| 1. |
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| 2. |
- Andersson, Lena, et al.
(författare)
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Estimating trends in quartz exposure in Swedish iron foundries : predicting past and present exposures
- 2012
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Ingår i: Annals of Occupational Hygiene. - Oxford, United Kingdom : Oxford University Press. - 0003-4878 .- 1475-3162. ; 56:3, s. 362-372
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Tidskriftsartikel (refereegranskat)abstract
- Background: Swedish foundries have a long tradition of legally required surveys in the work place that, from the late 1960s onwards, included measurements of quartz. The availability of exposure data spanning almost 40 years presents a unique opportunity to study trends over that time and to evaluate the validity of exposure models based on data from shorter time spans. The aims of this study were (i) to investigate long term trends in quartz exposure over time, (ii) using routinely collected quartz exposure measurements to develop a mathematical model that could predict both historical and current exposure patterns, and (iii) to validate this exposure model with up-to-date measurements from a targeted survey of the industry.Methods: Eleven foundries, representative of the Swedish iron foundry industry, were divided into three groups based on the size of the companies, i.e. the number of employees. A database containing 2333 quartz exposure measurements for 11 different job descriptionswas used to create three models that covered time periods which reflected different work conditions and production processes: a historical model (1968– 1989), a development model (1990–2004), and a validation model (2005–2006). A linear mixed model for repeated measurements was used to investigate trends over time. In all mixed models, time period, company size, and job title were included as fixed (categorical) determinants of exposure. The within- and between-worker variances were considered to be random effects. A linear regression analysis was erformed to investigate agreement between the models. The average exposure was estimated for each combination of job title and company size.Results: A large reduction in exposure (51%) was seen between 1968 and 1974 and between 1975 and 1979 (28%). In later periods, quartz exposure was reduced by 8% per 5 years at best. In the first period, employees at smaller companies experienced ~50%higher exposure levels than those at large companies, but these differences became much smaller in later years. The furnace and ladle repair job were associated with the highest exposure, with 3.9–8.0 times the average exposure compared to the lowest exposed group. Without adjusting for this autonomous trend over time, predicting early historical exposures using our development model resulted in a statistically significant regression coefficient of 2.42 (R2 5 0.81), indicating an underestimation of historical exposure levels. Similar patterns were seen for other historical time periods. Comparing our development model with our validation model resulted in a statistically significant regression coefficient of 0.31, indicating an overestimation of current exposure levels.Conclusion: To investigate long-term trends in quartz exposure over time, overall linear trends can be determined by using mixed model analysis. To create individual exposure measures to predict historical exposures, it is necessary to consider factors such as the time period, type of job, type of company, and company size. The mixed model analysis showed systematic changes in concentration levels, implying that extrapolation of exposure estimates outside the range of years covered by measurements may result in underestimation or overestimation of exposure.
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| 3. |
- Burdorf, Alex, et al.
(författare)
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Asbestos exposure and differences in occurrence of peritoneal mesothelioma in the Netherlands and Sweden.
- 2007
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Ingår i: Occupational and environmental medicine. - : BMJ. - 1470-7926 .- 1351-0711. ; :64, s. 839-42
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: In several countries the incidence of peritoneal mesotheliomas among women closely mirrors the pattern among men. The aim was to investigate the role of asbestos exposure in the aetiology of peritoneal mesotheliomas in women and men. METHODS: All cases of peritoneal mesothelioma were selected from the Swedish and Netherlands Cancer Registers for the period 1989-2003. For both countries incidence rates were calculated, stratified by sex. A linear regression analysis was used to analyse the existence of a trend over time. RESULTS: Among men the incidence rate of peritoneal mesothelioma in The Netherlands (0.60 per 100,000 persons) was consistently higher than in Sweden with an average ratio of 1.8 (range 1.4-2.8). In both countries no trend over time was observed. During the 15 year period in The Netherlands the incidence rate among men was about 3.3-fold higher than among women. In Sweden the incidence rate among women was slightly higher than in men up to 1999, and thereafter about 3-fold higher among men. This sudden shift was statistically significant and seemed mainly caused by changes in classification of peritoneal tumours. CONCLUSION: The absence of a time trend in the incidence rate of peritoneal mesothelioma in the Netherlands and Sweden in the past 15 years may point at a more limited role of occupational exposure to asbestos in the etiology of peritoneal mesothelioma than for pleural mesothelioma, especially among women. The observed drop around 2000 in annual incidence of peritoneal mesothelioma among Swedish women indicates the presence in the past of a substantial misclassification with other tumours in the peritoneum.
