Long-term health effects of the Eyjafjallajökull volcanic eruption: a prospective cohort study in 2010 and 2013.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.To examine the long-term development of physical and mental health following exposure to a volcanic eruption.Population-based prospective cohort study.In spring 2010, the Icelandic volcano Eyjafjallajökull erupted. Data were collected at 2 time points: in 2010 and 2013.Adult residents in areas close to the Eyjafjallajökull volcano (N=1096), divided according to exposure levels, and a non-exposed sample (n=475), with 80% participation rate in 2013.Physical symptoms in the previous year (chronic) and previous month (recent), and psychological distress (General Health Questionnaire-12-item version, GHQ-12), perceived stress (Perceived Stress Scale, PSS-4) and post traumatic stress disorder (PTSD) symptoms (Primary Care PTSD, PC-PTSD).In the exposed group, certain symptoms were higher in 2013 than in 2010, for example, morning phlegm during winter (OR 2.14; 95% CI 1.49 to 3.06), skin rash/eczema (OR 2.86; 95% CI 1.76 to 4.65), back pain (OR 1.45; 95% CI 1.03 to 2.05) and insomnia (OR 1.53; 95% CI 1.01 to 2.30), in addition to a higher prevalence of regular use of certain medications (eg, for asthma (OR 2.80; 95% CI 1.01 to 7.77)). PTSD symptoms decreased between 2010 and 2013 (OR 0.33; 95% CI 0.17 to 0.61), while the prevalence of psychological distress and perceived stress remained similar. In 2013, the exposed group showed a higher prevalence of various respiratory symptoms than did the non-exposed group, such as wheezing without a cold (high exposure OR 2.35; 95% CI 1.27 to 4.47) and phlegm (high exposure OR 2.81; 95% CI 1.48 to 5.55), some symptoms reflecting the degree of exposure (eg, nocturnal chest tightness (medium exposed OR 3.09; 95% CI 1.21 to 10.46; high exposed OR 3.42; 95% CI 1.30 to 11.79)).The findings indicate that people exposed to a volcanic eruption, especially those most exposed, exhibit increased risk of certain symptoms 3-4 years after the eruption.The government in Iceland, Nordic Centre of Excellence for Resilience and Societal Security—NORDRESS, which is funded by the Nordic Societal Security Program (grant number 68825)

Emergency hospital visits in association with volcanic ash, dust storms and other sources of ambient particles: a time-series study in Reykjavík, Iceland.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Volcanic ash contributed significantly to particulate matter (PM) in Iceland following the eruptions in Eyjafjallajökull 2010 and Grímsvötn 2011. This study aimed to investigate the association between different PM sources and emergency hospital visits for cardiorespiratory causes from 2007 to 2012. Indicators of PM10 sources; "volcanic ash", "dust storms", or "other sources" (traffic, fireworks, and re-suspension) on days when PM10 exceeded the daily air quality guideline value of 50 µg/m3 were entered into generalized additive models, adjusted for weather, time trend and co-pollutants. The average number of daily emergency hospital visits was 10.5. PM10 exceeded the air quality guideline value 115 out of 2191 days; 20 days due to volcanic ash, 14 due to dust storms (two days had both dust storm and ash contribution) and 83 due to other sources. High PM10 levels from volcanic ash tended to be significantly associated with the emergency hospital visits; estimates ranged from 4.8% (95% Confidence Interval (CI): 0.6, 9.2%) per day of exposure in unadjusted models to 7.3% (95% CI: -0.4, 15.5%) in adjusted models. Dust storms were not consistently associated with daily emergency hospital visits and other sources tended to show a negative association. We found some evidence indicating that volcanic ash particles were more harmful than particles from other sources, but the results were inconclusive and should be interpreted with caution.Icelandic Centre for Research PhD fun

