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1.
  • Cedstrand, Emma, et al. (författare)
  • Co-Creating an Occupational Health Intervention within the Construction Industry in Sweden : Stakeholder Perceptions of the Process and Output
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:24
  • Tidskriftsartikel (refereegranskat)abstract
    • One way to prevent work-related stress, is to implement primary occupational health interventions aimed at improving the psychosocial work environment. However, such interventions have shown a limited effect, often due to implementation failure and poor contextual fit. Co-creation, where researchers, together with end-users and other relevant stakeholders, develop the intervention is increasingly encouraged. However, few studies have evaluated the effects of co-created interventions, and participants' experience of the co-creation process. This is one of the first studies evaluating stakeholder perceptions of co-creating an occupational health intervention. We applied a thematic analysis, with data from 12 semi-structured interviews with stakeholders involved in the co-creation. Our results show that the respondents, in general, were satisfied with engaging in the co-creation, and they reported an increased awareness regarding risk factors of stress and how these should be handled. Additionally, the respondents described trust in the intervention activities and a good fit into the context. The study indicates that co-creating occupational health interventions can enhance the implementation and the contextual fit.
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2.
  • Albin, Maria, et al. (författare)
  • Ageing workers and an extended working life
  • 2017
  • Ingår i: Arbetslivet och socialförsäkringen. - Stockholm : Försäkringskassan. ; , s. 45-58
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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3.
  • Albin, Maria, et al. (författare)
  • Ska alla behöva arbeta längre?
  • 2020
  • Ingår i: Förlängt arbetsliv – förutsättningar, utmaningar och konsekvenser. - Stockholm : Försäkringskassan. ; , s. 72-83
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Det finns flera skäl till att öppna för att människor skall ha möjlighet att arbeta längre. Hit hör en i allmänhet förbättrad folkhälsa, behovet av arbetskraft och att ett gott och meningsfullt arbete kan berika livet för den enskilde samtidigt som det bidrar till samhällets välstånd och finansieringen av välfärdssystemen. Men ett arbetsmedicinskt svar på om alla ska behöva arbeta längre är klart Nej. Det grundar sig på: • folkhälsans ojämlika utveckling • att de fysiska kraven fortfarande är höga i många yrken, främst arbetaryrken • att arbetets fysiska krav är det som främst är begränsande vid högre åldrar • att många rapporterar att arbetets fysiska krav överstiger deras förmåga • den sjunkande tillgången till kvalificerad arbetsanpassning genom exempelvis företagshälsovård, särskilt för kvinnor och i arbetaryrken.
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4.
  • Albin, Maria, et al. (författare)
  • Sustainable work for health and job longevity
  • 2021
  • Ingår i: European Journal of Workplace Innovation. - : University of Agder. - 2387-4570. ; 6:2, s. 147-162
  • Tidskriftsartikel (refereegranskat)abstract
    • While improved public health in groups with high or middle socioeconomic status (e.g. educational level) permits many to work for more years, the gap is widening for less advantaged groups, such as those with only compulsory level education. Within manual jobs, individual health status and the challenges of physical demands exceed the physical capacity of many middle-aged, and with a low bargaining power, constitute major threats to job longevity. Artificial intelligence and digitization are also rapidly transforming the labour market, especially for low-mid grade (level) white-collar workers. Young workers often have insecure job contracts, while older workers may have a permanent position but have a fear of leaving a safe position for a new one, and ultimately may be forced to leave their job when they are unable to meet the demands.Current economic incentives to prolong working life – often combined with more restrictive unemployment and disability benefits – may overall increase work participation but may also decrease sustainability in the more disadvantaged part of the labour market.Recent research suggests that unemployment is the most important factor behind lost working years among workers with less education, and that primary prevention focused on the work environment rather than individual health promotion (lifestyle habits), will enhance sustainability together with inclusive welfare systems. Resilience, or reduced vulnerability, in the workforce on a macro- and workplace level can be achieved by well-established societal measures.
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5.
  • Almroth, Melody, 1989-, et al. (författare)
  • Labour market exit routes in high- and low-educated older workers before and after social insurance and retirement policy reforms in Sweden
  • 2024
  • Ingår i: Ageing & Society. - 0144-686X .- 1469-1779.
