A platform for collaborations in respiratory research in Sweden
Anchor: intro


Respiratory Health In Northern Europe (RHINE) is a longitudinal study of respiratory health and allergy including 6 centres in Northern Europe: Reykjavik, Bergen, Aarhus, Tartu, Gothenburg, Umeå and Uppsala. The study started in 1990 and included randomly selected adults from 20-44 years of age. The participants have been reinvestigated in 2000, 2010 and 2022.

The study is conducted by questionnaire but a subsample has also undergone repeated clinical investigations as part of the European Community Respiratory Health Survey (ECRHS) which also included centres from other parts of Europe, Australia and the United States.

The study also includes information from national registers such as use of medication, cause of death, hospital care and pregnancies. Information on the current and historical address have been used to model air pollution and greenness.

The clinical investigation includes spirometry, exhaled nitric oxide, inflammatory markers, allergy testing and measures of bronchial responsiveness. The study has also expanded its population by including children of the participants in the RHINESSA cohort.

RHINE is not divided in different subprojects but different aspects of respiratory health are examines such as associations to: gastroesophageal reflux, cough, sleep disorders, associations with inflammatory bowel disease, obesity, air pollution, noise and greenness. Proposals for analyses are submitted to a group consisting of one PI and one co-PI from each centre.

Anchor: Investigators and study personnel


• Christer Janson, Andrei Malinovschi, Össur Emilsson and Eva Lindberg, Uppsala University
• Lars Modig, Bertil Forsberg, Karl Franklin, Umeå University
• Mathias Holm, Kjell Torén, University of Gothenburg
• Anne Johannessen, Cecilie Svanes, Francisco Gomez Real, Randi Jacobsen Bertelsen, University of Bergen
• Vivi Schlünssen, Torben Sigsgaard, University of Aarhus
• Thorarinn Gislason, Bryndis Benediktsdottir, University of Iceland
• Rain Jõgi, Tartu University

Anchor: Responsible university or institution

Responsible university or institution

Uppsala University
University of Gothenburg
Umeå University
University of Bergen
Aarhus University
University of Iceland
Tartu University

Anchor: Collaborators


The BOLD study
The GA2LEN study
Thermo Fisher Scientific, Sweden
The EPHOR consortium
The ALEC consortium
• The Metahealth consortium

Anchor: Funders


Anchor: Collaborate with RHINE

How to collaborate with RHINE

Contact one of the contact persons below with proposals.

Anchor: contacts

Contact information

Christer Janson

Andrei Malinovschi

Lars Modig

Mathias Holm

Ane Johannessen

Cecilie Svanes

Thorarinn Gislason

Vivi Schlünssen

Rain Jögi

Anchor: publications

Key publications

Janson C, Johannessen A, Franklin K, Svanes C, Schiöler L, Malinovschi A, Gislason T, Benediktsdottir B, Schlunssen V, Jogi R, Jarvis D, Lindberg E. Change in the prevalence asthma, rhinitis and respiratory symptom over a 20 year period: associations to year of birth, life style and sleep related symptoms. BMC Pulm Med. 2018 Sep 12;18:152.

Janson C, Accordini S, Cazzoletti L, Cerveri I, Chanoine S, Corsico A, Ferreira DS, Garcia-Aymerich J, Gislason D, Nielsen R, Johannessen A, Jogi R, Malinovschi A, Martinez-Moratalla Rovira J, Marcon A, Pin I, Quint J, Siroux V, Almar E, Bellisario V, Franklin KA, Gullón JA, Holm M, Heinrich J, Nowak D, Sánchez-Ramos JL, Weyler JJ, Jarvis D. Pharmacological treatment of asthma in a cohort of adults during a 20-year period: results from the European Community Respiratory Health Survey I, II and III. Eur Respir J Open Reearch 2019; 5: pii: 00073-2018.

Emilsson ÖI, Hägg SA, Lindberg E, Franklin KA, Toren K, Benediktsdottir B, Aspelund T, Gómez Real F, Leynaert B, Demoly P, Sigsgaard T, Perret J, Malinovschi A, Jarvis D, Garcia-Aymerich J, Gislason T, Janson C. Snoring and nocturnal reflux: Association to lung function decline and respiratory symptoms. Eur Respir J Open Res 2019; 5:00010-2019.

Wang J, Pindus M, Janson C, Sigsgaard T, Kim JL, Holm M, Sommar J, Orru H, Gislason T, Johannessen A, Bertelsen RJ, Norbäck D. Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis. Eur Respir J 2019; 53: pii: 1801921.

Janson C, Malinovschi A, Amaral AFS, Accordini S, Bousquet J, Sonia Buist A, Canonica GW, Dahlén B, Garcia-Aymerich J, Gnatiuc L, Kowalski ML, Patel J, Tan W, Torén K, Zuberbier T, Burney P, Jarvis D. Bronchodilator reversibility in asthma and COPD: Findings from three large population studies. Eur Respir J 2019;54: pii: 1900561.

Ekbom E, Quint J, Schöler L, Malinovschi A, Franklin K, Holm M, Torén K, Lindberg E, Jarvis D, Janson C. Asthma and treatment with inhaled corticosteroids: associations with hospitalisations with pneumonia. BMC Pulm Med 2019; 19:254.

