Indoor environment and recurrent wheezing in young children

Recurrent wheezing is one of the most common causes of morbidity and hospitalisation among infants and young children in many westernised countries. Respiratory infections and exposure to tobacco smoke have been identified as important risk factors. The indoor environment is also clearly of importance since we spend most of our time indoors. The aim of this thesis was to study the influence of various ventilation systems on indoor air quality, and to elucidate the impact of outdoor and indoor environment, primarily with focus on indoor air, on the development of recurrent wheezing in children up to the age of two years. The thesis is based on two main studies: The first study assesses the impact of various ventilation systems on the indoor quality of singlefamily homes, located within a small residential area outside Stockholm. All houses were originally designed for natural ventilation. Twenty-two of the 59 investigated houses had been refitted with mechanical supply and exhaust ventilation systems. In another eight houses the original natural ventilation had been adjusted in order to improve the air change rate. In the second study, we followed a birth cohort (BAMSE), comprising 4,089 children, born in predefined areas of Stockholm, during the two first years of the children’s lives. Both urban and suburban districts were represented, including different types of buildings, dwellings with and without gas stoves for cooking, different socio-economic groups, and areas with various types of traffic exposure. Information on exposures was obtained from parental questionnaires. In addition, children with recurrent wheezing, and two age-matched controls per case, were identified and enrolled in a nested case-control study. Their homes were investigated and ventilation rate, humidity, temperature and NO2 measured. In BAMSE, an increased risk of recurrent wheezing was shown for children living in apartment buildings constructed after 1940 and single-family homes with crawl space/concrete slab foundation, compared with those living in buildings erected before 1940, OR 2.5 (1.3-4.8) and OR 2.5 (1.1-5.4). This was not primarily explained by differences in type of ventilation system, measured ventilation rate, occurrence of house dust mite allergen in the home, or other known risk factors for childhood wheezing. Air change rate (ACH) was inversely related to indoor humidity, and increased humidity above median level 5.8 g/kg was associated with infant recurrent wheezing, OR 1.7 (1.0-2.9). In single-family homes, both studies show that mechanical ventilation increases the possibility of reaching an ACH of ≥0.5, which in cold temperate regions protects buildings from increased indoor humidity, including levels that promote mite survival. Furthermore, occurrence of windowpane condensation on the interior side of double-glazed windows in wintertime indicated indoor humidity above 5.8 g/kg. Windowpane condensation, reported consistently over several years in the same home, was also associated with an increased risk of infant recurrent wheezing, OR 2.2 (1.1-4.5). There was also a higher proportion of recurrent wheezing in children exposed to signs of dampness, prospectively reported by parents, OR 1.4 (0.9-2.2) or observed at home inspections 1.6 (1.0-2.5). Moreover, recently painted surfaces in the child’s bedroom were associated with an increased OR for recurrent wheezing, 1.7 (1.3-2.6). It was further suggested that exposure to air pollution including NO2, particularly in combination with exposure to environmental tobacco smoke (ETS), increases the risk of recurrent wheezing in children: the OR was 3.1 (1.3-7.3) among children exposed to the highest quartile of indoor (NO2) and ETS. It may be concluded that various building-related exposures such as certain types of building constructions, signs of dampness and newly painted interior surfaces, were associated with recurrent wheezing in children up to the age of two. In addition NO2, especially in combination with ETS seems to increase the risk of infant recurrent wheezin

