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Järvholm, Bengt
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Jackson, J. A., Olsson, D., Burdorf, A., Punnett, L., Järvholm, B. & Wahlström, J. (2019). Occupational biomechanical risk factors for radial nerve entrapment in a 13-year prospective study among male construction workers. Occupational and Environmental Medicine, 76(5), 326-331
Open this publication in new window or tab >>Occupational biomechanical risk factors for radial nerve entrapment in a 13-year prospective study among male construction workers
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2019 (English)In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 76, no 5, p. 326-331Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim was to assess the association between occupational biomechanical exposure and the occurrence of radial nerve entrapment (RNE) in construction workers over a 13-year follow-up period.

METHODS: A cohort of 229 707 male construction workers who participated in a national occupational health surveillance programme (1971-1993) was examined prospectively (2001-2013) for RNE. Height, weight, age, smoking status and job title (construction trade) were obtained on health examination. RNE case status was defined by surgical release of RNE, with data from the Swedish national registry for out-patient surgery records. A job exposure matrix was developed, and biomechanical exposure estimates were assigned according to job title. Highly correlated exposures were summed into biomechanical exposure scores. Negative binomial models were used to estimate the relative risks (RR) (incidence rate ratios) of RNE surgical release for the biomechanical factors and exposure sum scores. Predicted incidence was assessed for each exposure score modelled as a continuous variable to assess exposure-response relationships.

RESULTS: The total incidence rate of surgically treated RNE over the 13-year observation period was 3.53 cases per 100 000 person-years. There were 92 cases with occupational information. Increased risk for RNE was seen in workers with elevated hand-grip forces (RR=1.79, 95% CI 0.97 to 3.28) and exposure to hand-arm vibration (RR=1.47, 95% CI 1.08 to 2.00).

CONCLUSIONS: Occupational exposure to forceful handgrip work and vibration increased the risk for surgical treatment of RNE.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
elbow flexion/extension, hand tools, hand-arm vibration, job exposure matrix, nerve entrapment, neuropathy, repetitive, static work, upper extremity load
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-157109 (URN)10.1136/oemed-2018-105311 (DOI)30850390 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2019-03-11 Created: 2019-03-11 Last updated: 2019-07-11Bibliographically approved
Jackson, J. A., Olsson, D., Punnett, L., Burdorf, A., Järvholm, B. & Wahlström, J. (2019). Occupational biomechanical risk factors for surgically treated ulnar nerve entrapment in a prospective study of male construction workers. Scandinavian Journal of Work, Environment and Health, 45(1), 63-72
Open this publication in new window or tab >>Occupational biomechanical risk factors for surgically treated ulnar nerve entrapment in a prospective study of male construction workers
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2019 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 1, p. 63-72Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of this study was to determine the association between occupational biomechanical exposures and occurrence of surgically treated ulnar nerve entrapment (UNE).

Methods: A cohort of 229 689 male construction workers who participated in a national occupational health surveillance program (1971–1993) were examined prospectively over a 13-year case ascertainment period (2001–2013) for surgically treated UNE. Job title (construction trade), smoking status, height, weight and age were recorded on examination. Job titles were merged into occupational groups of workers performing similar work tasks and having similar training. Occupational biomechanical exposure estimates were assigned to each occupational group with a job exposure matrix (JEM) developed for the study. Negative binomial models were used to assess the relative risks for each biomechanical exposure and the sums of highly correlated biomechanical exposures. Surgical treatment of UNE was determined via a linkage with the Swedish Hospital Outpatient Surgery Register.

Results: There were 555 cases of surgically treated UNE within the cohort. Workers exposed to forceful hand-grip factors had a 1.4-fold higher relative risk (95% CI 1.18–1.63) of undergoing surgical treatment for UNE compared to unexposed workers. Occupational groups comprising workers exposed to forceful hand-grip work showed the highest risks for UNE and included concrete workers, floor layers, ground preparatory workers, rock blasters, and sheet-metal workers.

Conclusion: Forceful hand-grip work increases the risk for surgically treated ulnar nerve entrapment.

