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Biomedical subjects

Kari Reijula

Publications and source records attributed to Kari Reijula.

18 recordsLinked to original sources
PubMed2006

Cladosporium herbarum and Pityrosporum ovale allergen extracts share cross-reacting glycoproteins.

BACKGROUND: Patients sensitized to airborne fungi such as Alternaria alternata and Cladosporium herbarum often also show positive skin prick test results and specific serum IgE antibodies to a yeast, Pityrosporum ovale. We examined whether part of the IgE binding to these fungi is explained by cross-reacting mould and yeast allergens. METHODS: Serum samples from 36 patients with positive skin prick test to A. alternata or C. herbarum were analyzed for IgE antibodies to fungal extracts by ELISA and immunoblot analysis. Cross-reactivity between mould and yeast extracts was studied by ELISA and immunoblot inhibition assays. In further analysis, the mannan-containing glycoproteins were removed from the yeast extract by concanavalin A-Sepharose chromatography, and the IgE binding properties of the extracts were compared. RESULTS: Serum IgE reactivity to P. ovale was found in 40% of the mould-sensitized patients. The IgE antibody binding to A. alternata and C. herbarum moulds was partially inhibited by the yeast P. ovale in ELISA and immunoblot inhibition assays. When the glycoproteins were removed from the extract, cross-reactivity was markedly reduced. CONCLUSION: Part of the IgE binding to mould and yeast allergen extracts is due to cross-reacting glycoproteins. False-positive IgE and skin prick test results should be taken into account in the diagnosis of mould allergy.

Allergens↗
PubMed2006

Environmental tobacco smoke in Finnish restaurants and bars before and after smoking restrictions were introduced.

OBJECTIVES: The Finnish Tobacco Act was amended on 1 March 2000 to include restrictions on smoking in restaurants and bars. To evaluate the effectiveness of the restrictions, environmental tobacco smoke (ETS) concentrations in restaurants and bars were measured prior and after the amended Act entered into force. The Act was enforced in stages so that all stages were effective on 1 July 2003. According to the Act, smoking is prohibited in all Finnish restaurants and bars with certain exceptions. Smoking may be allowed in establishments where the service area is not larger than 50 m(2) if the exposure of employees working there to ETS can be prevented. On premises with larger service area, smoking may be allowed on 50% of the service area, provided tobacco smoke does not spread into the area where smoking is prohibited. At bar counters or gambling tables smoking is not allowed, if the spreading of tobacco smoke cannot be restricted to the employee side of the counter. Therefore, according to the Act all areas where smoking is prohibited are to be smoke-free. METHODS: Establishments with a serving area larger than 100 m(2) were selected for the present study. The evaluation both before and after the enforcement of the Act included the following: The ventilation rate was first measured in each establishment. Then 3-5 area samplers, depending on the layout, were placed in locations that best described the establishment and the working areas of the personnel. The measurements were performed twice at each establishment, during peak hours. The sample collection time was 4 h during which the guests and the cigarettes smoked were counted. The air samples were analysed for nicotine, 3-ethenylpyridine (3-EP) and total volatile organic compounds (TVOC) by thermodesorption-gas chromatography-mass spectrometry. RESULTS: Altogether 20 restaurants and bars situated in three Finnish cities participated in the study out of which 16 participated during all four measurement periods. None of the establishments had introduced a total ban on smoking and they all had reserved only the smallest area allowed by the Finnish Tobacco Act as the smoke-free area. The measured geometric mean (GM) nicotine concentration in all participating establishments was 7.1 microg m(-3) before the amended act was in force and 7.3 microg m(-3) after all stages of the Act had been enforced. The GM concentration of nicotine in food and dining restaurants was 0.7 microg m(-3) before and 0.6 microg m(-3) after the enforcement of the Act, in bars and taverns the concentrations were 10.6 and 12.7 microg m(-3), and in discos and night-clubs 15.2 and 8.1 microg m(-3), respectively. The GM nicotine concentrations measured in the smoke-free sections varied between 2.9 and 3 microg m(-3). 3-EP concentrations measured correlated well with the nicotine concentrations and were approximately one-fifth of the nicotine concentrations. The measurements showed higher TVOC values in the smoking sections than in the smoke-free sections, but because there are many other sources of TVOC compounds in restaurants and bars TVOC cannot be regarded as a marker for ETS. CONCLUSIONS: The overall air nicotine concentration decreased in 10 out of the 18 establishments that participated in the study both before and after all stages of the amended Act had been in force. Structural changes or changes to the ventilation systems had been carried out in nine of these establishments, i.e. the smoke-free sections were actually non-smoking and were mainly separated from other sections by signs and very little was done to keep the smoke from spreading into the smoke-free sections. In four establishments, the highest air nicotine concentration was measured in the smoke-free section. In 10 establishments, the air nicotine concentration at bar counters had dropped after the Act. Exposure of the workers and the public to ETS was, therefore, not reduced as intended by the Finnish legislature. Thus, it seems obvious from the present study that improving ventilation will not be a solution to restricting tobacco smoke from reaching smoke-free areas and physical barriers separating smoking from smoke-free areas are required.

