Biomedical subjects

L Alfredsson

Publications and source records attributed to L Alfredsson.

At least 19 recordsLinked to original sources

PubMed2006

Promoting excellent work ability and preventing poor work ability: the same determinants? Results from the Swedish HAKuL study.

AIM: Health has been described as a continuum between the two poles of excellent health and ill health. Research has so far focused on the negative pole, leaving knowledge about the positive pole vague. With a main focus on working life, the authors aim was to identify determinants promoting excellent work ability and determinants preventing poor work ability. METHODS: 5638 (73% answering rate) employees in the public sector in Sweden answered a questionnaire both at baseline and at follow up 18 months later. The employees were divided into three groups based on sick leave at follow up: excellent work ability (13%), poor work ability (15%), and a middle group (72%). Self reported sociodemographic data, lifestyle data, and working life exposures at baseline were fitted into logistic regression models to determine which factors, if any, promoted excellent work ability or protected against poor work ability. RESULTS: Some determinants were mutual, but more than half of the determinants in the final model were associated solely with promoting excellent work ability or preventing poor work ability, thus creating different patterns of associations. Promotion of excellent work ability seemed more dependent on physical factors, clear work tasks, and positive feedback, while prevention of poor work ability seemed more dependent on job security and psychosocial factors. CONCLUSIONS: This explorative longitudinal study showed slightly different patterns of determinants promoting excellent work ability and preventing poor work ability. As most of the identified determinants are amenable to influence, our results open up the possibility of interventions for promoting excellent work ability and preventing poor work ability.

Adult↗

PubMed2006

Incidence of asthma among workers exposed to sulphur dioxide and other irritant gases.

The aim of the present study was to investigate whether repeated peak exposure (gassings) to sulphur dioxide (SO2) and other irritant gases increases the risk of new-onset asthma. A questionnaire was sent to 4,112 sulphite workers, of whom 1,919 completed the questionnaire and 396 completed the short-form questionnaire, which was sent out as a last reminder. A sample of 130 nonrespondents completed a telephone interview using the short-form questionnaire. The incidence of adult-onset, physician-diagnosed asthma during employment duration was analysed in relation to exposure to SO2 and gassings giving rise to respiratory symptoms. Incidence rates, as well as incidence rate ratios with 95% confidence interval (CI), were calculated. Further Cox regression models were used allowing assessment of hazard ratios (HR) stratified for sex and adjusted for atopy, smoking habits and age. The incidence rate for asthma among sulphite mill workers reporting gassings of SO2 was 6.2 out of 1,000 person-yrs, compared with 1.9 out of 1,000 person-yrs among subjects unexposed to SO2 and any gassings (HR (95% CI) 4.0 (2.1-7.7)). Among males reporting gassings to SO2, the HR (95% CI) for asthma was 5.8 (2.6-13) compared with unexposed males. In conclusion, repeated peak exposure to sulphur dioxide increased the incidence of asthma during work in sulphite pulp mills, which supports the hypothesis of irritant-induced asthma.

Adolescent↗

PubMed2005

Socioeconomic status and the risk of developing rheumatoid arthritis: results from the Swedish EIRA study.

OBJECTIVE: To study whether formal education and occupational class are associated with incidence of rheumatoid arthritis overall and with the incidence of the two major subgroups of rheumatoid arthritis-seropositive (RF+) and seronegative (RF-) disease. METHODS: 930 cases and 1126 controls participated in a population based case-control study using incident cases of rheumatoid arthritis, carried out in Sweden during the period May 1996 to June 2001. The relative risk (RR) of developing rheumatoid arthritis with 95% confidence interval (CI) was calculated for different levels of formal education compared with university degree and for different occupational classes compared with higher non-manual employees. RESULTS SUBJECTS: without a university degree had an increased risk of rheumatoid arthritis compared with those with a university degree (RR = 1.4 (95% CI, 1.2 to 1.8)). For manual employees, assistant and intermediate non-manual employees together, the risk of developing rheumatoid arthritis was about 20% more than for non-manual employees. These increased risks were more pronounced for RF+ than for RF- rheumatoid arthritis and were mainly confined to women. Smoking could not of its own explain the observed associations between risk of rheumatoid arthritis in different socioeconomic groups in Sweden. CONCLUSIONS: There was an association between high socioeconomic status and lower risk of rheumatoid arthritis in a population based investigation that was representative for the Swedish population. The study shows that as yet unexplained environmental or lifestyle factors, or both, influence the risk of rheumatoid arthritis, even in the relatively egalitarian Swedish society.

