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Biomedical subjects

L Alfredsson

Publications and source records attributed to L Alfredsson.

At least 55 records · Page 3Linked to original sources
PubMed1998

Myocardial infarction in male and female dominated occupations.

The aim of the study was to investigate whether workers in jobs dominated by the opposite sex have an increased risk of myocardial infarction (MI). A case-referent study was carried out to estimate the relative risk of first MI in different occupational groups. The study base comprised all men and women in five counties in the middle of Sweden during 1976-84. Cases of MI were identified from both hospital discharge records and death records. Information on occupation was obtained from two consecutive censuses. Primary health related selection was analysed for men with data from the physical examination of conscripts to compulsory military service in 1969-70 combined with data from the censuses of 1970-90 and data on early retirement in 1971-92. Increased risk of MI was found among both women (relative risk (RR) 1.41, 95% confidence interval (95% CI) 1.15 to 1.73) and men (1.21, 1.10 to 1.32) in blue collar jobs where men predominate, and among men with white collar jobs (1.26, 1.09 to 1.45) where women predominate. However, the increased risk among men in white collar jobs was probably due to negative health selection into these occupations. These results do not support the notion that being of the sexual minority in an occupation is in itself an important risk factor for MI.

Adult↗
PubMed1997

Reproducibility of a questionnaire for assessment of present and past physical activities.

OBJECTIVE: The aim of this study was to evaluate the reproducibility of a self-administered questionnaire about present and past physical activities at work and during leisure time. METHODS AND DESIGN: The questionnaire, covering the period 1970-1993, comprised 12 questions on physical activities at work, and 12, with similar wording, for such activities in leisure time. There were also four questions on physical training. Two-week reproducibility (test-retest reliability) concerning the period 1970-1993 was analysed in a group of 44 subjects, and 1-year reproducibility, concerning current activities in 1993, was analysed in a second group of 123 subjects in relation to gender, age and low-back health. RESULTS: Test-retest reliability calculated as intraclass correlation coefficients (ri) for physical activities at work (ri 0.41-0.98) exceeded that for leisure time and physical training activities (ri 0.33-0.68). Calculated correlations did not differ markedly between past and present activities. No distinct influence of gender or low back health on 1-year reproducibility was found, in contrast to a slight tendency towards higher reproducibility among subjects of 50 years and older compared with younger subjects. CONCLUSIONS: Reproducibility of this questionnaire about physical activities at work showed no clear tendency to deteriorate regarding activities during the immediately preceding two decades. The questions about physical activities during leisure time have to be revised. Reliable retrospective information about physical activities in leisure time could perhaps not be collected by self-administered questionnaires and other methods, e.g. interview-based questionnaires, may be more suitable.

Adult↗
PubMed1997

Alcohol consumption, drinking pattern and acute myocardial infarction. A case referent study based on the Swedish Twin Register.

OBJECTIVES: Little is known about the possible influence of different kinds of alcohol drinking pattern on the risk of acute myocardial infarction. In this study the association between average daily alcohol consumption, as well as large intakes of alcohol on single occasions, and myocardial infarction incidence was investigated. DESIGN: A case referent analysis nested within a prospective cohort study. SETTING: Incident cases of myocardial infarction were identified by using hospital discharge data and deaths. Referents were selected from the study population through a stratified random sample. SUBJECTS: Individuals of the Swedish Twin Register below 75 years of age living in a region of 10 Swedish counties in 1972-1981 or in Stockholm County in 1972-1987. MAIN OUTCOME MEASURE: Incidence of acute myocardial infarction. RESULTS: No difference in myocardial infarction incidence was found between former alcohol drinkers and lifelong abstainers. For men, drinkers had a 40% lower incidence than non-drinkers, as did those with a drinking pattern involving a large intake on single occasions. Women had on average a very low level of alcohol consumption and there were only small differences in incidence of myocardial infarction between drinkers and non-drinkers. An increased incidence was indicated for women reporting some-times drinking comparatively large amounts of alcohol on single occasions. CONCLUSIONS: The results support the suggestion that low and moderate alcohol consumption is protective for myocardial infarction. A drinking pattern involving a large intake of alcohol on single occasions did not seem to substantially influence myocardial infarction incidence except possibly for women with an overall very low level of consumption.

Aged↗
PubMed1997

Alcoholism in social classes and occupations in Sweden.

