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Biomedical subjects

E Läärä

Publications and source records attributed to E Läärä.

At least 19 recordsLinked to original sources
PubMed2004

Parental separation at birth and depression in adulthood: a long-term follow-up of the Finnish Christmas Seal Home Children.

BACKGROUND: Early separation of a child from the mother has been considered a risk factor for later depression. We investigated the association between very early separation and depression in adulthood in a unique dataset. METHOD: The index cohort consisted of 3020 subjects born in 1945-1965 in Finland, isolated from their family due to tuberculosis in the family and placed in special nurseries, immediately after birth, for an average time of 7 months. Those subjects alive at 1 January, 1971 were identified. For every index subject two reference subjects were chosen, the matching criteria being sex, year of birth and place of birth. Data on depression were obtained from the Finnish Hospital Discharge Register by the end of year 1998. RESULTS: In males, 4.2% of the index subjects and 2.6% (Adjusted Rate Ratio RR 1.7, 95% CI 1.3-2.3) of the reference subjects had been treated in hospital due to a depressive episode. In females the respective figures were 3.9% for index subjects and 3.6% (RR 1.1, 95% CI 0.8-1.5) for reference subjects. CONCLUSIONS: The index subjects had an elevated risk for hospital treated depression in adulthood. One explanation may be that the very early temporal separation from the mother at birth may have unfavourable effects on later psychological development. On the other hand, separation from the parents at birth was not found to be strongly associated with severe adulthood depression.

Adolescent↗
PubMed2001

Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study.

BACKGROUND: Dietary vitamin D supplementation is associated with reduced risk of type 1 diabetes in animals. Our aim was to ascertain whether or not vitamin D supplementation or deficiency in infancy could affect development of type 1 diabetes. METHODS: A birth-cohort study was done, in which all pregnant women (n=12055) in Oulu and Lapland, northern Finland, who were due to give birth in 1966 were enrolled. Data was collected in the first year of life about frequency and dose of vitamin D supplementation and presence of suspected rickets. Our primary outcome measure was diagnosis of type 1 diabetes by end of December, 1997. FINDINGS: 12058 of 12231 represented live births, and 10821 (91% of those alive) children were followed-up at age 1 year. Of the 10366 children included in analyses, 81 were diagnosed with diabetes during the study. Vitamin D supplementation was associated with a decreased frequency of type 1 diabetes when adjusted for neonatal, anthropometric, and social characteristics (rate ratio [RR] for regular vs no supplementation 0.12, 95% CI 0.03-0.51, and irregular vs no supplementation 0.16, 0.04-0.74. Children who regularly took the recommended dose of vitamin D (2000 IU daily) had a RR of 0.22 (0.05-0.89) compared with those who regularly received less than the recommended amount. Children suspected of having rickets during the first year of life had a RR of 3.0 (1.0-9.0) compared with those without such a suspicion. INTERPRETATION: Dietary vitamin D supplementation is associated with reduced risk of type 1 diabetes. Ensuring adequate vitamin D supplementation for infants could help to reverse the increasing trend in the incidence of type 1 diabetes.

Adult↗
PubMed2001

Decreasing incidence and improved survival of laryngeal cancer in Finland.

The decreasing incidence rate and improvement in survival of laryngeal cancer patients in Finland are exceptions among western countries. A descriptive study of these trends was conducted including both nationwide population-based cancer registry data with 5 766 patients diagnosed in 1956-1995 and regional hospital-based data from Northern Finland, allowing classification into supraglottic and glottic cancers, with 353 patients diagnosed in 1976-1995. In Finland, the age-adjusted incidence rate among males decreased from 6.5 per 100 000 in 1956-1965 to 3.5 in 1986-1995, while in females the rate remained around 0.3 per 100 000. The rates in Northern Finland were slightly higher and the supraglottic to glottic incidence ratio diminished from 1.4:1 in 1976-1985 to 0.5:1 in 1986-1995. The 5-year relative survival rate improved in both Northern Finland and the whole country, most noticeably among males and the elderly. In the data from Northern Finland, the survival rate was more favourable in glottic (80%) than in supraglottic cancer (64%). Considering the marked decrease in the incidence of the less favourable supraglottic disease, the observed improvement in survival was small.

Adolescent↗
PubMed2001

Dynamic pattern of disease-associated autoantibodies in siblings of children with type 1 diabetes: a population-based study.