Livelihood and transition to certified cacao production in the Peruvian Amazonas

Peru is recorded as the second largest organic cacao producer and the second largest coca producer in the world. Consequently, the demand has made cacao an important alternative crop for coca. Cacao can just be grown around the equator and is therefore an attractive cash-crop for export to countries in Europe and North America. Therefore governments, enterprises and non-governmental organisations are supporting organic cultivations of cacao. This thesis has the objective to find out the situation of the livelihood of cacao producers in the process of becoming certified cacao producers. What challenges and which hopes were considered by the woman and man in the households? Would there be clear divides of work locations relating to gender, and who was responsible for making the decisions in the family? By the use of semi-structured interviews and participating practical methods, ten families in the district of Irazola in the Peruvian Amazon were selected. The study proved customary roles of women in charge of domestic work, children and small animals while men were more often working in the fields and going to meetings. Off-farm work for women was found to be selling food on the main street, while men were driving taxis and worked as technicians. Decision and opinions were more similar within households than between women and men as a group. Although men often had the main responsibility over money and decision for instance to become part of the certification process. The farmers - women and men - wished to grow more cacao trees so they could afford education for their children, a better house, move to other places, start a restaurant or shop. There have not been many studies of small-holding cacao producers in Latin America and therefore this study is useful to draw examples from without making any generalisations

Indoor environment and recurrent wheezing in young children

Recurrent wheezing is one of the most common causes of morbidity and hospitalisation among infants and young children in many westernised countries. Respiratory infections and exposure to tobacco smoke have been identified as important risk factors. The indoor environment is also clearly of importance since we spend most of our time indoors. The aim of this thesis was to study the influence of various ventilation systems on indoor air quality, and to elucidate the impact of outdoor and indoor environment, primarily with focus on indoor air, on the development of recurrent wheezing in children up to the age of two years. The thesis is based on two main studies: The first study assesses the impact of various ventilation systems on the indoor quality of singlefamily homes, located within a small residential area outside Stockholm. All houses were originally designed for natural ventilation. Twenty-two of the 59 investigated houses had been refitted with mechanical supply and exhaust ventilation systems. In another eight houses the original natural ventilation had been adjusted in order to improve the air change rate. In the second study, we followed a birth cohort (BAMSE), comprising 4,089 children, born in predefined areas of Stockholm, during the two first years of the children's lives. Both urban and suburban districts were represented, including different types of buildings, dwellings with and without gas stoves for cooking, different socio-economic groups, and areas with various types of traffic exposure. Information on exposures was obtained from parental questionnaires. In addition, children with recurrent wheezing, and two age-matched controls per case, were identified and enrolled in a nested case-control study. Their homes were investigated and ventilation rate, humidity, temperature and N02 measured. In BAMSE, an increased risk of recurrent wheezing was shown for children living in apartment buildings constructed after 1940 and single-family homes with crawl space/concrete slab foundation, compared with those living in buildings erected before 1940, OR 2.5 (1.3-4.8) and OR 2.5 (1.1-5.4). This was not primarily explained by differences in type of ventilation systems, measured ventilation rate, occurrence of house dust mite allergen in the home, or other known risk factors for childhood wheezing. Air change rate (ACH) was inversely related to indoor humidity, and increased humidity above median level 5.8 g/kg was associated with infant recurrent wheezing, OR 1.7 (1.0-2.9). In single-family homes, both studies show that mechanical ventilation increases the possibility of reaching an ACH of >=O.5, which in cold temperate regions protects buildings from increased indoor humidity, including levels that promote mite survival. Furthermore, occurrence of windowpane condensation on the interior side of double-glazed windows in wintertime indicated indoor humidity above 5.8 g/kg. Windowpane condensation, reported consistently over several years in the same home, was also associated with an increased risk of infant recurrent wheezing, OR2.2 (1.1-4.5). There was also a higher proportion of recurrent wheezing in children exposed to signs of dampness, prospectively reported by parents, OR 1.4 (0.9-2.2) or observed at home inspections 1.6 (1.0-2.5). Moreover, recently painted surfaces in the child's bedroom were associated with an increased OR for recurrent wheezing, 1.7 (1.3-2.6). It was further suggested that exposure to air pollution including N02, Particularly in combination with exposure to environmental tobacco smoke (ETS), increases the risk of recurrent wheezing in children: the OR was 3.1 (1.3-7.3) among children exposed to the highest quartile of indoor (N02) and ETS. It may be concluded that various building-related exposures such as certain types of building constructions, signs of dampness and newly painted interior surfaces, were associated with recurrent wheezing in children up to the age of two. In addition N02, especially in combination with ETS seems to increase the risk of infant recurrent wheezing

Quantifying uncertainty in health impact assessment: a case-study example on indoor housing ventilation.

