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Evaluation of the Quick Environmental Exposure and Sensitivity Inventory in a Danish Population  [PDF]
Sine Skovbjerg,Nikolaj Drimer Berg,Jesper Elberling,Karl Bang Christensen
Journal of Environmental and Public Health , 2012, DOI: 10.1155/2012/304314
Abstract: Objectives. To evaluate a Danish translation of the Quick Environmental Exposure and Sensitivity Inventory (QEESI). Methods. The study included two groups: one comprised a random sample of 2000 individuals drawn from the Danish Civil Registration System; the other comprised 315 patients with chemical intolerance. Results. The evaluation suggested good reliability for the four QEESI scales in terms of internal consistency and coefficients between test and retest scores. The discriminatory validity was the largest for the Chemical (inhalant) Intolerance and Life Impact Scales. Using combined cut-off scores for these two scales provided a sensitivity of 92.1 and a specificity of 91.8 and yielded a prevalence of 8.2% in the population group. Conclusions. The Danish translation of the QEESI showed overall good reliability and validity. We recommend the use of the combined Chemical (inhalant) Intolerance and Life Impact Scales in future studies.
In-Utero Exposure to Bereavement and Offspring IQ: A Danish National Cohort Study  [PDF]
Jasveer Virk, Carsten Obel, Jiong Li, J?rn Olsen
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0088477
Abstract: Background Intelligence is a life-long trait that has strong influences on lifestyle, adult morbidity and life expectancy. Hence, lower cognitive abilities are therefore of public health interest. Our primary aim was to examine if prenatal bereavement measured as exposure to death of a close family member is associated with the intelligence quotient (IQ) scores at 18-years of age of adult Danish males completing a military cognitive screening examination. Methods We extracted records for the Danish military screening test and found kinship links with biological parents, siblings, and maternal grandparents using the Danish Civil Registration System (N = 167,900). The prenatal exposure period was defined as 12 months before conception until birth of the child. We categorized children as exposed in utero to severe stress (bereavement) during prenatal life if their mothers lost an elder child, husband, parent or sibling during the prenatal period; the remaining children were included in the unexposed cohort. Mean score estimates were adjusted for maternal and paternal age at birth, residence, income, maternal education, gestational age at birth and birth weight. Results When exposure was due to death of a father the offsprings' mean IQ scores were lower among men completing the military recruitment exam compared to their unexposed counterparts, adjusted difference of 6.5 standard IQ points (p-value = 0.01). We did not observe a clinically significant association between exposure to prenatal maternal bereavement caused by death of a sibling, maternal uncle/aunt or maternal grandparent even after stratifying deaths only due to traumatic events. Conclusion We found maternal bereavement to be adversely associated with IQ in male offspring, which could be related to prenatal stress exposure though more likely is due to changes in family conditions after death of the father. This finding supports other literature on maternal adversity during fetal life and cognitive development in the offspring.
Exposure to Mebendazole and Pyrvinium during Pregnancy: A Danish Nationwide Cohort Study  [PDF]
A. Torp-Pedersen,E. Jimenez-Solem,J. T. Andersen,K. Broedbaek,C. Torp-Pedersen,H. E. Poulsen
Infectious Diseases in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/769851
Abstract: Purpose. Families with children are frequently exposed to pinworm infection and treatment involves the whole family. Information on consequences of exposure during, pregnancy is limited. The aim of this study was to investigate the exposure to pyrvinium and mebendazole before, during, and after pregnancy in a Danish nationwide cohort. Methods. From nationwide administrative registers, we identified 718, 900 births in Denmark between January 1997 and December 2007 as well as maternal prescription data of anthelmintics and maternal characteristics. Redemption of a prescription for pyrvinium or mebendazole was used to identify exposure. Results. 4715 women redeemed a prescription for pyrvinium or mebendazole during pregnancy; 1606 for pyrvinium, 2575 for mebendazole, and 534 for both drugs. Having >2 children compared to having no previous children was associated with exposure to pyrvinium (OR: 7.1, 95% CI: 5.8–8.7) and mebendazole (OR: 20.8, 95% CI: 17.3–24.9). Conclusion. 