PubMed Health⌕ Search

Biomedical subjects

I Vohlonen

Publications and source records attributed to I Vohlonen.

At least 19 recordsLinked to original sources
PubMed2000

Increase of specific symptoms after long-term use of chlorophenol polluted drinking water in a community.

Chlorophenols contaminated the drinking water system and a local lake in the village of Järvelä in southern Finland. Period prevalence rates of symptoms, signs and diseases among the residents 15 years or older who responded (69%) to a survey in the contaminated area (1773 subjects) were compared with the rates of three uncontaminated areas (2018 subjects). Gastrointestinal and skin symptoms, in particular, were significantly (p < 0.05) more common in the contaminated area than in each control area. Nausea, general malaise, headache, anorexia, exceptional tiredness, and respiratory infections were significantly increased compared to the control areas combined. A dose-response was also observed: higher consumption of drinking water and contaminated fish further significantly increased (p < 0.05) reported symptoms. In conclusion, long-term use of chlorophenol polluted household water and fish can cause symptoms already familiar in connection with occupational chlorophenol exposures.

Chlorophenols↗
PubMed1989

Risk factors for fever, endometritis and wound infection after abdominal delivery.

Risk factors for postoperative fever, endometritis and wound infection were analyzed in 761 consecutive cesarean sections. Postoperative fever was observed in 12%, endometritis in 4.7% and wound infection in 3% of cases. The relative risk for postoperative fever was increased in cases with postoperative hematoma (relative risk = 16.0), in cases with blood loss over 500 g (relative risk = 1.8) and if the duration of labor exceeded 6 h (relative risk = 1.9). The only significant risk factors for endometritis were amnionitis (relative risk = 8.7), postoperative hematoma (relative risk = 5.0) and age under 24 years (relative risk = 3.0). Wound infections were less frequent in cases with previous cesarean sections (relative risk = 0.15) and after elective cesarean sections (relative risk = 0.22), but duration of operation over 1 h (relative risk = 2.8), induction of labor (relative risk = 3.2) and puerperal endometritis (relative risk = 7.9) increased the risk of wound infection. By elimination of amnionitis and postoperative hematomas the rate of endometritis would have diminished only from 4.7% to 3.8%, a percentage equally unacceptable; diagnostics and prevention should be directed to young patients undergoing caesarean section. Besides technical procedures prevention of endometritis is important for the prevention of wound infection. In hospitals with low postcesarean infectious morbidity antibiotic prophylaxis seems to be unwarranted.

Cesarean Section↗
PubMed1989

Re-organizing primary medical care in Finland: the personal doctor program.

This article reports the results of an evaluation of the 'Personal Doctor Program' in Finland, a demonstration project to re-structure the primary medical activities of general practitioners within publicly operated health centers. The goal of the personal doctor program is to achieve the clinical advantages and performance incentives of enrolling each citizen on a specific general practitioners's list, but within the broader team-based and demographic responsibility framework of a primary health center. The background and methodology of the project is presented, followed by the methodology and analysis of the evaluation itself. The two key conclusions from this assessment suggest that the personal doctor approach considerably improved the quality of primary medical care within the health center, and that publicly salaried physicians produce at least the same overall value as their privately employed counterparts.

Data Collection↗
PubMed1989

Reproducibility of the skin prick test.

Reproducibility of the skin prick method of testing for allergy was studied in 20 subjects examined by four nurses. Hypodermic needles were used for pricking and the test panel included a histamine control, a diluent control, and nine allergens. The reproducibility of the method was best when the size of the weal reaction caused by an allergen was expressed as the geometric area of the weal. When the weal reaction was expressed as the ratio of the weal reaction caused by an allergen to that caused by histamine, the reproducibility of the method was decreased considerably. When the ratios were further classified into three class ratings, reproducibility was very low. The reduction in reproducibility was due to the low reproducibility of histamine reactions. According to these results, at least in epidemiological studies the weal reactions should be expressed as geometric areas. In clinical practice it might also be preferable to express prick test results as the diameters of the weals without adjusting them by histamine reactions.

