Inflammatory and coagulatory markers and exposure to different size fractions of particle mass, number and surface area air concentrations in the Swedish hard metal industry, in particular to cobalt

Figures & data

Table 1. Exposure concentration levels of inhalable dust and cobalt. Stationary concentration levels of inhalable, total and respirable dust, inhalable, total and respirable cobalt, PM₁₀, PM_2.5, PM_1.0, particle surface area (A-trak), particle number (P-trak) and nanoparticles (Nanotracer). Non-adjusted.

Aerosol concentration levels	N	AM	Median	SD	GM	GSD	Min	Max
Exposure measurements
Inhalable dust mg/m^3	72	0.11	0.1	0.064	0.099	1.7	0.039	0.36
Inhalable cobalt mg/m^3	72	0.0034	0.0023	0.0035	0.002	3	0.00016	0.019
Stationary measurements
Inhalable dust mg/m^3	36	0.052	0.044	0.016	0.05	1.3	0.039	0.096
Total dust mg/m^3	36	0.078	0.078	0.008	0.078	1.1	0.068	0.11
Respirable dust mg/m^3	36	0.062	0.061	0.0048	0.061	1.1	0.054	0.078
Inhalable cobalt mg/m^3	36	0.00076	0.00042	0.00098	0.00043	2.8	0.00008	0.0041
Total cobalt mg/m^3	36	0.00067	0.00078	0.00024	0.00057	2.1	0.000078	0.00099
Respirable cobalt mg/m^3	36	0.000074	0.000062	0.000035	0.00007	1.4	0.000054	0.00019
PM10 mg/m^3	36	0.09	0.085	0.03	0.085	1.4	0.036	0.17
PM2.5 mg/m^3	36	0.079	0.085	0.017	0.077	1.3	0.035	0.11
PM1.0 mg/m^3	36	0.0066	0.0045	0.0064	0.0032	4.9	0.0001	0.028
Total particle area (A-trak) µm^2/cm^3	36	9.7	6.6	9.1	3.8	16	0.0001	33
Particle number (P-trak)/cm^3	36	2700	1600	3900	1700	2.4	320	22000
Nanoparticles number/cm^3	36	880	79	1300	220	5.6	32	3700

N: number of measurements; AM: arithmetic mean; SD: standard deviation; GM: geometric mean; GSD: geometric standard deviation.

Table 2. Exposure concentration levels of inhalable dust, cobalt and tungsten by job title. Non-adjusted.

Aerosols and metals	Job	N	AM	Median	SD	GM	GSD	Min	Max
Inhalable dust (mg/m³)
	Powder	16	0.16	0.14	0.057	0.16	1.4	0.097	0.27
	Forming/prototype	5	0.071	0.072	0.028	0.066	1.5	0.039	0.11
	Pressing	39	0.1	0.087	0.051	0.088	1.7	0.04	0.22
	Laboratory	5	0.074	0.061	0.03	0.07	1.5	0.05	0.12
	Maintenance	7	0.14	0.095	0.11	0.11	1.9	0.05	0.36
	Total	72	0.11	0.1	0.064	0.099	1.7	0.039	0.36
Cobalt (Co) inhalable fraction (mg/m³)
	Powder	16	0.0072	0.0065	0.0043	0.0061	1.8	0.0018	0.019
	Forming/prototype	5	0.002	0.0017	0.0012	0.0017	2	0.00061	0.0034
	Pressing	39	0.0028	0.0022	0.0026	0.0018	2.8	0.00016	0.010
	Laboratory	5	0.0006	0.00037	0.00048	0.00046	2.3	0.0002	0.0013
	Maintenance	7	0.00099	0.00092	0.00047	0.0009	1.6	0.00039	0.0018
	Total	72	0.0034	0.0023	0.0035	0.002	3	0.00016	0.019
Tungsten (W) inhalable fraction (mg/m³)
	Powder	16	0.08	0.071	0.047	0.067	1.9	0.019	0.2
	Forming/ prototype	5	0.015	0.013	0.0084	0.013	1.8	0.0058	0.026
	Pressing	39	0.023	0.017	0.02	0.015	2.8	0.0016	0.076
	Laboratory	5	0.0051	0.0035	0.0037	0.0042	2	0.0017	0.011
	Maintenance	7	0.032	0.011	0.061	0.013	3.4	0.0039	0.17
	Total	72	0.035	0.019	0.04	0.019	3.2	0.0016	0.2

N: number of measurements; AM: arithmetic mean; SD: standard deviation; GM: geometric mean; GSD: geometric standard deviation.

