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1.
Cancer Causes Control ; 32(9): 935-942, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34050843

RESUMO

PURPOSE: The etiology of Hodgkin lymphoma (HL) is obscure. Research on air pollution and risk of HL provides inconsistent results. We aimed to investigate the association between long-term residential exposure to air pollution and risk of adult Hodgkin lymphoma in Denmark. METHODS: We performed a nationwide register-based case-control study, including all (n = 2,681) Hodgkin lymphoma cases registered in the nationwide Danish Cancer Registry between 1989 and 2014. We randomly selected 8,853 age- and sex-matched controls from the entire Danish population using the Civil Registration System, and identified 20-year residential address history for all cases and controls. We modeled outdoor air pollution concentrations at all these addresses using the high-resolution multiscale air pollution model system DEHM/UBM/AirGIS. We used conditional logistic regression to estimate odds ratios adjusted for individual and neighborhood level sociodemographic variables. RESULTS: There was no association between 1, 5, 10, and 20 years' time-weighted average exposure to fine particles (PM2.5), O3, SO2, NO2, or the PM2.5 constituents OC, NH4, NO3, and SO4 and risk of Hodgkin lymphoma. CONCLUSION: Residential exposure to ambient air pollution does not seem to increase the risk of developing Hodgkin lymphoma.


Assuntos
Poluição do Ar , Doença de Hodgkin , Adulto , Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Estudos de Casos e Controles , Dinamarca/epidemiologia , Exposição Ambiental/efeitos adversos , Doença de Hodgkin/epidemiologia , Doença de Hodgkin/etiologia , Humanos , Material Particulado
2.
Environ Res ; 196: 110418, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33157111

RESUMO

BACKGROUND: Leukemia is one of the most common forms of hematologic malignancy, which can affect people of all ages. We previously showed an association between exposure to ambient particulate matter 2.5 µg (PM2.5) and risk for leukemia in adults. The aim of this study was to investigate which PM2.5 constituents were responsible for our previous observation. METHODS: This is a nationwide register-based case-control study. We identified 14,983 persons diagnosed with leukemia at age 20 or above, 1989-2014, in the Danish Cancer Registry. We selected up to four sex and age-matched controls per case at random from the entire Danish population (n = 51,613). We modelled concentrations of ambient PM2.5 and its constituents at the addresses of cases and controls for the 10-year period before index date with a state-of-the-art multiscale air pollution modeling system. We used conditional logistic regression to estimate odds ratios (ORs) adjusted for individual and neighborhood level socio-demographic variables. RESULT: The results showed higher risk for overall leukemia in association with interquartile range exposure to PM2.5 (OR = 1.09; 95% CI: 1.02, 1.17), black carbon (BC) (OR = 1.02; 95% CI: 1.00, 1.03), secondary inorganic aerosols (SIA) (OR = 1.15; 95% CI: 1.03, 1.29) and its components ammonium (NH4) (OR = 1.08; 95% CI: 1.00, 1.17) and nitrate (NO3) (OR = 1.08; 95% CI: 1.02, 1.14). In leukemia subtype analysis, statistically significant associations were found for AML with PM2.5 (OR = 1.14; 95% CI: 1.00, 1.29), BC (OR = 1.03; 95% CI: 1.00, 1.07), SIA (OR = 1.23; 95% CI: 1.01, 1.51), NH4 (OR = 1.16; 95% CI: 1.01, 1.34) and NO3 (OR = 1.12; 95% CI: 1.01, 1.24). The association between PM2.5 and leukemia persisted in two pollutants models including sum of primary emitted black and organic carbon (BC + OC), secondary organic aerosols (SOA), or sea-salt. The association between black carbon (BC) and leukemia persisted in two pollutants models including organic carbon (OC). The three pollutant model with sulfate (SO4), NH4 and NO3 showed an association with NO3 but not with SO4 or NH4. CONCLUSION: Ambient concentrations of the PM2.5 components BC, NH4 and NO3 at the residence showed associations with risk of incident leukemia in adults.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Leucemia , Adulto , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Estudos de Casos e Controles , Dinamarca/epidemiologia , Exposição Ambiental/análise , Humanos , Leucemia/induzido quimicamente , Leucemia/epidemiologia , Material Particulado/efeitos adversos , Material Particulado/análise , Adulto Jovem
3.
Scand J Work Environ Health ; 47(1): 52-61, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32725248

