1.
Kjeldgård, Linnea, 1985-, et al.
(författare)
Diagnosis-specific sickness absence among injured working-aged pedestrians: a sequence analysis
2023
Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 23:1, s. 367-
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: The knowledge about the long-term consequences in terms of sickness absence (SA) among pedestrians injured in a traffic-related accident, including falls, is scarce. Therefore, the aim was to explore diagnosis-specific patterns of SA during a four-year period and their association with different sociodemographic and occupational factors among all individuals of working ages who were injured as a pedestrian. METHODS: A nationwide register-based study, including all individuals aged 20-59 and living in Sweden, who in 2014-2016 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Diagnosis-specific SA (> 14 days) was assessed weekly from one year before the accident up until three years after the accident. Sequence analysis was used to identify patterns (sequences) of SA, and cluster analysis to form clusters of individuals with similar sequences. Odds ratios (ORs) with 95% confidence intervals (CIs) for association of the different factors and cluster memberships were estimated by multinomial logistic regression. RESULTS: In total, 11,432 pedestrians received healthcare due to a traffic-related accident. Eight clusters of SA patterns were identified. The largest cluster was characterized by no SA, three clusters had different SA patterns due to injury diagnoses (immediate, episodic, and later). One cluster had SA both due to injury and other diagnoses. Two clusters had SA due to other diagnoses (short-term and long-term) and one cluster mainly consisted of individuals with disability pension (DP). Compared to the cluster "No SA", all other clusters were associated with older age, no university education, having been hospitalized, and working in health and social care. The clusters "Immediate SA", "Episodic SA" and "Both SA due to injury and other diagnoses" were also associated with higher odds of pedestrians who sustained a fracture. CONCLUSIONS: This nationwide study of the working-aged pedestrians observed diverging patterns of SA after their accident. The largest cluster of pedestrians had no SA, and the other seven clusters had different patterns of SA in terms of diagnosis (injury and other diagnoses) and timing of SA. Differences were found between all clusters regarding sociodemographic and occupational factors. This information can contribute to the understanding of long-term consequences of road traffic accidents.
2.
Rizzi, Maria C, et al.
(författare)
The potential of different countermeasures to prevent injuries with high risk of health loss among bicyclists in Sweden
2020
Ingår i: Traffic Injury Prevention. - : Informa UK Limited. - 1538-9588 .- 1538-957X. ; 21:3, s. 215-221
Tidskriftsartikel (refereegranskat) abstract
Objective: As bicyclists account for the largest share of serious injuries in Sweden, focus to improve safety for bicyclists is needed. While knowledge about fatal bicycle crashes is rather extensive, the number of studies that have investigated non-fatal injuries is still rather limited. The aim of this study was to estimate the potential of different countermeasures to reduce crashes resulting in injuries with high risk of health-loss among cyclists in Sweden. A further aim was to describe the residual—that is, crashes that were not considered to be addressed by the analyzed countermeasures. Methods: A sample of individuals with specific injury diagnoses was drawn from the Swedish national crash database Strada. A survey form was used to collect additional information about the crash and the health-related outcomes. The potential of countermeasures currently included in the Swedish Safety Performance Indicators, as well as of countermeasures that could be described as “existing but not fully implemented” was assessed. The overall potential of all countermeasures assessed was calculated, giving a grand total without double counting. Cases that were considered not to be addressed by any of the countermeasures included (i.e., the residual crashes) were described in more detail. Results: The current Swedish Safety Performance Indicators that relate to safe cycling addressed 22% of crashes. Improved maintenance by deicing and removal of snow from bicycle infrastructure was found to have the highest potential (8%), followed by improved crashworthiness of passenger cars (5%) and safer bicycle crossings (4%). The potential for existing but not fully implemented safety improvements was 56%. The greatest potential was found for Autonomous Emergency Braking with cyclist detection for passenger cars (12%), followed by studded winter tyres for bicycles (12%), and improved maintenance on non-bicycle infrastructure (11%). In total, taking double counting into consideration, all safety improvements could address 64% of all crashes. Among the residual crashes, the majority (69%) were single bicycle crashes of which most were related to wheel locking during braking and losing balance at low speed or stationary. Conclusions: Compared with fatal crashes that involve a majority of bicycle-car crashes, the crashes leading to health-loss are mostly single bicycle crashes. Therefore, innovation and development of additional countermeasures to improve safety for bicyclists should focus on single bicycle crashes.
3.
Kjeldgård, Linnea, 1985-, et al.
