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  • 1.
    Ahlstrom, Linda
    et al.
    Sahlgrenska akademin, Göteborgs universitet.
    Grimby-Ekman, Anna
    Sahlgrenska akademin, Göteborgs universitet.
    Hagberg, Mats
    Sahlgrenska akademin, Göteborgs universitet.
    Dellve, Lotta
    Sahlgrenska akademin, Göteborgs universitet.
    Measures of work ability and association with sick leave, symptoms and health: A prospective study of female workers on long term sick leave2010In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 36, no 5, p. 404-412Article in journal (Refereed)
  • 2.
    Boström, Maria
    et al.
    Sahlgrenska akademin, Göteborgs universitet.
    Dellve, Lotta
    Sahlgrenska akademin, Göteborgs universitet.
    Thomée, Sara
    Sahlgrenska akademin, Göteborgs universitet.
    Hagberg, Mats
    Sahlgrenska akademin, Göteborgs universitet.
    Risk factor for decreased performance among young adults2008In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 34, no 2, p. 120-132Article in journal (Refereed)
  • 3. Dahlgren, Anna
    et al.
    Kecklund, Göran
    Åkerstedt, Torbjörn
    Different levels of work-related stress and the effects on sleep, fatigue and cortisol2005In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 31, no 4, p. 277-285Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of the study was to relate different levels of work stress to measures of sleep and the diurnal pattern of salivary cortisol and subjective sleepiness.

    Methods Thirty-four white-collar workers participated under two different conditions. One workweek with a relatively high stress level (H) and one with a lower stress level (L) as measured through self-rated stress during workdays. The workers wore activity monitors, filled out a sleep diary, gave saliva samples (for cortisol), and rated their sleepiness and stress during one workday and one free day.

    Results During the week with stress the number of workhours increased and total sleep time decreased. Sleepiness showed a significant interaction between weeks and time of day, with particularly high levels towards the evenings of the stress week. Cortisol also showed a significant interaction, with a more flattened pattern, probably due to increased evening levels during the stress week. Stress (restlessness) at bedtime was significantly increased during the stress week.

    Conclusion The results demonstrate that a workweek with a high workload and much stress increases sleepiness and workhours, impairs sleep, and affects the pattern of diurnal cortisol secretion.

  • 4. Dahlgren, Anna
    et al.
    Kecklund, Göran
    Åkerstedt, Torbjörn
    Overtime work and its effects on sleep, sleepiness, cortisol and blood pressure in an experimental field study2006In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 32, no 4, p. 318-327Article in journal (Refereed)
    Abstract [en]

    Objectives Previous studies of long workhours and their effects on stress, sleep, and health show inconclusive results. This inconclusiveness may be partly due to methodological problems such as the use of between-group designs or comparisons before and after reorganizations. In addition, stress is usually a confounder. A within-person design was used to examine the effects of working 8- or 12-hour shifts in the absence of additional stress.

    Methods In an experimental field study, 16 white-collar workers [9 women, mean age 45.9 (SD 15) years] undertook one workweek with normal workhours (8 hours) and 1 week of overtime with 4 extra hours of regular worktasks (12 hours). The participants wore actigraphs, rated sleepiness (Karolinska Sleepiness Scale) and stress throughout the day, and rated workload and how exhausted they felt. Saliva samples were collected on Mondays and Thursdays for cortisol analysis. On these days, ambulatory heart rate and blood pressure were also measured for 24 hours.

    Results Overtime was associated with higher levels of exhaustion. Sleepiness showed a significant interaction between conditions, with higher levels at the end of the workweek featuring overtime. Total sleep time was shorter in the overtime week. There were no significant differences between ratings of stress and workload. Cortisol showed a circadian variation but no main effect of condition.

    Conclusions One week of overtime work with a moderate workload produced no main effects on physiological stress markers. Nevertheless, sleep was negatively affected, with shorter sleeps during overtime work and greater problems with fatigue and sleepiness.

  • 5.
    Ekstedt, M
    et al.
    Karolinska Institutet.
    Söderström, M
    Karolinska Institutet.
    Åkerstedt, T
    Karolinska Institutet.
    Nilsson, J
    Karolinska Institutet.
    Søndergaard, H-P
    Karolinska Institutet.
    Aleksander, Perski
    Karolinska Institutet.
    Disturbed sleep and fatigue in occupational burnout2006In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 32, no 2, p. 121-31Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this study was to investigate sleep with polysomnography and self-ratings and the diurnal pattern of sleepiness and fatigue in a group suffering from severe occupational burnout.

    METHOD: Twelve white-collar workers on long-term sick leave (>3 months) and 12 healthy controls with high and low scores on the Shirom Melamed Burnout Questionnaire (SMBQ) were included. A 1-night polysomnographic recording (after habituation) was carried out at home, and sleepiness and mental fatigue were rated at different times of the day for weekdays and the weekend. Precipitating factors at the time of the illness at work and real life were considered, and different dimensions of occupational fatigue were described. A repeated-measures analysis of variance using two or three within group factors was used to analyze the data.