Place, publisher, year, edition, pages
Nordic Association of Occupational Safety and Health (NOROSH), 2019
Keywords
biomechanical, biomechanical risk factor, construction worker, cubital tunnel syndrome, elbow, elbow extension, grip force, hand tool, hand-arm vibration, HAV, JEM, job-exposure matrix, male construction worker, neuropathy, occupational biomechanical risk factor, prospective study, repetitive, risk factor, static work, ulnar nerve entrapment, upper-arm load
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-152108 (URN)10.5271/sjweh.3757 (DOI)000466176700007 ()30132781 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-01016
Available from: 2018-09-27 Created: 2018-09-27 Last updated: 2019-05-17Bibliographically approved
Sundström, J., Söderholm, M., Söderberg, S., Alfredsson, L., Andersson, M., Bellocco, R., . . . Wiberg, B. (2019). Risk factors for subarachnoid haemorrhage: a nationwide cohort of 950 000 adults. International Journal of Epidemiology, Article ID dyz163.
Open this publication in new window or tab >>Risk factors for subarachnoid haemorrhage: a nationwide cohort of 950 000 adults
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2019 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, article id dyz163Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Subarachnoid haemorrhage (SAH) is a devastating disease, with high mortality rate and substantial disability among survivors. Its causes are poorly understood. We aimed to investigate risk factors for SAH using a novel nationwide cohort consortium.

METHODS: We obtained individual participant data of 949 683 persons (330 334 women) between 25 and 90 years old, with no history of SAH at baseline, from 21 population-based cohorts. Outcomes were obtained from the Swedish Patient and Causes of Death Registries.

RESULTS: During 13 704 959 person-years of follow-up, 2659 cases of first-ever fatal or non-fatal SAH occurred, with an age-standardized incidence rate of 9.0 [95% confidence interval (CI) (7.4-10.6)/100 000 person-years] in men and 13.8 [(11.4-16.2)/100 000 person-years] in women. The incidence rate increased exponentially with higher age. In multivariable-adjusted Poisson models, marked sex interactions for current smoking and body mass index (BMI) were observed. Current smoking conferred a rate ratio (RR) of 2.24 (95% CI 1.95-2.57) in women and 1.62 (1.47-1.79) in men. One standard deviation higher BMI was associated with an RR of 0.86 (0.81-0.92) in women and 1.02 (0.96-1.08) in men. Higher blood pressure and lower education level were also associated with higher risk of SAH.

CONCLUSIONS: The risk of SAH is 45% higher in women than in men, with substantial sex differences in risk factor strengths. In particular, a markedly stronger adverse effect of smoking in women may motivate targeted public health initiatives.

Keywords
Stroke, cohort study, epidemiology
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-162427 (URN)10.1093/ije/dyz163 (DOI)31363756 (PubMedID)
Note

2019-08-22: Epub ahead of print. Granskad. /LiL

Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-22Bibliographically approved
Jonsson, E., Järvholm, B. & Andersson, M. (2019). Silica dust and sarcoidosis in Swedish construction workers. Occupational Medicine, Article ID kqz118.
Open this publication in new window or tab >>Silica dust and sarcoidosis in Swedish construction workers
2019 (English)In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, article id kqz118Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: The aetiology of sarcoidosis is not well established. In previous studies, smoking has been negatively associated with sarcoidosis and there are some indications of an association between exposure to silica dust and sarcoidosis.

AIMS: To study the risk of sarcoidosis in relation to silica dust exposure.

METHODS: A longitudinal cohort of construction workers linked with a registry of Swedish inpatient diagnoses. Workers were designated as exposed or unexposed to silica based on job titles in a job-exposure matrix. The relative risk (RR) was analysed with Poisson regression adjusting for age and smoking.

RESULTS: We identified 371 cases of sarcoidosis among 297 917 male workers. There was an increased risk of sarcoidosis in the medium- to high-exposure group [RR 1.83 (95% confidence interval {CI} 1.14-2.95)]. A stratified analysis according to smoking showed that ever-smoking workers had an increased risk of sarcoidosis if highly exposed to silica dust [RR 2.44 (95% CI 1.37-4.33)] compared to non-exposed ever-smokers. The risk of non-smokers highly exposed to silica was not significantly increased [RR 1.07 (95% CI 0.72-1.58)] compared to non-exposed non-smokers.

CONCLUSION: The study indicates an increased risk of developing sarcoidosis in ever-smoking men exposed to silica.

