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C Reuterwall

Publications and source records attributed to C Reuterwall.

31 records · Page 2Linked to original sources
PubMed1998

Is the effect of job strain on myocardial infarction risk due to interaction between high psychological demands and low decision latitude? Results from Stockholm Heart Epidemiology Program (SHEEP).

The objectives are to examine if the excess risk of myocardial infarction from exposure to job strain is due to interaction between high demands and low control and to analyse what role such an interaction has regarding socioeconomic differences in risk of myocardial infarction. The material is a population-based case-referent study having incident first events of myocardial infarction as outcome (SHEEP: Stockholm Heart Epidemiology Program). The analysis is restricted to males 45-64 yr of age with a more detailed analysis confined to those still working at inclusion. In total, 1047 cases and 1450 referents were included in the analysis. Exposure categories of job strain were formed from self reported questionnaire information. The results show that high demands and low decision latitude interact with a synergy index of 7.5 (95% C.I.: 1.8-30.6) providing empirical support for the core mechanism of the job strain model. Manual workers are more susceptible when exposed to job strain and its components and this increased susceptibility explains about 25-50% of the relative excess risk among manual workers. Low decision latitude may also, as a causal link, explain about 30% of the socioeconomic difference in risk of myocardial infarction. The distinction between the interaction and the causal link mechanisms identifies new etiologic questions and intervention alternatives. The specific causes of the increased susceptibility among manual workers to job strain and its components seem to be an interesting and important research question.

Case-Control Studies↗
PubMed1998

Myocardial infarction in male and female dominated occupations.

The aim of the study was to investigate whether workers in jobs dominated by the opposite sex have an increased risk of myocardial infarction (MI). A case-referent study was carried out to estimate the relative risk of first MI in different occupational groups. The study base comprised all men and women in five counties in the middle of Sweden during 1976-84. Cases of MI were identified from both hospital discharge records and death records. Information on occupation was obtained from two consecutive censuses. Primary health related selection was analysed for men with data from the physical examination of conscripts to compulsory military service in 1969-70 combined with data from the censuses of 1970-90 and data on early retirement in 1971-92. Increased risk of MI was found among both women (relative risk (RR) 1.41, 95% confidence interval (95% CI) 1.15 to 1.73) and men (1.21, 1.10 to 1.32) in blue collar jobs where men predominate, and among men with white collar jobs (1.26, 1.09 to 1.45) where women predominate. However, the increased risk among men in white collar jobs was probably due to negative health selection into these occupations. These results do not support the notion that being of the sexual minority in an occupation is in itself an important risk factor for MI.

Adult↗
PubMed1998

Decision latitude, job strain, and myocardial infarction: a study of working men in Stockholm. The SHEEP Study Group. Stockholm Heart epidemiology Program.

OBJECTIVES: This study examined the role of decision latitude and job strain in the etiology of a first myocardial infarction. METHODS: Eligible case patients were all full-time working men 45 to 64 years of age who suffered a first myocardial infarction during the period January 1992 to January 1993 in the greater Stockholm region. Referents were selected from the general population. Participation rates were 82% (case patients) and 75% (referents). RESULTS: Both inferred and self-reported low decision latitude were associated with increased risk of a first myocardial infarction, although this association was weakened after adjustment for social class. A decrease in inferred decision latitude during the 10 years preceding the myocardial infarction was associated with increased risk after all adjustments, including chest pain and social class. The combination of high self-reported demands and low self-reported decision latitude was an independent predictor of risk after all adjustments. CONCLUSIONS: Both negative change in inferred decision latitude and self-reported job strain are important risk indicators in men less than 55 years of age and in blue-collar workers.

Decision Making↗
PubMed1996

How to evaluate interaction between causes: a review of practices in cardiovascular epidemiology.

To increase the knowledge of interaction or synergy between risk factors in an important task in medical research. Still, current literature in cardiovascular epidemiology reflects major misconceptions as how to evaluate interaction. This paper presents Rothman's model of causation from which strict empirical criteria of interaction can be derived. In principle, the method to apply consists of comparing risk differences for one risk factor of interest across strata of the other. Commonly used but incorrect approaches are exemplified and discussed. These include reporting risk of disease among those with combined exposure, comparing relative risks for one exposure after stratification by level of the other, and including an interaction term in the regression model and drawing conclusions from its P-value.

Cardiovascular Diseases↗
PubMed1996

Myocardial infarction among male bus, taxi, and lorry drivers in middle Sweden.

OBJECTIVES: The aim of the present case-referent study was to investigate the incidence of myocardial infarction among male professional drivers, taking the type of vehicles and area of residence into account. METHODS: The study base comprised all men aged 30-74 in five counties in middle Sweden during 1976-81 or 1976-84. Incident cases of the first episode of myocardial infarction were identified from registers of hospital admissions and causes of deaths. Referents were selected randomly from the study base. Information about occupation was obtained from the national censuses in 1970 and 1975. The possible impact from tobacco smoking and overweight were evaluated by simulations in combination with indirect data on these factors. RESULTS: The incidence of myocardial infarction was increased among bus drivers in Stockholm (relative risk (RR) = 1.53, 95% confidence interval (95% CI) 1.15-2.05), and among taxi drivers both in Stockholm (RR 1.65, 95% CI 1.30-2.11) and in the surrounding rural counties (RR 1.82, 95% CI 1.17-2.82). A smaller increase was found among long distance lorry drivers, whereas the relative risk among short distance lorry drivers was close to unity. Indirect comparisons make it unlikely that the excess among bus drivers in Stockholm could be explained by uncontrolled confounding from tobacco smoking or overweight. A very high proportion (more than 80%) of urban bus drivers in Sweden report a combination of high psychological demands and low control at work. CONCLUSIONS: Different types of drivers are at different risk of myocardial infarction. Bus drivers in urban areas seem to be at an increased risk, which is unlikely to be explained by uncontrolled confounding from tobacco smoking or overweight. Psychosocial work conditions may play a part in the increased incidence of myocardial infarction among urban bus drivers and should be investigated further.