4715 pregnant women redeemed a prescription for either mebendazole or pyrvinium. We believe the exposure to be even higher since pyrvinium is also sold over-the-counter. Limited information on birth outcomes is available at present time, and considering the number of exposed pregnancies, we recommend that studies are to be undertaken to assess the safety of pyrvinium and mebendazole during pregnancy. 1. Introduction In Denmark, mebendazole and pyrvinium are used in the treatment of enterobiasis caused by enterobius vermicularis (threadworm, seatworm, or pinworm). The pinworm is a nematode that mostly infects children. In Denmark, the prevalence among children has been reported to be 29% [1]. Among pregnant women the prevalence is unknown. Pinworm infections spread easily between family members. Treatment of the whole family is therefore recommended, if a child has been infected. Pinworms are commonly resided in the colon, but can in rare cases migrate to the vagina or bladder and cause a variety of symptoms such as vaginitis, cervicitis, endometritis, myometritis, and salpingitis [2]. Most pinworm infections are, however, symptom-free and harmless. Mebendazole is the drug of choice for treating pinworm infections outside pregnancy. During pregnancy the recommended treatment in Denmark is pyrvinium due to its low systemic absorption [3]. Treatment of nematodes in pregnancy has been shown to reduce early infant mortality [4]. There is, however, limited information concerning the frequency of use of these drugs during pregnancy, and whether these recommendations are followed. Studies in
Legionella Antibodies in a Danish Hospital Staff with Known Occupational Exposure  [PDF]
M. Rudbeck,S. Viskum,K. M lbak,S. A. Uldum
Journal of Environmental and Public Health , 2009, DOI: 10.1155/2009/812829
Abstract: Although legionnaires' disease frequently is acquired in health care institutions, little is known about the occupational risk of Legionella infection among health care workers. The aim of the present cross-sectional study was to analyse antibody levels among exposed hospital workers and to determine the correlation between antibodies to Legionella and self-reported symptoms. The study included 258 hospital employees and a reference group of 708 healthy blood donors. Hospital workers had a higher prevalence of Legionella antibody titres (≥1 : 128) than blood donors (odds ratio 3.4; 95% CI 2.4–4.8). Antibody levels were not higher among staff members at risk of frequent aerosol exposure than among less exposed employees. There was no consistent association between a history of influenza-like symptom complex and the presence of antibodies. The results indicate that hospital workers have a higher risk of Legionella infections than the general population. However, since no excess morbidity was associated with seropositivity, most Legionella infections may be asymptomatic.
Parental occupational exposure to endocrine disrupting chemicals and male genital malformations: A study in the danish national birth cohort study
María M Morales-Suárez-Varela, Gunnar V Toft, Morten S Jensen, Cecilia Ramlau-Hansen, Linda Kaerlev, Ane-Marie Thulstrup, Agustín Llopis-González, J?rn Olsen, Jens P Bonde
Environmental Health , 2011, DOI: 10.1186/1476-069x-10-3
Abstract: We analyse occurrence of hypospadias and cryptorchidism according to maternal and paternal occupational exposure to possible endocrine disrupting chemicals.We conducted a follow-up study of 45,341 male singleton deliveries in the Danish National Birth Cohort during 1997-2009. Information on work during pregnancy was obtained by telephone interviews around gestational week 16. Parents' job titles were classified according to DISCO-88. A job exposure matrix for endocrine disrupting chemicals (EDCs) was implemented to assess occupational exposures. The Medical Birth and National Hospital Register provided data on congenital anomalies diagnosed at birth or during follow-up, which ended in 2009. Crude and adjusted hazard ratios (HR) were obtained from Cox regression models.Among all pregnancies, 6.3% were classified as possibly or probably exposed to EDCs. The most prevalent occupations conferring possible exposure were cleaners, laboratory technicians, hairdressers and agricultural workers (58% of all potentially exposed). The final cumulative incidence of cryptorchidism in boys was 2.2% (1002 cases), and of hypospadias 0.6% (262 cases). The occurrence of hypospadias increased when mothers were probably [HRa = 1.8 (95% CI 1.0-2.6)] or possibly exposed to one or more EDCs [HRa = 2.6 (95% CI 1.8-3.4). Possible paternal exposure to heavy metals increased the risk of hypospadias [HRa 2.2 (95% CI: 1.0-3.4)] and cryptorchidism [HRa 1.9 (95% CI: 1.1-2.7)]. None of the exposure groups reached statistical significance.The study provides some but limited evidence that occupational exposure to possible endocrine disrupting chemicals during pregnancy increases the risk of hypospadias.Cryptorchidism (incomplete testicular descent) is a common congenital disorder, but may also be acquired [1]. The prevalence at three months of age was 1.9% in a Danish sample [2], 1.0 in a sample from USA [3] and between 1.6% [4] and 2.4% [5] in large samples from UK. Hypospadias (abnormal location of