Table 3. Blood concentrations of biological markers and cobalt in blood and urine (mean, median minimum and maximum) among 71 participants on different days.

	Sampling day 1					Sampling day 2
Marker	N	Mean	Median	Min	Max	N	Mean	Median	Min	Max
Inflammation
CC16 (µg/L)	71	20	19	8	34	65	20	19	8.5	38
TNF (pg/mL)	71	2.1	2	1.1	5.1	68	1.9	1.9	1.1	3.7
IL-6 (pg/mL)	71	0.55	0.49	0.16	1.7	68	0.54	0.45	0.11	2.1
IL-8 (pg/mL)	71	3.3	2.8	1.6	6.6	68	3.2	3.1	1.7	6.9
IL-10 (pg/mL)	71	0.21	0.19	0.09	1.2	68	0.23	0.21	0.08	0.51
SAA (mg/L)	66	13	8.9	1.1	66	59	11	6.7	0.79	49
CRP (mg/L)	71	1.7	0.8	0.11	19	66	1.2	0.67	0.11	6.4
Coagulation
FVIII (kIU/L)	71	1.1	1.1	0.6	2.0	65	1.2	1.2	0.6	3.0
vWF (kIU/L)	71	1.2	1.1	0.38	4.4	65	1.2	1	0.44	3.7
Fibrinogen (g/L)	71	2.8	2.6	1.7	4.6	66	2.7	2.6	1.2	4.5
PAI-1 (kIU/L)	71	2.6	1.4	1.4	16	65	2.6	1.4	1.4	14
D-dimer (µg/mL)	71	0.34	0.22	0.07	7.8	66	0.23	0.19	0.07	0.76
Cobalt in blood (nmol/L)	69	6.9	6.5	2.8	14	66	6.6	5.9	2.8	15
Cobalt in urine (nmol/L)	70	44	35	3.4	220	67	44	33	3.4	150

N: number of measurements.

Table 4. A mixed model for inflammatory markers CC16, TNF, IL-6, IL-8, IL-10, SAA and CRP by exposure class of particle mass, particle number, particle area and air concentrations.

