Date of filling in this questionnaire or last update: 21/09/2020
Cohort name
  SNOW - Swedish National Cohort on Work and Health

  • Sweden

Please provide any other information on the cohort location/s if needed
  Jenny Selander
  Institute of Environmental Medicine, Karolinska Institutet
  +46 8 524 800 29
Name of committee
  Regional ethical committ√© in Stockholm
Contact Principal Investigator (name)
  Jenny Selander
Participation in pooled analyses

  • The cohort is potentially interested in participating in pooled analyses of (European) occupational cohort studies (note pooled analyses also includes remote decentralized analyses that would not require any transfer of primary data as well as meta-analyses).

Study design (please select as many as appropriate)

  • Prospective cohort

Source population (please select as many as appropriate)

  • General population: National

Comparators (please select as many as appropriate)

  • External comparison of workers with other exposure

Inclusion criteria
  All residents in Sweden born between 1930 and 1990
Age range at entry (main cohort)

Minimum Maximum Mean
16 40

Men at enrollment
Women at enrollment
Men at last follow-up
Women at last follow-up
Participation rate at enrollment (if known)
  Registry based cohort of all women and men born between 1930 and 1990 that are occupationally active. The cohort is also connected by personal identification number with tree sub cohorts where physical measurements and lifestyle factors are available.The cohort have been collected and is under data management.
Type of data for outcome follow-up (please select as many as appropriate)

  • Death certificate
  • Disease incidence records
  • Hospital / physician diagnoses
  • Use of registers (specify)

Death certificate (specify)

  • Cause of death register

Disease incidence records (specify)

  • National patient registers

Hospital / Physician diagnoses (specify)

  • National patient registers

First follow-up period (provide year)
Last follow-up period (provide year)
Number of follow-ups after baseline (provide number)
  every year.
Participation at last follow-up (if known)
Source of exposure data collected (please select as many as appropriate)

  • Job-employment records
  • Registry-based

Occupational history/time frame
Occupational coding performed
Occupation (specify coding system used)

  • FOB80, FOB85/90, SSYK96 (ISCO-88), SSYK12 (ISCO-08)

Types of exposure measurements

  • Biomarkers (see also section 5)

Methods for exposure assessment (please select as many as appropriate)

  • Job Exposure Matrix


  • Other

Specify: Job Exposure Matrix / Other
Main categories

  • Dusts and fibres
  • Solvents
  • Pesticides
  • Metals and metal oxides
  • Other chemicals
  • Biological factors
  • Physical agents
  • Ergonomics, physical workload, and injury related
  • Psychosocial domains
  • Organisation of work including working time

Dusts and fibres | Fibres

  • Asbestos (any form of asbestos chrysotile, crocidolite, tremolite, anthophyllite, etc. or asbestos-containing material)

Dusts and fibres | Inorganic dusts

  • Cement
  • Inorganic dusts, not specified
  • Quartz (quartz or crystalline silica containing dusts)
  • Stone (Natural or Artificial)

Dusts and fibres | Organic dusts

  • Animal dust (from living animals or hairs of animals, e.g. raw wool, furs of minks, etc.)
  • Flour dust
  • Leather dust
  • Organic dusts (not specified)
  • Textile dust
  • Wood dust (not specified)

Solvents | Aromatic hydrocarbon solvents

  • Benzene

Metals and metal oxides

  • Iron (metallic iron and all compounds)
  • Lead and all compounds

Other chemicals | Oil mist

  • Synthetic metal processing or drilling oils or fluids

Other chemicals | Polycyclic aromatic hydrocarbons (PAHs)

  • Asphalt/Bitumen fumes
  • Benzo(a)pyrene
  • Bitumen fumes

Physical agents

  • Cold
  • Hand-arm vibration
  • Heat
  • Noise
  • Whole body vibration

Ergonomics, physical workload, and injury related

  • Awkward work postures (e.g. kneeling/squatting, elevated arms, neck flection, back bent forward without support)
  • Physical work load (e.g. heavy lifting of people or objects, pushing/pulling)
  • Repetitive work movements
  • Sedentary work
  • Standing work

Psychosocial domains | Job task characteristics/organization of work

  • Effort-reward imbalance (ERI)
  • Job control, autonomy
  • Psychological job demands
  • Role conflict/ambiguity/clarity
  • Social support at work from supervisors
  • Skill use opportunities
  • Work engagement

