oru.sePublications
Change search
Refine search result
1 - 20 of 20
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1. Ahlström, Gerd
    et al.
    Lindvall, B.
    Wenneberg, Stig
    Örebro University, Department of Nursing and Caring Sciences.
    Gunnarsson, Lars-Gunnar
    Örebro University, Department of Clinical Medicine.
    A comprehensive rehabilitation programme tailored to the needs of adults with muscular dystrophy2006In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, no 2, p. 132-141Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess if activities of daily living (ADL), coping and quality of life could be improved in adults with muscular dystrophy through a comprehensive rehabilitation programme. DESIGN: Quasi-experimental, controlled clinical study comparing patients with similar age and disease aspects. SETTING: Two different counties in Sweden, being either study or control setting. SUBJECTS: The study group comprised 37 adults (21 women, 16 men; mean age 50 years), while the control group comprised 39 people (25 women, 14 men; mean age 46 years). INTERVENTIONS: Four rehabilitation sessions tailored to different medical, physical and psychosocial needs of the patients, comprising a total of 10 days over a period of 18 months. MAIN MEASURES: ADL, the Mental Adjustment to Cancer Scale measuring coping strategies, the Sickness Impact Profile measuring health-related quality of life, the Hospital Anxiety and Depression Scale, and the Psychosocial Well-being Questionnaire. RESULTS: No significant differences were found between groups with regard to the outcome measures. There was increased dependence on others in ADL after 18 months in both groups, but it was more pronounced in the control group. Furthermore, a clear trend was observed in the data with regard to coping patterns, the control group using more coping strategies such as 'Helplessness/hopelessness' (P= 0.057), 'Anxious preoccupation' (P = 0.085) and 'Fatalistic' (P= 0.073) when being compared to the study group. CONCLUSIONS: No apparent effects on ADL were found from the rehabilitation programme, although there was a tendency of reduction of maladaptive coping patterns in the study group. This initial study may provide the rationale and basis for a randomized controlled trial.

  • 2.
    Gunnarsson, Lars-Gunnar
    et al.
    Örebro University, School of Medical Sciences. Department of Occupational and Environmental Medicine, Örebro University, Sweden.
    Bodin, Lennart
    Örebro University, Örebro University School of Business. Institute of Environmental Medicine, Karolinska Institute, Solna, Sweden.
    Alzheimer’s Disease and Occupational Exposures: A Systematic Literature Review and Meta-Analyses2018In: Alzheimer's Disease & Treatment, Open Access ebooks , 2018Chapter in book (Refereed)
    Abstract [en]

    Six systematic literature reviews together with meta-analyses have been published on the associations between Alzheimer’s disease and occupational risk factors. Our meta-analyses were based only on studies fulfilling good standards of scientific quality. We scrutinized the 54 relevant original publications found using a checklist proposed by the MOOSE-group together with a new elaborated protocol. Thus our results are not hampered by bias from studies of lower scientific quality. Thirty publications fulfilled good scientific standards and were thus used in our meta-analyses. Exposures to electromagnetic fields were concerned in 12 publications. The weighted relative risk estimate was 1.35 (95% confidence interval: 1.08-1.70). Exposure to pesticides or other chemicals resulted in the statistically significant relative risk 1.5 while exposure to metals involved no increase of risk. A high degree of work complexity (especially in relation to people) and long education were both protective against Alzheimer’s disease. Based on ten studies the weighted relative risk was 0.47 (95% CI: 0.35-0.63). Both work-related risk factors and protective factors are discussed in relation to possible pathophysiological mechanisms.

  • 3.
    Gunnarsson, Lars-Gunnar
    et al.
    Örebro University, School of Medical Sciences. Department of Occupational and Environmental Medicine.
    Bodin, Lennart
    Örebro University, Örebro University School of Business. Department of Statistics, Örebro University, Örebro, Sweden; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Amyotrophic Lateral Sclerosis and Occupational Exposures: A Systematic Literature Review and Meta-Analyses2018In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 11, article id 2371Article in journal (Refereed)
    Abstract [en]

    Objectives: We conducted a systematic literature review to identify studies fulfilling good scientific epidemiological standards for use in meta-analyses of occupational risk factors for amyotrophic lateral sclerosis (ALS). 

    Methods: We identified 79 original publications on associations between work and ALS. The MOOSE (Meta-analysis Of Observational Studies in Epidemiology) and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) guidelines were used to ensure high scientific quality, and reliable protocols were applied to classify the articles. Thirty-seven articles fulfilled good scientific standards, while 42 were methodologically deficient and thus were excluded from our meta-analyses. 

