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Björnstig, Ulf
Publications (10 of 86) Show all publications
Engström, K. G., Angrén, J., Björnstig, U. & Saveman, B.-I. (2018). Mass casualty incidents in the underground mining industry: applying the Haddon Matrix on an integrative literature review. Disaster Medicine and Public Health Preparedness, 12(1), 138-146
Open this publication in new window or tab >>Mass casualty incidents in the underground mining industry: applying the Haddon Matrix on an integrative literature review
2018 (English)In: Disaster Medicine and Public Health Preparedness, ISSN 1935-7893, E-ISSN 1938-744X, Vol. 12, no 1, p. 138-146Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Underground mining is associated with obvious risks that can lead to mass casualty incidents. Information about such incidents was analyzed in an integrated literature review.

METHODS: A literature search (1980-2015) identified 564 modern-era underground mining reports from countries sharing similar occupational health legislation. These reports were condensed to 31 reports after consideration of quality grading and appropriateness to the aim. The Haddon matrix was used for structure, separating human factors from technical and environmental details, and timing.

RESULTS: Most of the reports were descriptive regarding injury-creating technical and environmental factors. The influence of rock characteristics was an important pre-event environmental factor. The organic nature of coal adds risks not shared in hard-rock mines. A sequence of mechanisms is commonly described, often initiated by a human factor in interaction with technology and step-wise escalation to involve environmental circumstances. Socioeconomic factors introduce heterogeneity. In the Haddon matrix, emergency medical services are mainly a post-event environmental issue, which were not well described in the available literature. The US Quecreek Coal Mine incident of 2002 stands out as a well-planned rescue mission.

CONCLUSION: Evaluation of the preparedness to handle underground mining incidents deserves further scientific attention. Preparedness must include the medical aspects of rescue operations.

Place, publisher, year, edition, pages
Cambridge University Press, 2018
Keywords
mass casualty incident, medical emergency, preparedness, rescue, underground mining
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-137579 (URN)10.1017/dmp.2017.31 (DOI)000428215300023 ()28592339 (PubMedID)
Available from: 2017-07-05 Created: 2017-07-05 Last updated: 2018-06-09Bibliographically approved
Björnstig, J., Björnstig, U. & Järvholm, B. (2017). Dödsolyckor i arbetslivet: Delrapport 2. Stockholm: Arbetsmiljöverket
Open this publication in new window or tab >>Dödsolyckor i arbetslivet: Delrapport 2
2017 (Swedish)Report (Other academic)
Abstract [sv]

Denna sammanfattning redovisar de viktigaste resultaten och slutsatserna i delrapport 1 och 2.

Dödsolyckor och allvarliga olyckor i arbetet har minskat kraftigt sedan 1950-talet i Sverige. I dag drabbas i genomsnitt 1 av 100 000 personer av en dödsolycka i arbetet och 1 av 500 personer av en allvarlig arbetsolycka.1 Nio av tio arbetsrelaterade dödsolyckor drabbar män. Dödsolyckor drabbar i högre grad äldre personer och mer än hälften av männen som omkom 2010-2014 var över 50 år. En delförklaring är att äldre får svårare skador än yngre om de utsätts för samma skadevåld och därmed ökar risken för en dödlig utgång.

Fordonsrelaterade olyckor utgör ca hälften av alla dödsolyckor. Hälften av dem sker i vägtrafikområden och hälften i andra miljöer. Fallolyckor är en annan viktig orsak till dödsolyckor och då främst fall från en höjd. Många sådana olyckor inträffar inom byggverksamhet, och vår analys tyder på att byggställningar kan vara ett område för förbättringar för att undvika tekniska brister. Dödliga elolyckor drabbar framför allt äldre elinstallatörer, som sannolikt har långvarig yrkeserfarenhet. Det talar för att också personer med lång erfarenhet kan behöva återkommande utbildningar. Trädfällning är en annan betydande orsak till dödsolyckor, framför allt inom jord- och skogsbruk.

