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Biomedical subjects

L Alfredsson

Publications and source records attributed to L Alfredsson.

At least 73 records · Page 4Linked to original sources
PubMed1995

Musculoskeletal disorders in former athletes. A cohort study in 114 track and field champions.

We studied the influence of elite track and field activities on the musculoskeletal system in a cohort of 114 Swedish men 50-80 years of age compared to 355 randomly selected referents in the same age group. Arthrosis of the hip was increased more than threefold among the athletes (8 percent) compared to the referents (2 percent). For other musculoskeletal disorders the distribution was similar between the groups but the prevalence of arthrosis of the knee tended to increase while that of neck/shoulder disorders tended to decrease in the athlete group.

Aged↗
PubMed1995

Children's dental health in Europe. Clinical calibration of dental examiners in eight EU countries.

An epidemiological investigation has been initiated from Sweden with the aim to study and compare dental health, dental treatment needs and attitudes to dental care in two well-defined age-groups, children of 5 and 12 years of age, in eight EU countries. To ensure comparability of the clinical registrations, data collection was preceded by clinical calibrations of the examiners from the participating countries. All the examiners participated in a workshop with initial calibration exercises. Agreement, expressed as sensitivity, was measured between the Swedish examiner acting as the reference examiner and each of the other examiners in turn, and assessed separately for the two age-groups. For DMFS/dmfs, agreement ranged from 44.3% to 82.2%. These results were discussed and where necessary the criteria were modified and/or made more stringent, so that they were clearcut and could be adhered to consistently. In a second calibration between the Swedish and the national examiner undertaken in each of the seven countries, the inter-examiner agreement (sensitivity) varied between 85.4% and 100%. The mean sensitivity for DMFS/dmfs after the total calibration procedures was 89.5% for the 12-year olds and 91.7 for the 5-year olds. The mean sensitivity for both age-groups together was 90.6% and the corresponding value for specificity was 98.9%.

Age Factors↗
PubMed1995

Neuropsychiatric function of housepainters with previous long-term heavy exposure to organic solvents.

Neuropsychiatric effects were examined among 206 men, of whom 135 had been house painters and 71 had been house carpenters, affiliated with their respective trade unions for at least 10 years before 1970. Their lifetime organic solvent exposure was evaluated through the aid of an interview. Relevant potential confounding factors were accounted for in the statistical analysis. Neuropsychiatric symptoms compatible with chronic toxic encephalopathy were more common among the painters than among the carpenters, and these symptoms became increasingly prevalent with increasing cumulative solvent exposure. On only one of 12 psychometric tests, block design, did the painters perform worse than the carpenters, and in this test the painters' performance deteriorated with increasing cumulative exposure. For the majority of the psychometric tests, and for the coordination tests, there were no differences between the painters and carpenters, but the painters with "low" exposure tended to show better, and "heavily" exposed painters worse, results than the carpenters. The 52 painters with the heaviest cumulative exposures and 45 carpenters were examined for psychiatric diagnosis according to DSM-III, with electroencephalography and auditory evoked potential, P-300. Three painters and two carpenters had diagnoses compatible with an organic mental disorder. There were no overall differences between the painters and carpenters, either for the visually examined electroencephalograms or the P-300 latencies. The excess of neuropsychiatric symptoms among the painters was probably causally linked to solvent exposure. However, these symptoms seemed only rarely, if ever, serious enough to entail a psychiatric diagnosis. Concerning other outcomes, the investigation may not lead to a determination of whether the exposure-response relationship among the painters, with no difference between the entire group of painters and carpenters, is caused by solvent exposure or by selection factors within the group of painters.

Adult↗
PubMed1994

Job characteristics and the incidence of myocardial infarction.

