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The CHemical Exposure and Children’s Health (CHECH) study is an ongoing pregnancy cohort study in Tianjin, China. This paper describes the background, aim and the study design, which can be followed by future researchers to design and conduct similar studies. The abundance and the potential adverse health outcomes of endocrine disrupting chemicals (EDCs) is concerning. More notably, developing fetuses and infants are more vulnerable to EDCs exposure. The CHECH study aims to investigate the importance of early life exposure to multiple EDCs (phthalates and their metabolites, bisphenol A and their substitutes, perfluorinated compounds and poly brominated diphenyl ethers) for multiple health outcomes in Chinese children, namely sexual development, neurodevelopment, metabolism and growth, as well as asthma and allergy. A total of 2238 pregnant women were recruited in Tianjin from May 2017 to April 2021 with a response rate of 90 %. Among these women, 2255 children were born with available information, including 47 pairs of twins. Urine samples were collected from pregnant women and children, while air and dust samples were obtained from the home environment during pregnancy and infancy periods. Information on children’s health was gathered through physical examinations and questionnaires. The CHECH study, which collected exposure information and health outcomes at multiple time points, will contribute to the understanding of prenatal exposure to EDCs and their impact on children’s health, thereby facilitating the development of risk assessments aimed at reducing exposure and associated health risks.

BACKGROUND: Perfluoroalkyl and polyfluoroalkyl substances are classed as endocrine disrupting compounds but continue to be used in many products such as firefighting foams, flame retardants, utensil coatings, and waterproofing of food packaging. Perfluoroalkyl exposure aberrantly modulates lipid, metabolite, and bile acid levels, increasing susceptibility to onset and severity of metabolic diseases, such as diabetes and metabolic dysfunction-associated steatotic liver disease. To date, most studies in humans have focused on perfluoroalkyl-exposure effects in adults. In this study we aimed to show if perfluoroalkyls are present in the human fetal liver and if they have metabolic consequences for the human fetus. METHODS: In this cross-sectional study, human fetal livers from elective termination of pregnancies at the Aberdeen Pregnancy Counselling Service, Aberdeen, UK, were analysed by both targeted (bile acids and perfluoroalkyl substances) and combined targeted and untargeted (lipids and polar metabolites) mass spectrometry based metabolomic analyses, as well as with RNA-Seq. Only fetuses from normally progressing pregnancies (determined at ultrasound scan before termination), terminated for non-medical reasons, from women older than 16 years, fluent in English, and between 11 and 21 weeks of gestation were collected. Women exhibiting considerable emotional distress or whose fetuses had anomalies identified at ultrasound scan were excluded. Stringent bioinformatic and statistical methods such as partial correlation network analysis, linear regression, and pathway analysis were applied to this data to investigate the association of perfluoroalkyl exposure with hepatic metabolic pathways. FINDINGS: Fetuses included in this study were collected between Dec 2, 2004, and Oct 27, 2014. 78 fetuses were included in the study: all 78 fetuses were included in the metabolomics analysis (40 female and 38 male) and 57 fetuses were included in the RNA-Seq analysis (28 female an, FUNDING: UK Medical Research Council, Horizon Europe Program of the European Union, Seventh Framework Programme of the European Union, NHS Grampian Endowments grants, European Partnership for the Assessment of Risks from Chemicals, Swedish Research Council, Formas, Novo Nordisk Foundation, and the Academy of Finland.

The composition of human breast milk (HBM) exhibits significant variability both between individuals and within the same individual. While environmental factors are believed to play a role in this variation, their influence on breast milk composition remains inadequately understood. Herein, we investigate the impact of environmental factors on HBM lipid composition in a general population cohort. The study included mothers (All Babies In Southeast Sweden study) whose children later progressed to one or more immune-mediated diseases later in life: type 1 diabetes (n = 9), celiac disease (n = 24), juvenile idiopathic arthritis (n = 9), inflammatory bowel disease (n = 7), hypothyroidism (n = 6), and matched controls (n = 173). Lipidome of HBM was characterized by liquid chromatography combined with high-resolution mass spectrometry. We observed that maternal age, body mass index, diet, and exposure to perfluorinated alkyl substances (PFASs) had a marked impact on breast milk lipidome, with larger changes observed in the milk of those mothers whose children later developed autoimmune diseases. We also observed differences in breast milk lipid composition in those mothers whose offspring later developed autoimmune diseases. Our study suggests that breast milk lipid composition is modified by a complex interaction between genetic and environmental factors, and, importantly, this impact was significantly more pronounced in those mothers whose offspring later developed autoimmune/inflammatory diseases. Our findings also suggest that merely assessing PFAS concentration may not capture the full extent of the impact of chemical exposures; thus, the more comprehensive exposome approach is essential for accurately assessing the impact of PFAS exposure on HBM and, consequently, on the health outcomes of the offspring., This study was supported by the Swedish Research Council (grant nos. and 2020-03674 and 2016-05176 to T.H. and M.O.), Formas (grant no. 2019-00869 to T.H. and M.O.), and the Novo Nordisk Foundation (grant nos. NNF20OC0063971 and NNF21OC0070309 to T.H. and M.O.). ABIS study (J.L.) was supported by Barndiabetesfonden (Swedish Child Diabetes Foundation); the Swedish Council for Working Life and Social Research, grant/award numbers: FAS2004-1775 and FAS2004-1775; the Swedish Research Council, grant/award numbers: K2005-72X-11242-11A, K2008-69X-20826-01-4, and K2008-69X-20826-01-4; Östgöta Brandstodsbolag; the Medical Research Council of Southeast Sweden (FORSS); the Wallenberg Foundation, grant/award number: K 98-99D-12813-01A; ALF-and LFoU grants from Region Östergötland and Linköping university, Sweden; and Joanna Cocozza Foundation.

Isotope dilution ultrahigh-performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS) is commonly used for trace analysis of polyfluoroalkyl and perfluoroalkyl substances (PFAS) in difficult matrices. Commercial nontargeted analysis of major PFAS where relative concentrations are obtained cost effectively is rapidly emerging and is claimed to provide comparable results to that of absolute quantification using matrix matched calibration and isotope dilution UHPLC-MS/MS. However, this remains to be demonstrated on a large scale. We aimed to assess the performance of a targeted absolute quantification isotope dilution LC-MS/MS assay versus a commercial nontargeted relative quantification assay for detection of three major PFAS in human blood. We evaluated a population-based cohort of 503 individuals. Correlations were assessed using Spearman's rank correlation coefficients (rho). Precision and bias were assessed using Bland-Altman plots. For perfluorooctane sulfonic acid, the median concentrations were 5.10 ng/mL (interquartile range [IQR] 3.50-7.24 ng/mL), the two assays correlated with rho 0.83. For perfluorooctanoic acid, the median concentrations were 2.14 ng/mL (IQR 1.60-3.0 ng/mL), the two assays correlated with rho 0.92. For perfluorohexanesulfonate, the median concentrations were 5.5 ng/mL (IQR 2.50-11.61 ng/mL), the two assays correlated with rho 0.96. The Bland-Altman statistical test showed agreement of the mean difference for the majority of samples (97-98%) between the two assays. Absolute plasma concentrations of PFAS obtained using matrix matched calibration and isotope dilution UHPLC-MS/MS show agreement with relative plasma concentrations from a nontargeted commercial platform by Metabolon. We observed striking consistency between the two assays when examining the associations of the three PFAS with cholesterol, offering additional confidence in the validity of utilizing the nontargeted approach for correlations with various he

OBJECTIVE: Dust exposure is high in several industries. We investigated associations of exposure in paper mills, wood pellet plants and iron foundries with lung function impairment. METHODS: Respirable silica, inhalable paper dust or inhalable wood dust were collected in personal samples and spirometry was performed. Multiple linear regression analyzed associations with FEV1%pred and FVC%pred. RESULTS: Wood pellet workers with high exposure to inhalable dust had lower FEV1%pred (95%CI) (-9.4(-16,-2.6)) and FVC%pred (-9.8(-15,-4.0)) compared with lowest exposure level. Workers at paper mills and foundries had no dose-dependent association but lower FEV1%pred and FVC%pred than in workers at wood pellets plants. CONCLUSIONS: Increased exposure to inhalable wood dust is associated with decreased lung function. Foundry and paper mill workers have generally lower lung function than wood pellet workers. Spirometry should be considered in workers in industries with airborne particulate matter pollution.

