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Amin H, Šantl-Temkiv T, Cramer C, Finster K, Real FG, Gislason T, Holm M, Janson C, Jögi NO, Jogi R, Malinovschi A, Marshall IPG, Modig L, Norbäck D, Shigdel R, Sigsgaard T, Svanes C, Thorarinsdottir H, Wouters IM, Schlünssen V, Bertelsen RJ. Indoor Airborne Microbiome and Endotoxin: Meteorological Events and Occupant Characteristics Are Important Determinants. Environ Sci Technol 2023; 57:11750-11766. [PMID: 37523308 PMCID: PMC10433529 DOI: 10.1021/acs.est.3c01616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023]
Abstract
Airborne bacteria and endotoxin may affect asthma and allergies. However, there is limited understanding of the environmental determinants that influence them. This study investigated the airborne microbiomes in the homes of 1038 participants from five cities in Northern Europe: Aarhus, Bergen, Reykjavik, Tartu, and Uppsala. Airborne dust particles were sampled with electrostatic dust fall collectors (EDCs) from the participants' bedrooms. The dust washed from the EDCs' clothes was used to extract DNA and endotoxin. The DNA extracts were used for quantitative polymerase chain (qPCR) measurement and 16S rRNA gene sequencing, while endotoxin was measured using the kinetic chromogenic limulus amoebocyte lysate (LAL) assay. The results showed that households in Tartu and Aarhus had a higher bacterial load and diversity than those in Bergen and Reykjavik, possibly due to elevated concentrations of outdoor bacterial taxa associated with low precipitation and high wind speeds. Bergen-Tartu had the highest difference (ANOSIM R = 0.203) in β diversity. Multivariate regression models showed that α diversity indices and bacterial and endotoxin loads were positively associated with the occupants' age, number of occupants, cleaning frequency, presence of dogs, and age of the house. Further studies are needed to understand how meteorological factors influence the indoor bacterial community in light of climate change.
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Affiliation(s)
- Hesham Amin
- Department
of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Tina Šantl-Temkiv
- Section
for Microbiology, Department of Biology, Aarhus University, 8000 Aarhus, Denmark
| | - Christine Cramer
- Department
of Public Health, Environment, Work and Health, Danish Ramazzini Center, Aarhus University, 8000 Aarhus, Denmark
- Department
of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Kai Finster
- Section
for Microbiology, Department of Biology, Aarhus University, 8000 Aarhus, Denmark
| | | | | | - Mathias Holm
- Department
of Occupational and Environmental Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Christer Janson
- Department
of Medical Sciences: Respiratory, Allergy, Sleep Research, Uppsala University, 751 85 Uppsala, Sweden
- Department
of Medical Sciences: Clinical Physiology, Uppsala University, 751
85 Uppsala, Sweden
| | - Nils Oskar Jögi
- Department
of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Rain Jogi
- Tartu
University Hospital, Lung Clinic, 50406 Tartu, Estonia
| | - Andrei Malinovschi
- Department
of Medical Sciences: Clinical Physiology, Uppsala University, 751
85 Uppsala, Sweden
| | - Ian P. G. Marshall
- Section
for Microbiology, Department of Biology, Aarhus University, 8000 Aarhus, Denmark
| | - Lars Modig
- Division
of Occupational and Environmental Medicine, Department of Public Health
and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden
| | - Dan Norbäck
- Department of Medical
Sciences, Occupational and Environmental Medicine, Uppsala University, 751
85 Uppsala, Sweden
| | - Rajesh Shigdel
- Department
of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Torben Sigsgaard
- Department
of Public Health, Environment, Work and Health, Danish Ramazzini Center, Aarhus University, 8000 Aarhus, Denmark
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland
University Hospital, 5053 Bergen, Norway
- Centre for International Health, University
of Bergen Department of Global Public Health and Primary Care, 5009 Bergen, Norway
| | - Hulda Thorarinsdottir
- Department of Anesthesia
and Intensive Care, Landspitali University
Hospital, 101 Reykjavik, Iceland
| | - Inge M. Wouters
- Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Vivi Schlünssen
- Department
of Public Health, Environment, Work and Health, Danish Ramazzini Center, Aarhus University, 8000 Aarhus, Denmark
| | - Randi J. Bertelsen
- Department
of Clinical Science, University of Bergen, 5021 Bergen, Norway
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Khomich M, Lin H, Malinovschi A, Brix S, Cestelli L, Peddada S, Johannessen A, Eriksen C, Real FG, Svanes C, Bertelsen RJ. Association between lipid-A-producing oral bacteria of different potency and fractional exhaled nitric oxide in a Norwegian population-based adult cohort. J Transl Med 2023; 21:354. [PMID: 37246224 DOI: 10.1186/s12967-023-04199-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/14/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Lipid A is the primary immunostimulatory part of the lipopolysaccharide (LPS) molecule. The inflammatory response of LPS varies and depends upon the number of acyl chains and phosphate groups in lipid A which is specific for a bacterial species or strain. Traditional LPS quantification assays cannot distinguish between the acylation degree of lipid A molecules, and therefore little is known about how bacteria with different inflammation-inducing potencies affect fractional exhaled nitric oxide (FeNO). We aimed to explore the association between pro-inflammatory hexa- and less inflammatory penta-acylated LPS-producing oral bacteria and FeNO as a marker of airway inflammation. METHODS We used data from a population-based adult cohort from Norway (n = 477), a study center of the RHINESSA multi-center generation study. We applied statistical methods on the bacterial community- (prediction with MiRKAT) and genus-level (differential abundance analysis with ANCOM-BC) to investigate the association between the oral microbiota composition and FeNO. RESULTS We found the overall composition to be significantly associated with increasing FeNO levels independent of covariate adjustment, and abundances of 27 bacterial genera to differ in individuals with high FeNO vs. low FeNO levels. Hexa- and penta-acylated LPS producers made up 2.4% and 40.8% of the oral bacterial genera, respectively. The Bray-Curtis dissimilarity within hexa- and penta-acylated LPS-producing oral bacteria was associated with increasing FeNO levels independent of covariate adjustment. A few single penta-acylated LPS producers were more abundant in individuals with low FeNO vs. high FeNO, while hexa-acylated LPS producers were found not to be enriched. CONCLUSIONS In a population-based adult cohort, FeNO was observed to be associated with the overall oral bacterial community composition. The effect of hexa- and penta-acylated LPS-producing oral bacteria was overall significant when focusing on Bray-Curtis dissimilarity within each of the two communities and FeNO levels, but only penta-acylated LPS producers appeared to be reduced or absent in individuals with high FeNO. It is likely that the pro-inflammatory effect of hexa-acylated LPS producers is counteracted by the dominance of the more abundant penta-acylated LPS producers in this population-based adult cohort involving mainly healthy individuals.
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Affiliation(s)
- Maryia Khomich
- Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Huang Lin
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, Research Triangle Park, Durham, NC, USA
| | - Andrei Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Susanne Brix
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Lucia Cestelli
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Shyamal Peddada
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences (NIEHS), NIH, Research Triangle Park, Durham, NC, USA
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, Center for International Health, University of Bergen, Bergen, Norway
| | - Carsten Eriksen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
- Center for Molecular Prediction of Inflammatory Bowel Disease (PREDICT), Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark
| | - Francisco Gomez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Cecilie Svanes
- Department of Global Public Health and Primary Care, Center for International Health, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Randi Jacobsen Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.
- Oral Health Center of Expertise in Western Norway, Bergen, Norway.
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Kisiel MA, Arnfelt O, Lindberg E, Jogi O, Malinovschi A, Johannessen A, Benediktsdottir B, Franklin K, Holm M, Real FG, Sigsgaard T, Gislason T, Modig L, Janson C. Association between abdominal and general obesity and respiratory symptoms, asthma and COPD. Results from the RHINE study. Respir Med 2023; 211:107213. [PMID: 36933674 DOI: 10.1016/j.rmed.2023.107213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/20/2023]
Abstract
INTRODUCTION Previous studies on the association between abdominal and general obesity and respiratory disease have provided conflicting results. AIMS AND OBJECTIVES We aimed to explore the associations of abdominal obesity with respiratory symptoms, asthma, and chronic obstructive pulmonary disease independently from general obesity in women and men. METHODS This cross-sectional study was based on the Respiratory Health in Northern Europe (RHINE) III questionnaire (n = 12 290) conducted in 2010-2012. Abdominal obesity was self-measured waist circumference using a sex-specific standard cut-off point: ≥102 cm in males and ≥88 cm in females. General obesity was defined as self-reported BMI ≥30.0 kg/m2. RESULTS There were 4261 subjects (63% women) with abdominal obesity and 1837 subjects (50% women) with general obesity. Both abdominal and general obesity was independent of each other and associated with respiratory symptoms (odds ratio (OR) from 1.25 to 2.00)). Asthma was significantly associated with abdominal and general obesity in women, OR (95% CI) 1.56 (1.30-1.87) and 1.95 (1.56-2.43), respectively, but not in men, OR 1.22 (0.97-3.17) and 1.28 (0.97-1.68) respectively. A similar sex difference was found for self-reported chronic obstructive pulmonary disease. CONCLUSIONS General and abdominal obesity were independent factors associated with respiratory symptoms in adults. Asthma and chronic obstructive pulmonary disease were independently linked to abdominal and general obesity in women but not men.
