarthrosis of the hip and knee during 1981-1983 by linkage to the Swedish Hospital Discharge Register. Different blue-collar occupations were classified as high or low with regard to exposure to forces acting on the hip and knee and the frequencies of the outcomes were compared. Male farmers, construction workers, firefighters and some food processing workers had an excess risk of hospitalization due to osteoarthrosis of the hip. Male farmers, construction workers and firefighters also had increased risks of osteoarthrosis of the knee. Female mail carriers had an excess risk of osteoarthrosis of the hip, and female cleaners, of osteoarthrosis of the knee. The findings support the hypothesis that heavy physical work load contributes to osteoarthrosis of the hip and knee.

Cohort Studies

Coxarthrosis and physical work load.

A case-referent study was performed on the possible relationship between physical work loads and an increased risk of developing coxarthrosis. The cases were 239 male recipients of a hip prosthesis as a result of severe idiopathic coxarthrosis; the referents were 302 men randomly selected from the general population. The work load was assessed through an interview and a self-administered questionnaire on the men's specific work periods. Men highly exposed to dynamic or static work loads had an increased relative risk of 2.42 (95% confidence interval 1.45-4.04) for developing coxarthrosis when compared with men with low exposure. Men with high exposure to heavy lifting between the ages of 30 and 49 years had the highest relative risk, 3.31 (95% confidence interval 1.97-5.57). Long-time exposure to physical work loads seems to be a risk factor for severe coxarthrosis among men.

Adult

Increased risk of urothelial cancer in Stockholm during 1985-87 after exposure to benzene and exhausts.

In a population-based case-referent study of urothelial cancer in Stockholm during 1985-87, information was obtained from 80% of 320 identified male cases and 79% of 363 selected male referents. Industrial exposures were assessed for each subject by an industrial hygienist on the basis of questionnaire data. Exposure to benzene (any annual dose) gave a relative risk (with 95% confidence interval) of 2.0 (1.0-3.8). The highest risk was seen for a high annual dose. Subjects exposed to both diesel and petrol exhausts (moderate/high annual dose) had a relative risk of 7.1 (0.9-58.8). However, adjusting for benzene changed the relative risk to 5.1 (0.6-43.6). It might be rewarding to consider whether benzene from petrol confounds the associations previously suggested between exhausts and urothelial cancer. Exposure to polychlorinated biphenyls (PCB) gave a relative risk of 3.3 (0.6-18.4).

Benzene

Lung cancer and exposure to diesel exhaust among bus garage workers.

Mortality and cancer incidence was investigated among the 695 bus garage workers employed as mechanics, servicemen, or hostlers for at least six months in five bus garages in Stockholm between 1945 and 1970. The exposure to diesel exhaust and asbestos was estimated by industrial hygienists. A small excess of lung cancer mortality was found in the cohort when occupationally active men in Stockholm were used as the reference group. A case-referent study was performed within the cohort, six referents being selected for each of the 20 lung cancer cases. The lung cancer risk increased with increasing cumulative exposure to diesel exhaust, but not with cumulative asbestos exposure. The relative risk for lung cancer among the highly exposed men was 2.4 (95% CI 1.3-4.5) as compared with those with low exposure. The study indicates that exposure to diesel exhaust increases the risk for lung cancer.

Asbestos

Leukemia in workers exposed to ethylene oxide.

Ethylene oxide, a gaseous sterilant extensively used within health care facilities, is known to be a mutagen in bacteria and in human lymphocytes. The Environmental Protection Agency as well as the National Institue of Occupational Safety and Health have recently stipulated certain conditions for the use of ethylene oxide despite the lack of case reports or epidemiologic studies concerning carcinogenicity. We report three cases of leukemia that occurred between 1972 and 1977 in a relatively small group of Swedish workers exposed to ethylene oxide. According to national statistics, 0.2 cases of leukemia would have been expected. The time-weighted average ethylene oxide concentration was 20+/-10 ppm.

Adult

A cohort study of mortality and cancer incidence in ethylene oxide production workers.

Ethylene oxide, important as an intermediate product in the chemical industry and for sterilising hospital equipment, is mutagenic in several organisms; carcinogenicity has been suspected although this had not been supported by clinical data. Ethylene oxide has been produced by a Swedish company since the beginning of the 1940s. This paper describes a cohort study of the mortality and the cancer incidence among full-time exposed workers in ethylene oxide production, a group of maintenance workers with intermittent exposure and a group of unexposed controls. Investigation of the production processes in the building at different times has shown that workers were exposed to ethylene dichloride, ethylene chlorohydrin, ethylene, and small amounts of bis-(2-chloroethyl) ether as well as to ethylene oxide and traces of other chemicals. The full-time exposed cohort shows a considerable excess mortality deriving mainly from increased mortality from tumours and also from diseases of the circulatory system. The cancer incidence study, including living persons with malignancies, showed a significant excess in the full-time cohort. Of the 16 patients with tumours in the two more exposed cohorts there were three cases of leukaemia, six of tumours in the alimentary tract and four of urogenital malignancy. The excess mortality and cancer incidence cannot be attributed to any particular chemical in the production process, but ethylene oxide and ethylene dichloride are the prime suspects.

Chemical Industry

A cohort study on mortality among dynamite workers.

Exposure to nitroglycerine and nitroglycol in the explosives industry is suspected of having caused isolated cases of sudden death. There have also been suggestions of an increased risk of chronic cardio-cerebrovascular diseases among dynamite workers. This study examines the mortality experience of a cohort of male workers from a small Swedish dynamite industry. Cause-, sex-, age-, and calendar-year-specific national incidence rates were used to calculate the expected number of deaths in a group of individuals with exposure to the dynamite manufacturing process and in an unexposed group from the same industry. During the period 1965-77, nine deaths from cardiocerebrovascular diseases were observed, versus 4.5 expected (p less than 0.05), among men with at least one year of exposure to dynamite and 20 years of induction-latency time. The unexposed group had a mortality pattern in good agreement with the national average. Exposure occurred by inhalation as well as through the skin. Precautions are urged to diminish exposure from both these absorption routes as the findings of the study support earlier reports regarding chronic vascular effects.

Adult

A case of severe compression of the coeliac artery.

A man, aged 42 years, presented as an emergency with a history of stabbing upper abdominal pain, nausea and diarrhoea of two weeks' duration. Apart from abnormal transaminase and alkaline phosphatase values, the routine clinical and laboratory examinations did not reveal any abnormality. As the abdominal pain increased in severity, particularly in association with eating, and projectile vomiting supervened, aortography was carried out and showed severe stenosis of the coeliac axis, involving about 1 cm of the artery. At operation a thick fibrous band, which originated from the median arcuate diaphragm, was seen to constrict the point of origin of the artery and to compress the vessel against the aorta. The band was divided, whereupon the coeliac artery immediately showed strong pulsations and adequate filling. Microscopic examination of the fibrous band revealed, among other structures, those characteristic of a ganglion. The symptoms disappeared after operation.

Adult