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Biomedical subjects

Henrik A Kolstad

Publications and source records attributed to Henrik A Kolstad.

9 recordsLinked to original sources

[Multiple chemical sensitivity, a well-defined illness?].

Some people react to smells or chemicals at levels far below toxicological thresholds with nonspecific symptoms, fear and social isolation. They may be diagnosed with multiple chemical sensitivity. There is no empirical evidence indicating that this condition is explained by toxicological mechanisms, even though a number of theories have been proposed. The authors of this review conclude that this is a functional condition. These patients need information and treatment in accordance with this fact. Instead of being advised how to avoid exposure to chemicals, they should be properly trained in appropriate confrontation with the chemicals encountered in everyday life.

Humans↗

Occupational disorders and return to work: a randomized controlled study.

OBJECTIVE: Goal setting and motivational factors are strongly associated with maintaining a job and return to work after sick leave, but research into the effects of interventions targeting these factors is limited. We conducted a randomized controlled study to examine the vocational effect of intervention focusing on motivation, goal setting and planning for return to work. DESIGN AND METHODS: Of 243 patients at risk of long-term sick leave or job dropout, 184 (76%) provided complete baseline information for the study. After randomization to an intervention group (n=92) and a reference group (n=92), occupational physicians examined the participants in accordance with standard guidelines. The intervention group received additional support from a social worker in order to enhance goal setting, motivation and planning for return to work. After 1 year 163 participants (89%) provided data on general health and employment status. The risk of not being gainfully employed was analysed by logistic regression analysis with adjustment for several covariates. RESULTS: The intervention did not increase the likelihood of gainful employment after 1 year or reduce the average number of days of sick leave. CONCLUSION: A low-cost counselling program addressing motivation, goal setting and planning for return to work did not improve vocational outcomes or reduce sick leave among patients with work-related disorders.

Adult↗

Company-level, semi-quantitative assessment of occupational styrene exposure when individual data are not available.

In epidemiological research, self-reported information about determinants and levels of occupational exposures is difficult to obtain, especially if the disease under study has a high mortality rate or follow-up has exceeded several years. In this paper, we present a semi-quantitative exposure assessment strategy for nested case-control studies of styrene exposure among workers of the Danish reinforced plastics industry when no information on job title, task or other indicators of individual exposure were readily available from cases and controls. The strategy takes advantage of the variability in styrene exposure level and styrene exposure probability across companies. The study comprised 1522 cases of selected malignancies and neurodegenerative diseases and controls employed in 230 reinforced plastics companies and other related industries. Between 1960 and 1996, 3057 measurements of styrene exposure level obtained from 191 companies, were identified. Mixed effects models were used to estimate expected styrene exposure levels by production characteristics for all companies. Styrene exposure probability within each company was estimated for all but three cases and controls from the fraction of laminators, which was reported by a sample of 945 living colleagues of the cases and controls and by employers and dealers of plastic raw materials. The estimates were validated from a subset of 427 living cases and controls that reported their own work as laminators in the industry. We computed styrene exposure scores that integrated estimated styrene exposure level and styrene exposure probability. Product (boats), process (hand and spray lamination) and calendar year period were the major determinants of styrene exposure level. Within-company styrene exposure variability increased by calendar year and was accounted for when computing the styrene exposure scores. Exposure probability estimates based on colleagues' reports showed the highest predictive values in the validation test, which also indicated that up to 67% of the workers were correctly classified into a styrene-exposed job. Styrene exposure scores declined about 10-fold from the 1960s-1990s. This exposure assessment approach may be justified in other industries, and especially in industries dominated by small companies with simple exposure conditions.

Case-Control Studies↗

A cohort study of Parkinson's disease and other neurodegenerative disorders in Danish welders.

OBJECTIVE: We sought to evaluate rates of hospitalizations for neurodegenerative disorders in a cohort of Danish metal manufacturing employees. METHODS: A retrospective cohort study was conducted from 1977 to 2002 among 27,839 male Danish metal-manufacturing employees, with 9,817 of those employed in departments engaged in mild or stainless-steel welding and 6,163 welders. RESULTS: The standardized hospitalization ratio and 95% confidence intervals (CI) for Parkinson's disease were 0.9 (CI = 0.7-1.2) for men in steel-manufacturing companies, 1.0 (CI = 0.7-1.5) for men in welding departments, and 0.9 (CI = 0.4-1.5) for welders. Observed numbers for other neurological conditions were small and not above population expectations. Analyses for time period worked, age, and duration of welding were unremarkable. CONCLUSIONS: This relatively large cohort study with long-term follow-up provides no support for the hypothesis that rates of hospitalization for Parkinson's disease or other neurological conditions are elevated under the exposure circumstances of these Danish workers.