Exposure	CC16		TNF		IL-6		IL-8
	β	95 % CI	β	95 % CI	β	95 % CI	β	95 % CI
Inhalable dust (mg/m^3 p)
0.08401+	1.08	0.88–1.34	1.10	0.97–1.24	0.85	0.65–1.10	0.96	0.81–1.13
0.05801–0.0840	1.02	0.82–1.25	0.93	0.82–1.06	1.00	0.77–1.32	0.87	0.74–1.03
< =0.05800	1		1		1		1
Inhalable cobalt (mg/m^3 p)
0.00168+	1.04	0.85–1.28	0.94	0.82–1.07	0.91	0.69–1.20	1.06	0.89–1.25
0.00044–0.00167	1.29	1.05–1.59	0.92	0.80–1.05	0.82	0.62–1.07	0.91	0.77–1.07
< =0.00043	1		1		1		1
Inhalable dust (mg/m^3 s)
0.0439+	1.00	0.80–1.24	1.00	0.88–1.13	0.96	0.72–1.28	1.13	0.95–1.35
0.0428–0.0438	0.95	0.78–1.17	1.17	1.03–1.31	1.06	0.81–1.38	1.03	0.87–1.21
< =0.0427	1		1		1		1
Inhalable cobalt (mg/m^3 s)
0.0004701+	1.20	0.98–1.47	0.99	0.87–1.12	1.20	0.92–1.57	1.05	0.89–1.24
0.001501–0.000470	1.08	0.87–1.33	1.09	0.96–1.24	1.09	0.83–1.43	1.15	0.97–1.36
< =0.0001500	1		1		1		1
Total dust (mg/m^3 s)
0.0779+	1.05	0.76–1.43	0.95	0.78–1.16	1.00	0.66–1.51	1.08	0.84–1.40
0.0747–0.0778	0.98	0.81–1.17	1.01	0.90–1.13	0.95	0.74–1.20	0.98	0.84–1.13
< =0.0746	1		1		1		1
Total dust cobalt (mg/m^3 s)
0.0004101+	1.28	1.04–1.59	0.98	0.86–1.12	1.19	0.90–1.57	1.12	0.94–1.33
0.0001201–0.0004100	1.21	0.97–1.51	1.01	0.88–1.17	1.13	0.84–1.51	1.07	0.89–1.30
< =0.0001200	1		1		1		1
Respirable dust (mg/m^3 s)
0.0616+	0.97	0.78–1.21	1.00	0.87–1.14	0.99	0.74–1.34	0.92	0.77–1.10
0.0595–0.0615	1.17	0.95–1.44	1.15	1.02–1.31	1.12	0.86–1.48	1.03	0.87–1.22
< =0.0594	1		1		1		1
Respirable dust cobalt (mg/m^3 s)
0.0000666+	1.05	0.84–1.33	1.08	0.94–1.25	1.02	0.76–1.37	0.95	0.79–1.14
0.0000595–0.0000665	1.10	0.89–1.37	1.09	0.95–1.24	1.11	0.84–1.84	1.01	0.85–1.20
< =0.0000594	1		1		1		1
PM10 (mg/m^3 s)
0.1201+	0.87	0.67–1.13	0.88	0.75–1.02	0.83	0.60–1.16	0.92	0.75–1.14
0.1101–0.1200	1.30	0.83–2.02	0.82	0.63–1.08	1.22	0.68–2.16	0.89	0.62–1.27
< =0.1100	1		1		1		1
PM2.5 (mg/m^3 s)
0.12+	0.94	0.55–1.61	0.86	0.62–1.19	0.71	0.36–1.41	0.79	0.52–1.20
0.078–0.110	0.90	0.72–1.14	0.92	0.80–1.06	0.95	0.71–1.28	0.89	0.74–1.07
< =0.077	1		1		1		1
PM1.0 (mg/m^3 s)
0.0101+	1.06	0.88–1.28	0.96	0.85–1.07	1.06	0.83–1.35	0.89	0.78–1.04
0.0031–0.0100	1.27	1.03–1.55	0.89	0.78–1.01	1.11	0.84–1.47	0.90	0.78–1.05
< =0.0030	1		1		1		1
A–trak, (µm^2/cm^3)
7.7551+	1.06	0.85–1.33	0.93	0.81–1.06	1.17	0.88–1.56	0.97	0.81–1.16
4.0751–7.7550	0.95	0.78–1.16	0.94	0.83–1.05	0.99	0.77–1.27	0.88	0.75–1.02
< =4.0750	1		1		1		1
P–trak (particle number/cm^3)
2017+	1.20	0.95–1.51	0.92	0.80–1.07	1.04	0.76–1.41	0.92	0.77–1.11
1181–2016	1.12	0.93–1.36	0.90	0.80–1.02	1.08	0.83–1.38	0.82	0.70–0.95