Adolescent↗

PubMed2004

Silica exposure is associated with increased risk of developing rheumatoid arthritis: results from the Swedish EIRA study.

OBJECTIVE: To study the association between silica exposure and rheumatoid arthritis and how it is modified by cigarette smoking. METHODS: Data were analysed from 276 male cases and 276 male controls aged 18 to 70 years, included in a Swedish population based study between May 1996 and June 2001. A case was defined as a person recently diagnosed with rheumatoid arthritis according to the ACR criteria. Controls were selected from the study base as a stratified random sample accounting for age, sex, and residency. Men with a self reported history of work with rock drilling, stone crushing, or exposure to stone dust in general were defined as silica exposed. Rheumatoid factor (RF) status among cases was recorded. RESULTS: Silica exposed men had increased risk of rheumatoid arthritis, with an odds ratio (OR), adjusted for age, residential area, and smoking, of 2.2 (95% confidence interval, 1.2 to 3.9) among men aged 18 to 70 years, and 2.7 (1.2 to 5.8) among those aged 50 to 70 years. Men who had worked with rock drilling or stone crushing (regarded as highly exposed) had a slightly greater increase in risk of rheumatoid arthritis than silica exposed men in general, with an OR of 3.0 (1.2 to 7.6). The joint effects of silica exposure and smoking were compatible with synergy between these two exposures in the development of rheumatoid arthritis but this was not conclusive. CONCLUSIONS: Silica exposure is associated with increased risk of developing rheumatoid arthritis. This association is not explained by smoking habits.

Adolescent↗

PubMed2004

Mental fatigue, work and sleep.

OBJECTIVE: The study examined the multivariate relationship between mental fatigue and different work-related (work load, work hours) and background/life style factors, as well as disturbed sleep. METHODS: A total of 5720 healthy employed men and women living in the greater Stockholm area participated in a questionnaire study on cardiovascular risk factors. The data were analysed using a multiple logistic regression analysis with self-rated fatigue as the dependent variable. RESULTS: Fatigue was predicted by disturbed sleep (4.31; 3.50-5.45, high immersion in work (4.17; 2.93-5.94), high work demands (2.39; 1.54-3.69), social support, being a female, being a supervisor and high age. Shift work, work hours (including overtime) and influence at work did not become significant predictors. With control for work demands a high number of work hours was associated with lower fatigue. CONCLUSION: Disturbed sleep is an important predictor of fatigue, apparently stronger than previously well-established predictors such as work load, female gender, lack of exercise, etc.

Adult↗

PubMed2004

What precedes development of rheumatoid arthritis?

Studies on aetiology of inflammatory diseases such as rheumatoid arthritis (RA) need to investigate the potential environmental triggers that are active before onset of disease, the genetic context in which these triggers act, and whether the presence of such triggers in an arthritis prone genetic context will give rise to the immune reactions associated with/preceding RA. Such knowledge would help not only to address much better the issue of causality of these potential triggers and the immune reactions, but also to carry out various interventions aimed at influencing the disease provoking immune events before development of clinical signs of disease. This short report summarises recent data demonstrating (a) the presence of anticitrullin antibodies or rheumatoid factors in between a third and half of patients with RA before development of clinical signs; (b) long term smoking is associated with a high risk of future development of seropositive but not seronegative RA; and (c) a strong gene-environment interaction between smoking and SE genes in the development of seropositive RA. We conclude that, in a certain genetic context, smoking is a potential trigger of RA, and a combination of the two factors is associated with the occurrence of immune reactions long before the onset of RA.

Arthritis, Rheumatoid↗

PubMed2003

Association of boiled and filtered coffee with incidence of first nonfatal myocardial infarction: the SHEEP and the VHEEP study.

