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  • 1. Ainsbury, E A
    et al.
    Bakhanova, E
    Barquinero, J F
    Brai, M
    Chumak, V
    Correcher, V
    Darroudi, F
    Fattibene, P
    Gruel, G
    Guclu, I
    Horn, S
    Jaworska, A
    Kulka, U
    Lindholm, C
    Lloyd, D
    Longo, A
    Marrale, M
    Monteiro Gil, O
    Oestreicher, U
    Pajic, J
    Rakic, B
    Romm, H
    Trompier, F
    Veronese, I
    Voisin, P
    Vral, A
    Whitehouse, C A
    Wieser, A
    Woda, C
    Wojcik, Andrzej
    Stockholm University, Faculty of Science, Department of Genetics, Microbiology and Toxicology.
    Rothkamm, K
    REVIEW OF RETROSPECTIVE DOSIMETRY TECHNIQUES FOR EXTERNAL IONISING RADIATION EXPOSURES.2011In: Radiation Protection Dosimetry, ISSN 0144-8420, E-ISSN 1742-3406, Vol. 147, no 4, 573-592 p.Article in journal (Refereed)
    Abstract [en]

    The current focus on networking and mutual assistance in the management of radiation accidents or incidents has demonstrated the importance of a joined-up approach in physical and biological dosimetry. To this end, the European Radiation Dosimetry Working Group 10 on 'Retrospective Dosimetry' has been set up by individuals from a wide range of disciplines across Europe. Here, established and emerging dosimetry methods are reviewed, which can be used immediately and retrospectively following external ionising radiation exposure. Endpoints and assays include dicentrics, translocations, premature chromosome condensation, micronuclei, somatic mutations, gene expression, electron paramagnetic resonance, thermoluminescence, optically stimulated luminescence, neutron activation, haematology, protein biomarkers and analytical dose reconstruction. Individual characteristics of these techniques, their limitations and potential for further development are reviewed, and their usefulness in specific exposure scenarios is discussed. Whilst no single technique fulfils the criteria of an ideal dosemeter, an integrated approach using multiple techniques tailored to the exposure scenario can cover most requirements.

  • 2. Alexanderson, K.
    et al.
    Kivimäki, M.
    Ferrie, J. E.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Vahtera, J.
    Singh-Manoux, A.
    Melchior, M.
    Zins, M.
    Goldberg, M.
    Head, J.
    Diagnosis-specific sick leave as a long-term predictor of disability pension: a 13-year follow-up of the GAZEL cohort study2012In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 2, 155-159 p.Article in journal (Refereed)
    Abstract [en]

    Background Factors that increase the risk of labour market exclusion are poorly understood. In this study, we examined the extent to which all-cause and diagnosis-specific sick leave predict subsequent disability pension (DP).

    Methods Prospective cohort study of 20 434 persons employed by the French national gas and electric company (the GAZEL study). New sick-leave spells >7 days in 1990–1992 were obtained from company records. Follow-up for DP was from 1994 to 2007.

    Results The HR, adjusted for age and occupational position, for DP was 3.5 (95% CI 2.7 to 4.5) in men and 2.6 (95% CI 1.9 to 3.5) in women with one or more sick-leave spells >7 days compared with those with no sick leave. The strongest predictor of DP was sick leave with a psychiatric diagnosis, HR 7.6 (95% CI 5.2 to 10.9) for men and 4.1 (95% CI 2.9 to 5.9) for women. Corresponding HRs for sick leave due to circulatory diagnoses in men and women were 5.6 (95% CI 3.7 to 8.6) and 3.1 (95% CI 1.8 to 5.3), for respiratory diagnoses 3.9 (95% CI 2.6 to 5.8) and 2.6 (95% CI 1.7 to 4.0), and musculoskeletal diagnoses 4.6 (95% CI 3.4 to 6.4) and 3.3 (95% CI 2.2 to 4.8), respectively.

    Conclusions Sick leave with a psychiatric diagnosis is a major risk factor for subsequent DP, especially among men. Sick leave due to musculoskeletal or circulatory disorders was also a strong predictor of DP. Diagnosis-specific sick leave should be recognised as an early risk marker for future exclusion from the labour market.

  • 3.
    Almquist, Ylva B.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Augustine, Lilly
    Peer acceptance in the school class and subjective health complaints: a multilevel approach2013In: Journal of School Health, ISSN 0022-4391, E-ISSN 1746-1561, Vol. 83, no 10, 690-696 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Feeling accepted by peers is important for young people's health but few studies have examined the overall degree of acceptance in school and its health consequences. The purpose of the study was to investigate whether health complaints among Swedish students can be attributed to the acceptance climate in their school class even when the health effects of their own (individual) acceptance score have been taken into account. METHODS: The data used were from the Health Behaviour in School-aged Children (HBSC) study for the years 2001 to 2002, 2005 to 2006, and 2009 to 2010, consisting of 13,902 5th-, 7th-, and 9th-grade Swedish students nested into 742 school classes. The statistical analyses were performed by means of linear regression multilevel analysis. RESULTS: The results indicated that the variation in subjective health complaints could be ascribed partly to the school-class level (boys: 5.0%; girls: 13.5%). Peer acceptance at the individual level demonstrated a clear association with health: the lower the acceptance, the higher the complaint scores. For girls, but not for boys, the overall degree of peer acceptance in the school class demonstrated a contextual effect on health, net of acceptance at the student level. Interaction analyses also revealed an increasingly favorable health among poorly accepted girls as the acceptance climate in the school class declined. CONCLUSIONS: A lower overall degree of peer acceptance in the school class is associated with poorer health among girls. However, girls who

  • 4.
    Almquist, Ylva B.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Rostila, Mikael
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Edling, Christofer
    Rydgren, Jens
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Friendship network characteristics and psychological well-being in late adolescence: Exploring differences by gender and gender composition2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 2, 146-154 p.Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of the present study was to examine the association between friendship networks and psychological well-being among 19-year-olds. Methods: The data used was a random sample of Swedish individuals born in 1990 who answered a questionnaire in 2009-2010. Friendship networks were considered in terms of three measures of emotional support. Six statements about the individual's emotional state were used to create a summary measure of psychological well-being. Gender and gender composition were included as potentially moderating factors. The association between friendship networks and psychological well-being was analysed by means of linear regression analysis (n = 1289). Results: The results indicate that males' and females' friendship networks were similar with regard to quality and trust, whereas males' networks were characterized by less self-disclosure and a stronger preference for same-gender friendships. Gender composition did not matter for the support levels. Emotional support was associated with psychological well-being but there were gender differences: females seemed to benefit more health-wise from having high-quality (and trusting) networks. Moreover, whereas self-disclosure among males was positively linked to well-being, this was not the case among females. None of these associations were moderated by gender composition. Conclusions: In sum, friendship networks are beneficial for the psychological well-being among late adolescents, but there are some important differences according to gender.

  • 5. Anund, Anna
    et al.
    Fors, Carina
    Hallvig, David
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Observer rated sleepiness and real road driving: an explorative study2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 5, e64782Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to explore if observer rated sleepiness (ORS) is a feasible method for quantification of driver sleepiness in field studies. Two measures of ORS were used: (1) one for behavioural signs based on facial expression, body gestures and body movements labelled B-ORS, and (2) one based on driving performance e.g. if swerving and other indicators of impaired driving occurs, labelled D-ORS. A limited number of observers sitting in the back of an experimental vehicle on a motorway about 2 hours repeatedly 3 times per day (before lunch, after lunch, at night) observed 24 participant's sleepiness level with help of the two observer scales. At the same time the participant reported subjective sleepiness (KSS), EOG was recorded (for calculation of blink duration) and several driving measure were taken and synchronized with the reporting. Based on mixed model Anova and correlation analysis the result showed that observer ratings of sleepiness based on drivers' impaired performance and behavioural signs are sensitive to extend the general pattern of time awake, circadian phase and time of driving. The detailed analysis of the subjective sleepiness and ORS showed weak correspondence on an individual level. Only 16% of the changes in KSS were predicted by the observer. The correlation between the observer ratings based on performance (D-ORS) and behavioural signs (B-ORS) are high (r = .588), and the B-ORS shows a moderately strong association (r = .360) with blink duration. Both ORS measures show an association (r>0.45) with KSS, whereas the association with driving performance is weak. The results show that the ORS-method detects the expected general variations in sleepy driving in field studies, however, sudden changes in driver sleepiness on a detailed level as 5 minutes is usually not detected; this holds true both when taking into account driving behaviour or driver behavioural signs.

  • 6. Anund, Anna
    et al.
    Ihlström, Jonas
    Fors, Carina
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Filtness, Ashleigh
    Factors associated with self-reported driver sleepiness and incidents in city bus drivers2016In: Industrial Health, ISSN 0019-8366, E-ISSN 1880-8026, Vol. 54, no 4, 337-346 p.Article in journal (Refereed)
    Abstract [en]

    Driver fatigue has received increased attention during recent years and is now considered to be a major contributor to approximately 15-30% of all crashes. However, little is known about fatigue in city bus drivers. It is hypothesized that city bus drivers suffer from sleepiness, which is due to a combination of working conditions, lack of health and reduced sleep quantity and quality. The overall aim with the current study is to investigate if severe driver sleepiness, as indicated by subjective reports of having to fight sleep while driving, is a problem for city based bus drivers in Sweden and if so, to identify the determinants related to working conditions, health and sleep which contribute towards this. The results indicate that driver sleepiness is a problem for city bus drivers, with 19% having to fight to stay awake while driving the bus 2-3 times each week or more and nearly half experiencing this at least 2-4 times per month. In conclusion, severe sleepiness, as indicated by having to fight sleep during driving, was common among the city bus drivers. Severe sleepiness correlated with fatigue related safety risks, such as near crashes.