Quantitative health impact assessment (HIA) is increasingly being used to assess the health impacts attributable to an environmental policy or intervention. As a consequence, there is a need to assess uncertainties in the assessments because of the uncertainty in the HIA models. In this paper, a framework is developed to quantify the uncertainty in the health impacts of environmental interventions and is applied to evaluate the impacts of poor housing ventilation. The paper describes the development of the framework through three steps: (i) selecting the relevant exposure metric and quantifying the evidence of potential health effects of the exposure; (ii) estimating the size of the population affected by the exposure and selecting the associated outcome measure; (iii) quantifying the health impact and its uncertainty. The framework introduces a novel application for the propagation of uncertainty in HIA, based on fuzzy set theory. Fuzzy sets are used to propagate parametric uncertainty in a non-probabilistic space and are applied to calculate the uncertainty in the morbidity burdens associated with three indoor ventilation exposure scenarios: poor, fair and adequate. The case-study example demonstrates how the framework can be used in practice, to quantify the uncertainty in health impact assessment where there is insufficient information to carry out a probabilistic uncertainty analysis

Finns kulturreservat utanför Sverige? : - En introduktion till bevarande av kulturhistoriskt värdefulla miljöer i utvalda europeiska länder.

Verksamhetsförlagda studie

Vägen till externhandel

Etableringen av externhandeln i svenska kommuner har ökat under senare år och flera kommuner har projekt som ligger i startgroparna. Mellan åren 2000 och 2005 dubblerades antalet områden med handel i externa lägen (2008, Länsstyrelsen i Skåne län). Sedan 2000 har 64 nya köpcentrum öppnats runt om i landet. Totalt finns nu 298 stycken och ytterligare 22 är planerade fram till 2016 (ncscnordic.org). Externhandelns förespråkare hävdar nödvändigheten i externa köpcentrum för att kunna konkurera med andra orters utbud. De menar att handeln centraliseras och att de kommuner som inte satsar nu riskerar att missa tåget. Det får till viss del stöd av en utredning som gjordes av Handelns utredningsinstitut 2008. Den visar att 2007 stod 50 av landets 290 kommuner för 75% av den totala sällanköpsvaruhandeln, samtidigt som 100 kommuner delade på 80% av den totala dagligvaruhandeln. Enligt handelns utredningsinstitut är konsumenter också beredda att åka allt längre sträckor för att handla sällanköpsvaror som kläder och möbler. Förespråkarna menar vidare att externhandel lockar ett annat klientel och därmed inte påverkar den befintliga handeln i staden. Kritiker hävdar istället att antalet konsumenter är begränsat och pengarna i deras plånböcker likaså. De menar att handel utanför stadskärnan riskerar att slå ut handeln i centrum. De menar också att externhandel bygger in kommuner i ett ökat bilberoende och en ohållbar utveckling som strider mot miljömål. En annan aspekt är att dagligvaruhandel flyttar ut från centrum till externhandelsområden och att det i hög grad påverkar dem som inte har tillgång till bil och människor som redan är socialt utstötta (Länsstyrelsen Skåne län 2001). Handelns utredningsinstitut talar i sin rapport från 2008 om substitutionseffekt och överspillningseffekt som två möjliga effekter av externhandel. Substitutionseffekt innebär att en konsument som bor i stadens centrum alternativt i grannkommunen ersätter sina inköp i stadskärnan, eller den egna kommunen, med handel i ett externt köpcentrum utanför centralorten. Överspillningseffekten innebär att konsumenten som reser till ett externt köpcentrum för att handla sedan också handlar i stadens centrum. Substitutionseffekten leder till en utarmning av stadens centrum och kranskommuner medan överspillningseffekten leder till en positiv utveckling för både den centrala och externa handeln. Vilka avvägningar gör kommuner inför en etablering av extern detaljhandel? Hur använder kommunen sig av sitt planmonopol och i vilken utsträckning samarbetar kommuner och regioner i frågor om externhandel? Vilka förväntningar har kommuner, representanter för handel och politiker på utvecklingen i kommunen efter en nyetablering av externhandel? Hur påverkas de gamla stadskärnorna av att ny handel etableras utanför stadens centrum och erbjuder stora shoppingytor, lättåtkomligt från motorvägen, med gratis parkering och tak som skyddar mot väder och vind

