The health effects of sea buckthorn berries and oil

Sea buckthorn (Hippophaë) berries are ingredients of the Chinese traditional medicine. In addition to China, they are nowadays cultivated for food in several European countries, Russia, Canada, the USA, and Japan. Sea buckthorn berries are a rich source of flavonoids, mainly flavonol glycosides and proanthocyanidins. Depending on the genetic background, growth conditions, and ripeness of the berries, vitamin C concentrations up to over 1 g/100 ml juice, have been reported. Sea buckthorn berries contain inositols and methyl inositols, components of messenger molecules in humans. Sea buckthorn seed oil is rich in essential aplha-linolenic and linoleic acids, whereas the most abundant fatty acids in the berry oil are palmitoleic, palmitic and oleic acids. Other potentially beneficial lipophilic compounds of sea buckthorn seeds and berries include carotenoids, phytosterols, tocopherols and tocotrienols. The effects of sea buckthorn fractions on inflammation, platelet aggregation, oxidation injuries, the liver, skin and mucosa, among others, have been reported. The aim of the thesis work was to investigate the health effects of sea buckthorn berries and oil in humans. The physiological effects of sea buckthorn berries, berry components, and oil have mostly been studied in vitro and in animal models, leaving a demand for more clinical trials. In the first randomized, placebo-controlled trial of this thesis healthy adults consumed 28 g/day of sea buckthorn berries for three months. The main objective was to investigate the effects on the common cold. In addition, effects on other infections, inflammation and circulating lipid markers associated with cardiovascular disease risk were studied. In the second randomized, placebocontrolled trial participants reporting dry eye symptoms consumed 2 g/day of sea buckthorn oil from the seeds and berries for three months. The effects on symptoms and clinical signs of dry eye were monitored. In addition, the effects on circulating markers of inflammation and liver functions were analyzed. Sea buckthorn berries did not affect the common cold or other infections in healthy adults. However, a decrease in serum C-reactive protein was detected, indicating effects on inflammation. Fasting concentrations of serum flavonols, typical to sea buckthorn berry, increased without affecting the circulating total, HDL, LDL cholesterol, or triacylglycerol concentrations. Tear film hyperosmolarity and activation of inflammation at the ocular surface are among the core mechanisms of dry eye. Combined sea buckthorn berry and seed oil attenuated the rise in tear film osmolarity taking place during the cold season. It also positively affected some of the dry eye symptoms. Based on the tear film fatty acid analysis, the effects were not mediated through direct incorporation of sea buckthorn oil fatty acids to tear film lipids. It is likely that the fatty acids, carotenoids, tocopherols and tocotrienols of sea buckthorn oil affected the inflammation of the ocular surface, lacrimal and/or meibomian glands. The effects on the differentiation of meibomian gland cells are also possible. Sea buckthorn oil did not affect the serum concentrations of inflammation markers or liver enzymes investigated. In conclusion, this thesis work suggests positive effects of sea buckthorn berries and oil on inflammation and dry eye, respectively, in humans.

Cardiovascular effects of short term exposure to electric and magnetic fields of electricity power transmission

In the electrical industry the 50 Hz electric and magnetic fields are often higher than in the average working environment. The electric and magnetic fields can be studied by measuring or by calculatingthe fields in the environment. For example, the electric field under a 400 kV power line is 1 to 10 kV/m, and the magnetic flux density is 1 to 15 µT. Electricand magnetic fields of a power line induce a weak electric field and electric currents in the exposed body. The average current density in a human being standing under a 400 kV line is 1 to 2 mA/m2. The aim of this study is to find out thepossible effects of short term exposure to electric and magnetic fields of electricity power transmission on workers' health, in particular the cardiovascular effects. The study consists of two parts; Experiment I: influence on extrasystoles, and Experiment II: influence on heart rate. In Experiment I two groups, 26 voluntary men (Group 1) and 27 transmission-line workers (Group 2), were measured. Their electrocardiogram (ECG) was recorded with an ambulatory recorder both in and outside the field. In Group 1 the fields were 1.7 to 4.9 kV/m and 1.1 to 7.1 pT; in Group 2 they were 0.1 to 10.2 kV/m and 1.0 to 15.4 pT. In the ECG analysis the only significant observation was a decrease in the heart rate after field exposure (Group 1). The drop cannot be explained with the first measuring method. Therefore Experiment II was carried out. In Experiment II two groups were used; Group 1 (26 male volunteers) were measured in real field exposure, Group 2 (15 male volunteers) in "sham" fields. The subjects of Group 1 spent 1 h outside the field, then 1 h in the field under a 400 kV transmission line, and then again 1 h outside the field. Under the 400 kV linethe field strength varied from 3.5 to 4.3 kV/m, and from 1.4 to 6.6 pT. Group 2spent the entire test period (3 h) in a 33 kV outdoor testing station in a "sham" field. ECG, blood pressure, and electroencephalogram (EEG) were measured by ambulatory methods. Before and after the field exposure, the subjects performed some cardiovascular autonomic function tests. The analysis of the results (Experiments I and II) showed that extrasystoles or arrythmias were as frequent in the field (below 4 kV/m and 4 pT) as outside it. In Experiment II there was no decrease detected in the heart rate, and the systolic and diastolic blood pressure stayed nearly the same. No health effects were found in this study.