  • Tidskriftsartikel (refereegranskat)abstract
    • Few previous studies have investigated how socioeconomic differences in labour market exit have changed after restrictions in social insurance policies. The aim of this register-based study is to investigate how early labour market exit pathways among older men and women with different levels of education changed after major restrictive social insurance and retirement policy reforms in Sweden. Cohort 1 (pre-reform) consisted of individuals who were 60 or 61 years old in 2005 (N = 186,145) and Cohort 2 (post-reform) consisted of individuals who were 60 or 61 years old in 2012 (N = 176,216). Educational differences in four labour market exit pathways were investigated using Cox proportional hazards regression; the exit pathways were disability pension, early old-age pension with and without income respectively, and no income for two consecutive years. As expected, exits through disability pension were rarer in Cohort 2. Lower education was also more strongly associated with disability pension in Cohort 2. Parallel to this, lower education showed a stronger association with both early old-age pension types in Cohort 2. Additionally, a tendency towards a relatively higher likelihood of earning no income was seen among the less educated. Increases in inequalities tended to be greater for women. Our results indicate that educational inequalities in labour market exit have grown significantly after restrictions in social insurance and changes in retirement policies, which can have negative financial repercussions for those already in a vulnerable position. These results indicate that careful analyses of effects on disparities are needed before making major changes in welfare systems.
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6.
  • Badarin, Kathryn, et al. (författare)
  • Safety and health among undeclared workers : A mixed methods study investigating social partner experiences and strategies
  • 2024
  • Ingår i: Safety Science. - : Elsevier B.V.. - 0925-7535 .- 1879-1042. ; 175
  • Tidskriftsartikel (refereegranskat)abstract
    • Little is known about the experiences of the social partners in helping undeclared workers resist Occupational Safety and Health (OSH) issues. This study draws upon Walter Korpi’s ‘power resource theory’ to gain a deeper understanding of how power resources within the construction, transport, and cleaning sectors influence the ability of social partners to respond to OSH issues related to undeclared work. This mixed-method study uses survey data from employer representatives in the construction (n = 686) and transport (n = 650) sectors in Sweden in 2019 to estimate the nature and magnitude of undeclared work-related problems. To also study the view of union representatives, a duplicate survey was sent to union representatives in the transport, construction, and cleaning sectors (n = 57) in 2020, followed by 13 semi-structured interviews with Regional Safety Representatives (RSRs) in 2021–2023. Our findings show that employer representatives in construction and transport reported that the violation of OSH regulations was uncommon and remained unchanged, most union representatives said the opposite. We found a gradient of activism among the unions towards OSH issues related to undeclared work dependent on their power resources. Furthermore, structural and organizational factors limited the RSRs’ ability to address undeclared work. The RSRs identified strategies to tackle OSH issues related to undeclared work in their sectors, these included but were not limited to, dismantling the language barrier between unions and undeclared foreign-born workers, for OSH coordinators and main contractors to be held responsible for OSH violations and greater cooperation between the relevant authorities dealing with undeclared work. 
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7.
  • Bodin, Theo, et al. (författare)
  • Activity in neck-shoulder and lower arm muscles during computer and smartphone work
  • 2019
  • Ingår i: International Journal of Industrial Ergonomics. - : ELSEVIER. - 0169-8141 .- 1872-8219. ; 74
  • Tidskriftsartikel (refereegranskat)abstract
    • Relevance to industry: There is emerging evidence of musculoskeletal problems related to smartphone work and a rapid transition to mobile workplaces, where smartphones are key working tools. Aim: The study's aim was to compare muscle activity during computer work with smartphone work and to see what possible effects ergonomic recommendations for smartphone usage have on muscle activity. Methods: Activity was measured bilaterally from the upper trapezius muscle and from lower arm muscles on the right hand side, on twelve participants with surface electromyography who performed e-mail work on the computer using ergonomic recommendations, smartphone in a self-chosen way of working and on smartphone with ergonomic recommendations. Effects on productivity was not assessed in this study. Results: Activity in m. trapezius and m. extensor digitorum was significantly higher during computer work (p < 0.05) than during the two smartphone usages and activity in m. interossei dorsalis 1 was, vice versa, significantly higher during smartphone work fp < 0.05). Comparison of smartphone in self-chosen way of working and smartphone with ergonomic recommendations showed no significant differences. Conclusions: Previous research has highlighted the benefits of variation of work postures. This paper indicates that replacing the computer with a smartphone gives the trapezius muscle an opportunity to rest.
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8.
  • Bodin, Theo, et al. (författare)
  • Annoyance, Sleep and Concentration Problems due to Combined Traffic Noise and the Benefit of Quiet Side.
