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Results are reported from follow-up examination 6–9 years (average 8.3 years) after cessation of exposure, in 28 men who developed work-related bronchial asthma (potroom asthma) in a primary aluminium production plant, after exposure to strong respiratory irritants in the potroom atmosphere. Compared to exposed (other potroom workers) and non-exposed (non-potroom workers) controls from the same plant in a 1:3 matched analysis, the potroom-asthma patients had increased relative risk of self reported chest tightness (RR = 12.9, CL 95% = 3.9–42.5), wheezing (RR = 22.1, CL 95% = 5.1–96.3) and cough (RR = 8.4, CL 95% =2.2–31.9), and of reduced spirometric values measuring expiratory flow: FEV1 <70% of predicted (RR = 9.0, CL 95% = 1.4–58.1). Two cases were using a bronchodilator inhaler due to persistent asthmatic symptoms. [ABSTRACT FROM PUBLISHER]

Declining smoking prevalences in the general population may not be reproduced in the pregnant subpopulation, due to selective recruitment. To examine the extent of selection, the study compares smoking in a pregnant population, prior to pregnancy, with the general female population of Norway 1989. Data were collected from an interview survey of the general population and questionnaires to parturients the same year. The results indicate an association between smoking and pregnancy in the youngest and between non-smoking and pregnancy in the older pregnant population which may reflect smoking-associated sexual activity and subfertility, respectively. [ABSTRACT FROM AUTHOR]

Background: Globally, work-related deaths (injuries and diseases) are a major social and public health problem. Register data on fatal occupational injuries in high-income countries may be considered to have high quality, especially when reporting is mandatory and regulated by law. We aimed to assess the accuracy of work-related injury death statistics in Norway, with reference to the Labour Inspection Authority and three other on-going registration systems (the cause-specific mortality register, the register for governmental compensations, and the register for insurance companies)., Methods: In this register-based study, we used the capture-recapture technique to adjust for undercounting. We investigated whether the capture-recapture method using two or three sources gave a valid estimate of fatal occupational injuries as compared with the number of cases identified in four registers administrated by the Norwegian Labour Inspection Authority, Statistics Norway, the Labour and Welfare Administration, and Finance Norway. The inclusion criteria were fatal unintentional injuries among residents of Norway between 2000 and 2003 that occurred while working for income in private and public land-based industries. We obtained ethical and legal approvals., Results: In a period of four years (2000-2003), the Labour Inspection Authority registered 171 occupational injury deaths among residents employed in land-based industries. Two combinations of data sources gave capture-recapture estimates of 246 [95% CI 216; 279] and 265 [95% CI 234; 299] deaths. In total, 246 cases were identified in the four registration systems, which was 44% higher than the number of deaths registered by the Labour Inspection Authority. The Labour Inspection Authority had the most complete register out of the four registration systems., Conclusions: The capture-recapture method used on two overlapping data sources gave highly valid estimates of the total deaths. We demonstrated the existence of significant weaknesses in the registration systems in a country considered to have high-quality register data., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

Background: This study updates information on mortality and cancer morbidity in a cohort of Norwegian talc workers., Methods: Follow-up was extended with 24 years, covering 1953-2011. Comparisons were made with the general population and between subgroups within the cohort., Results: Standardized mortality ratio for non-malignant respiratory disease (NMRD) was 0.38 (95%CI: 0.18, 0.69) and for diseases of the circulatory system (CVD) 0.98 (95%CI: 0.82, 1.16). A non-significantly increased NMRD risk was observed at high dust exposures. There were no deaths from pneumoconiosis., Conclusions: With the clear limitations of a small cohort, our results do hint at an effect of talc dust on mortality from NMRD other than pneumoconiosis, covered by a strong and persisting healthy worker effect. Also, an effect on CVD mortality, masked by a healthy worker selection into the cohort cannot be ruled out. Excess mortality from pneumoconiosis seen in other studies, may reflect exposure to quartz and, possibly, bias due to comparability problems., (© 2017 Wiley Periodicals, Inc.)

