Enligt arbetsmiljölagen ska arbetsgivare när det saknas kunskap och kompetens i det systematiska arbetsmiljöarbetet (SAM) anlita en företagshälsovård (FHV) eller liknande resurs. Detta bygger på en programteori där FHV förväntas vara den externa resurs som behövs för arbetsgivare och arbetsplatser i arbetsmiljöarbetet. Samarbetet och FHVs stöd ska generera god arbetsmiljö och hälsa hos kunderna. Forskning om hur detta samarbete fungerar är begränsad.   Avhandlingens syfte är att utforska om FHV fungerar som stöd i kundens förebyggande arbetsmiljö-arbete och att identifiera mekanismer som har betydelse för samarbetet mellan FHV och kund. Mer precist har avhandlingen syftat till att öka kunskap och förståelse för om lagens intention uppfylls.   Datainsamlingen i de fyra kvalitativa fallstudierna utfördes med hjälp av semistrukturerade och tematiska intervjuer, telefonintervjuer och gruppintervjuer. Empirin samlades in i små- och stora företag samt inom den offentliga sektorn och fokuserade även på vilken betydelse avtalet har för samarbetet. Intervjuerna har genomförts med ledning, chefer och skyddsombud samt HR-personal i deltagande verksamheter samt FHV professioner i kundens FHV. Intervjuerna har analyserats med kvalitativ innehållsanalys och det sammanlagda resultatet analyserades med hjälp av realistisk utvärdering.    Resultatet visar att samarbete och FHVs stöd i förebyggande SAM brister. Förändrade styrformer i offentlig sektor; New Public Management och HR transformationen identifieras som kontextuella förutsättningar som påverkar samarbetet. I den realistiska utvärderingen identifierades mekanismer som positivt eller negativt påverkar samarbetet mellan FHV och kund.   Mekanismer som påverkar samarbete positivt är; att det finns en fungerande samverkan och SAM hos kunden och att FHV får information och tillgång till kundens inre processer. Att FHV har en oberoende ställning med kontakter på flera nivåer i verksamheten är andra mekanismer som påverkar samarbete positivt. Att ledningen är engagerad i samarbetet med FHV och att avtalen stöder samarbetet bidrar också positivt till ett framgångsrikt samarbete. Ytterligare mekanismer som gynnsamt påverkar samarbete är att det finns kontinuerliga uppföljningar där tjänster och service kontinuerligt stäms av och anpassas efter kundens behov. En viktig mekanism som påverkar samarbetet positivt är att HR stöder samverkan och SAM i kundföretaget.   Identifierade mekanismer som påverkar samarbete negativt är att SAM och samverkan på arbetsplatsen mellan arbetsgivare och arbetstagare brister. Andra mekanismer som negativt påverkar är att ledningen inte är engagerad i samarbetet och att FHV inte får ta del av kundens SAM. Samarbetet påverkas även negativt när HR definierar avtalsinnehåll och är enda kontakt med FHV. En ytterligare mekanism som påverkar samarbetet negativt är att kunden upplever ett bristande förtroende; att FHV saknar kompetens.  Ett antal mekanismer har även identifierats som påverkar samarbete negativt mellan FHV och småföretag.  Bland annat saknas samverkan mellan arbetsgivare och arbetstagare i stor utsträckning och småföretagen arbetar inte systematiskt med sin arbetsmiljö. Detta innebär att FHV inte fungerar som stöd i SAM utan de tjänster som används består framför allt av hälsoundersökningar.  Samma mekanismer som påverkar samarbetet negativt framkommer i den offentliga sektorn; när samverkan och SAM saknas på arbetsplatsen, används FHV främst till individuella hälsofrämjande tjänster och rehabilitering. Andra mekanismer som påverkar samarbetet negativt i den offentliga sektorn är bristen på kunskap om samverkan och SAM hos både HR och skyddsombud. Det finns en otydlighet kring varandras roller som påverkar samarbetet negativt. Även kundens föreställning om FHV; att de uppfattas sakna kompetens och vara en efterhjälpande resurs, påverkar samarbetet negativt.  