The purpose of the study was to find out how Swedbank Insurance view of health characterizes wellness work at the company. It was a qualitative study in which five persons involved in their health and wellness work were interviewed. Their business plan was based generally on the basis of the biomedical approach, but the results proved otherwise. The four categories that were set up after the results were; Health is to feel good physically as well as psychologically, health is the absence of illness, wellness is to do things together in a healthy environment and wellness is to challenge their co-workers with different kinds of challenges.

Arbetsplatsen är en arena där det finns goda möjligheter att arbeta hälsofrämjande. Inom äldreomsorgen finns det både utmaningar och möjligheter när det gäller att förändra arbetssituationen och på så vis förbättra de anställdas hälsa. För att underlätta detta arbete kan arbetsplatsen ta hjälp av externa samarbetspartners, till exempel företagshälsovården. Syftet med studien var att ta reda på hur de anställda inom äldreomsorgen i en kommun i södra Sverige uppfattar att samarbetet kring hälsofrämjande insatser mellan deras arbetsplats och företagshälsovården fungerar. Datainsamlingsmetoden som användes i denna studie var enkäter utdelade till alla 345 fast anställda. Svarsfrekvensen blev 49 procent. Resultatet visade att personalen uppfattade samarbete mellan chefen och företagshälsovården som bra men att det var obefintligt mellan dem själva och företagshälsovården. De anställda anser att samarbetet kan utvecklas genom bättre kommunikation och information. Slutsatsen som dras i denna studie är att cheferna bör tydligöra företagshälsovårdens roll i det hälsofrämjande arbetet. Genom välfungerande kommunikation och bra informationsspridning kan samarbetet mellan cheferna, de anställda och företagshälsovården förbättras. / The workplace is an arena where there are good opportunities to work health promotive. In the elderly care, there are both challenges and opportunities when it comes to changing the work situation and thereby improve the employees’ health. To facilitate this work, the workplace can take the help of external partners, such as the occupational health service. The purpose of this study was to find out how the employees of the elderly care in a municipality in southern Sweden perceive the cooperation between their workplace and the occupational health service when it comes to working health promotive. The data collection method used in this study was questionnaires distributed to all 345 of the permanently employed. The response rate was 49 percent. The results showed that the employees perceived that the cooperation between managers and the occupational health service was good, but that it was non-existent between themselves and the occupational health service. The staff has the opinion that the cooperation can be developed through better communication and information. The conclusion of this study is that managers should clarify the occupational health service´s role in the health promotive work. Through effective communication and good methods of spreading information, the cooperation between managers, employees and the occupational health service can be improved.

Till största delen anlitas företagshälsan för efterhjälpande insatser på individnivå. Alla arbetsgivare ska enligt arbetsmiljölagen bedriva ett förebyggande systematiskt arbetsmiljöarbete (SAM). Företagshälsans kompetens utnyttjas sällan i SAM, även om arbetsmiljölagen föreskriver att det ska göras om kompetensen saknas i den egna organisationen. Vid Arbetsmiljöenheten, som är Region Jönköpings läns inbyggda företagshälsa, har en metod arbetats fram för att användas i företagshälsans förebyggande arbetsmiljöarbete. Den kallas SMAK (Strukturerad Multidisciplinär Arbetsmiljökartläggning). Den bygger på nära samarbete med arbetsgivarorganisationen och dess anställda och den ligger till grund för arbetsmiljöarbete och utvärdering av effekten av olika interventioner insatta i syfte att förbättra arbetsmiljön. Arbetssättet har testats i liten skala med goda erfarenheter och syftet med förbättringsarbetet var att skala upp användningen och att fler av medarbetarna på Arbetsmiljöenheten skulle vara involverade. Förbättringsidén var att ett utbildningskoncept utformades och genomfördes för medarbetarna vid Arbetsmiljöenheten och som avslutades med att möjligheter och hinder identifierades tillsammans för den fortsatta utvecklingen av arbetssättet. För att studera vilken påverkan utbildningskonceptet haft för de anställda på Arbetsmiljöenheten användes flermetodsperspektiv. Förbättringsarbetet ledde inte till att SMAK användningen skalades upp eller att fler involverades i det under projekttiden. Däremot