Differences in how women and men in a Swedish population-based sample think about sick leave: A cross-sectional vignette study.

BACKGROUND: Gender differences in attitudes towards depression gives reason to believe that sociocultural gender norms play a role in other areas. OBJECTIVE: The aim was to test (i) if the likelihood to think that sick leave with depression symptoms is not reasonable varies between women and men, and (ii) if the likelihood to think sick leave is not reasonable varies depending on the gender of the individual with depression symptoms. METHODS: A study population of 3147 participants responded to a web-survey with a written case briefly describing a man or woman with symptoms of depression. Respondents were asked if they thought it is reasonable that the person was sick listed for two weeks. Logistic regression was used to analyse the data. RESULTS: After controlling for age, education, self-rated health, and respondent's own experience of sickness absence the adjusted OR was 1.45 (95% CI 1.25-1.67) for men being less likely to think sick-leave was reasonable. Gender difference decreased when adjusting for negative attitudes towards depression (adjusted OR 1.24, 95% CI 1.06-1.44). No difference was found between how women and men thought about sick leave in relation to the gender of the case described in the vignette. CONCLUSION: Men were more likely to think that sick leave was not reasonable with decreased OR after adjustment for negative attitudes towards depression. Gender norms might be part of the explanation for differences but are challenging to test. This study contributes to a bourgeoning research field on gendered attitudes and sick leave, in terms of theoretical reasoning and methodological choice.

Restoring areas after a radioactive fallout: A multidisciplinary study on decontamination.

Land remediation is an important part of restoration measures after a radioactive fallout containing long-lived fission products such as 137Cs. In this multidisciplinary study, we focused on three main issues related to remediation of contaminated urban areas. First, we assessed how much decontamination contributes to reducing resident radiation exposure and how much this reduction depends on the timing of implemented measures. Second, we calculated direct and indirect costs of decontamination in an industrialized country such as Sweden. Finally, in a survey study, we considered reactions of Swedish citizens to being given the hypothetical option of moving to a site decontaminated after radioactive fallout and how this predicted response might influence the design of contingency plans. The main findings are that clean-up operations must be done within the first few years after a fallout to contribute significantly to reducing residual dose. If conducted within 1-2 years, large-scale decontamination can, on average, avert 20-200 manSv per km2 residential area and unit ground deposition of 137Cs (1 MBq). The estimated direct costs (in 2020 purchasing power) would amount to 100 million Euro per km2 decontaminated residential area (comparable to Japanese estimates after the Fukushima accident), generating 39,000 m3 of radioactive waste on average, mainly in the form of 137Cs-contaminated topsoil. In our survey study of 2291 Swedish respondents about their willingness to return to decontaminated homes, women, families with resident children, and high-income earners exhibited more skepticism about returning, even if authorities were to deem it safe. The demographic pattern in attitudes was similar to that found among evacuees in the Fukushima prefecture after 2011. We conclude that predefined ranges of measured 137Cs ground deposition can be used as guidance for rescue leaders in the early post-accident phase in long-term planning for affected areas. This planning should include timing and intensity of decontamination measures, duration of evacuation, and risk communication to citizens. Because some citizens expressed both high risk perception and risk aversion, however, timely and dialogic communication is unlikely to limit a shift after the incident to an older and more male-dominated population composition. There is a risk that those who can afford to do so will move away, whereas people whose wealth is locked in property (houses or businesses) will feel stuck. Perceptions of unfairness may fray the social fabric and complicate resettlement, which in some cases may mean inefficient outlay of decontamination costs. We believe that the issue of monetary compensation to affected residents requires priority in future work.

Time-dependence of decontamination efficiency after a fallout of gamma-emitting radionuclides in suburban areas: a theoretical outlook on topsoil removal.