FYSISK PLANERING OCH FÖREBYGGANDE AV ÖVERSVÄMNINGSKONSEKVENSER

Arbetet undersöker hur man genom fysisk planering kan reglera förebyggande för att minska risken för och konsekvenserna av översvämning

Visions and dreams in polycentric regions of Sweden : The importance of railway commutations in Linköping/Norrköping

Regioner har alltid funnits. Det har stått för det intermediära, en funktion mellan det lokala och det centrala styret. Den geografiska omfattningen har varit allt från länsindelningar till stora internationella eller kulturella regioner. Historiskt sätt, kan regioner vara funktionella, administrativa eller kulturella. När Sverige övergick till att bli ett industrisamhälle, blev regioner en viktig utgångspunkt för att förändra de nationella näten. För att förstå regioners utveckling, kan vi dela upp den i nyregionalism och gammal regionalism. Den gamla regionalismen innebar att staten hjälpte regioner att utvecklas genom att ge dem statliga bidrag. Detta var en process under 1960-1980-talet. Nyregionalismen, som kom därefter, utgjordes av att regioner fick större makt att själva förändra sin situation. Samtidigt i världen, började en in-ternationaliseringsprocess att märkas allt tydligare. Ekonomin i världen, påverkade även ekonomin i Sverige. Det lokala och det globala påverkade varandra och regioner började konkurrera globalt. Regioner styrdes inte längre av bara staten, utan av flera aktörer. Regioner skapas med hjälp av olika drivkrafter, samt de möjligheter som finns förankrade på platsen. Samtidigt som de måste drivas av en tro på sig själva och våga satsa på det de tror på. Ett annat sätt att förstå samhällsutvecklingen är genom Törnqvists uppdelning av regionalisering och globalisering. Regionalisering förutsätter att regionala eller lokala band gör att verk-samheter och människor binder sig till vissa platser. Globalisering innebär tvärtom att verk-samheter och människor är beroende av sin stora rörlighet och ett nätverk utan gränser. Både globalisering och regionalisering påverkas av suveräna stater, nätverk och självmedvetna regioner (som har kraft att styra sitt eget område, utan en Superior makt). Ohmae talar för att världen idag består av regioner och överstatliga/suveräna stater. Vi har ingått en andra globaliseringsfas, där världen är gränslös och digital. Även om regioner idag påverkas av landets lagar för att kontrollera människor och varor, så att samhället upprätthåller säkerhet och ord-ning. I regioner måste det finnas noder, där den globala världen knyts ihop och människor kan träffas i verkligheten. Regioner måste dessutom vara flexibla för att kunna anpassa sig efter den globala utvecklingen. En region är en social konstruktion som skapas genom människorna som vistas dagligen i den, samt hur de som ser den utifrån. Dess identitet skapas genom det sätt som den särskiljer sig från andra regioner. Enligt Soja förstår vi regioner ge-nom dess formation i landskapet och inte genom dess historia. Ett sätt att förstå regioner är genom att se dem som en polycentrisk urban region. Det vill säga, som ett stort geografiskt område med flera centrala punkter som gör att området hänger ihop, utan att någon punkt/nod dominerar. Genom områdets gemensamma resurser och till-gångar, blir den polycentriskt urbana regionen en starkare global konkurrenskraft. Ett sätt att stärka regionen är internt genom dess infrastruktur. De starka förbindelserna bygger bland annat upp regionens ekonomiska och sociala nätverk. Det har hävdats att det inte kan finnas polycentriska noder, utan att det alltid måste finnas en central punkt i samhället. Exempelvis måste det finnas centrala noder i ett globalt nät-verk. Linköping/Norrköping utgör ett undantag. Där har