Unit of Occupational Medicine

The aim of our research is to identify and prevent chemical, physical, ergonomical and psychosocial health hazards in the work environment. Our main activities include research, education and dissemination of information. The unit takes part in education of medical students, occupational health nurses and physicians, and specialists in occupational and environmental medicine.

Unit of Occupational Medicine

The unit consists of five research groups – Bodin, Brulin, Falkstedt, Forsman, and Selander. 

The unit consists of approximately 70 employees and affiliates who research and educate in the field of occupational medicine.

Cohorts and epidemiological research

Within the unit, the multidimensional job exposure matrix SWEJEM is also being developed for the classification of exposure to chemicals, particles, noise, vibrations, physical strain, psychosocial factors, and precarious employment conditions. SWEJEM is used in large-scale epidemiological cohort studies and is a national research infrastructure. We also have several extensive datasets where health outcomes among working men and women are studied over time: ATHOS, SNOW, and SWIP, as well as the mother-child cohort FAIR.  Health outcomes studied include cardiovascular disease, cancer, pregnancy complications, mental health issues, and exclusion from the labor market due to health problems.

Measurement projects 

The unit also conducts ongoing measurement projects at workplaces where new measurement methods for ergonomic strain are evaluated with smart textiles alongside more traditional measurements of particles, chemicals, noise, and vibrations in relation to biomarkers. Additionally, the work environment is evaluated using qualitative methods, and new types of workplace interventions are developed and assessed.

Ongoing research projects 

The unit leads parts of the EU projects EPHOR, Equal-Life, and Intercambio, as well as the Nordic projects Nordsound and NOCCA. We also lead several national program grants from FORTE and numerous individual projects.

Research groups

Staff and contact

Head of Unit

All members of the group

SweJEM

The Institute for Environmental Medicine (IMM) has together with the Centre for Occupational and Environmental Medicine (CAMM) developed job-exposure matrices (JEM) for assessment of occupational exposure in large populations. SweJEM contains information on the most common exposures with a suspected association to ill health in the working population. SweJEM has detailed information about physical, chemical, and psychosocial exposure, as well as low employment quality in various occupations.

About SweJEM

The purpose of SweJEM is to have a cohesive tool for exposure classification of the work environment. With this, we can evaluate occurrences and trends of work-related exposures to physical, chemical, psychosocial, and precarious working conditions nationally in Sweden and classify occupational exposure in large scale epidemiological studies. The basis for SweJEM varies depending on the exposure classified. The exposure assessment for noise, vibration, air pollutants and chemicals are based on measurement reports from Swedish and Finnish workplaces. These have been processed to reflect Swedish working conditions. Data from Statistics Sweden's Labour Force Surveys regarding the reported level of physical workload  and psychosocial stress have also been used. Low quality employment has been assessed by register data from the longitudinal integrated database for health insurance and labour market studies at Statistics Sweden, the LISA register, that has been merged with matrices over precarious dimensions.  

All these occupational exposures are built together into a multifactorial job-exposure matrix.  A level of exposure is defined for each occupational group according to different occupational coding systems so it can be used to classify exposure in both new and old epidemiological data. These occupational codes can be merged into different working populations if occupational codes are available in population data. 

The matrix has also been applied to a national register to observe exposure patterns in the entire working population in Sweden. Occurrence and time trends have been evaluated in relation to individual factors such as age, gender, level of education and information concerning companies and industry, such as number of employees or form of ownership. 

SweJEM has been developed through a collaboration between the Institute for Environmental Medicine (IMM) at Karolinska Institutet and the Centre for Occupational and Environmental Medicine (CAMM) at Region Stockholm. In the development work, experts at other universities, such as Gothenburg University and Umeå University, have also contributed. Decisions regarding the development and use of SWEJEM are made by a joint steering committee. SweJEM is maintained and hosted by Karolinska Institutet (SweJEM@ki.se). 