RESUMO

Objective This study investigated whether low-to-moderate exposure to welding fumes is associated with adverse effects on the cardiovascular system. Methods To test this, we performed a longitudinal analysis of 78 mild steel welders and 96 controls; these subjects were examined twice, six years apart (ie, timepoints 1 and 2). All subjects (male and non-smoking at recruitment) completed questionnaires describing their health, work history, and lifestyle. We measured their blood pressure, endothelial function (by EndoPAT), and risk markers for cardiovascular disease [low-density lioprotein (LDL), homocysteine, C-reactive protein]. Exposure to welding fumes was assessed from the responses to questionnaires and measurements of respirable dust in their breathing zones adjusted for use of respiratory protection equipment. Linear mixed-effect regression models were used for the longitudinal analysis. Results Median respirable dust concentrations, adjusted for respirable protection, of the welders were 0.7 (5-95 percentile range 0.2-4.2) and 0.5 (0.1-1.9) mg/m 3at timepoints 1 and 2, respectively. Over the six-year period, welders showed a statistically significant increase in systolic [5.11 mm Hg, 95% confidence interval (CI) 1.92-8.31] and diastolic (3.12 mm Hg, 95% CI 0.74-5.5) blood pressure compared with controls (multi-variable adjusted mixed effect models). Diastolic blood pressure increased non-significantly by 0.22 mm Hg (95% CI -0.02-0.45) with every additional year of welding work. No consistent significant associations were found between exposure and endothelial function, LDL, homocysteine, or C-reactive protein. Conclusion Exposure to welding fumes at low-to-moderate levels is associated with increased blood pressure, suggesting that reducing the occupational exposure limit (2.5 mg/m 3for inorganic respirable dust in Sweden) is needed to protect cardiovascular health of workers.

4.
Annu Rev Public Health ; 42: 193-210, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33348996

RESUMO

This review highlights the importance of air quality in the African urban development process. We address connections between air pollution and (a) rapid urbanization, (b) social problems, (c) health impacts, (d) climate change, (e) policies, and (f) new innovations. We acknowledge that air pollution levels in Africa can be extremely high and a serious health threat. The toxic content of the pollution could relate to region-specific sources such as low standards for vehicles and fuels, cooking with solid fuels, and burning household waste. We implore the pursuit of interdisciplinary research to create new approaches with relevant stakeholders. Moreover, successful air pollution research must regard conflicts, tensions, and synergies inherent to development processes in African municipalities, regions, and countries. This includes global relationships regarding climate change, trade, urban planning, and transportation. Incorporating aspects of local political situations (e.g., democracy) can also enhance greater political accountability and awareness about air pollution.


Assuntos
Poluição do Ar , Saúde Pública , África , Humanos
5.
Front Public Health ; 8: 422, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32984236

RESUMO

Welders are exposed to high levels of metal particles, consisting mainly of iron and manganese (Mn) oxide. Metal particles, especially those containing Mn can be neurotoxic. In this exploratory study, we evaluated associations between welding and expression of 87 putative neurology-related proteins in serum in a longitudinal approach. The study cohort from southern Sweden included welders working with mild steel (n = 56) and controls (n = 67), all male and non-smoking, which were sampled at two timepoints (T1, T2) 6-year apart. Observed associations in the longitudinal analysis (linear mixed models) were further evaluated (linear regression models) in another cross-sectional sample which included welders (n = 102) and controls (n = 89) who were sampled only once (T1 or T2). The median respirable dust levels for welders after adjusting for respiratory protection was at T1 0.6 (5-95 percentile: 0.2-4.2) and at T2 0.5 (0.1-1.8) mg/m3. The adjusted median respirable Mn concentration was at T2 0.049 mg/m3 (0.003-0.314) with a Spearman correlation between adjusted respirable dust and respirable Mn of r S = 0.88. We identified five neurology-related proteins that were differentially expressed in welders vs. controls in the longitudinal sample, of which one (nicotinamide/nicotinic acid mononucleotide adenylyltransferase 1; NMNAT1) was also differentially expressed in the cross-sectional sample. NMNAT1, an axon-protective protein linked to Alzheimers disease, was upregulated in welders compared with controls but no associations were discerned with degree of exposure (welders only: years welding, respirable dust, cumulative exposure). However, we identified five additional proteins that were associated with years welding (GCSF, EFNA4, CTSS, CLM6, VWC2; welders only) both in the longitudinal and in the cross-sectional samples. We also observed several neurology-related proteins that were associated with age and BMI. Our study indicates that low-to-moderate exposure to welding fumes is associated with changes in circulating levels of neurology-related proteins.


