| 1. |
- Dellve, Lotta, 1965, et al.
(author)
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Safe work environments: Target 8.8 and its indicators regarding inequalities in occupational disorders and rights of compensation for migrant workers
- 2021
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In: The 2021 Gothenburg International Research Conference on SDG 8.
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Conference paper (other academic/artistic)abstract
- Decent and safe working conditions and non-discrimination in the rights of compensation for serious occupational disorders are of central policy concern in Sweden and for societies in a global sustainability perspective (UN). Despite overall improvements in work-related health in the WHO European Region, inequities within countries persist (WHO, 2019) and relatively large health inequalities still prevail also in welfare countries, such as Sweden (Mackenbach, 2019). The UN SDG target 8.8 consider “Protect labour rights and promote safe and secure working environments for all workers, including migrant workers, in particular women and migrants, and those in precarious employment”. While a number of studies within occupational health research have focused inequalities in relation to gender (sex), few studies have focused migrant workers and the combined sustainability approach of inequalities related to migrant status and gender perspectives. This paper reviews studies of indicators of target achievement regarding frequency rates of occupational disorders and equal compensation for occupational disorders, in particular for migrant workers. The aim is to identify and critically analyze previous research conducted within the indicators (the applied methodology and results) and suggest areas where research and academy may contribute towards achievement in these matter.
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| 2. |
- Olofsdotter Stensöta, Helena, 1965, et al.
(author)
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Fördomar eller okunskap - könsasymmetrier i handläggning?
- 2020
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In: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 26:2, s. 91-110
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Journal article (peer-reviewed)abstract
- Kvinnor har något svårare att få ersättning än män från arbetsskadeförsäkringen. Tidigare studier fokuserar främst på egenskaper hos de försäkrade, vi undersöker istället om bedömningar i handläggningen kan bidra till skillnaderna genom omedvetna bias och/eller kunskapsluckor. Vi använder ett datamaterial bestående dels av en enkät med ett vinjettexperiment som riktats till samtliga handläggare och dels reellaarbetsskadeakter. Undersökningen ger inte stöd för att handläggarna diskriminerar utifrån kön, men att den medicinska bedömningen ofta är undermålig. Vi rekommenderar utökad utbildning av handläggare för att undvika rättsosäkra bedömningar och risk för ojämlikhet i utfall av arbetsskadeärenden med avseende på kön.
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| 3. |
- Dahlin, Lars, et al.
(author)
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Low myelinated nerve-fibre density may lead to symptoms associated with nerve entrapment in vibration-induced neuropathy.
- 2014
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In: Journal of Occupational Medicine and Toxicology. - : Springer Science and Business Media LLC. - 1745-6673. ; 9:1
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Research review (peer-reviewed)abstract
- Prolonged exposure to hand-held vibrating tools may cause a hand-arm vibration syndrome (HAVS), sometimes with individual susceptibility. The neurological symptoms seen in HAVS are similar to symptoms seen in patients with carpal tunnel syndrome (CTS) and there is a strong relationship between CTS and the use of vibrating tools. Vibration exposure to the hand is known to induce demyelination of nerve fibres and to reduce the density of myelinated nerve fibres in the nerve trunks. In view of current knowledge regarding the clinical effects of low nerve-fibre density in patients with neuropathies of varying aetiologies, such as diabetes, and that such a low density may lead to nerve entrapment symptoms, a reduction in myelinated nerve fibres may be a key factor behind the symptoms also seen in patients with HAVS and CTS. Furthermore, a reduced nerve-fibre density may result in a changed afferent signal pattern, resulting in turn in alterations in the brain, further prompting the symptoms seen in patients with HAVS and CTS. We conclude that a low nerve-fibre density lead to symptoms associated with nerve entrapment, such as CTS, in some patients with HAVS.
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| 4. |
- Edlund, Maria, 1972, et al.
(author)
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A prospective cohort study investigating an exposure-response relationship among vibration-exposed male workers with numbness of the hands
- 2014
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In: Scandinavian Journal of Work Environment & Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 40:2, s. 203-209
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Journal article (peer-reviewed)abstract
- Objective The aim of this study was to investigate the exposure response relationship of hand-arm vibration (HAY) exposure to neurological symptoms (numbness) of the hand in a cohort of vibration-exposed workers. Methods The baseline cohort comprised 241 office and manual workers with and without exposure to HAY. Numbness (the symptom or event) in the hand was assessed for all subjects at baseline and follow-ups after 5, 10, and 16 years. The workers were stratified into quartiles with no exposure in the first quartile and increasing intensity of exposure in quartiles 2-4 (groups 1-3). Data analysis was performed using survival analysis (time-to-event). Information on cumulative exposure and years of exposure to event was collected via questionnaires. Measurements were performed in accordance with the International Organization for Standardization (ISO) 5349-1. Results The hazard ratio (HR) of risk of event (numbness) differed statistically significantly between the non-exposed group (group 0) and the two higher exposure groups (groups 2 and 3). There was also a significant ratio difference between the lowest exposure group (group 1) and the two higher groups. The ratio for group 1 was 1.77 [95% confidence interval (95% CI) 0.96-3.26] compared with 3.78 (95% CI 2.15-6.62) and 5.31(95% CI 3.06-9.20) for groups 2 and 3, respectively. Conclusion The results suggest a dose response relationship between vibration exposure and numbness of the hands. This underlines the importance of keeping vibration levels low to prevent neurological injury to the hands.
