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  • 101.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Views of Bullying and Antibullying Working Styles Among School Nurses and School Social Workers in Sweden2016In: Journal of School Violence, ISSN 1538-8220, E-ISSN 1538-8239, Vol. 15, no 4, p. 438-459Article in journal (Refereed)
  • 102.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health. Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Hellström, Lisa
    Karlstad University, Faculty of Social and Life Sciences.
    Discrepant gender patterns for cyberbullying and traditional bullying - An analysis of Swedish adolescent data (vol 29, pg 1896, 2013)2014In: Computers in human behavior, ISSN 0747-5632, E-ISSN 1873-7692, Vol. 34, p. 353-353Article in journal (Refereed)
  • 103.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Hagquist, Curt
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Hellström, Lisa
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Does the association with psychosomatic health problems differ between cyberbullying and traditional bullying?2012In: Emotional and Behavioural Difficulties, ISSN 1363-2752, E-ISSN 1741-2692, Vol. 17, no 3-4, p. 421-434Article in journal (Refereed)
    Abstract [en]

    The association between mental health problems and traditional bullying is well known,whereas the strength of the association in cyberbullying is less known. This study aimedto compare the association between mutually exclusive groups of bullying involvementand psychosomatic problems as measured by the PsychoSomatic Problems scale. Thesample comprised 3820 students (13–16 years old) in Sweden. The results indicate anassociation between bullying and psychosomatic problems, regardless of type of bullyinginvolvement. No statistically significant differences in psychosomatic problemswere found between cyberbullying and traditional bullying, either for victims or forbullies. The results do not confirm the hypothesis that the association between bullyingand mental health is stronger for cyberbullying than for traditional bullying. Anotherimportant finding is that cyberbullies seem as likely as cybervictims to be at risk formental health problems.

  • 104.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Hellström, Lisa
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Traditional bullying and cyberbullying2011Conference paper (Other academic)
  • 105.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Hellström, Lisa
    Department of School Development and Leadership, Malmö University, Malmö, Sweden.
    von Kobyletzki, Laura Beate
    Lund University, Skåne University Hospital, Department of Dermatology, Malmö, Sweden.
    Cyber bullying among children with neurodevelopmental disorders: A systematic review2019In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450Article in journal (Refereed)
    Abstract [en]

    Children and young adults with neurodevelopmental disorders (ND) are at increased risk of bullying compared to typically developing peers. It is still unclear to what extent they are involved in cyber bullying. This systematic review aimed at studying the prevalence of cyber bullying as perpetrators, victims, or both (“bully-victims”) among students with ND in a school setting and in need of special education. The Web of Science, Scopus, ERIC, PsycINFO, PubMED, and Cochrane databases were searched including a manual search of reference lists, until February 24, 2018. Eight studies conducted in Europe, North America, the Middle East, and Australia were included reporting a prevalence of cyber-victimization among students with ND of 0%–41%, a prevalence of cyber-perpetration of 0%–16.7%, and a prevalence of bully-victims of 6.7%. Three out of five studies using control groups showed that students with ND might be more involved in cyber bullying overall compared to typically developing students. Students in segregated school settings report slightly higher prevalence rates of cyber bullying compared to students with ND in inclusive school settings, especially among girls. When comparing prevalence rates among studies using the same definition, we found similar prevalence rates. There was a tendency towards students with ND being more involved in cyber bullying compared to typically developing students, but this needs to be confirmed in future studies that should include control groups with typically developing students as well as validated and standardized measurements of cyber bullying and ND diagnoses. © 2019 Scandinavian Psychological Associations and John Wiley & Sons Ltd

  • 106.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    von Kobyletzki, Laura B.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Lund Univ, Skne Univ Hosp, Dept Dermatol, Inst Clin Res Malmo, Malmo, Sweden.;Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Associations between neurodevelopmental disorders and factors related to school, health, and social interaction in schoolchildren: Results from a Swedish population-based survey2016In: Disability and Health Journal, ISSN 1936-6574, E-ISSN 1876-7583, Vol. 9, no 4, p. 663-672Article in journal (Refereed)
    Abstract [en]

    Background: Children and adolescents with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) are more likely to be surrounded by different risk factors. In order to work preventively with decreasing ADHD and ASD symptoms, there is a need of more knowledge concerning risk factors. Objective: This study aimed to investigate school, health, lifestyle and social interactions association with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) among schoolchildren aged 6-17 years. Methods: Data for 18,416 children and adolescents aged 6-17 years in the county of Varmland, Sweden, from the school year 2012/2013 and 2013/2014 were obtained from the Student Health Database, which includes information on health examinations by school nurses and self-reported information of mental and physical health, social relations, physical activity, and school conditions. Results: Of all participants, 2.4% reported only ADHD and 1.6% reported only ASD. The results confirmed that ADHD or ASD was significantly associated with worse school experiences, lower socioeconomic status, less physical activity, more substance use, weaker social network and more impairments than those without ADHD or ASD. Conclusions: Knowledge of risk or protective factors during school years is needed to develop interventions to reduce symptoms of neurodevelopmental disorders in children and adolescents.

  • 107.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    von Kobyletzki, Laura B.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Lund University, Skåne University Hospital, Department of Dermatology, Malmö, Sweden.
    Corrigendum to “Associations between neurodevelopmental disorders and factors related to school, health, and social interaction in schoolchildren Results from a Swedish population-based survey” [Disabil Health J 9(4) (2016) 663–672](S1936657416300723)(10.1016/j.dhjo.2016.05.002)2018Other (Refereed)
    Abstract [en]

    In the article ‘‘Associations between neurodevelopmental disorders and factors related to school, health, and social interaction in schoolchildren: Results from a Swedish population-based survey’’ Disability and Health Journal 2016; 9(4):663–672 by Linda Beckman, Staffan Janson, and Laura von Kobyletzki on page 2 the ethical considerations under section “Questionnaires, interviews, and health examinations”, the following sentence “The ELSA project has been approved by the regional ethical research committee in Uppsala, Sweden (reg. no: 2013/160).”should read as “The study has been reviewed by the local ethical research committee in Karlstad, Sweden (reg. no: C2015/65).”

  • 108.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Stenbeck, Magnus
    Karolinska institutet.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Disability in Relation to Different Peer-Victimization Groups and Psychosomatic Problems2016In: Children & Schools, ISSN 1532-8759, E-ISSN 1545-682X, Vol. 38, no 3, p. 153-161Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to examine the associations between disability, victims, perpetrators, and so-called "bully-victims" (someone reporting being both a victim and a perpetrator) of traditional, cyber, or combined victimization or perpetration and psychosomatic health among adolescents. Authors analyzed cross-sectional data from 3,820 Swedish students (ages 13 through 15) using linear and multinomial regression. The results show that students with a disability were more likely to be bully-victims and, more particularly, involved in both traditional and cyber victimization. Authors did not find any differences between adolescents with a disability and others with respect to the association between peer victimization and psychosomatic health. When developing intervention programs, schools may take a comprehensive approach due to the relatively large overlap between traditional and cyber victimization. Targeting groups with known disadvantages may also help reach out to bully-victims.