    Results: The weighted relative risks for the various occupational exposures were respectively; 1.29 (95% confidence interval (CI): 0.97⁻1.72; six articles) for heavy physical work, 3.98 (95% CI: 2.04⁻7.77; three articles) for professional sports, 1.45 (95% CI: 1.07⁻1.96; six articles) for metals, 1.19 (95% CI: 1.07⁻1.33; 10 articles) for chemicals, 1.18 (95% CI: 1.07⁻1.31; 16 articles) for electromagnetic fields or working with electricity, and 1.18 (95% CI: 1.05⁻1.34; four articles) for working as a nurse or physician. 

    Conclusions: Meta-analyses based only on epidemiologic publications of good scientific quality show that the risk of ALS is statistically significantly elevated for occupational exposures to excessive physical work, chemicals (especially pesticides), metals (especially lead), and possibly also to electromagnetic fields and health care work. These results are not explained by publication bias.

  • 4.
    Gunnarsson, Lars-Gunnar
    et al.
    Örebro University, School of Medicine, Örebro University, Sweden.
    Bodin, Lennart
    Epidemiologiskt påvisade samband mellan Parkinsons sjukdom och faktorer i arbetsmiljön2014In: Systematiska kunskapsöversikter: 6. Epidemiologiskt påvisade samband mellan Parkinsons sjukdom och faktorer i arbetsmiljön / [ed] Lars-Gunnar Gunnarsson och Lennart Bodin, Göteborg: Göteborgs universitet , 2014, p. 11-79Chapter in book (Refereed)
    Abstract [en]

    Epidemiological evidence on associations between work environment and Parkinson’s disease.

    Lars-Gunnar Gunnarsson, assistant professor at School of Medicine, Örebro University, Sweden and

    Lennart Bodin, professor emeritus, Department of Statistics, Örebro University, Sweden and senior researcher at Institute of Environmental Medicine, Karolinska Institute, Sweden.

    In this systematic literature review we identified 93 original publications on associations between work and Parkinson’s disease (PD). GRADE guidelines were used to secure high scientific quality and reliable guidelines were applied to classify the papers. Forty-nine papers fulfilled high quality standards while 44 were methodologically deficient and thus were excluded from our meta-analyses.

    Twenty five publications concerned work exposure to pesticides. The weighted relative risk (RR) estimate was 1.72 (95% confidence interval 1.46-2.04). A funnel plot and tests indicated that some publication bias concerning smaller studies might have been present. The risk estimate was not influenced by study design (case-control, cohort or cross section study) or gender. Higher estimates were found when there was a hereditary taint or onset below age 60.

    In 15 publications exposure to electromagnetic fields was considered and there was no indication of risk, RR 1.07 (95% confidence interval 0.98-1.18).

    Meta-analyses of ten studies on exposure for metals showed a statistically diminished risk estimate, RR 0.85 (95% confidence interval 0.82-0.89). A proposed explanation to this seemingly beneficial effect is hormesis meaning that exposures of a low-moderate dosage of toxic agents can induce neuroprotective mechanisms.

     

  • 5.
    Gunnarsson, Lars-Gunnar
    et al.
    Örebro University, School of Medical Sciences.
    Bodin, Lennart
    Örebro University, Örebro University School of Business.
    Epidemiologiskt undersökta samband mellan Alzheimers sjukdom och faktorer i arbetsmiljön2015Report (Refereed)
    Abstract [en]

    Epidemiological evidence on associations between work environment and Alzheimers disease

    Lars-Gunnar Gunnarsson, assistant professor at School of Medicine, Örebro University, Sweden and

    Lennart Bodin, professor emeritus, Department of Statistics, Örebro University, Sweden and senior researcher at Institute of Environmental Medicine, Karolinska Institute, Sweden.

    In this systematic literature review we identified 50 original publications on associations between work and Alzheimer’s disease. GRADE guidelines were used to secure high scientific quality and reliable guidelines were applied to classify the papers. Thirty-one papers fulfilled high quality standards while 19 were methodologically deficient and thus were excluded from our meta-analyses.

