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Biomedical subjects

L Alfredsson

Publications and source records attributed to L Alfredsson.

At least 91 records · Page 5Linked to original sources
PubMed1989

Industry-related urothelial carcinogens: application of a job-exposure matrix to census data.

A job-exposure matrix has been developed linking the work tasks in the Swedish National Census of population 1960 to exposure to 50 single agents or groups of substances. All 1,905,660 men, aged 20-64 years in 1960, reporting themselves as gainfully employed in the Census, were observed for the occurrence of urothelial cancer 1961-1979 by linkage to the National Swedish Cancer Registry. Subjects classified as exposed to creosote had a relative risk (with 95% confidence interval) of 2.6 (1.2-5.9) for renal pelvis cancer and 1.3 (1.0-1.8) for urinary bladder cancer; subjects exposed to polychlorinated biphenyls (PCB) had a relative risk of 1.3 (1.0-1.8) for urinary bladder cancer. Adjustment was made for age, socioeconomic group, and degree of urbanization. Exposure to combustion gases from coal gave a relative risk of 1.2 (1.0-1.4) for bladder cancer. The study carries several sources of nondifferential misclassification diluting the estimates of the relative risks toward 1.0. The limitations of exposure classification by job-exposure matrices are discussed.

Adult↗
PubMed1986

Mortality from and incidence of stroke in Stockholm.

To study trends in the incidence of and mortality from stroke in Stockholm during 1974-81 all cases (n = 56566) of stroke in patients aged over 40 were identified from the Swedish Cause of Death Register and the Inpatient Care Register. Information on the population at risk was obtained from the civil registration system. A multiplicative model was used to control for changes in the distribution of age during the study. Mortality from stroke decreased annually throughout the study by a mean of 2.3% for men and 3.5% for women. This favourable development was not accompanied by a similar decrease in the incidence of stroke. In men the total incidence (including recurrent strokes) and incidence of first stroke increased continuously. In women the total incidence showed virtually no change, whereas the incidence of first stroke decreased somewhat. These findings, in addition to an expected shift of age profile in the population towards more elderly people, should be considered in the planning of future health care resources.

Adult↗
PubMed1985

Type of occupation and near-future hospitalization for myocardial infarction and some other diagnoses.

Using three different registers a cohort study was undertaken to describe the relationship between type of occupation and hospitalization. A total of 958 096 subjects aged 20-64 years were followed-up for one year regarding inpatient care. Several significant associations between type of occupation and incidence of hospitalization for different diagnoses were observed. Male subjects employed in occupations where a high proportion reported a combination of hectic work and few possibilities to learn new things were more frequently hospitalized for myocardial infarction than other working men. The relative 'hospitalization' ratio for men 20-54 years of age in these strenuous occupations was estimated as 1.6 with a 95% confidence interval of 1.3-1.9. For women, the relative 'hospitalization' ratio in the ages 20-64 in occupations where a high proportion reported a combination of hectic and monotonous work was estimated as 1.6 with a 95% confidence interval of 1.1-2.3. Both these associations were statistically significant even after controlling for 12 possible confounding factors.

Adult↗
PubMed1985

Myocardial infarction and environment. Use of registers in epidemiology.

In the present thesis methods for utilizing some of the many registers in Sweden for epidemiological purposes were further developed. These purposes include immigrant studies, case-control studies dealing with psychosocial job characteristics, and studies of time trends. A theoretical framework for handling problems of misclassification when using register data was developed. Register data were used to examine several hypotheses concerning the occurrence and etiology of myocardial infarction (MI). The result of these all emphasize the role of environmental factors in the etiology of MI. Further information on the relationship between migration and MI was obtained. Male Finnish immigrants in Sweden tend to adopt the lower risk of native Swedes. This implies that environmental factors are important in explaining the difference in incidence of MI between Finland and Sweden. This also implies that it may be possible to decrease the risk by changing environmental conditions. The relationship between psychosocial work environment and MI risk was studied in a new way by using information on occupation. Occupations characterized by hectic work and at the same time providing little possibility for control or growth were significantly associated with an elevated MI risk. The risk for men aged 40-54 years employed in these strenuous occupations was about twice as high as for those in other occupations. This result remained relatively unaffected when several potential confounding factors were taken into consideration. A study was undertaken to examine trends in the incidence and mortality of MI in Stockholm (1974-80). For men the incidence as well as the mortality was appreciably increased. For women there was an appreciable increase in incidence while the increase in mortality was more uncertain. The observed increases in incidence and mortality are contrary to the trend for most other nations in the Western hemisphere. The reason for the increasing trend in Stockholm is, however, unknown.