Biotransformation and endocrine disruptive effects of contaminants in ringed seals - implications for monitoring and risk assessment

Marine mammals are exposed to persistent organic pollutants (POPs), which may be biotransformed to metabolites some of which are highly toxic. Both POPs and their metabolites may lead to adverse health effects, which have been studied using various biomarkers. Changes in endocrine homeostasis have been suggested to be sensitive biomarkers for contaminant-related effects. The overall objective of this doctoral thesis was to investigate biotransformation capacity of POPs and their potential endocrine disruptive effects in two contrasting ringed seal populations from the low contaminated Svalbard area and from the highly contaminated Baltic Sea. Biotransformation capacity was studied by determining the relationships between congener-specific patterns and concentrations of polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), polybrominated diphenyl ethers (PBDEs) and their hydroxyl (OH)- and/or methylsulfonyl (MeSO₂)-metabolites, and catalytic activities of hepatic xenobiotic-metabolizing phase I and II enzymes. The results suggest that the biotransformation of PCBs, PBDEs and toxaphenes in ringed seals depends on the congener-specific halogen-substitution pattern. Biotransformation products detected in the seals included OH-PCBs, MeSO₂-PCBs and –DDE, pentachlorophenol, 4-OHheptachlorostyrene, and to a minor extent OH-PBDEs. The effects of life history state (moulting and fasting) on contaminant status and potential biomarkers for endocrine disruption, including hormone and vitamin homeostasis, were investigated in the low contaminated ringed seal population from Svalbard. Moulting/fasting status strongly affected thyroid, vitamin A and calcitriol homeostasis, body condition and concentrations of POPs and their OH-metabolites. In contrast, moulting/fasting status was not associated with variations in vitamin E levels. Endocrine disruptive effects on multiple endpoints were investigated in the two contrasting ringed seal populations. The results suggest that thyroid, vitamin A and calcitriol homeostasis may be affected by the exposure of contaminants and/or their metabolites in the Baltic ringed seals. Complex and non-linear relationships were observed between the contaminant levels and the endocrine variables. Positive relationships between circulating free and total thyroid hormone concentration ratios and OH-PCBs suggest that OH-PCBs may mediate the disruption of thyroid hormone transport in plasma. Species differences in thyroid and bone-related effects of contaminants were studied in ringed and grey seals from low contaminated references areas and from the highly contaminated Baltic Sea. The results indicate that these two species living at the same environment approximately at the same trophic level respond in a very different way to contaminant exposure. The results of this thesis suggest that the health status of the Baltic ringed seals has still improved during the last decade. PCB and DDE levels have decreased in these seals and the contaminant-related effects are different today than a decade ago. The health of the Baltic ringed seals is still suggested to be affected by the contaminant exposure. At the present level of the contaminant exposure the Baltic ringed seals seem to be at a zone where their body is able to compensate for the contaminant-mediated endocrine disruption. Based on the results of this thesis, several recommendations that could be applied on monitoring and assessing risk for contaminant effects are provided. Circulating OH-metabolites should be included in monitoring and risk assessment programs due to their high toxic potential. It should be noted that endogenous variables may have complex and highly variable responses to contaminant exposure including non-linear responses. These relationships may be further confounded by life history status. Therefore, it is highly recommended that when using variables related to endocrine homeostasis to investigate/monitor or assess the risk of contaminant effects in seals, the life history status of the animal should be carefully taken into consideration. This applies especially when using thyroid, vitamin A or calcitriolrelated parameters during moulting/fasting period. Extrapolations between species for assessing risk for contaminant effects in phocid seals should be avoided.