Objectives: While suicidal behaviour has become less prevalent in non-manual workers in recent decades, rates have increased in manual workers. We aimed to identify occupations within the construction industry with excess risk of suicide and non-fatal self-harm. Methods: This cohort of Swedish construction workers comprises 389 132 individuals examined 1971-1993 and followed 1987-2018 using national hospital and cause of death registers. More than 200 job titles were merged into 22 occupational groups. For 296 891 men alive in 1987 and active in the construction sector, survival was calculated from baseline to first event of non-fatal self-harm or suicide and censored for emigration, long-term unemployment, disability pension, retirement, death from other causes or end of follow-up. HRs with 95% CIs were obtained from multiple Cox proportional hazard regression. Results: Overall, 1618 cases of suicide and 4774 events of non-fatal self-harm were registered. Self-harm before baseline was the single largest risk factor for suicide, HR 9.3 (95% CI 7.5 to 11.6). Compared with the overall mean, labourers and rock workers had excess risk for suicide, HR 1.4 (95% CI 1.1 to 1.7) and 1.5 (95% CI 1.0 to 2.3), respectively, while electricians, clerks and foremen had reduced risk. Labourers, concrete workers, sheet metal workers, painters, glaziers and the group € other construction workers' were at increased risk for non-fatal self-harm. Almost all categories of manual workers were at increased risk for suicidal behaviour relative to clerks and foremen. Conclusions: Specific occupations within the construction sector were associated with excess risk for suicidal behaviour. Future studies should identify underlying risk factors to inform tailored interventions.

Hand-arm vibration injury is a well-known occupational disorder that affects many workers globally. The diagnosis is based mainly on quantitative psychophysical tests and medical history. Typical manifestations of hand-arm vibration injury entail episodes of finger blanching, Raynaud’s phenomenon (RP) and sensorineural symptoms from affected nerve fibres and mechanoreceptors in the skin. Differences in serum levels of 17 different biomarkers between 92 patients with hand-arm vibration injury and 51 controls were analysed. Patients with hand-arm vibration injury entailing RP and sensorineural manifestations showed elevated levels of biomarkers associated with endothelial injury or dysfunction, inflammation, vaso- or neuroprotective compensatory, or apoptotic mechanisms: intercellular adhesion molecule-1 (ICAM-1), monocyte chemoattractant protein-1 (MCP-1); thrombomodulin (TM), heat shock protein 27 (HSP27); von Willebrand factor, calcitonin gene-related peptide (CGRP) and caspase-3. This study adds important knowledge on pathophysiological mechanisms that can contribute to the implementation of a more objective method for diagnosis of hand-arm vibration injury.

Background: Hazardous chemicals are essential for modern society but the use and transportation of them bears the risk of major incidents. Past incidents have revealed the importance of preparation and training of emergency medical service (EMS) personnel when responding to these incidents. However, studies have shown the level of preparedness to be insufficient. There is a lack of knowledge as to how EMS personnel perceive their preparedness and response when facing chemical incidents. Aim: The aim of this study was to qualitative investigate working procedures regarding chemical incidents among a cohort of EMS personnel. Method: Seventeen ambulance nurses from rural and urban areas were individually interviewed using four different realistic scenarios (vignettes). The transcribed text from the interviews was analyzed using qualitative content analysis. Result: The results were derived into two categories with underlying sub-categories: a struggle to organize the onsite work situation (insufficient managerial support, limited resources, trust in rescue services, difficult decision making, stressful responsibilities); and decontamination—a demanding and risky situation (risk management, work in protective gear, aggravating circumstances). Participants often lack real life experience in facing a chemical incident and training that improves preparedness and the ability to respond adequately. Conclusion: Chemical incidents pose many challenges for EMS personnel, but with proper training efforts many of these challenges could be solved. This study has shown the need for more accessible chemical incident training targeting EMS personnel: especially focusing on risk assessment; managerial support; resource management; equipment; and decontamination, including stress management and decision-making. Research in the area of chemical incidents is sparse and there remains much to understand concerning work procedures during chemical incidents.

Sexual and gender-based harassment is a work environment concern, especially in hierarchical and male-dominant organisations such as the police. This scoping review aims to examine the existing literature on such harassment against police employees in Europe to identify the available knowledge and highlight the gaps for future studies. Following the Arksey and O’Malley framework, 16 relevant articles were analysed. Most of the studies were focused on sexual harassment, and gender-based harassment was mostly absent or mixed with other discriminations. The analysis resulted in six main themes: existence of sexual and gender-based harassment; perpetrators; associated factors; consequences; individual response; and impact of organisational policies. The findings demonstrate that such harassment remains prevalent among police employees, emphasising the need for continuous and rigorous supervision, evaluation, and comprehensive revision of policies by police authorities. This study recommends further research to address the identified gaps in this field., Originally included in thesis in manuscript form.

The literature on Raynaud’s phenomenon (RP) in the feet is scarce, especially in the occupational setting. The primary aim of our study was to investigate the occurrence of RP in the feet of miners. As part of the MineHealth project, written surveys and clinical examinations were completed by 260 Arctic open-pit miners working in northern Sweden and Norway (participation rate 53.6%). Data on RP were collected using standardised colour charts and questionnaire items. Clinical examination included assessing the perception of vibration and pain in both feet. There were eight women and three men who reported RP in the feet. Four also had RP in their hands but none acknowledged any first-degree relatives with the condition. Nine reported exposure to foot-transmitted vibration and one to hand-arm vibration. Seven showed signs of neurosensory injury in the feet. To conclude, the occurrence of RP in the feet of miners was 4.4%. Most cases with RP in the feet did not report the condition in the hands and were exposed to vibration transmitted directly to the feet. There were no reports of a hereditary component. Most cases with RP in the feet also had clinical findings suggestive of peripheral neuropathy in the feet.

Cardiovascular disease (CVD) development may be linked to persistent organic pollutants (POPs), including organochlorine compounds (OCs) and perfluoroalkyl and polyfluoroalkyl substances (PFAS). To explore underlying mechanisms, we investigated metabolites, proteins, and genes linking POPs with CVD risk. We used data from a nested case-control study on myocardial infarction (MI) and stroke from the Swedish Mammography Cohort - Clinical (n = 657 subjects). OCs, PFAS, and multiomics (9511 liquid chromatography-mass spectrometry (LC-MS) metabolite features; 248 proteins; 8110 gene variants) were measured in baseline plasma. POP-related omics features were selected using random forest followed by Spearman correlation adjusted for confounders. From these, CVD-related omics features were selected using conditional logistic regression. Finally, 29 (for OCs) and 12 (for PFAS) unique features associated with POPs and CVD. One omics subpattern, driven by lipids and inflammatory proteins, associated with MI (OR = 2.03; 95% CI = 1.47; 2.79), OCs, age, and BMI, and correlated negatively with PFAS. Another subpattern, driven by carnitines, associated with stroke (OR = 1.55; 95% CI = 1.16; 2.09), OCs, and age, but not with PFAS. This may imply that OCs and PFAS associate with different omics patterns with opposite effects on CVD risk, but more research is needed to disentangle potential modifications by other factors.

Purpose: Environmental particulate matter (PM) exposure has been shown to cause excess all-cause and disease-specific mortality. Our aim was to compare disease-specific mortality by estimated occupational exposure to vapors, gasses, dusts, and fumes (VGDF). Methods: The data source is the Helsinki part of the population-based FinEsS study on chronic obstructive pulmonary diseases including information on age, education level, main occupation, sex, and tobacco smoking combined with death registry information. We compared estimated VGDF exposure to mortality using adjusted competing-risks regression for disease-specific survival analysis for a 24-year follow-up. Results: Compared to the no-exposure group, the high occupational VGDF exposure group had sub-hazard ratios (sHR) of 1.7 (95% CI 1.3–2.2) for all cardiovascular-related and sHR 2.1 (1.5–3.9) for just coronary artery-related mortality. It also had sHR 1.7 (1.0–2.8) for Alzheimer’s or vascular dementia-related mortality and sHR 1.7(1.2–2.4) for all respiratory disease-related mortality. Conclusion: Long-term occupational exposure to VGDF increased the hazard of mortality- to cardiovascular-, respiratory-, and dementia-related causes. This emphasizes the need for minimizing occupational long-term respiratory exposure to dust, gasses, and fumes.