Slutsatserna från avhandlingen visar att samarbetet mellan FHV och kund i stor utsträckning inte stöder förebyggande SAM. I analysen identifieras ett antal mekanismer som påverkar samarbetet mellan FHV och kund, både positivt och negativt. Framför allt kunskap om arbetsmiljö, en fungerande samverkan och SAM identifieras som viktiga mekanismer som på ett positivt sätt bidrar till att nå ett framgångsrikt samarbete. / According to the Work Environment Act, employers should, when there is lack of knowledge and competence regarding the occupational health and safety management (OHSM, employ an occupational health service (OHS) provider or comparable resource. Research on how this collaboration works is however limited. The purpose of the thesis is to investigate whether the OHS provider serves as support in the custom-er's preventive OHSM and to identify which mechanisms are important for the collaboration between the OHS provider and customer.The data collection in the four qualitative case studies was conducted using semi-structured and the-matic interviews, telephone interviews and group interviews in small and large companies as well as the public sector. The interviews were analyzed with qualitative content analysis and the overall result has been analyzed using realistic evaluation.The results show that collaboration and support from OHS providers in preventative OHSM is lacking. Contextual conditions affected collaboration, such as New Public Management and HR transformation. In the realistic evaluation, mechanisms were identified that positively or negatively affect collaboration between OHS provider and client customer. Mechanisms that affect the collaboration positively are for example; a cooperative relationship between the employers and safety representatives in OHSM at the client customer, OHS providers also need access to the client customer's internal processes. Identified mechanisms that affect the collaboration negatively are; that cooperation in the workplace between employers and employees is lacking, the OHSM does not work. Other mechanisms that negatively affect are when top management not is involved in the collaboration with the OHS provider and when the OHS provider does not get information of the client customer's OHSM.  The conclusion from the thesis is that OHS providers do not largely support the client customer's pre-ventive OHSM. / <p>QC 20171019</p>

The thesis titled "Occupational safety and health" is focused on summarizing the current legal regulations that impose rights and obligations on employers and employees in the field of occupational health and safety. Introductory chapter emphasizes the understanding of the importance and function of safety aspects, historical context and role of the state. In the crucial second chapter the Czech legal regulations are analyzed in detail and the basic concepts of this issue (prevention of risk, work categorization, training...) are characterized. Following the legislation chapter three introduces options above standard approaches, by which the employer can be inspired or directly certified in task of the safety system solution. In the next chapter the analysis of the current legislation of "Occupational Services" is presented and also compared with the previous one. The theoretical part is concluded with an article concerning work accidents and occupational diseases, in which are also defined possibilities of accident insurance. In the case study, I focused on the application of the legal regulations for a particular employer, evaluation of the current state and the proposal for possible remedy measurements.

