Biomedical subjects

Harald Hannerz

Publications and source records attributed to Harald Hannerz.

16 recordsLinked to original sources

PubMed2007

Industrial sectors with high risk of women's hospital-treated injuries.

BACKGROUND: Women's occupational injury rates are converging with those of males. Associations between female workers' hospital treated injury rates, industrial sector and injured body area were analyzed to provide for better-focused injury prevention of women's hazardous jobs. METHODS: Females' standardized hospital treatment ratios (SHR) and the excess fraction for five body regions (head/neck, thorax, back, upper and lower extremities) were calculated for 58 industrial sectors for 1999-2003. RESULTS: Five industrial sectors, "Cleaning, laundries and dry cleaners," "Transport of passengers," "Hotels and restaurants," "Hospitals" and "Transport of goods" had significantly high SHRs for all five body regions. The excess fraction for upper extremity injuries revealed that 14%-27% of injuries could theoretically have been avoided. CONCLUSIONS: There is strong evidence for an association between women's hospital treated injuries and industrial sector. The results justify the need for gender-sensitive analyses to orient injury prevention programs.

Adult↗

PubMed2006

Quantifying inequality in health in the absence of a natural reference group.

When quantifying inequality in health, the excess fraction (i.e. the proportional reduction in the outcome in question that would occur if all groups had the same, lowest, risk rate) is an appealing measure. If the population contains a natural, healthiest reference group, the excess fraction is straightforward to estimate. In the absence of an a priori reference group, calculating the excess fraction requires reflection, since using the group with the lowest observed risk rate as reference can lead to erroneous conclusions. This paper proposes a simple simulation procedure for calculating the excess fraction, without fixing a reference group.

Computer Simulation↗

PubMed2005

The Copenhagen Psychosocial Questionnaire--a tool for the assessment and improvement of the psychosocial work environment.

OBJECTIVES: The aim of this article is to present the Copenhagen Psychosocial Questionnaire (COPSOQ), a questionnaire developed in three different lengths for assessing psychosocial factors at work, stress, and the well-being of employees and some personality factors. The purpose of the COPSOQ concept is to improve and facilitate research, as well as practical interventions at workplaces. METHODS: The development of the questionnaire was based on a survey of a representative sample of 1858 Danish employees aged 20-59 years. The response rate was 62%; 49% were women. Altogether 145 questions from some international and Danish questionnaires and 20 self-developed questions were tested with factor analyses, analyses of internal reliability, and analyses of response patterns. RESULTS: The analyses resulted in a long research version of the questionnaire with 141 questions and 30 dimensions, a medium-length version for work environment professionals with 95 questions and 26 dimensions, and a short version for workplaces with 44 questions and 8 dimensions. Most of the scales have good reliability, and there seems to be very little overlap between the scales. A novel feature of the COPSOQ is the development of five different scales on demands at work. CONCLUSIONS: The COPSOQ concept is a valid and reliable tool for workplace surveys, analytic research, interventions, and international comparisons. The questionnaire seems to be comprehensive and to include most of the relevant dimensions according to several important theories on psychosocial factors at work. The three versions facilitate communication between researchers, work environment professionals, and workplaces.

Adult↗

PubMed2005

Mortality and morbidity among bridge and tunnel construction workers who worked long hours and long days constructing the Great Belt Fixed Link.