This systematic review summarizes the evidence on associations between physical and psychosocial work-related exposures and the development of carpal tunnel syndrome (CTS). Relevant databases were searched up to January 2020 for cohort studies reporting associations between work-related physical or psychosocial risk factors and the incidence of CTS. Two independent reviewers selected eligible studies, extracted relevant data, and assessed risk of bias (RoB). We identified fourteen articles for inclusion which reported data from nine cohort studies. Eight reported associations between physical exposure and the incidence of CTS and five reported associations between psychosocial exposures and the incidence of CTS. Quality items were generally rated as unclear or low RoB. Work-related physical exposure factors including high levels of repetition, velocity, and a combination of multiple physical exposures were associated with an increased risk of developing CTS. No other consistent associations were observed for physical or psychosocial exposures at work and CTS incidence.

European and International sustainable development agendas aim to reduce inequalities in working conditions and work-related health, yet disparate occupational health outcomes are evident between both men and women and domestic- and foreign-born workers. In Sweden, major growth in online retail warehousing has increased occupational opportunities for foreign-born workers. The rapid change has left research lagging on working conditions, i.e., employment conditions, facility design, work organisation, physical and psychosocial work environment conditions, and their effects on worker health. Further, no known studies have considered patterns of inequality related to these factors. The overall aim of this study is to describe working conditions and musculoskeletal health in online retail warehousing, determine the extent to which differences exist related to sex/gender and place of birth (as a proxy for race/ethnicity), and examine factors at the organisational and individual levels to understand why any differences exist. Three online retail warehouses, each employing 50-150 operations workers performing receiving, order picking, order packing and dispatching tasks will be recruited. Warehouses will, to the extent possible, differ in their extent of digital technology use. Employment conditions, facility design (including digital tool use), work organisation, physical and psychosocial work environment conditions and worker health will be assessed by survey, interview and technical measurements. Analysis of quantitative data stratified by sex and place of birth will consider the extent to which inequalities exist. Focus group interviews with operations employees and in-depth interviews with managers, union and health and safety representatives will be conducted to assess how employee working conditions and musculoskeletal health are related to inequality regimes of sex/gender and/or race/ethnicity in organisational processes and practices in online retail warehousing.

Background: Flexible work arrangements (FWAs), which allows employees to decide when, where, and how to perform the work, is more prevalent than ever in modern working life. However, research about how FWAs can be organized to promote work-life balance (WLB) is sparse. The overall aim of this thesis was to develop, implement, and evaluate a workplace intervention among office-based employees with FWAs. More specifically, the aims wereto: 1) identify demands and resources related to WLB; 2) in co-creation with the investigated organization, identify suggestions for improvements to guide the development of a workplace intervention; and 3) implement and evaluate the effect of an intervention, addressing some of the identified suggestions on proximal (i.e., work strategies, use of work-related information and communication technology (ICT), productivity, and expectations of availability) and distal outcomes (i.e., WLB and interference between work and private life). Methods: Paper I was a cross-sectional study based on a comprehensive questionnaire that examined occupational factors and their associations with WLB. Paper II comprised focus group interviews to collect suggestions for improvements in FWAs at an organizational, work group and individual level. Therefore, while paper I and II informed the design of the intervention, papers III and IV comprised its implementation and evaluation. Paper III examined effects on proximal outcomes and paper IV on distal outcomes. Results: Identified resources related to employees’ WLB in FWAs were boundary management, information about how to organize work, and relation-oriented leadership. Identified demands were over-commitment to work, quantitative job demands, and expectations of availability. Perceived flexibility was a resource for WLB, which interacted with several demands and buffering their negative associations with WLB. Suggestions from the focus groups related to organizational (e.g., common guidelines for FWAs), work, Bakgrund: Flexibelt arbete, vilket definieras som anställdas möjlighet att bestämma när, var och hur arbetet ska utföras, är vanligare än någonsin i dagens arbetsliv. Forskning om hur flexibelt arbete kan utformas för att främja balans mellan arbete och privatliv är sparsam. Syftet med avhandlingen var att utveckla, implementera och utvärdera en arbetsplatsintervention bland kontorsanställda med flexibelt arbete. I synnerhet var avhandlingens syfte att: 1) identifiera krav och resurser relaterade till balans; 2) att i samskapande med organisationen identifiera förslag på förbättringar som önskas implementeras i en arbetsplatsintervention; och 3) implementera och utvärdera effekten av en intervention som antar några av förslagen, på proximala (dvs. arbetsstrategier, arbetsrelaterad användning av informations- och kommunikationsteknologi, produktivitet och förväntningar på tillgänglighet), och distala utfall (dvs. balans mellan arbete och privatliv och konflikt mellan arbete och privatliv). Metod: Studie I var en tvärsnittsstudie baserad på ett omfattande frågeformulär som undersökte sambanden mellan arbetsrelaterade faktorer och balans mellan arbete och privatliv i flexibelt arbete. Studie II bestod av fokusgruppsintervjuer för att kartlägga förslag på förbättringar på organisations-, arbetsgrupp-, och individnivå. Studie I och II låg således till grund för utformningen av interventionen, medan studie III och IV bestod av implementering och utvärdering av interventionen. Studie III undersökte effekterna på proximala utfall och studie IV på distala utfall. Resultat: Resurser för balans mellan arbete och privatliv var gränshantering, information om hur arbetet kan organiseras och ett relations inriktat ledarskap. Krav för balans var överengagemang i arbetet, arbetskrav och förväntningar om tillgänglighet. Förslag från intervjuerna berörde organisationen (t.ex. gemensamma riktlinjer för flexibelt arbete), gruppen (t.ex. klargöra förväntningar om tillgänglighet) och indi

The sound environment in shared indoor workspaces emerges through the interplay of physical layout, materials, technology, and social dynamics. These spaces are designed with specific purposes in mind, taking acoustics into account during construction. However, the true quality of the sound environment can only be assessed when these spaces are actively used. The perception of a shared indoor sound environment is not fixed or absolute but is influenced by individual perceptions, attitudes, and intentions. A significant challenge in designing shared indoor workspaces is thus to accommodate the diverse preferences of various users in a common area, a task complicated by the subjective experience of sound. Prior research has primarily focused on reducing unwanted noise through physical installations and assessing their effects, with the emphasis of sound environment management being the implementation of broad, global solutions that aim to cater to the majority. However, there has been minimal initiative toward proactively improving these complex environments while acknowledging the subjective and context-dependent nature of sound environments. This thesis suggests that the sound environment within a workspace ought to be perceived as a socio-technical system, wherein the design of such environments is a complex and 'wicked' problem. By adopting a design approach that introduces prototypes of an ambient sound environment system into the workspace, this study aims to explore whether various adaptations of the sound xi environment using this technical solution can improve perceived sound quality. The research endeavors to examine the practical use of sound as a design element within workplace settings. The study incorporates laboratory research, field tests in four different offices, and interviews with professionals in indoor environment design. The thesis presents a design program for shared indoor workplace sound environments, emphasizing the creation of pleasant, unn, Ljudmiljön spelar en stor roll för vår upplevelse, vårt beteende och vår hälsa. I arbetsmiljöer där utrymmen delas, som i öppna kontorslandskap, skapas ljudmiljön genom en kombination av rummets design, materialval, tekniska lösningar och den sociala dynamiken. Dessa utrymmen är designade med tanke på verksamhetens behov och funktioner, där ljudmiljön tas i beaktning under planeringsstadiet. Dock blir den verkliga kvaliteten på ljudmiljön tydlig först när utrymmena tas i bruk. Hur en ljudmiljö uppfattas är personligt och varierar mellan individer, baserat på deras egna tolkningar och attityder till platsen samt deras avsikter i den miljön. Därför är utformningen av ljudmiljöer i gemensamma arbetsytor en utmanande uppgift. Det kräver omsorgsfull hänsyn till och uppfyllande av de olika önskemål och behov som medarbetarna kan ha. Detta arbete blir ännu mer komplext på grund av det subjektiva sättet som ljud upplevs på. Den här avhandlingen föreslår att ljudmiljön på en arbetsplats bör ses som ett sociotekniskt system, där en ömsesidig påverkan mellan den byggda platsen, teknik och människors agerande ger upphov till ljudmiljön. Att designa för den här typen av gemensamma ljudmiljöer utgör därför ett så kallat ”wicked problem”. Wicked problems är komplexa, flertydiga problem utan klara lösningar, där varje försök att hitta en lösning påverkar förståelsen av själva problemet. Tidigare forskning har i stor utsträckning inriktats mot att minska oönskat buller med fysiska lösningar och att bedöma effektiviteten hos dessa åtgärder. Huvudmålet har varit att implementera omfattande, allmängiltiga lösningar som syftar till att tillgodose behoven hos de flesta. Dock har det gjorts begränsade viiiansträngningar för att proaktivt förbättra dessa komplexa miljöer, där fokus har legat på att förhålla sig till ljudmiljöns subjektiva och situationsspecifika karaktär. Under tre designcykler har avhandlingen undersökt design och implementering av ljudmiljöprototyper på arbetsplatsen. De, Paper D and E are under submission and not included in this thesis.