Allergens↗
PubMed1987

Atopy, smoking, and chronic bronchitis.

The aim was to test the hypothesis that atopy increases the occurrence of chronic bronchitis. Relations between atopy, smoking, and chronic bronchitis were studied in farmers. The data were from two successive postal surveys and a skin prick tested subsample. The cross-sectional study consisted of 9017 farmers. Those 6899 farmers who did not have chronic bronchitis at the beginning and who continued farming were followed for three years. A sample of 150 farmers was skin-tested with 36 allergens. The prevalence of chronic bronchitis (rate per 1000), standardised for age and sex, was 41 in non-atopic non-smokers, 101 in atopic non-smokers, 106 in non-atopic smokers, and 257 in atopic smokers (effect of atopy: p less than 0.001; effect of smoking: p less than 0.001). The standardised incidence rates of chronic bronchitis (per 1000 farming years) were 14, 34, 36, and 50, respectively (atopy: p less than 0.001; smoking p less than 0.001). The relative risk of chronic bronchitis, calculated from the incidence data adjusting for the effects of age, sex, smoking or atopy by logistic regression analysis was 2.2 for atopy (95% confidence interval 1.8-2.7) and 2.3 for smoking (1.8-2.9). Only 20 farmers had chronic bronchitis in the skin-tested subjects; the results were consistent with the findings in the surveys but did not reach statistical significance for atopy. In conclusion, atopy and smoking have independent and additive effects on the occurrence of chronic bronchitis at least in dusty farming work.

Adult↗
PubMed1987

Precipitins against microbes in mouldy hay in the sera of farmers with farmer's lung or chronic bronchitis and of healthy farmers.

The aim of this study was to determine which precipitins against four antigens in 2,440 farmers are associated with the occurrence of farmer's lung (FL). The antigen panel consisted of mycelial antigens of Micropolyspora faeni, Thermoactinomyces vulgaris, Aspergillus fumigatus and Aspergillus umbrosus. As reference groups we used healthy farmers and those with chronic bronchitis. For the occurrence of precipitins against the four antigens there was a statistically significant difference between farmers with FL and healthy farmers but not between farmers with chronic bronchitis and healthy farmers. In a stepwise logistic linear regression analysis, farmers with FL and chronic bronchitis were compared to healthy farmers with respect to precipitins to the four antigens. Precipitins against Thermoactinomyces vulgaris differentiated farmers with FL (p less than 0.05) but not farmers with chronic bronchitis from healthy farmers. In Finland the occurrence of FL seems to be associated mainly with precipitins against Thermoactinomyces vulgaris, not with precipitins against Micropolyspora faeni as in Great Britain, and not with precipitins of Aspergillus umbrosus, which occurred most frequently in the sera of Finnish farmers. This association is in accordance with the exposure to spores of airborne moulds in farmers' work environment, where spore concentrations of Thermoactinomyces vulgaris have been measured to be about six times higher than those of Micropolyspora faeni.

Antibodies, Bacterial↗
PubMed1987

Prevalence of serum precipitins against microbes in mouldy hay, and of chronic bronchitis and farmer's lung with respect to farmers' occupational health hazards.

During the farmers' occupational health study 1979-82, the work conditions of 3,358 randomly selected farmers were investigated with respect to occurrence of work-related health hazards. The farmers also underwent a health examination in their local health centre, and precipitating antibodies against four microbes present in mouldy hay were analyzed. Results of the precipitin tests and the symptoms of chronic bronchitis and farmer's lung were analyzed with respect to the occurrence of work-related exposures to biological agents and dust in farming. The prevalence of antibodies against Aspergillus umbrosus was largest (6.9%) among farmers with biological health hazards. The occurrence of antibodies against any of the four microbes was associated more with work-related biological agents than with dust exposures. Chronic bronchitis and farmer's lung were also more common among farmers with exposures to biological agents and dust than among those without such exposures. The work conditions were investigated independently of the results of the health examinations. Occurrence of chronic bronchitis and farmer's lung are associated with the work-related health hazards in farming. For proper delivery of occupational health services methods of investigating work-related health hazards need to be improved.