OBJECTIVES: This study aimed at estimating the mortality and morbidity of hospital treatment among bridge and tunnel workers who worked round the clock, long hours, and long weeks to construct the Great Belt Fixed Link. METHODS: A cohort of all Danish workers in the construction industry was followed for death and first hospitalization and outpatient or emergency ward treatment over 6 years. Standardized mortality and morbidity ratios (SMR) were calculated for selected diagnoses, and 5123 bridge and tunnel construction workers were compared with all 109 383 Danish construction workers. RESULTS: The comparison showed an overall SMR of 124 with a 95% confidence interval (95% CI) of 97-155. For infectious diseases and intestinal infectious diseases, the corresponding values were 156 (95% CI 132-184) and 167 (95% CI 117-230), respectively. For diseases of the nervous system, it was 138 (95% CI 118-160), and including nerve, nerve root and plexus disorders it was 135 (95% CI 104-171), for instance, mononeuropathies of the upper limbs (SMR 136, 95% CI 101-180). The SMR was 139 (95% CI 126-153) for circulatory diseases, 157 (95% CI 130-189) for ischemic heart disease, 129 (95% CI 114-146) for diseases of the respiratory system, 124 (95% CI 114-135) for diseases of the digestive system, and 115 (95% CI 108-123) for diseases of the musculoskeletal system and connective tissue, including other intervertebral disc disorders (than cervical) (SMR 130, 95% CI 109-154). CONCLUSIONS: Bridge and tunnel workers who work round the clock, long hours, and long weeks have a mortality rate that is as high as that of other construction workers, and they are treated more often in hospitals.

Adult↗

PubMed2004

Work environment and somatic hospital admissions in Denmark 1994-1999.

OBJECTIVE: The aim was to elucidate the usefulness of the excess hospitalisation fraction (EHF) approach-as a practical alternative to the calculation of etiological fractions-for prioritising national preventive measures in the total environment. In this study we used the inequality in somatic hospitalisation across industrial sectors as an example. The presented EHFs may provide an estimate of the order of magnitude of the prevention potential, which may also be useful in priority setting in countries comparable to Denmark. METHODS: All economically active adults in Denmark were followed-up for 6 years after hospital discharge, and industrial specific EHFs for 58 industrial sectors were calculated for 11 main diagnostic groups. Assuming 'education and research' to be the industrial sector which is least exposed to occupational hazards, we calculated the EHFs as a practical approximation to the etiologic fraction for all other industries, using hospitalisation rates adjusted for age. In addition, we also controlled for social class since many risk factors may also be related to life style or living conditions. RESULTS: Compared to 'education and research' the EHF in all other industries was (additional control for social class in brackets): Women 11% (7%), men 15% (8%). The EHFs for some of the main diagnostic groups were as follows: Circulatory diseases: Women 18% (12%), men 16% (10%). Neoplasms: Women 3% (4%), men 8% (6%). Musculoskeletal diseases: Women 19% (12%), men 21% (10%). Diseases in the respiratory system: Women 12% (8%), men 16% (9%). Diseases in the nervous system: Women 12% (7%), men 17% (12%). Violent events (injuries and trauma): Women 6% (5%), men 17% (6%). CONCLUSIONS: The advantage of this method is that the EHF can be calculated for all diseases and for the whole population without detailed knowledge of causal risk factors and their distribution in the population. Two main methodological problems are that we cannot control for selection bias related to occupation, and that the control for social class may lead to conservative estimates. Our estimates are, however, close to estimates of etiologic fractions published in the literature. Large unexpected EHFs for diseases of the blood and blood-forming organs should be seen as challenges for future research.

Adult↗

PubMed2004

Occupational factors and 5-year weight change among men in a danish national cohort.

This study explored whether factors related to the work environment could predict changes in body mass index (BMI) and whether the effect of psychosocial factors was dependent on baseline BMI. The sample consisted of 1,980 male employees from the Danish National Work Environment Cohort Study. Changes in BMI between 1995 and 2000 were analyzed, by multiple regression, as a function of background variables and a series of occupational variables obtained in 1995. Age, baseline BMI, job insecurity, and psychological demands predicted changes in BMI. Job insecurity and high or low psychological demands increased the likelihood of weight gain among obese employees, whereas they increased the likelihood of weight loss among employees with a low BMI.

Adolescent↗

PubMed2004

Work environment and smoking cessation over a five-year period.

