1. |
- Eriksson, Helena, 1971, et al.
(author)
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Longitudinal study of occupational noise exposure and joint effects with job strain and risk for coronary heart disease and stroke in Swedish men.
- 2018
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In: BMJ open. - : BMJ. - 2044-6055. ; 8:4
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Journal article (peer-reviewed)abstract
- The aims were to investigate whether occupational noise increased the risk for coronary heart disease (CHD) and stroke and to elucidate interactions with stressful working conditions in a cohort of Swedish men.This is a prospective cohort study on CHD and stroke in Swedish men followed until death, hospital discharge or until 75 years of age, using Swedish national registers on cause of death and hospital discharges. Baseline data on occupation from 1974 to 1977 were used for classification of levels of occupational noise and job demand-control. Cox regression was used to analyse HRs for CHD and stroke.Swedish men born in 1915-1925.CHD and stroke.The participants of the study were men from the Primary Prevention Study, a random sample of 10 000 men born in 1915-1925 in Gothenburg. Subjects with CHD or stroke at baseline or were not employed were excluded. The remaining subjects with complete baseline data on occupation, weight, height, hypertension, diabetes, serum cholesterol and smoking constituted the study sample (5753 men).There was an increased risk for CHD in relation to noise levels 75-85 dB(A) and >85dB(A) compared with <75dB(A) (HR 1.15, 95% CI 1.01 to 1.31, and HR 1.27, 95% CI 0.99 to 1.63, respectively). Exposure to noise peaks also increased the risk for CHD (HR 1.19, 95%CI 1.03 to 1.38). Among those with high strain (high demands and low control) combined with noise >75dB(A), the risk for CHD further increased (HR 1.80, 95% CI 1.19 to 2.73). There was no significantly increased risk for stroke in any noise category.Exposure to occupational noise was associated with an increased risk for CHD and the risk further increased among those with concomitant exposure to high strain. None of the analysed variables were related to increased risk for stroke.
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2. |
- Eriksson, Peter, et al.
(author)
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Job strain and resting heart rate: a cross-sectional study in a Swedish random working sample
- 2016
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16
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Journal article (peer-reviewed)abstract
- Abstract Background: Numerous studies have reported an association between stressing work conditions and cardiovascular disease. However, more evidence is needed, and the etiological mechanisms are unknown. Elevated resting heart rate has emerged as a possible risk factor for cardiovascular disease, but little is known about the relation to work-related stress. This study therefore investigated the association between job strain, job control, and job demands and resting heart rate. Methods: We conducted a cross-sectional survey of randomly selected men and women in Västra Götalandsregionen, Sweden (West county of Sweden) ( n = 1552). Information about job strain, job demands, job control, heart rate and covariates was collected during the period 2001 – 2004 as part of the INTERGENE/ADONIX research project. Six different linear regression models were used with adjustments for gender, age, BMI, smoking, education, and physical activity in the fully adjusted model. Job strain was operationalized as the log-transformed ratio of job demands over job control in the statistical analyses. Results: No associations were seen between resting heart rate and job demands. Job strain was associated with elevated resting heart rate in the unadjusted model (linear regression coefficient 1.26, 95 % CI 0.14 to 2.38), but not in any of the extended models. Low job control was associated with elevated resting heart rate after adjustments for gender, age, BMI, and smoking (linear regression coefficient − 0.18, 95 % CI − 0.30 to − 0.02). However, there were no significant associations in the fully adjusted model. Conclusions: Low job control and job strain, but not job demands, were associated with elevated resting heart rate. However, the observed associations were modest and may be explained by confounding effects. Keywords: Work-related stress, Job strain, Job demands, Job control, Resting heart rate
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3. |
- Fredriksson, Sofie, 1983, et al.
(author)
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Hearing-related symptoms and occupational noise exposure among women: An intervention study in preschool and obstetrics care
- 2020
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In: 13th ICBEN Congress on Noise as a Public Health Problem, Stockholm.
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Conference paper (peer-reviewed)abstract
- Recent cross-sectional studies have showed that preschool teachers and obstetrics personnel risk developing hearing-related symptoms associated with noise exposure. An ongoing cohort follow-up and intervention study will provide causal interpretations and evaluation of preventive factors. This presentation will include an overview of the project with focus on the intervention study, assessing effects on self-reported noise exposure and hearing-related symptoms. The intervention was performed at one preschool and one obstetrics care unit with two control workplaces each. A participatory approach was used, involving personnel, managers and health and safety representatives. The process followed a common structure in identifying, selecting, implementing and evaluating the interventions, whereas the interventions were tailored to each workplace. Survey data was collected at baseline and two follow-ups, and analysed using generalised estimating equation (GEE). We did not find significant positive effects of the intervention. Factors such as limited resources for implementation and other work environment deteriorations probably explain some of the negative results. Meanwhile, qualitative data indicated positive experiences of the interventions. Thus, we suggest further studies with control of implementation and other changes in the workplace.
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4. |
- Fredriksson, Sofie, 1983, et al.
(author)
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Occupational noise exposure, noise annoyance, hearing-related symptoms, and emotional exhaustion - a participatory-based intervention study in preschool and obstetrics care
- 2023
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In: Archives of Environmental & Occupational Health. - : Taylor & Francis Group. - 1933-8244 .- 2154-4700. ; 78:7-8, s. 423-434
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Journal article (peer-reviewed)abstract
- A participatory-based intervention was performed in Sweden, aimed at improving the sound environment in one preschool (n=20) and one obstetric ward (n=50), with two controls each (n=28, n=66). Measured sound levels, and surveys of noise annoyance, hearing-related symptoms and emotional exhaustion were collected before, and three and nine months after the interventions, comparing intervention and control groups over time. The results of this first implementation in a limited number of workplaces showed significantly worsening of hyperacusis, sound-induced auditory fatigue, emotional exhaustion and increased sound levels in the preschool, and worsening of noise annoyance in both intervention groups. Increased risk awareness, limited implementation support and lack of psychosocial interventions may explain the worsening in outcomes, as might the worse baseline in the intervention groups. The complexity of the demands in human-service workplaces calls for further intervention studies.
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5. |
- Fredriksson, Sofie, 1983, et al.
(author)
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Qualitative studies on the experience of noise in communication-intense workplaces before and after a participatory intervention
- 2023
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In: 14th ICBEN Congress on Noise as a Public Health Problem, 18-22 June, Belgrade Serbia.
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Conference paper (other academic/artistic)abstract
- Personnel in communication-intense workplaces are exposed to noise, occasionally so high they risk hearing-related disorders. Still, intervention studies are few, with ambiguous results. To increase the impact and sustainability of the interventions, we used a participatory method in which personnel and managers at one preschool and one obstetrics ward were actively involved in the intervention process. To identify work environment problems to target in the intervention, we performed qualitative focus group interviews prior to the intervention among 16 personnel and managers. Four main themes emerged from the inductive thematic analysis: a challenging and harmful sound environment, the sound environment causing hearing-related symptoms and health effects, a good sound environment not being prioritised, and resourceful and motivated personnel. As the participatory intervention entailed implementation of several changes, we also performed interviews post-intervention among nine personnel and managers from the preschool and the obstetrics ward where interventions had been implemented. Five main themes emerged from the inductive thematic analysis: increased awareness of the sound environment and risks to hearing and health, increased control over the sound environment, influence of the building and interior design, other factors influencing the intervention process (concurrent work environment issues such as stress, and limited resources), and motivation to maintain the positive changes. We conclude that the personnel perceive a risk to their hearing and health and that sound environment improvements should be prioritised in communication-intense workplaces. A participatory approach may facilitate motivation and empowerment to change, but resources and support are needed for comprehensive and effective implementation.
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6. |
- Gyllensten, Kristina, 1977, et al.
(author)
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A sustainable working life in the car manufacturing industry: The role of psychosocial factors, gender and occupation.
- 2020
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In: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 15:5
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Journal article (peer-reviewed)abstract
- In order to add to the existing knowledge about factors associated with retirement timing, in the car industry, it is useful to consider the psychosocial working conditions prior to retirement. This case-control study aimed to investigate relationships between psychosocial job factors and extended work after the age of 62 years among workers in the car industry in Sweden.A study invitation with a survey was sent to workers in one of Sweden's largest car manufacturing company, who were employed 2005-2015 and either retired at the age 55-62 years or working at 63 years or older. Psychosocial variables such as job demand-control (JDC) and effort-reward imbalance (ERI) were recorded through the survey. Multiple logistic regression models were used to investigate associations between psychosocial variables and retirement in 572 cases that had continued to work ≥ 63 years, and 771 controls who had retired at 62 or earlier.No associations were found between JDC-variables and retirement in the total sample or gender stratified analyses, but high demands-low control (high strain) was related to retirement before the age of 63 years in blue-collar workers. In contrast, high strain was related to continuing to work after 62 years for white-collar men and, high ERI was associated with extended work for the total sample of white-collar workers, and white-collar men, however these effects became non-significant in fully adjusted models.The relationships between psychosocial factors and extended work after 62 years were inconsistent, with high strain being related to retiring earlier for blue-collar workers.