Assuntos
Poluentes Ocupacionais do Ar , Nicotinamida-Nucleotídeo Adenililtransferase , Exposição Ocupacional , Soldagem , Poluentes Ocupacionais do Ar/efeitos adversos , Proteínas Sanguíneas , Estudos Transversais , Humanos , Estudos Longitudinais , Masculino , Exposição Ocupacional/efeitos adversos , Aço , Suécia
6.
Br J Cancer ; 123(12): 1818-1824, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32939055

RESUMO

BACKGROUND: Few population-based epidemiological studies of adults have examined the relationship between air pollution and leukaemias. METHODS: Using Danish National Cancer Registry data and Danish DEHM-UBM-AirGIS system-modelled air pollution exposures, we examined whether particulate matter (PM2.5), black carbon (BC), nitrogen dioxide (NO2) and ozone (O3) averaged over 1, 5 or 10 years were associated with adult leukaemia in general or by subtype. In all, 14,986 adult cases diagnosed 1989-2014 and 51,624 age, sex and time-matched controls were included. Separate conditional logistic regression models, adjusted for socio-demographic factors, assessed exposure to each pollutant with leukaemias. RESULTS: Fully adjusted models showed a higher risk of leukaemia with higher 1-, 5- and 10-year-average exposures to PM2.5 prior to diagnosis (e.g. OR per 10 µg/m3 for 10-year average: 1.17, 95% CI: 1.03, 1.32), and a positive relationship with 1-year average BC. Results were driven by participants 70 years and older (OR per 10 µg/m3 for 10-year average: 1.35, 95% CI: 1.15-1.58). Null findings for younger participants. Higher 1-year average PM2.5 exposures were associated with higher risks for acute myeloid and chronic lymphoblastic leukaemia. CONCLUSION: Among older adults, higher risk for leukaemia was associated with higher residential PM2.5 concentrations averaged over 1, 5 and 10 years prior to diagnosis.


Assuntos
Poluentes Atmosféricos/toxicidade , Poluição do Ar/efeitos adversos , Exposição Ambiental/efeitos adversos , Leucemia/etiologia , Material Particulado/toxicidade , Adulto , Idoso , Estudos de Casos e Controles , Dinamarca/epidemiologia , Feminino , Humanos , Incidência , Leucemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Dióxido de Nitrogênio/toxicidade , Ozônio/toxicidade , Fuligem/toxicidade , Fatores de Tempo , Adulto Jovem
7.
Environ Res ; 188: 109762, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32535359

RESUMO

BACKGROUND: Particulate matter (PM) air pollution is a complex mixture and the various PM constituents likely affect health differently. The literature on the relationships among specific PM constituents and the risk of cancer is sparse. In this study, we aimed to evaluate the association of PM2.5 and its constituents with the incidence of non-Hodgkin lymphoma (NHL) and the two main NHL subtypes. METHODS: We undertook a nationwide register-based case-control study including 20,847 cases registered in the Danish Cancer Registry with NHL between 1989 and 2014. Among the entire Danish population, we selected 41,749 age and sex-matched controls randomly from the Civil Registration System. We assessed modelled outdoor PM concentrations at addresses of cases and controls with a state-of-the-art multi scale air pollution modelling system and used conditional logistic regression to estimate odds ratios (ORs) adjusted for individual and neighborhood level socio-demographic variables. RESULTS: The 10-year time-weighted average concentrations of PM2.5, primary carbonaceous particles (BC/OC), secondary inorganic aerosols (SIA), secondary organic aerosols (SOA) and sea salt were 17.4, 2.3, 7.8, 0.3, and 4.1 µg/m3, respectively among controls. The results showed higher risk for NHL in association with exposure to BC/OC (OR = 1.03; 95% CI: 1.00, 1.07, per interquartile range (IQR)) and SOA (OR = 1.54; 95% CI: 1.13, 2.09, per IQR). The results indicated a higher risk for follicular lymphoma in association with several PM components. Including PM2.5 (OR = 1.16; 95% CI: 0.98-1.38), BC/OC (OR = 1.05; 95% CI: 0.97-1.14), SIA (OR = 1.44; 95% CI: 0.80-1.08), SOA (OR = 4.52; 95% CI: 0.86-23.83) per IQR. CONCLUSION: This is the first study on PM constituents and the risk of NHL. The results indicated an association with primary carbonaceous and secondary organic PM. The results need replication in other settings before any firm conclusion can be reached.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Linfoma não Hodgkin , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Estudos de Casos e Controles , Dinamarca/epidemiologia , Exposição Ambiental/efeitos adversos , Humanos , Linfoma não Hodgkin/induzido quimicamente , Linfoma não Hodgkin/epidemiologia , Material Particulado/análise , Material Particulado/toxicidade
8.
Int J Cancer ; 147(7): 1874-1880, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32175588