Dans nos pays industrialisés, les comportements sédentaires entrainent des enjeux de santé pour de nombreux travailleurs, les exigences physiques de leur travail étant désormais insuffisantes. Afin de répondre à cette problématique, la recherche s’intéresse aux bureaux actifs (poste de travail debout, avec pédalier ou avec tapis roulant) qui comparativement au poste de travail conventionnel permettent aux travailleurs d’augmenter l’apport d’activité physique au travail et ainsi, réduire le temps sédentaire quotidien. Lorsqu’ils sont comparés au poste conventionnel (assis), les bureaux actifs ont des effets sur des biomarqueurs physiologiques et biomécaniques liés à l’amélioration de la santé. En plus, ils offrent quelques avantages sur la productivité et le bien-être au travail des travailleurs. Malgré l’accumulation des connaissances sur les bureaux actifs, les différences entre bureaux actifs sont toujours méconnues. Ce mémoire s’adresse donc à la compréhension et à la comparaison entre les types de bureaux actifs, plus précisément à leurs impacts sur le temps sédentaire au travail, leurs effets sur les biomarqueurs physiologiques et biomécaniques et à leurs effets sur la productivité et le bien-être au travail. Pour ce faire, les résultats et la discussion sont développés autour d’un article de revue systématique (Dupont et al., 2019) et d’un article issu d’une recherche expérimentale soumis en octobre 2019. Dans un premier temps, les avantages associés à chaque type de poste de travail actif (debout, avec pédalier ou avec tapis roulant) ne sont pas équivalents. En effet, les postes avec pédalier et avec tapis roulant semblent apporter de plus grands changements physiologiques à court terme que les postes de travail debout et pourraient potentiellement améliorer la santé. De plus, les postes debout, avec pédalier et avec tapis roulants semblent tous présenter des avantages de productivité à court terme, toutefois les postes avec tapis roulants réduisent les performances des tâches faites à l’aide de clavier et de souris d’ordinateur. Dans un deuxième temps, à court terme (2 semaines), l’introduction d’un poste debout et d’un poste à pédalier dans leur bureau permet aux travailleurs d’accumuler en moyenne 132 minutes de temps actif (ex. travail fait avec poste debout et/ou avec poste avec pédalier) par jour, ce qui représente 46 % du temps total passé dans leur espace de travail personnel. Ce faisant, les travailleurs réduisent de moitié leur temps assis au travail en fractionnant le temps assis en courtes périodes de 30 minutes. Basé sur nos résultats, l’ajout de deux postes de travail actif à même le bureau d’un travailleur permet de diminuer le temps sédentaire au travail. / In our industrialized countries, sedentary behaviours lead to health issues for many workers, as the physical demands of their work are now insufficient. To answer this problem, the research focuses on active workstations (standing, with pedals or treadmill workstations) which compared to the conventional workstation allow workers to increase physical load at work and thus, reduce daily sedentary time. When compared to the conventional (sit) workstation, active workstations have effects on physiological and biomechanical biomarkers related to better health. Also, they offer some advantages over workers’ productivity and wellbeing at work. Despite the accumulation of knowledge about active workstations, the differences between active workstations are still unknown. This thesis is aimed at understanding and comparison between active workstation types, specifically their impacts on sedentary time at work, their effects on physiological and biomechanical biomarkers and their effects on productivity and well-being at work. The results and the discussion are developed around a systematic review article (Dupont et al., 2019) and an article from an experimental research submitted in October 2019. First of all, the benefits associated with each type of active workstation (i.e. standing, cycling, treadmill) may not be equivalent. Cycling and treadmill workstations appear to provide greater short-term physiologic changes than standing workstations that could potentially lead to better health. Cycling, treadmill and standing workstations appear to show short-term productivity benefits, while treadmill workstations reduce the performance of computer-related work. Secondly, in the short term (2 weeks), the introduction of a standing workstation and a pedal workstation in their office allows workers to accumulate an average of 132 minutes of active time (i.e. work done with standing and/or cycling workstations) per day, which represents 46% of the total time spent in their personal workspace. As a result, workers reduce their total desk-sitting time by half and sat on average 30 minutes per sedentary bout. Based on our findings, adding two active workstations to an office worker’s helps reduce sedentary time at work.