En jämförelse av data ur registren för dödliga och allvarliga arbetsolyckor visar att det finns skillnader, bland annat när det gäller vem som drabbas och var skadan inträffar. Det innebär att register om allvarliga men icke dödliga skador ger begränsad information om vilka förebyggande åtgärder som är lämpliga mot dödsolyckor och var de ska sättas in.

Vi har även analyserat uppgifter från dödsorsaksregistret i kombination med yrkesregistret. Resultatet ger ingen ytterligare information utöver den man kan få ur Arbetsmiljöverkets register. Vi har också studerat data från registret över personer som vårdats i sluten vård på sjukhus och kombinerat detta med data från yrkesregistret. Resultatet ger ingen ytterligare information utöver den man kan få ur Arbetsmiljöverkets eller AFA Försäkrings register.

1 En olycka som kräver mer än 14 dagars sjukskrivning.10

Våra viktigaste slutsatser är:

  • Dödsolyckor och allvarliga olyckor är sällsynta händelser och händelseförloppet varierar mycket. Därför är det svårt för företag, organisationer och grupper av individer (arbetskamrater, den drabbade etcetera) att lära sig något av en olycka. Därmed bedömer vi att personliga erfarenheter och allmän information om olycksrisker har begränsat värde för att minska antalet dödsolyckor och allvarliga olyckor. I stället anser vi att det förebyggande arbetet bör inriktas mot att prioritera tekniska lösningar som minskar risker samt att införa strikta organisatoriska rutiner för till exempel skyddsutrustning och handhavande där det finns risk för dödsolyckor. Så sker redan idag i mycket riskmedvetna organisationer som till exempel flyget.
  • Strategierna för att förebygga dödsolyckor respektive allvarliga olyckor bör delvis ha olika fokus. Det går alltså inte att prioritera åtgärder mot dödsolyckor i arbetslivet enbart utifrån var och hur allvarliga skadefall inträffar.
  • Vissa typer av dödsolyckor är vanligare än andra och ca två tredjedelar av alla dödsolyckor gäller fordonsolyckor och fallolyckor från höjd. För att minska förekomsten mer påtagligt måste man inrikta åtgärder mot dem.
  • Vissa grupper är också mer utsatta än andra, till exempel personer som arbetar med eller vid fordon och på hög höjd. Många sådana arbeten är på tillfälliga arbetsplatser, vilket ofta ställer särskilda krav på att individen själv förebygger risker. Därför krävs särskild och fortlöpande utbildning. Dödsolyckor bland elektriker drabbar främst äldre personer, liksom dödsolyckor i samband med trädfällning. Därför är det viktigt att upprätthålla kunskap och medvetenhet om risker även hos personer med långvarig yrkeserfarenhet. Vidare kan det behövas särskilt anpassade åtgärder för små företag eller egenföretagare.
  • Utredningarna av dödsolyckor och allvarliga olyckor kan utvecklas för att få ett ännu tydligare fokus på det förebyggande arbetet.
Abstract [en]

Fatal and serious occupational accidents have decreased in Sweden since the 1950s. Today, there is on average, about 1 fatal outcome of occupational accidents per 100 000 persons, and 1 serious accident per 500 persons.2 Nine of ten occupational accidents with fatal outcome 2010-2014 happened to men. Fatal accidents are more common among elderly people and more than half of the male victims were over the age of 50. Older people often suffer more severe injuries than younger people for the same trauma, which may have contributed to the observed higher death rate among mature and elderly persons.

Accidents related to vehicles represented about half of all fatalities. Half of these happened on public roads in ordinary road traffic, and the other half happened in other places and under other circumstances than vehicle crashes. Falls, especially from higher level, were another significant cause of fatal accidents. Many such accidents occurred in the construction industry, and our analysis indicates that e.g. improvement of scaffolding could decrease the risk. Half of fatally injured electricians were older than 58 years with long occupational experience. This indicates that persons with long experience may also need repeated training and education. Cutting down trees was another important cause of fatalities, especially among older persons working within forestry and agriculture.

Comparative data from registers of fatal and serious occupational accidents indicates differences in who had the accident and where the accident occurred. This means that a register of non-fatal accidents gives limited information about possible strategies for the prevention of accidents with fatal outcome.