To study the dynamics of disease-associated humoral immune responses, we analyzed autoantibodies to the IA-2 protein (IA-2A), glutamic acid decarboxylase (GADA), and insulin (IAA) and also islet cell antibodies (ICA) in a population-based, prospective, representative series of 710 siblings (<20 years of age) of children with type 1 diabetes. Positivity for single autoantibodies was observed in 8-13% of these siblings during an average follow-up of 4 years. The overall incidence rates per 1,000 years (number of cases/person-years in parentheses) for positive seroconversion of IA-2A were nine (19/2,123), followed by six (12/2,049) for GADA, 19 (40/2,111) for IAA, and 16 (31/1965) for ICA. Positive seroconversions seemed to be associated with a young age of the sibling, HLA DR3/DR4 heterozygosity, HLA identity, and a high initial number of detectable autoantibodies. The overall incidence rates per 1,000 years (number of cases/person-years in parentheses) for inverse seroconversion of IA-2A were 76 (12/157), followed by 42 (10/237) for GADA, 460 (32/70) for IAA, and 27 (9/331) for ICA. No consistent risk factor for inverse seroconversions was present, although seroconversions were most frequent in siblings with older age, male sex, HLA phenotypes other than DR3/DR4, a small family size, and no other autoantibodies detectable at seroconversion. Altogether, these observations indicate that beta-cell autoimmunity may be induced at any age in childhood and adolescence. HLA-conferred genetic disease susceptibility is a strong determinant of persistent beta-cell autoimmunity, but environmental factors may also contribute to such autoimmunity.

Adolescent↗
PubMed2000

Search for an optimal combination of structural and functional parameters for the diagnosis of glaucoma. Multivariate analysis of confocal scanning laser tomograph, blue-on-yellow visual field and retinal nerve fiber layer data.

BACKGROUND: The purpose of this study was to evaluate which of the structural and functional parameters--the Heidelberg Retina Tomograph (HRT), white-on-white (W/W) and blue-on-yellow (B/Y) visual fields and semiquantitative retinal nerve fiber layer (RNFL) scoring parameters--can give the best separation between non-glaucomatous and glaucomatous eyes. METHODS: Fifty-five subjects were included in this study: 32 nonglaucomatous subjects with mean age of 54 years, and 23 patients with ocular hypertension or glaucoma and mean age of 59 years. The HRT with software 1.11, the Humphrey 30-2 W/W and lens coloration-corrected B/Y visual fields, and semiquantitative RNFL scores were utilized. Stepwise logistic regression analysis was used in finding, from a given set of parameters, a best discriminating parsimonious subset to a logistic model, the discriminatory performance of which was evaluated by the area under the ROC curve. RESULTS: When all the structural and functional variables were considered, the RNFL total overall score gave the best separation between glaucomatous and non-glaucomatous eyes (ROC area 0.98). Without the RNFL scores and optic disc size-dependent HRT parameters in the model, the cup shape measure was selected first (ROC area 0.88). In the second step the RNFL thickness was selected (ROC area 0.91), and in the third step the corrected B/Y mean deviation (MD) was selected (ROC area 0.91). With only the HRT parameters in the model, the cup/disc ratio was selected first (ROC area 0.88). However, when the groups were matched for optic disc size, all disc size-dependent HRT variables lost their discriminant power. CONCLUSION: Cup shape measure and RNFL thickness, together with age- and lens coloration-corrected MD of the B/Y perimetry provided good discrimination between healthy individuals and patients with glaucoma.

Adult↗
PubMed2000

Comparison of ultrasound, radiography, and clinical examination in the diagnosis of acute maxillary sinusitis: a systematic review.

The objective of this study was to assess the discriminative properties of the methods for diagnosing acute maxillary sinusitis (AMS) in unselected patients. The study design was a systematic review of evaluation studies identified by using Medline, by searching reference lists, by hand searches, and by contacting investigators. Evaluation studies were conducted anywhere in the world. Subjects were adults with suspected AMS. Main outcome measures were: sensitivity, specificity, positive and negative likelihood ratios of the primary studies, weighted means of these parameters in each comparison (clinical examination, radiography, and ultrasound compared to a reference standard in diagnosing AMS), and summary ROC curves and their Q* points where sensitivity equals specificity. For the years from 1962 to present, 49 study reports were found; 11 articles on studies that included a total of 1144 patients were eligible. Compared to sinus puncture, radiography was the most accurate method for diagnosing AMS: the Q* point on the summary ROC curve was 0.82 (95% confidence interval, CI, 0.78-0.85). Ultrasound was slightly less accurate than radiography compared to sinus puncture (Q* 0.80, 95% CI 0.76-0.83). Only two articles reported clinical examination compared to sinus puncture and the Q* for them was 0.75 (95% 0.58-0.86). Clinical examination is a rather unreliable method for diagnosing AMS, even in the hands of experienced specialists. Using radiography or ultrasound improves the accuracy of diagnosis. The diagnosis of AMS is rarely studied in primary care settings. Future comparative trials should preferably combine diagnosis and treatment, evaluating the two aspects of clinical management as unit.