Background: Noise-induced hearing loss is the diagnosis that is most frequently reported to the Norwegian Labour Inspection Authority. The objective of this study was to describe the doctors' reports on noise-induced hearing loss and assess the quality of the information., Material and Method: The study is based on reports to the Labour Inspection Authority for the years 2005-09. We grouped the reporting incidence according to industry, gender and age on the basis of Statistics Norway's employment statistics. The reports were compared to data from Statistics Norway's living conditions survey from 2009., Results: A total of 7,888 reports had been submitted in the study period (2005-2009), 96% of which concerned men. The annual reporting incidence amounted to 66 per 100,000 employees; six and 120 for women and men respectively. The reporting incidence was highest in the age group 55-74 years and for the construction and manufacturing industries. Altogether 52% of the reports pertained to employees who were no longer working in the enterprise where they had been exposed to noise. The proportion of reports pertaining to employees aged under 40 years was lower than the corresponding proportion of those who reported work-related hearing loss in Statistics Norway's living conditions survey from 2009. Occupational health physicians submitted 85% of the reports., Interpretation: Of those exposed to noise, only a small proportion of women, younger employees and employees in enterprises with no access to occupational health services are captured by the reporting system. The same may apply to employees in industries such as transport and retail trade, but this will require further investigation.

Background: Work-related amputations are serious yet preventable injuries. Workers in the manufacturing sector in particular are vulnerable to amputation injuries compared to workers in other sectors., Methods: In this study, we used a two-source capture recapture method to estimate the true number of annual work-related amputations in the Norwegian manufacturing sector for a 10-year study period (1998-2007). The two-sources utilized in this study were the Norwegian Labor Inspection Authorities Registry of Work-Related Injuries (RWI) and the Association of Norwegian Private Insurance Companies registry for occupational injuries (ANPIC)., Results: We estimated an annual incidence rate that ranged from 21/100 000 to 62/100 000 workers during the study period. Our findings indicate an undercount of amputations reported to the Norwegian Labour Inspection Authority's registry ranging from 16% to 58% during the study period., Conclusions: Work-related amputations remain a challenge in the Norwegian manufacturing sector. This study underscores the need of robust epidemiological surveillance infrastructure and effective interventions to prevent amputations at work.

Background: The Norwegian Labour Inspection Authority records fatal occupational injuries in mainland bases activities, i.e. all sectors except offshore, aviation, shipping, hunting and fishing; the Registry's information on these injuries has been considered complete. The present study aimed at testing this assumption., Material and Methods: In 2000 - 03, the Labour Inspection Authority recorded 183 fatal occupational injuries; 171 of the deceased were residents in Norway. Each of these deaths were compared with fatal occupational injuries in the Norwegian Cause of Death Registry. A capture-recapture model was used to estimate the real number of fatal occupational injuries., Results: In 2000 - 03, 214 fatal occupational injuries were recorded among residents in Norway employed in all sectors (except offshore, aviation, shipping, hunting and fishing) in at least one of the two registries (98 cases were reported in both registries). The Norwegian Labour Inspection Authority mainly lacked information about (in comparison with the Death Registry) deaths in the military (1 of 9), in the health and social services (3 of 7), road traffic accidents (36 of 52) and deaths in Northern Norway/Spitsbergen (17 of 28). One third of all recorded cases (77 of 214) were caused by transport accidents. Risk by industry (deaths per 100 million work hours) was highest for primary industries (7.0) and for <> (4.1). The real number of fatal injuries was estimated to 246, or 44 % more than the 171 deaths registered by the Labour Inspection Authority., Interpretation: Fatal occupational injuries are much more frequent than reported in the official registries. Underreporting, particularly of road traffic accidents/transport accidents, may lead to misinterpretation of risks and time trends and of need for preventive action.