  • 109.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Svensson, Mikael
    Göteborgs universitet.
    Frisén, Ann
    Göteborgs universitet.
    Preference-based health-related quality of life among victims of bullying2016In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, no 2, p. 303-309Article in journal (Refereed)
    Abstract [en]

    Abstract Purpose No previous study has estimated the association between bullying and preference-based health-related quality of life (HRQoL) (‘‘utility’’), knowledge of which may be used for cost-effectiveness studies of interventions designed to prevent bullying. Therefore, the aim of the study was to estimate preference-based HRQoL among victims of bullying compared to non-victims. Methods A cross-sectional survey data collection among Swedish adolescents aged 15–17 years in the first year of upper secondary school was conducted in the city of Gothenburg in Sweden (N = 758). Preference-based HRQoL was estimated with the SF-6D. Regression analyses were conducted to adjust for some individual-level background variable. Results Mean preference-based health-related quality of life scores were 0.77 and 0.71 for non-victims and victims of bullying, respectively. The difference of 0.06 points was statistically significant (p\0.05) and robust to inclusion of gender, age, and parental immigrant status. Conclusions The preference-based HRQoL estimates in this study may be used as an upper bound in economic evaluations of bullying prevention interventions, facilitating a comparison between costs and quality-adjusted lifeyears.

  • 110.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    von Kobyletzki, Laura B.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Economic Costs of Antidepressant Use: A Population-Based Study in Sweden.2019In: Journal of Mental Health Policy and Economics, ISSN 1091-4358, E-ISSN 1099-176XArticle in journal (Refereed)
  • 111. Bennstam, A.
    et al.
    Strandmark, Margaretha
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Diwan, V.
    Perception of tuberculosis in the Democratic Republic of Congo: Wali ya nkunu in the Mai Ndombe disstrict2004In: Qualitative Health Research 14; 299-312Article in journal (Refereed)
  • 112.
    Bergh, Daniel
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Political, Historical, Religious and Cultural Studies (from 2013).
    School Pressure, Family Relationships and psycho-somatic health complaints: are the associations similar for boys and girls?2017Conference paper (Refereed)
    Abstract [en]

    In adolescence, the experiences of psychosomatic health complaints emerge among some students. During later parts of adolescence (14-16 years old), differences between girls and boys have been observed. Adolescents spend a considerable amount of their time in school, but still the family is very influential. In order to improve adolescent psychosomatic health, it is important to rule out how different factors influence health for different groups of adolescents.To analyze the associations between school pressure, family relationships and psychosomatic health complaints among Swedish adolescents. A specific objective is to rule out whether the associations are similar for boys and girls i.e. to investigate potential statistical interaction effects by sex.This study is based on HBSC data collected in 2013/14 among Swedish adolescents. Statistical analysis was conducted using linear regression analysis (OLS) and multinomial logistic regression.Tentative results indicate that there are strong connections between students’ experiences of school pressure (risk factor), as well as family relationships (protective factor), and psychosomatic complaints (psychological, somatic and psychosomatic). However, it is important to recognize that the associations may work differently for girls and boys.In order to be able to improve the health of adolescents, it may be necessary to rule out the influence of different factors on psychosomatic health, and if this influence is similar for different groups of adolescents.

  • 113.
    Bergh, Daniel
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Skolprestationer & psykisk ohälsa2019In: Skolhälsan, ISSN 0284-284X, no 1, p. 14-16Article in journal (Other (popular science, discussion, etc.))
  • 114. Bergman, Åke
    et al.
    Andersson, Anna-Maria
    Becher, Georg
    van den Berg, Martin
    Blumberg, Bruce
    Bjerregaard, Poul
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Bornman, Riana
    Brandt, Ingvar
    Brian, Jayne V
    Casey, Stephanie C
    Fowler, Paul A
    Frouin, Heloise
    Giudice, Linda C
    Iguchi, Taisen
    Hass, Ulla
    Jobling, Susan
    Juul, Anders
    Kidd, Karen A
    Kortenkamp, Andreas
    Lind, Monica
    Martin, Olwenn V
    Muir, Derek
    Ochieng, Roseline
    Olea, Nicolas
    Norrgren, Leif
    Ropstad, Erik
    Ross, Peter S
    Rudén, Christina
    Scheringer, Martin
    Skakkebaek, Niels Erik
    Söder, Olle
    Sonnenschein, Carlos
    Soto, Ana
    Swan, Shanna
    Toppari, Jorma
    Tyler, Charles R
    Vandenberg, Laura N
    Vinggaard, Anne Marie
    Wiberg, Karin
    Zoeller, R Thomas
    Science and policy on endocrine disrupters must not be mixed: A reply to a "common sense" intervention by toxicology journal editors.2013In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 12, p. 69-Article in journal (Refereed)
    Abstract [en]

    The "common sense" intervention by toxicology journal editors regarding proposed European Union endocrine disrupter regulations ignores scientific evidence and well-established principles of chemical risk assessment. In this commentary, endocrine disrupter experts express their concerns about a recently published, and is in our considered opinion inaccurate and factually incorrect, editorial that has appeared in several journals in toxicology. Some of the shortcomings of the editorial are discussed in detail. We call for a better founded scientific debate which may help to overcome a polarisation of views detrimental to reaching a consensus about scientific foundations for endocrine disrupter regulation in the EU.

  • 115.
    Bergqvist, Anders
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Harms-Ringdahl, Lars
    Strömgren, Mattias
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Säkerhetsutredningar av bränder: Fallstudie av lägenhetsbrand med dödlig utgång2013Report (Other academic)
  • 116. Berman, Philip
    et al.
    Busse, Reinhard
    Nio Ong, Bie
    Rehnberg, Clas
    Renck, Barbro
    Romo Aviles, Nuria
    Silio, Fernando
    Sundh, Mona
    Wismar, Matthias
    The European Union and Health services - The Impact of the Single European Market on Member States: Summary of a Report to the European Commission2001Other (Other (popular science, discussion, etc.))
  • 117. Berman, Philip
    et al.
    Busse, Reinhard
    Nio Ong, Bie
    Rehnberg, Clas
    Romo Aviles, Nuria
    Silio, Fernando
    Renck, Barbro
    Sundh, Mona
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health. Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Wismar, Matthias
    The European Union and Health services - The Impact of the Single European Market on Member States: Summary of a Report to the European Commission2001Other (Other (popular science, discussion, etc.))
  • 118.
    Biswas, Priti
    et al.
    University of East Anglia.
    Kabir, Zarina Nahar
    Karolinska Institutet.
    Nilsson, Jan
    Zaman, Shahaduz
    BRAC.
    Dynamics of Health Care Seeking Behaviourof Elderly People in Rural Bangladesh2006In: International Journal of Ageing and Later Life, ISSN 1652-8670, E-ISSN 1652-8670, Vol. 1, no 1, p. 69-89Article in journal (Refereed)
    Abstract [en]