OBJECTIVES: To evaluate the influence of consumption of filtered and boiled coffee, on the incidence of first nonfatal myocardial infarction. DESIGN: Population-based case-control study. SETTING AND SUBJECTS: The study base consisted of the population 45-65/70 years-old in two Swedish counties, Stockholm and Västernorrland, 1992/93-94. In all, 1943 cases of first nonfatal myocardial infarction were identified. For each case one control was selected from the study base concurrently with disease incidence by matching the sex, age and place of residence of the case. Information about coffee consumption and other factors was obtained by mailed questionnaire and a medical examination. The participation rate was 85% amongst cases and 74% amongst controls. RESULTS: Men with a reported consumption of 7-9 dL filtered coffee per day showed an increased incidence of first myocardial infarction compared with consumers of 3 dL day-1 or less (RR: 1.32; 95% CI: 1.03-1.70). A consumption of at least 10 dL day-1 was associated with an RR of 1.93 (95% CI: 1.42-2.63) for filtered and 2.20 (95% CI: 1.17-4.15) for boiled coffee. Amongst women, no clear association was seen between consumption of filtered coffee and myocardial infarction but consumption of boiled coffee tended to be related to an increased incidence. Comparing subjects drinking boiled coffee with those drinking filtered coffee and adjusting for the amount consumed gave an increased incidence for boiled coffee amongst both men (RR: 1.41; 95% CI: 1.07-1.80) and women (RR: 1.63; 95% CI: 1.04-2.56). CONCLUSIONS: Consumption of boiled coffee appears to increase the incidence of first nonfatal myocardial infarction. This increased incidence is consistent with randomized trials showing an adverse impact of boiled coffee on blood lipids.

Aged↗

PubMed2003

Quantification of the influence of cigarette smoking on rheumatoid arthritis: results from a population based case-control study, using incident cases.

OBJECTIVE: To quantify the influence of cigarette smoking on the risk of developing rheumatoid arthritis (RA). METHODS: 679 cases and 847 controls included during May 1996-June 2000 in a case-control study, using incident cases, comprising the population aged 18-70 years of a defined area of Sweden, were investigated. A case was defined as a person from the study base who received for the first time a diagnosis of RA using the 1987 American College of Rheumatology criteria, and controls were randomly selected from the study base. Self reported smoking habits among cases and controls, and rheumatoid factor status among cases were registered. The incidence of RA in current smokers, ex-smokers, and ever-smokers, respectively, was compared with that of never-smokers. RESULTS: Current smokers, ex-smokers, and ever-smokers of both sexes had an increased risk for seropositive RA (for ever-smokers the odds ratio was 1.7 (95% confidence interval (95% CI) 1.2 to 2.3) for women, and 1.9 (95% CI 1.0 to 3.5) for men), but not for seronegative RA. The increased risk was only apparent among subjects who had smoked > or =20 years, was evident at an intensity of smoking of 6-9 cigarettes/day, and remained for up to 10-19 years after smoking cessation. The risk increased with increasing cumulative dose of smoking. CONCLUSION: Smokers of both sexes have an increased risk of developing seropositive, but not seronegative, RA. The increased risk occurs after a long duration, but merely a moderate intensity, of smoking and may remain for several years after smoking cessation.

Adult↗

PubMed2003

Downsizing of staff is associated with lowered medically certified sick leave in female employees.

AIM: To determine whether changes in number of staff in work sites are associated with medically certified sick leave among employees with an increased risk of developing cardiovascular disease. METHODS: The 5720 employees (aged 18-65) were from the WOLF study of cardiovascular risk factors in working men and women in greater Stockholm during the years 1992-95. From the medical examination a cardiovascular score was calculated for each participant. The WOLF study base was linked to a Statistics Sweden registry of economic and administrative activities. Sick leave spells lasting for at least 15 days during the calendar year following downsizing/expansion were identified for each subject. RESULTS: In multiple logistic regression an increased likelihood of having no medically certified sick leave (15 days or more) was found in women during the year following both downsizing and expansion. These analyses were adjusted for age and cardiovascular score. A high cardiovascular risk score reduced the likelihood of having no medically certified sick leave. The inclusion of psychosocial work environment variables did not change the results markedly. Separate analyses of women with and without high cardiovascular score showed that downsizing had a more pronounced effect on reduced long term sick leave among those with high than among those without low cardiovascular score. There were no consistent findings in men. CONCLUSIONS: There is evidence of a reduction of long term sick leave in women after downsizing and this is particularly evident among those with high cardiovascular score.

Adolescent↗

PubMed2002

Population-based twin study of the effects of migration from Finland to Sweden on endothelial function and intima-media thickness.

