Introduction: Baggage handling is considered to be a heavy manual handling job including biomechanical exposures suspected of increasing the risk for musculoskeletal disorders. Aims: To document low back pain (LBP), shoulder pain (SP), and physical and psychosocial factors in baggage handlers, and to evaluate the implementation of an ergonomic intervention aiming to increase the use of loading assist devices. Methods: A questionnaire was utilized to characterize pain and psychosocial work conditions in 525 baggage handlers. The postures of 55 baggage handlers during 114 shifts were measured using inclinometry, half shift video-recordings were made for subsequent task analysis, and the number of aircraft handled was registered. Associations for psychosocial and biomechanical exposures with pain were assessed using regression analyses. An ergonomic intervention was implemented and evaluated using questionnaires and repeated interviews. Feasibility, intermediate outcomes, barriers and facilitators were assessed. Results: The prevalence rates of reported LBP and SP were 70% and 60%, respectively. Pain interfering with work (LBP - 30% and SP - 18%) and high pain intensity (LBP - 34% and SP - 28%) were associated with poor psychosocial working conditions. Extreme postures with arms elevated >60° occurred for 6.4% of the total time, and in trunk flexion >60° for 2.1% total time. In contrast, 71% of the total time was spent in a neutral trunk posture. The 90^th percentile trunk forward flexion was 34.1°.  Daily shoulder pain increased in approximately one-third of all shifts and was positively associated with extreme work posture and the number of aircraft handled; this association was modified by influence and support. The intervention was delivered as planned, and dose received and satisfaction were rated as high. Motivated trainees facilitated implementation while lack of manager support, opportunities to observe and practice behaviors, follow-up activities, staff reduction, and job insecurity were barriers. Conclusion: The high prevalence rates of LBP and SP in baggage handlers were associated with psychosocial exposures, and daily shoulder pain was associated with higher biomechanical exposure. Barriers to implementation can be minimized by recruiting motivated trainees, securing strong organizational support, and carrying out follow-up activities.

Den övergripande målsättningen med projektet var att få en ökad kunskap om hur saneringsföretag i Uppsala, Gävleborgs och Dalarnas län arbetar för att förebygga negativa hälsoeffekter av exponering av hand- arm vibrationer. Syftet med studien var att undersöka kunskapsläget angående risker med arbete med vibrerande verktyg, samarbetet med företagshälsovården och genomförande av medicinska kontroller hos saneringsföretag i regionen. Strukturerade telefonintervjuer med 15 saneringsföretag genomfördes. Ett samarbete med ett större saneringsföretag inleddes och medicinska undersökningar genomfördes på deras anställda av ergonom ute på arbetsplatsen. Aktiviteterna i projektet inspirerade företaget att själva initiera riskbedömningar och vibrationsmätningar som en start på ett eget förbättringsarbete. Intervjuerna visade att kunskapsläget i företagen angående regelverk och arbete med vibrerande verktyg var dåligt och trots att de flesta hade företagshälsovård så uttalades ett missnöje gentemot företagshälsovården angående stöd och information i dessa frågor. Bristfällig kunskap och svårigheter att tolka regelverket kan ligga bakom att det brister vad gäller riskbedömningar och lagstadgade medicinska kontroller i saneringsföretagen. Besvärsfrekvenserna i nacke och övre extremiteter hos sanerarna i det undersökta företaget var höga och det fanns också personer med tidiga tecken på kärl- och nervskador. Resultatet av det här projektet är ett litet komplement till den kunskap som redan finns på området men visar att det finns all anledning att lägga resurser på ett förebyggande arbete för den här yrkesgruppen som tidigare inte studerats i någon större utsträckning. Det finns ett outtalat behov av informations- och utbildningsinsatser på området som till stor del beror på okunskap hos företagen men kanske också hos företagshälsovården eftersom deras insatser ser ut att ha varit begränsade. En viktig följd av projektet var att det undersökta företaget på eget initiativ men med stöd av projektet initierade en arbetsgrupp och ett förebyggande arbete för att minska exponeringen för vibrationer. Detta arbete inkluderade riktlinjer för riskbedömningar och vibrationsmätningar av verktyg samt utbildning av ledning och personal. Projektets upplägg och innehåll lämpar sig således väl för att följas av företagshälsovård i deras arbete med att stötta sina kundföretag