BACKGROUND: A number of studies have shown variations in the occurrence of alcoholism between different socioeconomic groups and occupations, but it has not been clear to what extent this is related to the average alcohol consumption in the same socioeconomic groups or occupations. METHODS: The relationship between socioeconomic group and occupation and hospital discharge 1981-1983 due to 'diagnoses related to alcoholism' (AD) (alcohol psychosis, alcoholism, and alcohol intoxication) and liver cirrhosis was studied in a cohort of 375,035 men and 140,139 women in 13 counties in Sweden who had reported the same occupation in the censuses of 1960 and 1970. Data on alcohol consumption in different socioeconomic groups and occupations were collected from a conscription investigation and from the Swedish twin registry with data from 1969/70 and 1973 respectively. RESULTS: Intermediate or higher non-manual employees had lower risk of AD as well as of liver cirrhosis compared to manual workers for both sexes. Among males several, mostly blue-collar, occupations had increased relative risks of AD. A high level of association was found between the relative risks of AD and liver cirrhosis in socioeconomic groups, and the relative risk of AD in occupations, and the average alcohol consumption in the same socioeconomic groups/occupations among males. Such an association was not evident among women. CONCLUSION: The study shows, contrary to previous Swedish evidence, that there is a strong relationship between the incidence of alcoholism in socioeconomic groups and occupations and the average alcohol consumption in these groups among men.

Alcohol Drinking↗
PubMed1997

Osteoarthrosis of the hip in women and its relation to physical load at work and in the home.

OBJECTIVES: The aim of this case referent study was to investigate the relation between physical workload and osteoarthrosis of the hip in women. METHODS: The study base comprised all women of ages 50-70 years, living in five counties and four towns in Sweden 1991-1994. Cases (n = 230), who had undergone total hip replacement for primary osteoarthrosis of the hip were identified by means of the Swedish National Register of Total Hip Replacements, and the referents (n = 273) were women without hip problems randomly selected from the study base. All women were interviewed about state of health, smoking habits, occupational history, work in the home, sports activities, etc. Each subject's history of occupational work and work in the home up to the age of 50 was divided into periods within each of which the work tasks were similar, and a questionnaire for each such period was filled in by the participants. On the basis of information given by the referents, the women were classified as having had low, medium, and high exposure to different factors. Relative risks (RRs) and 95% confidence intervals (CI) were calculated. RESULTS: Physically demanding tasks at work and in the home were associated with increased RRs of osteoarthrosis of the hip in those with high exposure compared with the low exposure group. A RR in the range of 2 or higher was found for those who frequently jumped or moved between different levels (RR = 2.1, CI 1.9, 4.2), who frequently climbed stairs (RR = 2.1, CI 1.2, 3.6), and who had physically demanding tasks outside occupational life (RR = 2.3, CI 1.5, 3.6). The highest RR (RR = 4.3, CI 1.7, 11.0) was found for those exposed to high physical loads both at work and during sports activities. CONCLUSION: High physical loads at work and in the home up to the age of 50 seem to be risk factors for development of severe osteoarthrosis of the hip in women.

Aged↗
PubMed1997

Lifestyle factors and hip arthrosis. A case referent study of body mass index, smoking and hormone therapy in 503 Swedish women.

We investigated in a case-referent study the relationship between arthrosis of the hip in women and lifestyle factors such as body mass index (BMI), smoking and hormone therapy. The study comprised all women of ages 50-70 years, living in 5 counties and 5 towns in Sweden 1991-1994. The cases (n 230) were women with total hip replacements (THR) because of primary arthrosis, and the referents (n 273) were randomly selected women from the study base, without hip problems. All women were interviewed about height, weight, smoking habits, hormone therapy, sports activities, occupational history, home work, etc, to the age of 50. The relative risk of developing hip arthrosis leading to a THR after the age of 50 was associated with an increased BMI. The highest value, 2.9 (Cl 1.3-6.5), was reported in those with BMI > or = 25 at the age of 40. The preventive value of weight loss seems substantial. There was a greater risk of 1.5 (Cl 1.0-2.2) for smokers than for non-smokers. Use of contraceptive pills meant an increase in the relative risk for THR, unlike estrogen substitution which was associated with a lower risk than in unexposed persons.

Aged↗
PubMed1997

Possible bias from rating behavior when subjects rate both exposure and outcome.