Objectives: The aim of this study was to compare self-reported work-relatedness of neck-shoulder and arm pain with experts' assessments based on specific criteria., Methods: A sample of 217 employed participants in the Oslo Health Study 2000-2001, aged 30, 40, and 45 years, who reported neck-shoulder or arm pain in the past month, underwent a health examination. A criteria document for evaluating the work-relatedness of upper-extremity musculoskeletal disorders was used to -establish clinical diagnoses and assess the work-relatedness of pain with respect to the subject's present job. We measured agreement between the participants and experts on whether pain was related to work as observed agreement, positive and negative specific agreement, and kappa., Results: A major proportion of the cases were assessed as work-related, somewhat more frequently by self-report than when assessed by experts (80% versus 65% for neck-shoulder pain, and 78% versus 72% for arm pain, respectively). However, there was considerable disagreement as to which cases were work-related. The experts disagreed more frequently in cases that were reported as non-work-related (particularly for neck-shoulder pain and cases reported by men). Positive specific agreement was fairly high (76-85% in the total population), while negative specific agreement was lower (37-51%). Kappa values were also low (0.16-0.34)., Conclusions: Compared with expert assessment, self-reporting did not seem to particularly exaggerate work-relatedness. Nevertheless, there was considerable disagreement, especially on cases assessed as non-work--related. However, agreement will depend on the case definitions and the criteria for work-relatedness used both by the participants and the experts.

The Norwegian Labour Inspectorates (NLI's) Registry for Work-Related Diseases was established in 1920. Based on the principle of sentinel health events (SHE), its central purpose is to provide information to the NLI to enable workplace interventions and the prevention of hazardous exposures. Although physicians are required to report work-related diseases to the NLI, only 3% did so in 2006. There were 3392 cases of work-related diseases reported to the NLI by 561 physicians in 2006. Diseases of the ear (noise-induced hearing loss) comprised 59% (n=1987) of the cases, while 12% (n=398) of the cases were attributed to the diseases of the respiratory system and 7% (n =239) were diseases of the skin and subcutaneous tissue. Despite limitations, the registry continues to inform NLI's prevention strategies, supplements data concerning work-environment surveillance, and provides impetus for epidemiological studies.

Objectives: The aim of this study was to quantify socioeconomic inequalities in low-back pain, neck-shoulder pain, and arm pain in the general working population in Oslo and to examine the impact of job characteristics on these inequalities., Methods: All economically active 30-, 40-, and 45-year-old persons who attended the Oslo health study in 2000-2001 and answered questions on physical job demands, job autonomy, and musculoskeletal pain were included (N=7293). Occupational class was used as an indicator of socioeconomic status. The lower occupational classes were compared with higher grade professionals, and prevalences, prevalence ratios, prevalence differences, and population attributable fractions were calculated., Results: There were marked, stepwise socioeconomic gradients for musculoskeletal pain, steeper for the men than for the women. The relative differences (prevalence ratios) were larger for low-back pain and arm pain than for neck-shoulder pain. The absolute differences (prevalence differences) were the largest for low-back pain. Physical job demands explained a substantial proportion of the absolute occupational class inequalities in low-back pain, while job autonomy was more important in explaining the inequalities in neck-shoulder pain and arm pain. The estimated population attributable fractions supported the impact of job characteristics at the working population level, especially for low-back pain., Conclusions: In this cross-sectional study, physical job demands and job autonomy explained a substantial proportion of occupational class inequalities in self-reported musculoskeletal pain in the working population in Oslo. This finding indicates that the workplace may be an important arena for preventive efforts to reduce socioeconomic inequalities in musculoskeletal pain.

Background: Lack of knowledge about the occurrence of work-related health problems in the general population makes it difficult to estimate the potential for their prevention in the workplace., Aims: To examine the prevalence of self-reported work-related health problems among adult citizens of Oslo, Norway., Methods: The study was part of the Oslo Health Study 2000-2001, in which all individuals in certain age cohorts were invited to a comprehensive health screening. All 30-, 40- and 45-year old subjects who attended the screening were asked if they had experienced any of 11 common health problems in the past month, and whether they considered these to be work-related. Of the 26,074 invitees in these age cohorts, 8,594 (33%) answered the questionnaire., Results: Nearly 60% of subjects reported one or more work-related health problems, most commonly reported were pain in the neck/shoulders (38%) and low back pain (23%). Neck/shoulder pain was most frequently attributed to working conditions, by 74% of subjects with this problem; followed by arm pain (72%), fatigue (51%) and low back pain (50%). Work-related fractions for eczema and asthma symptoms were 23 and 18%, respectively. There were marked gender differences, but small age differences., Conclusions: A substantial proportion of common health problems in the Oslo population were attributed to working conditions. This implies a large preventive potential and call for increased preventive efforts targeted at known risk factors in the workplace.