Finland↗
PubMed2006

Prevalence of building-related symptoms as an indicator of health and productivity.

BACKGROUND: The prevalence of building-related symptoms (BRS) is commonly used to characterize the indoor air quality in office buildings. To analyze the costs of building renovation and the improvement of the indoor environment, it is useful to quantitatively relate the prevalence or intensity of BRS to productivity. The intent of this study is to summarize the links between the BRS and productivity, and demonstrate this linkage in two case buildings. MATERIAL AND METHODS: A literature was surveyed for studies that measured simultaneously the prevalence or intensity of BRS and subjectively reported or objectively measured productivity. Case studies in two office environments were performed. An association between the prevalence of BRS and productivity of workers in a call center and in an insurance office were investigated. In the first case study, the productivity was expressed using the direct productivity metrics, namely the number of telephone contacts during active working hours while in the second case, the productivity was assessed by using the data concerning sick leave rates. RESULTS: Employees who report more BRS also have more often absences which relate to indoor environment quality (IEQ). Their productivity is lower than those who have better IEQ in their offices. Despite uncertainties related to the data concerning recorded sick leave and self-reported productivity, the number of studies showing an association between BRS and productivity or sick leave suggests that such a relationship exists. The present case studies also demonstrated an association between the BRS and the direct productivity. Based on the data from the call center, a reduction of 10%-units in the prevalence of general symptoms (such as fatigue, headache, nausea, etc.) corresponded with a gain of 1.5% in performance. Based on the findings in the insurance company, a reduction of 10%-units in the prevalence of irritation symptoms corresponded with a decrease of 0.7% in the short-term absenteeism. CONCLUSIONS: A review of 23 studies suggests that a linkage exists between typical BRS and productivity indicators such as task or work performance or absence from work. Quantitative associations between BRS and productivity were demonstrated in two office environments. Quantitative associations between BRS and economic metrics enable cost-benefits analysis.

Absenteeism↗
PubMed2006

Overtime work, cigarette consumption, and addiction to cigarette among workers subject to mild smoking restrictions.

The goal of the present study was to investigate the relation of hours of overtime work to cigarette consumption and addiction to cigarette, which was measured by the heaviness of smoking index. The subjects were 571 male daily smokers who responded to a cross-sectional survey of municipal employees of a Japanese city office, in which smoking was permitted in designated areas. Those who engaged in moderate overtime work (10-29 h per month) consumed less number of cigarettes per day and had lower levels of heaviness of smoking index, compared with those who worked either shorter or longer hours of overtime, although the differences were not statistically significant. In the workplace, men who worked 50 h or longer overtime last month consumed, on average, 4 cigarettes more than men who worked less than 30 h of overtime. Home cigarette consumption decreased as hours of overtime work increased. In stratified analysis, there was a significant difference in daily cigarette consumption according to hours of overtime work among smokers in staff position or under low psychological work stress; showing reduced consumption associated with medium levels of overtime work, compared to either no overtime work or extended overtime hours. The U-shaped relations of hours of overtime work to overall cigarette consumption and addiction to smoking deserve further investigations.