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| 5. |
- Edlund, Maria, 1972, et al.
(author)
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Quantitatively measured tremor in hand-arm vibration-exposed workers
- 2015
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In: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 88:3, s. 305-310
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Journal article (peer-reviewed)abstract
- The aim of the present study was to investigate the possible increase in hand tremor in relation to hand-arm vibration (HAV) exposure in a cohort of exposed and unexposed workers. Participants were 178 male workers with or without exposure to HAV. The study is cross-sectional regarding the outcome of tremor and has a longitudinal design with respect to exposure. The dose of HAV exposure was collected via questionnaires and measurements at several follow-ups. The CATSYS Tremor Pen(A (R)) was used for measuring postural tremor. Multiple linear regression methods were used to analyze associations between different tremor variables and HAV exposure, along with predictor variables with biological relevance. There were no statistically significant associations between the different tremor variables and cumulative HAV or current exposure. Age was a statistically significant predictor of variation in tremor outcomes for three of the four tremor variables, whereas nicotine use was a statistically significant predictor of either left or right hand or both hands for all four tremor variables. In the present study, there was no evidence of an exposure-response association between HAV exposure and measured postural tremor. Increase in age and nicotine use appeared to be the strongest predictors of tremor.
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| 6. |
- Försth, Peter, 1966-
(author)
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On Surgery for Lumbar Spinal Stenosis
- 2015
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Doctoral thesis (other academic/artistic)abstract
- The incidence of lumbar spinal stenosis (LSS) is steadily rising, mostly because of a noticeably older age structure. In Sweden, LSS surgery has increased continuously over the years and is presently the most common argument to undergo spine surgery. The purpose of the surgery is to decompress the neural elements in the stenotic spinal canal. To avoid instability, there has been a tradition to do the decompression with a complementary fusion, especially if degenerative spondylolisthesis is present preoperatively.The overall aims of this thesis were to evaluate which method of surgery that generally can be considered to give sufficiently good clinical results with least cost to society and risk of complications and to determine whether there is a difference in outcome between smokers and non-smokers.The Swespine Register was used to collect data on clinical outcome after LSS surgery. In two of the studies, large cohorts were observed prospectively with follow-up after 2 years. Data were analysed in a multivariate model and logistic regression. In a randomised controlled trial (RCT, the Swedish Spinal Stenosis Study), 233 patients were randomised to either decompression with fusion or decompression alone and then followed for 2 years. The consequence of preoperative degenerative spondylolisthesis on the results was analysed and a health economic evaluation performed. The three-dimensional CT technique was used in a radiologic biomechanical pilot study to evaluate the stabilising role of the segmental midline structures in LSS with preoperative degenerative spondylolisthesis by comparing laminectomy with bilateral laminotomies.Smokers, in comparison with non-smokers, showed less improvement after surgery for LSS. Decompression with fusion did not lead to better results compared with decompression alone, no matter if degenerative spondylolisthesis was present preoperatively or not; nor was decompression with fusion found to be more cost-effective than decomression alone. The instability caused by a decompression proved to be minimal and removal of the midline structures by laminectomy did not result in increased instability compared with the preservation of these structures by bilateral laminotomies.In LSS surgery, decompression without fusion should generally be the treatment of choice, regardless of whether preoperative degenerative spondylolisthesis is present or not. Special efforts should be targeted towards smoking cessation prior to surgery.
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| 7. |
- Grimby-Ekman, Anna, et al.
(author)
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Different DHEA-S Levels and Response Patterns in Individuals with Chronic Neck Pain, Compared with a Pain Free Group-a Pilot Study.
- 2017
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In: Pain medicine (Malden, Mass.). - : Oxford University Press. - 1526-2375 .- 1526-4637. ; 18:5, s. 846-855
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To test, in this pilot study, whether DHEA-S (Dehydroepiandrosterone, sulfated form) plasma levels are lower among persons with chronic neck pain, compared to control persons, and to investigate the DHEA-S response after a physical exercise.SUBJECTS: Included were 12 persons with chronic neck pain and eight controls without present pain, all 18 and 65 years of age. Exclusion criteria for both groups were articular diseases or tendinosis, fibromyalgia, systemic inflammatory and neuromuscular diseases, pain conditions due to trauma, or severe psychiatric diseases.DESIGN AND METHODS: The participants arm-cycled on an ergometer for 30 minutes. Blood samples were taken before, 60 minutes, and 150 minutes after this standardized physical exercise.RESULTS: The estimated plasma DHEA-S levels at baseline were 2.0 µmol/L (95% confidence interval [CI] 1.00; 4.01) in the pain group and 4.1 µmol/L (95% CI2.0; 8.6) in the control group, adjusted for sex, age, body mass index (BMI), and Shirom-Melamed Burnout Questionnaire (SMBQ), with a ratio of 0.48 (P = 0.094).The total DHEA-S (AUCG) in the pain group were 183 min*µmol/L lower than in the control group (P = 0.068). For the response to the exercise (AUCI), the difference between the pain group and the control group was 148 min*µmol/L (P = 0.011).CONCLUSIONS: In this pilot study, the plasma DHEA-S levels appeared to be lower among the persons with chronic neck pain, compared with the control group. It was indicated that DHEA-S decreased during the physical exercise in the control group, and either increased or was unaffected in the chronic pain group.