Effects of Obesity and Weight Loss Following Bariatric Surgery on Brain Function, Structural Integrity and Metabolism

Obesity is one of the key challenges to health care system worldwide and its prevalence is estimated to rise to pandemic proportions. Numerous adverse health effects follow with increasing body weight, including increased risk of hypertension, diabetes, hypercholesterolemia, musculoskeletal pain and cancer. Current evidence suggests that obesity is associated with altered cerebral reward circuit functioning and decreased inhibitory control over appetitive food cues. Furthermore, obesity causes adverse shifts in metabolism and loss of structural integrity within the brain. Prior cross-sectional studies do not allow delineating which of these cerebral changes are recoverable after weight loss. We compared morbidly obese subjects with healthy controls to unravel brain changes associated with obesity. Bariatric surgery was used as an intervention to study which cerebral changes are recoverable after weight loss. In Study I we employed functional magnetic resonance imaging (fMRI) to detect the brain basis of volitional appetite control and its alterations in obesity. In Studies II-III we used diffusion tensor imaging (DTI) and voxel-based morphometry (VBM) to quantify the effects of obesity and the effects of weight loss on structural integrity of the brain. In study IV we used positron emission tomography (PET) with [18F]-FDG in fasting state and during euglycemic hyperinsulinemia to quantify effects of obesity and weight loss on brain glucose uptake. The fMRI experiment revealed that a fronto-parietal network is involved in volitional appetite control. Obese subjects had lower medial frontal and dorsal striatal brain activity during cognitive appetite control and increased functional connectivity within the appetite control circuit. Obese subjects had initially lower grey matter and white matter densities than healthy controls in VBM analysis and loss of integrity in white matter tracts as measured by DTI. They also had initially elevated glucose metabolism under insulin stimulation but not in fasting state. After the weight loss following bariatric surgery, obese individuals’ brain volumes recovered and the insulin-induced increase in glucose metabolism was attenuated. In conclusion, obesity is associated with altered brain function, coupled with loss of structural integrity and elevated glucose metabolism, which are likely signs of adverse health effects to the brain. These changes are reversed by weight loss after bariatric surgery, implicating that weight loss has a causal role on these adverse cerebral changes. Altogether these findings suggest that weight loss also promotes brain health.Key words: brain, obesity, bariatric surgery, appetite control, structural magnetic resonance

Lihantuotannossa käytettävien kasvunedistäjien käyttö ja mahdolliset terveysvaikutukset ihmisissä

Summary: The use of growth promoters in meat production and their potential health effects for human

Aerosolianalysaattorin jatkokehitys

Kiinnostus pienhiukkasia kohtaan on kasvanut voimakkaasti, koska niiden haitallisista terveysvaikutuksista on saatu uutta tietoa. Asiasta on julkaistu lukuisia tieteellisiä tutkimuksia ja viimeisimpien tietojan mukaan kohonneilla pienhiukkaspitoisuuksilla on vaikutusta jopa sydän- ja verisuonisairauksiin. Vakavien terveysvaikutusten ja kiristyvän lainsäädännön vuoksi uusille reaaliaikaisille hiukkasmittalaitteille on kova kysyntä. Tämä työ on osa suurempaa Dekati Oy:ssä toteutettua Autotest –projektia, jossa kehitetään hiukkasmittalaitteita autoteollisuudelle. Tavoitteena työssä oli kehittää hiukkasmittalaitteeseen varaaja, jossa olisi huomattavasti pienemmät pienhiukkashäviöt kuin sähköisen alipaineimpaktorin ELPI:n varaajassa. Lainsäädäntö pohjautuu nykyään pelkästään massapitoisuuden mittaamiseen eikä reaaliaikaisesti massapitoisuutta mittaavaa laitetta ole olemassa. Tässä työssä testattiin uutta hiukkasten tiheydenmääritysmenetelmää, jonka avulla on mahdollista mitata massapitoisuutta reaaliaikaisesti. Suunniteltu varaaja on helppokäyttöinen ja varaustehokkuudeltaan odotusten mukainen, mutta pienhiukkashäviöt ovat edelleen tavoiteltua suuremmat vaikkakin pienemmät kuin ELPI:ssä. Tämä johtuu osittain tilavaraushäviöistä ja osittain koronan sähkökentän vaikutuksesta näytekanavaan. Tiheysmittauksesta saatiin lupaavia tuloksia, mutta jatkokehitystä vaaditaan häiriöiden suodattamiseksi ja kuormituskestävyyden parantamiseksi.