RESUMO

There is limited evidence regarding a possible association between exposure to ambient air pollutants and the risk of non-Hodgkin lymphoma (NHL). Previous epidemiological studies have relied on crude estimations for air pollution exposure and/or small numbers of NHL cases. The objective of our study was to analyze this association based on air pollution modeled at the address level and NHL cases identified from the nationwide Danish Cancer Registry. We identified 20,874 incident NHL cases diagnosed between 1989 and 2014 and randomly selected 41,749 controls matched on age and gender among the entire Danish population. We used conditional logistic regression to estimate odds ratios (ORs) and adjusted for individual and neighborhood level sociodemographic variables. There was no association between exposure to PM2.5 , BC, O3 , SO2 or NO2 and overall risk of NHL but several air pollutants were associated with higher risk of follicular lymphoma, but statistically insignificant, for example, PM2.5 (OR = 1.15 per 5 µg/m3 ; 95% CI: 0.98-1.34) and lower risk for diffuse large B-cell lymphoma (OR = 0.92 per 5 µg/m3 ; 95% CI: 0.82-1.03). In this population-based study, we did not observe any convincing evidence of a higher overall risk for NHL with higher exposure to ambient air pollutants.


Assuntos
Poluição do Ar/análise , Linfoma não Hodgkin/epidemiologia , Adulto , Poluição do Ar/efeitos adversos , Estudos de Casos e Controles , Dinamarca/epidemiologia , Feminino , Humanos , Modelos Logísticos , Linfoma não Hodgkin/etiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros
9.
Arch Toxicol ; 93(12): 3535-3547, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31641807

RESUMO

Welding fumes were recently classified as carcinogenic to humans and worldwide millions work as welders or perform welding operations. The purpose of this study was to identify new biomarkers of welding-induced carcinogenesis. We evaluated a panel of 91 putative cancer-related proteins in serum in a cohort of welders working with mild steel (n = 77) and controls (n = 94) from southern Sweden sampled on two occasions 6-year apart using a longitudinal analysis (linear mixed models). The significant results from the longitudinal analysis were tested for reproducibility in welders (n = 88) and controls (n = 69) sampled once during the same sampling period as timepoint 1 or timepoint 2 (linear regression models), i.e., in a cross-sectional setting. The models were adjusted for age, body-mass index, and use of snus. All study participants were non-smokers at recruitment. Exposure to welding fumes was assessed using questionnaires and respirable dust measurement in the breathing zone that was adjusted for personal respiratory protection equipment. The median respirable dust in welders was 0.7 (0.2-4.2) and 0.5 (0.1-1.9) mg/m3 at the first and second timepoints, respectively. We identified 14 cancer-related proteins that were differentially expressed in welders versus controls in the longitudinal analysis, out of which three were also differentially expressed in the cross-sectional analysis (cross-sectional group). Namely, syndecan 1 (SDC1), folate receptor 1 (FOLR1), and secreted protein acidic and cysteine rich (SPARC) were downregulated, in welders compared with controls. In addition, FOLR1 was negatively associated with years welding. Disease and function analysis indicated that the top proteins are related to lung cancer as well as cell invasion and migration. Our study indicates that moderate exposure to welding fumes is associated with changes in circulating levels of putative cancer-related proteins, out of which FOLR1 showed a clear dose-response relationship. It is, however, unclear to which extent these changes are adaptive or potential early biomarkers of cancer.