  • 2015
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 12:2, s. 1612-1628
  • Tidskriftsartikel (refereegranskat)abstract
    • Access to a quiet side in one's dwelling is thought to compensate for higher noise levels at the most exposed façade. It has also been indicated that noise from combined traffic sources causes more noise annoyance than equal average levels from either road traffic or railway noise separately.
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9.
  • Bodin, Theo, et al. (författare)
  • Road traffic noise, air pollution and myocardial infarction: a prospective cohort study.
  • 2016
  • Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 89:5, s. 793-802
  • Tidskriftsartikel (refereegranskat)abstract
    • Both road traffic noise and air pollution have been linked to cardiovascular disease. However, there are few prospective epidemiological studies available where both road traffic noise and air pollution have been analyzed simultaneously. The aim of this study was to investigate the relation between road traffic noise, air pollution and incident myocardial infarction in both current (1-year average) and medium-term (3-year average) perspective.
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10.
  • Bodin, Theo, et al. (författare)
  • Road traffic noise and hypertension: results from a cross-sectional public health survey in southern Sweden.
  • 2009
  • Ingår i: Environmental Health. - 1476-069X. ; 8:38
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Results from studies of road traffic noise and hypertension are heterogeneous with respect to effect size, effects among males and females and with respect to effects across age groups. Our objective was to further explore these associations. METHODS: The study used cross-sectional public health survey data from southern Sweden, including 24,238 adults (18 - 80 years old). We used a geographic information system (GIS) to assess the average road noise (LAeq 24 hr) at the current residential address. Effects on self-reported hypertension were estimated by logistic regression with adjustment for age, sex, BMI, alcohol intake, exercise, education, smoking and socioeconomic status. RESULTS: Modest exposure effects (OR approximately 1.1) were generally noted in intermediate exposure categories (45 -64 dB(A)), and with no obvious trend. The effect was more pronounced at > 64 dB(A) (OR 1.45, 95% CI 1.04 - 2.02). Age modified the relative effect (p = 0.018). An effect was seen among middle-aged (40 - 59 years old) at noise levels 60 - 64 dB(A) (OR = 1.27, 95% CI 1.02 - 1.58)) and at > 64 dB(A) (OR = 1.91, 95% CI 1.19 - 3.06)). An effect was also indicated among younger adults but not among elderly. No apparent effect modification by gender, country of origin, disturbed sleep or strained economy was noted. CONCLUSION: The study supports an association between road traffic noise at high average levels and self-reported hypertension in middle-aged. Future studies should use age group -specific relative effect models to account for differences in prevalence.
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11.
  • Bodin, Theo (författare)
  • Road Traffic Noise - Factors modifying its relation to annoyance and cardiovascular disease
  • 2014
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Traffic noise causes annoyance and sleep disturbance and has been linked with several other adverse effects on life quality and health, including increased risk of hypertension and myocardial infarction. Conservative estimates assume that at least one million healthy life years are lost every year from traffic related noise in the western part of Europe. We know from earlier studies that the adverse effects of environmental noise may be modified by social, demographic and individual factors. However, there is a need to better evaluate exposure-response in susceptible groups. The aim of this thesis was to test a number of factors hypothesised to modify the association between road traffic noise, annoyance and cardiovascular disease. Paper I-III are cross-sectional, while paper IV is a cohort study. The four different study populations in this thesis were selected through stratified random sampling of men and women aged 18-80 years old in the county of Skåne and its major city Malmö in southern Sweden. Exposures of road traffic and railway noise as well as air pollution were modelled using geographic information system (GIS) for the survey participants’ residential addresses. Possible confounding and modifying factors were mainly drawn from survey responses while outcomes were based on both self-reporting and inpatient registers. We were not able to show a relation between current and medium-term noise exposure to road traffic noise and incident myocardial infarction or ischemic heart disease in the general population. Air-pollution at low levels did not modify this effect. An association was however found between road traffic noise and hypertension in a cross-sectional study >60dB(A). We also found strong and positive relations between road traffic noise and annoyance. Railway noise was found to be less annoying at intermediate levels, but not >55dB(A). Access to quiet side had a protective effect and decreased the risk of annoyance, sleep and concentration problems equal to a 5dB(A) decrease in noise exposure. Generally middle-aged persons were found to be more susceptible to noise. Higher socioeconomic status and educational level were related to noise annoyance. With regard to sex, findings were less consistent. We also found that results in our studies might be biased due to selective participation, that noise sensitive individuals were likely to have a higher response rate and that inter-study comparison may be difficult since different annoyance scales can produce very different results. In conclusion, the health effects of noise are modified by noise source, co-exposures, environmental and socio-demographic factors (as well as personal traits) and research methodology. To develop better policies for residential noise environment, future research should focus on combined exposures and stressors as well as further explaining age differences and developing better ways to account for social class.