Adult↗
PubMed1984

Shift work and cardiovascular disease.

This paper reviews a number of studies which have presented results on the association between shift work and cardiovascular disease. It is suggested that many of the early studies suffer from methodological flaws which render them difficult to interpret. In studies in which incidence of disease has been computed and related to exposure to shift work, the results indicate a higher risk for cardiovascular disease among shift workers as compared to day workers. The evidence cannot yet, however, be considered conclusive.

Cardiovascular Diseases↗
PubMed1984

On the interplay between socioeconomic factors, personality and work environment in the pathogenesis of cardiovascular disease.

This article summarizes some of the major findings in research on associations between psychosocial factors and cardiovascular illness. Methodological difficulties are discussed. Findings from some of the authors' own studies serve as illustrations. It is emphasized that an interplay between environmental and individual factors is of great importance. Personality factors relevant to the risk of cardiovascular illness may distort individual descriptions of the work environment. Cardiovascular risk factors such as cigarette smoking and repeated blood pressure elevations may be influenced by psychosocial factors. Lack of intellectual discretion at work, particularly if combined with excessive demands, may increase the risk of cardiovascular illness.

Adult↗
PubMed1983

Increasing incidence and mortality from myocardial infarction in Stockholm county.

A study was undertaken to examine trends in the incidence and mortality of myocardial infarction in Sweden. All cases (n = 19908) of myocardial infarction diagnosed in the population of Stockholm county during 1974-80 were identified by means of the cause of death register and the inpatient care register. Information on patients at risk was obtained from the civil registration system. The relative risk of developing, or dying of, myocardial infarction in one specific year, compared with the average for the whole period, was taken as the basis for describing the trends. For men in Stockholm the incidence as well as the mortality was appreciably increased; the annual increase in incidence was 3% and in mortality 4%. There were no signs of decreasing lethality. For women there was an appreciable increase in incidence; for mortality the result was less specific but was compatible with an increase. The observed increases in incidence and mortality appeared to be real and were probably not due to an increasing tendency for patients to seek hospital treatment or for doctors to make the diagnosis. The reason for the increase is unknown.

Adult↗
PubMed1983

Job characteristics of occupations and myocardial infarction risk:effect of possible confounding factors.

In this paper some previously found associations between psychosocial occupational characteristics and myocardial infarction (MI) risk are scrutinized regarding confounding effects. Standardized occupational characteristics were obtained for 118 occupational groups by means of a nation wide interview survey (3876 men). Possible confounding factors available were smoking, low level of education, high proportion of immigrants (mainly of Finnish origin) and heavy lifting. The standardized characteristics were utilized in a case-control study of 1216 men 40-64 years of age, living in the Stockholm County. It was concluded that occupations characterized by both high demand and at the same time small possibility of control or growth ('strain') are associated with an elevated MI risk regardless of the confounding factors. Taking each of the confounding factors into account the risk of developing MI for men aged 40-54 years employed in these strenuous occupations is about twice as high as for those employed in other occupations.

Adult↗
PubMed1982

Myocardial infarction risk and psychosocial work environment: an analysis of the male Swedish working force.

The project was designed to test the assumption that certain psychosocial characteristics of occupational groups are associated with elevated myocardial infarction risk. All cases of myocardial infarction below the age of 65 in men living in the region of greater Stockholm during the years 1974-1976 were identified (deaths as well as survivals) in the official registries of hospitalizations and deaths. For each case two controls without infarction (in younger ages four) matched for age, area of residence and sex were selected randomly from the parish registries. For each case and control (n = 334 and 882, respectively) information was available regarding occupation. The psychosocial characteristics of each one of the 118 occupations were recorded by means of a nation wide interview survey (3876 working men) in 1977. Relative age-adjusted risks of developing a myocardial infarction were calculated for occupations in which many vs occupations in which few subjects reported a given characteristic (50% with most vs 50% with least). Shift work and monotony were associated with significant excess risk. Hectic work was not associated with excess risk by itself but in combination with variables associated with low decision latitude and/or few possibilities for growth it was associated with significant excess risk.