Assuntos
Biomarcadores Tumorais/sangue , Proteínas de Neoplasias/sangue , Neoplasias/sangue , Exposição Ocupacional/efeitos adversos , Soldagem , Adulto , Estudos de Casos e Controles , Estudos Transversais , Biomarcadores Ambientais , Receptor 1 de Folato/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Osteonectina/sangue , Análise de Componente Principal , Aço , Suécia , Sindecana-1/sangue
10.
Environ Int ; 130: 104908, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31233999

RESUMO

There is increasing evidence that environmental manganese (Mn) exposure early in life can have negative effects on children's neurodevelopment and increase the risk of behavioral problems, including attention deficit hyperactivity disorder (ADHD). Factors that may contribute to differences in sensitivity to Mn exposure are sex and genetic variation of proteins involved in the regulation of Mn concentrations. Here we investigate if sex and polymorphisms in Mn transporter genes SLC30A10 and SLC39A8 influence the association between Mn exposure and ADHD-related behavioral problems in children. The SNPs rs1776029 and rs12064812 in SLC30A10, and rs13107325 in SLC39A8 were genotyped by TaqMan PCR or pyrosequencing in a population of Italian children (aged 11-14 years; n = 645) with a wide range of environmental Mn exposure. Mn in surface soil was measured in situ using XRF technology or modeled by geospatial analysis. Linear regression models or generalized additive models (GAM) were used for analyzing associations between soil Mn and neurobehavioral problems assessed by the Conners' behavior rating scales (self-, and parent-reported). Gene-environment interactions (Mn transporter genotype x soil Mn) were evaluated using a genetic score in which genotypes for the three SNPs were combined based on their association with blood Mn, as an indication of their influence on Mn regulation. We observed differences in associations between soil Mn and neurobehavior between sexes. For several self-reported Conners' scales, girls showed U-shaped relationships with higher (worse) Conners' scoring at higher soil Mn levels, and several parent-reported scales showed positive linear relationships between increasing soil Mn and higher Conner's scores. For boys, we observed a positive linear relationship with soil Mn for one Conner's outcome only (hyperactivity, parent-reported). We also observed some interactions between soil Mn and the genetic score on Conner's scales in girls and girls with genotypes linked to high blood Mn showed particularly strong positive associations between soil Mn and parent-reported Conners' scales. Our results indicate that sex and polymorphisms in Mn transporter genes contribute to differences in sensitivity to Mn exposure from the environment and that girls that are genetically less efficient at regulating Mn, may be a particularly vulnerable group.


Assuntos
Comportamento Infantil , Exposição Ambiental , Manganês , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/genética , Proteínas de Transporte de Cátions/genética , Criança , Exposição Ambiental/análise , Exposição Ambiental/estatística & dados numéricos , Feminino , Humanos , Masculino , Manganês/análise , Manganês/metabolismo , Comportamento Problema
11.
World Allergy Organ J ; 11(1): 9, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29796150

RESUMO

Background: Atopic disorders are a global concern. Studies in migrant populations can illuminate the interplay of genetic and environmental factors. Exposures related to bad housing (indoor dampness, mould growth, crowding etc.) are likely to play a role in how socioeconomic inequalities can turn into health disparities for disadvantaged populations. The sizable immigrant population living in very poor-quality housing in Malmö, Sweden, became the focus of a cross-sectional study. Objective: To describe atopic disorders and sensitizations in a population living in substandard housing in Malmö, Sweden, with an emphasis on their relation to harmful exposures from the built environment. Methods: Families were recruited via identification of any children with symptomatic airway afflictions from health care records, and also asymptomatic children from school lists. Interviewer-led health questionnaire data and data from self-reports about living conditions were obtained together with data from home inspections carried out by health communicators. Families underwent skin prick tests (SPT) against common aeroallergens. Results: As could be expected from background demographic information, it turned out that we effectively studied an immigrant population inhabiting very precarious housing outside the center of Malmö. A total of 359 children from 130 families (total 650 participants) were included. Overall the prevalence of potentially harmful environmental exposures was high (signs of moisture or mould in more than 50% of apartments, indoor smoking in 37% of households). Atopic disorders were common among both adults and children. SPTs showed a spectrum of sensitizations consistent with unselected populations in Sweden. Paternal sensitization in the SPT was associated with higher risk of sensitization for offspring than maternal sensitization. Few statistically significant associations of atopic sensitization with studied environmental exposures were detected (for example objective signs of dampness /mould in bathrooms). There were marked discrepancies between asthma diagnoses obtained from the health records and parental reports of such diagnoses and treatment for their children. Conclusions: The atopic burden in this selected immigrant population was high, and results point to unmet medical needs. Health care systems caring for such populations need to be aware of their specific health needs; comprehensive asthma and allergy care should include consideration of harmful environmental exposures, adhering to the precautionary principle.

12.
Artigo em Inglês | MEDLINE | ID: mdl-28561792

RESUMO

Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 µg/m³ increase in nitrogen dioxide (NO2) levels in Malmö, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 µg/m³ increase in PM10). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area.