Fluoriditasetarkastelu ja päästöjen hallinta ferrokromi- ja terästeollisuudessa

Työn alkuosassa kartoitettiin AvestaPolarit –yhtiöiden Tornion tehtaiden keskeiset fluoridilähteet kuten fluspaatti, valukuonat, valupulverit ja fluorivetyhappo. Valupulverien ja kuonien haihtumis- ja liukoisuuskäyttäytymistä valaistiin kotimaisten ja kansainvälisten tutkimusten avulla. Tutkimustuloksia sovellettiin pääpiirteittäin Tornion tehtaiden tilanteeseen ottamalla huomioon tekijät, jotka saattoivat lieventää tai vahvistaa fluoridien vaikutusta ympäristöön. Yleisesti fluoridien ympäristö- ja terveysvaikutukset arvioitiin vähäisiksi. Työn kokeellisessa osassa määritettiin Tornion tehtaiden ferrokromitehtaan, terässulaton, kuumavalssaamon ja kylmävalssaamon fluoriditaseet. Jokaisen osastojen syötteiden fluoridipitoisuudet selvitettiin tuottajien ilmoittamien tuotekoostumuksien, spesifikaatioiden ja fluoridianalyysien perusteella. Fluoridien kokonaismäärät laskettiin jokaiselle syötteelle ja ne suhteutettiin kunkin osaston vuoden 2001 tuotantotasoon. Tasetarkastelussa suurimpina fluoridisyötteinä nousivat odotetusti esiin terässulaton käyttämä kuonanmuodostaja-aine fluspaatti (CaF2) ja kylmävalssaamon peittaushappo, 70 prosenttinen fluorivetyhappo (HF). Lisäksi muita merkittäviä syötteitä olivat kylmävalssaamon käyttämä kalkkipitoinen sekakuona ja ferrokromitehtaan sulatuskoksi. Tuotoksien eli päästöjen fluoridipitoisuudet saatiin selville päästömittauksin. Jätevesistä otettiin pääosin viikoittaisia kokoomanäytteitä, jotka analysoitiin tehtaan laboratoriossa. Kaasumaiset tuotokset oli määritetty kertamittauksien perusteella. Kiinteiden tuotoksien eli sakkojen ja kuonien fluoridimittaukset suoritettiin 3 sulatuksen kuonanäytteistä ja sakan vuosinäytteestä. Tuotoksista suurimmat ominaispäästökertoimet olivat juuri terässulaton AOD-konvertterin ja senkkauunin kuonilla ja kylmävalssaamon neutraloidulla regenerointisakalla ja neutralointisakoilla. Näistä ei aiheutunut varsinaista päästöä lähiympäristöön, koska sakat ja kuonat loppusijoitetaan tehtaan kaatopaikalle tai niitä käytetään liukenemattomassa muodossa. Tornion tehtaiden fluoridisyötteiden ja -tuotoksien mittausepätarkkuudet vaikuttivat fluoriditaseeseen. Ferrokromitehtaan fluoridisyötteet olivat kokonaismäärältään selvästi suurempia kuin tuotokset. Terässulaton fluoriditaseen tuotokset olivat suurempia kuin syötteet ja kylmävalssaamon syötteet sekä tuotokset olivat karkeasti arvioiden samaa suuruusluokkaa. Kuumavalssaamon fluoridisyötteet ja -tuotokset olivat mitättömiä. Fluoriditaseen epävarmuustekijöitä voidaan vähentää suorittamalla esimerkiksi useita fluoridimittauksia kaasumaisista päästöistä.