ökade uppfattningen om användbarheten för SMAK i företagshälsans arbete och för egen del. De möjligheter och hinder som identifierades ligger till grund för fortsatt arbete. Studien visade att förbättringsarbetet har stärkt det interna samarbetet och bidragit med entusiasm inför en fortsatt gemensam utveckling av användningen av SMAK i förebyggande arbetsmiljöarbete. Studien visade också att även om initiativet till det utvidgade arbetssättet kom från företagshälsans ledning så har förbättringsarbetet lett till en grund för fortsatt utveckling som utgår från medarbetarna på företagshälsan, vilket är en viktig faktor för att lyckas med förbättringsarbete. / The Occupational Health Service (OHS) mostly work with aftercare for the individual. There are general demands for every employer to work with the occupational environment in a planned and systematic way. The competence in OHS is rarely used in the proactive work environment management. The Swedish Work Environment Act tells us to involve the OHS if knowledge and capabilities in your organization is not sufficient. At Arbetsmiljöenheten, which is Region Jönköping County built in OHS, has a tool developed to be used in the OHS involvement in proactive work environment management. It is called SMET (Structured Multidisciplinary Work Evaluation Tool). It depends on close cooperation with the employer and the employees and is the basis for work environment management and evaluation of interventions done to improve the work environment. SMET has been tested with good experiences in a small scale and the aim of the improvement work was to scale up the use and let it be possible for more of the coworkers at Arbetsmiljöenheten to use the tool. The idea to test in the improvement work was to construct an educational program for the coworker at the OHS and then together identify possibilities and obstacles for future work. A multi perspective approach was used to study the effect for the coworkers. There was no increase in the usage of SMET, neither were more coworkers involved during the project. However, coworkers thought SMET was usable both for them as individuals and for the OHS. The possibilities and the obstacles identified after the education became the base for the future work. The result from the study tells that the improvement work has strengthen the cooperation at the occupational health service and there is an enthusiasm for the future codevelopment of the way to work with SMET in preventive and proactive work environment management. The result from the study also says that even if the initiative for an extended way of working initially come from the management, the improvement work has led to a foundation on which to build on where the coworkers are central, which is important for successful improvement work.

Bakgrund: Arbetsgivaren har det övergripande ansvaret för att arbetsmiljön är tillfredställande på arbetsplatsen - bruksskedet. Flertalet av de fysiska arbetsmiljöfaktorerna som arbetsgivaren har att ansvara för bestäms tidigt i byggprocessen, i planerings- och projekteringsstadiet. Arbetsmiljölagen beskriver vilka uppgifter och ansvar som åligger byggherre och projektörer som låter utföra ett byggnads- eller anläggningsarbete. Litteraturen beskriver en utveckling där arkitekter och andra projektörers ansvar för att beakta arbetsmiljöaspekten har ökat. Ett ansvar där deras insatser ofta är begränsade. Syfte: Syftet med uppsatsen är att undersöka vilken roll arbetsmiljö­ingenjören kan ha i att beakta arbetsmiljön gällande bruksskedet vid planering och projektering av nya kontorsarbetsplatser. Metod: Uppsatsen bygger på litteraturgenomgång samt intervjuer med huvudsakligen arbetsmiljöingenjörer och arkitekter. Resultat: Litteratur och intervjuer visar att arbetsmiljöingenjörer engageras sent i processen vilket resulterar i brister i arbetsmiljön och ombyggnationer som åtgärd. Här framträder också en situation där kunskapsläget runt arbetsmiljöfrågor hos arkitekter upplevs som svagt, vilket bekräftas av de intervjuade. Respondenterna menar att checklista som arbetsverktyg används i mer eller mindre stor utsträckning. Befintliga checklistor från Arbetsmiljöverket presenteras i uppsatsen, dessa rekommenderas som arbetsverktyg. Slutsats: Av intervjuerna framkommer att respondenterna menar att arbetsmiljöingenjören kan agera sakkunnig, utifrån sin kunskap och erfarenhet, i projekteringsprocessen. Arbetsmiljöingenjören utgör därmed med sin sakkunskap runt arbetsmiljöfrågor ett stöd för byggherre och projektör. Den ansvarsroll som Arbetsmiljölagen beskriver, Byggarbets­miljösamordnare - planering och projektering (BAS-P), torde utgöra en naturlig roll för arbetsmiljöingenjören. I och med detta får arbetsmiljöingenjören en naturlig roll tidigt i byggprocessen.   