    Twenty-seven studies concerned exposure to electromagnetic fields and two published meta-analyses indicated a weighted relative risk (RR) reaching 2.0. Our meta-analysis was only based on twelve high quality publications and the weighted relative risk included statistically over chemicals was evaluated in seven studies and the weighted RR was 1.55 (95% confidence interval 1.19-2.02). Only some few publications concerned pesticides and other chemicals and the weighted RR indicated increased risk.

    Higher education and work complexity were evaluated in eleven publications and our meta-analysis show a reduced the risk for Alzheimer’s disease. The weighted RR was 0.47 (95% confidence interval 0.35-0.63). Both factors were independently and additively protective.

    There are indications of an association between ALS and exposure to heavy muscle work especially in combination with muscle trauma, i.e. professional football players are reported to have an elevated risk. More studies are needed with more precise measures on these exposures.

  • 6.
    Gunnarsson, Lars-Gunnar
    et al.
    Örebro University, School of Medical Sciences. Department of Occupational and Environmental Medicine.
    Bodin, Lennart
    Örebro University, Örebro University School of Business. Department of Statistics, Örebro University, Örebro, Sweden; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Occupational Exposures and Neurodegenerative Diseases: A Systematic Literature Review and Meta-Analyses2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 3, article id 337Article, review/survey (Refereed)
    Abstract [en]

    Objectives: To carry out an integrated and stratified meta-analysis on occupational exposure to electromagnetic fields (EMFs), metals and pesticides and its effects on amyotrophic lateral sclerosis (ALS) and Parkinson's and Alzheimer's disease, and investigate the possibility of publication bias.

    Methods: In the current study, we updated our recently published meta-analyses on occupational exposures in relation to ALS, Alzheimer's and Parkinson's disease. Based on 66 original publications of good scientific epidemiological standard, according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines, we analysed subgroups by carrying out stratified meta-analyses on publication year, statistical precision of the relative risk (RR) estimates, inspection of the funnel plots and test of bias.

    Results: Based on 19 studies the weighted RR for occupational exposure to EMFs was 1.26 (95% confidence interval (CI) 1.07-1.50) for ALS, 1.33 (95% CI 1.07-1.64) for Alzheimer's disease and 1.02 (95% CI 0.83-1.26) for Parkinson's disease. Thirty-one studies concerned occupational exposure to pesticides and the weighted RR was 1.35 (95% CI 1.02-1.79) for ALS, 1.50 (95% CI 0.98-2.29) for Alzheimer's disease and 1.66 (95% CI 1.42-1.94) for Parkinson's disease. Finally, 14 studies concerned occupational exposure to metals and only exposure to lead (five studies) involved an elevated risk for ALS or Parkinson's disease and the weighted RR was 1.57 (95% CI 1.11-2.20). The weighted RR for all the non-lead exposures was 0.97 (95% CI 0.88-1.06).

    Conclusions: Exposure to pesticides increased the risk of getting the mentioned neurodegenerative diseases by at least 50%. Exposure to lead was only studied for ALS and Parkinson's disease and involved 50% increased risk. Occupational exposure to EMFs seemed to involve some 10% increase in risk for ALS and Alzheimer's disease only.

  • 7.
    Gunnarsson, Lars-Gunnar
    et al.
    Örebro University, School of Medical Sciences. Department of Occupational and Environmental Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Bodin, Lennart
    Örebro University, Örebro University School of Business. Department of Statistics, Örebro University, Örebro, Sweden; Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institute Solna, Stockholm, Sweden.
    Parkinson's disease and occupational exposures: a systematic literature review and meta-analyses2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 3, p. 197-209, article id 3641Article in journal (Refereed)
    Abstract [en]

    Objectives: We conducted a systematic literature review to identify studies fulfilling good scientific epidemiological standards for use in meta-analyses of relevant risk factors for Parkinson's disease.

    Methods: Our search identified 103 original publications on associations between work and Parkinson's disease. GRADE guidelines were used to ensure high scientific quality, and reliable guidelines were applied to classify the papers. Of the 103 articles, 47 fulfilled good scientific standards while 56 were methodologically deficient and thus excluded from our meta-analyses.

    Results: A total of 23 publications concerned work exposure to pesticides. The weighted relative risk estimate was 1.67 (95% confidence interval 1.42-1.97). A funnel plot and bias test indicated that some publication bias concerning smaller studies might have been present. The risk estimate was not influenced by study design (case-control, cohort, or cross-sectional study) or gender. Higher estimates were found when there was a hereditary taint or onset below age 60. Studies on exposure to metals or electromagnetic fields did not show increased risk.