Steering Committee

Jenny Selander (Chair), Associate Professor, Research Group Leader and Head of Unit of Occupational Medicine, IMM, KI

Anette Linnersjö (Coordinator), Lic.Med., KI and Statistician, CAMM

Theo Bodin, Associate Professor, Research Group Leader, IMM, KI and Director, CAMM

Daniel Falkstedt, Associate Professor, Research Group Leader, IMM, KI

Katarina Kjellberg, Associate Professor, KI and Ergonomist, CAMM

Mattias Sjöström, PhD, KI and Occupational hygienist, CAMM

Pernilla Wiebert, PhD, KI and Occupational hygienist, CAMM

Education

three people, two guys and girl at a small table filled with papers and a computer
Photo: Pexels-William Fortunato

Master's programme in Work and Health

Our unit is responsible for the Master's Program in Work and Health, where our staff from the unit, IMM, and the Center for Occupational and Environmental Medicine, Region Stockholm, teach. The program is part-time (50%) and starts every autumn semester.

The program aims to equip students with scientifically grounded knowledge and skills in occupational health and work-related well-being. This prepares them to work in occupational health services or other organizations and authorities focused on promoting health and improving working conditions. It also provides the expertise needed to prevent ill health and exclusion from the workforce. The program offers three specializations:

Occupational Safety and Health Management: 

This specialization trains a broad group for strategic work environment roles within companies, authorities, or occupational health services. It includes an in-depth focus on systematic work environment management.

Ergonomics: 

This specialization further educates occupational therapists and physiotherapists to work strategically and comprehensively in both preventive and rehabilitative roles related to work and health. It includes a special focus on ergonomic measurement techniques and the relationship between occupational exposure and musculoskeletal disorders.

Occupational Health Nurse: 

This specialization further educates nurses to work strategically and comprehensively in both preventive and rehabilitative roles related to work and health. It includes a special focus on occupational medicine, medical examinations, health promotion, and more.

After Graduation: 

Graduates can work in occupational health services, in both private and public sectors, at authorities, and within companies and organizations responsible for work environment and health issues. They can also pursue careers in research (PhD) and teaching.

Photo: Erik Cronberg

Health in Society and Environment

Medical Programme (Year 6)

Our unit is involved in teaching at the Karolinska Institutet's medical program, focusing on occupational and environmental medicine. The teaching takes place both during the program's first semester and in the 11th semester, where the course "Health in Society and Environment" is managed by IMM. In the new medical program, the teaching of occupational and environmental medicine has become even more integrated into several courses, resulting in a continued high demand for teaching efforts. The education involves several employees from the unit in collaboration with IMM and the Center for Occupational and Environmental Medicine, Region Stockholm. Physicians undergoing specialist training in occupational and environmental medicine or occupational health also participate in parts of their specialist training under the direction of CAMM, in collaboration with staff from the Occupational Medicine unit.

Programme director - Master's programme in Work and Health

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Jenny Selander

Programme director, Associate Professor, Head of Unit

Course leader - Health in Society and Environment

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Karin Leander

Head of course, Associate Professor

Centre for Occupational and Environmental Medicine

The unit is closely associated with the Centre for Occupational and Environmental Medicine (CAMM) at Region Stockholm. 

Centre for Occupational and Environmental Medicine (CAMM) aims to promote equal and improved public health by identifying, assessing, and preventing health risks in both the workplace and the surrounding environment. Their work includes patient investigations, risk mapping, knowledge dissemination, teaching, and research.

CAMM is a knowledge centre within Region Stockholm. They address health risks in occupational and environmental settings caused by:

  • Chemical and biological factors, such as air pollution, chemicals, and allergens.
  • Physical factors, such as noise, vibrations, electromagnetic fields, and other radiation, as well as the direct and indirect effects of climate change.
  • Social and organisational factors, such as work organisation, working conditions, and stress.
  • Ergonomic factors, such as heavy manual handling, uncomfortable working positions, and sedentary work.

Patient Clinics 

CAMM has three patient clinics: the Occupational and Environmental Medicine Clinic, the Skin Allergy Clinic, and the Allergy Consultant Clinic, which accept patients by referral. 

University Healthcare Unit 

CAMM is a university healthcare unit and meets the requirements for academic infrastructure, competence, and quality as stipulated in the national ALF agreement.