Background: The construction industry is prone to accidents. In Norway there is little research-based knowledge on accident pattern and risk factors. The main objective of the study was to examine whether in-depth studies of accidents in this industry, leading to injuries registered by the health services, could identify preventable risk factors and preventive measures., Material and Methods: 50 accidents in the construction industry were thoroughly investigated. All had led to serious personal injury. Patients were interviewed after treatment in emergency wards and hospitals in Oslo, and inspections of the accident sites were performed. An interdisciplinary expert group discussed the accidents in order to identify risk factors and suggest preventive measures. The accident reports in the study were compared to reports from the Labour Inspectorate on the same accidents., Results: The investigation identified several risk factors, and a number of detailed preventive measures were proposed. We submitted these proposals to the authorities and organisations involved. Accidents because of time pressure and electricity were two main groups. More than one third of the respondents said that time pressure had contributed to the accident. Accident risk caused by time pressure can be reduced by avoiding piecework contracts, unrealistic time limits, and the use of day penalties for breach of contract. Possible preventive measures for electric injuries imply modification of the reporting system and of the work organisation so that workers can comply with the regulations more easily. The study reports generally contained more information of relevance for prevention than the routine reports from the Labour Inspectorate did. For accidents reported by the Inspectorate to the police, their reports were more informative than the study reports., Interpretation: By the method presented, we obtained detailed information about accidents and preventable risk factors, so that preventive measures could be proposed. The method can also be used for other types of accidents.

This paper presents a two-step injury surveillance system. In the first step, limited data (a minimum data set) on all (or a representative sample of all) injuries to residents and non-residents within a defined geographical area were obtained using routine collection procedures within the medical care system. The second step involved periodically sampling of specific injuries, injured persons, or places for in-depth investigations from the database established by the first step, or selecting relevant injured persons seeking treatment in the medical care system, to collect many data (an expanded data set) on a limited number of injuries. This system was implemented in Oslo. Data from about 48,000 injuries were collected annually. Two in-depth investigations of serious occupational injuries were carried out. The first involved 223 cases and the second, 50 cases. Some in-site studies were included. Experiences from the implementation in Oslo suggest that this system can function in the medical care system and provide data required for making estimates of injury incidence rates, establishing trends, and on contributing factors to injuries. A crucial factor in the success of the first part of such a system is to have enough resources for continuous quality control and feedback to personnel involved in the registration of data. Combining the registered data from general practitioners, accident and emergency departments, hospitals and notifications of fatalities in Oslo, and on assessments of the number of injuries treated by private clinics and occupational health centres in Oslo, and in the health care system outside of Oslo, leads to the conclusion that 11.9% of the residents of Oslo will annually be treated for an injury.

Background: There is little reliable information about the incidence and severity of occupational injuries in Norway., Material and Methods: Occupational injuries occurring at worksites in Oslo and treated by Oslo Emergency Ward or Oslo Ambulance Service were recorded over a period of three months. Patients with serious injuries were interviewed about the accident., Results: 1153 injury incidents were registered, 229 (20%) of which were considered serious. Median age of patients was 32 years. Estimated annual incidence of injuries at worksites in Oslo treated by Oslo Emergency Ward/Oslo Ambulance Service was 14 per 1000 employees, for all injuries in Oslo requiring treatment, 20 per 1000 employees. Men had three times the incidence of women. The incidence was highest in the youngest age groups. Of those with serious injuries, 30% had a non-Scandinavian language as their first language. Electricians, carpenters and police officers had the highest observed incidences. 87 injuries (8%) were caused by violence., Interpretation: The incidence of occupational injuries in Oslo is reduced by about 40% since the 1970s. There is, however, no reduction for women. Construction workers are still at high risk. Workers of non-Scandinavian origin are also at high risk, probably because of selection into high-risk occupations. The injury register provides a good overview, but in-depth studies are needed to identify specific risk factors.