La labor de un profesional de construcción se orienta al diseño y desarrollo de proyectos inmobiliarios que busquen satisfacer las necesidades del público objetivo, bajo estrictos estándares de seguridad y calidad; y con énfasis en la integración del proyecto en su propio entorno de acuerdo con sus diversas características sociodemográficas, urbanísticas y ambientales, de manera que sean un hito que potencie el entorno y sus complejas relaciones sociales. En particular, existe una cada vez mayor tendencia global que busca disminuir al máximo el impacto ambiental de las diversas obras de edificación. Un claro ejemplo de lo anterior se basa en las diversas certificaciones de edificios verdes o sostenibles; alcanzables bajo estrictos estándares en cuanto a materiales, procesos, mantenimiento, etc. Por esta razón, el presente trabajo de investigación consiste en el desarrollo de un proyecto inmobiliario de 101 viviendas unifamiliares, enfocado para satisfacer la necesidad del sector socioeconómico “C” en la ciudad de Arequipa. En consecuencia, se ha previsto que para el desarrollo del proyecto se deban cumplir con los requerimientos propuestos por la Normas G 050 – Seguridad durante la construcción; la OHSAS 18001 – Sistema de Gestión de Seguridad y Salud en el Trabajo, y la Ley 29873 de Seguridad y Salud en el Trabajo. Asimismo, se implementarán los ocho principios básicos de Edificaciones Verdes. Finalmente, los resultados de la evaluación económica resultan ser prometedores luego de realizar el análisis financiero y el flujo de caja. Esto predice un proyecto rentable y viable. / The construction professional’s work, it is oriented to design and development projects that seek to satisfy the needs of target audience, under strict safety and quality standards; and with emphasis on the project in its own environment integration according to its various sociodemographic, urban and environmental characteristics, so that they are a milestone that enhances the environment and its complex social relationships. In particular, there is a growing global trend that seeks to minimize the environmental impact of the various building works. A clear example of the above, it is based on the various certifications of green or sustainable buildings, achievable under strict standards regarding materials, processes, maintenance, etc. For this reason, the present research consists in the development of a real estate project of 101 single-family homes, focused to satisfy the need of the socioeconomic sector "C" in Arequipa city. Consequently, it has been foreseen that for the development of the project the requirements proposed by Norms G 050 - Safety during construction must be met; OHSAS 18001 - Occupational Health and Safety Management System, and Law 29873 on Occupational Safety and Health. Likewise, the eight basic principles of Green Buildings will be implemented. Finally, the results of the economic evaluation turn out to be promising after carrying out the financial analysis and the cash flow. This predicts a profitable and viable Project. / Trabajo de investigación

1 ABSTRACT Participation on occupational health and safety training is one of the basic duties in the field of professional education of employees. With respect to the fact that the law imposes an obligation on employers to provide this training but does not specify its form any further, e-learning is becoming an indivisible part of completing the requirements in this field. This thesis will execute a thorough theoretical look into three major parts which are professional education, e-learning and occupational health and safety training, which are linked together throughout the selected chapters. The empirical part depicts a data analysis and results of a research investigation that was executed through a standardized questionnaire in collaboration with respondents who acquired direct experience with a training in the field of occupational health and safety in e-learning form. The questionnaire was conceived and published at the end of an e-learning training in collaboration with a company providing complex services in the field of occupational health and safety, a significant part of which is based on the aforementioned e-learning courses. The processed data and research investigation results are used for fulfilling the goal of the thesis - preparing a concept of intervention for improving legal training...

The increasing number of occupational health and safety issues is a problem. Legislationsthat are anchored in European law, such as “machinery directive 2006/42/EC”, the “Use ofwork equipment 2009/104/EC” and the Swedish AFS 2001:1 (Systematic Work EnvironmentManagement) are defined but still lack the power to stop accidents/ incidents fromhappening. When risks are being made conscious they are not stopped by the legalrequirements in place. Scientific approaches such as the Swiss cheese model, safety management systems (SMS),and HTO (Human- Technology- Organization) explain how increased complexity inside asocio-technical system needs more attention. As the cases of accidents/ incidents in anoccupational setting still increase a need for solving this appears, with the help of sciencebasedtools. In cooperation with the company AFRY, I conducted four interviews (n=4) and analyzed twoABRA (activity-based risk assessments) already conducted by the company. Using thecommon themes identified from the interviews to analyze the ABRA helped to identify twokey problems: unclear communication and insufficient knowledge. With that in mind, I’m advocating for an increased emphasis on risk communication andresilience engineering. With the awareness that communication must be clearer and thatknowledge has to be increased, it is possible to work proactively on decreasing occupationalaccidents by mitigating the risks.