Composition of Hawthorn (Crataegus spp.) Fruits and Leaves and emblic Leafflower (Phyllanthus emblica) Fruits

Hawthorn (Crataegus sp.) is widely distributed in the northern hemisphere (Asia, Europe and North America). It has been used as a medicinal material and food for hundreds of years both in Europe and in China. Clinical investigations and other research suggest that extracts of hawthorn fruits and leaves have multiple health effects including hypolipidaemic, anti-atherosclerotic, hypotensive, cardioprotective and blood vessel relaxing activities. Hawthorn fruit extracts have also displayed antioxidant and radical scavenging activities. Emblic leafflower fruit (Phyllanthus emblica) is widely used in Chinese and Indian traditional medicine. It has been found to have anti-cancer, hypoglycaemic and hypolipidaemic activities as well as cardioprotective effects and antioxidant activity. The fruit is currently used as a functional food targeted at obese people in China. Phenolic compounds, procyanidins (PCs), flavonols and C-glycosyl flavones in hawthorn and hydrolysable tannins in emblic leafflower fruits are considered among the major bioactive compounds in these berries. Moreover, hawthorn and emblic leafflower fruits are rich in vitamin C, triterpenoids, fruit acids, sugar alcohols and some other components with beneficial effects on the health of human beings. The aim of the thesis work was to characterise the major phenolic compounds in hawthorn fruits and leaves and emblic leafflower fruits as well as other components contributing to the nutritional profile and sensory properties of hawthorn fruits. Differences in the content and compositional profile of the major phenolic compounds, sugars, acids and sugar alcohols within various origins and species of hawthorn were also investigated. Acids, sugars and sugar alcohols in the fruits of different origins/cultivars belonging to three species (C. pinnatifida, C. brettschneideri and C. scabrifolia) of hawthorn were analysed by gas chromatography (GC-FID) and mass spectrometry (Publication I). Citric acid, quinic acid, malic acid, fructose, glucose, sorbitol and myo-inositol were found in all the subspecies. Sucrose was present only in C. scabrifolia and three cultivars of C. pinnatifida var. major. Forty-two phenolic compounds were identified/tentatively identified in fruits of C. pinnatifida var. major by polyamide column chromatography combined with high-performance liquid chromatograph-electrospray ionisation mass spectrometry (HPLC-ESI-MS) (Publication II). Ideain, chlorogenic acid, procyanidin (PC) B2, (-)-epicatechin, hyperoside and isoquercitrin were the major phenolic components identified. In addition, 35 phenolic compounds were tentatively identified based on UV and mass spectra. Eleven major phenolic compounds (hyperoside, isoquercitrin, chlorogenic acid, ideain, (-)-epicatechin, two PC dimers, three PC trimers and a PC dimer-hexoside) were quantified in the fruits of 22 cultivars/origins of three species of Chinese hawthorn by HPLC-ESI-MS with single ion recording function (SIR) (Publication III). The fruits of the hawthorn cultivars/origins investigated fell into two groups, one rich in sugars and flavonols, the other rich in acids and procyanidins. Based on the compositional features, different biological activities and sensory properties may be expected between cultivars/origins of the two groups. The results suggest that the contents of phenolic compounds, acids, sugars and sugar alcohols may be used as chemotaxonomic information distinguishing the hawthorn species from each other. Phenolic compounds in fruits and leaves of C. grayana and their changes during fruit ripening/harvesting were investigated using HPLC-UV-ESI-MS (Publication IV). (-)-Epicatechin, PC B2 and C1, hyperoside and a quercetin-pentoside were the major phenolic compounds in both fruits and leaves. Three C-glycosyl flavones (a luteolin-C-hexoside, a methyl luteolin-C-hexoside and an apigenin-C-hexoside) were present in leaves in abundance, but only at trace levels in fruits. Ideain and 5-O-caffeoylquinic acid were found in fruits only. Additionally, eleven phenolic compounds were identified/tentatively identified in both leaves and fruits (three B-type PC trimers, two B-type PC tetramers, a quercetin-rhamnosylhexoside, a quercetin-pentoside, a methoxykaempferol-methylpentosylhexoside, a quercetin-hexoside acetate, a methoxykaempferol-pentoside, chlorogenic acid and an unknown hydroxycinnamic acid derivative). The total content of phenolic compounds reached the highest level by the end of August in fruits and by the end of September in leaves. The compositional profiles of phenolic compounds in fruits and leaves of C. grayana were different from those of C. pinnatifida, C. brettschneideri, C. scabrifolia, C. pinnatifida. var. major, C. monogyna, C. laevigata and C. pentagyna. Phenolic compounds in emblic leafflower fruits were characterised by Sephadex LH-20 column chromatography combined with HPLC-ESI-MS (Publication V). A mucic acid gallate, three isomers of mucic acid lactone gallate, a galloylglucose, gallic acid, a digalloylglucose, putranjivain A, a galloyl-HHDP-glucose, elaeocarpusin and chebulagic acid represented the major phenolic compounds in fruits of emblic leafflower. In conclusion, results of this study significantly increase the current knowledge on the key bioactive and nutritional components of hawthorn and emblic leafflower fruits. These results provide important information for research on the mechanism responsible for the health benefits of these fruits.

