Magnus Alderling

The demand control model and circadian saliva cortisol variations in a Swedish population based sample (The PART study)

BackgroundPrevious studies of the relationship between job strain and blood or saliva cortisol levels have been small and based on selected occupational groups. Our aim was to examine the association between job strain and saliva cortisol levels in a population-based study in which a number of potential confounders could be adjusted for.MethodsThe material derives from a population-based study in Stockholm on mental health and its potential determinants. Two data collections were performed three years apart with more than 8500 subjects responding to a questionnaire in both waves. In this paper our analyses are based on 529 individuals who held a job, participated in both waves as well as in an interview linked to the second wave. They gave saliva samples at awakening, half an hour later, at lunchtime and before going to bed on a weekday in close connection with the interview. Job control and job demands were assessed from the questionnaire in the second wave. Mixed models were used to analyse the association between the demand control model and saliva cortisol.ResultsWomen in low strain jobs (high control and low demands) had significantly lower cortisol levels half an hour after awakening than women in high strain (low control and high demands), active (high control and high demands) or passive jobs (low control and low demands). There were no significant differences between the groups during other parts of the day and furthermore there was no difference between the job strain, active and passive groups. For men, no differences were found between demand control groups.ConclusionThis population-based study, on a relatively large sample, weakly support the hypothesis that the demand control model is associated with saliva cortisol concentrations.

Blood markers of inflammation and coagulation and exposure to airborne particles in employees in the Stockholm underground

Objectives: Although associations have been found between levels of ambient airborne particles and cardiovascular disease (CVD) in the general population, little is known about possible cardiovascular effects from high exposure to particles in underground railway systems. This study investigates risk markers for CVD in employees exposed to particles in the Stockholm underground system. Methods: 79 workers (54 men and 25 women) in the Stockholm underground were investigated between November 2004 and March 2005. All were non-smokers aged 25–50 years. Three exposure groups were delineated: 29 platform workers with high exposure to particles, 29 train drivers with medium exposure and 21 ticket sellers with low exposure (control group). A baseline blood sample was taken after 2 non-working days, and a second sample after 2 working days, for analysis of levels of plasminogen activator inhibitor-1 (PAI-1), high-sensitivity C-reactive protein (hs-CRP), interleukin-6, fibrinogen, von Willebrand factor and factor VII. The study investigated changes in plasma concentrations between sample 1 and sample 2, and differences in average concentrations between the groups. Results: No changes between sample 1 and 2 were found that could be attributed to particle exposure. However, the highly exposed platform workers were found to have higher plasma concentrations of PAI-1 and hs-CRP than the ticket sellers and train drivers. This suggests that particle exposure could have a long-term inflammatory effect. These differences remained for PAI-1 in the comparison between platform workers and ticket sellers after adjusting for body mass index. Conclusions: Employees who were highly exposed to airborne particles in the Stockholm underground tended to have elevated levels of risk markers for CVD relative to employees with low exposure. However, the differences observed cannot definitely be linked to particle exposure as such.

Self‐reported skin exposure – validation of questions by observation

The aim of this study was to validate questions regarding skin exposure using observation. The study group consisted of 40 individuals in 5 different occupations: nurse in an intensive care unit, car mechanic, hairdresser, kitchen worker, and office worker. The participants completed a questionnaire before the start of a working day. The questionnaire covered total skin exposure times to water, foodstuffs, chemicals, and occlusive gloves and also covered the frequency of hand‐washing during a working day. Observers subsequently used a hand‐held computer to register the time and the frequency of each exposure. A strong correlation between self‐reports and observations was found for questions regarding exposure times to water, foodstuffs, and occlusive gloves and also a moderate correlation for questions regarding frequency of hand‐washing. The present observation method was insufficient for estimating total exposure times to chemicals as the true exposure time is influenced by, e.g. the use of contaminated protective gloves and the efficacy with which the chemicals were removed. The inter‐observer reliability showed a very strong correlation. We consider the questions regarding skin exposure to water, foodstuffs, protective gloves, and hand‐washing to be useful for future studies. The observation method seems to be reliable, useful, and easy to apply.