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12.
  • Bodin, Theo, et al. (författare)
  • Survey context and question wording affects self reported annoyance due to road traffic noise: a comparison between two cross-sectional studies.
  • 2012
  • Ingår i: Environmental health : a global access science source. - 1476-069X. ; 11:1
  • Tidskriftsartikel (refereegranskat)abstract
    • ABSTRACT: BACKGROUND: Surveys are a common way to measure annoyance due to road traffic noise, but the method has some draw-backs. Survey context, question wording and answer alternatives could affect participation and answers and could have implications when comparing studies and/or performing pooled analyses. The aim of this study was to investigate the difference in annoyance reporting due to road traffic noise in two types of surveys of which one was introduced broadly and the other with the clearly stated aim of investigating noise and health METHODS: Data was collected from two surveys carried out in the municipality of Malmo, southern Sweden in 2007 and 2008 (n = 2612 and n = 3810). The first survey stated an aim of investigating residential environmental exposure, especially noise and health. The second survey was a broad public health survey stating a broader aim. The two surveys had comparable questions regarding noise annoyance, although one used a 5-point scale and the other a 4-point scale. We used geographic information systems (GIS) to assess the average road and railway noise (LAeq,24h) at the participants' residential address. Logistic regression was used to calculate odds ratios for annoyance in relation to noise exposure. RESULTS: Annoyance at least once a week due to road traffic noise was significantly more prevalent in the survey investigating environment and health compared to the public health survey at levels >45 dB(A), but not at lower exposure levels. However no differences in annoyance were found when comparing the extreme alternatives "never" and "every day". In the study investigating environment and health, "Noise sensitive" persons were more likely to readily respond to the survey and were more annoyed by road traffic noise compared to the other participants in that survey. CONCLUSIONS: The differences in annoyance reporting between the two surveys were mainly due to different scales, suggesting that extreme alternatives are to prefer before dichotomization when comparing results between the two. Although some findings suggested that noise-sensitive individuals were more likely to respond to the survey investigating noise and health, we could not find convincing evidence that contextual differences affected either answers or participation.
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13.
  • Bodin, Theo, et al. (författare)
  • Trends in Precarious Employment in Sweden 1992–2017 : A Social Determinant of Health
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:19
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to identify trends in precarious employment in the Swedish workforce from 1992 to 2017. This is a repeated cross-sectional study, analyzing the total working population aged 16–75 in Sweden at five-year intervals. We used version 2.0 of the Swedish Register-based Operationalization of Precarious Employment, covering the following dimensions: employment insecurity, income inadequacy, lack of rights and protection. The proportion in precarious employment increased from 9.7 to 12% between 1992 and 2017, a relative increase of 24%. The prevalence was higher among those of lower age, of low education, and immigrants. Differences between sexes converged, and there were slightly more precarious men than women in 2017. The relative increase was most pronounced among men, especially those with low educational attainment and of European origin. The increasing proportion of precarious employees is a clear challenge to the tripartite Nordic model, which requires sufficient trade-union bargaining power.
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14.
  • Bosmans, Kim, et al. (författare)
  • Experiences of insecurity among non-standard workers across different welfare states : A qualitative cross-country study
  • 2023
  • Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 327
  • Tidskriftsartikel (refereegranskat)abstract
    • In recent decades, economic crises and political reforms focused on employment flexibilization have increased the use of non-standard employment (NSE). National political and economic contexts determine how employers interact with labour and how the state interacts with labour markets and manages social welfare policies. These factors influence the prevalence of NSE and the level of employment insecurity it creates, but the extent to which a country’s policy context mitigates the health influences of NSE is unclear. This study describes how workers experience insecurities created by NSE, and how this influences their health and well-being, in countries with different welfare states: Belgium, Canada, Chile, Spain, Sweden, and the United States. Interviews with 250 workers in NSE were analysed using a multiple-case study approach. Workers in all countries experienced multiple insecurities (e.g., income and employment insecurity) and relational tension with employers/clients, with negative health and well-being influences, in ways that were shaped by social inequalities (e.g., related to family support or immigration status). Welfare state differences were reflected in the level of workers’ exclusion from social protections, the time scale of their insecurity (threatening daily survival or longer-term life planning), and their ability to derive a sense of control from NSE. Workers in Belgium, Sweden, and Spain, countries with more generous welfare states, navigated these insecurities with greater success and with less influence on health and well-being. Findings contribute to our understanding of the health and well-being influences of NSE across different welfare regimes and suggest the need in all six countries for stronger state responses to NSE. Increased investment in universal and more equal rights and benefits in NSE could reduce the widening gap between standard and NSE. 