2 A serious accident is an accident with at least 14 days sick absenteeism.12

Important conclusions are

  • Fatal and serious occupational accidents are rare events with different causes. It is therefore difficult for organizations and working groups to learn from incidents in their own organization. Personal experience and general information about risks have thus limited potential to prevent fatal and serious accidents within a single organization if not compiled or aggregated in e.g. a wider national perspective. We think that injury mitigation work should focus on technical measures and support strict organizational procedures, e.g. for the use of protective equipment especially where there is risk for fatal accidents. Today that is routine procedure in organizations with high awareness of risks, such as the aviation industry.
  • The strategy for prevention of fatal and serious occupational injuries may partly have different focus as their epidemiology is different.
  • Two of three fatal accidents are related to vehicles, or to falls from higher level, which are the two most important areas to address in the injury reducing work of fatalities.
  • Many of the most risky activities above happened at temporary workplaces, which often require that the worker themselves prevent risks. This requires special training and education.
  • Fatal accidents due to electricity or cutting of trees often happened to mature and elderly persons. It may indicate that continuous training and education could be of value also in experienced persons as well as in small enterprises and among the self-employed.
  • Investigation of fatal and serious occupational accidents could be developed to have an even stronger focus on injury mitigation and prevention.
Place, publisher, year, edition, pages
Stockholm: Arbetsmiljöverket, 2017. p. 63
Series
Arbetsmiljöverket: Kunskapssammanställning, ISSN 1650-3171 ; 2017:3
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-134772 (URN)
Available from: 2017-05-11 Created: 2017-05-11 Last updated: 2018-06-09Bibliographically approved
Doohan, I., Björnstig, U., Östtlund, U. & Saveman, B.-I. (2017). Exploring Injury Panorama, Consequences, and Recovery among Bus Crash Survivors: A Mixed-Methods Research Study. Prehospital and Disaster Medicine, 32(2), 165-174
Open this publication in new window or tab >>Exploring Injury Panorama, Consequences, and Recovery among Bus Crash Survivors: A Mixed-Methods Research Study
2017 (English)In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 32, no 2, p. 165-174Article in journal (Refereed) Published
Abstract [en]

Objective The aim of this study was to explore physical and mental consequences and injury mechanisms among bus crash survivors to identify aspects that influence recovery. Methods The study participants were the total population of survivors (N=56) from a bus crash in Sweden. The study had a mixed-methods design that provided quantitative and qualitative data on injuries, mental well-being, and experiences. Results from descriptive statistics and qualitative thematic analysis were interpreted and integrated in a mixed-methods analysis. Results Among the survivors, 11 passengers (20%) sustained moderate to severe injuries, and the remaining 45 (80%) had minor or no physical injuries. Two-thirds of the survivors screened for posttraumatic stress disorder (PTSD) risk were assessed, during the period of one to three months after the bus crash, as not being at-risk, and the remaining one-third were at-risk. The thematic analysis resulted in themes covering the consequences and varying aspects that affected the survivors' recoveries. The integrated findings are in the form of four core cases of survivors who represent a combination of characteristics: injury severity, mental well-being, social context, and other aspects hindering and facilitating recovery. Core case Avery represents a survivor who had minor or no injuries and who demonstrated a successful mental recovery. Core case Blair represents a survivor with moderate to severe injuries who experienced a successful mental recovery. Core case Casey represents a survivor who sustained minor injuries or no injuries in the crash but who was at-risk of developing PTSD. Core case Daryl represents a survivor who was at-risk of developing PTSD and who also sustained moderate to severe injuries in the crash. Conclusion The present study provides a multi-faceted understanding of mass-casualty incident (MCI) survivors (ie, having minor injuries does not always correspond to minimal risk for PTSD and moderate to severe injuries do not always correspond to increased risk for PTSD). Injury mitigation measures (eg, safer roadside material and anti-lacerative windows) would reduce the consequences of bus crashes. A well-educated rescue team and a compassionate and competent social environment will facilitate recovery.