Administration of Bifidobacterium animalis subsp. lactis BB-12 and xylitol with a novel pacifier in early childhood

Probiotic bifidobacteria are used in the prevention and treatment of childhood diseases. On the other hand, these bacteria are also connected to dental caries. The purpose of the present work was to test a food supplement containing Bifidobacterium animalis subsp. lactis BB-12 (B. lactis BB-12) and xylitol, and to investigate its health effects, properties and safety when used in a novel pacifier in early childhood. In a double-blind, placebo-controlled trial, newborn infants (n=163) were assigned randomly to receive B. lactis BB-12, xylitol, or sorbitol from the age of 1– 2 monthsto 2 years with a pacifier or a spoon. Children were followed up to four years of age. A part of the parents participating in the clinical trial evaluated the feasibility of the novel administration method. The pattern of tablet release from the pouch of the pacifier was tested in adults. The food supplement tablet containing B. lactis BB-12 and xylitol could be delivered in a safe and controlled way with the novel pacifier. The early administration of B. lactis BB-12 did not result in permanent oral colonization of this probiotic or affect the colonization of mutans streptococci in early childhood. Moreover, B. lactis BB-12 did not increase the occurrence of caries. Controlled administration of B. lactis BB-12 significantly reduced the incidence of respiratory infections during the first eight months of life in a Finnish population with breastfed infants. To conclude, administration of B. lactis BB-12 in early childhood is safe with regard to the future dental health of the child. In addition, B. lactis BB-12 may add to the protection against respiratory infections provided by human breast milk in infancy.

Cost-effectiveness analysis in South Karelia Central Hospital

The target organization of this study, otherwise South-Karelia Social and Health Care District (Eksote) provides health, senior, family and social welfare services. South Karelia Central Hospital provides special health care and offers health services from all of the most important medical specialties. Eksote has in use 15D instrument to measure the health-related quality of life (HRQoL) of their patients before and after their interventions for observing the health effects of the medical care. Furthermore, 15D allows measuring the effectiveness and cost-effectiveness of health care when comparing these before and after results of the 15D measurements and adding the costs of the interventions into this research. The main purposes of this study were to analyze the effectiveness and cost-effectiveness of medical care in South Karelia Central Hospital by using the gathered 15D data to calculate effectiveness and cost-effectiveness ratios and to analyze the reliability and availability of the data. Study has been conducted using literature review and quantitative research methods. The results indicate that from the patients within the eight units selected to this study the 15D change information was available from the 52 %, the 15D change and the cost information from 38 % and the information of quality-adjusted life years (QALYs) produced and the cost information from 35 %. The effectiveness and cost-effectiveness of medical care were greatest at the units of Pain Outpatient Clinic and Rheumatic Diseases Outpatient Clinic. The most effective medical care is given in the unit where the average price of one produced QALY is the highest (Orthopedics). However, the calculated standard deviations pointed out that there are great variances in the effectiveness and cost-effectiveness within the units also.