Acute Disease↗
PubMed2000

Psoriasis, its treatment, and cancer in a cohort of Finnish patients.

This study was designed to estimate the relative cancer risk of patients with moderate to severe psoriasis, with reference to different treatments. A cohort of 5687 hospitalized patients with psoriasis obtained from the Finnish Hospital Discharge Register in 1973-84 was linked with the records of the Finnish Cancer Registry. Standardized incidence ratios for cancer were calculated by dividing the observed number of cases by the expected cases, which were based on the national sex-specific and age-specific cancer incidence rates. By the end of 1995, 533 cancer cases were observed in the cohort. The overall cancer incidence was increased (standardized incidence ratio 1.3, 95% confidence interval 1.2-1.4). The estimated relative risks were highest for Hodgkin's disease (standardized incidence ratio 3.3, 95% confidence interval 1.4-6.4), squamous cell skin carcinoma (standardized incidence ratio 3.2, 95% confidence interval 2.3-4.4), non-Hodgkin's lymphoma (standardized incidence ratio 2.2, 95% confidence interval 1.4-3.4), and laryngeal cancer (standardized incidence ratio 2.9, 95% confidence interval 1.5-5.0). The role of prior oral antipsoriatic medications or phototherapy on the development of these cancers was assessed in a nested case-control study, for which 67 cases and 199 sex and age matched controls were selected from the psoriasis cohort. The relative risks were estimated using conditional logistic regression analysis. Oral 8-methoxy-psoralen plus ultraviolet-A radiation therapy and the use of retinoids were associated with an increased risk of squamous cell skin carcinoma (relative risk adjusted for the other treatment variables 6.5, 95% confidence interval 1.4-31, and 7.4, 95% confidence interval 1.4-40, respectively), whereas none of the treatments could be linked with the occurrence of non-Hodgkin's lymphoma.

Carcinoma, Squamous Cell↗
PubMed2000

Cow's milk consumption, HLA-DQB1 genotype, and type 1 diabetes: a nested case-control study of siblings of children with diabetes. Childhood diabetes in Finland study group.

The evidence for the putative role of cow's milk in the development of type 1 diabetes is controversial. We studied infant feeding patterns and childhood diet by structured questionnaire (n = 725) and HLA-DQB1 genotype by a polymerase chain reaction-based method (n = 556) in siblings of affected children and followed them for clinical type 1 diabetes. In a nested case-control design in a population who had both dietary and genetic data available, we selected as cases those siblings who progressed to clinical diabetes during the follow-up period (n = 33). For each case, we chose as matched control subjects siblings who fulfilled the following criteria: same sex, age within 1 year, not from the same family, the start of the follow-up within 6 months of that of the respective case, and being at risk for type 1 diabetes at the time the case presented with that disease (n = 254). The median follow-up time was 9.7 years (range 0.2-11.3). Early age at introduction of cow's milk supplements was not significantly associated with progression to clinical type 1 diabetes (relative risk adjusted for matching factors, maternal education, maternal and child's ages, childhood milk consumption, and genetic susceptibility markers was 1.60 [95% CI 0.5-5.1]). The estimated relative risk of childhood milk consumption for progression to type 1 diabetes was 5.37 (1.6-18.4) when adjusted for the matching and aforementioned sociodemographic factors, age at introduction of supplementary milk feeding, as well as for genetic susceptibility markers. In conclusion, our results provide support for the hypothesis that high consumption of cow's milk during childhood can be diabetogenic in siblings of children with type 1 diabetes. However, further studies are needed to assess the possible interaction between genetic disease susceptibility and dietary exposures in the development of this disease.

