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Biomedical subjects

K Kurppa

Publications and source records attributed to K Kurppa.

At least 19 recordsLinked to original sources
PubMed2001

Work is related to a substantial portion of adult-onset asthma incidence in the Finnish population.

There are no population-based follow-up studies to estimate the fraction of asthma incidence that is attributable to work. In Finland, individuals with clinically well-established persistent asthma are registered for reimbursement of medication from the national health insurance scheme. We combined, at an individual level, these data with the population census data of 1985, 1990, and 1995 to estimate the attributable fraction of work in adult-onset persistent asthma. Our follow-up study covered the entire 25- to 59-yr-old employed population of Finland in 1986-1998. Relative risks (RR) for occupational categories were estimated in comparison to those employed in administrative work. There were 49,575 incident cases of asthma. The attributable fraction of occupation was 29% (95% CI 25-33%) for men and 17% (95% CI 15-19%) for women. The risk was increased especially in agricultural work, manufacturing work, and service work. In addition to already established risk occupations of occupational asthma, such as food and beverage work, the analysis identified a large number of occupations with significant excess of asthma incidence. The results indicate that the impact of occupational factors in the inception of adult-onset persistent asthma, and consequently the potential for prevention, is much larger and more widely spread than generally assumed.

Adult↗
PubMed2000

Incidence of occupational asthma by occupation and industry in Finland.

BACKGROUND: Systematic research on occupation or industry-specific incidence of occupational asthma (OA) is sparse. We calculated the incidence of notified OA by occupation, industry and causative agent in Finland for the years 1989-95. METHODS: The numbers of cases of reported OA were retrieved from the Finnish Registry of Occupational Diseases for the population between 20 and 64 years of age. The numbers of employed workers were retrieved from Statistics Finland. Incidence rates were calculated for each occupation, industry and the total workforce. RESULTS: Altogether 2602 cases of OA were notified and the mean annual incidence rate was 17.4 cases/100,000 employed workers. The incidence rate was the highest in bakers, other painters and lacquerers, veterinary surgeons, chemical workers, farmers, animal husbandry workers, other food manufacturing workers, welders, plastic product workers, butchers and sausage makers, and floor layers. Cases caused by animal epithelia, hairs and secretions or flours, grains, and fodders accounted for 60% of the total. CONCLUSIONS: Estimation of occupation and industry-specific incidence rates forms the basis for successful prevention of OA, but necessitates collection of data over several years from well-established surveillance systems.

Adult↗
PubMed1999

Collaboration between developing and developed countries and between developing countries in occupational health research and surveillance.

Collaborative occupational health and safety studies between counterparts in developing and developed countries and between developing countries have demonstrated their potential for improving occupational health and safety. Such collaboration in occupational health and safety is encouraged in the development of infrastructure in research empowerment and capacity building. This action includes the setting of priorities, the identification and documentation of problems, sponsorship, data bases and surveillance systems, technical support, methodology, publishing, research and training programs, controlled intervention, information exchange, and networking. Examples of priorities in occupational health and safety in the developing world include the informal sector (informally hired and independent workers), temporary work, pesticides, accidents, dusts, carcinogens, solvents, ergonomics, women and child labor, human immunodeficiency virus/acquired immunodeficiencey syndrome (HIV/AIDS), and transfer of hazardous materials and technologies. The sustainability of occupational health and safety structures and functions in the developing countries is a primary concern. Socioethical principles emphasize local, national, mutual and global gains. Examples of collaboration are given. Pervasive problems and strategies toward their solution are highlighted.

Developed Countries↗
PubMed1995

Agricultural work during pregnancy and selected structural malformations in Finland.