Pienten yksiköiden talousveden laatuvaatimukset ja - suositukset

Talousvesi sisältää paljon erilaisia yhdisteitä, joista osa on ihmiselle haitallisia, tällaisia yhdisteitä ovat muun muassa klooratut hiilivedyt. Haitallisten yhdisteiden määrän minimoimiseksi talousvedessä talousveden vieraille aineille on määrätty asetuksissa enimmäispitoisuuksia sekä – tiheyksiä. Näitä laatuvaatimuksia sekä – suosituksia noudattamalla talousvesi on käyttökelpoista. Talousvedellä ei tällöin ole haitallisia terveysvaikutuksia eikä se vahingoita vesilinjastoja. Kirjallisuusosassa selvitetään pienten yksiköiden talousveteen liittyvän sosiaali- ja terveysministeriön asetuksen sisältöä. Mitä asetus pitää sisällään, keitä asetus koskee ja miksi asetukseen kirjatut yhdisteet ja aineet ovat ihmiselle haitallisia sekä mitä terveysvaikutuksia kyseisillä aineilla on. Kokeellisessa osiossa analysoitiin kolmesta näytteestä osa sosiaali- ja terveysministeriön asettamista vaatimuksista. Pääsääntöisesti mitattiin epäorgaanisia aineita sekä ioneja. Mittaukset suoritettiin ionikromatografilla, liekki-atomiabsorptiospektrometrillä, TOC-analysaattorilla, COD-putkilla, pH-, johtokyky- sekä sameusmittarilla.

Sähkösuodattimen mahdollisuudet sisäilman parantajana

Diplomityön tavoitteena oli selvittää, kuinka sähkösuodattimella voidaan vaikuttaa sisäilman laatuun ja kuinka kilpailukykyinen vaihtoehto pienkiinteistöissä sähkösuodatin on perinteisiin kuitusuodattimiin verrattuna. Teoriaosassa tarkasteltiin, kuinka ilman hengitettävät hiukkaset muodostuvat ja miten ne vaikuttavat sisäilman laatuun sekä ihmisten terveyteen. Tarkasteltiin hiukkasten koon, lukumäärän, massan ja pinta-alan yhteyksiä niiden terveysvaikutuksiin. Ultrapienet hiukkaset ovat terveydelle haitallisimpia, koska hiukkasten lukumäärä ja pinta-ala lisäävät terveyshaittoja enemmän kuin hiukkasten massa. Tutkittiin pienkiinteistöjen ilmanvaihtoratkaisuja ja erilaisia tuloilmanpuhdistus-menetelmiä. Soveltavassa osassa tarkasteltiin sähkösuodattimen toimintaa ja sen mahdollisuuksia sisäilman parantajana verrattuna perinteisiin kuitusuodattimiin. Tehtiin sähkösuodattimen ja kuitusuodattimen välinen elinkaarikustannusvertailu keskisuurelle omakotitalolle. Kirjallisuuden ja tutkimushavaintojen perusteella sähkösuodattimen suurin etu muihin suodattimiin verrattuna on sen kyky poistaa kaiken kokoisia, myös ultrapieniä, hengitettäviä hiukkasia ja siten tehokkaasti vähentää hengitettävien hiukkasten lukumäärää ja pinta-alaa. Tällä voi olla vaikutusta yleisten terveyshaittojen ja ympäristöherkkyyden ennaltaehkäisemisessä. Ympäristöherkkyyteen sairastuneiden oireiluun sähkösuodatin voi tuottaa helpotusta kotioloissa ja siirrettävän ilmanpuhdistimen avulla myös työpaikoilla. Elinkaarikustannusvertailun perusteella selvisi, että sähkösuodatin on kalliimmasta hinnastaan huolimatta kokonaiskustannuksiltaan selvästi edullisempi vaihtoehto kuin kuitusuodattimet. Sähkösuodattimen haasteena on uuden teknologian lanseeraaminen pientalorakentamiseen. Pienrakennusten tuloilman puhdistusmenetelmien kehittämisellä olisi mahdollista parantaa suomalaisten elämänlaatua ja saavuttaa merkittäviä säästöjä terveydenhoitokuluissa.

Delivery of European Cross-Border Health Care and the Relevance and Effects of EU Regulations and Judicial Processes with Reference to Delivery of Drugs and Blood Donor Information Material.