Organisation of work including working time | Employment conditions

  • Size of the workplace and company

Baseline - type of outcome data collected (select more than one if applicable)

  • Biomarker (specify)
  • Clinical/functional evaluation, e.g. spirometry, ECGs (specify)
  • Death certificates
  • Medical records
  • Registry-based

Specify: Clinical/functional evaluation, e.g. spirometry, ECGs
  subsample have clinical examination
Specify: Biomarker
  subsample have biomarkers, blood samples

  • Birth register
  • Cancer incidence
  • Disease specific clinical database
  • Employment status
  • Hospital discharge
  • Medication usage
  • Mortality register
  • Migration
  • Other

Specify: Other
  a lot more....
Follow-up - type of outcome data collected (select more than one if applicable)

  • Biomarker (specify)
  • Clinical/functional evaluation, e.g. spirometry, ECGs (specify)
  • Death certificates
  • Medical records
  • Registry-based

Specify: Clinical/functional evaluation, e.g. spirometry, ECGs
  for subsample
Specify: Biomarker
  for subsample

  • Birth register
  • Cancer incidence
  • Disease specific clinical database
  • Employment status
  • Hospital discharge
  • Medication usage
  • Mortality register
  • Migration
  • Other

Specify: Other
  a lot more registies
Outcome type (please select as many as appropriate)

  • Mortality
  • Morbidity

Diagnostic groups based on ICD10

  • C + D Neoplasms
  • E Endocrinological disease
  • E Metabolism disease
  • F Mental disorders
  • G Disease in the nervous system
  • H Disorders of the ear
  • I Heart disease
  • I Cerebrovascular diseases
  • J Respiratory disease
  • O+P Pregnancy and labour
  • Other (specify)

Other (specify)
  can attach more outcome measures if needed
C + D Neoplasms

  • Benign neoplasm
  • Carcinoma in situ
  • Leukemia
  • Malignant neoplasms gastro intes. system including liver, gall bladder, pancreas
  • Malignant neoplasm lung
  • Mesothelioma
  • Other malignant neoplasm of respiratory and intrathoracic organs, heart, pleura
  • Malignant neoplasm of bone and articular cartilage
  • Melanoma and other malignant neoplasms of skin
  • Neoplasms connective and soft tissue including nerves
  • Malignant neoplasm of breast
  • Malignant neoplasms, females gynecological
  • Malignant neoplasms of male genital organs
  • Malignant neoplasm of urinary tract and kidney
  • Malignant neoplasms of eye, brain and other parts of central nervous system
  • Malignant neoplasms of thyroid and other endocrine glands
  • Malignant neoplasms of ill-defined, secondary and unspecified sites
  • Malignant neoplasm without specification of site including excl. leukemia
  • Other, please state

E Endocrinological disease

  • Thyroidea
  • Parathyroidea
  • Diabetes mellitus
  • Pituitary
  • Other endocrinological disease
  • Adrenogenital disorders
  • Testicular dysfunction
  • Other, please state

E Metabolism disease

  • Disorder of amino-acid metabolism, unspecified
  • Lactose intolerance
  • Disorders of sphingolipid metabolism and other lipid storage disorders
  • Disorders of glycosaminoglycan and glucoprotein metabolism metabolism
  • Disorders of lipoprotein metabolism and other lipidaemias
  • Hypercholesterolemia
  • Disorders of purine and pyrimidine metabolism
  • Disorders of porphyrin and bilirubin metabolism
  • Disorders of mineral metabolism
  • Cystic fibrosis
  • Other, please state

F Mental disorders

  • Dementia
  • Personality and behavioural disorders
  • Schizophrenia
  • Mood [affective] disorders
  • Depression
  • Eating disorders
  • Mental retardation
  • Disorders of psychological development including autism and Aspergers syndrome
  • Other mental disorder, not otherwise specified
  • Other, please state