< =1180	1		1		1		1
Nanoparticles (number/cm^3)
2121.5392+	0.95	0.77–1.18	1.04	0.91–1.19	1.07	0.82–1.40	0.89	0.76–1.06
73.8611–2121.5391	0.90	0.73–1.10	1.10	0.97–1.25	1.24	0.95–1.60	1.00	0.85–1.75
< =73.8610	1		1		1		1
Exposure	IL-10		SAA		CRP
	β	95 % CI	β	95 % CI	β	95 % CI
Inhalable dust (mg/m^3 p)
0.08401+	1.02	0.79–1.32	0.91	0.58–1.44	1.24	0.73–2.08
0.05801–0.08400	0.90	0.69–1.16	0.98	0.61–1.56	1.03	0.61–1.73
< =0.05800	1		1		1
Inhalable cobalt (mg/m^3 p)
0.00168+	0.82	0.64–1.06	1.24	0.78–1.98	0.89	0.52–1.54
0.00044–0.00167	0.76	0.59–0.98	1.41	0.89–2.25	0.99	0.58–1.69
< =0.00043	1		1		1
Inhalable dust (mg/m^3 s)
0.0439+	0.91	0.70–1.19	1.05	0.64–1.71	1.18	0.68–2.03
0.0428–0.0438	1.15	0.90–1.48	1.02	0.64–1.63	1.35	0.81–2.26
< =0.0427	1		1		1
Inhalable cobalt (mg/m^3 s)
0.0004701+	1.04	0.81–1.33	1.11	0.70–1.76	1.16	0.69–1.95
0.001501–0.0004700	1.23	0.95–1.60	1.05	0.66–1.66	0.90	0.53–1.54
< =0.0001500	1		1		1
Total dust (mg/m^3 s)
0.0779+	1.15	0.70–1.90	1.07	0.55–2.08	1.20	0.54–2.63
0.0747–0.0778	1.16	0.86–1.56	0.78	0.52–1.16	1.09	0.69–1.73
< =0.0746	1		1		1
Total dust cobalt (mg/m^3 s)
0.0004101+	1.02	0.79–1.32	1.17	0.72–1.91	1.21	0.69–2.10
0.0001201–0.0004100	1.32	0.86–1.73	0.88	0.54–1.45	1.15	0.65–2.04
< =0.0001200	1		1		1
Respirable dust (mg/m^3 s)
0.0616+	1.08	0.82–1.41	0.91	0.55–1.49	1.25	0.71–2.19
0.0595–0.0615	1.30	1.01–1.67	1.30	0.81–2.08	1.51	0.90–2.55
< =0.0594	1		1		1
Respirable dust cobalt (mg/m^3 s)
0.0000666+	1.10	0.83–1.44	0.98	0.59–1.62	1.44	0.82–2.53
0.0000595–0.0000665	1.28	0.99–1.65	1.22	0.76–1.95	1.37	0.81–2.31
< =0.0000594	1		1		1
PM10 (mg/m^3 s)
0.1201+	0.87	0.64–1.19	0.69	0.41–1.19	1.04	0.54–2.00
0.1101–0.1200	0.63	0.37–1.08	2.38	0.94–6.01	0.94	0.30–2.90
< =0.1100	1		1		1
PM2.5 (mg/m^3 s)
0.12+	0.88	0.46–1.67	0.53	0.17–1.62	1.55	0.42–5.76
0.078–0.110	0.80	0.61–1.06	0.72	0.44–1.18	0.75	0.43–1.32
< =0.077	1		1		1
PM1.0 (mg/m^3 s)
0.0101+	0.94	0.75–1.19	1.09	0.71–1.66	1.09	0.67–1.80
0.0031–0.0100	1.12	0.86–1.45	0.78	0.50–1.24	1.23	0.72–2.09
< =0.0030	1		1		1
A–trak (µm^2/cm^3)
7.7551+	0.79	0.60–1.03	1.22	0.75–2.00	1.07	0.61–1.87
4.0751–7.7550	0.88	0.70–1.11	0.92	0.60–1.40	0.95	0.58–1.55
< =4.0750	1		1		1
P–trak (particle number/cm^3)
2017+	0.90	0.67–1.21	0.88	0.53–1.47	0.87	0.48–1.57
1181–2016	0.99	0.78–1.26	0.73	0.48–1.11	1.03	0.63–1.68
< =1180	1		1		1
Nanoparticles (number/cm^3)
2121.54+	1.83	0.92–1.53	0.76	0.48–1.22	0.87	0.51–1.47
73.8611–2121.53	1.27	0.99–1.62	1.07	0.69–1.65	0.88	0.53–1.46
< =73.8610	1		1		1