    Bangladesh is projected to experience a doubling of its elderly populationfrom the current level of 7 million to 14 million by the end of the nextdecade. Drawing upon qualitative evidence from rural Bangladesh, thisarticle focuses on coping strategies in cases of illness of elderly peopleand the contributing factors in determining the health-seeking behaviourof elderly persons. The sample for this study consisted of elderly menand women aged 60 years or older and their caregivers. Nine focus groupdiscussions and 30 in-depth interviews were conducted. Findingsindicate that old age and ill-health are perceived to be inseparableentities. Seeking health care from a formally qualified doctor is avoideddue to high costs. Familiarity and accessibility of health care providersplay important roles in health-seeking behaviour of elderly persons.Flexibility of health care providers in receiving payment is a crucialdeciding factor of whether or not to seek treatment, and even the type oftreatment sought.

  • 119.
    Bjorvang, R. D.
    et al.
    Karolinska institutet.
    Gennings, C.
    Mt Sinai, Dept Environm Med & Publ Hlth, New York.
    Lin, Ping-I
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Hussein, G.
    Centrasjukhuset Karlstad.
    Kiviranta, H.
    Natl Inst Hlth & Welf, Dept Hlth Secur, Kuopio, Finland.
    Rantakokko, P.
    Natl Inst Hlth & Welf, Dept Hlth Secur, Kuopio, Finland.
    Ruokojarvi, P.
    Natl Inst Hlth & Welf, Dept Hlth Secur, Kuopio, Finland.
    Damdimopoulou, P.
    Karolinska institutet.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Mt Sinai, Dept Environm Med & Publ Hlth, New York.
    Persistent organic pollutants, pre-pregnancy use of combined oral contraceptive and time-to-pregnancy in SELMA cohort2018In: Toxicology Letters, ISSN 0378-4274, E-ISSN 1879-3169, Vol. 295, p. S63-S63Article in journal (Refereed)
  • 120.
    Björklund, Maria
    et al.
    Karlstad University, Division for Business and Economics.
    Guldbrandsson, Ingrid
    Faculty of Social and Life Sciences.
    Ideal och realiteter om miljö- och hälsofrämjande skola i Värmland2006Independent thesis Advanced level (degree of Magister), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Hälsofrämjande skola är en skola som målmedvetet och långsiktigt satsar på att dels,utifrån ett salutogent perspektiv, utveckla hela skolans vardag som en stödjande och främjande fysisk och psykosocial miljö för hälsa och lärande, dels stärka och utveckla hälsoundervisningen.

    Ett stort europeiskt hälsoprojekt, The European Network of Health Promoting Schools (ENHPS), startades år 1992 och bygger på en vid syn av begreppet hälsa. Initiativet togs av Europarådet, EU och

    WHO: s europakontor, där det sistnämnda har hand om projektsekretariatet. För att ett land ska få delta i nätverket med hälsofrämjande skolor krävs att projektet förankras på högsta nivå inom såväl skol- som hälsodepartement.Under 1999 beslutades att Landstinget i Värmland skulle avsätta medel för att införa konceptet miljö- och hälsofrämjande skola i Värmland. Projektansvaret förlades

    till dåvarande Folkhälsan Värmland samt Kommunförbundet Värmland.

    Syftet med denna studie var att undersöka om nätverksarbetet med miljö- och hälsofrämjande skola i Värmland lett till en skolutveckling i hälsofrämjande riktning. Studien

    genomfördes som en enkätstudie omfattande kontaktpersonerna i nätverket. För att få en helhetsbild gjordes också en genomgång av källmaterial samt intervjuer med nyckelpersoner. Studien visar att några av de väsentligaste åtaganden som de projektansvariga

    men också skolorna förbundit sig med inte genomförts. Årsrapportering

    från skolorna angående utveckling redovisades enbart från två skolor efter första året. En utvärdering av nätverksamarbetet har genomförts vid ett tillfälle med frågorna ”vad var bra, vad var mindre bra, vad kan göras bättre?”. Den processutvärdering

    som skulle genomföras under hela projekttiden har inte genomförts. Hälften av kontaktpersonerna i nätverket upplevde att de genom nätverksarbetet nått en skolutveckling i miljö- och hälsofrämjande riktning. Faktorer som de upplevt avgörande var att alla på skolan engagerar sig och att eleverna blir delaktiga. Resultatet visar också att hälften av de tillfrågade tror att deras skolor skulle ha utvecklats i miljö och hälsofrämjande

    riktning även utan deltagande i nätverket.

    Nyckelord: hälsa, hälsofrämjande skola, nätverk, miljö, skolutveckling

  • 121.
    Bodin, Maja
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Alkoholkonsumtion och skadeprevalens bland unga i Sverige – En genomgång av tidigare publicerad statistik2011In: Alkoholrelaterade skador bland barn och unga: en antologi / [ed] Nilson, F., Andersson, R, Karlstad: Karlstads universitet, 2011Chapter in book (Other academic)
  • 122.
    Bodin, Maja
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Nilson, Finn
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Nationella interventioner för att förebygga alkoholrelaterade skador bland barn och unga: en sammanställning av myndigheternas arbete och resultat2011Report (Other academic)
  • 123.
    Bodin, Maja
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Nilson, Finn
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Prevention av alkoholrelaterade skador bland unga: en forskningsöversikt2011Report (Other academic)
  • 124.
    Boman Lindström, Cecilia
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    von Kobyletzki, Laura
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Hallerbäck, M.U.
    Central Hospital Karlstad.
    Lindh, C.H.
    Lund University.
    Jönsson, B.A.
    Lund University.
    Knutz, Malin
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Shu, Huan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Perfluorinated compounds in serum from 2, 373 pregnant women in Sweden2014In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, p. 927-929Article in journal (Refereed)
  • 125.
    Bonander, Carl
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety. Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Assessing the effects of societal injury control interventions2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Injuries have emerged as one of the biggest public health issues of the 21th century. Yet, the causal effects of injury control strategies are often questioned due to a lack of randomized experiments. In this thesis, a set of quasi-experimental methods are applied and discussed in the light of causal inference theory and the type of data commonly available in injury surveillance systems. I begin by defining the interrupted time series design as a special case of the regression-discontinuity design, and the method is applied to two empirical cases. The first is a ban on the sale and production of non-reduced ignition propensity (RIP) cigarettes, and the second is a tightening of the licensing rules for mopeds. A two-way fixed effects model is then applied to a case with time-varying starting dates, attempting to identify the causal effects of municipality-provided home help services for the elderly. Lastly, the effect of the Swedish bicycle helmet law is evaluated using the comparative interrupted time series and synthetic control methods. The results from the empirical studies suggest that the stricter licensing rules and the bicycle helmet law were effective in reducing injury rates, while the home help services and RIP cigarette interventions have had limited or no impact on safety as measured by fatalities and hospital admissions. I conclude that identification of the impact of injury control interventions is possible using low cost means. However, the ability to infer causality varies greatly by empirical case and method, which highlights the important role of causal inference theory in applied intervention research. While existing methods can be used with data from injury surveillance systems, additional improvements and development of new estimators specifically tailored for injury data will likely further enhance the ability to draw causal conclusions in natural settings. Implications for future research and recommendations for practice are also discussed.