BackgroundWe have previously reported on the design and efficacy of two cluster-randomized multi-level workplace interventions, attempting to decrease sedentary behavior (SED) or increase moderate to vigorous physical activity (MVPA) among office workers to improve mental health outcomes. The aim of this study was to investigate intervention effects on mental health outcomes, i.e., mental wellbeing, depression or anxiety symptoms, and stress immediately after the 6-month intervention period.MethodsTeams of 263 office workers were cluster-randomized to one of two interventions or a waitlist control group. The PA intervention (iPA) focused on increasing MVPA and the SED intervention (iSED) on reducing SED. Both multi-level interventions targeted individual office workers and their social, physical, and organizational work environment, incorporating counseling based on cognitive behavioral therapy and motivational interviewing. Mental health outcomes were assessed using validated questionnaires before and immediately after the intervention. Intervention effects were analyzed using linear mixed effects models.ResultsParticipants were mostly female and highly educated, with a mean age of 42 years and had favorable levels of mental health at baseline. Mental wellbeing improved for the iSED group (beta = 8, 95% CI 1 to 15, p = 0.030) but not for the iPA group (beta = 6, 95% CI -1 to 12, p = 0.072) compared to the control group. No effects were found for depression or anxiety symptoms or stress.ConclusionsThe multi-level interventions improved mental wellbeing among this population of office workers, reaching statistical significance in the iSED group. The size of the effect can be regarded meaningful, considering favorable mental health and high PA level at baseline. Thus, workplace interventions that provide support on multiple levels appear to have potential for improving mental wellbeing, but not reducing ill-health variables, among healthy office workers. More research

Background: Flexible work arrangements (FWA) are common, but knowledge on how to organize flexible work to reduce negative consequences and preserve positive aspects is currently sparse, which hampers organizational initiatives. Purpose: This study aimed at determining the extent to which work strategies, work-related ICT use outside regular working hours (i.e., use of laptop, tablet, or smartphone, to handle information and facilitate communication), productivity, expectations of availability, and clarity of expectations about availability, had changed among office-based employees with FWA two and four months after a participative two-step workplace intervention. Methods: An intervention group (n=97) was compared to a control group working as usual (n=70). The intervention, initiated and approved by the top management of the organization, included individual education intended to change work strategies, and workshops developing common rules and routines for FWA within the work group. Results: Participants were satisfied with the intervention and reported larger changes than the control group in work strategies. No statistically significant effects were, however, found on ICT use, productivity, or expectations of availability. Conclusions: This participative workplace intervention was successful in changing employees work strategies but may not be effective in influencing ICT use outside regular working hours, productivity, expectations of availability, and clarity of expectations about availability.

The aim of this randomized controlled study was to explore if an intervention with biofeedback training in combination with ergonomic discussions, could improve working technique and work postures, and reduce pain intensity and perceived exertion in young adult computer users with ongoing neck and upper extremity symptoms. 39 participants were divided into an intervention group and a control group. The intervention consisted of 4 sessions during a three-month period. Working technique, working postures, rated perceived exertion, pain intensity, and duration of computer use were measured at baseline and follow ups after 6 and 12 months. The intervention did not significantly improve working technique and working postures, nor reduce pain intensity and perceived exertion in the intervention group compared to the control group. However, there was a statistically significant reduction in reported pain intensity in the neck/shoulder for the whole group. Also, there was a trend that time spent with computer work without breaks was more reduced in the intervention group than in the control group.

The primary aim of this study was to determine if occupational exposure to whole-body vibration (WBV) was associated with reporting neck pain. A cross-sectional study was conducted on a sample of the general population living in northern Sweden, aged 24 to 76 years. Data was retrieved through a digital survey that collected information on exposure to WBV and biomechanical exposures as well as subjectively reported neck pain. The study included 5,017 participants (response rate 44%). Neck pain was reported by 269 men (11.8%) and 536 women (20.2%). There was a statistically significant association between reporting occupational exposure to WBV half the time or more (adjusted OR 1.91; 95% CI 1.22-3.00) and reporting neck pain. In gender-stratified analyses, the same pattern was observed in men, while there were too few women to determine any association. We conclude that occupational exposure to whole-body vibration was associated with neck pain in men.

This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and specific disorders of the shoulders. Medline, Embase, Web of Science Core Collection, Cochrane Central and PsycINFO were searched and study eligibility and risk of bias assessment was performed by two independent reviewers. A total of 14 new articles were added with the majority focusing on rotator cuff syndrome (RCS) with seven studies. Nine articles reported psychosocial exposures in addition to physical exposures. The strongest evidence was found for the association between elevation, repetition, force and vibration and the occurrence of SIS and tendinosis/tendonitis. Evidence also suggests that psychosocial exposures are associated with the occurrence of RCS and tendinosis/tendonitis. Other findings were inconsistent which prevents drawing strong conclusions.

Introduction: Industrial workers with physically demanding work have increased risk of musculoskeletal pain. The present 12-week Goldilocks Work intervention aimed to organize work among industrial workers to comprise a ‘just right’ ergonomic balance of physical behaviors (i.e., sit, stand and active) intended to promote musculoskeletal health. The paper investigates the effectiveness of the intervention in reducing low back pain after work. Methods: 83 workers across 28 workteams in a biotech organization were recruited. Workteams were randomly allocated to receive the intervention or work as usual (control). Intervention workteams implemented the Goldilocks Work planning tool to organize their work tasks towards a predefined ‘just right’ ergonomic balance (i.e., composition of 60% sitting, 30% standing, 10% active work and hourly task alternation). The primary outcome was low back pain intensity. Secondary outcomes were bodily pain, fatigue, physical exertion, productivity and energy after work measured in the survey, and composition and alternations of physical behaviors measured using wearable sensors. Results: The intervention was delivered almost as planned, with good quality and high adherence among most workteams. However, the intervention did not change physical behaviors towards the intended ‘just right’ ergonomic balance. No significant reduction in low back pain (0.07, CI 95%: -0.68; 0.82), bodily pain (0.10, CI 95%: -0.57; 0.76), tiredness (-0.53, CI 95%: -1.24; 0.19), physical exertion (-0.18, CI 95%: -0.83; 0.48), or improvement in energy (0.39, CI 95%: -1.02; 0.23) or productivity (-0.03, CI 95%: -0.77; 0.72) were found. Conclusion: This Goldilocks Work intervention did not promote musculoskeletal health among industrial workers, and did not change physical behaviors as intended. Thus, more research is needed into implementation strategies to change physical behaviors during productive work towards an evidence-based ‘just right’ ergonomic

Objective Poor cardiorespiratory fitness and health is common among childcare workers. We designed “Goldilocks-games” according to the Goldilocks Work principle to provide high-intensity physical activity for childcare workers. We investigated the effectiveness of this Goldilocks Work intervention in increasing occupational high-intensity physical activity and improving work-related health. Methods In a two-arm cluster randomized trial, 16 childcare institutions with 142 workers were randomly allocated to either an 8-week Goldilocks Work intervention or a control group. The primary outcome was occupational time in high-intensity physical activity. Secondary outcomes were occupational time in active physical behaviors, heart rate during sleep, pain, physical exhaustion, energy at work, work productivity, and need for recovery. Results The intervention was successfully delivered and received. Both groups had a low amount of occupational high-intensity physical activity at baseline, and the intervention group reported playing the games 3.1 (SD 1.5) times/week for a duration of 112.2 (SD 175.0) min/week. However, the intervention did not increase high-intensity physical activity or the secondary outcomes, except for energy at work, measured on a scale from 0-10, increasing 0.65 (95% CI, 0.08-1.21), and need for recovery, measured on a scale from 1-5, decreasing -0.32 (95% CI, -0.54- -0.09). Conclusion The intervention was successfully delivered and received, but did not increase high-intensity physical activity. The intervention group increased their energy at work and decreased their need for recovery, but not the other health-related outcomes. Research on how to design and implement health-promoting work environment interventions in childcare are needed.