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15.
  • Canivet, Catarina, et al. (författare)
  • Precarious employment is a risk factor for poor mental health in young individuals in Sweden : a cohort study with multiple follow-ups
  • 2016
  • Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 16
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The globalisation of the economy and the labour markets has resulted in a growing proportion of individuals who find themselves in a precarious labour market situation, especially among the young. This pertains also to the Nordic countries, despite their characterisation as well developed welfare states with active labour market policies. This should be viewed against the background of a number of studies, which have shown that several aspects of precarious employment are detrimental to mental health. However, longitudinal studies from the Nordic region that examine the impact of precarious labour market conditions on mental health in young individuals are currently lacking. The present study aims to examine this impact in a general cohort of Swedish young people.METHODS: Postal questionnaires were sent out in 1999/2000 to a stratified random sample of the Scania population, Sweden; the response rate was 58 %. All of those who responded at baseline were invited to follow-ups after 5 and 10 years. Employment precariousness was determined based on detailed questions about present employment, previous unemployment, and self-rated risk of future unemployment. Mental health was assessed by GHQ-12. For this study individuals in the age range of 18-34 years at baseline, who were active in the labour market (employed or seeking job) and had submitted complete data from 1999/2000, 2005, and 2010 on employment precariousness and mental health status, were selected (N = 1135).RESULTS: Forty-two percent of the participants had a precarious employment situation at baseline. Labour market trajectories that included precarious employment in 1999/2000 or 2005 predicted poor mental health in 2010: the incidence ratio ratio was 1.4 (95 % CI: 1.1-2.0) when excluding all individuals with mental health problems at baseline and adjusting for age, gender, social support, social capital, and economic difficulties in childhood. The population attributable fraction regarding poor mental health in the studied age group was 18 %.CONCLUSIONS: This study supported the hypothesis that precarious employment should be regarded as an important social determinant for subsequent development of mental health problems in previously mentally healthy young people.
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16.
  • Cedstrand, Emma, et al. (författare)
  • A Participatory Intervention to Improve the Psychosocial Work Environment and Mental Health in Human Service Organisations. A Mixed Methods Evaluation Study
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Work-related stress is a global problem causing suffering and economic costs. In Sweden, employees in human service occupations are overrepresented among persons on sick leave due to mental health problems such as stress-related disorders. The psychosocial work environment is one contributing factor for this problem, making it urgent to identify effective methods to decrease stress at the workplace. The aim of the study is to evaluate a participatory intervention to improve the psychosocial work environment and mental health using an embedded mixed methods design. The study is a controlled trial with a parallel process evaluation exploring fidelity and participants' reactions to the intervention activities, experiences of learning and changes in behaviours and work routines. We collected data through documentation, interviews and three waves of questionnaires. Our results show small changes in behaviours and work routines and no positive effects of the intervention on the psychosocial work environment nor health outcomes. One explanation is end-users' perceived lack of involvement over the process causing the intervention to be seen as a burden. Another explanation is that the intervention activities were perceived targeting the wrong organisational level. A representative participation over both content and process can be an effective strategy to change psychosocial working conditions and mental health.
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17.
  • Cedstrand, Emma, et al. (författare)
  • Effects of a co-created occupational health intervention on stress and psychosocial working conditions within the construction industry : a controlled trial
  • 2022
  • Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Work-related stress problems, i.e., burnout, depression, and anxiety, is a rising global health challenge. Poor mental health also appears to be a challenge for the construction industry, even though the occupational health focus has traditionally been on the physical work environment and musculoskeletal disorders. Yet, studies targeting the organisational level (i.e., work environment, policy) to enhance mental health within the construction industry are scant. Therefore, our first objective was to evaluate the effectiveness of a co-created occupational health intervention on stress and psychosocial working conditions within the construction industry in Sweden. The second objective was to evaluate whether the intervention was implemented as intended, i.e., implementation fidelity. The trial is registered in the ISRCTN clinical trial registry (ISRCTN16548039, ). Methods This is a controlled trial with one intervention and one matched control group. We co-created the program logic with stakeholders from the intervention group. The essence of the chosen intervention components, duties clarification, and structured roundmaking was enhanced planning and role clarification. We assessed adherence to the intervention and dose delivered (i.e., fidelity). We collected data on the outcomes (role clarity, team effectiveness, planning, staffing, quantitative demands, and the psychosocial safety climate) with online questionnaires at baseline, 12, and 24 months. Marginal means models adjusting for missing data patterns were applied to estimate potential differences in outcomes between groups over time. Results Fidelity was considered reasonably high. Yet, we found no intervention effects on the primary outcome stress. All outcomes, except role clarity deteriorated during the trial in the intervention and control group. However, the results indicate a positive effect of the intervention components on professionals' role clarity. The pandemic appears to have negatively affected stress and psychosocial working conditions. Conclusion The study's results suggest that co-creating occupational health interventions could be one solution for improved implementation fidelity. More studies are needed to evaluate these intervention components. Also, we recommend researchers of future intervention studies consider using missing not at random, sensitivity analysis.
