Showing papers by "Bertil Forsberg published in 2017"
University of London1, University of Queensland2, Monash University3, Potsdam Institute for Climate Impact Research4, Queensland University of Technology5, Shanghai Jiao Tong University6, Anhui Medical University7, University of São Paulo8, University of Ottawa9, University of Los Andes10, Fudan University11, Czech University of Life Sciences Prague12, Academy of Sciences of the Czech Republic13, Oulu University Hospital14, University of Oulu15, Dublin Institute of Technology16, Brunel University London17, Nagasaki University18, University of Tsukuba19, Kyoto University20, Seoul National University21, Spanish National Research Council22, University of Valencia23, Umeå University24, Lund University25, University of Basel26, Swiss Tropical and Public Health Institute27, National Taiwan University28, Harvard University29, Yale University30, Duy Tan University31, Ho Chi Minh City Medicine and Pharmacy University32, Public Health England33
TL;DR: In this article, the authors show that climate change can directly affect human health by varying exposure to non-optimal outdoor temperature, however, evidence on this direct impact at a global scale is limited.
436 citations
New York University1, Rutgers University2, University of Paris3, University of California, Berkeley4, University of California, San Francisco5, University of Michigan6, National Institutes of Health7, Umeå University8, University of Rochester Medical Center9, Queen Mary University of London10, Utrecht University11, National Institute for Health Research12, University of Basel13, Swiss Tropical and Public Health Institute14, University of Maryland, Baltimore15, University of California, Los Angeles16, University of Southern California17, Aarhus University18, Pompeu Fabra University19
TL;DR: A set of considerations that can be applied in forming judgments of the adversity of not only currently documented, but also emerging and future effects of air pollution on human health are proposed.
Abstract: The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies.This current report seeks to integrate the latest science into a general framework for interpreting the adversity of the human health effects of air pollution. Rather than trying to provide a catalogue of what is and what is not an adverse effect of air pollution, we propose a set of considerations that can be applied in forming judgments of the adversity of not only currently documented, but also emerging and future effects of air pollution on human health. These considerations are illustrated by the inclusion of examples for different types of health effects of air pollution.
336 citations
TL;DR: This review explores the relationships between climate change, air pollution and air pollution-related health impacts and finds results highly depend on the climate change scenario used and on projections of future air pollution emissions, with relatively high uncertainty.
Abstract: Purpose of review: Air pollution significantly affects health, causing up to 7 million premature deaths annually with an even larger number of hospitalizations and days of sick leave. Climate chang ...
212 citations
TL;DR: There is a very large potential for reducing emissions and exposure if all car drivers living within a distance corresponding to a maximum of a 30min bicycle ride to work would change to commuting by bicycle.
129 citations
TL;DR: Sectorial contributions to PM exposure and related premature mortality for three Swedish cities are described and it is implied that control actions on local PM emissions have a strong potential in abatement strategies.
Abstract: The most important anthropogenic sources of primary particulate matter (PM) in ambient air in Europe are exhaust and non-exhaust emissions from road traffic and combustion of solid biomass. There is convincing evidence that PM, almost regardless of source, has detrimental health effects. An important issue in health impact assessments is what metric, indicator and exposure-response function to use for different types of PM. The aim of this study is to describe sectorial contributions to PM exposure and related premature mortality for three Swedish cities: Gothenburg, Stockholm and Umea. Exposure is calculated with high spatial resolution using atmospheric dispersion models. Attributed premature mortality is calculated separately for the main local sources and the contribution from long-range transport (LRT), applying different relative risks. In general, the main part of the exposure is due to LRT, while for black carbon, the local sources are equally or more important. The major part of the premature deaths is in our assessment related to local emissions, with road traffic and residential wood combustion having the largest impact. This emphasizes the importance to resolve within-city concentration gradients when assessing exposure. It also implies that control actions on local PM emissions have a strong potential in abatement strategies.
111 citations
University of Copenhagen1, Karolinska Institutet2, University of Ulm3, Umeå University4, Norwegian Institute of Public Health5, Imperial College London6, Utrecht University7, University of Malaya8, Cancer Epidemiology Unit9, University of Washington10, University of Basel11, Swiss Tropical and Public Health Institute12, Institut Gustave Roussy13, French Institute of Health and Medical Research14, University of Verona15, Pompeu Fabra University16, University of Hertfordshire17, Netherlands Organisation for Applied Scientific Research18, Aarhus University19
TL;DR: Positive and statistically insignificant associations between breast cancer and PM2.5 are found, and suggestive evidence of an association between ambient air pollution and incidence of postmenopausal breast cancer in European women is found.