We evaluated differences in work environment conditions and health by gender and place of birth in a commercial laundromat prior to (baseline) and at the end of the first wave of the COVID-19 pandemic (follow-up). Using survey data, including dimensions from the Copenhagen Psychosocial Questionnaire, from forty-one workers, we assessed work environment conditions and health at baseline, follow-up and in change scores between baseline and follow-up. At baseline, men and women reported similar scores, while foreign-born (FB) workers reported better work environment conditions than Swedish-born (SB) workers. During the pandemic, conditions generally declined for all workers, but FB reported smaller declines than SB. A consistent inequality hierarchy across the 4 groups was not clear at baseline, follow-up or in change scores between time points. The study suggests potential cultural differences may exist in how work environment conditions are experienced. This should be considered in future studies and when managing future crises

Our previous studies have linked gestational methylmercury exposure, originating from seafood, to changes in maternal thyroid hormones and infant birth size in a Swedish birth cohort. Herein we aimed to determine associations between maternal thyroid hormones and infant birth size and elucidate if maternal hormones could mediate the relationship between methylmercury and lower birth size. In 515 women, without known thyroid disease, we assessed metal exposure by erythrocyte mercury concentrations (mainly methylmercury, reflecting exposure over the past months) in early third trimester measured with inductively coupled plasma-mass spectrometry. Plasma concentrations of total and free thyroxine (tT4 and fT4) and triiodothyronine (tT3 and fT3), and thyroid-stimulating hormone (TSH) were measured at an accredited clinical laboratory. In multivariable-adjusted linear regression models, maternal tT3 (per 1 nmol/L increase) was positively associated with birth weight (B: 125 g; 95% CI 36, 214) and length (B: 0.59 cm; 95% CI 0.21, 0.97). Maternal fT4 was inversely associated with birth weight (B: − 33 g; 95% CI − 57, − 9.5), driven by obese women (n = 76). Causal mediation analyses suggested that a doubling of erythrocyte mercury (> 1 µg/kg; n = 374) was associated with a mean tT3-mediated decrease in birth weight of 11 g (95% CI − 25, − 1.6) and in birth length of 0.1 cm (95% CI − 0.12, − 0.01), both equivalent to about 12% of the total effect. To conclude, tT3 was positively associated with infant birth size. Reduced tT3 levels appeared to mediate a minor part of the inverse association between methylmercury exposure and birth size.

Purpose: There is a wide range of individual and work environment factors that influence work ability among workers with pain and stress-related ill-health. The multiple interactions and overlap between these factors are insufficiently understood, and a network approach could mitigate limitations of previous research. This pilot study aimed to explore interactions between individual characteristics and psychosocial work environment and potential links to long-term work ability. Methods: Prospective data from a prevention project was used. Individuals (N = 147) with pain and/or stress-related ill-health (95% women) at public sector workplaces filled out baseline questionnaires about a collection of individual and work environment factors, which were used for constructing undirected networks. The model was run in three subsamples of workplaces. Finally, a separate model was established with work ability at 6-month follow-up as outcome variable. A shortest pathway analysis was calculated to identify mediators of work ability. Results: Symptom catastrophizing and perceived stress were the most influential factors in all network models. Symptom catastrophizing and pain-disability risk were found to mediate the relation between perceived stress and long-term work ability. Further, demand-control-support factors were interrelated, and patterns of interaction differed between different types of workplaces. Conclusion: The findings support the importance of individual factors, specifically symptom catastrophizing in an individual’s coping with pain or stress-problems and its influence on long-term work ability. Catastrophizing might play a role in stress-related disorders which should be further investigated. Individual and work environment factors interact and vary across context, which needs to be taken into consideration to prevent pain and stress-related ill-health at work.

BACKGROUND: Work-related musculoskeletal disorders are common among healthcare workers (HCWs) but might be prevented by risk assessment and further promotion of occupational safety and health. The aim of this study was to investigate if the risk assessment instrument TilThermometer can be used to identify risk profiles of physical exposure in HCWs working with patient handling and movement (PHM). Further aims were to describe HCWs' perceptions and experiences of using the TilThermometer. METHODS: This feasibility study has a mixed design methodology. In total, 54 HCWs from 17 Swedish care units participated and performed risk assessments with the TilThermometer. Data collected from the risk assessments were used to identify risk profiles of physical exposure. HCWs' experiences of using the TilThermometer were collected from activity logs and analysed qualitatively. Three questionnaires were used to assess perceived acceptability, appropriateness, and feasibility of the risk assessment, and eight study specific questions were used for perceived usefulness. RESULTS: The TilThermometer was used at the care units by assessing each care recipient, and when compiling the data at a group level, a summarized risk profile for the care unit could be provided. Risk for physical exposure was reported as high in two work tasks; no care unit used the high-low adjustable seat when showering care recipients sitting down, and 13% used the recommended assistive devices when putting compression stockings on. However, 99% used high-low adjustable assistive devices when caring and bathing care recipients lying down. TilThermometer was described as easy to use, enabling team reflections and providing an overview of the care units' recipients and workload, but difficulties in categorizing for mobility groups were also reported. The TilThermometer was, on a five-point scale, perceived as acceptable (mean 3.93), appropriate (mean 3.9), and feasible (mean 3.97). These scores are in line with

Objectives. This study aimed to describe work-, lifestyle-, and health-related factors among ambulance personnel, and to analyse differences between women and men. Methods. The cross-sectional study (N = 106) included self-reported and objective measures of work, lifestyle, and health in 10 Swedish ambulance stations. The data collection comprised clinical health examination, blood samples, tests of physical capacity, and questionnaires. Results. A high proportion of the ambulance personnel reported heavy lifting, risk of accidents, threats and violence at work. A low level of smoking and alcohol use, and a high level of leisure-time physical activity were reported. The ambulance personnel had, on average, good self-rated health, high work ability and high physical capacity. However, the results also showed high proportions with risk factors for cardiovascular disease (CVD), e.g., high blood pressure, and high levels of blood lipids. More women than men reported high work demands. Furthermore, women performed better in tests of physical capacity and had a lower level of CVD risk factors. Conclusions. Exposure to work-related factors that might affect health was common among ambulance personnel. Lifestyle- and health-related factors were somewhat contradictory, with a low proportion reporting lifestyle-related risk factors, but a high proportion having risk factors for CVD.

Endocrine-disrupting chemicals (EDCs) are environmental toxicants found in a wide variety of materials and items. They include pesticides (e.g. DDT, DDE), herbicides (e.g. atrazine), plasticizers (bisphenol A and other phthalates) and PCBs (Dominguez 2019), among others. Everyday household items such as non-biodegradable detergents and personal care products can contain EDCs (Khetan 2014). For instance, phthalate BPA (bisphenol A) and similar substances are widely used as softeners (‘plasticizers’) to create flexibility in PVC items such as plastic bags, shower curtains, cables and Tupperware containers. They are also used in liners for food cans, Teflon pans, baby bottles and a variety of cosmetics. These chemical compounds enter the food chain, for example, through plastic breakages, spurred on by heat, frost or age, off-gassing into household air, or through manufacturing effluents. They enter human and animal bodies, where they disrupt endocrine signalling pathways. Consequently, EDCs affect the well-being of aquatic, aerial and terrestrial ecosystems....