Valtion rajat ylittävät terveyspalvelut Euroopan unionissa sekä Euroopan unionin säädösten merkitys ja vaikutus erityisesti lääkejakeluun ja verenluovuttajille jaettavaan tiedotusaineistoon Valtion rajat ylittävä terveydenhuolto on suuren kiinnostuksen kohteena Euroopan unionissa. Resurssien hyödyntäminen parhaalla mahdollisella tavalla ja tiedon keskittäminen ovat tarpeen terveydenhuollon kustannusten alati noustessa. Terveydenhuoltopalvelut kuuluvat Euroopan sisämarkkinoiden vapaan liikkuvuuden piiriin. Euroopan unionilla ei ole kuitenkaan toimivaltaa säädellä terveydenhuoltojärjestelmiä, vaan sen mahdollisuudet ovat enimmäkseen kansanterveyden edistämisessä ja suojelussa, myös muilla toimialueilla kuin terveydenhuollossa. Tutkimuksen tavoitteena oli tutkia Euroopan unionin säädösten vaikutusta terveydenhuoltosektoriin, erityisesti valtion rajat ylittäviin terveydenhuoltopalveluihin. Erityiskohteena olivat lääkemääräyksen toimittaminen toisen Euroopan unionin jäsenmaan apteekista, resepti-lääkkeiden maahantuonti omaan henkilökohtaiseen käyttöön, sähköisen lääkemääräyksen käyttö kansallisesti ja mahdollisuudet sen käyttöön eri jäsenmaiden välillä, online-apteekkien soveltuvuus Euroopan unionin sisämarkkinoille sekä verenluovuttajille jaettavan tiedotusaineiston yhtenäistämistarve Euroopan unionin alueella. Tutkimuksen osa-alueiden aineisto koottiin vuosina 1999–2003, jolloin Euroopan unioniin kuului 15 jäsenmaata. Apteekit toimittivat useimmiten myös ei-kansalliset, toisessa Euroopan unionin jäsenmaassa annetut lääkemääräykset. Kaikki jäsenmaat rajoittivat lääkemääräyksen vaativien lääkkeiden maahantuontia. Rajoituksia oli maahantuontimäärissä ja -tavoissa. Lisäksi sairasvakuutuskorvausten saaminen ulkomailla lunastetuista reseptilääkkeistä oli hankalaa. Sähköiset lääkemääräykset olivat käytössä vain kahdessa maassa, mutta useissa maissa suunniteltiin niiden kokeilua. Standardit ja käyttöjärjestelmät olivat erilaisia eri maissa. Euroopan unionin alueelle on perustettu online-apteekkeja, joiden toiminta on kuitenkin vaatimatonta. Verenluovuttajille annettava tiedotusaineisto ei missään maassa täyttänyt veridirektiivin vaatimuksia. Tutkimuksen tulokset osoittivat kansallisten käytäntöjen eroavaisuuksien rajoittavan valtion rajat ylittäviä terveydenhuoltopalveluita. Vaikka Euroopan unionin tavoitteena ei ole yhtenäistää terveydenhuoltojärjestelmiä, on tarpeen arvioida uudelleen unionin ja jäsenmaiden välistä työnjakoa. Kansalliset terveydenhuoltojärjestelmät eivät ole erillään Euroopan sisämarkkinoista, jotka merkittävästi vaikuttavat terveydenhuoltoon.

Late effects of cancer at a young age: Registry-based studies of the health of cancer patients and their off-spring

Modern cancer therapy has resulted in increased survival among patients diagnosed with cancer at a young age. These improvements have led to the investigation of late morbidity and mortality associated with cancer and its treatments. The aim of this study was to evaluate late effects of cancer treated at a young age on the health of patients and their offspring. Utilising the nationwide population-based registries in Finland, we evaluated the risk of hypothyroidism and the probability of parenthood in cancer survivors as well as preterm birth, neonatal outcomes, and the risk of cancer among offspring of patients. The survivor cohort, identified from the Finnish Cancer Registry, consisted of 25,784 cancer patients diag-nosed between ages 0 and 34 in 1953–2004. By linkage to the population register, siblings of these patients were identified for comparison. The prevalence of hypothyroidism was higher among former childhood cancer (aged 0–16) patients than in the general population. The probability of parenthood following early onset cancer was overall significantly reduced compared to siblings. Offspring of female cancer survivors were at an increased risk of preterm birth, this risk being highest among patients diagnosed in childhood and early adulthood (aged 20–34 years). The offspring were not, however, at a significantly increased risk of neonatal death or stillbirth, though they were more likely to need monitoring or intensive care in the neonatal period. The risk of sporadic cancer among offspring of male and female cancer survivors was not elevated in comparison to the general population. The study showed that former cancer patients are at risk of certain adverse endocrine and reproductive health outcomes and should be followed for timely intervention. The offspring of cancer survivors do not appear to be at risk for adverse health outcomes.