Abstract: BACKGROUND: Epidemiological evidence on the association between ambient air pollution and breast cancer risk is inconsistent. OBJECTIVE: We examined the association between long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in European women. METHODS: In 15 cohorts from nine European countries, individual estimates of air pollution levels at the residence were estimated by standardized land-use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE) and Transport related Air Pollution and Health impacts - Integrated Methodologies for Assessing Particulate Matter (TRANSPHORM) projects: particulate matter (PM) ≤2:5 μm, ≤10 μm, and 2:5–10 μm in diameter (PM2:5, PM10, and PMcoarse, respectively); PM2:5 absorbance; nitrogen oxides (NO2 and NOx); traffic intensity; and elemental composition of PM. We estimated cohort-specific associations between breast cancer and air pollutants using Cox regression models, adjusting for major lifestyle risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. RESULTS: Of 74,750 postmenopausal women included in the study, 3,612 developed breast cancer during 991,353 person-years of follow-up. We found positive and statistically insignificant associations between breast cancer and PM2:5 {hazard ratio (HR) =1:08 [95% confidence interval (CI): 0.77, 1.51] per 5 μg/m3 }, PM10 [1.07 (95% CI: 0.89, 1.30) per 10 μg/m3 ], PMcoarse [1.20 (95% CI: 0.96, 1.49 per 5 μg/m3 ], and NO2 [1.02 (95% CI: 0.98, 1.07 per 10 μg/m3 ], and a statistically significant association with NOx [1.04 (95% CI: 1.00, 1.08) per 20 μg/m3, p =0:04]. CONCLUSIONS: We found suggestive evidence of an association between ambient air pollution and incidence of postmenopausal breast cancer in European women. © 2017, Public Health Services, US Dept of Health and Human Services. All rights reserved. Chemicals/CAS: copper, 15158-11-9, 7440-50-8; iron, 14093-02-8, 53858-86-9, 7439-89-6; nickel, 7440-02-0; nitrogen oxide, 11104-93-1; potassium, 7440-09-7; silicon, 7440-21-3; sulfur, 13981-57-2, 7704-34-9; vanadium, 7440-62-2; zinc, 7440-66-6, 14378-32-6
97 citations
TL;DR: The suitability of periostin as a biomarker for asthma driven by type 2 inflammation remains unclear and large studies examining relationships between circulating periOSTin and patient characteristics are lacking.
Abstract: Background: Periostin has been suggested as a novel, phenotype-specific biomarker for asthma driven by type-2 inflammation. However, large studies examining relationships between circulating perios ...
62 citations
15 Jan 2017
TL;DR: The results indicate that the association between mortality and temperature variation is generally minimal compared with mean daily temperatures, although further research on intraday changes is needed.
Abstract: An illustrative example of analysis that assesses the association between indices of inter and intra-day temperature variability and mortality. The indices are built following specific assumptions about the impact of temperature variability and absolute temperature. The code reproduces the results for London, one of the six cities included in the analysis. It consists of: [1] london.csv stores the dataset used in the illustrative examples; [2] 01.model.R defines the indices and runs the models; [3] 02.results.R summarizes the results; and [4] 03.graphs.R produces the graphs
54 citations
Aarhus University1, University of Copenhagen2, Karolinska Institutet3, University of Ulm4, Umeå University5, Norwegian Institute of Public Health6, Utrecht University7, Imperial College London8, University of Malaya9, Cancer Epidemiology Unit10, University of Washington11, University of Basel12, Swiss Tropical and Public Health Institute13, University of Verona14, Pompeu Fabra University15, University of Hertfordshire16, Netherlands Organisation for Applied Scientific Research17
TL;DR: There is suggestive evidence that exposure to outdoor PM at the residence may be associated with higher risk for kidney parenchyma cancer; the results should be interpreted cautiously as associations may be due to chance.
Abstract: Several studies have indicated weakly increased risk for kidney cancer among occupational groups exposed to gasoline vapors, engine exhaust, polycyclic aromatic hydrocarbons and other air pollutant ...