Background: The Labour Inspection investigates occupational accidents and publishes injury statistics annually. Information is based upon two main sources: Copies of reports to the National Insurance Service and mandatory reports from employers to the Labour Inspection., Material and Methods: Occupational injuries treated by Oslo Emergency Ward and Oslo Ambulance Service during a period of three months were compared with injuries recorded by the Labour Inspection., Results: Four months after the end of the study period, the Labour Inspection had received reports from the National Insurance Service on 150 (13%) of the 1,153 injuries recorded by Oslo Emergency Ward/Oslo Ambulance Service. Among all injuries registered, 208 were serious according to the criteria of the Labour Inspection. Only 19 (9%) of these were reported directly to the Labour Inspection from employers in accordance with the legal requirement. The study recorded 17 serious injuries caused by violence affecting employees; none of these were reported directly to the Labour Inspection., Interpretation: Data on occupational injuries collected by the Labour Inspection are far from complete. In Oslo alone, the Labour Inspection may annually overlook some 900-1,000 serious injuries. Data quality can be improved and delayed reporting avoided by using information from doctors and medical institutions that provide treatment.

Objective: To examine whether a woman's need for job adjustment in pregnancy can be predicted by a short interview on working conditions at the first prenatal visit., Design: Midwives included a semi-structured work history during the interview of unselected first prenatal visits. Their early prediction about the woman's need for job adjustment was compared with the woman's own later report of such need and the need expressed as a risk score for preterm birth based on the woman's self-reported working conditions. Data on both were collected by a questionnaire presented to the woman at about the 36th week of pregnancy., Setting: Seven maternity centres in Oslo, Norway, April 1993-March 1994., Subjects: 160 pregnant women in paid work., Main Outcome Measures: The proportion of predictions of presence (positive predictive value) or absence (negative predictive value) of need that was confirmed by the woman's later report, or the risk score., Results: The positive predictive value was 86% and the negative predictive value 50% with the woman's later report as reference, and 56 and 79%, respectively, with the risk score for preterm birth as reference., Conclusion: The work history allows early prediction of need for job adjustment in pregnancy.

Objectives: This study explored the possible effects of power to control one's own work pace on pregnancy health., Methods: Questionnaires were sent to all parturients in Norway between 16 October and 26 November 1989 for completion prior to discharge from the hospital; 87.2% responded. The study population comprised 3321 respondents with singleton pregnancies and paid work beyond the 3rd month of pregnancy. Power to control work pace was measured as self-reported influence on breaks and work pace and absence of external pacing. Pregnancy health was defined by the prevalence of preeclampsia, disabling posterior pelvic pain, low-back pain, and birthweight of <2500 g for the offspring., Results: Pregnancy health improved with increasing power to control work pace, both in manual and nonmanual work. The risk decreased with increasing control for all 4 outcomes, but the impact on birthweight was restricted to nullipara. After adjustment for age, parity, education, smoking, and manual work, the decreasing trend remained significant for preeclampsia and low birthweight of the first born. In a comparison with women with the highest level of control, the adjusted odds ratios for women with no control were 1.6 [95% confidence interval (95% CI) 0.9-3.1] for preeclampsia, 1.6 (95% CI 1.0-2.4) for disabling posterior pelvic pain, 1.3 (95% CI 1.0-1.8) for low-back pain, and 2.5 (95% CI 0.9-6.8) for low birthweight (nullipara)., Conclusions: Women with power to control their own work pace had better pregnancy health than women without such power. The results suggest increased individual control over work pace as a prime target for job adjustment during pregnancy.