  • 126.
    Bonander, Carl
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Compared with what?: Estimating the effects of injury prevention policies using the synthetic control method2018In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 24, p. I60-I66Article in journal (Refereed)
    Abstract [en]

    Introduction This paper discusses the application of the synthetic control method to injury-related interventions using aggregate data from public information systems. The method selects and determines the optimal control unit in the data by minimising the difference between the pre-intervention outcomes in one treated unit (eg, a state) and a weighted combination of potential control units. Method I demonstrate the synthetic control method by an application to Florida's post-2010 policy and law enforcement initiatives aimed at bringing down opioid overdose deaths. Using opioid-related mortality data for a panel of 46 states observed from 1999 to 2015, the analysis suggests that a weighted combination of Maine (46.1%), Pennsylvania (34.4%), Nevada (5.4%), Washington (5.3%), West Virginia (4.3%) and Oklahoma (3.4%) best predicts the preintervention trajectory of opioid-related deaths in Florida between 1999 and 2009. Model specification and placebo tests, as well as an iterative leave-k-out sensitivity analysis are used as falsification tests. Results The results indicate that the policies have decreased the incidence of opioid-related deaths in Florida by roughly 40% (or -6.19 deaths per 100.000 person-years) by 2015 compared with the evolution projected by the synthetic control unit. Sensitivity analyses yield an average estimate of -4.55 deaths per 100.000 person-years (2.5th percentile: -1.24, 97.5th percentile: -7.92). The estimated cumulative effect in terms of deaths prevented in the postperiod is 3705 (2.5th percentile: 1302, 97.5th percentile: 6412). Discussion Recommendations for practice, future research and potential pitfalls, especially concerning low-count data, are discussed. Replication codes for Stata are provided.

  • 127.
    Bonander, Carl
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Data-Driven Incidence Difference-In-Differences Estimators For Causal Inference With Aggregate Counts And Rates2018In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 24, p. A173-A173, article id PW 1200Article in journal (Refereed)
  • 128.
    Bonander, Carl
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences. Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Searching for causal effects of road traffic safety interventions: applications of the interrupted time series design2015Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Traffic-related injuries represent a global public health problem, and contribute largely to mortality and years lived with disability worldwide. Over the course of the last decades, improvements to road traffic safety and injury surveillance systems have resulted in a shift in focus from the prevention of motor vehicle accidents to the control of injury events involving vulnerable road users (VRUs), such as cyclists and moped riders. There have been calls for improvements to the evaluation of safety interventions due to methodological problems associated with the most commonly used study designs. The purpose of this licentiate thesis was to assess the strengths and limitations of the interrupted time series (ITS) design, which has gained some attention for its ability to provide valid effect estimates. Two national road safety interventions involving VRUs were selected as cases: the Swedish bicycle helmet law for children under the age 15, and the tightening of licensing rules for Class 1 mopeds. The empirical results suggest that both interventions were effective in improving the safety of VRUs. Unless other concurrent events affect the treatment population at the exact time of intervention, the effect estimates should be internally valid. One of the main limitations of the study design is the inability to identify why the interventions were successful, especially if they are complex and multifaceted. A lack of reliable exposure data can also pose a further threat to studies of interventions involving VRUs if the intervention can affect the exposure itself. It may also be difficult to generalize the exact effect estimates to other regions and populations. Future studies should consider the use of the ITS design to enhance the internal validity of before-after measurements.

  • 129. Bonander, Carl
    Utvärdering av den svenska cykelhjälmslagen för barn under 15 år: Analys av nationella trender i cykelrelaterade huvudskador mellan 1998-20112013Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: In January 2005, a nationwide mandatory bicycle helmet law for children under the age of 15 was introduced in Sweden. In the current study, the effect of this law was evaluated by analyzing national trends in hospital admissions due to bicycle-related head injuries during the period 1998-2011.

    Methods: An interrupted time-series design with segmented regression analysis was used to evaluate the intervention effect on head injuries as a percentage of all injuries (%HI) among cyclists in age- and sex-specific groups. Effect was measured as a change in level and/or slope of the trend at the time of legislation.

    Results: A total of 35261 cyclists (0-54 years) were hospitalized due to a bicycle injury during the study period. Linear regression analyses of the entire study period (not segmented) showed significant year-to-year decreases in the %HI of 1.3-1.7% in all age and sex-specific groups (p < .0001). Results from the segmented regression analysis showed that, at the time of legislation, a significant drop in level occurred among males under 15 years (-4.5% [95% CI: -7.7% to -1.3%], p = .01) and a significant change in slope occurred among females aged 30-54 years (-1.6% [95% CI: -2.9% to -0.2%], p = .025).

    Conclusions: The law seems to have had an effect on males in the target population (<15 years). Although no significant changes were observed among females in this group as an immediate result of the law, the difference in %HI between genders was minimal at the end of the study period due to the steeper general decline among females.

  • 130.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Andersson, Ragnar
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Nilson, Finn
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    The effect of stricter licensing on road traffic injury events involving 15 to 17-year-old moped drivers in Sweden: a time series intervention study2015In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 83, p. 154-161Article in journal (Refereed)
    Abstract [en]

    This study aimed to evaluate and quantify the effect of the introduction of the AM driving license on non-fatal moped-related injuries in Sweden. With the introduction of the new license category in October 2009, prospective moped drivers are now required to pass a mandatory theory test following a practical and theoretical course. In addition, obtaining a license to operate a moped is now considerably more costly.

    METHODS:Time series intervention analysis on monthly aggregated injury data (1st Jan 2007-31st Dec 2013) was performed using generalized additive models for location, shape and scale (GAMLSS) to quantify the effect size on injury events involving teenage (15-17 years) moped drivers, while controlling for trend and seasonality. Exposure was adjusted for by using the number of registered mopeds in traffic as a proxy.