    Conclusions: Using an elaborated quality protocol, there is now strong evidence that exposure to any pesticide involves a ≥50% increased risk for developing Parkinson's disease.

  • 8.
    Gunnarsson, Lars-Gunnar
    et al.
    Örebro University, School of Medicine, Örebro University, Sweden.
    Bodin, Lennart
    Örebro University, Örebro University School of Business. Karolinska institutet, Stockholm, Sweden.
    Systematiska kunskapsöversikter;: 7. Epidemiologiskt påvisade samband mellan Amyotrofisk Lateral Skleros (ALS) och faktorer i arbetsmiljön2014Report (Refereed)
    Abstract [sv]

    Metod

    Vid systematisk litteraturgenomgång identifierade vi 61 relevanta epidemiologiska publikationer med originaldata över samband mellan ALS och exponeringar i arbetslivet. Samtliga artiklar granskades och 34 av dessa studier uppfyllde kriterierna för god vetenskaplig kvalitet

    Resultat

    Bekämpningsmedel och andra kemikalier har i sju studier värderats med hjälp av fråge­formulär/intervjuer. Våra metaanalyser visade att riskskattningarna var något högre för fall-kontrollstudier än för kohortstudier (1,82 respektive 1,47) och sammantaget blev riskmåttet 1,67 (95% konfidensintervall 1,14-2,44). Höga och statistiskt signifikant ökade risker rapporteras i de tre studier som fokuserade på jordbruksarbete; riskmått 2,4-4,7. Ett möjligt samband finns också mellan ALS och yrkesmässig exponering för metaller.

    Tungt och långvarigt muskelarbete ofta i kombination med muskeltrauma kunna öka risken för ALS med RR runt 2,0. Till denna risk grupp hör professionella fotbolls­spelare i europeisk och amerikansk fotboll. Däremot verkar inte fysisk aktivitet i arbetet och på fritiden påverka risken för att drabbas av ALS.

    I 14 metodologiskt relevanta publikationer granskas eventuellt samband mellan ALS och exponering för elektromagnetiska fält (EMF) och/eller arbete med elektriskt utrustning. Våra egna metaanalyser samt tre publicerade metaanalyser indikerade en låg riskökning. Samman­vägd analys av exponeringar och resultat indikerar att också andra exponeringar än EMF skulle kunna förklara sambandet, t ex muskeltrauma till följd av elstötar.

    Diskussion

    Longitudinella epidemiologiska studier indikerar att ALS huvudsakligen drabbar personer som har en ökad sårbarhet (en genetisk disposition) för att sjukdomsprocessen skall starta. I kombination med olika exponeringar blir nervcellens sjukdomsbörda för stor så att sjukdomsprocessen startar.

  • 9.
    Johansson, Ann-Christin
    et al.
    Örebro University, School of Health and Medical Sciences.
    Gunnarsson, Lars-Gunnar
    Örebro University, School of Health and Medical Sciences.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Bergkvist, Leif
    Stridsberg, Mats
    Nilsson, Olle
    Cornefjord, Michael
    Pain, disability and coping reflected in the diurnal cortisol variability in patients scheduled for lumbar disc surgery2008In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 12, no 5, p. 633-640Article in journal (Refereed)
    Abstract [en]

    Background: Symptoms of lumbar disc herniation can be induced by both mechanical compression of the nerve roots and by biochemical irritants from the disc tissues. Proinflammatory cytokines, as well as stress are potent stimulators of the hypothalamic–pituitary–adrenal axis, reflected in enhanced release of cortisol from the adrenal cortex. Altered cortisol production is also associated to behaviour and coping patterns.The aim of the present study was to explore the relation between pain, physical function, psychosocial factors and quality of life to the diurnal cortisol variability, in patients with lumbar disc herniation.

    Method: This study had a cross-sectional design. Forty-two patients with lumbar disc herniation, verified by magnetic resonance imaging and a clinical examination by an orthopaedic surgeon, were included in the study. All patients were scheduled for disc surgery. The diurnal cortisol variability was examined before surgery. The patients were dichotomised into two groups based on low or high diurnal cortisol variability. Pain, disability, work related stress, quality of life, coping and fear avoidance beliefs, were estimated by standardised questionnaires.

    Results: The low diurnal cortisol variability group was distinguished by a higher median score regarding leg pain at activity and significantly more disability (p < 0.05). The patients with a low diurnal cortisol variability had significantly lower coping self-statement scores, but higher pain coping catastrophising scores (p < 0.05).