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18.
  • Cedstrand, Emma, et al. (författare)
  • Study protocol of a co-created primary organizational-level intervention with the aim to improve organizational and social working conditions and decrease stress within the construction industry : a controlled trial
  • 2020
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Within construction industry, physical work exposures have long been recognized as possible determinants for musculoskeletal disorders, but less attention has been given the increasing organizational and social work hazards and stress within this industry. There is to date a lack of knowledge about how to improve organizational and social working conditions and decrease stress within the construction industry.Methods: This paper outlines the design of a controlled trial to evaluate the effectiveness of a co-created organizational-level intervention with the aim to improve role clarity, quantitative demands, staffing, planning, team effectiveness, psychosocial safety climate and stress. Two regions (> 700 employees) within one large construction company in Sweden will participate as intervention and control group. Further we present the design of the process evaluation assessing fidelity, support from managers, readiness for change and contextual factors. We will utilize questionnaires, semi-structured interviews, observations and documentation as means for data collection, hence a mixed methods approach is applied.Discussion: The study is expected to contribute to the understanding of how adverse organizational and social working conditions and stress can be improved within the construction industry. By applying co-creation we wish to develop an intervention and implementation strategies that fit to the context, are in line with the needs of end-users and are supported by all management levels - all of which are highlighted features in successful workplace interventions.
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19.
  • Ekström, Ulf, et al. (författare)
  • Insufficient mixing of thawed serum samples leading to erroneous results - experience from a field study and use of a correction procedure
  • 2020
  • Ingår i: Scandinavian Journal of Clinical & Laboratory Investigation. - : Informa UK Limited. - 0036-5513 .- 1502-7686. ; 80:2, s. 99-105
  • Tidskriftsartikel (refereegranskat)abstract
    • Incorrect analysis results that are close to expected might not be recognized in scientific studies or routine patient care. In two field studies we obtained unexpected results in a large number of samples. The present study aimed to identify the source of error in the samples from these studies and to validate a method to obtain correct results. Pre-analytical procedures were scrutinized, giving no indications of inappropriate pre-analytical sample handling in the field or during transport in a tropical climate. Using a new set of samples from volunteers in simulation experiments, we observed the known concentration gradient of analytes sampled in gel as well as plain tubes after freezer storage and thawing. Experiments demonstrated that mixing of samples by vortexing alone was not sufficient to disrupt the gradient formed by freezing and thawing, which appeared to cause the problem encountered when we in field studies analyzed and biobanked large sample sets by robot pipetting. A correction procedure was introduced, in which the obtained value of an analyte was multiplied by a correction factor calculated for each sample using the expected sodium level (140 mmol/L) divided by the measured sodium value. When it was validated on results from the simulation experiments, we repeatedly found that the correction lead to results very close to true values for analytes of different size and charge. Usefulness of the procedure was demonstrated when applied to a large set of field study results.
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20.
  • Falkstedt, Daniel, et al. (författare)
  • Disability pensions related to heavy physical workload : a cohort study of middle-aged and older workers in Sweden
  • 2021
  • Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 94, s. 1851-1861
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives The aim of the study was to examine the associations between heavy physical workload among middle-aged and older workers and disability pension due to any diagnosis, as well as musculoskeletal, psychiatric, cardiovascular or respiratory diagnoses. The population-based design made it possible to examine dose-response and potential gender differences in the associations. Methods About 1.8 million men and women aged 44-63 years and registered as living in Sweden in 2005 were followed regarding disability pension during 2006-2016, until ages 55-65 years. Mean values of physical workload and job control, estimated through gender-specific job-exposure matrices (JEMs), were assigned to individuals through their occupational titles in 2005. Exposure values were ranked separately for women and men and divided into quintiles. Associations were analyzed with Cox proportional-hazards regression. Results The analyses showed robust, dose-response associations between physical workload and disability pension with a musculoskeletal diagnosis in both genders: the adjusted hazard ratio and 95% confidence interval for those with the heaviest exposure was 2.58 (2.37-2.81) in women and 3.34 (2.83-3.94) in men. Dose-response associations were also seen in relation to disability pension with a cardiovascular or a respiratory diagnosis, though the hazard ratios were smaller. Physical workload was not associated with disability pension with a psychiatric diagnosis after adjustment for job control. Conclusion This study of the entire Swedish population of middle-aged and older workers suggests that higher degrees of physical workload may increase the risk of disability pension overall, and specifically with musculoskeletal, cardiovascular or respiratory diagnosis, in both women and men.