Severe volcanic SO exposure and respiratory morbidity in the Icelandic population - a register study.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: The Holuhraun volcanic eruption September 2014 to February 2015 emitted large amounts of sulfur dioxide (SO2). The aim of this study was to determine the association between volcanic SO2 gases on general population respiratory health some 250 km from the eruption site, in the Icelandic capital area. Methods: Respiratory health outcomes were: asthma medication dispensing (AMD) from the Icelandic Medicines Register, medical doctor consultations in primary care (PCMD) and hospital emergency department visits (HED) in Reykjavík (population: 215000) for respiratory disease from 1 January 2010 to 31 December 2014. The associations between daily counts of health events and daily mean SO2 concentration and high SO2 levels (24-h mean SO2 > 125 μg/m3) were analysed using generalized additive models. Results: After the eruption began, AMD was higher than before (129.4 vs. 158.4 individuals per day, p < 0.05). For PCMD and HED, there were no significant differences between the number of daily events before and after the eruption (142.2 vs 144.8 and 18.3 vs 17.5, respectively). In regression analysis adjusted for other pollutants, SO2 was associated with estimated increases in AMD by 0.99% (95% CI 0.39-1.58%) per 10 μg/m3 at lag 0-2, in PCMD for respiratory causes 1.26% (95% CI 0.72-1.80%) per 10 μg/m3 SO2 at lag 0-2, and in HED by 1.02% (95% CI 0.02-2.03%) per 10 μg/m3 SO2 at lag 0-2. For days over the health limit, the estimated increases were 10.9% (95% CI 2.1-19.6%), 17.2% (95% CI 10.0-24.4%) for AMD and PCMD. Dispensing of short-acting medication increased significantly by 1.09% (95% CI 0.49-1.70%), and PCMD for respiratory infections and asthma and COPD diagnoses and increased significantly by 1.12% (95% CI 0.54-1.71%) and 2.08% (1.13-3.04%). Conclusion: High levels of volcanic SO2 are associated with increases in dispensing of AMD, and health care utilization in primary and tertiary care. Individuals with prevalent respiratory disease may be particularly susceptible. Keywords: Atmospheric transport; Epidemiology; Public health; Respiratory disease; Volcanic eruption.Icelandic Ministry of Healt

Increased respiratory morbidity associated with exposure to a mature volcanic plume from a large Icelandic fissure eruption.

The 2014-15 Holuhraun eruption in Iceland was the largest fissure eruption in over 200 years, emitting prodigious amounts of gas and particulate matter into the troposphere. Reykjavík, the capital area of Iceland (250 km from eruption site) was exposed to air pollution events from advection of (i) a relatively young and chemically primitive volcanic plume with a high sulphur dioxide gas (SO2) to sulphate PM (SO42-) ratio, and (ii) an older and chemically mature volcanic plume with a low SO2/SO42- ratio. Whereas the advection and air pollution caused by the primitive plume were successfully forecast and forewarned in public advisories, the mature plume was not. Here, we show that exposure to the mature plume is associated with an increase in register-measured health care utilisation for respiratory disease by 23% (95% CI 19.7-27.4%) and for asthma medication dispensing by 19.3% (95% CI 9.6-29.1%). Absence of public advisories is associated with increases in visits to primary care medical doctors and to the hospital emergency department. We recommend that operational response to volcanic air pollution considers both primitive and mature types of plumes

Joint effect of heat and air pollution on mortality in 620 cities of 36 countries

Background: The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent. Objectives: To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries. Methods: We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995-2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants. Results: We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2. Conclusions: Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.Funding: Massimo Stafoggia, Francesca K. de’ Donato, Masna Rai and Alexandra Schneider were partially supported by the European Union’s Horizon 2020 Project Exhaustion (Grant ID: 820655). Jan Kyselý and Aleš Urban were supported by the Czech Science Foundation project (22-24920S). Joana Madureira was supported by the Fundação para a Ciência e a Tecnologia (FCT) (grant SFRH/BPD/115112/2016). Masahiro Hashizume was supported by the Japan Science and Technology Agency (JST) as part of SICORP, Grant Number JPMJSC20E4. Noah Scovronick was supported by the NIEHS-funded HERCULES Center (P30ES019776). South African Data were provided by Statistics South Africa, which did not have any role in conducting the study. Antonio Gasparrini was supported by the Medical Research Council-UK (Grants ID: MR/V034162/1 and MR/R013349/1), the Natural Environment Research Council UK (Grant ID: NE/R009384/1), and the European Union’s Horizon 2020 Project Exhaustion (Grant ID: 820655).info:eu-repo/semantics/publishedVersio

Health effects of air pollution in Iceland : respiratory health in volcanic environments