Place, publisher, year, edition, pages
CAMBRIDGE UNIV PRESS, 2017
Keywords
Emergency Medical Services, injuries, mass-casualty incident, survivors
National Category
Other Medical Sciences not elsewhere specified Nursing
Identifiers
urn:nbn:se:umu:diva-134251 (URN)10.1017/S1049023X16001485 (DOI)000398228600007 ()28132665 (PubMedID)
Available from: 2017-05-23 Created: 2017-05-23 Last updated: 2018-06-09Bibliographically approved
Henriksson, O., Björnstig, U., Saveman, B.-I. & Lundgren, P. J. (2017). Protection against cold: a survey of available equipment in Swedish pre-hospital services. Acta Anaesthesiologica Scandinavica, 61(10), 1354-1360
Open this publication in new window or tab >>Protection against cold: a survey of available equipment in Swedish pre-hospital services
2017 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 61, no 10, p. 1354-1360Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this study was to survey the current equipment used for prevention, treatment and monitoring of accidental hypothermia in Swedish pre-hospital services.

Methods: A questionnaire was sent to all road ambulance services (AS), the helicopter emergency medical services (HEMS), the national helicopter search and rescue service (SAR) and the municipal rescue services (RS) in Sweden to determine the availability of insulation, active warming, fluid heating, and low-reading thermometers.

Results: The response rate was 77% (n = 255). All units carried woollen or polyester blankets for basic insulation. Specific windproof insulation materials were common in the HEMS, SAR and RS units but only present in about half of the AS units. Active warming equipment was present in all the SAR units, but only in about two-thirds of the HEMS units and about one-third of the AS units. About half of the RS units had the ability to provide a heated tent or container. Low-reading thermometers were present in less than half of the AS and HEMS units and were non-existent in the SAR units. Pre-warmed intravenous fluids were carried by almost all of the AS units and half of the HEMS units but infusion heaters were absent in most units.

Conclusion: Basic insulation capabilities are well established in the Swedish pre-hospital services. Specific wind and waterproof insulation materials, active warming devices, low-reading thermometers and IV fluid heating systems are less common. We suggest the development and implementation of national guidelines on accidental hypothermia that include basic recommendations on equipment requirements.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
National Category
Anesthesiology and Intensive Care Nursing
Identifiers
urn:nbn:se:umu:diva-140731 (URN)10.1111/aas.13002 (DOI)000412533500014 ()28940249 (PubMedID)
Available from: 2017-10-18 Created: 2017-10-18 Last updated: 2018-06-09Bibliographically approved
Björnstig, J., Bylund, P.-O. & Björnstig, U. (2017). Vehicle-related injuries in and around a medium sized Swedish City - bicyclist injuries caused the heaviest burden on the medical sector. Injury Epidemiology, 4, Article ID 4.
Open this publication in new window or tab >>Vehicle-related injuries in and around a medium sized Swedish City - bicyclist injuries caused the heaviest burden on the medical sector
2017 (English)In: Injury Epidemiology, ISSN 0176-3733, E-ISSN 2197-1714, Vol. 4, article id 4Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: A data acquisition from the medical sector may give one important view of the burden on the society caused by vehicle related injuries. The official police-reported statistics may only reflect a part of all vehicle-related injured seeking medical attention. The aim is to provide a comprehensive picture of the burden of vehicle related injuries on the medical sector (2013), and to compare with official police-reported statistics and the development year 2000-2013.

METHODS: The data set includes 1085 injured from the Injury Data Base at Umeå University Hospital's catchment area with 148,500 inhabitants in 2013.

RESULTS: Bicyclists were the most frequently injured (54%). One-third had non-minor (MAIS2+) injuries, and bicyclists accounted for 58% of the 1071 hospital bed days for all vehicle-related injuries. Car occupants represented 23% of all injured, and only 9% had MAIS2+ injuries. They accounted for 17% of the hospital bed days. Motorized two wheel vehicle riders represented 11% of the injured and 39% had MAIS2+ injuries and they occupied 11% of the hospital bed days. Of the 1085 medically treated persons, 767 were injured in public traffic areas, and, therefore, should be included in the official police statistics; however, only a third (232) of them were reported by the police. The annual injury rate had not changed during 2000-2013 for bicyclists, motor-cycle riders, pedestrians or snowmobile riders. However, for passenger car occupants a decrease was observed after 2008, and for mopedists the injury rate was halved after 2009 when a licensing regulation was introduced.