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| 4. |
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| 5. |
- Burdorf, Alex, et al.
(författare)
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The importance of preventing work-related disability
- 2014
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health. - 0355-3140 .- 1795-990X. ; 40:4, s. 331-333
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Tidskriftsartikel (refereegranskat)
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| 6. |
- Chiarotto, Alessandro, et al.
(författare)
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Physical and psychosocial work-related exposures and the occurrence of disorders of the elbow: A systematic review
- 2023
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Ingår i: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 108
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Forskningsöversikt (refereegranskat)abstract
- This systematic review updates a previous systematic review on work-related physical and psychosocial risk factors for elbow disorders. Medline, Embase, Web of Science, Cochrane Central and PsycINFO were searched for studies on associations between work-related physical or psychosocial risk factors and the occurrence of elbow disorders. Two independent reviewers selected eligible studies and assessed risk of bias (RoB). Results of studies were synthesized narratively. We identified 17 new studies and lateral epicondylitis was the most studied disorder (13 studies). Five studies had a prospective cohort design, eight were cross-sectional and four were case-control. Only one study had no items rated as high RoB. Combined physical exposure indicators (e.g. physical exertion combined with elbow movement) were associated with the occurrence of lateral epicondylitis. No other consistent associations were observed for other physical and psychosocial exposures. These results prevent strong conclusions regarding associations between work-related exposures, and the occurrence of elbow disorders.
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| 7. |
- Gerger, Heike, et al.
(författare)
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Exposure to hand-arm vibrations in the workplace and the occurrence of hand-arm vibration syndrome, Dupuytren’s disease, and hypothenar hammer syndrome. A systematic review and meta-analysis
- 2023
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Ingår i: Journal of Occupational and Environmental Hygiene. - : Taylor & Francis. - 1545-9624 .- 1545-9632. ; 20:7, s. 257-267
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Forskningsöversikt (refereegranskat)abstract
- This study provides an overview on the relationships between exposure to work-related, hand-arm vibration and the occurrence of pre-defined disorders of the hands. We searched Medline, Embase, Web of Science, Cochrane Central, and PsycINFO for cross-sectional and longitudinal studies on the association between work-related vibration exposure and the occurrence of hand-arm vibration syndrome (including vibration-induced white finger), Dupuytren’s contracture, or hypothenar hammer syndrome. We used a 16-item checklist for assessing risk of bias. We present results narratively, and we conducted random effects meta-analyses if possible. We included 10 studies with more than 24,381 participants. Our results showed statistically significant associations between the exposure to hand-arm vibrations and the occurrence of the selected disorders, with pooled odds ratios ranging between 1.35 (95% CI: 1.28 to 2.80) and 3.43 (95% CI: 2.10 to 5.59). Considerable between-study hetereogeneity was observed. Our analyses show that exposure to vibrating tools at work is associated with an increased risk for the occurrence of selected disorders of the hands. Due to the majority of studies being cross-sectional, no firm conclusion is possible regarding causal relationships between vibration exposure and disorder occurrence. Future research should specifically address whether reducing the exposure to hand-held vibrating tools at work reduces the incidence of the disorders of the hands investigated in this systematic review.
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| 8. |
- Gerger, Heike, et al.
(författare)
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Physical and psychosocial work-related exposures and the incidence of carpal tunnel syndrome: A systematic review of prospective studies
- 2024
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Elsevier. - 0355-3140 .- 1795-990X. ; 117
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Forskningsöversikt (refereegranskat)abstract
- This systematic review summarizes the evidence on associations between physical and psychosocial work-related exposures and the development of carpal tunnel syndrome (CTS). Relevant databases were searched up to January 2020 for cohort studies reporting associations between work-related physical or psychosocial risk factors and the incidence of CTS. Two independent reviewers selected eligible studies, extracted relevant data, and assessed risk of bias (RoB). We identified fourteen articles for inclusion which reported data from nine cohort studies. Eight reported associations between physical exposure and the incidence of CTS and five reported associations between psychosocial exposures and the incidence of CTS. Quality items were generally rated as unclear or low RoB. Work-related physical exposure factors including high levels of repetition, velocity, and a combination of multiple physical exposures were associated with an increased risk of developing CTS. No other consistent associations were observed for physical or psychosocial exposures at work and CTS incidence.
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| 9. |
- Jackson, Jennie A, et al.