    RESULTS: The main polysomnographic findings were more arousals and sleep fragmentation, more wake time and stage-1 sleep, lower sleep efficiency, less slow wave sleep and rapid eye movement sleep, and a lower delta power density in non-rapid eye movement sleep in the burnout group. The burnout patients showed pronounced sleepiness and mental fatigue at most times of the day for weekdays without reduction during weekends. The precipitating factor was occupational stress (psychiatric interview), and work stress indicators were increased.

    CONCLUSIONS: Occupational burnout is characterized by impaired sleep. It is suggested that impaired sleep may play a role in the development of fatigue or exhaustion in burnout.

  • 6.
    Hansson, Sven Ove
    KTH, School of Architecture and the Built Environment (ABE), Philosophy and History of Technology, Philosophy.
    Philosophy of Epidemiology, New Directions in the Philosophy of Science2014In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 40, no 4, p. 435-436Article, book review (Other academic)
  • 7.
    Ingre, M
    et al.
    Stockholm University, Sweden.
    Åkerstedt, Torbjörn
    Stockholm University, Sweden.
    Ekstedt, Mirjam
    KTH, School of Technology and Health (STH). Malardalen University, Sweden.
    Kecklund, G
    Stockholm University, Sweden.
    Periodic self-rostering in shift work: correspondence between objective work hours, work hour preferences (personal fit), and work schedule satisfaction2012In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 38, no 4, p. 327-336Article in journal (Refereed)
    Abstract [en]

    Objectives The main objective of the present study was to investigate relative personal fit as the association between rated needs and preferences for work hours, on the one hand, and actual work hours, on the other hand, in three groups (hospital, call-center, and police) working with periodic self-rostering. We also examined the association between personal fit and satisfaction with the work schedule and preference for a fixed and regular shift schedule, respectively. Methods We collected questionnaire data and objective work hour data over 6-12 months from the computerized self-rostering system. The response rate of the questionnaire was 69% at the hospital and call-center and 98% among the police. In total, 29 433 shifts for 285 shift workers were included in the study. Data was analyzed by means of mixed ANOVA, Kendal tau correlations and ordinal (proportional odds) logistic regression. Results The results show that evening types worked relatively more hours during the evening and night hours compared to morning types as an indication of relative personal fit. Relative personal fit was also found for long shift, short rest, and morning-, evening- and night-shift frequency, but only personal fit related to morning, evening and night-shift was associated with satisfaction with work hours. Reported conflicts at the workplace about work hours and problems with lack of predictability of time for family/leisure activities, was associated with poor satisfaction and a preference for a fixed shift schedule. Conclusions The present study shows that periodic self-rostering is associated with relative personal fit, in particular with respect to night, evening, and morning work. Personal fit seems to be associated with satisfaction with work hours and may be a moderator of tolerance to shift work exposure.

  • 8. Linnersjö, Anette
    et al.
    Brodin, Lars-Åke
    KTH, School of Technology and Health (STH), Medical Engineering.
    Andersson, Carin
    Alfredsson, Lars
    Hammar, Niklas
    Low mortality and myocardial infarction incidence among flying personnel during working career and beyond2011In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 37, no 3, p. 219-226Article in journal (Refereed)
    Abstract [en]

    Objective The aim of this study was to evaluate mortality and acute myocardial infarction (AM!) incidence among commercial and military flying personnel in Sweden. Methods Flying personnel, employed at the Swedish part of Scandinavian Airlines and/or the Swedish Armed Forces at some point between 1957-1994, were included. The cohort was followed regarding mortality and AMI incidence using national registers of hospital discharges and deaths. The observed mortality and AMI incidence was compared with the expected rate in the general Swedish population through standardized mortality ratios (SMR) and standardized incidence ratios (SIR) taking age, gender, and calendar year into account. Results Swedish flying personnel, except male cabin crew, had a lower-than-expected all-cause mortality (SMR ranging from 0.57 among female cabin crew to 0.79 among navigators and mechanics; male cabin crew 0.89) and cardiovascular mortality (SMR from 0.31 among female cabin crew to 0.79 among navigators and mechanics). We observed an elevated mortality in aircraft accidents (SMR ranging from 23.87 among commercial pilots to 165.68 among military pilots). Male cabin attendants had a higher-than-expected mortality for alcohol-related death causes and acquired immunodeficiency syndrome (AIDS). AMI incidence was reduced in all groups and across the lifespan (SIR between 0.13 among female cabin crew and 0.61 among navigators and mechanics). Conclusions Swedish flying personnel have a low all-cause mortality. This is mostly due to a reduced cardiovascular mortality reflecting a low AMI incidence during the working life as well as after retirement.

