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Bertil Forsberg

Bio: Bertil Forsberg is an academic researcher from Umeå University. The author has contributed to research in topics: Population & Asthma. The author has an hindex of 72, co-authored 371 publications receiving 21541 citations. Previous affiliations of Bertil Forsberg include National Institute of Occupational Health & Stockholm County Council.


Papers
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Journal ArticleDOI
TL;DR: The meta-analyses showed a statistically significant association between risk for lung cancer and PM10 and PM2·5, and no association between lungcancer and nitrogen oxides concentration or traffic intensity on the nearest street.
Abstract: Summary Background Ambient air pollution is suspected to cause lung cancer. We aimed to assess the association between long-term exposure to ambient air pollution and lung cancer incidence in European populations. Methods This prospective analysis of data obtained by the European Study of Cohorts for Air Pollution Eff ects used data from 17 cohort studies based in nine European countries. Baseline addresses were geocoded and we assessed air pollution by land-use regression models for particulate matter (PM) with diameter of less than 10 μm (PM10), less than 2·5 μm (PM2·5), and between 2·5 and 10 μm (PMcoarse), soot (PM2·5absorbance), nitrogen oxides, and two traffi c indicators. We used Cox regression models with adjustment for potential confounders for cohort-specifi c analyses and random eff ects models for meta-analyses. Findings The 312 944 cohort members contributed 4 013 131 person-years at risk. During follow-up (mean 12·8 years), 2095 incident lung cancer cases were diagnosed. The meta-analyses showed a statistically signifi cant association between risk for lung cancer and PM10 (hazard ratio [HR] 1·22 [95% CI 1·03–1·45] per 10 μg/m³). For PM2·5 the HR was 1·18 (0·96–1·46) per 5 μg/m³. The same increments of PM10 and PM2·5 were associated with HRs for adenocarcinomas of the lung of 1·51 (1·10–2·08) and 1·55 (1·05–2·29), respectively. An increase in road traffi c of 4000 vehicle-km per day within 100 m of the residence was associated with an HR for lung cancer of 1·09 (0·99–1·21). The results showed no association between lung cancer and nitrogen oxides concentration (HR 1·01 [0·95–1·07] per 20 μg/m³) or traffi c intensity on the nearest street (HR 1·00 [0·97–1·04] per 5000 vehicles per day).

1,257 citations

Journal ArticleDOI
Rob Beelen1, Ole Raaschou-Nielsen, Massimo Stafoggia, Zorana Jovanovic Andersen2, Gudrun Weinmayr3, Gudrun Weinmayr4, Barbara Hoffmann4, Kathrin Wolf, Evangelia Samoli5, Paul Fischer, Mark J. Nieuwenhuijsen, Paolo Vineis6, Wei W. Xun6, Wei W. Xun7, Klea Katsouyanni5, Konstantina Dimakopoulou5, Anna Oudin8, Bertil Forsberg8, Lars Modig8, Aki S. Havulinna9, Timo Lanki9, Anu W. Turunen9, Bente Oftedal10, Wenche Nystad10, Per Nafstad11, Per Nafstad10, Ulf de Faire12, Nancy L. Pedersen12, Claes-Göran Östenson12, Laura Fratiglioni12, Johanna Penell12, Michal Korek12, Göran Pershagen12, Kirsten Thorup Eriksen, Kim Overvad13, Thomas Ellermann13, Marloes Eeftens1, Petra H.M. Peeters14, Petra H.M. Peeters6, Kees Meliefste1, Meng Wang1, Bas Bueno-de-Mesquita, Dorothea Sugiri4, Ursula Krämer4, Joachim Heinrich, Kees de Hoogh6, Timothy J. Key15, Annette Peters, Regina Hampel, Hans Concin, Gabriele Nagel3, Alex Ineichen16, Alex Ineichen17, Emmanuel Schaffner17, Emmanuel Schaffner16, Nicole Probst-Hensch17, Nicole Probst-Hensch16, Nino Künzli16, Nino Künzli17, Christian Schindler16, Christian Schindler17, Tamara Schikowski16, Tamara Schikowski17, Martin Adam17, Martin Adam16, Harish C. Phuleria17, Harish C. Phuleria16, Alice Vilier18, Alice Vilier19, Françoise Clavel-Chapelon19, Françoise Clavel-Chapelon18, Christophe Declercq, Sara Grioni, Vittorio Krogh, Ming-Yi Tsai17, Ming-Yi Tsai20, Ming-Yi Tsai16, Fulvio Ricceri, Carlotta Sacerdote21, C Galassi21, Enrica Migliore21, Andrea Ranzi, Giulia Cesaroni, Chiara Badaloni, Francesco Forastiere, Ibon Tamayo22, Pilar Amiano22, Miren Dorronsoro22, Michail Katsoulis, Antonia Trichopoulou, Bert Brunekreef14, Bert Brunekreef1, Gerard Hoek1 
TL;DR: In this article, the authors investigated the association between natural-cause mortality and long-term exposure to several air pollutants, such as PM2.5, nitrogen oxides, and NOx.

