The social context of active distress in patients with early myocardial infarction

Data of a retrospective case control study on 380 male patients with clinically documented first myocardial infarction (MI) (age 30-55) as well as findings of a follow-up over 18 months of 70% of this sample are presented. Results show first, that specific work stressors, lack of social support, and acute life changes are each significantly more prevalent among subjects with MI than among healthy controls; second, that significantly greater parts of MI subjects can be classified as simultaneously exposed to several chronic and acute social risks; third, that social stressors are related to the recurrence of cardiac symptoms in a follow-up after rehabilitation. These findings are discussed with regard to possible methodological bias such as the role of denial and neuroticism in patients under study, influences caused by interviewers, and limited validity of subjective stress rating. After controlling for these biases, findings basically remain stable. It is argued that a certain class of critical socio-emotional experiences, labeled 'active distress' may be harmful to neurohormonal imbalance, and, consequently, to several precursors of cardiovascular diseases. This class of experiences is reinforced and sustained by social contexts as the ones investigated in this study.

Exposure to local, source-specific ambient air pollution during pregnancy and autism in children : a cohort study from southern Sweden

Evidence of air pollution exposure, namely, ambient particulate matter (PM), during pregnancy and an increased risk of autism in children is growing; however, the unique PM sources that contribute to this association are currently unknown. The aim of the present study was to investigate local, source-specific ambient PM exposure during pregnancy and its associations with childhood autism, specifically, and autism spectrum disorders (ASD) as a group. A cohort of 40,245 singleton births from 2000 to 2009 in Scania, Sweden, was combined with data on locally emitted PM with an aerodynamic diameter < 2.5 µm (PM2.5). A flat, two-dimensional dispersion model was used to assess local PM2.5 concentrations (all-source PM2.5, small-scale residential heating- mainly wood burning, tailpipe exhaust, and vehicle wear-and-tear) at the mother’s residential address during pregnancy. Associations were analyzed using binary logistic regression. Exposure to local PM2.5 during pregnancy from each of the investigated sources was associated with childhood autism in the fully adjusted models. For ASD, similar, but less pronounced, associations were found. The results add to existing evidence that exposure to air pollution during pregnancy may be associated with an increased risk of childhood autism. Further, these findings suggest that locally produced emissions from both residential wood burning and road traffic-related sources (tailpipe exhaust and vehicle wear-and-tear) contribute to this association

Prenatal Exposure to Locally Emitted Air Pollutants Is Associated with Birth Weight : An Administrative Cohort Study from Southern Sweden

While prenatal exposure to ambient air pollution has been shown to be associated with reduced birth weight, there is substantial heterogeneity across studies, and few epidemiological studies have utilized source-specific exposure data. The aim of the present study was, therefore, to investigate the associations between local, source-specific exposure to fine particulate matter (PM2.5) during pregnancy and birth weight. An administrative cohort comprising 40,245 singleton births from 2000 to 2009 in Scania, Sweden, was combined with data on relevant covariates. Investigated sources of PM2.5 included all local sources together as well as tailpipe exhaust, vehicle wear-and-tear, and small-scale residential heating separately. The relationships between these exposures, rep-resented as interquartile range (IQR) increases, and birth weight (continuous) and low birth weight (LBW; &lt;2500 g) were analyzed in crude and adjusted models. Each local PM2.5 source investigated was associated with reduced birth weight; average decreases varied by source (12–34 g). Only small-scale residential heating was clearly associated with LBW (adjusted odds ratio: 1.14 (95% confidence interval: 1.04–1.26) per IQR increase). These results add to existing evidence that prenatal exposure to ambient air pollution disrupts fetal growth and suggest that PM2.5 from both vehicles and small-scale residential heating may reduce birth weight

Fetal growth and air pollution - A study on ultrasound and birth measures

Air pollution has been suggested to affect fetal growth, but more data is needed to assess the timing of exposure effects by using ultrasound measures. It is also important to study effects in low exposure areas to assess eventual thresholds of effects. The MAPSS (Maternal Air Pollution in Southern Sweden) cohort consists of linked registry data for around 48,000 pregnancies from an ultrasound database, birth registry and exposure data based on residential addresses. Measures of air pollution exposure were obtained through dispersion modelling with input data from an emissions database (NOx) with high resolution (100–500 m grids). Air pollution effects were assessed with linear regressions for the following endpoints; biparietal diameter, femur length, abdominal diameter and estimated fetal weight measured in late pregnancy and birth weight and head circumference measured at birth. We estimated negative effects for NOx; in the adjusted analyses the decrease of abdominal diameter and femur length were −0.10 (−0.17, −0.03) and −0.13 (−0.17, −0.01) mm, respectively, per 10 µg/m3 increment of NOx. We also estimated an effect of NOx-exposures on birth weight by reducing birth weight by 9 g per 10 µg/m3 increment of NOx. We estimated small but statistically significant effects of air pollution on late fetal and birth size and reduced fetal growth late in pregnancy in a geographic area with levels below current WHO air quality guidelines

Estimated health benefits of exhaust free transport in the city of Malmö, Southern Sweden

Luftföroreningar står för ett av åtta förtida dödsfall i världen, och utgör därmed ett stort hot mot människors hälsa. HIA (hälsokonsekvensbedömningar) av hypotetiska förändringar i luftföroreningshalter kan användas som ett sätt att bedöma hälsoeffekter, planer och projekt som beslutsfattare behöver för att förhindra sjukdom. Syftet med denna studie var att beräkna hälsoeffekter som kan tillskrivas hypotetisk nedgång i luftföroreningshalter i Malmö i södra Sverige om en policy med avgasfri innerstad skulle genomföras.Air pollution is responsible for one in eight premature deaths worldwide, and thereby a major threat to human health. Health impact assessments of hypothetic changes in air pollution concentrations can be used as a mean of assessing the health impacts of policy, plans and projects, and support decision-makers in choices to prevent disease. The aim of this study was to estimate health impacts attributable to a hypothetical decrease in air pollution concentrations in the city of Malmö in Southern Sweden corresponding to a policy on-road transportations without tail-pipe emissions in the municipality. We used air pollution data modelled for each of the 326,092 inhabitants in Malmö by a Gaussian dispersion model combined with an emission database with &gt;40,000 sources. The dispersion model calculates Nitrogen Oxides (NO) (later transformed into Nitrogen Dioxide (NO)) and particulate matter with an aerodynamic diameter &lt; 2.5 μg/m (PM) with high spatial and temporal resolution (85 m and 1 h, respectively). The average individual reduction was 5.1 (ranging from 0.6 to 11.8) μg/m in NO which would prevent 55 (2% of all deaths) to 93 (4%) deaths annually, depending on dose-response function used. Furthermore, we estimate that the NO reduction would result in 21 (6%) fewer cases of incident asthma in children, 95 (10%) fewer children with bronchitis every year, 30 (1%) fewer hospital admissions for respiratory disease, 87(4%) fewer dementia cases, and 11(11%) fewer cases of preeclampsia every year. The average reduction in PM of 0.6 (ranging from 0.1 till 1.7) μg/m would mean that 2729 (0.3%) work days would not be lost due to sick-days and that there would be 16,472 fewer restricted activity days (0.3%) that year had all on-road transportations been without tail-pipe emissions. Even though the estimates are sensitive to the dose-response functions used and to exposure misclassification errors, even the most conservative estimate of the number of prevented deaths is 7 times larger than the annual traffic fatalities in Malmö, indicating a substantial possibility to reduce the health burden attributed to tail-pipe emissions in the study area