Time trends and occupational risk factors for pleural mesothelioma in Sweden.

Epidemiologic data on pleural mesothelioma are scarce on regional and occupational time trends, which would monitor the effects of changes in exposure to asbestos. We aim to characterize time trends, regional, socioeconomic, and occupational risk factors for pleural mesothelioma in Sweden in the years from 1961 to 1998. The Swedish Family-Cancer Database was used to identify patients with pleural mesothelioma. Age-standardized incidence rates and standardized incidence ratio (SIR) were calculated for the population in the Database. A total of 1298 male and 233 female pleural mesotheliomas were retrieved. Age-standardized incidence of the disease was highest, and the trend increased in residents of large industrial and shipbuilding cities. In the last follow-up period, the male rate exceeded the female rate about 10-fold. Among male socioeconomic groups, manual workers showed the highest and ever-increasing SIR. No female socioeconomic group was at risk. For men, plumbers and seamen had the highest risk of 4.56 and 2.83, respectively, but the risks appeared to be decreasing for plumbers, whereas no clear trend was noted for seamen, probably because of indirect expose in ships. Farmers showed an SIR of 0.28, indicating that the population at large was at four times higher risk than farmers. The SIRs of many academic/college-educated groups were two to six times higher than those of farmers, suggesting indirect exposure to asbestos in these groups.     

Socioeconomic/occupational risk factors for lymphoproliferative diseases in Sweden

PURPOSE: The aim of the study is to investigate associations between socioeconomic and occupational factors and lymphoproliferative (LP) diseases. METHODS: We performed a follow-up study on the economically active Swedish population, based on the Swedish Family-Cancer Database. Standardized incidence ratios and 95% confidence intervals were calculated in different social classes and occupations. RESULTS: An increased risk for LP diseases was observed for physicians, plumbers, chemical process workers, and food manufacture workers among men and shoe and leather workers, mechanics, iron and metalware workers, and launderers and dry cleaners among women. CONCLUSIONS: Results suggest that socioeconomic and occupational factors have a minor effect on risk for LP diseases. Exposure to organic solvents may increase the risk for some LP diseases, although inconsistencies of findings between subcohorts do not rule out spurious associations.     

Socioeconomic and occupational risk factors for pancreatic cancer: a cohort study in Sweden

OBJECTIVE: The objective of this study was to examine the associations between socioeconomic/occupational factors and pancreatic cancer. METHODS: The Swedish Family-Cancer Database was used to calculate standardized incidence ratios for different social classes and occupational groups. Lung cancer risks were also determined. The reference group was all the economically active population. RESULTS: Farmers were at a decreased risk of pancreatic cancer. A slightly increased risk of pancreatic cancer, independent of lung cancer, was observed for male professionals and administrators and managers. For women, increased risks were observed for cooks and stewards, and glass, ceramic, and tile workers. CONCLUSIONS: The results show that socioeconomic/occupational factors play a small role in the etiology of pancreatic cancer. In addition to smoking, physical inactivity and obesity may contribute to the observed differences.     

Time trends in human fecundability in Sweden

BACKGROUND: Trends in biologic fertility are elusive. Possible negative trends in male reproductive health are still debated, and their effect on human fertility might be negligible. Time-to-pregnancy (TTP) is a functional measure of couple fecundability. METHODS: We analyzed data on TTP among 832,000 primiparous women 20 years of age and older in the nationwide Swedish Medical Birth Registry from 1983 through 2002. This age restriction led to an exclusion of 10% of primiparous pregnancies. Subfertility (TTP > or =1 year) was analyzed as a function of maternal age, calendar time at initiation of attempt, and birth cohort-taking into account the truncation problems that are inherent in birth-based retrospective sampling. RESULTS: Subfertility generally decreased over successive birth cohorts. When studied as a period effect, a transient increase in subfertility was seen in the early 1990s. Subfertility increased with age, except that for women in their late 1930s, an apparent decrease was observed, particularly among the early cohorts. CONCLUSION: We found decreasing subfertility over time. We speculate that these patterns might be related to a Sweden-specific decrease over time in sexually transmitted diseases, to changes in sexual behavior induced by socioeconomic conditions, or to broader biologic or educational trends.     

