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Objectives Health effects associated with air pollution at exposure levels below toxicity may not be directly related to level of exposure, but rather mediated by perception of the air pollution and by top-down processing (e.g., beliefs that the exposure is hazardous). The aim of the study was to test a model that describes interrelations between odorous air pollution at non-toxic exposure levels, perceived pollution, health risk perception, annoyance and health symptoms. Methods A population-based questionnaire study was conducted in a Swedish community of residents living near a biofuel facility that emitted odorous substances. Individuals aged 18–75 years were selected at random for participation ( n  = 1,118); 722 (65 %) agreed to participate. Path analyses were performed to test the validity of the model. Results The data support a model proposing that exposure level does not directly influence annoyance and symptoms, and that these relations instead are mediated by perceived pollution and health risk perception. Conclusions Perceived pollution and health risk perception play important roles in understanding and predicting environmentally induced annoyance and health symptoms in odorous environments at non-toxic levels of exposure.

Objective The aim was to study the impact of metabolic syndrome on the risk for disability pension among Swedish employees. Methods A working population-based prospective cohort [Work, Lipids and Fibrinogen (WOLF) cohort, N=10 803], was linked to national registry records of all-cause disability pension for the period 1992-2013. Occupational health service data included 1992-2009 anthropometric measurements, blood samples, and questionnaires. Metabolic syndrome was defined according to International Diabetes Federation criteria, and risk for any all-cause disability pension was analyzed using Cox proportional hazard regression as hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age, sex and other covariates. Results Of the employees, 17.9% (men 21.5%, women 9.7%) met the criteria for metabolic syndrome. The prevalence of all-cause disability pension was 15.2% in men with metabolic syndrome and 7.5% in men without metabolic syndrome; for women, the corresponding results were 23.2% and 12.7%. After adjustment for socio-demographic factors, health behaviors, work-related factors, diabetes, and obesity, the risk for all-cause disability pension among subjects with metabolic syndrome displayed an HR of 1.37 (95% CI 1.18-1.60). Results were similar for men and women. In a subgroup, further adjustment for chronic diseases resulted in an HR of 1.32 (95% CI 1.04-1.68). Conclusion This study demonstrates an increased risk for all-cause disability pension, even after adjustment for other risk factors, among Swedish employees with metabolic syndrome compared to those without at baseline.