Occupational and Environmental Medicine, Uppsala University Hospital and Department of Medical Sciences, Uppsala University
Occupational medicine has a long tradition in Uppsala where the famous Carl von Linné was the first occupational physician. He described the so-called “Orsa* disease,” now known as silicosis, which caused the death of many young miners. He was ahead of his time in his attempts to implement preventive strategies to minimize the risk of occupational diseases and death.
The Occupational and Environmental Medicine unit is comprised of a clinical unit at the Uppsala University Hospital serving the Counties of Uppsala, Dalarna and Gävleborg and a unit at the Department of Medical Sciences at Uppsala University. The activities of the two units are integrated with each other.
The main task for occupational and environmental medicine today is to find exposures at workplaces and in the indoor and outdoor environment which may affect human beings in a negative or positive way. Negative exposures should be eliminated and positive ones strengthened. As working life and work environments continue to change rapidly, it is a challenge for medical sciences to keep up.
Preventive strategies for the work environment and the environment in general as well as investigations and help for individual patients are the primary tasks of the Occupational and Environmental Medicine unit in Uppsala.
Chemical and physical factors continue to pose significant problems. Health effects from noise, vibration and factors causing allergy and hyperreactivity are prevalent. Most of the patients visiting the clinic are referred from other specialists and insurance authorities. The task of The Center for Occupational and Environmental Medicine is to find out if an association of causal origin exists between the work or environment and the patient’s disease. This is often a complicated matter requiring investigations from different specialists within the clinic such as physicians, hygienists, toxicologists, ergonomists and psychologists.
Physical and chemical exposures as well as very heavy work have decreased in Sweden but there has been an increase in ergonomic problems from static and repetitive exposures in the physical realm as well as an increase in psychosocial problems. Stress related problems and symptoms of burnout have increased. The association between work factors, private life, personality and these disorders are not very well understood and are investigated.
In Sweden today about one million people between the ages of 18 and 64 are not gainfully employed. They are on long term sick leave, have taken early retirement due to illness, or are unemployed. Studies on rehabilitation, return to work and part time sick leave are of great interest to our department.
Although agricultural employment is not so common in Sweden these days, there are still many people who work very hard daily on farms. The effects farm work has, in particular on the lungs and airways, is one area of research at the clinic.
For environmental medicine an important task is to answer questions from other societal authorities concerning new building plans and other activities that may influence the environment, for example how to plan road traffic in the centre of Uppsala in order to minimize noise and pollution, how to deal with waste products from a steel plant in a manner that does not harm the environment or risk people’s health, or how the oil depot in the harbour of Gävle can be enlarged without jeopardizing human health and the environment.
Effects of indoor climate both in private homes and public places such as schools have been a main interest for many years. Hyperreactive reactions and comfort problems can be the result of new building techniques and energy saving efforts. The environment around horse stables, in particular the investigation and reduction of the dispersion of allergens, is another area of interest.
We have an international profile with contacts with various research groups in Europe and are involved in EU-financed projects. Furthermore, there are bilateral research collaborations with Estonia, Norway, Iran, China, Japan, Korea, Singapore and Canada. There have also been collaborations in teaching, including development of courses in occupational and environmental medicine in the Baltic States and Russia. We have also been consulted by WHO, Europe and the European Commission as experts on indoor environment and health.
We participate in the RHINES project which is a multi-centre study of respiratory diseases in a cohort of 18,000 young adults, and collaborate with lung clinics in seven medical centres (Uppsala, Umeå, Gothenburg, Tartu, Bergen, Århus and Reykjavik). In addition we have a collaboration with the Department of Occupational Medicine in Bergen, Norway concerning the indoor environment in universities, as well as collaboration with other Nordic countries concerning the working environment of nurses.
Our participation in the multi-centre study “European community respiratory health survey” (ECRHSII) involves collaboration with lung clinics and research institutes in 26 cities in the EU, together with centres in the USA, Australia, and New Zealand. The study includes outdoor and indoor environments, together with occupational and children’s environments. We are also involved in HESE (Health effects of the school environment) and the intervention project HESEINT, two EU-funded projects that include schools in Uppsala, Oslo, Århus, Reims (France), together with Udine and Siena (Italy). Another EU-project we participate in is (GERIE), which studies the indoor environment in homes for the elderly and its effect on the occupants. We are also involved in collaboration within nutrition and nutrient allergy, and research into the health consequences of buckwheat with the University of Lubljana, Slovakia, and the National Institute for Nutrition in Rome.
We collaborate with several institutes in a number of Asian countries. This includes researchers in universities in Kobe, Japan, in Chunchon, Korea, in Shanghai, Taiyuan, in Guanzhou, China, in Kebangsaan University, Kuala Lumpur, Malaysia, and with the Ministries of Health and Education in Iran. We are participating in a large population study based in the Canadian prairie, in collaboration with the Institute of Agricultural, Rural and Environmental Health, University of Saskatchewan, Saskatoon, Canada. The study involves the risk of atopy in connection with a polymorphism in TLR4 (Toll-like receptor 4).
There are presently PhD students and postdoctoral scholars from China and Iran at our institution.
* Orsa is a small town in Sweden where mining took place during the time of Carl von Linné.