Keywords
Occupation, occupational health, sarcoidosis, silica, smoking
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-163976 (URN)10.1093/occmed/kqz118 (DOI)31504840 (PubMedID)
Available from: 2019-10-10 Created: 2019-10-10 Last updated: 2019-10-15
Torén, K., Andersson, M., Olin, A.-C., Blanc, P. D. & Järvholm, B. (2018). Airflow limitation classified with the fixed ratio or the lower limit of normal and cause-specific mortality: a prospective study. Respiratory Medicine, 144, 36-41
Open this publication in new window or tab >>Airflow limitation classified with the fixed ratio or the lower limit of normal and cause-specific mortality: a prospective study
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2018 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 144, p. 36-41Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: There is controversy as to whether airflow limitation should be defined as forced expiratory volume in 1 s (FEV1)/vital capacity (VC) < 0.7 or as FEV1/VC< the lower limit of normal (LLN). The aim was to examine whether different definitions of airflow limitation differ in predicting mortality.

METHODS: Longitudinal prospective study of a national cohort of Swedish workers (199,408 men; 7988 women), aged 20-64 years with spirometry without bronchodilation at baseline followed from 1979 until death, or censorship at 2010. Airflow limitation (AL) by Global Obstructive Lung Disease criteria, ALGOLD, was defined as FEV1/VC < 0.7; ALLLN as FEV1/VC < LLN. All all-cause, COPD and cardiovascular disease mortality was analyzed among men and women in relation to ALGOLD and ALLLN, adjusted for age and smoking.

RESULTS: Among men, all-cause mortality risks were similar by airflow limitation criteria: ALGOLD RR = 1.32, 95% CI 1.26-1.38; ALLLN, RR = 1.37, 95% CI 1.31-1.44. The risk estimates were also similar by airflow limitation definition for cardiovascular mortality and for COPD mortality. Among women, all-cause mortality was also similar by airflow limitation criteria, but significantly higher as compared to men: ALGOLD RR = 2.10, 95% CI 1.66-2.66; ALLLN, RR = 2.09, 95% CI 1.66-2.62. Also cardiovascular and COPD mortality by airflow limitation criteria was significantly higher among women as compared to men.

CONCLUSIONS: Defined either as FEV1/VC < 0.7 or as FEV1/VC < LLN, airflow limitation predicted excess mortality risk of similar magnitude. Mortality in relation to airflow limitation was higher among women compared to men.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
COPD, Epidemiology, GOLD, Never smokers, Spirometry, Women
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-153027 (URN)10.1016/j.rmed.2018.10.001 (DOI)000448159000006 ()30366582 (PubMedID)
Available from: 2018-11-02 Created: 2018-11-02 Last updated: 2018-12-07Bibliographically approved
Jackson, J. A., Olsson, D., Punnett, L., Burdorf, A., Järvholm, B. & Wahlström, J. (2018). Biomechanical risk factors for surgically treated ulnar nerve entrapment in a cohort of Swedish male construction workers.. In: : . Paper presented at 20th Congress International Ergonomics Association, Florence, August 26-30 , 2018.
Open this publication in new window or tab >>Biomechanical risk factors for surgically treated ulnar nerve entrapment in a cohort of Swedish male construction workers.
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2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-152127 (URN)
Conference
20th Congress International Ergonomics Association, Florence, August 26-30 , 2018
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-01016
Available from: 2018-09-27 Created: 2018-09-27 Last updated: 2018-09-27
Wahlström, J., Burström, L., Johnson, P. W., Nilsson, T. & Järvholm, B. (2018). Exposure to whole-body vibration and hospitalization due to lumbar disc herniation. International Archives of Occupational and Environmental Health, 91(6), 689-694
Open this publication in new window or tab >>Exposure to whole-body vibration and hospitalization due to lumbar disc herniation
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2018 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 6, p. 689-694Article in journal (Refereed) Published
Abstract [en]

Objective: The aim was to examine if exposure to whole-body vibration (WBV) increases the risk for hospitalization due to lumbar disc herniation.

Methods: The study basis is a cohort of 288,926 Swedish construction workers who participated in a national occupational health surveillance programme from 1971 until 1992. Job title, smoking habits, body weight, height and age were registered at the examinations. Assessment of WBV were made for each of the constituent occupations by constructing a job-exposure matrix (JEM). Exposure to WBV was graded on a scale from 0 to 5. In addition, the occurrence of hospitalization due to lumbar disc herniation from January 1st 1987 until December 31st 2010 was collected from a linkage with the Swedish Hospital Discharge Register. Poisson regressions were used to estimate relative risk with 95 percent confidence intervals (95% CI), adjusting for age, height, weight and smoking, using white-collar workers and foremen as a reference group.

