Introduction: Work-related ill-health and resulting sickness absence is detrimental to the employees themselves, the employer and the national economy as a whole. To reduce the risk of work on health, information about causal factors and sectors at risk must first be gathered. General practice had been referred to as the ‘blind spot’ in occupational health as so little was known about work-related ill-health seen by GPs. The principal aim of this thesis was to estimate the incidence of work-related ill-health in the UK/GB as determined in general practice, to critically compare general practice reporting with other data sources and to evaluate the incidence and sickness absence burden of work-related ill-health. Methods: Data on incident cases of work-related ill-health and sickness absence were collected from GPs reporting to a UK-wide surveillance scheme (The Health and Occupation Reporting network in General Practice (THOR-GP)), and compared to information from other sources. To enable the calculation of incidence rates, THOR-GP population denominator information was gathered and characterised using Census information based on patient and practice postcode. Results were presented as a series of four peer-reviewed published papers and an additional chapter exploring the calculation of incidence rates.Results: The work-related ill-health diagnoses reported by GPs were mainly musculoskeletal (53%) and mental ill-health (30%). Overall, half the cases were issued with sickness certification. The proportion of cases issued with sickness certification differed by diagnosis; 79% of psychological cases had certified time away from work and these conditions were responsible for the majority of sickness absence days certified (56%) however these cases were rarely referred to secondary care (1%). Industries operating within the public and financial sectors had the highest incidence rates of work-related mental ill-health and correspondingly the highest rates of sickness absence. Industries with the highest proportions of self-employment had the lowest rates of sickness absence. When compared to reports from occupational physicians (OPs), GP information was more representative of the employed population of the UK, whereas OP data concentrated on industries covered by occupational health services. Incidence rates based on clinical specialists’ reports were much smaller than GP rates and biased by severity and referral patterns. Rates based on self-reported (SWI) data were higher than GP rates due to greater inclusivity; however diagnoses were unsubstantiated by medical opinion. The THOR-GP population denominator was characterised using approximately a million patient postcodes (and linking these to Census data) from over a hundred GPs. These population estimates compared well with those based on the practice postcode and enabled the calculation of incidence rates of work-related ill-health for this and (with weighting methods) the GB population. Rates of work-related ill-health were highest for those employed within construction and agriculture.Conclusion: This thesis has shown how the systematic collection of work-related ill-health data from GPs adds to the knowledge base about the distribution and determinants of work-related ill-health (and sickness absence) within the UK/GB workforce. This work also contributes to knowledge relating to the ‘primary care denominator problem’ in calculating rates of incidence from general practice.

Introduction: Increased ill health in the workplace in terms of increased workload, stress and pressure from employers is common in Sweden today, which may lead to a future variety of medical conditions and disabilities. Aim: The aim of the present study was to describe what employees at companies in the health industry experienced as a health and illhealth on a workplace. Method: A qualitative approach was used in which the interviews were based on an interview guide. The method of analysis was thematic analysis in which three themes emerged. Results: Tree themes emerged; a social interaction with colleagues, good leadership, and access to health care and movement. The findings of the study indicated that the tasks themselves were not as important as the social interaction and the leadership so that the workplace was perceived as healthy. Implication: Suggestions for further research is to try to get more equal number of men and women engaged in further study and to develop the questions in the interview more to answer the purpose better. Furthermore, the health factors reported in the results could still be a good foundation to refer to, for interventions in the workplace or for the overall development of a healthy workplace within a specific company.