Activity-based workplaces (ABWs) are becoming popular in Western countries and were implemented at four office sites of a large Swedish government agency. A fifth office was used as a control group. The study aim was to examine the effects of relocation to ABW on perceived productivity among employees and to determine if perceived change-oriented leadership behavior prior to relocation moderates potential effects. Data were collected three months prior to relocation, and three and 12 months after. 407 respondents were included in linear mixed regression models. Perceived productivity decreased significantly after relocation compared to the control group and these effects persisted 12 months after the relocation. However, the decrease in perceived productivity was significantly smaller among employees perceiving high change-oriented leadership before relocation. Our results point out the importance of a change-oriented leadership behavior during the implementation to avoid productivity loss among employees when implementing ABWs.

Objectives: This study explores pedestrian fall accidents and collisions with other road users in the Swedish road transport system, and sickness absence (SA) in relation to accident type, injury, and occupation. Further, it studies the associations between accident type, occupation, and duration of SA. Methods: Data from several national registers were used that included 15,359 working age pedestrians (20–64 years) receiving healthcare after a fall or collision throughout 2014–2016. Individual characteristics, accident type, injury, and occupation were presented and related to SA. Logistic regression was used to estimate odds ratios (OR), with 95% confidence intervals, for associations between accident type, occupation, and SA duration. Results: About 11,000 pedestrians (72%) were involved in fall accidents in the road traffic environment and well over 4,000 in collisions with another road user; 22% of all injured pedestrians had a new SA. The population had a higher proportion of women and individuals in older age groups (≥45). Of the falls, 31% were due to snow or ice, and these were associated with a higher OR for both short SA (<90 days) 1.76 (95% CI 1.56–1.98) and long SA (≥90 days) 1.81 (95% CI 1.51–2.18), compared to the group slipping, tripping, and stumbling. The working sectors health & social care, and construction had the highest ORs for SA. A higher OR was found for health & social care, short SA 1.58 (95% CI 1.38–1.81), long SA 1.79 (95% CI 1.45–2.20) and for construction, short SA 1.56 (95% CI 1.24–1.96), long SA 1.75 (95% CI 1.26–2.44), compared to the sector finance, communication, & cultural service. Conclusions: The OR for having short and long SA was higher in falls due to snow or ice and differed between occupational sectors. Practical implications: This information contributes to the knowledge base for planning a safe road transport system for pedestrians.

SAMMANFATTNING

Detta pilotprojekt har utförts under våren 2010 på Arlandas terminal 4 av en ergonom (Eva Bergsten) vid Högskolan i Gävle, Centrum för Belastningsskadeforskning (CBF), på uppdrag av Transports yrkes- och arbetsmiljönämnd (TYA). Projektet var en förstudie till det större huvudprojektet "Skadefria flygplanslastare" som TYA under våren sökte och sedermera beviljades pengar för att genomföra.

Huvudprojektets övergripande syfte är att kartlägga och beskriva flygplanslastarnas arbetsförhållanden utifrån ett ergonomiskt helhetsperspektiv med hänsyn tagen till fysiska, psykosociala, tekniska, organisatoriska och kognitiva faktorer vid ramp och sorteringsarbete.

Syftet med pilotprojektet var att inför huvudprojektet

• göra en litteratursammanställning på området: vad har man redan beforskat när det gäller flygplanslastning i Sverige och internationellt?
• ta fram och testa frågeformulär och observationsmetoder för den större datainsamlingen i huvudprojektet
• ta reda på vilka företagsdata som kan och bör samlas in i huvudprojektet

En genomgång av publicerade artiklar och så kallad grå litteratur (ej vetskapligt granskade artiklar och rapporter) gjordes för att se vilken kunskap som redan finns på området, och för att identifiera kunskapsluckor inför den skarpa planeringen av huvudprojektet. En styrgrupp, en projektledare och en projektgrupp samt fyra mindre arbetsgrupper var redan tillsatta av TYA och Transportfacken med namngivna personer vilket underlättade uppdraget.

