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  • 1.
    Rezagholi, Mahmoud
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research. Uppsala universitet, Institutionen för medicinska vetenskaper.
    Cost-Efficient Designs for Assessing Work-Related Biomechanical Exposures2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Work-related disorders due to biomechanical exposures have been subject to extensive research. Studies addressing these exposures have, however, paid limited attention to an efficient use of resources in exposure assessment. The present thesis investigates cost-efficient procedures for assessment of work-related biomechanical exposures, i.e. procedures aiming at a proper balance between statistical and economic performance.

    Paper I is a systematic review of tools used in literature providing cost-efficient data collection designs. Two main approaches were identified in nine publications, i.e. comparing cost efficiency among alternative data collection designs, and optimizing resource allocation between different stages of data collection, e.g. subjects and samples within subjects. The studies presented, in general, simplified analyses, in particular with respect to economics.

    Paper II compared the cost-efficiency of four video-based techniques for assessing upper arm postures. The comparison was based both on a comprehensive model of cost and error and additionally on two simplified models. Labour costs were a dominant factor in the cost efficiency comparison. Measurement bias and costs other than labour cost influenced the rank and economic evaluation of the assessment techniques.

    Paper III compared the cost efficiency of different combinations of direct and indirect methods for exposure assessments. Although a combination of methods could significantly reduce the total cost of obtaining a desired level of precision, the total cost was, in the investigated scenario, lowest when only direct measurements were performed. However, when the total number of measurements was fixed, a combination was the most cost efficient choice.

    In Paper IV, demand functions were derived for a four-stage measurement strategy with the focus of either minimizing the cost for a required precision, or maximizing the precision for a predetermined budget. The paper presents algorithms for identifying optimal values of measurement inputs at all four stages, adjusted to integers, as necessary for practical application.

    In summary, the thesis shows that it is important to address all sources of costs and errors associated with alternative measurement designs in any particular study, and that an optimal determination of samples at different stages can be identified in several cases not previously addressed in the literature.         

  • 2.
    Rezagholi, Mahmoud
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Economics.
    Deriving cost-efficient strategies for observational assessments of postural loads2014In: Occupational Medicine & Health Affairs, ISSN 1463-502X, E-ISSN 2329-6879, Vol. 2, article id 174Article in journal (Refereed)
    Abstract [en]

    Studies aimed at optimizing resource allocation between different sampling stages are characterized by both simplicity and incompleteness in optimization and economic analysis. The aim of this study was therefore to completely resolve the allocation problem for a fourstage measurement strategy devoted to observational assessment of work-related postural loads with the precision of the mean estimate considered as ‘output’. The derived demand functions for inputs to the four stages were used to derive functions for the minimized cost and the maximized precision of the measurement strategy. The application of the theoretical results to a working posture assessment study led to increased cost efficiency of the measurement strategy investigated in the study. Under the additional constraint that the optimal values must be integers, optimization of this measurement strategy would result in either a 12% reduction in cost or a 7% increase in precision.

  • 3.
    Rezagholi, Mahmoud
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Differential Socio-Economic Effects of Work Environmental Risk Faktors2016In: Journal of Health & Medical Economics, Vol. 2, no 2, article id 9Article in journal (Refereed)
    Abstract [en]

    Efficient resource allocation in the management of occupational health and safety (OHS) in the workplace requires access to information about the effects of different psychosocial and physical risk factors in the workplace on lost working hours and reduced productivity. The present article aims to help the OHS policy-makers in their decisions on allocating economic and human resources to deal with different environmental risk factors and their socio-economic consequences in the workplace. The socio-economic consequences refer substantially to missed and unproductive working hours due to sickness absences and sickness presenteeism respectively. The methodologies employed to fulfil the purpose of this study included methods to estimate marginal effects of different risk factors on lost working hours and labour productivity. The empirical results of the study showed that the psychosocial and physical dimensions of the work environment of the Swedish company Sandvik Materials Technology had different socio-economic impacts in terms of lost working hours and labour productivity. The psychosocial work environment had the greatest impacts, particularly on reducing work ability and work interest among workers and on work-related disorders among female workers. 