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7. |
- Gyllensten, Kristina, 1977, et al.
(author)
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Nurses’ and preschool teachers’ experiences of taking part in a participatory intervention project in communication-intense working environments
- 2022
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In: WORK: A Journal of Prevention, Assessment & Rehabilitation. - : IOS Press. - 1051-9815 .- 1875-9270. ; 73:3, s. 857-869
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Journal article (peer-reviewed)abstract
- Abstract BACKGROUND: Noise is a common workplace problem that can affect health and performance. High sound levels have been found in sectors that largely has been overlooked in noise research such as health care and education. In these communication-intense environments the work requires speech communication, thus making it difficult to wear hearing protection. OBJECTIVE: To explore nurses’ and preschool teachers’ experiences of taking part in a participatory intervention project aiming to improve the sound environment and the psychosocial work environment. METHODS: One preschool and one obstetrics ward took part in the study, and a qualitative design was used to evaluate the experience of the participatory intervention approach. RESULTS: Five main themes were found in the analysis: Awareness; Taking control of the sound environment; Influence of the building and interior design; Circumstances influencing the intervention process; and Motivation to maintain change. CONCLUSIONS: Despite demanding working situations and lack of financial resources, preschool and obstetrics staff described being creative in planning and implementing several different solutions to improve the sound environment at their workplaces, while interventions specifically improving the psychosocial work environment were fewer. Hence, our study suggest that a participatory intervention approach may facilitate participation and motivation, but resources and support are needed for a comprehensive and effective implementation.
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8. |
- Henriksson, Malin, et al.
(author)
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Cause-specific mortality in Swedish males diagnosed with non-psychotic mental disorders in late adolescence: a prospective population-based study.
- 2018
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In: Journal of epidemiology and community health. - : BMJ. - 1470-2738 .- 0143-005X. ; 72:7, s. 582-8
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Journal article (peer-reviewed)abstract
- While risk of premature death is most pronounced among persons with severe mental illness, also milder conditions are associated with increased all-cause mortality. We examined non-psychotic mental (NPM) disorders and specific causes of natural death in a cohort of late adolescent men followed for up to 46 years.Prospective cohort study of Swedish males (n=1 784 626) who took part in structured conscription interviews 1968-2005. 74 525 men were diagnosed with NPM disorders at or prior to conscription. Median follow-up time was 26 years. HRs for cause-specific mortality were calculated using Cox proportional hazards models.Risks in fully adjusted models were particularly elevated for death by infectious diseases (depressive and neurotic/adjustment disorders (HR 2.07; 95%CI 1.60 to 2.67), personality disorders (HR 2.90; 95%CI 1.96 to 4.28) and alcohol-related and other substance use disorders (HR 9.02; 95%CI 6.63 to 12.27)) as well as by gastrointestinal causes (depressive and neurotic/adjustment disorders (HR 1.64; 95%CI 1.42 to 1.89), personality disorders (HR 2.77; 95%CI 2.27 to 3.38) and alcohol-related/substance use disorders (HR 4.41; 95%CI 3.59 to 5.42)).Young men diagnosed with NPM disorders had a long-term increased mortality risk, in particular due to infectious and gastrointestinal conditions. These findings highlight the importance of early preventive actions for adolescents with mental illness.
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9. |
- Robertson, Josefina, et al.
(author)
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Mental disorders and stress resilience in adolescence and long-term risk of early heart failure among Swedish men.
- 2017
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In: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 243, s. 326-331
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Journal article (peer-reviewed)abstract
- Recent research suggests that the prevalence of early heart failure may be on the rise. Compromised mental health in adolescence may help to explain this phenomenon. We aimed to investigate whether nonpsychotic mental disorder and low stress resilience in late adolescence were associated with increased risk of early heart failure.A prospective cohort study of 18-year-old men (n=1,784,450) who enlisted 1968-2005. At the conscription examination, 74,522 individuals were diagnosed with nonpsychotic mental disorders. Stress resilience was rated by psychologists; values were trichotomized. The risk of heart failure during the 46-year follow-up was calculated with Cox proportional hazards models. Baseline comorbidities, BMI, blood pressure, fitness, IQ, and parental education were included in the models.Incident cases of heart failure (n=9962) were identified in the National Hospital Register. In fully adjusted models, increased risk of early heart failure was observed in males diagnosed with nonpsychotic mental disorders at conscription (hazard ratio (HR), 1.36; 95% confidence interval (CI), 1.25-1.47). The highest risk was seen among men with the risk factor alcohol/substance use (HR 1.90; 95% CI 1.59-2.28). Conscripts with the risk factor low stress resilience showed increased risk of heart failure compared to those with high scores (HR 1.41; 95% CI 1.30-1.53).Nonpsychotic mental disorder, as well as low stress resilience in late adolescence may be associated with increased risk of early heart failure. Adolescence is potentially an important time for mental health interventions that may reduce both short and long-term consequences.
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10. |
- Schiöler, Linus, 1977, et al.
(author)
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Psychosocial work environment and risk of ischemic stroke and coronary heart disease: a prospective longitudinal study of 75 236 construction workers.
- 2015
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In: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 41:3, s. 280-287
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The present study aimed to investigate whether different dimensions of psychosocial stress, as measured by the job demand-control model (JDC), were associated with increased risks of ischemic stroke and coronary heart disease (CHD). METHODS: A cohort of 75 236 male construction workers was followed from 1989-2004. Exposure to psychosocial stress was determined by a questionnaire answered in 1989-1993. Events of ischemic stroke and CHD were found by linkage to the Swedish Causes of Death and National Patient registers. Hazard ratios (HR) were obtained from Cox regression models, adjusted for age, smoking habits, body mass index and systolic blood pressure. RESULTS: There were 1884 cases of CHD and 739 cases of ischemic stroke. Regarding ischemic stroke, no association was found between job demands [HR 1.12, 95% confidence interval (95% CI) 0.89-1.40, highest versus lowest quintile] or job control (HR 1.04, 95% CI 0.82-1.32, lowest versus highest quintile). Regarding CHD, job demands were associated to CHD (HR 1.18, 95% CI 1.02-1.37, highest vs. lowest quintile), but no consistent trend was seen among quintiles. The results were inconsistent in relation to job control. The division of JDC into four categories showed no significant associations with either ischemic stroke or CHD. CONCLUSIONS: This exploratory study showed no significant associations between psychosocial work environment and ischemic stroke, and the associations between job demands and control and CHD were inconsistent and weak. The combination of job control and job demand showed no significant associations with either ischemic stroke or CHD.
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11. |
- Söderberg, Mia, 1977, et al.
(author)
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Impact of changes in welfare legislation on the incidence of disability pension. A cohort study of construction workers
- 2020
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In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 48:4, s. 405-411
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Journal article (peer-reviewed)abstract
- AIMS: Study objectives were to investigate how changes in social insurance legislation influenced the incidence of disability pension.METHODS: The study included 295,636 male construction workers who attended health examinations between 1971 and 1993, aged 20-60 years and without previous disability pension. Via the Swedish National Insurance Agency national register we identified 66,046 subjects who were granted disability pension up until 2010. The incidence rates were calculated and stratified according to age and diagnosis.RESULTS: The incidence rate of disability pension was fairly stable until the 1990s when large variations occurred, followed by a strong decreasing trend from the early 2000s to 2010. Trends in incidence rates, stratified by age and diagnosis, showed a consistent decrease in cardiovascular disease for all age groups. In subjects aged 30-49 years there was a high peak around 2003 for musculoskeletal diseases and psychiatric diseases. For the age group 50-59 years, musculoskeletal diagnosis, the most common cause of disability pension, had a sharp peak around 1993 and then a decreasing trend. In the 60-64 age group, the incidence rate for psychiatric diagnosis was stable, while incidence rates for musculoskeletal diagnosis varied during the 1990s.CONCLUSIONS: There are considerable variations in the incidence rate of disability pension over time, with different patterns depending on age and diagnosis. Changes in social insurance legislation, as well as in administration processes, seem to influence the variation.
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12. |
- Söderberg, Mia, 1977, et al.
(author)
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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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In: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 48:8, s. 832-838
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Journal article (peer-reviewed)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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13. |
- Söderberg, Mia, 1977, et al.