  • 7. Beelen, Rob
    et al.
    Stafoggia, Massimo
    Raaschou-Nielsen, Ole
    Andersen, Zorana Jovanovic
    Xun, Wei W.
    Katsouyanni, Klea
    Dimakopoulou, Konstantina
    Brunekreef, Bert
    Weinmayr, Gudrun
    Hoffmann, Barbara
    Wolf, Kathrin
    Samoli, Evangelia
    Houthuijs, Danny
    Nieuwenhuijsen, Mark
    Oudin, Anna
    Forsberg, Bertil
    Olsson, David
    Salomaa, Veikko
    Lanki, Timo
    Yli-Tuomi, Tarja
    Oftedal, Bente
    Aamodt, Geir
    Nafstad, Per
    De Faire, Ulf
    Pedersen, Nancy L.
    Östenson, Claes-Göran
    Fratiglioni, Laura
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Penell, Johanna
    Korek, Michal
    Pyko, Andrei
    Thorup Eriksen, Kirsten
    Tjonneland, Anne
    Becker, Thomas
    Eeftens, Marloes
    Bots, Michiel
    Meliefste, Kees
    Wang, Meng
    Bueno-de-Mesquita, Bas
    Sugiri, Dorothea
    Kraemer, Ursula
    Heinrich, Joachim
    de Hoogh, Kees
    Key, Timothy
    Peters, Annette
    Cyrys, Josef
    Concin, Hans
    Nagel, Gabriele
    Ineichen, Alex
    Schaffner, Emmanuel
    Probst-Hensch, Nicole
    Dratva, Julia
    Ducret-Stich, Regina
    Vilier, Alice
    Clavel-Chapelon, Francoise
    Stempfelet, Morgane
    Grioni, Sara
    Krogh, Vittorio
    Tsai, Ming-Yi
    Marcon, Alessandro
    Ricceri, Fulvio
    Sacerdote, Carlotta
    Galassi, Claudia
    Migliore, Enrica
    Ranzi, Andrea
    Cesaroni, Giulia
    Badaloni, Chiara
    Forastiere, Francesco
    Tamayo, Ibon
    Amiano, Pilar
    Dorronsoro, Miren
    Katsoulis, Michail
    Trichopoulou, Antonia
    Vineis, Paolo
    Hoek, Gerard
    Long-term Exposure to Air Pollution and Cardiovascular Mortality An Analysis of 22 European Cohorts2014In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 25, no 3, 368-378 p.Article in journal (Refereed)
    Abstract [en]

    Background: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death. Methods: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2 and NOx); particles with diameters of less than 2.5 mu m (PM2.5), less than 10 mu m (PM10), and 10 mu m to 2.5 mu m (PMcoarse); PM2.5 absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates. Results: The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM2.5, the hazard ratio was 1.21 (95% confidence interval = 0.87-1.69) per 5 mu g/m(3) and for PM10, 1.22 (0.91-1.63) per 10 mu g/m(3). Conclusion: In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association.

  • 8.
    Bellavia, Andrea
    et al.
    Karolinska Inst, Inst Environm Med, Unit Nutr Epidemiol.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bottai, Matteo
    Wolk, Alicja
    Karolinska Inst, Inst Environm Med, Unit Nutr Epidemiol.
    Orsini, Nicola
    Karolinska Inst, Inst Environm Med, Unit Nutr Epidemiol.
    Sleep Duration and Survival Percentiles Across Categories of Physical Activity2014In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 179, no 4, 484-491 p.Article in journal (Refereed)
    Abstract [en]

    The association between long sleep duration and death is not fully understood. Long sleep is associated with low physical activity, which is a strong predictor of death. Our aim was to investigate the association between sleep duration and death across categories of total physical activity in a large prospective cohort of Swedish men and women. We followed a population-based cohort of 70,973 participants (37,846 men and 33,127 women), aged 45-83 years, from January 1998 to December 2012. Sleep duration and physical activity levels were assessed through a questionnaire. We evaluated the association of interest in terms of mortality rates by estimating hazard ratios with Cox regression and in terms of survival by evaluating 15th survival percentile differences with Laplace regression. During 15 years of follow-up, we recorded 14,575 deaths (8,436 men and 6,139 women). We observed a significant interaction between sleep duration and physical activity in predicting death (P < 0.001). Long sleep duration (>8 hours) was associated with increased mortality risk (hazard ratio = 1.24; 95% confidence interval: 1.11, 1.39) and shorter survival (15th percentile difference = -20 months; 95% confidence interval: -30, -11) among only those with low physical activity. The association between long sleep duration and death might be partly explained by comorbidity with low physical activity.

  • 9. Bergvall, Tomas
    et al.
    Norén, G. Niklas
    Stockholm University, Faculty of Science, Department of Mathematics.
    Lindquist, Marie
    vigiGrade: A Tool to Identify Well-Documented Individual Case Reports and Highlight Systematic Data Quality Issues2014In: Drug Safety, ISSN 0114-5916, Vol. 37, no 1, 65-77 p.Article in journal (Refereed)
    Abstract [en]

    Individual case safety reports of suspected harm from medicines are fundamental to post-marketing surveillance. Their value is directly proportional to the amount of clinically relevant information they include. To improve the quality of the data, communication between stakeholders is essential and can be facilitated by a simple score and visualisation of the results. The objective of this study was to propose a measure of completeness and identify predictors of well-documented reports, globally. The Uppsala Monitoring Centre has developed the vigiGrade completeness score to measure the amount of clinically relevant information in structured format, without reflecting whether the information establishes causality between the drug and adverse event. The vigiGrade completeness score (C) starts at 1 for reports with information on time-to-onset, age, sex, indication, outcome, report type, dose, country, primary reporter and comments. For each missing dimension, a penalty is detracted which varies with clinical relevance. We classified reports with C > 0.8 as well-documented and identified all such reports in the WHO global individual case safety report database, VigiBase, from 2007 to January 2012. We utilised odds ratios with statistical shrinkage to identify subgroups with unexpectedly high proportions of well-documented reports. Altogether, 430,000 (13 %) of the studied reports achieved C > 0.8 in VigiBase. For VigiBase as a whole, the median completeness was 0.41 with an interquartile range of 0.26-0.63. Two out of three well-documented reports come from Europe, and two out of three from physicians. Among the countries with more than 1,000 reports in total, the highest rate of well-documented reports is 65 % in Italy. Tunisia, Spain, Portugal, Croatia and Denmark each have rates above 50 %, and another 20 countries have rates above 30 %. On the whole, 24 % of the reports from physicians are well-documented compared with only 4 % for consumers/non-health professionals. Notably, Denmark and Norway have more than 50 % well-documented reports from consumers/non-health professionals and higher rates than for physicians. The rate of well-documented reports for the E2B format is 11 % compared with 22 % for the older INTDIS (International Drug Information System) format. However, for E2B reports entered via the WHO programme's e-reporting system VigiFlow, the rate is 29 %. Overall, only one report in eight provides the desired level of information, but much higher proportions are observed for individual countries. Physicians and e-reporting tools also generate greater proportions of well-documented reports overall. Reports from consumers/non-health professionals in specific regions have excellent quality, which illustrates their potential for the future. vigiGrade has already provided valuable information by highlighting data quality issues both in Italy and the USA.

  • 10.
    Bernard-Oettel, Claudia
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Temporary, self-employed and permanent workers: A Swedish study on work characteristics and individual well-being over time2013In: , 2013Conference paper (Refereed)
  • 11. Beronius, A.
    et al.
    Ågerstrand, Marlene
    Stockholm University, Faculty of Science, Department of Environmental Science and Analytical Chemistry.
    Making the most of expert judgment in hazard and risk assessment of chemicals2017In: Toxicology Research, ISSN 2045-452X, E-ISSN 2045-4538, Vol. 6, no 5, 571-577 p.Article in journal (Refereed)
    Abstract [en]

    Evaluation of the reliability and relevance of toxicity and ecotoxicity studies is an integral step in the assessment of the hazards and risks of chemicals. This evaluation is inherently reliant on expert judgment, which often leads to differences between experts' conclusions regarding how individual studies can contribute to the body of evidence. The conclusions of regulatory assessment, such as establishing safe exposure levels for humans and the environment and calculations of margins of exposure, may have large consequences for which chemicals are permitted on the market and their allowed uses. It is therefore important that such assessments are based on all reliable and relevant scientific data, and that assessment principles and assumptions, such as expert judgment, are transparently applied. It is not possible nor desirable to completely eliminate expert judgment from the evaluation of (eco) toxicity studies. However, it is desirable to introduce measures that increase structure and transparency in the evaluation process so as to provide scientifically robust risk assessments that can be used for regulatory decision making. In this article we present results from workshop exercises with Nordic experts to illustrate how experts' evaluations regarding the reliability and relevance of (eco) toxicity studies for risk assessment may vary and discuss methods intended to promote structure and transparency in the evaluation process.

  • 12. Berthelsen, Hanne
    et al.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hakanen, Jari J.
    Kristensen, Tage S.
    It is not just about occupation, but also about where you work2017In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 45, no 4, 372-379 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: Dentistry is characterized by a meaningful but also stressful psychosocial working environment. Job satisfaction varies among staff working under different organizational forms. The aim of this study was to identify (i) to what extent crucial psychosocial work environment characteristics differ among occupations in general public dental clinics in Sweden, and (ii) how much of the variation within each occupation is attributable to the organizational level. Methods: All staff (N=1782) employed in four public dental organizations received an email with personal log-in to an electronic questionnaire based on the Copenhagen Psychosocial Questionnaire. After two reminders, a response rate of 75% was obtained. Responses from 880 nonmanagerial dentists, dental hygienists and dental nurses working in general practices were included in our analyses. Results: First, we compared the three dental occupations. We found that job demands, task resources (eg influence, possibilities for development and role clarity), strain symptoms and attitudes to work differed among occupations, dentists having the least favourable situation. Next, we compared the four organizations for each occupational group, separately. For dentists, a significant and relevant amount of variance (P<.05 and ICC >.05) was explained by the organizational level for 15 of 26 subscales, least pronounced for task resources. By contrast, for dental nurses and hygienists, the corresponding number was 2 subscales of 26. The psychosocial working environment of people working at the organization with the highest levels of strain indicators and the least positive work-related attitudes differed systematically from the organization with the most favourable profile, in particular regarding job demands and leadership aspects. Conclusion: In conclusion, the psychosocial working environment depended to a large degree on occupation and, for dentists in particular, also on their organizational affiliation. The findings suggest a potential for designing interventions at organizational level for improvements of the psychosocial working environment for dentists.

  • 13. Björkenstam, C.
    et al.
    Weitoft, G.R.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Nordstrom, P.
    Hallqvist, J.
    Ljung, R.
    School grades, parental education and suicide: a national register-based cohort study2010In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738Article in journal (Refereed)
    Abstract [en]

    Background To investigate whether school performance is a risk factor for suicide death later in life and, if so, to what extent this is explained by intergenerational effects of parental education.

    Methods This population-based cohort study comprises national birth cohorts between 1972 and 1981 in Sweden. We followed 898 342 students, graduating between 1988 and 1997 from the 9 years of compulsory school, equivalent to junior high school, until 31 December 2006, generating 11 148 758 person-years and 1490 suicides. Final school grades, in six categories, and risk of suicide were analysed with Poisson regression.

    Results The incidence rate ratio (RR) for suicide death for students with the lowest grades was 4.57 (95% CI 2.82 to 7.40) for men and 2.67 (1.42 to 5.01) for women compared to those with highest grades after adjustment for a number of sociodemographic and parental morbidity variables, such as year of graduation, parental education, lone parenthood, household receiving social welfare or disability pension, place of schooling, adoption, maternal age and parent's mental illness. Students with grades in the middle categories had RRs in between. These relationships were not modified by parental education.