OBJECTIVE To investigate the potential association between prenatal opioid exposure and the risk of neuropsychiatric disorders in children. DESIGN Nationwide birth cohort study. SETTING From 1 January 2009 to 31 December 2020, birth cohort data of pregnant women in South Korea linked to their liveborn infants from the National Health Insurance Service of South Korea were collected. PARTICIPANTS All 3 251 594 infants (paired mothers, n=2 369 322; age 32.1 years (standard deviation 4.2)) in South Korea from the start of 2010 to the end of 2017, with follow-up from the date of birth until the date of death or 31 December 2020, were included. MAIN OUTCOME MEASURES Diagnosis of neuropsychiatric disorders in liveborn infants with mental and behaviour disorders (International Classification of Diseases 10th edition codes F00-99). Follow-up continued until the first diagnosis of neuropsychiatric disorder, 31 December 2020 (end of the study period), or the date of death, whichever occurred first. Eight cohorts were created: three cohorts (full unmatched, propensity score matched, and child screening cohorts) were formed, all of which were paired with sibling comparison cohorts, in addition to two more propensity score groups. Multiple subgroup analyses were performed. RESULTS Of the 3 128 571 infants included (from 2 299 664 mothers), we identified 2 912 559 (51.3% male, 48.7% female) infants with no prenatal opioid exposure and 216 012 (51.2% male, 48.8% female) infants with prenatal opioid exposure. The risk of neuropsychiatric disorders in the child with prenatal opioid exposure was 1.07 (95% confidence interval 1.05 to 1.10) for fully adjusted hazard ratio in the matched cohort, but no significant association was noted in the sibling comparison cohort (hazard ratio 1.00 (0.93 to 1.07)). Prenatal opioid exposure during the first trimester (1.11 (1.07 to 1.15)), higher opioid doses (1.15 (1.09 to 1.21)), and long term opioid use of 60 days or more (1.95 (1.24 to 3.06)) wer, Funding Agencies|National Research Foundation of Korea (NRF) - Korea government (MSIT) [RS-2023-00248157]; Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) [HE23C002800]; Ministry of Food and Drug Safety [21153MFDS601]; NIHR [NIHR303122, NIHR203684, NIHR203035, NIHR130077, NIHR128472, RP-PG-0618-20003]; European Research Executive Agency [101095568-HORIZONHLTH-2022-DISEASE-07-03]

Objective: Using a large longitudinal sample of adults from the Midlife in the United States (MIDUS) study, the present study extended a recently developed hierarchical model to determine how best to model the accumulation of stressors, and to determine whether the rate of change in stressors or traditional composite scores of stressors are stronger predictors of health outcomes. Method: We used factor analysis to estimate a stress-factor score and then, to operationalize the accumulation of stressors we examined five approaches to aggregating information about repeated exposures to multiple stressors. The predictive validity of these approaches was then assessed in relation to different health outcomes. Results: The prediction of chronic conditions, body mass index, difficulty with activities of daily living, executive function, and episodic memory later in life was strongest when the accumulation of stressors was modeled using total area under the curve (AUC) of estimated factor scores, compared to composite scores that have traditionally been used in studies of cumulative stress, as well as linear rates of change. Conclusions: Like endogenous, biological markers of stress reactivity, AUC for individual trajectories of self-reported stressors shows promise as a data reduction technique to model the accumulation of stressors in longitudinal studies. Overall, our results indicate that considering different quantitative models is critical to understanding the sequelae and predictive power of psychosocial stressors from midlife to late adulthood., Funding Agencies|National Institute of Health [1L60AG074424-01]

Background Prenatal exposure to environmental contaminants is a significant health concern because it has the potential to interfere with host metabolism, leading to adverse health effects in early childhood and later in life. Growing evidence suggests that genetic and environmental factors, as well as their interactions, play a significant role in the development of autoimmune diseases.Objective In this study, we hypothesized that prenatal exposure to environmental contaminants impacts cord serum metabolome and contributes to the development of autoimmune diseases.Methods We selected cord serum samples from All Babies in Southeast Sweden (ABIS) general population cohort, from infants who later developed one or more autoimmune-mediated and inflammatory diseases: celiac disease (CD), Crohn's disease (IBD), hypothyroidism (HT), juvenile idiopathic arthritis (JIA), and type 1 diabetes (T1D) (all cases, N = 62), along with matched controls (N = 268). Using integrated exposomics and metabolomics mass spectrometry (MS) based platforms, we determined the levels of environmental contaminants and metabolites.Results Differences in exposure levels were found between the controls and those who later developed various diseases. High contaminant exposure levels were associated with changes in metabolome, including amino acids and free fatty acids. Specifically, we identified marked associations between metabolite profiles and exposure levels of deoxynivalenol (DON), bisphenol S (BPS), and specific per- and polyfluorinated substances (PFAS).Impact statement Abnormal metabolism is a common feature preceding several autoimmune and inflammatory diseases. However, few studies compared common and specific metabolic patterns preceding these diseases. Here we hypothesized that exposure to environmental contaminants impacts cord serum metabolome, which may contribute to the development of autoimmune diseases. We found differences in exposure levels between the controls and those who late, Funding Agencies|Swedish Research Council [202003674, K2005-72 x-11242-11A, K2008-69 x-20826-01-4]; Formas [2019-00869]; European Union [101094099]; Barndiabetesfonden (Swedish Child Diabetes Foundation); Swedish Council for Working Life and Social Research [FAS2004-1775]; Ostgota Brandstodsbolag; Medical Research Council of Southeast Sweden(FORSS); JDRF Wallenberg Foundation [K 98-99D-12813-01A]; Joanna Cocozza Foundation; ALF-and LfoU grants from Region Ostergot-land and Linkoping University, Sweden; Orebro University

This article traces the origin of various charts and tables delineating the stages of alcohol influence in relation to the clinical signs and symptoms of drunkenness and a person's blood-alcohol concentration (BAC). In forensic science and legal medicine, the most widely used such table was created by Professor Kurt M. Dubowski (University of Oklahoma). The first version of the Dubowski alcohol table was published in 1957, and minor modifications appeared in various articles and book chapters until the final version was published in 2012. Seven stages of alcohol influence were identified including subclinical (sobriety), euphoria, excitement, confusion, stupor, alcoholic coma and death. The BAC causing death was initially reported as 0.45+ g%, although the latest version cited a mean and median BAC of 0.36 g% with a 90% range from 0.21 g% to 0.50 g%. An important feature of the Dubowski alcohol table was the overlapping ranges of BAC for each of the stages of alcohol influence. This was done to reflect variations in the physiological effects of ethanol on the nervous system between different individuals. Information gleaned from the Dubowski table is not intended to apply to any specific individual but more generally for a population of social drinkers, not regular heavy drinkers or alcoholics. Under real-world conditions, much will depend on a person's age, race, gender, pattern of drinking, habituation to alcohol and the development of central nervous tolerance. The impairment effects of ethanol also depend to some extent on whether observations are made on the rising or declining phase of the blood-alcohol curve (Mellanby effect). There will always be some individuals who do not exhibit the expected behavioral impairment effects of ethanol, such as regular heavy drinkers and those suffering from an alcohol use disorder.

The Journal of Chemical Education (JCE) recently published a letter to the editor by Dominick Labianca that was critical of methods of breath alcohol analysis because of biological variability in the blood/breath ratio (BBR) of alcohol (). His opinions deserve further comment and discussion. As background information, breath-alcohol instruments are used for two main purposes: (i) as a roadside screening test of driver sobriety and (ii) evidential quality instruments are used to generate evidence for prosecution of traffic offenders. Variations in the BBR are irrelevant in jurisdictions that enforce a statutory breath-alcohol concentration (BrAC) limit for driving, such as 0.08 g/210 L in USA. Such legislation makes it unnecessary to convert BrAC into the coexisting blood-alcohol concentration (BAC) for legal purposes. Variability in the BBR is explained by various physiological factors, such as lung function and the volume of breath discarded before a sample is captured for analysis. Moreover, BrAC is more closely related to ethanol concentration in arterial blood rather than cubital venous blood, which is the specimen used for analysis in forensic casework. In those jurisdictions that might convert BrAC into the coexisting BAC, the use of a 2100:1 BBR as a calibration factor underestimates the true venous BAC in the majority of cases.