Asbestos-related mesothelioma: factors discriminating between pleural and peritoneal sites.

Up to the end of 1980, 144 confirmed cases of mesothelioma were identified among employees of an organisation using asbestos in manufacturing and insulation. The primary site was peritoneal in 74 cases, pleural in 66, and undetermined in four. All employees had been exposed to amphibole asbestos, and evidence from different factories confirmed the predominant role of crocidolite in the production of mesothelioma. The ratio of pleural to peritoneal sites showed a continuous change when related to the year of first exposure, varying from 5:1 pleural to peritoneal before 1921 to 1:3 after 1950. The strong temporal relationship appeared to reflect progressive dust suppression, including the non-fibrous dusts present in insulation materials and perhaps also the degree to which the fibres had been opened. Other predisposing factors were related to the degree of individual exposure, the peritoneal site being associated preferentially with longer and heavier exposures.     

Time trends of spina bifida in Sweden 1947-81.

The spina bifida rate in Sweden from 1947 to 1981 has been studied using various sources of information, including two central computerised registers. During the period the rate approximately halved, but the decline was not smooth and occurred in three "waves." When the geographical location of high risk areas within each wave was studied, they were found to differ. The findings are discussed in the light of an environmental aetiology hypothesis of this malformation.     

Socioeconomic and occupational groups and risk of asthma in Sweden

AIM: To investigate possible associations between hospitalization for asthma and socioeconomic status and occupation. METHODS: A nationwide database was constructed by linking Swedish Census data to the Hospital Discharge Register (1987-2004). The hospital diagnoses of asthma were based on the International Classification of Diseases. Standardized incidence ratios were calculated for different socioeconomic and occupational groups. Ninety-five per cent confidence intervals were calculated assuming a Poisson distribution. RESULTS: A total of 13,202 male and 11,876 female hospitalizations for asthma were retrieved at ages >30 years. The socioeconomic groups with < 9 years of education were associated with a significantly increased risk of hospitalization for asthma. Among male occupations, increased risks were noted for farmers, mechanics and iron and metal workers, welders, bricklayers, workers in food manufacture, packers, loaders and warehouse workers, waiters and chimney sweeps with prolonged exposures in two censuses. For female occupations, increased risks were observed among assistant nurses, religious, juridical and other social science-related workers, drivers, mechanics and iron and metalware workers and wood workers. CONCLUSIONS: The present study suggests that socioeconomic status (low educational level) and occupation have an effect on the population's risk of hospitalization for asthma.     

Asbestos-related mesothelioma: factors discriminating between pleural and peritoneal sites

Up to the end of 1980, 144 confirmed cases of mesothelioma were identified among employees of an organisation using asbestos in manufacturing and insulation. The primary site was peritoneal in 74 cases, pleural in 66, and undetermined in four. All employees had been exposed to amphibole asbestos, and evidence from different factories confirmed the predominant role of crocidolite in the production of mesothelioma. The ratio of pleural to peritoneal sites showed a continuous change when related to the year of first exposure, varying from 5:1 pleural to peritoneal before 1921 to 1:3 after 1950. The strong temporal relationship appeared to reflect progressive dust suppression, including the non-fibrous dusts present in insulation materials and perhaps also the degree to which the fibres had been opened. Other predisposing factors were related to the degree of individual exposure, the peritoneal site being associated preferentially with longer and heavier exposures.     

A case-control study of occupational risk factors for laryngeal cancer.