Adult↗
PubMed2005

Respiratory symptoms and diseases among construction painters.

OBJECTIVE: To study the self-reported prevalence of respiratory symptoms and diseases among construction painters and estimate the potential risk for this group compared with a representative group of carpenters sharing the construction work environment but without significant exposure to paint. METHODS: A questionnaire study was conducted on 1,000 male Finnish construction painters and 1,000 carpenters (mean response rate 60.5%). Symptoms and diseases of the respiratory tract were studied, by logistic regression modelling, in relation to occupation and duration of painting experience. Age, atopy and smoking habits were taken into account. RESULTS: The painters reported more asthma-like, rhinitis, laryngeal and eye symptoms than the carpenters [odds ratio (OR) 1.4-1.8]. The difference in the prevalence of asthma between the occupations was not statistically significant, but the painters with 1-10 years of painting experience had a threefold risk of asthma compared with the carpenters. Chronic bronchitis was linked to painting occupation [OR 1.9, 95% confidence interval (CI) 1.2-3.0] and to the duration of exposure; OR (CI) for over 30 years of painting was 2.2 (1.2-4.0). Occupation was not associated with allergic rhinitis or conjunctivitis. CONCLUSIONS: The results indicate a higher risk for respiratory symptoms and chronic bronchitis among construction painters than among carpenters.

Age Factors↗
PubMed2004

Good practices in managing work-related indoor air problems: a psychosocial perspective.

BACKGROUND: Indoor air problems at workplaces are often exceedingly complex. Technical questions are interrelated with the dynamics of the work community, and the cooperation and interaction skills of the parties involved in the problem solving process are also put to the test. The objective of our study was to analyze the process of managing and solving indoor air problems from a psychosocial perspective. METHODS: This collective case study was based on data from questionnaires, interviews and various documentary materials. Technical inspections of the buildings and indoor air measurements were also carried out. RESULTS: The following four factors best differentiated successful cases from impeded cases: extensive multiprofessional collaboration and participative action, systematic action and perseverance, investment in information and communication, and process thinking and learning. The study also proposed a theoretical model for the role of the psychosocial work environment in indoor air problems. CONCLUSIONS: The expertise related to social and human aspects of problem solving plays a significant role in solving indoor air problems. Failures to properly handle these aspects may lead to resources being wasted and result in a problematic situation becoming stagnant or worse.

Air Pollutants, Occupational↗
PubMed2004

Solvent-related health effects among construction painters with decreasing exposure.

BACKGROUND: The prevalence of solvent-related symptoms among construction painters is unclear due to their declining exposure. METHODS: A questionnaire study was conducted on 1000 male Finnish construction painters and 1000 carpenters. Symptom questions were combined with exposure parameters, medical history, and health behavior. RESULTS: Highly significant associations were found between cumulative intensity of long-term solvent exposure (CE-LT) and symptoms of memory and concentration, and mood. CE-LT was a better measure of solvent exposure than the number of years as a painter. Exposure was also associated with diagnosed psychiatric disorders, hypertension and arrhythmia. Recent exposure in the 1990s had no major effect on symptoms. CONCLUSIONS: The results strengthen the dose-response relationship of exposure and long-term neurotoxic effects. No clear association was found between recent exposure and symptoms. Cardiovascular effects in solvent-exposed construction painters is further suggested.

Adult↗
PubMed2004

Smoking prevalence, smoking-related lung diseases, and national tobacco control legislation.

OBJECTIVES: To review statistics on smoking prevalence and to analyze whether the implementation of national tobacco control legislation had an association with the prevalence of smoking, and thereby, with the occurrence of smoking-related lung diseases. DESIGN: Smoking prevalence rates (from 1960 to 2000), lung cancer incidence rates (from 1980 to 2000), and respiratory disease mortality rates (from 1980 to 1998) were obtained from Finnish national surveys and registers. Regression models with 20-year lag times for disease occurrence were applied in the statistical analysis. RESULTS: Daily smoking prevalence among men decreased continuously from 58 to 28% in the period from 1960 to 2000. Between 1965 and 1971, male lung cancer incidence was still on the increase, but from 1971 it decreased from 80 to 32 per 100,000 men. The male respiratory disease mortality rate declined steeply during the study period. From 1960 to 1973, women's smoking prevalence increased from 12 to 20%. At the introduction of the tobacco control bill in 1975, the increase leveled off and female smoking prevalence slightly decreased, but then rose again after 1985 to remain at 20%. Lung cancer incidence among women increased throughout the study period, but the gradient of the curve lowered in the 1980s. CONCLUSIONS: National legislative actions were found to be associated with a change in smoking prevalence among women from a linear rise to a plateau. The results of the present study showed a very strong association between reduced smoking prevalence and the occurrence of lung cancer.

