Trends in Work Place Injury and Consequent Absence from Work in the County of Gävleborg, Sweden

Leah Okenwa Emegwa O.D, MPH, PhD2014-06-24

• The University of Gävle

Background

Work place injuries contribute to the global burden of disease and injuries

Roughly a million workers injured and a thousand die per day

One year incidence is about 3.2%

Known risk factors include age, gender, occupation etc.

Different direction of association in different contexts

Causes of work related injury includeFalls, Loss of control

Movement with or without load

Violence, Electricity/fire/explosion

Leakage/overflow

Slip/snapping/splitting/breaking of an object

About 317 million workers were injured in accidents at work that resulted in absence from work of four days or more

Equivalent to roughly 850,000 injuries per day

(Global Estimates)

• Sick leave good for reccuperation • Grave consequences if too long or too short

Examples for too long• Negative psychosocial health outcomes• Loss of job etc

Examples too short (sickness presence)• Non full recovery• Risk of reccurrent short sick leave• Loss/waste of economic resources• Lower productivity

Work related injury and illness pattern, Sweden

Work related injury womenWork related illnesses women men

Work related injury menWork related illnesses men

Source: Statistics Sweden

Rationale for studyMost studies address certain injuries types in certain industrial sectors

Others present aggregates

Same for sick leave duration

Need for studies at county level due to:

-i.Health care administered at county level)

-ii. Companies pay sickness benefits first two weeks

Aim

To explore trends in workplace injuries and associated risk factors in the county of Gävleborg, Sweden

The study also aims to investigate sick leave duration and its determinants

Gävleborg, SwedenCentrally located by the east coast

280 000 inhabitants living on almost 20 000 km2

Three-quarter woodlands

Lakes, hills and mountains

Gävleborg, Sweden.

Method

DesignBased on Register kept by the Swedish National Working Environment Agency

Includes all cases of occupational injuries requiring at least one day of sick leave reported to the Swedish social security board

For the present studyAll cases of non fatal occupational accident between 2007-2012

Total 5291cases

Measures

Dependent Variables

Injury Cause

Sick leave

<2weeks

>2weeks

Independent Variables

-age

-gender

-occupational sector

-Employment status

Data analysisSPSSDescriptive analysis Logistics regressions Significance level p<0.05 95% confidence interval.

Ethical considerationEthical approval granted by institutional review board for the region.

Results

Loss of controllProportion decreases with age (49% vs. 23%)More menAgriculture (43.7%) and mining (55.6%)Student/trainees (49.4%) and self employed and (36%)

Adjusted odds ratio (significant)1.8 odds for <20yrs 1.5 for 20-29yrs2.5 odds for students/trainees

FallIncreases with age (12.9% vs. 41.4%)More women (35.1% vs. 22.4%)More than one third of workers from Specific sectors e.g. electricity/gas, infomation & communication, transport, real estate, health and education.

Adjusted Odds RatioIncreasing OR with ageSex remained a predictor (more women)2times risk in real estate sector1.4 times risk for permanent workers

Movement involving load

Significantly more amongAge 40-49yrs (10.3%)Women (13.5%)Healthcare sector (23.3%)

Adjusted oddsRisk increases with age up to 40-49 yrs (1.6times)Higher risk remained for women4.6 times risk for workers in health care

Slip/snapping/splitting/breaking of an object More men (7.6%) Mostly in construction (11.5%) Mostly among self employed (22%)

Adjusted OR Greatest risk for 30-39yr (1.6times) 2.8times risk for men Significance remained for self employed

Interpersonal Violence Highest for age 20-29yrs (15.8%) then reduces with age More men (13.6% vs. 11%) Most common in Financial sector (50%) and

Manufacturing (19.5%)

Adjusted OR Risk 1.6 times for 20-29 yrs 3.5 times risk for manufacturing 15.8 times for financial sector

Movement not involving load Significant only for age Remains after adjusting for other factors

Electricity/fire/explosionIncreasing proportions among younger workersMore menConstruction sector (3.1%)

Adjusted odds10.8 times risk for men

Leakage/Overflow Higher among men (2%) More in mining sector (11.1%)

Adjusted OR Significance disappears

Sick leave longer than two weeks

Increases with age

About 2 times risk for injuries resulting from fall, slip/snapp/splitting/breaking of object and violence

Sick leave longer than two weeks less likely among workers in Healthcare and Manufacturing sectors

More than twice likelihood (2.2 times) among self employed

Discussion/Conclussions Loss of controll associated with age and inexperience (students/trainee)

Risk for fall with increasing age: a time for setting age limit for certain task?

Movement while carring a load: healthsector and women

Interpersonal violence (16 times risk for financial & 3.5 manufacturing)

Lenght of sick leave- an indication of severity and/or other factors

Quick return to work and Sickness presenteeism following injury: how beneficial in the long run? (lower reporting of injuries requiring sick leave)

’Iceberg’ of Presenteeism

Reccomendations More industry specific safety policies and monitoring

Gender consideration in prevention and rehabilitation

Closer monitoring of self employed to minimise injury risks

Calls to build resilience against presenteeism in organisations (Health and Wellbeing Questionnaire: first step)

The need for continous emphasis on training, monitoring and evaluation of existing policies

Strengths and Weaknesses

Strengths Reliable database shown by level of precision

Weaknesses Few variables Not able to compare non injured workers vs. Injured

Implications for Future Research/Policy/Innovation

1. The dynamics involved and factors responsible for shorter sick leave duration in health and manufacturing sectors. i.e. severity vs. Sickness presenteeism

2. Opportunities for Bussiness innovations- development of more safety products (movement under load)

3. Review of existing policies, training programs and monitoring systems

• Tack! (Thank You!)