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Biomedical subjects

P Ostlin

Publications and source records attributed to P Ostlin.

11 recordsLinked to original sources
PubMed2007

Introducing Health Impact Assessment: an analysis of political and administrative intersectoral working methods.

BACKGROUND: Intersectoral Action for Health (IAH) and its Health Impact Assessment (HIA) tool are built on collaboration between actors and sectors, requiring multidimensional and horizontal way of working. The study aims to analyse the enablers and barriers when such a new way of working and tool have been initiated to replace a traditional, vertical operation at the local level in Slovakia-a country in transition-in 2004. METHODS: Up to date, there are few studies that have analysed intersectoral initiatives in relation to politics. In this study the conceptual framework of Kingdon has been used by which the actual problems, the governmental actions (or non-actions) (politics) and the understanding, implementation and evaluation of the initiative (policy) could be analysed. All actors involved, civil servants, politicians, representatives of the local public health institute and researchers, were interviewed and made to answer a questionnaire. RESULTS: The results showed that there were a number of factors behind the initiation of HIA, which either delayed or accelerated the process. The problems identified were e.g. the prevailing traditional health care focus and the deteriorating health status of the population. There was a lack of multi-intersectoral knowledge, co-operation and function between sectors and actors. Enablers on the other hand were the membership of international organizations which called for new solutions, and the strong political commitment and belief that intersectorality would have a positive effect on health. CONCLUSION: The actors on the local level would have the capacity to work intersectorally to bring about policy change if HIA was to be more supported/institutionalized.

Community Health Planning↗
PubMed1998

Myocardial infarction in male and female dominated occupations.

The aim of the study was to investigate whether workers in jobs dominated by the opposite sex have an increased risk of myocardial infarction (MI). A case-referent study was carried out to estimate the relative risk of first MI in different occupational groups. The study base comprised all men and women in five counties in the middle of Sweden during 1976-84. Cases of MI were identified from both hospital discharge records and death records. Information on occupation was obtained from two consecutive censuses. Primary health related selection was analysed for men with data from the physical examination of conscripts to compulsory military service in 1969-70 combined with data from the censuses of 1970-90 and data on early retirement in 1971-92. Increased risk of MI was found among both women (relative risk (RR) 1.41, 95% confidence interval (95% CI) 1.15 to 1.73) and men (1.21, 1.10 to 1.32) in blue collar jobs where men predominate, and among men with white collar jobs (1.26, 1.09 to 1.45) where women predominate. However, the increased risk among men in white collar jobs was probably due to negative health selection into these occupations. These results do not support the notion that being of the sexual minority in an occupation is in itself an important risk factor for MI.

Adult↗
PubMed1996

Myocardial infarction among male bus, taxi, and lorry drivers in middle Sweden.

OBJECTIVES: The aim of the present case-referent study was to investigate the incidence of myocardial infarction among male professional drivers, taking the type of vehicles and area of residence into account. METHODS: The study base comprised all men aged 30-74 in five counties in middle Sweden during 1976-81 or 1976-84. Incident cases of the first episode of myocardial infarction were identified from registers of hospital admissions and causes of deaths. Referents were selected randomly from the study base. Information about occupation was obtained from the national censuses in 1970 and 1975. The possible impact from tobacco smoking and overweight were evaluated by simulations in combination with indirect data on these factors. RESULTS: The incidence of myocardial infarction was increased among bus drivers in Stockholm (relative risk (RR) = 1.53, 95% confidence interval (95% CI) 1.15-2.05), and among taxi drivers both in Stockholm (RR 1.65, 95% CI 1.30-2.11) and in the surrounding rural counties (RR 1.82, 95% CI 1.17-2.82). A smaller increase was found among long distance lorry drivers, whereas the relative risk among short distance lorry drivers was close to unity. Indirect comparisons make it unlikely that the excess among bus drivers in Stockholm could be explained by uncontrolled confounding from tobacco smoking or overweight. A very high proportion (more than 80%) of urban bus drivers in Sweden report a combination of high psychological demands and low control at work. CONCLUSIONS: Different types of drivers are at different risk of myocardial infarction. Bus drivers in urban areas seem to be at an increased risk, which is unlikely to be explained by uncontrolled confounding from tobacco smoking or overweight. Psychosocial work conditions may play a part in the increased incidence of myocardial infarction among urban bus drivers and should be investigated further.

Adult↗
PubMed1991

The quality of retrospective questions about occupational history--a comparison between survey and census data.