β: fixed effect by exposure class, 95% CI: 95% confidence interval, bold values: statistically significant β values (p < 0.05), italic values: indicate non-significant exposure-response, p: personal sampling, s: stationary sampling.

Antilog values, adjusted TWA.

Table 5. A mixed model for coagulatory markers FVIII, vWF, Fibrinogen, PAI-1 and D-dimer by exposure class of particle mass, particle number, particle area and air concentrations.

Exposure	FVIII		vWF		Fibrinogen		PAI-1		D-dimer
	β	95 % CI	β	95 % CI	β	95 % CI	β	95 % CI	β	95 % CI
Inhalable dust (mg/m^3 p)
0.08401+	1.04	0.91–1.19	1.11	0.90–1.37	1.05	0.92–1.18	0.86	0.62–1.21	1.07	0.77–1.48
0.05801–0.08400	0.96	0.83–1.09	1.12	0.91–1.38	0.98	0.86–1.10	0.81	0.58–1.13	1.07	0.77–1.49
< =0.05800	1		1		1		1		1
Inhalable cobalt (mg/m^3 p)
0.00168+	1.06	0.92–1.21	1.10	0.89–1.35	1.06	0.93–1.20	1.17	0.83–1.64	0.85	0.61–1.19
0.00044–0.00167	1.15	1.00–1.31	1.22	0.99–1.51	1.03	0.91–1.17	0.93	0.66–1.30	0.84	0.60–1.17
< =0.00043	1		1		1		1		1
Inhalable dust (mg/m^3 s)
0.0439+	1.21	1.06–1.38	1.19	0.96–1.47	1.18	0.81–1.71	1.27	0.90–1.80	0.88	0.62–1.24
0.0428–0.0438	1.11	0.97–1.26	1.27	1.04–1.55	1.17	0.83–1.70	1.04	0.75–1.44	1.00	0.72–1.38
< =0.0427	1		1		1		1		1
Inhalable cobalt (mg/m^3 s)
0.0004701+	1.18	1.03–1.34	1.03	0.84–1.27	0.99	0.69–1.41	1.31	0.94–1.82	1.18	0.86–1.63
0.0001501–0.0004700	1.07	0.93–1.22	1.02	0.82–1.26	0.90	0.62–1.30	0.97	0.69–1.36	1.23	0.89–1.72
< =0.0001500	1		1		1		1		1
Total dust (mg/m^3 s)
0.0779+	1.26	1.04–1.52	1.21	0.89–1.64	1.30	0.77–2.24	1.15	0.70–1.90	0.97	0.60–1.59
0.0747–0.0778	1.18	1.05–1.31	1.23	1.03–1.46	1.09	0.80–1.49	1.16	0.86–1.56	0.92	0.69–1.23
< =0.0746	1		1		1		1		1
Total dust cobalt (mg/m^3 s)
0.0004101+	1.16	1.01–1.34	1.03	0.83–1.29	1.07	0.73–1.56	1.25	0.88–1.78	1.12	0.79–1.58
0.0001201–0.0004100	1.08	0.93–1.24	0.96	0.76–1.21	0.95	0.64–1.41	1.07	0.74–1.55	1.19	0.83–1.69
< =0.0001200	1		1		1		1		1
Respirable dust (mg/m^3 s)
0.0616+	1.19	1.03–1.37	1.21	0.96–1.51	1.04	0.70–1.54	0.96	0.66–1.38	0.93	0.65–1.32
0.0595–0.0615	1.15	0.93–1.32	1.21	0.98–1.49	1.09	0.76–1.57	1.10	0.78–1.55	1.08	0.78–1.51
< =0.0594	1		1		1		1		1
Respirable dust cobalt (mg/m^3 s)
0.0000666+	1.25	1.04–1.43	1.28	1.03–1.60	1.25	0.85–1.85	1.10	0.76–1.59	0.99	0.69–1.42
0.0000595–0.0000665	1.12	0.98–1.27	1.16	0.94–1.42	0.96	0.67–1.37	1.00	0.71–1.41	1.03	0.74–1.44
< =0.0000594	1		1		1		1		1
PM10 (mg/m^3 s)
0.1201+	1.20	1.02–1.42	1.09	0.84–1.42	0.97	0.62–1.51	0.86	0.57–1.29	1.05	0.70–1.58
0.1101–0.1200	1.06	0.80–1.40	0.95	0.61–1.49	0.73	0.34–1.58	1.82	0.90–3.66	0.99	0.49–1.99
< =0.1100	1		1		1		1		1
PM2.5 (mg/m^3 s)
0.12+	1.64	1.18–2.26	1.58	0.94–2.65	0.98	0.39–2.43	0.71	0.30–1.66	1.14	0.50–2.59
0.078–0.110	1.15	0.99–1.32	1.20	0.96–1.50	0.94	0.63–1.39	0.79	0.54–1.14	1.24	0.87–1.77
< =0.077	1		1		1		1		1
PM1.0 (mg/m^3 s)
0.0101+	1.04	0.92–1.18	1.06	0.87–1.29	0.89	0.64–1.24	1.09	0.71–1.66	0.98	0.72–1.32
0.0031–0.0100	1.00	0.87–1.15	0.90	0.73–1.11	0.86	0.60–1.24	0.78	0.50–1.24	0.90	0.64–1.25
< =0.0030	1		1		1		1		1
A–trak (µm^2/cm^3)
7.7551+	1.00	0.87–1.15	1.02	0.82–1.28	0.88	0.60–1.29	1.06	0.75–1.52	1.10	0.78–1.54
4.0751–7.7550	0.87	0.77–0.98	0.92	0.75–1.11	0.93	0.67–1.30	0.86	0.63–1.17	0.81	0.60–1.08
< =4.0750	1		1		1		1		1
P–trak (particle number/cm^3)
2017+	1.08	0.93–1.26	1.03	0.81–1.30	0.97	0.65–1.45	0.96	0.66–1.41	1.12	0.77–1.62
1181–2016	1.01	0.89–1.15	0.95	0.78–1.16	1.01	0.72–1.41	0.94	0.69–1.29	0.97	0.71–1.31
< =1180	1		1		1		1		1
Nanoparticles (number/cm^3)
2121.54+	0.91	0.80–1.05	0.95	0.77–1.19	0.96	0.66–1.39	0.98	0.69–1.40	0.91	0.65–1.28
73.8611–2121.53	0.90	0.79–1.02	0.94	0.77–1.16	0.91	0.64–1.29	1.02	0.73–1.42	0.91	0.66–1.25
< =73.8610	1		1		1		1		1

