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Nordstrom A.,Occupational and Environmental Medicine | Nordstrom A.,Umea University
Neurology | Year: 2015

To evaluate maximal isometric muscle force at 18 years of age in relation to Parkinson disease (PD) later in life. Methods: The cohort consisted of 1,317,713 men who had their muscle strength measured during conscription (1969-1996). Associations between participants' muscle strength at conscription and PD diagnoses, also in their parents, were examined using multivariate statistical models. Results: After adjustment for confounders, the lowest compared to thehighest fifth of handgrip strength (hazard ratio [HR] 1.38, 95% confidence interval [CI] 1.06-1.79), elbow flexion strength (HR 1.34, 95% CI 1.02-1.76), but not knee extension strength (HR 1.24, 95% CI 0.94-1.62) was associated with an increased risk of PD during follow-up. Furthermore, men whose parents were diagnosed with PD had reduced handgrip (fathers: mean difference [MD]-5.7 N [95% CI-7.3 to-4.0]; mothers: MD-5.0 N [95% CI-7.0 to-2.9]) and elbow flexion (fathers: MD-4.3 N [95% CI-5.7 to-2.9]; mothers: MD-3.9 N [95% CI-5.7 to-2.2]) strength, but not knee extension strength (fathers: MD-1.1 N [95% CI-2.9 to 0.8]; mothers: MD-0.7 N [95% CI-3.1 to 1.6]), than those with no such familial history. Conclusions: Maximal upper extremity voluntary muscle force was reduced in late adolescence in men diagnosed with PD 30 years later. The findings suggest the presence of subclinical motor deficits 3 decades beforethe clinical onset of PD. © 2015 American Academy of Neurology.

Svedberg U.,Occupational and Environmental Medicine | Johanson G.,Karolinska Institutet
Annals of Occupational Hygiene | Year: 2013

More than 500 million ocean freight container units are shipped annually between countries an continents. Residual levels of fumigants, as well as naturally occurring off-gassing chemicals emanating from the goods, constitute safety risks, which may affect uniformed workers upon entering the container. The aim of this study was to assess workers' exposure during stripping of containers and is the first study of its kind. First, an experimental tracer gas method was investigated to determine its usefulness to approximate real exposures from gaseous fumigants and off-gassing volatile organic compounds (VOCs). Nitrous oxide was injected and left to distribute in the closed containers. The distribution of the tracer gas and initial (arrival) concentrations of off-gassing volatiles were measured prior to opening the containers. Second, personal exposure (breathing zone) and work zone air monitoring of both tracer gas and VOCs were carried out during stripping. Adsorbent tubes, bag samples, and direct-readings instruments (photoionization detector and Fourier transform infrared spectrometry) were used. The distribution studies with nitrous oxide, and the high correlation between the former and VOCs (r2 ∼ 0.8) during stripping, showed that the tracer gas method may well be used to approximate real exposures in containers. The average breathing zone and work zone concentrations during stripping of naturally ventilated 40-foot containers were 1-7% of the arrival concentrations; however, peaks up to 70% were seen during opening. Even if average exposures during stripping are significantly lower than arrival concentrations, they may still represent serious violations of occupational exposure limits in high-risk containers. The results from this and previous studies illustrate the need to establish practices for the safe handling of ocean freight containers. Until comprehensive recommendations are in place, personnel that need to enter such containers should, in addition to appropriate personal protective equipment, have access to equipment for measuring contaminants and for applying forced ventilation when necessary. © The Author 2013. Published by Oxford University Press.

Annerback E.-M.,Linkoping University | Annerback E.-M.,Uppsala University | Sahlqvist L.,Uppsala University | Svedin C.G.,Linkoping University | And 2 more authors.
Child Abuse and Neglect | Year: 2012

Objective: To examine the associations between child physical abuse executed by a parent or caretaker and self-rated health problems/risk-taking behaviors among teenagers. Further to evaluate concurrence of other types of abuse and how these alone and in addition to child physical abuse were associated with bad health status and risk-taking behaviors. Methods: A population-based survey was carried out in 2008 among all the pupils in 2 different grades (15 respectively 17. years old) in Södermanland County, Sweden (. n=. 7,262). The response rate was 81.8%. The pupils were asked among other things about their exposure to child physical abuse, exposure to parental intimate violence, bullying, and exposure to being forced to engage in sexual acts. Adjusted analyses were conducted to estimate associations between exposure and ill-health/risk-taking behaviors. Results: Child physical abuse was associated with poor health and risk-taking behaviors with adjusted odds ratios (OR) ranging from 1.6 to 6.2. The associations were stronger when the pupils reported repeated abuse with OR ranging from 2.0 to 13.2. Also experiencing parental intimate partner violence, bullying and being forced to engage in sexual acts was associated with poor health and risk-taking behaviors with the same graded relationship to repeated abuse. Finally there was a cumulative effect of multiple abuse in the form of being exposed to child physical abuse plus other types of abuse and the associations increased with the number of concurrent abuse. Conclusions: This study provides strong indications that child abuse is a serious public health problem based on the clear links seen between abuse and poor health and behavioral problems. Consistent with other studies showing a graded relationship between experiences of abuse and poor health/risk-taking behaviors our study shows poorer outcomes for repeated and multiple abuse. Thus, our study calls for improvement of methods of comprehensive assessments, interventions and treatment in all settings where professionals meet young people. © 2012 Elsevier Ltd.