Adolescent↗
PubMed1999

Incremental effectiveness of pneumococcal vaccine on simultaneously administered influenza vaccine in preventing pneumonia and pneumococcal pneumonia among persons aged 65 years or older.

The effectiveness of simultaneously administered influenza and pneumococcal vaccines vs. influenza vaccine alone in preventing pneumonia, pneumococcal pneumonia and pneumococcal bacteraemia among the elderly was studied. The vaccines were offered to all persons aged 65 years or older (N=43,500) living in 35 administrative districts in Northern Finland. A total of 26,925 persons (62%) decided to participate. Allocation to the vaccination groups took place by year of birth (odd/even). The total follow-up of those vaccinated consisted of 38,037 person years. The incremental effectiveness of the pneumococcal vaccine was -20 (95% CI -50- + 10%) for pneumonia, -20 (95% CI -90- + 20%) for pneumococcal pneumonia and + 60% (95% CI -40- +90%) for pneumococcal bacteraemia. Thus the pneumococcal polysaccharide vaccine did not offer any additional protection from pneumonia among elderly people in Finland although it reduced the incidence of bacteraemia.

Aged↗
PubMed1999

Changes in glucose tolerance during three years' follow-up in an elderly population.

The aim of this study was to describe changes in glucose tolerance over 3 y and to establish the prevalence of diabetes and impaired glucose tolerance in an unselected non-institutionalised elderly population aged 70 y or over at the beginning of the study. Diabetes was assessed on the basis of self-reports and 2 h oral glucose tolerance tests which were classified according to the 1985 WHO criteria. At the end of the follow-up period, 15% (n=14) of the men were diagnosed as having previously diagnosed diabetes, 8% (n=7) as having previously undiagnosed diabetes, 36% (n=33) as having IGT and the remaining 41% (n=38) as having normal glucose tolerance. The corresponding figures for the women were: 22% (n=37), 8% (n=13), 37% (n=61) and 34% (n=56), respectively. More than one third of the people with baseline normal glucose tolerance (NGT) had progressed to impaired glucose tolerance (IGT) or diabetes mellitus (DM) (n=44). Almost one third of those with baseline IGT had reverted to NGT (n=24), half had persisting IGT (n=41) and one fifth had progressed to DM (n=14). Almost one fifth of the subjects with baseline DM had reverted to IGT (n=12), and only one had reverted to NGT. In conclusion, a comparatively high proportion of both previously diagnosed diabetes, previously undiagnosed diabetes and IGT were found in the follow-up examinations of this elderly study population. The rate of deterioration of glucose tolerance during 3 y follow-up was also moderately high among these elderly subjects.

Age Factors↗
PubMed1999

Cancer of the mobile tongue in Finland--increasing incidence, but improved survival.

A population-based descriptive study was conducted to describe incidence and survival of cancer of the mobile tongue in Finland between 1953 and 1994. The study included 1504 patients, drawn from the Finnish Cancer Registry, with first primary mobile tongue cancer diagnosed between 1953 and 1994. Incidence and relative survival were determined. The age-standardized overall incidence rate was 0.6 per 100000 years in 1953-1994. At the time of diagnosis 78% of the patients had either localized or regional disease. The age-standardized incidence rate decreased after the mid-1960s, but increased in the 1990s. The 5-year relative survival rate increased gradually from 40% in 1953 1959 to 58% in 1988-1994. Disease stage at the time of the diagnosis strongly affected the survival rate. Survival increased especially in regional disease. Cancer of the mobile tongue is increasing in Finland, but survival has increased particularly in regional disease, probably because of improved treatment. Early diagnosis is emphasized for a good prognosis.

Adolescent↗
PubMed1999

A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers.