The impact of nonlinear exposure-risk relationships on seasonal time-series data: modelling Danish neonatal birth anthropometric data
John McGrath, Adrian Barnett, Darryl Eyles, Thomas Burne, Carsten B Pedersen, Preben Mortensen
BMC Medical Research Methodology , 2007, DOI: 10.1186/1471-2288-7-45
Abstract: Birth weight and birth lengths on over 1.5 million Danish singleton, live births were examined for seasonality. We modelled seasonal patterns based on linear, U- and J-shaped exposure-risk relationships. We then added an extra layer of complexity by modelling weighted population-based exposure patterns.The Danish data showed clear seasonal fluctuations for both birth weight and birth length. A bimodal model best fits the data, however the amplitude of the 6 and 12 month peaks changed over time. In the modelling exercises, U- and J-shaped exposure-risk relationships generate time series with both 6 and 12 month periodicities. Changing the weightings of the population exposure risks result in unexpected properties. A J-shaped exposure-risk relationship with a diminishing population exposure over time fitted the observed seasonal pattern in the Danish birth weight data.In keeping with many other studies, Danish birth anthropometric data show complex and shifting seasonal patterns. We speculate that annual periodicities with non-linear exposure-risk models may underlie these findings. Understanding the nature of seasonal fluctuations can help generate candidate exposures.Birth weight has long been acknowledged as an important measure of neonatal health [1]. In addition to providing insights into prenatal development, this variable is known to be associated with a wide range of important cognitive, behavioural and health outcomes in infancy, childhood and adulthood. While there is widespread agreement that birth weight shows seasonal fluctuations [2,3], there is a lack of between-location agreement about features such as: (a) the timing (or phase) of maximum weight, and (b) the presence of a single peak (unimodal, 12 month periodicity) or two peaks (bimodal, 6 and 12 month periodicities). With respect to the phase of peak birth weight, some populations had regular, sine wave-like 12 month periodicities, with peak birth weight in spring [4], while other studies found no a
The cohort of young Danish farmers – A longitudinal study of the health effects of farming exposure
Grethe Elholm, yvind Omland, Vivi Schlünssen, et al
Clinical Epidemiology , 2010, DOI: http://dx.doi.org/10.2147/CLEP.S9255
Abstract: ohort of young Danish farmers – A longitudinal study of the health effects of farming exposure Rapid Communication (4885) Total Article Views Authors: Grethe Elholm, yvind Omland, Vivi Schlünssen, et al Published Date March 2010 Volume 2010:2 Pages 45 - 50 DOI: http://dx.doi.org/10.2147/CLEP.S9255 Grethe Elholm1,2, yvind Omland1,2, Vivi Schlünssen1, Charlotte Hjort3, Ioannis Basinas1, Torben Sigsgaard1 1Department of Environmental and Occupational Medicine, Institute of Public Health, Aarhus University; 2Department of Occupational Health, Aalborg Hospital, Aarhus University Hospital; 3Regional Hospital Viborg, Skive, Kjellerup Abstract: Working in agriculture poses a serious risk for development of respiratory diseases, especially when working in animal housing. Animal workers are exposed to a mixture of organic and inorganic dust together with fumes and gases, including allergens and microbial-associated molecular patterns with a potentially major impact on respiratory health and the immune system. Exposure to microbial agents in animal housing is associated with an increased prevalence of respiratory symptoms, including bronchial hyperresponsiveness, accelerated lung function decline, and neutrophil-mediated inflammation. These clinical findings are often seen without IgE-mediated sensitization. In fact it has been found in recent studies that the prevalence of atopic sensitization and atopic asthma is low among farmers compared with other populations. The SUS study was designed to identify the type and occurrence of respiratory symptoms and disease, and to investigate risk factors for respiratory disorders and changes in lung function among young farming students. The cohort of young Danish farmers was established in 1992/1994 and followed up in 2007/2008 with a participation rate of 51.7%. The cohort consists of 1734 male farming students, 230 female farming students, and 407 army recruits as controls.
