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P Bakke

Publications and source records attributed to P Bakke.

At least 19 recordsLinked to original sources
PubMed2003

Long-term changes in adult asthma prevalence.

There has been an increase in asthma prevalence among children. Little evidence is available regarding long-term changes in asthma prevalence in adults. Two cross-sectional studies were performed among adults aged 15-70 yrs in Oslo, Norway, in 1972 and again in 1998-1999 (n=39,998). A postal self-completed questionnaire was used. Exactly the same questions and survey methods were used in both studies. In 1998-1999, additional telephone follow-up was included for postal nonresponders. The crude prevalence of ever having had a doctor's diagnosis of asthma increased from 3.4 to 9.3%. The prevalence of wheezing increased from 17.8 to 25.8% and attacks of breathlessness from 12.6 to 16.7%. After controlling for smoking, the risk of asthma among those aged <40 yrs had tripled. The increase in asthma was 50% greater in females than males. The prevalence of symptoms increased less than asthma diagnosis. Wheezing increased by 50% in those aged <40 yrs, with smaller increases at greater ages. The increase in symptoms was seen among both asthmatics and nonasthmatics. There has been a large increase in the prevalence of asthma diagnosis and asthma-like symptoms in adults. The increase is less pronounced among those aged >40 yrs.

Adolescent↗
PubMed2003

Epidemiological aspects and early detection of chronic obstructive airway diseases in the elderly.

The burdens of chronic obstructive airway diseases among the elderly in Europe, and worldwide, are increasing. Although asthma is common in all ages, the main airway disease affecting the elderly is chronic obstructive pulmonary disease (COPD). The aim of this paper is to review the prevalence and incidence of COPD on the basis of population studies. As the prevalence estimates of asthma are probably well known, only the incidence and remission of asthma will be discussed. The underdiagnosis of obstructive airway diseases is huge. A Dutch programme for early detection of obstructive airway disease among the elderly has, thus, been included in the presentation. A prerequisite for fighting COPD is to acquire data on illnesses and death. COPD has only recently been defined by cut-off points of spirometric outcomes, which is why measures of the prevalence of COPD have been distorted by use of a large number of different diagnostic terms and lung function criteria. The prevalence of clinically-relevant COPD has been estimated in several community studies to 4-6% in adult population samples, with a considerable increase by age, particularly among smokers. The incidence of COPD not only increases heavily with age and smoking, but also occupational exposure to dust, gas and damp. Precise estimates of the incidence of COPD or spirometric airflow limitation are not available. Demographic changes will result in a further substantial increase of chronic obstructive airway disorders, mainly chronic obstructive pulmonary disease, among the elderly. The increasing burden of chronic obstructive pulmonary disease has to come to the awareness of the public, governments, health authorities, and industry.

Aged↗
PubMed2001

Standardized submaximal exercise testing in never smokers: a normative study.

In a population survey on the south-western coast of Norway, 373 never smokers aged 18-73 years (230 women) without respiratory symptoms performed a standardized, progressive, incremental submaximal bicycle exercise test. All individuals were able to do an exercise involving oxygen uptake of 1.0 l min(-1), 80% of the subjects reached 1.5 l min(-1) and 50% of the subjects reached 2.0 l min(-1). The respiratory frequency (RF), ventilation (VE) and heart rate (HR) for a given oxygen uptake were all higher in women than in men. Significant predictors of failure to reach oxygen uptake of 1.5 and 2.0 l min(-1) were sex, age, body height and weight. Prediction equations are given for respiratory frequency, heart rate and ventilation for an oxygen uptake of 1.0 l min(-1) in women and 1.5 l min(-1) in men; and body height is a strong predictor for all dependent variables. A multiple linear regression analysis in women showed that age was a significant predictor of respiratory frequency (P<0.05), ventilation (P<0.001) and heart rate (P<0.001), while in men age was a significant predictor only of ventilation (P<0.001) during the bicycle exercise protocol.