Results: There was an increased risk for hospitalization due to lumbar disc herniation for workers in the construction industry exposed to medium to high WBV compared to white-collar workers and foremen 1.35 (1.12-1.63). When restricting the analyses to include workers 30-49 years of age at the time of the hospital admission the risk was 1.69 (95% CI 1.29-2.21).

Conclusion: This study further supports that occupational exposure to whole-body vibration increases the risk for hospitalization due to lumbar disc herniation.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
epidemiology, low back pain, lumbar disc disease, lumbar radiculopathy, occupational drivers, sciatica, whole-body vibration
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-148400 (URN)10.1007/s00420-018-1316-5 (DOI)000438571100003 ()29855719 (PubMedID)2-s2.0-85047906460 (Scopus ID)
Available from: 2018-06-05 Created: 2018-06-05 Last updated: 2018-09-19Bibliographically approved
Söderberg, M., Mannelqvist, R., Järvholm, B., Schiöler, L. & Stattin, M. (2018). Impact of changes in welfare legislation on the incidence of disability pension. A cohort study of construction workers. Scandinavian Journal of Public Health, Article ID 1403494818754747.
Open this publication in new window or tab >>Impact of changes in welfare legislation on the incidence of disability pension. A cohort study of construction workers
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2018 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, article id 1403494818754747Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Disability pension, construction workers, social insurance legislation, time trends
National Category
Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-144283 (URN)10.1177/1403494818754747 (DOI)29366393 (PubMedID)
Available from: 2018-01-30 Created: 2018-01-30 Last updated: 2019-04-04
Knutsson, B., Mukka, S., Wahlström, J., Järvholm, B. & Sayed-Noor, A. S. (2018). The association between tobacco smoking and surgical intervention for lumbar spinal stenosis: cohort study of 331,941 workers. The spine journal, 18(8), 1313-1317
Open this publication in new window or tab >>The association between tobacco smoking and surgical intervention for lumbar spinal stenosis: cohort study of 331,941 workers
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2018 (English)In: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 18, no 8, p. 1313-1317Article in journal (Refereed) Published
Abstract [en]

BACKGROUND CONTEXT: Tobacco smoking is an injurious habit associated with a number of chronic disorders. Its influence on disc metabolism and degeneration including lumbar spinal stenosis (LSS) has been investigated in the literature.

PURPOSE: We aimed to investigate whether tobacco smoking is an independent risk factor for undergoing surgical intervention for LSS.

STUDY DESIGN/SETTING: This is a prospective cohort study.

PATIENT SAMPLE: The patient sample of 331,941 workers was derived from a Swedish nationwide occupational surveillance program for construction workers.

OUTCOME MEASURE: The outcome measure included the incidence of undergoing surgical intervention for LSS in tobacco smokers versus no smokers.

MATERIALS AND METHODS: At inclusion, age, sex, body mass index (BMI), workers' job title, and self-reported smoking habits were registered. The workers were divided into four categories: never smoked, former smoker, moderate current (1-14 cigarettes/day), and heavy current (≥15 cigarettes/day). Patients who underwent a surgically treated LSS were defined using the relevant International Classification of Diseases (ICD) disease code derived from the Swedish National Patient Register.

RESULTS: A total of 331,941 participants were included in the analysis. Forty-four percent of the participants were non-smokers, 16% were former smokers, 26% were moderate smokers, and 14% were heavy smokers. The vast majority of construction workers were males (95%). During the average follow-up of 30.7 years, 1,623 participants were surgically treated for LSS. The incidence rate ratio (IRRs) of LSS varied across smoking categories, with the highest values found in heavy smokers. Compared with non-smokers, all smoking categories show an increased incidence of surgically treated LSS. The findings were consistent even when the comparison was performed for participants with BMIs between 18.5 and 25 and for participants aged between 40 and 74 years.

CONCLUSIONS: Tobacco smoking is associated with an increased incidence of surgically treated LSS. The effect seems to be dose related, whereby heavy smokers have a higher risk than moderate or former smokers.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Incidence, Lumbar, Risk factor, Spinal stenosis, Surgery, Tobacco smoking
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-145217 (URN)10.1016/j.spinee.2017.11.018 (DOI)000443585000002 ()29246850 (PubMedID)
Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2018-10-01Bibliographically 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
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