Decontamination of urban areas may be necessary in the case of extensive fallout of radioactive material after a nuclear accident, as removal of contaminated soil and vegetation will significantly reduce doses for the residents in an area affected by fallout. Experience from Japan shows that cleanup operations of urban areas may take years despite investment in ample resources. The time delay between the initial fallout and completion of the decontamination measures allows natural and physical processes to affect the results. The efficiency of the decontamination will therefore depend significantly on time. Radioecological modeling and computer simulation of urban topography with one-story houses were applied in this study to estimate action-influenced time-integrated dose reductions (TDR) of contaminated topsoil removal as a function of time after the fallout. Results indicate that the TDR decreases gradually after the fallout depending on the vertical migration rate of radiocesium and, to some extent, the initial 134Cs/137Cs ratio. Delaying the topsoil removal from 1 to 10 years will result in a TDR decrease by more than a factor of two. Removing the topsoil within one year after fallout results typically in an averted effective dose between 34 and 80 mSv per MBq m-2 deposition of 137Cs for residents in wooden houses. The corresponding values for residents in brick houses are about 50% lower due to higher shielding. Additional modeling is needed to estimate how age and sex influence the averted detriment to affected cohorts. In addition, more in-depth knowledge of how the efficiency of topsoil removal in practice compares with hypothetical models and the effect of incomplete removal of radiocesium is needed to improve calculations of TDR values.

Citizens' Communication Needs and Attitudes to Risk in a Nuclear Accident Scenario: A Mixed Methods Study.

The potential devastation that a nuclear accident can cause to public health and the surrounding environment demands robust emergency preparedness. This includes gaining a greater knowledge of citizens' needs in situations involving radiation risk. The present study examines citizens' attitudes to a remediation scenario and their information and communication needs, using focus group data (n = 39) and survey data (n = 2291) from Sweden. The focus groups uniquely showed that adults of all ages express health concerns regarding young children, and many also do so regarding domestic animals. Said protective sentiments stem from a worry that even low-dose radiation is a transboundary, lingering health risk. It leads to doubts about living in a decontaminated area, and high demands on fast, continuous communication that in key phases of decontamination affords dialogue. Additionally, the survey results show that less favorable attitudes to the remediation scenario-worry over risk, doubt about decontamination effectiveness, and preferences to move away from a remediation area-are associated with the need for in-person meetings and dialogue. Risk managers should thus prepare for the need for both in-person meetings and frequent information provision tasks, but also that in-person, citizen meetings are likely to feature an over-representation of critical voices, forming very challenging communication tasks.

Association of stigmatizing attitudes with people's opinion of depression as a valid reason for sickness absence: A Swedish vignette study.

BACKGROUND: Depression is a common cause of sickness absence (SA) and also highly associated with stigma. Few studies have addressed the role of stigma in relation to SA. OBJECTIVE: To investigate if attitudes to depression were associated with the public's opinion of depression as a valid reason of SA. METHODS: The study population (n = 2413) originated from a web-based panel of citizens. The survey included a short vignette describing a person with symptoms of depression and the person's work tasks, followed by a question on recommendation of SA. Negative attitudes were measured by the Depression Stigma Scale. Logistic regressions were used to estimate the odds ratios (OR) for the likelihood of not recommending SA, controlling for individual and work-related co-variates. RESULTS: The crude association between negative attitudes and not recommending SA was OR 2.15 (95% CI, 1.76-2.62). In the fully adjusted model the OR was 1.76 (95% CI, 1.40 -2.21) for not recommending SA. CONCLUSIONS: Participants with negative attitudes to depression were more likely to not consider depression as a valid reason of sickness absence. The study supports theories on layered stigma; attitudes from one arena are related to other arenas. Future studies are needed to confirm our findings.

Real-Time Emission and Exposure Measurements of Multi-walled Carbon Nanotubes during Production, Power Sawing, and Testing of Epoxy-Based Nanocomposites.