(författare)
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Occupational biomechanical risk factors for surgically treated ulnar nerve entrapment in a prospective study of male construction workers
- 2019
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health (NOROSH). - 0355-3140 .- 1795-990X. ; 45:1, s. 63-72
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to determine the association between occupational biomechanical exposures and occurrence of surgically treated ulnar nerve entrapment (UNE).Methods: A cohort of 229 689 male construction workers who participated in a national occupational health surveillance program (1971–1993) were examined prospectively over a 13-year case ascertainment period (2001–2013) for surgically treated UNE. Job title (construction trade), smoking status, height, weight and age were recorded on examination. Job titles were merged into occupational groups of workers performing similar work tasks and having similar training. Occupational biomechanical exposure estimates were assigned to each occupational group with a job exposure matrix (JEM) developed for the study. Negative binomial models were used to assess the relative risks for each biomechanical exposure and the sums of highly correlated biomechanical exposures. Surgical treatment of UNE was determined via a linkage with the Swedish Hospital Outpatient Surgery Register.Results: There were 555 cases of surgically treated UNE within the cohort. Workers exposed to forceful hand-grip factors had a 1.4-fold higher relative risk (95% CI 1.18–1.63) of undergoing surgical treatment for UNE compared to unexposed workers. Occupational groups comprising workers exposed to forceful hand-grip work showed the highest risks for UNE and included concrete workers, floor layers, ground preparatory workers, rock blasters, and sheet-metal workers.Conclusion: Forceful hand-grip work increases the risk for surgically treated ulnar nerve entrapment.
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| 10. |
- Jackson, Jennie, et al.
(författare)
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Biomechanical risk factors for surgically treated ulnar nerve entrapment in a cohort of Swedish male construction workers
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The literature on occupational risk factors for ulnar nerve entrapment (UNE), also called cubital tunnel syndrome is sparse.Objectives: The aim was study the association between occupational biomechanical exposures and UNE.Methods: The occurrence of UNE was examined prospectively in a cohort of 229 689 Swedish male construction workers who participated in a nation-wide occupational health surveillance program between 1971 and 1996. UNE case status was defined on the basis of a surgical release of ulnar nerve entrapment; case data were obtained from a national outpatient database for a 13 year observation period (2001-2013). Individual risk factors considered were smoking status, BMI and age. Biomechanical exposure estimates were assigned at the occupational group level using a job exposure matrix developed specifically for the study and included 10 ergonomic (force/posture/repetition) and 2 hand-arm vibration exposure parameters determined a priori to be relevant to UNE. Relative risks (RR) for all biomechanical factors were modelled using negative binomial regression analyses and adjusted for age, smoking habits and BMI.Results: There were 555 cases of surgically treated UNE in the cohort and the average annual incidence was 19.2 cases per 100,000 person-years. Smoking status (ever vs. never smoker RR=1.28, 95% CI=1.07-1.54) and BMI (≥25 kg/m2 vs. < 25 kg/m2 RR=1.60 , 95% CI=1.34-1.91) were associated with increased risk of UNE. Increased grip force (RR=1.54, 95% CI =1.24-1.92), hand-Arm-vibration (RR=1.35, 95% CI=1.07-1.71) upper extremity load (RR=1.63, 95% CI=1.30-1.92), and increased frequency of hand tool use (RR =1.37, 95% CI=1.09-1.71), elbow flexion and extension (RR=1.36, 95% CI=1.10-1.68), and static work (RR=1.36, 95% CI=1.12-1.65) were also associated with increased risk of UNE.Discussion and Conclusions: Our findings demonstrate that multiple biomechanical factors were associated with increased risk of UNE. Many of the identified risk factors involved elevated hand grip force (grip force, upper extremity load, and frequency of hand tool use and hand-arm vibration) which may indicate it is a key etiological aspect of UNE.
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| 11. |
- Jackson, Jennie, et al.
(författare)
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Occupational biomechanical risk factors for radial nerve entrapment in a 13-year prospective study among male construction workers
- 2019
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Ingår i: Occupational and Environmental Medicine. - : BMJ Publishing Group. - 1351-0711 .- 1470-7926. ; 76:5, s. 326-331
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim was to assess the association between occupational biomechanical exposure and the occurrence of radial nerve entrapment (RNE) in construction workers over a 13-year follow-up period. Methods A cohort of 229 707 male construction workers who participated in a national occupational health surveillance programme (1971-1993) was examined prospectively (2001-2013) for RNE. Height, weight, age, smoking status and job title (construction trade) were obtained on health examination. RNE case status was defined by surgical release of RNE, with data from the Swedish national registry for out-patient surgery records. A job exposure matrix was developed, and biomechanical exposure estimates were assigned according to job title. Highly correlated exposures were summed into biomechanical exposure scores. Negative binomial models were used to estimate the relative risks (RR) (incidence rate ratios) of RNE surgical release for the biomechanical factors and exposure sum scores. Predicted incidence was assessed for each exposure score modelled as a continuous variable to assess exposure-response relationships. Results The total incidence rate of surgically treated RNE over the 13-year observation period was 3.53 cases per 100 000 person-years. There were 92 cases with occupational information. Increased risk for RNE was seen in workers with elevated hand-grip forces (RR=1.79, 95% CI 0.97 to 3.28) and exposure to hand-arm vibration (RR=1.47, 95% CI 1.08 to 2.00). Conclusions Occupational exposure to forceful handgrip work and vibration increased the risk for surgical treatment of RNE.