Assuntos
Poluição do Ar/análise , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Doenças Respiratórias/epidemiologia , Adulto , Poluentes Atmosféricos/análise , Cidades/epidemiologia , Feminino , Humanos , Masculino , Dióxido de Nitrogênio/análise , Material Particulado/análise , Suécia/epidemiologia
13.
PLoS One ; 11(11): e0166614, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27861543

RESUMO

BACKGROUND AND AIMS: Asthma is one of the most common respiratory diseases in the world. Research has shown that temporal increases in air pollution concentrations can aggravate asthma symptoms. The aim of this study was to assess whether individuals living in areas with higher air pollution concentrations responded differently to short-term temporal exposure to air pollution than those living in lower air pollution areas. METHOD: The study was designed as a case-crossover study in Scania, Sweden. Outcome data was visits to primary health care clinics with asthma as the main complaint during the years 2007 to 2010. Nitrogen dioxide levels were obtained from 21 different air pollution monitoring stations. Short-term exposure was defined as the average concentration four days prior to the visit. Data was pooled for areas above and below a two-year average NO2 concentration of 10 µg/m3, dispersion modelled with an emission database. RESULTS: The short-term association between NO2 and asthma visits seemed stronger in areas with NO2 levels below 10 µg/m3, with an odds ratio (OR) of 1.15 (95% confidence interval (CI): 1.08-1.23) associated with a 10 µg/m3 increase in NO2 compared to areas above 10 µg/m3 NO2 levels, where corresponding OR of 1.09 (95% CI: 1.02-1.17). However, this difference was not statistically significant. (p = 0.13). CONCLUSIONS: The study provided some evidence, although not statistically significant, that short-term associations between air pollution and asthma may depend on background air pollution levels. However, we cannot rule out that the association is due to other spatially dependent factors in Scania. The study should be reproduced in other study areas.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Asma/epidemiologia , Asma/etiologia , Adulto , Idoso , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Exposição Ambiental , Monitoramento Ambiental , Feminino , Geografia , Humanos , Masculino , Pessoa de Meia-Idade , Dióxido de Nitrogênio/efeitos adversos , Razão de Chances , Suécia/epidemiologia , Fatores de Tempo
14.
Spat Spatiotemporal Epidemiol ; 17: 37-44, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-27246271

RESUMO

BACKGROUND: Air pollution can increase the symptoms of asthma and has an acute effect on the number of emergency room visits and hospital admissions because of asthma, but little is known about the effect of air pollution on the number of primary health care (PHC) visits for asthma. OBJECTIVE: To investigate the association between air pollution and the number of PHC visits for asthma in Scania, southern Sweden. METHODS: Data on daily PHC visits for asthma were obtained from a regional healthcare database in Scania, which covers approximately half a million people. Air pollution data from 2005 to 2010 were obtained from six urban background stations. We used a case-crossover study design and a distributed lag non-linear model in the analysis. RESULTS: The air pollution levels were generally within the EU air quality guidelines. The mean number of daily PHC visits for asthma was 34. The number of PHC visits increased by 5% (95% confidence interval (CI): 3.91-6.25%) with every 10µg m(-3) increase in daily mean NO2 lag (0-15), suggesting that daily air pollution levels are associated with PHC visits for asthma. CONCLUSION: Even though the air quality in Scania between 2005 and 2010 was within EU's guidelines, the number of PHC visits for asthma increased with increasing levels of air pollution. This suggests that as well as increasing hospital and emergency room visits, air pollution increases the burden on PHC due to milder symptoms of asthma.


Assuntos
Poluição do Ar/estatística & dados numéricos , Asma/epidemiologia , Visita a Consultório Médico/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Poluentes Atmosféricos/análise , Estudos Cross-Over , Humanos , Dinâmica não Linear , Suécia/epidemiologia , População Urbana
15.
BMJ Open ; 6(1): e007979, 2016 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-26739718