Air pollution has adverse effects on human health. The respiratory system is the most exposed and short-term changes in air pollution levels have been associated with worsening of asthma symptoms and increased rates of heart attacks and stroke. Air pollution in cities due to traffic is the major concern, as many people are exposed. However, natural sources of air pollution such as natural dust storms and ash from volcanic eruptions can also compromise human health. Exposure to volcanic eruptions and other natural hazards can also threaten mental health. Air pollution has not been extensively studied in Iceland, in spite of the presence of several natural pollution sources and a sizeable car fleet in the capital area. The aim of this thesis was to determine if there was a measurable effect on health which could be attributed to air pollution in Iceland. This aim was pursued along two paths; time series studies using register data aimed to determine the short-term association between daily variation in air pollution and on one hand daily dispensing of anti-asthma medication or the daily number of emergency room visits and emergency admissions for cardiopulmonary causes and stroke. The other method was to investigate if exposure to the Eyjafjallajökull volcanic eruption was associated with adverse health outcomes, either at the end of the eruption, or 6 months later. In paper I time series regression was used to investigate the association between the daily number of individuals who were dispensed anti-asthma medication and levels of the air pollutants particle matter with an aerodynamic diameter less than 10 μm (PM10), nitrogen dioxide (NO2), ozone (O3), and hydrogen sulfide (H2S) during the preceding days. For the study period 2006-9, there were significant associations between the daily mean of PM10 and H2S and the sales of anti-asthma medication 3 to 5 days later. Giving the exposure as the highest daily one-hour mean gave more significant results. Air pollution negatively affected the respiratory health of asthma medication users, prompting them to refill their prescriptions before they had originally intended to. In paper II the main outcome was the number of individuals seeking help at Landspitali University Hospital emergency room for cardiopulmonary disease or stroke. Time series regression was used to identify the lag that gave the best predictive power, and models were run for data for 2003-9 pollutants PM10, NO2, and O3. O3 was significantly associated with the number of emergency hospital visits the same day and two days later in all models, and both for men, women and the elderly. Only emergency hospital visits of the elderly were associated with NO2, and there were no associations with PM10. In paper III the aim was to investigate if the health effects of PM10 were affected by the addition of volcanic ash from the 2010 eruption of Eyjafjallajökull and 2011 eruption of Grímsvötn to PM10 in the capital area. Time series regression of emergency hospital visits and PM10 before and after the Eyjafjallajökull eruption showed that the effect tended to be higher after the eruption, but the results were not significant. Analysis with a binary indicator for high levels of PM10 from volcanic ash and other sources showed that volcanic ash was associated with increased emergency hospital visits. There were no associations with high levels of PM10 from other sources. In paper IV, the health of the population exposed to the ongoing eruption of Eyjafjallajökull in 2010 was investigated thoroughly. Lung function in adults was better than in a reference group from the capital area, though many reported sensory organ irritation symptoms and symptoms of stress and mental unhealth, especially those with underlying diseases. Paper V report the results from a questionnaire study which was carried out six months after the Eyjafjallajökull eruption. The study population comprised a cohort of south Icelanders exposed to the eruption to varying degrees and a reference group from north Iceland. Respiratory and eye symptoms were much more common in south Icelanders than in the reference group, after adjusting for demographic characteristics. Mental unhealth rates had declined considerably. In the studies, we found that urban air pollution and natural particles have short-term effects on anti-asthma medication dispensing and emergency room visits and hospital admissions. Exposure to natural particles in the form of volcanic dust was associated with increased respiratory symptoms in a very exposed population. There were indications that volcanic ash particles were associated with increased emergency hospital visits in the following days.Statement of collaborationThis thesis and the work in it have been produced in collaboration between University of Iceland and Umeå University. The thesis was issued and defended at both institutions. Responsible</p

Loftmengun í Reykjavík og notkun lyfja gegn teppusjúkdómum í öndunarvegi

Ritgerðin er lokuð til janúar 2012 vegna birtingar í ritrýndu tímaritiIntroduction: Iceland's capital region has overall good air quality, but sulphur gas (H2S) emissions from geothermal power plants and particle pollution (PM) are of concern. Short¬ term effects of ambient H2S at moderate levels are largely unknown. PM is known to aggravate symptoms of respiratory disease. This is the first study to examine the association between daily air pollution levels and respiratory health in Iceland's capital area. Data: A timeline of the daily number of adults in the capital area who were dispensed one or more drugs for obstructive pulmonary diseases (WHO ATC category R03) were obtained from by the Directorate of Health drug registry. Data on PM10, NO2, O3 and H2S as well as weather factor measurements were provided by the City of Reykjavík Environmental Office. The study period was from February 22nd 2006 to September 30th 2008. Methods: The daily number of individuals dispensed drugs for obstructive pulmonary disease was modeled as a function of three-day moving average¬ and the three-day moving average of the daily maximum 1¬hour mean (peak pollution) of the pollutants with lag 0 to 14 days using Poisson regression. The model included covariates to adjust for climate, time trends, influenza season and day¬ of week. Insignificant covariates were excluded from the model. Results: There was a positive association between air pollution levels and the daily number of individuals who were dispensed drugs with a lag of three days. The association was significant (p < 0.05) for lag 3 to 5 of the 24¬hour mean of H2S and PM10 in a three-day moving average model. The increase corresponds to an increase in the number of individuals who were dispensed drugs of 3% and 2% between the 10th and 90th percentile of PM10 and H2S respectively. Risk estimates for the number of individuals dispensed drugs as a function of peak pollution were similar to estimates for three-day moving average for PM10 and H2S, 6% and 5% for NO2 and O3, all significant. Conclusion: There was a small but statistically significant association between ambient air pollution in Iceland's capital and dispensings of respiratory drugs, particularly for peak pollution. The results indicate that intermittent exposure to ambient H2S may aggravate symptoms of respiratory disease.Sjóður Odds Ólafssonar, Styrktar- og minningarsjóður Samtaka gegn astma­ og ofnæmi, Rannsóknarsjóður Vegagerðarinnar, Rannsóknarsjóður Háskóla Ísland