OBJECTIVES: The use of manufactured nanomaterials is increasing globally. Although multi-walled carbon nanotubes (CNTs) are used in a wide range of applications, only limited data are available on emissions and exposures during CNT composite production. No exposure data using portable aethalometers in the personal breathing zone (PBZ) to monitor occupational exposure to CNTs have yet been published. The aim of this study was to characterize emissions of and exposures to CNTs during CNT composite production, sawing, and shear testing. We also investigated whether real-time aethalometer measurements of equivalent black carbon (eBC) could be used as a proxy filter sampling of elemental carbon (EC). The presence of CNTs as surface contamination in the production facility was monitored since this could contribute to airborne exposure. METHODS: During CNT composite production in an industrial setting including both chemical and manufacturing laboratories, different work tasks (WTs) were studied with a combination of direct-reading instruments (aethalometer, aerodynamic particle sizer, condensation particle counter) and filter-based methods. Measurements were performed to monitor concentrations in the emission zone (EZ), PBZ, and background zone. The filter samples were analysed for EC and fibre concentration of CNTs using scanning electron microscopy (SEM). Additionally, surfaces in the facility were tape sampled for monitoring of CNT contamination, and analysed with SEM. RESULTS: Clear eBC peaks were observed in the PBZ during several WTs, most clearly during open handling of CNT powder. Power sawing emitted the highest particle number concentration in the EZ of both nanoparticles and coarse particles, but no individual airborne CNTs, agglomerates, or aggregates were detected. Airborne CNTs were identified, for example, in a filter sample collected in the PBZ of a worker during mixing of CNT epoxy. The airborne CNT particles were large agglomerates which looked like porous balls in the SEM images. Significant EC exposures were found in the inhalable fraction while all respirable fractions of EC were below detection. The highest inhalable EC concentrations were detected during the composite production. No significant correlation was found between inhalable EC and eBC, most likely due to losses of large EC containing particles in the sampling lines and inside the eBC monitor. In total, 39 tape samples were collected. Surface contamination of CNTs was detected on eight surfaces in the chemical and manufacturing laboratories, mainly in the near-field zone. Elongated CNT-like features were detected in the sawdust after sawing of CNT composite. CONCLUSIONS: Characterization of a workplace producing CNT composite showed that open handling of the CNT powder during weighing and mixing of CNT powder material generated the highest particle emissions and exposures. The portable direct-reading aethalometer provided time-resolved eBC exposure data with complementary information to time-integrated EC filter samples by linking peak exposures to specific WTs. Based on the results it was not possible to conclude that eBC is a good proxy of EC. Surface contamination of CNTs was detected on several surfaces in the near-field zone in the facility. This contamination could potentially be resuspended into the workplace air, and may cause secondary inhalation exposure.

Influence of variable oxygen concentration on the combustion derived release of radiocesium from boreal soil and peat.

Radiocesium, 137Cs, is one of the most common and dispersed human-made radionuclides. Substantial stocks of 137Cs are stored in organic layers, like soils and peat, as a consequence of nuclear weapons fallout and accidental releases. As climate warming progresses these organic layers are subject to enhanced risks of wildfires, especially in the vast boreal biome of the northern hemisphere. Reemission of 137Cs to the atmosphere is therefore presumed to increase. Here, we experimentally investigated the emissions and redistribution of 137Cs in smoldering fires of boreal soil and peat by varying the oxygen concentration during combustion. For both soil and peat, significantly more 137Cs was released through flaming combustion in 21% O2 (50% and 31%, respectively) compared to smoldering in reduced O2 environments (14% and 8%, respectively). The residual ashes were heavily enriched (>100%) in 137Cs. Hence, after a wildfire induced volatilization of 137Cs, there exists further pathways of 137Cs enriched ash to proliferate in the environment. These results serve as a link between wildfire combustion conditions and the mobility of the 137Cs inventory found in ground fuels of the boreal environment and can be valuable for radiological risk assessments in a warmer and a more nuclear energy reliant world.

Experimental wildfire induced mobility of radiocesium in a boreal forest environment.