    Conclusions The strong association between low school grades and suicide in youth and young adulthood emphasises the importance of both primary and secondary prevention in schools.

  • 14. Blom, Victoria
    et al.
    Sverke, Magnus
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Bodin, Lennart
    Bergström, Gunnar
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Svedberg, Pia
    Work-Home Interference and Burnout A Study Based on Swedish Twins2014In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 56, no 4, 361-366 p.Article in journal (Refereed)
    Abstract [en]

    Objective: This study sets out to investigate the impact of work-home interference on burnout in women and men, while taking genetic and family environmental factors into account. Methods: A total of 4446 Swedish twins were included in the study. The effects of work-home conflict (WHC) and home-work conflict (HWC) on burnout between and within pairs were analyzed with co-twin control analyses. Results: Both WHC and HWC were significantly associated with burnout. Genetic factors may be involved in the association between HWC and burnout in women. Familial factors were not involved for WHC and burnout, neither for women nor for men. Conclusions: This study shows the importance to encounter WHC per se to prevent burnout. Because of genetic confounding in HWC and burnout in women, preventive efforts may also take into account individual characteristics.

  • 15.
    Bodin Danielsson, Christina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. School of Architecture, School of Architecture & Built Environment, The Royal Institute of Technology, Sweden.
    Office type's association to employees' welfare: Three studies2016In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 54, no 4, 779-790 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The workplace is important for employees' daily life and well-being. This article investigates exploratory the office design's role for employees' welfare from different perspectives.

    OBJECTIVE: By comparing different studies of the office, type's influence on different factors of employees' welfare the aim is to see if any common patterns exist in office design's impact.

    METHODS: The three included studies investigate office type's association with employees' welfare by measuring its influence on: a) perception of leadership, b) sick leave, and c) job satisfaction.The sample consists of office employees from a large, national representative work environment survey that work in one of the seven identified office types in contemporary office design: (1) cell-offices; (2) shared-room offices; (3) small, (4) medium-sized and (5) large open-plan offices; (6) flex-offices and (7) combi-offices. Statistical method used is multivariate logistic and linear regression analysis with adjustment for background factors.

    RESULTS: Overall results show that shared-room office, traditional open plan offices and flex-office stand out negatively, but to different degree(s) on the different outcomes measured.

    CONCLUSIONS: This explorative comparison of different studies finds a pattern of office types that repeatedly show indications of negative influence on employees' welfare, but further studies are needed to clarify this.

  • 16. Bokenberger, Kathleen
    et al.
    Ström, Peter
    Aslan, Anna K. Dahl
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Pedersen, Nancy L.
    Shift work and cognitive aging: a longitudinal study2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 5, 485-493 p.Article in journal (Refereed)
    Abstract [en]

    Objectives The few studies of shift work and late life cognitive functioning have yielded mixed findings. The aim of the present study is to estimate the association between shift-work experience and change in cognitive performance before and after retirement age among older adults who were gainfully employed. Methods Five hundred and ninety five participants with no dementia were followed up for a mean of 17.6 standard deviation (SD) 8.8 years from a Swedish population-based sample. Participants had self-reported information on any type of shift-work experience (ever/never) in 1984 and measures of cognitive performance (verbal, spatial, memory, processing speed, and general cognitive ability) from up to 9 waves of cognitive assessments during 1986-2012. Night work history (ever/never) from 1998-2002 was available from a subsample (N = 320). Early adult cognitive test scores were available for 77 men. Results In latent growth curve modeling, there were no main effects of any-type or night shift work on the mean scores or rate of change in any of the cognitive domains. An interaction effect between any-type shift work and education on cognitive performance at retirement was noted. Lower-educated shift workers performed better on cognitive tests than lower-educated day workers at retirement. Sensitivity analyses, however, indicated that the interactions appeared to be driven by selection effects. Lower-educated day workers demonstrated poorer cognitive ability in early adulthood than lower-educated shift workers, who may have selected jobs entailing higher cognitive demand. Conclusion There was no difference in late-life cognitive aging between individuals with a history of working shifts compared to those who had typical day work schedules during midlife.

  • 17. Brooks, Steven J.
    et al.
    Harman, Christopher
    Grung, Merete
    Farmen, Eivind
    Ruus, Anders
    Vingen, Sjur
    Godal, Brit F.
    Barsiene, Janina
    Andreikenaite, Laura
    Skarpheoinsdottir, Halldora
    Stockholm University, Faculty of Science, Department of Applied Environmental Science (ITM).
    Liewenborg, Birgitta
    Stockholm University, Faculty of Science, Department of Applied Environmental Science (ITM).
    Sundt, Rolf C.
    Water Column Monitoring of the Biological Effects of Produced Water from the Ekofisk Offshore Oil Installation from 2006 to 20092011In: Journal of Toxicology and Environmental Health, ISSN 1528-7394, E-ISSN 1087-2620, Vol. 74, no 7-9, 582-604 p.Article in journal (Refereed)
    Abstract [en]

    The Norwegian water column monitoring program investigates the biological effects of offshore oil and gas activities in Norwegian waters. In three separate surveys in 2006, 2008, and 2009, bioaccumulation and biomarker responses were measured in mussels (Mytilus edulis) and Atlantic cod (Gadus morhua) held in cages at known distances from the produced water (PW) discharge at the Ekofisk oil field. Identical monitoring studies performed in all three years have allowed the biological effects and bioaccumulation data to be compared, and in addition, enabled the potential environmental benefits of a PW treatment system (CTour), implemented in 2008, to be evaluated. The results of the 2009 survey showed that caged animals were exposed to low levels of PW components, with highest tissue concentrations in mussels located closest to the PW discharge. Mussels located approximately 1-2 km away demonstrated only background concentrations of target compounds. Concentrations of polycyclic aromatic hydrocarbons (PAH) and alkyl phenol (AP) metabolites in the bile of caged cod were elevated at stations 200-250 m from the discharge. There was also a signal of exposure relative to discharge for the biomarkers CYP1A in fish and micronuclei in mussels. All other fish and mussel biomarkers showed no significant exposure effects in 2009. The mussel bioaccumulation data in 2009 indicated a lower exposure to the PW effluent than seen previously in 2008 and 2006, resulting in an associated general improvement in the health of the caged mussels. This was due to the reduction in overall discharge of PW components (measured as oil in water) into the area in 2009 compared to previous years as a result of the improved PW treatment system.

  • 18. Bruckner, Tim .A.
    et al.
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Vågerö, Denny
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Cold ambient temperature in utero and birth outcomes in Uppsala, Sweden, 1915 to 19292014In: Annals of Epidemiology, ISSN 1047-2797, E-ISSN 1873-2585, Vol. 24, no 2, 116-121 p.Article in journal (Refereed)
    Abstract [en]

    Purpose

    Although the literature reports adverse birth outcomes following ambient heat, less work focuses on cold. We, moreover, know of no studies of cold that examine stillbirth. We tested the relation between cold ambient temperature during pregnancy in Sweden and four outcomes: stillbirth, preterm, birth weight for gestational age, and birth length. We examined births from 1915 to 1929 in Uppsala, Sweden, which—unlike most societies today—experienced substandard indoor-heating and fewer amenities to provide shelter from cold.

    Methods

    We retrieved data on almost 14,000 deliveries from the Uppsala Birth Cohort Study. We linked a validated, daily ambient temperature series to all pregnancies and applied Cox proportional hazards (stillbirth and preterm) and linear regression models (birth weight and length). We tested for nonlinearity using quadratic splines.

    Results

    The risk of stillbirth rose as ambient temperature during pregnancy fell (hazard ratio for a 1°C decrease in temperature, 1.08; 95% confidence interval, 1.00 to 1.17). Cold extremes adversely affected preterm and birth length, whereas warm extremes increased preterm risk. We observed no relation between cold and birth weight for gestational age.

    Conclusion

    In historical Sweden, cold temperatures during pregnancy increased stillbirth and preterm risk and reduced birth length among live births.

  • 19.
    Bryngelson, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bacchus Hertzman, Jennie
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The relationship between gender segregation in the workplace and long-term sickness absence in Sweden2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 6, 618-626 p.Article in journal (Refereed)
    Abstract [en]

    The aim of the study is to investigate whether the gender composition in workplaces is related to long-term sickness absence (LSA). We start off with Kanter’s theory on “tokenism,” suggesting an increased risk of stress among minority groups (tokens), which, in turn, might increase the risk of ill health and LSA. Methods: The dataset consists of information obtained from the Swedish level of Living Survey (LNU) and the Swedish Establishment Survey (APU), linked to register-based data from the Swedish Social Insurance Agency. The longitudinal data is representative for the Swedish population and consists of 496 women and 566 men, aged 20–55 at baseline. Our study group consisted of employed persons in 1991 and we analyze, by means of piecewise constant intensity regressions, the first entry into LSA with a follow-up period of nine years. Results: Compared with women in gender-integrated workplaces, women’s risk of LSA is most elevated at both extremely male-dominated (0–20% females) and extremely female-dominated workplaces (80–100% females), although the result among women in the most male-dominated group did not reach statistical significance at the 5% level. Men’s risk seems less varied by gender composition.

    Conclusions: The present study suggests that the gender composition in the workplace has an impact on the risk of LSA, especially among women. Our findings lend no support for Kanter’s theory on the effects of being a token. Most likely, women’s and men’s different status positions have an impact on the different associations found.

  • 20. Bustamante, Mariona
    et al.
    Hernandez-Ferrer, Caries
    Sarria, Yaris
    Harrison, Graham I.
    Nonell, Lara
    Kang, Wenjing
    Stockholm University, Faculty of Science, Department of Molecular Biosciences, The Wenner-Gren Institute. Stockholm University, Science for Life Laboratory (SciLifeLab).
    Friedlander, Marc R.
    Stockholm University, Faculty of Science, Department of Molecular Biosciences, The Wenner-Gren Institute. Stockholm University, Science for Life Laboratory (SciLifeLab).
    Estivill, Xavier
    Gonzalez, Juan R.
    Nieuwenhuijsen, Mark
    Young, Antony R.
    The acute effects of ultraviolet radiation on the blood transcriptome are independent of plasma 25OHD(3)2017In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 159, 239-248 p.Article in journal (Refereed)
    Abstract [en]

    The molecular basis of many health outcomes attributed to solar ultraviolet radiation (UVR) is unknown. We tested the hypothesis that they may originate from transcriptional changes in blood cells. This was determined by assessing the effect of fluorescent solar simulated radiation (FSSR) on the transcriptional profile of peripheral blood pre- and 6 h, 24 h and 48 h post-exposure in nine healthy volunteers. Expression of 20 genes was down regulated and one was up-regulated at 6 h after FSSR. All recovered to baseline expression at 24 h or 48 h. These genes have been associated with immune regulation, cancer and blood pressure; health effects attributed to vitamin D via solar UVR exposure. Plasma 25-hydroxyvitamin D-3 [250HD(3)] levels increased over time after FSSR and were maximal at 48 h. The increase was more pronounced in participants with low basal 250HD(3) levels. Mediation analyses suggested that changes in gene expression due to FSSR were independent of 250HD(3) and blood cell subpopulations.