Finnish men have higher coronary heart disease (CHD) mortality than Swedish men do. To assess the impact of migration to a country with lower CHD mortality on subclinical atherosclerosis, we measured early functional and structural atherosclerotic vascular changes in twins discordant for migration from Finland to Sweden. Conventional CHD risk factors, flow-mediated dilatation (FMD) of the brachial artery, carotid intima-media thickness, and carotid artery compliance were measured in 74 male twin pairs (20 monozygous, 54 dizygous), aged 42 to 69 years, in which co-one twin had migrated more than 20 years ago permanently to Sweden. There were no significant differences in CHD risk factors except for diastolic blood pressure and body fat percentage, which were higher in Sweden. In all subjects, mean FMD was non-significantly higher in Sweden (5.7+/-4.3% vs 4.9+/-4.2%, P=0.22), but in monozygous twins the difference in FMD was highly significant (7.2+/-4.4 vs 3.7+/-2.9%, P=0.003). There was no significant difference in intima-media thickness or carotid artery compliance between Sweden and Finland. We conclude that in Finnish monozygous twins the endothelial function is better among the twins that have migrated to a country with lower CHD prevalence.

Adult↗

PubMed2002

Sleep disturbances, work stress and work hours: a cross-sectional study.

OBJECTIVE: The study examined the multivariate relationship between disturbed sleep and different work-related and background/life style factors. METHODS: 5720 healthy employed men and women living in the greater Stockholm area participated. A factor analysis of eight items provided one main factor: "disturbed sleep." The data were analyzed using a multiple logistic regression analysis against the index disturbed sleep as well as the separate items "not well rested" and "difficulties awakening." RESULTS: The results showed that high work demands [odds ratio (OR) = 2.15] and physical effort at work (OR = 1.94) are risk indicators for disturbed sleep, while high social support is associated with reduced risk (OR = 0.44). In addition, higher age (45+), female gender, a high body mass index (BMI) and lack of exercise are background/life style risk indicators. Introducing into the model an item representing inability to stop thinking about work during free time yielded the highest OR (3.20) and forced work demands out of the regression. With regard to not feeling well rested, the same significant predictors, except physical effort, were obtained, as well as for having night work and being married. In addition, the age effect was reversed--high age predicted reduced risk of not feeling well rested. Difficulties awakening was predicted by high work demands, low social support, being male, low age and smoking. It is notable that, whereas subjective sleep quality decreased with age, the difficulties awakening and feelings of not being well rested after sleep increased with age. CONCLUSION: It was concluded that stress and the social situation at work are strongly linked to disturbed sleep and impaired awakening, that gender and, even more so, age may modify this and that the inability to stop worrying about work during free time may be an important link in the relation between stress and sleep.

Adult↗

PubMed2002

Migration and mortality: a 20 year follow up of Finnish twin pairs with migrant co-twins in Sweden.

STUDY OBJECTIVE: Finland has a higher mortality overall and for major causes of death than Sweden, primarily in men. The objective of this study was to analyse mortality in migrants from Finland to Sweden. DESIGN: A longitudinal study based on the Finnish Twin Cohort Study. Information about migration from Finland to Sweden, duration of stay in Sweden for the migrants, and deaths 1976-1995 was obtained from national registers. Observed numbers of deaths in migrants were compared with expected numbers based on the age standardised mortality experience of the Finnish Twin Cohort. First deaths in migrants and non-migrants of migrant discordant pairs were compared controlling for genetic and early childhood factors. PARTICIPANTS: Twin pairs of the Finnish Twin Cohort Study where at least one twin had migrated to Sweden (1542 twin pairs). MAIN RESULTS: Among men, migrants from Finland to Sweden showed an overall similar mortality compared with all subjects of the Finnish Twin Cohort (SMR 1.1; 95% CI 0.9 to 1.4). Mortality from non-violent causes was increased for migrants with at most 20 years in Sweden (SMR 1.9; 95% CI 1.2 to 2.6) and decreased in those with a longer stay (SMR 0.7; 95% CI 0.4 to 0.9). Similar results were obtained concerning first deaths in twin pairs discordant for migration. Among women, migrants had an increased mortality overall (SMR 1.4; 95% CI 1.0 to 1.8), from cardiovascular disease (SMR 1.7; 95% CI 1.0 to 2.7), and from violent causes (SMR 2.5; 95% CI 1.2 to 4.6) compared with all women of the Finnish Twin Cohort. In analyses of migrant discordant pairs only first deaths from cardiovascular disease tended to be more common in the migrants than in non-migrant co-twins. CONCLUSIONS: Migrants from Finland to Sweden seem to have an overall mortality comparable to that prevailing in Finland suggesting no strong influence on mortality by the migration. Duration of stay seems to be associated with mortality in the migrants, at least in men, with a lower mortality after several years in Sweden.

Adult↗

PubMed2002

Work environment and neck and shoulder pain: the influence of exposure time. Results from a population based case-control study.