Utifrån telefonkontakter, möten och intervjuer med nyckelpersoner i handlingbolag, på Transport, AFA, försäkringskassan och arbetsmiljöverket kunde väsentlig information inhämtas som fick ligga till grund för att sammanställa ett frågeformulär angående flygplanslastarnas fysiska och psykosociala arbetsförhållanden, baserat på vetenskapliga grunder. Frågeformuläret testades på ett 20-tal personer, lastare, skyddsombud, huvudskyddsombud och ombudsmän på Transport och reviderades därefter. Mycket och värdefull information om vilka relevanta företagsdata som finns tillgängliga och hos vilken aktör, och vilka som inte kan påräknas i huvudstudien, har också kunnat kartläggas.

En genomgång av vetenskapliga observationsmetoder gjordes och en valdes ut för att testas vid lastning av en narrow body aircraft som metodmässigt bedömdes vara ett svårt arbetsmoment att observera och studera.

Pilotprojektet har resulterat i basen till ett frågeformulär som dock fortfarande kan revideras om det vid samtal med de fyra arbetsgrupperna uppkommer relevanta tillägg. Observation av lastning och lossning av narrow body aircraft samt dokumentation med videokamera visade sig vara möjligt, och metoden som testades (REBA) kan användas för att komplettera de i huvudprojektet planerade heldagsmätningarna med teknisk utrustning av arbetsställningar.

Litteraturgenomgången av 17 artiklar/rapporter som lokaliserats i en omfattande sökning visade att de största belastningsergonomiska riskerna i arbetet verkar uppstå i samband med att lasta och lossa en narrow body aircraft och det på grund av de trånga lastutrymmena som tvingar lastarna till ogynnsamma arbetsställningar. Det finns också några få studier som styrker att vissa hjälpmedel och arbetsmetoder skulle kunna minska antalet dåliga arbetsställningar, muskulär belastning, kompressionskrafter i ryggen och fysiologisk ansträngning, och att bagagets vikt har betydelse för belastningen. Däremot kan man inte i litteraturen finna några studier av hur olika organisatoriska lösningar påverkar lastarnas arbetsställningar och den belastning de i övrigt utsätts för. Enskilda arbetsmoment har studerats men ingen har tittat på hur belastningsmönstret ser ut för lastarna under ett helt arbetsskift.

Besvärsfrekvensen bland flygplanslastare är, enligt den funna litteraturen hög vad gäller rygg, nacke, axlar och knän. Någon större kartläggning av detta eller hur sjukfrånvaron ser ut har inte gjorts i Sverige. Inte heller har man i Sverige eller något annat land tittat på psykosociala faktorer och dess betydelse för flygplanslastares arbetsförhållanden.

Resultaten av det här pilotprojektet ligger till grund för de "kunskapsluckor" som vi rekommenderar (i Kapitel 4) att huvudstudien arbetar vidare med, i överensstämmelse med dess övergripande målsättning och den projektplan som tagits fram av projektgruppen.

Sammanfattning

Arbetsmiljöprojektet Skadefria cargo- och flygplanslastare har utförts på uppdrag av Svenska Transportarbetareförbundet och Svenska Flygbranschen med syfte att kartlägga flygplanslastarnas arbetsförhållanden och att komma med förslag på förbättringsåtgärder för att minska belastningsrelaterade skador och sjukdomar i branschen.

Projektledningsgruppen har bestått av fem personer: Eva Bergsten, ergonom, anställd av projektet; Erik Alphonse, projektledare, TYA; Reidar Pettersson, arbetsmiljökonsult, Arbetsmiljölotsen; Svend Erik Mathiassen, professor, Centrum för belastningsskadeforskning vid Högskolan i Gävle; och Dan Holmberg, regionalt skyddsombud, Transportarbetareförbundet.

Projektet som omfattade 14 bolag (11 handling, 3 cargo) på sex flygplatser (Arlanda, Malmö, Göteborg, Växjö, Skavsta och Arvidsjaur) startades våren 2010 och avslutades våren 2012, efter en inledande pilotstudie våren 2010 som finansierades av TYA. Inom projektet har 1 039 enkäter distribuerats med frågor om psykosociala arbetsförhållanden, upplevd arbetsbelastning, trötthet och besvär. Svarsfrekvensen var 72 procent. Heldagsmätningar av arbetsställningar för rygg och armar har genomförts på 5-6 lastare per flygplats samtidigt som lastarna filmats och fyllt i dagböcker. Fokusgrupper har intervjuats och data om till exempel sjukskrivningar och olyckstillbud har samlats in från företagen.