    Conclusion: Patients with lumbar disc herniation and a low diurnal cortisol variability had lower physical function, perceived lower possibilities of influencing their pain, and were more prone to catastrophise than patients with lumbar disc herniation and a high diurnal cortisol variability. 

  • 10. Morita, M.
    et al.
    Al-Chalabi, A.
    Andersen, P. M.
    Hosler, B.
    Sapp, P.
    Englund, E.
    Mitchell, J. E.
    Habgood, J. J.
    de Belleroche, J.
    Xi, J.
    Jongjaroenprasert, W.
    Horvitz, H. R.
    Gunnarsson, Lars-Gunnar
    Örebro University, Department of Clinical Medicine.
    Brown, R. H.
    A locus on chromosome 9p confers susceptibility to ALS and frontotemporal dementia2006In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 66, no 6, p. 839-844Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To perform genetic linkage analysis in a family affected with ALS and frontotemporal dementia (FTD). METHODS: The authors performed a genome-wide linkage analysis of a four-generation, 50-member Scandinavian family in which five individuals were diagnosed with ALS and nine with FTD. Linkage calculations assuming autosomal dominant inheritance of a single neurodegenerative disease manifesting as either ALS or FTD with age-dependent penetrance were performed. Further analyses for ALS alone and FTD alone were performed. A parametric logarithm of odds (lod) score of 2.0 or greater was required for further study of a potential locus and crossover (haplotype) analysis. RESULTS: A new ALS-FTD locus was identified between markers D9s1870 and D9s1791 on human chromosome 9p21.3-p13.3. A maximum multipoint lod score of 3.00 was obtained between markers D9s1121 and D9s2154. Crossover analysis indicates this region covers approximately 21.8 cM, or 14Mb. CONCLUSIONS: A locus on chromosome 9p21.3-p13.3 is linked to ALS-FTD.

  • 11.
    Nilsagård, Ylva
    et al.
    Örebro University, Department of Clinical Medicine.
    Denison, Eva
    Gunnarsson, Lars-Gunnar
    Örebro University, Department of Clinical Medicine.
    Evaluation of a single session with cooling garment for persons with multiple sclerosis: a randomized trial2006In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, Vol. 1, no 4, p. 225-233Article in journal (Refereed)
  • 12.
    Nilsagård, Ylva
    et al.
    Örebro University, School of Health and Medical Sciences.
    Denison, Eva
    Gunnarsson, Lars-Gunnar
    Boström, Katrin
    Factors perceived as being related to accidental falls by persons with multiple sclerosis2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 16, p. 1301-1310Article in journal (Refereed)
    Abstract [en]

    Purpose. This study explores and describes factors that persons with multiple sclerosis (MS) perceive as being related to accidental falls. Method. A qualitative content analysis with primarily deductive approach was conducted using the International Classification of Functioning, Disability and Health. Twelve persons with MS, and identified as fallers, were interviewed. Results. Factors perceived to cause accidental falls that had not previously been targeted in MS populations in relation to falls were identified as divided attention, reduced muscular endurance, fatigue and heat sensitivity. Previously reported risk factors such as changed gait pattern, limited walking ability, impaired proprioception, vision and spasticity were supported. Activities involving walking, recreation and leisure, maintaining and changing body position, lifting or carrying, taking care of the home, washing the body, moving around, preparing meals and housekeeping were limited and considered to be risk activities. Supportive persons and assistive device reduced falls, and unsuitable physical environments and climate conditions induced falls. Several preventative strategies were described as partially compensating for the impairments, limitations and restrictions. Conclusions. Investigating accidental falls using the perspective of the patient gave important information about variables not earlier targeted in MS research.