två lika stora storstäder gått ihop och börjat skapa sig en identitet genom att marknadsföra sig som Sveriges fjärde största Stor-stadsregion. Städerna har tidigare drivits av en stor konkurrenskraft sinsemellan, men har på senare tid börjat inse värdet i att arbeta tillsammans och därmed bilda ett flerkärnigt centrum i regionen. Detta för att åstadkomma en starkare konkurrenskraft, inte bara mot andra städer och storstadsregioner i Sverige, utan även internationellt och globalt. Tillsammans utgörs de båda kommunerna av ungefär 250 000 invånare och 22 300 dagliga in- och utpendlare. Norrköping har växt mycket tack vare att de fick utlokaliserat en del av Linköpings universitet för ungefär tio år sedan. Studenterna i staden har lyft fram industrilandskapet och attraherat både kultur och företag. Utbildning och infrastruktur är enligt många det som skulle utveckla Linköping/ Norrköpingsregionen bäst. Ett utvecklat transportnät skapar grunden till den funktionella regionen. Därför behövs infrastrukturen i Sveriges nya storstadsregion stärkas. När de fysiska nätverken fungerar, är det även möjligt att skapa en fullt integrerad arbetsmarknad i regionen. Därför är det viktigt att projektet med att binda ihop Norrköping och Linköping med en snabbtågsförbindelse, den så kallade Ostlänken, genomförs. Ostlänken är en del av både Europakorridoren och den nordiska triangeln. Den stöds till viss del av medel från EU-fonden Transeuropeiska nätverket – transporter (TEN-T), vars uppgift är att förbättra inf-rastrukturen i Europa (se bilaga 1-3). Ostlänken ska bli 15 mil lång, byggnationen planeras att starta 2010-2015 och vara klar 2025-2030 (se bilaga5). Med den här studien vill jag visa att Ostlänken är en viktig förutsättning för att regionen i Linköping/Norrköping ska kunna bli en bärkraftig Storstadsregion.In Sweden during the 1960s to 1980s, regions became an important aid to arrange a more uniform distribution of work. The northern parts of Sweden had lost ten thousands of job opportunities in a period of five years. The government decided to react and supported the northern regions, and this was the start of regional development in Sweden. Since then regional development has become more of a bottom up issue where regions are believed to have an ability to change their position by themselves, even if they still are very affected by different authorities like the European Union. Today regions are often understood as policy areas in-between the local and central government. But according to Ohmae, we have also entered a second global stage, which means that the world is increasingly dependent on digital technologies and in some respect less depend-ent on traditional borders. At the same time, the rate of urbanisation is speeding up in many places. This has brought about the development of various forms of metropolis and polycentric regions. There are different kinds of polycentric regions, such as the functional which is a region that is made up of good communication abilities. This could be physical infrastructure such as railroads. As an empirical example of this, I have chosen to examine the visions concerning a polycentric region in Sweden, i.e. the new region uniting Linköping and Norrköping. In the summer of 2006 this urban space was officially recognized by Nutek, the Swedish Agency for Economic and Regional Growth, as a potential new urban region. Both city regions have started a co-operation which strives to identify the two cities as a twin-city. The essay concludes that for the region to become an attractive and integrated new polycentric region, it is essential to develop functional commuting opportunities, such as the vision of the railway communication Ostlänken