AIMS: The authors set out to estimate effects of occupational factors on smoking cessation among Danish employees. METHODS: Data from 3,606 observations of smokers gathered from the Danish National Work Environment Cohort Study in 1990, 1995, and 2000 were analysed by logistic regression. The model comprised background variables, smoking variables, and measures of psychosocial and other aspects of the work environment. RESULTS: Statistically significant odds ratios (OR) for cessation were found for medium versus no exposure to noise (OR 0.71, 95% CI 0.54-0.93), for high versus low physical workload (OR 0.49, 95% CI 0.47-0.73), for high versus low psychological demands (OR 1.42, 95% CI 1.12-1.80), and for medium versus low levels of responsibility at work (OR 1.31, 95% CI 1.03-1.65). CONCLUSION: The probability of smoking cessation differs between people with different exposures to certain work environmental factors.

Adolescent↗

PubMed2004

Industrial differences in disability retirement rates in Denmark, 1996-2000.

OBJECTIVES: The objective of the study was to identify industries associated with a high risk of disability retirement and to roughly estimate the fraction of the retirements that can be attributed to a non-optimum work environment. MATERIALS AND METHODS: All economically active people in Denmark, aged 20-54 years, in the beginning of 1996 (1196235 men and 1063058 women) were followed-up from 1996 to 2000. Gender stratified and age standardized incidence ratios (SIR) for disability retirement were calculated for each of 58 baseline industries. A Monte-Carlo simulation model was used to estimate attributable fractions. RESULTS: In total, we observed 17242 disability retirements among the men and 20910 among the women. The attributable fraction was 38% for the women and 40% for the men. Twenty-six of the SIR-values (13 among the men and 13 among the women) were statistically significantly high. Twenty-two of the 26 groups with a high SIR had been identified by previous research as groups at high risk of circulatory disease and/or musculoskeletal disorders. Two of the remaining four groups with a high SIR were associated with hard physical work (men and women engaged in horticulture and forestry) while the other two consisted of men in female-dominated industries (child-care and cleaning). CONCLUSIONS: The present study identified a series of high-risk industries. It also corroborated previous findings, which state that circulatory disease and musculoskeletal disorders are major risk factors and that hard physical work is an independent risk factor of disability retirement. Further research is needed to find out why men in some stereotypically feminine industries are at high risk of disability retirement.

Adult↗

PubMed2004

Referral bias in hospital register studies of geographical and industrial differences in health.

INTRODUCTION: The Danish National Hospital Register contains four patient types: full-time inpatients, part-time inpatients, outpatients and emergency ward patients. The aim of the present study was to investigate whether results from comparative hospital register studies depend on which patient types we choose to include in the analysis. METHODOLOGY: The hospital register was linked to the centralised civil register and the employment classification module. All economically active persons in Denmark aged 20-59 years 1st January 1995 (N = 2,281,480) were followed for six years. We calculated SIRs, first by county then by industry and finally by industry adjusted for county, for a variety of diagnostic groups and for each of the following types of cases: A) full-time inpatients, B) all inpatients, C) all inpatients and outpatients, D) all patients. The ratio between the maximum and the minimum of the four types of SIRs was calculated for each combination of the examined population groups and diseases. A max/min ratio was regarded as a sign of referral bias if it was above 1.2 and statistically significant. RESULTS: When calculating SIRs by county 46.7 percent of the max/min ratios signified referral bias. The percentage was 5.5 when calculating SIRs by industry and only 1.7 when they were calculated by industry adjusted for county. CONCLUSIONS: Estimates of geographical health differences are often distorted by differences in the health care organisation. Estimates of industrial health differences tend to be robust with a few identifiable exceptions. Standardisation for county will eliminate bias.

Adult↗

PubMed2003

The effect of work environment and heavy smoking on the social inequalities in smoking cessation.