(författare)
Bicycle crashes and sickness absence - a population-based Swedish register study of all individuals of working ages
2019
Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
Tidskriftsartikel (refereegranskat) abstract
BackgroundIn recent years, bicycle injuries have increased, yet little is known about the impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore SA and DP among individuals of working ages injured in a bicycle crash.MethodA nationwide register-based study, including all individuals aged 16-64years and living in Sweden, who in 2010 had in- or specialized out-patient healthcare (including emergency units) after a bicycle crash. Information on age, sex, sociodemographics, SA, DP, crash type, injury type, and injured body region was used. We analyzed individuals with no SA or DP, with ongoing SA or full-time DP already at the time of the crash, and with new SA >14days in connection to the crash. Crude and adjusted odds ratios (OR) with 95% confidence intervals for new SA were estimated by logistic regression.ResultsIn total, 7643 individuals had healthcare due to a new bicycle crash (of which 85% were single-bicycle crashes). Among all, 10% were already on SA or full-time DP at the time of the crash, while 18% had a new SA spell. The most common types of injuries were external injuries (38%) and fractures (37%). The body region most frequently injured was the upper extremities (43%). Women had higher OR (1.40; 1.23-1.58) for new SA than men, as did older individuals compared with younger (OR 2.50; 2.02-3.09, for ages: 55-64 vs. 25-34). The injury types with the highest ORs for new SA, compared with the reference group external injuries was fractures (8.04; 6.62-9.77) and internal injuries (7.34; 3.67-14.66). Individuals with traumatic brain injury and injuries to the vertebral column and spinal cord had higher ORs for SA compared with other head, face, and neck injuries (2.72; 1.19-6.22 and 3.53; 2.24-5.55, respectively).ConclusionsIn this explorative nationwide study of new bicycle crashes among individuals of working ages, 18% had a new SA spell in connection to the crash while 10% were already on SA or DP. The ORs for new SA were higher among women, older individuals, and among individuals with a fracture.
4.
Ohlin, Maria, 1987, et al.
(författare)
Duration of sickness absence following a bicycle crash, by injury type and injured body region: A nationwide register-based study
2018
Ingår i: Journal of Transport & Health. - : Elsevier BV. - 2214-1405 .- 2214-1413. ; 9, s. 275-281
Tidskriftsartikel (refereegranskat) abstract
In recent years, bicycle injuries have increased but little is known about the relation of such injures to sickness absence (SA). The aim of this study was to investigate duration of SA > 14 days after a bicycle crash, in general and by injury type and injured body region. A population-based study was conducted, including all individuals living in Sweden, aged 16-64 years, who in 2009-2011 had in-or specialized outpatient medical care due to a new injury from a bicycle crash (n = 22,045), excluding those already on SA or full-time disability pension at the time of the crash. Crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) for a new SA were estimated by logistic regression. In total, 4387 (20%) had new SA in connection to the crash. SA was most common among individuals aged 55-64 years (32%), and more common among women (23%) than men (18%). Fractures was the injury type with the highest OR for SA across all durations, but highest for 30-89 days (8.09; CI 6.30-10.39). Spine and back was the body region with the highest OR for SA >= 90 days (11.98; CI 7.38-19.46), followed by Traumatic Brain Injuries (6.64; CI 4.01-10.98), and injuries to lower extremities (5.28; CI 3.58-7.78). For 235 individuals (5%) the SA spell lasted >= 180 days. Among those cases, the most commonly injured body regions were lower leg (21%) followed by shoulder and upper arm (17%), and Traumatic Brain Injuries (15%). In conclusion, the duration of SA varied with type of injury and injured body region. Among the very long SA spells, common injuries were injuries to the lower leg, to the shoulder and upper arm, and traumatic brain injuries.
5.
Thorslund, Birgitta, 1976-, et al.