Female↗
PubMed2004

Seasonal variation in perceived indoor environment and nonspecific symptoms in a temperate climate.

Few epidemiological studies have examined the effects of season on symptoms typical of sick building syndrome (SBS). The present study aims to clarify seasonal variation in a perceived indoor environment and SBS symptoms in a temperate climate. A total of 116 workers were recruited from office buildings in southern Japan that presented no apparent serious indoor problems. A validated questionnaire was distributed four times, once at the end of each season. Seasonal effects on the perceived indoor environment and SBS symptoms were investigated with a parametric test for repeated measurement of categorical data. Logits were used as the response function, and were compared to overall logits to determine the relevant odds ratios (OR). The effect of season/building interaction was also evaluated. Significant seasonal variation in the perceived indoor environment was found for temperature, dryness, air stuffiness, and static electricity (p for season, <0.05), although the seasonal patterns for temperature and dryness differed according to the building (p for interaction, <0.05). Symptoms in the mucous membrane (eyes, nose, and throat) and skin increased considerably in the winter and spring (p for season, <0.05), whereas general symptoms varied little, but such seasonality of symptoms was not modified by the building factor. The associations between perception of indoor environments and mucous and skin symptoms became stronger during winter and spring. The present results suggest that perceived indoor environments, nonspecific symptoms and their associations are closely associated with the season among office workers in a temperate climate.

Air Pollution, Indoor↗
PubMed2003

Mycotoxins of aspergilli: exposure and health effects.

Mycotoxins derived from Aspergilli can be encountered both in domestic and occupational environments, and the exposure may lead to severe health hazards. Several Aspergillus species are associated with mycotoxin production: A. ochraceus with ochratoxin A, A. fumigatus with fumitremorgins, gliotoxin and verrucologen, A. versicolor with sterigmatocystin, and A. flavus and A. parasiticus with aflatoxins. Sterigmatocystin may also be produced by A. flavus, A. nidulans, A. rugulosus, and A. unguis. Exposure to mycotoxin may occur via enteric, inhalation or direct contact to skin and mucosa. Acute and chronic disorders, irritation, systemic reactions and even cancer may develop after the exposure to these toxins. Mycotoxins act as immunosuppressants which may be in association with an increased prevalence of repeated infections found among the inhabitants of buildings with moisture problems.

Animals↗
PubMed2003

Occupational exposure of non-smoking restaurant personnel to environmental tobacco smoke in Finland.

BACKGROUND: Environmental tobacco smoke (ETS) exposure levels in different restaurant types in Finland were assessed before the National Tobacco Act restricting smoking in restaurants was activated. METHODS: Exposure to ETS was determined by measuring nicotine in the breathing zone of non-smoking restaurant workers and by quantification of the nicotine metabolites cotinine and 3-hydroxycotinine in the urine of these workers during one whole work week. Altogether 23 workers from 15 restaurants were included in the study. RESULTS: The geometric mean (GM) breathing-zone nicotine level was 3.9 microg/m(3) (3.7 microg/m(3) in pubs, 1.4 microg/m(3) in dining restaurants, and 10.2 microg/m(3) in nightclubs). The GM cotinine and trans-3'-hydroxycotinine level in urine were 3.3 ng/mg((creatinine)) and 15.3 ng/mg((creatinine)), respectively. The exposure to ETS of restaurant workers in dining restaurants was clearly lower than that of workers in pubs and nightclubs as indicated by all ETS-markers used in the present study. During the work week, the cotinine and 3'-hydroxycotinine levels in urine of the study subjects increased. The correlation between breathing zone nicotine and urine cotinine and hydroxycotinine was 0.66 for both compounds. Post-shift cotinine and hydroxycotinine levels were not significantly higher than the pre-shift levels. CONCLUSIONS: If 9 ng cotinine/mg((creatinine)) is considered as the level above which heavy exposure has occurred, then this level was exceeded by 14 (approximately 60%) subjects at least once during the work week. Nicotine metabolite concentrations in the urine increased during the work week in 80% of the subjects, and the increase was especially noticeable for subjects working in both pubs and nightclubs. The study indicates that measures to restrict ETS exposure in restaurants are needed.