    RESULTS:The introduction of AM license was associated with a 41% reduction in the rate of injury events involving 15-year-old moped drivers (IRR 0.59 [95% CI: 0.48-0.72]), and a 39% and 36% decrease in those involving 16-year-old (IRR 0.61 [95% CI: 0.48-0.79]) and 17-year-old drivers (IRR 0.64 [95% CI: 0.46-0.90]), respectively. The effect in the 15-year-old stratum was decreased roughly by half after adjusting for exposure, but remained significant, and the corresponding estimates in the other age groups did not change noticeably.

    CONCLUSIONS:This study provides quasi-experimental evidence of an effect on non-fatal moped-related injuries as a result of stricter licensing rules. Only part of the effect could be explained by a reduction in the number of mopeds in traffic, indicating that other mechanisms must be studied to fully understand the cause of the reduction in injuries.

  • 131.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Jernbro, Carolina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Injury risks in schoolchildren with attention-deficit/hyperactivity or autismspectrumdisorder: Results from two school-based health surveys of 6- to 17-year-old children in Sweden2016In: Journal of Safety Research, ISSN 0022-4375, E-ISSN 1879-1247, Vol. 58, p. 49-56Article in journal (Refereed)
    Abstract [en]

    Introduction: Injuries are one of the leading causes of death and disability among children in Sweden and attention-deficit/hyperactivity disorder (ADHD) has previously been associated with an increased risk of injury in pediatric populations elsewhere in the world. Current evidence regarding the possible link between autism spectrum disorder (ASD) and injury risk appears limited, even though some potentially risk-increasing symptoms overlap. The purpose of this study was thus to study the association between both ADHD and ASD concerning the risk of injury among Swedish schoolchildren. Methods: Two samples were used: a population based register study containing data from 18,416 children ranging from the ages of 6-17 years collected by school nurses during 2012/2014 (Survey A), and a national cross-sectional study of 3202 ninth-grade children (similar to 15 years old) collected from 92 schools in 2011 (Survey B). The data were analyzed using chi(2)-tests and log binomial generalized linear models to obtain risk ratios (RR), comparing cases reportedly affected by ADHD or ASD to unaffected controls. Results: After adjusting for confounders, ADHD was associated with a 65% increased risk of injury (RR 1.65 [95% CI: 132-2.05] in Survey A, and a 57% increased risk of injury (RR 1.57 [95% CI: 1.27-1.95]) in Survey B. ASD was not significantly associated with any differences in injury risk (RR 0.81 [95% CI: 0.57-1.14]). Conclusions: The results indicate that there is an elevated injury risk among Swedish schoolchildren with ADHD but not for children with ASD. Future studies should focus on causal mechanisms mediating the association between ADHD and injuries in order to facilitate injury prevention strategies. Practical applications: Parents and teachers of schoolchildren with ADHD should be made aware of the elevated injury risks associated with the diagnosis. Safety experts and injury control professionals should consider the development of specialized prevention strategies in order to reduce these risks.

  • 132.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Gustavsson, Johanna
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Andersson, Ragnar
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Evidensbaserade åtgärder för cyklisters säkerhet: kunskapsöversikt2013Report (Other academic)
    Abstract [sv]

    Att cykla förespråkas ofta av hälso-, miljö- och framkomlighetsskäl, men är samtidigt ett av de farligare transportmedlen utifrån ett skadeperspektiv. För att cyklismen ska kunna utvecklas hållbart krävs därmed även att fokus läggs på säkerhetsaspekten vid policybeslut som syftar till att öka cyklandet. Syftet med denna rapport är att återge en samlad bild av det vetenskapliga kunskapsläget när det gäller säkerhetsfrämjande åtgärder för cyklister.

    Cykelhjälmar är ett välbeforskat ämne inom detta område och evidensen pekar relativt entydigt att hjälmar ger ett bra skydd mot huvud- och hjärnskador. Vissa studier har även uppmätt en skyddande effekt mot ansiktsskador, men detta har på senare tid delvis ifrågasatts. En ytterligare aspekt som har belysts är om dagens mjukare cykelhjälmar ger ett lika bra skydd som hjälmar med hårdare skal, som var vanligare förr. Denna hypotes har hittills varken kunnat styrkas eller förkastas, bl a till följd av att man inte registrerar hjälmtyp inom sjukvården. Cykelhjälmslagstiftning är ett annat kontroversiellt ämne där det har hävdats att hjälmlagarna som infördes i Australien och Nya Zeeland på 1990-talet avskräckte människor från att cykla, med åtföljande negativ effekt på folkhälsan till flöjd av minskad motion. Ingen stark evidens för denna hypotes har hittats, och det verkar för övrigt som att cykelhjälmslagar har haft en reducerande effekt på antalet cykelrelaterade huvudskador i de länder som har lyckats implementera dem på ett sätt som faktiskt ökar hjälmanvändningen i populationen. Effekten förefaller dock kulturellt betingad, och skillnader i bötesavgift eller risken att bli bötfälld är troligtvis av stor betydelse. Utbildning och ekonomiska styrmedel kan fungera som alternativ till lagstiftning, men evidensen för att utbildning verkligen ökar hjälmanvändningen är svag. Gällande ekonomiska styrmedel pekar evidensen mot att gratis hjälmutdelning är det som fungerar bäst. Större satsningar på samhällsnivå verkar fungera bättre än hjälmprogram som inriktar sig på skolor.

    När det gäller åtgärder för trafikmiljön är evidensen inte helt entydig, men det verkar som att fysiskt separerade cykelbanor är att föredra framför cykelfält (ett fält för cyklister på vägen, avgränsas med en spärrlinje). Fysiskt separerade cykelbanor kan dock vara mer problematiska i väjningsreglerade korsningar, vilket kan bero på att bilister inte uppmärksammar cyklister på samma sätt som när ett cykelfält finns anlagt på sidan av vägbanan. Detta ökar behovet av säkra cykelöverfarter och när det gäller sådana förefaller förhöjda cykelöverfarter fungera bättre än färgmarkerade överfarter. Olycksrisken på kombinerade gång- och cykelvägar bör inte förväxlas med olycksrisken på cykelspecifika banor, och ytterligare forskning behövs för att avgöra effekten av kombinerade banor. Rondeller verkar vara problematiska för cyklister om det inte finns en fysiskt separerad cykelbana i anslutning till dem. Övriga åtgärder som har uppvisat en positiv effekt är belysning på landsbygdsvägar, refuger i bostadsområden och dynamiska hastighetsskyltar i skolzoner.

    Intressant nog ser det ut att finnas få studier som har försökt mäta effekten av synbarhetsökande medel (t.ex. reflexer) med tillförlitliga utvärderingsmått (skaderisk eller olycksrisk). Att montera varselljus på cykeln som går igång automatiskt och inte kan kontrolleras av cyklisten verkar dock minska risken för kollisionsolyckor under dagtid.