51 citations
TL;DR: Successful smoking cessation is common in middle-aged smokers, and is associated with few smoking years and higher education, while an acute episode of ischaemic heart disease encouraged smoking cessation in the study population.
49 citations
TL;DR: Sleep problems are highly prevalent among subjects with CRS and the disease severity of CRS negatively affects sleep quality, and the addition of persistent allergic rhinitis to CRS further increased the risk of sleep problems.
Abstract: STUDY OBJECTIVES: To analyse the prevalence of sleep problems in subjects with CRS and to determine whether the disease severity of CRS affects sleep quality.METHODS: Questionnaires were sent to a ...
Lund University1, University of Gothenburg2, Haukeland University Hospital3, University of Bergen4, French Institute of Health and Medical Research5, National Institutes of Health6, University of Iceland7, Swiss Tropical and Public Health Institute8, University of Grenoble9, University of Pavia10, Umeå University11, Ludwig Maximilian University of Munich12, University of Melbourne13, University of Turin14, University of Huelva15, Uppsala University16
TL;DR: In this paper, a cross-sectional analysis of 3250 subjects (51% female) aged 38-67 years across 13 countries in the population-based third European Community Respiratory Health Survey was conducted.
Abstract: Activity-related breathlessness is twice as common among females as males in the general population and is associated with adverse health outcomes. We tested whether this sex difference is explained by the lower absolute forced expiratory volume in 1 s (FEV1) or forced vital capacity (FVC) in females.This was a cross-sectional analysis of 3250 subjects (51% female) aged 38-67 years across 13 countries in the population-based third European Community Respiratory Health Survey. Activity-related breathlessness was measured using the modified Medical Research Council (mMRC) scale. Associations with mMRC were analysed using ordered logistic regression clustering on centre, adjusting for post-bronchodilator spirometry, body mass index, pack-years smoking, cardiopulmonary diseases, depression and level of exercise.Activity-related breathlessness (mMRC ≥1) was twice as common in females (27%) as in males (14%) (odds ratio (OR) 2.21, 95% CI 1.79-2.72). The sex difference was not reduced when controlling for FEV1 % predicted (OR 2.33), but disappeared when controlling for absolute FEV1 (OR 0.89, 95% CI 0.69-1.14). Absolute FEV1 explained 98-100% of the sex difference adjusting for confounders. The effect was similar within males and females, when using FVC instead of FEV1 and in healthy never-smokers.The markedly more severe activity-related breathlessness among females in the general population is explained by their smaller spirometric lung volumes.
Journal Article•
TL;DR: The markedly more severe activity-related breathlessness among females in the general population is explained by their smaller spirometric lung volumes, which is similar within males and females, when using FVC instead of FEV1 and in healthy never-smokers.
TL;DR: There did not seem to be any association between exposure to traffic air pollution and episodic memory change, with a ΔEMM estimate of per 1 µg/m3 increase in NOx of 0.01 (95% Confidence Interval: −0.02,0.03).
Abstract: Associations between long-term exposure to ambient air pollution and cognitive function have been observed in a few longitudinal studies. Our aim was to investigate the association between long-term exposure to air pollution and episodic memory, a marker of early cognitive decline. We used data from the Betula study in Northern Sweden, and included participants 60 to 85 of age at inclusion, 1,469 persons in total. The participants were followed for up to 22 years, five years apart between 1988 and 2010. A composite of five tasks was used as a measure of episodic memory measure (EMM), and the five-year change in EMM score (ΔEMM) was calculated such that a participant could contribute with up to four measurement pairs. A Land Use Regression Model was used to estimate cumulative annual mean of NOx at the residential address of the participants (a marker for long-term exposure to traffic-related air pollution). There did not seem to be any association between exposure to traffic air pollution and episodic memory change, with a ΔEMM estimate of per 1 µg/m3 increase in NOx of 0.01 (95% Confidence Interval: −0.02,0.03). This is in contrast to a growing body of evidence suggesting associations between air pollution and cognitive function.
TL;DR: The magnitude of adaptation needed to lower vulnerability to heat in order to prevent an increase in heat-related deaths in the 2050s is estimated; this is the Adaptive Risk Reduction (ARR) needed.