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Affiliation(s)
- Marta A Kisiel
- Department of Medical Sciences: Environmental and Occupational Medicine, Uppsala University, Uppsala, Sweden.
| | - Oscar Arnfelt
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Eva Lindberg
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Oscar Jogi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bryndis Benediktsdottir
- The Medical Faculty, University of Iceland, Reykjavik, Iceland; Department of Sleep, Landspitali University Hospital Reykjavik, Reykjavik, Iceland
| | - Karl Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Mathias Holm
- Section of Occupational and Environmental Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Francisco Gomez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Torben Sigsgaard
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Thorarinn Gislason
- The Medical Faculty, University of Iceland, Reykjavik, Iceland; Department of Sleep, Landspitali University Hospital Reykjavik, Reykjavik, Iceland
| | - Lars Modig
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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Svanes C, Johannessen A, Bertelsen RJ, Dharmage S, Benediktsdottir B, Bråbäck L, Gislason T, Holm M, Jõgi O, Lodge CJ, Malinovschi A, Martinez-Moratalla J, Oudin A, Sánchez-Ramos JL, Timm S, Janson C, Real FG, Schlünssen V. Cohort profile: the multigeneration Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) cohort. BMJ Open 2022; 12:e059434. [PMID: 35654464 PMCID: PMC9163543 DOI: 10.1136/bmjopen-2021-059434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/07/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) cohort was established to (1) investigate how exposures before conception and in previous generations influence health and disease, particularly allergies and respiratory health, (2) identify susceptible time windows and (3) explore underlying mechanisms. The ultimate aim is to facilitate efficient intervention strategies targeting multiple generations. PARTICIPANTS RHINESSA includes study participants of multiple generations from ten study centres in Norway (1), Denmark (1), Sweden (3), Iceland (1), Estonia (1), Spain (2) and Australia (1). The RHINESSA core cohort, adult offspring generation 3 (G3), was first investigated in 2014-17 in a questionnaire study (N=8818, age 18-53 years) and a clinical study (subsample, n=1405). Their G2 parents participated in the population-based cohorts, European Community Respiratory Heath Survey and Respiratory Health In Northern Europe, followed since the early 1990s when they were 20-44 years old, at 8-10 years intervals. Study protocols are harmonised across generations. FINDINGS TO DATE Collected data include spirometry, skin prick tests, exhaled nitric oxide, anthropometrics, bioimpedance, blood pressure; questionnaire/interview data on respiratory/general/reproductive health, indoor/outdoor environment, smoking, occupation, general characteristics and lifestyle; biobanked blood, urine, gingival fluid, skin swabs; measured specific and total IgE, DNA methylation, sex hormones and oral microbiome. Research results suggest that parental environment years before conception, in particular, father's exposures such as smoking and overweight, may be of key importance for asthma and lung function, and that there is an important susceptibility window in male prepuberty. Statistical analyses developed to approach causal inference suggest that these associations may be causal. DNA methylation studies suggest a mechanism for transfer of father's exposures to offspring health and disease through impact on offspring DNA methylation. FUTURE PLANS Follow-up is planned at 5-8 years intervals, first in 2021-2023. Linkage with health registries contributes to follow-up of the cohort.
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Affiliation(s)
- Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Centre for International Health, University of Bergen Department of Global Public Health and Primary Care, Bergen, Norway
| | - Ane Johannessen
- Centre for International Health, University of Bergen Department of Global Public Health and Primary Care, Bergen, Norway
| | - Randi Jacobsen Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Oral Helath Centre of Expertise Western Norway, Bergen, Norway
| | - Shyamali Dharmage
- Allergy and Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Bryndis Benediktsdottir
- Medical Faculty, University of Iceland, Reykjavik, Iceland
- Department of Sleep, Landspitali University Hospital Reykjavík, Reykjavik, Iceland
| | - Lennart Bråbäck
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Sweden
| | - Thorarinn Gislason
- Department of Sleep, Landspitali University Hospital Reykjavík, Reykjavik, Iceland
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
| | - Oskar Jõgi
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Jesus Martinez-Moratalla
- Servicio de Neumología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
- Facultad de Medicina, Universidad de Castilla-La Mancha - Campus de Albacete, Albacete, Spain
| | - Anna Oudin
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Sweden
| | | | - Signe Timm
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research Unit, Kolding Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Christer Janson
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences: Respiratory, Allergy, Sleep Research, Uppsala University, Uppsala, Sweden
| | - Francisco Gomez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health - Work, Environment and Health, Danish Ramazzini Centre, Aarhus Universitet, Aarhus, Denmark
- National Research Centre for the Working Environment, Kobenhavn, Denmark
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Vindenes HK, Lin H, Shigdel R, Ringel-Kulka T, Real FG, Svanes C, Peddada SD, Bertelsen RJ. Exposure to Antibacterial Chemicals Is Associated With Altered Composition of Oral Microbiome. Front Microbiol 2022; 13:790496. [PMID: 35572708 PMCID: PMC9096491 DOI: 10.3389/fmicb.2022.790496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
Antimicrobial chemicals are used as preservatives in cosmetics, pharmaceuticals, and food to prevent the growth of bacteria and fungi in the products. Unintentional exposure in humans to such chemicals is well documented, but whether they also interfere with human oral microbiome composition is largely unexplored. In this study, we explored whether the oral bacterial composition is affected by exposure to antibacterial and environmental chemicals. Gingival fluid, urine, and interview data were collected from 477 adults (18–47 years) from the RHINESSA study in Bergen, Norway. Urine biomarkers of triclosan, triclocarban, parabens, benzophenone-3, bisphenols, and 2,4- and 2,5-dichlorophenols (DCPs) were quantified (by mass spectrometry). Microbiome analysis was based on 16S amplicon sequencing. Diversity and differential abundance analyses were performed to identify how microbial communities may change when comparing groups of different chemical exposure. We identified that high urine levels (>75th percentile) of propyl parabens were associated with a lower abundance of bacteria genera TM7 [G-3], Helicobacter, Megasphaera, Mitsuokella, Tannerella, Propionibacteriaceae [G-2], and Dermabacter, as compared with low propylparaben levels (<25th percentile). High exposure to ethylparaben was associated with a higher abundance of Paracoccus. High urine levels of bisphenol A were associated with a lower abundance of Streptococcus and exposure to another environmental chemical, 2,4-DCP, was associated with a lower abundance of Treponema, Fretibacterium, and Bacteroidales [G-2]. High exposure to antibacterial and environmental chemicals was associated with an altered composition of gingiva bacteria; mostly commensal bacteria in the oral cavity. Our results highlight a need for a better understanding of how antimicrobial chemical exposure influences the human microbiome.