    Även allmän cykelsäkerhetsutbildning i skolar har undersökts. Av de få studier som använt tillförlitliga utvärderingsmått har ingen kunnat uppvisa en positiv effekt. Fler studier behövs för att bedöma effekten av sådana åtgärder innan utbildning kan rekommenderas med starkt vetenskapligt stöd.

  • 133.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Gustavsson, Johanna
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Andersson, Ragnar
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Säker cykling: Vägledning för systematiskt cykelsäkerhetsarbete i lokalsamhället2014Report (Other academic)
    Abstract [sv]

    Cyklismen får en allt viktigare roll i det hållbara transportsystemet. Att cykla förespråkas av hälso-, miljö- och framkomlighetsskäl, men är samtidigt ett av de farligaste färdsätten utifrån ett personskadeperspektiv. Lokala strävanden mot ökat cyklande måste ta säkerhetsaspekten i beaktande om dessa satsningar ska bli lyckade. Enligt målet för trafiksäkerhet i regeringens proposition "Mål för framtida transporter" (prop.2008/09:93) ska antalet döda halveras och allvarligt skadade i trafiken minskas 25 procent fram till år 2020. För att kunna uppnå detta behövs satsningar både nationellt som lokalt. På nationell nivå finns möjlighet att arbeta med övergripande och generaliserbara trafiksäkerhetsproblem, medan det på lokal nivå finns unika möjligheter att identifiera och åtgärda olycksdrabbade platser.

    I SKL:s trafiksäkerhetshandbok "Trafiksäkra staden

    " (Sveriges Kommuner och Landsting 2013), presenteras ett systematiskt sätt att arbeta med trafikskadedata på kommunnivå. Utgångspunkten i handboken är att analysera den lokala skadebilden och sätta igång en systematisk process med verksamhetsövergripande samarbete och kontinuerlig förbättring. Den nu föreliggande vägledningen är tänkt att fungera som ett komplement till SKL:s metodhandbok, med fokus på identifiering och analys av särskilt skadedrabbade platser i lokalsamhället.

    Denna vägledning är tänkt att utgöra ett stöd för det lokala cykelsäkerhetsarbetet mot bakgrund av i lokala förutsättningar och problem. Utgångspunkten är att ta tillvara faktaunderlag som ofta finns tillgängliga lokalt, i kombination med annan lokal kunskap. Dessa underlag kan sedan nyttiggöras vid beslut om utformning av trafikmiljöer. Genom att systematiskt studera och sammanställa uppgifter om olyckor finns möjlighet att hitta typiska olycksmönster eller farliga platser inom en avgränsad befolkning eller geografiskt område. Denna kunskap kan sedan användas vid planering av nya trafikmiljöer, som underlag för löpande trafiksäkerhetsarbete i befintliga miljöer, samt vid utvärdering av satsningar syftande till ökad säkerhet.

  • 134.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Gustavsson, Johanna
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Nilson, Finn
    Can the provision of a home help service for the elderly population reduce the incidence of fall-related injuries?2016In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 22, no Suppl.2, p. A181-A181Article in journal (Refereed)
    Abstract [en]

    Background Fall-related injuries are a global public health problem, especially in elderly populations. In this study, the effect of an intervention aimed at reducing the risk of falls in the homes of community-dwelling elderly persons was evaluated. The intervention, which involves home hazards reduction by providing a minor home help service, is provided in the majority of Swedish municipalities.

    Methods Intention-to-treat effect estimates were derived using quasi-experimental time series intervention (ITS) analysis for immediate effects and a difference-in-discontinuity (RD) design for long term effects, and community-level estimates were pooled using meta-analysis. The outcome measure was the incidence of fall-related hospitalizations in the treatment population, the age of which varied by municipality (≥65 years, ≥67 years, ≥70 years or ≥75 years).

    Results We found no statistically significant reductions in injury incidence in the ITS (IRR 1.01 [95% CI: 0.98–1.05]) or RD (IRR 1.00 [95% CI: 0.97–1.03]) analyses. The results are robust to several different model specifications, including segmented panel regression analysis with linear trend change and community fixed effects parameters.

    Conclusions It is unclear whether absence of an effect is due to a low efficacy of the home hazards modifications provided, or a result of low utilisation. Additional studies of the effects on other quality of life measures are recommended before conclusions are drawn regarding the cost-effectiveness of the provision of home help services

  • 135.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety. Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Gustavsson, Johanna
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Nilson, Finn
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Can the provision of a minor home help service for the elderly population reduce the incidence of fall-related injuries?: A quasi-experimental study of the community-level effects on hospital admissions in Swedish municipalities2016In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 22, no 6, p. 412-419Article in journal (Refereed)
    Abstract [en]

    Background

    Fall-related injuries are a global public health problem, especially in elderly populations. The effect of an intervention aimed at reducing the risk of falls in the homes of community-dwelling elderly persons was evaluated. The intervention mainly involves the performance of complicated tasks and hazards assessment by a trained assessor, and has been adopted gradually over the last decade by 191 of 290 Swedish municipalities.   

    Methods

    A quasi-experimental design was used where intention-to-treat effect estimates were derived using panel regression analysis and a regression-discontinuity (RD) design. The outcome measure was the incidence of fall-related hospitalizations in the treatment population, the age of which varied by municipality (≥65 years, ≥67 years, ≥70 years or ≥75 years).

    Results

    We found no statistically significant reductions in injury incidence in the panel regression (IRR 1.01 [95% CI: 0.98-1.05]) or RD (IRR 1.00 [95% CI: 0.97-1.03]) analyses. The results are robust to several different model specifications, including segmented panel regression analysis with linear trend change and community fixed effects parameters.

    Conclusions

    It is unclear whether the absence of an effect is due to a low efficacy of the services provided, or a result of low adherence. Additional studies of the effects on other quality of life measures are recommended before conclusions are drawn regarding the cost-effectiveness of the provision of home help service programs.

  • 136.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety. Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Jakobsson, Niklas
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Karlstad Business School.
    The Effects of Bicycle Helmets and Helmet Legislation on the Severity of Children’s Head InjuriesManuscript (preprint) (Other academic)
  • 137.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Jakobsson, Niklas
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Karlstad Business School (from 2013). Norwegian Social Research (NOVA), Oslo, Norway.
    Nilson, Finn
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Are fire safe cigarettes actually fire safe?: Evidence from changes in US state laws2018In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 24, no 3, p. 193-198Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To estimate the effects of fire safe cigarette laws on fire mortality and cigarette-related fires in the USA.

    METHODS: We examined the gradual implementation of the laws to identify their average effects, using difference-in-differences analysis to account for common year effects, time-invariant state effects, state-specific trends and observable time-varying state-level covariates.