Adolescent↗
PubMed2001

Expiratory and inspiratory forced vital capacity and one-second forced volume in asymptomatic never-smokers in Norway.

The objectives of this study were to examine within and between individual variation detected during forced expiratory (FE) and forced inspiratory (FI) manoeuvers in a general population and to investigate the dependence of these variables on age, body size, and gender. A random sample of asymptomatic never smokers who had never been exposed occupationally to quartz or asbestos and who were living on the south-western coast of Norway were examined by spirometry; 81% of the individuals invited to attend did so. Of the 488 subjects between 18 and 73 years of age, 98% contributed three acceptable recordings for forced expiratory vital capacity (FVC) and one-second forced expiratory volume (FEV1), 94% contributed three acceptable recordings for forced inspiratory vital capacity (FIVC) and 85% contributed three acceptable recordings for one-second forced inspiratory volume (FIV(1)). The within-subject variation increased with body height and was considerably larger for FIV(1) than for FVC, FEV(1) or FIVC. A four-parameter model of pulmonary function measurement divided by height squared, including a gender term and a linear and quadratic term of age, fit the median of the observed values well. The residuals had a close-to-normal distribution, and the fifth-percentile values were estimated as the lower limit of normal. The peak value of dynamic lung volumes was observed into the middle of the fourth decade of life, and the decline thereafter did not differ greatly between the genders or among the different indices. The forced inspiratory volumes are the first reported in any reference population.

Adolescent↗
PubMed2000

[Do health personnel talk about passive smoking with parents of small children?].

INTRODUCTION: Almost seven out of ten parents who smoke state that they have never received information on passive smoking from health personnel when they bring their children in for routine medical examination. We examined what GPs, doctors and nurses at mother-and-child clinics and midwives reported. MATERIAL AND METHODS: A self-administered questionnaire focusing on practice as regards the matter of passive smoking and children was mailed to a representative sample of 1050 GPs, the senior midwives at Norway's 77 maternity departments, 492 senior public health nurses, and health personnel at 1024 mother-and-child clinics. The response rate varied from 71% (GPs) to 82% (senior midwives). RESULTS: 70% of the personnel at mother-and-child clinics less often than "always" ask about exposure to passive smoking. 60% of the senior midwives report that the department's personnel less than "to a large extent" allocate time to talk with parents about passive smoking. 40% of the GPs and 50% of the paediatricians say that they "never" bring up the matter of passive smoking when they examine small children and do not know whether members of the household smoke or not. The rest of the GPs bring up the matter in 46% of consultations and the rest of the paediatricians in 63% of consultations. When the child has symptoms that can be associated with passive smoking, the GPs discuss the parents' smoking habits in 88% of the consultations and paediatricians in 100% of consultations. INTERPRETATION: Only to a small extent do health personnel use their opportunities of motivating parents to change their smoking habits for the sake of the health of their children. Smoking is only brought up by professionals as a matter routine when the children develop symptoms of exposure to tobacco smoke.

Adult↗
PubMed2000

Performance of population specific job exposure matrices (JEMs): European collaborative analyses on occupational risk factors for chronic obstructive pulmonary disease with job exposure matrices (ECOJEM).

