Søren Spangenberg

Factors contributing to the differences in work related injury rates between Danish and Swedish construction workers

Comparison of Danish and Swedish national occupational injury statistics shows that the reported LTI-rate, or number of reported lost-time injuries per million working hours, for Danish construction workers is significantly higher than the reported LTI-rate for Swedish construction workers. In terms of injury prevention it is important to identify injury risk factors that contribute to the observed differences in LTI-rates. In the present Oresund Link case study Danish and Swedish workers worked in cross-national work gangs, carried out the same types of tasks and utilized the same reporting procedures for occupational injuries. Thus, factors that usually confound comparisons between countries were eliminated in this study. Furthermore, factors at company level were to a great extent excluded in the study design, which therefore provided a unique opportunity to investigate the importance of injury risk factors at group and individual level for Danish and Swedish workers. LTI-rates and injury risk factors were compared for Danish and Swedish workers during the construction of the combined rail and road link across the 16-km wide sound, Oresund, between Denmark and Sweden. The comparison showed that the LTI-rate of the Danish construction workers was approximately fourfold the LTI-rate of the Swedish construction workers. Factors at the micro-level (group and individual level) e.g. differences in education and experience, training and learning, and attitude were important for the explanation of the significant difference in LTI-rates between Danish and Swedish construction workers. The study also indicated that comparison of national data on LTI-rates should be carried out with great caution.

Social inequalities in injury occurrence and in disability retirement attributable to injuries: a 5 year follow-up study of a 2.1 million gainfully employed people

BackgroundInequalities in injury related disability retirement may be due to differences in injury risk and or differences in retirement given injury. The aim of the present study was to measure social inequalities in injury occurrence and injury related disability retirement.MethodsAll people in the Danish labour force aged 20–59 years 1 January 1997 were followed for injury related hospital contacts during 1997 and all people in the Danish labour force aged 21–54 years 1 January 1998 were followed for injury related hospital contacts during 1997 and for disability retirements during 1998–2002. As inequality indices we used excess fractions (EF) i.e. the proportions of the cases that would not have occurred if the risks in each social group had been as low as they were in the occupational group with the highest skill requirements.ResultsWith regard to the risk that an injury will occur, the EF was 36% among men and 10% among women. With regard to the risk that an injury will lead to disability retirement, the EF was 43% among men and 47% among women. The combined effect of the two types of inequalities rendered an EF for injury related disability retirement of 64% among men and 53% among women. The correlation between the case disability rate ratios among men and those among women was low (r = -0.110, P = 0.795).ConclusionThe social inequality in injury related disability retirement lies only to some degree in the differences in the injury risk. More important are differences in the consequences of an injury. This was especially pronounced among the women.

A nationwide population study of severe head injury and Parkinson's disease

The aim was to analyze prospectively the association between severe head injury and Parkinsons disease. All people in Denmark who were at least 20 years old as on 1 January 1981 were followed for hospitalisation due to previous head trauma during 1981-1993 and for hospital contacts due to PD during 1995-2004. We observed 107 cases of PD among people at hypothetical risk due to previous head injury. The expected number was 112.1, which yielded a standardised morbidity ratio of 0.954 (95% CI: 0.782-1.15). The study provides no support for severe head injury among adults being a risk factor for Parkinsons disease.

Disability retirement among workers involved in large construction projects

BACKGROUND The aim of this study was to evaluate the incidence of disability pension among workers engaged in the construction of the Øresund Link or the Copenhagen Metro, representing high levels of safety management. METHODS The study subjects (n = 1,808) were followed for disability retirement. Age standardized incidence ratios (SIRs) were calculated and compared with SIRs of disability pension established in a previous study of workers engaged in the construction of the Great Belt Link (N = 5,882), representing a low level of safety management. RESULTS Compared with all economically active men, the age SIR of disability retirement was 2.22 (95% CI = 1.61, 2.98) among the study subjects and 2.29 (95% CI = 1.9, 2.67) among workers at the Great Belt Link. CONCLUSION No significant progress was found in the incidence of disability pension among the study subjects despite substantial improvements in safety management compared with the Great Belt Link.

Hospitalized injuries among bridge and tunnel construction workers

The aim of the present study was to compare relative risks for hospitalizing injuries among 7761 Danish workers engaged in the construction of different types of major tunnel and bridge traffic links during 1991–2000 in order to determine construction types with high injury risk. Standardized hospitalization ratios (SHR) for injuries were calculated by type of construction (low‐level bridge, high‐level bridge, bored tunnel and submerged tunnel). All employed males in the total population of Denmark were used as the standard population. Neither the SHR nor the distribution of injury types were independent of the construction type (p<0.05). The hospitalization ratio was highest for bored tunnel workers (SHR = 1.91; 95% CI: 1.65–2.21) and here toxic gases and smoke were a major problem, whereas head injuries were more frequent among workers engaged in other types of construction. The substantial variation in SHR values with construction type might be an argument for inclusion of workers safety in pre‐project decision making.

Protocol for a mixed-methods study on leader-based interventions in construction contractors' safety commitments

Background Owing to high injury rates, safety interventions are needed in the construction industry. Evidence-based interventions tailored to this industry are, however, scarce. Leader-based safety interventions have proven more effective than worker-based interventions in other industries. Objective To test a leader-based safety intervention for construction sites. The intervention consists of encouraging safety coordinators to provide feedback on work safety to the client and line management. The intention is to increase communication and interactions regarding safety within the line management and between the client and the senior management. It is hypothesised that this, in turn, will lead to increased communication and interaction about safety between management and coworkers as well as an increased on-site safety level. Setting A group-randomised double-blinded case study of six Danish construction sites (three intervention sites and three control sites). The recruitment of the construction sites is performed continuously from January 2010 to June 2010. The investigation of each site lasts 20 continuous weeks. Methods Confirmatory statistical analysis is used to test if the safety level increased, and if the probability of safety communications between management and coworkers increases as a consequence of the intervention. The data collection will be blinded. Qualitative methods are used to evaluate if communication and interactions about safety at all managerial levels, including the client, increase. Outcome measures (1) The proportion of safety-related communications out of all studied communications between management and coworkers. (2) The safety level index of the construction sites.