  • 13.
    Nilsagård, Ylva
    et al.
    Örebro University, School of Health and Medical Sciences.
    Lundholm, Cecilia
    Department of Medical Epidemiology and Biostatistics, Karolinska Institute.
    Denison, E.
    School of Health, Care and Social Welfare, Mälardalen University.
    Gunnarsson, Lars-Gunnar
    Örebro University, School of Health and Medical Sciences.
    Predicting accidental falls in people with multiple sclerosis: a longitudinal study2009In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, no 3, p. 259-269Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate accidental falls and near fall incidents in people with multiple sclerosis with respect to clinical variables and the predictive values of four tests. Design: A longitudinal, multi-centred cohort study with prospectively collected falls. Procedures: Self-reported incidents during the three months following a standardized test procedure. Subjects: Seventy-six people with multiple sclerosis and an Expanded Disability Status Scale score between 3.5 and 6.0. Main outcome measures: Berg Balance Scale, Timed Up and Go cognitive, Four Square Step Test (FSST) and 12-item Multiple Sclerosis Walking Scale. Results: Forty-eight people (63%) registered 270 falls. Most falls occurred indoors during activities of daily life. We found a correlation of rs=0.57 between near falls and falls, and of rs = 0.82 between registered and retrospectively recalled falls. Fallers and non-fallers differed significantly regarding Expanded Disability Status Score (odds ratio (OR) 1.99, 95% confidence interval (CI) 1.22; 3.40), spasticity (OR 1.14, CI 1.02; 1.31), proprioception (OR 2.50, CI 1.36; 5.12) and use of walking aids (OR 2.27, CI 1.23; 4.37). Reported use of walking aids both indoors and outdoors increased the odds of falling fivefold while disturbed proprioception increased the odds 2.5—15.6 times depending on severity. The odds of falling were doubled for each degree of increased Expanded Disability Status Score and more than doubled for each degree of increased spasticity. The Berg Balance Scale, use of walking aids and Timed Up and Go cognitive best identified fallers (73—94%) and proprioception, Expanded Disability Status Score, 12-item Multiple Sclerosis Walking Scale and Four Square Step Test best identified non-fallers (75—93%). Conclusions: In clinical practice, looking at the use of walking aids, investigating proprioception and spasticity, rating Expanded Disability Status Score and using Berg Balance Scale or Timed Up and Go cognitive all contribute when identifying fallers.

  • 14.
    Nilsagård, Ylva
    et al.
    Örebro University, Department of Clinical Medicine.
    Lundholm, Cecilia
    Gunnarsson, Lars-Gunnar
    Örebro University, Department of Clinical Medicine.
    Denison, Eva
    Clinical relevance using timed walk tests and 'timed up and go' testing in persons with multiple sclerosis2007In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 12, no 2, p. 105-14Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: One must understand the potentials and limitations of all tests used to evaluate interventions. The aim of the present study was to clarify the reproducibility, smallest percentage difference needed to be able to detect a genuine change and correlation regarding the 10-m and 30-m timed walks (10TW 30TW) and the 'timed up and go' (TUG) test in people with moderate multiple sclerosis (MS).

    METHOD: A repeated-measures design was used, with randomization into two groups and different time intervals used for testing. The 10TW and 30TW were performed three times and TUG twice at each testing. Self-selected speed was used for 10TW and forced speed (quickly but safely) for 30TW and TUG. Forty-three people were tested on three occasions within one week. Each person was tested at approximately the same time of the day and by the same physiotherapist on each occasion.

    RESULTS: The reproducibility was very high. For a single testing occasion, the intraclass correlation was 0.97 for the 10TW and 0.98 for the 30TW and TUG. The smallest percentage difference needed to be able to detect a genuine change in the entire study group was approximately -23% or +31% for either the 1OTW or TUG. It was evident from the 30TW testing results that lower values applied to those with less (-14% to +17%) rather than more (-38% or +60%) disability. The correlation between all tests for the entire study group was 0.85 (0.76-0.91).

    CONCLUSION: It is sufficient to use only one attempt and to choose only one of the tests when evaluating people with moderate MS. In the case of the 30TW greater attention must be paid to the degree of disability when determining the smallest percentage difference needed to establish a genuine change, than

  • 15.
    Nilsagård, Ylva
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Rådman, Lisa
    Jakobsson, Kristina
    Gunnarsson, Lars-Gunnar
    Örebro University, School of Medical Sciences.
    Symtom efter strömgenomgång2017In: Elolyckor i arbetet / [ed] Kjell Torén, Lars-Gunnar Gunnarsson, Sara Thomée och Kristina Jakobsson, Göteborg, Sweden: Göteborgs universitet, 2017, p. 21-26Chapter in book (Other academic)
    Abstract [sv]

    523 elektriker som hade varit med om minst en elolycka med strömgenomgång besvarade en fördjupad enkät med fokus på frågor om symtom från perifera och centrala nervsystemet och muskulatur.

     Nio av tio som varit med om högspänningsolycka hade sökt akut sjukvård. Endast två av tio hade sökt vård efter lågspänningsolycka.