This thesis aims at investigating the importance of effective implementation of health safety and hygiene legislations and practices in Health Care delivery systems. A new System Based Approach for Strategic Implementation of Occupational Health & Safety Practices is proposed in this thesis. The underlying principle of the approach is based on involvement and inputs from staff and management rather than by pre-specified requirements and objectives. Furthermore, the development process is a closed loop process that provides a mechanism for continuously evaluating system performance and monitoring activities that have considerable impact on health and safety practices. A case study was conducted in the medical laboratories of five major hospitals in the Emirate of Abu Dhabi. Data were collected through questionnaires, staff interviews, and reviewing laboratory safety reports compiled over a three years period. The main conclusions from this study are: 1. The proposed approach has proven to be useful in analyzing existing health and safety systems. The methodology and tools proved to be instrumental in defining inefficiencies and determining the status of the Health & Safety policies & practices in the selected medical laboratories. 2. Effective implementation of the proposed approach has shown improvements in productivity, operational cost, service quality, staff and management satisfaction. 3. The case study has demonstrated that a developing country such the UAE, with no previously existing Health & Safety legislation and little risk prevention culture, can rapidly and effectively introduce effective industry specific H&S by adopting an integrated systems based approach. 4. UAE has highly advanced and economically developing base, there is a general willingness at senior level within the UAE to achieve high levels of competence and standards in all industrial sectors. 5. CAP is a system based management tool which has been implemented globally, but only limited in the gulf region; CAP has been implemented by the author and colleges within Zayed Military Hospital between 2003-2007.

While agricultural work is hazardous for all workers, migrant workers face additional challenges that make them more vulnerable than domestic workers. The lack of access to permanent immigration status in the Seasonal Agricultural Worker Program (SAWP) and the agricultural stream of the Temporary Foreign Workers Program (TFWP) makes workers’ jobs hinge on retaining their employers’ favour and creates a particular type of job insecurity that overshadows their behaviour, decisions, and agency to assert their rights for safe and healthy workplaces and workers’ compensation. While researchers argue that the TFWP competes with the SAWP as employers search for the cheapest and most docile workers, less research has examined whether workers’ health and safety exposures and experiences differ within the two programs. Drawing primarily from interviews with advocates and system stakeholders and participant observation at advocate-organized events, this research will offer preliminary answers to discovering whether the programs pose different obstacles to improving health and safety and access to compensation that affect migrant workers’ experiences in Ontario before and after injury. The research will help gather information about possible avenues to improve the health and safety of migrant workers given how the two programs operate within both federal and provincial frameworks. Advocates’ experience assisting workers in both programs offers important insights about whether differences between the programs create particular vulnerabilities for some migrant workers. / Thesis / Master of Arts (MA) / This research identifies opportunities and barriers that migrant agricultural workers and their advocates face in improving occupational health and safety and access to workers' compensation in the Seasonal Agricultural Workers Program (SAWP) and the agricultural stream of the Temporary Foreign Workers Program (TFWP). Through semi-structured interviews, participant observation, and document review, the research will help identify whether interplay between the programs causes additional vulnerabilities for some workers. The research will help gather information about possible avenues to improve the health and safety of migrant workers given how the two programs operate in a federal and provincial framework.