OBJECTIVES: In many epidemiologic studies the subjects rate both the exposure and the outcome, assigning numerical values to the variables according to their perceptions and judgments. Hypothetically, subjects who tend to overestimate, exaggerate, or use high numerical values in rating tasks would rate both exposure and outcome higher than subjects who tend to underestimate, dissimulate, or use low numerical values. A range of such rating behaviors among the subjects would introduce uncontrollable bias to relative risk estimates, in most cases an overestimation. The aim of this study was to assess the possible presence of and effects on relative risk estimates of such high and low rating behavior among subjects in an epidemiologic study of musculoskeletal disorders. METHODS: Rating behavior was analyzed by intercorrelating the ratings of 19 different stimuli. High positive correlations would indicate the presence of high and low rating behavior. RESULTS: The correlations were, however, both positive and negative and close to zero. Adjusting for rating behavior did not affect relative risk estimates, based on subjective ratings of both exposure and outcome. CONCLUSION: There is no support in this study for the existence of a range of high and low rating behavior among subjects who rate neutral and nonaffective stimuli, such as time, weight, number and physical exposure, as well as pain and other symptoms. There is therefore no support for the idea of a bias to relative risk estimates from such rating behavior in studies where subjects rate both exposure and outcome variables of this kind.

Adult↗
PubMed1996

Cancer incidence among male railway engine-drivers and conductors in Sweden, 1976-90.

During recent years, the relationship between exposure to magnetic fields and cancer has attracted increasing interest. In Sweden, train personnel are exposed to comparatively strong magnetic fields in their work. The aim of the present study was to investigate cancer incidence, particularly leukemia and brain tumors, among male railway engine drivers and conductors, respectively, and to compare their cancer incidence with that of the general male population. The study population comprised all male railway engine drivers (n = 7,466) and conductors (n = 2,272) who were ever employed at the Swedish State Railways during the period 1976-90. The study population was observed with regard to cancer incidence by means of the National Cancer Register for the period 1976-90. The total cancer incidence (all tumors included) among railway engine drivers was lower than in the general Swedish population. An increased incidence of lymphocytic leukemia was observed among railway engine drivers and conductors combined (relative risk = 2.3; 95 percent confidence interval = 1.3-3.2), with the same point estimate for both occupational groups. For brain tumor (astrocytoma), the observed relative risk was close to one. The study provides evidence of an excess risk of lymphocytic leukemia in railway engine drivers and conductors, workers with known occupational exposure to magnetic fields.

Adult↗
PubMed1996

Evaluation of perceived and self-reported manual forces exerted in occupational materials handling.

The main objective of the study was to evaluate the ability of workers to reproduce simulated manual work forces correctly and to quantify these forces in Newtons (N) by means of self-reports. Fourteen male and 14 female workers participated in the study. Three experiments were carried out. In the first experiment, the ability to reproduce the magnitudes of simulated manual forces occurring in daily work and to estimate these forces in Newtons was tested. A specially designed force-measuring device was used for this purpose. In the second experiment, the subjects estimated the weights of five boxes ranging from 1 to 30 kg. In the third experiment, the subjects were asked to produce five predetermined push and pull forces ranging in magnitude from 10 to 300 N on to the handle of the force-measuring device. The ability to reproduce the magnitudes of manual forces when simulating four familiar work tasks was good (the intraclass correlation coefficients ranged from 0.75 to 0.95). The ability to quantify these forces in Newtons was not as good (the product moment correlation coefficients ranged from 0.21 to 0.69). When the subjects estimated the weights of boxes they underestimated the weights. When they produced predetermined push and pull forces they exerted higher forces than expected when low force levels were requested and lower forces when high force levels were requested. However, the forces were correctly ranked. In summary, simulation of the manual push/pull forces used in familiar work tasks seemed to offer sufficient reproducibility to be worth testing for validity. Self-reports, used without previous training or without known 'reference forces', seemed to be very rough when the aim was to estimate in kg or Newtons. However, the fact that individuals could rank the forces correctly opens a potential for refinement of self-reports as a method for quantifying manual forces in objective terms, e.g. kg or Newtons.

Journal Article↗
PubMed1996

An interview technique for recording work postures in epidemiological studies. Music-Norrtälje Study Group.