We studied the relation between birth defects and maternal agricultural work in a nationwide time- and area-matched case-referent series of 1,306 pairs of infants (581 orofacial clefts, 365 central nervous system defects, 360 skeletal defects) obtained through the Finnish Register of Congenital Malformations. We supplemented the Register data, including the mothers' latest and previous pregnancies, diseases, consumption of drugs and alcohol, smoking habits, and the like, with detailed interviews on the mothers' work conditions. When all of the birth defects were pooled and agricultural work was compared with nonagricultural work in the first trimester of pregnancy, the adjusted odds ratio was 1.4 [95% confidence interval (CI) = 0.9-2.0]. For orofacial clefts, the corresponding odds ratio was 1.9 (95% CI = 1.1-3.5). An industrial hygienist's blinded assessment indicated that seven mothers of infants with orofacial clefts and three reference mothers had been exposed to pesticides in agricultural work; the adjusted odds ratio for work with pesticide exposure, when compared with unexposed agricultural work, was 1.9 (95% CI = 0.4-8.3). Exposure to solvents did not explain the observed association.

Abnormalities, Drug-Induced↗
PubMed1995

Rheumatoid factor and HLA antigens in wrist tenosynovitis and humeral epicondylitis.

A matched case-referent study was undertaken to assess whether rheumatoid factor (RF) is associated with repeating tenosynovitis or peritendinitis and whether HLA-B27 predisposes to epicondylitis. The study subjects consisted of 25 workers in manually strenuous jobs with a history of at least two episodes of tenosynovitis or peritendinitis in the wrist or forearm, or humeral epicondylitis, and their matched referents. The latex agglutination test was positive in seven of the 23 cases with tenosynovitis and in one of the referents (p = 0.03). The corresponding figures for IgM-RF by enzyme immunoassay were ten and two, respectively (p = 0.008). HLA-B27 antigen was found in five of the 13 workers with epicondylitis and in one worker with no such history (p = 0.13). It is possible that RF-positive repeating tenosynovitis represents an incomplete form of rheumatoid disease.

Case-Control Studies↗
PubMed1994

Increased incidence of lung and skin cancer in Finnish silicotic patients.

Cancer incidence during 1953 to 1991 in 811 Finnish silicotic patients diagnosed between 1936 and 1977 was evaluated. In comparison with the general population, excesses were observed for all cancers (standardized incidence ratio, 1.7 [95% confidence interval, 1.4 to 1.9]), all lung cancers (2.9 [2.4 to 3.5]), squamous cell lung cancers (3.3 [2.3 to 4.5]), and skin cancers: melanoma (3.0 [0.8 to 7.6]) and nonmelanoma (2.9 [1.2 to 6.1]). Confounding by tobacco smoking did not explain the lung cancer increment. The consistency of the association between silicosis and lung cancer across a large number of studies suggests that silicosis represents a direct or indirect lung cancer hazard. The skin cancer excess, a relatively novel finding, may be explained either by carcinogens in foundries, or silica-induced lowering of immunocompetence, which would lead to a more pronounced effect of solar ultraviolet radiation.

Adult↗
PubMed1994

Psychomotor capacity and occurrence of wrist tenosynovitis.

A case-referent study was carried out among meatcutters, sausage markers, and packers in a large meat-processing plant to investigate the association between psychomotor capacity and occurrence of tenosynovitis. Reaction time, movement time, manual dexterity, visual attention and visuospatial ability were measured in 26 cases with a history of two or more episodes of tenosynovitis and 26 referents of similar gender, occupation, age, and job seniority with no episodes of the disease. No differences were found between the cases and the referents in any of the tests of psychomotor capacity. The results suggest that psychomotor capacity, as measured with the tests of this study, is a poor predictor of wrist tenosynovitis.

Adult↗
PubMed1991

Anencephaly and maternal common cold.

To study the risk of anencephaly related to common cold during pregnancy, a case-control study was made. The series comprised 393 Finnish mothers of anencephalic children and their time-area-matched controls in the period 1964 through 1982. Seventy mothers of anencephalic infants and 17 controls had reported common cold in the first trimester [adjusted odds ratio 4.5; 95% confidence interval (2.2-9.1)]. Reported common cold in the second trimester was not associated with anencephaly. As suggested by our previous cohort study in the same population, a true viral influenza resembling "common cold" might not explain the observed association.

Anencephaly↗
PubMed1991

Prevalence of epicondylitis and elbow pain in the meat-processing industry.