β: fixed effect by exposure class, 95% CI: 95% confidence interval, bold values: statistically significant β value (p < 0.05), italic values: indicate non-significant exposure-response, p: personal sampling, s: stationary sampling.

Antilog values, adjusted TWA.

Table 6. A mixed model for inflammatory (CC16, TNF, IL-6, IL-8, IL-10, SAA, CRP) and coagulatory markers (FVIII, vWF, Fibrinogen, PAI-1, D-dimer) by cobalt in blood and urine.

Inflammatory markers
Exposure	CC16		TNF		IL-6		IL-8		IL-10
	β	95 % CI	β	95 % CI	β	95 % CI	β	95 % CI	β	95 % CI
Cobalt in blood (nmol/L)
8.01+	1.04	0.94–1.16	1.00	0.90–1.12	1.01	0.78–1.29	1.03	0.89–1.18	0.99	0.80–1.23
5.21–8.0	1.01	0.93–1.09	0.96	0.86–1.07	0.95	0.76–1.20	1.07	0.94–1.22	0.91	0.75–1.11
< =5.20	1		1		1		1		1
Cobalt in urine (nmol/L)
53.68+	0.97	0.90–1.04	1.05	0.95–1.17	1.10	0.88–1.38	1.00	0.88–1.14	1.04	0.86–1.25
25.57–53.67	0.92	0.86–0.98	1.04	0.94–1.15	1.10	0.89–1.36	0.99	0.88–1.12	1.19	1.00–1.42
< =25.56	1		1		1		1		1
Exposure	SAA		CRP
	β	95 % CI	β	95 % CI
Cobalt in blood (nmol/L)
8.01+	0.89	0.62–1.27	1.04	0.75–1.43
5.21–8.0	0.93	0.68–1.26	1.03	0.79–1.32
< =5.20	1		1
Cobalt in urine (nmol/L)
53.68+	0.99	0.74–1.33	1.00	0.79–1.26
25.57–53.67	0.89	0.68–1.66	0.95	0.77–1.17
< =25.56	1		1
Coagulatory markers
Exposure	FVIII		vWF		Fibrinogen		PAI-1		D-dimer
	β	95 % CI	β	95 % CI	β	95 % CI	β	95 % CI	β	95 % CI
Cobalt in blood (nmol/L)
8.01+	0.96	0.86–1.08	1.04	0.94–1.15	0.95	0.87–1.03	1.12	0.84–1.48	0.76	0.58–1.00
5.21–8.0	0.91	0.82–1.00	1.00	0.92–1.08	0.96	0.89–1.02	0.92	0.71–1.19	0.71	0.55–0.91
< =5.20	1		1		1		1		1
Cobalt in urine (nmol/L)
53.68+	0.98	0.89–1.07	1.03	0.96–1.10	0.93	0.88–0.99	1.06	0.82–1.37	0.93	0.72–1.0
25.57–53.67	1.01	0.93–1.09	1.01	0.95–1.07	0.96	0.91–1.02	1.03	0.81–1.30	0.94	0.73–1.19
< =25.56	1		1		1		1		1

β: fixed effect by exposure class, 95% CI: 95% confidence interval, bold values: statistically significant β value (p < 0.05).

Data availability statement

Data cannot be shared publicly due to legal restrictions imposed by Swedish Law regarding identifiable data. Data access requests can be directed to Etikprövningsmyndigheten i Uppsala (Swedish Ethical Review Authority in Uppsala): https://etikprovningsmyndigheten.se/ or [email protected].