Petter Ljungman

Petter Ljungman

Principal Researcher | Docent
Telephone: +46852487232
Visiting address: Nobels väg 13, 17177 Stockholm
Postal address: C6 Institutet för miljömedicin, C6 Miljömedicinsk epidemiologi Ljungman, 171 77 Stockholm
Part of:

About me

  • I am a cardiologist and environmental epidemiologist. I grew up in the US, Kenya, India, Chile, Italy and Sweden, experiences that have contributed to my interest in global environmental health. At KI, I am Associate Professor and Research Group Leader at the Unit of Environmental Epidemiology, Institute of Environmental Medicine, and expert coordinator at the Centre for Health Crises, in the field of extreme weather, climate and health effects. Moreover, I am a Senior Consultant of Cardiology at the Department of Cardiology Danderyd Hospital.

    I have been investigating the cardiovascular effects of air pollution exposure in national as well as in European collaborations since 2004. I completed a 2 year postdoc at Harvard Medical School, researching vascular effects of air pollution in the Framingham Heart Study. 
    My current research interests center around cardiovascular effects of environmental exposures including air pollution, ambient noise as well as ambient temperature. Recently, I am expanding air pollution research efforts into low and middle income countries that are experiencing extreme levels of air pollution and rapid urban development. Together with colleagues at Harvard and the Public Health Foundation of India, I am heading a large-scale effort to comprehensively assess PM2.5 levels across India and collaborate with Indian health researchers to conduct health association studies for a range of outcomes. I believe an important future direction is to harness the opportunities to prevent non-communicable disease through creating healthy urban environments, translating research into policy.

    CV:

    • 2016: 2+2 year Strategic Research Area (SFO) Epidemiology Assistant Professor position
    • 2015: FORTE Junior researcher grant
    • 2012: 36-month COFAS Marie Curie Research Program fellowship for postdoctoral research at Harvard Medical School and Karolinska Institutet
    • 2012-2014: Swedish Society for Medical Research (SSMF) postdoc and researcher grants
    • 2012: Swedish Heart-Lung Foundation grant
    • 2019: Associate Professor of Epidemiology
    • 2017: Assistant Professor of Epidemiology
    • 2012-2014: Post doc Cardiovascular Epidemiology Research Unit, Dep of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
    • 2012: Specialist of Cardiology
    • 2010: Specialist of Internal Medicine
    • 2009: PhD Karolinska Institutet "Cardiovascular effects of short-term exposure to air pollution"
    • 1999: Medical License
    • 1996: MD Uppsala University

Research

  • Current projects:
    AIRFIB and DANTE: Air pollution and atrial fibrillation: We are investigating associations between short-term exposure to air pollution in relation to the burden and onset of paroxysmal atrial fibrillation using handheld EKG devices as well as implanted pacemakers and defibrillators. Funded by FORTE.

    SCAC: Sources of particulate air pollution and cardiovascular and cerebrovascular disease: Using detailed dispersion models in Stockholm, Göteborg and Umeå we are investigating which local particulate matter source emissions may be most responsible for effects on mortality and incidence of ischemic heart disease and stroke. Funded by Swedish EPA.

    ELAPSE: Low-level air pollution exposure and mortality and morbidity in Europe: We are participating in a multi-center European study headed by University of Utrecht using hybrid air pollution models to study associations with mortality, cardiovascular disease, respiratory disease and cancer in the low exposure range, exploring the relevance of current air pollution standards. Funded by Horizon 2020.

    CHAIR-India: Air pollution, temperature and health in India: In this international collaboration between Karolinska Institutet, Harvard T H Chan School of Public Health and the Public Health Foundation of India, including researchers from Brown University, Boston University and Ben Gurion University of the Negev, Israel, we are setting up a comprehensive assessment model by applying machine learning algorithms to estimate daily levels of ambient fine particulate matter air pollution (PM2.5) and ambient temperature for every square kilometer across India since 2008. By linking historical air pollution estimates to existing health studies, we can then characterize the links between air pollution and temperature and different disorders such as heart and lung disease, dementia, pregnancy and birth outcomes. Financed through Formas and donations from Carl Bennet.

    MiljöSCAPIS: Road traffic noise and air pollution and cardiometabolic outcomes in the Swedish Cardio Pulmonary Imaging Study (SCAPIS). Dispersion models of air pollution and noise models will be used to understand how environmental exposures may affect the risk of atherosclerosis and metabolic disease characterised by advanced computer tomography exams in 30 000 individuals from 6 Swedish cities. Financed through FORTE.