(författare)
The influence of hearing loss on transport safety and mobility
2013
Ingår i: European Transport Research Review. - : Springer. - 1867-0717 .- 1866-8887. ; 5:3, s. 117-127
Tidskriftsartikel (refereegranskat) abstract
Purpose: To examine how road users with different degree of hearing loss experience safety and mobility in transport situations, compared to road users with normal hearing.Methods: A questionnaire study was conducted with participants recruited from the local branch of The Swedish hard of hearing society. A normal hearing control group, matched on age, gender and geographical location, was selected from a commercial database. The response rate was 35% (n = 194) in the group with Hearing Loss (HL) and 42% (n = 125) in the group with Normal Hearing (NH). The individuals with hearing loss were grouped into four groups according to the degree of their hearing loss (mild, moderate, severe and profound).Results: Hearing loss affected some specific aspects regarding transport situations, while others remained unaffected. Individuals with hearing loss were not as likely to have a driving license, but for those who have, hearing loss had no effect on mileage per year. Loss of hearing had an effect on criteria for choosing mode of transportation, but in the aggregate, no difference between the groups could be shown in the distribution of how much each mode of transportation was used. With a few exceptions, hearing loss did not affect the ratings of importance of hearing for different transportation modes. Hearing loss affected most questions regarding hearing and driver abilities, while avoidance of specific traffic situations was not associated with hearing loss. Hearing loss had only minor effects on the factors causing inattention when driving, and on the interest in a warning system for driver inattention. The interest in a warning system for driver inattention was high regardless of hearing category.Conclusions: Hearing loss influences the prevalence of driving license and criteria for choosing mode of transportation, however has no effect on the distribution of how much each mode of transportation was used. In general, in this study, respondents with higher degree of hearing loss were less concerned about the effect of hearing loss, indicating that they might be using coping strategies. The interest in warning system for inattention and the attitude towards strengthening of auditory information in traffic situations is high regardless of hearing category. This suggests further research on coping strategies and on design of support systems accessible for drivers with hearing loss.
6.
Algurén, Beatrix, 1977, et al.
(författare)
In-depth understanding of single bicycle crashes in Sweden : Crash characteristics, injury types and health outcomes differentiated by gender and age-groups
2022
Ingår i: Journal of Transport & Health. - : Elsevier. - 2214-1405 .- 2214-1413. ; 24
Tidskriftsartikel (refereegranskat) abstract
Introduction: To study in-depth characteristics of single bicycle crashes and type of injuries considering gender and age differences. Methods: Hospital reported bicycle crashes identified in the Swedish national database STRADA were combined with self-reported detailed information regarding crash circumstances and injury outcomes. Gender and age-group differences were investigated using univariate statistics and Pearson Chi- Square test. Results: A total of 616 cyclists injured in single bicycle crashes between 2013 and 2017 were included. Participants (49% women) had a mean age of 58 years (ranged 15–89 years), most rode a comfort bike (54%) and cycled several times a week (81%). The most common crash type was skidding on ice or snow (26%). This crash type was significantly more common among women than men (30% versus 21%). Women more than twice as often lost balance at low or no speed (13% versus 5%). While men's injuries were located more than twice as often at shoulder and upper arm (28% versus 11%), women injured more than four times as often the lower leg and ankle (30% versus 7%). Differences regarding age-groups could be observed as an exponential increase of hip and upper leg injuries with increased age (9, 19 and 38%). Older cyclists were more often injured while losing balance at no or low speed and while getting on or off the bicycle. Conclusions: Concrete countermeasures to prevent injuries in single bicycle crashes can be suggested and directed to different target groups, i.e. women or men or younger or elderly.
7.
Forsman, Åsa, 1972-, et al.
(författare)
Injury crashes and the relationship with disease causing excessive daytime sleepiness
2021
Ingår i: Traffic Injury Prevention. - : Informa UK Limited. - 1538-9588 .- 1538-957X. ; 22:4, s. 272-277
Tidskriftsartikel (refereegranskat) abstract
Objective: The objective of this study was to understand the relationship between some of the most common diseases that are known to contribute to excessive daytime sleepiness (EDS) and traffic injury crashes. Specific focus was on the relationship between disease and crash type (single-vehicle or multiple-vehicle crash) and between disease and injury severity.Methods: This registry-based study considered all passenger car drivers involved in a crash in Sweden between 2011 and 2016 who were 40 years or older at the time of the crash (n = 54,090). For each crash-involved driver, selected medical diagnoses registered from 1997 until the day before the crash were extracted from the National Patient Register. The drivers were assigned to 1 of 4 groups, depending on prior diseases: sleep apnea (SA; group 1, n = 2,165), sleep disorders (group 2, n = 724), Parkinson's or epilepsy (group 3, n = 645) and a reference group (group 4, n = 50,556). Logistic regression analysis compared single-vehicle crashes with multiple-vehicle crashes and moderately/severely injured drivers with slightly/uninjured drivers.Results: Drivers with EDS-related diseases (groups 1-3) had higher probability of a single-vehicle crash than a multiple-vehicle crash compared to the reference group. The most sizeable effect was found for Parkinson's/epilepsy with an odds ratio (OR) of 2.5 (confidence interval [CI], 2.1-3.0). For multiple-vehicle crashes, the probability of a moderate/severe injury was higher for drivers with other sleep disorders (OR = 1.5; CI, 1.0-2.2) and Parkinson's/epilepsy (OR = 1.6; CI, 1.1-2.3) compared to the reference group.Conclusions: This study has made first steps toward understanding the relationship between some of the most common diseases that are known to contribute to EDS and crashes. Having Parkinson's/epilepsy, in particular, elevated the probability of a single-vehicle crash compared to a multiple-vehicle crash. A single-vehicle crash was seen as indicative of causing a crash; thus, having Parkinson's/epilepsy could be interpreted as a risk factor for crash involvement. Having Parkinson's/epilepsy, as well as other sleep disorders, was also related to more severe outcomes in multiple-vehicle crashes, given that a crash occurred. This was not identified in single-vehicle crashes.