OBJECTIVES: To compare the performance of population specific job exposure matrices (JEMs) and self reported occupational exposure with data on exposure and lung function from three European general populations. METHODS: Self reported occupational exposure (yes or no) and present occupation were recorded in the three general population surveys conducted in France, The Netherlands, and Norway. Analysis was performed on subjects, aged 25-64, who provided good forced expiratory volume in 1 second (FEV1) tracings and whose occupations were performed by at least two people, in the French (6217 men and 5571 women), the Dutch (men from urban (854) and rural (780) areas), and the Norwegian (395 men) surveys. Two population specific JEMs, based on the percentage of subjects who reported themselves exposed in each job, were constructed for each survey and each sex. The first matrix classified jobs into three categories of exposure according to the proportion of subjects who reported themselves exposed in each job (P10-50 JEM, low < 10%, moderate 10-49%, high > or = 50%). For the second matrix, a dichotomous variable was constructed to have the same statistical power as the self reported exposure--that is, the exposure prevalence (p) was the same with both exposure assessment methods (Pp JEM). Relations between occupational exposure, as estimated by the two JEMs and self reported exposure, and age, height, city, and smoking adjusted FEV1 score were compared. RESULTS: Significant associations between occupational exposure estimated by the population specific JEM and lung function were found in the French and the rural Dutch surveys, whereas no significant relation was found with self reported exposure. In populations with few subjects in most jobs, exposure cannot be estimated with sufficient precision by a population specific JEM, which may explain the lack of relation in the Norwegian and the Dutch (urban area) surveys. CONCLUSION: The population specific JEM, which was easy to construct and cost little, seemed to perform better than crude self reported exposures, in populations with sufficient numbers of subjects per job.

Adult↗
PubMed1999

Reproducibility of indoor environment characteristics obtained in a walk through questionnaire. A pilot study.

Walk through questionnaires may be feasible tools to obtain data on the indoor environment in community studies. However, limited information is available regarding the reproducibility of the data obtained through these questionnaires. In this pilot study, two construction engineering students inspected ten dwellings twice by means of a standardized walk through questionnaire. The two engineering students inspected the dwellings independent of each other within two months. Time between the two visits varied between 14 and 40 days. The variables presented were based on information from the residents and inspection. The continuous variables recorded included number of rooms in the dwellings, room volume, length of filled shelves and textile area. The inter- and intra-observed variabilities were poorer for number of rooms and shelf factor than for the other variables. For the 3 of the 9 categorical variables based on inspection, the inter-observer comparison showed complete agreement with a kappa statistics of 1.0, these variables being condition of the window frames and construction of outside walls and roof. One of the categorical variables showed a kappa statistics of < 0.5, these variables being presence of basement and presence of condensation at windows. This study indicates a wide variation in observer variability between various items of a walk through questionnaire. Clear definitions of all the parts of the questionnaire are needed, as well as thorough training of observers.

Air Pollution, Indoor↗
PubMed1998

[Medication practice and personal knowledge of the disease among patients with obstructive lung disease].

250 patients with obstructive lung disease who had attended an out-patient clinic were assessed after reporting on individual medication practices and their personal knowledge of the disease. 56% of the patients reported using two types of asthma medicine. The use of three, four, and five or more antasthmatica was reported by 26%, 9% and 5%, respectively. 90% had been prescribed an inhalation corticosteroid. Of these, one in five reported using it only when required, whereas in the age group 18-34 years the corresponding figure was one in three (34%). Regardless of what medication the patients were using, 20% reported that they often forgot to take it, 20% that they stopped taking it when their asthma improved, and 38% that they did not think about what time of the day they took their medicine. These practices of taking medication occurred more frequently in the young than in older patients. Practices did not vary with either a person's sex, duration of disease, or the patient's personal assessment of the seriousness of the disease. Patients with a higher level of education seemed to have greater knowledge of their disease than those with only secondary education, as was also the case with nonsmokers compared to smokers.

Adrenal Cortex Hormones↗
PubMed1998

[Immunoglobulin E, viral antibodies and obstructive lung disease in adults. The relation between antibody level in serum, lung function and non-specific bronchial reactivity].

We have measured immunoglobulin E levels and respiratory virus antibodies and examined their possible role as risk factors for obstructive lung disease in adults. We observed that increased total serum IgE levels were associated with reduced lung function in subjects with obstructive lung disease, but not in asymptomatic subjects. Subjects sensitised to indoor allergens (house dust mites, cats and mould) had reduced lung function and increased, non-specific, bronchial responsiveness compared with individuals who were not sensitised to indoor allergens. Similar relationships were not observed for subjects sensitised to outdoor allergens (birch and timothy). The presence of respiratory virus antibodies was vaguely associated with reduced lung function, but was not related to increased, non-specific, bronchial responsiveness. In adults in this community sensitisation to indoor allergens is a strong predictor of reduced lung function and increased, non-specific, bronchial responsiveness, which are again closely associated with obstructive lung disease.