(author)
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Psychosocial job conditions, fear avoidance beliefs and expected return to work following acute coronary syndrome : A cross-sectional study of fear-avoidance as a potential mediator
- 2015
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15
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Journal article (peer-reviewed)abstract
- Background: Despite improvements in treatment, acute coronary syndrome remains a substantial cause for prolonged sick absences and premature retirement. Knowledge regarding what benefits return to work is limited, especially the effect of psychological processes and psychosocial work factors. The purposes of this cross-sectional study were two-fold: to examine associations between adverse psychosocial job conditions and fear-avoidance beliefs towards work, and to determine whether such beliefs mediated the relationship between work conditions and expected return to work in acute coronary syndrome survivors.Methods: Study inclusion criteria: acute myocardial infarction or unstable angina diagnosis, below 65 years of age, being a resident in the West county of Sweden and currently working. In all, 509 individuals (21.8 % women) accepted study participation and for whom all data of study interest were available for analysis. Psychosocial work variables; job demand-control and effort-reward imbalance, were assessed with standard questionnaire batteries. Linear regression models were used to investigate relationships between psychosocial factors and fear-avoidance, and to evaluate mediator effects for fear-avoidance. Both total sample and gender stratified analyses were calculated.Results: Fear-avoidance beliefs about work were associated to psychosocial job environments characterized by high strain (β 1.4; CI 1.2–1.6), active and passive work and high effort-reward imbalance (β 0.6; CI 0.5–0.7). Further, such beliefs also mediated the relationship between adverse work conditions and expected time for return to work. However, these results were only observed in total sample analyses or among or male participants. For women only high strain was linked to fear-avoidance, and these relationships became non-significant when entering chosen confounders.Conclusions: This cross-sectional study showed that acute coronary syndrome survivors, who laboured under adverse psychosocial work conditions, held fear-avoidance beliefs towards their workplace. Furthermore, these beliefs mediated the relationships between - high strained or high effort-reward imbalanced work - and expected return to work. However, mentioned results were primarily found among men, which could results from few female study participants or gender differences in return to work mechanisms. Still, an earlier return to work might be promoted by interventions focusing on improved psychosocial work conditions and cognitive behavioural therapy targeting fear-avoidance beliefs.
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14. |
- Söderberg, Mia, 1977, et al.
(author)
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Psychosocial work environment, job mobility and gender differences in turnover behaviour: a prospective study among the Swedish general population
- 2014
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14
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Journal article (peer-reviewed)abstract
- BACKGROUND: Throughout the literature, substantial evidence supports associations between poor psychosocial work characteristics and a variety of ill-health outcomes. Yet, few reports strategies workers carry out to improve detrimental work conditions and consequently their health, such as changing jobs. The aim of this study was to examine if adverse psychosocial work exposure, as measured with the job demand-control and effort-reward imbalance models, could predict job mobility over a 5 years observation period. METHOD: Participants were working men and women (n = 940; 54.3% women), aged 24-60 years from the population of Gothenburg and surrounding metropolitan area. Job demand-control and effort-reward variables were compared with independent t-tests and chi2-test in persons with and without job mobility. Multivariate logistic regression was used to analyse whether psychosocial factors could predict job mobility. All regression analyses were stratified by gender. RESULTS: Exposure to a combination of high demands-low control or high imbalance between effort and reward was related to increased odds of changing jobs (OR 1.63; CI 1.03-2.59 and OR 1.46; CI 1.13-1.89 respectively). When analysing men and women separately, men had a higher OR of changing jobs when exposed to either high demands-low control (OR 2.72; CI 1.24-5.98) or high effort-reward imbalance (OR 1.74; CI 1.11-2.72) compared to reference values. The only significant associations for women was slightly decreased odds for turnover in high reward jobs (OR 0.96; CI 0.92-0.99). CONCLUSIONS: The results indicate that workers will seek to improve poor work environment by changing jobs. There were notable gender differences, where men tended to engage in job mobility when exposed to adverse psychosocial factors, while women did not. The lack of measures for mechanisms driving job mobility was a limitation of this study, thus preventing conclusions regarding psychosocial factors as the primary source for job mobility.
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15. |
- Torén, Kjell, 1952, et al.
(author)
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A longitudinal general population-based study of job strain and risk for coronary heart disease and stroke in Swedish men
- 2014
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In: Bmj Open. - : BMJ. - 2044-6055. ; 4:3
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Journal article (peer-reviewed)abstract
- Objectives The aim was to investigate whether psychosocial stress based on the job-demand-control (JDC) model increased the risk for coronary heart disease (CHD) and stroke. The Primary Prevention Study (PPS) comprises 6070 men born between 1915 and 1925 free from previous history of CHD and stroke at baseline (1974-1977). Psychosocial workplace exposure was assessed using a job-exposure matrix (JEM) for the JDC model based on occupation at baseline. The participants were followed from baseline examination, until death, until hospital discharge or until 75 years of age, whichever occurred first, using the Swedish national register on cause of death and the Swedish hospital discharge register for non-fatal and fatal stroke and CHD events. Cox regression models were used with stroke or CHD as the outcome, using JDC model and age as explanatory variables, as well as stratified models with regard to smoking, self-reported stress, socioeconomic status, obesity, hypertension and diabetes. There was an increased risk (HR) for CHD in relation to high strain (HR 1.31, 95% CI 1.01 to 1.70). The risk was further increased among ever-smokers and among blue-collar workers. There was a relation between low control and increased risk for CHD (HR 1.19, 95% CI 1.06 to 1.35). There was no increased risk for stroke in any of the JDC categories. Exposure to occupational psychosocial stress defined as job strain or low control increased the risk for CHD, especially among smokers and blue-collar workers. There was no increased risk for stroke in any of the JDC categories.
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16. |
- Torén, Kjell, 1952, et al.
(author)
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The association between job strain and atrial fibrillation in Swedish men
- 2015
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In: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 72:3, s. 177-180
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Journal article (peer-reviewed)abstract
- Objectives The purpose of this study was to investigate whether psychosocial stress defined as high strain based on the job demand-control model increases risk for atrial fibrillation. Methods The present study comprised 6035 men born between 1915 and 1925 and free from previous coronary heart disease, atrial fibrillation and stroke at baseline (1974-1977). Work-related psychosocial stress was measured using a job-exposure matrix for the job demand-control model based on occupation at baseline. The participants were followed from baseline examination until death, hospital discharge or 75 years of age, using the Swedish national register on cause of death and the Swedish hospital discharge register for any registration for atrial fibrillation, resulting in the identification of 436 cases. Data were analysed with Cox regression models with atrial fibrillation as the outcome using high strain as the explanatory variable adjusted for age, smoking, body mass index, hypertension, diabetes and socioeconomic status. Results There was an increased risk for atrial fibrillation in relation to high strain (HR 1.32, 95% CI 1.003 to 1.75). When the four categories of the job-strain model were included and low strain was used as reference, the risk for high strain decreased (HR 1.23, 95% CI 0.84 to 1.82). Conclusions Exposure to occupational psychosocial stress defined as high strain may be associated with increased risk for atrial fibrillation. The observed increase in risk is small and residual confounding may also be present.
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17. |
- Åberg, Maria A I, 1972, et al.
(author)
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Psychosocial job stressors and risk of suicidal behavior – an observational study among Swedish men
- 2022
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In: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 48:6, s. 435-445
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Journal article (peer-reviewed)abstract
- Passive occupations (low job demands and low job control) were associated with increased risk of male suicidal behavior, whereas active occupations were protective. Adjusting for adolescent psychological factors attenuated the relation of adult psychosocial workplace conditions and suicide risk. Interventions improving job control could help prevent suicidal behaviors in men, a group often not seeking help for mental ill-health.
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18. |
- Aurelius, Kristina, et al.
(author)
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Perceptions of mental health, suicide and working conditions in the construction industry-A qualitative study.
- 2024
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In: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 19:7
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Journal article (peer-reviewed)abstract
- The aim of the study was to explore perceptions of mental ill health, suicidal behaviour and working conditions among male construction workers, in order to gain an in-depth understanding of these phenomenon and to identify relevant avenues for workplace interventions.Data were collected in individual and group interviews, and 43 individuals from the Swedish construction industry, workers, union representative and managers, participated in the study. Inductive thematic analysis was used to analyse the data.Five main themes were found: Difficult to talk about mental health, Demanding working environment affects mental health, Substance abuse among construction workers, Importance of management, and Need for routines and social support in the workplace. Many participants reported that there was a stigma related to mental health. Suicides that had occurred among colleagues were perceived to come out of the blue. The working environment in the construction industry was perceived to have a negative effect on mental health, and it was reported that the management played an important role in both the cause and prevention of mental health problems.The results from this Swedish study are in accordance with previous international research regarding a macho culture, stigma of mental health and a demanding working environment in the construction industry. The study adds to existing knowledge by highlighting that suicides were perceived to be very unexpected, that poor physical health affected mental health and that many participants did not know how to deal with mental health issues in the workplace.
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19. |
- Björk, Lisa, 1981, et al.
(author)
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Beginning teachers’ work satisfaction, self-efficacy and willingness to stay in the profession: a question of job demands-resources balance?