To determine whether specific jobs and occupational exposures are associated with laryngeal cancer lifetime occupational histories from a population-based case-control study in western Washington were examined. The study included 235 cases diagnosed between September 1983 and February 1987, and 547 controls identified by random digit dialing. After controlling for alcohol use, cigarette smoking, age and education, significantly increased risks were found for painters in construction (odds ratio (OR)) = 2.8, (95% confidence interval (95% CI) 1.1-6.9), supervisors and miscellaneous mechanics (OR = 2.3, 95% CI 1.1-4.8), construction workers (OR = 3.4, 95% CI 1.4-8.1), metalworking and plastic working machine operators (OR = 2.6, 95% CI 1.3-4.9) and handlers, and equipment cleaners and labourers (OR = 1.5, 95% CI 1.0-2.2). Allowing for a 10 year induction and latent period did not have a consistent effect on the associations. Potential exposures to asbestos, chromium, nickel, formaldehyde, diesel fumes, and cutting oils were assessed by using a job exposure matrix developed for this study. Three measures of exposure were examined--namely, peak, duration, and an intensity weighted exposure score. No significantly raised risks were seen, although increased risk was suggested among those exposed long term to formaldehyde in jobs with the highest exposures.     

A case-control study of occupational risk factors for laryngeal cancer.

To determine whether specific jobs and occupational exposures are associated with laryngeal cancer lifetime occupational histories from a population-based case-control study in western Washington were examined. The study included 235 cases diagnosed between September 1983 and February 1987, and 547 controls identified by random digit dialing. After controlling for alcohol use, cigarette smoking, age and education, significantly increased risks were found for painters in construction (odds ratio (OR)) = 2.8, (95% confidence interval (95% CI) 1.1-6.9), supervisors and miscellaneous mechanics (OR = 2.3, 95% CI 1.1-4.8), construction workers (OR = 3.4, 95% CI 1.4-8.1), metalworking and plastic working machine operators (OR = 2.6, 95% CI 1.3-4.9) and handlers, and equipment cleaners and labourers (OR = 1.5, 95% CI 1.0-2.2). Allowing for a 10 year induction and latent period did not have a consistent effect on the associations. Potential exposures to asbestos, chromium, nickel, formaldehyde, diesel fumes, and cutting oils were assessed by using a job exposure matrix developed for this study. Three measures of exposure were examined--namely, peak, duration, and an intensity weighted exposure score. No significantly raised risks were seen, although increased risk was suggested among those exposed long term to formaldehyde in jobs with the highest exposures.     

Recent trends in coronary risk factors in the USSR.

The soviet Union has experienced an increase in the incidence of coronary heart disease over the last 15 years sufficient to result in an overall deterioration in the health of adults. The distribution of coronary risk factors, and the secular trends in diet and cigarette consumption, provide a potential explanation for the upsurge in death rates. The animal fat content of the Soviet diet has been steadily enriched since the 1950s and cigarette production increased 72 per cent from 1959 to 1980. The post-Stalin orientation of the Soviet economy toward a policy of motivating the work force primarily through the provision of consumer goods, in a pattern comparable to western capitalist countries, appear to have laid the basis for these developments. Given the central control of Soviet society, the negative impact of current economic policy on the public health could be viewed as paradoxical. Our analysis suggests that the paradox is only apparent, however, and that the basis for the widespread occurrence of coronary heart disease is similar in the Soviet Union and western societies.     

Main factors of occupational risk for railway workers

The paper shows the specific features of development of occupational diseases associated with the classes of working conditions by the degree of hazard and risk. It provides a scientifically founded evidence for that the indicators of a potential risk of working conditions should be included into the methodology of assessment of a professional risk.     

Time trends in occupational exposure to chemicals in Sweden: proportion exposed,distribution across demographic and labor market strata,and exposure levels

ObjectiveThis study investigated time trends in occupational exposure to various chemicals in Sweden and the distribution across demographic and labor market sectors.MethodsExposure to six chemicals was investigated from 1980 to 2013 by application of a job exposure matrix to national population registers. Respirable crystalline silica (RCS), diesel engine exhaust, welding fumes, wood dust, chlorinated hydrocarbon solvents, and lead were selected to represent different groups of chemicals. Trends in exposure prevalence were investigated by linear regression and compared to the occupationally active population. Confidence intervals for the rate of change over time were obtained by bootstrapping.ResultsThe proportion of workers born outside the Nordic countries increased over time in those exposed to RCS, diesel exhaust and wood dust. There was a shift of exposed jobs to small companies (<50 employees), especially for RCS, welding fumes, wood dust, and chlorinated hydrocarbon solvents. For RCS and welding fumes, there was a marked drop in exposure levels from 1980 to 1990 but small changes thereafter. Exposure to lead diminished, both in terms of prevalence and intensity.ConclusionsOver time, several exposures tended to shift to small companies, the construction sector, and migrant workers, all factors being indicative of less well-controlled working conditions. Occupational exposure to chlorinated organic solvents and lead diminished, while exposure levels to RCS and welding fumes have changed little since 1990. In view of the serious and well-established negative health effects, increased efforts to reduce exposure to RCS and welding fumes are needed.     