     
    Past projects include air pollution and ventricular arrhythmias in ICD patients, cardiac arrest patients, vascular function in the Framingham Heart
    Study, and biomarkers of inflammation in myocardial infarction survivors. We have also studied the associations between ambient temperature and the risk of cardiac arrest.

    PhD supervision:

    • Auriba Raza, completed 2018, main supervisor
    • Marcus Dahlquist, completed 2023, main supervisor
    • Suganthi Jaganathan, reg 2020, halftime 2023, main supervisor
    • Federica Nobile, reg 2023, main supervisor
    • Joakim Olbers, completed 2020, co-supervisor
    • Martin Jonsson, completed 2020, co-supervisor
    • Jing Wu, completed 2023, Co-supervisor
    • Anna Zettergren, reg 2020, halftime 2023, co-supervisor
    • Charles Batte, reg 2023, co-supervisor
    • Karl Edlund Kilbo, reg 2021, halftime 2023, co-supervisor
    • Matija Maric reg 2021, co-supervisor
    • Huyen Nguyen Thi Kanh, reg 2023, co-supervisor
    • Shajan Shekarestan, reg 2022, co-supervisor

    Postdoc supervision

    • Åsa Persson 2021-2023
    • Jeroen de Bont 2021-

    Master students

    • Marcus Dahlquist 2007
    • Susanna Viita 2019
    • Nabeel Aziz 2022

Articles

All other publications

Grants

  • Swedish Research Council for Health Working Life and Welfare
    1 October 2023 - 30 September 2029
    Research problem and specific questions: Strong evidence links high outdoor temperatures to increased population morbidity, but little is known about the relationship between heat exposure indoors and its impact on health. Presently, no empirically supported recommendations regarding an upper indoor temperature threshold for health exist. Defining such a threshold is important as without this it will be difficult to establish any regulatory requirements that ensure that future buildings are sufficiently resilient to warmer summers. As the frequency of heat waves increases, understanding the sensitivity of different dwellings to outdoor temperature, especially in homes occupied by the elderly, is critical. This collaboration programme between six Swedish Universities aims to establish an evidence-based upper indoor temperature threshold for wellbeing
    identify dwelling-specific characteristics that are most likely to increase the risk of heat-related illness, develop a temperature sensitivity regression model for indoor temperature prediction, and visualise area-level heat-vulnerability of the buildings on interactive maps, made available for a wide variety of endusers.Data and method: We aim to collect indoor temperature and humidity data, self-reported information about sleep quality, mental and physical health, as well as dwelling-specific characteristics from 4,000 adults across Sockholm, Malmö, Göteborg and Umeå during summer months, 2024-2027, by using temperature loggers, automatic text messages and electronic questionnaires. Physiological health data will be collected from 400 senior citizens by using Actiheart-5, activity, heart rate and sleep monitors. The associations between indoor temperatures and physical and mental health outcomes will be examined by multiple regression models. A model for prediction of indoor temperatures in different types of buildings will be developed by fitting the collected indoor temperature data to a modified energy balance model.Relevance and utilisation: The sustainability of housing policy includes ensuring access to a healthy indoor environment for all socio-economic groups. Being able to predict how different buildings are likely to respond to high outdoor temperatures is important for mitigating their potentially harmful impact. The present programme aims to fill the gaps in knowledge regarding the role that different building characteristics play in personal temperature exposure and visualise these problems on interactive maps for wider public, which is important for improving heat epidemiology, preparing prevention programmes.Plan for programme realisation: The data will be collected during four summers, after which model development and data analyse will be conducted. Regular research group and stakeholder meetings will be held. Programme costs include salaries for a research assistant and statistician, costs for technical devices, as well as postal costs for the distribution of temperature loggers.
  • Swedish Research Council for Health Working Life and Welfare
    1 October 2023 - 30 September 2029
    Research problem and specific questionsUrban living environments challenge the individual’s capacity to maintain a good health throughout the course of life. In Sweden, current trends in housing and neighborhood conditions tend to further increase disparities in health. The rapid urbanization and densification of Stockholm County makes it an optimal setting for studying health effects of urban living, for example in relation to air quality, transportation noise, urban greenness, climate change and overcrowded housing. In this program, we aim to assess and develop strategies for building a sustainable city promoting equitable public health among inhabitants of urbanized areas.Data and methodsThe program will use a variety of different data materials and methods. To map environmental hazards in Stockholm County, a new GIS-based tool aimed at regional stakeholders will be developed. A new cohort, based on the National Environmental Health Survey 2023, will form the basis for analyses of environmental health associations and estimates of disease burden. Furthermore, the effects on children’s development, education and health from overcrowded housing will be investigated in a nation-wide cohort study and in an intervention setting. In a literature review, we will summarize evidence on