Parallellt med den vetenskapliga delen har projektet haft en praktisk del med fyra arbetsgrupper bestående av representanter från både arbetsgivar- och arbetstagarsidan. Grupperna har träffats två gånger per termin och jobbat inom områdena: I) fysisk belastning och arbetsskadestatistik, II) arbetsorganisation, schemaläggning och psykosocial arbetsmiljö, III) hjälpmedel och metoder samt IV) utbildning och utveckling.

Våra resultat visar att besvärsfrekvenserna i muskler och leder är relativt höga. Det finns arbetsmoment i lastaryrket som är ogynnsamma och som ökar risken för besvär, framför allt i axlar/skuldra, rygg och handleder/händer. De arbetsuppgifter som en lastare har skiljer sig inte så mycket åt mellan de olika flygplatserna, men det finns betydande skillnader i hur ofta och hur länge uppgifterna förekommer. Vid vissa flygplatser är således flyglastararbetet mera varierat än vid andra, vilket förmodligen har en betydelse för risken att utveckla besvär.

Överlag fanns det hjälpmedel för de mest belastande arbetsmomenten, men också brister i hur dessa används.

Inom den psykosociala arbetsmiljön visade projektet på ett behov av att förbättra ledarskapet och lastarnas inflytande i planering och genomförande av det egna arbetet. Bättre feedback i form av stöd och uppmuntran från ledare efterfrågades också.

Arbetsgrupperna, som löpande delgavs resultaten från den vetenskapliga kartläggningen, utvecklade i enlighet med projektets målsättning ett antal åtgärdsförslag, med stöd i kartläggningen. Förslagen, som presenteras i denna rapport, är av generell natur. Flera av förslagen omfattar ett flertal möjliga delåtgärder och initiativ, som naturligtvis måste anpassas för och prioriteras av det enskilda bolaget utifrån dess egna förutsättningar. Mot bakgrund av våra projektresultat vill vi dock generellt rekommendera samtliga bolag att lägga en viss prioritet på de psykosociala arbetsförhållandena i sitt förbättringsarbete. Det fanns även uppenbara möjligheter att förbättra den fysiska belastningsprofilen, särskilt genom att bredda arbetsinnehållet på vissa flygplatser, och genom en mera effektiv användning av tekniska hjälpmedel. Samtidigt är det viktigt att framhålla att lastaryrket även har många goda sidor i form av ett rörligt och spännande arbete med ett bra socialt klimat.

Vår bedömning är att de förslag till förändringar i arbetsmiljö och arbetsvillkor som föreslås i denna rapport skulle leda till en bättre arbetsmiljö men sannolikt också kunna påverka effektiviteten i arbetet i positiv riktning.

Projektet Skadefria cargo- och flygplanlastare är föremål för en avhandling vilket betyder att vidare analyser av insamlade data kommer att ske. Resultaten kommer framöver att publiceras i vetenskapliga tidsskrifter.

Objectives: This study of flight baggage handlers aimed at examining the extent to which shoulder pain developed during single work shifts, and whether a possible development was associated with biomechanical exposures and psychosocial factors during the same shift.

Methods: Data were collected during, in total, 82 work shifts in 44 workers. Right and left shoulder pain intensity was rated just before and just after the shift (VAS scale 0-100 mm). Objective data on time in extreme and time in neutral upper arm postures were obtained for the full shift using accelerometers, and the baggage handlers registered the number of aircrafts handled in a diary. During half of the shift, workers were recorded on video for subsequent task analysis of baggage handling. Influence at work and support from colleagues were measured by use of Copenhagen Psychosocial Questionnaire (COPSOQ). Associations between exposures and the increase in pain intensity during the shift (daily pain) were analysed for the right and left shoulder separately using Generalized Estimating Equations (GEE).

Results: Daily pain was observed in approximately one third of all shifts.  It was significantly associated with the number of aircrafts handled for both the right and left shoulder. In multivariate models including both biomechanical exposures and the psychosocial factors influence at work and support from colleagues, aircrafts handled was still significantly associated with daily pain in both shoulders, and so was influence and support, however in opposite directions.