  • 21. Celeste, Roger Keller
    et al.
    Nadanovsky, Paulo
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Trends in socioeconomic disparities in the utilization of dental care in Brazil and Sweden2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 6, 640-648 p.Article in journal (Refereed)
    Abstract [en]

    Aims: To describe trends in socioeconomic disparities in utilization of dental care. Methods: We obtained cross-sectional data from Sweden in the period 1968-2000 and from Brazil in 1986 and 2002 for 16 state capitals. The outcome was the percentage of people who reported that they had visited the dentist in the last 12 months, calculated for a higher and a lower income group and stratified by sex, age (two groups: young and adults) and dental status. Adjusted prevalence differences and prevalence ratios were produced using Poisson regression. Results: In Brazil, there was a decline in use of dental care among the 15-19 year olds in the period 1986-2002, but not among the 35-44 year olds. In Sweden, there was a decline among the young and adults between 1991 and 2000. Overall, socioeconomic disparities in use of dental services between the higher and the lower economic groups showed a decline in both countries. The reduction in disparities among young Brazilians was 1.1 percentage points per year (p < 0.01), but among the other age groups the decline was not significant (p>0.01). In the last surveys, the gap remained in both countries and age groups (p < 0.01). Conclusions: The recent decline in utilization of dental care and in the socioeconomic gap may mirror improvements in oral health. However, there are still relevant and persistent disparities in utilization of dental care in both countries, with a higher proportion of people of higher socioeconomic status visiting the dentist.

  • 22. Chen, Yiqin
    et al.
    McLachlan, Michael S.
    Stockholm University, Faculty of Science, Department of Environmental Science and Analytical Chemistry.
    Kaserzon, Sarit
    Wang, Xianyu
    Weijs, Liesbeth
    Gallen, Michael
    Toms, Leisa-Maree L.
    Li, Yan
    Aylward, Lesa L.
    Sly, Peter D.
    Mueller, Jochen E.
    Monthly variation in faeces: blood concentration ratio of persistent organic pollutants over the first year of life2016In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 147, 259-268 p.Article in journal (Refereed)
    Abstract [en]

    Previous studies have found that the concentrations of a range of persistent organic pollutants (POPs) in faeces is linearly proportional to the POP concentrations in blood of human adults irrespective of age and gender. In order to investigate the correlation between POP concentrations in faeces and blood in infants, the monthly variation of POP concentrations in faeces over the first year of life of one infant was investigated in this study and compared to modelled blood concentrations. Faecal samples were collected from one male infant daily. The samples were pooled by month and analysed for three selected POPs (2,2',4,4',5,5'-Hexachlorobiphenyl (PCB153), p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) and 2,2',4,4'-tetrabromodiphenyl ether (BDE47)). The POP concentrations in faecal samples increased for the first four months by a factor of 2.9, 4.9 and 1.4 for PCB153, BDE47, and p,p'-DDE, respectively. The faecal concentrations of all POPs decreased rapidly following the introduction of formula and solid food to the diet and subsequent weaning of the infant. Further, a one-compartment model was developed to estimate the daily POP concentrations in the blood of the infant. The POP concentrations in blood were predicted to vary much less over the first year than those observed in faeces. The faeces:blood concentration ratio of selected POPs (K-fb) differed significantly (P < 0.0001) between the period before and after weaning, and observed changes in K-fb are far greater than the uncertainty in the estimated K-fb. A more stable K-fb after weaning indicates the possibility of applying the stable K-fb values for non-invasive assessment of internal exposure in infants after weaning. The intra-individual variation in K-fb in infants is worthy of further investigation.

  • 23. da Silva, Marisa
    et al.
    Stadlinger, Nadja
    Stockholm University, Faculty of Science, Department of Ecology, Environment and Plant Sciences.
    Mmochi, Aviti J.
    Lundborg, Cecilia Stalsby
    Marrone, Gaetano
    Pesticide Use and Self-Reported Health Symptoms Among Rice Farmers in Zanzibar2016In: Journal of Agromedicine, ISSN 1059-924X, E-ISSN 1545-0813, Vol. 21, no 4, 335-344 p.Article in journal (Refereed)
    Abstract [en]

    The agrarian population in low- and middle-income countries suffers from a number of adverse health effects due to pesticide exposure. In Zanzibar, the government subsidizes pesticides to enhance local rice production. The objectives of this study were to assess Zanzibar smallholder rice farmers' pesticide use and self-reported health symptoms in relation to pesticide exposure, training, and use of protective measures and to raise awareness for future local policy formulation. An exploratory cross-sectional interviewer-administered study was conducted among 99 rice farmers. Participants were selected based on convenience sampling and stratified by expected exposure category. The study participants reported using pesticides in World Health Organization (WHO) Class II. Of pesticide users, 61% reported one or more symptoms of possible acute pesticide poisoning. Only 50% of pesticide users had received training in safe handling and application of pesticides, but those who had displayed a higher use of protective measures. Farmers who did not use protective measures were more likely to have reported skin irritation and headache, which, together with eye irritation, were the most commonly reported acute symptoms. The main sociodemographic differences between the expected exposure categories of pesticide users and nonusers were in gender and education level. Scaling up of training in safe handling and application of pesticides is needed. Further studies are required to better understand the mechanisms behind the choice to use pesticides or not.

  • 24.
    Dahlgren, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Kecklund, Göran
    Åkerstedt, Torbjörn
    Different levels of work-related stress and the effects on sleep, fatigue and cortisol2005In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 31, no 4, 277-285 p.Article in journal (Refereed)
    Abstract [en]

    Methods Thirty-four white-collar workers participated under two different conditions. One workweek with a relatively high stress level (H) and one with a lower stress level (L) as measured through self-rated stress during workdays. The workers wore activity monitors, filled out a sleep diary, gave saliva samples (for cortisol), and rated their sleepiness and stress during one workday and one free day. Results During the week with stress the number of workhours increased and total sleep time decreased. Sleepiness showed a significant interaction between weeks and time of day, with particularly high levels towards the evenings of the stress week. Cortisol also showed a significant interaction, with a more flattened pattern, probably due to increased evening levels during the stress week. Stress (restlessness) at bedtime was significantly increased during the stress week. Conclusion The results demonstrate that a workweek with a high workload and much stress increases sleepiness and workhours, impairs sleep, and affects the pattern of diurnal cortisol secretion.

  • 25.
    Dahlgren, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology. National Institute for Psychosocial Medicine, Stockholm.
    Kecklund, Göran
    National Institute for Psychosocial Medicine, Stockholm.
    Åkerstedt, Torbjörn
    National Institute for Psychosocial Medicine, Stockholm.
    Overtime work and its effects on sleep, sleepiness, cortisol and blood pressure in an experimental field study2006In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, Vol. 32, no 4, 318-327 p.Article in journal (Refereed)
    Abstract [en]

    Objectives Previous studies of long workhours and their effects on stress, sleep, and health show inconclusive results. This inconclusiveness may be partly due to methodological problems such as the use of between-group designs or comparisons before and after reorganizations. In addition, stress is usually a confounder. A within-person design was used to examine the effects of working 8- or 12-hour shifts in the absence of additional stress. Methods In an experimental field study, 16 white-collar workers [9 women, mean age 45.9 (SD 15) years] undertook one workweek with normal workhours (8 hours) and 1 week of overtime with 4 extra hours of regular worktasks (12 hours). The participants wore actigraphs, rated sleepiness (Karolinska Sleepiness Scale) and stress throughout the day, and rated workload and how exhausted they felt. Saliva samples were collected on Mondays and Thursdays for cortisol analysis. On these days, ambulatory heart rate and blood pressure were also measured for 24 hours. Results Overtime was associated with higher levels of exhaustion. Sleepiness showed a significant interaction between conditions, with higher levels at the end of the workweek featuring overtime. Total sleep time was shorter in the overtime week. There were no significant differences between ratings of stress and workload. Cortisol showed a circadian variation but no main effect of condition. Conclusions One week of overtime work with a moderate workload produced no main effects on physiological stress markers. Nevertheless, sleep was negatively affected, with shorter sleeps during overtime work and greater problems with fatigue and sleepiness.

  • 26.
    Dahlgren, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Gustavsson, Petter
    Rudman, Ann
    Quick returns and night work as predictors of sleep quality, fatigue, work-family balance and satisfaction with work hours2016In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 33, no 6, 759-767 p.Article in journal (Refereed)
    Abstract [en]

    Quick returns (intervals of <11 h between the end of one shift and the start of the next) are associated with short sleeps and fatigue on the subsequent shift. Recent evidence suggests that shift workers regard quick returns as being more problematic than night work. The current study explored quick returns and night work in terms of their impact on sleep, unwinding, recovery, exhaustion, satisfaction with work hours and work-family interference. Data from the 2006 cohort of Swedish nursing students within the national Longitudinal Analysis of Nursing Education (LANE) study were analysed (N = 1459). Respondents completed a questionnaire prior to graduation (response rate 69.2%) and 3 years after graduation (65.9%). The analyses examined associations between frequency of quick returns and night work and measures taken in year three, while adjusting for confounding factors (in year three and prior graduation). Frequency of quick returns was a significant predictor of poor sleep quality, short sleeps, unwinding, exhaustion, satisfaction with work hours and work-to-family interference, with higher frequency predicting more negative outcomes. Quick returns did not predict recovery after rest days. Frequency of night work did not predict any of the outcomes. In conclusion, quick returns were an important determinant of sleep, recovery and wellbeing, whereas night work did not show such an association.