OBJECTIVES: To study associations between long term and short term exposure to different work environmental conditions and the incidence of neck or shoulder pain. The results were obtained as part of the MUSIC-Norrtälje study, which is a population based case-control study conducted in Sweden in 1993-7. METHODS: The cases were people from the study base who sought medical care or treatment for neck or shoulder pain. Information on physical and psychosocial conditions in the work environment, currently and 5 years ago, and lifestyle factors, was obtained by self administered questionnaires from 310 cases and 1277 randomly selected referents. RESULTS: Associations between both physical and psychosocial exposures in the work environment and seeking care for neck or shoulder pain were found. The risk patterns differed for the sexes, and risk ratios exceeding 1.5 were more often found among women than among men. Generally, subjects who had experienced a recent increase of exposure were more likely (relative risk (RR) 2.1-3.7) to seek care than those who had been exposed long term (RR 1.5-1.8). Among women, an increased amount of visual display terminal (VDT) work, work above shoulder level, and reduced opportunities to acquire new knowledge, and among men, an increased amount of seated work were associated with neck or shoulder pain. This might indicate short induction periods for neck or shoulder pain for these exposures. However, for repetitive work with the hands and hindrance at work among women, and possibly also local vibrations among men, the induction periods seem to be longer. Interactive effects between factors, both at work and in the family, were found, but only among women. CONCLUSIONS: Associations between some exposures in the work environment and seeking care for neck or shoulder pain were found. The high RRs for short term exposure might indicate that for many factors the induction period for neck or shoulder pain is short.

Adult↗

PubMed2002

Work organisation and unintentional sleep: results from the WOLF study.

BACKGROUND: Falling asleep at work is receiving increasing attention as a cause of work accidents. AIMS: To investigate which variables (related to work, lifestyle, or background) are related to the tendency to fall asleep unintentionally, either during work hours, or during leisure time. METHODS: 5589 individuals (76% response rate) responded to a questionnaire. A multiple logistic regression analysis of the cross sectional data was used to estimate the risk of falling asleep. RESULTS: The prevalence for falling asleep unintentionally at least once a month was 7.0% during work hours and 23.1% during leisure time. The risk of unintentional sleep at work was related to disturbed sleep, having shift work, and higher socioeconomic group. Being older, being a woman, and being a smoker were associated with a reduced risk of unintentionally falling asleep at work. Work demands, decision latitude at work, physical load, sedentary work, solitary work, extra work, and overtime work were not related to falling asleep at work. Removing "disturbed sleep" as a predictor did not change the odds ratios of the other predictors in any significant way. With respect to falling asleep during leisure time, disturbed sleep, snoring, high work demands, being a smoker, not exercising, and higher age (>45 years) became risk indicators. CONCLUSION: The risk of involuntary sleep at work is increased in connection with disturbed sleep but also with night work, socioeconomic group, low age, being a male, and being a non-smoker.

Accidents, Occupational↗

PubMed2001

The association between exposure to a rear-end collision and future health complaints.

Different symptoms, together with neck pain, have been attributed to persons with persistent complaints after a previous motor vehicle crash (MVC) and are sometimes referred to as the "late whiplash syndrome." A cohort study was conducted to determine whether exposure to a rear-end collision, with or without whiplash injury, is associated with future health complaints. The results regarding future neck or shoulder pain have previously been described, and the objective of the present report was to focus on outcomes other than neck pain. Included in the study were persons 18 to 65 years of age and covered by traffic insurance at one of the largest insurance companies in Sweden. Claim reports were collected from the period November 1987 to April 1988. Drivers exposed to a rear-end collision were divided into two subgroups: those with reported whiplash injury (n = 232) and those without reported whiplash injury (n = 204). For comparison, 3688 subjects who were unexposed to MVCs were selected, with consideration taken to the age and gender distribution in the exposed subgroups. The prevalence of different health complaints among the study subjects was estimated according to a mailed questionnaire at follow-up in 1994, 7 years after the rear-end collision. When exposed subjects with whiplash injury were compared to unexposed subjects, increased relative risks in the range of 1.6-3.7 were seen for headache, thoracic and low back pain, as well as for fatigue, sleep disturbances and ill health. No corresponding increased risks were found among the exposed subjects without reported whiplash injury. We conclude that rear-end collisions resulting in reported whiplash injuries seem to have a substantial impact on health complaints, even a long time after the collision. There is a need to identify factors that predict a non-favorable outcome in order to improve clinical management.

