Sustainable work & occupational safety and health – Emma Brulin's research group

The research group investigates 1) organizational and individual risk and protective factors in the psychosocial work environment, 2) effects of shift and night work, and 3) symptom development and rehabilitation in stress-related ill health. We have a particular focus on employees within healthcare and how the work environment and health of the personnel affect the quality and safety of healthcare.

The healthcare system faces significant challenges as the population increases and ages, while healthcare resources gradually decrease. To cope with these challenges, healthcare services must establish a sustainable work environment where employees maintain good health, remain in their profession, and provide quality-assured care. To create a sustainable and healthy healthcare system, factors causing and perpetuating ill health among different occupational groups within healthcare need to be identified and addressed.


Organizational and Individual Risk and Protective Factors in the Psychosocial Work Environment

Healthcare employees work within a complex organization where individual, interpersonal, organizational, political, and societal factors directly or indirectly affect employees. Much of the research conducted so far has almost exclusively focused on the relationship at the individual level, i.e., between psychosocial working conditions and work-related well-being. Organizational-level demands have been systematically excluded despite studies indicating that organizational factors affect the relationships between demands/resources and health at the individual level. In this project, we research the links between organizational factors and employee health and working conditions.


Effects of Shift and Night Work

Shift and night work are prerequisites for providing 24/7 care. They pose challenges for workers and entail risks of accidents, ill health, and sick leave. In this area, we deepen our understanding of how shift and night work lead to ill health and how schedules should be designed to reduce the risk of ill health.


Symptom Development and Rehabilitation in Stress-Related Ill Health

The prevalence of sick leave due to stress-related ill health is high among healthcare employees. To develop effective preventive measures, we are building better knowledge of symptom development in stress-related ill health and develop methods for early detection. We have also developed and are clinically testing a treatment method for returning to work after sick leave due to stress-related ill health.


Relationship between Staff Work Environment and Health and Quality and Safety in Healthcare

Poor working conditions, mental ill health, sick leave, and high turnover have many consequences, including loss of production and increased societal costs. These problems also lead to significant personal suffering for those affected and can directly impact patient care and healthcare provision. Therefore, in this project, we research the link between workplace issues, employee health, and Quality and Safety in Healthcare.


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The group is responsible for and manages two databases:

Swedish Longitudinal Study of Work Environment and Health in Healthcare (LOHHCS)

The LOHHCS cohort consists of a representative sample of physicians, nurses (including midwives and radiology nurses), and assistant nurses working in healthcare in Sweden. It is an open cohort replenished with newly graduated physicians, nurses, and assistant nurses before each data collection. The study is conducted annually starting in 2022 (for physicians, the study began in 2021). Register data from various registers, including sick leave registers, are linked to the survey responses.

The questionnaire contains four parts:

  1. Occupational Background: education and occupational background, working hours, and schedule.
  2. Work Environment: validated questions about psychosocial and physical work environment and working hours.
  3. Health: health and healthy habits.
  4. Demographics: marital status and family situation.


Working Hours and Health in Healthcare in Sweden (ATOHS)

ATHOS is a cohort of 60,000 healthcare employees in the Stockholm region between 2008 and 2022. An update is planned to include other regions in Sweden.

ATHOS contains detailed information on working hours obtained from register-based wage data for each workday during the study period. Health outcome variables, including cancer, cardiovascular diseases, childbirth outcomes, mental disorders, and sick leave, are obtained from regional and national registers.

We use longitudinal multivariate analysis to examine working hours and shift types in relation to health outcomes and sick leave.

The Network for Sustainable Healthcare

The research group leads this network of approximately 20 multidisciplinary national and international researchers. The network regularly convenes to discuss research aimed at creating a healthier and more sustainable healthcare system. We conduct environmental scans and provide knowledge support to authorities and employers.

Data Mining Health Care Service and Management, Health Policy and Services and Health Economy Health Services Occupational Exposure Occupational Health Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology Shift Work Schedule Show all
Anna Persson