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21.
  • Falkstedt, Daniel, et al. (författare)
  • Job demands and job control and their associations with disability pension—a register-based cohort study of middle-aged and older Swedish workers
  • 2023
  • Ingår i: International Archives of Occupational and Environmental Health. - 0340-0131 .- 1432-1246. ; 96:8, s. 1137-1147
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives Job demands and control at work and their combination, job strain, have been studied in relation to risk of disability pension (DP) previously. In the present study, based on registry data, we aimed to deepen the knowledge by analyzing major disease groups among the DPs, dose–response shape of the associations, and potential confounding effects of physical workload.Methods Approximately 1.8 million workers aged 44 or older and living in Sweden in 2005 were followed up for 16 years, up to a maximum of 65 years of age. We linked mean values of job demands and job control, estimated in a job-exposure matrice (JEM) by gender, to individuals through their occupational titles in 2005. These values were categorized by rank order, and, for the construction of job-strain quadrants, we used a median cut-off. Associations with DP were estimated in Cox proportional-hazards models.Results In models accounting for covariates including physical workload, low levels of job control were associated with higher risk of DP among both men and women. This association was most clear for DP with a psychiatric diagnosis, although a dose–response shape was found only among the men. High levels of job demands were associated with decreased risk of DP across diagnoses among men, but the same association varied from weak to non-existing among women. The high- and passive job-strain quadrants both showed increased risk of DP with a psychiatric diagnosis.Conclusion The results suggest that, at the occupational level, low job control, but not high job demands, contributes to an increased incidence of DP, particularly regarding DP with a psychiatric diagnosis.
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22.
  • Gunn, Virginia, et al. (författare)
  • Initiatives addressing precarious employment and its effects on workers' health and well-being : a protocol for a systematic review
  • 2021
  • Ingår i: Systematic Reviews. - : BioMed Central (BMC). - 2046-4053. ; 10:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Precarious employment is a significant determinant of population health and health inequities and has complex public health consequences both for a given nation and internationally. Precarious employment is conceptualized as a multi-dimensional construct including but not limited to employment insecurity, income inadequacy, and lack of rights and protection in the employment relation, which could affect both informal and formal workers. The purpose of this review is to identify, appraise, and synthesize existing research on the effectiveness of initiatives aiming to or having the potential to eliminate, reduce, or mitigate workers' exposure to precarious employment conditions and its effects on the health and well-being of workers and their families. Methods: The electronic databases searched (from January 2000 onwards) are Scopus, Web of Science Core Collection, and PubMed, along with three institutional databases as sources of grey literature. We will include any study (e.g. quantitative, qualitative, or mixed-methods design) evaluating the effects of initiatives that aim to or have the potential to address workers' exposure to precarious employment or its effects on the health and well-being of workers and their families, whether or not such initiatives were designed specifically to address precarious employment. The primary outcomes will be changes in (i) the prevalence of precarious employment and workers' exposure to precarious employment and (ii) the health and well-being of precariously employed workers and their families. No secondary outcomes will be included. Given the large body of evidence screened, the initial screening of each study will be done by one reviewer, after implementing several strategies to ensure decision-making consistency across reviewers. The screening of full-text articles, data extraction, and critical appraisal will be done independently by two reviewers. Potential conflicts will be resolved through discussion. Established checklists will be used to assess a study's methodological quality or bias. A narrative synthesis will be employed to describe and summarize the included studies' characteristics and findings and to explore relationships both within and between the included studies. Discussion: We expect that this review's findings will provide stakeholders interested in tackling precarious employment and its harmful health effects with evidence on effectiveness of solutions that have been implemented to inform considerations for adaptation of these to their unique contexts. In addition, the review will increase our understanding of existing research gaps and enable us to make recommendations to address them. Our work aligns with the sustainable development agenda to protect workers, promote decent work and economic growth, eliminate poverty, and reduce inequalities.