- 2019
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In: Teachers and Teaching: Theory and Practice. - : Informa UK Limited. - 1354-0602 .- 1470-1278. ; 25:8, s. 955-971
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Journal article (peer-reviewed)abstract
- As many other countries around the world, Sweden is currently facing an urgent need for new teachers. Creating sound work environments that can retain beginning teachers in the profession—as well as attract new ones—is one way to address the problem. In order to accomplish this task, research must be able to reflect the complex nature of work environments. In the present study, a cluster analysis of four job demands and five job resources among 328 Swedish teachers in their first year of teaching, resulted in four typical work situations: the advantageous situation (n =103); the balanced situation (n =148); the threat situation (n =34); and the pressed situation (n =43). Clear differences were found in how teachers in these different clusters perceived their work satisfaction, self-efficacy and willingness to stay, with the teachers in the former two work situations scoring significantly higher than the latter two. The results indicate that teachers can have a very different experience of work at the start of their careers. These findings imply that work environment interventions and induction programmes to support new teachers and prevent them from leaving the profession must be well adapted to the context.
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20. |
- Eriksson, Helena, 1971, et al.
(author)
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Cardiovascular mortality in a Swedish cohort of female industrial workers exposed to noise and shift work.
- 2021
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In: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 94:2, s. 285-293
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Journal article (peer-reviewed)abstract
- The aim was to study mortality due to cardiovascular disease as well as total mortality, among female industrial workers, and the association to occupational noise and shift work.Women from cohorts of soft tissue paper mills (N=3013) and pulp and paper mills (N=1483) were merged into one cohort. Job exposure matrices were developed and used for classification of shift work and noise exposure. Every year was classified as shift work excluding nights or shift work including nights. Noise was classified into seven 5dB(A) bins from<75 to≥100dB(A). Mortality from cardiovascular diseases and total mortality during 1956-2013 was calculated as a standardized mortality ratio (SMR) with 95% confidence interval (CI) using the female general population as a reference.Fatal myocardial infarctions (N=144) were increased in the total cohort, SMR 1.20 (95% CI 1.01-1.41) but not total mortality. The SMR for myocardial infarction for women exposed to noise≥90dB(A) for>10years was 1.41 (95% CI 1.02-1.89) and for those exposed to night shifts>10years, 1.33 (95% CI 0.91-1.89). Shift workers without nights≤65years, with noise exposure≥90dB(A), had SMR 2.41 (95% CI 1.20-4.31) from myocardial infarction. There was no increased mortality from cerebrovascular disease.Female paper mill workers had an increased mortality from acute myocardial infarction, especially before retirement age, when exposed to noise≥90dB(A) and with long-time employment. Exposure to shift work and noise usually occurred concurrently.
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21. |
- Eriksson, Helena, 1971, et al.
(author)
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Psychosocial job exposure and risk of coronary artery calcification
- 2021
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In: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 16:5
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Journal article (peer-reviewed)abstract
- Purpose The aim was to examine potential associations between psychosocial job exposures, evaluated with the Job Demand-Control-model, and presence of coronary artery calcium. Methods We performed a cross-sectional study using the Swedish CArdioPulmonary bioImage Study,(SCAPIS)pilot study. Coronary artery calcium was assessed through computed tomography of the coronary arteries and with coronary artery scoring, CACS. Main outcome was CACS >= 100 compared to CACS 0. Job demand and control was analysed according to the standard categorization of the two variables into: high strain, active, passive and low strain (reference). Associations between these variables and CACS were calculated with prevalence ratios (PR) using Cox regression with robust variance, 95% confidence intervals (CI) and adjusted for age, smoking, education, socioeconomic area and metabolic syndrome. Results In total 777 participants were used in our analyses, for which 20% of the men and 5% of the women had CACS >= 100, respectively. The PR of having CACS >= 100 was non-significantly elevated for men in high strain jobs 1.54 (95% CI 0.88-2.69) and in active jobs 1.67 (95% CI 0.92-3.06), adjusted for covariates. For women there was no association between exposure to high strain and having CACS >= 100 PR 1.02 (95% CI 0.24-4.31). Among women reporting passive job, the PR was non-significantly elevated, 2.40 (95% CI 0.83-6.92), adjusted for covariates. Conclusion The statistical power of the study was limited, but our results suggests the possibility that exposure to a high strain or an active job situation may increase the risk of CACS in men, while in women, it may rather be exposure to passive job.
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22. |
- Fredriksson, Sofie, 1983, et al.
(author)
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Working in preschool increases the risk of hearing-related symptoms: a cohort study among Swedish women
- 2019
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In: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 92:8, s. 1179-90
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Journal article (peer-reviewed)abstract
- © 2019, The Author(s). Purpose: To assess whether working in preschools increases the risk of hearing-related symptoms and whether age, occupational noise, and stressful working conditions affect the risk. Methods: Questionnaire data on hearing-related symptoms were analysed in women aged 24–65 (4718 preschool teachers, and 4122 randomly selected general population controls). Prevalence and risk ratio (RR) of self-reported hearing loss, tinnitus, difficulty perceiving speech, hyperacusis and sound-induced auditory fatigue were assessed by comparing the cohorts in relation to age and self-reported occupational noise and stressful working conditions (effort–reward imbalance and emotional demands). RR was calculated using log-binomial regression models adjusted for age, education, income, smoking, hearing protection, and leisure noise. Incidence rates and incidence rate ratios (IRR) were calculated for retrospectively reported onset of all symptoms except sound-induced auditory fatigue. Results: Compared to the controls, preschool teachers had overall more than twofold RR of sound-induced auditory fatigue (RR 2.4, 95% confidence interval 2.2–2.5) and hyperacusis (RR 2.3, 2.1–2.5) and almost twofold for difficulty perceiving speech (RR 1.9, 1.7–2.0). Preschool teachers had a threefold IRR of hyperacusis (IRR 3.1, 2.8–3.4) and twofold for difficulty perceiving speech (IRR 2.4, 2.2–2.6). Significantly although slightly less increased RR and IRR were observed for hearing loss and tinnitus. RR and IRR were generally still increased for preschool teachers when stratified by age and occupational exposure to noise and stress. Conclusions: This large cohort study showed that working as preschool teacher increases the risk of self-reported hearing-related symptoms, indicating a need of preventative measures.
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23. |
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24. |
- Löve, Jesper, 1974, et al.
(author)
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Future marginalisation and mortality in young Swedish men with non-psychotic psychiatric disorders and the resilience effect of cognitive ability: a prospective, population-based study
- 2016
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In: BMJ Open. - : BMJ. - 2044-6055. ; 6:8
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Journal article (peer-reviewed)abstract
- Objective: Large-scale studies examining future trajectories of marginalisation and health in adolescents with mental illness are scarce. The aim of this study was to examine if non-psychotic psychiatric disorders (NPDs) were associated with future indicators of marginalisation and mortality. We also aimed to determine whether these associations might be mediated by education level and attenuated by high cognitive ability. Design: This is a prospective cohort study with baseline data from the Swedish Conscription register. Setting: The study was carried out in Sweden from 1969 to 2005. Participants: All of the participants were 18-year-old men at mandatory conscription in Sweden between 1969 and 2005 (n=1 609 690). Measures: NPDs were clinically diagnosed at conscription. Cognitive ability was measured by a standardised IQ test at conscription. National register data covered information on welfare support, long-term unemployment, disability pension (DP) and mortality over a period of 1–36 years. Results: NPD at the age of 18 years was a predictor of future welfare support, OR 3.73 (95% CI 3.65 to 3.80); long-term unemployment, OR 1.97 (95% CI 1.94 to 2.01); DP, HR 2.95 (95% CI 2.89 to 3.02); and mortality, HR 2.45 (2.33–2.52). The adjusted models suggested that these associations were not confounded by fathers’ educational level, cognitive ability had only a minor attenuating effect on most associations and the mediating effect of own educational level was small. Conclusions: The present study underlines a higher prevalence of future adversities in young men experiencing NPDs at the age of 18 years. It also indicates that higher cognitive ability may work as a potential resilience factor against future marginalisation and mortality.
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25. |
- Midhage, Robin, et al.
(author)
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Psychometric evaluation of the Swedish self-rated 36-item version of WHODAS 2.0 for use in psychiatric populations - using classical test theory.
- 2021
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In: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 75:7, s. 494-501
-
Journal article (peer-reviewed)abstract
- Aim The aim of this study was to evaluate the reliability and validity of the Swedish version of the self-rated 36-item WHODAS 2.0 in patients from Swedish psychiatric outpatient settings, using classical test theory.Methods The 36-item WHODAS 2.0, together with the Sheehan Disability Scale (SDS), was filled in by a sample of 780 participating psychiatric patients: 512 (65.6%) women, 263 (33.7%) men, and 5 (0.6%) who did not report any sex.Results The internal consistency, measured by Cronbach’s alpha, for the different domains of functioning were between 0.70 and 0.94, and interpreted as good. The confirmatory factor analysis (CFA) revealed two levels: the first level consisted of a general disability factor, while the second level consisted of the six domains of the scale, respectively. The model had borderline fit. There was a significant correlation between WHODAS 2.0 36-item and SDS (n = 395). The WHODAS 2.0 differed significantly between diagnostic groups.Conclusion The present study demonstrates that the Swedish self-rated 36-item version of WHODAS 2.0, within a psychiatric outpatient population, showed good reliability and convergent validity. We conclude that the self-rated 36-item Swedish version of WHODAS 2.0 can be used for valid interpretations of disability in patients with psychiatric health conditions.