     Besvär framför allt i form av smärta och nedsatt känsel efter strömgenomgång var relativt vanligt, men för de allra flesta blev inte dessa besvär bestående.

     Symtom från nervsystem och hjärna var betydligt vanligare hos de som hade varit utsatta för högspänningsolyckor eller fastnat vid strömkällan på grund av muskelkramp.

  • 16.
    Rehfisch, Pia
    et al.
    Department of Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden.
    Anderson, Martin
    Department of Clinical Physiology, Södersjukhuset, Stockholm, Sweden; Division of Occupational and Environmental Medicine, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
    Berg, Peter
    Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Lampa, Erik
    Department of Occupational and Environmental Medicine Uppsala University Hospital, Uppsala, Sweden.
    Nordling, Yvonne
    Occupational Health Service, Fagerstahälsan AB, Fagersta, Sweden.
    Svartengren, Magnus
    Division of Occupational and Environmental Medicine, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
    Westberg, Håkan
    Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Gunnarsson, Lars-Gunnar
    Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Lung function and respiratory symptoms in hard metal workers exposed to cobalt2012In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 54, no 4, p. 409-13Article in journal (Refereed)
    Abstract [en]

    Objective: To follow-up lung function and airway symptoms in workers exposed to cobalt dust at a hard metal plant.

    Methods: A total of 582 employees underwent spirometry and completed a questionnaire. A historical exposure matrix was created, assigning figures for historical and recent work-related exposure.

    Results: At the time of employment, 5% reported symptoms from respiratory tract. At follow-up, 5% suffered from persistent coughing and 7% reported asthma; 20% were daily smokers. Among nonsmokers without asthma, an evident, statistically nonsignificant, dose-response effect was seen between increasing cobalt exposure and decline in FEV1 (forced expiratory volume in the first second). In all exposure categories, the FEV1 in smokers declined 10 mL more per year than for nonsmokers.

    Conclusions: Even low levels of cobalt exposure seem to hamper lung function both in smokers and nonsmokers. This impact is considered low in relation to the effect of aging.

  • 17.
    Rådman, Lisa
    et al.
    Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden; Department of Physiotherapy, Örebro University Hospital, Örebro, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden.
    Gunnarsson, Lars-Gunnar
    Örebro University, School of Medical Sciences. Department of Occupational and Environmental Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro University, School of Health Sciences.
    Nilsson, Tohr
    Department of Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
    Neurosensory findings among electricians with self-reported remaining symptoms after an electrical injury: A case series2016In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, no 8, p. 1712-1720Article in journal (Refereed)
    Abstract [en]

    Purpose: Symptoms described in previous studies indicate that electrical injury can cause longstanding injuries to the neurosensory nerves. The aim of the present case series was to objectively assess the profile of neurosensory dysfunction in electricians in relation to high voltage or low voltage electrical injury and the "no-let-go phenomenon".

    Methods: Twenty-three Swedish male electricians exposed to electrical injury were studied by using a battery of clinical instruments, including quantitative sensory testing (QST). The clinical test followed a predetermined order of assessments: thermal perceptions thresholds, vibration perception thresholds, tactile gnosis (the Shape and Texture Identification test), manual dexterity (Purdue Pegboard Test), and grip strength. In addition, pain was studied by means of a questionnaire, and a colour chart was used for estimation of white fingers.

    Results: The main findings in the present case series were reduced thermal perceptions thresholds, where half of the group showed abnormal values for warm thermal perception and/or cold thermal perception. Also, the tactile gnosis and manual dexterity were reduced. High voltage injury was associated with more reduced sensibility compared to those with low voltage.

    Conclusion: Neurosensory injury can be objectively assessed after an electrical injury by using QST with thermal perception thresholds. The findings are consistent with injuries to small nerve fibres. In the clinical setting thermal perception threshold is therefore recommended, in addition to tests of tactile gnosis and manual dexterity (Purdue Pegboard).

  • 18.
    Rådman, Lisa
    et al.
    Department of Occupational and Environmental Medicin, Örebro University Hospital, Örebro, Sweden; Department of Physiotherapy, Örebro University Hospital, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro University, School of Health Sciences.
    Jakobsson, Kristina
    Division of Occupational and Environmental Medicine, Scania University Hospital, Lund, Sweden.
    Ek, Åsa
    Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden.
    Gunnarsson, Lars-Gunnar
    Örebro University, School of Medical Sciences.
    Electrical injury in relation to voltage, "no-let-go" phenomenon, symptoms and perceived safety culture: a survey of Swedish male electricians2016In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 2, p. 261-270Article in journal (Refereed)
    Abstract [en]

    Professional electricians are highly subjected to electrical injuries. Previous studies describing symptoms after electrical injury have not included people with less severe initial injuries. The purpose of the present study was to describe symptoms at different time points after electrical injury, the impact of "no-let-go" phenomenon and different electrical potential [high voltage (HV) vs. low voltage (LV)], and the safety culture at the workplace.