OBJECTIVES: To investigate social differences with regard to smoking cessation in Denmark. METHODS: Social differences in smoking cessation were estimated from 3606 smokers from the Danish National Work Environment Cohort Study in 1990, 1995 and 2000. The differences were investigated using heavy smoking and four work environment factors as explanatory variables. RESULTS: The odds ratio for cessation was more than twice as high in social class I compared with social class V. When heavy smoking was controlled, this explained 28% of social differences, the work-environment factors alone explained 36% of social differences, and together the factors explained 55% of social differences. CONCLUSIONS: A large proportion of the social differences in smoking cessation could be explained by differences in work-environment exposures and smoking intensity.

Adolescent↗

PubMed2003

Risk factors predicting hip pain in a 5-year prospective cohort study.

OBJECTIVES: The aim of the study was to identify and quantify risk factors for hip pain. METHODS: A representative sample of 5001 Danish men and women aged 18-65 years in 1990 were interviewed about occupational exposures (response rate 90%); 5 years later they were reinterviewed about hip pain (response rate 86%). Logistic regression with forced entry of all the independent variables was used to estimate the odds ratios for the possible risk factors. The impact of the various predictors was assessed through the calculation of population etiologic fractions. RESULTS: A double risk of hip pain was found for the women as compared with the men [odds ratio (OR) 2.28, 95% confidence interval (95% CI) 1.68-3.09]. The risk increased with body mass index. Whole-body vibration (OR 1.86, 95% CI 1.09-2.71) and physically demanding work (OR 1.83, 95% CI 1.23-2.71) were strong predictors of hip pain, while a squatting work posture was protective (OR 0.64, 95% CI 0.42-0.98). The impact of the statistically significant predictors (the etiologic fractions) was as follows: 0.49 for body mass index, 0.05 for whole body vibration, 0.10 for physically demanding work, and 0.32 for squatting (preventive). CONCLUSIONS: Female gender, age, high body mass index, whole-body vibration, and physically demanding work are significant risk factors for hip pain.

Adolescent↗

PubMed2002

A validation of information on occupation--data from a nested case-control study.

OBJECTIVES: To evaluate the validity of information about employment obtained from self-respondents and proxies in a nested case-control study. METHODS: We interviewed 230 self-respondents and 652 proxies covering 237 cancer cases and 645 controls. Questions about employment as a bus driver, other jobs, and residence were asked. Golden standard was employment data obtained from personnel records. RESULTS: All categories of respondents tended to over-report the length of employment, and respondents aged above 70 years had significantly decreased odds ratio for disagreement between interview and company files compared with respondents below the age of 60 years. There were no significant differences in whether the respondent was a case or control as there were no differences in whether the respondent was a self-respondent or a proxy. The validity of the reported employment time was statistically independent of the interval between death and proxy contact. Compared with the self-responders, the proxies reported significantly fewer jobs and residential areas. CONCLUSIONS: In general, data obtained from cases and controls not knowing that the study was about cancer and without the interviewer's knowing who were cases and who were controls appeared good. The quality of information obtained from proxies appeared good as well. There seems to be no problem in interviewing very old people about a specific job when they are mentally prepared for it. The time interval between death and proxy contact was without importance.

Adult↗

PubMed2002

Hospitalizations among female home-helpers in Denmark, 1981-1997.

BACKGROUND: Occupational health problems among home-helpers have been reported in a series of studies, and the need for intervention has been pointed out. To facilitate decisions regarding interventions and to establish baseline values for future evaluation of preventive efforts, the present study aimed to elucidate the disease pattern among female home-helpers in Denmark. METHODS: Cohorts of all 20-59-year-old Danish female home-helpers in the years 1981, 1986, 1991, and 1994 were formed, to calculate age standardized hospitalization ratios (SHR) and time trends (1981-1997) for a large variety of diagnostic aggregations. RESULTS: Significantly high SHRs were found for injuries, infectious and parasitic diseases, and for diseases of the nervous system, circulatory system, the respiratory organs, digestive system, and the musculoskeletal system. When adjusting for social group the SHRs for varicose veins, ischemic heart diseases (IHD), and musculoskeletal disorders were still significantly high while the SHR for malignant neoplasm of respiratory organs became significantly low. The time trends revealed increased relative risks for IHD and asthma, and a decreasing relative risk for duodenal ulcer. CONCLUSIONS: Employment in the Danish home-help sector is associated with an elevated hospitalization risk due to many work-related diseases.