Knowledge Dissemination and Expert Support 

A significant part of CAMM's work involves providing knowledge support and dissemination. They produce reports, hold seminars and training sessions, send out newsletters, and teach, primarily at Karolinska Institutet. They also provide expert support to the Health and Medical Care Administration (HSF) and other parts of Region Stockholm when developing policies and action plans.

Research 

CAMM collaborates with Karolinska Institutet in research and teaching. They are mainly affiliated with the Institute of Environmental Medicine. 

Director - CAMM

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Theo Bodin

MD, Director (CAMM), Associate professor (KI)
Institute of Environmental Medicine

ErgoArmMeter

ErgoArmMeter is a professional inclinometer application for measuring arm elevation during work. It is developed by Liyun Yang (KTH Royal Institute of Technology) under the supervision of Mikael Forsman (Karolinska Institutet). This project is a collaboration between Institute of Environmental Medicine at Karolinska Institutet (KI) and School of Technology and Health at KTH Royal Institute of Technology (KTH).

ErgoArmMeter – A novel iOS application for measuring arm inclination

It is shown by research that work with elevated arm may lead to shoulder/neck disorders. Ergonomists have been using inclinometers to measure arm elevation, which have a better precision than self-reports and observational methods. ErgoArmMeter is validated in an optical motion lab at KI and it has shown similar accuracy compared to other former validated inclinometers.

The validation experiment in the optical motion lab. A: Placement of two reflective markers and the iPhone with armband on right arm. B: Arm flexion posture. C: Sorting envelopes.
Upper arm inclination measurement during arm flexion. From the static experiment (B in the previous figure).

The validation experiments showed a high level of agreement between the two systems. In the static experiment (B, in the experiment-figure), the mean absolute difference between the optical system’s angles and those of the app was 1.5°.

In ergonomics practice, ErgoArmMeter would serve as a good alternative to other validated accelerometers. It has the advantage of low cost, easiness for use and directly obtained results. Also, due to the signal combination of the embedded gyroscope with accelerometer in the iPhone, it largely reduces the errors from the acceleration during fast movements. It can be used for evaluating the differences in arm inclinations between, e.g. two workstations, or before and after interventions. It can also be used for educational purpose. Together with other information about certain work task, it can add valuable information for risk assessments of the work task.

ErgoArmMeter has now been updated to version 2.0 and is free to download from the App Store. Generalized angular velocity is calculated and presented instead of inclination velocity. The generalized angular velocity is the time derivative of the distance traveled on the unit sphere, which can show the movements even on horizontal direction where inclination does not change. Recommended limits for safe work have been added to the result screen based on a report from the Center of Occupational and Environmental Medicine in Lund (Hansson et al., 2016).

Updates

ErgoArmMeter has now been updated to version 2.0 and is free to download from the App Store and Google Play Elisa Perini and Jitse Jan van Esch (master students from Sport Technology, KTH) have developed the updated Android version of ErgoArmMeter.

Related articles & reports

Yang, L., Grooten, W. J. A., & Forsman, M. (2017). An iPhone application for upper arm posture and movement measurements. Applied Ergonomics, 65, 492–500.

Yang, L. and Forsman, M., 2015. Development and validation of a novel iOS application for measuring arm inclination. Abstracts NES 2015. Lillehammer, Norway: Nordic Ergonomics Society.

Yang, L., 2015. Development and validation of a novel iOS application for measuring arm inclination. Master thesis, KTH Royal Institute of Technology. Available at: http://kth.diva-portal.org/smash/record.jsf?pid=diva2%3A852824&dswid=5654

Forsman, M., Dahlqvist, C., Yang, L., Wahlström, J., Hansson, G.-Å., 2015. Ny förenklad metod för heldagsmätningar av arbetsställningar och rörelser för huvud, nacke, rygg och överarmar - validitet och användbarhet [A new simplified method for whole-day measurements of postures and movements of head, neck, back and both upper arms - validity and usability]. Final project report to AFA Insurance. In Swedish with an English Abstract. Karolinska Institutet, Stockholm, Sverige.