Life-style factors and hand eczema: Life-style factors and hand eczema

Background  Previous knowledge of the impact of certain life‐style factors on hand eczema is scanty.

Tobacco smoking and hand eczema: a population-based study.

Background  Tobacco smoking has been proposed to promote hand eczema.

Occupational skin exposure to water: a population‐based study

Background  Occupational exposure to skin irritants, in particular to water, is an important risk factor for hand eczema.

Is skin exposure to water mainly occupational or nonoccupational? A population-based study

Skin exposure to water is considered to contribute to hand eczema. Knowledge about total water exposure during a day is scanty.

A Job-Exposure Matrix for Occupational Noise: Development and Validation

OBJECTIVE To develop a job-exposure matrix (JEM) for occupational noise in Sweden and to estimate its validity. METHODS The JEM, developed by a group of experienced occupational hygienists, contains 321 job families with information regarding occupational noise from 1970 to 2004. The occupational noise information derives from measurements collected from different sources. The time period label has a 5-year scale starting in 1970. The estimated average 8h (TWA) noise level in decibel [dB(A)] for every 5-year period was coded either as <75 dB(A), 75-84 dB(A), or ≥85 dB(A) and the risk of peak level exposure assessed. The validity of the JEM is tested, using Svenssons non-parametric methods based on classification consensus, reached by a second group of occupational hygienists. RESULTS/DISCUSSION Validation results show ~ 80% agreement and no systematic differences, in classification, between the two different groups of occupational hygienists, classifying the occupational noise exposure. However, classification of peak level exposure did show a systematic difference in relative position. The results will give more power to the JEM that it gives a good general estimate for the occupational noise levels in Sweden for different job families during 1970-2004. We, thus, intend to use it in further studies and also make it available to collaborators.

Psychiatric diagnoses and circadian saliva cortisol variations in a Swedish population-based sample (the PART study).

Psychiatric diagnoses and circadian saliva cortisol variations in a Swedish population-based sample (the PART study).

Mortality among Swedish chimney sweeps (1952-2006): an extended cohort study.

Objectives We extended a cohort study of Swedish chimney sweeps and prolonged follow-up in order to increase power and study those first employed after 1950 when oil began to replace wood as a main fuel for heating in Sweden. Methods Male Swedish chimney sweeps who were members of the national trade union in 1981–2006 were identified (n=1087) and included to a previous cohort of those employed in 1918–1980 (n=5287). All employment histories were updated, and the total extended cohort (n=6374) was linked to the registers of Causes of Death and Total Population and followed for mortality from 1952 through 2006. Standardised mortality ratios (SMRs) were estimated using the Swedish male population as reference. Results 1841 observed deaths resulted in an SMR for all causes of deaths of 1.29 (95% CI 1.24 to 1.36). Mortality was significantly increased for all malignant tumours, oesophageal cancer, bowel cancer, liver cancer, lung cancer, alcoholism, ischaemic heart disease, non-malignant respiratory diseases, liver cirrhosis, external causes and suicides. The lung cancer SMR remained increased, although attenuated, after adjustment for group-level smoking data, SMR of 1.52 (95% CI 1.26 to 1.89). Duration of employment showed no consistent evidence of dose–response associations. Alcohol-related deaths (liver cirrhosis and alcoholism) were not increased among those employed >30 years. Mortality among those employed after 1950 was similar to that of the entire cohort. Conclusions Chimney sweeps are exposed to high levels of toxic substances in the occupation, but excess alcohol and smoking habits were also observed, and the results must be interpreted cautiously. However, group-level data on tobacco smoking indicated that the lung cancer excess only to some extent could be explained by smoking habits, and the increased mortality from oesophageal cancer and ischaemic heart disease among chimney sweeps employed >30 years is less likely to be caused by excess alcohol habits.