Adult↗

PubMed2002

Hospitalizations among employees in the Danish hotel and restaurant industry.

BACKGROUND: The aim of the present study was to provide a broad picture of the morbidity among employees in the Danish hotel and restaurant industry. METHODS: Cohorts of all 20-59-year-old employees in the Danish hotel and restaurant industry in the years 1981, 1986, 1991 and 1994 were formed to calculate age-standardized hospitalization ratios (SHR) and time trends (1981-1997) for many different diagnoses. RESULTS: Both for women and men, significantly higher SHRs were found for infectious and parasitic diseases, neoplasms, diseases in the nervous system and sense organs, diseases of the circulatory system, diseases of the respiratory system, diseases of the digestive system and diseases of the musculoskeletal system among employees in hotels and restaurants than in the digestive system and diseases of the musculoskeletal system among employees in hotels and restaurants than in the working population at large. Furthermore, among women a significantly elevated risk was found for injuries in the lower extremities, injuries in the upper extremities and head injuries, and among men a high risk was found for head injuries and a low risk for ruptures in ligaments and muscles. The trend assessments did not detect any significant changes in SHRs over time. CONCLUSION: Employment in the Danish hotel and restaurant industry is associated with an elevated hospitalization risk due to many diseases, which may be related to occupation and lifestyle. In line with the official policy of reducing inequality in health, focus should be placed on the health problems in this group.

Adult↗

PubMed2002

Socioeconomic status and psychosocial work environment: results from a Danish national study.

OBJECTIVE: The aim of this study was to analyse the associations between socioeconomic status (SES ) and a number of psychosocial work environment factors with a potential impact on inequality in health. METHODS: A representative sample of 1,684 adult Danish employees filled in a standardized questionnaire or were interviewed by telephone. The response rate was 62%. The population was divided into four levels of SES (I to IV ). The psychosocial work environment was described with 19 scales. RESULTS: Quantitative, cognitive, and emotional job demands and a number of dimensions related to active and developmental work showed higher levels among high SES individuals. Job insecurity was highest among women with low SES. Dimensions describing interpersonal relations, social support, and leadership showed no clear associations with SES. CONCLUSIONS: Prevention aiming at improving health and reducing inequality in health should focus on the dimensions of active and developmental work: influence at work, possibilities for development, degrees of freedom, and meaning of work. Furthermore, job insecurity should be reduced.

Adult↗

PubMed2002

Hospitalizations among teachers in Denmark, 1981-1997.

It is a common notion that teachers constitute a group at high risk of occupational stress, but the potential health consequences of the assumed high stress levels are still poorly illuminated. The aim of the present study was to investigate morbidity among Danish teachers. Cohorts of Danish teachers of primary, secondary and vocational schools, aged 20-59 years in 1981, 1986, 1991 and 1994, were formed to calculate age standardized hospitalization ratios (SHRs) and time trends (1981-1997) for a large variety of diagostic aggregations. Statistically significantly low SHRs for the major disease categories: neoplasms, diseases of the nervous, circulatory, respiratory. digestive and musculoskeletal systems were found both for men and women. We also found significantly low SHRs for the aggregated diagnostic group "injury and poisoning" in men and for diseases of the nervous system and sense organs in women. Age standardized hospitalization rates with respect to diseases observed in practically all systems and organs of the body were statistically significantly lower among teachers compared with other economically active people of Denmark.

Adult↗