Adult↗
PubMed1991

Assessment of genotoxic exposure in Swedish coke-oven work by different methods of biological monitoring.

This study evaluated the results of several biological methods used simultaneously to monitor coke-oven work. Blood samples from 44 male coke-oven workers and 48 male referents, matched for age and smoking/snuff consumption, were examined for cytogenetic damage in lymphocytes. Urinary thioether excretion was determined for 62, and urine mutagenicity for 31, of the subjects, who followed a standardized diet during the urine sampling. Exposure to polycyclic aromatic hydrocarbons varied with work task, the ambient air levels of benzo[a]pyrene sometimes exceeding 5 micrograms/m3. Cytogenetic damage, urine mutagenicity, and thioether excretion did not differ between the groups. The smokers, however, had significantly higher sister chromatid exchange frequencies, urine mutagenicity, and thioether excretion than the nonsmokers. The absence of biological indications of genotoxic exposure was unexpected and indicates that the studied methods are not adequate to assess the carcinogenic risks of Swedish coke-oven workers.

Adult↗
PubMed1990

Mortality and incidence of cancer among Swedish gas workers.

The mortality and incidence of cancer was studied among 295 workers at a Swedish gas production company. All men employed for at least one year between 1965 and 1972 were included in the study. The follow up period for mortality was 1966 to 1986, and the incidence of cancer was followed up from 1966 to 1983. Expected numbers of deaths were based on local death rates among occupationally active men, the expected numbers of cancer were based on national statistics. The total mortality was increased, mainly due to an excess of deaths from circulatory diseases. The excess was larger after long follow up and after long employment periods. Two cases of cancer in the nose and nasal sinuses were found; there was no excess of lung cancer. Smoking habits were investigated for a subset of the cohort and did not differ from the average for men in large cities. The findings are discussed in relation to other studies of soot and combustion exposed workers.

Adult↗
PubMed1983

Genetic differentiation in four European subspecies of red deer (Cervus elaphus L.).

Red deer representing the four different European subspecies Cervus elaphus atlanticus, C. e. elaphus, C. e. germanicus, and C. e. scoticus were examined for allozyme variability at 35 enzyme loci. The proportion of polymorphic loci within populations (P) ranged from 0 to 13.8 per cent and the average heterozygosity (H) from 0 to 3.6 per cent. These estimates are within the range previously observed among mammalian species. Significant allele frequency differences were found both within and between subspecies. The mean genetic distance between subspecies (D = 0.0164) was smaller than the differentiation at similar taxonomic levels among other ungulates, probably because of a shorter time since divergence. Within subspecies the genetic differences between populations were similar to those reported between populations within closely related species in the same geographic region. Cluster analysis based on genetic distances indicated a major genetic dichotomy between the British C. e. scoticus and the Norwegian C. e. atlanticus on one hand and the Swedish C. e. elaphus and the continental C. e. germanicus on the other. Populations of pure C. e. elaphus were not found to differ genetically in any substantial way from Swedish populations of possible heterogeneous subspecific origin. An allele unique to C. e. scoticus was found in a Swedish enclosed population where imports of British deer are known to have taken place. A population established to preserve the genetic characteristics of the C. e. elaphus subspecies appeared to have lost 36 per cent of the electrophoretically measurable heterozygosity.

Alleles↗
PubMedDate not supplied

Do episodes of anger trigger myocardial infarction? A case-crossover analysis in the Stockholm Heart Epidemiology Program (SHEEP).

OBJECTIVE: Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility. METHODS: This study was a case-crossover study within the Stockholm Heart Epidemiology Program. Exposure in the period immediately preceding MI was compared with exposure during a control period for each case. From April 1993 to December 1994, 699 patients admitted to coronary care units in Stockholm County were interviewed. RESULTS: During a period of 1 hour after an episode of anger, with an intensity of at least "very angry," the relative risk of MI was 9.0 (95% CI, 4.4-18.2). In patients with premonitory symptoms, the time of disease initiation may be misclassified. When restricting the analyses to those without such symptoms, the trigger risk was 15.7 (95% CI, 7.6-32.4). The possibility of examining effect modification was limited by a lack of statistical power (eight exposed cases). Results of the analyses suggested, however, an increased trigger effect among subjects reporting nonhostile usual behavior patterns, nonovert strategies of coping with aggressive situations (not protesting when being treated unfairly), and nonuse of beta-blockers. CONCLUSIONS: The hypothesis that anger may trigger MI is further supported, with an increased risk lasting for approximately 1 hour after an outburst of anger. It is suggested that the trigger risk may be modified by personal behavior patterns.

Adult↗