Adolescent↗
PubMed1998

Applicability of the single-breath carbon monoxide diffusing capacity in a Norwegian Community Study.

The test of single-breath diffusing capacity for carbon monoxide (DLCO) has been widely used in population surveys. However, little is known about the effect of meeting or failing to meet the criteria for acceptability of this test. The American Thoracic Society (ATS) recommends a breathholding time of 9 to 11 s, two measurements within +/- 10% or 3 ml CO(STPD)/min/mm Hg of the average DLCO, and an inspiratory vital capacity (IVC) of at least 90% of the largest previously measured forced vital capacity (FVC) as criteria for this test. The objective of the present study was to examine the extent to which these criteria were met in a community study. To do this, a random sample of 3,740 persons, aged 15 to 70 yr, of the general population of the city of Bergen and 11 surrounding municipalities on the southwest coast of Norway were enrolled in a two-phase cross-sectional study. In the second phase, a stratified sample (n = 1,512) of the respondents to the postal questionnaire used for recruitment for the study (n = 3,370) were invited to a clinical and respiratory physiologic examination that included the DLCO test. The attendance rate was 84% (1,275 of 1,512). In the examination, all subjects were able to maintain a breathholding time of 9 to 11 s, and 98% had two DLCO values within +/- 10% or 3 ml CO(STPD)/min/mm Hg of the average DLCO. The criterion of an IVC of at least 90% of FVC in the two tests was met by 68% of the subjects. Younger age was an independent predictor of failure to meet the required criteria. Thus, only two-thirds of the participants fulfilled all of the ATS criteria for the DLCO test, the main reason for failure being an IVC of less than 90% FVC. This should not necessarily lead to the exclusion from further analysis of those failing to meet this criterion.

Adolescent↗
PubMed1997

Smoking and ulcer perforation.

BACKGROUND: The use of ulcerogenic drugs is the only well documented risk factor for peptic ulcer perforation, but accounts for only a quarter of the events. Smoking is a well known risk factor for uncomplicated ulcer disease, and patients with ulcer bleeding have increased death rates from smoking related disorders. AIM: To assess the role of smoking in ulcer perforation. SUBJECTS: A total of 168 consecutive patients with gastroduodenal ulcer perforation and 4469 control subjects from a population based health survey. METHODS: The association between ulcer perforation and smoking habits was analysed by logistic regression while adjusting for age and sex. RESULTS: Current smoking increased the risk for ulcer perforation 10-fold in the age group 15-74 years (OR 9.7, 95% CI 5.9 to 15.8) and there was a highly significant dose-response relationship (p < 0.001). The results were similar in men (OR 9.3, 95% CI 4.9 to 17) and women (OR 11.6, 95% CI 5.3 to 25), and for gastric (OR 10.5, 95% CI 4.5 to 25) and duodenal (OR 8.6, 95% CI 4.9 to 15.4) ulcer perforation. No increase in risk was found in previous smokers (OR 0.8, 95% CI 0.2 to 2.2). CONCLUSION: Our findings suggest that smoking is a causal factor for ulcer perforation and accounts for a major part of ulcer perforations in the population aged less than 75 years.

Adolescent↗
PubMed1996

Serum respiratory virus antibodies: predictor of reduced one-second forced expiratory volume (FEV1) in Norwegian adults.