BACKGROUND: The aim of the study was to present and evaluate a work-task-oriented interview technique focusing on the placement of the hands relative to the body and assessing per cent time spent in five standard work postures during a working day. METHODS: The reproducibility of estimated time spent in each work posture was tested by the test-retest method in 32 subjects; 16 were interviewed by the same interviewer and 16 were interviewed by another one at the retest. The validity concerning estimated time spent in th five standard work postures was tested in relation to observations in 58 male blue-collar workers. The mean registration (assessment) time was 6 hours and 15 minutes. RESULTS: No evident differences in the reproducibility depending on same or different interviewers at test and retest could be observed. The linear relationship between times estimated by the interview and by observations was high for four of the work postures: 'sitting' (r = 0.86), 'standing with hands above shoulder level' (r = 0.87), 'between shoulder and knuckle level' (r = 0.75), and 'below knuckle level' (r = 0.93). When the work posture 'standing with hands between shoulder and knuckle level' was divided into 'hands fixed' (r = 0.62) and 'hands not fixed' (r = 0.50) the correlations were weak. Current musculoskeletal complaints did not influence the accuracy of the estimations. CONCLUSIONS: The present task-oriented interview technique may be the best available method to estimate these work postures in a way that requires few resources compared to observations and technical measurements.

Adult↗
PubMed1996

Myocardial infarction among male bus, taxi, and lorry drivers in middle Sweden.

OBJECTIVES: The aim of the present case-referent study was to investigate the incidence of myocardial infarction among male professional drivers, taking the type of vehicles and area of residence into account. METHODS: The study base comprised all men aged 30-74 in five counties in middle Sweden during 1976-81 or 1976-84. Incident cases of the first episode of myocardial infarction were identified from registers of hospital admissions and causes of deaths. Referents were selected randomly from the study base. Information about occupation was obtained from the national censuses in 1970 and 1975. The possible impact from tobacco smoking and overweight were evaluated by simulations in combination with indirect data on these factors. RESULTS: The incidence of myocardial infarction was increased among bus drivers in Stockholm (relative risk (RR) = 1.53, 95% confidence interval (95% CI) 1.15-2.05), and among taxi drivers both in Stockholm (RR 1.65, 95% CI 1.30-2.11) and in the surrounding rural counties (RR 1.82, 95% CI 1.17-2.82). A smaller increase was found among long distance lorry drivers, whereas the relative risk among short distance lorry drivers was close to unity. Indirect comparisons make it unlikely that the excess among bus drivers in Stockholm could be explained by uncontrolled confounding from tobacco smoking or overweight. A very high proportion (more than 80%) of urban bus drivers in Sweden report a combination of high psychological demands and low control at work. CONCLUSIONS: Different types of drivers are at different risk of myocardial infarction. Bus drivers in urban areas seem to be at an increased risk, which is unlikely to be explained by uncontrolled confounding from tobacco smoking or overweight. Psychosocial work conditions may play a part in the increased incidence of myocardial infarction among urban bus drivers and should be investigated further.

Adult↗
PubMed1996

Children's dental health in Europe. Caries treatment need in 5- and 12-year-old children from eight EU countries.

The purpose of this study was to develop methods to evaluate treatment needs (TNEED) and previous treatment (TDONE) in different populations. In the collaborative study, 'Children's Dental Health in Europe', the methods were used in connection with a clinical examination to document and compare treatment needs in 200 5-year-olds and 200 12-year-olds from each of the 8 participating countries. The study comprised a total of 3200 children from Belgium, Germany, Greece, Ireland, Italy, Scotland, Spain, and Sweden. The method for calculating TNEED was validated by estimation of required time to meet the treatment needs (TNTIME). The calculated TNEED shows a clear relationship with the evaluated TNTIME, and the method is applicable to different population subgroups. The results revealed large differences in both TNEED and TDONE among the different countries and between the two age groups.

Child↗
PubMed1995

Self-administered examination versus conventional medical examination of the musculoskeletal system in the neck, shoulders, and upper limbs. The Stockholm MUSIC I Study Group.

A self-administered examination protocol of the musculoskeletal system in the neck, shoulders, and upper limbs was mailed to 350 subjects and the results were compared to those of a subsequent medical examination. The prevalences of reported positive findings were higher than in the medical examination. Validity ranged between poor and good. Acceptable validity was noted for items measuring tenderness. No systematic substantial exposure-related misclassification was noted. Self-administered examination of the musculoskeletal system is not suitable to replace a traditional medical examination in epidemiological studies. Self-administered examination of tenderness could, however, be used as a screening method in analytical studies of relations between exposure and disorders in the musculoskeletal system. Subjects reporting such findings at a self-administered examination could be further examined by professional examiners for definite diagnostic appraisal. Substantial savings in medical examination resources could thereby be obtained.

Adult↗