1. Trends in Work Place Injury and Consequent Absence from Work in the County of Gävleborg, Sweden Leah Okenwa Emegwa O.D, MPH, PhD 2014-06-24

2. The University of Gävle

3. 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

4. Causes of work related injury include  Falls, Loss of control  Movement with or without load  Violence, Electricity/fire/explosion  Leakage/overflow  Slip/snapping/splitting/breaking of an object

5.  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)

6. 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

7. Work related injury and illness pattern, Sweden Work related injury women Work related illnesses women men Work related injury men Work related illnesses men Source: Statistics Sweden

8. Rationale for study  Most 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

9. 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

10. Gävleborg, Sweden  Centrally located by the east coast  280 000 inhabitants living on almost 20 000 km2  Three-quarter woodlands  Lakes, hills and mountains Gävleborg, Sweden.

11. Method Design  Based 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

12. For the present study  All cases of non fatal occupational accident between 2007-2012  Total 5291cases

13. Measures Dependent Variables  Injury Cause  Sick leave <2weeks >2weeks

14.  Independent Variables -age -gender -occupational sector -Employment status

15. Data analysis  SPSS  Descriptive analysis  Logistics regressions  Significance level p<0.05  95% confidence interval.

16. Ethical consideration  Ethical approval granted by institutional review board for the region.

17. Results Loss of controll  Proportion decreases with age (49% vs. 23%)  More men  Agriculture (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 20-29yrs  2.5 odds for students/trainees

18. Fall  Increases 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 Ratio  Increasing OR with age  Sex remained a predictor (more women)  2times risk in real estate sector  1.4 times risk for permanent workers

19. Movement involving load Significantly more among  Age 40-49yrs (10.3%)  Women (13.5%)  Healthcare sector (23.3%) Adjusted odds  Risk increases with age up to 40-49 yrs (1.6times)  Higher risk remained for women  4.6 times risk for workers in health care

20. 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

21. 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

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

23. Electricity/fire/explosion  Increasing proportions among younger workers  More men  Construction sector (3.1%) Adjusted odds  10.8 times risk for men

24. Leakage/Overflow  Higher among men (2%)  More in mining sector (11.1%) Adjusted OR  Significance disappears

25. 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

26. 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)

27. ’Iceberg’ of Presenteeism

28. 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

29.  Strengths and Weaknesses Strengths  Reliable database shown by level of precision  Weaknesses  Few variables  Not able to compare non injured workers vs. Injured

30. 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

31. Tack! (Thank You!)