CONCLUSION: The Swedish traffic injury reducing strategy Vision Zero, may have contributed to the reduction of injured car occupants and moped riders. The official police-reported statistics was a biased data source for vehicle related injuries and the total number medically treated was in total five times higher. Bicyclists caused the heaviest burden on the medical sector; consequently, they need to be prioritized in future safety work, as recently declared in the Government plan Vision Zero 2.0.

Keywords
Traffic injuries, Vehicle, Crashes, Bicyclists, Police statistics, Hospitalization
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-131971 (URN)10.1186/s40621-016-0101-8 (DOI)28116658 (PubMedID)
Available from: 2017-02-27 Created: 2017-02-27 Last updated: 2018-06-09Bibliographically approved
Öman, M., Fredriksson, R., Bylund, P.-O. & Björnstig, U. (2016). Analysis of the mechanism of injury in non-fatal vehicle-to-pedestrian and vehicle-to-bicyclist frontal crashes in Sweden. International Journal of Injury Control and Safety Promotion, 23(4), 405-412
Open this publication in new window or tab >>Analysis of the mechanism of injury in non-fatal vehicle-to-pedestrian and vehicle-to-bicyclist frontal crashes in Sweden
2016 (English)In: International Journal of Injury Control and Safety Promotion, ISSN 1745-7300, E-ISSN 1745-7319, Vol. 23, no 4, p. 405-412Article in journal (Refereed) Published
Abstract [en]

The aim of this paper is to analyse and compare injuries and injury sources in pedestrian and bicyclist non-fatal real-life frontal passengercar crashes, considering in what way pedestrian injury mitigation systems also might be adequate for bicyclists. Data from 203 non-fatal vehicle-to-pedestrian and vehicle-to-bicyclist crashes from 1997 through 2006 in a city in northern Sweden were analysed by use of the hospitals injury data base in addition to interviews with the injured. In vehicle-to-pedestrian crashes (n = 103) head and neck injuries were in general due to hitting the windscreen frame, while in vehicle-to-bicycle crashes (n = 100) head and neck injuries were typically sustained by ground impact. Abdominal, pelvic and thoracic injuries in pedestrians and thoracic injuries in bicyclists were in general caused by impacting the bonnet. In vehicle-to-pedestrian crashes, energy reducing airbags at critical impact points with low yielding ability on the car, as the bonnet and the windscreen frame, might reduce injuries. As vehicle-to-bicyclist crashes occurred mostly in good lighting conditions and visibility and the ground impact causing almost four times as many injuries as an impact to the different regions of the car, crash avoidance systems as well as separating bicyclists from motor traffic, may contribute to mitigate these injuries.

Keywords
pedestrian, bicyclist, mechanism of injury, frontal crash, non-fatal, impact point, real-life crash, vehicle-to-pedestrian, vehicle-to-bicyclist
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-132331 (URN)10.1080/17457300.2015.1047869 (DOI)000394177800010 ()26076708 (PubMedID)
Available from: 2017-03-23 Created: 2017-03-23 Last updated: 2018-06-09Bibliographically approved
Björnstig, J., Björnstig, U. & Järvholm, B. (2016). Dödsolyckor i arbetslivet: Delrapport 1. Stockholm: Arbetsmiljöverket
Open this publication in new window or tab >>Dödsolyckor i arbetslivet: Delrapport 1
2016 (Swedish)Report (Other academic)
Abstract [sv]

Nio av tio arbetsrelaterade dödsolyckor drabbar män. Utifrån vår analys verkar det som att kvinnor och män har liknande risk att drabbas av en dödsolycka om förhållandena i arbetsmiljön är likartade.

Dödsolyckor drabbar också i högre grad äldre personer än yngre, och mer än hälften av männen som omkom var över 50 år. En viktig delförklaring är att äldre får svårare skador och har högre risk för dödlig utgång än yngre om de utsätts för samma skadevåld.