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| 12. |
- Järvholm, Bengt, et al.
(författare)
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Asbestos and disease : a public health success story?
- 2024
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health. - 0355-3140 .- 1795-990X. ; 50:2, s. 53-60
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This paper discusses the failure and success of society to decrease the adverse health effects of asbestos exposure on workers’ health in relation to scientific knowledge.Methods: The findings are based on a narrative literature review.Results: Early warnings of the adverse health effects of workplace exposure to asbestos were published already in the 1930s. Serious health effects, such as malignancies and fibrosis due to occupational asbestos exposure, were highlighted in major medical journals and textbooks in late 1960s. New technologies could detect also asbestos fibers in the lung of non-occupational exposed persons in the 1970s. The first bans for using asbestos came in the early 1970s, and more general bans by authorities came in the 1980s and continue until today.Conclusions: The rather late recognition of adverse effects of asbestos exposure in the general population and measures to decrease the exposure through more general bans came rather late. However, the very strong measures such as general bans in many countries have been a success. A Swedish study showed that the general ban and other measures have decreased the risk of malignancies due to occupational exposure. The effect of the bans on adverse effects in the general population has yet to be studied. Analysis of fibers in the lungs of persons born after the bans could be an efficient method.
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| 13. |
- Järvholm, Bengt, et al.
(författare)
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Changing smoking habits and the occurrence of lung cancer in Sweden-a population analysis
- 2024
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Ingår i: EUROPEAN JOURNAL OF PUBLIC HEALTH. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 34:3, s. 566-571
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Tidskriftsartikel (refereegranskat)abstract
- Background The objective is to estimate the importance of the decrease of smoking habits in Sweden for the occurrence of lung cancer.Methods The change in smoking habits in the general population was retrieved from surveys and on taxation of sale of cigarettes. We used data from the Swedish Cancer Register on incidence of lung cancer between 1970 and 2021, stratified for sex, age and cell type, and compared the occurrence overtime in ages between 40 and 84 years.Results The sale of cigarettes peaked in 1980 to 1800 cigarettes per person and decreased to 600 per person in 2021. The change in incidence rates of squamous cell cancer and other cell types varied over time, sex, and age in a pattern that partly seems to be explained by change in the prevalence of daily smokers. The incidence of adenocarcinoma was similar in men and women 1970-2021 and increased, e.g. for women and men 75-79 years of age from around 20 cases in early 1970s to around 120 cases per 100 000 person-years in the 2020s.Conclusions Our data indicate that the risk of lung cancer several years after smoking cessation is less favourable than previously studies have indicated. There is a similar increase in the incidence of adenocarcinoma in men and women which is hard to explain only with changing smoking habits. The change from non-filter to filter cigarettes in the 1960s-1970s may be a contributing factor.
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| 14. |
- Järvholm, Bengt, et al.
(författare)
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Effect of reduced use of organic solvents on disability pension in painters
- 2017
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Ingår i: Occupational and Environmental Medicine. - London : BMJ Publishing Group Ltd. - 1351-0711 .- 1470-7926. ; 74:11, s. 827-829
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether the decreased use of paints based on organic solvents has caused a decreased risk for neuropsychiatric disorders in painters by studying their incidence in disability pensions.METHODS: The incidence of disability pension in Swedish painters who had participated in health examinations between 1971 and 1993 was studied through linkage with Swedish registers of disability pension over 1971-2010 and compared with the incidence in other construction workers as woodworkers, concrete workers and platers. When phasing out began in the 1970s, about 40% of paints were based on organic solvents and it had decreased to 4% in 1990s. The analysis was adjusted for age, time period, body mass index and smoking.RESULTS: The painters (n=23 065) had an increased risk of disability pension due to neurological diagnosis (n=285, relative risk (RR) 1.92, 95% CI 1.67 to 2.20) and psychiatric diagnosis (n=632, RR=1.61, 95 % CI 1.42 to 1.82). For neurological disorders there was a time trend with a continuously decreasing risk from 1980 onwards, but there was no such trend for psychiatric disorders.CONCLUSIONS: High exposure to organic solvents increased the risk for disability pension in neurological disorders, and the risk decreased when the use of organic solvents decreased. The painters also had an increased risk of disability pension due to psychiatric disorders, but the causes have to be further investigated.