environmental interventions which can guide stakeholders in implementing planning and mitigation measures.Relevance and utilizationThe national Commission for Equity in Health listed 7 key areas of life which determine health inequalities. Among these, the intended program has a focus on Housing and neighborhood conditions but is also of relevance for aspects of Early life development, Health behavior, and Control, influence and participation. By this program, we aim to establish a strong research infrastructure for monitoring and assessing the impact of the built environment on public health and for the promotion of environmental health equity. This is in line with several other initiatives and governing documents within Sweden, e.g. “Health as a driving force for the environmental goals and sustainable development”, initiated by Miljömålsrådet.Plan for program realizationThe program will be carried out at the Institute of Environmental Medicine, Karolinska Institutet, in collaboration with the Center for Occupational and Environmental medicine, Region Stockholm, and builds on six different work packages, each with its specific aims, activities, and deliverables. The researchers of the program represent many different disciplines, spanning from environmental medicine, public health and epidemiology to GIS, nursing and multicultural psychiatry, and will work closely together in the different work-packages. To ensure a good dialogue with end-users of our research, we will host, and take part in, an array of activities throughout the program progression, e.g. via reference groups, seminars, workshops, regional networks and other applied activities.
  • Dwelling vulnerability in a changing climate: Indoor heat exposure and public health
    Forte
    1 October 2023 - 30 September 2029
    Research problem and specific questions: Strong evidence links high outdoor temperatures to increased population morbidity, but little is known about the relationship between heat exposure indoors and its impact on health. Presently, no empirically supported recommendations regarding an upper indoor temperature threshold for health exist. Defining such a threshold is important as without this it will be difficult to establish any regulatory requirements that ensure that future buildings are sufficiently resilient to warmer summers. As the frequency of heat waves increases, understanding the sensitivity of different dwellings to outdoor temperature, especially in homes occupied by the elderly, is critical. This collaboration programme between six Swedish Universities aims to establish an evidence-based upper indoor temperature threshold for wellbeing
    identify dwelling-specific characteristics that are most likely to increase the risk of heat-related illness, develop a temperature sensitivity regression model for indoor temperature prediction, and visualise area-level heat-vulnerability of the buildings on interactive maps, made available for a wide variety of endusers. Data and method: We aim to collect indoor temperature and humidity data, self-reported information about sleep quality, mental and physical health, as well as dwelling-specific characteristics from 4,000 adults across Sockholm, Malmö, Göteborg and Umeå during summer months, 2024-2027, by using temperature loggers, automatic text messages and electronic questionnaires. Physiological health data will be collected from 400 senior citizens by using Actiheart-5, activity, heart rate and sleep monitors. The associations between indoor temperatures and physical and mental health outcomes will be examined by multiple regression models. A model for prediction of indoor temperatures in different types of buildings will be developed by fitting the collected indoor temperature data to a modified energy balance model. Relevance and utilisation: The sustainability of housing policy includes ensuring access to a healthy indoor environment for all socio-economic groups. Being able to predict how different buildings are likely to respond to high outdoor temperatures is important for mitigating their potentially harmful impact. The present programme aims to fill the gaps in knowledge regarding the role that different building characteristics play in personal temperature exposure and visualise these problems on interactive maps for wider public, which is important for improving heat epidemiology, preparing prevention programmes. Plan for programme realisation: The data will be collected during four summers, after which model development and data analyse will be conducted. Regular research group and stakeholder meetings will be held. Programme costs include salaries for a research assistant and statistician, costs for technical devices, as well as postal costs for the distribution of temperature loggers.
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2023 - 31 December 2025
    Research problem and specific questionsOccupational noise affects a large number of the workforce in Sweden and globally. Cardiometabolic diseases such as diabetes, metabolic syndrome and cardiovascular illness are prevalent with substantial consequences for the individual and society. While there is growing evidence on the detrimental effects of occupational noise on cardiometabolic health, the mechanisms are still unclarified, also given the influence of social vulnerability. To understand how occupational noise affects cardiometabolic health, we will apply multiple exposure rationale, focusing on biopsychosocial mechanisms. Specific research questions are: Is occupational noise associated with cardiometabolic diseases (diabetes, metabolic syndrome)? How can an early-stage association be identified, using biomarkers of unhealthy fat-glucose metabolism? What roles do occupational