Wildfires are expected to increase with warmer climate, which can contribute to the mobility and the resuspension of long-lived and potentially hazardous radionuclides. The release of 137Cs during combustion of dried litter, forest floor organic soil, and peat was investigated in a small-scale experimental set-up. Combustion conditions were varied to simulate different wildfire scenarios, and the fuels were dried organic material collected in a boreal environment of Sweden that was contaminated following the Chernobyl accident in 1986. The combustion-related release of 137Cs to the air was on average 29% of the initial fuel content, while 71% of the initial 137Cs remained in the ashes after the combustion. Peat and forest soil had the highest releases (39% and 37%, respectively), although these numbers should be viewed as potential releases since authentic wildfire combustion of these fuels are usually less effective than observed in these experiments. These results indicates that the 137Cs has migrated downwards in the organic material, which imply potentially significantly more 137Cs emissions in severe wildfires with intense combustion of the organic vertical profile in peatbogs and forests. More 137Cs tended to be released during intense and efficient combustion processes, although no significant differences among combustion intensities were observed. The generated experimental data was used in an emission scenario to investigate the possible range in 137Cs emissions from a wildfire. Our study shows that a severe wildfire in a contaminated area of 10,000 ha could potentially release up to 7 TBq of 137Cs. This is the first laboratory study to investigate 137Cs release upon varying combustion conditions using real fallout contaminated organic material obtained from a boreal environment.

Maximizing avertable doses with a minimum amount of waste for remediation of land areas around typical single family houses after radioactive fallout based on Monte Carlo simulations.

The uncontrolled release of long-lived radioactive substances from nuclear accidents can contaminate inhabited land areas. The removal of topsoil is an important method for reducing future radiation exposure but can also generate a large amount of waste that needs safe disposal. To the best of our knowledge, previous studies have determined the optimal depth of topsoil removal but not the size of the area designated for this measure. For this purpose, this study performed Monte Carlo simulations of hypothetical 137Cs surface contamination on various ground areas in a typical northern European suburban area. The goal was to study the size of the areas needed and amount of waste generated to achieve a certain relative and absolute dose reduction. The results showed that removing the topsoil from areas larger than 3000 m2 around the houses in the study neighbourhood results in only marginal reduction in radiation exposure. If, on average, 5 cm of topsoil is removed over 3000 m2, then 150 m3 of waste would be generated. However, in this scenario adjacent properties benefit from each other's decontamination, leading to a smaller amount of waste for a given reduction in future radiation exposure per inhabitant of these dwellings. Additionally, it was shown that topsoil removal over limited areas has a higher impact on the absolute dose reduction at an observation point inside or outside the houses with higher initial dose.

Emissions and exposures of graphene nanomaterials, titanium dioxide nanofibers, and nanoparticles during down-stream industrial handling.

Today, engineered nanomaterials are frequently used. Nanosized titanium dioxide (TiO2) has been extensively used for many years and graphene is one type of emerging nanomaterial. Occupational airborne exposures to engineered nanomaterials are important to ensure safe workplaces and to extend the information needed for complete risk assessments. The main aim of this study was to characterize workplace emissions and exposure of graphene nanoplatelets, graphene oxide, TiO2 nanofibers (NFs) and nanoparticles (NPs) during down-stream industrial handling. Surface contaminations were also investigated to assess the potential for secondary inhalation exposures. In addition, a range of different sampling and aerosol monitoring methods were used and evaluated. The results showed that powder handling, regardless of handling graphene nanoplatelets, graphene oxide, TiO2 NFs, or NPs, contributes to the highest particle emissions and exposures. However, the exposure levels were below suggested occupational exposure limits. It was also shown that a range of different methods can be used to selectively detect and quantify nanomaterials both in the air and as surface contaminations. However, to be able to make an accurate determination of which nanomaterial that has been emitted a combination of different methods, both offline and online, must be used.

Monte-Carlo simulations of external dose contributions from the surrounding ground areas of residential homes in a typical Northern European suburban area after a radioactive fallout scenario.