Objectives: Hexavalent chromium (Cr(VI)) is classified as a human carcinogen. Occupational Cr(VI) exposure can occur during different work processes, but the current exposure to Cr(VI) at Swedish workplaces is unknown.Methods: This cross-sectional study (SafeChrom) recruited non-smoking men and women from 14 companies with potential Cr(VI) exposure (n = 113) and controls from 6 companies without Cr(VI) exposure (n = 72). Inhalable Cr(VI) was measured by personal air sampling (outside of respiratory protection) in exposed workers. Total Cr was measured in urine (pre-and post-shift, density-adjusted) and red blood cells (RBC) (reflecting Cr(VI)) in exposed workers and controls. The Bayesian tool Expostats was used to assess risk and evaluate occupational exposure limit (OEL) compliance.Results: The exposed workers performed processing of metal products, steel production, welding, plating, and various chemical processes. The geometric mean concentration of inhalable Cr(VI) in exposed workers was 0.15 mu g/m3 (95% confidence interval: 0.11-0.21). Eight of the 113 exposed workers (7%) exceeded the Swedish OEL of 5 mu g/m3, and the Bayesian analysis estimated the share of OEL exceedances up to 19.6% for stainless steel welders. Median post-shift urinary (0.60 mu g/L, 5th-95th percentile 0.10-3.20) and RBC concentrations (0.73 mu g/ L, 0.51-2.33) of Cr were significantly higher in the exposed group compared with the controls (urinary 0.10 mu g/ L, 0.06-0.56 and RBC 0.53 mu g/L, 0.42-0.72). Inhalable Cr(VI) correlated with urinary Cr (rS = 0.64) and RBC-Cr (rS = 0.53). Workers within steel production showed the highest concentrations of inhalable, urinary and RBC Cr. Workers with inferred non-acceptable local exhaustion ventilation showed significantly higher inhalable Cr(VI), urinary and RBC Cr concentrations compared with those with inferred acceptable ventilation. Furthermore, workers with inferred correct use of respiratory protection were exposed to significantly highe, Funding Agencies|Forskningsradet for halsa, arbetsliv och valfard (Forte) [2020-00208]; Afa Forsakring [200279]

BACKGROUND: Persons with hearing loss (HL) are a vulnerable group in working life. Studies have shown that they are more likely than the general population to be in part-time work, to be unemployed, receive disability pension, and to be on sick leave. Many workers with HL also experience unhealthy work conditions, such as jobs where they experience high demands combined with low control as well as safety concerns and social isolation. There is a lack of studies that focus on factors that promote a healthy, sustainable work situation for the target group. OBJECTIVE: To investigate health factors that contribute to a sustainable work situation for employees with HL. METHODS: The current study was a comparative, observational study with a cross-sectional design including a clinical population of adults with HL. Comparisons were made between workers with HL "in work" and workers with HL on "HL-related sick leave". RESULTS: Seven health factors were identified. Those "in work" experienced a healthier work environment as well as lower levels of mental strain, hearing-related work characteristics and content, cognitively demanding work content, hearing-related symptoms, energy-demanding activities, and bodily aches and pain than those on "HL-related sick leave". CONCLUSION: The results demonstrate a clear pattern regarding health factors for a sustainable working life. The type of job was not related to whether an individual was on sick leave or working. Rather, the work climate and the content of the work mattered.

Hand-arm vibration is a common occupational exposure that causes neurological impairment, myalgia, and vibration-induced Raynaud's phenomena or vibration white fingers (VWF). The pathological mechanism is largely unknown, though several mechanisms have been proposed, involving both immunological vascular damage and defective neural responses. The aim of this study was to test whether the substances interleukin-33 (IL-33), macrophage-derived chemokine (MDC), interleukin-10 (IL-10), endothelin-1 (ET-1), C-C motif chemokine ligand 20 (CCL20), calcitonin, and thromboxane (TXA2) changed before and after occupational hand-arm vibration exposure. 38 full-time shift workers exposed to hand-arm vibration were recruited. All the participants underwent medical examinations regarding symptoms of Raynaud's phenomena. In 29 of the participants, the concentration of IL-33, MDC, IL-10, ET-1, CCL20, calcitonin, and TXA2 was measured before and after a workday. There was a significant increase in ET-1 and calcitonin concentration and a decrease in the CCL20 concentration after the work shift in all participants. In the group suffering from VWF, but not in the non-VWF group, MDC was statistically significantly lower before the work shift (p = .023). The VWF group also showed a significant increase in MDC after the work shift. Exposure to occupational hand-arm vibration is associated with changes in ET-1, calcitonin, and MDC concentration in subjects suffering from vibration white fingers, suggesting a role of these biomarkers in the pathophysiology of this condition.

BACKGROUND: Prenatal exposure to environmental contaminants is a significant health concern because it has the potential to interfere with host metabolism, leading to adverse health effects in early childhood and later in life. Growing evidence suggests that genetic and environmental factors, as well as their interactions, play a significant role in the development of autoimmune diseases. OBJECTIVE: In this study, we hypothesized that prenatal exposure to environmental contaminants impacts cord serum metabolome and contributes to the development of autoimmune diseases. METHODS: We selected cord serum samples from All Babies in Southeast Sweden (ABIS) general population cohort, from infants who later developed one or more autoimmune-mediated and inflammatory diseases: celiac disease (CD), Crohn's disease (IBD), hypothyroidism (HT), juvenile idiopathic arthritis (JIA), and type 1 diabetes (T1D) (all cases, N = 62), along with matched controls (N = 268). Using integrated exposomics and metabolomics mass spectrometry (MS) based platforms, we determined the levels of environmental contaminants and metabolites. RESULTS: Differences in exposure levels were found between the controls and those who later developed various diseases. High contaminant exposure levels were associated with changes in metabolome, including amino acids and free fatty acids. Specifically, we identified marked associations between metabolite profiles and exposure levels of deoxynivalenol (DON), bisphenol S (BPS), and specific per- and polyfluorinated substances (PFAS). IMPACT STATEMENT: Abnormal metabolism is a common feature preceding several autoimmune and inflammatory diseases. However, few studies compared common and specific metabolic patterns preceding these diseases. Here we hypothesized that exposure to environmental contaminants impacts cord serum metabolome, which may contribute to the development of autoimmune diseases. We found differences in exposure levels between the controls and those, This work was supported by the Swedish Research Council [grant number 2020-03674; to TH], Formas [grant number 2019-00869; to TH], and by the “Inflammation in human early life: targeting impacts on life-course health” (INITIALISE) consortium funded by the Horizon Europe Program of the European Union under Grant Agreement 101094099 (to T.H., E.W.T., M.O., and J.L.). The ABIS cohort study (JL) was supported by Barndiabetesfonden (Swedish Child Diabetes Foundation), the Swedish Council for Working Life and Social Research [grant numbers FAS2004-1775 and FAS2004–1775], Swedish Research Council [Grant/Award Numbers: K2005-72 × -11242-11A and K2008-69 × -20826-01-4, K2008-69 × -20826-01-4], Östgöta Brandstodsbolag, Medical Research Council of Southeast Sweden (FORSS), JDRF Wallenberg Foundation [Grant/Award Number: K 98-99D-12813-01A], Joanna Cocozza Foundation and ALF-and LfoU grants from Region Östergötland and Linköping University, Sweden. Open access funding provided by Örebro University.

