Maria Albin

Research problem and specific questionsDespite the overall decrease in cardiovascular (CV) mortality there is, especially among women, an increasing social gradient in Sweden. The explanation is not known. Our aim is to analyse to what extent this gradient can be explained by the increasingly unsecure labour market. The research questions are: How large a proportion of the effect of education on CV health is mediated through weak labour market attachment (LMA, unemployment and precarious employment)? What are the other possible work-related mechanisms?Data and methodFour life-course cohorts, born 1965 and 1973, will be used. Two of them are based on extensive register data about all Swedish inhabitants. Two are based on repeated questionnaires and extensive register data on all school-leavers from grade 9, in a middle-sized town. One contains repeated clinical data for 40 years. Data on exposure to LMA are available from school to midlife. Incident CV diagnoses and metabolic risks will be measured around age 56 and 51. All cohorts will be controlled for reverse causation and other confounders.While the register cohorts are complete and provide power and national representativity, the school cohorts provide rich data of high validity for analysing mechanisms and clinical outcomes. A qualitative study about possible mechanisms will be performed among those with highest risk of weak LMA who have been followed during 40 years with interviews.Sociatal relevance and utilisationElimination of avoidable health inequalities is a major goal in the Swedish public health policy. To reach the goal, knowledge is needed about the mechanisms behind. The increasingly insecure labour market is our focus, a priority also in policies around EU. Our results can be used in health promotion and by work environmental actors to support targeted interventions aiming at improved equality in health and sustainable work conditions during life.Plan for project realisationRegister update will be made of one school cohort. Advanced mediation analyses of work conditions will be made for the educational gradient in CV health, using latest methods for selecting confounders.  Several mediators can be included at the same time, so the effect of structural factors on health behaviour can be analysed. Follow-up interviews will be performed with the early unemployed group. The theoretical development aim at developing a working life-course theory. The budget cover salaries and register updates.

Research problem and specific questionsUrban living environments challenge the individual’s capacity to maintain a good health throughout the course of life. In Sweden, current trends in housing and neighborhood conditions tend to further increase disparities in health. The rapid urbanization and densification of Stockholm County makes it an optimal setting for studying health effects of urban living, for example in relation to air quality, transportation noise, urban greenness, climate change and overcrowded housing. In this program, we aim to assess and develop strategies for building a sustainable city promoting equitable public health among inhabitants of urbanized areas.Data and methodsThe program will use a variety of different data materials and methods. To map environmental hazards in Stockholm County, a new GIS-based tool aimed at regional stakeholders will be developed. A new cohort, based on the National Environmental Health Survey 2023, will form the basis for analyses of environmental health associations and estimates of disease burden. Furthermore, the effects on children’s development, education and health from overcrowded housing will be investigated in a nation-wide cohort study and in an intervention setting. In a literature review, we will summarize evidence on environmental interventions which can guide stakeholders in implementing planning and mitigation measures.Relevance and utilizationThe national Commission for Equity in Health listed 7 key areas of life which determine health inequalities. Among these, the intended program has a focus on Housing and neighborhood conditions but is also of relevance for aspects of Early life development, Health behavior, and Control, influence and participation. By this program, we aim to establish a strong research infrastructure for monitoring and assessing the impact of the built environment on public health and for the promotion of environmental health equity. This is in line with several other initiatives and governing documents within Sweden, e.g. “Health as a driving force for the environmental goals and sustainable development”, initiated by Miljömålsrådet.Plan for program realizationThe program will be carried out at the Institute of Environmental Medicine, Karolinska Institutet, in collaboration with the Center for Occupational and Environmental medicine, Region Stockholm, and builds on six different work packages, each with its specific aims, activities, and deliverables. The researchers of the program represent many different disciplines, spanning from environmental medicine, public health and epidemiology to GIS, nursing and multicultural psychiatry, and will work closely together in the different work-packages. To ensure a good dialogue with end-users of our research, we will host, and take part in, an array of activities throughout the program progression, e.g. via reference groups, seminars, workshops, regional networks and other applied activities.

Algorithms are changing the World of Work: from the tasks that consitute work to how it is organised and governed. Lack of data and knowledge about the impacts of algorithmic management (AM) on work and workers pose a societal challenge today. This deficit is particularly pronounced outside of platform work - in economic sectors where the use of AM is growing, such as logistics, including transport, storage and delivery services and the retail and hospitality industry. In both platform and non-platform work there is a lack of research about the effects of AM on the work environment and workers’ health and well-being. Therefore, the overall aim of this multi-disciplinary research program is to improve data and knowledge about algorithmic management in non-platform sectors and its effects on health, safety, and well-being, as well as develop risk-reducing tools and strategies by:Facilitating the development of a standard for measurement of algorithmic management at work and related risks for health, safety and well-being.Increasing knowledge about the effects of algorithmic management on workers’ health, safety, and well-being.Investigating the balance of interests related to the control of algorithms in different legal contexts regarding occupational health and safety (OSH).The proposed program will contribute with enhanced data and knowledge about challenges and opportunities of AM to safety, health and well-being as well as evidence-based tools and strategies to be used by stakeholders in discussions and action related to AM. The program applies multiple methods including quantitative, qualitative, literature reviews and participatory research.The program will be performed by an international and multidisciplinary team of researchers, involving experts in human-computer-interaction, cognitive ergonomics, labour economics, political science, occupational epidemiology, comparative labour law, industrial relations, work organization and psychology.