Conclusions: Daily pain was, in general, associated with biomechanical exposures during the same shift and with general influence and support in the job. In an effort to reduce pain among flight baggage handlers, it may therefore be justified to consider a reduction of biomechanical exposures during handling of aircrafts, combined with due attention to psychosocial factors at work.

Background: Flight baggage handling is a worldwide occupation where baggage and cargo is sorted, loaded and unloaded on and off aircrafts. With the ultimate purpose of reducing and preventing musculoskeletal disorders among flight baggage handlers in Sweden, the Vocational Training and Working Environment Council (TYA) - a council formed by employers and unions in the Swedish transportation sector – initiated and implemented a project (2010-2012). This project revealed that ergonomics equipment was not used adequately, and this was considered a major factor of concern. Therefore, a training program was initiated 2014 in one handling company, aiming to improve ergonomics, behavior and attitudes. We evaluated the implementation process with regard to process items, intermediate outcomes, barriers and facilitators; for the purpose of gaining knowledge that could facilitate successful implementation in other handling companies. Methods: A mixed methods design was applied, based on qualitative and quantitative data. We evaluated six process items, recruitment, context, reach, dose delivered, dose received and satisfaction; intermediate outcomes of the intervention; skills, confidence and behaviour in the workforce; barriers and facilitators for successful implementation. Data was retrieved using company data, course evaluations, web questionnaires, and telephone interviews with company ‘observers’ and key persons. Preliminary results: The implementation process was judged to be feasible with regard to some of the process items. According to the informants, work place behaviour related to use of equipment had, however, not changed after the training period. Reported barriers were, 1) insufficient time and leader support for practicing new procedures during and after the training, 2) simultaneous reorganization of teams and work tasks, 3) lack of follow-up of the training, which would have supported good performance according to the informants. Conclusion: The implementation process was hampered by barriers, some of which could be addressed in future ergonomics training programs in other baggage handling companies.

Objective: To conduct a process evaluation of the implementation of an ergonomics training program aimed at increasing the use of loading assist devices in flight baggage handling.

Methods: Feasibility (recruitment, reach, context, dose delivered, dose received, satisfaction); intermediate outcomes (skills, confidence and behaviors); and barriers and facilitators of the training intervention were assessed by qualitative and quantitative methods.

Results: Implementation proved feasible regarding dose delivered, dose received and satisfaction. Confidence among participants in the training program in using and talking about devices, observed use of devices among colleagues, and internal feedback on work behavior increased significantly (p<0.01). Main facilitators were self-efficacy, motivation, and perceived utility of training among the trainees. Barriers included lack of peer support, opportunities to observe and practice behaviors, and follow-up activities; as well as staff reduction and job insecurity.

Conclusions: In identifying important barriers and facilitators for a successful outcome, our study can help supporting the effectiveness of future interventions. Our results show that barriers caused by organizational changes may likely be alleviated by recruiting motivated trainees and securing strong organizational support for the implementation.   

Objective. Flight baggage handlers sort and load luggage to airplanes. This study aimed at investigating associations between psychosocial exposures and low back and shoulder musculoskeletal disorders (MSDs) among Swedish flight baggage handlers.

Methods. A questionnaire addressing MSDs (Standardized Nordic Questionnaire) and psychosocial factors (Copenhagen Psychosocial Questionnaire, COPSOQ) was answered by 525 baggage handlers in six Swedish airports.

Results. Low back (LBP) and shoulder pain (SP) was reported by 70% and 60%, respectively. Pain was reported to interfere with work (PIW) by 30% (low back) and 18% (shoulders), and intense pain (PINT) occurred in 34% and 28% of the population. Quality of leadership was the most dissatisfying psychosocial factor, while the most positive was social community at work. Low ratings in the combined domain Work organization and job content were significantly associated with PIW in both low back and shoulders (Adjusted Hazard Ratios 3.65 (95% CI 1.67-7.99) and 2.68 (1.09-6.61)) while lower ratings in the domain Interpersonal relations and leadership were associated with PIW LBP (HR 2.18 (1.06-4.49)) and PINT LBP and SP (HRs 1.95 (1.05-3.65) and 2.11 (1.08-4.12)).