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Affiliation(s)
- Hilde Kristin Vindenes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Huang Lin
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Rajesh Shigdel
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Tamar Ringel-Kulka
- Department of Maternal and Child Care, University of North Carolina, Chapel Hill, NC, United States
| | - Francisco Gomez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Gynaecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.,Centre for International Health, University of Bergen, Bergen, Norway
| | - Shyamal D Peddada
- Biostatistics and Bioinformatics Branch, National Institute of Child Health and Human Development, Bethesda, MD, United States
| | - Randi J Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Oral Health Center of Expertise in Western Norway, Bergen, Norway
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6
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Bertelsen RJ, Barrionuevo AMP, Shigdel R, Lie SA, Lin H, Real FG, Ringel-Kulka T, Åstrøm AN, Svanes C. Association of oral bacteria with oral hygiene habits and self-reported gingival bleeding. J Clin Periodontol 2022; 49:768-781. [PMID: 35569028 PMCID: PMC9542802 DOI: 10.1111/jcpe.13644] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 03/23/2022] [Accepted: 05/02/2022] [Indexed: 12/03/2022]
Abstract
Aim To describe associations of gingival bacterial composition and diversity with self‐reported gingival bleeding and oral hygiene habits in a Norwegian regional‐based population. Materials and Methods We examined the microbiome composition of the gingival fluid (16S amplicon sequencing) in 484 adult participants (47% females; median age 28 years) in the Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) study in Bergen, Norway. We explored bacterial diversity and abundance differences by the community periodontal index score, self‐reported frequency of gingival bleeding, and oral hygiene habits. Results Gingival bacterial diversity increased with increasing frequency of self‐reported gingival bleeding, with higher Shannon diversity index for “always” β = 0.51 and “often” β = 0.75 (p < .001) compared to “never” gingival bleeding. Frequent gingival bleeding was associated with higher abundance of several bacteria such as Porphyromonas endodontalis, Treponema denticola, and Fretibacterium spp., but lower abundance of bacteria within the gram‐positive phyla Firmicutes and Actinobacteria. Flossing and rinsing with mouthwash twice daily were associated with higher total abundance of bacteria in the Proteobacteria phylum but with lower bacterial diversity compared to those who never flossed or never used mouthwash. Conclusions A high frequency of self‐reported gingival bleeding was associated with higher bacterial diversity than found in participants reporting no gingival bleeding and with higher total abundance of known periodontal pathogens such as Porphyromonas spp., Treponema spp., and Bacteroides spp.
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Affiliation(s)
- Randi Jacobsen Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway, Bergen, Norway
| | | | - Rajesh Shigdel
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Huang Lin
- Roche Product Development Shanghai, Roche (China) Holding Ltd., Shanghai, China
| | - Francisco Gomez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
| | - Tamar Ringel-Kulka
- Department of Maternal and Child Health, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anne Nordrehaug Åstrøm
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway.,Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
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7
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Tjalvin G, Svanes Ø, Igland J, Bertelsen RJ, Benediktsdóttir B, Dharmage S, Forsberg B, Holm M, Janson C, Jõgi NO, Johannessen A, Malinovschi A, Pape K, Real FG, Sigsgaard T, Torén K, Vindenes HK, Zock JP, Schlünssen V, Svanes C. Maternal preconception occupational exposure to cleaning products and disinfectants and offspring asthma. J Allergy Clin Immunol 2021; 149:422-431.e5. [PMID: 34674855 DOI: 10.1016/j.jaci.2021.08.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/08/2021] [Accepted: 08/31/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Emerging research suggests health effects in offspring after parental chemical exposures before conception. Many future mothers are exposed to potent chemicals at work, but potential offspring health effects are hardly investigated. OBJECTIVE We sought to investigate childhood asthma in relation to mother's occupational exposure to cleaning products and disinfectants before conception. METHODS The multicenter Respiratory Health In Northern Europe/Respiratory Health In Northern Europe, Spain and Australia generation study investigated asthma and wheeze starting at age less than 10 years in 3318 mother-offspring pairs. From an asthma-specific Job-Exposure Matrix and mothers' occupational history, we defined maternal occupational exposure to indoor cleaning agents (cleaning products/detergents and disinfectants) starting before conception, in the 2-year period around conception and pregnancy, or after birth. Never-employed mothers were excluded. Exposed groups include cleaners, health care workers, cooks, and so forth. Associations were analyzed using mixed-effects logistic regression and ordinary logistic regression with clustered robust SEs and adjustment for maternal education. RESULTS Maternal occupational exposure to indoor cleaning starting preconception and continuing (n = 610) was associated with offspring's childhood asthma: odds ratio 1.56 (95% CI, 1.05-2.31), childhood asthma with nasal allergies: 1.77 (1.13-2.77), and childhood wheeze and/or asthma: 1.71 (95% CI, 1.19-2.44). Exposure starting around conception and pregnancy (n = 77) was associated with increased childhood wheeze and/or asthma: 2.25 (95% CI, 1.03-4.91). Exposure starting after birth was not associated with asthma outcomes (1.13 [95% CI, 0.71-1.80], 1.15 [95% CI, 0.67-1.97], 1.08 [95% CI, 0.69-1.67]). CONCLUSIONS Mother's occupational exposure to indoor cleaning agents starting before conception, or around conception and pregnancy, was associated with more childhood asthma and wheeze in offspring. Considering potential implications for vast numbers of women in childbearing age using cleaning agents, and their children, further research is imperative.
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Affiliation(s)
- Gro Tjalvin
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
| | - Øistein Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Randi Jacobsen Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway; Oral Health Center of Expertise in Western Norway, Bergen, Norway
| | - Bryndís Benediktsdóttir
- Medical Faculty, University of Iceland, Reykjavík, Iceland; Department of Sleep, Landspitali University Hospital Reykjavík, Reykjavík, Iceland
| | - Shyamali Dharmage
- Allergy and Lung Health Unit, University of Melbourne, Melbourne, Australia
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Nils Oskar Jõgi
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway; Tartu University Lung Clinic, Tartu, Estonia
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Kathrine Pape
- National Research Centre for the Working Environment, Aarhus, Denmark; Department of Public Health, Aarhus University, Environment, Work and Health, Danish Ramazzini Centre, Aarhus, Denmark
| | - Francisco Gomez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Torben Sigsgaard
- Department of Public Health, Aarhus University, Environment, Work and Health, Danish Ramazzini Centre, Aarhus, Denmark
| | - Kjell Torén
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hilde Kristin Vindenes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jan-Paul Zock
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Vivi Schlünssen
- National Research Centre for the Working Environment, Aarhus, Denmark; Department of Public Health, Aarhus University, Environment, Work and Health, Danish Ramazzini Centre, Aarhus, Denmark
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Shigdel R, Johannessen A, Svanes C, Real FG, Bertelsen RJ. Oral bacterial composition and low lung function in a general population. Epidemiology 2021. [DOI: 10.1183/13993003.congress-2021.oa2868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Vindenes HK, Svanes C, Lygre SHL, Real FG, Ringel-Kulka T, Bertelsen RJ. Exposure to environmental phenols and parabens, and relation to body mass index, eczema and respiratory outcomes in the Norwegian RHINESSA study. Environ Health 2021; 20:81. [PMID: 34256787 PMCID: PMC8278607 DOI: 10.1186/s12940-021-00767-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 07/01/2021] [Indexed: 05/09/2023]
Abstract
BACKGROUND Many phenols and parabens are applied in cosmetics, pharmaceuticals and food, to prevent growth of bacteria and fungi. Whether these chemicals affect inflammatory diseases like allergies and overweight is largely unexplored. We aimed to assess the associations of use of personal care products with urine biomarkers levels of phenols and paraben exposure, and whether urine levels (reflecting body burden of this chemical exposures) are associated with eczema, rhinitis, asthma, specific IgE and body mass index. METHODS Demographics, clinical variables, and self-report of personal care products use along with urine samples were collected concurrently from 496 adults (48% females, median age: 28 years) and 90 adolescents (10-17 years of age) from the RHINESSA study in Bergen, Norway. Urine biomarkers of triclosan (TCS), triclocarban (TCC), parabens and benzophenone-3, bisphenols and dichlorophenols (DCP) were quantified by mass spectrometry. RESULTS Detection of the urine biomarkers varied according to chemical type and demographics. TCC was detected in 5% of adults and in 45% of adolescents, while propyl (PPB) and methyl (MPB) parabens were detected in 95% of adults and in 94% (PPB) and 99% (MPB) of adolescents. Women had higher median urine concentrations of phenolic chemicals and reported a higher frequency of use of personal care products than men. Urine concentration of MPB increased in a dose-dependent manner with increased frequency of use of several cosmetic products. Overall, urinary biomarker levels of parabens were lower in those with current eczema. The biomarker concentrations of bisphenol S was higher in participants with positive specific IgE and females with current asthma, but did not differ by eczema or rhinitis status. MPB, ethylparaben (EPB), 2,4-DCP and TCS were inversely related to BMI in adults; interaction by gender were not significant. CONCLUSIONS Reported frequency of use of personal care products correlated very well with urine biomarker levels of paraben and phenols. Several chemicals were inversley related to BMI, and lower levels of parabens was observed for participants with current eczema. There is a need for further studies of health effects of chemicals from personal care products, in particular in longitudinally designed studies.