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26. |
- Moradi, Faraidoun, et al.
(author)
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Gendered lived experiences of marriage and family following exposure to chemical warfare agents: content analysis of qualitative interviews with survivors in Halabja, Kurdistan-Iraq.
- 2020
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In: BMJ open. - : BMJ. - 2044-6055. ; 10:10
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Journal article (peer-reviewed)abstract
- To study gendered experiences of the long-term effects of a chemical warfare agent (CWA; sulfur mustard).Qualitative face-to-face semi-structured in-depth interview study using content analysis approach with thematic analysis and anthropological inquiries.The city of Halabja in the Kurdistan Region of Iraq.Survivors of CWA (n=16, female:male 10:6, mean age 45.5 years (range 34 to 67)) with lung damage diagnosis and with a range of sociodemographic variables.Latent content was expressed as: To get or not to get married? Two categories-social abandonment and uncertain marriage-emerged as expressions of the manifest content. The majority of the participants showed uncertainty as a central concern that affects all decision-making in their private and social life. Uncertainty over marriage and family were huge, corresponding to their fear of giving birth to children with congenital birth defects. Exposure to CWAs was conceptualised in terms of stigmatised illnesses, and consequently resulted in loneliness and social isolation, leading to negative impacts on other aspects of professional and social life. The results demonstrated a gendered pattern: CWA-exposed women were more affected psychosocially than CWA-exposed men. More CWA-exposed women were unemployed, divorced or single, or lived under vulnerable circumstances compared with men.Survivors of CWA exposure have developed a sense of gendered uncertainty around getting married and building a family. Sulfur mustard-exposed women, in particular, long to be desired in the community as they face social exclusion. Survivors should be provided evidence-based consultancy to optimise their decision-making around marriage and other social and family challenges.
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27. |
- Moradi, Faraidoun, et al.
(author)
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Health perspectives among Halabja’s civilian survivors of sulfur mustard exposure with respiratory symptoms—A qualitative study
- 2019
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:6
-
Journal article (peer-reviewed)abstract
- Background In 1988, Halabja came under heavy chemical warfare attack using chemicals such as sulfur mustard (SM). Thousands of survivors of SM exposure in the city today live with multiple health complaints, such as severe, long-lasting respiratory symptoms; but their perceptions of health have never been adequately researched. We aimed to explore current major health concern topics in civilian survivors with long-term respiratory symptoms. Method Sixteen subjects (f:m10:6, mean age 45.5 years (range 34–67)) were interviewed. Study participants were recruited in 2016 via a purposive sampling strategy among civilian survivors of chemical warfare in the city of Halabja in Kurdistan-Iraq. A qualitative research design was applied including semi-structured, face-to-face interviews. Data was analyzed using systematic text condensation. Results The analysis yielded fourteen themes related to: (1) General health: all participants described a deterioration in physical and psychological health, following the SM exposure, foremost involving respiratory symptoms, fatigue, sleeping disorders, ocular problems, depressive symptoms, and anxiety; (2) Quality of life: most notably, they reported a limited family life, limited social relations, lack of work ability, and concern about their financial situation. Moreover, many lived in constant fear of a renewed attack; (3) access to health care services: all participants reported that they had no, or only poor, access to health care services and limited access to specialist care, and all reported lack of financial resources to obtain treatment. Conclusions The post-exposure somatic and psychosocial effects such as respiratory symptoms of CWA are plausible contributor to poor general health and quality of life among survivors. We conclude that multidisciplinary interventions are needed to tackle the biopsychosocial complications in survivors of SM exposure to minimize further health damage in the future, as well as to promote their health-related quality of life.
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28. |
- Nyberg, Jenny, 1976, et al.
(author)
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Cardiovascular fitness in late adolescent males and later risk of serious non-affective mental disorders: a prospective, population-based study.
- 2018
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In: Psychological medicine. - 1469-8978. ; 48:3, s. 416-425
-
Journal article (peer-reviewed)abstract
- Cardiovascular fitness in late adolescence is associated with future risk of depression. Relationships with other mental disorders need elucidation. This study investigated whether fitness in late adolescence is associated with future risk of serious non-affective mental disorders. Further, we examined how having an affected brother might impact the relationship.Prospective, population-based cohort study of 1 109 786 Swedish male conscripts with no history of mental illness, who underwent conscription examinations at age 18 between 1968 and 2005. Cardiovascular fitness was objectively measured at conscription using a bicycle ergometer test. During the follow-up (3-42 years), incident cases of serious non-affective mental disorders (schizophrenia and schizophrenia-like disorders, other psychotic disorders and neurotic, stress-related and somatoform disorders) were identified through the Swedish National Hospital Discharge Register. Cox proportional hazards models were used to assess the influence of cardiovascular fitness at conscription and risk of serious non-affective mental disorders later in life.Low fitness was associated with increased risk for schizophrenia and schizophrenia-like disorders [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.29-1.61], other psychotic disorders (HR 1.41, 95% CI 1.27-1.56), and neurotic or stress-related and somatoform disorders (HR 1.45, 95% CI 1.37-1.54). Relationships persisted in models that included illness in brothers.Lower fitness in late adolescent males is associated with increased risk of serious non-affective mental disorders in adulthood.
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29. |
- Ramklint, Mia, Professor, et al.
(author)
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Validity of the self-rated 36-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 as a measure of functioning in Swedish psychiatric outpatients
- 2023
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In: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 77:3, s. 276-281
-
Journal article (peer-reviewed)abstract
- Purpose: The aim of this study was to investigate concurrent validity of the Swedish self-rated 36-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 by comparison with professional Global Assessment of Functioning (GAF) ratings in psychiatric outpatients.Material and methods: A cross-sectional convenience sample of 444 patients was recruited from their regular psychiatric outpatient settings. The patients filled out the WHODAS 2.0; their clinicians provided clinical information and performed GAF ratings blinded to the patients' assessments. Analyses of correlations, variance components, and ROC curves were performed to investigate the validity of the WHODAS 2.0 through comparison with the GAF. The variance component analyses included working status, psychosocial problems, number of diagnostic groups, and remission status. GAF ratings were separated as total (GAF-T), symptoms (GAF-S), and functioning (GAF-F).Results: There was significant correlation (p < 0.001) between WHODAS 2.0 total and domain scores and GAF-S, GAF-F, and GAF-T ratings. The correlations varied from r = 0.29 to r = 0.48, with the highest being between GAF-F rating and WHODAS 2.0 total score. Repeating the analyses for separate diagnostic groups replicated the findings, though not for psychotic, substance-related, and eating disorders. The WHODAS 2.0 showed good ability to distinguish impaired functioning below a fixed GAF-T cut-off of 70 (area under the curve: 0.74-0.78). The explained variance was lower for the WHODAS 2.0 than for the GAF (38.9% vs. 59.2%).Conclusions: Concurrent validity was found when comparing the Swedish self-administered 36-item version of WHODAS 2.0 with the expert-rated GAF in psychiatric outpatients.
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30. |
- Rosengren, Annika, 1951, et al.
(author)
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COVID-19 in people aged 18–64 in Sweden in the first year of the pandemic: Key factors for severe disease and death
- 2022
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In: Global Epidemiology. - : Elsevier BV. - 2590-1133. ; 4
-
Journal article (peer-reviewed)abstract
- Background: Studies on risk factors for severe COVID-19 in people of working age have generally not included non-working persons or established population attributable fractions (PAFs) for occupational and other factors. Objectives: We describe the effect of job-related, sociodemographic, and other exposures on the incidence, relative risks and PAFs of severe COVID-19 in individuals aged 18–64. Methods: We conducted a registry-based study in Swedish citizens aged 18–64 from 1 January 2020 to 1 February 2021 with respect to COVID-19-related hospitalizations and death. Results: Of 6,205,459 persons, 272,043 (7.5%) were registered as infected, 3399 (0.05%) needed intensive care, and 620 (0.01%) died, with an estimated case fatality rate of 0.06% over the last 4-month period when testing was adequate. Non-Nordic origin was associated with a RR for need of intensive care of 3·13, 95%CI 2·91–3·36, and a PAF of 32·2% after adjustment for age, sex, work, region and comorbidities. In a second model with occupation as main exposure, and adjusted for age, sex, region, comorbidities and origin, essential workers had an RR of 1·51, 95%CI, 1·35–1·6, blue-collar workers 1·18, 95%CI 1·06–1·31, school staff 1·21, 95%CI 1·01–1·46, and health and social care workers 1·89, 95%CI 1·67–2·135) compared with people able to work from home, with altogether about 13% of the PAF associated with these occupations. Essential workers and blue-collar workers, but no other job categories had higher risk of death, adjusted RRs of 1·79, 95%CI 1·34–2·38 and 1·37, 95%CI 1·04–1·81, with adjusted PAFs of altogether 9%. Conclusion: Among people of working age in Sweden, overall mortality and case fatality were low. Occupations that require physical presence at work were associated with elevated risk of needing intensive care for COVID-19, with 14% cases attributable to this factor, and 9% of deaths.