The emissions of [Formula: see text] into the environment from the nuclear accidents in Chernobyl in 1986 and Fukushima in 2011 led to the need to decontaminate large areas to avert radiation doses to the population in the affected areas. To be able to perform cost-effective and sustainable remediation, knowledge is needed about how radiation doses can be minimized through optimized interventions such that the greatest possible reduction in radiation dose is obtained with the smallest possible negative impact on the area. Theoretical calculations have been performed to determine how radiation doses in single family houses in a typical Swedish residential suburb arise from a hypothetical [Formula: see text] deposition on the ground. The intention was to highlight how remediation of different parts of the surroundings affects the radiation dose to the residents in a particular property. A Monte Carlo model of the houses and the environment in a suburban area was set up to allow calculations of the dose contributions from different contaminated ground areas such as their own property, neighbouring properties, streets and surrounding recreational areas. Calculations were performed for eleven observation points inside different rooms of the house and one observation point in the garden outside the house, for four houses in the neighbourhood, and for two types of building construction material. The influence of the time spent in different rooms of the house and the contamination of areas surrounding the house was studied. The results show that in general the main dose contribution originates from their own property, but that a significant part (30-80%, depending on the observation point) can come from other areas, showing the importance of considering the surroundings in remediation actions. More detailed analysis of the results showed that the dose contribution from a source region is in general highly dependent on the position of windows in a brick house, whereas for a wooden house the distance to the source region is also of relevance.

Political Ideology and Stigmatizing Attitudes Toward Depression: The Swedish Case.

BACKGROUND: Stigmatizing attitudes toward persons with mental disorders is a well-established and global phenomenon often leading to discrimination and social exclusion. Although previous research in the United States showed that conservative ideology has been related to stigmatizing attitudes toward mental disorders, there is reason to believe that this mechanism plays a different role in the context of a universal welfare state with a multi-party system such as Sweden. Furthermore, "mental disorders" may signify severe psychotic disorders, which may evoke more negative attitudes. This suggests the importance of specific studies focusing on the more common phenomenon of depression. This paper investigates the relationship between political ideology and stigmatizing attitudes toward depression in Sweden. METHODS: This study is part of the New Ways research program. Data were collected by the Laboratory of Opinion Research (LORE) at the University of Gothenburg in 2014 (N = 3246). Independent variables were political ideology and party affiliation. The dependent variable was the Depression Stigma Scale (DSS). Data were analyzed with linear regression analyses and analyses of variance. RESULTS: More conservative ideology (B = 0.68, standard error [SE] = 0.04, P<.001) and more conservative party affiliation (F(8 2920) = 38.45, P<.001) showed more stigmatizing attitudes toward depression. Item-level analyses revealed a difference where the supporters of the conservative party differed (P<.05) from supporters of the liberal party, with a higher proportion agreeing that "people could snap out of " depression if they wanted to; the populist right-wing party differed from the conservative party with a higher proportion agreeing on items displaying people with depression as "dangerous" and "unpredictable." Even self-stigma was highest among the populist right-wing party with 22.3% agreeing that "if I had depression I wouldn't tell…." CONCLUSION: Political ideology was associated with stigmatizing attitudes toward depression in Sweden. The results also confirm the need to distinguish between different forms of conservatism by observing social distance as being a more important driver among voters for the populist right-wing party compared with personal agency and responsibility among voters for the more traditional conservative party.

Influence of the migration of radioactive contaminants in soil, resident occupancy, and variability in contamination on isodose lines for typical Northern European houses.

In the remedial phase following an accidental radioactive release, it is important that soil decontamination measures are carried out on the areas that contribute most to the radiation dose. In this study, the newly developed concept of isodose lines was applied to the area around typical Swedish dwellings to identify these areas. The influence of the most common building materials in Sweden, wood and brick, and the importance of the positions of doors and windows on the isodose lines were demonstrated for specific positions inside the houses, as well as for the entire house, assuming the residents exhibit typical resident occupancy. Decontamination of the areas within certain isodose lines was shown to result in a greater dose reduction than decontaminating the same area of soil within a certain distance of the house. Furthermore, the impact of vertical migration of the radioactive contaminants in the soil on the isodose lines was studied, showing that the area enclosed by isodose lines decreases over time as the contaminants migrate deeper into the soil. The resulting isodose lines and their change over time are dominated by the downward movement of the contamination in the upper layer of soil. The impact of the variability in contamination on the final isodose lines and their dependence on building materials are demonstrated.

Attitudes towards sales and use of over-the-counter drugs in Sweden in a reregulated pharmacy market: a population-based study.