Conclusion. Severity of pain among flight baggage handlers was associated with psychosocial factors at work, suggesting that they may be a relevant target for intervention in this occupation.

Flight baggage handlers are employed by handling companies engaged in sorting, loading and unloading luggage, cargo and mail, so called ramp service work. After check-in, luggage are transported through a sorting area and further out to the ramp. This transportation involves manual handling by baggage handlers at several stages, using conveyor belts, carts and trucks for transport. In addition to these tasks, baggage handlers are also engaged in communicating with air traffic controllers directing air traffic on the ground, towing aircrafts to gates and serving them with auxiliary power units, brakes and light. Baggage handling services are similar in all larger airports, and so baggage handlers perform similar tasks all over the world. In Sweden the handlers’ union claimed a high prevalence of low back and shoulder pain and a dissatisfying psychosocial work environment, but systematically collected empirical data were not available, and the literature was surprisingly sparse, considering that the occupation is global. Thus, a comprehensive project initiated by the Vocational Training and Working Environment Council, TYA, in Sweden - a council formed by employers’ and employees’ organizations in the transportation sector -was conducted at 14 handling companies in six Swedish airports between 2010 and 2012. The project aimed to document the physical and psychosocial work environment and to contribute to the development of ergonomic interventions within this occupation, which could, eventually, lead to better health among the employees. The present study was part of this project, in aiming at documenting psychosocial exposures and musculoskeletal disorders (MSDs) in the flight baggage handler population, and at determining possible associations between exposures and disorders.

Introduction

Flight baggage handlers are mainly engaged in sorting luggage or cargo, loading and unloading it to and from the airplanes. The Vocational Training and Working Environment Council, TYA - formed by employer’s and employee’s organizations in the transportation sector - initiated a scientific study in 2009 to investigate the prevalence of musculoskeletal disorders and their suspected determinants in six Swedish airports involving a total of about 1000 handlers in 14 cargo- and handling companies. Encouraged by an initial literature review, the present field study was designed to contain qualitative, questionnaire-based, and observational surveys of working conditions, as well as extensive direct measurements of postures using full-shift inclinometry. This paper reports the design and results of the questionnaire part of the study.

Method

All baggage handlers working at least half-time (n=1044) were encouraged to fill in an extensive questionnaire handed out at the workplace by a research team member. In general the researcher collected the questionnaires at the same occasion. The questionnaire addressed general health, work capacity and physical exposures in relevant handling tasks. It also included a modified version of the Copenhagen Psychosocial Questionnaire (COPSOQ), the Nordic Council of Minister’s Questionnaire (NMQ) on disorders, and the SOFI-questionnaire measuring perceived fatigue.

Results

The response rate was 73%. The prevalence of musculoskeletal disorders in the back, shoulders and wrists during the last 12 months was 70%, 60% and 45%. Positive effects of devices used for reducing perceived physical load were confirmed. The handlers expressed a low confidence in the leadership, and insufficient feedback, information and influence at work. Fatigue particularly occurred in the dimensions lack of energy and physical discomfort.

Discussion

The observed prevalence of low back pain (70%) is high, and in parity with results among nurses in Sweden (64%; Josephson et al. 1997) and China (56%; Smith et al. 2004). Further examination of questionnaires, interviews and direct posture measurements will identify determinants to consider for intervention to reduce the prevalence of disorders among the baggage handlers.

Josephson M, et al. Occup Environ Med 1997;54:681-685.

Smith DR, et al. Occup Med 2004;54:579-582

Relocation to new office solutions such as activity-based workplaces (ABW) has increased but satisfaction with the ABW among employees varies, and the importance of participation in the relocation process is unclear. This study aimed to examine the association between employees’ extent of participation in the implementation process activities and satisfaction with the relocation to ABW. Data were collected from 699 employees in a Swedish governmental agency 3-months prior to, 3-months and 9-months after relocation to the ABW. Questionnaires were used to assess participation in process activities and perceived satisfaction with knowledge about working in ABW, office rules, and information and support during the process. Participation in activities was significantly associated with higher overall satisfaction with knowledge, office rules, information and support, and effects were generally more pronounced as the number of attended activities increased. Satisfaction also increased among non-participants, although without reaching the same levels as participants. Our results show the importance to offer and facilitate a high participation in the relocation process activities to obtain satisfaction with a relocation to ABW.