In recent years, environmental stresses viz., drought and high-temperature negatively impacts the tomato growth, yield and quality. The effects of combined drought and high-temperature (HT) stresses during the flowering stage were investigated. The main objective was to assess the effects of foliar spray of melatonin under both individual and combined drought and HT stresses at the flowering stage. Drought stress was imposed by withholding irrigation, whereas HT stress was imposed by exposing the plants to an ambient temperature (AT)+5°C temperature. The drought+HT stress was imposed by exposing the plants to drought first, followed by exposure to AT+5°C temperature. The duration of individual and combined drought or HT stress was 10 days. The results showed that drought+HT stress had a significant negative effect compared with individual drought or HT stress alone. However, spraying 100 µM melatonin on the plants challenged with individual or combined drought and HT stress showed a significant increase in total chlorophyll content [drought: 16%, HT: 14%, and drought+HT: 11%], Fv/Fm [drought: 16%, HT: 15%, and drought+HT: 13%], relative water content [drought: 10%, HT: 2%, and drought+HT: 8%], and proline [drought: 26%, HT: 17%, and drought+HT: 14%] compared with their respective stress control. Additionally, melatonin positively influenced the stomatal and trichome characteristics compared with stress control plants. Also, the osmotic adjustment was found to be significantly increased in the melatonin-sprayed plants, which, in turn, resulted in an increased number of fruits, fruit set percentage, and fruit yield. Moreover, melatonin spray also enhanced the quality of fruits through increased lycopene content, carotenoid content, titratable acidity, and ascorbic acid content, compared with the stress control. Overall, this study highlights the usefulness of melatonin in effectively mitigating the negative effects of drought, HT, and drought+HT stress, thus leading t

The purpose of this article is to explore structural preconditions for occupational well-being among blue-collar temporary agency workers within the Swedish manufacturing industry based on managers’ views and expectations of the worker. Through 25 interviews, we investigate how blue-collar temporary agency workers are seen by management using critical realism and the concept of ‘norm circles’ to analyse spatial, relational, sociotechnical and normative structures. We show how structures and norm circles possess alienating or dealienating mechanisms that precondition blue-collar temporary agency workers’ occupational well-being. The findings indicate management’s role as an important gatekeeper in determining structural preconditions for blue-collar temporary agency workers’ occupational well-being. By introducing aspects of skill and acquired skill, along with social aspects changing over time, this article contributes to the existing literature on blue-collar temporary agency workers’ occupational well-being.

Leader–member exchange (LMX) is the foremost relational approach to leadership. Building upon the LMX theory, this study aimed to examine the associations between three types of relationship appraisals in the workplace: leader–member (leader LMX), member–leader (member LMX), and member–member relationships (collegial climate), and their impact on employee work attitudes (i.e., employee job satisfaction and commitment). Questionnaire data were obtained from a sample of retail managers (n = 113) and retail workers (n = 555) in the Swedish retail sector. Mediation analyses confirmed the novel hypotheses that member LMX and collegial climate fully mediate the association between leader LMX and employee job satisfaction. However, in predicting employee commitment, the only significant mediator was member LMX. This study not only contributes to the existing LMX theory and research but also adds to the expanding body of knowledge in the field of positive organizational scholarship exploring the significance of positive workplace relationships in shaping employee attitudes. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Objective: This study aimed to investigate and explore Occupational Health and Safety (OHS) management, office ergonomics, and musculoskeletal symptoms in a group of office workers relocating from cell offices to activity-based flex offices (AFOs). Methods: The analysis was based on qualitative interview data with 77 employees and longitudinal questionnaire data from 152 employees. Results: Results indicate that there was a need to clarify roles and processes related to the management of OHS. Self-rated sit comfort, working posture, and availability of daylight deteriorated and symptoms in neck and shoulders increased after the relocation and seemed to be influenced by many factors, such as difficulties adjusting the workstations, the availability of suitable workplaces, and age, sex, and individual needs. Conclusion: Research on the long-term effects of physical work environments and management of (OHS) issues after implementing activity-based flex offices is sparse. This study demonstrates the importance of planning and organising OHS issue management when implementing an AFO, and to carefully implement office ergonomics among office workers.

The objective of the current study was to investigate, for the first time, the association between individual-level residential greenspace and redemption of antidepressant drugs in a longitudinal nationwide population-based sample in Sweden. A nationwide population-based sample of adults residing in Sweden was studied during 2013–2016 (Nindividuals = 108716; Nobservations = 324378). Residential greenspace land cover was assessed via high resolution geographic information systems, at 50, 100, 300, and 500 m buffers around individual residences. Antidepressant redemptions were assessed through the Swedish National Prescribed Drug Register. Greenspace-antidepressant associations were analyzed using generalized estimating equations (GEE), adjusting for demographic, socioeconomic and urban factors. Higher greenspace within 50–500 m residential buffer zones was associated with lower levels of prevalent antidepressant redemptions (50 m, odds ratio [OR] 0.878; 100 m, OR 0.891; 300 m, OR 0.873; 500 m, OR 0.899), while only greenspace in the 50 m buffer was associated with incident antidepressant redemptions (OR 0.853), in covariate-adjusted models. In conclusion, residential greenspace is associated with statistically significantly lower prevalent and incident antidepressant medication redemptions. The association is particularly salient for greenspace in the closest buffer zone around the residence. The results underscore the importance of green infrastructure and greenspace in the immediate residential-surrounding environment for mental health, and further point towards the need for an environmental psychiatry framework, and the importance of integrating health and environmental policies, urban planning and greening.

Objectives: Increasing epidemiological and experimental evidence suggests that particle exposure is an environmental risk factor for chronic kidney disease (CKD). However, only a few case-control studies have investigated this association in an occupational setting. Hence, our objective was to investigate associations between particle exposure and CKD in a large cohort of Swedish construction workers. Methods: We performed a retrospective cohort study in the Swedish Construction Workers' Cohort, recruited 1971-1993 (n=286 089). A job-exposure matrix was used to identify workers exposed to nine different particulate exposures, which were combined into three main categories (inorganic dust and fumes, wood dust and fibres). Incident CKD and start of renal replacement therapy (RRT) were obtained from validated national registries until 2021 and analysed using adjusted Cox proportional hazards models. Results: Exposure to inorganic dust and fumes was associated with an increased risk of CKD and RRT during working age (adjusted HR for CKD at age <65 years 1.15, 95% CI 1.05 to 1.26). The elevated risk did not persist after retirement age. Exposure to cement dust, concrete dust and diesel exhaust was associated with CKD. Elevated HRs were also found for quartz dust and welding fumes. Conclusions: Workers exposed to inorganic particles seem to be at elevated risk of CKD and RRT. Our results are in line with previous evidence of renal effects of ambient air pollution and warrant further efforts to reduce occupational and ambient particle exposure.

Arctic miners face significant risks from diesel exhaust and dust exposure, potentially leading to adverse respiratory health. Employers must limit harmful exposures, using personal protective equipment (PPE) as a last line of defense. This study explored the association between reported respiratory exposure and symptoms, and PPE training and usage. Data from the MineHealth study (2012–2014) included a total of 453 Arctic open pit miners in Norway, Sweden, and Finland. Participants answered questions on exposure to dust and diesel exhaust, respiratory symptoms, and PPE use, in addition to age, gender, BMI, smoking, and self-rated health. Estimated exposure to dust was common, reported by 91%, 80%, and 82% and that of diesel exhaust by 84%, 43%, and 47% of workers in Sweden, Finland, and Norway, respectively. Reported dust exposure was significantly related to respiratory symptoms (OR 2.2, 95% CI 1.3–3.7), diesel exposure increased the occurrence of wheezing (OR 2.6, 95% CI 1.3–5.4). PPE use varied between the studied mines. Non-use was common and related to reduced visibility, wetness, skin irritation and fogging of the respiratory PPE. Future research should employ more precise exposure assessment, respiratory function as well as explore the reasons behind the non-compliance of PPE use.

Objective: This paper discusses the failure and success of society to decrease the adverse health effects of asbestos exposure on workers’ health in relation to scientific knowledge. Methods: The findings are based on a narrative literature review. Results: Early warnings of the adverse health effects of workplace exposure to asbestos were published already in the 1930s. Serious health effects, such as malignancies and fibrosis due to occupational asbestos exposure, were highlighted in major medical journals and textbooks in late 1960s. New technologies could detect also asbestos fibers in the lung of non-occupational exposed persons in the 1970s. The first bans for using asbestos came in the early 1970s, and more general bans by authorities came in the 1980s and continue until today. Conclusions: The rather late recognition of adverse effects of asbestos exposure in the general population and measures to decrease the exposure through more general bans came rather late. However, the very strong measures such as general bans in many countries have been a success. A Swedish study showed that the general ban and other measures have decreased the risk of malignancies due to occupational exposure. The effect of the bans on adverse effects in the general population has yet to be studied. Analysis of fibers in the lungs of persons born after the bans could be an efficient method.