BACKGROUND: The purpose of this cross-sectional study was to investigate whether the presence of serum complement antibodies was associated with reduced one-second forced expiratory volume (FEV1) in adults. METHODS: From a stratified random sample of 18-73 year old adults, we performed measurements of serum complement fixing virus antibodies against influenza type A and B, parainfluenza type 1, 2, and 3, respiratory syncytial virus and adenovirus on 82% (n = 1239). RESULTS: In the crude data, subjects having five of the seven virus antibodies had significantly lower lung function, given as sex-, age- and height-standardized residuals of FEV1 (SFEV1), compared with those without. After adjusting in addition for smoking habits, lifetime smoking consumption and season, the lung function levels were significantly lower in subjects with influenza type B and respiratory syncytial virus antibodies compared to those without (P < 0.01). Increasing influenza and respiratory syncytial virus antibody titres and increasing numbers of virus antibodies, respectively, were related to progressively lower lung function. Subjects with respiratory symptoms but without obstructive lung disease had lower antibody levels than subjects with obstructive lung disease, but higher levels than asymptomatic subjects. In a final multiple linear regression analysis adjusting in addition for respiratory symptom and disease status as well as for the other respiratory virus antibodies, the presence of respiratory syncytial virus antibodies was a significant predictor for reduced SFEV1 (regression coefficient: -0.226; SE = 0.112; P = 0.04). The magnitude of the effect on lung function remained after excluding subjects reporting symptoms of respiratory infection within 3 weeks prior to the examination (regression coefficient: -0.252; SE = -0.218; P = 0.25). CONCLUSIONS: This cross-sectional community study indicates that respiratory syncytial virus infection or re-infection is an independent predictor for reduced lung function in adults of a wide age range.

Adult↗
PubMed1996

Serum house dust mite antibodies: predictor of increased bronchial responsiveness in adults of a community.

The purpose of this study was to determine whether the presence of serum specific immunoglobulin E (IgE) antibodies was associated with increased bronchial responsiveness in adults. We studied cross-sectionally a random community sample of 18-73 year old adults, of whom 83% (n = 489) performed bronchial responsiveness testing as well as serum measurements of five specific IgE antibodies. In the crude data, 39% of those with house dust mite antibodies (n = 18) had a bronchial responsiveness < or = 32 g.L-1 methacholine compared with 19% in subjects without any of the five specific IgE antibodies (n = 453). The corresponding percentages for subjects with timothy antibodies (n = 16) was 25%, birch antibodies (n = 13) 23%, cat antibodies (n = 10) 40% and mould antibodies (n = 2) 50%. When assessing the multivariate relationship between the presence of one specific IgE antibody and degree of bronchial responsiveness we used a semi-proportional hazards model with the response as a 20% fall in forced expiratory volume in one second (FEV1) from pretest value. Covariates included in the model were: gender, age, pretest FEV1, smoking habits, pack-years, season and other specific IgE antibodies than that examined. The presence of house dust mite antibodies was a significant predictor (p < 0.01) of increased bronchial responsiveness in never- and ex-smokers. Indoor allergic sensitization (house dust mite, cat and mould) was a significant predictor of increased bronchial responsiveness, while outdoor allergic sensitization (timothy and birch) was not. Excluding subjects with obstructive lung disease (n = 39) or including the covariate log total serum IgE as a potential confounder yielded the same result. Thus, in this community, indoor allergic sensitization rather than allergic sensitization per se was related to increased bronchial responsiveness after adjusting for other relevant covariates.

Adolescent↗
PubMed1995

Respiratory virus antibodies in adults of a Norwegian community: prevalences and risk factors.