Objective: To examine whether strenuous working conditions in pregnancy are associated with reduced birthweight., Method: Cross-sectional, population based study. Retrospective data collection by questionnaire to parturients in all maternity wards in Norway 16.10-26.11.89, completed before discharge from hospital, with response rate 87.2%. The study population consists of the 5388 women with singleton births, of whom 3321 were in paid work beyond the third month of pregnancy. Main outcome measures are prevalence of birthweight <2500 grams (LBW) and mean birthweight., Results: Strenuous working conditions increased risk of LBW, but only for nullipara, particularly non-smoking nullipara. Odds ratios with 95% confidence intervals for non-smoking nullipara, adjusted for age, education and income, were 0.3 (0.1,0.9) for influence on work pace, 2.8 (1.2,6.5) for exposure to heavy lifting and 2.2 (0.8,5.8) for twisting/bending. Four groups of occupations were defined according to exposure, solely based on reports from mothers with non-LBW children in order to avoid recall bias. Prevalence of LBW increased from 0.8% in the least exposed to 8.3% in the most exposed group. (Test for trend: p<0.05, after adjustment for age, education and income.) Strenuous working conditions had no independent effect on mean birthweight after adjustment for age, education, income and smoking., Conclusion: Strenuous work increased the risk of LBW in nulliparae, particularly in non-smokers. Lack of influence on work pace was the strongest risk factor. The preventive effect of job modification in pregnancy may parallel smoking cessation.

Objectives: This study examined the effect of job adjustment on sickness absence during pregnancy and also determined the conditions under which such adjustments are obtained., Methods: Data were derived from a nationally representative survey on work conditions during pregnancy in Norway in 1989. For employees (N = 2713) remaining in the same job throughout pregnancy, the percentage of women on sick leave immediately before delivery was determined according to the need for job adjustment and the obtainment of job adjustment. Those obtaining job adjustment were grouped according to workplace size, labor-market sector, co-worker gender, educational level, work schedules, weekly workhours, children under 16 years of age in the household, and age., Results: All told, 1691 women (62.3%) needed job adjustment, among whom 936 (55.4%) obtained such adjustment. The proportions of those on sick leave before delivery were 45.2% for "no need", 67.9% for "need - adjustment obtained", and 79.2% for "need - adjustment not obtained". In the last category, the difference (versus "adjustment obtained") constituted 44.5% of the weeks lost because of sickness absence in the last half of pregnancy. The odds ratio (OR) for obtaining job adjustment was larger for workplaces with more than 50 employees (OR 1.4) and smaller for jobs with work schedules other than daytime or shift work (OR 0.5) and also for women living with children under 16 years of age (OR 0.8)., Conclusions: Job adjustment is associated with reduced sickness absence during pregnancy. Further studies should explore workplace characteristics that make it difficult to obtain such adjustments, as required by law.

Sickness absence in pregnancy has been shown to be associated with strenuous working conditions and parity. So far, few studies have made adjustments for possible interaction and confounding. Such adjustments are needed to more precisely identify targets for preventive measures. We have, therefore, in a representative population of pregnant employees in Norway 1989, computed adjusted odds ratios for leaving work by sickness absence more than three (LSC > 3) and eight (LSC > 8) weeks before delivery according to working conditions identified as risk factors in earlier studies; adjusted for job control, domestic conditions and sickness absence the year prior to pregnancy. The cumulative percentage of LSC > 8 and LSC > 3 was 26.4 and 51.1. Ergonomically strenuous postures and heavy lifting increased the risk of both outcomes. In addition, shift work and hectic work pace increased the risk of LSC > 3. Influence on breaks reduced risk. Only para experienced reduced risk of LSC when working part-time. Sicklisting the year prior to pregnancy had no confounding effect, which suggest that pregnancy represents a new incompatibility with work. Preventive measures should address work postures and heavy lifting, as well as conditions influencing the woman's control with her time.