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Affiliation(s)
- Hilde Kristin Vindenes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
- Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Centre for International Health, University of Bergen, Bergen, Norway
| | | | | | - Tamar Ringel-Kulka
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Randi Jacobsen Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Oral Health Center of Expertise, Western Norway, Bergen, Norway
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Kirkeleit J, Riise T, Wielscher M, Dratva J, Accordini S, Carsin AE, Corsico AG, Franklin K, Holm M, Janson C, Leynaert B, Lodge C, Raherison C, Real FG, Schlunssen V, Garcia-Aymerich J, Dharmage S, Jarvis D, Jarvelin MR, Svanes C. Early life origins of lung ageing: A study of lung function decline the ECRHS and NFBC1966 cohorts. Epidemiology 2020. [DOI: 10.1183/13993003.congress-2020.1433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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11
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Knudsen GTM, Dharmage S, Janson C, Abramson MJ, Benediktsdóttir B, Malinovschi A, Skulstad SM, Bertelsen RJ, Real FG, Schlünssen V, Jõgi NO, Sánchez-Ramos JL, Holm M, Garcia-Aymerich J, Forsberg B, Svanes C, Johannessen A. Parents' smoking onset before conception as related to body mass index and fat mass in adult offspring: Findings from the RHINESSA generation study. PLoS One 2020; 15:e0235632. [PMID: 32628720 PMCID: PMC7337347 DOI: 10.1371/journal.pone.0235632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/18/2020] [Indexed: 01/11/2023] Open
Abstract
Emerging evidence suggests that parents' preconception exposures may influence offspring health. We aimed to investigate maternal and paternal smoking onset in specific time windows in relation to offspring body mass index (BMI) and fat mass index (FMI). We investigated fathers (n = 2111) and mothers (n = 2569) aged 39-65 years, of the population based RHINE and ECRHS studies, and their offspring aged 18-49 years (n = 6487, mean age 29.6 years) who participated in the RHINESSA study. BMI was calculated from self-reported height and weight, and FMI was estimated from bioelectrical impedance measures in a subsample. Associations with parental smoking were analysed with generalized linear regression adjusting for parental education and clustering by study centre and family. Interactions between offspring sex were analysed, as was mediation by parental pack years, parental BMI, offspring smoking and offspring birthweight. Fathers' smoking onset before conception of the offspring (onset ≥15 years) was associated with higher BMI in the offspring when adult (β 0.551, 95%CI: 0.174-0.929, p = 0.004). Mothers' preconception and postnatal smoking onset was associated with higher offspring BMI (onset <15 years: β1.161, 95%CI 0.378-1.944; onset ≥15 years: β0.720, 95%CI 0.293-1.147; onset after offspring birth: β2.257, 95%CI 1.220-3.294). However, mediation analysis indicated that these effects were fully mediated by parents' postnatal pack years, and partially mediated by parents' BMI and offspring smoking. Regarding FMI, sons of smoking fathers also had higher fat mass (onset <15 years β1.604, 95%CI 0.269-2.939; onset ≥15 years β2.590, 95%CI 0.544-4.636; and onset after birth β2.736, 95%CI 0.621-4.851). There was no association between maternal smoking and offspring fat mass. We found that parents' smoking before conception was associated with higher BMI in offspring when they reached adulthood, but that these effects were mediated through parents' pack years, suggesting that cumulative smoking exposure during offspring's childhood may elicit long lasting effects on offspring BMI.
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Affiliation(s)
- Gerd Toril Mørkve Knudsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Shyamali Dharmage
- School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Michael J. Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Bryndís Benediktsdóttir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Sleep Medicine, Landspitali, Reykjavik, Iceland
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Svein Magne Skulstad
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Randi Jacobsen Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Oral Health Center of Expertise in Western Norway, Hordaland, Bergen, Norway
| | | | - Vivi Schlünssen
- Department of Public Health, Work, Environment and Health, Danish Ramazzini Centre, Aarhus University Denmark, Aarhus, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Nils Oskar Jõgi
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | | | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Lindberg E, Janson C, Johannessen A, Svanes C, Real FG, Malinovschi A, Franklin KA, Holm M, Schlünssen V, Jogi NO, Gislason T, Benediktsdóttir B. Sleep time and sleep-related symptoms across two generations – results of the community-based RHINE and RHINESSA studies. Sleep Med 2020; 69:8-13. [DOI: 10.1016/j.sleep.2019.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 09/03/2019] [Accepted: 12/23/2019] [Indexed: 12/15/2022]
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Mørkve Knudsen GT, Rezwan FI, Johannessen A, Skulstad SM, Bertelsen RJ, Real FG, Krauss-Etschmann S, Patil V, Jarvis D, Arshad SH, Holloway JW, Svanes C. Erratum: Epigenome-wide association of father's smoking with offspring DNA methylation: a hypothesis-generating study. Environ Epigenet 2020; 6:dvz027. [PMID: 32042449 PMCID: PMC6999171 DOI: 10.1093/eep/dvz027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
[This corrects the article DOI: 10.1093/eep/dvz023.][This corrects the article DOI: 10.1093/eep/dvz023.].
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Mørkve Knudsen GT, Rezwan FI, Johannessen A, Skulstad SM, Bertelsen RJ, Real FG, Krauss-Etschmann S, Patil V, Jarvis D, Arshad SH, Holloway JW, Svanes C. Epigenome-wide association of father's smoking with offspring DNA methylation: a hypothesis-generating study. Environ Epigenet 2019; 5:dvz023. [PMID: 31827900 PMCID: PMC6896979 DOI: 10.1093/eep/dvz023] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 08/22/2019] [Accepted: 11/04/2019] [Indexed: 05/23/2023]
Abstract
Epidemiological studies suggest that father's smoking might influence their future children's health, but few studies have addressed whether paternal line effects might be related to altered DNA methylation patterns in the offspring. To investigate a potential association between fathers' smoking exposures and offspring DNA methylation using epigenome-wide association studies. We used data from 195 males and females (11-54 years) participating in two population-based cohorts. DNA methylation was quantified in whole blood using Illumina Infinium MethylationEPIC Beadchip. Comb-p was used to analyse differentially methylated regions (DMRs). Robust multivariate linear models, adjusted for personal/maternal smoking and cell-type proportion, were used to analyse offspring differentially associated probes (DMPs) related to paternal smoking. In sensitivity analyses, we adjusted for socio-economic position and clustering by family. Adjustment for inflation was based on estimation of the empirical null distribution in BACON. Enrichment and pathway analyses were performed on genes annotated to cytosine-phosphate-guanine (CpG) sites using the gometh function in missMethyl. We identified six significant DMRs (Sidak-corrected P values: 0.0006-0.0173), associated with paternal smoking, annotated to genes involved in innate and adaptive immunity, fatty acid synthesis, development and function of neuronal systems and cellular processes. DMP analysis identified 33 CpGs [false discovery rate (FDR) < 0.05]. Following adjustment for genomic control (λ = 1.462), no DMPs remained epigenome-wide significant (FDR < 0.05). This hypothesis-generating study found that fathers' smoking was associated with differential methylation in their adolescent and adult offspring. Future studies are needed to explore the intriguing hypothesis that fathers' exposures might persistently modify their future offspring's epigenome.