Fordonsrelaterade olyckor utgör ca hälften av alla dödsolyckor, och hälften av dem sker i vägtrafikområden. Det finns dock redan många aktörer som arbetar för att förebygga olyckor i trafiken, så aktörer inom arbetsmiljöområdet bör prioritera förebyggande åtgärder i andra miljöer. Olyckor i sådana andra miljöer utgör ca en fjärdedel av alla dödsolyckor.

Fallolyckor är en viktig orsak till dödsolyckor och då främst fall från höjd. Många sådana olyckor inträffar inom byggverksamhet, och vår analys tyder på att tekniska brister i byggställningar kan vara ett område för förbättringar. Dessutom bör åtgärder riktas mot gruppen äldre elinstallatörer eftersom de förhållandevis ofta drabbas av dödliga elolyckor.

Trädfällning är en annan betydande orsak till dödsolyckor, framför allt inom jord- och skogsbruk.

En jämförelse mellan data ur registren för dödliga och svåra men icke-dödliga arbetsolyckor visar på stora skillnader ibland annat vem som drabbas och var skadan inträffar. Det innebär att register om svåra men icke-dödliga skador ger begränsad information om vilka förebyggande åtgärder som är lämpliga mot dödsolyckor och var de ska sättas in.

Sammantaget visar vår analys att statistik över allvarliga arbetsrelaterade olyckor, baserat på sjukskrivningstid, har begränsat värde när det gäller att prioritera åtgärder för att förebygga arbetsrelaterade dödsolyckor. I registren finns fritextsvar som beskriver händelseförloppet för varje anmäld olycka. En textanalys av dessa beskrivningar kan ge värdefull kunskap, men det är något som behöver studeras ytterligare.

Place, publisher, year, edition, pages
Stockholm: Arbetsmiljöverket, 2016. p. 123
Series
Arbetsmiljöverket: Kunskapssammanställning, ISSN 1650-3171 ; 2016:9
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-134761 (URN)
Available from: 2017-05-11 Created: 2017-05-11 Last updated: 2018-06-09Bibliographically approved
Larcher, M., Forsberg, R., Björnstig, U., Holgersson, A. & Solomos, G. (2016). Effectiveness of finite-element modelling of damage and injuries for explosions inside trains. Journal of Transportation Safety and Security, 8, 83-100
Open this publication in new window or tab >>Effectiveness of finite-element modelling of damage and injuries for explosions inside trains
Show others...
2016 (English)In: Journal of Transportation Safety and Security, ISSN 1943-9962, Vol. 8, p. 83-100Article in journal (Refereed) Published
Abstract [en]

The rail-bound sector has become a preferred target of terrorist attacks because of its vulnerability, and the most frequent way to carry out these attacks has been the use of explosive devices.The aim of this study is to investigate the effectiveness of modelling detonation effects inside train carriages using explicit finite element techniques. The numerical simulations consider fluid-structure interaction phenomena and several parametric studies are conducted. Carriage damage and injuries to the passengers are examined. Displacements in the model of the carriage structure do not vary greatly for small changes of the charge size, its location, or by open doors. Changing charge size, the location of the detonation, and door setting however had significant impact on the risk of eardrum rupture and fatality. Comparison of the simulation and real life data demonstrate a good agreement between the real and calculated displacements of the carriage, whereas the risk of death and eardrum rupture is slightly higher in the calculations. The model presented can reproduce a reliable actual situation if more parameters that influence injuries of blast waves were considered.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2016
Keywords
blast wave, finite element model, rail bound, risk, security, structural damage
National Category
Mathematics Surgery
Identifiers
urn:nbn:se:umu:diva-117258 (URN)10.1080/19439962.2015.1046619 (DOI)000380366000007 ()
External cooperation:
Projects
Preparedness for mass-casualty attacks on public transportation
Funder
Swedish National Board of Health and Welfare
Note