  • 4.
    Rezagholi, Mahmoud
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Economic Decisions on Proposed Work Environmental Studies: a Theory for Cost and Value of Information2016In: Science Journal of Public Health, ISSN 2328-7950, Vol. 4, no 1, p. 11-19Article in journal (Refereed)
    Abstract [en]

    Assessment studies of occupational exposures are retrospectively evaluated based on their achieved statistical efficiency and/or their imposed costs. However, any decision on the performance of such studies strongly requires an economic evaluation in advance. The economic evaluation of proposed work environmental studies needs, in turn, access to information on the socio-economic impacts of occupational exposures. The present article aims to help policy makers in their decisions on proposed work environmental studies by introducing a cost-value approach to the information to be produced during the studies. The cost-value approach is not exposed to subjective judgements, as in the approach of “willingness to pay”, nor to consideration of invaluable statistical efficiency as “output”, as in exposure assessment studies. The work environmental study investigated in this article contained three different groups of occupational exposures that caused sickness absences and impairments at work in a Swedish company, Sandvik Materials Technology. The results show that the suggested study would be acceptable to the policy makers in the company, as its estimated value was strictly greater than its estimated costs.

  • 5.
    Rezagholi, Mahmoud
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Economics.
    Marginal socio-economic effects of an employer's efforts to improve the work environment2018In: Annals of Occupational and Environmental Medicine, ISSN 2052-4374, Vol. 30, no 1Article in journal (Refereed)
    Abstract [en]

    Background

    Workplace health promotion (WHP) strongly requires the employer’s efforts to improve the psychosocial, ergonomic, and physical environments of the workplace. There are many studies discussing the socio-economic advantage of WHP intervention programmes and thus the internal and external factors motivating employers to implement and integrate such programmes. However, the socio-economic impacts of the employer’s multifactorial efforts to improve the work environment need to be adequately assessed.

    Methods

    Data were collected from Swedish company Sandvik Materials Technology (SMT) through a work environment survey in April 2014. Different regression equations were analysed to assess marginal effects of the employer’s efforts on overall labour effectiveness (OLE), informal work impairments (IWI), lost working hours (LWH), and labour productivity loss (LPL) in terms of money.

    Results

    The employer’s multifactorial efforts resulted in increasing OLE, decreasing IWI and illness-related LWH, and cost savings in terms of decreasing LPL.

    Conclusion

    Environmental factors at the workplace are the important determinant factor for OLE, and the latter is where socio-economic impacts of the employer’s efforts primarily manifest.

  • 6.
    Rezagholi, Mahmoud
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Bantekas, Apostolos
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Economics.
    Making Economic Social Decisions for Improving Occupational Health: A Predictive Cost-Benefit Analysis2015In: Occupational Medicine & Health Affairs, ISSN 1463-502X, E-ISSN 2329-6879, Vol. 3, no 6, article id 225Article in journal (Refereed)
    Abstract [en]

    The few studies attempting to estimate costs of work-related disorders suffer from poor applied methodologies. Further, as the costs are often limited to the company, decisions about investment in improving the work environment are made at the company level. However, economic decisions on changing work environments and improving occupational health need to be made at the societal level. In an economic social decision, all direct and indirect costs imposed on society by work-related disorders are considered, regardless of who pays which cost. This study introduces and demonstrates a methodology appropriate for economic decisions at the societal level for preventing work-related disorders and promoting occupational health in the workplace. The methodology uses the concept of human capital in assessing productivity loss associated with the disorders. The empirical results show that Swedish society could have gained up to 442 855 537 SEK by preventing work-related disorders at the Swedish company Sandvik Materials Technology during 2014, 87% of which would have been captured by the company.

  • 7.
    Rezagholi, Mahmoud
    et al.
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Economics.
    Bantekas, Apostolos
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Economics.
    Optimizing the fraction of expensive direct measurements in an exposure assessment study2014In: International Journal of Statistics in Medical Research, ISSN 1929-6029, Vol. 3, no 1, p. 44-54Article in journal (Refereed)
    Abstract [en]

    When designing studies to assess occupational and environmental exposures, one persistent decision problem is the selection between two technical methods, where one is expensive but efficient and the other is cheap but inefficient. While a few studies have attempted to determine the relatively more cost-efficient design between two technical methods, no successful study has optimized the fraction of the expensive efficient technical method in a combined technique intended for long-run exposure assessment studies. The purpose of this study was therefore to optimize the fraction of the expensive efficient measurements by resolving a precision-requiring cost minimization problem. For an indefinite total number of measurements, the total cost of a working posture assessment study was minimized by performing only direct measurements. However, for a definite total number of measurements, the use of combined techniques in assessing the posture could be optimal, depending on the constraints placed on the precision and on the research budget.