Accidents, Traffic↗

PubMed2001

Sex differences in survival after myocardial infarction in Sweden; data from the Swedish National Acute Myocardial Infarction Register.

AIMS: Women, particularly younger women, hospitalized with acute myocardial infarction have been found to have poorer prognosis than men. A large proportion of deaths due to myocardial infarction, however, occur in the pre-hospital phase. We set out to analyse age-specific sex differences in survival after myocardial infarction at different time intervals from the onset of acute myocardial infarction, including pre-hospital deaths and 1-year overall survival. METHODS AND RESULTS: The National Acute Myocardial Infarction Register in Sweden was used to analyse age-specific sex differences in mortality outside hospital, 28-day mortality and 1-year mortality in 353 905 cases occurring between 1987 and 1995 in Swedish men and women aged 30 to 89 years. Overall, one in four of all myocardial infarction victims died outside hospital. At all ages, except in individuals younger than 50 years, men had higher pre-hospital mortality. The odds of dying within 28 days for women below 50 years of age, compared to men, was 1.84 (1.56--2.18) in hospitalized patients and 1.31 (1.18--1.46) in all infarction patients. Above the age of 65, in the total population with myocardial infarction, women had a better prognosis, with odds ratios ranging from 0.83 to 0.89. In patients surviving the first 28 days, 4.0% of the women and 2.9% of the men below the age of 50 were dead within a year after the infarction, odds ratio 1.37 (1.06--1.76). This excess mortality was mainly due to diabetes and non-cardiac causes. Only women younger than 50 years had a significantly poorer overall 1-year survival than men of the same age. At the age of 70 or more, women had a small survival advantage. CONCLUSION: In the total acute myocardial infarction population, only women under 50 years of age have a consistently worse prognosis than men. Much of the excess mortality in young women seems to be associated with diabetes.

Aged↗

PubMed2001

A national record linkage to study acute myocardial infarction incidence and case fatality in Sweden.

BACKGROUND: During the last decades substantial temporal changes, as well as population differences, in coronary heart disease mortality have occurred in Sweden. There is little information to what extent these changes and differences also apply to myocardial infarction incidence. The aim of this paper was to describe the methods used to identify cases in a recently developed National Acute Myocardial Infarction Register in Sweden, and to present estimates of incidence and case fatality in Sweden. MATERIAL AND METHODS: Incident cases of acute myocardial infarction (AMI) were identified by record linkage of routinely collected data on hospital discharges and deaths. Case fatality within 28 days was ascertained by linkage of incident cases to the National Cause of Death Register. RESULTS: About 40 000 new cases of AMI per year were recorded in Sweden during 1987-1995. Well-known differences in incidence with regard to age and gender were observed, as well as a decline in incidence between 1987 and 1995. A similar case fatality was seen in men and women aged 30-89 among hospitalized cases. When fatal cases outside hospital were also considered the case fatality was somewhat higher in men. Examination of medical records for a national sample of ischaemic heart disease patients suggested a high sensitivity (94%) and a high positive predictive value (86%) for ICD-9 code 410 in hospital discharge data with regard to definite AMI. CONCLUSIONS: The National Acute Myocardial Infarction Register offers a new possibility to study the incidence of AMI, as well as case fatality, in Sweden.

Acute Disease↗

PubMed2001

The influence on seeking care because of neck and shoulder disorders from work-related exposures.

The aim of this study was to assess the influence of work-related physical and psychosocial factors on seeking care for neck or shoulder disorders among men and women in a general working population. The study population comprised gainfully employed (>17 hours per week) men and women in the municipality of Norrtälje, altogether 392 cases and 1,511 controls. Cases were defined as persons seeking care because of neck or shoulder disorders by any caregiver in the region. The study began in 1994 and continued to 1997. We assessed physical and psychosocial exposures by questionnaires and interviews. The pattern of seeking care for neck or shoulder disorders differed between men and women. Among men, work with vibrating tools [relative risk (RR) = 1.6], not having a fixed salary (RR = 1.9), and low demands in relation to competence (RR = 1.5) were the strongest risk indicators obtained in analyses stratified for age and previous symptoms. Among women, repetitive hand or finger movements (RR = 1.6), constrained sitting (RR = 1.6), not having a fixed salary (RR = 2.0), and solitary work (RR = 1.8) were the strongest risk indicators. A large proportion of the general population was exposed to several of these moderately harmful conditions, and their concomitant effect may explain the high incidence of neck and shoulder disorders in the general working population.

Adult↗