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| 15. |
- Järvholm, Bengt, et al.
(författare)
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Emerging evidence that the ban on asbestos use is reducing the occurrence of pleural mesothelioma in Sweden
- 2015
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 43:8, s. 875-881
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Several countries have banned the use of asbestos. The future health impacts of previous use have been modeled but there are to our knowledge no convincing studies showing a decreased occurrence of asbestos-related diseases due to a ban. The aim of our study was to estimate the effects of the ban and other measures to decrease the use of asbestos in Sweden.METHODS: The effect was measured through comparing the incidence of pleural malignant mesothelioma in birth cohorts who started to work before and after the decrease in the use of asbestos, i.e. in mid-1970s. Cases were identified through the Swedish Cancer Registry and the analysis was restricted to persons born in Sweden.RESULTS: Men and women born 1955-79 had a decreased risk of malignant pleural mesothelioma compared to men and women born 1940-49 (RR 0.16, 95% CI 0.11-0.25; and RR 0.47, 95% CI 0.23-0.97 respectively). The decreased use of asbestos prevented each year about 10 cases in men and two cases in women below the age of 57 years in 2012.CONCLUSIONS: The ban and decreased use of asbestos in Sweden can be measured today in birth cohorts that started their working career after the decrease.
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| 16. |
- Järvholm, Bengt, et al.
(författare)
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Heavy work and disability pension : a long term follow-up of Swedish construction workers
- 2014
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health. - 0355-3140 .- 1795-990X. ; 40:4, s. 335-342
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The objective of this study was to investigate the occurrence of disability pensions over time among workers with physically demanding jobs.METHODS: The occurrence of disability pension was prospectively studied between 1980-2008 among 325 549 Swedish construction workers. The risks for disability pension and years lost of working life were compared among 22 occupational groups, adjusting for age, body mass index, height, and smoking habits.RESULTS: The risk varied considerably among blue-collar workers. For example, rock workers had double the risk of disability pension [relative risk (RR) 2.16, 95% confidence interval (95% CI) 1.96-2.39] compared to electricians. Most working years lost due to disability pensions (about 75%) were found among men >50 years, mainly due to musculoskeletal and cardiovascular diseases. The years of working life lost due to disability pension varied from 0.7 (salaried employees) to 3.2 years (rock workers) among occupational groups.CONCLUSION: Work environment is an important predictor for disability pension among construction workers with those in physically heavy jobs having the highest burden of disability. If the purpose is to increase labor force participation for workers with heavy jobs, strategies to reduce physical demands at work among elderly workers are important.
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| 17. |
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| 18. |
- Meding, Birgitta, et al.
(författare)
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Disability Pensions due to Skin Diseases : A Cohort Study in Swedish Construction Workers
- 2016
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 96:2, s. 232-236
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Tidskriftsartikel (refereegranskat)abstract
- Disability pensions due to skin diseases in Swedish male construction workers were studied by linking data from pension registers and an occupational health service. Incidence rates of disability pensions for cement workers, painters and plumbers were compared with 2 control groups. A total of 623 disability pensions were granted during 4 decades of follow-up. The main diagnoses were eczema (36%) and psoriasis (49%). Pensions were mostly granted in the age range 55-64 years. Among painters, cement workers and plumbers the incidence rates for disability pensions were 33.3, 24.5 and 20.4 cases/100,000 person-years, respectively, compared with 13.7 and 9.2 cases/100,000 person-years in control groups. Relative risks were highest for eczema, and were notable for psoriasis. Attributable fractions for eczema were 90% in cement workers and painters and 75% in plumbers compared with control groups. Attributable fractions for psoriasis in the occupational groups studied were in the range 54-67%. In conclusion, eczema and psoriasis have a high impact on loss of work ability, as reflected by disability pensions.
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| 19. |
- Robroek, Suzan J.W., et al.
