Tuula Putus - Academia.edu (original) (raw)

Papers by Tuula Putus

Suomen lääkärilehti, 2007

Journal of investigational allergology & clinical immunology, 2012

Intrapartum factors may have a role in the development of asthma and allergic diseases among offs... more Intrapartum factors may have a role in the development of asthma and allergic diseases among offspring. To investigate the association between umbilical arterial pH values at birth and asthma, allergic rhinitis, and atopic eczema in children. We performed a case-control study of 222 asthmatic children and 183 control children aged 5 to 6 years with umbilical artery pH values recorded at birth. Associations were evaluated using logistic regression analysis. Asthmatic children had significantly lower umbilical artery pH values at birth than nonasthmatics, even after adjusting. Children who were born with pH values of 7.20-7.25 had a 2.62-fold (95% confidence interval [CI], 1.31-5.23) higher risk of asthma and children who were born with umbilical arterial pH values < or = 7.19 had a 3.22-fold (95% CI, 1.51-6.87) higher risk of asthma than children who were born with umbilical arterial pH values of 7.26-7.30. In contrast, children who were born with umbilical arterial pH values >...

Frontiers in Oncology

Naturally occurring radioactive elements can be found in groundwater and exposure to such element... more Naturally occurring radioactive elements can be found in groundwater and exposure to such elements is associated with an increased risk of lung cancer. In this study, we aimed to observe the association between exposure to these radioactive elements in groundwater and the risk of lung cancer in selected regions in Finland. This is a population-based study from 1955 to 2019 in Finland. The exposed municipalities with their corresponding hospital districts were selected based on radon measurements at groundwater treatment plants. Lung cancer cases were obtained from the Finnish cancer registry. The 5-year incidence rates for lung cancer were calculated and a comparison was made between each of the hospital districts with radon exposure. More than 93,000 cases of lung cancer were reported in the radon-exposed regions over the examined period of 64 years. The highest number of cases was recorded in the Helsinki University hospital district and the least in the Southern Savo hospital dis...

British Educational Research Journal, 2012

Home dampness, moulds and their influence on respiratory infections and symptoms in adults in Fin... more Home dampness, moulds and their influence on respiratory infections and symptoms in adults in Finland. I. Pirhonen, A. Nevalainen, T. Husman, J. Pekkanen. ERS Journals Ltd 1996. ABSTRACT: The aim of this study was to analyse the prevalence of mouldy homes and their association with respiratory symptoms and diseases in a subarctic cli- mate. A questionnaire was mailed to a

Journal of Exposure Science & Environmental Epidemiology, 2004

Indoor Air, 2002

Microbial indoor air quality and respiratory symptoms of children were studied in 24 schools with... more Microbial indoor air quality and respiratory symptoms of children were studied in 24 schools with visible moisture and mold problems, and in eight non-damaged schools. School buildings of concrete/brick and wooden construction were included. The indoor environment investigations included technical building inspections for visible moisture signs and microbial sampling using six-stage impactor for viable airborne microbes. Children&amp;#39;s health information was collected by questionnaires. The effect of moisture damage on concentrations of fungi was clearly seen in buildings of concrete/brick construction, but not in wooden school buildings. Occurrence of Cladosporium, Aspergillus versicolor, Stachybotrys, and actinobacteria showed some indicator value for moisture damage. Presence of moisture damage in school buildings was a significant risk factor for respiratory symptoms in schoolchildren. Association between moisture damage and respiratory symptoms of children was significant for buildings of concrete/brick construction but not for wooden school buildings. The highest symptom prevalence was found during spring seasons, after a long exposure period in damaged schools. The results emphasize the importance of the building frame as a determinant of exposure and symptoms.