Adult↗
PubMed2003

Work environment and occupational health of Finnish veterinarians.

BACKGROUND: Health and work environment of Finnish veterinarians was evaluated by The Finnish Veterinary Association and the Finnish Institute of Occupational Health in a questionnaire survey. METHODS: The questionnaire was mailed in the spring of 2000 to all veterinarians under 65 years of age and working in Finland (n = 1169); 785 (67%) responded. RESULTS: A veterinarian's work was physically demanding, and often involved an elevated risk of accident. The risks were considered moderately or considerably high by over half of the respondents, and the highest risks occurred among veterinarians working in equine, mixed (both small and large animals), or in production animal practice. The veterinarians were committed to their work, although, at the same time they experienced work-related stress and fatigue. Particularly veterinarians working in towns, or those involved in education and research, reported the most stress. Serious work-related exhaustion was experienced most often by women in the youngest and by men in the oldest age groups. On average, the veterinarians spent over 100 hr a month on call. Over two-thirds of the participants in the survey reported their general state of health as good or fairly good, while less than 5% of the participants reported their health as rather poor or poor. CONCLUSIONS: The work of a Finnish veterinarian, the work environment, and the risks of the work varied greatly depending on the tasks assigned to the veterinarian. This has to be taken into consideration when occupational health services are planned for veterinarians.

Accidents, Occupational↗
PubMed2003

IgE-mediated allergy to fungal allergens in Finland with special reference to Alternaria alternata and Cladosporium herbarum.

BACKGROUND: Alternaria alternata and Cladosporium herbarum are common fungi in outdoor environments, but their clinical significance has not been elucidated in Finland. OBJECTIVE: To evaluate the prevalence of IgE-mediated allergy and clinical outcomes caused by sensitization to fungal allergens in patients with suspected allergy. METHODS: Skin prick tests (SPTs) were performed with C. herbarum in 6,376 patients and also with A. alternata in 1,504 of these patients. SPTs were repeated in 40 patients who showed a positive reaction to either allergen using commercial and in-house extracts. The association of SPT with allergen-specific IgE antibodies in serum was evaluated. Seven patients also underwent a conjunctival challenge test with these fungal allergens. RESULTS: The prevalence of positive SPT results to A. alternata and C. herbarum was low (2.8% and 2.7%, respectively). Among the 40 patients, atopic eczema/dermatitis syndrome was found in 58%, asthma in 44%, and rhinitis in 31%. Most of the patients displayed SPT reactions also to several other fungal allergens, and 75% to 80% showed a positive SPT reaction to allergens of pet animals or pollens. Four patients had a positive reaction to A. alternata and 6 to C. herbarum in the conjunctival challenge test. CONCLUSION: In the Finnish population with allergic symptoms, IgE-mediated sensitization to 2 common fungal allergens was rare and of minor clinical importance. SPT reactions to fungi are mostly observed in patients with multiple sensitivity to various allergens.

Allergens↗
PubMed2003

Incidence of cancer among the participants of the Finnish Asbestos Screening Campaign.