In Sweden, there are large differences in the incidence of myocardial infarction (MI) among occupational groups. These differences may to some extent be due to work environment factors, including psychosocial job strain. The aim of the present study was to estimate the relative risk (RR) of MI for Swedish men and women in high strain occupations as compared to those in low strain occupations. The association between job strain and MI was studied by case-control methods. The study base comprised the population of four Swedish counties from 1976-1981 and of Stockholm county from 1976-1984. Incident cases of MI were identified through hospital discharges together with deaths. Information about occupation was obtained from the 1970 and the 1975 censuses and individuals were characterized with regard to job strain on the basis of their job title. In all, 9295 cases and 26 101 controls with unchanged type of occupation from 1970 to 1975 were included in the analyses. Men and women aged < 65 in high strain occupations showed an RR of 1.1-1.4, and men age < 55 an RR of 1.2-1.6 compared to those in low strain occupations. Similar results were obtained in analyses of male white and blue collar workers respectively. If the association between job strain and MI is causal this could be of great importance in explaining differences in MI incidence among occupational groups in Sweden.

Cross-Sectional Studies↗
PubMed1994

Smokeless tobacco use and increased cardiovascular mortality among Swedish construction workers.

OBJECTIVES: Little is known about the risks of cardiovascular disease associated with the use of smokeless tobacco, which produces blood nicotine levels similar to those caused by cigarette smoking. METHODS: Male Swedish construction industry employees (n = 135,036) who attended a health examination were followed by studying cause-specific mortality during a 12-year period. The study population comprised 6297 smokeless tobacco users, 14,983 smokers of fewer than 15 cigarettes per day, 13,518 smokers of 15 or more cigarettes per day, 17,437 ex-smokers, 50,255 "other" tobacco users, and 32,546 nonusers. RESULTS: The age-adjusted relative risk of dying from cardiovascular disease was 1.4 for smokeless tobacco users and 1.9 for smokers of 15 or more cigarettes per day, compared with nonusers. Among men aged 35 through 54 years at the start of follow-up, the relative risk was 2.1 for smokeless tobacco users and 3.2 for smokers. When data were adjusted for body mass index, blood pressure, and history of heart symptoms, the results were essentially unchanged. Cancer mortality was not raised in smokeless tobacco users. CONCLUSIONS: Both smokeless tobacco users and smokers face a higher risk of dying from cardiovascular disease than nonusers. Although the risk is lower for smokeless tobacco users than for smokers, the excess risk gives cause for preventive actions.

Adult↗
PubMed1994

Occupation, occupational exposure to chemicals and rheumatological disease. A register based cohort study.

The cumulative incidence of rheumatoid arthritis (RA) was compared between different occupations, and between different exposure groups based on a job-exposure matrix (JEM). The study population comprised those subjects who in 1980 lived in one of 13 Swedish counties, were born between 1905 and 1945, and who had stated the same occupation in the censuses of 1960 and 1970, a total of 375,035 men and 140,139 women. The study population was followed concerning hospital care for rheumatoid arthritis in 1981-1983 by lineage to the Swedish Hospital Discharge Register. In general there were rather small differences in the relative risk of RA in different exposure groups and different occupations. Most of the occupations associated with an increased risk of RA were occupations in which it was possible to work when the disease was present, i.e. cost accountants, estimating clerks and working proprietors in the retail trade. However, an increased relative risk of RA was also observed in some occupations where selection of RA patients out of heavy work should have biased genuinely increased relative risks towards unity. Such occupations were farmers, upholsterers, lacquerers, concrete workers, and hair-dressers. Substantial handling of organic solvents, according to the JEM, was associated with an increased relative risk.

Adult↗
PubMed1994

Etiologic fractions for physical work load, sports and overweight in the occurrence of coxarthrosis.

OBJECTIVES: The aim of this study was to estimate the impact of physical work load, sports, and overweight on the incidence of coxarthrosis. METHODS: A case-referent study was made of 239 male recipients of a hip prosthesis and 302 men randomly selected from the general population. Information was obtained by means of an interview and questionnaire. Exposures to physical work load and sports were measured as the cumulative number of hours of exposure up to 49 years of age. Overweight was measured as the estimated body mass index at 30 or 40 years of age. RESULTS: The etiologic fraction related to the three risk factors was 40% for physical work load, 55% for sports, and 15% for overweight. Various measures of physical work load were considered, but they all proved to be correlated. CONCLUSIONS: Approximately 80% of the idiopathic coxarthrosis was explained by the presence of the three risk factors.

