Prevalence of bronchial asthma and chronic bronchitis in a community in northern Sweden; relation to environmental and occupational exposure to sulphur dioxide

The prevalence of chronic bronchitis and bronchial asthma has been studied in a community in northern Sweden, where the major air pollutant is sulphur dioxide (SO2) from a sulphite pulp factory. In the town the annual mean winter concentration of SO2 during the years 1975-1979 was 20-40 micrograms SO2/m3 air. A questionnaire concerning respiratory symptoms was distributed to all individuals (2374) within the age group 16-72 years, and was answered by 2203 individuals (93%). Bronchial asthma was found in 78 (3.5%) individuals, chronic bronchitis in 57 (2.6%) and both diagnoses in 3 individuals (0.1%). There was a statistically significant relationship between presence of chronic bronchitis and sex, age, smoking and employment at the sulphite pulp factory. Sulphur dioxide exposure at the factory apparently acted synergistically with smoking in increasing the relative risk for chronic bronchitis in smoking employees compared to non-smoking non-employees. However, our results indicate no excess risk of chronic bronchitis in a population with long-term environmental exposure to SO2 in concentrations between 20-40 micrograms, when the concentration of other air pollutants is low.

Guidelines for regional mortality analysis: an epidemiological approach to health planning

In view of the epidemiological responsibility that the new Swedish health legislation gives to the local county councils, it has been increasingly necessary to identify and monitor the health status of the local population, eg the commune. As part of a large-scale collaborative project this paper focuses on problems of analysing regional mortality data and presents an attempt to deal with them by means of a systematic procedure.

The Swedish mortality pattern: a basis for health planning?

In response to new Swedish health legislation, which gives local county councils formal 'epidemiological' responsibility for the health of the whole population, the regional mortality pattern is presented here for the period 1969-78. The findings show that total mortality has decreased somewhat during the ten-year period, while at the same time the difference in life expectancy between men and women has increased to six years. The concept 'lost years before 65' is used as a measure of premature death. Suicide is the cause of death that has resulted in the greatest number of lost years among men as well as women. During the 1970's positive changes have come about for leukaemias, cervical cancers and motor vehicle accidents, changes that can be interpreted as being due to better treatment, increased screening and efficient prevention. On the other hand, failures are obvious when considering, for example, a twofold increase in premature alcohol-related mortality over the decade. The report also discusses the quality of mortality statistics as a basis for health planning.

Anaerobic treatability of waste water from pulp and paper industries

A black liquor evaporator condensate from a Kraft mill and a waste water from production of corrugating medium were anaerobically treated on a laboratory scale. The composition of the waste waters was determined before and after treatment in fixed bed reactors. Toxicity studies by the Microtox-method showed that both waste waters were highly toxic and a slight decrease in toxicity was achieved by anaerobic treatment. Despite the toxicity efficient anaerobic treatment was obtained. Major components of the condensate were methanol, ethanol, acetone, guaiacol, hydrogen sulfide and dimethyl disulfide. Anaerobic treatment reduced the concentration of the major components considerably with one exception. The concentration of hydrogen sulfide was unchanged. Organic overloading of the fixed bed reactor or a temperature drop resulted in an accumulation of acetone, although methanol and ethanol were degraded. Major components of the waste water from the production of corrugating medium were: Klason-lignin, acid-soluble lignin, carbohydrates, extractives and ash. When the fixed bed reactor was operated at a volumetric load of 1.6 kg COD/m(3).d the following reductions were obtained: Klason - lignin (solids fraction 84%; soluble and colloidal fraction 76%), acid-soluble lignin (solids fraction 56%; soluble and colloidal fraction 7%), carbohydrates (100%), extractives (71%), total-S (80%), COD (73%) and BOD(7) (78%). Kinetic studies showed that condensate was more easily degraded anaerobically than corrugating medium waste water.

Alpha-1-antitrypsin types and pulmonary disease among employees at a sulphite pulp factory in northern Sweden

Alpha-1-antitrypsin (alpha 1-AT) phenotypes and serum levels were measured in 518 employees at a sulphite pulp factory. There were 439 men and 79 women with the mean age of 42 years (range 18-65 years). Mean time of employment at the factory was 17.5 years and 216 (42%) individuals had been employed for more than 20 years. Chronic bronchitis was present in 47 (9.1%) individuals. alpha 1-AT rare types (MZ, MS, MF) were present in 12.8% of the individuals with chronic bronchitis compared to 8.4% in employees with no respiratory symptoms, the difference being not statistically significant. Individuals with chronic bronchitis and rare types were evenly distributed with regard to work place at the factory. Serum levels of alpha 1-AT were somewhat higher in smokers compared to non-smokers, but the difference was not statistically significant. Exposure to SO2 and chlorine did not seem to affect the serum levels of alpha 1-AT in M type individuals. In the present study, individuals heterozygous for alpha 1-AT deficiency phenotypes (MZ, MS, MF) did not seem to have an increased rate of chronic bronchitis. However, the rate of chronic bronchitis in factory employees was significantly increased compared to that among non-employees in the surrounding community. This increase appears to be due to a higher rate of smoking and to occupational exposure (SO2 and chlorine) among the sulphite pulp factory workers.

Blood components in an elderly population

The reference intervals of 18 blood components were established for an elderly population in the 8th decade of life. The most significant findings were a broader range of values for most of the components, lower values of plasma folate and plasma potassium and higher values of erythrocyte sedimentation rate, plasma creatinine and serum cholesterol, the lattermost in women only, compared to younger people.

Prognosis curves for patients with polycystic kidney disease

In patients with polycystic kidney disease and in many patients with other chronic renal diseases kidney function decreases from year to year. When the increase in serum creatinine concentration is followed graphically, the time for dialysis/transplantation can be predicted long beforehand. Based on the course of azotaemia in 34 patients with polycystic disease prognosis curves have been prepared. By comparing the course of a patient with the average course of similar patients, additional information can be gained. A statistical method for making a prognosis curve for kidney function in end-stage polycystic renal disease is described.

Prevalence of dementia disorders in institutionalized Swedish old people. The work load imposed by caring for these patients

The prevalence of dementia disorders were determined among 3,523 institutionalized patients aged 65 years or more in the county of Västerbotten. Approximately one-third of the clientele were considered demented. The prevalence was calculated to be 3.7% of the population in the county. The frequency of dementia disorders among the patients in the somatic long-stay wards, the nursing homes, and the mental hospital was rather similar (55-65%). A surprisingly high percentage of demented (17.1%) was found in the homes for the aged. The work load was highest in the somatic long-stay wards and in the nursing homes. Patients in the mental hospital, however, differed markedly from those in other institutions with higher scores for aggressive and disturbing behaviour, which accounted for the large number of patients in the mental hospital with maximal work load. The findings are discussed with regard to future institutional care of demented patients and point out the need for better education in psychiatric care for the staff.