Idiopathic pulmonary fibrosis and occupational risk factors

Idiopathic pulmonary fibrosis (IPF) is a rare lung disease of unknown origin that rapidly leads to death. However, the rate of disease progression varies from one individual to another and is still difficult to predict. The prognosis of IPF is poor, with a median survival of three to five years after diagnosis, without curative therapies other than lung transplantation. The factors leading to disease onset and progression are not yet completely known. The current disease paradigm is that sustained alveolar epithelial micro-injury caused by environmental triggers (e.g., cigarette smoke, microaspiration of gastric content, particulate dust, viral infections or lung microbial composition) leads to alveolar damage resulting in fibrosis in genetically susceptible individuals. Numerous epidemiological studies and case reports have shown that occupational factors contribute to the risk of developing IPF. In this perspective, we briefly review the current understanding of the pathophysiology of IPF and the importance of occupational factors in the pathogenesis and prognosis of the disease. Prompt identification and elimination of occult exposure may represent a novel treatment approach in patients with IPF.Key words: Idiopathic pulmonary fibrosis, lung fibrosis, occupation, occupational factors, environmental factors     

Major risk factors for cardiovascular disease in elderly migrants in Sweden

Objective. The knowledge of elderly migrants' health, particularly those who are retired or in transition to retirement is limited. The purpose of this study was to analyse the association between migration, socio-economic status (SES), and risk factors for cardiovascular disease (CVD). Design. A simple random sample of 253 foreign-born persons and 2847 Swedish-born persons aged 55-74 were drawn from the Swedish Population Registry. They were interviewed by Statistics Sweden in 1988-89. Outcome variables were leisure-time physical inactivity, smoker/non-smoker status, body mass index (BMI), hypertension, and diabetes mellitus. Explanatory variables were sex, age, marital status, migration status (country of birth), and SES (income). Logistic and linear regression were used. Results. Elderly foreign-born people ran an increased risk of engaging in no physical activity (men only), being a current smoker, and having an increased BMI after adjustment for background factors. In addition, a low income (first tertile) was an independent risk factor for physical inactivity (men only), as was being a current smoker (men only), BMI, hypertension, and diabetes mellitus. Thus, the burden of being an elderly migrant increases the risk of a disadvantaged lifestyle between 50 and 80% compared with Swedes. Conclusions. This study shows that migrants who are retired or in transition to retirement have a disadvantaged risk profile for cardiovascular disease. It might be possible to improve this situation by intervention, as for example by increasing a person's interest in walking.     

Future trends of mesothelioma mortality in Japan based on a risk function

Mesothelioma is a malignancy with poor prognosis. It is chiefly caused by asbestos exposure and its symptoms can occur about 30-50 yr after the initial exposure. This study aims to predict the future trends in mesothelioma mortality in Japan using a method that is an alternative to the age-cohort model. Our approach is based on a risk function that links mesothelioma mortality combined with data pertaining to the population, size of the labor force, and quantity of asbestos imports. We projected the number of deaths occurring in individuals aged 50-89 for yr 2003-2050 using risk functions. Our results have indicated that mesothelioma mortality among Japanese people aged 50-89 yr will continue to increase until 2027 and reach a maximum of 66,327 deaths in the years 2003-2050. Our estimate has also suggested that the number of mesothelioma deaths could be significantly reduced if there were adequate compliance with the administrative level guidelines for occupational asbestos exposure.