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31. |
- Rosengren, Annika, 1951, et al.
(author)
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Severe COVID-19 in people 55 and older during the first year of the pandemic in Sweden
- 2022
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In: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796 .- 0955-7873. ; 292:4, s. 641-653
-
Journal article (peer-reviewed)abstract
- Background Exposure to many contacts is the main risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, while risk of serious disease and death is chiefly determined by old age and comorbidities. Relative and population-attributable fractions (PAFs) of multiple medical and social exposures for COVID-19 outcomes have not been evaluated among older adults. Objectives We describe the effect of multiple exposures on the odds of testing positive for the virus and of severe disease (hospital care or death) and PAFs in Swedish citizens aged 55 years and above. Methods We used national registers to follow all citizens aged 55 years and above with respect to (1) testing positive, (2) hospitalization, and (3) death between 31 January 2020 and 1 February 2021. Results Of 3,410,241 persons, 156,017 (4.6%, mean age 68.3 years) tested positive for SARS-CoV-2, while 35,999 (1.1%, mean age 76.7 years) were hospitalized or died (12,384 deaths, 0.4%, mean age 84.0 years). Among the total cohort, the proportion living without home care or long-term care was 98.8% among persons aged 55-64 and 22.1% of those aged 95 and above. After multiple adjustment, home care and long-term care were associated with odds ratios of 7.9 (95% confidence interval [CI] 6.8-9.1) and 22.5 (95% CI 19.6-25.7) for mortality, with PAFs of 21.9% (95% CI 20.9-22.9) and 33.3% (95% CI 32.4-34.3), respectively. Conclusion Among Swedish residents aged 55 years and above, those with home care or long-term care had markedly increased risk for COVID-19 death during the first year of the pandemic, with over 50% of deaths attributable to these factors.
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32. |
- Schmidt, Caroline, 1966, et al.
(author)
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Psychosocial work conditions and prediabetes risks: a cross-sectional study in middle-aged men and women.
- 2023
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In: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 13:1
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Journal article (peer-reviewed)abstract
- Prediabetes is a condition between diabetes and normoglycemia, and is a state of major health concern, as a large proportion of people with prediabetes are likely to develop diabetes which is associated with high mortality and morbidity. The purpose of this study was to investigate whether adverse psychosocial work conditions, based on the Job Demand-Control-social support model, increases risk for early dysregulated glucose metabolism in 50-64-year-old men and women. Job conditions were measured with the Swedish Demand-Control-Support questionnaire. Impaired glucose metabolism was assessed by an oral glucose tolerance test. Differences between groups were analyzed with Chi-square test and one-way ANOVA with Bonferroni post-hoc test. Odds ratios (OR) and 95% confidence intervals (95% CI) between Job Demand-control-support and prediabetes outcome were calculated with multiple logistic regression. Results from an adjusted logistic regression model showed that in men and woman separately, an active work situation (high demands-high control) was associated with significantly lower prediabetes risk (OR 0.657, 95% CI 0.513-0.842). This finding is consistent through all logistic regression models with different levels of adjustments. Further, the current study does not lend support for the hypothesis that work conditions characterized by high demands-low control were associated with dysregulated glucose metabolism in men nor women despite accumulation of many life-style related risk factors in the high strain group. In conclusion, we could show that men and women assessing their work conditions as active, had lower risk for prediabetes.
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33. |
- Söderberg, Mia, 1977, et al.
(author)
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A cross-sectional study of the relationship between job demand-control, effort-reward imbalance and cardiovascular heart disease risk factors.
- 2012
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In: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12
-
Journal article (peer-reviewed)abstract
- ABSTRACT: Background: This cross-sectional study explored relationships between psychosocial work environment, captured by job demand-control (JDC) and effort-reward imbalance (ERI), and seven cardiovascular heart disease (CHD) risk factors in a general population. Method: The sampled consists of randomly-selected men and women from Gothenburg, Sweden and the city’s surrounding metropolitan areas. Associations between psychosocial variables and biomarkers were analysed with multiple linear regression adjusted for age, smoking, education and occupational status. Results: The study included 638 men and 668 women aged 24–71. Analysis between JDC and CHD risk factors illustrated that, for men, JDC was associated with impaired scores in several biomarkers, especially among those in high strain jobs. For women, there were no relationships between JDC and biomarkers. In the analysis of links between ERI and CHD risk factors, most associations tested null. The only findings were raised triglycerides and BMI among men in the fourth quartile of the ERI-ratio distribution, and lowered LDL-cholesterol for women. An complementary ERI analysis, combining high/low effort and reward into categories, illustrated lowered triglycerides and elevated HDL-cholesterol values among women reporting high efforts and high rewards, compared to women experiencing low effort and high reward. Conclusions: There were some associations between psychosocial stressors and CHD risk factors. The cross-sectional design did not allow conclusions about causality but some results indicated gender differences regarding sensitivity to work stressors and also how the models might capture different psychosocial dimensions.
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34. |
- Söderberg, Mia, 1977, et al.
(author)
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Arbetsrisker, livsvillkor och bristande tillgång till information - En intervjustudie bland utlandsfödda arbetare i högriskyrken för covid-19
- 2021
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Reports (other academic/artistic)abstract
- Covid-19 är överrepresenterad i flera yrkesgrupper utanför den uppmärksammade vård- och omsorgssektorn. Dessa mindre uppmärksammade yrken kännetecknas av låg lön, låga utbildningskrav och en hög andel utlandsfödda arbetare. Men trots en noterbart högre förekomst av smitta saknas kunskap om yrkesspecifika smittrisker och om livsvillkor inom denna grupp eller att vara utlandsfödd, bidrar till ökade risker. Sådana kunskapsluckor försvårar preventiva insatser och riskerar att grupper i samhället som redan kännetecknas av sämre hälsa blir särskilt utsatta vid pandemier. Syftet med den här studien är att undersöka arbetsfaktorer och livsvillkor som kan utgöra smittrisker för covid-19 bland utlandsfödda personer i yrken utanför vård- och omsorgssektorn, där man noterat en hög förekomst av covid-19. Baserat på tidigare studier har vi valt att titta närmare på taxiförare, buss- och spårvagnsförare, pizzabagare, städare och fastighetsskötare. Data samlades in genom semi-strukturerade intervjuer, vilket innebar att alla frågor utgick från en intervjumall, men med öppna frågor vilket möjliggjorde att deltagarna fritt kunde beskriva sin situation. Samtliga intervjuer transkriberades och innehållet analyserades utifrån en metod baserad på systematisk textkondensering. Elva personer intervjuades, varav tio var män, med Syrien, Turkiet, Somalia, Irak och Palestina som ursprungsländer. Studiens initiala fokus var yrkesrisker och levnadsförhållanden, men det framgick snabbt att aspekter av tillgång till anpassad information också var av betydelse. De två övergripande huvudtemana mynnade därmed ut i: ”Smittrisker i arbetet” och ”Otillräckligt anpassad information”. Under huvudtemat ”Smittrisker i arbetet” identifierade vi följande delteman: Smittade ytor, Brist på skyddsutrustning, Nära sociala kontakter, Bristande säkerhetskultur och Ekonomiska svårigheter till sjukskrivning. Inom huvudtemat ”Otillräckligt anpassad information” framstod delteman: Ej språkligt anpassad, Bristande kännedom om andra typer av informationskanaler, Skapar ej tillit och Bristande kännedom om specifika skyddsbehov. Även om våra teman spänner över flera dimensioner återkommer strukturella faktorer relaterade till arbetsförhållanden, utsatthet och bristande livskontroll, som minskar möjligheter att skydda sig för smitta. Då vår studie baserats på ett litet antal personer har resultaten begränsad överförbarhet, men kan utgöra ett underlag till större och fördjupade studier och bidra med förslag till anpassat stöd till grupper med särskilda behov.
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35. |
- Söderberg, Mia, 1977, et al.