Le diagnostic de l'asthme professionnel (AP) est toujours un défi. Le test de provocation bronchique spécifique (TPS), comme une méthode de diagnostic de référence, n’est pas aisément accessible. Cette étude diagnostique rétrospective vise à évaluer des outils diagnostiques actuels et à développer des scores cliniques pour AP (définis comme ayant le résultat positif en TPS). Les données concernant les travailleurs soupçonnés d'avoir de l’AP qui, d’une part, ont été exposés aux agents de haut-poids-moléculaire élevé (HPM) (n=139) et à bas-poids-moléculaire (BPM) (n=285), et d’autre part, ont travaillé encore un mois avant de l’évaluation de TPS. Par ailleurs, les modèles de régression logistique sont développés dans chaque groupe d'exposition. Ainsi, concernant des tests objectifs, les valeurs de différents tests distinctifs sont ajoutées aux caractéristiques cliniques, et enfin, le résultat a été évalué. Les modèles ont été testés pour l’exactitude, et pour la validation interne par la procédure bootstrapping. Suite à cela, les modèles finaux sont traduits en scores cliniques et le score total est stratifié en groupes à risque. Chez les travailleurs exposés à des agents BPM, si le test de la méthacholine est fait isolément, le modèle prédictif n'a pas montré de meilleures valeurs diagnostiques que le test de provocation. Cependant, dans le groupe HPM, le modèle final, y compris le sexe, l'âge> 40 ans, la durée des symptômes ≥1 an, la rhinoconjonctivite, l'utilisation de corticostéroïdes inhalés, le test de provocation à la méthacholine, et le test de la piqûre épidermique spécifique, avait un bon calibrage et une validation interne raisonnable. Par ailleurs, la catégorie de sujets avec une probabilité élevée d’avoir AP avait une meilleure spécificité et une meilleure valeur prédite positive par rapport à la combinaison de test de provocation à la méthacholine et de la piqûre épidermique spécifique dans la détection de l'AP, cependant n'avait pas de signification statistique. En conclusion, ce modèle quantifie la probabilité individuelle d'AP. Dans les centres où l'accès à TPS est difficile ou impossible, notre modèle serait utile dans le diagnostic d’OA, néanmoins, la validation externe du modèle reste nécessaire. Mots-clés : asthme professionnel, modèle diagnostique, prévention, score clinique. / The diagnosis of occupational asthma (OA) is challenging since the use of specific inhalation challenge (SIC) as the reference test is not widely accessible. This retrospective diagnostic study is aimed to evaluate current diagnostic tools and to develop clinical scores for OA (defined as positive SIC). Data from workers with suspected OA who were exposed to high-molecular-weight (HMW) (n=139) and low-molecular-weight (LMW) agents (n=285) and still working one month before the SIC were evaluated. Logistic regression models were developed in each exposure group. The added values of different objective tests to clinical and exposure characteristics were evaluated. The models were tested for accuracy, and, validated internally by the bootstrapping procedure. The final models were translated into clinical score and the sum scores were stratified into risk groups. In workers exposed to LMW agents, the predictive model did not perform better diagnostically than the methacholine challenge test alone. In the HMW group, the final model including sex, age >40 years, symptom duration ≥1 year, rhinoconjunctivitis, inhaled corticosteroid use, the methacholine challenge test, and specific SPT had a good accuracy and reasonable internal validation. The high probability category of the predictive model had a better specificity and positive predicted value compared to the combination of methacholine challenge test and specific SPT in detecting OA but did not reach the statistical significance. Our results suggest that this model could quantify an individual’s probability of OA. This model emphasizes the necessity of performing both tests in order to have a more accurate diagnosis in workers exposed to HMW agents. In centers where access to SIC is difficult or impossible, our model might be of benefit in diagnosing OA. Nevertheless, external validation of the model is necessary. Key words: occupational asthma, diagnostic model, prevention, clinical score.

A good Occupational Health and Safety (OHS) is needed to reach sustainability. OHS consists of three parts: 1) physical, 2) mental and 3) social.  The purpose of this study was to explore and foresee the main physical OHS risks when upscaling the recycling of wood in Lithuania, with the goal to prevent those risks.  The study was explorative and interviews with semi-structured questions were used as a method. Three of the four informants mentioned air pollution, traffic, working equipment, safety equipment, and chemical risk. The highest rate of physical risks mentioned was the physical ones and then the mechanical risks. Opinions differ whether the risks would change when upscaling the industry, from no stressed or additional risks to all risks being stressed and added risk.  Results should be seen as a hint of direction when it comes to OHS risks within wood recycling in Lithuania.