OBJECTIVES: To analyse attitudes towards sales and use of over-the-counter (OTC) drugs in the Swedish adult population. METHODS: Data were collected through the web-based Citizen Panel comprising 21 000 Swedes. A stratified sample of 4058 participants was emailed a survey invitation. Questions concerned use of OTC drugs, and attitudes towards sales and use of OTC drugs. Correlations between the attitudinal statements were assessed using Spearman's rank correlation. Associations between attitudes and participant characteristics were analysed using multinomial logistic regression. KEY FINDINGS: Participation rate was 64%. Altogether 87% reported use of OTC drugs in the last 6 months. Approximately 10% of participants stated that they used OTC drugs at the first sign of illness, and 9% stated that they used more OTC drugs compared with previously, due to increased availability. The statement on use of OTC drugs at first sign of illness correlated with the statement about using more OTC drugs with increased availability. Socio-demographic factors (age, sex and education) and frequent use of OTC drugs were associated with attitudes to sales and use of OTC drugs. CONCLUSIONS: Increased use due to greater availability, in combination with OTC drug use at first sign of illness illustrates the need for continuous education of the population about self-care with OTC drugs. Increased awareness of the incautious views on OTC drugs in part of the population is important. Swedish policy-makers may use such knowledge in their continuous evaluation of the 2009 pharmacy reform to review the impact of sales of OTC drugs in retail outlets on patient safety and public health. Pharmacy and healthcare staff could be more proactive in asking customers and patients about their use of OTC drugs and offering them advice.

Towards the isolation and estimation of elemental carbon in atmospheric aerosols using supercritical fluid extraction and thermo-optical analysis.

Air-starved combustion of biomass and fossil fuels releases aerosols, including airborne carbonaceous particles, causing negative climatic and health effects. Radiocarbon analysis of the elemental carbon (EC) fraction can help apportion sources of its emission, which is greatly constrained by the challenges in isolation of EC from organic compounds in atmospheric aerosols. The isolation of EC using thermo-optical analysis is however biased by the presence of interfering compounds that undergo pyrolysis during the analysis. EC is considered insoluble in all acidic, basic, and organic solvents. Based on the property of insolubility, a sample preparation method using supercritical CO2 and methanol as co-solvent was developed to remove interfering organic compounds. The efficiency of the method was studied by varying the density of supercritical carbon dioxide by means of temperature and pressure and by varying the methanol content. Supercritical CO2 with 10% methanol by volume at a temperature of 60 °C, a pressure of 350 bar and 20 min static mode extraction were found to be the most suitable conditions for the removal of 59 ± 3% organic carbon, including compounds responsible for pyrolysis with 78 ± 16% EC recovery. The results indicate that the method has potential for the estimation and isolation of EC from OC for subsequent analysis methods and source apportionment studies.

Consumer preferences for over-the-counter drug retailers in the reregulated Swedish pharmacy market.

Following a large regulatory reform in 2009, which ended the state's pharmacy monopoly, non-pharmacy retailers in Sweden today sell certain over-the-counter (OTC) drugs. The aim of this study was to investigate consumer preferences regarding OTC drug retailers and the reasons for choosing a pharmacy versus non-pharmacy retailer. We conducted a web survey aimed at Swedish adults. Out of a stratified sample of 4058 persons, 2594 agreed to take part (48% women; mean age: 50.3 years). Questions related to OTC drug use, retailer choice and factors affecting the participants' preferences for OTC drug retailers. Logistic regression was conducted to analyse OTC drug use and reasons for retailer choice in relation to sex, age and education. Nine in ten participants reported OTC drug use in the 6 months prior to the study. For their last OTC purchase, 76% had gone to a pharmacy, 20% to a grocery shop and 4% to a convenience store, gas station or online. Geographic proximity, opening hours and product range were reported as the most important factors in retailer choice. Counselling by trained staff was important to 57% of participants. The end of the state's pharmacy monopoly and the increase in number of pharmacies seem to have impacted more on Swedish consumers' purchase behaviours compared with the deregulation of OTC drug sales.