Background

The relative importance of genetic and environmental factors for the occurrence of lower urinary tract symptoms (LUTS) is poorly understood.

Objective

To (1) estimate the prevalence of urinary incontinence (UI), overactive bladder (OAB), and other LUTS and (2) to assess the heritability of these symptoms.

Design, setting, and participants

Cross-sectional survey of LUTS in a national population-based cohort of Swedish twins 20–46 yr of age (n = 42 582) from the Swedish Twin Registry.

Measurements

Prevalence rates were determined and heritability of LUTS (in female twins) was assessed using indicators of twin similarity.

Results and limitations

A total of 25 364 twins completed the questionnaire (response rate: 59.6%). LUTS were more common in women (UI: 7%; OAB: 9%; nocturia: 61%; micturition frequency: 18%) than in men (UI: 1%; OAB: 5%; nocturia: 40%; micturition frequency: 11%), and prevalence increased with age. The strongest genetic effects were observed for UI, frequency, and nocturia. The lowest estimate for genetic effects was observed for OAB where environmental effects dominated, and more specifically shared family environment accounted for a third or more of the total variation. For stress UI, a fifth of the total variation in susceptibility to the disorder could be attributed to shared environment. Nonshared environmental effects were seen in the range of 45–65% for the various LUTS. The prevalence of LUTS was low in the men, and there were too few male cases to compute measures of similarity or heritability estimates.

Conclusions

This study provides robust evidence of a genetic influence for susceptibility to UI, frequency, and nocturia in women. In contrast, shared environmental factors seem more important for the predisposition to develop OAB, which may reflect familial patterns such as learning from parental behaviours.

Background

Prenatal factors such as prenatal psychological stress might influence the development of childhood asthma.

Methodology and Principal Findings

We assessed the association between maternal bereavement shortly before and during pregnancy, as a proxy for prenatal stress, and the risk of childhood asthma in the offspring, based on two samples of children 1–4 (n = 426 334) and 7–12 (n = 493 813) years assembled from the Swedish Medical Birth Register. Exposure was maternal bereavement of a close relative from one year before pregnancy to child birth. Asthma event was defined by a hospital contact for asthma or at least two dispenses of inhaled corticosteroids or montelukast. In the younger sample we calculated hazards ratios (HRs) of a first-ever asthma event using Cox models and in the older sample odds ratio (ORs) of an asthma attack during 12 months using logistic regression. Compared to unexposed boys, exposed boys seemed to have a weakly higher risk of first-ever asthma event at 1–4 years (HR: 1.09; 95% confidence interval [CI]: 0.98, 1.22) as well as an asthma attack during 12 months at 7–12 years (OR: 1.10; 95% CI: 0.96, 1.24). No association was suggested for girls. Boys exposed during the second trimester had a significantly higher risk of asthma event at 1–4 years (HR: 1.55; 95% CI: 1.19, 2.02) and asthma attack at 7–12 years if the bereavement was an older child (OR: 1.58; 95% CI: 1.11, 2.25). The associations tended to be stronger if the bereavement was due to a traumatic death compared to natural death, but the difference was not statistically significant.

Conclusions/Significance

Our results showed some evidence for a positive association between prenatal stress and childhood asthma among boys but not girls.

Objectives

To estimate the internal PCB level in Swedish workers specialised in PCB abatement in buildings and to measure possible effects of PCB on thyroid function and aspects of the immune system.

Methods

Thirty six of 40 eligible workers (90%) removing old elastic sealants containing PCB and 33 control construction workers provided blood samples for determination of 19 PCB congeners and some other organochlorine compounds (hexachlorobenzene and p,p′-DDE), thyroid function hormones and a set of cytokines. The PCB exposed group was reinvestigated after 10 months for a trend assessment.

Results

The sum of 19 PCB congeners in blood plasma from the occupationally PCB-exposed group was twice the level in the controls (geometric mean 580 vs. 260 ng/g lipid; P < 0.001), and there was also some difference in p,p′-DDE between the groups while the lipid-adjusted hexachlorobenzene levels were of the same magnitude. No statistically significant increase in overall PCB levels was observed in the abatement workers at follow-up and some congeners even declined. Thyroid function was not associated with PCB exposure at the current levels and this applied also to the cytokines investigated.

Conclusions

Swedish workers removing old elastic sealants with PCB have a higher internal PCB load than unexposed colleague construction workers, tentatively secondary to historical exposure. A system of protective measures seemed to be efficient since no further increase was noted after a longish period of additional exposure. There was no evidence of thyroid function or immune system involvement, as expressed by a set of cytokines, at the low PCB levels recorded.