BACKGROUND: Recently, two centers have independently developed a risk score for predicting postoperative nausea and vomiting (PONV). This study investigated (1) whether risk scores are valid across centers and (2) whether risk scores based on logistic regression coefficients can be simplified without loss of discriminating power. METHODS: Adult patients from two centers (Oulu, Finland: n = 520, and Wuerzburg, Germany: n = 2202) received inhalational anesthesia (without antiemetic prophylaxis) for various types of surgery. PONV was defined as nausea or vomiting within 24 h of surgery. Risk scores to estimate the probability of PONV were obtained by fitting logistic regression models. Simplified risk scores were constructed based on the number of risk factors that were found significant in the logistic regression analyses. Original and simplified scores were cross-validated. A combined data set was created to estimate a potential center effect and to construct a final risk score. The discriminating power of each score was assessed using the area under the receiver operating characteristic curves. RESULTS: Risk scores derived from one center were able to predict PONV from the other center (area under the curve = 0.65-0.75). Simplification did not essentially weaken the discriminating power (area under the curve = 0.63-0.73). No center effect could be detected in a combined data set (odds ratio = 1.06, 95% confidence interval = 0.71-1.59). The final score consisted of four predictors: female gender, history of motion sickness (MS) or PONV, nonsmoking, and the use of postoperative opioids. If none, one, two, three, or four of these risk factors were present, the incidences of PONV were 10%, 21%, 39%, 61% and 79%. CONCLUSIONS: The risk scores derived from one center proved valid in the other and could be simplified without significant loss of discriminating power. Therefore, it appears that this risk score has broad applicability in predicting PONV in adult patients undergoing inhalational anesthesia for various types of surgery. For patients with at least two out of these four identified predictors a prophylactic antiemetic strategy should be considered.

Adult↗
PubMed1999

Trends in chronic maxillary sinusitis that require surgical treatment in northern Finland.

To examine trends in the incidence of chronic maxillary sinusitis that require surgical treatment in northern Finland, a retrospective population-based survey from 1974 through 1995 was conducted. Data on surgical cases and on various demographic factors and on variables describing medical care in the area were collected for every third year. The overall crude incidence rate (per 100,000 person-years) of chronic maxillary sinusitis requiring surgical therapy was 44 for children and 76 for adults. The age-standardized incidence rate dropped by 78% in children, and by 66% in adults during the period. The changes found to have taken place in the population and in medical care and which could have promoted the decrease were higher educational level and mean income, smaller families, improved level of hygiene, a higher number of physicians and an expanded use of broader-spectrum antibiotics. In conclusion, the most serious forms of chronic maxillary sinusitis, that require operative treatment, are decreasing in both children and adults in northern Finland.

Adolescent↗
PubMed1998

Cow's milk consumption, disease-associated autoantibodies and type 1 diabetes mellitus: a follow-up study in siblings of diabetic children. Childhood Diabetes in Finland Study Group.

Evidence from case-control studies for the diabetogenicity of introduction of cow's milk-based formulas at early age in infancy is inconclusive. We followed siblings of children with Type 1 diabetes mellitus (Type 1 DM) to investigate a possible relationship between cow's milk consumption during infancy or later in childhood and the emergence of diabetes-associated autoantibodies and progression to clinical Type 1 DM. A cohort of 725 initially unaffected 0 to 25-year-old siblings of 801 index children with Type 1 DM diagnosed in 1986-1989 participated in the study (82% of those invited). The siblings were observed for Type 1 DM associated autoantibodies at intervals of 3-12 months for 4 years, starting from the diagnosis of Type 1 DM in the index child. The follow-up for Type 1 DM started at the same time and ended on 31 October 1995. The combined prevalence of Type 1 DM associated autoantibodies (islet cell antibodies (ICA), insulin autoantibodies (IAA), GAD autoantibodies (GADA), and/or antibodies to the insulinoma associated cDNA2 protein (IA-2A)) was 13.6% (95/697) at the beginning of the study. Of the initially seronegative siblings, 7.5% (45/602) converted to antibody positivity during 4 years, and of all siblings 4.6% (33/725) developed Type 1 DM during the total follow-up time. The age at introduction of supplementary milk feeding was not significantly related to seroconversion to positivity for Type 1 DM associated autoantibodies or to the development of Type 1 DM in the siblings. When adjusted for age, sex, infant feeding patterns, and maternal age and education, high milk consumption in childhood (> or =3 glasses daily) was associated with more frequent emergence of Type 1 DM-associated autoantibodies than low consumption (<3 glasses daily) (adjusted odds ratio 3.97, 95% confidence interval 1.3-11.7, p = 0.01). There was a non-significant association between high milk consumption and progression to clinical Type 1 DM (adjusted hazard ratio 2.75, 95% confidence interval 0.9-8.4, p = 0.07). To conclude, this study suggests that high consumption of cow's milk during childhood may be associated both with seroconversion to positivity for diabetes-associated autoantibodies and progression to clinical Type 1 DM among siblings of children with diabetes.

Adolescent↗
PubMed1998

Glucose tolerance and mortality in an elderly Finnish population.