Jeong H.,Catholic University of Korea | Yim H.W.,Catholic University of Korea | Cho Y.,Occupational and Environmental Medicine | Park H.J.,Seoul St. Marys Hospital | And 4 more authors.
Stem Cell Research and Therapy | Year: 2013

Introduction. Although blinding is a methodologic safeguard to ensure obtaining comparability of groups in a clinical trial, it is very difficult to maintain blinding from the beginning to the end of a study. The aim of the study was to see how proper blinding of both participants and treatment providers from the planning phase of the study to during the study affected the study outcomes. Methods. We searched Medline, EMBASE, and Cochrane databases from inception to November 2011. The studies included in this review were randomized controlled trials, with acute myocardial infarction (AMI) patients who received percutaneous coronary intervention (PCI), intracoronary (IC) infusion of autologous bone marrow stem cells (BMSCs), unselected BMSCs, 108 or more cell dose, and up to 6-month follow-up periods. Results: The initial search identified 881 references, of which 17 references were eligible for inclusion. Six of 17 trials isolated cells directly from bone marrow by aspiration in the control group as well as in the BMSC group. Nine of 17 trials underwent both cardiac catheterization and an identical injection procedure on the control group as well as the BMSC group.Compared with the control group, BMSC transplantation improved left ventricular ejection fraction (LVEF) by 2.51 (95% CI, 1.20 to 3.83; P = 0.0002; I 2 = 75%) at 6 months. In the present results, the studies that did not perform bone marrow aspiration in the control group showed significant improvement in LVEF by 3.81% (95% CI, 2.44 to 5.17), whereas no significant treatment effect was found in the studies in which the control group underwent bone marrow aspiration, as indicated the LVEF change of -1.29% (95% CI, 4.15 to 1.58). The trials that did not conduct catheterization on control subjects showed significant LVEF changes (4.45%; 95% CI, 2.48 to 6.43); however, those with cardiac catheterization as a sham procedure on the control group did not show significant changes in LVEF at 6 months (0.92%; 95% CI, -0.61 to 2.44). Conclusions: Unblinding might be overestimating the treatment effect. These findings suggest that randomized controlled trials testing the efficacy of BMSC therapy should be appropriately designed and rigorously applied to avoid bias. © 2013 Jeong et al.; licensee BioMed Central Ltd.

Aberg M.A.I.,Institute of Neuroscience and Physiology | Toren K.,Occupational and Environmental Medicine | Nilsson M.,Institute of Neuroscience and Physiology | Henriksson M.,Institute of Neuroscience and Physiology | And 5 more authors.
Stroke | Year: 2016

Background and Purpose-Although the incidence of stroke is on the decline worldwide, this is not the case for early stroke. We aimed to determine whether nonpsychotic mental disorder at the age of 18 years is a risk factor for early stroke, and if adolescent cardiovascular fitness and intelligence quotient might attenuate the risk. Method-Population-based Swedish cohort study of conscripts (n=1 163 845) who enlisted during 1968 to 2005. At conscription, 45 064 males were diagnosed with nonpsychotic mental disorder. Risk of stroke during follow-up (5-42 years) was calculated with Cox proportional hazards models. Objective baseline measures of fitness and cognition were included in the models in a second set of analyses. Results-There were 7770 first-time stroke events. In adjusted models, increased risk for stroke was observed in men diagnosed with depressive/neurotic disorders (hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.11-1.37), personality disorders (HR, 1.52; 95% CI, 1.29-1.78), and alcohol/substance use disorders (HR, 1.61; 95% CI, 1.41-1.83) at conscription. Corresponding figures for fatal stroke were HR, 1.38; 95% CI, 1.06 to 1.79; HR, 2.26; 95% CI, 1.60 to 3.19; and HR, 2.20; 95% CI, 1.63 to 2.96. HRs for stroke were attenuated when fitness level and intelligence quotient were introduced. Associations remained significant for personality disorders and alcohol/substance use in the fully adjusted models. The interaction term was statistically significant for fitness but not for intelligence quotient. Conclusions-Our findings suggest that fitness may modify associations between nonpsychotic disorders and stroke. It remains to be clarified whether interventions designed to improve fitness in mentally ill youth can influence future risk of early stroke. © 2015 American Heart Association, Inc.

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