The cohort of young Danish farmers – A longitudinal study of the health effects of farming exposure  [cached]
Grethe Elholm,Øyvind Omland,Vivi Schlünssen,et al
Clinical Epidemiology , 2010,
Abstract: Grethe Elholm1,2, yvind Omland1,2, Vivi Schlünssen1, Charlotte Hjort3, Ioannis Basinas1, Torben Sigsgaard11Department of Environmental and Occupational Medicine, Institute of Public Health, Aarhus University; 2Department of Occupational Health, Aalborg Hospital, Aarhus University Hospital; 3Regional Hospital Viborg, Skive, KjellerupAbstract: Working in agriculture poses a serious risk for development of respiratory diseases, especially when working in animal housing. Animal workers are exposed to a mixture of organic and inorganic dust together with fumes and gases, including allergens and microbial-associated molecular patterns with a potentially major impact on respiratory health and the immune system. Exposure to microbial agents in animal housing is associated with an increased prevalence of respiratory symptoms, including bronchial hyperresponsiveness, accelerated lung function decline, and neutrophil-mediated inflammation. These clinical findings are often seen without IgE-mediated sensitization. In fact it has been found in recent studies that the prevalence of atopic sensitization and atopic asthma is low among farmers compared with other populations. The SUS study was designed to identify the type and occurrence of respiratory symptoms and disease, and to investigate risk factors for respiratory disorders and changes in lung function among young farming students. The cohort of young Danish farmers was established in 1992/1994 and followed up in 2007/2008 with a participation rate of 51.7%. The cohort consists of 1734 male farming students, 230 female farming students, and 407 army recruits as controls.Keywords: respiratory health, atopy, asthma, rhinitis, lung function, farming environment, occupational exposure, cohort study
Prenatal Exposure to Bereavement and Type-2 Diabetes: A Danish Longitudinal Population Based Study  [PDF]
Jiong Li, J?rn Olsen, Mogens Vestergaard, Carsten Obel, Jette Kolding Kristensen, Jasveer Virk
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0043508
Abstract: Background The etiology of type-2 diabetes is only partly known, and a possible role of prenatal stress in programming offspring for insulin resistance has been suggested by animal models. Previously, we found an association between prenatal stress and type-1 diabetes. Here we examine the association between prenatal exposure to maternal bereavement during preconception and pregnancy and development of type-2 diabetes in the off-spring. Methods We utilized data from the Danish Civil Registration System to identify singleton births in Denmark born January 1st 1979 through December 31st 2008 (N = 1,878,246), and linked them to their parents, grandparents, and siblings. We categorized children as exposed to bereavement during prenatal life if their mothers lost an elder child, husband or parent during the period from one year before conception to the child’s birth. We identified 45,302 children exposed to maternal bereavement; the remaining children were included in the unexposed cohort. The outcome of interest was diagnosis of type-2 diabetes. We estimated incidence rate ratios (IRRs) from birth using log-linear poisson regression models and used person-years as the offset variable. All models were adjusted for maternal residence, income, education, marital status, sibling order, calendar year, sex, and parents’ history of diabetes at the time of pregnancy. Results We found children exposed to bereavement during their prenatal life were more likely to have a type-2 diabetes diagnosis later in life (aIRR: 1.31, 1.01–1.69). These findings were most pronounced when bereavement was caused by death of an elder child (aIRR: 1.51, 0.94–2.44). Results also indicated the second trimester of pregnancy to be the most sensitive period of bereavement exposure (aIRR:2.08, 1.15–3.76). Conclusions Our data suggests that fetal exposure to maternal bereavement during preconception and the prenatal period may increase the risk for developing type-2 diabetes in childhood and young adulthood.
The Jurassic of Denmark and Greenland: Sedimentology and sequence stratigraphy of the Bryne and Lulu Formations, Middle Jurassic, northern Danish Central Graben  [PDF]
Andsbjerg, Jan
Geological Survey of Denmark and Greenland Bulletin , 2003,
Abstract: The Middle Jurassic Bryne and Lulu Formations of the S gne Basin (northern part of the Danish Central Graben) consist of fluvially-dominated coastal plain deposits, overlain by interfingering shoreface and back-barrier deposits. Laterally continuous, mainly fining-upwards fluvial channel sandstones that locally show evidence for tidal influence dominate the alluvial/coastal plain deposits of the lower Bryne Formation. The sandstones are separated by units of fine-grained floodplain sediments that show a fining-upwards - coarsening-upwards pattern and locally grade into lacustrine mudstones. A regional unconformity that separates the lower Bryne Formation from the mainly estuarine upper Bryne Formation is defined by the strongly erosional base of a succession of stacked channel sandstones, interpreted as the fill of a system of incised valleys. Most of the stacked channel sandstones show abundant mud laminae and flasers, and rare herringbone structures, suggesting that they were deposited in a tidal environment, probably an estuary. Several tens of metres of the lower Bryne Formation may have been removed by erosion at this unconformity. The estuarine channel sandstone succession is capped by coal beds that attain a thickness of several metres in the western part of the S gne Basin, but are thin and poorly developed in the central part of the basin. Above the coal beds, the Lulu Formation is dominated by various types of tidally influenced paralic deposits in the western part of the basin and by coarsening-upwards shoreface and beach deposits in central parts. Westwards-thickening wedges of paralic deposits interfinger with eastwards-thickening wedges of shallow marine deposits. The Middle Jurassic succession is subdivided into nine sequences. In the lower Bryne Formation, sequence boundaries are situated at the base of laterally continuous fluvial channel sandstones whereas maximum flooding surfaces are placed in laterally extensive floodplain or lacustrine mudstones. The unconformity that separates the alluvial plain deposits of the lower Bryne Formation from the estuary deposits of the upper Bryne Formation is interpreted as a sequence boundary that bounds a system of incised valleys in the western and southern parts of the basin. Sequence boundaries in the Lulu Formation are situated at the top of progradational shoreface units or at the base of estuarine channels. Maximum flooding surfaces are located within marine or lagoonal mudstone units. Marine highstand deposits are partitioned seawards, in the eastern part of the basin, whereas paralic transg
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