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Affiliation(s)
- G T Mørkve Knudsen
- Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, N-5021 Bergen, Norway
- Correspondence address. Haukanesvegen 260, N-5650 Tysse, Norway; Tel: +47 977 98 147; E-mail: and
| | - F I Rezwan
- Human Genetics and Genomic Medicine, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - A Johannessen
- Department of Occupational Medicine, Haukeland University Hospital, N-5021 Bergen, Norway
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, N-5018 Bergen, Norway
| | - S M Skulstad
- Department of Occupational Medicine, Haukeland University Hospital, N-5021 Bergen, Norway
| | - R J Bertelsen
- Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
| | - F G Real
- Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
| | - S Krauss-Etschmann
- Division of Experimental Asthma Research, Research Center Borstel, 23845 Borstel, Germany
- German Center for Lung Research (DZL) and Institute of Experimental Medicine, Christian-Albrechts University of Kiel, 24118 Kiel, Germany
| | - V Patil
- David Hide Asthma and Allergy Research Centre, St. Mary’s Hospital, Isle of Wight PO30 5TG, UK
| | - D Jarvis
- Faculty of Medicine, National Heart & Lung Institute, Imperial College, London SW3 6LY, UK
| | - S H Arshad
- Clinical and Experimental Sciences, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
- NIHR Respiratory Biomedical Research Unit, University Hospital Southampton, Southampton SO16 6YD, UK
| | - J W Holloway
- Human Genetics and Genomic Medicine, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - C Svanes
- Department of Occupational Medicine, Haukeland University Hospital, N-5021 Bergen, Norway
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, N-5018 Bergen, Norway
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Triebner K, Hustad S, Barrera J, Basagana X, Benediktsdóttir B, Dharmage S, Franklin K, Garcia-Larsen V, Gullon-Blanco J, Jarvis D, Jogi R, Leynaert B, Lindberg E, Moratalla J, Muniozguren-Agirre N, Pin I, Raherison C, Sanchez-Ramos JL, Schlünssen V, Gomez Real F, Dadvand P. Late Breaking Abstract - Ultraviolet radiation and lung function in aging women: A European multi-centre study (ECRHS). Epidemiology 2019. [DOI: 10.1183/13993003.congress-2019.oa1937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lenoir A, Fuertes E, Gomez Real F, Leynaert B, Jarvis D. Late Breaking Abstract - Longitudinal associations of testosterone status with lung function decline in UK Biobank. Epidemiology 2019. [DOI: 10.1183/13993003.congress-2019.pa4404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Accordini S, Calciano L, Johannessen A, Portas L, Benediktsdóttir B, Bertelsen RJ, Bråbäck L, Carsin AE, Dharmage SC, Dratva J, Forsberg B, Gomez Real F, Heinrich J, Holloway JW, Holm M, Janson C, Jögi R, Leynaert B, Malinovschi A, Marcon A, Martínez-Moratalla Rovira J, Raherison C, Sánchez-Ramos JL, Schlünssen V, Bono R, Corsico AG, Demoly P, Dorado Arenas S, Nowak D, Pin I, Weyler J, Jarvis D, Svanes C. A three-generation study on the association of tobacco smoking with asthma. Int J Epidemiol 2019. [PMID: 29534228 PMCID: PMC6124624 DOI: 10.1093/ije/dyy031] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Mothers’ smoking during pregnancy increases asthma risk in their offspring. There is some evidence that grandmothers’ smoking may have a similar effect, and biological plausibility that fathers’ smoking during adolescence may influence offspring’s health through transmittable epigenetic changes in sperm precursor cells. We evaluated the three-generation associations of tobacco smoking with asthma. Methods Between 2010 and 2013, at the European Community Respiratory Health Survey III clinical interview, 2233 mothers and 1964 fathers from 26 centres reported whether their offspring (aged ≤51 years) had ever had asthma and whether it had coexisted with nasal allergies or not. Mothers and fathers also provided information on their parents’ (grandparents) and their own asthma, education and smoking history. Multilevel mediation models within a multicentre three-generation framework were fitted separately within the maternal (4666 offspring) and paternal (4192 offspring) lines. Results Fathers’ smoking before they were 15 [relative risk ratio (RRR) = 1.43, 95% confidence interval (CI): 1.01–2.01] and mothers’ smoking during pregnancy (RRR = 1.27, 95% CI: 1.01–1.59) were associated with asthma without nasal allergies in their offspring. Grandmothers’ smoking during pregnancy was associated with asthma in their daughters [odds ratio (OR) = 1.55, 95% CI: 1.17–2.06] and with asthma with nasal allergies in their grandchildren within the maternal line (RRR = 1.25, 95% CI: 1.02–1.55). Conclusions Fathers’ smoking during early adolescence and grandmothers’ and mothers’ smoking during pregnancy may independently increase asthma risk in offspring. Thus, risk factors for asthma should be sought in both parents and before conception. Funding European Union (Horizon 2020, GA-633212).
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Affiliation(s)
- Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lucia Calciano
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Laura Portas
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Randi Jacobsen Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Lennart Bråbäck
- Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anne-Elie Carsin
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Shyamali C Dharmage
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Julia Dratva
- ZHAW School of Health Professions, Institute of Health Sciences, Winterthur, Switzerland.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel University, Basel, Switzerland
| | - Bertil Forsberg
- Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Joachim Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital Munich, Ludwig-Maximilians-Universität München, Munich, Germany
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Rain Jögi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Bénédicte Leynaert
- INSERM UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Jesús Martínez-Moratalla Rovira
- Pneumology Service of the University Hospital Complex of Albacete (CHUA), Health Service of Castilla-La Mancha (SESCAM), Albacete, Spain.,School of Medicine, University of Castilla-La Mancha, Albacete, Spain
| | | | | | - Vivi Schlünssen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,National Research Center for the Working Environment, Copenhagen, Denmark
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Angelo G Corsico
- Division of Respiratory Diseases, IRCCS 'San Matteo' Hospital Foundation-University of Pavia, Pavia, Italy
| | - Pascal Demoly
- Département de Pneumologie et Addictologie, Hôpital Arnaud de Villeneuve, University of Montpellier, Montpellier, France.,Sorbonne Université, INSERM, IPLESP, Paris, France
| | | | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital Munich, Ludwig-Maximilians-Universität München, Munich, Germany.,Comprehensive Pneumology Center Munich, Member of the German Center for Lung Research, Munich, Germany
| | - Isabelle Pin
- Pediatrie, CHU Grenoble Alpes, Grenoble, France.,INSERM 1209, Institute for Advanced Biosciences, Grenoble, France.,Université Grenoble Alpes, Grenoble, France
| | - Joost Weyler
- Department of Epidemiology and Social Medicine and the StatUA Statistics Centre, University of Antwerp, Antwerp, Belgium
| | - Deborah Jarvis
- Population Health and Occupational Disease, National Heart & Lung Institute, Imperial College, London, UK.,MRC-PHE Centre for Environment and Health, Imperial College, London, UK
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
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Moitra S, Carsin AE, Abramson M, Amaral A, Anto JM, Chatzi VL, Forsberg B, Gilliland F, Real FG, Jarvis D, Kim JL, Leynaert B, Piccioni P, Probst-Hensch N, Siroux V, Guerra S, Garcia-Aymerich J, Kogevinas M. Effect of asthma on the development of obesity among adults: Results of the European Community Respiratory Health Survey (ECRHS). Epidemiology 2018. [DOI: 10.1183/13993003.congress-2018.oa297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lønnebotn M, Nilsen RM, Dharmage S, Franklin KA, Holm M, Janson C, Jarvis D, Johannessen A, Kirkeleit J, Malinovschi A, Schlünssen V, Svanes C, Real FG. Late Breaking Abstract - Associations of fathers and their offsprings weight gain with non-allergic asthma. Epidemiology 2018. [DOI: 10.1183/13993003.congress-2018.pa3903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Svanes C, Koplin J, Skulstad SM, Johannessen A, Bertelsen RJ, Benediktsdottir B, Bråbäck L, Elie Carsin A, Dharmage S, Dratva J, Forsberg B, Gislason T, Heinrich J, Holm M, Janson C, Jarvis D, Jögi R, Krauss-Etschmann S, Lindberg E, Macsali F, Malinovschi A, Modig L, Norbäck D, Omenaas E, Waatevik Saure E, Sigsgaard T, Skorge TD, Svanes Ø, Torén K, Torres C, Schlünssen V, Gomez Real F. Father's environment before conception and asthma risk in his children: a multi-generation analysis of the Respiratory Health In Northern Europe study. Int J Epidemiol 2018; 46:235-245. [PMID: 27565179 DOI: 10.1093/ije/dyw151] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 01/04/2023] Open
Abstract
Background Whereas it is generally accepted that maternal environment plays a key role in child health, emerging evidence suggests that paternal environment before conception also impacts child health. We aimed to investigate the association between children's asthma risk and parental smoking and welding exposures prior to conception. Methods In a longitudinal, multi-country study, parents of 24 168 offspring aged 2-51 years provided information on their life-course smoking habits, occupational exposure to welding and metal fumes, and offspring's asthma before/after age 10 years and hay fever. Logistic regressions investigated the relevant associations controlled for age, study centre, parental characteristics (age, asthma, education) and clustering by family. Results Non-allergic early-onset asthma (asthma without hay fever, present in 5.8%) was more common in the offspring with fathers who smoked before conception {odds ratio [OR] = 1.68 [95% confidence interval (CI) = 1.18-2.41]}, whereas mothers' smoking before conception did not predict offspring asthma. The risk was highest if father started smoking before age 15 years [3.24 (1.67-6.27)], even if he stopped more than 5 years before conception [2.68 (1.17-6.13)]. Fathers' pre-conception welding was independently associated with non-allergic asthma in his offspring [1.80 (1.29-2.50)]. There was no effect if the father started welding or smoking after birth. The associations were consistent across countries. Conclusions Environmental exposures in young men appear to influence the respiratory health of their offspring born many years later. Influences during susceptible stages of spermatocyte development might be important and needs further investigation in humans. We hypothesize that protecting young men from harmful exposures may lead to improved respiratory health in future generations.
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Affiliation(s)
- Cecilie Svanes
- Centre for International Health, University of Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Norway
| | - Jennifer Koplin
- Centre for International Health, University of Bergen, Norway.,School of Population and Global Health, University of Melbourne, Australia.,Murdoch Childrens Research Institute, Melbourne, Australia
| | - Svein Magne Skulstad
- Department of Clinical Science, University of Bergen, Norway.,Department of Obstetrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ane Johannessen
- Department of Clinical Science, University of Bergen, Norway.,Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Randi Jakobsen Bertelsen
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Norway
| | - Byndis Benediktsdottir
- Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland.,University of Iceland, Medical Faculty
| | - Lennart Bråbäck
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Anne Elie Carsin
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Shyamali Dharmage
- Department of Clinical Science, University of Bergen, Norway.,School of Population and Global Health, University of Melbourne, Australia
| | - Julia Dratva
- Centre for International Health, University of Bergen, Norway.,Department of Epidemiology and Public Health, Gender & Health, Swiss Tropical and Public Health Institute, Basel University, Switzerland
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Thorarinn Gislason
- Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland.,University of Iceland, Medical Faculty
| | | | - Mathias Holm
- Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Deborah Jarvis
- Faculty of Medicine, National Heart & Lung Institute, Imperial College, London, UK
| | - Rain Jögi
- Lung Clinic, Foundation Tartu University Clinics, Tartu, Estonia.,Department of Pulmonary Medicine, Tartu University, Estonia
| | - Susanne Krauss-Etschmann
- Research Center Borstel, Leibniz-Center for Medicine and Biosciences, Divison of Experimental Asthma Research, University of Kiel, Germany
| | - Eva Lindberg
- Department of Medical Sciences, Uppsala University, Sweden
| | - Ferenc Macsali
- Department of Obstetrics and Gynecology, Haukeland, University Hospital, Bergen, Norway
| | | | - Lars Modig
- Centre for International Health, University of Bergen, Norway.,Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Sweden
| | - Ernst Omenaas
- Department of Clinical Science, University of Bergen, Norway.,Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | | | | | - Trude Duelien Skorge
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Øistein Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Norway
| | - Kjell Torén
- Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Carl Torres
- Department of Clinical Science, University of Bergen, Norway
| | | | - Francisco Gomez Real
- Department of Clinical Science, University of Bergen, Norway.,Department of Obstetrics and Gynecology, Haukeland, University Hospital, Bergen, Norway
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Jõgi NO, Svanes C, Siiak SP, Logan E, Holloway JW, Igland J, Johannessen A, Levin M, Real FG, Schlunssen V, Horsnell WGC, Bertelsen RJ. Zoonotic helminth exposure and risk of allergic diseases: A study of two generations in Norway. Clin Exp Allergy 2017; 48:66-77. [PMID: 29117468 DOI: 10.1111/cea.13055] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/01/2017] [Accepted: 10/27/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Animal and human studies indicate that definitive host helminth infections may confer protection from allergies. However, zoonotic helminths, such as Toxocara species (spp.), have been associated with increased allergies. OBJECTIVE We describe the prevalence of Toxocara spp. and Ascaris spp. seropositivity and associations with allergic diseases and sensitization, in 2 generations in Bergen, Norway. METHODS Serum levels of total IgG4, anti-Toxocara spp. IgG4 and Ascaris spp. IgG4 were established by ELISA in 2 cohorts: parents born 1945-1972 (n = 171) and their offspring born 1969-2003 (n = 264). Allergic outcomes and covariates were recorded through interviews and clinical examinations including serum IgEs and skin prick tests. RESULTS Anti-Ascaris spp. IgG4 was detected in 29.2% of parents and 10.3% of offspring, and anti-Toxocara spp. IgG4 in 17.5% and 8.0% of parents and offspring, respectively. Among offspring, anti-Toxocara spp. IgG4 was associated with pet keeping before age 15 (OR = 6.15; 95% CI = 1.37-27.5) and increasing BMI (1.16[1.06-1.25] per kg/m2 ). Toxocara spp. seropositivity was associated with wheeze (2.97[1.45- 7.76]), hayfever (4.03[1.63-9.95]), eczema (2.89[1.08-7.76]) and cat sensitization (5.65[1.92-16.6]) among offspring, but was not associated with allergic outcomes among parents. Adjustment for childhood or current pet keeping did not alter associations with allergies. Parental Toxocara spp. seropositivity was associated with increased offspring allergies following a sex-specific pattern. CONCLUSIONS & CLINICAL RELEVANCE Zoonotic helminth exposure in Norway was less frequent in offspring than parents; however, Toxocara spp. seropositivity was associated with increased risk of allergic manifestations in the offspring generation, but not among parents. Changes in response to helminth exposure may provide insights into the increase in allergy incidence in affluent countries.
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Affiliation(s)
- N O Jõgi
- University of Tartu, Tartu, Estonia.,Centre for International Health, University of Bergen, Bergen, Norway
| | - C Svanes
- Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | | | - E Logan
- University of Cape Town, Cape Town, South Africa
| | - J W Holloway
- Human Development & Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - J Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - A Johannessen
- Centre for International Health, University of Bergen, Bergen, Norway
| | - M Levin
- University of Cape Town, Cape Town, South Africa
| | - F G Real
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - V Schlunssen
- Aarhus University, Aarhus, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - W G C Horsnell
- Institute of Infectious Disease and Molecular Medicine/Division of Immunology, University of Cape Town, Cape Town, South Africa.,Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK.,Laboratory of Molecular and Experimental Immunology and Neurogenetics, UMR 7355, CNRS-University of Orleans and Le Studium Institute for Advanced Studies, Orléans, France
| | - R J Bertelsen
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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23
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Matulonga Diakiese B, Triebner K, Courbon D, Accordini S, Heinrich J, Janson C, Jarvis D, Lindberg E, Pin I, Probst-Hensch N, Siroux V, Raherison C, Zemp E, Dharmage S, Gomez Real F, Leynaert B. Gender differences in allergic and non-allergic asthma over 20 years of follow-up. Epidemiology 2017. [DOI: 10.1183/1393003.congress-2017.pa2620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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24
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Lønnebotn M, Calciano L, Johannessen A, Bertelsen R, Holm M, Jogi R, Kirkeleit J, Lodge C, Malinovschi A, Martinez-Moratalla Rovira J, Nilsen RM, Sanchez-Ramos JL, Schlunssen V, Real FG, Accordini S, Svanes C, Jarvis D. Late Breaking Abstract - Mothers' preconception overweight and offspring asthma. Epidemiology 2017. [DOI: 10.1183/1393003.congress-2017.pa3502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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25
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Johannessen A, Calciano L, Lonnebotn M, Bertelsen RJ, Braback L, Holm M, Janson C, Jogi R, Kirkeleit J, Lodge C, Malinovschi A, Nilsen RM, Real FG, Sanchez Ramos JL, Schlunssen V, Jarvis D, Accordini S, Svanes C. Late Breaking Abstract - Fathers’ overweight and offspring asthma – an intergenerational perspective. Epidemiology 2017. [DOI: 10.1183/1393003.congress-2017.pa2615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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26
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Accordini S, Johannessen A, Calciano L, Jögi R, Martínez-Moratalla Rovira J, Benediktsdóttir B, Jacobsen Bertelsen R, Bråbäck L, Dharmage S, Gomez Real F, Holm M, Jarvis D, Malinovschi A, Marcon A, Portas L, Sánchez-Ramos JL, Svanes C, Schlünssen V. Three-generation effects of tobacco smoking on lung function within the paternal line. Epidemiology 2017. [DOI: 10.1183/1393003.congress-2017.pa1178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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27
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Knudsen TM, Rezwan F, Johannessen A, Skulstad SM, Bertelsen RJ, Real FG, Probst-Hensch N, Jarvis D, Holloway J, Svanes C. Late Breaking Abstract - Epigenome-wide association of father’s smoking on offspring DNA methylation. Genes Environ 2017. [DOI: 10.1183/1393003.congress-2017.oa2948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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28
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Skulstad SM, Igland J, Johannessen A, Bertelsen RJ, Lønnebotn M, Omenaas ER, Svanes C, Real FG. Validation of maternal reported pregnancy and birth characteristics against the Medical Birth Registry of Norway. PLoS One 2017; 12:e0181794. [PMID: 28783742 PMCID: PMC5544234 DOI: 10.1371/journal.pone.0181794] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/09/2017] [Indexed: 11/19/2022] Open
Abstract
Studies using mothers' self-reported information on birth and pregnancy characteristics are common, but the validity of such data is uncertain. We evaluated questionnaire data from the RHINE III study on reproductive health provided by 715 mothers from Bergen, Norway, about their 1629 births between 1967 and 2010, using the Medical Birth Registry of Norway (MBRN) as gold standard. Validity of dichotomous variables (gender, preterm birth [<37 weeks' gestation], postterm birth [>42 weeks' gestation], induction of labour, forceps delivery, vacuum delivery, caesarean section, were assessed by sensitivity, specificity, positive and negative predictive values (PPV and NPV) and Cohen's kappa. Paired t-test, Pearson's correlation coefficient and Bland-Altman plots were used to validate birthweight, stratified by mother's level of education, parity, birth year and child's asthma status. Child's gender and caesarean section showed high degree of validity (kappa = 0.99, sensitivity and specificity 100%). Instrumental delivery and extremely preterm birth showed good agreement with sensitivity 75-92%. Preterm birth and induction of labour showed moderate agreement. Post-term delivery was poorly reported. The validity appeared to be independent of recall time over 45 years, and of the child's asthma status. Maternally reported birth and pregnancy information is feasible and cheap, showed high validity for important birth and pregnancy parameters, and showed similar risk-associations compared to registry data.
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Affiliation(s)
- Svein Magne Skulstad
- Dept. of Clinical Science, University of Bergen, Bergen, Norway
- Dept. of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
- * E-mail:
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Ane Johannessen
- Centre for International Health, University of Bergen, Bergen, Norway
| | - Randi Jacobsen Bertelsen
- Dept. of Clinical Science, University of Bergen, Bergen, Norway
- Centre for International Health, University of Bergen, Bergen, Norway
| | - Marianne Lønnebotn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Dept. of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | | | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway
- Dept. of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Francisco Gomez Real
- Dept. of Clinical Science, University of Bergen, Bergen, Norway
- Dept. of Obstetrics and Gynecology, Haukeland, University Hospital, Bergen, Norway
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29
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Lindberg E, Benediktsdottir B, Franklin KA, Holm M, Johannessen A, Jögi R, Gislason T, Real FG, Schlünssen V, Janson C. Women with symptoms of sleep-disordered breathing are less likely to be diagnosed and treated for sleep apnea than men. Sleep Med 2017; 35:17-22. [PMID: 28619177 DOI: 10.1016/j.sleep.2017.02.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/16/2017] [Accepted: 02/21/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Women are often underrepresented at sleep clinics evaluating sleep-disordered breathing (SDB). The aim of the present study was to analyze gender differences in sleep apnea diagnosis and treatment in men and women with similar symptoms of SDB. METHODS Respiratory Health in Northern Europe (RHINE) provided information about snoring, excessive daytime sleepiness (EDS), BMI and somatic diseases at baseline (1999-2001) and follow-up (2010-2012) from 4962 men and 5892 women. At follow-up participants were asked whether they had a diagnosis of and/or treatment for sleep apnea. RESULTS Among those with symptoms of SDB (snoring and EDS), more men than women had been given the diagnosis of sleep apnea (25% vs. 14%, p < 0.001), any treatment (17% vs. 11%, p = 0.05) and CPAP (6% vs. 3%, p = 0.04) at follow-up. Predictors of receiving treatment were age, BMI, SDB symptoms at baseline and weight gain, while female gender was related to a lower probability of receiving treatment (adj. OR 0.3, 95% CI 0.3-0.5). In both genders, the symptoms of SDB increased the risk of developing hypertension (adj OR, 95% CI: 1.5, 1.2-1.8) and diabetes (1.5, 1.05-2.3), independent of age, BMI, smoking and weight gain. CONCLUSIONS Snoring females with daytime sleepiness may be under-diagnosed and under-treated for sleep apnea compared with males, despite running a similar risk of developing hypertension and diabetes.
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Affiliation(s)
- Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Sweden.
| | - Bryndis Benediktsdottir
- Department of Respiratory Medicine and Sleep, The National University Hospital of Iceland, Reykjavik, Iceland; University of Iceland, Faculty of Medicine, Iceland
| | - Karl A Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umea University, Sweden
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Rain Jögi
- Lung Clinic, Tartu University Clinics, Tartu, Estonia
| | - Thorarinn Gislason
- Department of Respiratory Medicine and Sleep, The National University Hospital of Iceland, Reykjavik, Iceland; University of Iceland, Faculty of Medicine, Iceland
| | - Francisco Gomez Real
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health, Section for Environment, Occupation and Health, Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Sweden
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30
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Gislason T, Bertelsen RJ, Real FG, Sigsgaard T, Franklin KA, Lindberg E, Janson C, Arnardottir ES, Hellgren J, Benediktsdottir B, Forsberg B, Johannessen A. Self-reported exposure to traffic pollution in relation to daytime sleepiness and habitual snoring: a questionnaire study in seven North-European cities. Sleep Med 2016; 24:93-99. [PMID: 27810192 DOI: 10.1016/j.sleep.2016.08.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/16/2016] [Accepted: 08/17/2016] [Indexed: 01/27/2023]
Abstract
OBJECTIVE/BACKGROUND Little is known about associations between traffic exposure and sleep disturbances. We examined if self-reported exposure to traffic is associated with habitual snoring and daytime sleepiness in a general population. METHODS In the RHINE III study, 12184 adults answered questions on sleep disturbances and traffic exposure. We analysed bedrooms near roads with traffic, bedrooms with traffic noise, and travelling regularly along busy roads as proxies for traffic exposures, using logistic regression. Adjustment factors were study centre, gender, age, smoking habits, educational level, body mass index, physical activity, obstructive sleep apnoea, and sleep duration. RESULTS One in ten lived near a busy road, 6% slept in a bedroom with traffic noise, and 11% travelled regularly along busy roads. Habitual snoring affected 25% and daytime sleepiness 21%. More men reported snoring and more women reported daytime sleepiness. Having a bedroom with traffic noise was associated with snoring (adjusted OR 1.29, [95% CI 1.12, 1.48]). For daytime sleepiness, on the other hand, bedroom with traffic noise and high exposure to traffic pollution have significant risk factors (adjusted ORs 1.46 [1.11, 1.92] and 1.65 [1.11, 2.45]). Results were consistent across study centres. CONCLUSIONS Daytime sleepiness is associated with traffic pollution and traffic noise, while habitual snoring is only associated with traffic noise. Self-reported traffic exposure should be taken into account when diagnosing and planning treatment for patients with sleep disturbances, because reducing noise and pollution exposure in the bedroom may have a beneficial effect.
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Affiliation(s)
- Thorarinn Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Respiratory Medicine and Sleep, Landspitali - National University Hospital of Iceland, Iceland
| | - Randi J Bertelsen
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Institute of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | | | - Karl A Franklin
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory-, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory-, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Erna Sif Arnardottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Respiratory Medicine and Sleep, Landspitali - National University Hospital of Iceland, Iceland
| | - Johan Hellgren
- Institute of Clinical Science, University of Gothenburg, Sweden; Department of Otorhinolaryngology, Head & Neck Surgery, Sahlgrenska Academy, Gothenburg, Sweden
| | - Bryndis Benediktsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Respiratory Medicine and Sleep, Landspitali - National University Hospital of Iceland, Iceland
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine/Occupational & Environmental Medicine, Umeå University, Umeå, Sweden
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
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31
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Dratva J, Bertelsen R, Janson C, Johannessen A, Benediktsdóttir B, Bråbäck L, Dharmage SC, Forsberg B, Gislason T, Jarvis D, Jogi R, Lindberg E, Norback D, Omenaas E, Skorge TD, Sigsgaard T, Toren K, Waatevik M, Wieslander G, Schlünssen V, Svanes C, Real FG. Validation of self-reported figural drawing scales against anthropometric measurements in adults. Public Health Nutr 2016; 19:1944-51. [PMID: 26879067 PMCID: PMC10270874 DOI: 10.1017/s136898001600015x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 12/15/2015] [Accepted: 01/11/2016] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of the present study was to validate figural drawing scales depicting extremely lean to extremely obese subjects to obtain proxies for BMI and waist circumference in postal surveys. DESIGN Reported figural scales and anthropometric data from a large population-based postal survey were validated with measured anthropometric data from the same individuals by means of receiver-operating characteristic curves and a BMI prediction model. SETTING Adult participants in a Scandinavian cohort study first recruited in 1990 and followed up twice since. SUBJECTS Individuals aged 38-66 years with complete data for BMI (n 1580) and waist circumference (n 1017). RESULTS Median BMI and waist circumference increased exponentially with increasing figural scales. Receiver-operating characteristic curve analyses showed a high predictive ability to identify individuals with BMI > 25·0 kg/m2 in both sexes. The optimal figural scales for identifying overweight or obese individuals with a correct detection rate were 4 and 5 in women, and 5 and 6 in men, respectively. The prediction model explained 74 % of the variance among women and 62 % among men. Predicted BMI differed only marginally from objectively measured BMI. CONCLUSIONS Figural drawing scales explained a large part of the anthropometric variance in this population and showed a high predictive ability for identifying overweight/obese subjects. These figural scales can be used with confidence as proxies of BMI and waist circumference in settings where objective measures are not feasible.
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Affiliation(s)
- Julia Dratva
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, PO Box 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Randi Bertelsen
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Christer Janson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ane Johannessen
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Bryndis Benediktsdóttir
- Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Lennart Bråbäck
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Thorarinn Gislason
- Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Debbie Jarvis
- Faculty of Medicine, National Heart & Lung Institute, Imperial College, London, UK
| | - Rain Jogi
- Lung Clinic, Foundation Tartu University Clinics, Tartu, Estonia
- Department of Pulmonary Medicine, Tartu University, Tartu, Estonia
| | - Eva Lindberg
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Dan Norback
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ernst Omenaas
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Trude D Skorge
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | | | - Kjell Toren
- Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marie Waatevik
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | | | - Vivi Schlünssen
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Centre for International Health, University of Bergen, Bergen, Norway
| | - Francisco Gomez Real
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
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Waatevik M, Johannessen A, Gomez Real F, Aanerud M, Hardie JA, Bakke PS, Lind Eagan TM. Oxygen desaturation in 6-min walk test is a risk factor for adverse outcomes in COPD. Eur Respir J 2016; 48:82-91. [PMID: 27076586 DOI: 10.1183/13993003.00975-2015] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 02/15/2016] [Indexed: 11/05/2022]
Abstract
The 6-min walk test (6MWT) is an exercise test that measures functional status in chronic obstructive pulmonary disease (COPD) patients and provides information on oxygen desaturation. We investigated oxygen desaturation during 6MWT as a risk factor for important COPD outcomes: mortality, frequency of exacerbations, decline in lung function and decline in lean body mass.433 COPD patients were included in the Bergen COPD Cohort Study 2006-2009, and followed-up for 3 years. Patients were characterised using spirometry, bioelectrical impedance measurements, Charlson comorbidity score, exacerbation history, smoking and arterial blood gases. 370 patients completed the 6MWT at the baseline of the study. Information on all-cause mortality was collected in 2011.Patients who experienced oxygen desaturation during the 6MWT had an approximately twofold increased risk of death (hazard ratio 2.4, 95% CI 1.2-5.1), a 50% increased risk for experiencing later COPD exacerbations (incidence rate ratio 1.6, 95% CI 1.1-2.2), double the yearly rate of decline in both forced vital capacity and forced expiratory volume in 1 s (3.2% and 1.7% versus 1.7% and 0.9%, respectively) and manifold increased yearly rate of loss of lean body mass (0.18 kg·m(-2) versus 0.03 kg·m(-2) among those who did not desaturate).Desaturating COPD patients had a significantly worse prognosis than non-desaturating COPD patients, for multiple important disease outcomes.
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Affiliation(s)
- Marie Waatevik
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Ane Johannessen
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Francisco Gomez Real
- Dept of Clinical Science, University of Bergen, Bergen, Norway Dept of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
| | - Marianne Aanerud
- Dept of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | | | | | - Tomas Mikal Lind Eagan
- Dept of Clinical Science, University of Bergen, Bergen, Norway Dept of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
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Johannessen A, Verlato G, Benediktsdottir B, Forsberg B, Franklin K, Gislason T, Holm M, Janson C, Jögi R, Lindberg E, Macsali F, Omenaas E, Real FG, Saure EW, Schlünssen V, Sigsgaard T, Skorge TD, Svanes C, Torén K, Waatevik M, Nilsen RM, de Marco R. Longterm follow-up in European respiratory health studies - patterns and implications. BMC Pulm Med 2014; 14:63. [PMID: 24739530 PMCID: PMC4021078 DOI: 10.1186/1471-2466-14-63] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/03/2014] [Indexed: 11/25/2022] Open
Abstract
Background Selection bias is a systematic error in epidemiologic studies that may seriously distort true measures of associations between exposure and disease. Observational studies are highly susceptible to selection bias, and researchers should therefore always examine to what extent selection bias may be present in their material and what characterizes the bias in their material. In the present study we examined long-term participation and consequences of loss to follow-up in the studies Respiratory Health in Northern Europe (RHINE), Italian centers of European Community Respiratory Health Survey (I-ECRHS), and the Italian Study on Asthma in Young Adults (ISAYA). Methods Logistic regression identified predictors for follow-up participation. Baseline prevalence of 9 respiratory symptoms (asthma attack, asthma medication, combined variable with asthma attack and/or asthma medication, wheeze, rhinitis, wheeze with dyspnea, wheeze without cold, waking with chest tightness, waking with dyspnea) and 9 exposure-outcome associations (predictors sex, age and smoking; outcomes wheeze, asthma and rhinitis) were compared between all baseline participants and long-term participants. Bias was measured as ratios of relative frequencies and ratios of odds ratios (ROR). Results Follow-up response rates after 10 years were 75% in RHINE, 64% in I-ECRHS and 53% in ISAYA. After 20 years of follow-up, response was 53% in RHINE and 49% in I-ECRHS. Female sex predicted long-term participation (in RHINE OR (95% CI) 1.30(1.22, 1.38); in I-ECRHS 1.29 (1.11, 1.50); and in ISAYA 1.42 (1.25, 1.61)), as did increasing age. Baseline prevalence of respiratory symptoms were lower among long-term participants (relative deviations compared to total baseline population 0-15% (RHINE), 0-48% (I-ECRHS), 3-20% (ISAYA)), except rhinitis which had a slightly higher prevalence. Most exposure-outcome associations did not differ between long-term participants and all baseline participants, except lower OR for rhinitis among ISAYA long-term participating smokers (relative deviation 17% (smokers) and 44% (10–20 pack years)). Conclusions We found comparable patterns of long-term participation and loss to follow-up in RHINE, I-ECRHS and ISAYA. Baseline prevalence estimates for long-term participants were slightly lower than for the total baseline population, while exposure-outcome associations were mainly unchanged by loss to follow-up.
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Affiliation(s)
- Ane Johannessen
- Centre for Clinical Research, Haukeland University Hospital, Bergen 5021, Norway.
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Abstract
Sex hormones appear to play an important role in the lung health of women. This is, however, poorly understood and, in most aspects, poorly investigated; and the literature has been contradictory and confusing. This review presents recent research concerning the involvement of sex hormones in respiratory health of adult women, using the population surveys European Community Respiratory Health Survey and Respiratory Health in Northern Europe. Respiratory health varied substantially according to hormonal and metabolic conditions. First, menopause was associated with lower lung function and more respiratory symptoms, especially among lean women. Second, hormonal replacement therapy (HRT) was associated with increased risk for asthma and wheeze; also, this association was particularly strong among lean women. Third, women with irregular menstruations in fertile age had more asthma, particularly allergic asthma, and reduced lung function, independently of body mass index (BMI) and physical activity. The findings were consistent across cultural and geographical borders. Our studies revealed that considering interplay between hormonal and metabolic factors is a clue to understand the effects of female sex hormones on the airways. A BMI of around 24-25 kg/m(2) appeared to be optimal; women with this BMI had no increase in respiratory health problems when reaching menopause or using HRT, and women in fertile age with this BMI had optimal lung function independently of menstrual status. In conclusion, female sex hormones appear to play a most important role for lung health in women. Further research on effects of sex hormones on the airways should take into account potential interplay with metabolic factors.
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Affiliation(s)
- F G Real
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway.
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Real FG. [Contribution to the study of cerebral hemodynamics in anesthetized patients by means of palencephalography]. Rev Esp Otoneurooftalmol Neurocir 1972; 30:157-98. [PMID: 5084215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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