The main purpose of the present study was to assess the quality of information about occupational history obtained via retrospective interview questions. This assessment is achieved by linking interview data from the Swedish survey of Living Conditions (ULF) with occupational information about the same individuals obtained from a number of censuses. This has been done for the census years 1960, 1970, 1975 and 1980. In both ULF and the census, occupations have been classified according to the Nordic Occupational Classification (NYK). Both data sources contain errors. There are also differences in definitions and measurement procedures. Still, the survey question on occupational history gives results of good quality in terms of agreement with census data. This is especially the case for coarse levels of the classification scheme (NYK 1-digit level). The agreement is somewhat lower for the comparisons farthest back in time.

Adult↗
PubMed1990

Occupational history, self reported chronic illness, and mortality: a follow up of 25,586 Swedish men and women.

STUDY OBJECTIVE: The aim of the study was to analyse the extent to which mortality can be predicted from data on self assessed chronic illness. DESIGN: The study used data obtained from ongoing surveys of living conditions conducted by Statistics Sweden using annual interviews of cohorts of about 8000 people. SETTING: The study was a population based survey of the whole of Sweden. PARTICIPANTS: The analysis involved a group of 25,586 respondents (males 12,812, females 12,774), aged 25-74 years, interviewed in 1977 and 1979-81. MEASUREMENTS AND RESULTS: Mortality and occupational health selection were analysed in different occupational categories. The association between mortality and self reported morbidity was assessed. Level of physical strain at work was associated with mortality in men. Occupational health selection could be detected for men but not for women when mortality from all causes was investigated. Self assessment of health predicted mortality. CONCLUSIONS: Subjective assessments of health through surveys are valuable as predictors of mortality for both men and women.

Adult↗
PubMed1989

The 'health-related selection effect' on occupational morbidity rates.

The aim of this study was to investigate the extent to which differences between physically light and heavy work, with respect to the development of health problems, might in cross-sectional data be eliminated or diminished by health-related selection into and out of occupations. The study population comprised 12,314 men and 12,393 women between 25 and 74 years of age, who were interviewed within the framework of the Statistics Sweden Survey of Living Conditions. For all respondents, detailed occupational histories were recorded. For all the diseases and functional disorders studied, morbidity differences were apparently diminished compared to what would be expected if there was no selection. This association was most apparent when studying musculoskeletal disorders, impaired hearing and impaired working capacity for men.

Adult↗
PubMed1988

Negative health selection into physically light occupations.

Health selection, which transfers workers with health problems from physically heavy to physically light occupations, may be a factor contributing to excessive morbidity in the latter group. The aim of this study was to investigate whether workers who had stopped doing heavy work and moved to occupations with low physical demand are generally more ill than workers who had always done light work. The study population comprised 5436 men and 5486 women aged 25 to 74 years, who were interviewed within the scope of the Statistics Sweden Survey of Living Conditions in the years 1977 and 1979-81. For all respondents detailed recording of the occupational histories was completed. For all the diseases and functional disorders studied an increase in risk could be seen for movers. Moreover, movers who had left their heavy work most recently had the greatest risks. This association was most apparent when studying musculoskeletal disorders and impaired working capacity for men and diseases of the circulatory organs and impaired hearing for women. The findings indicate clearly that there is a negative health selection into physically light occupations, introducing a bias (especially in cross-sectional studies) that causes an apparent excess morbidity in occupations with low physical demand.

Adult↗
PubMed1988

Problems with cross-sectional data in research on working environment and health.

Occupational turnover due to health related selection might introduce a bias in cross-sectional studies that tends to mask real occupational health effects. People could have changed occupation so that they, when disease occurs and/or the data collection is accomplished, are working in an environment that is irrelevant for the disease in question. The aim of this study was to determine whether there is any difference in morbidity between 'stable' workers and 'changers'. Occurrence of long-term illness was studied on four exposure levels, defined according to the physical demands at work. The study populations comprised 10,487 men and 10,058 women between 25 to 74 years of age, who were interviewed within the scope of the Statistics Sweden Survey of Living Conditions in the years 1977 and 1979-81. Considerable differences in health outcomes were found between stable workers and changers, especially when considering the degree of physical strain at work. Thus, the findings indicate the necessity of detailed recording of occupational histories within the framework of cross-sectional studies, especially when the aim of the investigation is to study and compare health outcomes for workers in occupations with different turnover rates.

Adult↗