G Disease in the nervous system

  • Infectious diseases of the central nervous system
  • Non-infectious encephalitis, myelitis and encephalomyelitis
  • Intracranial and intraspinal abscess and granuloma
  • Systemic atrophies primarily affecting the central nervous system including
  • Huntington's disease and Hereditary ataxia
  • Spinal muscular atrophy and related syndromes
  • Parkinson's disease
  • Dystonia
  • Alzheimer's disease
  • Other degenerative disorders of nervous system in diseases classified elsewhere
  • Multiple sclerosis
  • Epilepsy
  • Migraine
  • Sleep disorders
  • Facial nerve disorders
  • Disorders of other cranial nerves
  • Nerve root and plexus disorders
  • Carpal tunnel syndrome
  • Lesion of ulnar nerve
  • Lesion of radial nerve
  • Other mononeuropathies
  • Polyneuropathies and other disorders of the peripheral nervous system
  • Myasthenia gravis and other myoneural disorders
  • Muscular dystrophy
  • Muscular myopathy
  • Cerebral palsy and other paralytic syndromes
  • Toxic encephalopathy
  • Hydrocephalus
  • Other, please state

H Disorders of the ear

  • Diseases of middle ear and mastoid
  • Diseases of inner ear
  • Other, please state

I Heart disease

  • Rheumatic heart disease, unspecified
  • Hypertensive diseases
  • Angina pectoris
  • Acute myocardial infarction
  • Atrial septal defect
  • Chronic ischaemic heart disease
  • Pulmonary embolism
  • Other pulmonary heart diseases
  • Nonrheumatic mitral valve disorders
  • Pulmonary valve disorders
  • Endocarditis
  • Myocarditis
  • Cardiomyopathy
  • Atrioventricular arrhythmia
  • Heart failure
  • Other, please state

I Cerebrovascular diseases

  • Subarachnoid haemorrhage
  • Intracerebral haemorrhage
  • Cerebral infarction
  • Stroke, not specified as haemorrhage or infarction
  • Atherosclerosis
  • Aneurysm and dissection
  • Raynaud's syndrome
  • Thromboangiitis obliterans [Buerger]
  • Arterial embolism and thrombosis
  • Phlebitis and thrombophlebitis
  • Haemorrhoids
  • Oesophageal varices
  • Varicose veins of other sites
  • Lymphadenitis
  • Hypotension
  • Other, please state

J Respiratory disease

  • Acute upper respiratory infections of multiple and unspecified sites
  • Influenza
  • Viral pneumonia
  • Bacterial pneumonia
  • Pneumonia due to other infectious organisms, not elsewhere classified
  • Abscess of lung and mediastinum
  • Pyothorax
  • Acute bronchitis
  • Acute bronchiolitis
  • Vasomotor and allergic rhinitis
  • Chronic rhinitis, nasopharyngitis and pharyngitis
  • Chronic sinusitis
  • Nasal polyp
  • Chronic diseases of tonsils and adenoids
  • Diseases of vocal cords and larynx, not elsewhere classified
  • Chronic Bronchitis
  • Emphysema
  • Chronic obstructive pulmonary disease (COPD)
  • Asthma
  • Byssinosis
  • Bronchiectasis
  • Pneumoconiosis
  • Hypersensitivity pneumonitis due to organic dust
  • Other interstitial lung disease
  • Adult respiratory distress syndrome
  • Pulmonary edema
  • Pneumothorax
  • Respiratory failure, not elsewhere classified
  • Other, please state

O+P Pregnancy and labour

  • Oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium
  • Eclampsia in pregnancy, labour or puerperium
  • Excessive vomiting in pregnancy
  • Venous complications in pregnancy
  • Infections of genito-urinary tract in pregnancy
  • Diabetes mellitus in pregnancy
  • Malnutrition in pregnancy
  • Other specified pregnancy-related conditions
  • Complications of labour and delivery
  • Preterm delivery
  • Extremely low birth weight
  • Other low birth weight
  • Exceptionally large baby
  • Birth trauma
  • Congenital viral diseases
  • Foetal death of unspecified cause
  • Other, please state

Biological samples collected

  • Blood

  only a subsample, that belong to the WOLF-cohort
6. Other Information

  • Anthropometry
  • Demographics
  • Education
  • Medical history
  • Socioeconomic status
  • Smoking

Possibility for linkage to data registries/data enrichment via data linkage

  • Birth register
  • Cancer incidence
  • Disease specific clinical database
  • Employment status
  • Hospital discharge
  • Medication usage
  • Migration
  • Mortality register
  • Other (specify)

Please describe plans that are funded or most likely to be funded
  follow-up until 2060.