psychosocial stressors, sleep quality and social vulnerability have in these associations?Data and methodWe will use unique data from the SCAPIS cohort with over 30,000 participants aged between 50 and 64, in Sweden. The data includes extensive clinical and laboratory measurements of cardiometabolic health, and questionnaire data covering self‐reported health, occupational and environmental exposures, lifestyle factors and socioeconomic status. A subsample (n=5300) of SCAPIS has occupational history available, allowing retrospective analyses of exposure. Registry data on diabetes 3-5 years after baseline will be used to strengthen causality inferences. We will use different analytical approaches: cross-sectional, retrospective, and prospective.Plan for project realizationThis research project will be developed on a three-year structure. Data is already collected, although extensive data management will be required. Other steps include advanced data analysis, reporting and communication with stakeholders. The research group is multi-disciplinary including expertise in areas of psychology, medicine, acoustics, epidemiology, statistics, occupational health and public health.RelevanceThis project relates to Forte’s areas of responsibility health/working life and is aligned with the goal to achieve equal health and sustainable working life. Our findings will clarify biopsychosocial mechanisms from occupational noise to cardiometabolic health, assisting in new preventive strategies. The focus on social vulnerability will inform policies targeting specific groups and working conditions.
  • Swedish Research Council for Environment Agricultural Sciences and Spatial Planning
    1 January 2023 - 31 December 2025
    To meet the sustainable development goals (SDG) for “good health and well-being (SDG3)”, it is important to reduce the morbidity and mortality attributed to cardiovascular diseases (CVD) as CVD is the first cause of death globally. It is increasingly recognized that air pollution and noise may affect CVD, providing important opportunities for community intervention by reshaping urban environments to create healthier and sustainable cities (SDG11). However, most previous studies have reported the effect of air pollution and noise on CVD individually without accounting for the interaction/combined effect of these exposures, especially within the urban context, known as the urban exposome. APNOI-CARDIO will evaluate the role of the complex mixture of air pollution and noise for CVD within the urban exposome. APNOI-CARDIO will exploit large resources of longitudinal studies from multiple countries in Europe. Geographic information system technologies will be applied to estimate multiple urban environment exposures using uniform high- resolution exposure modelling across Europe. In addition, innovative statistical approaches will be applied to evaluate how air pollution and noise interact within the urban exposome, and focusing on whether changing residential address can have a long-term impact on CVD. This project has the unique opportunity to improve cardiovascular health linked to environmental deterioration by providing new evidence to guide better preventive policies.
  • Swedish Research Council for Environment Agricultural Sciences and Spatial Planning
    1 January 2023 - 31 December 2025
    Cardiovascular and metabolic diseases (CMD) remain the leading cause of morbidity and mortality globally, including myocardial infarction, stroke and type 2 diabetes. Although young people are not typically affected by CMD, the risk factors for these conditions are present during the early years of life, affecting long-term disease risk and the disease burden in the adulthood. Air pollution, transportation noise, and greenness are among the modifiable risk factors that may influence cardiometabolic health. Previous research on causes of CVD often focuses on single risk factors while effects from multiple environmental exposures in young adults are understudied. This project aims to investigate how air pollution, transportation noise and neighborhood greenness contribute to the development of a wide range of early markers of CMD and to elucidate characteristics that may modify the relation between environmental exposures and CMD traits. The project will be based on the prospective population-based birth cohort BAMSE comprising 4000 individuals followed from birth up to young adulthood with repeated questionnaires and extensive clinical investigations. Exposure to environmental factors is estimated based on residential address history. The results of the project will serve as a basis for policy makers in decision making processes, particularly related to environmental policies and urban planning as well as for individual risk assessment and prevention in clinical practice.
  • Swedish Research Council
    1 January 2021 - 31 December 2024
  • Swedish Research Council for Environment Agricultural Sciences and Spatial Planning
    1 August 2020 - 31 July 2024
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2020 - 31 December 2022
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2020 - 31 December 2022
  • Swedish Research Council for Health Working Life and Welfare
    1 December 2017 - 30 November 2020
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2016 - 31 December 2019
  • Swedish Research Council for Health Working Life and Welfare
    1 August 2012 - 31 July 2015

Employments

  • Principal Researcher, Institute of Environmental Medicine, Karolinska Institutet, 2021-

Degrees and Education

  • Docent, Karolinska Institutet, 2019
  • Degree Of Doctor Of Philosophy, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 2009

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