(författare)
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Educational differences in duration of working life and loss of paid employment : working life expectancy in The Netherlands
- 2020
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health (NOROSH). - 0355-3140 .- 1795-990X. ; 46:1, s. 77-84
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study aims to provide insight into educational differences in duration of working life by working life expectancy (WLE) and working years lost (WYL) through disability benefits and other non-employment states in the Netherlands.Methods: Monthly information on employment status of the Dutch population (N=4 999 947) between 16 and 66 years from 2001‒2015 was used to estimate working life courses and loss of working years for specific non-employment states. Across educational groups, bi-directional transitions between paid employment and non-employment states were calculated. Using a multistate model, the WLE and WYL at age 16, 30, 50 and up to 66 years as statutory retirement age were estimated for each educational group, stratified by gender.Results: Low-educated men and women had a 7.3 (men) and 9.9 (women) years lower WLE at age 30 than high-educated men and women. Among low-educated men, 3.4 working years were lost due to disability benefit compared to 0.8 among high-educated men. Low-educated women lost 3.0 working years due to disability benefit compared to 1.4 among high-educated women.Conclusions: There are large educational inequalities over the course of working life. Among low-educated workers, more working years are lost due to unemployment, no income, and especially disability benefits. The latter reflects large educational inequalities in health and working conditions. The metrics of WLE and WYL provide useful insights into the life-course perspective on working careers.
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| 20. |
- Robroek, Suzan J W, et al.
(författare)
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Influence of obesity and physical workload on disability benefits among construction workers followed up for 37 years
- 2017
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Ingår i: Journal of Occupational and Environmental Medicine. - : BMJ Publishing Group Ltd. - 1076-2752 .- 1536-5948 .- 1351-0711 .- 1470-7926. ; 74:9, s. 621-627
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The objectives of this study are to investigate the relation between obesity and labour force exit via diagnosis-specific disability benefits, and whether physical workload modifies this association.METHODS: A longitudinal analysis was performed among 3 28 743 Swedish construction workers in the age of 15-65 years. Body weight and height were measured at a health examination and enriched with register information on disability benefits up to 37 years later. Diagnoses of disability benefits were categorised into cardiovascular diseases (CVDs), musculoskeletal diseases (MSDs), mental disorders and others. A job exposure matrix, based on self-reported lifting of heavy loads and working in bent forward or twisted position, was applied as a measure of physical workload. Cox proportional hazards regression analyses were performed, and the relative excess risk due to interaction (RERI) between obesity and physical workload was calculated.RESULTS: Obese construction workers were at increased risk of receiving disability benefits (HR 1.70, 95% CI 1.65 to 2.76), mainly through CVD (HR 2.30) and MSD (HR 1.71). Construction workers with a high physical workload were also more likely to receive a disability benefit (HR 2.28, 95% CI 2.21 to 2.34), particularly via MSD (HR 3.02). Obesity in combination with a higher physical workload increased the risk of disability benefits (RERI 0.28) more than the sum of the risks of obesity and higher physical workload, particularly for MSD (RERI 0.44).CONCLUSIONS: Obesity and a high physical workload are risk factors for disability benefit. Furthermore, these factors are synergistic risk factors for labour force exit via disability benefit through MSD. Comprehensive programmes that target health promotion to prevent obesity and ergonomic interventions to reduce physical workload are important to facilitate sustained employment.
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| 21. |
- Söderberg, Mia, 1977, et al.
(författare)
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Industry mobility and disability benefits in heavy manual jobs: A cohort study of swedish construction workers
- 2021
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 47:3, s. 217-223
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study aimed to investigate whether change from the construction industry to work in other industries at age 45–55 years lowered risks of disability benefits (DB) later in life (60–64 years of age). We hypothesized that risks would be lowered the most among those changing from the heaviest occupations.Methods: The study included men employed in the construction industry during 1971–1993. We selected workers from the largest occupational groups in heavy (concrete workers and painters) and less heavy (drivers, electricians and foremen) occupations. The occurrence of DB in 1990–2015 was retrieved from national registers. Regression analyses were used to calculate relative risks (RR) of DB at 60–64 years, comparing those working in other industries to those still in the construction industry at the age of 45, 50 and 55 years.Results: Mobility away from the construction industry was related to lowered DB risks at 60–64 years in all selected occupations. Effects were most pronounced among those who, at 55 years of age, worked in an industry other than construction, with significantly reduced RR for DB among concrete workers [RR 0.63, 95% confidence interval (CI) 0.51–0.77], electricians (RR 0.61, 95% CI 0.47–0.77) and foremen (RR 0.78, 95% 0.63–0.96).Conclusions: Risks for DB at 60–64 years of age were reduced among those who changed from construction work to other industries. Notable reductions were observed among workers originating from both heavy and less heavy occupations, and future studies should explore other factors, in addition to heavy workload, as motivators for leaving the construction industry.