Indoor Air, 2001

A total of 630 randomly selected dwellings were surveyed for visible signs of moisture damage by ... more A total of 630 randomly selected dwellings were surveyed for visible signs of moisture damage by civil engineers, and questionnaire responses were collected from the occupants (a total of 1,017 adults) to analyse the association between moisture damage and occupant health. A three-level grading system was developed, which took into account the number of damage sites in buildings and estimated the severity of the damage. In the present study, this grading system was tested as an improved model of moisture damage-related exposure in comparison to a conventional two-category system: based on independent, technical criteria it also allowed dose-response to be estimated. The questionnaire probed 28 individual health symptoms, based on earlier reported associations with building moisture and mould-related exposure. Criteria in evaluating the goodness of the selected exposure model were (1) dose-responsiveness and (2) higher risk compared to a two-level classification. Dose-responsiveness was observed with the three-level classification in 7, higher risk in 10, and both criteria in 5 out of 28 health symptoms. Two-level classification had higher risk in 4 health symptoms. Dose-dependent risk increases for respiratory infections and lower respiratory symptoms, and recurrent irritative and skin symptoms were observed with the three-level classification using symptom score variables. Although the results did not unambiguously support the three-level model, they underline the importance of developing more accurate exposure models in assessing the severity of moisture damage.

European Respiratory Journal, 1996

The aim of this study was to analyse the prevalence of mouldy homes and their association with re... more The aim of this study was to analyse the prevalence of mouldy homes and their association with respiratory symptoms and diseases in a subarctic climate. A questionnaire was mailed to a random sample of 2,000 males and females, aged 25-64 yrs, living in the county of Kuopio, Finland. A total of 1,521 (76%) responded and 1,460 were selected for the final analysis. The prevalence of homes with visible mould was 4%; with the odour of mould 5%; with damp spots, visible mould or the odour of mould 15%; and with moisture/water damage, damp spots, visible mould or the odour of mould 23%. The number of reports of bronchitis, common cold, atopy, allergic rhinitis, rhinitis, fever and chills, hoarseness, fatigue, difficulties in concentration, lumbar backache and stomach ache were strongly associated with living in a damp home. Bronchitis, hoarseness and difficulties in concentration had the strongest associations, with adjusted odds ratios (95% confidence limits) of: 2.04 (1.49-2.78), 2.23 (1.37-3.63) and 2.17 (1.35-3.50), respectively. After controlling for a possible reporting bias by excluding those subjects reporting lumbar bachache and recurrent stomach pain, eye irritation and tiredness remained significant. In conclusion, living in a home with mould problems may increase the risk of respiratory infections and symptoms in adults.

European Respiratory Journal, 1997

Environmental Modeling & Assessment, 2003

An empirical moisture damage index was developed in order to reduce the subjectivity of the estim... more An empirical moisture damage index was developed in order to reduce the subjectivity of the estimation of moisture damage in domestic residences, in relation to occupant health. The database was generated using information gathered from a sample of 164 houses that were examined by civil engineers, and questionnaire data collected from the occupants. The index was formulated to associate with the occupant reported respiratory symptoms by calculating weighted estimates of selected moisture damage attributes using 80% of the sample. The remaining 20% of the sample was used to verify the final index. The index associated strongly with the health symptoms of interest. This index is a tool that may be used as an indicator of moisture damage induced exposure in domestic residences.

Clinical Rheumatology, 2003

BMC Health Services Research, 2014

Background: Several studies have shown considerable differences in the way that physicians prescr... more Background: Several studies have shown considerable differences in the way that physicians prescribe sick leave. The aim of this study was to examine the sick leave prescribing practices of occupational health care physicians and factors affecting these practices. Methods: A questionnaire study with 19 hypothetical patient cases was conducted among 356 Finnish occupational health care physicians. The effects of both physician-related and local structural background variables on sick leave prescribing were studied using regression models. Economic consequences of the variation in sick leave prescribing were estimated. Results: When the cases were considered individually, the variation in prescribed sick leave days was relatively small. However, when considered together, variation in prescribing practice became apparent. On average, the overall number of days of sick leave prescribed for the entire group of 19 patient cases was 85.8, varying between 21 and 170 days. The physicians working at a public health center and those with more than 20 years experience as an occupational health physician tended to prescribe more days of sick leave than others. The quartile of physicians who prescribed the fewest days of sick leave would have resulted in mean production losses (17,100 euro, 95% CI 16,400-17,700) that were half those in the quartile with the most days of sick leave (34,800 euro, 95% CI 33,600-35,900). Conclusions: There was variation in the sick leave prescribing practices of occupational health care physicians. The most significant factor affecting this variation was the health care sector (public, private or employer clinic) employing the physicians. Variation in sick leave prescribing patterns can lead to inequality between patients.