(author)
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En rapport om studiemiljö, stress och hälsa bland Sahlgrenska akademins studenter
- 2017
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Reports (other academic/artistic)abstract
- Rapporter från både Göteborgs universitets Akademihälsa och Sahlgrenska akademin Studentkår har uppmärksammat en hög förekomst av överbelastning och psykisk ohälsa bland studenter vid Sahlgrenska akademin. Därför beslöt Sahlgrenska akademins dåvarande dekan Olle Larkö, att utföra en studie om upplevd stress, studiemiljö och hälsa bland Sahlgrenska akademins studenter. Uppdraget att genomföra studien tilldelades Avdelningen för Arbets- och miljömedicin, Institutionen för medicin, Sahlgrenska Akademin & Göteborgs universitet. Det övergripande syftet var att undersöka studiemiljöns betydelse för studenternas grad av upplevd stress och hälsa som underlag för förebyggande åtgärder. Övriga frågeställningar var om det fanns skillnader avseende sådana variabler mellan könen eller mellan studenter på olika program. Frågeställningarna undersöktes via en webenkät som skickades till alla studenter som under HT-2016 aktivt studerade vid något grundutbildningsprogram vid Sahlgrenska akademin. Enkäten mätte företrädelsevis olika psykosociala aspekter i studiemiljön, såsom studieintensitet, möjligheter till inflytande, socialt klimat och hur man upplevde föreläsare och kursledare. Som utfall utvärderades grad av utmattning, ångest- och depressionssyndrom, om man sökt vård pga. sina studier eller starkt övervägt att avbryta sin utbildning. Utav 3961 tillfrågade, besvarades enkäten av 2398 studenter, vilket innebär en svarsfrekvens på 61%. Svarsfrekvenserna skiljde sig mycket mellan olika program, vilket man bör ha i åtanke när man tolkar resultaten för enskilda program. De deskriptiva resultaten visade att de flesta studenter var stolta över sitt framtida yrkesval, blev stimulerade av sina studier och kände att man blev väl förberedd för sin yrkesroll. Det var också tydligt att det fanns en god och stöttande social stämning studenter emellan. Ungefär en tredjedel av alla studenter upplevde dock en anspänd studiesituation, dvs. stor arbetsbelastning, men med begränsade möjligheter att påverka sin studiesituation, en typ av psykosocial miljö som är starkt kopplat till psykisk ohälsa. Många kände också en hög grad av oro inför framtida höga stressnivåer och stort ansvar inom det blivande yrket. Det fanns en utbredd förekomst av psykisk ohälsa, ungefär en tredjedel rapporterade nivåer över de standardiserade cut-off värdena för hög grad av utmattning eller ångestsymtom som kan indikera en ångeststörning. Andel personer som sökt vård pga. studierelaterad ohälsa låg på 15%, och ungefär en tredjedel av alla studenter hade någon gång starkt övervägt att avbryta sina studier. Vid jämförelse med andra grupper som besvarat samma typ av frågeformulär går det att se att Sahlgrenska akademins studenter rapporterar högre grad av utmattning, ångest- och depressionssymtom, än t.ex. svenska lärarstudenter eller unga vuxna i den svenska allmänbefolkningen. Noterbara skillnader fanns även mellan könen. Resultaten visade t.ex. att kvinnor lade fler studietimmar per vecka på sina studier och i högre utsträckning hade en anspänd studiesituation, jämfört med männen. Kvinnor rapporterade också en högre förekomst av psykisk ohälsa, avseende både grad av utmattning och ångestsymtom. Det fanns även skillnader mellan olika utbildningsprogram, där de stora programmen, apotekar-, läkar-, tandläkare- och sjuksköterskeprogrammen, utmärker sig avseende variabler såsom hög arbetsbelastning och förekomst av psykisk ohälsa. Den högsta andelen personer som sökt vård pga. studierelaterad ohälsa återfanns bland de kvinnliga läkarstudenterna (27%). Detta kan jämföras med vårdbehov hos manliga läkarstudenter (9%) eller den grupp av kvinnliga studenter med näst högst reliabel förekomst av vårdbehov, kvinnliga tandläkarstudenter (15%). Sambandsanalyserna visade att en av de starkaste riskfaktorerna för utmattning, vårdsökande och övervägandet att avbryta sina studier, var en anspänd studiemiljö (höga krav och låg kontroll). En sådan studiesituation var förknippad med en tredubbelt så hög risk för hög grad av utmattning och dubbelt så högt vårdbehov, jämfört med de som hade låga studiekrav och högt inflytande. Brister från fakulteten, såsom otydliga kursmål eller bristande feedback, var också associerat till en fördubblad risk för hög grad av utmattning och övervägande att avbryta sina studier. Därutöver var oro inför framtida kapacitet och emotionella krav på verksamhetsförlagd utbildning kopplat till psykisk ohälsa. Ett annat intressant resultat var att könsdiskriminering var associerat till att man sökte vård, däremot fanns det inga signifikanta samband mellan att söka vård, och utmattning eller ångest. Mindre förvånande var att den starkaste faktorn för att överväga att avbryta sina studier, var ett bristande engagemang för sin utbildning och kommande yrket. Resultaten visade även samband till viktiga friskfaktorer. Som tidigare påvisats i flera studier, var fysisk aktivitet kopplat till lägre nivåer av utmattning. En annan betydelsefull faktor, som var associerad till både minskad utmattning och ångestsymtom, var tid till återhämtning, vilket också är konsekvent med tidigare forskning. Sammanfattningsvis, trots många positiva aspekter såsom engagemang, stimulans och bra social gemenskap, rapporterade Sahlgrenska akademins studenter en hög förekomst av krävande och stressande studieförhållanden och en utbredd psykisk ohälsa. Studenterna vid Sahlgrenska akademin går på krävande utbildningar som ska förbereda dom för yrken med högt tempo och stort ansvar gentemot andra människor. Detta kräver god stresstålighet, men också att man kan känna igen mekanismer som kan orsaka stress och att man har kunskap om hur man kan skydda sin hälsa. Idag läggs stort ansvar för den egna hälsan på studenterna själva. Man bör diskutera huruvida inte universitet bör ha en tydligare och mer ansvarstagande roll i att minska förekomst av skadliga studieförhållanden och stärka studenternas förmåga att hantera krävande förhållanden och därmed bättre förbereda dom inför arbetslivet. Förslagna åtgärder bör därför fokusera på utökad tillgång till stresshanteringsprogram, förändra kulturer där stress och att må psykiskt dåligt ses som en svaghet, schemaläggning som gynnar tid för återhämtning och lyfta positiva och hälsofrämjande aspekter av fysisk aktivitet.
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36. |
- Söderberg, Mia, 1977, et al.
(author)
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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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In: 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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Journal article (peer-reviewed)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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37. |
- Söderberg, Mia, 1977
(author)
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Intervjustudie av arbetsförhållanden för psykologer och beteendevetare inom företagshälsovården i Västra Götalandsregionen.
- 2008
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In: Rapport från Arbets- och miljömedicin. - 1650-4321. ; :119, s. 1-20
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Journal article (other academic/artistic)abstract
- Intervjustudiens syfte var att undersöka arbetsförhållanden för psykologer och beteendevetare inom företagshälsovården i Västra Götalandsregionen. Metoden var strukturerad intervju och grundade sig på ARIA arbetsinnehållsanalys. Sammanlagt deltog sju psykologer och tre beteendevetare. Resultaten visade bland annat att pressen på att uppfylla kvoten för debiterbar tid hade stor påverkan på arbetssituationen. Så länge debiterbarheten uppfylldes var man dock mycket fri i utförande och metod. Friheten hade ett pris av att arbetet blev avvägt av att man själv satte gränser och normer för sitt arbete. Många upplevde även ökad konkurrens på marknaden och det fanns viss oro för hur det kommer att inverka på arbetsförhållanden i framtiden
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38. |
- Söderberg, Mia, 1977, et al.
(author)
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Psychosocial job conditions and biomarkers of cardiovascular disease: A cross-sectional study in the Swedish CArdioPulmonary bioImage Study (SCAPIS).
- 2023
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In: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 51:6, s. 843-852
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Journal article (peer-reviewed)abstract
- The aim of this study was to investigate associations between psychosocial work exposure and the presence of biological and imaging biomarkers of cardiovascular disease.This cross-sectional study was conducted in a sub-cohort of the Swedish CArdioPulmonary bioImage Study (SCAPIS). Psychosocial exposure was evaluated with the job demand-control model, and analysed according to the standard categorization: high strain, active, passive and low strain (reference). Biomarkers (blood pressure, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, coronary artery calcification (CAC) and metabolic syndrome) were measured, or derived through measurements, from clinical examinations. Gender-specific prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated with regression models and adjusted for age, education, smoking, physical activity, general life stress and body mass index (BMI).The analyses included 3882 participants (52.5% women). High strain (high demands-low control) was linked to increased PR for low HDL cholesterol in women, adjusted for all covariates (PR 1.76; 95% CI 1.25-2.48). High strain was also related to moderately increased PR for metabolic syndrome in men, after adjustments for all covariates except BMI (PR 1.25; 95% CI 1.02-1.52). In addition, passive work (low demands-low control) was associated with diastolic hypertension in women (fully adjusted: PR 1.29; 95% CI 1.05-1.59). All relationships between psychosocial factors and LDL cholesterol or CAC (both genders), or hypertension (men), were non-significant.Poor psychosocial job conditions was associated with the presence of low HDL cholesterol and diastolic hypertension in women, and metabolic syndrome in men. These findings contribute to the knowledge of potential pathways between stressful work and coronary heart disease.