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| 22. |
- Söderberg, Mia, 1977, et al.
(författare)
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Mortality in persons with disability pension due to common mental disorders: A cohort study of Swedish construction workers.
- 2020
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 48:8, s. 832-838
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This study investigated mortality in disability pensions due to common mental disorder, and variation over time after first receiving disability pension. Methods: Objectives were explored in 301,863 construction workers (97.2% men) recruited through healthcare examinations from 1971-1993. By linking with the Swedish National Insurance Agency registers, disability pensions until 2014 were identified. Common mental disorder was defined as disability pension diagnosis due to anxiety, stress-related disorders or moderate depression. Mortality was calculated in all-psychiatric diagnosis and diagnostic sub-groups, and compared to persons without disability pensions, using Poisson regression. Additional analyses were stratified by age at follow-up. Results: In total 6030 subjects received disability pensions based on psychiatric diagnoses, and 2624 constituted common mental disorder. Analyses in an all-psychiatric diagnosis displayed increased mortality risks in men (relative risk 3.6; 95% confidence interval 3.3-3.9) and women (relative risk 2.1; 95% confidence interval 1.6-2.6). Common mental disorder was associated with mortality, especially in men (relative risk 2.5; 95% confidence interval 2.2-2.8). Increased relative risks in alcohol and substance abuse were also observed. Results in analyses stratified by age at follow-up displayed persistent high relative risks for mortality in older ages (75-89 years) in men in all-psychiatric disability pensions diagnosis (relative risk 2.8; 95% confidence interval 2.1-3.7) and common mental disorder diagnosis (relative risk 2.6; 95% confidence interval 1.8-3.6), compared to men without disability pensions. Similar results were found in women, but few cases lowered the precision of estimates. Conclusions: This study shows that disability pension based on common mental disorders, often regarded as a 'lighter' psychiatric diagnosis, is a risk for early mortality in construction workers, even several years after first receiving disability pension.
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| 23. |
- van der Beek, Allard, et al.
(författare)
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A research framework for the development and implementation of interventions preventing work-related musculoskeletal disorders
- 2017
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 43:6, s. 526-539
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Work-related musculoskeletal disorders (MSD) are highly prevalent and put a large burden on the (working) society. Primary prevention of work-related MSD focuses often on physical risk factors (such as on manual lifting and awkward postures), but has not been too successful in reducing the MSD burden. This may partly be caused by insufficient knowledge of etiological mechanisms and/or a lack of adequately feasible interventions (theory failure and program failure, respectively), possibly due to limited integration of research disciplines. A research framework could link research disciplines thereby strengthening the development and implementation of preventive interventions. Our objective was to define and describe such a framework for multi-disciplinary research on work-related MSD prevention.Methods: We described a framework for MSD prevention research, partly based on frameworks from other research fields (i.e., sports injury prevention and public health).Results: The framework is composed of a repeated sequence of six steps comprising the assessment of 1) incidence and severity of MSD, 2) risk factors for MSD, and 3) underlying mechanisms; and the 4) development, 5) evaluation, and 6) implementation of preventive intervention(s).Conclusions: In the present framework for optimal work-related MSD prevention, research disciplines are linked. This framework can thereby help to improve theories and strengthen the development and implementation of prevention strategies for work-related MSD.
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| 24. |
- van der Beek, Allard, et al.
(författare)
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Efficient assessment of exposure to manual lifting using company data
- 2013
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Ingår i: Applied Ergonomics. - : Elsevier BV. - 0003-6870 .- 1872-9126. ; 44:3, s. 360-365
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study, based on an extensive dataset on manual materials handling during scaffolding, was to explore whether routinely collected company data can be used to estimate exposure to manual lifting.The number of manual lifts of scaffold parts while constructing/dismantling scaffolds was well predicted by the number of scaffolders in the team and the type of worksite, in combination with company data of either the number of scaffold parts or the scaffold volume. The proportion of explained variance in the number of lifts ranged from 77% to 92%, depending on the variables in the model. Data on scaffold parts and scaffold volume can easily be obtained from the company’s administration, since this is its usual paperwork supporting logistics and customer invoicing, respectively.We conclude that company data can be a promising source of information for ergonomic practitioners and researchers, to support assessment of manual lifting in scaffolding.
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| 25. |
- van der Beek, Allard J, et al.
(författare)
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An evaluation of methods assessing the physical demands of manual lifting in scaffolding.