  • 27.
    Darin-Mattsson, Alexander
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Andel, Ross
    Fors, Stefan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Kåreholt, Ingemar
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Jönköping University, Sweden.
    Are Occupational Complexity and Socioeconomic Position Related to Psychological Distress 20 Years Later?2015In: Journal of Aging and Health, ISSN 0898-2643, E-ISSN 1552-6887, Vol. 27, no 7, 1266-1285 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To assess occupational complexity in midlife in relation to psychological distress in older adulthood (69+ years) and explore the role of socioeconomic position. Method: Baseline data from the Swedish Level of Living Survey and follow-up data from the Swedish Longitudinal Study of Living Conditions of the Oldest Old were combined, resulting in 20+ years of follow-up. Data were analyzed using ordered logistic regressions. Results: Higher occupational complexity was associated with less psychological distress 20 years later adjusted for age, sex, follow-up year, hours worked the year before baseline, and psychological distress at baseline. Higher socioeconomic position yielded the same pattern of results. Socioeconomic position partially accounted for the association between occupational complexity and psychological distress. Discussion: With social gradient not easily amenable to modification, efforts to increase engagement at work may offer a viable option to attenuate the influence of work environment on psychological distress later in life.

  • 28. Dragano, Nico
    et al.
    Siegrist, Johannes
    Nyberg, Solja T.
    Lunau, Thorsten
    Fransson, Eleonor I.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Jönköping University, Sweden.
    Alfredsson, Lars
    Bjorner, Jakob B.
    Borritz, Marianne
    Burr, Hermann
    Erbel, Raimund
    Fahlén, Göran
    Goldberg, Marcel
    Hamer, Mark
    Heikkilä, Katriina
    Jöckel, Karl-Heinz
    Knutsson, Anders
    Madsen, Ida E. H.
    Nielsen, Martin L.
    Nordin, Maria
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Umeå University, Sweden.
    Oksanen, Tuula
    Pejtersen, Jan H.
    Pentti, Jaana
    Rugulies, Reiner
    Salo, Paula
    Schupp, Jürgen
    Singh-Manoux, Archana
    Steptoe, Andrew
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Vahtera, Jussi
    Westerholm, Peter J. M.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Virtanen, Marianna
    Zins, Marie
    Batty, G. David
    Kivimäki, Mika
    Effort-Reward Imbalance at Work and Incident Coronary Heart Disease A Multicohort Study of 90,164 Individuals2017In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 28, no 4, 619-626 p.Article in journal (Refereed)
    Abstract [en]

    Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease.

    Methods: This multicohort study (the IPD-Work consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort-reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis.

    Results: At baseline, 31.7% of study members reported effort-reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00-1.35) was observed for effort-reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01-1.34) for having either effort-reward imbalance or job strain and 1.41 (1.12-1.76) for having both these stressors compared to having neither effort-reward imbalance nor job strain.

    Conclusions: Individuals with effort-reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress.

  • 29. Duarte-Salles, Talita
    et al.
    von Stedingk, Hans
    Stockholm University, Faculty of Science, Department of Materials and Environmental Chemistry (MMK), Environmental Chemistry.
    Granum, Berit
    Gutzkow, Kristine B.
    Rydberg, Per
    Stockholm University, Faculty of Science, Department of Materials and Environmental Chemistry (MMK), Environmental Chemistry.
    Törnqvist, Margareta
    Stockholm University, Faculty of Science, Department of Materials and Environmental Chemistry (MMK), Environmental Chemistry.
    Mendez, Michelle A.
    Brunborg, Gunnar
    Brantsaeter, Anne Lise
    Meltzer, Helle Margrete
    Alexander, Jan
    Haugen, Margaretha
    Dietary Acrylamide Intake during Pregnancy and Fetal Growth-Results from the Norwegian Mother and Child Cohort Study (MoBa)2013In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 121, no 3, 374-379 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Acrylamide has shown developmental and reproductive toxicity in animals, as well as neurotoxic effects in humans with occupational exposures. Because it is widespread in food and can pass through the human placenta, concerns have been raised about potential developmental effects of dietary exposures in humans. OBJECTIVES: We assessed associations of prenatal exposure to dietary acrylamide with small for gestational age (SGA) and birth weight. METHODS: This study included 50,651 women in the Norwegian Mother and Child Cohort Study (MoBa). Acrylamide exposure assessment was based on intake estimates obtained from a food frequency questionnaire (FFQ), which were compared with hemoglobin (Hb) adduct measurements reflecting acrylamide exposure in a subset of samples (n = 79). Data on infant birth weight and gestational age were obtained from the Medical Birth Registry of Norway. Multivariable regression was used to estimate associations between prenatal acrylamide and birth outcomes. RESULTS: Acrylamide intake during pregnancy was negatively associated with fetal growth. When women in the highest quartile of acrylamide intake were compared with women in the lowest quartile, the multivariable-adjusted odds ratio (OR) for SGA was 1.11 (95% CI: 1.02, 1.21) and the coefficient for birth weight was -25.7 g (95% CI: -35.9, -15.4). Results were similar after excluding mothers who smoked during pregnancy. Maternal acrylamide-and glycidamide-Hb adduct levels were correlated with estimated dietary acrylamide intakes (Spearman correlations = 0.24; 95% CI: 0.02, 0.44; and 0.48; 95% CI: 0.29, 0.63, respectively). CONCLUSIONS: Lowering dietary acrylamide intake during pregnancy may improve fetal growth.

  • 30.
    Engdahl, Barbro
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Ramstedt, Mats
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Is the population level link between drinking and harm similar for women and men?: a time series analysis with focus on gender-specific drinking and alcohol-related hospitalizations in Sweden2011In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 21, no 4, 432-437 p.Article in journal (Refereed)
    Abstract [en]

    Background: A question that has not been addressed in the literature is whether the population level association between alcohol and harm differs between men and women. The main aim of this article is to fill this gap by analysing recently collected time series data of male and female self-reported drinking in relation to gender-specific harm indicators in Sweden. Methods: Male and female per capita and risk consumption was estimated on the basis of self-reported data from monthly alcohol surveys for the period 2002-07. Overall per capita consumption including recorded sales and estimates of unrecorded consumption were also collected for the same period. Alcohol-related hospitalizations were used as indicators of alcohol-related harm. Data were aggregated into quarterly observations and analysed by means of time series analyses (ARIMA-modelling). Results: Overall per capita consumption was significantly related to both male and female alcohol-related hospitalizations. Male per capita consumption and risk consumption were also significantly related to alcohol-related hospitalizations among men. Female per capita consumption and risk consumption had also a positive association with alcohol-related hospitalizations but statistical significance was only reached for alcohol poisonings where the association was even stronger than for men. Conclusions: Changes in alcohol consumption in Sweden was associated with changes in male and female alcohol-related hospitalizations also in analyses based on gender-specific consumption measures. There was no clear evidence that the population level association between alcohol and harm differed between men and women.

  • 31. Farioli, Andrea
    et al.
    Kriebel, David
    Mattioli, Stefano
    Kjellberg, Katarina
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden.
    Occupational lifting and rhegmatogenous retinal detachment: a follow-up study of Swedish conscripts2017In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 74, no 7, 489-495 p.Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate the association between occupational lifting and the risk of rhegmatogenous retinal detachment (RRD) using data from a large population of men.

    Methods We used data from a national cohort of 49 321 Swedish men conscripted for compulsory military service in 1969–1970. We collected information on surgically treated RRD from the National Patient Register and we followed up the cohort between 1991 and 2009 at ages 40–60 years. Exposure to occupational lifting was assessed by applying a job exposure matrix to occupational data from the 1990 census. Incidence rate ratios (IRRs) and 95% CIs were estimated through Poisson regression models adjusted by degree of myopia, income and education level.

    Results We observed 217 cases of RRD in 7 80 166 person-years. In univariate analyses we did not observe an association between occupational lifting and RRD. However, after adjustment for myopia and socioeconomic factors, we found an increased risk of RRD (IRR 2.38, 95% CI 1.15 to 4.93) for subjects in the highest category of exposure compared with those in the lowest one. The incidence rate of RRD among subjects lifting heavy loads at least twice per week, aged between 50 years and 59 years, and affected by severe myopia was as high as 7.9 cases per 1000 person-years, compared with an overall rate of 0.28.

    Conclusions Our study supports the hypothesis that heavy occupational lifting is a risk factor for RRD. Information on myopia degree and socioeconomic status is necessary when studying the association between occupational lifting and RRD.

  • 32. Fireman, Elizabeth
    et al.
    Bar Shai, Amir
    Alcalay, Yifat
    Ophir, Noa
    Kivity, Shmuel
    Stejskal, Vera
    Stockholm University, Faculty of Science, Department of Molecular Biosciences, The Wenner-Gren Institute. Masaryk University, Czech Republic.
    Identification of metal sensitization in sarcoid-like metal-exposed patients by the MELISA (R) lymphocyte proliferation test - a pilot study2016In: Journal of Occupational Medicine and Toxicology, ISSN 1745-6673, E-ISSN 1745-6673, Vol. 11, 18Article in journal (Refereed)
    Abstract [en]

    Background: Pulmonary function is often affected by the inhalation of metal particles. The resulting pathology might trigger various lung diseases, e.g., parenchymal lung fibrosis and granulomatous lung disorders. We previously demonstrated that 6 % of tissue-proven sarcoid patients had a positive beryllium lymphocyte proliferation test (BeLPT), thus correcting the diagnosis to chronic beryllium disease. The aim of this study was to examine if MEmory Lymphocyte Immnuno Stimulation Assay (MELISA (R)), currently used for non-pulmonary diseases, can identify metals other than beryllium that can also trigger sensitization and induce granulomatous disease. Methods: This pilot study included 13 sarcoid-like patients who underwent MELISA (R). Eleven patients also underwent BeLPT. Biopsy samples were tested for metal content by scanning electron microscope. Eleven study patients had been exposed to metals at the workplace and 2 had silicone implants. Results: Two patients who had undergone BeLPT were positive for beryllium. MELISA (R) detected 9 patients (9/13, 69 %) who were positive for at least one of the tested metals: 4 reacted positively to nickel, 4 to titanium, 2 to chromium, 2 to beryllium, 2 to silica, and one each to palladium, mercury and lead. Conclusion: It is proposed that MELISA (R) can be exploited to also identify specific sensitization in individuals exposed to inhaled particles from a variety of metals.