Abstract: The health burden from heatwaves is expected to increase with rising global mean temperatures and more extreme heat events over the coming decades. Health-related effects from extreme heat are more common in elderly populations. The population of Europe is rapidly aging, which will increase the health effects of future temperatures. In this study, we estimate the magnitude of adaptation needed to lower vulnerability to heat in order to prevent an increase in heat-related deaths in the 2050s; this is the Adaptive Risk Reduction (ARR) needed. Temperature projections under Representative Concentration Pathway (RCP) 4.5 and RCP 8.5 from 18 climate models were coupled with gridded population data and exposure-response relationships from a European multi-city study on heat-related mortality. In the 2050s, the ARR for the general population is 53.5%, based on temperature projections under RCP 4.5. For the population above 65 years in Southern Europe, the ARR is projected to be 45.9% in a future with an unchanged climate and 74.7% with climate change under RCP 4.5. The ARRs were higher under RCP 8.5. Whichever emission scenario is followed or population projection assumed, Europe will need to adapt to a great degree to maintain heat-related mortality at present levels, which are themselves unacceptably high, posing an even greater challenge.
Imperial College London1, King's College London2, University of Southampton3, University of Helsinki4, University of Coimbra5, Medical University of Silesia6, Medical University of Łódź7, University of Southern Denmark8, Charité9, University of Würzburg10, University of Gothenburg11, Ghent University12, Karolinska Institutet13, Uppsala University14, Umeå University15, Jagiellonian University16
TL;DR: There was no consistent evidence for an association of asthma or CRS with fruit and vegetable intake in this representative sample of European adults.
Abstract: Fruits and vegetables are rich in compounds with proposed antioxidant, anti-allergic and anti-inflammatory properties, which could contribute to reduce the prevalence of asthma and allergic diseases. We investigated the association between asthma, and chronic rhino-sinusitis (CRS) with intake of fruits and vegetables in European adults. A stratified random sample was drawn from the Global Allergy and Asthma Network of Excellence (GA2LEN) screening survey, in which 55,000 adults aged 15–75 answered a questionnaire on respiratory symptoms. Asthma score (derived from self-reported asthma symptoms) and CRS were the outcomes of interest. Dietary intake of 22 subgroups of fruits and vegetables was ascertained using the internationally validated GA2LEN Food Frequency Questionnaire. Adjusted associations were examined with negative binomial and multiple regressions. Simes procedure was used to control for multiple testing. A total of 3206 individuals had valid data on asthma and dietary exposures of interest. 22.8% reported having at least 1 asthma symptom (asthma score ≥1), whilst 19.5% had CRS. After adjustment for potential confounders, asthma score was negatively associated with intake of dried fruits (β-coefficient −2.34; 95% confidence interval [CI] −4.09, −0.59), whilst CRS was statistically negatively associated with total intake of fruits (OR 0.73; 95% CI 0.55, 0.97). Conversely, a positive association was observed between asthma score and alliums vegetables (adjusted β-coefficient 0.23; 95% CI 0.06, 0.40). None of these associations remained statistically significant after controlling for multiple testing. There was no consistent evidence for an association of asthma or CRS with fruit and vegetable intake in this representative sample of European adults.
TL;DR: Snus use was associated with a higher prevalence of asthma, respiratory symptoms and snoring, and healthcare professionals should be aware of these possible adverse effects of snus use.
Abstract: Introduction Studies of the health effects of moist oral tobacco, snus, have produced inconsistent results The main objective of this study is to examine the health effects of snus use on asthma,
TL;DR: Air pollution was associated with dispensed asthma medications, especially in areas with comparatively higher levels of air pollution, and in children to parents with high education and children to mothers and father with a high education, respectively.
Abstract: It has been suggested that children that are exposed to a stressful environment at home have an increased susceptibility for air pollution-related asthma. The aim here was to investigate the associ ...
TL;DR: In this article, the authors examined correlations between self-reported and modelled exposure to traffic pollution, and found that selfreported exposure was positively associated with traffic pollution in the United Kingdom.
TL;DR: The association between being exposed to a desert environment and respiratory symptoms indicates that further protective measures should be introduced for military personnel serving in a desert environments.
Abstract: Introduction: The aim of this paper was to study whether Swedish soldiers who have served abroad had a higher prevalence of respiratory symptoms than the general population and, if this was the cas ...