Persons with pleuramesothelioma were studied to find out the share receiving occupational injury benefit from the National Insurance Scheme. This disease, caused by inhaling asbestos, was chosen because it has been estimated that between 70 and 80 per cent of persons with pleuramesothelioma fulfil the criteria for compensation. During the period 1970-93, 662 men and 104 women were recorded as having this disease. Up to June 1996, the National Insurance Administration had considered the cases of only 163 men, and no women. A further 25-30 patients may have filed claims with the local national insurance office. This implies that, overall, maximum one third of those entitled to occupational injury benefit have received it. The fraction would probably be even lower in the case of diseases where the association with occupation is less certain. It is recommended that national disease registries, such as the Cancer Registry, should report possible cases of occupational disease to the National Insurance Administration.

Objective: To examine if abstention from smoking in pregnancy increases with opportunities to limit workload., Design: Cross-sectional study based on self-administered questionnaires to women post partum., Setting: All maternity wards in Norway, 16 October-26 November 1989., Subjects: 5 438 women, or 87.2% of all parturients in Norway during the study period., Main Outcome Measure: The abstention fraction (AF) defined as percentage of nonsmokers in pregnancy among prepregnancy daily smokers., Results: The abstention fraction was lower for women with lack of influence on work pace, with hectic work pace, exhaustion after work or work schedules other than daytime, for women with children <16 years of age in the household, and for women in paid work with 20 hours or more of housework weekly, than for women without these conditions. Adjusted odds ratios (OR) for abstention were low for women with children <16 years both when in paid work (OR 0.4) and as housewives (OR 0.3). Women who received extra help with housework had a high abstention fraction (OR 1.6) both when in paid work and as housewives. The abstention fraction was high for women with daytime work (OR 1.5) and low with hectic work pace (OR 0.7), compared with women without these conditions., Conclusion: Abstention from smoking in pregnancy increases with opportunities to limit total workload.

In the early 1990s, most pregnant women in Norway were in gainful employment. This led to increased interest in the possible consequences for reproductive health, and a growing concern for the need to accommodate the pregnancy. We have therefore investigated how accurately general fertility rates predict the number of pregnancies in the workforce. Fertility rates (FR) among employed women and standardized fertility ratios (SFR) in occupational groups were estimated on the basis of information from the Labour Market Statistics and the national survey "Pregnancy and Work", Norway, 1989. The fertility rate among employed women was 17% higher than the general fertility rate. Two occupational groups had significantly different SFRs: technical/professional workers (SFR 118) and transport/communication workers (SFR 82). In addition, differences were found for parity-specific SFRs in administrative/executive work (SFR nullipara 80, SFR para 125) and service work (SFR nullipara 114, SFR para 80). We suggest that work status and occupation should be included among the variables registered in the Medical Birth Registry of Norway, in order to facilitate routine presentations of fertility rates and pregnancy outcomes for women in paid work. The results further indicate that work-specific conditions influence first-birth fertility. This should be explored in demographic studies of the relation between women's fertility and participation in paid work.

Altogether 9,516 women, 16-67 years of age, were granted a disability pension in Norway in 1993. Musculoskeletal disease was registered as the main diagnosis for 3,730. Employment status is known for 3,125 of these 3,730 women. Analyses, based on age standardized incidence rates--SIR's, pointed to shop assistants, practical nurses and charladies as the three major occupational groups with high risk of being disability pensioned because of musculoskeletal disease. These three occupations accounted for more than one third of all women in paid employment who were granted a disability pension for musculoskeletal disease 1993. Compensation will amount to about NOK 600 million before these women reach the normal retirement age of 67 years. Prevention of musculoskeletal diseases in the labour force would appear to be potentially cost-effective. So far, prevention of work-related musculoskeletal diseases has focused mainly on the technical ergonomic aspects of the working conditions. It is recommended that more attention be given to organizational aspects, such as daily hours of work, the timing and duration of breaks, work pace and potential to influence one's own work situation.

To what extent can general practitioners elucidate connections between working conditions and patterns of health and disease for preventive purposes? Data were collected by means of questionnaires to general practitioners, interviews with patients and by testing out questions to establish an occupational history. Questions covering seven key topics revealed a multitude of possible causal links between working conditions and symptoms. The information may appear irrelevant to the general practitioner, however, if the Labour Inspection (Arbeidstilsynet) or the companies' health services fail to assist.