RESUMO

OBJECTIVES: To describe the home environment in terms of housing conditions and their association with child health in a disadvantaged immigrant population. DESIGN: A cross-sectional observational study. SETTING: Enrolment took place during 2010-2011 in Rosengård, Malmö, Sweden. PARTICIPANTS: Children aged 0-13 years in 2 study neighbourhoods were recruited from local health records and from schools. 359 children participated, with a participation rate of 40%. Data on health, lifestyle and apartment characteristics from questionnaire-led interviews with the mothers of the children were obtained together with data from home inspections carried out by trained health communicators. OUTCOME MEASURES: Logistic regression analysis was used to estimate ORs for various health outcomes, adjusted for demographic information and lifestyle factors. RESULTS: The housing conditions were very poor, especially in one of the study neighbourhoods where 67% of the apartments had been sanitised of cockroaches, 27% were infested with cockroaches and 40% had a visible mould. The association between housing conditions and health was mostly inconclusive, but there were statistically significant associations between current asthma and dampness (OR=4.1, 95% CI 1.7 to 9.9), between asthma medication and dampness (OR=2.8, 95% CI 1.2 to 6.4), and between mould and headache (OR=4.2, 95% CI 1.2 to 14.8). The presence of cockroaches was associated with emergency care visits, with colds, with headache and with difficulty falling asleep, and worse general health was associated with mould and presence of cockroaches. CONCLUSIONS: The associations between dampness and asthma, and the association between mould and headache, are in line with current knowledge. The presence of cockroaches seemed to be associated with various outcomes, including those related to mental well-being, which is less described in the literature. The results of the present study are hypothesis generating and provide strong incentives for future studies in this study population.


Assuntos
Saúde da Criança , Baratas , Emigrantes e Imigrantes , Fungos , Habitação , Pobreza , Populações Vulneráveis , Animais , Asma/etiologia , Criança , Pré-Escolar , Resfriado Comum/etiologia , Estudos Transversais , Feminino , Cefaleia/etiologia , Habitação/normas , Humanos , Masculino , Infecções Respiratórias/etiologia , Transtornos do Sono-Vigília/etiologia , Inquéritos e Questionários , Suécia , Água
17.
Tob Control ; 21(5): 460-4, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21680561

RESUMO

OBJECTIVE: To determine particulate matter smaller than 2.5 µm (PM(2.5)) levels at various hospitality and entertainment venues of Karachi, Pakistan. METHODS: This was a descriptive cross-sectional study conducted at various locations in Karachi, during July 2009. Sampling was performed at 20 enclosed public places, including hospitality (restaurants and cafés) and entertainment (snooker/billiard clubs and gaming zones) venues. PM(2.5) levels were measured using an aerosol monitor. RESULTS: All entertainment venues had higher indoor PM(2.5) levels as compared to the immediate outdoors. The indoor PM(2.5) levels ranged from 25 to 390 µg/m(3) and the outdoor PM(2.5) levels ranged from 18 to 96 µg/m(3). The overall mean indoor PM(2.5) level was 138.8 µg/m(3) (± 112.8). Among the four types of venues, the highest mean indoor PM(2.5) level was reported from snooker/billiard clubs: 264.7 µg/m(3) (± 85.4) and the lowest from restaurants: 66.4 µg/m(3) (± 57.6) while the indoor/outdoor ratio ranged from 0.97 to 10.2, highest being at the snooker/billiard clubs. The smoking density ranged from 0.21 to 0.57, highest being at gaming zones. The indoor PM(2.5) concentration and smoking density were not significantly correlated (Spearman's correlation coefficient = 0.113; p = 0.636). CONCLUSIONS: This study demonstrates unacceptably high levels of PM(2.5) exposure associated with secondhand smoke (SHS) at various entertainment venues of Karachi even after 8 years since the promulgation of smoke-free ordinance (2002) in Pakistan; however, better compliance may be evident at hospitality venues. The results of this study call for effective implementation and enforcement of smoke-free environment at public places in the country.


Assuntos
Poluição do Ar em Ambientes Fechados/análise , Monitoramento Ambiental , Exposição por Inalação/análise , Atividades de Lazer , Restaurantes , Fumar/efeitos adversos , Poluição por Fumaça de Tabaco/análise , Poluição do Ar em Ambientes Fechados/legislação & jurisprudência , Estudos Transversais , Humanos , Exposição por Inalação/legislação & jurisprudência , Paquistão , Restaurantes/legislação & jurisprudência , Fumar/legislação & jurisprudência , Poluição por Fumaça de Tabaco/legislação & jurisprudência
18.
J Coll Physicians Surg Pak ; 21(11): 662-5, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22078344