- 2005
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Ingår i: Applied Ergonomics. - : Elsevier BV. - 0003-6870 .- 1872-9126. ; 36:2, s. 213-222
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Tidskriftsartikel (refereegranskat)abstract
- Four methods assessing the physical demands of manual lifting were compared. The scaffolding job was evaluated and three distinct scaffolding tasks were ranked using: (1) the revised NIOSH lifting equation (NIOSH method), (2) lifting guidelines for the Dutch construction industry (Arbouw method), (3) rapid appraisal of the NIOSH lifting equation (practitioners' method), and (4) systematic observations. For the three first-mentioned methods the same dataset was used; observation took place in a different setting in the same company. At job level, all methods indicated that ergonomic interventions are required to protect scaffolders from an increased risk for low back pain. The NIOSH, Arbouw and practitioners' method resulted in a similar ranking order of tasks (transport>construction>dismantlement). In contrast, the observational method gave transport the lowest ranking. The underlying cause was probably that the observational method is more sensitive to durations of tasks and lifting within tasks than the three other methods.
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| 26. |
- van Veen, Ernest, et al.
(författare)
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Occurrence and timing of withdrawal of life-sustaining measures in traumatic brain injury patients : a CENTER-TBI study
- 2021
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Ingår i: Intensive Care Medicine. - : Springer Science+Business Media B.V.. - 0342-4642 .- 1432-1238. ; 47:10, s. 1115-1129
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In patients with severe brain injury, withdrawal of life-sustaining measures (WLSM) is common in intensive care units (ICU). WLSM constitutes a dilemma: instituting WLSM too early could result in death despite the possibility of an acceptable functional outcome, whereas delaying WLSM could unnecessarily burden patients, families, clinicians, and hospital resources. We aimed to describe the occurrence and timing of WLSM, and factors associated with timing of WLSM in European ICUs in patients with traumatic brain injury (TBI).METHODS: The CENTER-TBI Study is a prospective multi-center cohort study. For the current study, patients with traumatic brain injury (TBI) admitted to the ICU and aged 16 or older were included. Occurrence and timing of WLSM were documented. For the analyses, we dichotomized timing of WLSM in early (< 72 h after injury) versus later (≥ 72 h after injury) based on recent guideline recommendations. We assessed factors associated with initiating WLSM early versus later, including geographic region, center, patient, injury, and treatment characteristics with univariable and multivariable (mixed effects) logistic regression.RESULTS: A total of 2022 patients aged 16 or older were admitted to the ICU. ICU mortality was 13% (n = 267). Of these, 229 (86%) patients died after WLSM, and were included in the analyses. The occurrence of WLSM varied between regions ranging from 0% in Eastern Europe to 96% in Northern Europe. In 51% of the patients, WLSM was early. Patients in the early WLSM group had a lower maximum therapy intensity level (TIL) score than patients in the later WLSM group (median of 5 versus 10) The strongest independent variables associated with early WLSM were one unreactive pupil (odds ratio (OR) 4.0, 95% confidence interval (CI) 1.3-12.4) or two unreactive pupils (OR 5.8, CI 2.6-13.1) compared to two reactive pupils, and an Injury Severity Score (ISS) if over 41 (OR per point above 41 = 1.1, CI 1.0-1.1). Timing of WLSM was not significantly associated with region or center.CONCLUSION: WLSM occurs early in half of the patients, mostly in patients with severe TBI affecting brainstem reflexes who were severely injured. We found no regional or center influences in timing of WLSM. Whether WLSM is always appropriate or may contribute to a self-fulfilling prophecy requires further research and argues for reluctance to institute WLSM early in case of any doubt on prognosis.
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| 27. |
- Versloot, Annelotte, et al.
(författare)
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Physical and psychosocial work-related exposures and the occurrence of disorders of the shoulder: A systematic review update
- 2024
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Ingår i: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 118
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Forskningsöversikt (refereegranskat)abstract
- This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and specific disorders of the shoulders. Medline, Embase, Web of Science Core Collection, Cochrane Central and PsycINFO were searched and study eligibility and risk of bias assessment was performed by two independent reviewers. A total of 14 new articles were added with the majority focusing on rotator cuff syndrome (RCS) with seven studies. Nine articles reported psychosocial exposures in addition to physical exposures. The strongest evidence was found for the association between elevation, repetition, force and vibration and the occurrence of SIS and tendinosis/tendonitis. Evidence also suggests that psychosocial exposures are associated with the occurrence of RCS and tendinosis/tendonitis. Other findings were inconsistent which prevents drawing strong conclusions.
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