Research problem and specific questions: The number of children with neurodevelopmental disorders have increased during the last coupleof years. Physical, psychosocial, and chemical exposures in residential settings during pregnancy have been indicated as possible risk factors in relation to neurodevelopmental disorders in children. However, few studies have assessed these associations in occupational settings even though the exposure levels usually are much higher.Specific questions: Does occupational exposure to chemicals, particles, noise, whole body vibration, or psychosocial work during pregnancy increase the risk of neurodevelopmental disorders in children? Do residential exposures and socioeconomic factors modify that association?Data and method: A national cohort of 1,5 million births in Sweden between 1994 and 2014, with data on occupational title, full-time/part-time work and leave of absence during pregnancy will be used. Individual information on the mother’s lifestyle (smoking, BMI etc.), heredity of neurodevelopmental disorders, socioeconomic factors (education, income etc.) and residential exposure (noise, air pollution, green/blue space etc.) during pregnancy is also attached. Occupational exposure to stone/concreate, silica, organic particles, combustion particles, welding fumes, oil mist, noise, solvents, whole body vibration, physically strenuous work, psychosocial work will be classified through job-exposure matricesbased on measurements and questionnaire data. Diagnosis of neurological disorders are gathered through the national Swedish inpatient registry.Plan for project realisation: The project build on existing data that will be linked to new exposure assessments and registry data. The research group has vast experience preforming these kind of studies.Relevance: More and more women start working in exposed occupations previously only held by men. Risk assessments are lacking, especially regarding occupational exposures during pregancy. Better assessments of which occupational exposures during pregnancy that might increasethe risk of neurological disorders will give better guidance for preventive work in these exposed occupations.

Research problem and specific questions: Long-term disruption of circadian rhythms, particularly due to light exposure during the biological night, is associated with a wide range of common non-communicable diseases (NCDs). Approximately 12% of the European working population engages in night-shift work

therefore, studying the impact of night-shift work has important implications for public health. The proposed study aims to a) collect individual-level data on multiple exposures among night-shift workers, using new sensors, information technology, and advanced biomonitoring

b) examine how short-term night-shift work affects bodily functions related to the development of NCDs and ageing

c) identify key biological pathways for health effects associated with night-shift work

d) evaluate longitudinal changes in biomarkers among night- and day-shift workers from baseline to a two-year follow-up

and e) develop a screening battery relevant to night-shift work and development of NCDs to be implemented in the pre-assignment and periodical medical examination conducted by the occupational health services.Data and method: We will address these aims by collecting comprehensive information about occupational and environmental exposures, lifestyle factors, and dietary patterns. We will measure cognitive function, established biomarkers of cardiovascular and metabolic health, hormones, stress, immune function, ageing and epigenetic programming in blood, saliva, and adipose tissue of night- and day-shift workers.Plan for project realization: At baseline, we will compare night- with day-shift workers among Swedish workers (county council health workers n=400) and European workers (n=800) examined with the same protocol during a work week, and we will follow up the Swedish workers (n=400) two years later applying the same protocol.Relevance: This study will generate new knowledge of the long-term impact of circadian disruption on determinants of NCDs and identify the important biological pathways underlying health outcomes among night-shift workers. This will inform preventive actions such as improved work schedules, medical surveillance via the occupational health service of exposed populations, and advising exposed workers.

The retirement age is being raised gradually to counteract the financial consequences of an increasingly older population. However, with increasing age, and in particular after 50 years of age, an increasing number of persons are excluded from the labour market due to health problems. There are also increasing difficulties for young people and people in marginalized labor market positions to establish in the labor market. The research program addresses major challenges to create opportunities for a sustainable working life for all groups on the labor market by strengthening and updating the research on risk factors for poor health, and labor market marginalization and exclusion over the life-span among young, middle aged, and older male and female workers.The aims of the program are to extend knowledge on risk factors for labor market marginalisation and exclusion over the life course (WP1-3), and to identify policies and measures at workplaces that support a long working life (WP4). In four work packages we will study:WP1. Effects of long-term and accumulated poor working conditions on preterm labor-market exit, and potentially risk-reducing effects of occupational change and reduced occupational exposure WP2 Working-life expectancy among different occupational and socioeconomic groups WP3. Determinants and consequences of labor market marginalization over the life courseWP4. Work organizational structures promoting a sustainable working life for all The program is based on research and research collaborations that we have been involved in for many years, in an established environment now under expansion and development. The research team consists of both established and junior researchers from Sweden, the Netherlands, Norway, and the USA. A large, compiled register-based cohort (SWIP) that includes the entire Swedish population, born around 1990 or earlier, will be used in WP1-3. Data from surveys and qualitative interviews will also be collected (WP4).