8.
Kjeldgård, Linnea, 1985-, et al.
(författare)
Sequence analysis of sickness absence and disability pension in the year before and the three years following a bicycle crash; a nationwide longitudinal cohort study of 6353 injured individuals
2020
Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
Tidskriftsartikel (refereegranskat) abstract
Background: Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries. Aims: To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods: A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results: Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor vehicles (1.9;1.1–3.2) and traumatic brain injury, not concussion (18.4;2.2–155.2). Conclusion: Sequence analysis enabled exploration of the large heterogeneity of SA and DP following a bicycle crash. More knowledge is needed on how to prevent bicycle crashes and especially those crashes/injuries leading to long-term consequences.
9.
Anund, Anna, 1964-, et al.
(författare)
Are professional drivers less sleepy than non-professional drivers?
2018
Ingår i: Scandinavian Journal of Work, Environment and Health. - : SCANDINAVIAN JOURNAL WORK ENVIRONMENT & HEALTH. - 0355-3140 .- 1795-990X. ; 44:1, s. 88-95
Tidskriftsartikel (refereegranskat) abstract
Objective It is generally believed that professional drivers can manage quite severe fatigue before routine driving performance is affected. In addition, there are results indicating that professional drivers can adapt to prolonged night shifts and may be able to learn to drive without decreased performance under high levels of sleepiness. However, very little research has been conducted to compare professionals and non-professionals when controlling for time driven and time of day.Method The aim of this study was to use a driving simulator to investigate whether professional drivers are more resistant to sleep deprivation than non-professional drivers. Differences in the development of sleepiness (self-reported, physiological and behavioral) during driving was investigated in 11 young professional and 15 non-professional drivers.Results Professional drivers self-reported significantly lower sleepiness while driving a simulator than nonprofessional drivers. In contradiction, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness. They also drove faster. The reason for the discrepancy in the relation between the different sleepiness indicators for the two groups could be due to more experience to sleepiness among the professional drivers or possibly to the faster speed, which might unconsciously have been used by the professionals to try to counteract sleepiness.Conclusion Professional drivers self-reported significantly lower sleepiness while driving a simulator than non-professional drivers. However, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness, and they drove faster.
10.
Halava, Heli, et al.
(författare)
Influence of Retirement on Adherence to Statins in the Insurance Medicine All-Sweden Total Population Data Base
2015
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:6
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: Retirement has been suggested to reduce medication adherence, but no evidence is available for statins. We investigated changes in adherence to statins among Swedish adults after retirement.METHODS: A prospective cohort study was carried out on all individuals living in Sweden on 31 December 2004, alive in 2010, having purchased statins in the second half of 2005, and retired in 2008 (n=11 718). We used prescription dispensing data in 2006-2010 to determine nonadherence (defined as <80% of days covered by filled prescriptions) before and after old-age or disability retirement. Using multiple repeat measurements of filled statin prescriptions, we calculated the annual prevalence rates of nonadherence for those who continued therapy. Discontinuation was defined as no statin dispensations during a calendar year.RESULTS: After adjustment for age at retirement, the prevalence ratio (PR) of nonadherence after retirement in comparison with those before retirement was 1.23 [95% confidence interval (CI) 1.17-1.29] for the men and 1.19 (95% CI 1.13-1.26) for the women. A post-retirement increase in nonadherence was consistently observed across the strata of age at retirement, marital status, education, income, type of retirement, and participants with and without cardiovascular disease, the largest increases being observed for statin use in secondary prevention (men: PR 1.38, 95% CI 1.26-1.54; women: PR 1.43, 1.18-1.72). For primary prevention, the corresponding prevalence ratios were 1.18 (95% CI 1.13‒1.25) and 1.18 (95% CI 1.11-1.24), respectively.INTERPRETATION: Retirement appears to be associated with increased nonadherence to statin therapy among Swedish men and women.