RESUMO

OBJECTIVE: To determine the factors related to tobacco smoking among students of grade 6-10 in an urban setting in Sindh, Pakistan. STUDY DESIGN: Cross-sectional survey. PLACE AND DURATION OF STUDY: The study was conducted in public and private schools of Hyderabad, Sindh, Pakistan, from January 2008 to June 2009. METHODOLOGY: A sample of 501 students from grade 6-10 were selected through simple random sampling and probability proportional to size. Students answered to a pre-tested questionnaire on sociodemography and tobacco use. Descriptive statistics were used to determine frequency distribution. RESULTS: About 9% of the students were smoking some form of tobacco. Ten percent had tried cigarette smoking and about 80% and 61% were chewing Areca nuts and 'Paan' (concoction of Areca nuts, tobacco, hydrated lime, herbs and spices wrapped in betel leaf. Being old, male gender, peer influence, personal attitude toward future smoking, chewing 'Gutka' (concoction of tobacco, Areca nuts and hydrated lime) and having a more educated mother was associated with greater frequency of smoking any form of tobacco. CONCLUSION: High frequency of tobacco smoking, the attitude toward tobacco consumption and a very high consumption of Areca nuts and other chewable tobacco products by the children warrants urgent action in order to control the tobacco epidemic in Pakistan.


Assuntos
Fumar/epidemiologia , Inquéritos e Questionários , População Urbana , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Paquistão/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fumar/efeitos adversos , Fatores Socioeconômicos , Tabaco , Adulto Jovem
19.
J Coll Physicians Surg Pak ; 20(3): 150-3, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20392374

RESUMO

OBJECTIVE: To estimate the frequency of needle stick injuries (NSI) among health care workers (nurses, student nurses and paramedical staff) in public hospitals of Karachi. STUDY DESIGN: Cross sectional, observational. PLACE AND DURATION OF STUDY: This study was conducted in three public tertiary care hospitals of Karachi, from November 2007 to January 2008. METHODOLOGY: Data was collected by structured interview-based questionnaires in Urdu and English language. Questionnaire was designed to obtain information regarding demography, work experience, hepatitis vaccination status, and occurrence of needle stick injuries with associated factors. Needle stick injury that occurred in the previous month was the defined outcome. Data was entered in Epi Data and analyzed in SPSS version 15. RESULTS: A total of 417 health care workers participated in the study. Mean age of the participants was 24+/-11 years. Estimated proportion of participants with history of at least one time NSI was found in 66%. Around 13% (n=54) had one or more NSI in the previous one month at work and half of them were affected by non-sterile needle. None of them sought medical care. Almost 90% of them were not wearing gloves or taking any other protective measures at the time of injury. CONCLUSION: There can be serious consequences of needle stick injuries in public hospitals as large proportion of injuries involve non-sterile used needles and health care workers do not take appropriate measures of protection.


Assuntos
Pessoal Técnico de Saúde/estatística & dados numéricos , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Hospitais Públicos/estatística & dados numéricos , Humanos , Masculino , Paquistão/epidemiologia , População Urbana/estatística & dados numéricos , Adulto Jovem
20.
J Coll Physicians Surg Pak ; 20(12): 806-10, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21205546

RESUMO

OBJECTIVE: To estimate the proportion of children 1-4 years of age vaccinated in the first year of their life and determine socio-demographic factors associated with vaccination in the rural sub-district Khairpur, Sindh, Pakistan. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: The study was conducted in 9 Union Councils of sub-district Gambat, district Khairpur, Sindh, from August to October 2008. METHODOLOGY: A questionnaire based representative multi-stage cluster survey was conducted. A total of 549 children aged 1-4 years were assessed for coverage and predictors of vaccination. Univariate and multivariate analysis was done using logistic regression to determine the unadjusted and adjusted relationship between socio-demographic predictor and outcome (vaccination status). RESULTS: The coverage for complete vaccination was 71.9% (95%CI=68.1%-75.7%). Educational level of mother (p=0.042), father (p=0.001) and child birth at hospital (p=0.006) were significantly associated with the vaccination status. Mother's educational level of intermediate and above was the strongest predictor (OR=12.19, 95%CI=1.57-94.3) for vaccination. CONCLUSION: Education of parents, particularly mother's education was important determinant of vaccination status of the children. In addition, distance from taluka health facility and misconception of parents were among the main reasons of not getting the children vaccinated. There is a need to educate the parents especially mothers about the importance of vaccination and organize EPI services at Basic Health Unit level to improve the vaccination coverage in rural areas of Pakistan.


Assuntos
População Rural/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Pré-Escolar , Coleta de Dados , Feminino , Humanos , Lactente , Masculino , Paquistão , Fatores Socioeconômicos
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