BACKGROUND: The aims were to examine prevalences as well as demographic and environmental predictors of respiratory virus antibodies in serum. METHODS: In a cross-sectional study of 18-73 year old Norwegian adults a random stratified sample (n = 1512) was invited to attend an examination at an outpatient clinic. Seven respiratory virus antibodies were assessed by the complement fixation test. RESULTS: The attendance rate was 84%. The most frequent virus antibodies with titre of > or = 1:8 were influenza virus type A with a population standardized prevalence of 44%, adenovirus 25% and influenza virus type B 22%. The prevalences of antibodies against parainfluenza virus type 1, 2 and 3 increased with age. Smokers compared to non-smokers had an adjusted odds ratio (OR) of 1.7 (95% confidence interval [CI]: 1.3-2.4) for having one or more of the seven examined virus antibodies. The presence of one or more of the virus antibodies increased from summer to winter months (adjusted OR = 1.3 per month; 95% CI: 1.2-1.4) and it was higher in occupational dust or gas exposed smokers (adjusted OR = 2.0; 95% CI: 1.1-3.7) compared with unexposed smokers. CONCLUSIONS: Ageing, smoking, occupational dust or gas exposure as well as season of the year may thus be predictors for levels of respiratory virus antibodies in adults. These observations should be taken into account when comparing prevalences of virus antibodies in various communities as well as when examining the relationship between presence of virus antibodies and airway disease.

Adenoviridae↗
PubMed1995

Total serum IgE and FEV1 by respiratory symptoms and obstructive lung disease in adults of a Norwegian community.

BACKGROUND: The importance of total serum IgE level on lung function impairment has not been established in a general population. OBJECTIVE: The aim of this cross-sectional community study was to examine the relationship between total serum IgE and level of lung function in adults, and whether this relationship differed by sex, age, smoking habits or by respiratory symptoms and disease status. METHODS: A stratified random sample of 18-73 year old adults from the general population were invited to spirometry and serum analyses of total and specific IgE. Of 1512 subjects invited, 82% met and performed complete examinations. RESULTS: Increasing level of total serum IgE was related to reduced lung function (P < 0.01) given as sex, age, and height standardized residuals of one second forced expiratory volume (SFEV1). Subjects with total serum IgE in the highest vs the lowest tertile had a mean SFEV1 of -0.28, corresponding to age and height adjusted FEV1 differences of 120 and 150 mL in women and men, respectively. The relationship between IgE and lung function impairment did not differ significantly by sex, age or smoking habits. In subjects with obstructive lung disease increasing level of total serum IgE was more negatively associated with lung function level than in subjects with respiratory symptoms alone. No relationship was observed in asymptomatic subjects. This was confirmed in a multiple linear regression analysis adjusting for sex, age, smoking habits and lifetime smoking consumption showing that SFEV1 was predicted by an interaction between total serum IgE level and symptom and disease status (P < 0.01). This interaction remained after excluding subjects (n = 105) having specific IgE antibodies. CONCLUSION: Increasing total serum IgE level was associated with progressively lower lung function in a general adult population after taking other predictors of impaired spirometric lung function into account, though dependent on the subjects' respiratory symptom and disease status. Variation in prevalences of respiratory symptoms and obstructive lung disease in previous examined populations may thus explain conflicting observations of the association between total IgE and airflow impairment.

Adolescent↗
PubMed1995

Serum house-dust-mite antibodies and reduced FEV1 in adults of a Norwegian community.

In this cross-sectional study we investigated whether the presence of specific serum IgE antibodies to house dust mite, timothy, birch, cat, and mold was associated with a reduced FEV1 in adults. We performed complete examinations on 82% of a stratified random sample of 18 to 73-yr-old adults (n = 1,239). Subjects with house-dust-mite antibodies had lower (p = 0.002) sex, age, and height standardized residuals of FEV1 (SFEV1) than those without any specific IgE antibody. This relationship did not differ significantly by sex, age, smoking habit, total serum IgE level, or season, and remained significant after excluding subjects with obstructive lung disease. For house-dust-mite antibodies we also observed a dose-response relationship between antibody levels and impaired lung function. In a final multiple linear regression analysis the presence of house-dust-mite antibodies was the only significant predictor (regression coefficient: -0.425; SE = 0.189; p = 0.02) of reduced SFEV1 after adjusting for smoking habit and lifetime tobacco consumption, season, total serum IgE level, and respiratory-symptom and disease status. Thus, house-dust-mite allergy is an independent predictor of reduced lung function in adults of a wide age range.

Adult↗