  • 33. Flo, Elisabeth
    et al.
    Pallesen, Stale
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Mageroy, Nils
    Moen, Bente Elisabeth
    Gronli, Janne
    Nordhus, Inger Hilde
    Bjorvatn, Bjorn
    Shift-related sleep problems vary according to work schedule2013In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 70, no 4, 238-245 p.Article in journal (Refereed)
    Abstract [en]

    Objectives Shift-related sleep and sleepiness problems may be due to characteristics of both shifts (ie, day, evening and night shifts) and work schedules (ie, permanent vs rotational schedules). The Bergen Shift Work Sleep Questionnaire (BSWSQ) was used to investigate associations between shift-related sleep problems and work schedules. Methods 1586 nurses completed the BSWSQ. Participants who, in relation to a shift, 'often' or 'always' experienced both a sleep problem and a tiredness/sleepiness problem were defined as having shift-related insomnia (separate for day, evening and night shifts and rest-days). Logistic regression analyses were conducted for day, evening, night, and rest-day insomnia with participants on both permanent and rotational schedules. Results Shift-related insomnia differed between the work schedules. The evening shift insomnia was more prevalent in the two-shift rotation schedule than the three-shift rotation schedule (29.8% and 19.8%, respectively). Night shift insomnia showed higher frequencies among three-shift rotation workers compared with permanent night workers (67.7% and 41.7%, respectively). Rest-day insomnia was more prevalent among permanent night workers compared with two- and three-shift rotations (11.4% compared with 4.2% and 3.6%, respectively). Conclusions The prevalences of shift-related insomnia differed between the work schedules with higher frequencies for three-shift rotations and night shifts. However, sleep problems were present in all shifts and schedules. This suggests that both shifts and work schedules should be considered in the study of shift work-related sleep problems.

  • 34. Folkard, Simon
    et al.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Shiftwork, metabolic dysfunction and safety: a review2013In: Sleep Science (1984-0659) volume 6, Supplement 1, 2013, São Paulo: Associação Brasileira do Sono , 2013, Vol. 6, no suppl 1, 27-27 p.Conference paper (Refereed)
  • 35. Fransson, Eleonor I.
    et al.
    Stadin, Magdalena
    Nordin, Maria
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Umeå University, Sweden.
    Malm, Dan
    Knutsson, Anders
    Alfredsson, Lars
    Westerholm, Peter J. M.
    The Association between Job Strain and Atrial Fibrillation: Results from the Swedish WOLF Study2015In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, 371905Article in journal (Refereed)
    Abstract [en]

    Introduction. Atrial fibrillation (AF) is a common heart rhythmdisorder. Several life-style factors have been identified as risk factors for AF, but less is known about the impact of work-related stress. This study aims to evaluate the association between work-related stress, defined as job strain, and risk of AF. Methods. Data from the Swedish WOLF study was used, comprising 10,121 working men and women. Job strain was measured by the demand-control model. Information on incident AF was derived from national registers. Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between job strain and AF risk. Results. In total, 253 incident AF cases were identified during a total follow-up time of 132,387 person-years. Job strain was associated with AF risk in a time-dependent manner, with stronger association after 10.7 years of follow-up (HR 1.93, 95% CI 1.10-3.36 after 10.7 years, versus HR 1.11, 95% CI 0.67-1.83 before 10.7 years). The results pointed towards a dose-response relationship when taking accumulated exposure to job strain over time into account. Conclusion. This study provides support to the hypothesis that work-related stress defined as job strain is linked to an increased risk of AF.

  • 36. Fuks, Kateryna B.
    et al.
    Weinmayr, Gudrun
    Foraster, Maria
    Dratva, Julia
    Hampel, Regina
    Houthuijs, Danny
    Oftedal, Bente
    Oudin, Anna
    Panasevich, Sviatlana
    Penell, Johanna
    Sommar, Johan N.
    Sorensen, Mette
    Tiittanen, Pekka
    Wolf, Kathrin
    Xun, Wei W.
    Aguilera, Inmaculada
    Basagana, Xavier
    Beelen, Rob
    Bots, Michiel L.
    Brunekreef, Bert
    Bueno-de-Mesquita, H. Bas
    Caracciolo, Barbara
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Cirach, Marta
    de Faire, Ulf
    de Nazelle, Audrey
    Eeftens, Marloes
    Elosua, Roberto
    Erbel, Raimund
    Forsberg, Bertil
    Fratiglioni, Laura
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Karolinska Institutet, Sweden.
    Gaspoz, Jean-Michel
    Hilding, Agneta
    Jula, Antti
    Korek, Michal
    Kraemer, Ursula
    Kuenzli, Nino
    Lanki, Timo
    Leander, Karin
    Magnusson, Patrik K. E.
    Marrugat, Jaume
    Nieuwenhuijsen, Mark J.
    Oestenson, Claes-Goeran
    Pedersen, Nancy L.
    Pershagen, Goeran
    Phuleria, Harish C.
    Probst-Hensch, Nicole M.
    Raaschou-Nielsen, Ole
    Schaffner, Emmanuel
    Schikowski, Tamara
    Schindler, Christian
    Schwarze, Per E.
    Sogaard, Anne J.
    Sugiri, Dorothea
    Swart, Wim J. R.
    Tsai, Ming-Yi
    Turunen, Anu W.
    Vineis, Paolo
    Peters, Annette
    Hoffmann, Barbara
    Arterial Blood Pressure and Long-Term Exposure to Traffic-Related Air Pollution: An Analysis in the European Study of Cohorts for Air Pollution Effects (ESCAPE)2014In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 122, no 9, 896-905 p.Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Long-term exposure to air pollution has been hypothesized to elevate arterial blood pressure (BP). The existing evidence is scarce and country specific. OBJECTIVES: We investigated the cross-sectional association of long-term traffic-related air pollution with BP and prevalent hyper-tension in European populations. METHODS: We analyzed 15 population-based cohorts, participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE). We modeled residential exposure to particulate matter and nitrogen oxides with land use regression using a uniform protocol. We assessed traffic exposure with traffic indicator variables. We analyzed systolic and diastolic BP in participants medicated and nonmedicated with BP-lowering medication (BPLM) separately, adjusting for personal and area-level risk factors and environmental noise. Prevalent hyper-tension was defined as >= 140 mmHg systolic BP, or >= 90 mmHg diastolic BP, or intake of BPLM. We combined cohort-specific results using random-effects meta-analysis. RESULTS: In the main meta-analysis of 113,926 participants, traffic load on major roads within 100 m of the residence was associated with increased systolic and diastolic BP in nonmedicated participants [0.35 mmHg (95% CI: 0.02, 0.68) and 0.22 mmHg (95% CI: 0.04, 0.40) per 4,000,000 vehicles x m/day, respectively]. The estimated odds ratio (OR) for prevalent hyper-tension was 1.05 (95% CI: 0.99, 1.11) per 4,000,000 vehicles x m/day. Modeled air pollutants and BP were not clearly associated. CONCLUSIONS: In this first comprehensive meta-analysis of European population-based cohorts, we observed a weak positive association of high residential traffic exposure with BP in nonmedicated participants, and an elevated OR for prevalent hyper-tension. The relationship of modeled air pollutants with BP was inconsistent.

  • 37.
    Garcy, Anthony
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Vågerö, Denny
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Unemployment and suicide during and after a deep recession: a longitudinal study of 3.4 million Swedish men and women2013In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 103, no 6, 1031-1038 p.Article in journal (Refereed)
    Abstract [en]

    Objectives. We tested 2 hypotheses found in studies of the relationship between suicide and unemployment: causal (stress and adversity) and selective interpretation (previous poor health).

    Methods. We estimated Cox models for adults (n = 3 424 550) born between 1931 and 1965. We examined mortality during the recession (1993–1996), postrecession (1997–2002), and a combined follow-up. Models controlled for previous medical problems, and social, family, and employer characteristics.

    Results. During the recession there was no excess hazard of mortality from suicide or events of undetermined intent. Postrecession, there was an excess hazard of suicide mortality for unemployed men but not unemployed women. However, for unemployed women with no health-problem history there was a modest hazard of suicide. Finally, there was elevated mortality from events of undetermined intent for unemployed men and women postrecession.

    Conclusions. A small part of the relationship may be related to health selection, more so during the recession. However, postrecessionary period findings suggest that much of the association could be causal. A narrow focus on suicide mortality may understate the mortality effects of unemployment in Sweden.

  • 38.
    Gauffin, Karl
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet.
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet.
    The effect of childhood socioeconomic position on alcohol-related disorders later in life: a Swedish national cohort study2013In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 67, no 11, 932-938 p.Article in journal (Refereed)
    Abstract [en]

    Background: Alcohol use is the third most important global-health risk factor and a main contributor to health inequalities. Previous research on social determinants of alcohol-related disorders has delivered inconsistent results. We aimed to investigate whether socioeconomic position (SEP) in childhood predicts alcohol-related disorders in young adulthood in a Swedish national cohort.

    Methods: We studied a register-based national cohort of Swedish citizens born during 1973–1984 (N=948 518) and followed them up to 2009 from age 15. Childhood SEP was defined by a six-category socioeconomic index from the Censuses of 1985 and 1990. Rs of alcohol-related disorders, as indicated by register entries on alcohol-related death and alcohol-related medical care, were analysed in Cox regression models with adjustment for sociodemographic variables and indicators of parental morbidity and criminality.

    Results: Low childhood SEP was associated with alcohol-related disorders later in life among both men and women in a stepwise manner. Growing up in a household with the lowest SEP was associated with risk for alcohol-related disorders of HR: 2.24 (95% CI 2.08 to 2.42) after adjustment for sociodemographic variables, compared with the highest SEP group. Adjusting the analysis for parental psychosocial problems attenuated the association to HR 1.87 (95% CI 1.73 to 2.01).

    Conclusions: The study demonstrates that low SEP in childhood predicts alcohol-related disorders in young adulthood. Alcohol abuse needs to be addressed in policies to bridge the gap of health inequalities.                                                                                 

  • 39. Gidlöf Gunnarsson, Anita
    The role of residents' perception and personality in the assessment of the sick building syndrome2002Doctoral thesis, comprehensive summary (Other academic)
  • 40.
    Giovanoulis, Georgios
    et al.
    Stockholm University, Faculty of Science, Department of Environmental Science and Analytical Chemistry. IVL Swedish Environmental Research Institute, Sweden.
    Alves, Andreia
    Papadopoulou, Eleni
    Palm Cousins, Anna
    Schütze, André
    Koch, Holger M.
    Haug, Line S.
    Covaci, Adrian
    Magnér, Jörgen
    Voorspoels, Stefan
    Evaluation of exposure to phthalate esters and DINCH in urine and nails from a Norwegian study population2016In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 151, 80-90 p.Article in journal (Refereed)
    Abstract [en]

    Phthalate esters (PEs) and 1,2-cyclohexane dicarboxylic acid diisononyl ester (DINCH) used as additives in numerous consumer products are continuously released into the environment, leading to subsequent human exposure which might cause adverse health effects. The human biomonitoring approach allows the detection of PEs and DINCH in specific populations, by taking into account all possible routes of exposure (e.g. inhalation, transdermal and oral) and all relevant sources (e.g. air, dust, personal care products, diet). We have investigated the presence of nine PE and two DINCH metabolites and their exposure determinants in 61 adult residents of the Oslo area (Norway). Three urine spots and fingernails were collected from each participant according to established sampling protocols. Metabolite analysis was performed by LC-MS/MS. Metabolite levels in urine were used to back-calculate the total exposure to their corresponding parent compound. The primary monoesters, such as monomethyl phthalate (MMP, geometric mean 89.7 ng/g), monoethyl phthalate (MEP, 104.8 ng/g) and mono-n-butyl phthalate (MnBP, 893 ng/g) were observed in higher levels in nails, whereas the secondary bis(2-ethylhexyl) phthalate (DEHP) and DINCH oxidative metabolites were more abundant in urine (detection frequency 84-100%). The estimated daily intakes of PEs and DINCH for this Norwegian population did not exceed the established tolerable daily intake and reference doses, and the cumulative risk assessment for combined exposure to plasticizers with similar toxic endpoints indicated no health concerns for the selected population. We found a moderate positive correlation between MEP levels in 3 urine spots and nails (range: 0.56-0.68). Higher frequency of personal care products use was associated with greater MEP concentrations in both urine and nail samples. Increased age, smoking, wearing plastic gloves during house cleaning, consuming food with plastic packaging and eating with hands were associated with higher levels in urine and nails for some of the metabolites. In contrast, frequent hair and hand washing was associated with lower urinary levels of monoisobutyl phthalate (MiBP) and mono(2-ethyl-5-hydroxyhexyl) phthalate (5-OH-MEHP), respectively.