OBJECTIVES: Cancer risk has been estimated for asbestos production workers or other heavily exposed asbestos workers in numerous studies. The bulk of the asbestos epidemic results come, however, from past intermittent exposures during asbestos product use. This study concentrated on estimating the risk of cancer in such a population. METHODS: Altogether 23285 men and 930 women invited to a nationwide screening campaign for benign asbestos-related diseases in 1990-1992 were followed for cancer through the Finnish Cancer Register up to 1998. Standardized incidence ratios (SIR) were calculated in comparison with the total Finnish population. RESULTS: Altogether 1392 cases of cancer were found among the men. The risk was slightly, but significantly elevated for lung cancer [SIR 1.14, 95% confidence interval (95% CI) 1.01-1.26), mesothelioma (SIR 2.77, 95% CI 1.66-4.31), and prostate cancer (SIR 1.21, 95% CI 1.09-1.34). The risk of lung cancer was slightly higher among the invited nonparticipants (SIR 1.48, 95% CI 1.20-1.79) than among the participants (SIR 1.02, 95% CI 0.88-1.17). About 98% of the lung cancers occurred in current or ex-smokers. CONCLUSIONS: In a population of long-term construction workers, the risk of lung cancer and mesothelioma was increased, but considerably lower than among insulators, asbestos sprayers, or patients with asbestosis. As it was not possible to follow most of the invited nonparticipants in the original screening study, selection bias by smoking or other life-style factors possibly correlated to the individual's decision to participate in the health screening cannot be excluded.

Asbestos↗
PubMed2002

Work environment effects on labor productivity: an intervention study in a storage building.

BACKGROUND: Although increased attention has been focused on the relationship between occupational health and productivity, solid scientific data on this topic are sparse. The purpose of the present case study was to assess the relationship between productivity and work environment in a storage building. MATERIALS AND METHODS: The study was implemented as an intervention consisting of the renovation of a harbor storage facility. The study design consisted of a single group of employees working in the storage hall. The physical and chemical factors, perceived environment, and labor productivity were measured before and after the renovation. RESULTS: As a result of the renovation, thermal conditions, air quality, and lighting conditions improved notably. In addition, the employees' subjective evaluations showed the significant decrease in dissatisfaction ratings. The direct measure for the labor productivity, expressed as zinc tons/work-hour (tn) increased about 9% after the renovation. DISCUSSION: We conclude that increased productivity is most likely related to the combined effect of the improved work environment, i.e., better thermal climate, reduced contaminant concentrations, and better lighting conditions.

Adult↗
PubMed2002

Psychosocial dimensions of solving an indoor air problem.

This investigation focuses on the psychological and social dimensions of managing and solving indoor air problems. The data were collected in nine workplaces by interviews (n = 85) and questionnaires (n = 375). Indoor air problems in office environments have traditionally utilized industrial hygiene or technical expertise. However, indoor air problems at workplaces are often more complex issues to solve. Technical questions are inter-related with the dynamics of the work community, and the cooperation and interaction skills of the parties involved in the solving process are also put to the test. In the present study, the interviewees were very critical of the process of solving the indoor air problem. The responsibility for coordinating the problem-managing process was generally considered vague, as were the roles and functions of the various parties. Communication problems occurred and rumors about the indoor air problem circulated widely. Conflicts were common, complicating the process in several ways. The research focused on examining different ways of managing and resolving an indoor air problem. In addition, reference material on the causal factors of the indoor air problem was also acquired. The study supported the hypothesis that psychosocial factors play a significant role in indoor air problems.

Adult↗
PubMed2002

Different measures of asbestos exposure in estimating risk of lung cancer and mesothelioma among construction workers.

To analyze occupation, expert-evaluated cumulative exposure, and radiographic abnormalities as indicators of asbestos-related cancer risk we followed 16,696 male construction workers for cancer in 1990-2000. We calculated standardized incidence ratios (SIR) in comparison to the Finnish population and relative risks (RR) in a multivariate analysis in comparison to the internal low-exposure category of each indicator. Overall, the risk was increased for mesothelioma (SIR 2.0, 95% CI = 1.0-3.3), but not for lung cancer (SIR 1.1, 95% CI = 0.9-1.2). Radiographic lung fibrosis indicated a 2-fold and a high value of the exposure index a 3-fold RR of lung cancer, while there was no risk among those with pleural plaques. The risk of lung cancer was the highest in insulators (RR 3.7, 95% CI = 1.4-9.9). Occupation, expert-evaluated cumulative exposure, and lung fibrosis are useful indicators of lung cancer risk among construction workers.

Asbestos↗