Antibodies, Bacterial↗
PubMed1987

Atopic sensitization of dairy farmers to work-related and common allergens.

Atopic sensitization was studied using skin tests on 93 randomly selected, non-smoking dairy farmers. The farmers lived in the municipality of Pielavesi, in eastern Finland. The reference group consisted of 84 non-smoking teachers randomly selected from all the teachers employed by the city of Kuopio, which is in the same administrative district as Pielavesi. Thirty-four allergens were included in the test panel. For testing these allergens, we used the prick technique with disposable precision lancets. The prevalence of a positive skin-test reaction (weal size at least 3 mm X 3 mm) was 19.4% among the farmers and 15.5% among the teachers. The number of positive reactions to cow epithelium was significantly greater among farmers than among teachers. Only to mugwort pollen did teachers have significantly more positive reactions than farmers. Teachers had stronger reactions than farmers to cat, dog, and horse epithelium. Farmers had significantly stronger reactions than teachers to cow epithelium and oat pollen. Our results emphasize the importance of cow epithelium and oat pollen as occupational sources of allergens among dairy farmers.

Adult↗
PubMed1987

Sensitization to storage mites and other work-related and common allergens among Finnish dairy farmers.

Skin-tests with the prick technique were made on 121 dairy farmers with allergic rhinitis and/or asthma (symptomatic subjects), 64 dairy farmers without respiratory symptoms (asymptomatic subjects), and 26 non-farming controls. The antigen panel consisted of the storage mites Acarus siro, Lepidoglyphus destructor, and Tyrophagus putrescentiae, as well as other work-related allergens (cereal grains, animal epithelia, fungi and yeasts), and common allergens (house dust mite, pollens). Mean areas of weals formed by individual allergens were adjusted by analysis of covariance for age, sex, and atopic background (past or present atopic dermatitis including infantile eczema). Adjusted mean weal areas for almost all allergens, except pollens and few other allergens, were significantly larger in farmers than in non-farming controls. In contrast, only skin reactions to cow dander, to a non-dialyzed crude preparation of fodder yeast Candida utilis, and to Candida albicans distinguished symptomatic subjects from asymptomatic ones. Stepwise discriminant analysis, in which reactions to all allergens as well as age, sex, and atopy were taken into account simultaneously, revealed that reactions to a dialysed preparation of fodder yeast best distinguished symptomatic farmers from asymptomatic ones. C. utilis and C. albicans may be cross-reactive. The results imply that skin tests alone are of limited value in the search for work-related causes of rhinitis or asthma among dairy farmers. Our study confirms the importance of cow dander as an occupational allergen in dairy farming. Fodder yeast seems to be another important occupational sensitizer.

Agricultural Workers' Diseases↗
PubMed1987

Lung function of farmers with respect to atopy and smoking.

This study was based on a sample of 1,831 farmers with no symptoms of the lower respiratory tract, which was taken from a larger survey population of 12,056 farmers. Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were determined cross-sectionally in connection with health examinations at local health centres. Background data, which included age, sex, height, presence of atopic symptoms, and smoking habits, were gathered in a postal survey conducted by the Social Insurance Institution of Finland. Mean FEV1 and mean FVC were adjusted for age, sex, and height; FEV1 was also adjusted for FVC. Although atopy (defined on the basis of past or present atopic dermatitis, including infantile eczema, and/or hay fever or other allergic rhinitis) had no effect on mean FEV1, mean FVC was lower in atopic than in non-atopic subjects. Both mean FEV1 and mean FVC were lower in smokers than in non-smokers. Smoking thus influenced both FEV1 and FVC, but affected FEV1 slightly more. The effects of atopy and smoking on FVC seemed to be additive. These results, which imply that atopy may predispose obstruction of small airways, match our previous finding that atopy and smoking increase the occurrence of chronic bronchitis additively.

Adult↗
PubMed1987

Effect of indoor feeding season for cattle on lung function of dairy farmers.