  • 8.
    Rezagholi, Mahmoud
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Cost-Efficient Design of Occupational Exposure Assessment Strategies: A Review2010In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 54, no 8, p. 858-868Article in journal (Refereed)
    Abstract [en]

    When designing a strategy for collecting occupational exposure data, both economic and statistical performance criteria should be considered. However, very few studies have addressed the trade-off between the cost of obtaining data and the precision/accuracy of the exposure estimate as a research issue. To highlight the need of providing cost-efficient designs for assessing exposure variables in occupational research, the present review explains and critically evaluates the concepts and analytical tools used in available cost efficiency studies. Nine studies were identified through a systematic search using two algorithms in the databases PubMed and ScienceDirect. Two main approaches could be identified in these studies: comparisons of the cost efficiency associated with different measurement designs, and optimizations of resource allocation on the basis of functions describing cost and statistical efficiency. In either case, the reviewed studies use simplified analytical tools and insufficient economic analyses. More research is needed to understand whether these drawbacks jeopardize the guidance on cost-efficient exposure assessment provided by the studies, as well as to support theoretical results by empirical data from occupational life.

  • 9.
    Rezagholi, Mahmoud
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Liv, Per
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Cost efficiency comparison of four video-based techniques for assessing upper arm postures2012In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 55, no 3, p. 350-360Article in journal (Refereed)
    Abstract [en]

    Many video-based techniques for assessing postures at work have been developed. Choosing the most appropriate technique should be based on an evaluation of different alternatives in terms of their ability to produce posture information at low input costs, i.e. their cost efficiency. This study compared four video-based techniques for assessing upper arm postures, using cost and error data from an investigation on hairdressers. Labour costs associated with the posture assessments from the video recordings were the dominant factor in the cost efficiency comparison. Thus, a work sampling technique associated with relatively large errors appeared, in general, to be the most cost-efficient because it was labour-saving. Measurement bias and other costs than labour cost for posture assessment influenced the ranking and economic evaluation of techniques, as did the applied measurement strategy, i.e. the number of video recordings and the number of repeated assessments of them.

  • 10.
    Trask, Catherine
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Wahlström, Jens
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Rezagholi, Mahmoud
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Data collection costs in industrial environments for three occupational posture exposure assessment methods2012In: BMC Medical Research Methodology, ISSN 1471-2288, E-ISSN 1471-2288, Vol. 12, p. 89-Article in journal (Refereed)
    Abstract [en]

    Background. Documentation of posture measurement costs is rare and cost models that do exist are generally naïve. This paper provides a comprehensive cost model for biomechanical exposure assessment in occupational studies, documents the monetary costs of three exposure assessment methods for different stakeholders in data collection, and uses simulations to evaluate the relative importance of cost components.  Trunk and shoulder posture variables were assessed for 27 aircraft baggage handlers for 3 full shifts each using three methods typical to ergonomic studies: self-report via questionnaire, observation via video film, and full-shift inclinometer registration.  The cost model accounted for expenses related to meetings to plan the study, administration, recruitment, equipment, training of data collectors, travel, and onsite data collection.  Sensitivity analyses were conducted using simulated study parameters and cost components to investigate the impact on total study cost.

    Results. Inclinometery was the most expensive method (with a total study cost of € 66,657), followed by observation (€ 55,369) and then self report (€ 36,865). The majority of costs (90%) were borne by researchers.  Study design parameters such as sample size, measurement scheduling and spacing, concurrent measurements, location and travel, and equipment acquisition were shown to have wide-ranging impacts on costs. 

    Conclusions. This study provided a general cost modelling approach that can facilitate decision making and planning of data collection in future studies, as well as investigation into cost efficiency and cost efficient study design. Empirical cost data from a large field study demonstrated the usefulness of the proposed models.

  • 11.
    Trask, Catherine
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Wahlström, Jens
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Rezagholi, Mahmoud
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, CBF. University of Gävle, Centre for Musculoskeletal Research.
    Modeling costs of exposure assessment methods in industrial environments2012In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, p. 6079-6086Article in journal (Refereed)
    Abstract [en]

    Documentation of posture measurement cost is rare and cost models that do exist are generally naïve. This paper provides a comprehensive cost model for ergonomic research, documents the monetary costs of three exposure assessment methods (inclinometry, video observation, and self-report), and discusses cost components. Trunk and shoulder posture were assessed for 27 aircraft baggage handlers for 3 full shifts each using three methods typical to ergonomics: self-report via questionnaire, observation via video film, and full-shift inclinometer registration. The model accounted for costs related to meetings to plan the study, administration, recruitment, equipment, training of data collectors, travel, and onsite data collection. Findings show that inclinometer was the most expensive method, followed by observation and then self report; the majority of costs (90%) were borne by researchers. Study design parameters such as sample size, measurement scheduling and spacing, concurrent measurements, location and travel, and equipment acquisition were shown to have wideranging impacts on costs. This study provided empirical cost data for use in cost models that can facilitate decision making and planning of future studies, and can be used to investigate cost efficiency in future studies

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