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| 8. |
- Grimby-Ekman, Anna, 1967, et al.
(author)
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Pain intensity and pressure pain thresholds after a light dynamic physical load in patients with chronic neck-shoulder pain
- 2020
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In: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 21:1
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Journal article (peer-reviewed)abstract
- Background To investigate the development of pain intensity and pressure pain thresholds during and 24 h after a light dynamic physical load among patients with chronic neck-shoulder pain. Methods Twenty-six patients with chronic neck-shoulder pain and 12 healthy controls were included. The participants arm-cycled on an ergometer. Effort was rated with the Borg Rating of Perceived Exertion scale (RPE), and pain intensity with an numeric rating scale (NRS). Pressure pain thresholds were measured by an algometer. Participants started a pain diary 1 week before the physical exercise and continued until 1 week after. Pain intensity was assessed before, during and the following two evenings after arm-cycling. Pressure pain thresholds were assessed before, 15 min after, 105 min after and 24 h after. Results The chronic pain group showed increased pain intensity during, and the following two evenings after the arm cycling, and decreased pain thresholds immediately after the arm cycling involving painful regions. In the patient group there were no impact on pain thresholds in the neck the following day. Conclusions Patients with chronic neck-shoulder pain reported increased pain intensity during and in the evenings after a light dynamic load involving painful regions. In addition, they showed decreased pain thresholds close to the exercise, indicating mechanical hyperalgesia.
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| 9. |
- Gyllensten, Kristina, 1977, et al.
(author)
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Workplace factors that promote and hinder work ability and return to work among individuals with long-term effects of COVID-19: A qualitative study.
- 2023
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In: Work (Reading, Mass.). - 1051-9815 .- 1875-9270. ; 75:4, s. 1101-1112
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Journal article (peer-reviewed)abstract
- Long COVID is defined by the persistence of physical and/or psychological and cognitive symptoms debuting after SARS-CoV-2 infection. Individuals affected describe impairing and debilitating symptoms sometimes making it difficult to take part in work and social life. Long COVID is likely to have an impact on the work force.The aim of the study was to explore workplace factors that promote and hinder work ability and return to work among individuals with long-term effects of COVID-19.A qualitative design was used. Data were collected by semi-structured focus group interviews and analysed using inductive thematic analysis. To increase trustworthiness, several researchers were involved in the data collection and analysis. Five focus group interviews were conducted with individuals suffering from long-term effects from COVID-19 affecting their work ability. In total, 19 individuals participated in the study, and all were working at least 50 per cent at the time of recruitment.Five main themes emerged from the analysis: Communication and support, Possibilities to adjust work, Acceptance of new limitations, Increased need for recovery from work and Lack of knowledge and understanding of the effects of Covid.The results suggested that it is useful to facilitate communication, support and work adjustments for individuals suffering from Long COVID. It is also important to accept limitations and fluctuations in work ability and encourage recovery during and after work.
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| 10. |
- Kjellberg, Sanna, et al.
(author)
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Impaired function in the lung periphery following COVID-19 is associated with lingering breathing difficulties
- 2024
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In: PHYSIOLOGICAL REPORTS. - 2051-817X. ; 12:2
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Journal article (peer-reviewed)abstract
- Lingering breathing difficulties are common after COVID-19. However, the underlying causes remains unclear, with spirometry often being normal. We hypothesized that small airway dysfunction (SAD) can partly explain these symptoms. We examined 48 individuals (32 women, 4 hospitalized in the acute phase) who experienced dyspnea and/or cough in the acute phase and/or aftermath of COVID-19, and 22 non-COVID-19 controls. Time since acute infection was, median (range), 65 (10-131) weeks. We assessed SAD using multiple breath washout (MBW) and impulse oscillometry (IOS) and included spirometry and diffusing-capacity test (DLCO). One-minute-sit-to-stand test estimated physical function, and breathing difficulties were defined as answering "yes" to the question "do you experience lingering breathing difficulties?" Spirometry, DLCO, and IOS were normal in almost all cases (spirometry: 90%, DLCO: 98%, IOS: 88%), while MBW identified ventilation inhomogeneity in 50%. Breathing difficulties (n = 21) was associated with increased MBW-derived Sacin. However, physical function did not correlate with SAD. Among individuals with breathing difficulties, 25% had reduced physical function, 25% had SAD, 35% had both, and 15% had normal lung function and physical function. Despite spirometry and DLCO being normal in almost all post-COVID-19 individuals, SAD was present in a high proportion and was associated with lingering breathing difficulties.
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