Adult↗
PubMed1982

Incidence of myocardial infarction among male Finnish immigrants in relation to length of stay in Sweden.

In Finland, the incidence of coronary heart disease is reported to be about twice as high as in the neighbouring country of Sweden. The aim of this study was to find out what happens to this excess risk among Finnish immigrants to Sweden. A geographically defined population in Stockholm County was followed up in the in-patient care registry and the cause-of-death registry in order to find cases for a case-control study. All episodes of myocardial infarction (ICD numbers 410.00 and 410.99) that had occurred in men born between 1911 and 1935 during the period 1974-76 were recorded. An age-matched control group was randomly selected from the population. By means of the civil registration system it was possible to identify country of birth and length of stay in Sweden. Of the 356 cases, 32 (9%) had been born in Finland compared with 55 (6%) of the 887 controls. The overall relative risk for the Finnish immigrants compared with native Swedes was 1.7. For the group of Finnish immigrants who had been in Sweden for 20 years or more the relative risk was 1.3. It was concluded that since the relative risk decreases during the stay in Sweden the environmental factors dominate the explanation of the difference in the relative risk of developing myocardial infarction between Finland and Sweden.

Age Factors↗
PubMed1982

Theophyllines three times daily - when are the doses actually taken? - Pharmacokinetic ideals versus clinical practice.

We asked patients "At what times of the day do you usually take your medicine?" In contrast to compliance interviews dealing with missed doses, this question was previously shown to give valid information. Here we present results from 126 patients on theophyllines three times daily, the most common dosage schedule for these drugs in Sweden in 1978. Only 2% of the patients stated the ideal 8-h intervals between all doses, while 72% had confined all their doses within 12 h. The first and second intervals ranged from 0 to 11 h with a mean of 5.5 and 6.1 h respectively. The third interval varied from 7 to 18 h with a mean of 12.4 h. Patients might benefit more from their therapy by even-spacing of their intake of theophylline.

Adolescent↗
PubMedDate not supplied

Coping with unfair treatment at work--what is the relationship between coping and hypertension in middle-aged men and Women? An epidemiological study of working men and women in Stockholm (the WOLF study).

BACKGROUND: An important hypothesis in psychosomatic medicine is that exposure to psychosocial factors that arouse anger may accelerate the onset of hypertension, particularly if the subject is not allowed to show anger or to deal constructively with the factor that evoked it. For working men and women, being treated in an unfair way at work may be crucial. The present study was designed to answer the question whether the pattern of coping - primarily directed towards the aggressor (open) or directed inwards or towards others (covert) - is associated with hypertension among working men and women. STUDY GROUP: Five thousand seven hundred and twenty working men and women aged 15-64 participated in the study. The participation rate was 76%. METHODS: The coping pattern was studied by means of a Swedish version of a self-administered questionnaire that was originally introduced by Harburg et al. RESULTS: Significant results were confined to the age group 45-54. All analyses were adjusted for age and body mass index. Smoking habits and social class had no effect on the relationships. Low scores (lowest quartile) for open coping tended to be associated with an elevated prevalence ratio (PR) of hypertension both among men (PR 1.3, 95% confidence interval, CI, 0.9-1.7) and women (PR 1.4, 95% CI 1.0-2.0). High scores for covert coping (highest quartile) were associated with an elevated PR of hypertension among men (PR 1.6, 95% CI 1.2-2.2) but not in women. If the analysis was confined to cases without medication, the relationship between a high level of covert coping and high blood pressure was still significant for men. For women, however, no significant findings were made after this operation. Accordingly, the relationship between a low level of open coping and hypertension in women was confined to women with medication. Coping patterns were correlated with psychosocial work environment factors, in particular decision latitude. CONCLUSION: In men, covert coping was associated with prevalence of hypertension. In women, there tended to be a relationship between low scores for open coping and hypertension.

Adaptation, Psychological↗