The effect of the indoor feeding season for cattle on pulmonary function was studied in 91 randomly selected healthy, non-smoking dairy farmers who did not use personal dust respirators. All the farmers lived in the rural municipality of Pielavesi in eastern Finland. The reference group consisted of 90 healthy, non-smoking urban dwellers who were teachers randomly selected from all the teachers employed by the city of Kuopio (situated in the same administrative district as Pielavesi). Studies of pulmonary function included flow-volume spirometry and measurement of pulmonary diffusing capacity. Among farmers, even a follow-up period of only 6 months was long enough to reveal restrictive impairment in lung function; among teachers restrictive impairment was not found. No evidence of impairment of pulmonary diffusing capacity was found in either of the study groups during the follow-up. Among teachers, changes in lung function did not differ from those previously reported as physiologically normal.

Adult↗
PubMed1987

Characteristics of farmers who have obtained personal dust respirators.

A postal survey was used to investigate the characteristics of farmers who have acquired dust respirators. In 1979 about a quarter of the farmers were using dust respirators, men more often than women. The more vocational training the farmer had and the larger the area of land under cultivation the more likely he was to own a dust respirator. Grain producers had purchased the protective devices more frequently than other farmers had. Farmers who participated in the occupational health intervention during 1980-82 had acquired dust respirators considerably more often than those in the control group. In the intervention group men under 30 years had most frequently purchased the dust respirators. Participation in the intervention influenced the acquisition of dust respirators more than did occurrence of symptoms of chronic bronchitis or farmer's lung.

Adult↗
PubMed1987

Serum precipitins against microbes in mouldy hay with respect to age, sex, atopy, and smoking of farmers.

This study was based on a sample of 3,065 farmers from a larger survey population of 12,056 Finnish farmers. Data were collected in a postal survey conducted by the Social Insurance Institution of Finland. Serum samples for determination of precipitating antibodies were taken at local health centres. Precipitins were determined by the method of microplate immune diffusion. The antigen panel consisted of mycelial antigens of Micropolyspora faeni, Thermoactinomyces vulgaris, Aspergillus fumigatus, and Aspergillus umbrosus. Precipitins to any one of the four microbes were detected in 8.6% of the sera. The most common causes of positive precipitin tests were Aspergillus umbrosus and Thermoactinomyces vulgaris, which agrees with previous findings reported from Finland. In general, the precipitins were more prevalent among women, which corresponds to local cultural traditions, and in older farmers. The prevalence of precipitins did not differ between non-atopic and atopic (defined as past or present co-existence of atopic dermatitis including infantile eczema and/or hay fever or other allergic rhinitis) subjects. In contrast, the prevalence of precipitins was about 1.5-2 times larger among non-smokers than among smokers, which confirms the findings in previous reports. In future studies on occurrence of precipitins, the data should be controlled with respect to age, sex, and smoking.

Adult↗
PubMed1987

Serum precipitins against microbes in mouldy hay with respect to the geographical location of the farm and to the work of farmers.

This study was based on a sample of 3,065 farmers from a larger survey population of 12,056 Finnish farmers. Data were gathered in a postal survey conducted by the Social Insurance Institution of Finland. Serum precipitins were determined by a microplate method of immune diffusion. The antigen panel consisted of mycelial antigens of Micropolyspora faeni, Thermoactinomyces vulgaris, Aspergillus fumigatus, and Aspergillus umbrosus. Geographical variation in the prevalence of precipitins was statistically significant, evidently due to climatic differences. The more intensive the cattle raising, the more commonly were precipitins found in the sera of farmers. For participation in animal tending (cattle, pigs, or poultry) or in plant cultivation work only, the prevalence of precipitins was largest among farmers who tended cattle or swine. According to earlier studies, serum precipitins to Thermoactinomyces vulgaris are associated with farmer's lung. Precipitins to this microbe were most commonly found in farmers who tended pigs and were also very common in farmers who worked only in plant cultivation. These findings imply that farmer's lung may also develop among pig farmers and grain producers. Precipitins to Thermoactinomyces vulgaris were clearly related to the type of grain drier used on the farm. The study failed to identify detailed tasks in farming associated with large prevalence of precipitins, probably owing to considerable overlap in the exposure encountered in different tasks.