    RESULTS: We found no statistically significant effects on all-cause fire mortality, residential fire mortality or cigarette-caused fire rates. The estimates for cigarette-caused fire deaths were significant under some specifications, but were not robust to the inclusion of state-specific trends or comparisons to effects on other cause-determined fires.

    CONCLUSIONS: Given the mixed state of our results, we conclude that previous claims regarding the effects of fire safe cigarette laws may be premature.

  • 138.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Jernbro, Carolina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Does gender moderate the association between intellectual ability and accidental injuries?: Evidence from the 1953 Stockholm Birth Cohort study2017In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 106, p. 109-114Article in journal (Refereed)
  • 139.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Jernbro, Carolina
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Andersson, Ragnar
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Funktionsnedsättningar som riskfaktor för olycksfall och andra skador.2014Report (Other academic)
  • 140.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Jonsson, Anders
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Nilson, Finn
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Investigating the effect of banning non-reduced ignition propensity cigarettes on fatal residential fires in Sweden 2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no 2, p. 334-338Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:Annually, 100 people die as a result of residential fires in Sweden and almost a third of the fatal fires are known to be caused by smoking. In an attempt to reduce the occurrence of these events, reduced ignition propensity (RIP) cigarettes have been developed. They are designed to reduce the risk of fire by preventing the cigarette from burning through the full length when left unattended. In November 2011, a ban was introduced, forbidding the production and sale of all non-RIP cigarettes in all member states of the European Union, including Sweden.

    METHODS:Monthly data on all recorded residential fires and associated fatalities in Sweden from January 2000 to December 2013 were analyzed using an interrupted time series design. The effect of the intervention [in relative risk (RR)] was quantified using generalised additive models for location, shape and scale.

    RESULTS:There were no statistically significant intervention effects on residential fires (RR 0.95 [95% CI: 0.89-1.01]), fatal residential fires (RR 0.99 [95% CI: 0.80-1.23]), residential fires where smoking was a known cause (RR 1.10 [95% CI: 0.95-1.28]) or fatal residential fires where smoking was a known cause (RR 0.92 [95% CI: 0.63-1.35]).

    CONCLUSION:No evidence of an effect of the ban on all non-RIP cigarettes on the risk of residential fires in Sweden was found. The results may not be generalisable to other countries.

  • 141.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Nilson, Finn
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Sociodemografiska skillnader i risken för bostadsbrand, prevalens av brandskydd i hemmet och hantering av bränder: En analys av nationella enkäter 2001, 2005 och 20082017Report (Other academic)
  • 142.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Nilson, Finn
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Andersson, Ragnar
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    The effect of the Swedish bicycle helmet law for children: An interrupted time series study2014In: Journal of Safety Research, ISSN 0022-4375, E-ISSN 1879-1247, Vol. 51, p. 15-22Article in journal (Refereed)
    Abstract [en]

    Previous population-based research has shown that bicycle helmet laws can reduce head injury rates among cyclists. According to deterrence theory, such laws are mainly effective if there is a high likelihood of being apprehended. In this study, we investigated the effect of the Swedish helmet law for children under the age of 15, a population that cannot be fined. Method  An interrupted time series design was used. Monthly inpatient data on injured cyclists from 1998–2012, stratified by age (0–14, 15 +), sex, and injury diagnosis, was obtained from the National Patient Register. The main outcome measure was the proportion of head injury admissions per month. Intervention effect estimates were obtained using generalized autoregressive moving average (GARMA) models. Pre-legislation trend and seasonality was adjusted for, and differences-in-differences estimation was obtained using adults as a non-equivalent control group. Results There was a statistically significant intervention effect among male children, where the proportion of head injuries dropped by 7.8 percentage points. There was no evidence of an intervention effect on the proportion of head injuries among female children. Conclusion According to hospital admission data, the bicycle helmet law appears to have had an effect only on male children.

  • 143. Bornehag, C. -G
    et al.
    Carlstedt, F.
    Jonsson, B. A.
    Anti-PVC advocacy disguised as science (Response to Carlstedt et al., PVC flooring is related to human uptake of phthalates in infants) Response2013In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 23, no 1, p. 87-88Article in journal (Refereed)
  • 144.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Mönsteranalys av inomhusluft: Undersökning av luftkvaliteten i sjuka hus med flytspackelproblem1994Doctoral thesis, monograph (Other academic)
    Abstract [sv]

    Den hälsomässiga effekten som rapporteras i samband med sjuka-hus syndromet (SBS), vars orsak är okänd, kan betraktas som ett mönster av icke specifika symptom såsom irritationer i ögon, näsa och mun, upplevelser av torra sletnhinnor och hud, hudrodnad, mental trötthet och upplevelse av svag men ihållande lukt. Aven exponeringar i inomhusluften kan beskrivas som ett mönster av en mängd olika ämnen, exempelvis VOC, partiklar, sporer m. m. Detta innebär att en av svårigheterna med att undersöka SBS problem är att koppla mönster av symptom till mönster av föroreningar, vilket är mycket komplicerat. Syftet med den genomförda studien har varit att (a) undersöka om det fanns mönsterskillnader med avseende på luftföroreningar (e g. VOC) mellan bostäder med, respektive utan, kaseinhaltigt flytspackel, (b) avgöra om eventuella kritiska substanser kunde hänföras till golvkonstruktionen, (c) studera hur tekniska faktorer (eg. ventilation, temperatur, relativ luftfuktighet) var kopplade till eventuellt kritiska VOC-ämnen, (d) undersöka om det fanns skillnader i symptommönster för boende i lägenheter med, respektive utan, kaseinhaltigt flytspackel. Tekniska mätningar och enkätundersökningar med avseende på de boendes klagomål på inomhusmiljön gjordes i tre bostadsområden. Två områden med uttalade flytspackelproblem (SBS) och ett friskt referensområde. De tre bostadsområdena kunde indelas i nio olika gårdar med 50-130 lägenheter per gård. Enkätundersökningar gjordes i de nio gårdarna med en svarsfrekvens på 75-90 % (n=1309). Tekniska mätningar genomfördes i 6-10 slumpmässigt utvalda lägenheteri varje gård (n=66). De tekniska mätningarna innefattade VOC i inomhusluften (eg. TVOC, enskilda ämnen), specifik emission av VOC från golvkonstruktionen (FLEC), ventilation, temperatur, relativ luftfuktighet m.m. Mönsteranalyser gjordes med Hierchical Cluster Analysis (H CA) och Principal Component Analysis (PCA)). Studien har inte kunnat identifiera någon enskild faktor (eg. TVOC, enskilda VOCämnen, naturliga grupper av,VOC-ämnen) som på ett konsistent sätt kunde förklara de uplevda problemen. Mönsteranalysen kunde emellertid identifiera 8 kritiska ämnen som kunde associeras till lägenheter med kaseinhaltigt flytspackel. Dessa 8 ämnen var bensaldehyd, oktanal, heptanal, dekanal, nonanal, 2-etylhexanol, metylheptenon, oktan. Studien visade vidare att andelen kritiska ämnen av TVOC var signifikant högre i inomhusluften i lägenheter med kaseinhaltigt flytspackel. De två enskilda VOC-ämnena bensaldehyd och 2-etylhexanol kunde eventuellt hänföras till golvkonstruktionen med kaseinhaltigt flytspackel. Det fanns vidare en svag korrelation mellan ammoniak under golvmattor och koncentrationen av 2-etylhexanol i inomhusluften respektive koncentrationen av ammoniak i inomhusluften och en svag korrelation mellan temperatur inomhus och vissa aldehyder i inomhusluften. Slutligen kunde olika mönster av symptom identifieras. Dessa mönster bestod emellertid av naturliga grupper såsom allmänsymptom, slemhinnesymptom och hudsymptom samt klagomål på luftkvaliteten. Studien har visat att flerfaktoriella analysmetoder (mönsteranalys) kan vara en alternativt sätt att studera SBS-problem. En användning av sådana metoder innebär att stora datamaterial blir mer överskådliga vilket kan ge nya hypoteser. Det kan också innebära att ur sensorisk synvinkel mer relevanta exponeringsmått kan identifieras.