  • 41.
    Goodman, A.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Gisselmann, Marit
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Koupil, Ilona
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Birth outcomes and early-life social characteristics predict unequal educational outcomes across the life course and across generation: Data from a Swedish cohort born 1915-1929 and their grandchildren born 1973-19802011In: IEA World Congress of Epidemiology, 7–11 August 2011, Edinburgh International Conference Centre, Edinburgh, Scotland. Programme and abstracts: Programme and abstracts, 2011, Vol. 65Conference paper (Refereed)
    Abstract [en]

    Educational inequalities are a major contributor to health and social inequalities. We investigated the effects of adverse birth characteristics and social disadvantage upon educational outcomes over the lifecourse and across generations. Our subjects were 12 674 Swedish infants born 1915–1929 and 9706 of their grandchildren born 1973–1980. Within both cohorts, better school achievement (schoolmarks in elementary school) was predicted by: heavier birthweight, lower birth order, older mother, married mother and higher family social class. These effects persisted after mutual-adjustment, and birth characteristics and family composition played little role in explaining social class effects. There were no independent effects of preterm or twin status, but weak evidence that postterm infants were disadvantaged. The predictors of education continuation (secondary school attendance and entrance to tertiary education) were very similar, with family composition and social class effects persisting even after adjusting for school achievement. Across generations, better grandchild educational outcomes were predicted by heavier birthweight, lower birth order and higher social class in the grandparents. These associations became non-significant and/or substantially attenuated after adjusting for grandchild socio-economic position in childhood, suggesting this was the major mechanism for this effect. We conclude that multiple early-life characteristics predict educational outcomes across the lifecourse and across generations, including birth outcome and family composition effects which typically receive little attention. Most effects were remarkably stable, suggesting their relevance for understanding educational inequalities in other populations. Such understanding would, in turn, clarify a major mechanism whereby health inequalities emerge across the lifecourse and are recreated across generations.

  • 42.
    Hasson, Dan
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    von Thiele Schwarz, Ulrica
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Self-rated Health and Allostatic Load in Women Working in Two Occupational Sectors2009In: Journal of Health Psychology, ISSN 1359-1053, Vol. 14, no 4, 568-577 p.Article in journal (Refereed)
    Abstract [en]

    This study set out to investigate how biological dysregulation, in terms of allostatic load (AL), relates to selfrated health (SRH) in women. Data on SRH and 12 biomarkers used to assess AL were available for 241 employees from the health care sector and 98 employees from the IT/media sector. In line with the hypothesis, results showed that a poor SRH, along with occupational sector, age and education, were significantly associated with a high AL, particularly for those working withinthe health care sector. This association between a poor SRH and AL, suggests a link between SRH and biological dysregulation.

  • 43. Hasson, Henna
    et al.
    Villaume, Karin
    Schwarz, Ulrica von Thiele
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Palm, Kristina
    Managing Implementation Roles of Line Managers, Senior Managers, and Human Resource Professionals in an Occupational Health Intervention2014In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 56, no 1, 58-65 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To contrast line managers', senior managers', and (human resource) HR professionals' descriptions of their roles, tasks, and possibilities to perform them during the implementation of an occupational health intervention. Methods: Interviews with line managers (n = 13), senior managers (n = 7), and HR professionals (n = 9) 6 months after initiation of an occupational health intervention at nine organizations. Results: The groups' roles were described coherently, except for the HR professionals. These roles were seldom performed in practice, and two main reasons appeared: use of individuals' engagement rather than an implementation strategy, and lack of integration of the intervention with other stakeholders and organizational processes. Conclusions: Evaluation of stakeholders' perceptions of each other's and their own roles is important, especially concerning HR professionals. Clear role descriptions and implementation strategies, and aligning an intervention to organizational processes, are crucial for efficient intervention management.

  • 44.
    Hedlund, Ebba
    Stockholm University, Faculty of Social Sciences, Centre for Research in International Migration and Ethnic Relations (CEIFO).
    International migration and coronary heart disease2007Doctoral thesis, monograph (Other academic)
    Abstract [en]

    In today’s globalised world, with considerable international migration, knowledge about the health of immigrants is becoming increasingly important. In Sweden, about 13% of the population or over one million persons are born outside the country. Large groups have moved to Sweden from Finland, other Nordic countries, the Baltic States and other Eastern European countries, Western Europe, Turkey, Iran, Iraq, and Latin America.

    The aim of the thesis was to describe incidence of myocardial infarction (MI) among foreign-born persons compared to Sweden-born, taking into consideration gender, socio-economic status and time spent in Sweden and to evaluate if the long term trend of decreasing MI incidence in Sweden was present in immigrants to Sweden. In addi-tion, the aim was to analyse survival after a first MI among immigrants and Sweden-born. Furthermore, the aim was to investigate to what extent migration from Finland to Sweden is related to the access to welfare components including education and socio-economic status as well as social support and coronary heart disease (CHD) prevalence.

    The association between country of birth and incident MI was studied by case control methods. The study base consisted of subjects 30-74 years of age in Stockholm County during the 20 year period 1977-96. Incident cases of first acute MI were identified us-ing registers of hospital discharges and deaths and controls were selected randomly from the study base. In the sampling of controls, sampling fractions were known, which enabled estimates of person time at risk and incidence rates employed in the analyses of time trends. Information on country of birth was obtained from national censuses and from a register on immigration. The study of survival utilised all the cases in the case control study. Cases surviving 28 days were followed with regard to mortality during one year.

    In the studies of welfare components and CHD in Finnish twins, the study population consisted of twin pairs of the Finnish Twin Cohort Study where at least one twin had lived one year or more in Sweden. The study included 1,534 migrant or non-migrant subjects and 251 complete twin pairs discordant regarding residency in Sweden. Emi-grant twins were compared to non-migrant co-twins regarding welfare components and prevalence of CHD. Data on welfare components and CHD was assessed by an exten-sive questionnaire administered in 1998 including questions on social factors, health, life style factors and migration history.

    Immigrants to Sweden had a higher incidence of first MI including non-fatal as well as fatal cases compared to Sweden-born during the period 1977-96 after adjustment for age and socioeconomic group. Immigrant men had a decreasing time trend of MI inci-dence during the period 1977-96 of the same magnitude as Sweden-born but among women immigrants had a somewhat less pronounced decline compared to natives. Fur-thermore immigrants did not have an increased case fatality within 28 days after a first MI compared to Sweden-born persons when differences in socioeconomic group were accounted for. Subjects born in Finland however had an increased case fatality during the first ten years in Sweden among men and after 20 years in Sweden among women. These results suggest that differences in CHD mortality between foreign-born and Sweden-born are primarily due to a higher disease incidence rather than a lower sur-vival. Migration from Finland to Sweden did not substantially improve access to central welfare components for the migrants but a reduced prevalence of CHD in emigrants compared to non-migrants was observed, taking genetic and early childhood factors into account.

    In conclusion the results of this thesis reinforce the impression that immigrants to Swe-den, from a number of countries including Finland, are at increased risk of MI com-pared to native Swedes. Concerning immigrants from Finland this appears to be the case in spite of a certain reduction in CHD prevalence associated with migration to Sweden.

  • 45. Heffernan, Amy L.
    et al.
    Aylward, Lesa
    Toms, Leisa-Maree L.
    Sly, Peter D.
    MacLeod, Matthew
    Stockholm University, Faculty of Science, Department of Applied Environmental Science (ITM).
    Mueller, Jochen F.
    Pooled biological specimens for human biomonitoring of environmental chemicals: Opportunities and limitations2014In: Journal of Exposure Science and Environmental Epidemiology, ISSN 1559-0631, E-ISSN 1559-064x, Vol. 24, 225-232 p.Article in journal (Refereed)
    Abstract [en]

    Biomonitoring has become the “gold standard” in assessing chemical exposures, and has an important role in risk assessment. The pooling of biological specimens—combining multiple individual specimens into a single sample—can be used in biomonitoring studies to monitor levels of exposure and identify exposure trends or to identify susceptible populations in a cost-effective manner. Pooled samples provide an estimate of central tendency and may also reveal information about variation within the population. The development of a pooling strategy requires careful consideration of the type and number of samples collected, the number of pools required and the number of specimens to combine per pool in order to maximise the type and robustness of the data. Creative pooling strategies can be used to explore exposure–outcome associations, and extrapolation from other larger studies can be useful in identifying elevated exposures in specific individuals. The use of pooled specimens is advantageous as it saves significantly on analytical costs, may reduce the time and resources required for recruitment and, in certain circumstances, allows quantification of samples approaching the limit of detection. In addition, the use of pooled samples can provide population estimates while avoiding ethical difficulties that may be associated with reporting individual results.