    A retrospective survey was conducted with 523 Swedish electricians. Two questionnaires were issued: the first to identify electricians who had experienced electrical injury and the second to gain information about symptoms and safety culture. Self-reported symptoms were described at different time points following injury. Symptoms for HV and LV accidents were compared. Occurrence or nonoccurrence of "no-let-go" phenomenon was analysed using two-tailed Chi-2. Safety culture was assessed with a validated questionnaire.

    Nearly all reported having symptoms directly after the injury, mainly paraesthesia and pain. For the first weeks after injury, pain and muscle weakness dominated. The most frequently occurring symptoms at follow-up were pain, muscle weakness and loss of sensation. HV injuries and "no-let go" phenomenon were associated with more sustained symptoms. Deficiencies in the reporting routines were present, as well as shortage of preventive measures.

    The results indicate that symptoms are reported also long time after an electrical injury and that special attention should be paid to HV injuries and "no-let go" accidents. The workplace routines to reduce the number of work-related electrical injuries for Swedish electricians can be improved.

  • 19. Seldén, Anders I.
    et al.
    Bergström, Bernt E. O.
    Gunnarsson, Lars-Gunnar
    Örebro University, School of Health and Medical Sciences.
    Lead exposure from tourist earthenware: a pilot survey2008In: International journal of hygiene and environmental health (Print), ISSN 1438-4639, E-ISSN 1618-131X, Vol. 211, no 5-6, p. 587-590Article in journal (Refereed)
    Abstract [en]

    Lead from glazed earthenware used for food storage is a well-known health hazard sporadically causing lead intoxication and may be a source of disseminating lead exposure in specific population groups. To obtain a contemporary scope of the problem a pilot survey was conducted in a random sample of 2000 households with Swedish charter tourists to Greece in 2003. Response was obtained from 214 (10.7%). From these households blood samples were obtained from 33 potentially lead exposed subjects and 33 controls (participation rate among selected participants of each category was 66% and 33%, respectively). No statistically significant difference in mean blood lead was found between groups (arithmetic mean 0.13 and 0.10 μmol/l for exposed and controls, respectively; p>0.05), but increased lead levels for two exposed subjects (1.0 and 0.77 μmol/l) were associated with their Hellenic earthenware (tea mugs). This pilot survey, probably the first epidemiological study of the current problem, did not indicate that earthenware purchased in Greece by Swedish tourists and used for food storage is a widespread source of lead, but limitations with regard to statistical power preclude definite conclusions.

  • 20.
    Vihlborg, Per
    et al.
    Örebro University, School of Medical Sciences. Department of Occupational and Environmental Medicine.
    Bryngelsson, Ing-Liss
    Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Lindgren, Bernt
    Feelgood Hallsberg, Hallsberg, Sweden.
    Gunnarsson, Lars-Gunnar
    Örebro University, School of Medical Sciences. Department of Occupational and Environmental Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Graff, Pål
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Association between vibration exposure and hand-arm vibration symptoms in a Swedish mechanical industry2017In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 62, p. 77-81Article in journal (Refereed)
    Abstract [en]

    Work with vibrating tools is common in many industries. Exposure to hand-arm vibrations is associated with a risk of hand injury in the form of: Vascular disorders, nerve malfunction, and effects on the musculoskeletal system. The aim of this study was to investigate the prevalence of hand-arm vibration symptoms among employees at a mechanical company, as well as to follow-up with patients presenting symptoms and evaluate the effects of certain proposed measures. We found that 21% of the employees were judged to have vibration-related problems even though the exposure to vibrations was judged to be relatively low. There seems to be an over-representation of Carpal tunnel syndrome among participants; this may suggest that ergonomic conditions at the investigated company, such as grinding with flexed wrists, are unfavorable.

    Relevance to industry: Regular screening for early signs of vibration-related damage, even if workers are subject to only moderate vibration exposure, is an important part of preventing the aggravation of health problems.

1 - 20 of 20
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf