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Räisänen, P., Backman, H., Hedman, L., Andersson, M., Stridsman, C., Kankaanranta, H., . . . Rönmark, E. (2021). High but stable incidence of adult-onset asthma in northern Sweden over the last decades. ERJ Open Research, 7(3), Article ID 00262-2021.
Open this publication in new window or tab >>High but stable incidence of adult-onset asthma in northern Sweden over the last decades
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2021 (English)In: ERJ Open Research, E-ISSN 2312-0541, Vol. 7, no 3, article id 00262-2021Article in journal (Refereed) Published
Abstract [en]

Background: The prevalence of asthma has increased both among children and adults during the latter half of the 20th century. The prevalence among adults is affected by the incidence of asthma not only in childhood but also in adulthood. Time trends in asthma incidence have been poorly studied.

Aims: The aim of this study was to review the incidence of adult-onset asthma from 1996 to 2006 and 2006 to 2016 and compare the risk factor patterns.

Methods: In the Obstructive Lung Disease in Northern Sweden (OLIN) studies, two randomly selected population-based samples in the 20-69-year age group participated in postal questionnaire surveys about asthma in 1996 (n=7104, 85%) and 2006 (n=6165, 77%). A 10-year follow-up of the two cohorts with the same validated questionnaire was performed, and 5709 and 4552 responded, respectively. Different definitions of population at risk were used in the calculations of asthma incidence. The protocol followed a study performed between 1986 and 1996 in the same area.

Results: The crude incidence rate of physician-diagnosed asthma was 4.4 per 1000 person-years (men 3.8, women 5.5) from 1996 to 2006, and 4.8 per 1000 person-years (men 3.7, women 6.2) from 2006 to 2016. When correcting for possible under-diagnosis at study entry, the incidence rate was 2.4 per 1000 person-years from 1996 to 2006 and 2.6 per 1000 person-years from 2006 to 2016. The incidence rates were similar across age groups. Allergic rhino-conjunctivitis was the main risk factor for incident asthma in both observation periods (risk ratio 2.4-2.6).

Conclusions: The incidence of adult-onset asthma has been stable over the last two decades and has remained at a similar level since the 1980s. The high incidence contributes to the increase in asthma prevalence.

Place, publisher, year, edition, pages
European Respiratory Society, 2021
National Category
Respiratory Medicine and Allergy
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-86682 (URN)10.1183/23120541.00262-2021 (DOI)000684273900035 ()34235212 (PubMedID)2-s2.0-85114081266 (Scopus ID)
Funder
Swedish Heart Lung FoundationSwedish Asthma and Allergy AssociationVisare NorrNorrbotten County Council
Note

Validerad;2021;Nivå 2;2021-08-18 (alebob);

Forskningsfinansiär: ALF, a regional agreement between Umeå University and Västerbotten and Norrbotten County Council

Available from: 2021-08-17 Created: 2021-08-17 Last updated: 2022-11-16Bibliographically approved
Karlsson Sundbaum, J., Vanfleteren, L. E. .., Konradsen, J. R., Nyberg, F., Ekberg-Jansson, A. & Stridsman, C. (2021). Severe COVID-19 among patients with asthma and COPD: a report from the Swedish National Airway Register. Therapeutic Advances in Respiratory Disease, 15, Article ID 175346662110497.
Open this publication in new window or tab >>Severe COVID-19 among patients with asthma and COPD: a report from the Swedish National Airway Register
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2021 (English)In: Therapeutic Advances in Respiratory Disease, ISSN 1753-4658, E-ISSN 1753-4666, Vol. 15, article id 175346662110497Article in journal (Refereed) Published
Abstract [en]

Background: Patients with obstructive lung diseases may be at risk of hospitalization and/or death due to COVID-19.

Aim: To estimate the frequency of severe COVID-19, and COVID-19-related mortality in a well-defined large population of patients with asthma and chronic inflammatory lung disease (COPD). Further to assess the frequency of asthma and COPD as registered comorbidities at discharge from hospital, and in death certificates.

Methods: At the start of the pandemic, the Swedish National Airway Register (SNAR) included 271,404 patients with a physician diagnosis of asthma and/or COPD. In September 2020, after the first COVID-19 wave in Sweden, the database was linked with the National Patient Register (NPR), the Swedish Intensive Care Register and the Swedish Cause of Death Register, which all provide data about COVID-19 based on International Classification of Diseases (ICD-10) codes. Severe COVID-19 was defined as hospitalization and/or intensive care or death due to COVID-19.

Results: Among patients in SNAR, 0.5% with asthma, and 1.2% with COPD were identified with severe COVID-19. Among patients  < 18 years with asthma, only 0.02% were severely infected. Of hospitalized adults, 14% with asthma and 29% with COPD died. Further, of patients in SNAR, 56% with asthma and 81% with COPD were also registered in the NPR, while on death certificates the agreement was lower (asthma 24% and COPD 71%).

Conclusion: The frequency of severe COVID-19 in asthma and COPD was relative low. Mortality for those hospitalized was double as high in COPD compared to asthma. Comorbid asthma and COPD were not always identified among patients with severe COVID-19.

Place, publisher, year, edition, pages
Sage Publications, 2021
Keywords
asthma, COPD, COVID-19, death certificates, hospitalization, obstructive lung diseases, quality register, register studies
National Category
Respiratory Medicine and Allergy
Research subject
Medical Science
Identifiers
urn:nbn:se:ltu:diva-87443 (URN)10.1177/17534666211049738 (DOI)000706299800001 ()34623194 (PubMedID)2-s2.0-85116642295 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 20200308
Note

Validerad;2021;Nivå 2;2021-10-11 (alebob)

Available from: 2021-10-11 Created: 2021-10-11 Last updated: 2022-11-16Bibliographically approved
Stridsman, C., Axelsson, M., Warm, K. & Backman, H. (2021). Uncontrolled asthma occurs in all GINA treatment steps and is associated with worse physical health: a report from the OLIN adult asthma cohort. Journal of Asthma, 58(5), 586-595
Open this publication in new window or tab >>Uncontrolled asthma occurs in all GINA treatment steps and is associated with worse physical health: a report from the OLIN adult asthma cohort
2021 (English)In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 58, no 5, p. 586-595Article in journal (Refereed) Published
Abstract [en]

Objective: To study asthma exacerbations, healthcare utilization and health status among subjects with asthma with different treatment regimens and levels of asthma control.

Methods: In 2012–2014, n = 1425 adults from a population-based asthma cohort within the OLIN studies (Obstructive Lung disease in Northern Sweden) were invited to a follow-up including spirometry and a structured interview, n = 1006 participated. Asthma Control Test (ACT) was used to detect uncontrolled asthma, and physical and mental dimensions of health were measured with SF-8. Pharmacological treatment use was classified by Global Initiative for Asthma treatment steps. Out of n = 830 with current asthma, n = 714 answered ACT (57% women, 32–92 years) and were included in the study.

Results: Uncontrolled asthma increased per treatment step (no treatment 9.9%, treatment step 1–3 24.1%, and treatment steps 4–5 39.9%, p < 0.001). A higher proportion of subjects with uncontrolled asthma reported exacerbations, healthcare utilization, and worse health status than those with controlled asthma. The proportion of subjects reporting exacerbations, healthcare visits, emergency room visits and regular follow-up visits increased per treatment step. Worse health was associated with uncontrolled asthma, but not with the level of treatment. A higher proportion of women than men reported exacerbations, any healthcare visits, and lower health. Regular follow-up visits to a physician were uncommon (women 21.2% vs. men 14.6%, p = 0.022).

Conclusions: Uncontrolled asthma is common in all treatment steps, and is associated with worse health status. However, health status did not differ by treatment steps. Identifying subjects with uncontrolled asthma regardless of treatment regimens should be a priority, thus follow-up visits are important.

Place, publisher, year, edition, pages
Taylor & Francis, 2021
Keywords
Epidemiology, management/control, quality of life, treatment
National Category
Respiratory Medicine and Allergy
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-77776 (URN)10.1080/02770903.2020.1713150 (DOI)000506948200001 ()31910044 (PubMedID)2-s2.0-85088063526 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 20170509Swedish Research CouncilNorrbotten County CouncilSwedish Asthma and Allergy AssociationVisare Norr
Note

Validerad;2021;Nivå 2;2021-06-09 (johcin)

Available from: 2020-02-19 Created: 2020-02-19 Last updated: 2022-11-16Bibliographically approved
Nilsson, U., Mills, N. L., McAllister, D. A., Backman, H., Stridsman, C., Hedman, L., . . . Lindberg, A. (2020). Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease. Respiratory Research, 21, Article ID 162.
Open this publication in new window or tab >>Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease
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2020 (English)In: Respiratory Research, ISSN 1465-9921, E-ISSN 1465-993X, Vol. 21, article id 162Article in journal (Refereed) Published
Abstract [en]

Background

Ischemic heart disease is common in COPD and associated with worse prognosis. This study aimed to investigate the presence and prognostic impact of biomarkers of myocardial injury and ischemia among individuals with COPD and normal lung function, respectively.

Methods

In 2002–04, all individuals with airway obstruction (FEV1/VC < 0.70, n = 993) were identified from population-based cohorts, together with age and sex-matched non-obstructive referents. At re-examination in 2005, spirometry, Minnesota-coded ECG and analyses of high-sensitivity cardiac troponin I (hs-cTnI) were performed in individuals with COPD (n = 601) and those with normal lung function (n = 755). Deaths were recorded until December 31st, 2010.

Results

Hs-cTnI concentrations were above the risk stratification threshold of ≥5 ng/L in 31.1 and 24.9% of those with COPD and normal lung function, respectively. Ischemic ECG abnormalities were present in 14.8 and 13.4%, while 7.7 and 6.6% had both elevated hs-cTnI concentrations and ischemic ECG abnormalities. The 5-year cumulative mortality was higher in those with COPD than those with normal lung function (13.6% vs. 7.7%, p < 0.001). Among individuals with COPD, elevated hs-cTnI both independently and in combination with ischemic ECG abnormalities were associated with an increased risk for death (adjusted hazard ratio [HR]; 95% confidence interval [CI] 2.72; 1.46–5.07 and 4.54; 2.25–9.13, respectively). Similar associations were observed also among individuals with COPD without reported ischemic heart disease.

Conclusions

In this study, elevated hs-cTnI concentrations in combination with myocardial ischemia on the electrocardiogram were associated with a more than four-fold increased risk for death in a population-based COPD-cohort, independent of disease severity.

Place, publisher, year, edition, pages
Springer Nature, 2020
Keywords
COPD, Multimorbidity, Myocardial ischemia, Troponin, Electrocardiography, Mortality
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-80128 (URN)10.1186/s12931-020-01430-z (DOI)000545590700001 ()32590988 (PubMedID)2-s2.0-85087165178 (Scopus ID)
Note

Validerad;2020;Nivå 2;2020-07-01 (alebob)

Available from: 2020-07-01 Created: 2020-07-01 Last updated: 2022-11-16Bibliographically approved
Backman, H., Vanfleteren, L., Lindberg, A., Ekerljung, L., Stridsman, C., Axelsson, M., . . . Lundbäck, B. (2020). Decreased COPD prevalence in Sweden after decades of decrease in smoking. Respiratory Research, 21, Article ID 283.
Open this publication in new window or tab >>Decreased COPD prevalence in Sweden after decades of decrease in smoking
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2020 (English)In: Respiratory Research, ISSN 1465-9921, E-ISSN 1465-993X, Vol. 21, article id 283Article in journal (Refereed) Published
Abstract [en]

Background

COPD has increased in prevalence worldwide over several decades until the first decade after the millennium shift. Evidence from a few recent population studies indicate that the prevalence may be levelling or even decreasing in some areas in Europe. Since the 1970s, a substantial and ongoing decrease in smoking prevalence has been observed in several European countries including Sweden. The aim of the current study was to estimate the prevalence, characteristics and risk factors for COPD in the Swedish general population. A further aim was to estimate the prevalence trend of COPD in Northern Sweden from 1994 to 2009.

Methods

Two large random population samples were invited to spirometry with bronchodilator testing and structured interviews in 2009–2012, one in south-western and one in northern Sweden, n = 1839 participants in total. The results from northern Sweden were compared to a study performed 15 years earlier in the same area and age-span. The diagnosis of COPD required both chronic airway obstruction (CAO) and the presence of respiratory symptoms, in line with the GOLD documents since 2017. CAO was defined as post-bronchodilator FEV1/FVC < 0.70, with sensitivity analyses based on the FEV1/FVC < lower limit of normal (LLN) criterion.

Results

Based on the fixed ratio definition, the prevalence of COPD was 7.0% (men 8.3%; women 5.8%) in 2009–2012. The prevalence of moderate to severe (GOLD ≥ 2) COPD was 3.5%. The LLN based results were about 30% lower. Smoking, occupational exposures, and older age were risk factors for COPD, whereof smoking was the most dominating risk factor. In northern Sweden the prevalence of COPD, particularly moderate to severe COPD, decreased significantly from 1994 to 2009, and the decrease followed a decrease in smoking.

Conclusions

The prevalence of COPD has decreased in Sweden, and the prevalence of moderate to severe COPD was particularly low. The decrease follows a major decrease in smoking prevalence over several decades, but smoking remained the dominating risk factor for COPD.

Place, publisher, year, edition, pages
Springer Nature, 2020
Keywords
COPD, Prevalence, Risk, Population study, Epidemiology
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-81283 (URN)10.1186/s12931-020-01536-4 (DOI)000582887600001 ()33115506 (PubMedID)2-s2.0-85094149463 (Scopus ID)
Note

Validerad;2020;Nivå 2;2020-11-02 (alebob)

Available from: 2020-11-02 Created: 2020-11-02 Last updated: 2022-11-16Bibliographically approved
Nilsson, U., Mills, N., Backman, H., Stridsman, C., Hedman, L., Rönmark, E., . . . Lindberg, A. (2020). Elevated cardiac troponin predicts 11-year mortality in COPD. Paper presented at ERS International Congress, 6-9 September, 2020, Virtual. European Respiratory Journal, 56(Suppl 64), Article ID 1439.
Open this publication in new window or tab >>Elevated cardiac troponin predicts 11-year mortality in COPD
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2020 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 56, no Suppl 64, article id 1439Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Ischemic heart disease (IHD) is a common multimorbidity in individuals with COPD. High sensitive cardiac troponin I (hs-cTnI) has been shown to predict short-term mortality, but longer follow-ups has rarely been performed in population-cohorts.

Aim: To evaluate the predictive value of elevated hs-cTnI on mortality among individuals with COPD compared with normal lung function (NLF).

Methods: In 2002-04, subjects with FEV1/VC <0.70 (COPD, n=993) and age and sex-matched referents withoutCOPD were identified from OLIN’s population-based cohorts. In 2005, structured interviews, post-bronchodilator spirometry, blood sampling and ECG were performed in individuals with COPD (n=599) and NLF (n=756). Hs-cTnI was analysed in serum and concentrations ≥5 ng/L were defined as elevated. Mortality data were collected until 2016.

Results: In 2005, the prevalence of reported IHD and elevated hs-cTnI was higher in COPD than NLF (16.2% vs 11.9% p=.02 and 31.1% vs 25.0% p=.01). The cumulative mortality was higher in COPD than NLF, both overall (36.5% vs 19.2% p<.001), and when restricting comparison to individuals with hs-cTnI≥5 (59.1% vs 34.9% p<.001). In a Cox-regression model adjusting for common confounders including reported IHD and ischemic ECG changes, hs-cTnI≥5 was associated with an increased risk for death in COPD (HR 1.41, 95%CI 1.03-1.93), but not in NLF (HR 0.84 95%CI 0.58-1.22). The increased risk remained after adjusting for FEV1% predicted.

Conclusion: Elevated hs-cTnI was associated with increased mortality over a 11 -year follow-up among individuals with COPD, but not among those with NLF in this population-based study. The use of troponin could identify individuals with stable COPD at the highest risk of death.

Place, publisher, year, edition, pages
European Respiratory Society (ERS), 2020
Keywords
Biomarkers, COPD, Comorbidities
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-82903 (URN)10.1183/13993003.congress-2020.1439 (DOI)000606501402405 ()
Conference
ERS International Congress, 6-9 September, 2020, Virtual
Note

Godkänd;2021;Nivå 0;2021-02-11 (alebob)

Available from: 2021-02-11 Created: 2021-02-11 Last updated: 2022-11-16Bibliographically approved
Backman, H., Lindberg, A., Hedman, L., Stridsman, C., Jansson, S.-A., Sandström, T., . . . Rönmark, E. (2020). FEV1 decline in relation to blood eosinophils and neutrophils in a population-based asthma cohort. World Allergy Organization Journal, 13(3), Article ID 100110.
Open this publication in new window or tab >>FEV1 decline in relation to blood eosinophils and neutrophils in a population-based asthma cohort
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2020 (English)In: World Allergy Organization Journal, ISSN 1731-3317, E-ISSN 1939-4551, Vol. 13, no 3, article id 100110Article in journal (Refereed) Published
Abstract [en]

Background

The relationship between lung function decline and eosinophils and neutrophils has important therapeutic implications among asthmatics, but it has rarely been studied in large cohort studies.

Objective

The aim is to study the relationship between blood eosinophils and neutrophils and FEV1 decline in a long-term follow-up of a population-based adult asthma cohort.

Methods

In 2012–2014, an adult asthma cohort was invited to a follow-up including spirometry, blood sampling, and structured interviews, and n = 892 participated (55% women, mean age 59 y, 32–92 y). Blood eosinophils, neutrophils and FEV 1 decline were analyzed both as continuous variables and divided into categories with different cut-offs. Regression models adjusted for smoking, exposure to vapors, gas, dust, or fumes (VGDF), use of inhaled and oral corticosteroids, and other possible confounders were utilized to analyze the relationship between eosinophils and neutrophils at follow-up and FEV1 decline.

Results

The mean follow-up time was 18 years, and the mean FEV 1 decline was 27 ml/year. The annual FEV1 decline was related to higher levels of both blood eosinophils and neutrophils at follow-up, but only the association with eosinophils remained when adjusted for confounders. Further, the association between FEV1 decline and eosinophils was stronger among those using ICS. With EOS <0.3 × 109/L as reference, a more rapid decline in FEV1 was independently related to EOS ≥0.4 × 109/L in adjusted analyses.

Conclusions and clinical relevance

Besides emphasizing the importance of smoking cessation and reduction of other harmful exposures, our real-world results indicate that there is an independent relationship between blood eosinophils and FEV1 decline among adults with asthma.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Asthma, FEV1, Eosinophils, Neutrophils, Cohort
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-78305 (URN)10.1016/j.waojou.2020.100110 (DOI)000528838100007 ()32206161 (PubMedID)2-s2.0-85081702790 (Scopus ID)
Note

Validerad;2020;Nivå 2;2020-04-03 (alebob)

Available from: 2020-04-02 Created: 2020-04-02 Last updated: 2022-11-16Bibliographically approved
Strandkvist, V., Andersson, M., Backman, H., Larsson, A., Stridsman, C. & Lindberg, A. (2020). Hand grip strength is associated with fatigue among men with COPD: epidemiological data from northern Sweden. Physiotherapy Theory and Practice, 36(3), 408-416
Open this publication in new window or tab >>Hand grip strength is associated with fatigue among men with COPD: epidemiological data from northern Sweden
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2020 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 36, no 3, p. 408-416Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate if hand grip strength (HGS) is associated with: 1) fatigue, and specifically clinically relevant fatigue (CRF); 2) low physical activity; and 3) fatigue independent of physical activity level, among individuals with and without COPD. Data were collected from the Obstructive Lung Disease in Northern Sweden (OLIN) COPD-study in 2014. HGS was measured with a hand-grip dynamometer, fatigue and physical activity were assessed by questionnaires; FACIT-Fatigue respectively IPAQ. Among individuals with COPD (n = 389), but not without COPD (n = 442), HGS was lower among those with CRF than those without CRF, significantly so among men (p = 0.001) and close to among women (p = 0.051). HGS was not associated with physical activity levels within any of the groups. HGS was associated with fatigue among men, but not women, with COPD independent of physical activity level, age, height, and smoking habits (Beta = 0.190, 95% CI 0.061-0.319, respectively Beta = 0.048, 95% CI-0.056-0.152), while there were no corresponding significant findings among individuals without COPD. In summary, HGS was associated with CRF among individuals with COPD in this population-based study. Among men with COPD, HGS was associated with fatigue independent of physical activity level and common confounders.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
COPD, muscle strength, fatigue, physical activity, epidemiology
National Category
Physiotherapy Nursing
Research subject
Physiotherapy; Nursing
Identifiers
urn:nbn:se:ltu:diva-69970 (URN)10.1080/09593985.2018.1486490 (DOI)000533128600006 ()29944062 (PubMedID)2-s2.0-85049104429 (Scopus ID)
Note

Validerad;2020;Nivå 2;2020-04-21 (johcin)

Available from: 2018-06-28 Created: 2018-06-28 Last updated: 2022-11-16Bibliographically approved
Jansson, S.-A., Hedman, L., Stridsman, C., Axelsson, M., Lindberg, A., Lundbäck, B., . . . Backman, H. (2020). Life-years lost due to asthma and COPD. Paper presented at ERS International Congress, 6-9 September, 2020, Virtual. European Respiratory Journal, 56(Suppl 64), Article ID 1400.
Open this publication in new window or tab >>Life-years lost due to asthma and COPD
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2020 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 56, no Suppl 64, article id 1400Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Quality-adjusted life-years (QALYs) is commonly used in health-economic evaluations. QALY-weights combine health status and time into one measure.

Aims: To investigate the association between multimorbidity and QALY-weights among adults with asthma and COPD.

Methods: Within the OLIN-studies in northern Sweden, a random sample was invited to a postal questionnaire survey. A random sample of 1016 responders was invited to clinical examinations and interviews in 2009 (737 participated, ages 21-86 years), of which 605 completed the health-related quality of life (HRQL) questionnaire SF-36. QALY-weights were derived from the SF-36 data using the SF-6D tool via the standard gamble method. The SF-6D scores are equivalent to QALY-weights with low values representing poor health and the score one representing perfect health.

Results: Of the 605 participants, 74 had current asthma, 81 had COPD (FEV1/FVC<0.7), 66 had heart disease, 30 had diabetes, 30 had rheumatic disease, and 160 had hypertension. There was an association between an increasing number of morbid conditions and lower QALY-weights (p<0.001). The mean QALY-weight tended to be lower among subjects with asthma compared to COPD, 0.77 and 0.81, respectively (p=0.078). Subjects with COPD and two or more non-respiratory conditions had significantly lower QALY-weights compared to subjects with COPD alone (0.75 vs.0.83, p=0.016). No significant difference in QALY-weights was found among asthmatics with versus without other non-respiratory conditions.

Conclusions: Subjects with asthma tended to have lower QALY-weights compared to subjects with COPD. Having two or more non-respiratory conditions affected the QALY-weight negatively among subjects with COPD but not among subjects with asthma.

Place, publisher, year, edition, pages
European Respiratory Society (ERS), 2020
Keywords
Quality of life, Asthma, Asthma - diagnosis
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-82902 (URN)10.1183/13993003.congress-2020.1400 (DOI)000606501402366 ()
Conference
ERS International Congress, 6-9 September, 2020, Virtual
Note

Godkänd;2021;Nivå 0;2021-02-11 (alebob)

Available from: 2021-02-11 Created: 2021-02-11 Last updated: 2022-11-16Bibliographically approved
Schyllert, C., Lindberg, A., Hedman, L., Stridsman, C., Andersson, M., Ilmarinen, P., . . . Backman, H. (2020). Low socioeconomic status relates to asthma and wheeze, especially in women. ERJ Open Research, 6(3), Article ID 00258-2019.
Open this publication in new window or tab >>Low socioeconomic status relates to asthma and wheeze, especially in women
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2020 (Swedish)In: ERJ Open Research, E-ISSN 2312-0541, Vol. 6, no 3, article id 00258-2019Article in journal (Refereed) Published
Abstract [en]

Low socioeconomic status (SES) has been associated with asthma and wheezing. Occupational group, educational level and income are commonly used indicators for SES, but no single indicator can illustrate the entire complexity of SES. The aim was to investigate how different indicators of SES associate with current asthma, allergic and nonallergic, and asthmatic wheeze. In 2016, a random sample of the population aged 20-79 years in Northern Sweden were invited to a postal questionnaire survey, with 58% participating (n=6854). The survey data were linked to the national Integrated Database for Labour Market Research by Statistics Sweden for the previous calendar year, 2015. Included SES indicators were occupation, educational level and income. Manual workers had increased risk for asthmatic wheeze, and manual workers in service for current asthma, especially allergic asthma. Primary school education associated with nonallergic asthma, whereas it tended to be inversely associated with allergic asthma. Low income was associated with asthmatic wheeze. Overall, the findings were more prominent among women, and interaction analyses between sex and income revealed that women, but not men, with low income had an increased risk both for asthmatic wheeze and current asthma, especially allergic asthma. To summarise, the different indicators of socioeconomic status illustrated various aspects of associations between low SES and asthma and wheeze, and the most prominent associations were found among women.

Place, publisher, year, edition, pages
European Respiratory Society (ERS), 2020
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-80964 (URN)10.1183/23120541.00258-2019 (DOI)000585055100015 ()32963998 (PubMedID)2-s2.0-85108818654 (Scopus ID)
Note

Validerad;2020;Nivå 2;2020-09-29 (johcin)

Available from: 2020-09-29 Created: 2020-09-29 Last updated: 2023-10-11Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6622-3838

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