  • 145.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Phthalate exposure heralds birth defects2015In: TrAC. Trends in analytical chemistry, ISSN 0165-9936, E-ISSN 1879-3142, Vol. 64, p. VI-VIArticle in journal (Other academic)
  • 146.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    The shift in human health from infection-related diseases to chronic illnesses and the importance of indoor chemical exposure2018In: Indoor Air Pollution / [ed] Peter Pluschke, Hans Schleibinger, Berlin, Germany: Springer, 2018, 2, p. 109-123Chapter in book (Refereed)
    Abstract [en]

    It has been recently estimated that the pattern of the global burden of diseases – expressed as disability-adjusted life years (DALY) – has changed over the last 20 years and a shift from communicable disorders to noncommunicable disorders has been observed. This shift is more pronounced in high-incomecountries. Even though there is lack of knowledge regarding the cause(s) behind the increase in chronic diseases/disorders, there are scientifically based suspicions that environmental factors do play an important role in interaction with genetic predisposition. Especially diffuse emissions of endocrine-disrupting compounds (EDCs) from consumer products are a matter of concern. The four reasons for concern with human EDC exposure are: The low-dose effect and a non-monotonic dose-response relationshipEarly life sensitivity and the persistency of effectsThe large number of EDC sources in our daily lifeThe wide range of health effects A full chain model is proposed which is following chemicals from their sources over environmental exposures in food, air, and dust over to human uptake and finally to human health effects. The model also includes modifying factors for environmental exposures, different pathways for human uptake, and biological mechanisms involved in health effects. With scientific information in this model risk management should be possible and result in preventive actions in order to reduce children’s exposure to health relevant factors. © Springer-Verlag Berlin Heidelberg 2014.

  • 147.
    Bornehag, Carl-Gustaf
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Arne, M
    Janson, C
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Boman, G
    Emtner, M
    Physical activity and quality of life in subjects with chronic diseases; Chronic obstructive pulmonary disease compared to rheumatoid arthritis and diabetes mellitus2009In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 27, no 3, p. 141-147Article in journal (Refereed)
  • 148.
    Bornehag, Carl-Gustaf
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Blomquist, G.
    Gyntelberg, F.
    Järvholm, B.
    Malmberg, P.
    Nordvall, L.
    Nielsen, A.
    Pershagen, G.
    Sundell, J.
    Dampness in Buildings and Health. Nordic interdisciplinary review of the scientific evidence on associations between exposure to dampness and health effects, NORDDAMP2001In: Indoor Air 2001;11:72-86Article in journal (Refereed)
  • 149.
    Bornehag, Carl-Gustaf
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Bonini, S.
    Custovic, A.
    Malmberg, P.
    Matricardi, P.
    Skerfving, S.
    Sigsgaard, T.
    Verhoeff, A.
    Sundell, J.
    Dampness in Buildings as a Risk Factor for Health Effects, EUROEXPO. A multidisciplinary review of the literature (1998-2000) on dampness and mite exposure in buildings and health effects2004In: Indoor Air 2004;14:243-257Article in journal (Refereed)
  • 150.
    Bornehag, Carl-Gustaf
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Carlstedt, Fredrik
    Cty Council Varmland, Karlstad, Sweden..
    Jonsson, Bo A. G.
    Lund Univ, Div Occupat & Environm Med, Lund, Sweden..
    Lindh, Christian H.
    Lund Univ, Div Occupat & Environm Med, Lund, Sweden..
    Jensen, Tina K.
    Univ Southern Denmark, Dept Environm Med, Odense, Denmark..
    Bodin, Anna
    Cty Council Varmland, Karlstad, Sweden..
    Jonsson, Carin
    Cty Council Varmland, Karlstad, Sweden..
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Swan, Shanna H.
    Icahn Sch Med Mt Sinai, New York, NY 10029 USA..
    Prenatal Phthalate Exposures and Anogenital Distance in Swedish Boys2015In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 123, no 1, p. 101-107Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Phthalates are used as plasticizers in soft polyvinyl chloride (PVC) and in a large number of consumer products. Because of reported health risks, diisononyl phthalate (DiNP) has been introduced as a replacement for di(2-ethylhexyl) phthalate (DEHP) in soft PVC. This raises concerns because animal data suggest that DiNP may have antiandrogenic properties similar to those of DEHP. The anogenital distance (AGD)-the distance from the anus to the genitals-has been used to assess reproductive toxicity. OBJECTIVE: The objective of this study was to examine the associations between prenatal phthalate exposure and AGD in Swedish infants. METHODS: AGD was measured in 196 boys at 21 months of age, and first-trimester urine was analyzed for 10 phthalate metabolites of DEP (diethyl phthalate), DBP (dibutyl phthalate), DEHP, BBzP (benzylbutyl phthalate), as well as DiNP and creatinine. Data on covariates were collected by questionnaires. RESULTS: The most significant associations were found between the shorter of two AGD measures (anoscrotal distance; AGDas) and DiNP metabolites and strongest for oh-MMeOP [mono(4-methyl-7-hydroxyloctyl) phthalate] and oxo-MMeOP [mono-(2-ethyl-5-oxohexyl) phthalate]. However, the AGDas reduction was small (4%) in relation to more than an interquartile range increase in DiNP exposure. CONCLUSIONS: These findings call into question the safety of substituting DiNP for DEHP in soft PVC, particularly because a shorter male AGD has been shown to relate to male genital birth defects in children and impaired reproductive function in adult males and the fact that human levels of DiNP are increasing globally.

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