Nyckelord: Byggprojektering, arkitekt, arbetsmiljö, företagshälsa, checklista. / Abstract Background: The employer has the overall responsibility that the work environment is satisfactory in the work place, the usage stage. Most of the physical working environment factors which the employer has the responsibility for are determined early in the construction process, in the planning and design stage. Work environment legislation describes the tasks and responsibilities for the property developer and design engineers, how the work environment should be considered and who is responsible for the construction process from design to operation stage. The literature describes a development in which architects and other property developers responsibility to take into account the working environment aspect has increased. A responsibility where their efforts are often limited. Purpose: The purpose of this thesis is to examine which role the occupational health and safetey (OHS) engineer may have to take into account in the planning and design of new office workplaces. Method: The thesis is based on literature review and interviews with mainly working engineers and architects. Results: The literature and interviews shows that the OHS engineer is involved late in the process, resulting in shortages and rebuilding as a measure. It also emerges a situation where the knowledge of work environment legislation of architects are perceived as weak, which is confirmed by those interviewed. Respondents believe that checklist as a tool is used more or less often. Existing checklists from the Swedish Work Environment Authority (Arbetsmiljöverket) are presented in the thesis and are recommended as tool to be used. Conclusion: The interviews reveal that respondents believe that the OHS engineer can act as an expert, based on their knowledge and experience in the planning process. The OHS engineer thus constitutes its expertise and supports the property developer and the design engineer. The role, described in Swedish Work Environment Legislation (Arbetsmiljöverket), construction work environmental coordinator - planning and design (BAS-P) would be a natural role for the OHS engineer. The OHS engineer is given a natural role early in the construction process. Keywords: Construction planning, Architect, Work Environment, Occupational Health Service, Checklist

This thesis focused on factors contributing to improved work environment in small-scale enterprises and sustainable health for the entrepreneurs. In Study I, implementation of the provision of Systematic Work Environment Management (SWEM) with and without support was investigated. Two implementation methods were used, supervised and network method. The effect of the project reached the employees faster in the enterprises with the supervised method. In general, the work environment improved in all enterprises. However, extensive support to small-scale enterprises in terms of advice and networking aimed at fulfilling SWEM regulations had limited effect – especially considering the cost of applying these methods. Studies II, III, and IV focused on entrepreneurs’ health, work conditions, strategies for maintaining good health, and utilisation of Occupational Health Service (OHS). A closed cohort of entrepreneurs in ten different trades responded to two self-administered questionnaires on health and work conditions, with five years between the surveys: at baseline, 496 entrepreneurs responded, and 251 entrepreneurs responded at follow-up. Differences were tested by Chi2-test, and associations estimated with logistic regression analyses. Qualitative interviews on entrepreneurs’ strategies for maintaining good health were included. In Study II, the most frequently reported complaints, musculoskeletal pain and mental health problems, were associated with poor job satisfaction and poor physical work environment. In Study III, consistent self-reported good health, i.e. good health both at baseline and at follow up, was associated with self-valued good social life when adjusted for physical work conditions and job satisfaction. Entrepreneurs’ strategies for maintaining good health included good planning and control over work, flexibility at work, good social contact with family, friends and other entrepreneurs, and regular physical exercise. Study IV concerned entrepreneur’s utilisation of OHS. Entrepreneurs affiliated to OHS had either better or more adverse work conditions than non-affiliated entrepreneurs. Medical care and health check-ups were the services most utilised. Affiliation to OHS correlated with use of specific information sources and active work environment management. The entrepreneurs were not consistently affiliated to OHS over the five-year-period.