Ísland og útlönd. Kennslubækur í Íslandssögu og viðhorf þeirra til útlanda

Fortíð Íslands sem nýlendu, einokunarverslunin og sjálfstæðisbaráttan hafa enn drjúg áhrif á samfélagsumræðuna á Íslandi og eru mikilvægur þáttur í sjálfsmynd Íslendinga. Kennslubækur í grunnskóla ná til margra einstaklinga og fræðimenn hafa áður greint innihald kennslubóka frá mismunandi sjónarhornum í samband við þjóðerni, kynþætti og útlendinga á Íslandi. Einnig hefur innihald kennslubóka í Íslandssögu frá aldamótunum 1900 verið rannsakað. Markmið þessarar rannsóknar er að skoða viðhorf nokkurra íslenskra kennslubóka sem voru notaðar í grunnskólum á 20. öld (útgáfuár 1915-1988) til útlanda og útlendinga og reyna að setja það í samhengi við umræðu nú á dögum um hlutskipti Íslands í alþjóðasamfélaginu. Greint var innihaldi fjögurra kennslubóka með tilliti til áherslu í efnisvali, stíls og orðalags. Einnig var leitað að merki um þjóðernishyggju og könnuð viðhorf höfunda til heimildanotkunar. Niðurstöður greiningarinnar leiddu í ljós mjög mikinn mun á bæði hversu mikla áherslu hver bók leggur á einstök tímabil (í blaðsíðum) og orðalagið, sérstaklega lýsingaorð. Því nýrri bók sem bókin er, því mildara er orðalag og dómharka minni. Elsta bókin, sem er nokkuð tilfinningahlaðin í orðavali, var hins vegar mjög vinsæl og þótti mjög skemmtilegar aflestrar en bækurnar sem komu út um miðja öldina voru taldar frekar leiðinlegar. Mikill munur fannst einnig hvað varðar tilvísum í heimildar, hlutlægni, magn umfjöllunar um einstaklinga og tilvísun í erlenda atburði. Eldri bækurnar voru hlutdrægari, fjölluðu mikið um einstaklinga, vísuðu ekki í heimildir og fjölluðu lítið um atburði í alþjóðlegu samhengi. Hins vegar notaði elsta bókin mest frásagnartækni. Yngsta bókin var sú eina sem gagnrýndi eða tjáði einhvern efa gagnvart hegðun Íslendinga í stjórnmálum, einkum gagnvart Dönum. Út frá þessari rannsókn má segja að íslenskar kennslubækur hafi þróast mikið á tímabilinu. Samt er víst, að mikið af þeim hugmyndum, skoðunum og þeirri sjálfsmynd sem kemur frem í eldri bókunum speglast enn í samfélagsumræðu nútímans, og taka mun tíma að breyta því

The changing gender gap in substance use disorder: a total population-based study of psychiatric in-patients.

To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.To study changes over a 25-year period in the gender gap in discharge diagnoses of alcohol use disorder (AUD) and other substance use disorder (SUD) in psychiatric in-patients. A register-based study of all admissions to psychiatric hospitals in Iceland between January 1983 and December 2007. Annual rate of admissions to psychiatric hospitals, adjusted for changes in the size of the population. Furthermore, gender-specific analysis of changes in discharge diagnoses of AUD solely and other SUD (including AUD with other SUDs). Of all psychiatric admissions, the proportion of any SUD admissions increased considerably during the study period. This increase was most pronounced in SUDs other than solely AUD. AUD increased for women and decreased for men. The male to female ratio of AUD alone decreased from 4.2 to 1.5 (P < 0.001). There was no significant change in the gender gap for other SUDs (P = 0.96). There has been a marked convergence of the gender gap in discharge diagnosis of alcohol use disorder among psychiatric in-patients in Iceland over the last decades. For other substance use disorders, the change was not as pronounced. Our results emphasize the importance of monitoring changes in substance use disorder diagnosis as this may uncover different treatment needs in this group of vulnerable individuals