Activity-based workplaces (ABW) have been implemented in many organizations to offer office flexibility and decrease facility costs. Evaluations of the ABW implementation process are rare. The study aimed to examine the ABW relocation process of two offices in a Swedish governmental agency and to explore factors that influence the implementation process and satisfaction with it. Qualitative or quantitative data were collected on process variables (context, recruitment, reach, dose delivered, dose received, satisfaction), barriers and facilitators to the process were explored in focus group interviews, and immediate outcomes (perceived knowledge, understanding office rules, satisfying information and support) were measured by questionnaire before and after the relocation. The evaluation showed that recruitment was unsatisfactory and reach insufficient—and participation in activities was thus low for both offices. However, intended changes improved. Unclear aims of ABW, lack of manager support and, lack of communication were some of the reported barriers to participation, while a well-planned process, work groups, and program activities were facilitators. Thus, to increase satisfaction with the relocation, our results suggest that recruitment should be thoroughly planned, taking these factors into account to increase participation. This knowledge may be useful for planning and designing successful ABW relocations and evaluations.

The aim was to investigate how Swedish small and medium enterprises (SMEs) within the manufacturing industry carry out work environment improvements, and to study if managers consider profitability to be associated with issues in the work environment. Workplace observations and interviews (n=60) with company managers were carried out. Forty-five enterprises were affiliated with an occupational health service, typically in order to get quick access to health care, rather than getting help planning and implementing changes. Fifty-eight managers believed that healthy work environments would have at least some positive effect on company profitability. Incentives for work environment improvements were external, individual and organizational and varied between companies of different sizes. External requirements from The Swedish Work Environment Authority and from established or potential customers were prioritized incentives in SMEs with < 50 employees. Organizational and individual incentives such as incident- and accident reports, productivity, health and sick-leave were prioritized in SMEs with >50 employees. Irrespective of company size, well-being among work-force was consistently mentioned as an important factor for successful business. Small companies urged quick decisions and actions while medium companies had more planned, systematic and organized work environment activities. Deliberate work environment improvements for increased profitability were for instance, changes to eliminate risks, reduce manual work and resolve planning and coordination problems in production that led to stress.

This study explored first-line managers’ leadership behavior profiles regarding their goals for utilizing the garden at residential care facilities for older people. Semi-structured interviews were conducted with a convenience sample of first-line managers (n = 12) in Sweden. Data were analyzed using deductive content analysis theoretically guided by the Three-dimensional Leadership Model. The results showed that the main leadership behavior profiles were related to the dimensions structure, relation and change. The managers emphasized workplace regulations and goals. They allowed staff to make decisions and encouraged them to see problems and opportunities.

Background

The knowledge about the long-term consequences in terms of sickness absence (SA) among pedestrians injured in a traffic-related accident, including falls, is scarce. Therefore, the aim was to explore diagnosis-specific patterns of SA during a four-year period and their association with different sociodemographic and occupational factors among all individuals of working ages who were injured as a pedestrian.

Methods

A nationwide register-based study, including all individuals aged 20–59 and living in Sweden, who in 2014–2016 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Diagnosis-specific SA (> 14 days) was assessed weekly from one year before the accident up until three years after the accident. Sequence analysis was used to identify patterns (sequences) of SA, and cluster analysis to form clusters of individuals with similar sequences. Odds ratios (ORs) with 95% confidence intervals (CIs) for association of the different factors and cluster memberships were estimated by multinomial logistic regression.

Results

In total, 11,432 pedestrians received healthcare due to a traffic-related accident. Eight clusters of SA patterns were identified. The largest cluster was characterized by no SA, three clusters had different SA patterns due to injury diagnoses (immediate, episodic, and later). One cluster had SA both due to injury and other diagnoses. Two clusters had SA due to other diagnoses (short-term and long-term) and one cluster mainly consisted of individuals with disability pension (DP). Compared to the cluster “No SA”, all other clusters were associated with older age, no university education, having been hospitalized, and working in health and social care. The clusters “Immediate SA”, “Episodic SA” and “Both SA due to injury and other diagnoses” were also associated with higher odds of pedestrians who sustained a fracture.