Allergology International, 2001

ABSTRACT Background: The purpose of the present study was to compare mold specific IgE results wi... more ABSTRACT Background: The purpose of the present study was to compare mold specific IgE results with skin test and exposure data, as well as in relation to asthma and other allergic manifestations.Methods: We performed skin prick tests (SPT) to 13 molds in 341 children from six schools and studied the microbial status of all school buildings. Subsequently, mold specific IgE was measured by enzyme immunoassay (EIA) to 10 molds in 31 of those chil-dren with a positive (≥ 3 mm) or weak SPT reaction (1–2 mm) and in 62 age- and sex-matched controls with no such reactions.Results: Mold-specific IgE was elevated by EIA (> 0.35 IU/mL) to at least one of the 10 studied species in 12 children (39%) with and in two children (3%) without skin test reactions. The calculated prevalence of elevated mold-specific IgE was 5% in the non-selected and 10% in children selected by respiratory morbidity. Six children had IgE to the dampness-indicative mold Aspergillus fumigatus, five children had IgE to the common outdoor mold Cladosporium herbarum and four children had IgE to the uncommon, but highly allergenic, indoor mold Rhizopus nigricans. All 14 children who had elevated IgE to molds were boys, 13 had atopy by skin tests and 12 had either asthma or had wheezed. However, no species-specific association was found between IgE or SPT responses and exposure to molds.Conclusions: Mold allergy, as assessed by IgE measurements or skin tests, is rare in children. School-aged asthmatic boys having exposed to indoor air dampness seem to form a susceptible group for mold allergy, being at risk for worsening of their asthma.

Acta Paediatrica, 2007

Having more siblings has been shown to be associated with lower risk of atopic diseases. This mig... more Having more siblings has been shown to be associated with lower risk of atopic diseases. This might be due to the higher number of infections in larger families. Because children attending day care centres have more respiratory infections, we analysed the association of number of siblings and day care attendance in children aged 1-3 y with atopic disease in a cross sectional survey of 8387 schoolchildren aged 13-14 y and their parents in four regions of Finland. Having no siblings, compared to three or more siblings, was associated with significantly higher risk of lifetime history of hay fever (odds ratios (OR) 1.53, 95% confidence interval (CI) 1.25-1.86) and atopic eczema (OR 1.28, 95%CI 1.04-1.56), and higher risk (ns) of doctor-diagnosed asthma ever (OR 1.26, 95%CI 0.85-1.88). Less strong associations were observed with the number of older siblings (birth order). No associations were observed with current symptoms of these diseases during the last 12 mo. Attending a day care centre at the age of 1-3 y was not associated with decreased risk of any of the atopic diseases studied, but, in contrast to the hypothesis, was associated with slightly increased risk of current symptoms of hay fever (OR 1.34, 95%CI 1.12-1.60). The present results suggest that other factors than early childhood respiratory infections explain the association between number of siblings and future risk of atopic disease. & Atopic disease, early life, infections

European Respiratory Journal, 1999

The relationship between moisture or mould observations in houses and the state of health of thei... more The relationship between moisture or mould observations in houses and the state of health of their occupants.

International Journal of Occupational Medicine and Environmental Health, 2005

The aim of this study was to investigate how the microbial conditions of kitchen facilities diffe... more The aim of this study was to investigate how the microbial conditions of kitchen facilities differ from those in other school facilities. The health status of the personnel was also studied. The microbial investigations were conducted in six moisture-damaged schools and two reference schools. The symptoms of the kitchen personnel were surveyed with questionnaires and inflammatory responses in nasal lavage (NAL) fluid were measured. The total concentrations of airborne microbes were lower in kitchens than in other facilities of the schools. However, the occurrence of moisture damage increased the airborne microbial concentrations both in kitchens, and in other facilities. Bacterial concentrations were high on surfaces in the damaged kitchens. Gram-negative bacteria predominated, but also thermophilic bacteria and mycobacteria were detected. Respiratory and general symptoms were prevalent both among kitchen workers and clerical personnel in the moisture-damaged environments. Reported ...