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23.
  • Gunn, Virginia, et al. (författare)
  • Initiatives Addressing Precarious Employment and Its Effects on Workers' Health and Well-Being : A Systematic Review
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:4
  • Forskningsöversikt (refereegranskat)abstract
    • The prevalence of precarious employment has increased in recent decades and aspects such as employment insecurity and income inadequacy have intensified during the COVID-19 pandemic. The purpose of this systematic review was to identify, appraise, and synthesise existing evidence pertaining to implemented initiatives addressing precarious employment that have evaluated and reported health and well-being outcomes. We used the PRISMA framework to guide this review and identified 11 relevant initiatives through searches in PubMed, Scopus, Web of Science, and three sources of grey literature. We found very few evaluated interventions addressing precarious employment and its impact on the health and well-being of workers globally. Ten out of 11 initiatives were not purposefully designed to address precarious employment in general, nor specific dimensions of it. Seven out of 11 initiatives evaluated outcomes related to the occupational health and safety of precariously employed workers and six out of 11 evaluated worker health and well-being outcomes. Most initiatives showed the potential to improve the health of workers, although the evaluation component was often described with less detail than the initiative itself. Given the heterogeneity of the 11 initiatives regarding study design, sample size, implementation, evaluation, economic and political contexts, and target population, we found insufficient evidence to compare outcomes across types of initiatives, generalize findings, or make specific recommendations for the adoption of initiatives.
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24.
  • Gunn, Virginia, et al. (författare)
  • Non-Standard Employment and Unemployment during the COVID-19 Crisis : Economic and Health Findings from a Six-Country Survey Study
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:10
  • Tidskriftsartikel (refereegranskat)abstract
    • The COVID-19 crisis is a global event that has created and amplified social inequalities, including an already existing and steadily increasing problem of employment and income insecurity and erosion of workplace rights, affecting workers globally. The aim of this exploratory study was to review employment-related determinants of health and health protection during the pandemic, or more specifically, to examine several links between non-standard employment, unemployment, economic, health, and safety outcomes during the COVID-19 pandemic in Sweden, Belgium, Spain, Canada, the United States, and Chile, based on an online survey conducted from November 2020 to June 2021. The study focused on both non-standard workers and unemployed workers and examined worker outcomes in the context of current type and duration of employment arrangements, as well as employment transitions triggered by the COVID-19 crisis. The results suggest that COVID-19-related changes in non-standard worker employment arrangements, or unemployment, are related to changes in work hours, income, and benefits, as well as the self-reported prevalence of suffering from severe to extreme anxiety or depression. The results also suggest a link between worker type, duration of employment arrangements, or unemployment, and the ability to cover regular expenses during the pandemic. Additionally, the findings indicate that the type and duration of employment arrangements are related to the provision of personal protective equipment or other COVID-19 protection measures. This study provides additional evidence that workers in non-standard employment and the unemployed have experienced numerous and complex adverse effects of the pandemic and require additional protection through tailored pandemic responses and recovery strategies.
  •  
25.
  • Hansson, Erik, et al. (författare)
  • Pathophysiological mechanisms by which heat stress potentially induces kidney inflammation and chronic kidney disease in sugarcane workers
  • 2020
  • Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 12:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Chronic kidney disease of non-traditional origin (CKDnt) is common among Mesoamerican sugarcane workers. Recurrent heat stress and dehydration is a leading hypothesis. Evidence indicate a key role of inflammation. Methods: Starting in sports and heat pathophysiology literature, we develop a theoretical framework of how strenuous work in heat could induce kidney inflammation. We describe the release of pro-inflammatory substances from a leaky gut and/or injured muscle, alone or in combination with tubular fructose and uric acid, aggravation by reduced renal blood flow and increased tubular metabolic demands. Then, we analyze longitudinal data from >800 sugarcane cutters followed across harvest and review the CKDnt literature to assess empirical support of the theoretical framework. Results: Inflammation (CRP elevation and fever) and hyperuricemia was tightly linked to kidney injury. Rehydrating with sugary liquids and NSAID intake increased the risk of kidney injury, whereas electrolyte solution consumption was protective. Hypokalemia and hypomagnesemia were associated with kidney injury. Discussion: Heat stress, muscle injury, reduced renal blood flow and fructose metabolism may induce kidney inflammation, the successful resolution of which may be impaired by daily repeating pro-inflammatory triggers. We outline further descriptive, experimental and intervention studies addressing the factors identified in this study.
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