Supplement: 1

Available from: 2016-02-25 Created: 2016-02-25 Last updated: 2018-06-07Bibliographically approved
Holgersson, A., Sahovic, D., Saveman, B.-I. & Björnstig, U. (2016). Factors influencing responders' perceptions of preparedness for terrorism. Disaster Prevention and Management, 25(4), 520-533
Open this publication in new window or tab >>Factors influencing responders' perceptions of preparedness for terrorism
2016 (English)In: Disaster Prevention and Management, ISSN 0965-3562, E-ISSN 1758-6100, Vol. 25, no 4, p. 520-533Article in journal (Other academic) Published
Abstract [en]

Purpose: The purpose of this paper is to analyse factors influencing perceptions of preparedness in the response to terrorist attacks of operational personnel in Swedish emergency organizations. Design/methodology/approach: Data were collected using a questionnaire distributed to operational personnel from the police, rescue and ambulance services in eight Swedish counties; 864 responses were received and analysed. Findings: Three aspects of the perception of preparedness for terrorist attacks among Swedish emergency responders were studied: willingness to respond; level of confidence with tasks; and estimated management capability. Factors which positively influenced these perceptions were male sex, training in first aid and dealing with mass casualty incidents, terrorism-related management training (MT), table-top simulations, participation in functional exercises, and access to personal protective equipment (PPE); work experience was inversely related. Occupation in police or rescue services was positively associated with willingness to respond whereas occupation within the emergency medical services was positively associated with estimated management capability. Practical implications: These findings show that terrorism-related MT and access to PPE increase the perceptions of preparedness for terrorism among the emergency services, aiding judgements about investments in preparedness by crisis management planners. Originality/value: Limited research in disaster management and hazard preparedness has been conducted in a European context, especially regarding terrorism. Little is known about aspects of preparedness for terrorism in Sweden, particularly from the perspective of the emergency responders.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2016
Keywords
Training, Confidence, Firefighters, Police, Capability, Willingness to respond, Emergency medical services
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Political Science Nursing
Identifiers
urn:nbn:se:umu:diva-117257 (URN)10.1108/DPM-12-2015-0280 (DOI)000381212600007 ()
Projects
Preparedness for mass-casualty attacks on public transportation
Funder
Swedish National Board of Health and Welfare
Note

First published in theses in manuscript form.

Available from: 2016-02-25 Created: 2016-02-25 Last updated: 2018-06-07Bibliographically approved
Aléx, J., Karlsson, S., Björnstig, U. & Saveman, B.-I. (2015). Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients' temperatures in prehospital emergency care - an intervention study. International Journal of Circumpolar Health, 74, Article ID 28878.
Open this publication in new window or tab >>Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients' temperatures in prehospital emergency care - an intervention study
2015 (English)In: International Journal of Circumpolar Health, ISSN 2242-3982, E-ISSN 2242-3982, Vol. 74, article id 28878Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients' exposure to cold temperatures combined with a cold ambulance mattress seems to be the major factor leading to an overall sensation of discomfort. There is little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients' temperatures in the prehospital emergency care.

METHODS: A quantitative intervention study on ambulance care was conducted in the north of Sweden. The ambulance used for the intervention group (n=30) was equipped with an electrically heated mattress on the regular ambulance stretcher whereas for the control group (n=30) no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS), subjective comments on cold experiences, and finger, ear and air temperatures.

RESULTS: Thermal comfort, measured by CDS, improved during the ambulance transport to the emergency department in the intervention group (p=0.001) but decreased in the control group (p=0.014). A significant higher proportion (57%) of the control group rated the stretcher as cold to lie down compared to the intervention group (3%, p<0.001). At arrival, finger, ear and compartment air temperature showed no statistical significant difference between groups. Mean transport time was approximately 15 minutes.

CONCLUSIONS: The use of active heat from underneath increases the patients' thermal comfort and may prevent the negative consequences of cold stress.

Keywords
thermal comfort, thermal discomfort, finger temperature, cold exposure, Cold Discomfort Scale, cold stress, active heat, heat transfer
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-109969 (URN)10.3402/ijch.v74.28878 (DOI)000369578900001 ()26374468 (PubMedID)
Available from: 2015-10-09 Created: 2015-10-09 Last updated: 2018-06-07Bibliographically approved
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