Agriculture↗
PubMed1987

Prevalence of chronic bronchitis in farmers according to smoking and atopic skin sensitization.

Development of chronic bronchitis has been shown to depend strongly on smoking habits. Atopy is known to predispose individuals to the development of asthma. Few studies, however, have dealt with the role of the atopic status of the individual as a predisposing factor for chronic bronchitis. In our previous survey among farmers, we observed that chronic bronchitis occurred more often among atopic than non-atopic subjects. Atopy was defined on the basis of past or present atopic manifestations. The association between atopy and chronic bronchitis was re-examined in a separate study of 169 individuals. Using the skin-prick technique we tested these farmers for atopy. The antigen panel included 36 common and farm-related allergens. Among non-smokers with negative skin tests the prevalence of chronic bronchitis was 5.6%, whereas among farmers with positive skin tests (area of at least one skin test reaction equal to 6 mm2 or larger) the prevalence of chronic bronchitis was 15.1%. When age, sex and smoking habits were accounted for statistically, individuals with positive skin tests suffered from chronic bronchitis twice as frequently as subjects with negative skin tests. The predisposing effects of smoking and atopy were of the same order of magnitude. The results of the clinical study of atopy correspond closely to those of the survey study. In the farming population, individuals with an atopic constitution are predisposed to development of chronic bronchitis.

Agricultural Workers' Diseases↗
PubMed1987

Prevalence and incidence of chronic bronchitis and farmer's lung with respect to age, sex, atopy, and smoking.

This study was based on data provided by 9,483 farmers from a larger sample of 12,056 Finnish farmers. The data were collected in two postal surveys, with a 3-year interval between them, conducted by the Social Insurance Institution of Finland. About one-third of the whole population were smokers. Among men the prevalence of smoking was 58.6% and among women 10.2%. Among men the prevalence of smokers was larger in older groups, among women the situation was reversed. Based on past or present infantile eczema, atopic dermatitis, or allergic rhinitis, one-third of the subjects were classified as atopic. The prevalence of atopy was essentially the same in all age groups. The prevalence of chronic bronchitis was 8.0%, and the mean annual incidence was 2,017 per 100,000 farmers. Among farmers who tended cattle the prevalence of farmer's lung was 1.7% and the mean annual incidence was 540 per 100,000 similar farmers. Chronic bronchitis was twice as common among atopic as among non-atopic subjects and twice as common among smokers as among non-smokers. Atopy and smoking seemed to have an additive effect on both the prevalence and incidence of chronic bronchitis. The results strongly support the so-called "Dutch hypothesis" about the natural history of chronic bronchitis, according to which chronic bronchitis is closely related to asthma. Farmer's lung was only slightly more common among atopic than among non-atopic subjects and twice as common among non-smokers as among smokers.

Adult↗
PubMed1987

Effects of respiratory morbidity on occupational activity among farmers.

Work-related respiratory diseases are common among farmers. Few studies, however, have dealt with the consequences of respiratory diseases for the lives of the afflicted farmers. To estimate the socioeconomic consequences of respiratory diseases in the farming population, we made a cross-sectional study and a follow-up study. In 1979 farmers with farmer's lung were twice as likely as healthy farmers to plan to reduce their farming work or to stop farming completely. Fifteen percent of the farmers who developed chronic bronchitis during a three-year follow-up had decided to reduce farming work, close down the farm or change the line of production on the farm. The respective rate for healthy farmers was 8%. In 1982, after the follow-up study of new cases of respiratory diseases, the rate of giving up occupational activities was twice as great among individuals with farmer's lung or asthma as in the rest of the farming population. Based on this study, we estimated that of the new cases of respiratory diseases, every tenth will stop farming in the near future, owing to one of the respiratory diseases analyzed. In Finland about 300 farmers per 100,000 and a total of about 600 farmers annually reduce their farming work or stop farming due to respiratory diseases.

Agriculture↗