Conclusions

This nationwide study of the working-aged pedestrians observed diverging patterns of SA after their accident. The largest cluster of pedestrians had no SA, and the other seven clusters had different patterns of SA in terms of diagnosis (injury and other diagnoses) and timing of SA. Differences were found between all clusters regarding sociodemographic and occupational factors. This information can contribute to the understanding of long-term consequences of road traffic accidents.

Objectives: The present study assessed full shift trunk and upper arm postural exposure amplitudes, frequencies, and durations among Swedish airport baggage handlers, and aimed to determine whether exposures differ between workers at the ramp (loading and unloading aircraft) and baggage sorting areas.

Methods: Trunk and upper arm postures were measured using inclinometers during three full work shifts on each of 27, male baggage handlers working at a large Swedish airport. Sixteen of the baggage handlers worked on the ramp and 11 in the sorting area. Variables summarizing postures and movements were calculated, and mean values and variance components between subjects and within subject (between days) were estimated using restricted maximum likelihood algorithms in a one-way random effect model.

Results: In total, data from 79 full shifts (651 hours) were collected with a mean recording time of 495 minutes per shift (range 319-632). On average, baggage handlers worked with the right and left arm elevated >60° for 6.4% and 6.3% of the total workday, respectively. The 90^th percentile trunk forward projection (FP) was 34.1° and the 50^th percentile trunk movement velocity was 8°s^-1. For most trunk (FP) and upper arm exposure variables, between-subject variability was considerable, suggesting that the flight baggage handlers were not a homogeneously exposed group. A notable between-days variability pointed to the contents of the job differing on different days. Peak exposures (>90°) were higher for ramp workers than for sorting area workers (trunk 0.6% ramp vs 0.3% sorting; right arm 1.3% ramp vs 0.7% sorting).

Conclusions: Trunk and upper arm postures and movements among flight baggage handlers measured by inclinometry were similar to those found in other jobs comprising manual material handling, known to be associated with increased risks for musculoskeletal disorders. The results showed that full-shift trunk (FP), and to some extent peak arm exposures, were higher for ramp workers compared to sorting workers.

Activity-based workplaces (ABWs) are implemented with possible implications for health, well-being, and work satisfaction in the workplace. Drawing on the theoretical framework, i.e., sense of coherence (SOC), the aim was to investigate how indicators pf SOC&mdash;meaningfulness, manageability and comprehensibility&mdash;are associated with, or function as barriers or facilitators for, health, well-being and work satisfaction during relocation to an ABW. We followed the implementation of ABWs at the Swedish Transport Administration (2018&ndash;2019). Questionnaires were administered before (n = 536), 3 months (n = 409) and 9 months (n = 373) after relocation. Focus group interviews (15) were conducted before and after. Data were analyzed using repeated measures ANOVA and content analysis. Relocation to an ABW was associated with a reduced work satisfaction (physical p &lt; 0.001; psychosocial p &lt; 0.001), and minor changes in health and occupational well-being during relocation (p &gt; 0.001). The reduction in work satisfaction was smaller among employees with high meaningfulness in the relocation process (p &lt; 0.001). All SOC indicators were positively associated with overall health, well-being and work satisfaction (p &lt; 0.001). Interviews suggested that meaningfulness was facilitated by participation in the presented activities and that communication before relocation was crucial. The results indicate that organizations implementing ABWs should promote perceived meaningfulness in the process to mitigate possible declines in satisfaction with the physical and psychosocial work environment.

Relocation to activity-based workplaces influences work environment satisfaction, but individual determinants of changes in satisfaction remain unknown. The aim of the present study was to determine whether age, gender, education, occupational position, or office type before relocation can predict work environment satisfaction among employees and managers relocated to activity-based offices. Respondents (n=422) rated work environment satisfaction three months before and nine months after relocation. The findings indicate that, on average, satisfaction decreased after relocation, while for some workers it increased. Occupational position and office type at baseline predicted changes in satisfaction with the work environment; specifically, managers and those working in open-plan offices before relocation reported a smaller decline in satisfaction after relocation, compared to those relocating from private offices. Participants with no university education were more satisfied with the physical and psychosocial work environment in activity-based workplaces than those with a university degree.