  • 9. Palm, P.
    et al.
    Risberg, Eva Hansson
    Mortimer, Monica
    Palmerud, Gunnar
    Toomingas, Allan
    Wigaeus Tornqvist, Ewa
    Computer use, neck and upper-extremity symptoms, eyestrain and headache among female and male upper secondary school students2007In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, p. 33-41Article in journal (Refereed)
    Abstract [en]

    Objectives Computer use, neck and upper-extremity symptoms, headache, and eyestrain were studied in upper secondary school students. Methods A questionnaire was completed by 1575 female and 1251 male students. Associations between computer use and health problems were analyzed by calculating the prevalence ratios for the health variables, considering computer use for >14-56 or >56 hours/week as compared with <= 14 hours/week (reference). Health problems were defined as aches or pain or other trouble at least three days in the preceding month. Results Computer use (median) was reported to be 31 hours/week by the male students and 19 hours/week by the females. Most computer use (about 90%) took place outside school (eg, for entertainment). Headache was reported by 51% and 24%, and neck or shoulder symptoms by 31% and 15%, of the females and mates, respectively. More than 50% of the females with health complaints indicated that their problems had disturbed their sleep, and they used painkillers to handle them. Between 10% and 43% experienced their health complaints as being related to computer use. For those using computers >56 hours/week, the prevalence ratios were significantly increased for neck or shoulder symptoms among both the females and the males, and for eyestrain and forearm symptoms among the females. Exposure-response relationships were indicated for the aforementioned associations. Approximately two-thirds of the students reported that they had not received any information in school about appropriate workplace layout and techniques for computer work. Conclusions Despite their young age, the students were not protected from computer-related health complaints. Therefore, providing adolescents with information about proper computer ergonomics may help prevent such health problems.

  • 10.
    Söderström, Marie
    et al.
    Karolinska Institutet.
    Ekstedt, Mirjam
    Karolinska Institutet.
    Akerstedt, Torbjörn
    Karolinska Institutet.
    Weekday and weekend patterns of diurnal cortisol, activation and fatigue among people scoring high for burnout2006In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, ISSN 0355-3140, no 2, p. 35-40Article in journal (Refereed)
    Abstract [en]

    Objectives The present pilot study attempted to investigate the diurnal pattern of cortisol, subjective activation, and mental fatigue among workers scoring high for burnout. The purpose was also to relate the cortisol data to objective sleep data. Methods One group with high (N=9) burnout scores and one with low (N=11) such scores were compared during a workday and a day off. Results The high-burnout group showed higher awakening cortisol during the workday than during the weekend. They also showed higher ratings for activation and mental fatigue during the weekend than the low-burnout group. A higher frequency of arousals during the prior sleep was associated with a higher diurnal amplitude and an earlier diurnal peak of cortisol during the workday. Conclusions The present results, which, due to the small sample size, should be interpreted with caution, may indicate that stress-induced frequency of arousal during sleep could contribute to the diurnal amplitude of cortisol. Furthermore, increased activation and mental fatigue during the weekend may reflect impaired recovery, which is of possible importance in the burnout process.

  • 11. Tucker, Philip
    et al.
    Brown, Menna
    Dahlgren, Anna
    Department of Shipping and Marine Technology, Chalmers University, Gothenburg, Sweden.
    Davies, Gwyneth
    Ebden, Philip
    Folkard, Simon
    Hutchings, Hayley
    Åkerstedt, Torbjörn
    The impact of junior doctors’ worktime arrangements on their fatigue and well-being2010In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 36, no 6, p. 458-465Article in journal (Refereed)
    Abstract [en]

    Objective Many doctors report working excessively demanding schedules that comply with the European Working Time Directive (EWTD). We compared groups of junior doctors working on different schedules in order to identify which features of schedule design most negatively affected their fatigue and well-being in recent weeks. Methods Completed by 336 doctors, the questionnaires focused on the respondents' personal circumstances, work situation, work schedules, sleep, and perceptions of fatigue, work-life balance and psychological strain. Results Working 7 consecutive nights was associated with greater accumulated fatigue and greater work life interference, compared with working just 3 or 4 nights. Having only I rest day after working nights was associated with increased fatigue. Working a weekend on-call between 2 consecutive working weeks was associated with increased work-life interference. Working frequent on-calls (either on weekends or during the week) was associated with increased work-life interference and psychological strain. Inter-shift intervals of <10 hours were associated with shorter periods of sleep and increased fatigue. The number of hours worked per week was positively associated with work-life interference and fatigue on night shifts. Conclusion The current findings identify parameters, in addition to those specified in the EWTD, for designing schedules that limit their impact on doctors' fatigue and well-being.

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