Adult↗

Bleeding problems associated with occupational exposure to anticoagulant rodenticides.

OBJECTIVE: Sporadic reports have occurred on adverse health effects due to occupational exposure to anticoagulant rodenticides. We report a case of coagulation derangement in a pest-control officer and present the results of a survey of his colleagues. METHODS AND RESULTS: A 48-year-old man worked as a part-time pest-control officer applying rodenticides 3 h a week using gloves, but no mask, and without washing his hands between applications. He developed a symptomatic coagulation disturbance, probably caused by absorption of the poisons during work. No signs of coagulopathy were found in the patient's colleagues ( n=16), although basic hygiene measures were not always taken. CONCLUSION: Occupational exposure to anticoagulants should be considered in cases of unexplained bleeding. We recommend that measures be taken to minimize the risk of occupational intoxication.

Anticoagulants↗

The importance of smoking and medical history for development of small bowel carcinoid tumor: a European population-based case-control study.

OBJECTIVE: Little is known about the etiology of small bowel carcinoid tumor (SBC), but a few studies have pointed to certain medical and lifestyle factors as potential risk factors. This study aims to evaluate these findings and to identify new associations. METHODS: A population-based European multicenter case-control study was conducted from 1995 through 1997. Incident histologically verified 35-69 year-old SBC cases (n = 99) and 3335 controls were recruited; 84 cases and 2070 controls were interviewed. RESULTS: Ever being a smoker was associated with SBC (odds ratio = 1.9; 95% confidence interval 1.1-3.2) and increased risk estimates were seen for all smoking categories. SBC was associated with previous gallstone disease and ovariectomy, but only when these conditions occurred within two years prior to the SBC diagnosis. No association was seen for a history of cholecystitis, liver cirrhosis, ulcerative disease, or Crohn's disease. Intake of alcoholic beverages--as well as medical treatments with radioactive substances, hormones, or corticosteroid tablets--were not associated with SBC. CONCLUSIONS: This study indicates that tobacco smoking is a risk factor for SBC. The associations with gallstone and ovarian diseases may be due to enhanced medical surveillance during the early phase of the cancer disease.

Adult↗

Occupational risk factors for small bowel carcinoid tumor: a European population-based case-control study.

Small bowel carcinoid tumor (SBC) is a rare disease of unknown etiology but with an age-, sex-, and place-specific occurrence that may indicate an occupational origin. A European multicenter population-based case-control study was conducted from 1995 through 1997. Incident SBC cases between 35 and 69 years of age (n = 101) were identified, together with 3335 controls sampled from the catchment area of the cases. Histological review performed by a reference pathologist left 99 cases for study; 84 cases and 2070 population controls were interviewed. The industries most closely associated (a twofold or more odds ratio [OR]) with SBC, taking into account a 10-year time lag after exposure were, among women, employment in wholesale industry of food and beverages (OR, 8.2; 95% confidence interval [CI], 1.9 to 34.9]) and among men, manufacture of motor vehicle bodies (OR, 5.2; 95% CI, 1.2 to 22.4), footwear (OR, 3.9; 95% CI, 0.9 to 16.1), and metal structures (OR, 3.3; 95% CI, 1.0 to 10.4). The identified high-risk occupations with an OR above 2 were shoemakers, structural metal preparers, construction painters and other construction workers, bookkeepers, machine fitters, and welders (men). The OR for regular occupational use of organic solvents for at least half a year was 2.0 (95% CI, 1.0 to 4.2). Exposure to rust-preventive paint containing lead was suggested as another potential occupational exposure (OR, 9.1; 95% CI, 0.8 to 107). This explorative study suggests an association between certain occupational exposures and SBC, but some of these associations could be attributable to chance. All findings should be regarded as tentative.

Adult↗