  • 46. Heikkila, K.
    et al.
    Madsen, I. E. H.
    Nyberg, S. T.
    Fransson, E. I.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerholm, P. J. M.
    Virtanen, M.
    Vahtera, J.
    Vaananen, A.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Suominen, S. B.
    Shipley, M. J.
    Salo, P.
    Rugulies, R.
    Pentti, J.
    Pejtersen, J. H.
    Oksanen, T.
    Nordin, M.
    Nielsen, M. L.
    Kouvonen, A.
    Koskinen, A.
    Koskenvuo, M.
    Knutsson, A.
    Ferrie, J. E.
    Dragano, N.
    Burr, H.
    Borritz, M.
    Bjorner, J. B.
    Alfredsson, L.
    Batty, G. D.
    Singh-Manoux, A.
    Kivimaki, M.
    Job strain and the risk of severe asthma exacerbations: a meta-analysis of individual-participant data from 100 000 European men and women2014In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 69, no 6, 775-783 p.Article in journal (Refereed)
    Abstract [en]

    BackgroundMany patients and healthcare professionals believe that work-related psychosocial stress, such as job strain, can make asthma worse, but this is not corroborated by empirical evidence. We investigated the associations between job strain and the incidence of severe asthma exacerbations in working-age European men and women. MethodsWe analysed individual-level data, collected between 1985 and 2010, from 102 175 working-age men and women in 11 prospective European studies. Job strain (a combination of high demands and low control at work) was self-reported at baseline. Incident severe asthma exacerbations were ascertained from national hospitalization and death registries. Associations between job strain and asthma exacerbations were modelled using Cox regression and the study-specific findings combined using random-effects meta-analyses. ResultsDuring a median follow-up of 10years, 1 109 individuals experienced a severe asthma exacerbation (430 with asthma as the primary diagnostic code). In the age- and sex-adjusted analyses, job strain was associated with an increased risk of severe asthma exacerbations defined using the primary diagnostic code (hazard ratio, HR: 1.27, 95% confidence interval, CI: 1.00, 1.61). This association attenuated towards the null after adjustment for potential confounders (HR: 1.22, 95% CI: 0.96, 1.55). No association was observed in the analyses with asthma defined using any diagnostic code (HR: 1.01, 95% CI: 0.86, 1.19). ConclusionsOur findings suggest that job strain is probably not an important risk factor for severe asthma exacerbations leading to hospitalization or death.

  • 47. Heikkila, Katriina
    et al.
    Nyberg, Solja T.
    Madsen, Ida E. H.
    de Vroome, Ernest
    Alfredsson, Lars
    Bjorner, Jacob J.
    Borritz, Marianne
    Burr, Hermann
    Erbel, Raimund
    Ferrie, Jane E.
    Fransson, Eleonor I.
    Geuskens, Goedele A.
    Hooftman, Wendela E.
    Houtman, Irene L.
    Jöckel, Karl-Heinz
    Knutsson, Anders
    Koskenvuo, Markku
    Lunau, Thorsten
    Nielsen, Martin L.
    Nordin, Maria
    Oksanen, Tuula
    Pejtersen, Jan H.
    Pentti, Jaana
    Shipley, Martin J.
    Steptoe, Andrew
    Suominen, Sakari B.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Vahtera, Jussi
    Westerholm, Peter J. M.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Dragano, Nico
    Rugulies, Reiner
    Kawachi, Ichiro
    Batty, G. David
    Singh-Manoux, Archana
    Virtanen, Marianna
    Kivimäki, Mika
    Long working hours and cancer risk: a multi-cohort study2016In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 114, 813-818 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear.

    METHODS: This multi-cohort study examined the association between working hours and cancer risk in 116 462 men and women who were free of cancer at baseline. Incident cancers were ascertained from national cancer, hospitalisation and death registers; weekly working hours were self-reported.

    RESULTS: During median follow-up of 10.8 years, 4371 participants developed cancer (n colorectal cancer: 393; n lung cancer: 247; n breast cancer: 833; and n prostate cancer: 534). We found no clear evidence for an association between working hours and the overall cancer risk. Working hours were also unrelated the risk of incident colorectal, lung or prostate cancers. Working ⩾55 h per week was associated with 1.60-fold (95% confidence interval 1.12-2.29) increase in female breast cancer risk independently of age, socioeconomic position, shift- and night-time work and lifestyle factors, but this observation may have been influenced by residual confounding from parity.

    CONCLUSIONS: Our findings suggest that working long hours is unrelated to the overall cancer risk or the risk of lung, colorectal or prostate cancers. The observed association with breast cancer would warrant further research.

  • 48. Heikkilä, Katriina
    et al.
    Fransson, Eleonor I
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Nyberg, Solja T
    Zins, Marie
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerholm, Peter
    Virtanen, Marianna
    Vahtera, Jussi
    Suominen, Sakari
    Steptoe, Andrew
    Salo, Paula
    Pentti, Jaana
    Oksanen, Tuula
    Nordin, Maria
    Marmot, Michael G
    Lunau, Thorsten
    Ladwig, Karl-Heinz
    Koskenvuo, Markku
    Knutsson, Anders
    Kittel, France
    Jöckel, Karl-Heinz
    Goldberg, Marcel
    Erbel, Raimund
    Dragano, Nico
    Debacquer, Dirk
    Clays, Els
    Casini, Annalisa
    Alfredsson, Lars
    Ferrie, Jane E
    Singh-Manoux, Archana
    Batty, G David
    Kivimäki, Mika
    Job Strain and Health-Related Lifestyle: Findings From an Individual-Participant Meta-Analysis of 118 000 Working Adults.2013In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 103, no 11, 2090-2097 p.Article in journal (Refereed)
    Abstract [en]

    Objectives. We examined the associations of job strain, an indicator of work-related stress, with overall unhealthy and healthy lifestyles. Methods. We conducted a meta-analysis of individual-level data from 11 European studies (cross-sectional data: n = 118 701; longitudinal data: n = 43 971). We analyzed job strain as a set of binary (job strain vs no job strain) and categorical (high job strain, active job, passive job, and low job strain) variables. Factors used to define healthy and unhealthy lifestyles were body mass index, smoking, alcohol intake, and leisure-time physical activity. Results. Individuals with job strain were more likely than those with no job strain to have 4 unhealthy lifestyle factors (odds ratio [OR] = 1.25; 95% confidence interval [CI] = 1.12, 1.39) and less likely to have 4 healthy lifestyle factors (OR = 0.89; 95% CI = 0.80, 0.99). The odds of adopting a healthy lifestyle during study follow-up were lower among individuals with high job strain than among those with low job strain (OR = 0.88; 95% CI = 0.81, 0.96). Conclusions. Work-related stress is associated with unhealthy lifestyles and the absence of stress is associated with healthy lifestyles, but longitudinal analyses suggest no straightforward cause-effect relationship between work-related stress and lifestyle. (Am J Public Health. Published online ahead of print May 16, 2013: e1-e8. doi:10.2105/AJPH.2012.301090).

  • 49. Heikkilä, Katriina
    et al.
    Madsen, Ida E. H.
    Nyberg, Solja T.
    Fransson, Eleonor I.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Ahola, Kirsi
    Alfredsson, Lars
    Bjorner, Jakob B.
    Borritz, Marianne
    Burr, Hermann
    Dragano, Nico
    Ferrie, Jane E.
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Nielsen, Martin L.
    Nordin, Maria
    Pejtersen, Jan H.
    Pentti, Jaana
    Rugulies, Reiner
    Oksanen, Tuula
    Shipley, Martin J.
    Suominen, Sakari B.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Vaananen, Ari
    Vahtera, Jussi
    Virtanen, Marianna
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerholm, Peter J. M.
    Batty, G. David
    Singh-Manoux, Archana
    Kivimäki, Mika
    Job Strain and the Risk of Inflammatory Bowel Diseases: Individual-Participant Meta-Analysis of 95 000 Men and Women2014In: PLoS ONE, ISSN 1932-6203, Vol. 9, no 2, Art.nr.-e88711 p.Article in journal (Refereed)
    Abstract [en]

    Background and Aims: Many clinicians, patients and patient advocacy groups believe stress to have a causal role in inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis. However, this is not corroborated by clear epidemiological research evidence. We investigated the association between work-related stress and incident Crohn's disease and ulcerative colitis using individual-level data from 95 000 European adults. Methods: We conducted individual-participant data meta-analyses in a set of pooled data from 11 prospective European studies. All studies are a part of the IPD-Work Consortium. Work-related psychosocial stress was operationalised as job strain (a combination of high demands and low control at work) and was self-reported at baseline. Crohn's disease and ulcerative colitis were ascertained from national hospitalisation and drug reimbursement registers. The associations between job strain and inflammatory bowel disease outcomes were modelled using Cox proportional hazards regression. The study-specific results were combined in random effects meta-analyses. Results: Of the 95 379 participants who were free of inflammatory bowel disease at baseline, 111 men and women developed Crohn's disease and 414 developed ulcerative colitis during follow-up. Job strain at baseline was not associated with incident Crohn's disease (multivariable-adjusted random effects hazard ratio: 0.83, 95% confidence interval: 0.48, 1.43) or ulcerative colitis (hazard ratio: 1.06, 95% CI: 0.76, 1.48). There was negligible heterogeneity among the study-specific associations. Conclusions: Our findings suggest that job strain, an indicator of work-related stress, is not a major risk factor for Crohn's disease or ulcerative colitis.

  • 50.
    Heshmati, Amy Frances
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Mishra, Gita
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). 2School of Population Health, University of Queensland.
    Koupil, Ilona
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Childhood and adulthood socio-economic position and hypertensive disorders in pregnancy: the Uppsala Birth Cohort Multigenerational Study2013In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 67, no 11, 939-946 p.Article in journal (Refereed)
    Abstract [en]

    Background Childhood and adulthood socio-economic position (SEP) is associated with cardiovascular disease in later life, but associations with hypertensive disorders in pregnancy are not well established.                                 

    Objective The aim of this study was to investigate the association of childhood and adulthood SEP with hypertensive disorders in pregnancy (chronic hypertension, gestational hypertension and pre-eclampsia/eclampsia).                                 

    Method Study participants were Swedish women (n=9507) from generation 3 of the Uppsala Birth Cohort Multigenerational Study (UBCoS Multigen) who delivered a live singleton offspring between 1982 and 2008. Social and health data were obtained from routine Swedish registers. Associations of own education (adulthood SEP), and parental education and social class (childhood SEP) with hypertensive disorders were studied using logistic regression with adjustments for age, calendar period, parity, smoking and body mass index.                                 

    Results Low own education was associated with chronic hypertension, but not with gestational hypertension or pre-eclampsia/eclampsia. Increased risk of chronic hypertension was seen in women whose mothers had medium education compared with women whose mothers had high education (OR 2.18, 95% CI 1.03 to 4.62). Women from a manual social class during childhood had twice the risk of chronic hypertension compared with those from non-manual backgrounds (OR 2.19, 95% CI 1.28 to 3.75). Childhood SEP was not associated with gestational hypertension or pre-eclampsia/eclampsia.                                 

    Conclusions Childhood and adulthood SEP was associated with chronic hypertension in pregnancy. In contrast, no association with childhood or adulthood SEP was seen for gestational hypertension or pre-eclampsia/eclampsia.

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