Santé et sécurité au travail, prévention des risques professionnels (risque routier, risques psychosociaux), intensification du travail… Autant de questions essentielles auxquelles l’entreprise est confrontée. Y répondre suppose souvent le croisement des regards et des compétences. Les services de santé au travail, qui ont pour mission exclusive d’éviter toute altération de la santé des travailleurs du fait de leur travail, y concourent. Acteurs de terrain, ils devraient constituer la pièce maîtresse du système de santé au travail ; ils sont pourtant victimes d’un désamour collectif. La délicate coexistence des concepts d’aptitude et de prévention y contribue. L’institution a, depuis 1942, connu de profondes métamorphoses nées, pour nombre d’entre elles, de la conjugaison, parfois source de tensions, du droit du travail et du droit de la santé publique. Le rattachement de l’institution, lors de la Libération, au ministère du Travail a longtemps scellé la domination du droit du travail. La montée en puissance du droit de la santé publique la remet progressivement en cause. La réforme du 20 juillet 2011 en a offert illustration. L’analyse des rapports entre droit du travail et droit de la santé publique invite à proposer de nouvelles logiques au service de la santé des travailleurs fondées sur l’idée - qui est aussi un constat - selon laquelle le service de santé au travail n’est pas un prestataire parmi d’autres : il participe de l’intérêt général. / Health and security at work, occupational risk prevention (road risk, psychosocial risks), intensification of labor conditions… A number of questions that the enterprise has to take into account. Answering them assumes a variety of points of view and skills. Occupational health services, that have the exclusive mission to prevent any worker health alteration occurring from their work, contribute to this debate. Due to their unique position, as a field actor, they should be the master piece of the occupational health system ; these services are, however, victim of a collective disaffection. The delicate combination of the “medical fitness for work” concept and the occupational risk prevention concept contributes to this disaffection. Since 1942, the institution has seen deep metamorphoses, a number of them appearing from the combination (sometimes being a cause for tension) of the labor law and the public health law. After the Liberation, the incorporation of the institution to the Ministry of Labor, sealed a long domination of the Labor law. The growing power of the Public Health has been jeopardizing progressively this domination. The reform dated 20th July 2011 illustrates this change of balance. The analysis of the links between the Labor Law and the Public Health Law suggests to propose a new paradigm for the sake of the workers’ health, based upon the idea – which is also a fact – that the occupational health service cannot be compared to other providers : this service contributes to the general interest.

Qualified persons in the field of occupational risks Abstract Qualified persons in the field of occupational risks are persons dealing with different levels of risk, different extent and type of risks. In this set is not only the person for health and safety, but there are other qualified persons as well. For example, a qualified person who provides and performs the ccupational health services, a qualified person for fire protection, a construction safety coordinator, as well as an inspection technician of dedicated technical equipment, etc. A key qualified person in occupational risk and health and safety prevention is a person who assist employers in occupational risk prevention by managing risk identification, providing risk assesments, identification of source and risks causes and incidents. This person takes care about risk factors on worplaces such as microclima, chemical and biological hazards, noise, ergonomy and many others risks and continuosly advises employers of identificated risk on workplaces. He leads as a expert in health and safety, but not responsible, for applying right and effective principles of work safety and accident prevention and provide high qualified consultating job for employers. As well as is need to be noticed that employers has a legal obligation to have minimum one these...