The aim of this study was to describe the association between glucose tolerance status and mortality in an elderly (> 70 years) Finnish community-living population (n = 379, of whom 141 were men). The baseline examination in 1991-1992 consisted of a postal questionnaire, a physical examination, and a 2-h oral glucose tolerance test. The follow-up was continued until death or 31 May 1996. The deaths were ascertained from official death certificates; 31% (n = 44) of the men and 18% (n = 40) of the women died within 4 years. The cumulative 4-year mortalities were 42% in previously diagnosed diabetic men, 25% in previously undiagnosed diabetic men, 27% in men with impaired glucose tolerance (IGT), and 31% in men with normal glucose tolerance (NGT). The corresponding figures for women were: 26%, 29%, 19%, and 8%, respectively. After adjusting for age, gender, smoking, body mass index and exercise by the Cox proportional hazards model in the total population, the estimated relative mortality rate was 2.2 (95% confidence interval (CI) 1.2 to 4.1) in previously diagnosed diabetic subjects, 1.7 (95% CI 0.8 to 3.7) in subjects with previously undiagnosed diabetes, and 1.2 (95% CI 0.7 to 2.1) in the IGT group, respectively, all in comparison to the NGT subjects. In separate modelling by gender these relative mortalities were higher in women than in men, but the gender difference could well be explained by chance variation. In conclusion, the results suggest that previously diagnosed diabetes is associated with increased mortality among the elderly and, particularly among elderly women, undiagnosed diabetes and even IGT may be associated with increased mortality.

Aged↗
PubMed1997

Serological evidence of an association between Chlamydia pneumoniae infection and lung cancer.

Epidemiological evidence suggests that airway obstruction is an independent risk factor for lung cancer and that this cannot be explained by active or passive smoking alone. Chlamydia pneumoniae infection has been associated with chronic bronchitis and its exacerbates. Our aim was to evaluate the association between chronic C. pneumoniae infection and risk of lung cancer among male smokers. Smoking males with lung cancer (n = 230) and their age- and locality-matched controls were selected among participants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. The presence of C. pneumoniae infection was assessed by analyzing specific antibodies and immune complexes in 2 serum samples collected with a 3-year interval before the lung cancer diagnosis. The diagnosis of chronic infection was based on stable levels of positive specific IgA antibody (titer > or = 16) and immune complex (titer > or = 4). Relative risks were estimated by odds ratios (OR) adjusted for age, locality and smoking history by a conditional logistic regression model. Markers suggesting chronic C. pneumoniae infection were present in 52% of cases and 45% of controls and hence were positively associated with the incidence of lung cancer (OR 1.6; 95% confidence interval [CI] 1.0-2.3). The incidence was especially increased in men younger than 60 years (OR 2.9; 95% CI 1.5-5.4) but not in the older age group (OR 0.9; 95% CI 0.5-1.6). Before concluding that C. pneumoniae infection is a new independent risk factor for lung cancer, corroboration from other studies with larger number of cases and longer follow-up is needed.

Age Factors↗
PubMed1997

Postal questionnaire study of disability associated with latex allergy among health care workers in Finland.

In this study, the association between natural rubber latex (NRL) sensitization and work ability index (WAI) among health care workers was investigated. Furthermore, the diagnostic sensitivity and specificity of a postal questionnaire as a screening device of NRL allergy was evaluated. The study population consisted of 32 female health care workers with an occupational latex allergy, and 51 control subjects who were individually matched for age and occupation. A self-administered two-part questionnaire, including seven items of a work ability index (WAI), as well as questions on glove-related symptoms, was mailed to the subjects. The median age for NRL allergic subjects was 40 years (range 23-62), and the diagnosis of occupational latex allergy had been made six years (range 2-16) before the present study. The WAI scores were on average lower among the sensitized subjects as compared with their nonsensitized controls. Even after removing the contribution of the presence of allergic eczema, diagnosed by a physician, from the original WAI score, the proportion of NRL allergic subjects and the control subjects in the good work ability category were 34% and 53%, respectively. Ten health care workers (31%) had changed occupation and one early retirement had occurred after sensitization to NRL. The sensitivity and specificity of the present self-administered questionnaire as an indicator for latex allergy was 84% and 98%, respectively. In conclusion, there is a clear association between NRL allergy and a decrease in the WAI among health care workers, which cannot be explained by age, gender, profession, or history of atopy.

Adult↗