Blöndal V, Sundbom F,  Borres MP, Högman M, Alving K,  Malinovschi A, Janson C. Study of atopic multimorbidity in subjects with rhinitis using multiplex allergen component analysis. Clin Transl Allergy 2020;10:6.

Wang J, Janson C, Lindberg E, Holm M,  Gislason T, Benediktsdóttir B, Johannessen A, Schlünssen V, Jogi R,  Franklin KA, Norbäck D. Dampness and mold at home and at work and onset of insomnia symptoms, snoring and excessive daytime sleepiness. Environ Inter 2020; 139:105691.

Lindberg E, Janson C, Johannessen A, Svanes C, Real FG, Malinovschi A, Franklin KA, Holm M, Schlünssen V, Jogi NO, Gislason T, Benediktsdóttir B. Sleep time and sleep-related symptoms across two generations – results of the community-based RHINE and RHINESSA studies. Sleep Med 2020; 69:8-13.

Amid Hägg S, Ljunggren M, Janson C, Holm M, Franklin K, Gislason T, Johannessen A, Jõgi R, Olin AC, Schlünssen V, Lindberg E. Smokers with insomnia symptoms are less prone to stop smoking. Respir Med 2020; 170:106069.

Mogensen I, Vonk J, Wijnant S, Zhou X, Boezen HM, Brusselle G, Lahousse L, Janson C, Malinovschi A. Blood eosinophil level and lung function trajectories – cross-sectional and longitudinal studies in European cohorts. Eur Respir J Open Res 2020; 6: 00320-2020.

Nerpin E, Ferreira DS, Weyler J, Schlunnsen V, Jogi R, Raherison Semjen C, Gislasson T, Demoly P, Heinrich J, Nowak D, Corsico A, Accordini S, Marcon A, Squillacioti G, Olivieri M, Nielsen R, Johannessen A, Gómez Real F, Garcia-Aymerich J, Urrutia I, Pereira-Vega A, Gullón JA, Olin AC, Forsberg B, Emilsson ÖI, Pin I, Jarvis D, Janson C, Malinovschi A. Bronchodilator response and lung function decline – associations with exhaled nitric oxide with regard to sex and smoking status. World Allergy Org J 2021; 14(5):100544.

Kisiel M, Zhou X, Björnsson E, Holm M, Dahlman-Höglund A, Wang J, Svanes C, Norbäck D, Franklin KA, Malinovschi A, Johannessen A, Schlünssen V, Janson C. The risk for respiratory infections and antibiotic use in a general population and among asthmatics. ERJ Open Res 2021;7:00429-2021.

Krantz C, Krantz C, Accordini S, Alving K, Corsico AG, Demoly P, Ferreira DS, Forsberg B, Garcia-Aymerich J, Gislason T, Heinrich J, Jõgi R, Johannessen A, Leynaert B, Marcon A, Martínez-Moratalla Rovira J, Nerpin E, Nowak D, Olin AC, Olivieri M, Pereira-Vega A, Raherison-Semjen C, Real FG, Sigsgaard T, Squillacioti G, Janson C, Malinovschi A. Cross-sectional study on exhaled nitric oxide in relation to upper airway inflammatory disorders with regard to asthma and perennial sensitisation. Clin Exp Allergy 2022; 52:297-311.

Ekström M, Johannessen A, Abramson MJ, Benediktsdottir B, Franklin K, Gislason T, Gómez Real F, Holm M, Janson C, Jogi R, Lowe A, Malinovschi A, Martínez-Moratalla J, Oudin A, Sánchez-Ramos JL, Schlünssen V, Svanes C. Breathlessness across generations: results from the RHINESSA generation study. Thorax 2022;77(2):172-177.

Svanes C, Johannessen A, Bertelsen R, Dharmage SC, Malinovschi A, Bråbäck L, Holm M, Jogi NO, Martinez- Moratalla J, Sanchez JL, Janson C, Real F, Schlünssen V. Cohort profile: The multi-generation Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) cohort. BMJ Open 2022; 12:e059434.

Heldin J, Malinovschi A, Johannessen A, Alving K, Holm M, Franklin KA , Forsberg B, Schlünssen V, Jögi R, Gislason T, Benediktsdottir B, Svanes C, Janson C. Clinical remission of asthma and allergic rhinitis – in a longitudinal population study. J Asthma Allergy 2022; 15:1569–1578.

Wang J, Janson C, Malinovschi A, Holm M, Franklin KA, Modig L, Johannessen A, Schlünssen V, Gislason T, Jogi NO, Norbäck D. Asthma, allergic rhinitis and atopic dermatitis in association with home environment – The RHINE study. J Sci Total Environ 2022; 853:158609.

Blöndal V, Sundbom F, Zhou X, Moverare R, Borres MP, Högman; Alving K Malinovschi A, Janson C. Allergic sensitisation and type-2 inflammation is associated with new-onset and persistent allergic disease. Clin Transl Allergy 2023; 13:e12240.

Kisiel MA, Arnfelt O, Lindberg E, Jogi O, Malinovschi A, Johannessen A, Benediktsdottir B, Franklin K, Holm M, Real FG, Sigsgaard T, Gislason T, Modig L, Janson C. Association between abdominal and general obesity and respiratory symptoms, asthma and COPD. Results from the RHINE study. Respir Med 2023; 211:107213.

Anchor: links


WSAS – West Sweden Asthma Study at the University of Gothenburg
Krefting Research Centre