Age Factors↗
PubMed1993

Nonsteroidal anti-inflammatory drug use in relation to major upper gastrointestinal bleeding.

In a study in the United States, Sweden, and Hungary, 335 cases of gastric bleeding without predisposing factors were compared with 670 control subjects, and 239 cases of duodenal bleeding were compared with 489 control subjects. For aspirin taken at least every other day during the week before the onset of bleeding (regular use), the relative risk of gastric bleeding was 4.4 (95% confidence interval [CI], 2.9 to 6.7); for occasional use, it was 3.3 (95% CI, 2.1 to 5.0). For ibuprofen, the corresponding estimates were 1.0 (95% CI, 0.4 to 2.6) and 1.1 (95% CI, 0.5 to 2.4). For naproxen, the estimate for regular use was 4.0 (95% CI, 1.5 to 11). The estimates for any use of piroxicam (crude estimate), indomethacin, and diclofenac during the week before onset were 18 (95% CI, 4.1 to 83), 1.6 (95% CI, 0.4 to 5.9), and 0.9 (95% CI, 0.2 to 4.2), respectively. The corresponding relative risks of duodenal bleeding were 7.1 (95% CI, 4.2 to 12) and 2.2 (95% CI, 1.3 to 3.7) for the regular and occasional use of aspirin, 2.4 (95% CI, 0.5 to 11) and 0.8 (95% CI, 0.3 to 2.0) for ibuprofen, 12 (95% CI, 2.8 to 54) and 9.9 (95% CI, 2.3 to 44) for naproxen, 17 (95% CI, 3.6 to 79) for any use of piroxicam (crude estimate), and 1.7 (95% CI, 0.2 to 14) for any use of indomethacin. There was a significant trend in the risk of gastric bleeding with increasing dose of regular aspirin use (p = 0.002). The relative risk estimates for the regular use of 325 mg or less were significantly elevated for both gastric and duodenal bleeding at 3.1 and 6.4, respectively.

Aged↗
PubMed1993

Incidence of myocardial infarction and mortality from specific causes among bus drivers in Sweden.

Previous studies have indicated that urban bus drivers have an increased risk of coronary heart disease. In the present investigation two separate studies were carried out. In the first study the mortality from myocardial infarction (MI), as well as from other causes for all male bus drivers in Sweden (9446), was investigated and compared to those of other employed men over a 15-year period. A 50% increase in mortality from MI was observed among drivers in Stockholm and Göteborg and Bohus counties, the two counties where the two largest cities in Sweden are situated. No increased mortality from lung cancer, any cancer (all sites combined), or from all causes combined was observed for these drivers. For bus drivers in the predominantly rural areas no excess mortality from MI, or any other cause, was observed. In the second study the incidence of MI among male bus drivers, as compared with other employed men, was studied in five Swedish counties by case referent methods. An increased incidence of first events of MI, (relative risk = 1.6, 95% confidence interval (CI) 1.1-1.9) was observed for bus drivers in Stockholm county. According to our results, urban bus drivers thus have an increased risk of developing MI. The findings also suggest that factors in the work environment of urban bus drivers may contribute to this increased risk. Factors of possible importance are job strain, irregular working hours, a sedentary job, automobile exhaust fumes, and noise.

Automobile Driving↗
PubMed1992

Time trends in survival from myocardial infarction in Stockholm County 1976-1984.

In Stockholm county, a rapid decline in mortality from acute myocardial infarction (AMI) was observed among middle-aged men in the early 1980s. In the present study survival among AMI patients from 1976 to 1984 was investigated in order to explore whether improvements in survival may have contributed to this decline. AMI patients aged 30-74 years (n = 16,108) were identified through a hospital discharge register. Deaths within one year of hospital admission were ascertained by means of linkage to the national cause of death register. Survival 1 year after hospital admission increased in both genders during the period 1981-1984, but among women there was no uniform trend over the whole study period. The estimated age-adjusted relative risk of death within one year after hospital admission for patients with a first infarction admitted to hospital in 1983-1984 as compared to in 1981-1982 was 0.88 for men and 0.79 for women. The causes of the observed increase in survival could not be determined from this study, but changes in medical intervention as well as diagnostic improvements may have been important. Improved survival may have contributed to about 30% of the decline in mortality from AMI among middle-aged men in Stockholm county during the early 1980s.