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39. |
- Söderberg, Mia, 1977
(author)
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Psychosocial work conditions - cardiovascular disease, perceptions and reactive behavior
- 2014
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Doctoral thesis (other academic/artistic)abstract
- The overall aims of this thesis were to improve our understanding of (1) associations between adverse psychosocial work conditions and less explored cardiovascular outcomes, and (2) workers’ perceptions and reactive behaviour when exposed to such conditions. Psychosocial job environment was evaluated with the job demand-control and effort-reward imbalance models. In the former construct, demand captures psychological work load, while control measures the employee’s influence over work tasks. Conceptually, effort is similar to job demand in measuring work intensity, while reward measures salary, esteem from colleagues and management, and job security. Examined subjects were drawn from three cohorts: randomly selected residents from Greater Gothenburg, patients with new onset acute coronary syndrome from the West county of Sweden and Swedish male construction workers. Results in paper I illustrated that a combination of high demands-low control, commonly referred to as high strain, and imbalance between effort and reward was related to adverse values in intermediate cardiovascular heart disease risk factors, foremost blood pressure and blood lipids. Surprisingly, findings in paper II showed that work conditions characterized by high demands-high control were more strongly associated to increased ischemic stroke, than high strain. Furthermore, high strained and effort-reward imbalanced jobs predicted job mobility in a general population sample (Paper III) and were related to delayed return to work and fear-avoidance perceptions towards the workplace, among patients with new onset acute coronary syndrome (Paper IV). Fear-avoidance attributions, in turn, mediated the relationship between poor psychosocial conditions and expected work resumption. The results partly concur with previous evidence on links between psychosocial job factors and cardiovascular outcomes. The results also indicate that workers are not passive receptors to impairing job conditions, but both react to and actively try to improve or avoid detrimental work environment, and consequently protect their health. In the gender stratified analyses (paper I, III, IV) notable differences were detected, as psychosocial job dimensions were not related to blood pressure, job mobility, expected return to work or fear-avoidance attributions among women. These differences could be due to a gender segregated labour market or lack of precision in reflecting female dominated work cultures. Further explanations might be that for women, private life stressors, e.g. child care or household work, deflate relationships between the psychosocial factors and outcomes used in this thesis.
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40. |
- Söderberg, Mia, 1977, et al.
(author)
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Study Demands, Social Support and Mental Health in Teacher Education Students: A Cross-Sectional Study
- 2020
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In: Journal of Educational and Social Research. - : Richtmann Publishing. - 2239-978X .- 2240-0524. ; 10:3
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Journal article (peer-reviewed)abstract
- The aim of this paper was to investigate relationships between psychosocial factors in a study environment and mental health in teacher education students. Study objectives were explored in 593 Swedish teacher education students (80% women). Psychosocial variables were measured with the standard Swedish demand-control-support questionnaire. Associations to mental health were calculated with logistic regression analyses, stratified by gender. Female students, on average reported higher demands, exhaustion and anxiety, than men. High study demands were associated with severe exhaustion in both men and women, even in models including all potential confounders and social support. Although, social support was related to lower exhaustion in women and less anxiety in men, this variable only contributed to minor effect changes in the associations study demands to mental ill-health. High study demands seem important for mental health in teacher education students. Future studies, perhaps using qualitative methods, would benefit the state of knowledge regarding students’ psychosocial conditions and poor mental health. Such knowledge could assist universities in interventions to enhance both health status and future stress resilience.
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41. |
- Söderberg, Mia, 1977, et al.
(author)
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The influence of overcrowding and socioeconomy on the spatio-temporal spread of COVID-19 - a Swedish register study
- 2022
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Reports (other academic/artistic)abstract
- Household overcrowding, which primarily occur in groups characterised by low socioeconomy, is a known risk factor for the spread of infectious diseases. Still, little is established whether overcrowding, in itself, or in combination with other disadvantageous sociodemographic factors has affected the incidence of COVID-19 infection over time and geographical areas. This register study investigated the effect of overcrowded housing, and its interaction with various markers of low socioeconomy, as predictors for the spread of COVID-19 infection, by using regressive spatial and spatio-temporal statistical methods. Through the Swedish Tax Agency database, we could identify all legal residents in Sweden, alive at 1st of January 2020 (baseline) and by using Sweden’s personal identification number system we could link this cohort to data from other national registers. Through Statistics Sweden, we gained access to information on several sociodemographic variables relevant for this study, including variables to calculate overcrowding, as well as individual information on income, immigration background, education, occupation, and car ownership. To this, we added data from the Public Health Agency of Sweden’s register SmiNet, a register for communicable diseases, through which we had access to all positive PCR-test results for COVID-19 in Sweden until the 30th of June 2021. Based on a definition of overcrowding proposed by Eurostat, and the data at hand, we defined overcrowding as more than one person per number of rooms in a household, with the exceptions of adult couples in a relationship, children under a certain age or anyone living in a villa, detached or semi-detached house. The spatial (geographical) aggregation level was determined by Sweden’s so called DeSO zones (“DEmografiska Statistik Områden”, translated: Demographical statistical areas), which divide Sweden into 5984 subregions of varying geographical size, with each zone being inhabited by 700–2700 people. The temporal unit of the data was calendar month. As each person appearing in the statistics Sweden’s register has a DeSO identifier, we could generate monthly counts of infection for each DeSO zone. We started the statistical analyses by evaluating correlations among the spatial covariates and their interaction terms, as well as correlations between the spatial covariates and the log-counts per DeSO, both monthly and accumulated over the whole study period (18 months). This highlighted that the dynamics of infection incidence over time and that certain groups with several highly dependent covariates had a pronounced impact on infection. Our spatial analyses were conducted using an elastic-net regularised Poisson regression approach where the DeSOs’ population sizes were used as off-sets and the model selection was carried out by means of cross-validation. In the spatio-temporal analyses, a dummy variable was added for each month, while keeping the rest of the covariates, including the interaction terms, as in the spatial analyses. This approach allowed us to interpret the fitted models as models for the risk that a generic individual from any kind of DeSO zone tested positive (at a given time point), while also adjusting for collinearity and carrying out variable selection in our models to achieve parsimony. The descriptive results, which we visualized by graphical illustration of the spatially aggregated data, showed clear co-existence of overcrowded housing, low education, low income and having an foreign background in several geographical zones, especially in some of the boroughs of Sweden’s largest cities. The analyses focusing on geographical areas’ vulnerability (spatial risks) revealed higher risks in areas with a high occurrence of overcrowding, especially in interaction with a high proportion of inhabitants with a foreign background, an income below the national median or persons in health and social care work. When incorporating time in the models (spatio-temporal risk), overcrowding appeared as a predictor for COVID-19 infection, however, only during the time periods of April, May, August, and November 2020. Overcrowding otherwise seemed to foremost constitute a risk factor when interplaying with other disadvantageous socioeconomic variables, thus indicating that general socioeconomic vulnerability constituted a risk enhancer. Else, being of foreign background or being employed in a low-income job during the second wave of the pandemic, were notable predictors for the risk of testing positive for the disease. By studying overcrowding and socioeconomic factors, we identified vulnerable groups per geographical area and over the duration of the COVID-19 pandemic. Identified risk factors were clearly more prevalent in groups whose structural living conditions meant less possibilities to protect themselves, and which also already displayed markedly worse health. Targeted interventions towards ill-disposed group and geographical areas are therefore of importance in the still on-going pandemic or in the event of future widespread diseases.
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42. |
- Söderberg, Mia, 1977, et al.
(author)
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Undervalued essential work and lacking health literacy as determinants of COVID-19 infection risks: a qualitative interview study among foreign-born workers in Sweden.
- 2023
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In: BMJ open. - 2044-6055. ; 13:12
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Journal article (peer-reviewed)abstract
- To investigate work and living conditions as determinants of COVID-19 infection risks in foreign-born workers in non-healthcare occupations.Data were collected according to a qualitative design, using semistructured interviews. Verbatim transcripts of these interviews were analysed according to systematic text condensation.We recruited foreign-born workers (n=15) and union representatives (n=6) among taxi drivers, bus and tram drivers, pizza bakers, cleaners and property caretakers, all indicated as risk occupations during COVID-19 in Sweden.Four overarching themes were found: 'virus exposure at work', 'aspects of low status and undervalued work', 'lack of access to information' and 'foreign-born persons' position'. Virus exposure was frequent due to many social interactions over a workday, out of which several were physically close, sometimes to the point of touching. The respondents fulfilled important societal functions, but their work was undervalued due to low job status, and they had little influence on improving safety at work. Lack of health literacy limited foreign-born workers to access information about COVID-19 infection risks and protection, since most information from health organisations and employers was only available in Swedish and not adapted to their living conditions or disseminated through unknown channels. Instead, many turned to personal contacts or social media, through which a lot of misinformation was spread. Foreign-born persons were also subjected to exploitation since a Swedish residency permit could depend on maintaining employment, making it almost impossible to make demands for improved safety at work.Structural factors and a lack of adapted information manifested themselves as fewer possibilities for protection against COVID-19. In a globalised world, new widespread diseases are likely to occur, and more knowledge is needed to protect all workers equally. Our results are transferable to similar contexts and bring forth aspects that can be tried in quantitative studies or public health interventions.Cite Now.
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