To determine the etiologic role of strenuous manual tasks in relation to epicondylitis, three clinical cross-sectional examinations were performed on meatcutters (N = 102), sausage makers (N = 125), packers (N = 150), and workers in nonstrenuous tasks (N = 332). The workers in strenuous jobs reported elbow symptoms 1.6-1.8 times as often as those in nonstrenuous jobs. Female sausage makers also showed epicondylar tenderness more often than the women in nonstrenuous jobs. In all the cross-sectional examinations combined, seven cases (0.8%) of epicondylitis were detected in both the strenuous and nonstrenuous jobs. A control for the possible sources of bias (leaving the company, changing task, being on sick leave) did not suggest a marked loss of potential cases of epicondylitis. A major role of strenuous tasks in the etiology of epicondylitis was not shown. However, because the number of clinical cases was small, the power of the study was low.

Adult↗
PubMed1991

Incidence of tenosynovitis or peritendinitis and epicondylitis in a meat-processing factory.

A 31-month follow-up study on the incidence of clinically ascertained tenosynovitis or peritendinitis in the hand and forearm regions and epicondylitis was conducted among 377 workers in strenuous manual jobs and 338 employees in manually nonstrenuous work in a large meat-processing factory. The clinical diagnosis of tenosynovitis or peritendinitis occurred 143 times and epicondylitis 68 times during the follow-up. The annual incidence of tenosynovitis or peritendinitis was less than 1% for employees in nonstrenuous jobs, 25.3% for female packers, 16.8% for female sausage makers, and 12.5% for male meatcutters. The annual incidence of epicondylitis was about 1% for employees in nonstrenuous jobs, 11.3% for female sausage markers, 7.0% for female packers, and 6.4% for male meatcutters. Workers typically resumed their jobs after returning from sick leave, and job transfers were rare.

Cohort Studies↗
PubMed1990

Cardiovascular malformations and maternal exposure to video display terminals during pregnancy.

The possible effects of working with video display terminals (VDTs) during pregnancy on the occurrence of cardiovascular malformations in the offspring was studied in 500 cases and 1055 controls. The cases represented all registered cardiovascular malformations reported in Finland during 1982-84, excluding those with chromosomal anomaly or known genetic syndrome. The controls were randomly selected from all babies born during the same period. Both the case and control mothers were interviewed by midwives using a structured questionnaire approximately three months after delivery. In this interview the mother's occupation, job description and employer during the first trimester were noted, as were large number of other exposures to chemical and physical factors. An industrial hygienist examined all these records for information indicating exposure to VDTs, unaware of case/control status. Work with VDTs during the first trimester of pregnancy was ascertained for 30 case mothers (6.0%, 30/500) and 53 control mothers (5.0%, 53/1055). In logistic regression analysis maternal exposure to VDTs for at least 20h a week during the first trimester of pregnancy showed a point estimate of odds ratio of 1.4 with 95% confidence limits of 0.5 and 3.8, when adjusted for age and alcohol use. Maternal exposure to VDTs was not associated with indicators of fetal growth such as birthweight, placental weight or length of gestation.

Computer Systems↗
PubMed1990

Influenza epidemics and anencephaly.

To explore the postulated association between maternal influenza and congenital defects of the central nervous system, 14 virologically verified epidemics in Finland, 1969-82, were studied. Mothers of 248 anencephalic children were grouped into those whose first trimester had occurred during an epidemic period and those whose pregnancy had commenced during a non-epidemic period. No significant differences in prevalence of anencephaly were noted in these groups.

Adult↗
PubMed1990

Occupational groups potentially exposed to silica dust: a comparative analysis of cancer mortality and incidence based on the Nordic occupational mortality and cancer incidence registers.

We have analysed mortality and cancer incidence data available in census-based record-linkage studies from the Nordic countries for males in occupational groups with potential exposure to silica dust. The study showed an excess lung cancer risk for foundry workers in all the Nordic countries, and also for miners in Sweden. These results are consistent with the findings of previous in-depth epidemiological studies. The lung cancer risk did not differ significantly from that of the respective national populations for males working in glass, porcelain, ceramics and tile manufacture, in excavation, and in stone quarries, sand and gravel pits. Stone cutters, who are probably not exposed to known lung carcinogens at the workplace but in some places to high concentrations of silica dust, showed a significant excess lung cancer risk in both Finland and Denmark.