1,056 citations

Journal ArticleDOI
TL;DR: The data show independent associations between short-term exposure to PM10 and PM2.5 and daily all-cause, cardiovascular, and respiratory mortality in more than 600 cities across the globe, and reinforce the evidence of a link between mortality and PM concentration established in regional and local studies.
Abstract: BACKGROUND: The systematic evaluation of the results of time-series studies of air pollution is challenged by differences in model specification and publication bias.METHODS: We evaluated the assoc ...

896 citations

Journal ArticleDOI
TL;DR: It is concluded that special consideration should be given to studying and regulating coarse particles separately from fine particles, suggesting that coarse PM may lead to adverse responses in the lungs triggering processes leading to hospital admissions.
Abstract: Studies on health effects of airborne particulate matter (PM) have traditionally focused on particles ,10 mm in diameter (PM10) or particles ,2.5 mm in diameter (PM2.5). The coarse fraction of PM10, particles .2.5 mm, has only been studied recently. These particles have different sources and composition compared with PM2.5. This paper is based on a systematic review of studies that have analysed fine and coarse PM jointly and examines the epidemiological evidence for effects of coarse particles on health. Time series studies relating ambient PM to mortality have in some places provided evidence of an independent effect of coarse PM on daily mortality, but in most urban areas, the evidence is stronger for fine particles. The few long-term studies of effects of coarse PM on survival do not provide any evidence of association. In studies of chronic obstructive pulmonary disease, asthma and respiratory admissions, coarse PM has a stronger or as strong short-term effect as fine PM, suggesting that coarse PM may lead to adverse responses in the lungs triggering processes leading to hospital admissions. There is also support for an association between coarse PM and cardiovascular admissions. It is concluded that special consideration should be given to studying and regulating coarse particles separately from fine particles.

822 citations


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TL;DR: It is recommended that spirometry is required for the clinical diagnosis of COPD to avoid misdiagnosis and to ensure proper evaluation of severity of airflow limitation.
Abstract: Chronic obstructive pulmonary disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States, and is projected to rank fifth in 2020 in burden of disease worldwide, according to a study published by the World Bank/World Health Organization. Yet, COPD remains relatively unknown or ignored by the public as well as public health and government officials. In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientists encouraged the U.S. National Heart, Lung, and Blood Institute and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Among the important objectives of GOLD are to increase awareness of COPD and to help the millions of people who suffer from this disease and die prematurely of it or its complications. The first step in the GOLD program was to prepare a consensus report, Global Strategy for the Diagnosis, Management, and Prevention of COPD, published in 2001. The present, newly revised document follows the same format as the original consensus report, but has been updated to reflect the many publications on COPD that have appeared. GOLD national leaders, a network of international experts, have initiated investigations of the causes and prevalence of COPD in their countries, and developed innovative approaches for the dissemination and implementation of COPD management guidelines. We appreciate the enormous amount of work the GOLD national leaders have done on behalf of their patients with COPD. Despite the achievements in the 5 years since the GOLD report was originally published, considerable additional work is ahead of us if we are to control this major public health problem. The GOLD initiative will continue to bring COPD to the attention of governments, public health officials, health care workers, and the general public, but a concerted effort by all involved in health care will be necessary.

17,023 citations

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TL;DR: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors.
Abstract: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

6,968 citations

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TL;DR: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) as discussed by the authors provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.

5,668 citations

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TL;DR: A comprehensive evaluation of the research findings provides persuasive evidence that exposure to fine particulate air pollution has adverse effects on cardiopulmonary health.
Abstract: Efforts to understand and mitigate the health effects of particulate matter (PM) air pollution have a rich and interesting history. This review focuses on six substantial lines of research that have been pursued since 1997 that have helped elucidate our understanding about the effects of PM on human health. There has been substantial progress in the evaluation of PM health effects at different time-scales of exposure and in the exploration of the shape of the concentration-response function. There has also been emerging evidence of PM-related cardiovascular health effects and growing knowledge regarding interconnected general pathophysiological pathways that link PM exposure with cardiopulmonary morbidity and mortality. Despite important gaps in scientific knowledge and continued reasons for some skepticism, a comprehensive evaluation of the research findings provides persuasive evidence that exposure to fine particulate air pollution has adverse effects on cardiopulmonary health. Although much of this research has been motivated by environmental public health policy, these results have important scientific, medical, and public health implications that are broader than debates over legally mandated air quality standards.

5,547 citations

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TL;DR: It is the opinion of the writing group that the overall evidence is consistent with a causal relationship between PM2.5 exposure and cardiovascular morbidity and mortality.
Abstract: In 2004, the first American Heart Association scientific statement on “Air Pollution and Cardiovascular Disease” concluded that exposure to particulate matter (PM) air pollution contributes to card...

5,227 citations