Adult↗
PubMed1992

Differences in the incidence of myocardial infarction among occupational groups.

An inverse relationship between social class and coronary heart disease has been observed in several countries, but few studies have investigated the incidence of this disease over different occupational groups. A case-referent study was carried out to estimate the relative risk of a first myocardial infarction in various occupational groups. Cases of myocardial infarction (N = 36,602) were identified from both hospital discharge and death records. Two referents for each case were randomly selected from the study base. Information about occupation was obtained from two consecutive censuses. An increased incidence, compared with that of others employed, was found for persons in some occupations in production work, transport work (men), and service work (women). Low relative risk were found mainly for persons in occupations demanding a high education. The relative risks ranged from 0.3 to 2.8. Several factors, occupational as well as nonoccupational, may be of importance in explaining the findings.

Adult↗
PubMed1991

Self-reported health and well-being amongst night security guards: a comparison with the working population.

The present study sought to relate the well-being of night workers to that of the working population in general. One hundred and ninety-seven male permanent night security guards were interviewed with regard to the occurrence of various symptoms during the previous 12-month period. The results were compared with the results from similar interviews with a representative national sample of males (n = 1769) in the Swedish workforce. An age standardized morbidity ratio was computed with control for various background variables. The results showed that the security guards had a 2-3 times higher occurrence of sleep disturbances and fatigue than the national sample. Among the variables not differing from the national sample were gastrointestinal problems, headache, nervous problems, depression, nausea, diarrhoea, and haemorrhoids. It was concluded that sleep/wake disturbances are considerably more usual in permanent night security guards than in the working population as a whole.

Adult↗
PubMed1991

Occupation and osteoarthrosis of the hip and knee: a register-based cohort study.

A register-based cohort study was performed to investigate if men and women in certain occupations with high physical workload had increased risks of developing severe symptomatic osteoarthrosis of the hip and knee, resulting in hospital care. The study population consisted of 250,217 people from the 1980 census, in blue-collar occupations, who had reported the same occupation in the 1960 and 1970 censuses. The study population was followed for hospital care for osteoarthrosis of the hip and knee during 1981-1983 by linkage to the Swedish Hospital Discharge Register. Different blue-collar occupations were classified as high or low with regard to exposure to forces acting on the hip and knee and the frequencies of the outcomes were compared. Male farmers, construction workers, firefighters and some food processing workers had an excess risk of hospitalization due to osteoarthrosis of the hip. Male farmers, construction workers and firefighters also had increased risks of osteoarthrosis of the knee. Female mail carriers had an excess risk of osteoarthrosis of the hip, and female cleaners, of osteoarthrosis of the knee. The findings support the hypothesis that heavy physical work load contributes to osteoarthrosis of the hip and knee.

Cohort Studies↗
PubMed1991

Coxarthrosis and physical work load.

A case-referent study was performed on the possible relationship between physical work loads and an increased risk of developing coxarthrosis. The cases were 239 male recipients of a hip prosthesis as a result of severe idiopathic coxarthrosis; the referents were 302 men randomly selected from the general population. The work load was assessed through an interview and a self-administered questionnaire on the men's specific work periods. Men highly exposed to dynamic or static work loads had an increased relative risk of 2.42 (95% confidence interval 1.45-4.04) for developing coxarthrosis when compared with men with low exposure. Men with high exposure to heavy lifting between the ages of 30 and 49 years had the highest relative risk, 3.31 (95% confidence interval 1.97-5.57). Long-time exposure to physical work loads seems to be a risk factor for severe coxarthrosis among men.

Adult↗