Nästan en tredjedel av alla anställda i Sverige upplevde under 2020 arbetsrelaterade besvär, så som hög arbetsbelastning, trötthet, oro, ångest eller utmattningssymptom. Arbetsgivare har ett ansvar att arbeta med organisatorisk och social arbetsmiljö och ska vid behov ta hjälp av företagshälsovård (FHV) och även samverka med företagshälsovård i preventivt syfte. En misstänkt bidragande orsak till den ökande ohälsan i arbetslivet kan vara att arbetsgivare inte uppfyller sitt fulla ansvar och införlivar arbetet med förebyggande och hälsofrämjande arbetsmiljöarbete. Studien undersökte behandlares (psykologer och beteendevetares) upplevelser av att arbeta med stöd till individer som upplever brister i organisatorisk och social arbetsmiljö. En intervjustudie gjordes med åtta informanter från tre olika företagshälsor över hela landet. Analysen bestod av en kvalitativ innehållsanalys som resulterade i fyra kategorier med det övergripande temat Behandlares förutsättningar att arbeta med stöd till hälsa i arbetslivet. Resultatet indikerar att behandlarens roll innebär en balansgång mellan organisationen och klienten vilket ibland kan innebära motstridiga intressen. Studien visar också att behandlarnas stöd i stor utsträckning handlar om att stötta klienter att göra anpassningar för att kunna hantera arbetssituationen i arbetsmiljöer som präglas av höga krav. En implikation av resultaten är att organisationer skulle behöva använda sig av FHV i större utsträckning än i dag i sitt arbetsmiljöarbete, för att förebygga ohälsa och främja hälsa. / Nearly one third of all employees in Sweden experienced work-related problems during 2020, such as heavy workload, worry, fatigue, anxiety or exhaustion disorder. Employers are responsible for the organizational and social work environment and are obliged to take assistance from occupational health services (OHS) when needed, and to collaborate with OHS for preventive purposes. A contributing factor to the increasing ill-health in working life could be that employers do not fulfill their responsibility and incorporate preventive and health-promoting work environment management. The study examined psychologists and behavioral scientists’ experiences of giving support to individuals who experience shortcomings in the organizational and social work environment. An interview study was conducted with eight informants from three different OHS across the country. The analysis consisted of a qualitative content analysis that resulted in four categories with the overall theme Conditions for working with support to increased health in working life. The results indicate that the supporting role involves balancing between the organization and the client, which can sometimes mean conflicting interests. The study also shows that the support is largely about supporting clients to make adjustments, to be able to handle the work situation in work environments that are characterized by high demands. One implication of the results is that organizations would need to use OHS to a greater extent, in order to support an improved work environment, to prevent ill-health and to promote health.

Introduktion En bra arbetsmiljö är av stor vikt för ett hälsosamt arbetsliv. Många människor drabbas av arbetsrelaterad ohälsa som kunde varit möjlig att förebygga om den uppmärksammats i tid. Att utifrån både nationella och internationella styrdokument arbeta för en hållbart arbetsliv med en hälsofrämjande arbetsmiljö är av hög folkhälsovetenskaplig relevans. Syfte I populationen anställda på statligt finansierade arbetsplatser undersöka attityder till användandet av ett digitalt verktyg för regelbunden avstämning av arbetsrelaterad ohälsa samt utformning av sådant verktyg. Undersöka om attityderna skiljer åt mellan åldersgrupper samt mellan arbetstagare som upplever hög eller låg arbetsrelaterad utmattning. Metod En enkätstudie som inkluderade 33 respondenter genomfördes i april 2022 där frågorna var av både kvalitativ och kvantitativ karaktär. Fishers exakta test användes för numerisk data och kvalitativ innehållsanalys för fritextsvar. Resultat Majoriteten hade positiv attityd till användandet av ett digitalt verktyg för regelbunden avstämning av arbetsrelaterad ohälsa. Ingen skillnad i attityd kunde identifieras mellan åldersgrupper eller grupper med olika nivå på arbetsrelaterad utmattning. Det framkom att det behövs rimliga krav på de anställda i arbetslivet och att ett digitalt verktyg skulle kunna bidra till att fånga tidiga tecken på ohälsa och vara ett hjälpmedel för det hälsofrämjande arbetet. Fysiska möten ansågs dock fortfarande viktiga. Slutsats Studien visar att statsfinansierade anställda generellt har en positiv attityd till ett digitalt verktyg som regelbundet stämmer av arbetsrelaterad ohälsa. Studien beskriver också tankar kring för- och nackdelar gällande utformning av ett sådant digitalt verktyg. Ett av önskemålen var tätare uppföljningar av hälsa och arbetsmiljö med ett digitalt verktyg. / Introduction A healthy work environment is important for a sustainable working life. Many people suffer from ill health connected to working life that could have been prevented if it had been noticed in time. Based on both national and international governing documents, working for a sustainable working life with a health-promoting workenvironment, is very relevant from a public health perspective. Aim In the population employed at government-funded workplaces, investigate attitudes to the use of a digital tool for regular reconciliation of work-related ill health and the design of such a tool. Investigate whether attitudes differ between age groups and between workers who experience high or low work-related exhaustion. Methods A survey study including 33 respondents was conducted in april 2022 where the questions were of both a qualitative and quantitative nature. Fischer’s Exact test was used for numerical data and qualitative content analysis for free-text answers. Results The majority had a positive attitude towards the use of a digital tool for regular reconciliation of work-related ill health. No difference in attitude could be identified between age groups or groups with different levels of work-related exhaustion. It emerged that reasonable demands are needed on employees in working life and that a digital toolcould help to capture early signs of ill health and be a tool for health promotion work. Physical meetings, however, were still considered important. Conclusion This study shows that government-funded employees generally have apositive attitude towards a digital tool that regularly checks work-related ill health. This study also describes pros and cons regarding the design of such a digital tool. One of the  wishes was closer follow-ups of health and working environment with a digital tool.