Adult↗
PubMed1989

Genetic and environmental factors in sciatica. Evidence from a nationwide panel of 9365 adult twin pairs.

The relative roles of genetic and environmental factors in sciatica were studied in the nationwide Finnish twin panel consisting of 9365 adult pairs of the same gender. Morbidity was analysed from two sources of data: the life-long cumulative incidence was measured by a postal questionnaire, and the rate of hospital admission during a 14-year period was measured by record-linkage of the twin panel and the nationwide hospital registry. Altogether 2220 individuals reported sciatica diagnosed by a doctor and 304 were admitted to hospital with a diagnosis of sciatica. The proportion of concordant pairs (calculated from affected pairs) was 17.7% for monozygotic and 12.0% for dizygotic pairs in the life-long cumulative incidence of reported sciatica, and correspondingly 4.6% and 1.9% for those admitted to hospital (a 14-year period) because of sciatica. The estimated heritability was 20.8% for those with reported sciatica and 10.6% for those admitted to hospital. The results show that environmental factors account for more than 80% of the etiology of sciatica, and more than 90% in the case of patients admitted to the hospital. Genetic factors, however, were relatively more significant in individuals under 40.

Adult↗
PubMed1989

Physical work load, fetal development and course of pregnancy.

The effects of physical work load during pregnancy were analyzed in connection with a nationwide case-referent study that screened for associations between selected structural malformations and occupational exposures. The strain of the occupational activities of 1475 mothers of malformed infants and an equal number of mothers of noncase babies was assessed from a description of the work tasks by an expert using a standardized method reflecting energy expenditure. The noncase mothers' experience revealed a relation between physical load and growth retardation that has also been suggested by other epidemiologic studies. No relation was found between an increase in mean physical load and the occurrence of threatened abortion; yet work involving much standing had an increased risk. Mothers whose work included occasional high physical loads had more pregnancy-induced hypertension. The data showed unexpected associations between physical load and structural malformations.

Abortion, Threatened↗
PubMed1989

Occupational noise exposure and course of pregnancy.

The study examined the possible relation of occupational noise exposure to adverse pregnancy outcomes. The experience of 1,190 reference mothers from a case-referent study based on the Finnish Register of Congenital Malformations was scrutinized. Exposure to noise was blindly assessed from a description of the mother's workday by two industrial hygienists. Women with an estimated level of noise of around 80 dB LAeq(8 h) or higher were considered exposed. Threatened abortion was not associated with noise exposure alone, but, when it was combined with shift work, the adjusted risk was over twofold. The adjusted risk of pregnancy-induced hypertension was twice as high among the mothers exposed to noise in shift work, and the duration of their pregnancy was shorter. The analyses produced indications of a relation between noise and growth retardation which was not connected with shift work. There were significantly ascending trends in the proportions of these outcomes according to increasing exposure intensity.

Abortion, Threatened↗
PubMed1989

Noise exposure during pregnancy and selected structural malformations in infants.

The study tested the hypothesis of exposure to noise during pregnancy being teratogenic. It included 1,475 Finnish mothers who had given birth to a malformed child (orofacial cleft or structural defect of the central nervous system, skeleton, or heart and great vessels) and 1,475 reference mothers. A special interview soon after delivery yielded the primary information on exposure. Of the 783 mothers who reported noise exposure in the first trimester, 370 were case mothers and 413 were referents. Hygienic assessment indicated that 102 case mothers and 103 referents had been exposed in the first trimester to a sound level of around 80 dB LAeq(8 h) or higher, the overall odds ratio being 1.0 (95% confidence interval 0.7-1.3). Adjustment for potential confounders by logistic regression methods gave similar results. There was no obvious trend suggesting a hazard when different exposure categories were considered.

Congenital Abnormalities↗